Background:Premalignant and malignant lesions are not uncommon in Pakistani women, especially in the older age-groupsAim:This study was conducted to determine the clinicopathological importance of conventional Papanicolaou (Pap) smears for the diagnosis of premalignant and malignant lesions of the cervix.Materials and Methods:Pap smears of 1000 women were examined from January 2007 to June 2009. Only cases with neoplastic cytology were included.Results:The overall frequency of normal, inadequate, neoplastic, and infective smears was 50%, 1.8%, 10.2%, and 38.3%, respectively. Most of the patients (67%) were in the postmenopausal age-group, with the mean age being 44.7±15.63 years. The commonest clinical signs/symptoms seen among the 102 patients with neoplastic gynecological lesions were vaginal discharge and abnormal bleeding (93/102;(91.2% and 62/102;60.7%). Of the 102 cases with neoplastic lesions 46 patients (45%) had low-grade squamous cell intraepithelial lesions (LSILs), 22 (21.5%) had high-grade squamous cell intraepithelial lesions (HSILs), 14 (13.7%) had squamous cell carcinoma, and 6 (5.8%) showed features of adenocarcinoma. Ten (9.8%) cases showed cytology of atypical squamous cells of undetermined significance (ASCUS) and four (3.9%) cases had atypical glandular cells of undetermined significance (AGUS).Conclusion:We conclude that cervical smear examination is well suited for diagnosing neoplastic disease. It is clear that cervical neoplastic lesions are becoming a problem in Pakistan.

HER2/neu protein is credibly overexpressed in colon and gastric adenocarcinomas in immunohistochemistry. There is significant association between grade of tumor and HER2/neu protein overexpression.

In the past, efforts have been made to determine the influence of sleep quantity and its deprivation, on functioning efficiency of human beings. However, determination of sleeping patterns that could improve intellectual performance has been largely neglected. This study is designed to discover the effects of different sleeping patterns on academic performance among medical students. A descriptive study was carried out in King Edward Medical University in Lahore, Pakistan during a six-month time span from May 11 th , 2011 to September 30 th , 2011. Of the total population of 1350 students in King Edward Medical University, 591 undergraduates were included in the study. A questionnaire designed on sleeping patterns and academic performance was distributed in May 2011. What was described as outstanding students were greater in number in group 4 (7/19) 36.8% and group 6 (6/19) 31.6%. Above average students with sleeping patterns were in group 4 (13/37) 35.1% and group 6 (10/37) 27%. Average students were shown to have sleeping patterns of group 4 (11/25) 44% and group 6 (7/25) 28%. Below average students were shown to have sleeping patterns of group 4 (3/3) 100%. Most of our students had a reduction in the total amount of sleeping hours throughout the years. Midnight to 6 o'clock in the morning with an afternoon nap was the sleeping pattern that was most commonly seen in all groups. We concluded that different sleeping patterns do not affect the performance of medical students in the academic prospective. Many other factors may be involved in the lack of significant achievement, in order to prove that the sleeping patterns are not related to the academic performance, and more data would need to be collected.

Objective:To see the efficiency, adequacy and accuracy of toluidine blue stained smears of FNAC of Breast thyroid and salivary glands swelling with comparison to conventional stained FNAC smears with Papanicolaou.Methods:A total of 114 aspirates from various sites were included in the study. The smears were stained with toluidine blue and conventional Papanicolaou stain and the cytomorphology of both the smears were compared. The values were tabulated and statistical tests of significance was applied.Results:Of the 114 aspirates included in our study the diagnostic accuracy by using papanicolaou was 78%, while it was upto 100% with supravital toluidine blue stained smears. The percentage of inadequacy was reduced to just 25%. The observations were statistically significant. Breast 37/48 (77%) and Salivary glands 11/48 (23%) respectively. The most commonly used categorization of a five-tier system was used for reporting of breast cytology, with categories ranging from insufficient materials (C1), benign (C2), atypical (C3), suspicious of malignancy (C4), or (C5) frankly malignant. Most of breast lesions were benign 25 (67.56%). There were only 9 (24.32%) malignant cases followed by 2 cases of C-4 and one case of C-3. Benign thyroid lesion were more frequent comprising of 51 (72.27%) cases. One case (1.5%) of papillary carcinoma was found while 13 case were follicular lesions. There were 4 (36.4%) cases of pleomorphic adenoma and 3 (27.3) cases of non-specific sialadenitis. There was one case (9%) of each lesion for mucoepidermoid carcinoma, adenoidcytic carcinoma and benign cyst.Conclusion:Toluidine blue stained study of FNAC improves the diagnostic accuracy by minimizing the smearing and drying artifact, loss of cell sample during fixation and staining which influences the diagnostic accuracy.

Objective:To determine the frequency of placenta Previa in patients coming to a tertiary care unit with previously scarred and non-scarred uterus.Methods:A descriptive cross sectional study was carried on 114 cases who underwent caesarean sections (37 cases out of 645 cases with non scarred uterus and 77 cases from 721 cases with scarred uterus) in the department of obstetrics and gynecology Lady Willingdon Hospital from January 2008– December 2011.Results:Most patients (47.36%) were between 26-30 years age group, presented with gestational age between 36-40 weeks (70.17%), were mostly G2-4, while frequency of placenta Previa in non-scarred uterus was 32.45% (37 cases), and frequency in previously scarred uterus was 67.54% (77 cases). Major degree Previa was found in 88 cases (77.19%). There were 5.70% cases of placenta Previa from non-scarred uteruses and 10.67% cases of placenta Previa (10.67%) from already scarred uteruses. Stratification revealed a higher trend of the morbidity with the increase in number of previous caesarean sections.Conclusion:A significantly higher frequency of placenta Previa was found among patients coming to a tertiary care hospital with previously scarred uterus.

The aim of this study was to see the usefulness of fine needle aspiration by “theBethesdasystem for reporting Thyroid Cytopathology” (TBS- RTC) for non palpable thyroid nodules through ultrasound-guidance for the evaluation and treatment planning of nonpalpable thyroid lesions. This study was conducted on 200 patients with non palpable thyroid nodules which are very low lying or felt on swallowing; in Department of Pathology and Radiology since January 2011 to June 2012. The patients were scanned and USG- FNAC was performed and reporting was done by “TBSRTC”. Of the 200 specimens 17 samples were nondiagnostic or unsatisfactory (Class I), 145 samples were benign (Class II), 20 samples were showing Atypical of Undetermined Significance (AUS) or Follicular Lesion of Undetermined Significance (FLUS); (Class III), 6 were showing follicular neoplasm or suspicious for a follicular neoplasm (Class IV), 7 samples were suspicious for malignancy (Class V) and 5 samples were positive for malignancy (Class VI). On comparison of ultrasound guided FNAC with histopathology the sensitivity for correct diagnosis was 93%, specificity was 86%, positive predictive value was 37%, negative predictive value was 99% and accuracy was 86%. USG-FNAC is a useful modality for the evaluation and treatment planning of nonpalpable thyroid lesions smaller than5 mmin the maximum diameter. TBSRTC is the best method of reporting but class III and IV are the main pitfall of this system for reporting Thyroid Cytopathology and show high sensitivity, specificity and accuracy.

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Hepatocellular carcinoma (HCC) is the fifth most common cancer in the world and the third most common cause of cancer mortality. Despite the high numbers of patients diagnosed worldwide, HCC continues to pose challenging clinical problems. Good-quality ultra sound with careful evaluation of the entire liver can be a screening examination for HCC in patients at risk. The aim of the study was to determine the diagnostic accuracy of the Doppler sonography for differentiation of hepatocellular carcinoma (HCC) from other focal liver lesions by taking histopathology as a gold standard. It was a cross-sectional survey, conducted in the Department of Diagnostic Radiology, King Edward Medical University/Mayo Hospital, Lahore in one year from 13-12-2010 to 12-12-2011. A total of 70 patients were included in this study with focal lesions on ultrasound are included while pregnant patients are excluded. After evaluating by Doppler sonography and doing core biopsy, the patients were sent to the Department of Pathology, Mayo Hospital for histopathological examination. Histopathology was assessed for confirmation of positive and negative cases. Mean age of the patients was 60.9 ± 4.7 years. Out of 70 patients, 47 patients (67.1%) were male while remaining 23 patients (32.9%) were female. On Doppler sonography 37 cases were positive for hepatocellular carcinoma and 33 cases were negative while 36 cases were positive and 34 negative on histopathology. On Doppler sonography, sensitivity (94.4%), specificity (91.1%), diagnostic accuracy (92.8%), positive predictive value (91.8%) and negative predictive value was 93.9%. We concluded that Doppler sonography is a useful method for differen-tiation of Hepatocellular carcinoma from other focal liver lesions, detection and characterization of hepatocellular carcinoma.