1.Traumatic cerebrospinal fluid leakage following septorhinoplasty.
Ahmed YOUSSEF ; Shahzad AHMED ; Ahmed Aly IBRAHIM ; Mulvihill DANIEL ; Hisham M ABDELFATTAH ; Haitham MORSI
Archives of Plastic Surgery 2018;45(4):379-383
Septoplasty/septorhinoplasty is a common ear, nose and throat procedure offered for those patients with deviated septum who are suffering from nasal obstruction and functional or cosmetic problems. Although it is a basic and simple procedure, it could lead to catastrophic complications including major skull base injuries which result in cerebrospinal fluid (CSF) leaks. We describe two different cases of traumatic CSF leaks following septoplasty/septorhinoplasty at two different sites. The first patient suffered a CSF leak following septoplasty and presented to Alexandria University Hospital. The leak was still active at presentation and identified as coming from a defect in the roof of the sphenoid sinus and was repaired surgically. The second patient presented 4 days after her cosmetic septorhinoplasty with a CSF leak and significant pneumocephalus. She was managed conservatively. Understanding the anatomical variations of the paranasal sinuses and implementing proper surgical techniques are crucial in preventing intracranial complications when performing either septoplasty or septorhinoplasty. A good quality computed tomography of the nose and paranasal sinuses is a valuable investigation to avoid major complications especially CSF leaks following either procedure.
Cerebrospinal Fluid Leak*
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Cerebrospinal Fluid Rhinorrhea
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Cerebrospinal Fluid*
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Diabetes Insipidus
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Ear
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Humans
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Nasal Obstruction
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Nose
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Paranasal Sinuses
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Pharynx
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Pneumocephalus
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Rhinoplasty
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Skull Base
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Sphenoid Sinus
2.Seroprevalence and Spatial Distribution of Toxoplasmosis in Sheep and Goats in North-Eastern Region of Pakistan.
Haroon AHMED ; Ayesha MALIK ; Irfan MUSTAFA ; Muhammad ARSHAD ; Mobushir Riaz KHAN ; Sohail AFZAL ; Shahzad ALI ; M Mobeen HASHMI ; Sami SIMSEK
The Korean Journal of Parasitology 2016;54(4):439-446
Toxoplasmosis is a protozoan disease that is caused by Toxoplasma gondii in livestock and humans. Due to its medical and veterinary importance, it is essential to study the seroprevalence of T. gondii infection among humans and animals in various parts of the world. The major objective of this study was to determine the seroprevalence and spatial distribution of toxoplasmosis in small ruminants (sheep and goats) of north-eastern region, Pakistan. A total of 1,000 animals comprising of sheep (n=470) and goats (n=530) were examined for T. gondii infection by using ELISA. An epidemiological data was collected in the form of questionnaire. A surface has been generated by using method of interpolation in Arc GIS with the help of IDW (inverse distance weight). The results showed higher seroprevalence of T. gondii in goats (42.8%) as compared to sheep (26.2%). The seroprevalence was higher in females as compared to males in all examined ruminants. Similarly, there is a wide variation in the seroprevalence of T. gondii in different breeds of sheep and goats showing higher seroprevalence in Teddy (52.8%) and Damani breed (34.5%) of goat and sheep's, respectively. The geographical and spatial distribution of T. gondii shows that it is widely distributed in different parts of the north-eastern region of Pakistan. Our results suggest widespread environmental contamination with T. gondii oocysts. It suggests us that small ruminants could be a potentially important source of T. gondii infection if their infected meat is consumed undercooked.
Animals
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Enzyme-Linked Immunosorbent Assay
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Female
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Goats*
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Humans
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Livestock
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Male
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Meat
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Methods
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Oocysts
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Pakistan*
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Ruminants
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Seroepidemiologic Studies*
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Sheep*
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Toxoplasma
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Toxoplasmosis*
3.Prevalence And Associated Factors Of Muscoskeletal Disorders Among Arabic Calligraphers Living In Saudi Arabia: A Cross-Sectional Study
Mustafa Ahmed Alshagga ; Ibrahim Abdel Aziz Ibrahim ; Naiyer Shahzad ; Shahnaz Hasan ; Mohammad Nizar Balilah ; Ahmad Salah Sadaqa ; Neveen Ali Awad ; Ayat Mohammed Aldosari ; Tafaol Ahmad Murad ; Sami Abdo Radman Al-Dubai
Malaysian Journal of Public Health Medicine 2018;18(2):39-44
Musculoskeletal disorders (MSDs) represent a significant occupational problem. Only limited research is available about the impact of MSD on the active Calligraphers. Uncertainty remains about MSD prevalence and associated factors among Arabic calligraphers in Saudi Arabia. A cross-sectional study was conducted among 124 Arabic calligraphers in Saudi Arabia. Data were collected by telephonic interviews using a structured questionnaire that consisted of the validated Standardized Nordic Questionnaire, socio-demographics and working characteristics. A total of 124 completed questionnaires were analyzed. The majority were men (96.8 %), worked for less than 10 hours/week (63.7%). The majority had musculoskeletal pain (59.7%) and about half of them worked for less than 15 years. The most commonly reported MSD was back pain (26.6%) followed by neck pain (21.0%) and shoulder pain (12.1%). In multiple logistic regression the significant predictors in the model were: not exercising (OR=7.1, 95% CI 2.6-19.2), age ≤40 (OR=2.8, 95% CI 1.1- 7.3), worked for ≤20 years (OR=3.4, 95% CI 1.3 -9.1) and being a professional calligrapher (OR=2.3, 95% CI 1.1 – 6.2). The total model is significant (p<0.001) and the adjusted r square= 0.37.MSDs among Arabic calligraphers in Saudi Arabia is relatively high; further clinical assessment is needed. We recommend that health authority in Saudi Arabia should increase the awareness among calligraphers about MSDs and its prevention.
Musculoskeletal disorders
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calligraphers
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Saudi Arabia
4.A Retrospective Analysis on the Cystic Echinococcosis Cases Occured in Northeastern Punjab Province, Pakistan
Aisha KHAN ; Sarmad ZAHOOR ; Haroon AHMED ; Uzma MALIK ; Rabia Amin BUTT ; Muhammad Sultanul MUZAM ; Seyma Gunyakti KILINC ; Noorulain NOOR ; Saroosh ZAHOOR ; Muhammad Sohail AFZAL ; Hamza MANSUR ; Shumaila IRUM ; Sami SIMSEK
The Korean Journal of Parasitology 2018;56(4):385-390
A retrospective study was performed to report the case occurrence of cystic echinococcosis (CE) in three hospitals of north-eastern region in Punjab Province, Pakistan. We reviewed retrospectively the clinical records of patients in 4 hospitals which were diagnosed with CE during 2012–2017. A total of 198 cases, 82 (41.4%) male and 116 (58.6%) females were detected as CE. The most Highest incidence was revealed in.... 21–30 years-old group (24.2%) followed by 41–50 (22.7%), 31–40 (16.2%), 11–20 (13.6%), 51–60 (8.1%), below 10 (5.5%), over 71 (5.1%) and 61–70 year-old group (4.5%). CE was detected in various organs of infected individuals. However, most of CE cases were detected in the liver (47.4%) and lung (18.6%). The present study indicated that CE is more or less prevalent in surveyed areas and one of the most important public health problems in Punjab Province, Pakistan.
Echinococcosis
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Epidemiology
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Female
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Humans
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Incidence
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Liver
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Lung
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Male
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Pakistan
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Public Health
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Retrospective Studies
5. Molecular detection of Leishmania species in human and animals from cutaneous leishmaniasis endemic areas of Waziristan, Khyber Pakhtunkhwa, Pakistan
Mubashir HUSSAIN ; Shahzad MUNIR ; Taj Ali KHAN ; Niaz Ullah MUHAMMAD ; Bahar KHATTAK ; Abdullah KHAN ; Humaira MAZHAR ; Maira RIAZ ; Shahzad MUNIR ; Nawaz Haider BASHIR ; Abdullah JALAL ; Irfan AHMED ; Zulqarnain BALOCH ; Muhammad Ameen JAMAL ; Kashif RAHIM ; Noha WATANY
Asian Pacific Journal of Tropical Medicine 2018;11(8):495-500
Objectives: To detect Leishmania species in human patients, animal reservoirs and Phlebotomus sandflies in Waziristan, Pakistan. Methods: Tissue smears and aspirates from 448 cutaneous leishmaniasis (CL) suspected patients were analyzed. To sort out role of the reservoir hosts, skin scrapings, spleen and liver samples from 104 rodents were collected. Furthermore, buffy coat samples were obtained from 60 domestic animals. Sandflies were also trapped. All human, animals and sandfly samples were tested by microscopy, kinetoplastic PCR and internal transcribed spacer 1 (ITS1) PCR followed by restriction fragment length polymorphism for detection of Leishmania species. Results: An overall prevalence of 3.83% and 5.21% through microscopy and ITS1 PCR respectively was found. However, the statistically non-significant correlation was found between area, gender, and number of lesions. The presence of rodents, sandflies, domestic animals and internally displaced people increased the risk of CL. Using ITS1-PCR-RFLP, Leishmania tropica (L. tropica) was confirmed in 106 samples while 25 of the isolates were diagnosed as Leishmania major (L. major). Similarly, 3/104 rodents were positive for L. major and 14 pools of DNA samples containing Phlebotomus sergenti sandflies were positive for L. tropica. None of samples from domestic animals were positive for leishmaniasis. Conclusions: In the present study, L. tropica and L. major are found to be the main causative agents of CL in study area. Movement of internally displaced people from CL endemic areas presents a risk for nearby CL free areas. To the best of our knowledge, we report for the first time L. major infection in rodents (Rattus rattus) and L. tropica in Phlebotomus sergenti sandflies trapped in Waziristan, Pakistan.
6. First report on molecular characterization of Leishmania species from cutaneous leishmaniasis patients in southern Khyber Pakhtunkhwa province of Pakistan
Mubbashir HUSSAIN ; Bahar Ullah KHATTAK ; Taj Ali KHAN ; Niaz MUHAMMAD ; Muhammad ANEES ; Hazir RAHMAN ; Muhammad QASIM ; Humaira MAZHAR ; Shahzad MUNIR ; Sultan AYAZ ; Muhammad Ameen JAMAL ; Irfan AHMED ; Kashif RAHIM ; Noha WATANAY ; Mohamed KASBARI
Asian Pacific Journal of Tropical Medicine 2017;10(7):718-721
Objective To report presence of Leishmania major in Khyber Pakhtunkhwa of Pakistan, where cutaneous leishmaniasis (CL) is endemic and was thought to be caused by Leishmania tropica only. Methods Biopsy samples from 432 CL suspected patients were collected from 3 southern districts of Khyber Pakhtunkhwa during years 2011–2016. Microscopy on Giemsa stained slides were done followed by amplification of the ribosomal internal transcribed spacer 1 gene. Results Leishmania amastigotes were detected by microscopy in 308 of 432 samples (71.3%) while 374 out of 432 samples (86.6%) were positive by ribosomal internal transcribed spacer 1 PCR. Subsequent restriction fragment length polymorphism confirmed L. tropica in 351 and L. major in 6 biopsy samples. Conclusions This study is the first molecular characterization of Leishmania species in southern Khyber Pakhtunkhwa. It confirmed the previous assumptions that anthroponotic CL is the major CL form present in Khyber Pakhtunkhwa province. Furthermore, this is the first report of L. major from a classical anthroponotic CL endemic focus identified in rural areas of Kohat district in southern Khyber Pakhtunkhwa.