Acute appendicitis is a common cause of acute surgical abdomen and many appendectomies are performed daily. All disease processes involving appendix will present as acute appendicitis. Clinically diagnosed acute appendicitis is treated by urgent appendectomy. As most of the removed appendices will reveal acute suppurative inflammation, therefore, appendectomy specimens are not usually submitted for histopathological examination unless the surgeon notices advanced disease or grossly recognizable abnormalities. Objectives: The purpose of this study is; 1, to explore the spectrum of diseases affecting the appendix in the community; 2, to find the age and gender association of appendicular diseases; and 3, to see if all the surgically removed appendices should be submitted for histopathological examination as a routine procedure. Study Design: Retrospective study. Setting: Charsada Teaching Hospital affiliated with Jinnah Medical College Peshawar. Period: January 2013 to January 2016. Methods: The histology slides and diagnoses of all the retrieved cases were reviewed with regards to morphology, patient's age, gender and presence or absence of any associated disease. Results: Nine disease entities were identified affecting the appendix, which from most to least common were acute suppurative appendicitis, lymphoid hyperplasia, fecalith, fibrous luminal obliteration, oxyuriasis, carcinoid tumor, submucosal fibrosis, acquired diverticulosis, and inflammatory mucocele. The first three commonest diseases were most frequent in the second decade of life; fibrous luminal obliteration in the fourth decade, carcinoid tumors in the third decade, and oxyuriasis in the first decade. Moreover, acute suppurative appendicitis, fecalith, oxyuriasis, and submucosal fibrosis were more frequent in males; whereas, lymphoid hyperplasia and fibrous luminal obliteration were more common in females. Conclusions: Acute suppurative appendicitis was the most common histological diagnosis. Acute suppurative appendicitis, fecalith, oxyuriasis, and submucosal fibrosis were more common in males; whereas, lymphoid hyperplasia and fibrous luminal atresia were more common in females. Acute suppurative appendicitis, lymphoid hyperplasia, and fecalith were most common in the second decade of life. In view of the nine different histological disease entities identified in this study under one clinical diagnosis of acute appendicitis, it is highly recommended to submit all appendectomy specimens for histopathological examination.

Aims & Objectives: Geographical variation in the rates of kidney stones has been observed for many years. Pakistan is situated in stone belt. Calculus diseases is endemic in Pakistan, perhaps the incidence in Pakistan is highest in the world. Purpose: To evaluate etiology and biochemical risk factors (inorganic phosphate) in the Peshawar. Subjects & Methods: Study was conducted at LHR and Hayatabad Hospitals of Peshawar for the period of nine months. Two hundred patients and same number of controls were selected. Results: The mean value of mean inorganic phosphate in non stone formers were less than that of stone formers. The mean of urinary inorganic phosphate excretion in stone formers was greater than that of non-stone formers. Conclusions: We conclude that inorganic phosphate is an independent risk factor for renal stone formation.

Background: Despite advances in the prevention and treatment of hypertension over the past decade, hypertension remains an important public health challenge. Recent efforts to reduce the prevalence of hypertension have been focused on non-pharmacologic means, specifically diet. An increased intake of magnesium has been shown in some but not all studies to reduce blood pressure in patients with hypertension. Decreased Serum magnesium levels are associated with development of hypertension. Aims: This study was planned to investigate relation of serum magnesium with blood pressure in patients with mild uncomplicated hypertension. Subjects & Methods: Study was conducted at LUMHS hospital Jamshoro and DHQ hospital charsadda for the period of six months. Fifty known cases of uncomplicated mild hypertensive patients were selected, same number of healthy controls were also examined. Results: When results were summed up and test parameters were compared, it was seen that no significant differences were found in serum magnesium levels among both groups, when compared statistically. Conclusion: Finally we conclude that no relation of magnesium with hypertension was observed. Suggestions: Much more work on wide scale population may be needed to clarify the idea.

Objectives: Urine cytology is an easy to perform non-invasive screening test forpatients who are suspected of having urinary tract malignancy. Urothelial carcinoma constitutesapproximately 90% of all primary tumors of urinary bladder.1 High-grade urothelial carcinomasare represented by well characterized cytological features. Whereas cytological features forlow-grade urothelial carcinomas show considerable overlap with features secondary to chronicinflammation, calculi, indwelling catheters or effects of intra-vesical chemotherapy.2 Thepurpose of this study is to find an appropriate set of cytological features of shed urothelial cellsthat will be useful to differentiate low-grade urothelial carcinoma cells from atypical urothelialcells secondary to non-neoplastic conditions. Study Design: Retrospective study. Setting:Charsada Teaching Hospital affiliated with Jinnah Medical College Peshawar. Period: 2010to 2015. Methods: All cases of urine and bladder washing cytology were retrieved for threediagnostic categories namely: low-grade urothelial carcinoma (LGUC), high-grade urothelialcarcinoma (HGUC), and “atypical urothelial cells”; for which histological diagnoses were alsoavailable. These cases were reviewed for cell clusters with smooth or irregular communityborders, cytoplasm texture, nucleomegaly, high nucleus to cytoplasm ratios (N/C ratio),presence of nucleoli, nuclear membrane irregularity, and chromatin texture. Results: Cellclusters with smooth borders were common in reactive changes, whereas irregular communityborders were seen in low-grade urothelial carcinomas and dyscohesive pattern was a featureof HGUC. The increase in N/C ratio ›2:1 was always associated with malignancy. The nuclearmembrane irregularity was also a strong indicator of malignancy. Cytoplasmic homogeneityand nuclear hyperchromasia were more prominent and consistently seen in high-gradeurothelial carcinomas. Conclusions: The study showed that nuclear membrane irregularity,nucleomegaly and high N/C ratio of › 2:1 were the most consistent features found in LGUC.These features can be used with high certainty to differentiate LGUC (malignant) from atypicalurothelial cells (non-neoplastic).

(SUMMARY) Objective: The study was conducted to determine the HBV vaccination status in health care workers of Muhammad Medical College Mirpurkhas. Study design, Setting & Duration of Study: This was a descriptive study carried out at Muhammad Medical College Mirpurkhas, from December 2007 to February 2008. Subjects & Methods: Total 480 health care workers were included; both male and female. Vaccination status & other data were filled on preformed Questionnaire proforma, if vaccinated or not. And if vaccinated either complete or incomplete. Results: Total 480 health care workers were studied, including 300 (62.5%) male and 180 (37.5%) females. The mean age was 34±8.7 and 36 ± 9.3 years in vaccinated and non-vaccinated subjects respectively. A total of 255 (53.15%) were vaccinated, including 215 males and 40 females. A 225 (44.875%) patients were non-vaccinated including 85 males and 140 females. The prevaccination HBsAg status was checked and found negative in all the subjects. The frequency of vaccination was highest among house officer 55 (91.66%) and lowest in the sanitary workers 3 (11.5%). The most common reason of not being vaccinated was non-affordability (high cost of vaccine). C o n c l u s i o n s : We conclude that a substantial number of health care workers are not vaccinated. So it demands a need for a more aggressive approach to be vaccinated and vaccine must be cost effective.