Physiology and Anatomy

Type 2 diabetes mellitus (T2DM) is multifactorial diseases caused by complex between genetic, lifestyle and environment risk factor; T2DM has also been recognized as an immune mediated disease leading to impaired insulin signaling and selective destruction of insulin producing beta cells in which cytokines play an important role. This study aimed to investigate the association of IL-6 gene polymorphism (-174G>C) with type 2 diabetes mellitus incidence in Iraqi population. Peripheral blood samples were collected from 50 diabetic patients and 50 apparently healthy individuals from both genders. DNA was extracted and Polymerase Chain Reaction - Restriction Fragment Length Polymorphism (PCR-RFLP) was carried out to detect polymorphism at the -174 position of IL-6 gene and determined the genotype for Iraqi population. The results revealed that the GG genotype in diabetic was significantly (p?0.05) lower than control group (64% versus 74%, respectively) while the GC genotype in diabetic was significantly (p?0.05) higher than control group (32% versus 22%, respectively), and there was no significant difference between diabetic and control group in the CC genotype with a non significant differences in either G or C allelic frequencies between diabetic patients and control group. The results of the present study indicate that heterozygous GC genotype was associated with the incidence of T2DM.

Repeated attempts at surgical repair of serious complications involving either the partial or complete breakdown of the hypospadias repair are less likely to succeed because the penisis densely scarred, or significantly shortened, and the skin over the penisis immobile and hypovascular. Buccal mucosa (BM) has become the preferred material for reconstruction, whenever a child with skin-deficient hypospadias needs reoperation. We report the results of our surgical experience with staged reoperation using BM, in the repair of hypospadias a patient of 22 years with complications after multiple failed repairs.

Buccal mucosa has been used in both primary and salvage urethroplasties, as dorsal onlay. Ventral onlay, and as tubed grafts in posterior and anterior urethral strictures. It’s recommended as ideal graft material which offers many advantages: availability, easy and less infectious complications. Repeat urethroplasties were performed by excising the fibrous tissue around the stricture; buccal mucosa was then harvested from the inner cheek, made into graft tubing, and interposed into the defect. We report the results of our surgical experience with staged reoperation using BM, in the repair of post-traumatic membranous urethra stricture with loss of substance estimated to 5cm a patient of 22 years with complications after multiple failed repairs.

Normally, humans have only one urinary bladder but it’s not so in the case of bladder duplication because more than one bladder is present in this case and it occurs as a result of an abnormal development of the body specifically the abnormal development of the urinary system during the fourth week of embryological development. Bladder duplication was classified by Abrahamson into two forms based on the degree of duplication; complete and incomplete bladder duplication. And also, it can be classified into sagittal or coronal duplication based on the position of the accessory bladder in relation to the normal bladder.

Although alternate system of medicine is still the choice of masses in developing countries. Unani system of medicine being one of them. UNANI was derived from the word IONIAN which indicates it origin to Greece TIBB means medicine. Unani system of medicine is a synthesis of Greek and Arabs system .Unani physicians were the first to classify the disease on the basis of different anatomical and physiological symptoms of the body. Hippocrates explained that the disease was a normal process and its symptoms were the reaction of the body to the disease. Inspite of time tested mode of treatment, Unani system of medicine is yet to gain the due popularity in masses. With this preview a cross sectional study was conducted on 100 participants by using a close ended questionnaire tested amd pretested before use to assess knowledge, attitude and practices of Unani in new comers of A& U Tibbia college & Hospital, Karol bagh ,New Delhi in 2011 and it was found that although they had fair knowledge of Unani but still their preferred medicine was allopathy.It can be concluded that Unani system of medicine can be propagated and promoted by educating masses about Unani and increasing dispensaries and hospitals of Unani.

The data was collected after seeking approval from authorizes who were dealing with these cases under the United Nation AIDS Control Programs and Sindh AIDS Control Programs they provide list of different hospitals/ originations in Karachi Pakistan. Then 60 patients with HIV/AIDS were selected through purposive sampling technique. Basic information, NEO five factors Inventory (NEO –FFI) and Coping Responses Inventory Adult-Form (CRI-Adult Form) were administrated and responses were scored according to the procedure give in manuals.

Sarcomatoid renal carcinoma is a rare and agressive variant of the cancer of the kidney. These tumors are indifferencied and originates from all renal cell carcinomas. The diagnosis is exclusively histologic and therapeutic modalities are limited to radical nephrectomy. We report a new case and will discuss diagnosis, therapeutic and prognostic characteristics of this rare and agressive entity

Objective: To determine superoxide dismutase (SOD), glutathione dismutase (GPX) malondialdehyde (MDA), uric acid, zinc, ascorbic acid, albumin, blood lipids and glycated hemoglobin A1 (HbA1c) in newly diagnosed type 2 diabetic patients. Study Design: Case control study Place & Duration: Department of Medicine -Liaquat University of Medical and Health Sciences Hospital from December 2014- August 2015. Subjects & Methods: 95 newly diagnosed type 2 diabetics and 55 controls selected through non-probability purposive sampling according to inclusion and exclusion criteria. 8-12 hour fasting was ensured for blood samples. BUN, serum creatinine, albumin, bilirubin, uric acid, blood glucose, HbA1c, blood lipids, triglycerides, cholesterol, glucose, MDA, SOD, GPX, zinc and Ascorbic acid were determined by standard methods. Data was entered in Statistix 8.1. (USA) Continuous and categorical data was analyzed by student’s t test and Chi square test respectively. Microsoft excel was used for graphing. Data was analyzed at 95% confidence interval (p- ? 0.05). Results: Blood pressure, obesity, blood glucose, blood urea nitrogen (BUN) and serum creatinine showed statistically significant differences (p<0.05). VLDL, triglycerides, LDLc were elevated in diabetics, while HDLc was reduced. MDA, SOD, GPX, zinc, ascorbic acid, uric acid and bilirubin showed significant differences (p<0.05). MDA in diabetics and controls was noted as 5.17±0.81 vs. 2.15±0.62 µmol/ml respectively (p=0.0001). SOD, GPX, AA, Zn++, UA, serum albumin and serum bilirubin were decreased in diabetics. Conclusion: The superoxide dismutase (SOD), glutathione peroxidase (GPX), uric acid, bilirubin and zinc were reduced and malondialdehyde (MDA), altered blood lipids and glycated HbA1 were increased in diabetics in present study.

The authors present unusual case of isolated fracture-dislocation of medial cuneiform bone in a 22-year old after falling from the horse with midfoot taken by the stirrup .The plain x-rays is not likely to reveal a fracture-dislocation on this part of foot .Computing tomography (CT scan) can useful in determing the nature of the injury in such a case. The fracture was treated surgically by performing a through debridement and an internal fixation using kirshner wire after reducing .Ligaments were repaired and a prevention antimicrobial and physiotherapy were instaured. At the end of three months, we obtained a painless foot, stable and the patient was returned his activity.

The Ovarian Vein Syndrome was first reported in 1964, corresponds to ureteral compression by a dilated ovarian vein. The true pathophysiological entity remains controversial and discussed. It appears to be multifactorial anatomical and hormonal. The diagnosis is essentially radiological (intravenous urography). The Treatment is Urological (drainage by stent) and / or vascular (embolization, resection-ligature by conventional surgery or Coelioscopic). The prognosis of ovarian vein syndrome is generally favorable, without impairment of renal function. Through A new observation, the authors propose to study the pathogenic, therapeutic and evolutionary aspects of the syndrome of the vein Ovarian. Using Embase and Medline, a literature search was undertaken, English and frensh articles on the ovarian vein syndrome were appraised.