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05). Age ?21 years also had a significant association with dysmenorrhea (p<0.05).

Dysmenorrhea was found to have a significant association with body mass index and age.

Dysmenorrhea was found to have a significant association with body mass index and age.Thoracic outlet syndrome (TOS) is the constellations of symptoms produced when the neurovascular structures that traverse the thoracic outlet are compressed. The symptoms are generally due to the compression of the subclavian artery and vein, lower trunk of the brachial plexus as they pass through the thoracic outlet. Diagnosing thoracic outlet syndrome can be difficult because the symptoms and their severity can vary greatly among people. We present a case of 30 years female presenting with arm and scapular pain radiating to hand along with restricted muscle movements; subsequently diagnosed with bilateral thoracic outlet syndrome on CT angiography and confirmed on multiphasic scan.Recent brain tumour research has shown abnormalities in gene expression as key features for almost all common brain tumours investigated. However, there is increasing evidence that epigenetic abnormalities are also crucial for tumorigenesis. Epigenetic abnormalities are heritable alterations affecting gene expression without changing the primary DNA sequence. Epigenetic abnormalities in meningiomas include abnormal microRNA expression, altered DNA methylation and histone and chromatin modifications. In this review we identify the role of altered expression of microRNA in the development and recurrence of meningioma. Based on the review of current literature, extensive knowledge of micro-RNA expression cannot only determine tumour recurrence and prognosis but also opens up new avenues for treatment.Diabetology is becoming more and more complex, and requires simple yet comprehensive models to facilitate appropriate management of the syndrome. This communication highlights the concept of glycaemic personality, defined as the sum of all attributes, both biomedical and psychosocial, which influence the glucophenotype of an individual. This concept can be explained by using the SURE model, which lists four factors that influence choice of glucose-lowering therapies and their targets. These include the Severity and Style of hyperglycaemia, Urgency and Utility of glucose control, Relative Risk of hypoglycaemia, and Expected adherence to therapy and Expectations of the person living with diabetes.Orthorexia nervosa is an eating disorder characterized by an obsessive focus on "healthy" eating, and inflexibility in diet, which leads to clinically significant medical or psychosocial impairment. This review describes the clinical features and management of orthorexia nervosa. Focusing on the endocrine aspects of the syndrome, it explores the multiple bidirectional links between endocrinopathy and orthorexia, as well as endocrine management and orthorexia.A 25-year-old male presented with a complaint of acute visual loss in his right eye for two days. There was a history of visual loss in the left eye six months ago. Comprehensive eye examination showed evidence of posterior uveitis, and a placoid lesion on the right fundus. Further physical examination showed maculopapular rashes on the upper back which was highly suggestive of syphilis. Blood tests for venereal disease research laboratory (VDRL) test and fluorescent treponemal antibody absorption (FTA-ABS) test were ordered, which were both positive. Ocular syphilis should be suspected in all cases of uveitis. Early diagnosis and prompt treatment with appropriate antibiotics can prevent permanent visual loss.Human brucellosis is a common zoonotic infectious disease in the world. Spinal epidural abscess development in brucellosis is a rare but serious complication. We aimed to discuss the clinical, radiological and serological findings of the spinal stenosis caused by epidural and paraspinal abscess due to brucella infection. Treatment of the abscess usually consists of surgical drainage, decompression and antibiotherapy. In our case, since the Brucellar spinal epidural abscess was diagnosed in the early period, it was improved with medical treatment without any surgical intervention. In the early diagnosis of the disease, serology and culture as well as magnetic resonance imaging are extremely important..Drug interaction is a common clinical problem which is often underestimated by physicians. Statins are one of the commonly prescribed medicines worldwide that are generally well tolerated. Muscle-related symptoms have a varied clinical presentation which usually increases if a new medicine is co-prescribed. We report the case of a 65- year-old woman who presented with a 10-day history of extreme fatigue, slowly progressing muscle weakness and insomnia. Drug-induced myopathy was diagnosed with concomitant use of atorvastatin and ciprofloxacin. Muscle weakness improved after the medicines were withdrawn. Co-prescription of Ciprofloxacin and statin therapy appeared to have contributed to muscle weakness in this patient. Drug interaction should also be kept in mind, when managing patients on statins as it may be underappreciated as a cause of muscle weakness and its consequences can have potentially serious outcomes.Trichobezoars present with stomach ache and with a mass in the stomach. It's common in the young and middle-aged women having psychiatric disorder, presenting with stomach ache and existence of mass in the stomach. Although it's one of the rare causes of anaemia it should be considered when dealing with cases of chronic and unresponsive anaemia.Pseudoangiomatous stromal hyperplasia (PASH), composed of proliferated stromal mesenchymal cells of myofibroblastic origin, is a benign lesion of the breast. A few cases associated with pseudoangiomatous stromal hyperplasia of the breast have been reported. We report this case of a 15-year-old girl with PASH accompanied by severe enlargement and painful mass in the right breast. There were no other palpable masses or lymph nodes. Biopsy of the mass showed histopathologic features characteristic of fibroadenoma. The palpable mass was around 6x5cm in diameter, while clinical manifestations aroused suspicion of malignancy mimicking sarcoma of the breast. Although, biopsy of the mass showed benign histopathologic features; surgical excision was performed because of the damage caused by enlarging breast tissue and clinical suspicion of malignancy.A knowledge, attitude and practice cross-sectional survey was conducted among dental practitioners doing private practice in district central, Karachi after checking eligibility and taking their written informed consent. The practitioners were interviewed by the principal investigator with the help of a pre-tested structured questionnaire developed specifically for this study. The study results revealed that 175(88.8%) of the participants were aware that waste management guidelines are applicable to them, 184(93.4%) were aware that healthcare waste is a source of infection whereas 145(73.6%) were aware about the colour coding of healthcare waste bags/containers. Moreover, 165(84.1%) thought that health care waste disposal protocol lessens the chance of injuries and infections whereas 182(92.0%) were in favour of the need to continue medical education about health care waste management. It is recommended that healthcare waste should be segregated and disposed of in a safe manner to protect the people at risk and the environment.Central retinal artery occlusion (CRAO) is one of the causes of sudden loss of vision. Homocystinuria is an autosomal recessive inherited disorder and is characterized by increased levels of homocysteine in the urine and blood. We present a case of homocyistinuria in a 14-year girl, presenting as CRAO with a family history of vascular thrombotic events. The patient did not have any local predisposing factors or prior history of thromboembolic episodes. Left eye fundus examination revealed a pale retina with sparing of cilioretinal artery. On examination Visual acuity of the right eye was 6/6 and left eye was completely blind with no perception of light. N-Hydroxyacetamide Homocysteine level on admission was 34.60umol/l. Patient was started on Rivaroxaban 10mg, Vitamin B6 , Vitamin B12 and folic acid. On follow up examination after 2 months the visual acuity in the left eye was 6/9. The dramatic improvement in the visual acuity can be attributed to the sparing of the cilioretinal artery. Followup Homocysteine levels after two months of treatment was 12umol/l. Ophthalmologist should be aware of this rare manifestation of homocystinuria as CRAO as they can play an important role of diagnosing the underlying medical illness.

To evaluate the value of single-photon emission computed tomography/computed tomography fusion alone and in addition to pertechnetate planar imaging in the diagnosis of ectopic gastric mucosa.

The retrospective study was conducted at the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China, and comprised medical records from May 2014 to April 2015 of children aged <14 years and suspected of ectopic gastric mucosa. All patients underwent both planar imaging and single-photon emission computed tomography/computed tomography fusion imaging, and were followed up for more than 6 months. The final diagnoses were determined based on the results of pathology and clinical follow-up. The sensitivity, specificity, and accuracy of diagnosing ectopic gastric mucosa were compared by using planar imaging, SPECT/CT fusion imaging and a combination of both. Data was analysed using SPSS 21.

Of the 41 patients, ectopic gastric mucosa was diagnosed in 24(58.5%) by pathological results or clinical follow-up. Planar imaging suggested 33(80.5%) positive and 8(19.5%) negative cases, while fusion imaging reported 23(56%) and 18(44%) respectively. The sensitivity, specificity and accuracy of planar imaging were 91.67%? 35.29% and 68.29%, and in fusion imaging they were 91.67%?94.12% and 89.47% respectively. The corresponding values of the combination of two imaging techniques were 91.67%?100% and 95.12% respectively (p=0.006). Kappa value of the diagnostic consistency between fusion imaging and a combination of two imagings was 0.951 (p=0.0001).

Planar imaging had a low specificity compared to fusion imaging and a combination of fusion and planar imagings.

Planar imaging had a low specificity compared to fusion imaging and a combination of fusion and planar imagings.Child labour is rampant in Pakistan since ages. Laws, policies, programmes and strategies to eliminate child labour have been in place with little gain. Implementation of laws and sustainability of programmes offer barriers to eliminate the menace. We recommend a new approach of regulating child labour as a strategy to eliminate it in the longer run. Model districts with drop-in-centres offering free education to the working children should be constructed. The key stakeholders should unite on a common platform to formulate guidelines defining the nature and duration of work for children in various sectors such that they have sufficient time to visit the drop-incentres. Once a generation of children is educated, the cycle will start to break itself and gradually we will overcome child labour.