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January 1989, Volume 39, Issue 1

Letter to the Editor


Fatema Jawad  ( 7/6, Rimpa Plaza, M. A. Jinnah Road, Karachi. )

FREQUENCY AND PATTERN OF HODGKIN\'S TYPE MALIGNANT LYMPHOMA (PRELI- MINARY REPORT). Muzaffar, M., Malik, I.A., Luqman, M., Khalilullah. Pak. J. Med. Res., 1987; 26:39-43.
A study was conducted between 1980 and 1986 at the Military Hospital, Rawalpindi to deter­mine the frequency of Hodgkin’s lymphoma in various age groups. 1276 patients with enlarged lymph nodes were biopsied and 166 cases were diagnosed as malignant lymphoma. 57 patients had Hodgkin’s lymphoma and 109 had Non-Hodgkin’s lymphoma. The sex distribution of the Hodgkin’s lymphoma cases was 39 males and 18 females and the maximum number of indivi­duals were between the ages of 10 and 49 years. The most common mode of presentation was cervical lymphadenopathy followed by enlargement of the axillary nodes. The histological pattern most commonly encountered was the mixed cellular type seen in 35 cases. 15 cases had the lymphocytic depletion type, 4 had nodular scierosing variety and 3 cases were of lympho­cytic predominance type. A comparison of this series with other the conclusion between the of Hodgkin’s to the racial and immunological differences. Male predo­minance was noted in all the series but the presen­ted series showed an absence of the bimodality in the age curve.
KARTAGENER\'S SYNDROME WITH MiTRAL flENOSIS. Ansari, N., Javaid, A., Butt, A.K., Rehman, C.A. Pak. J. Med. Res., 1987; 26:63-65.
Kartagener’s Syndrome consists of a triad of bronchiectasis, sinusitis and situs inversus. Two siblings of a family suffering from Kartagener’s syndrome are described. The first was an 18 years old unmarried female with a history of productive cough since childhood. Clinical examination revealed an irre­gularly regular pulse, JVP 5 cm above the sternal angle, right parasternal heave, loud first heart sound at the apex with a long mid-diastolic rumble and a grade 2/6 systolic murmur. X-ray chest showed dextrocardia, X-ray PNS showed hazy maxillary sinuses and ECG had atrial fibrillation with dextrocardia. Echocardiography revealed a tight mitral stenosis. Immunological studies showed a raised IgG level. The second case was a 12 year old brother of the first case. He had also been suffering from chronic sinusitis and bronchitis. Dextrocardia was detected on the X-ray chest. No cardiac lesion was noted clinically or on echocardiogram. Immuno­logical studies gave normal results. The pathogenesis of Kartagener’s syndrome is still disputed. Genetic studies have proved the abnormality to be on autosomal recessive trait with incomplete penetration. Immunological studies have shown normal immunity. The mitral stenosis in one of the presented cases, which is nOt a common feature of Kartagener’s syndrome, could be a chance association or may be related to repeated stre­ptococcal infections. So also the raised IgG levels could be secondary to repeated infections.
DENTAL CONDiTION OF PREGNANT MOTHERS ­AN ANALYTICAL REPORT. Soofi, M.A., Soofi, I., Qureshi, M.R. The Medicus, 1970; 40: 224-231.
407 pregnant women were examined for changes in the periodontal and dental tissues. The data was tabulated in age groups with an interval of five years and the first age group of 15 to 20 years was ignored as there were only 5 individuals. 16.6 percent of the women were illiterate, 42.9 percent had school education and 40.5 percent had been to college and university. The maximum number of pregnant cases were between the ages 30 to 34 with a mean of 4.54 pregnancies. Of all the cases 183 percent used a tooth brush, 49.2 percent tooth powder, 15.1 percent miswak and 174 percent were negligent about their oral hygiene. 23 percent were free of decayed missing and filled teeth. Gingivitis was found to be directly related to pregnancies. It is generally believed •that pregnancy is associated with an increased susceptibility to dental caries in the mother. “For every child a tooth”, is a well known saying. Different theories have been presented as increased demand of calcium and phosphorus by the foetus is met with by withdrawal from the mother’s bones and not the teeth. But dental caries may increase during pregnancy due to reduction of the mineral salts in the teeth. Mobility of the teeth may be increased due to loss of calcium content of the supporting bone. Gingival changes occur due to low resistance. It is thus necessary to stress on the oral hygiene and prophylactic checking of dental condition of pregnant women.
LENSECfOMY, VITRECTOMY AND LENS IMPLAN­TATION IN YOUNG CHILDREN WIT H TRAUMATIC CATARACT. Jalilud-daula, A., Naeemullah. J. Pak. Acad. Ophthalmol., 1987; 2: 77-78.
Lensectomy, vitrectomy and anterior chamber IOL implant was performed in 8 children with traumatic cataract. In most of the cases there was zonal or capsular rupture and retro­lenticular opacities. A limbal approach was selected and Haelon was injected in the anterior chamber and synaec­hotomy was performed. Lensectomy was done with the Microvit probe and the whole lens with the posterior capsule was removed. This was followed by vitrectomy. Haelon was again intro­duced in the anterior chamber and IOL was implanted. In all but one case Silco IOL was used. In one eye Pannu IOL was implanted. The cases were followed up for one year and the immediate results were very encouraging. 7 cases achieved 6/12 with 5 needing correction to have 100 percent vision and 2 without correction. One 4 year child could not be assessed due to lack of cooperation. Although the presented series is small but the results are encouraging and it is suggested that this practice should be adopted in cases of traumatic cataract.

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