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Background: Rheumatoid arthritis (RA) is an immune-mediated, polyarthritis linked with various genetic and environmental causative agents. Among environmental triggers, Epstein-Barr Virus (EBV) is considered the most potent etiological agent. Objective: This study aimed to investigate the prevalence of EBV and its genotypes in RA patients and to investigate their association with clinical and laboratory parameters of RA. Methodology: This study included blood samples of RA and control healthy individuals (100 each). Blood samples along with clinical and laboratory parameters were collected from patients after consent in the Department of Rheumatology, at Lady Reading Hospital, in Peshawar Pakistan. Blood samples were processed for DNA extraction followed by PCR amplification for EBV detection and genotype discrimination. Results: RA patients were 85 females and 15 males with a mean age of 40.13±14.05 years. EBV Type-1 was detected in 45% of RA and 9% of control cases. The mean disease duration of RA patients was 6.61±6.23 years. Out of 100 diseased patients, 43% were seropositive rheumatoid arthritis (SPRA) and showed a significant correlation with a family history of RA in EBV-positive individuals (P = 0.017). The demographic, clinical, and laboratory parameters of RA patients showed a non-significant association with EBV. Moreover, only a family history and Serum creatinine of RA patients showed a significant association with EBV (P = 0.0001 and P = 0.022 respectively). Conclusion: It is concluded that EBV-1 is prevalent and associated with RA. Further investigation is required for detailed genetic analysis of EBV to determine its possible role in modulating the immune system in RA. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to present six cases of cervical lymphadenopathy, diagnosed as Kikuchi's disease and raise the index of suspicion for this disease. Study Design: Case Series. Setting: Histopathology and Otolaryngology/Head & Neck Surgery Department at Rehman Medical Institute (RMI) Peshawar. Period: July 2016 to March 2021. Material & Methods: Records of patients for cases diagnosed as "histiocytic necrotising lymphadenitis" were retrieved, their corresponding patient files accessed from the archive, and case notes analyzed. Results: In this series, a total of six cases of Kikuchi's disease are presented. A female predominance is evident from the present data (2:1 female to male ratio). All patients presented with palpable lymph nodes in the neck, predominantly on the left (66.7%). Majority (66.7%) presented with neuralgic pain (on/off). Only one patient did not show weight loss and night sweating, the remaining had all the symptoms. All of the patients recovered spontaneously within 6 months (range 2 to 6 months) with symptomatic treatment for neuralgic pain. Conclusion: Kikuchi's disease should be kept in the differential diagnosis in young females with persistent neck masses, palpable lymph nodes and suspicious fine needle aspiration cytology (FNAC). [ABSTRACT FROM AUTHOR]

Objective: To account for the characteristic presentations, pathology and the post-operative complications of surgical treatment of retrosternal goitre. Study Design: Retrospective Descriptive study. Setting: Department of Otorhinolaryngology at Rehman Medical Institute, Peshawar. Period: July 2016 and December 2019. Material & Methods: All patients that underwent thyroidectomy during the study period were included in the study. The thyroid gland that did not have retrosternal extensions were excluded. Retrospective chart records of all these patients were analysed. Data obtained from the charts was recorded on Statistical package for social services version 23.0 and analysed for descriptive statistics. Results: 67 patients with goiters were at the tertiary care center of Peshawar, females (77.6%) and males (22.4%). 6 (8.9%) were retrosternal. The most common symptoms were neck swelling (83.3%) followed by shortness of breath (66.7%). Post-operative hypocalcaemia was the most common complication among retrosternal thyroidectomy patients (66.7%). Only one patient needed sternotomy. Conclusion: All patients with retrosternal goitre should be offered surgery. The post-operative complications are low and resolve uneventfully. [ABSTRACT FROM AUTHOR]

This study is designed to monitor the rapid virological response (RVR) for 8 weeks and sustained virological response (SVR) for 12 weeks during Sofosbuvir therapy in chronic hepatitis C patients in Peshawar, KPK, Pakistan. A total of 162 hepatitis C positive patients were enrolled in this study. After RNA isolation, Quantitative PCR was done to get viral load, and Ohn et al., 1997 protocol were used for hepatitis virus different genotypes. Statistical analysis was performed using SPSS. A Sample t-test was applied to compare gender and age. Chi Square test was applied to compare the RVR and SVR. In total 162 positive hepatitis C patients, 90 were male and 72 were female. High rate 153(94%) of RVR and 158(97%) SVR were achieved during 8 and 12 weeks of sofosbuvir therapy. High SVR and RVR were achieved in the <30 and 31-40 age groups. High EVR 125(99%) by genotype 3 were achieved at 8 weeks of therapy and high SVR 126(100%) by genotype 3 and 28(93%) by genotype 1 were achieved at 12 weeks of sofosbuvir therapy. The current study reveals that high RVR and SVR rates were obtained by shortening the SOF therapy's treatment time up to 8 and 12 weeks. We got a 98.7% response rate at the end of the treatment. [ABSTRACT FROM AUTHOR]