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Home > Utility of Free to Total Psa Ratio in the Prediction of Prostate Cancer in Patients With Intermediate Total Psa Levels and Negative Digital Rectal Examination

Utility of Free to Total Psa Ratio in the Prediction of Prostate Cancer in Patients With Intermediate Total Psa Levels and Negative Digital Rectal Examination

Thesis Info

Author

Kirimi, Muthoni. J. F.

Department

Pathology (East Africa)

Program

MMed

Institute

Aga Khan University

Institute Type

Private

City

Karachi

Province

Sindh

Country

Pakistan

Thesis Completing Year

2009

Thesis Completion Status

Completed

Subject

Medicine

Language

English

Added

2021-02-17 19:49:13

Modified

2024-03-24 20:25:49

ARI ID

1676728074770

Similar


Background: Prostate carcinoma is among the top 5 cancers occurring in Kenyan men. Prostate-specific antigen (PSA) is currently the most important biochemical marker for the diagnosis of prostate cancer and its widespread use as a serum tumor marker has revolutionized the management of patients with prostate cancer. The identification of early prostate cancer is vital in the management of especially men who have mild or vague prostatic symptoms. The most basic and important proxy for determining the need for a biopsy in both symptomatic and asymptomatic(screened) patients is the serum prostatic specific antigen (PSA).If a patients PSA level is above 11 ng/ml then there is a high probability of prostate cancer and a biopsy would be recommended. By contrast, of those patients whose PSA level is between 4 and 11 ng/ml (intermediate range) only25-30% are diagnosed with prostate cancer. As such in these instances the specificity of PSA is reduced, resulting in taking many unnecessary biopsies. Consequently several different methods to enhance the sensitivity and specificity of PSA have been proposed. one of these is the determination of Free PSA levels and use of this as a percentage or ratio of Total PSA. Objective: To determine utility of Free to Total PSA ratio in enhancing differentiation of prostate cancer from benign prostate disease in male patients with intermediate Total PSA levels (4-11ng/ml) and negative digital rectal examination (DRE) in three hospitals in Nairobi,Kenya. Design: Cross sectional study Setting:Aga KhanUniversityHospital,NazarethHospital and St.Marys hospital Subjects: 180 male patients aged 40 years and above attending urology/surgical clinics at three hospitals, found to have age adjusted total PSA values between 4-11ng/ml with negative digital rectal examination (non suspicious for cancer) and in whom either an ultrasound guided biopsy, transurethral resection of the prostate or prostatectomy was performed and histopathology examination carried out. Results: On histology, 138(77%) of the 180 patients were diagnosed with benign prostate hyperplasia, 18(10%) with High grade intraepithelial neoplasia(HGPIN )and 24(13%) with carcinoma. Analysis of variance (one way) was performed to compare the mean of age, Total PSA, Free PSA and Free to Total PSA ratio in patients with BPH, HGPIN and Carcinoma. No significant statistical difference in mean age and Total PSA (6.614, 6.781, and 7.6) was found between patients with BPH, HGPIN and Carcinoma respectively. Mean Free PSA was significantly higher in patients with BPH (1.637) than those with HGPIN (1.012) and prostate carcinoma (0.743). No significant statistical difference
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ایاز اصغر شاہینؔ

ایاز اصغر شاہینؔ
ایاز اصغر شاہینؔ(۱۹۴۳۰ئ) ڈسکہ میں پیدا ہوئے ۔۱۹۶۶ء میں ایم۔ا ے اردو کیا اور ۱۹۸۳ء میں گورنمنٹ کالج شکر گڑھ میں اردو لیکچرا ر تعینات ہوئے۔ ادبی زندگی کا آغاز نویں جماعت سے ہوا۔ اصغر شاہین نے سیالکوٹ میں کئی طرحی اور غیر طرحی مشاعروں میں حصہ لیا۔ (۹۶۲) اور اپنے فن کے جوہر دکھائے۔
ان کا شعری کلام مختلف ادبی رسائل وجرائد میں شائع ہوتا رہا۔ اب تک ان کا کوئی شعری مجموعہ طبع نہیں ہوا۔ شاہینؔ غزل اور نظم کے شاعر ہیں۔ ان کی شاعری میں تغزل کا عنصر نمایاں ہے۔ غزل ہو یا نظم، حمد ہو یا نعت، قطعہ ہو یار باعی ،قصیدہ ہو مرثیہ ہر صنف سخن میں وہ سوزِ دروں کو شامل کر کے اس فن پارے کو امر کر دیتے ہیں۔ ان کا ایک ادبی کارنامہ یہ ہے کہ انھوں نے قرآن مجید کے مختلف پاروں کا منظوم اردو ترجمہ کیا ہے۔ اس کے علاوہ بیـشتر احادیث اور متفرق آیات کا بھی منظوم ترجمہ کر کے اپنی قادر الکلامی کا ثبوت دیا ہے۔ ان کی شاعری کا اہم موضوع عشق حقیقی ہے۔ شاہین ؔکا نمونہ کلام ملاحظہ ہو:
نام سے ہے اس خدا کی ابتدا

ہرباں بے حد رحیم اس کی ثنا

بس خدا کی ذات ہے اس کے سوا

کوئی ہو سکتا نہیں ہرگز اِلہٰ

ہے میسر اس کو دائم زندگی

اونگھ نیند آتی نہیں اس کو کبھی

آسمانوں میں زمیں میں جو بھی ہے

اس کی ملکیت میں ہے ہر ایک شے
(۹۶۳)

فغاں ہے جستجو ہے بے کلی ہے

یہی اپنی متاعِ زندگی ہے

چھپے گا کس طرح رازِ محبت

جبیں...

المفاضلة بين معايير الموازنة الرأسمالية في قرار اختيار الموقع: دراسة استطلاعية لأراءعينة من مديري شركة مصافي الشمال - مصفى بيجي

تعد قرارات اختيار الموقع من القرارات الاستراتيجية التي تستحق البحث والدراسة لمعرفة العوامل ذات الارتباط المؤثر في اختيار الموقع وبالنظر لاهمية موقع مصافي النفط من النواحي الاقتصادية والمالية والسياسية والاجتماعية ,فقد تم اختيار موضوع الدراسة لتسليط الضوء على (المفاضلة بين معايير الموازنة الراسمالية في قرار اختيار الموقع ).وتحددت مشكلة الدراسة في اهمية الكشف عن مدى استخدام المعايير المالية في اختيار الموقع ,وتم تطبيق الدراسة في ميدان مهم من ميادين الاقتصاد الا وهو القطاع النفطي كدراسة استطلاعية لاراء عينة من مديري شركة مصافي الشمال - مصفى بيجي ومن اجل تحقيق اهداف الدراسة,تم صياغة خمس فرضيات لغرض اختبارها على عينة تتكون من (30) مديرا في المستويات الادارية المختلفة ,وبهدف الحصول على البيانات والمعلومات المتعلقة بمتغيرات الدراسة اعتمدت المقابلات الشخصية فضلا عن الاستبانة للحصول عليها ,ولغرض تحليل الاستجابات واختبار الفرضيات ,استخدم الباحث عددا من الوسائل الاحصائية منها النسب المؤية والوسط الحسابي والانحراف المعياري ومعامل الارتباط بيرسون واختباري (f,t) والانحدار البسيط والمتعدد(Multiple Liner Regression)وتحليل المسار (Path Analysis)

Evaluating Role of Plant Growth Promoting Rhizobacteria Pgpr to Increase Flower Production, Flower Periodicity and Essential Oil Contents in Rosa Damascena Mill.

The role of plant growth promoting rhizobacteria for improving yield and essential oil contents in Rosa damascena Mill. was evaluated in this study. Plant growth promoting rhizobacteria (PGPR) were isolated from the rhizosphere of Rosa damascena in first experiment, fifteen distinctive and fast growing rhizobacterial colonies (strains) were chosen to inoculate the Rosa cuttings by dipping in them. Results of the pot experiments revealed that most of the isolates showed growth promoting activities in Rosa cuttings except the isolates B5 which was proved to be growth limiting strain as it gave 20-40% less result for all parameters. All the other strains enhanced cutting growth characters up to 30- 60% compared to control. Strains LSI19, F6 and LC4 were proved to be superior strains in all growth attributes. Therefore, these three strains (LSI19, F6 and LC4) were selected for further studies. Three separate field experiments were laid out in factorial arrangement under randomized complete block design (RCBD) with four replications. Total eight inoculum combinations were made from three PGPR strains (alone and in different combination) for each experiment. Second experiment comprised of root application of eight combinations of PGPR treatments in the form of liquid inoculum along with zero, half of recommended and recommended dose of nitrogen and phosphorus. Maximum plant growth and production was observed in all PGPR treatments at NP @ 60 and 20 g/m2 only the stem diameter was found maximum when PGPR treatments were applied along with NP @ 30 and 10 g/m2. Combination of PGPR strains perform better than individual strains when applied at all three levels of nitrogen and phosphorus. Results regarding essential oil contents showed that PGPR combination of F6, LC4 and LSI19 at NP fertilization @ 30 and 10 g/m2 provided the highest concrete and absolute oil percentage but increasing levels of NP ultimately reduced oil contents. Third experiment comprised of foliar application of similar PGPR combinations, in which PGPR treatments were applied at three different growth stages (on new shoots after pruning, after flower bud formation and at flower burst). Results exhibited that plant growth and flower yield attained maximum values in triple inoculum of F6, LC4 and LSI19. Application of PGPR strains on new shoots after pruning (GS1) showed much better results regarding reproductive growth and flower yield than other growth stages while vegetative growth characters were enhanced by application of PGPR strains after flower bud formation (GS2). Last experiment was designed to assess the PGPR combinations by two methods of application (root and foliar). The results showed that plant growth, biomass of flowers, N contents in shoots and P contents in leaves and shoots were significantly improved by root application of PGPR strains while flower yield and N contents in leaves were improved with foliar application of PGPR strains. PGPR inoculation by different methods (root and foliar) significantly affected oil yield and chemical composition of essential oil. Overall results for all studies reflected that yield of Rosa damascena was enhanced with the application of PGPR inocula either single or in combination. However, co-inoculation performed better than individual inoculation.