Outcome of hand function after extensor indices proprius opponensplasty

Objective: To assess the functional improvement in the hand after Opponensplasty

Study Design: Descriptive study

Place and Duration of Study: This study was conducted at Plastic Surgery Department Jinnah Hospital, Lahore from October, 2005 to March, 2015

Materials and Methods: A total of 40 patients with loss of opposition of thumb were included in the study. Their opposition was lost either due to median nerve or both median and ulnar nerve injury or directly damaged thenar muscles. Patients in whom there is restricted range of thumb motion or scarring in the route of tendon transfer were excluded from the study. After taking informed consent Extensor Indices Proprius tendon transfer was done. Post- operatively cast was given for 4 weeks and protective splintage was applied for another 2 weeks. Improvement in the hand function was recorded at conclusion of study

Results: Four patients lost follow-up. Out of 36 patients, 26 [72%] patients showed good results, 6 [17%] showed fair results and 4 [11%] showed poor results. 25 patients [69%] had good Kapandji score, while 7 [20%] had fair and 4 [11%] had poor score. Mean DASH score was 24. Overall patient's satisfaction was very good. Most of the patients hand function improved significantly

Conclusion: Our study results strongly suggest Opponensplasty with Extensor Indices Proprius is an excellent procedure for restoring opposition in patients with median or both median and ulnar nerve injury at wrist

Histological evaluation of hydroxyapatite granules with and without platelet-rich plasma versus an autologous bone graft comparative study of biomaterials used for spinal fusion in a New Zealand white rabbit model

Objectives: Hydroxyapatite [HA] has osteoconductive properties and is widely used as a bone graft substitute. Platelet-rich plasma [PRP] is an autologous product with osteoinductive effects. Hypothetically, a combination of both would augment the bone formation effect of HA and widen its application in spinal fusion surgeries. This study aimed to compare new bone formation with HA granules alone and in combination with PRP versus an autologous bone graft during a lumbar intertransverse process spinal fusion

Methods: A total of 16 adult New Zealand white rabbits underwent single-level bilateral intertransverse process fusion at the L5-L6 vertebrae. One side of the spine received either HA granules alone or a combination of HA granules and PRP, while the contralateral side received an autologous bone graft. Four animals each from the HA group and the HA plus PRP group versus the autograft group were assessed either at six or 16 weeks by undecalcified histology and histomorphometry. The mean percentage of new bone areas over the corresponding fusion masses were compared between groups

Results: No significant difference in new bone formation was observed between the HA and HA plus PRP groups at six or 16 weeks. The autograft group had significantly more new bone formation at six and 16 weeks [P = 0.004 and <0.001, respectively]

Conclusion: An autologous bone graft remains superior to HA granules, with or without PRP. HA granules demonstrated an excellent osteoconductive scaffold but had poor biodegradability. While PRP enhances the properties of HA granules, these biomaterials do not have a synergistic effect

Knowledge and awareness of tuberculosis among students of university of Kassala, Sudan

Tuberculosis [TB] is a major health problem worldwide, as one third of the world population is infected with M. tuberculosis. It is still a major cause of morbidity and mortality and a major public health concern in Sudan. To determine the awareness and knowledge of tuberculosis among students. Cross- sectional study was conducted among 395 students from different faculties of University of Kasasala. Self-administered pretested questionnaire was used to collect data. A total of 395 students responded to the questionnaire, 185[46.8%] were male and 210 [53.2%] were female. The overall view of the study is the poor knowledge of TB regarding the infectious agent 107[27.1%], Curability 58[14.7%], the period of treatment 58[14.7%] preventive measure and BCG as TB vaccine 64[16.2%]. However, they were knowledgeable about the communicability 364[92.2%]. Moreover the students were unaware of mode of transmission [91.2%] and the symptoms of TB [94.7%]. Students understood that cough more than three weeks is the signs of TB 228[57.7%] and it is the route of transmission 320[81.0%].The findings highlighted poor knowledge and lack of awareness among students regarding the important aspects of TB. So intensive health education programs are required and included in the curriculum of faculties so as to contribute in the development of the community.

Clinical presentation of Parkinson's disease among sudanese patients

Parkinson Disease [PD] is a neurodegenerative disorder affecting motor system. It is a chronic progressive disorder leading to long standing disability. To study the clinical presentation of PD among Sudanese patients seen at Elshaab Teaching Hospital during the period from May 2004 - April 2008. In this descriptive prospective, cross sectional hospital based study, 94 patients were studied using standardized questionnaire including history and clinical examination. The total number diagnosed to have PD was 94 patients. Male to female ratio was found to bel .5:1. Common age group affected was 70-80 years [24.47%]. The common presenting symptom was found to be poverty of movement [93.6%] followed by tremor [82.9 8%]. On neurological examination; rigidity, dyskinesia and festinate gait were the common signs. Primitive reflexes were found in significant number of patients. Idiopathic PD was found to be the common type [75.53%]. Of the side effects of benzhexol, 66.67% of our patients developed dry mouth. Postural hypotension was seen in 10.42% of the patients who were taking levodopa. The clinical presentations of our patients does not differ from what was mentioned in the literature

Treatment of cutaneous leishmaniasis with methanol extract of Allium sativa [garlic], Azadirachta indica [Neem] and Accacia nilotica [Garad] in Gezira Central of Sudan

To assess the in vivo treatment of cutaneous leishmaniasis using certain medicinal agents and non medicinal agents in Gezira State, Sudan. To evaluate the in vivo anti-lesihmanial activity of certain plant extracts that used traditionally in Sudan [Azadirachta indica [neem], Accacia nilotica [garad], Allium sativa [garlic, Thoum]]. A total of 72 cases with cutaneous leishmanisis were studied in Wad Madani Dermatology Teaching Hospital [September 1999 - December 2000]. They were from different parts of the Gezira state. The patients were interviewed and examined followed a special designed questionnaire. The cases showed different types of lesions with different duration and appeared in different areas of the body. The cases divided equally into six main groups [12 for each] for treatment with different agents including medicinal agents and plant methanol extracts

Effects of Vitamin E on food intake and body weight in rats exposed to restraint stress

Many investigators have shown that stress suppresses food intake and reduces body weight in rats. The effect of vitamin E on body weight and food intake in rats exposed to stress were studied. Male Sprague Dawley rats [n = 80] were fed with either normal chow, vitamin E deficient diet or vitamin E with or without oral supplementation of either tocopherol, tocotrienol or Tocomin at 60mg/kg body weight. The rats were treated with these different diet regimes for 28 days prior to exposure to stress. Repetitive stress was applied, whereby the rats were restrained 2 hours daily for 4 consecutive days. The body weight and food intake was measured, weekly and after exposure to stress. The findings showed that vitamin E deficiency induced by feeding rats with vitamin E deficient diet for 28 days resulted in significantly lower body weight and food intake compared to the control animals given [normal chow]. Supplementation with vitamin E in different forms, tocopherol, tocotrienol or Tocomin to the deficient diet was unable to increase the body weight or food intake, where both parameters were comparable with rats fed with deficient diet alone. It is possible that the dose of the vitamin E given was inadequate to maintain the food consumption and prevent the drop in body weight. Exposure to stress caused a further reduction in both the food intake and body weight in all groups and this suggests that the normal level of vitamin E in normal chow nor the supplementation with tocopherol and tocotrienol at the dose 60mg/kg was able to protect against changes in the body weight and food intake due to stress. We therefore conclude that vitamin E deficiency and stress can reduce food intake and cause a reduction in body weight. Stress can worsen the status of the two parameters and in vitamin E supplementation at 60 mg/kg body weight is not sufficient to prevent the changes in the body weight or food intake due to vitamin E deficiency or stress

presence of dental fluorosis in the permanent dentition in Doha

The main purpose of this study is to draw attention to the presence and the severity of dental fluorosis in Doha [Qatar] through the high level of registered cases of fluorosis found among the groups examined. Of 4800 people aged 8-50 years, 2654 [55.29%] had dental fluorosis of some degree. This problem urgently requires more studies throughout the country to provide an accurate assessment

Endoscopic sclerotherapy plus ligation versus ligation for the management of esophageal varices

The aim of this work was to compare endoscopic scleroligation with endoscopic variceal ligation alone with regard to efficacy, complications, variceal recurrence and survival rate. Seventy-one patients with cirrhosis and esophageal varices were included in this study; 35 treated by endoscopic scleroligation and 36 treated by endoscopic variceal ligation. Both methods were equally effective in achieving a complete eradication of esophageal varices. The recurrence rates in the endoscopic scleroligation group were significantly lower than those in the endoscopic variceal ligation group. The survival rates and incidence of complications were similar among patients treated by both methods. The combined method, endoscopic scleroligation, was superior to endoscopic variceal ligation alone in preventing variceal recurrence

Density and molar volume of some high lead silicate glasses

Density measurements and molar volume calculations of some high lead silicate glasses were studied with the view to throw some light on the structure of these glasses. All glasses were melted in an electrically heated furnace at a temperature ranging from 1100 to 1200° for four hours. After complete melting, each molten glass was poured on an iron marver and was then annealed at the appropriate temperature. The experimental results obtained could be correlated to many factors such as the nature of the lead ion itself and also to the field strengths and ionic radii and volume of the different incorporated cations

Clinicoepidemiological features of adult leukemias in Pakistan

A total of 113 patients of leukemia, over 15 years of age, were seen in three different institutions from July, 1992 to June, 1994. There was an almost equal distribution of acute myeloid leukemia [AML] and acute lymphoblastic leukemia [ALL] [44 vs 43 cases respectively]. Chronic lymphocytic leukemia [CLL] was the least common, accounting for 5% of all cases. Mean age in CLL was 59 years. Chronic myeloid leukemia [CML] was three times commoner than CLL with a younger age distribution [median age was 34 years]. We conclude that the clinicoepidemiological features of adult leukemias differ considerably from that seen in the developed world. However, recruitment of patients needs to continue in order to define these features based on a larger patient population

Child bearing practices among khetrans of Balochistan

Balochistan is the largest province of Pakistan in terms of area. The population mainly includes Balochand Pathan ethnic groups. Among Balochis, Khetrans are one of the affluent tribe. They enjoy political power at the provincial and national levels. Their major settlements are in the district Barkhan and according to one estimate, their population is about one hundred thousand persons which gives them a prominent place among other Baloch tribes of the province. The concept of child hood is socially defined and culturally constructed. Every culture defines the meaning and extent of childhood and the concept includes all the beliefs and practices around children.The phenomenon of childhood does not exist in isolation. Rather, it is closely associated with the social,economic, and political institutions. The perceptions of childhood have very complex implication for the overall health status and development potentials of the well society. The enhanced understanding of childhood among the Khetrans would enable individuals and organizations to plan their activities in proper perspective

Outpatient flexible cystoscopy: an early experience

During a period of eighteen months 647 patients underwent diagnostic flexible cystoscopy under local anaesthesia in the outpatient department. 537 [82.9%] patients had normal examination and they were thus spared the trauma of hospital admission, general anaesthesia and tiresome wait on lengthy waiting list. This technique has proved to be a very cost effective alternative to conventional rigid cystoscopy and has very low failure rate [1.23%] and remarkable patient compliance

Ureteric stent: the outcome of long term drainage

A report of four patients with long term ureteric double-J stents is presented. The indications for stenting and the complications are discussed. After five months, all of the stents caused problems and they did not adequately drain the kidneys. It is recommended that long term ureteric stents should be changed every four months to prevent fragmentation of the stents and also to prevent hydronephrosis

Ureteric stent: the outcome of long drainage

A series of four patients with long term ureteric double-J stents is presented. The indications for stenting and the complications are discussed. After five months, all of the stents caused problems and they did not adequately drain the kidneys. It is recommended that long term ureteric stents should be changed every four months to prevent fragmentation of the stents and also to prevent hydronephrosis

Antibacterial activity of some medicinal plants and seeds

Antibacterial activity of some medicinal plants and seeds were tested against Escherichia coli and Staphylococcus aureus. All water extracts of plants and seeds were found to be inactive except of Carum copticum [ajowain] which exhibited antibacterial activity against S. aureus. Homogenized seeds of Nigella sative [kalongi] and Carum compticum [ajowain] showed antibacterial activity against S. aureus. The results indicated that the active components of ajowain were partially soluable and that of kalongi were completely in soluble in water. Extraction of active components of both ajowain and kalongi was carried out using ethanol and acetone as solvents. Alcohol extracted oil of kalongi and acetone extracted oil of ajowain were active and prevented the growth of S. aureus

effect of cimetidine, magnesium tri-silicate mixture, and metoclopramide on gastric pH and volume

Surgery patients are considered at risk for pulmonary acid aspiration if the gastric pH is 2.5 or less and/or the gastric aspirate volume is 25 ml or more. This study compares the effect of cimetidine, magnesium tri-silicate [MTS] and metoclopramide on the intragastric volume and pH in 120 elective surgery patients divided into four equal groups. Sixty to ninety minutes before anaesthesia, the cimetidine and metoclopramide groups received 300 and 10 mg i.m., respectively. One hundred twenty minutes before anaesthesia, the MTS group received 30 ml orally. Patients receiving MTS showed the highest gastric pH and intragastric volume. The cimetidine group had the lowest intragastric volume and a significant increase in pH. The metoclopramide group effectively reduced gastric volume but showed no significant effect on pH. We conclude that no single drug can be relied upon to reduce intragastric volume and neutralize gastric acid in all patients

use of atracurium in cesarean section

The use of atracurium in caesarean section was studied in 50 women at term; a dosage of 0.3-0.4 mg/kg body weight caused no significant change in arterial blood pressure and pulse rate. On delivery, regular spontaneous respiration was established in less than 90 s in 45 out of 50 neonates. The 1 -min Apgar score was 8-10 in 44 neonates, 7 in 3, 6 in 1, and 5 in 2. The 5-min Apgar score was 9-10 in 47 neonates and 8 in the remaining 3. At the end of surgery, full recovery was reported in 36 patients without anticholinesterase injection. Atracurium proved to be ideal for patients undergoing caesarean section as it is safe for both mother and fetus

Endoscopic periurethral teflon injection

Endoscopic Peri-urethral Teflon injection offers a simple form of treatment with a low morbidity rate for some patients with urinary incontinence. It is particularly useful in patients with stress incontinence, post-prostatectomy incontinence and in some cases of neuropath incontinence. Findings in a group of ten patients who underwent this technique are presented. Seventy percent of patients improved by this procedure