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Background: Lateral condyle fractures of the distal humerus are the second most common fractures at the elbow in the paediatric population usually between the ages of 6-10 years old making up 5-20% of fractures in children. The aim of the present study was to assess the early results of patients with a displaced lateral humeral condyle fracture treated with open reduction and internal fixation. Methods: Our clinical trial was conducted involving 12 patients treated with open reduction and internal fixation (ORIF). Preoperative stage included clinical evaluation, routine investigations and radiological evaluation. Fractures were classified using the Milch. Patients were followed up weekly until radiological union of the fracture was evident. Results: 83.3% of our patients were males, while 16.7% were females. According to mechanism of injury, falling down continues to play a major role in causing disability. At (3-5) weeks all cases were with soft callus remove K wire; at 8 weeks, all cases were with union fracture; but at 12 weeks, one case (8.3%) was with mild stiffness and the rest was with full range of motion. As regards the carrying angle in our study, only 16.7% were with abnormal carrying angle. 33.3% were complicated; one case with mild limitation of motion and valgus; one case with varus and two cases with superficial infection. Conclusions: The open reduction and internal fixation of lateral humeral condyle fracture is the ideal treatment and it has a rate of complications
Subject(s)
Bone and Bones , Egypt , Fracture Fixation, Internal , Open Fracture ReductionABSTRACT
@#Introduction: Newborns have low vitamin A reserves and rely on breastmilk to meet their vitamin A needs. This study aimed to determine factors associated with vitamin A concentration in colostrum of rural postpartum mothers. Methods: Out of 180 postpartum women interviewed at seven Community Health Centers in South Sulawesi Province, 160 who met the inclusion criteria were included in the study. Breastmilk (colostrum) samples were obtained shortly after delivery from the breast that was not full and not fed to the infant for at least 30 min. Breastmilk samples of 3-5 mls were collected into sterile plastic tubes using a manual pump. The samples were immediately placed in an icebox and transported to the laboratory within six hours after collection. Vitamin A concentrations were determined using HPLC method. Socioeconomic characteristics, anthropometric measurements, gestational age, and dietary intake of mothers (24-hour recall) were obtained. Bivariate and multiple linear regression analysis were undertaken to determine factors associated with vitamin A concentration in colostrum. Results: Dietary assessment showed unsatisfactory intake levels of calories, fat, protein, vitamin A, iron and zinc compared to the recommendations for Indonesia. Mean vitamin A concentration in colostrum was 58.2 μg/dl, and about 81.2% of the participants had normal colostrum vitamin A concentration. Iron intake and gestational age were significantly associated with colostrum vitamin A concentrations. Conclusion: Majority of the postpartum mothers had normal colostrum vitamin A concentration. Maternal dietary intake including iron is important to ensure adequacy of vitamin A in breastmilk.
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Objective: This cross-sectional observational study was accomplished at Isra University to evaluate the self-apprehension of dental students related to their own smile
Material and Methods: This study was comprised of 166 dental students belonging to both genders. A structured selfadministered questionnaire was used to conduct a survey among undergraduate dental students at all study levels in Isra University. Questionnaire was designed to observe the self-apprehension and satisfaction of students with reference to their dental appearance. Data analysis was done using descriptive statistics via 21st version of SPSS. 0.05% was established as the level of significance
Results: 166 students [32 males and 134 females] participated in this survey. 32.5% students were shy as against 91.6% students who were bold at smiling in public. 55.4% students preferred to be photographed from side pose while 69.9% were inspired by other's smile. In terms of teeth dimensions, 60.2%, 54.8% and 46.4% students were gratified with the length, breadth and form of their teeth respectively
Conclusion: This study concludes that greater number of dental student were self-assured regarding their apprehension on their own dental appearance. Majority of the females though contented with the dimensions and contour of their teeth, urged to have lighter teeth
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Background: Hepatocellular carcinoma [HCC] is one of the very frequent malignancies that has poor prognosis. Chronic hepatitis B is the most important risk factor in the world particularly in developping countries. In developed world, HCC occurs in the background of chronic infection with HCV or alcohol abuse. Several factors affects the development of HCC in chronic hepatitis patients including viral genotype
Objectives:The aim of this study was to determine HCV and HBV viral profile in Egyptian and Yemeni HCC patients. Additionally, HCV and HBV were genotyped to investigate any possible correlation with HCC development
Methodology:Thirty HCC Egyptian patients admitted to the Hepatology Unit, Medical Research Institute, Alexandria University and thirty HCC Yemeni patients attending the oncology center in Al-Gomhory hospital in Sanaahave been enrolled in this study.Hepatitis B surface Ag [HBs-Ag] was not detected in Egyptian HCC patients but in 36.7% of Yemeni HCC patients. On the other hand, anti-HCV antibodies were detected in 93.3% of the Egyptian HCC patients and in 16.7% only in Yemeni patients.HBV genotyping by direct sequencing of pol gene showed 11 cases of genotype D and 1 case of genotype E among HCC Yemeni patients. HCV genotyping by sequencing of NS5b and 5'UTR showed 21 cases of genotype 4 and 2 cases of genotype 1 and genotype 2 among Egyptian HCC patients
Conclusion:From the current study HCC appears to be significantly associated with HBV and HCV chronic infections in Yemen and Egypt respectively. In Egypt, occult HBV co-infection might escalate the danger of HCC development among HCV patients
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Objective: The main Purpose of this study was determine and compare the level of physical fitness among physical therapy students of rural and urban areas. The basic purpose is to find a difference in measured physical fitness of these students in Lahore [Punjab, Pakistan]
Duration: The study was completed in six months
Setting: The students of physical therapy from public and private sector institutions of Lahore were taken including AzraNaheed Medical College and Children school of Allied health sciences
Methodology: It was a cross sectional study. The sample size was 156. Participants were divided into two groups'. Sampling: Simple convenient sampling technique was used. Only undergraduate students having age limit 21-28, both male and females were included and the students with any trauma, surgical history or musculoskeletal diseases were excluded. Physical fitness was assessed by common clinical tests: Harvard step test, Push- up test, Squat test, flexibility test, Touch toe test. The Body Mass Index was evaluated in order to determine their body composition. All the data was evaluated in SPSS version 21
Results: The results of the study indicated that while performing push up test for physical fitness, in urban population only 1[1.2 percent] were good in physical fitness while in Rural Population 6[8.1 percent] were good. While performing Touch- Toe Test, in rural population 46[62.2 percent] were flexible and in Urban population 55[67.1 percent] were flexible. In squat test, in rural population 23[31.1 percent] and in urban population 50[61.0 percent] were considered poor in terms of physical fitness. in rural population 14[18.9 percent] and in urban population 22[26.8 percent] were considered to have poor strength
Conclusion: The results of the study showed that the rural physical therapy students were physically fit as compared to urban physical therapy students. Moreover, obesity is more common in urban students as the Body Mass Index was high in urban physical therapy students
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Background: Pulmonary Tuberculosis [TB] is traditionally classified into primary and post primary tuberculosis; both have distinct characteristics on radiology. Adetailed knowledge of different radiological patterns is helpful in diagnosis of TB
Objective: To determine the frequency of various radiological presentation of post primary tuberculosis in adult sputum smear positive patients
Methodology: This cross sectional study was carried out at Department of Pulmonology, Sheikh Zayed Medical College / Hospital, Rahim Yar Khan on adult sputum smear positive pulmonary TB patients. A total of 250 new cases of pulmonary TB with no previous history of Anti-Tuberculosis treatment were included in this study. Socio demographic data and findings of X -ray Chest from each sputum smear positive patient were collected and recorded on a predesigned performa. The data was entered and analyzed by using SPSS version 17
Result: Out of 250 patients, 146 were male and 104 were female with mean age of 35.76 +/- 16.25 years. Left lung was most affected in 40.4% cases, right lung in 35.6%, while 24% has bilateral involvement. Duration of illness prior to diagnosis was 3 +/- 1.66 months. Among the radiological presentation, cavitation was seen in 49.2% cases, alveolar consolidation in 42.4%, nodular pattern in 3.2%, reticulonodular pattern in 3.2% and reticular pattern in 2% cases. There was significant association of alveolar consolidation with male gender [0.03] while reticulonodular pattern was significantly seen in female gender [0.007]. Majority of the patients were young; 42.8% were below the age of 30 years and 82% patients were below the age of 50 years and there was a delay of > 03 months in the diagnosis
Conclusion: According to this study, cavitations and alveolar consolidation were the commonest radiological presentations of post primary TB. Majority of patients were young and there was a considerable delay in diagnosis
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Objective: To determine the benefits of elective splenectomy in selected patients with thalassemia major
Study Design: Prospective descriptive study
Place of Study: Liaquat University Hospital Jamshoro
Duration of Study: July 2014 to June 2015
Patients and Methods: 27 selected patients of Thalassemia major were evaluated after open elective splenectomy via midline incision for the benefits achieved post operatively
Results: Out of 27 patients 19 [70.3%] were male and 08[29.6%] were female, age ranges from 5-10 years with a mean age of 7 years. Out of 27 patients, 25 patients [81.48%] had a uneventful recovery, only 2 patients [7.4%] developed post-operative complications. No mortality was observed in this series. Post-operative long term maintenance of adequate hemoglobin and improved quality of life was observed in 26[96.29%] patients. Only 1[3.7%] patient who developed postoperative incisional hernia was not satisfied with the procedure
Conclusion: We conclude that splenectomy is a safe and beneficial procedure in selected patients of thalassemia major
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Background: Sugar- and artificially-sweetened beverage consumption have been connected to cardio metabolic hazard factors, which rise the danger of cerebrovascular illness and dementia
Purpose: We studied whether sugar or artificially sweetened beverage intake was related with the prospective dangers of incident stroke or dementia
Materials and methods: We studied 361 members aged more than 45 years for incident stroke [mean age 61 [SD, 10] years; 163 men] and 185 participants aged >60 years for incident dementia [mean age 68 [SD, 7] years; 85 men]. Beverage consumption was computed using a food-frequency questionnaire at cohort studies. We quantified latest consumption at investigation 7 and cumulative intake by averaging across examinations. Surveillance for incident events commenced at examination 7 and continued for 5 years. We observed 12 cases of incident stroke [10 ischemic] and 10 cases of incident dementia [8 consistent with Alzheimer's disease]
Results: After modifications for age, gender, education [for analysis of dementia], caloric consumption, diet feature, physical activity, and smoking, higher recent and higher cumulative consumption of artificially sweetened soft drinks were related with an increased risk of ischemic stroke, all-cause dementia, and Alzheimer's disease dementia. When comparing day-to-day aggregate consumption to 0 per week [reference], the risk ratios were 2.87 [95% confidence interval, 1.24-6.89] for ischemic stroke and 2.91 [95% confidence interval, 1.15-6.99] for Alzheimer's disease. Sugar-sweetened beverages were not associated with stroke or dementia
Conclusions: Artificially sweetened soft drink consumption was allied with a higher risk of stroke and dementia
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Objectives: To study mean platelet volume [MPV] in deep venous thrombosis [DVT] as evaluated by D-Dimmer and Doppler sonography. Study Design: Case control study. Place and Duration: Department of Surgery, Liaquat University of Medical and Health Sciences Jamshoro/Hyderabad from May 2013 to April 2014
Subjects and Methods: A sample of 106 subjects; 50 controls and 53 diagnosed patients of DVT were studied. DVT patients were included according to inclusion and exclusion criteria and after results of Sonography and D-Dimer were available. The Blood samples were collected in bottles containing sodium citrate as anticoagulant. MPV was generated by Sysmex KX 21 hematology analyzer. Informed consent was sought from the volunteer subjects. The Data was analyzed using SPSS version 21.0. Statistically significance was defined at p-value of
Results: Mean platelet volume was elevated in deep venous thrombosis patients which were confirmed by clinical examination, sonography and D-Dimer. MPV was elevated in cases; 10.0 +/- 0.7fl compared to controls; 9.55 +/- 0.63fl [p=0.001]. D-Dimmer was elevated in deep venous thrombosis patients [p=0.0001]. Age, gender and platelet counts did not revealed any significant differences between cases and controls [p>0.0.05]
Conclusion: The present study reports elevated MPV in patients suffering from deep venous thrombosis and it is concluded that MPV may be considered as a risk factor for DVT
Subject(s)
Humans , Male , Middle Aged , Female , Adult , Mean Platelet Volume , Fibrin Fibrinogen Degradation Products , Ultrasonography, Doppler , Patients' Rooms , Case-Control StudiesABSTRACT
Background: tuberculosis is an important infectious health issue and its control strongly rely upon effective treatment. The drug resistance and its pattern are important determinant of the treatment regimen, its duration and outcome
Objective: to determine the frequency and pattern of drug resistance among 1[st] line anti tuberculosis treatment
Methodology: it was a cross sectional study carried on 100 cases of smear positive TB. This study was conducted from 1[st] January 2010 to 30 June 2011. Detailed demographic data and history of ATT was taken and their sputa were sent for drug susceptibility testing on LJ media. The cases with drug resistance and no previous history of ATT were labeled as primary while those with previous history of ATT were labeled as secondary resistant cases. The data was entered and analyzed by using SPSS version 15
Results: out of 100 patients enrolled, drug susceptibility report was available for 87 isolates as sputum failed to grow any organism in 13 patients. Out of these 87 cases, 48 [55.17%] were males and 39 [44.83%] females with age range of 9-91 years. Seventeen out of 87 patients [19.5%] had previous history of ATT. Out of 87 isolate, 62 [71.26%] were sensitive to all 1[st] line drugs [R, H, E, Z, S] while 25 [28.74%] were resistant to one or more drugs. Primary resistance was seen in 17 [24%] out of 70 cases in contrast to secondary in 8 [47%] out 17. The difference between primary and secondary resistance among various drugs was statistically significant for isoniazid [p value 0.003] and pyrazinamide [p value 0.036] while the difference to streptomycin, ethambutol and rifampicin was insignificant with p values of 0.20, 0.35 and 0.09 respectively. There was no case of primary MDR-TB and 5.9% of secondary MDR-TB. None of the sociodemographic parameter was significantly associated with drug resistance
Conclusion: resistance to 1[st] line anti-tuberculosis drugs at Rahim Yar Khan is still common. There are good number of patients in which this resistance pattern compromise the currently recommended regimens. However, larger surveillance studies are needed to strengthen this evidence
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Background: Pakistan has a high burden of drug resistant TB. Effective management of these cases needs the inclusion of 2[nd] line anti-tuberculosis drugs. A comprehensive knowledge of susceptibility pattern to these drugs is mandatory to formulate the best possible regimen
Objective: to determine the susceptibility pattern of 2[nd] line anti tuberculosis drugs
Methodology: this cross sectional study was carried out at Department of Pulmonology, Sheikh Zayed Medical College / Hospital, Rahim Yar Khan on smear positive cases of PTB. This study was conducted from 1[st] March 2010 to 30[th] April 2011. A total of 64 smear positive tuberculosis patients of any age and sex regardless of previous treatment with 1[st] line ATT and no history of prior exposure to 2[nd] line ATT were included. Sociodemographic data like age, sex, marital status and income were recorded. Early morning sputum samples were cultured on LJ medium at a reference lab. Drug susceptibility testing [DST] was done for ethionamide, amikacin, kanamycin, capreomycin and ofloxacin to determine the presence of resistance. The data was analyzed on SPSS version 15
Results: in this study, out of total 64 cases, 36 [56.25%] were males and 28 [43.75%] females with age range of 9 to 76 years. Thirteen cases [20.31%] had previous exposure to 1[st] line ATT. Twelve [18.8%] were resistant to one or more drugs. Resistance was highest for ofloxacin [14.1%] followed by ethionamide [6.3%], capreomycin [3.1%], amikacin [1.6%] and kanamycin [1.6%]. Sociodemographic characteristics also did not show any statistically significant association with drug resistance
Conclusion: there is high frequency of resistance to ofloxacin and ethionamide. To avoid addition of further resistance, DST should be available as early as possible by conventional methods or by rapid genotypic methods at the start of treatment
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Objective/background: Thalassemia is a monogenic hematologic disease that has the highest prevalence globally. In addition, there is complexity of the genetic background associated with a variety of phenotypes presented among patients. Genetic heterogeneity related to fetal hemoglobin [HbF] production has been reported as an influencing phenotypic factor of beta-thalassemia [beta-thal]. Therefore, this study aimed to find the effect of these genetic modifiers, especially in the XmnI locus, rs11886868, rs766432 [BCL11A], and rs9399137 [HBS1L-MYB], among beta-thal and HbE/beta-thal patients in Indonesia, according to laboratory and clinical outcomes, including HbF levels and clinical scores. This study was also designed to compare these modifying effects among beta-thal and HbE/beta-thal patients in Indonesia
Methods: A total of 189 patients with genotyping of beta-thal and HbE/beta-thal were included in this study. The erythrocytes index and Hb electrophoresis measurements were calculated using appropriate methods. The severity of beta-thal and HbE/beta-thal was classified based on the Mahidol score. Polymorphism of the XmnI locus, rs11886868, rs766432 [BCL11A], and rs9399137 [HBS1L-MYB] was determined using polymerase chain reaction-restriction fragment length polymorphism [PCR-RFLP] and amplification refractory mutation system [ARMS] methods
Results: The distributions of minor allele in the XmnI locus, rs11886868, rs766432, and rs9399137 were 14%, 22%, 19% and 18% respectively. The variation allele in the XmnI locus, rs11886868, and rs766432 showed a significant value for modifying HbF and clinical score in HbE/beta-thal patients, but rs9399137 did not demonstrate such features. In beta-thal patients, however, no correlation was found for any single-nucleotide polymorphisms and clinical appearance
Conclusion: The XmnI locus, rs11886868, and rs766432 have a modifying effect on HbF and clinical score in HbE/beta-thal patients in Indonesia, but not in beta-thal patients
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Poultry by-products are great economic sources that need to be exploited. Poultry skin could be utilized to extract protein particularly elastin, which is often incorporated in the production of functional food, cosmetic industry or medicine due to its antioxidative properties. In this study, water-soluble elastin was successfully extracted from broiler and spent hen skin and analysed for antioxidant activities including DPPH (1,1-diphenyl-2-picryl hydrazyl), ABTS and metal chelating activity. Antioxidant activity of elastin extracted from broiler skin hydrolysed by Alcalase (EBA) and Elastase (EBE) also elastin extracted from spent hen skin hydrolyzed by Alcalase (ESA) and Elastease (ESE). The EBE, EBA, ESE and ESA had higher DPPH (16-30, 19-35, 29-48 and 31-50%, respectively), ABTS activity ( 73-79, 60-79, 67-79 and 72-79 %, respectively), and Fe2+ chelating activity ( 65-69, 50-56, 71-77 and 62-70 %, respectively). This concluded that water-soluble elastin is a bioactive component that could potentially be used in the formulation of functional foods, nutraceuticals, cosmetic and pharmaceutical industry.
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The countries of the Middle East possess an enormous potential for the development of rene- wable energy resources. This region of the globe captures a plentiful amount of direct sunshine, which in turn creates both wind and solar energy. Tapping into this potential will dramatically re- duce fossil fuel dependency, and thus create a cleaner environment and new platforms of socioeconomic growth. Although previous attempts to evaluate this renewable energy potential have been small in scale and scattered, they have demonstrated an encouraging outlook for the entire region and lead to the contention that there is a sufficient amount of renewable energy to meet all of these countries' energy needs. This paper examines future renewable energy exploitation goals for MENA countries and explains how solar and wind resource assessment and site selection models, along with strong governmental involvement, can create success or failure in emerging renewable markets
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Objectives: To study mean platelet volume [MPV] in acute appendicitis and its correlation with leukocyte count
Study Design: Case control study
Place and Duration: Department of Surgery, Liaquat University of Medical and Health Sciences Jamshoro/Hyderabad from January 2013 to February 2014
Subjects and Methods: Subjects with clinical suspicion of acute appendicitis were selected according inclusion and exclusion criteria. A sample of 49 acute appendicitis patients and 37 controls were studied. The Blood samples were collected in sodium citrate vacutainers and processed on Sysmex KX 21 analyzers. The main analysis was the comparison of the difference of MPV between acute appendicitis and controls. Data was analyzed on SPSS version 21.0 by student's t-test, Chi-square test and Pearson's correlation [r] was used to evaluate association of MPV with platelet counts and leukocytes. A p-value of
Results: The mean platelet volume and leukocytes were significantly elevated in patients with acute appendicitis. MPV and leukocytosis in controls and cases were noted as 7.93 +/- 2.1 vs. 9.10 +/- 2.9fl [p=0.0001] and 6980 +/- 120 vs. 13980 +/- 340 micro L[-1] respectively. MPV was positively correlated with leukocytosis [r=0.419] [p=0.0001], while Platelets showed a negative correlation
Conclusion: Elevated MPV and leukocytosis are observed in acute appendicitis. MPV may be exploited for clinical diagnosis of acute appendicitis but in a proper clinical context along with leukocytosis
Subject(s)
Humans , Male , Female , Adolescent , Young Adult , Mean Platelet Volume , Acute Disease , Leukocyte Count , Case-Control Studies , LeukocytosisABSTRACT
Background: Treatment outcome is key indicator to assess the effectiveness of TB control program
Objective: To determine the treatment outcome in tuberculosis patients registered at Department of Pulmonology, Sheikh Zayed Medical College / Hospital, Rahim Yar Khan
Patients and Methods: All the patients registered at DOTS clinic, Department of Pulmonology, Sheikh Zayed Medical College / Hospital, Rahim Yar Khan from 1[st] January, 2008 to 31[st] December 2009, were followed up till completion of their prescribed regimen to determine the WHO endorsed treatment outcome. Patients were classified according to site of disease [pulmonary vs extra pulmonary], history of previous treatment and sputum smear status
Results: Of the 1607 registered TB patients, majority of the patients [83.9%] were newly diagnosed, young [median age: 30 years] and have pulmonary TB [74.9%]. Overall treatment success rate was 77%. New cases fared better [80.6%] than previously treated patients [53.7%]. Among previously treated group, treatment outcome was as follows; relapse [62.7%], treatment after default [52.7%] and treatment failure [33.3%]. Extra pulmonary tuberculosis cases fare better than pulmonary case with success rate of 87.7% and 72.5%, death rate 11% and 3.2%, failure rate 1.9% and 0.2% and default rate of 6.9% and 10.6% respectively
Conclusion: Considering the WHO standard of 85% treatment success rates, only the newly diagnosed patients were close to achieve the target. Previous exposure to anti tuberculosis treatment especially inadequate one was closely associated with poor outcome. Efforts should be made to ensure proper management of all TB cases
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This study was designed to determine the frequency of uterine atony in cases of primary postpartum hemorrhage [PPH] and to point out risk factors for it and observe different ways of management for control of atonic primary [PPH]. Prospective cross sectional study. This prospective cross sectional study was conducted in Obstetrics and Gynecology Department unit-I, Bolan Medical Complex Hospital Quetta from 1st January to 31st December 2002 [one year]. The study was conducted on 80 patients. The study included all the pregnant women either booked or non-booked, who gave the inform consent. The sampling technique was convenience non probability. The patients were admitted through out-patient department and emergency, irrespective of age, place and mode of delivery, developing atonic primary PPH within twenty four hours and diagnosed as a case of uterine atony. All the cases of primary PPH other than due to uterine atony were excluded. Complete history, general physical examination, abdominal examination and pelvic examination was done. All the data was analyzed by SPSS version 10. Total number of deliveries during study period was 1438. Total number of patients with PPH were 155 out of which, the cases with primary PPH were 139, contributing about 89.7%. The incidence of primary PPH was 9.6 %. Out of 139 patients, the leading cause of primary PPH was uterine atony, contributing to 57.6%. The incidence of atonic uterus was 5.6 %. The highest incidence of uterine atony [37.5%] was found in women aged 26-30 years, followed by [27.5%] women aged 21-25 years.The highest incidence of primary PPH due to uterine atony was found in para 5-8 [56.3%], 6.3 % were primigravidas, 8.7% in para 1-4 and 28.7% in patients having more than eight children. Simple management included inj. Syntometrine, Oxytocin, uterine massage controlled bleeding in 53.7% cases. Prostaglandins [PGF2-alpha and PGE2] were administered in 32 cases and successful in 22 [68.7%] cases. Uterine packing was done in 8 cases, out of it, in 5 patients bleeding controlled [62.5%]. Ligation of uterine arteries was performed in 5 cases, it proved successful in 4[80%] and hysterectomy was done in 7.5% cases. Uterine atony is a major cause of primary PPH and major threat to the life of women in reproductive age. Uterine atony is more common in grand multipara, young women and in home delivery. Major risk factor for atony are previous history of primary PPH, grand multiparity, baby weight > 3.5kg and prolonged labour
Subject(s)
Humans , Women , Adult , Postpartum Hemorrhage/etiology , Risk Factors , Disease Management , Prospective Studies , Cross-Sectional StudiesABSTRACT
To review the causes, diagnosis and treatment of vesico-vaginal fistulae in the department of Gynaecology and Obstetrics, and Urology Department Civil Hospital Quetta. Vesico-vaginal fistula is not life threatening medical disease, but the woman face problems like demoralization, isolation, social boycott and even divorce. The etiology of the condition has been changed over the years and in developed countries obstetrical fistula are rare and they are usually result of gynecological surgeries or radiotherapy. In countries like Pakistan the situation is different, here literacy rate is low, parity rate is high and medical facilities are deficient. People manage delivery at home and usually multi parity. Urogenital fistula surgery doesn't require special or advance technology but needs experienced urogynecologist with trained team and post operative care which can restore health, hope and sense of dignity to women. A retrospective study of 60 patients with different types of vesico-vaginal fistula werereviewed between January 2005 to December 2008. Patients were analyzed with regard to age, parity, cause, diagnosis, mode of treatment and outcome. Patients were also evaluated initially according to prognosis. During the study of four year period 60 patients of vesico-vaginal fistulae were reviewed. Majority of the patients were belonging to middle age group. In 48 patients repair was done through transvaginal route and 12 were operated through transabdominal route. One Ca patient expired and in 4 patients recurrence occurred. Iatrogenic vesico-vaginal fistulae are more common. Difficult and complicated fistulae need experienced surgeon. Establishment of separate fistula surgery unit is suggested to get desired results
Subject(s)
Humans , Female , Vesicovaginal Fistula/surgery , Vesicovaginal Fistula/etiology , Iatrogenic Disease , Prospective StudiesABSTRACT
Cosmos caudatus [ulam raja] contains high mineral content and possesses high antioxidant activity which may be beneficial in bone disorder such as postmenopausal osteoporosis. The effects of C. caudatus on bone metabolism biomarkers in ovariectomized rats were studied. 48 Sprague-Dawley rats aged three months were divided into 6 groups. One group of rats was sham-operated while the remaining rats were ovariectomized. The ovariectomized rats were further divided into 5 groups: the control, three groups force-fed with C. caudatus at the doses of 100mg/kg, 200mg/kg or 300mg/kg and another group supplemented with calcium 1% ad libitum. Treatments were given 6 days per week for a period of eight weeks. Blood samples were collected twice; before and after treatment. Parameters measured were bone resorbing cytokine; interleukin-1 and the bone biomarkers; osteocalcin and pyridinoline. Serum IL-1 and pyridinoline levels were significantly increased in ovariectomized rats. Supplementation of C. caudatus was able to prevent the increase of IL-1 and pyridinoline in ovariectomized rats. Besides that, C. caudatus showed the same effect as calcium 1% on biochemical parameters of bone metabolism in ovariectomized rats. In conclusion, Cosmos caudatus was as effective as calcium in preventing the increase in bone resorption in ovariectomized rats
Subject(s)
Animals , Female , Ovariectomy , Osteoporosis/drug therapy , Phytotherapy , Plant Extracts/pharmacology , Plants, Medicinal , Bone Remodeling/drug effects , Bone and Bones/drug effects , Calcium/pharmacology , Dietary Supplements , Disease Models, Animal , Rats, Sprague-Dawley , Time Factors , Interleukin-1/blood , Osteocalcin/bloodABSTRACT
To determine the effects of prone versus supine positions of the patient on oxygen [O[2]] saturation in neonates with acute respiratory distress. Observational Cross sectional study. Department of Paediatrics Chandka Medical College Hospital Larkana, from December 2011 to June 2012. One hundred neonates were included in this study by non-probability sampling. All the patients with respiratory distress [RD] were kept in supine position for three hours after all necessary resuscitative measures and oxygen saturation was recorded with pulse oximeter. After that they were kept in prone position for six hours. With pulse oximeter oxygen saturation and respiratory rate were measured every two hours interval for six hours. Age ranged from 1 hour - 25 days. There were 77 [77%] term, 19 [19%] preterm and 4 [4%] post term babies with male to female ratio of 1.3:1. There were a total of 200 supineprone cycles. After 6 hour in prone position the PaO[2] of all patients increased by about 7%. In supine position it was 86.4 +/- 5.7 and in prone 93.5 +/- 4.1 with p value of < 0.001 which is statistically highly significant. Prone position improves oxygenation in majority of patients as compared to supine position