Breast Self-Examination: An Early Familiar Diagnostic Test of Breast Cancer

Background: Among female patients’ breast cancer are a growing threat for over a century. In women, breast cancer is the most common malignancy universally such as 154 of 185 nations. Breast self-examination (BSE) is a simple, very low-cost, non-invasive early detection method used to detect early breast cancer, which involves the woman herself looking at and feeling for any change in their breast as early as possible, which yields a better survival rate. BSE should be done for all women older than 20 years. This study intended to determine knowledge, attitude, and practice (KAP) of breast cancer among medical and non-medical undergraduate students. Material & Methods: A descriptive cross?sectional study was conducted from October to November 2019 to assess the knowledge, attitude, and practice of BSE. The target population consisted of undergraduate female medical and non?medical students. A total of 154 (N=154) undergraduate female students participated in this study. Verbal consent was taken before recruiting the study population. Completed data forms were reviewed, edited, and processed for computer data entry. The data analysis was performed using Statistical Package for the Social Sciences (SPSS) Version 25.0. Results: Among the study population (N=154) with an early familiar diagnosis of breast cancer ”breast self-examination, the mean age of them was 20.434±4.38. Of seventy-eight respondents (n=78), breast cancer screening test was heard by around half of the medical students (42, 53.8%) & of seventy-six non-medical respondents (n=76), around three-fifth of them (46, 60.5%) did not hear about breast cancer screening test. There was no significant relationship between them (p=0.394). Forty medical students (40, 51.3% and twenty-five non-medical students (25, 32.9%) had no idea, twenty-four medical students (24, 30.8%) & forty-three (43, 56.6%) non-medical students had monthly BSE done. Conclusion: Initial diagnosis and treatment of breast cancer have a definite survival benefit. So early detection is an issue of necessity to be uplifted. The results of the present study suggested that knowledge regarding breast cancer, its risk factors, sign symptoms, prevention measures, and performance of BSE is insufficient.

Exploratory analysis of the suitability of data from the civil registration system for estimating excess mortality due to COVID-19 in Faridabad district of India

Background & objectives: Due to shortcomings in death registration and medical certification, the excess death approach is recommended for COVID-19 mortality burden estimation. In this study the data from the civil registration system (CRS) from one district in India was explored for its suitability in the estimation of excess deaths, both directly and indirectly attributable to COVID-19. Methods: All deaths registered on the CRS portal at the selected registrar’s office of Faridabad district in Haryana between January 2016 and September 2021 were included. The deaths registered in 2020 and 2021 were compared to previous years (2016-2019), and excess mortality in both years was estimated by gender and age groups as the difference between the registered deaths and historical average month wise during 2016-2019 using three approaches – mean and 95 per cent confidence interval, FORECAST.ETS function in Microsoft Excel and linear regression. To assess the completeness of registration in the district, 150 deaths were sampled from crematoria and graveyards during 2020 and checked for registration in the CRS portal. Agreement in the cause of death (CoD) in CRS with the International Classification of Diseases-10 codes assigned for a subset of 585 deaths after verbal autopsy was calculated. Results: A total of 7017 deaths were registered in 2020, whereas 6792 deaths were registered till 30 September 2021 which represent a 9 and 44 per cent increase, respectively, from the historical average for that period. The highest increase was seen in the age group >60 yr (19% in 2020 and 56% in 2021). All deaths identified in crematoria and graveyards in 2020 had been registered. Observed peaks of all-cause excess deaths corresponded temporally and in magnitude to infection surges in the district. All three approaches gave overlapping estimates of the ratio of excess mortality to reported COVID-19 deaths of 1.8-4 in 2020 and 10.9-13.9 in 2021. There was poor agreement (?<0.4) between CoD in CRS and that assigned after physician review for most causes, except tuberculosis and injuries. Interpretation & conclusions: CRS data, despite the limitations, appeared to be appropriate for all-cause excess mortality estimation by age and sex but not by cause. There was an increase in death registration in 2020 and 2021 in the district.

Vertebral spine osteoporosis treatment efficacy in local population: a clinical study

In Pakistani population the prevalence of Calcium and vitamin D deficiency is at alarming rate. Previous studies show that globally vertebral osteoporosis is most commonly recognized site causing deterioration to personal life satisfaction. It is very unfortunate that in Pakistan ample amount of research work has not been done in the area, consequently, information on rate of vertebral osteoporosis and fracture are rare in Pakistan. There is no reduction in Tscore on supplementation with calcium and vitamin D3 administration. There is reduction in T-score on supplementation with calcium and vitamin D3 administration. The prime objective of the current work was to determine vertebral spine osteoporosis treatment efficacy in local population. This is an intervention experimental study with no control. The study population was selected from the local community; consisting of individuals with vertebral spine osteoporosis, further they were followed for up to 6 months. Data was analyzed by SPSS-22. Tabs Chewable: Calcium: 1250 mg, Cholecalciferol: 125 IU, BD/Day was advised. The mean T-score before and after treatment were recorded as; Mean +/- S.D: 2.890 +/- 1.7217 and Mean +/- S.D: -2.456 +/- 0.8064 respectively. The findings of the current work do not provide support for routine supplementation with calcium and vitamin D3 orally for osteoporosis

Prevalence of gall bladder disease in King Faisal medical complex [Taif]: a retrospective study

Background: gallstone disease is defined as the presence of gallstones accompanied by symptoms attributable to their presence [Biliary colic] or complications such as cholecystitis, cholangitis and biliary pancreatitis. In addition, the disease is thought to be a risk factor for developing pancreaticobiliary cancer

Objective: this study aimed to determine the rate of biliary disease in King Faisal Medical Complex as a reflection of the prevalence of the disease in Taif region

Methods: this a cross sectional retrospective analysis included 565 patients with gallstone disease, in King Fisal Medical Complex during 1 year [from 1 July 2015 to 30 Jun 2016]. Data of the patients were collected from patient's files which included 4 departments. 1-Emrgency Room 2-Surgical Outpatient Department 3-Operating Room and 4-Histopathological Department

Result: this study included 565 patients with gallstone disease, [10 years and above]. 398 [70%] females, 167[30%] males. Mean age for females was 44.89 years [SD+15.93], Mean age for males was 48.45 years [SD+19.67]. The overall ratio of gall bladder disease to all general surgery operation was 24%. The Majority of them diagnosed with chronic cholecystitis present to OPD [57%], while acute cholecystitis presented to ER was 43%. Most of them were females [77%] while, males were 23%. 85% of patients underwent to lap cholecystectomy with 1% rate of conversion. 14% of patients underwent ERCP and 1% open cholecystectomy. There was significant gender differences in type of operation [P value=.013]. 38% of male patients with gallstone disease came to the emergency department compared to 62 % of females. Variety of GBD diagnosis was observed, chronic calculous cholcystitis [50%] acute calculous cholecystitis and empyema [30%], obstructive jaundice [14%], Biliary colic [5%], GB mass [1%]

Conclusions: the number of patients presented with gall stones disease and it's complications to King Faisal Medical Complex, Taif alone showed significant high number, mostly due to hypoxia as our region is one of the highest altitude region in the Middle East. Prevalence of disease was more in female population and it showed the target population which should be educated regarding prevention of disease

Development and validation of stability indicating liquid chromatographic (RP-HPLC) method for estimation of ubidecarenone in bulk drug and formulations using quality by design (QBD) approach

ABSTRACT A novel, accurate, precise and economical stability indicating Reverse Phase-High Performance Liquid Chromatography (RP-HPLC) method, was developed and validated for the quantitative determination of ubidecarenone (UDC) in bulk drug, UDC marketed formulation and UDC loaded cubosomes (CBMs) nanocarriers through Response surface methodology (RSM) design with three factors and three levels was performed to optimize the chromatographic variables followed by forced degradation studies of UDC were performed to detect degradation peak. RP-HPLC separation was achieved using mobile phase consisting of Acetonitrile:Tetrahydrofuran:Deionised water in the ratio 55:42:3 and a flow rate of 1.0 mL/min was optimized with a standard retention time (Rt) of 2.15 min, through experiment. The method was found linear in the concentration range of 5-100 µg/mL with a regression coefficient of 0.999. The limit of detection (LOD) and limit of quantification (LOQ) were found to be 3.04 µg/mL and 9.11 µg/mL, respectively.

Fat embolism syndrome due to fracture right Femur: a case report

Fat embolism syndrome [FES] is usually associated with fractures of long bones and pelvis. Symptoms usually occurs hours to days after injury. We present a case with fat embolism syndrome due to fracture femur. Prompt supportive treatment of patient's respiratory system and additional pharmaceutical treatment provides the positive outcome. There is no specific therapy for fat embolism syndrome. Prevention, early diagnosis, and adequate symptomatic treatment are very important. The incidence of fat embolism syndrome is reduced markedly in last decades due to early stabilization and surgical correction of fractures of long bones

In vitro enzymatic investigation of Ficus carica [Fruit]

The present study demonstrates the biological study of Ficus carica fruit. Methanolic extract of plant fruit was prepared and evaporated under reduced pressure by rota vapor and n- hexane, Chloroform, ethyl acetate and n-butanol soluble fractions were prepared separately from crude methanolic extract. These fractions were then screened for acetyl cholinesterase, butryl cholinesterase and lipoxygenase activities. n-butanol soluble fraction showed significant antiacetylcholinesterase activity [78.55+/-0.76%] with IC[50] of 55.8+/-0.37[micro]g/ml, ethyl acetate soluble fraction showed significant anti-butrylcholinesterase activity [70.35+/-0.85%] with IC[50] of 276.5+/-0.64[micro]g/ml and significant antilipoxygenase activity was shown by ethyl acetate soluble fraction [62.52+/-0.26%] with IC[50] of 380+/-0.08[micro]g/ml

Effectiveness of Lawsonia Inermis for psychopharmacological activity on staircase in Nmri mice

Objective: To evaluate the psychopharmacological activity of methanolic extract of Lawsonia inermis [Meli] in Albino mice

Study Design: Observational study

Place and Duration of Study: This study was conducted at the Department of Pharmacology, Faculty of Pharmacy, Hamdard University, Karachi from January, 2014 to June, 2014

Materials and Methods: The study was approved by the ethical review committee of the institute. Lawsonia inermis leaves were gathered from the botanical greenery enclosure of the Hamdard University premises their pharmacognostic details were authenticated from Eastern Medication Faculty of Hamdard University, Karachi. Albino mice [30-35g] of either sex were gotten from the creature place of Dr. HMI Institute of Pharmacy and Herbal Sciences, Hamdard University, Karachi. Psychopharmacological activity was studied by utilizing stair case test which is normally utilized as a part of rat for hostile to tension like conduct that is based comprises of setting local queasiness in an encased box with 5 steps. Absolutely thirty six [N=36] were arbitrarily partitioned into six sets. For each of the model considered [n=6]. The groups incorporate controls [vehicle] and standard medications [Diazepam, Buspirone, 1mg/kg] and three groups of Meli [50, 100 and 200 mg/kg]

Results: Meli dosage of 100mg/kg drastically [P<0.05, 0.01] augmented the number of steps up in the Stair case with peak activity procured at the dosage of 100mg/kg [37.8 +/- 4.2] seconds compared to control [6.3 +/- 2.2 Seconds]. The extract at dosage of 100mg/kg notably [P<0.05, 0.01] accelerated the number of steps up with peak effect at the dosage of 100mg/kg [37.8 +/- 4.2] compared to control [6.3 +/- 2.2 seconds]. The impact at this measurement was not quite different that of Diazepam [41.8 +/- 3.4 seconds]

Conclusion: Meli has explored anxiolytic effect because it possesses one or a mix of Phytoconstituents in the concentrate

Etiological pattern of splenomegaly in adults at tertiary care hospital Jamshoro Sindh

Background: Splenomegaly is usually the result of an underlying disorder; causes ranging from infections to blood cancers. Primary diseases of spleen are uncommon. Etiology of splenomegaly varies according to the geographical areas studied and depends upon the endemic, genetic and hematological diseases in the particular region. Purpose of this study was to find out the causes of splenomegaly in a tertiary care hospital representing almost entire interior of Sindh

Material and methods: This descriptive case series study was carried out at Department of Medicine Liaquat University Hospital Jamshoro from 1[st] March 2007 to 31[st] August 2007, over a period of six months. 100 Male and Female patients older than 13 years of age and admitted in ward with clinically enlarged spleen were selected for this study. Sampling technique was Non Probability convenient sampling. After getting informed consent from patients proforma was filled, elaborating history, important clinical findings and investigations like abdominal ultrasonography, CBC, LFT, HBsAg, Anti HCV etc were performed. Data analysis was carried out by SPSS 16 statistical software

Results: Among 100 patients with splenomegaly there was majority of male patients i.e.60%.The most common cause of splenomegaly found in our study was chronic liver disease i.e. 64% followed by malaria 16%, and hematological malignancies 14%. There were 2% patients found with enlarged spleen due to tuberculosis, remaining 4% comprised 1% each of enteric fever, infective endocarditis, CCF and SLE. Among the patients of hematological malignancies there were 9% patients of leukemia, 4% of lymphoma and 1% of myelofibrosis. As to the 9% leukemic patients, 4% suffered from Chronic Myeloid Leukemia, 3% from Acute Myeloid Leukemia and 2% from Chronic Lymphocytic Leukemia. Most common associated clinical sign was anemia demonstrated in 77% of patients

Conclusions: Chronic liver disease is the most common that leads to splenomegaly in population studied. Malaria and hematological malignancies appear to be the major contributors for splenomegaly. Finding of enlarge spleen needs clinical work up to reach the correct diagnosis

Formulation design and characterization of a non-ionic surfactant based vesicular system for the sustained delivery of a new chondroprotective agent

Diacerein is used for symptomatic relief and cartilage regeneration in osteoarthritis. Due to gastrointestinal side effects, poor aqueous solubility and low bioavailability, its clinical usage has been restricted. The objective of the present study was to enhance its dissolution profile and to attain sustained release by designing a novel delivery system based on niosomes. Five niosomal formulations (F1-F5) with non-ionic surfactant (sorbitan monostearate) and cholesterol in varying ratios of 5:5, 6:4, 7:3, 8:2 and 9:1 were developed by the reverse-phase evaporation technique. The size and polydispersivity index (PDI) were found in the range of 0.608 µm to 1.010 µm and 0.409 to 0.781, respectively. Scanning electron microscopy (SEM) of the selected formulation (F3) revealed spherical vesicles, and 79.8% entrapment was achieved with F3 (7:3). Dissolution studies using the dialysis method showed sustained release behaviour for all formulations. The optimized surfactant-to-cholesterol concentration (7:3) in formulation F3sustained the drug-release time (T50%) up to 10 hours. Kinetic modelling exhibited a zero-order release (R2=0.9834) and the release exponent 'n' of the Korsmayer-Peppas model (n=0.90) confirmed non-fickian and anomalous release. The results of this study suggest that diacerein can be successfully entrapped into niosomes using sorbitan monostearate and that these niosomes have the potential to deliver diacerein efficiently at the absorption site.

A diacereína é usada para o alívio sintomático e para a regeneração da cartilagem na osteoartrite. Devido aos efeitos adversos gastrointestinais, baixa solubilidade aquosa e biodisponibilidade, o seu uso clínico tem sido restrito. O objetivo do presente estudo foi melhorar o perfil de dissolução deste fármaco e obter liberação prolongada através do planejamento de um novo sistema de liberação designado de niossoma. Cinco formulações distintas de niossomas (F1 a F5) contendo tensoativos não iônicos (monoestearato de sorbitano) e colesterol, em diferentes proporções, de 5:5, 6:4, 7:3, 8:2 e 9:1, foram desenvolvidas através da técnica de evaporacão de fase reversa. Os tamanhos e índices de polidispersibilidade (PDI) obtidos variam entre 0,608 e 1,01 µm e entre 0,409 e 0,7781, respectivamente. Imagens de microscopia electrônica de varrimento (SEM) da formulação selecionada (F3) revelaram vesículas esféricas. Obteve-se encapsulação de 79,8% com a formulação F3 (7:3). Estudos de dissolução usando o método de diálise demonstraram padrão de liberacão prolongada para todas as formulações. A proporção de tensoativo e colesterol (7:3) na formulacão F3 prolongou o tempo de liberação do fármaco (T50%) até 10 horas. Estudos de modelação cinética demonstraram ordem de liberacão zero (R2=0,9834) e o expoente de liberação "n" do modelo de Korsmayer-Peppas (n=0.90) confirmou a liberação não-fickiana e anômala. Os resultados deste estudo sugerem que a diacereína pode ser encapsulada com sucesso no interior de niossomas, utilizando monostearato de sorbitano, o qual tem potencial para liberar, eficientemente, a diacereína no local de absorção.

Trends in medical education from traditional to integrated system: valued by first year MBBS students at a private medical college of Peshawar

Introduction: Rehman Medical College Peshawar implemented a new modular integrated hybrid curriculum and modern mode of teaching strategies since its inception in 2010. The present study aimed to explore the viewpoints of students about the usefulness of the principles of integrated medical curriculum and teaching strategies and evaluation methods adopted

Material and Methods: A survey of first year MBBS students was conducted in 2011 using self-administered questionnaire which included quantitative and qualitative parts. Enough space was provided for the qualitative response. The qualitative part of the study entailed in self-response open ended format. Universal sampling approach was employed. Quantitative data analysis were done using SPSS version 15.0 while qualitative data were manually analyzed

Results: Fifty-eight students [58%] completed the questionnaires. Regarding the usefulness of integrated medical curriculum of basic medical subjects, 36 [62.1%] found it very useful, 15 [25.8%] found it useful. For preference of teaching methods, 50[87.7%] found small group format [SGF] very useful; also 34[58.6%] found large group format [LGF] very useful and 15[25.9%] found it useful; 30[51.7%] reported that mini-seminars are useful whereas 21[36.2%] students found self-directed learning [SDL] useful. Students' responses to the end of lesson examination were evaluated; 32[55.2%] students were in favor of these exams; 38[65.5%] were in favor of end of week evaluation while 49[84.5%] were in favor of end of module examinations. Similarly 41[70.7%] supported mid-term; 38[65.5%] favored inclusion of medical research in the undergraduate curriculum. Most of the students were in favor of current system with small reservations. According to them the current system should be continued with improvement in areas like; decrease in end of lesson exam, teacher student relationship, availability of reading materials, strict follow up of lesson plan

Conclusion: Majority of students prefer the new modular integrated system of teaching. A few areas of the previous system are still popular and may be continued by integrating them in suitable places in the new system. Based on evidence, diversity of teaching and evaluation method is a good thing and to be encouraged. The strategy [SGF] that promotes interaction is likely to be the most effective

Hemodialysis; psychosocial stressors in patients undergoing

To determine the nature and frequency of psychosocial stressors faced by the patients on hemodialysis admitted in Renal Dialysis Unit of Nishtar Hospital, Multan. A descriptive study. The study was conducted in the Renal Dialysis Unit of Nishtar Hospital, Multan, from 1[st] May, 2014 to 31[st] May, 2014. The sample consisted of 170 [112 Male, 58 Females] consecutive inpatients on Hemodialysis Treatment. They were interviewed and Hemodialysis Stressors Scale [HSS] was administrated to know the frequency of Hemodialysis Stressors. Results showed that all the patients reported Physiological and Psychosocial stressors. Most frequent physical stressors included feeling tired [92%] and stiffening of joints [91%]. In psychosocial stressors restriction of fluid [100%], dependence on dialysis machine and/ or equipment [95%], limitation of physical activity [93%], changes in family responsibilities [93%], dependency on nurses and technicians [93%], length of treatment [92%], dependency on physicians [91%], sleep disturbance [90%] and limitation of food [93%] were the most frequently reported. We concluded that both physiological and psychosocial stressors were present in significant majority of patients

Differences in various biochemical and clinical parameters with respect to family history of non communicable diseases in fourth year MBBS students of Karachi, Pakistan

To observe the differences of various biochemical and clinical parameters with respect to Family History [FH] of Non-communicable Diseases [NCDs] in fourth year Bachelor of Medicine, Bachelor of Surgery [MBBS] students. This observational study was conducted at Baqai Institute of Diabetology and Endocrinology from December 2013 to January 2014. Total 50 medical students from Dow University of Health Sciences [DUHS] participated in the study. Statistical Package for Social Sciences [SPSS] version 13 was used to analyze the data. For cross tabulation and mean comparison z-test and t test were applied. Out of 50 subjects, there were 26 [52%] females. Mean age of the study population was 21.56 +/- 0.90 years. Mean serum cholesterol levels with positive FH of NCDs was significantly higher than negative FH of NCDs [p=0.005]. Mean value of low density lipoprotein [LDL] of positive family history of NCDs was found higher than those with negative FH [p=0.006] being statistically significant. The insulin levels in subjects with positive FH of NCDs were higher than subjects with negative FH of NCDs [p=0.685]. However, serum leptin and plasma renin showed no significant difference with the negative FH of NCDs being higher compared to positive FH of NCDs [p=0.068] and [p=0.884] respectively. However, Waist circumference, Body mass index and central obesity in subjects with positive FH of NCDs shows increasing trend but no statistically significant difference [p > 0.05] was observed. In our study of various biochemical and clinical parameters with respect to FH of NCDs, Serum Cholesterol and LDL levels were observed higher and statistically significant

Urothelial carcinoma of urinary bladder; immunohistochemical demonstration of COX-2 in correlation with various grades

In spite of the fact that inflammation has been regarded as a localized or generalized defensive component of the body to different types harmful stimuli, there has been becoming confirmation of its strong part in initiation or progression of different ailments particularly related with cancer

Objectives: Aim of this study was to recognize the pattern of expression and level of intensity of COX-2 in different grades of papillary urothelial carcinoma of urinary bladder along with significance of COX 2 in tumerogenesis of urothelial carcinoma of urinary bladder

Period: 1.1.2009 to 31.12.2012

Methods: The marker of COX-2 was investigated by using Immuno- histochemistry

Results: COX 2 was not detected in normal urothelium, but its intensity was expressed as 68% in low grade, 72% in high grade and 80% in invasive urothelial carcinoma

Conclusion: Results of the present study indicate that COX-2 as a component of inflammation play an important role in progression of urinary bladder tumor and encourage use of COX 2 inhibitors as potential antitumor agent

Adverse fetomaternal outcome among pregnant overweight women

To compare the adverse fetometernal out come in overweight and normal weight pregnant women. This comparative cohort study was conducted from 1[st] October 2010 to 30 September 2012. Total 200 gravid women 100 were overweight and 100 normal weight pregnant women with gestational age for 08-40 weeks were included. Women having BMI [25 - 29.9 Kg/m[2]] were measured overweight and included in group A and 100 women having normal BMI of 18.5 to 24.9 as controls were in-group B. Chi-square test was applied to compare the proportion of maternal and fetal outcomes. Significant P - value of < 0.05 was considered. The age range was between 30 to 45 years with mean age of 30 +/- 4.1 years in both groups. Overweight pregnant women had significantly high frequency of pre-eclampsia [27% versus 9% in controls], PIH [24% versus 8% in controls], gestational diabetes mellitus [22% versus 5% in controls], prolonged labour [4% versus 6% in controls], Caesarean section [44% versus 16% in controls], Wound infection [3% versus 2% in controls] and Postpartum Hemorrhage [5% versus 2% in controls]. P-value < 0.001 was considered significance. Fetal complications in overweight pregnant women compared to controls i.e. Still birth [13% versus 2%], Early neonatal death [11% versus 1%], shoulder dystocia [5% versus 1%] and NICU admission [47% versus 10%]. Results were statistically significant except shoulder dystocia. We conclude that the result of present study indicates obesity exerts deleterious effect, both on fetal and maternal outcome

Microbial biotransformation of beclomethasone dipropionate by Aspergillus niger

In the present research, the steroidal anti-asthmatic drug beclomethasone dipropionate was subjected to microbial biotransformation by Aspergillus niger. Beclomethasone dipropionate was transformed into various metabolites first time from microbial transformation. New drug metabolites produced can act as new potential drug molecules and can replace the old drugs in terms of safety, efficacy, and least resistance. They were purified by preparative thin layer chromatography technique, and their structures were elucidated using modern spectroscopic techniques, such as 13C NMR, 1H NMR, HMQC, HMQC, COSY, and NOESY, and mass spectrometry, such as EI-MS. Four metabolites were purified: (i) beclomethasone 17-monopropionate, (ii) beclomethasone 21-monopropionate, (iii) beclomethasone, and (iv) 9beta,11beta-epoxy-17,21-dihydroxy-16beta-methylpregna-1,4-diene-3,20-dione 21-propionate.

Na pesquisa presente o fármaco esteróide antiasmático dipropionato de beclometasona foi submetido à biotransformação microbiana pelo Aspergillus niger. O dipropionato de beclometasona foi transformado, pela primeira vez, em metabólitos variados por biotransformação microbiana. Novos metabólitos do fármaco produzidos podem agir como novas moléculas potenciais e podem substituir os fármacos antigos em questão de segurança, eficácia e mínima resistência. Eles foram purificados por cromatografia em camada delgada preparativa e as suas estruturas foram elucidadas usando técnicas espectroscópicas modernas, como 13C NMR, 1H NMR; HMQC; HMQC; COSY, NOESY e espectrometria de massas, por exemplo, EI-MS. Purificaram-se quatro metabólitos, denominados (i) 17-monopropionato de beclometasona; (ii) 21-monopropionato de beclometasona: (iii) beclometasona e (iv) 21-propionato de 9beta,11beta-epoxi-17,21-diidroxi-16beta-metilpregna-1,4-dieno-3,20-diona.

Detection of osteoporosis by dual energy X-ray absorptiometry

An early detection of osteoporosis through DEXA procedure will not only improve the disease management practices but also would help in impeding national productivity losses by mass screening and awareness. Our objective was to measure efficacy of DEXA procedure in early detection of osteoporosis and prevention of its complications. This case series observational study was designed to confirm the bone mineral density by dual energy x-ray absorptiometery [DEXA]. The duration of study was three years from November 2010 to October 2013. Subjects aged between 30 [when the risk of osteoporosis is low] to 60 [when osteoporosis is almost sure to be found]. Three hundred thirty patients were evaluated. There were 23 [6.96%] male and 307 [93.03%] female. Normal male were 09 [39.10%], osteopenia 11 [47.80%] and osteoporosis 3 [13%]. Normal females were 72 [23.50%], osteopenia 140 [45.60%] and osteoporosis 95 [30.90%]. P-value was more then 0.005 and not significant. Mean age was 48.73, minimum 30, maximum 60 and SD 7.247. Population category distribution was 243 [76.6%] from urban and 87 [26.4%] rural. In urban areas normal were 56 [23%], osteopenia 113 [46.50%] and osteoporosis 74 [30.50%]. In rural areas normal 25 [28.70%], osteopenia 38 [43.70%] and osteoporosis 24 [27.60%]. P-value was 0.567. Out of 330 there were 81 [24.54%] normal, 98 [29.69%] osteoporosis and 151 [45.75%] osteopenia. Osteopenia was the most common diagnosis mostly in younger age group and early diagnosis of this problem can help prevent osteoporosis

Relation of breast cancer with parity and breastfeeding

Objective: The purpose of this study was to evaluate the relationship of breast cancer with parity and breastfeeding in local settings since no such studies have been carried out previously. The results of such study can provide data for comparison from other parts of country and international research

Study Design: Observational study

Place and Duration: Department of Surgery Allied Hospital Faisalabad between October 2013 and October 2014

Methods: A sample of 500 breast cancer patients diagnosed clinically and histopathologically was included in the study after informed consent. Patients were interviewed using a questionnaire. We observed the variables of age, parity, menstrual history and months of breastfeeding for each child. Analysis was done using SPSS version 12. 0

Results: In present study, 500 patients of breast cancer were included with age ranging from 28 years to 80 years. Most common age group was 40 to 50 years. 91.8% females with breast cancer were multiparous and all 91.8% females gave history of breastfeeding their children. 48% of the females breastfed for more than 5 years, 40% of them for 1to5 years and 3.8% of them for less than 1 year. Only 8.2% females who were either unmarried or had no issues did not breastfeed at all

Conclusion: In our local settings, multiparity and breastfeeding do not alter the risk of breast cancer and thus other risk factors must be studied

Myotonia congenita

Myotonia congenita is a rare genetic disease that affects chloride channels and cause transient stiffness in the muscles. It has two subtypes according to the genetic phenotyping. 1- Thomson disease. 2- Becker's disease. Becker's disease is an autosomal recessive sub type that affects more commonly leg muscles and the onset of symptoms manifest slightly in older age. We are reporting a case of Becker disease in 16yrs old boy having delayed relaxation of muscles noticing his symptoms for the last 8 years