Obstetric and neonatal outcomes of pregnant indian pilgrims

Objectives: The Hajj, an annual mass gathering of Muslim pilgrims, is known for its high morbidity and mortality rates. However, pregnant women sometimes participate in this pilgrimage, despite guidelines that discourage such an undertaking due to potential fetomaternal complications. This study aimed to evaluate fetomaternal outcomes among pregnant Indian Hajj pilgrims

Methods: This prospective cross-sectional study was conducted at two Indian Hajj Medical Mission [IHMM]-affiliated secondary care hospitals in Saudi Arabia during the Hajj periods of August–October 2015 and 2016 and July-September 2017. All female Indian pilgrims of reproductive age who underwent pregnancy screening at secondary care IHMM hospitals during this period were included in the study. Definitive obstetric care was provided at the Makkah Maternity and Child Hospital. Data regarding the pilgrims' obstetric characteristics, antenatal complications, management and fetomaternal outcomes were evaluated

Results: A total of 114 pregnant Indian pilgrims were identified during the study period. The most common antenatal complications were respiratory tract infections [51.75%], followed by iron deficiency anaemia [17.54%], hyperemesis gravidarum [14.04%], hypothyroidism [9.65%] and gestational diabetes mellitus [5.26%]. There were 20 vaginal deliveries [17.54%], two Caesarean sections [1.75%] and 32 abortions [28.07%]. The cumulative three-year birth rate was 24.60 per 1,000 females

Conclusion: During Hajj, pregnant pilgrims have a high risk of abortion, respiratory tract infections and various antenatal, perinatal and neonatal complications which may go unreported or untreated. Women should therefore be educated regarding the risk of adverse fetomaternal outcomes which may occur while undertaking a Hajj pilgrimage during pregnancy

Assessment of Bone Mineral Density in Elders of Various Socio-economic Status with Special Reference to Osteoporosis

Osteoporosis is a complex heterogeneous disorder of unknown etiology. Why otherwise normal process leads to bone density inadequate to support the body in some people is not known. Although the fracture-precipitating condition of inadequate bone mass is common to all types of osteoporosis, the processes by which this end is reached probably result from etiologies distinctive to each of the types or the many forms of disease. Risk factors for osteoporosis include age, race, sex, body weight, family history, premature menopause, nulliparity, number of lactations, dietary factors, limited exercise, use of cigarette, excessive alcohol consumption, and prolonged use of medications4. Loss of menses at any age is a major determinant of osteoporosis risk in women. Acceleration of bones loss coincides with menopause, either natural or surgical, at which time the ovaries stop producing estrogen. Estrogen and hormone replacement therapy have been shown to conserve Bone Mineral Density [BMD] and reduce the risk following menopause, but young amenorrheic women may also benefit from the use of oral contraceptive agents to promote a normal menstrual cycle. Any interruption of menstruation for an extended period results in bone loss14, 17. Many nutrients and several non-nutrients have been implicated as etiologic risk factors for osteoporosis. At present, safe and effective treatment is not readily available to replace bone that is already lost. It is nevertheless, important to identify women who are at risk of developing osteoporosis as early as possible, so that measures can be taken to prevent further bone loss. Because low BMD is a major risk factor for osteoporosis, its assessment is clinically useful.

Therapeutic Evaluation of Khameera Khashkhash and Arq-e-Gaozaban in Anxiety Disorder

Anxiety disorder [Iztirab-e-Nafsani/Tashweesh] and its treatment is usually multimodel and among the combination of pharmacotherapeutic and psychotherapeutic intervention is most effective to suppress the anxiety related disorder. Ancient literature is full of psychiatric disorders and their description is mainly based on humoral and temperamental theory. But anxiety itself is not separately explored and rather intermingled along with melancholia, mania, sehar, subara, qutrub etc. This study has been undertaken to explore the anxiety disorder in the light of Unani concept. And a combination of two pharmacopoeial formulations, [viz. Khameera Khashkhash and Arq-e-Gaozaban] already well described for such ailments were evaluated following modern parameters to establish their efficacy in anxiety disorder. The formulations were found effective and results were statistically significant.

Individual differences and stress-performance relationship

Medicine is a high risk profession. Infectious diseases, dealing with difficult patients, accidents on the job, and other hazards have shortened the careers of many practitioners. The extent to which they experience stress turns into poor performance in terms of quality of patient care. Personality traits are often thought to affect the stress that a person perceives. Specific types of personalities seem to be more susceptible to the effects of stress than others. Job performance is associated with different levels of stress. The purpose of the present study was to investigate any effect of job stress on job performance and effect of personality type on the stress-performance relationship. All 55 house officers enrolled at Ayub Teaching Hospital at the time of study were included in the study. Primary data was gathered through questionnaire designed to address personality type and to gathered information about job stress and performance. Individual semi-structured interviews and observations were used to collect information in order to find out how the work patterns have been influenced by environmental factors. The data obtained through questionnaire was analysed using the statistical methods including descriptive statistics, Spearman's correlation and multiple regression. The results indicated that Type A individuals tend to experience more stress than Type B, however no major statistical differences were found. Type a individuals performed slightly better than Type B. Identification of house officers' personality traits will be helpful in assessing stress and designing different stress coping strategies to reduce their level of stress and improve their performance. The correlation between job stress and job performance among house officers with Type A personality characteristics is high

Therapeutic evaluation of a combination of Bambusa arundinacea, Calotropis gigantea, piper nigrum, Zingiber officinole, Colchicum autoummale, Asphalt and Calcined iron in gout

Gout [Niqras: derived from Anqaroos meaning greater toe] is not a single disease. The term is used to describe a number of disorders in which crystals of monosodium urate deposit on joints give rise to acute gouty arthritis of metatarso-phalangeal joint of a greater toe in 70% of patients. Several Unani single and polypharmaceutical combinations are reported in literature as being highly beneficial in gout. In this study an attempt has been made to evaluate the efficacy of a combination of drugs in gout [Niqras]. The observations and results were analysed statistically and test of significance was done by applying paired 't' test

Titrated cyclocryopexy - a report on long term results

To determine the efficacy and safety of a titrated cyclocryopexy in advanced glaucomatous eyes in term of intraocular pressure control and complications. Retrospective Cohort analysis of a titrated cyclocryopexy in 30 eyes of 25 patients with uncontrolled glaucoma during July 1996 to July 2003 at Hayatabad Medical Complex, Peshawar. Inclusion criteria applied was; patients having uncontrolled IOP with maximum medical therapy, previous trabeculectomy and a minimum follow-up of 2 years. All patients were assessed for glaucoma. Numbers of cryoapplications were determined according to the IOP. Four to 12 applications in one sitting were used. Repeat cryoapplication were applied at least after six-weeks of previous therapy if IOP was not controlled. A total of 30 eyes of 25 patients were studied. IOP control of less than 21 mm Hg was achieved in 83% of the eyes. Mean IOP was reduced from 29 ' 4.96 pre-op to 17 ' 7.36 at two years follow-up. Forty percent of the eyes ne eded single session, 40% received 2 sessions and other 20% needed sessions. All the patients lost at least one line of Snellen chart at 2 years follow-up, 70% retained useful vision, 20% retained light perception and 10% lost perception of light. Serious complications included phthisis, persistent vitreous hemorrhage with retinal detachment, and total retinal detachment and persistent vitreous hemorrhage in 1 eye each. Cyclocryopexy appears to be an effective procedure in cases of advanced glaucoma with an acceptable risk / benefit ratio. If done in a titrated manner the number of complications are reduced in severity

Anticoagulant effect ofsome herbal drugs used inunani system of medicine

Atherosclerosis is the degenerative processaffecting all the sections of population of either sex, ageand socio-economic status. If the plaque is complicatedby blood clotting, it causes ischaemia and infarction ofthe tissues or organs, most vulnerable are heart andbrain. In the present [in vitro]study, twelve cardiotonicdrugs were selected which have been used by therenowned Unani physicians. The drugs were purchasedfrom Dawakhana Ajmal Khan Tibbiya College, AligarhMuslim University, Aligarh and properly identified.All the drugs were powdered separately and theiraqueous solutions were prepared. Fresh human venousblood was mixed with them. Eight drugs prevented theclotting of blood in different concentrations so theywere identified as having anticoagulant effect. Neitherthe morphology of centrifuged blood cells was altered or hemolysis took place. The details are given in fulllength paper. Out of eight, details of four drugs arebeing given here

Posterior mediastinal gastroenteric cyst in neonate

Posterior mediastinal enteric cysts are infrequently reported. They are mostly asymptomatic 1. The incidence of gastroenteric cysts presenting during immediate neonatal period is rare. Alimentary tract duplications are other rare congenital anomalies and are commonly seen in relation to the ileum. However, the high incidence of associated thoracic or cervical vertebral anomalies with foregut cysts provide an early clue to the diagnosis 2. A detailed timely antenatal scan can increase the awareness regarding such rare condition and help in diagnosis and better outcome. The purpose of this case report is to highlight the clinical diagnosis and management of a neonate with posterior mediastinal gastroenteric cyst

phytosociological study of vegetation of some highly saline and waterlogged sites of Hyderabad district, Sindh, Pakistan

Twelve stands of vegetation in highly saline and waterlogged areas of Hyderabad, Sindh, were sampled quantitatively and soil samples were analyzed for physical and chemical characteristics. Plant growth was scanty and vegetation was generally sparse. There were five leading dominants, viz. Salvadora persica, Suaeda monoica, Tamarix indica, Suaeda vermiculata and Cressa cretica. The diversity of all the sites was low and dominance high. The dominance-diversity curves for all the sites were linear on a semi-log plot indicating geometric distribution of abundance among the species; fitting well to the niche pre-emption model of resource apportionment. Based on cluster analysis, five ecological groupings or what may be referred to as community types were recognized. 1] Salvadora persica-Suaeda fruticosa type, 2] Suaeda monoica-Suaeda fruticosa type, 3] Tamarix indica-Suaeda fruticosa-Salvadora persica type, 4] Cressa critica type and 5] Suaeda vermiculata-Tamarix indica type. Structure and edaphic relations of the communities are described in this paper

Some physical and biochemical effects of automobile exhaust polution on common road-side plants in Karachi, Pakistan

The effects of vehicle exhaust pollution on leaf composition of some common road-side plants of Karachi were examined. Leaf samples from polluted locality were often chlorotic and with the deposited soot. Significantly higher frequencies of clogged and partially clogged stomata [with particulate matter] were found in the leaves from air-polluted locality as compared to those from unpolluted locality. Air pollution remarkably decreased the level of total chlorophyll, chlorophyll-a and ethanol soluble carbohydrate content as compared to the control. The lead content of leaf samples from the polluted locality was significantly higher

Germination, growth and ion regulation in saline-water-irrigated sporobolus arabicus boiss

Germination, growth and ion regulation in Sporobolus arabicus Boiss. Was investigated using 10-30% sea water dilutions [ECiw:4.5-14 dS.m-1]. Fifty per cent reduction in germination corresponded to ECiw:32.36 dS.m-1 and threshold ECiw for 50% reduction in growth was around 28.6 dS.m-1. The plant showed good regeneration after bimonthly clipping. The cumulative forage biomass per annum under 30% amended sea water irrigation was 3173.3 +/- 137.2 g.FW compared to 4185.2 +/- 252.8 g.FW in control [ECiw:1.2 dS/m]. the treated plants showed decrease in moisture and protein contents at least at higher salinities and increase in praline and sugar levels. Chlorophyll behaved somewhat irregularly. S. arabicus appeared to be sodiophillic with a tendency of excreting salts through leaves. The excretion was directly proportional to the concentration of salts in the irrigation medium. All major cations and anions were excreted but Na and Cl in preponderance. There was, however, substantial accumulation of Na in leaves. K and Ca declined progressively in root as well as leaves under increasing salinity. Mg behaved indifferently

Structure, composition and above ground standing phytomass of some grass dominated communities of Karachi: summer aspect

Some 120 species [83 dicotyledons and 37 monocotyledons] were seen growing naturally to make summer aspect of 22 grass dominated sites of Karachi, Pakistan. They have high percentage of therophytes [43.3%] followed by chamaephytes [30%]. Legumes were present invariably in all sites except that of Urochondra setulosa. The number of species in a site varied with the nature of site and its salinity status. The above ground standing biomass [AGSP] varied with species dominating the site [49.6 to 908 g/m[2]]. On phytomassbased quantitative spectrum, hemi-cryptophytes and sometimes geophytes [protected forms] were the dominant. The number of legume species varied as a function of number of grasses in a site. The litter component related positively with AGSP [r = 0.7175] and the percent proportion of legume biomass [PPLB] associated inversely with percent proportion of grass biomass [PPGB] [r = -0.6566] The more diverse communities of non-saline habitats appeared to be approaching to log-Normal distribution of biomass among the species whereas the distribution of biomass in less diverse communities of saline habitats was distinctly geometric. Twelve community types, recognized on the basis of 40% biomass-based compositional similarity, in accordance with the decreasing AGSP magnitude may be arranged as follows: Cenchrus setigerus > Desmostachya bipinnata=Urochondra setulosa > Lasiurus scindicus > Dichanthium annulaturn = Sporobolus arabicus > Aeluropus lagopoides > Sporobolus halvolus > Chrysopogon aucherii > Dactyloctenium scindicum > Aristida mutabilis > Sporobolus coromendelianus. Edapho-topographic relations of these communities are described. When stability was evaluated through life-span consideration of species, diversity-stability relations appeared to be negative. Salt marsh communities were more stable than those of the salt free habitats. The results are discussed in ecological context

Effects of saline water4 irrigation on germination, growth and mineral distribution in indigofera oblongifolia forsk

Germination, growth and mineral distribution in Indigofera oblongifolia Forsk. Were investigated, using 10-30% sea water for irrigation [ECiw: 4.5-14.0 dS.m-1]. Fifty% reduction in germination and growth [shoot] corresponded with ECiw: 10.03 dS.m-1 and 12.05 +/- 0.92 dS.m-1, respective. The cumulative shoot productivity per annum under 30% sea water 14.0 dS.m-1] was 801.83 +/- 76.03 g/plant compared to 1928.06 +/- 90.16 g/plant in control [1.2 ds.m-1]. The plant regenerated well after four-monthly clipping though high salinity adversely affected the growth. Plants irrigated with saline water showed an increase in moisture, sugar and praline and no change in chlorophyll and protein contents. Indigofera oblongifalia responded to salinity with foliar succulence accumulating sodium in relatively larger amounts in leaves and fruit wall. Selective transport of Mg++ to leaves and accumulation of Ca++ in roots were apparent. The transport of cations from fruit wall to seeds was selective. This selectively was, however, adversely affected beyond 20% sea water [9.5 dSm-1]

Prevalence of blindness and low vision in north west Frontier province of Pakistan

We studied 6,690 people in a population-based survey in order to determine the prevalence of blindness and its causes in the North West Frontier Province [NWFP] of Pakistan. The results showed that 1% of the population is blind in both eyes. The causes of blindness was cataract in 70%, trachoma in 9%, uncorrected aphakia in 7%, corneal opacity in 7% and miscellanea in 6%. Uniocular blindness occurred in 2.51% of the population. In uniocular blindness cataract was responsible for 45%, severe corneal opacity with or without phthisis for 29%, uncorrected aphakia for 10%, refractive errors for 8% and other diseases for 8%. Visual impairment occurred in 2.49% of the population. The leading causes of which were cataract and various types of refractive errors. [Pakistan Journal of Ophthalmology, Volume 10:39-42, April-July, 1994]

Timing of probing for nasolacrimal duct obstruction in infants and children

We report the results of management of congenital nasolacrimal duct impotency in infants and children, with a special reference to a comparison of conservative therapy and surgical probing-irrigation. The incidence of nasolacrimal stenosis was 53 patients [1.7%] out of a total of 3,108 patients we examined. During the period from December 1990 to December 1991, 53 patients with epiphora and discharge received treatment. Spontaneous recovery ensued conservative treatment and massage in 33 [62.4%] of the patients. One probing-irrigation procedure relieved tearing in 15 [28.3%] of the patients in whom conservative approach had failed. The second probing-irrigation succeeded in another four [7.5%] patients. On patient [1.8%] did not respond even to the third probing-irrigation. Therefore, probing-irrigation succeeded 75% of the time on the first attempt and 20% of the time on the second attempt, and failed even on the third attempt 5% of the time in patients who did not respond to conservative therapy [15 or 38%]. Probing was tried only in patients who were older than six months. [Pakistan Journal of Ophthalmology 10:82-84, October, 1994.]

Morphological and chemical study of urinary calculi

Of 50 patients with urinary calculi, upper tract stones were common between 15-44 and lower tract stones between 0-14 and above 44 years of age. Urinary calculi contained calcium, phosphate, oxalate, urate/uric acid, ammonium, magnesium and carbonate. The frequency of occurrence of each of these radicals in sixty stones was 93.33, 83.33, 61.67, 51.67, 25.00 and 13.33% respectively. Five [27.78%] out of eighteen different combinations of acidic and basic radicals seen in the stones analysed were of pure lithiasis and the rest were mixed. The most frequent combination observed in upper urinary tract stones was calcium oxalate and calcium phosphate.The cut surface of the stones revealed that 60% stones were featureless. Only vesical stones made of Ammonium urate, Ammonium urate + calcium phosphate and Ammonium urate + Calcium phosphate + Calcium oxalate were laminated and contained well defined nucleus

Epidemiology and socio-economic implications of dracunculiasis in eleven rural communities of district Bannu [Pakistan]

Dracunculiasis has been prevalent in some of the rural areas of southern part of Bannu District where the main source of drinking water is reservoired rain water. A survey of eleven villages in this area was conducted. Their total population was about 24,000. The majority of inhabitants were farmers [60% - 90%] with low income, poor education and primitive means of communication. The disease was prevalent in summer season [May to August]. The total number of recorded fresh cases was 232 while 5095 cases were recorded as healed Old Cases. Only two patients were reported to have died of the disease. The male: female ratio was 3:1. The method of treatment was reported to be the use of indigenous drugs which included application of herbs, burnt camel bones and antibiotics. The disease in its active stage was very disabling and did produce economic loss to the families by disabling the male earning members

Some common pediatric ophthalmic problems and their management

Some common paediatric ophthalmic illnesses met at the ophthalmic out patients of Khyber hospital Peshawar are discussed. The peculiar problems that some of these eye illnesses present to the practicing ophthalmologists of the region are pointed out. The management of these problems that is possible at present and the ways and means by which this can be improved in future is also discussed