Composition of urinary bladder stones in children as analyzed by FT-IR spectroscopy

Objectives: To determine the composition and hence types of bladder stones in children using Fourier Transform Infrared Spectroscopy [FT-IR]

Study design: A case control study

Place and duration: Pediatric Surgical Department of Liaquat University Hospital Jamshoro from June 2012 to October 2012

Methodology: The materials for this study were thirty bladder stones surgically recovered from as many children admitted in surgical pediatric wards. The standard FT-IR spectra of individual standards were acquired for comparison. The FTIR spectroscopy using Nicolet Avatar 330 FTIR spectrometer [Thermo Electron Corporation] in the frequency range 500-4000 cm was performed to determine the composition of bladder stones. The constituents of bladder stones were identified by comparing the spectra of stones with that of the pure standards obtained accordingly

Results: The mean age of thirty children [24 male and 6 female] was 4.84 + 2.82 years. Majority of cases 86.67% [n=26] had one, 3.33% [n=1] had two, 6.67% [n=2] had three and 10% [n=3] had more than three stones. Of thirty bladder stones analyzed by FT-IR spectroscopy, 83.3% [n=25] found to be mixed composition, with calcium oxalate monohydrate and ammonium hydrogen urate as the most frequent stone type identified in this series. Ammonium hydrogen urate in the central and was seen to be the most common constituent and calcium oxalate monohydrate in the inner and peripheral parts of the stones

Conclusion: Calcium oxalate monohydrate-ammonium hydrogen urate stone type is most frequent in children of less than ten years age. FT-IR spectroscopy may be used as a rapid, accurate and environment friendly technique for screening of urinary stones in children

Evaluation of dietary and biochemical risk factors involved in the pathogenesis of bladder stones in children of below ten years age at hyderabad Sindh

Bladder stones in children of below ten years age continue as a major pediatric health problem in Hyderabad-Sindh. To investigate dietary and metabolic risk factors involved in the pathogenesis of bladder stones in children of below ten years age. Case control study .This study was conducted at the Biochemistry and Surgery Departments, Isra University, Hyderabad from January 2011 to December 2011. Thirty four children with bladder stones admitted for treatment in the pediatric surgery unit, Liaquat Medical College Hospital Jamshoro during 6 months and 30 normal controls were examined. Information regarding diet and dietary habits of the subjects were obtained through standard questionnaire developed for that purpose. Biochemical aspect of bladder stone disease was studied by measuring creatinine, urea, uric acid, sodium, potassium, calcium, magnesium, phosphate, chloride and bicarbonate levels in serum samples of bladder stone patients and control subjects. The results of present study show that although, average intake of water and milk by patients and control subjects were comparable, majority [73.5%] of the bladder stone patients admitted to drink water when they felt thirsty, contrary to control subjects who used to take water at regular intervals. The mean tea intake by bladder stone patients was significantly [P<0.05] greater than that of the control subjects. Same was true for the intake of green leafy and seedy vegetables [P<0.05]. From the blood parameters measured in bladder stone patients and control subjects, the levels for potassium, magnesium and phosphate were found to be significantly [P<0.05] higher in bladder stone patients compared to control subjects, whereas reverse was true for creatinine, chloride and bicarbonate levels. Children with bladder stones were noted to have serum creatinine levels significantly lower than the control subjects. Their dietary and fluid intake habits were also found to be quite different from that of the control subjects. These observations suggest that malnutrition and poor dietary habits are the major risk factors involved in the pathogenesis of childhood vesicallithiasis at Hyderabad-Sindh

Hepatoprotective effects of curcuma longa against carbon tetrachloride induced liver injury in rats

To investigate the protective effect of Curcuma longa [CL] against carbon tetrachloride [CC1[4]] induced liver injury in adult male Wistar rat model. Study Experimental/Analytical study Place and Duration of Study: Animal House, Isra University Hyderabad from March to December 2013. Forty five adult male Wistar rats were divided into three groups; Group 1. controls received 0.9% isotonic saline, Group 2. received CC1[4] orally [1.9mg/kg] mixed in olive oil, and Group 3. received the CC1[4]+CL [250mg/kg] Blood samples were collected for liver biochemical assays. The animals were sacrificed, liver tissue, after fixation in 4% formaldehyde, was embedded in paraffin. Tissue sections of 5 micro thickness were subjected to haematoxylin and eosin staining and were assessed by light microscopy. The data was analyzed on SPSS 21.0 using one-way ANOVA, Fischer's LSD and Chi-square tests. A p-value of

Effect of thiamine on glycemic control in induced diabetic rat model

To evaluate the effect of high dose thiamine on postprandial blood glucose [PPBG] and hemoglobin A 1C levels in induced diabetic albino rat model. Experimental/Analytical study. Animal House, Isra University Hyderabad from March to October 2013. Forty adult albino rats were divided into four groups; Group I. Controls receiving normal diet, Group II. Controls receiving thiamine fortified diet, Group III. Diabetics receiving normal diet and Group IV. Diabetics receiving thiamine fortified diet. Diabetes mellitus was induced using Streptozocin. Thiamine was given at a dose of 1.6 g/kg body weight. Venous blood samples were drawn from animal's tail with a small bore cannula before and after 12 weeks of experimentation. The PPBG levels and Glycosylated HbA [HbA1c] were measured. The data was converted into database and analyzed on SPSS version 21.0 by ANOVA and Tukey-Kramer's test. A p-value of

effects of monosodium glutamate on the histology of fallopian tube in female rats

To investigate the effects of orally administered monosodium glutamate [MSG] on the fallopian tube histology in adult female Wistar rat model. Experimental/Analytical study. Animal House, Isra University Hyderabad from May to November 2013. Forty adult male Wistar rats were divided into three groups; Group A. controls received 0.9% isotonic saline, Group B. received MSG orally [1.5 mg/kg], and Group C. received MSG orally [3 mg/kg]. The animals were sacrificed after six weeks. Fallopian tubes were fixed in 4% formaldehyde, and were embedded in paraffin. Tissue sections of 5micro thicknesses were subjected to haematoxylin and eosin staining and were assessed by light microscopy. The fallopian tubes [FT] of the control group A showed normal histological features. The fallopian tubes of the treated groups showed some cellular hypertrophy of the columnar epithelium, distortion of the basement membrane separating the endosalpinx from the myosalpinx. There were degenerative and atrophic changes observed in some parts; these were more pronounced in those that received 3 mg/kg body weight of MSG. There were marked vacuolations and lysed red blood cells, [3 mg/kg body weight treated rats] appearing in the stroma cells. The monosodium glutamate may have deleterious effects on the fallopian tube histology in adult female Wistar rats particularly in high dose. Therefore caution must be taken for its frequent use in female because of possibility of female infertility

Current trends of acute poisoning reporting at private medical center of rural Sindh

The present study intends to evaluate the current trends of acute poisoning reporting at private medical center of Rural Sindh. Descriptive/Retrospective study. This study was carried out at Murk General Hospital Tando Adam from January through December 2012. Sixty patients with a history of poisoning were studied. The diagnosis of poisoning was based on history of patients as disclosed by relatives, clinical findings, investigations and response to treatment. The age, sex, social class, cause and types of poison were noted. The data was collected on a proforma. The variables were typed on SPSS version 21 for analysis. The mean age of subjects was 33 +/- 7.5 years. The most affected age group was 20-29.9 years [n=43] [71.6%]. Of sixty subjects, 23[38.3%] were male and 27 [61.6%] female. [p=0.001]. Of sixty subjects, 75% [n=45] are farmers belonging to lower social class of rural population, suffering from organophosphate pesticide poisoning [48.3%]. Comparing rural to urban population, it shows rural population is suffering more; 88.3% [n=53] vs. 11.6% [n=7]. The frequency of organophosphate poisoning is found high 48.3% [n=29] in patients coming from rural areas usually farmers. The accidental organophosphate poisoning is found most frequent in rural population. The alcohol is the second most frequent cause of acute poisoning found in 18.3% of cases. Incidence of accidental poisoning is found very high from organophosphate pesticides. Sale of drugs, Diazepam and Alprazolam, must be prohibited without proper prescription. It is recommended that measures may be taken to make aware the farmers for using the organophosphate pesticides properly

Glycemic control in type 2 diabetes mellitus and its association with duration of diabetes and glycosylated hemoglobin A1

The aim of present study was to evaluate glycemic control in type 2 diabetes mellitus [DM] subjects and its association with the duration of diabetes and glycosylated Hemoglobin A1 [HbA1c]. A descriptive study, comprising of 571 diagnosed cases of type 2 DM were studied at the Diabetic clinic of Isra University/ consultant private clinics over a year period. Diabetic subjects were divided as; controlled diabetics [Group I. HbA1c 7%]. The data was recorded on a proforma. Blood glucose was measured by glucose oxidase method and HbA1c on automated clinical chemistry analyzer. The student`s t-test and chi-square were used for the quantitative and qualitative data respectively. Spearman`s correlations was used for a linear correlation of HbA1c with the duration of DM and random blood sugar [RBS]. The data was analyzed on SPSS version 16.0 for windows. P-value at /= 7% [Group II]. The HbA1c values as high as >/= 13.1% was noted in 73 [12.7%]. A highly significant difference was observed in HbA1c [p=0.0001] between groups. Significant correlation of HbA1c was found with duration of DM [r=0.65, p=0.0001] but not with the RBS [r=0.038, p=0.36] We report poor glycemic control as indicated by glycosylated Hb A in type 2 diabetics. Public campaigns be attempted on regular basis to make diabetics aware of glycemic control

Clinical presentation and drug resistance patterns of Salmonellae typhi and paratyphi at a tertiary care hospital of Sindh

The aim of this study is to evaluate the clinical presentation and drug resistance patterns of Salmonellae typhi and paratyphi. Observational Descriptive Study. This study was conducted at the Muhammad Medical Hospital Mirpurkhas, from Jan 2010 to April 2011. One hundred twenty six patients were studied, who satisfied the clinical and laboratory criteria of typhoid/ paratyphoid fever. The blood samples, 5-10 ml from adults were inoculated directly into blood culture bottles. Subcultures were also performed. Antibiotic sensitivity was tested by the Kirby-Bauer technique according to Clinical and Laboratory Standards Institute guidelines. Statistical analysis was performed on SPSS version 10.9 [Chicago, Illinosis, USA], using the chi-square test and student's t-test for the qualitative and quantitative variables respectively. The identified organisms were S.typhi observed in 91 [72.22%], both S typhi/paratyphi in 18 [14.28%] and S.paratyphi A and B in the rest 17 [13.49%]. In 97 [76.98%] of patients, antibody O titers were >/= 1:160 and in 39 [30.95%] titers were <1:160. The overall multi-drug resistant isolates were found in >80% for the first line agent's i.e.; ampicillin, amoxicillin, cotrimoxazole and chloramphenicol. The highest sensitivity rate was found for the cefixime [98.41%] and the lowest one for the ampicillin [22.2%]. We found drug resistant and multi-drug resistant salmonellae in our study; this may be because of antibiotic use as self medication, medication by pharmacist and quacks

Circulating leukocytes; relation with acute mental stress and coronary artery disease

Evaluating circulating leukocytes in acute mental stress and relation with coronary artery disease. Descriptive study Muhammad Medical College Mirpurkhas, from March 2007 to August 2007. Two hundred young healthy adults were studied for stress experiment. Venous blood samples were drawn before and after stress for estimation of leukocyte counts. Values were presented as mean +/- standard error of mean [SEM]. The difference in Pre and during stress results of variables were TLC =-4630.85 +/- 140.65, N% =-11.8 +/- 0.36, L% =4.03 +/- 0.14, M% =5.48 +/- 0.37, E% = 1.18 +/- 0.07, B% = 1.11 +/- 0.022. Highly significant p-values [

Chloroquine resistant plasmodium falciparum

The study was conducted to determine the frequency of Chloroquine-resistant Plasmodium falciparum. This was a descriptive case series study conducted at Muhammad Medical College Mirpurkhas and Liaquat University Hospital Hyderabad/ Jamshoro, from January 2007 to December 2007. Total 160 patients with acute attack of fever were selected and studied who fulfilled the inclusion criteria. The WHO extended test was done by giving 25 mg/kg body weight of Chloroquine base over 3 days. The interpretation of the test was done as per criteria laid down by WHO. Out of one hundred sixty, 110 [68.75%] were males and 50 [31.25%] were females with ratio of 2.2:1. The age range 16-45 years with mean 28_12 years. Seventy one patients [44.375%] were Chloroquine sensitive. Chloroquine-resistance [CQR] Rl, Rll and both Rl Rll noted were 28.125%, 15.645% and 43.75% respectively. The CQR- R III was not observed in our study. In view of this situation, more organized and thorough studies must be conducted to elucidate the epidemiology, geographic-distribution and degree of Chloroquine resistance. And the local strategies be made to overcome this problem and to assess the need for changing the first line drug

Diabetic foot ulcers; common isolated pathogens and in vitro antimicrobial activity

To determine common pathogens isolated in diabetic foot ulcers and in vitro antimicrobial activity. Muhammad Medical College Hospital, Mirpurkhas and Liaquat University of Medical and Health Sciences Jamshoro. 1st November 2007 to 30th June 2008. Pus samples for bacterial culture were collected from 60 patients admitted with diabetic foot infections. Anti-microbial susceptibility testing of aerobic isolates was performed by the standard disc diffusion method as recommended by the National Committee for Clinical Laboratory Standards. Microbroth dilution test was arranged for susceptibility of anaerobic organisms to metronidazole and amoxicillin/clavulanate. A vancomycin screen agar [6 micro g/ml] was used to detect vancomycin intermediate isolates of Staphylococci. Clinical grading and bacteriological study of 60 patients revealed, 44 [73.33%] patients had gram-negative organisms, and Pseudomonas aeruginosa was the most common. While 16 [26.66%] patients had gram-positive organisms and Staphylococci was the most common organism. Infection with anaerobes was observed in one patient [1.66%]. Both gram-positive and -negative organisms were seen in 8 [13.33%]. Pseudomonas aeruginosa and S.aureus exhibited a high frequency of resistance to the antibiotics tested. All the isolates were uniformly susceptible to fosfomycin, levofloxacin, amikacin and vancomycin. Pseudomonas aeruginosa, Staphylococcus aureus, Escherichia coli, Staphylococcus epidermidis and Proteus were the most common causes of diabetic foot infections in this study. And the rate of antibiotic resistance was 66.66% among the isolates. All the isolates were uniformly susceptible to fosfomycin, levofloxacin, amikacin and vancomycin

HBV vaccination; status in health care workers

The study was conducted to determine the HBV vaccination status in health care workers of Muhammad Medical College Mirpurkhas. This was a descriptive study carried out at Muhammad Medical College Mirpurkhas, From December 2007 to February 2008. Total 480 health care workers were included; both male and female. Vaccination status and other data were filled on preformed Questionnaire proforma, if vaccinated or not. And if vaccinated either complete or incomplete. Total 480 health care workers were studied, including 300 [62.5%] male and 180 [37.5%] females. The mean age was 34 +/- 8.7 and 36 +/- 9.3 years in vaccinated and non-vaccinated subjects respectively. A total of 255 [53.15%] were vaccinated, including 215 males and 40 females. A 225 [44.875%] patients were non-vaccinated including 85 males and 140 females. The prevaccination HBsAg status was checked and found negative in all the subjects. The frequency of vaccination was highest among house officer 55 [91.66%] and lowest in the sanitary workers 3 [11.5%]. The most common reason of not being vaccinated was non-affordability [high cost of vaccine]. We conclude that a substantial number of health care workers are not vaccinated. So it demands a need for a more aggressive approach to be vaccinated and vaccine must be cost effective

Cardiac autonomic neuropathy [CAN] in type-1 diabetes, mellitus patients and its association with the duration of disease and glycemic control

To determine the frequency of Cardiac Autonomic Neuropathy [CAN] in type-1 Diabetes mellitus patients and its association with the duration of disease and glycemic control. Descriptive study. Department of Medicine, Liaquat University Hospital, Hyderabad/Jamshoro, from December, 2004 to April, 2005. Fifty patients of type-1 Diabetes Mellitus [DM] of >/= 10 years duration were selected. CAN was evaluated in terms of presence of resting tachycardia, loss of sinus arrhythmia and heart rate response to Valsalva maneuver by electrocardiogram [ECG]. An R-R variation with respiration of >15 beats per minute was taken normal, while 10-15 beats and <10 beats per minute were taken as borderline and definitive CAN respectively. QTc intervals were measured. Patients with HbA1c levels <7% were considered as well-controlled. The associations between CAN, the duration of diabetes and the diabetic control were determined. The mean age was 35.16 +/- 10.58 years with 32 males and 18 females. The mean values for the known duration of diabetes and HbA1c were 13 +/- 7.3 years and 9.36 +/- 2.5 mg/dl respectively. Definitive and borderline CAN were noted in 20% and 24% respectively. Variability of heart rate with respiration was significantly related to the duration but not to the control of the diabetes [p < 0.05]. QTc showed a significant correlation with the known duration of diabetes and heart rate variability with respiration [p < 0.05]. Most of the patients had uncontrolled glycemic status. Cardiac autonomic neuropathy is common in long standing type-1 diabetics. CAN resulted in prolonged QTc interval that may result in cardiac arrhythmias and even death. Intensive glycemic control improves the cardiac autonomic nerve functions

Frequency of cardiac autonomic neuropathy in patients with type 2 diabetes mellitus reporting at a teaching hospital of Sindh

To determine the frequency of Cardiac Autonomic Neuropathy [CAN] in patients with type 2 Diabetes mellitus. Study Design: Descriptive study. Place and Duration of Study: Department of Medicine, Liaquat University Hospital, Jamshoro, Hyderabad from December 2004 to April 2005. Patients with type 2 Diabetes Mellitus [DM] of at least 10 years duration were selected. CAN was evaluated in terms of presence of resting tachycardia, loss of sinus arrhythmia and heart rate response to Valsalva maneuver by ECG. A R-R variation with respiration of > 15 beats per minute, 10-15 beats per minute and <10 beats per minute were taken as normal, borderline CAN and definitive CAN, respectively. QTc intervals were measured. The association between CAN, diabetic control and duration of diabetes were determined. The mean age was 53.62 +/- 8.30 years, with male to female ratio of 1:1. Mean values for known duration of diabetes and HbA1c were 14 +/- 3.5 years and 11.36 +/- 3.6 mg/dl respectively. Definitive and borderline CAN was noted in 30% and 40% patients respectively. Variability of heart rate with respiration was significantly related to duration but not to the control of diabetes [p < 0.05]. QTc showed a significant correlation with the known duration of diabetes and heart rate variability with respiration [p < 0.05]. Most of the patients had very bad glycemic status as evidenced by HbA1c. CAN is common in long-standing diabetics, specifically those treated with oral hypoglycemic agents than those with insulin. Intensive glycemic control is associated with a better cardiac autonomic nerve functions