Characterization and survival of broad-spectrum biocontrol agents against phytopathogenic fungi / Caracterización y supervivencia de agentes de control biológico de amplio espectro frente a hongos fitopatógenos

Resumen Este estudio tuvo como objetivo aislar, caracterizar e identificar bacterias de control biológico que poseen actividad antifúngica de amplio espectro de la filosfera de diferentes cultivos, incluidos el maíz, el trigo y la papa, así como evaluar su actividad en la promoción del crecimiento. En este estudio, 14/113 bacterias de control biológico mostraron actividad antifúngica. Los aislamientos bacterianos M11 y M33 (de maíz), del total de 113, fueron reseleccionados debido a su fuerte actividad antifúngica de amplio espectro (más del 50%) después de su evaluación contra cuatro hongos fitopatógenos que afectan cultivos de alta importancia económica, entre ellos, Alternaría alternata, Rhizoctonia solani, Fusarium oxysporum y Fusarium verticillioides. Los aislamientos se evaluaron, adicionalmente, para determinar los rasgos que promueven el crecimiento de las plantas, es decir, producción de ácido indolacético, solubilización de fosfato, producción de celulasa, compuestos orgánicos volátiles microbianos, cianuro de hidrógeno y sideróforos. Las 14 cepas aisladas mostraron resultados positivos para la producción de la hormona ácido indolacético y la enzima celulasa; 10 cepas fueron positivas para la producción de cianuro de hidrógeno. Además, se observó producción de sideróforos en el caso de 7 cepas, mientras que 5 pudieron solubilizar fosfato inorgánico. Los compuestos orgánicos volátiles microbianos solo fueron sintetizados por los aislamientos M11 y M33, que fueron identificados como Bacillus amyloliquefaciens y Bacillus subtilis, respectivamente, mediante secuenciación del gen ARNr 16S. El estudio de supervivencia mostró que las bacterias de control biológico, es decir, B. amyloliquefaciens y B. subtilis, tienen la capacidad de sobrevivir sobre un sustrato a base de melasa, por un período de tres meses.

Ameliorative effects of MgSO4 on Dexamethasone – induced Histo-chemical alterations in the testes of Albino Rats.

Background: In experimental animal, Dexamethasone-induced impaired spermatogenesis, causes distortion of the normal architecture of seminiferous tubules along with alteration in male sexual hormone, testosterone. Concomitant administration of MgSO4 preserved the cytoarchitecture of testes as well as hormonal regulation in albino rats. Objective: This study was performed to observe the ameliorative effects of MgSO4 on the histology of testes and correlation with serum testosterone level during dexamethasone administration. Duration of study: twenty days (April 2012).Study design: Prospective experimental study.Place of study: Anatomy department Basic Medical Sciences Institute (BMSI), Jinnah Postgraduate Medical Centre (JPMC), Karachi. Methods: thirty healthy adult albino rats were included in this study and divided equally into three groups. Group-A served as control. Group-B received Dexamethasone (intraperitoneally) at the dose of 4.0 mg/kg body weight/24 hours. Group-C received Dexamethasone in the same dose as given in group-B and additionally received MgSO4 (intramuscularly) at the dose of 20mg/kg/24hours. Results: MgSO4 significantly preserved cytoarchitecture of the testes as well as minimized alteration in serum Testosterone level in group-C. Conclusion: This study showed that administration of MgSO4 has ameliorated both the histological and biochemical damaging effects induced by dexamethasone in rats’ testes.

Cervical lymphadenopathy: an audit of 116 cases

Objective: To find out the frequency of different pathologies causing enlarged cervical lymph nodes

Study Design: A Prospective observational study

Place and Duration: Study carried out from 1[st] Jan 2006 to 31[st] Dec 2006 at ENT Department of Khayber Teaching Hospital, Peshawar, Department of Pathology Kabeer Medical College, Peshawar and Department of Histopathology, Combined Military Hospital Peshawar Cantonment

Methodology: The patients presenting with cervical lymph node enlargement for more than one month duration were subjected to Fine Needle Aspiration. A Core Needle or open biopsy was performed when FNAC yielded a non diagnostic aspirate or when a histological confirmation of a malignant tumour was required

Results: A total of 116 patients, aged between 8-72 years with a mean age of 34.64 and male to female ratio of 1.23:1 were studied. Tuberculosis was the commonest cause of lymphadenopathy 36.2% [n=42], followed by metastatic disease 29.3% [n=34], reactive hyperplasia was the third commonest cause with 19.3% [n=22], followed by Lymphoma [both Non Hodgkin's and Hodgkin's] accounting for 13.8% of cases. A single case 0.86% of Kikuchi's or Necrotizing lymphadenitis was also found

Conclusion: Tuberculosis was the underlying cause in younger patients while metastatic disease was more commonly found in elderly patients

Assessment of periodontal status of miswak and toothbrush users from karachi. a comparative study

Objective: The purpose of this study was to assess the periodontal status of miswak and toothbrush users of Karachi

Study Design: Observational / Descriptive / cross sectional study

Place and Duration of Study: This study was conducted in the OPD Department, Jinnah Medical and Dental College Karachi from 02.05.2015 to 30.09.2015

Materials and Methods: Participants of the study include the students of Madrasah Islamia and patients presenting to OPD of Jinnah Medical and Dental College Karachi for routine dental checkups. We chose purposive sampling for the study. Subjects were selected on the basis of their use of miswak [Group A], use of toothbrush [Group B] and use of Miswak and Toothbrush [Group C]. Each subject was examined using CPITN probe to evaluate gingival bleeding, dental calculus and probing pocket depths of the selected surfaces. Selected surfaces were lingual surface of mandibular anterior teeth and buccal surface of maxillary posterior teeth

Subjects who did not consent to participate in the study were excluded from the study. SPSS version 20 was used for data analysis

Results: In group A 40% participants had calculus, 50% had less than 3mm pockets and 20% had more than 3mm pockets. 30% had no gingival pocketing. In group B [brushing only] 4% subjects had calculus and 96% had less than 3mm pockets. In group C [miswak plus toothbrush] 40% had calculus and less than 3mm pockets and 10% of subjects had more than 3mm pocket depth. 50% had no pockets at all. Gingival Bleeding was demonstrated in all groups with Miswak users being 30% and tooth brush users and tooth brush plus miswak users being 10 % each

Conclusion: The periodontai status of all 3 groups was found to be satisfactory but examination revealed that the users of toothbrush only [group B] possess healthier periodontal tissues

Children attention defict hyperactivity disorder; functional impairment in the domain of school and learning among school going age

To determine the frequency of functional impairment in the domain of "school and learning" among school going age children with ADHD. Cross-sectional study. Neuropsychiatry OPD at National Institute of Child Health [NICH], Karachi. April 2012 to October 2012. A total 122 child and adolescent patients of school going age i.e. 05-15 years diagnosed as having ADHD were included in the study. A Proforma was used to denote demographic details of the patients. Impairment in the domain of "school and learning" was measured by using the Weiss Functional Impairment Rating Scale - Parent Report [WFIRS-P]. of the total 122 patients 74% were males and 26% were females. 61% were studying in primary school whereas 28% either never went to school or had quit school. overall the domain of school and learning was impaired in about 48% of children with females' representation being slightly more [50%] compared to males [46%]. within the domain of school and learning maximum number of children were impaired in keeping up with schoolwork and needing tutoring [61%]; whereas the least frequency of impairment was observed in being suspended or expelled from school [30%]. ADHD causes functional impairment among children of school going age in the domain of school and learning

Lower gasrtointestinal bleeding; etiologic spectrum in Nishtar Hospital Multan

To determine the etiology of lower GI bleeding based on colonoscopic findings Retrospective study. This study was conducted at gastroenterology unit of Nishtar Hospital Multan from Feb 2013 to August 2014. Two hundred and fifty four patients, >/= 14 years old who presented with history of lower GI bleeding to the gastroenterology unit of Nishtar Hospital Multan out of 254 patients, 59.05% were males and 40.95% were females. Mean age of patients was 37.22 +/- 10.68 years. Most common findings were haemorrhoids [40.9% cases], ulcerative colitis [35.4%], no abnormality [8.2%], solitary rectal ulcer [7.5%], growth [7.1%], proctitis [3.5%], polyps[2%], rectal varix [1.2%], infective colitis [0.8%], uremic colopathy [0.8%], rectal prolapse [0.8%], multiple polyposis coli [0.8%], petechiae [0.8%], stricture [0.8%], diverticula[0.4%]and fissure [0.4%]. Colonoscopy is the investigation of choice for patients of lower gastrointestinal bleeding. More common colonoscopic findings in our study were haemorrhoids, ulcerative colitis, solitary rectal ulcer, malignancy and proctitis. Polyps and diverticula which are common in the west were uncommon in our patients. Rectal prolapse, petechiae, stricture, uremic colopathy and multiple polyposis coli were rare causes

Patients with suicide attempt; demographic profile of reporting to two tertiary care hospitals at Hyderabad, Pakistan

Objective: To determine the demographic details [gender, age, marital status, level of education, and occupation] of suicide attempters attending the tertiary care hospital services at Hyderabad, Pakistan

Study Design: Cross sectional study

Setting: Liaquat university hospital Hyderabad and Sir Cowasjee Jahangir Institute of psychiatry [CIJP] Hyderabad

Period: Twelve months from the 1st January 2011 to 31[st] December 2011

Methodology: The aim of the study was. Patients with a history of attempted suicide. Two hundred [200] consecutive cases were recruited and selected according to the inclusion criteria. An informed consent was obtained from patients for being included in the study. A specially designed semistructured Proforma was used to record demographic details of the patients. Data were entered into and analyzed through statistical software SPSS version 20

Results: Total 200 hundred cases were included in the study. Males 78.5% [N=157] outnumbered female patients 21.5% [N= 43]. The age range of study subjects was between 15 -59 years. Mean age of the total cases was 22.6 years. Majority of the patients presenting with suicide were single comprising 61% [N= 122] of study cases with a P value < 0.001. Total cases of married subjects were 27.5% [N= 55] with a P value < 0.001. While 5.5% subjects were separated and 6% were divorced. Unskilled labors made the largest group comprising of 24.5% [N=49] of all the cases. Other occupations included farmers [15.5%], skilled labor [15%], jobless [11.5%], house wives [8.5%], students [7%], and shopkeepers [6%]. Out of the total 200 patients with attempted suicide 32% were illiterate, 33.5% were educated up to primary level, 19.5% were matriculate, 09% were intermediate passed, and only 6% were graduate. [Table-II]

Conclusion: In Pakistan still Suicide attacks are reported. Our results suggest that suicidal thoughts can be entirely predict by common reported in male and younger age due to very sensitive to family issues, lower education level and major depression due to unemployment or low level earning of unskilled labor occupation in the Pakistan population

Severe psychiatric illnesses; effectiveness of illness management and recovery program as a group intervention in patients suffering

Objectives: To find out the effectiveness of "Illness management and Recovery [IMR]" program as a group intervention for improving daily functioning of clients suffering from severe psychiatric illnesses

Setting: The Recovery House, a Psychiatric Rehabilitation Center in Karachi, Pakistan

Period: Dec 2012 to Sep 2013

Methodology: Fifteen[15] patients were enrolled in the study. They were randomly divided into two groups, one group with 7 patients and the second with 8 patients. Informed consent was obtained from the patients and their family. A semi-structured Proforma was used to record the demographic details of patients. Before Starting the IMR program, 15 points rating scale was administered on patients [pre-IMR assessment] and after 9-month program implementation, the scale was again administered [post-IMR assessment] to evaluate the effectiveness of Illness management Program as a group intervention. After each IMR session patients received sheets to work as homework assignments from the handouts. Patients received IMR program with, supportive, educational, motivational and cognitive behavior interventions in group and individual sessions with practitioner. Data collected was entered into and analyzed by using statistical package for the social science - seventeenth version [SPSS 17]

Results: Out of the total 15 patients, 12 [80%] were male and 3 [20%] were female. Age range 15 to 67 years with mean age was 37+8.5 years. Education status of the patients revealed that all patients were educated; 04 [26.7%] had achieved education to the graduation level; 04 [26.7%] were matriculate; 04 [26.7%] were primary passed; and 03 [20%] were educated up to intermediate level. Patients with severe psychiatric illnesses were bipolar disorder 2[13.3%] cases, personality disorder 3[20%] cases, delusional disorder 1[6.7] case, schizophrenia 8[53.3%] cases and schizoaffective 1[6.7%] cases. Total number of WMR [Wellness management and recovery] session attended by each patient ranged from 30 to 62 sessions. Results in 15 areas of assessment on the rating scale before the application of illness management and recovery sessions [Pre-IMR sessions] and after the application of sessions [Post-IMR sessions]

Conclusion: Illness management and recovery program is an effective tool to bring about a significant improvement in several domains of life among patients suffering from severe psychiatric illnesses

Frequency of congenital heart diseases in infants of diabetic mothers referred to pediatrics department

To determine the frequency of congenital heart disease in infants of diabetic mothers referred to Pediatrics department. A total of 101 full-term neonates, aged from 0 to 29 days, admitted in the Neonatology unit, Lady Reading Hospital Peshawar - Pakistan, diagnosed clinically and confirmed by echocardiography were included in the study. All the children included in the study were sent to Cardiology Department of the Institute for echocardiography. After Echocardiography report, frequency of normal and congenital heart diseases [CHD] like VSD, ASD, PDA, TGA and PFO among these children was determined. Out of 101 neonates, 67 [66.30%] were males and 34 [33.7%] were female. Majority [n=97, 96.0%] neonates' age ranged from 0-10 days. Maternal history showed that 55 [54.5%] mothers got diabetes during the pregnancy and 46 [45.5%] were having pre-gestational diabetes. The frequency of CHD was 52.5% in infants of diabetic mothers. Following CHDs were found in 53 neonates of diabetic mothers; Patent ductus arteriosus [PDA] in 17 [16.8%] cases, Ventricular septal defect [VSD] in 13 [12.9%], Atrial septal defect [ASD] in 09 [08.9%], Patent foramen ovale [PFO] in 08 [7.9%] and Transposition of the great arteries [TGA] in 6 [5.9%] cases respectively. Frequency of congenital heart disease in IDMs was 52.5%. Careful evaluation and early diagnosis of CHD in this high-risk group are highly indicated and echocardiography is recommended for all infants of diabetic mothers as soon as possible

Risk factors of hypoglycemia in diabetics

To find the frequency of risk factors of hypoglycemia in diabetics in our setup. Prospective observational study. This study was conducted at Emergency and Medical Wards Nishtar Hospital Multan from January 2010 to December 2013. One hundred and eighteen patients presented with hypoglycemia to Nishtar Hospital Multan. One hundred and eighteen diabetic patients above the age of 16 years admitted with hypoglycemia were included in the study. Written informed consent was taken from the patients or the attendants in case of patients with altered state of consciousness. Approval was taken from hospital ethical committee. Mean age of patients was 60.46 +/- 14.20. Forty two patients [35.6%] were males and 76 [64.4%] were females. Mean duration of diabetes was 6.4 +/- 6.04years. Mean blood glucose level at the time of presentation was 36.25 +/- 12.49mg/dl. Thirty four [28.8%] patients had only neuroglycopenic symptoms without autonomic symptoms while 4[3.4%] hadautonomic symptoms alone. Eighty [67.8%] presented with both adrenergic and neuroglycopenic symptoms. Regarding risk factors, 77[65.25%] had renal failure, 66[55.93%] had missed meal, 37[31.35%] had vomiting, 23[19.49%] had recent increased dose of hypoglycemic agents, 19[16.10%] had delayed meal, 16[13.55%] had diarrhea, 14 [11.86%] had liver dysfunctionand 2[1.69%] had excessive physical activity. Hypoglycemia is common in old patients with long history of diabetes. Patients usually present late when they develop neuroglycopenic symptoms. Renal failure and missed meal are most common risk factors followed by vomiting and increased dosage of hypoglycemic agents. Patients need education about early symptoms of hypoglycemia, common risk factors and remedial steps to avoid this serious complication

Causes of acute renal failure in Nishtar hospital Multan

To identify the common causes of Acute Renal Failure [ARF] in Nishtar Hospital Multan. Prospective observational study. This study was conducted at Medical Wards, Nishtar Hospital Multan from September 2012 to March 2013. One hundred and thirty six [136] patients presented with Acute Renal Failure to Nishtar Hospital of ages 15 and above. Fifty three patients [39%] were males and 83[61%] were females. Mean age of patients was 40.43 +/- 18.56 years. Our study showed that common causes of ARF were diarrhea with or without vomiting [22%], septicemia [22%], obstetric causes like septic abortion and APH/PPH [19.11%],obstructive uropathy [11%], hair dye ingestion [9.6%], glomerulonephritis [7.35%], nephrotoxins [5.9%], hemolysis [4.4%] and cardiac failure [3.7%]. Diarrhea with/without vomiting,sepsis, post-partum and ante-partum hemorrhage, septic abortion, obstructive uropathy, hair dye, glomerulonephritis, nephrotoxic drugs, hemolysis and cardiac failureare the common causes of acute renalfailure in our setup. ARFis associated with high morbidity and mortality. So all these causes should be managed aggressively to avoid this life threatening complication

Quantification of sparfloxacin in pharmaceutical dosages and biological samples

A simple and fast method for spectrophotometric determination of sparfloxacin using p-dimethylaminobenzaldehyde [DMAB] has been developed. A yellow coloured product formed from reaction between sparfloxacin and DMAB as a result of condensation reaction at room temperature. The maximum absorbance was found at 392 nm with molar absorptivity of 4.9 × 10[3] L mol[-1] cm[-1]. All parameters for the reaction, as concentration of DMBA reagent, molarity of sulphuric acid, and reaction temperature were studied. Under the conditions studied, a linear relationship between absorbance of the condensation product and concentration of sparfloxacin in the range of 2.0-80.0 microg m[E1] was found with good correlation coefficient [0.9997]. The limits of detection [LOD] and quantification [LOQ] for the proposed method were found to be 0.22 and 0.75 microg m[E1] respectively. The repeatability and accuracy [model] of the method was studied at three different concentrations of sparfloxacin and found with value of relative standard deviation less than 2.0%. The method was found selective for determination of sparfloxacin in the presence of commonly used excipients in dosage forms. The developed method was validated statistically and applied successfully to the analysis of the drug in pure form, pharmaceutical preparations, and spiked blood plasma and urine samples with good accuracy [real] and precision. The percentage recovery was found from 99.0-100.0% with relative standard deviation less than 1%. The results of the proposed method were compared statistically with the results of literature HPLC method

Medical versus surgical management of otitis media with effusion in children

Otitis media with effusion [OME] is a leading cause of hearing difficulty in children. OME must be detected early and managed properly to prevent hearing and speech impairment in children. This study was aimed to compare results of medical and surgical treatments in terms of hearing improvement, recurrence of Middle Ear Effusion [MEE], time to offer surgical intervention. The study was conducted from June 2008 to December 2011. A performa was used to collect data. Every child having hearing difficulty was examined with pneumatic otoscope for fluid level and tympanic membrane mobility. These children were investigated with pure tone audiometry for level of hearing loss and tympanometry to confirm the middle ear effusion. X-Ray nasopharynx lateral view was taken to see if there were adenoids. All patients were treated conservatively in the first phase. Those not responding to conservative treatment were treated with myringotomy and adenoidectomy with or without ventilation tubes. Patients were followed-up for up to 36 months. Middle ear effusion cleared in 80 [71.5%] out of 112 ears. No improvement was noted in 32 ears for 9 months. Resistant and recurrent cases were managed with adenoidectomy and myringotomy alone or with insertion of ventilation tubes [VT]. Recurrence was noted more common with myringotomy alone than with ventilation tubes. Medical treatment failed in 32 ears. MEE recurred in 9 ears. VT was put in 41 ears. The hearing level improved with VT by 10-15 dB after first 3 months. All children with OME should be treated conservatively. It is cost effective and relieves MEE in about 70% of patients. The ears with OME that fails to resolve or recur should be managed with myringotomy and VT insertion or adenoidectomy.

Protective role of magnesium sulphate in dexamethasone induced histopathological alteration in spermatogenic cells of albino rats

This study has been undertaken to assess the spermatoprotective role of magnesium sulphate [MgSO[4]] on the histology of the seminiferous tubules in dexamethasone induced spermatogenic cells damage in albino rats. Prospective experimental study. This study was conducted at the Department of Anatomy, Basic Medical Sciences Institute [BMSI], Jinnah Postgraduate Medical Centre [JPMC], Karachi from April 2012 to May 2012. Thirty male albino rats of 90-120 days of age and around 200-250 grams of weight were selected and divided into three groups [A, B and C]. Each group comprising of ten rats. Group-A served as control, group-B was given dexamethasone [Dexa] at the dose of 4mg/kg/day intraperitoneally for 20 days. Group-C was administered MgSO[4] at the dose of 20mg/kg/day intramuscularly and Dexa at the same dose as given in group- B. The rats were sacrificed at the end of the experimental period and histopathological changes in the germ cells were recorded. The microscopic examination of group-B rats revealed marked changes in most of the seminiferous tubules such as, vacuolization, detachment of basement membrane, atrophy, sloughing, widening of the interstitial spaces and disorganization of the spermatogenic cells series. Group-C which was protected with magnesium sulphate, showed restoration of basement membrane and spermatogenic cell series. The present study concluded that magnesium sulphate [MgSO[4]] administration reduced the damaging effects of dexamethasone in testes

Foreign body nose in children presenting at a tertiary care teaching hospital in Pakistan

To determine the patient management factors and patient outcomes in pediatric patients of foreign bodies in nose. This descriptive study was performed in ENT Department, Khyber Teaching Hospital, Peshawar from February, 2006 to January, 2007. Two hundred fifty seven cases of foreign bodies in nose in patients upto 12 years of age were included. Personal data, clinical features, investigations, management details and complications were recorded on a pre-designed proforma. In younger non cooperative cases foreign bodies were removed under general anesthesia, while in cooperative children it was removed without anesthesia by using suction, use of forceps and foreign body hook. Among 257 cases of foreign bodies in nose 48.46% were between 4 to 8 years, with male preponderance i.e. 63%. Unilateral and bilateral presentations were seen in 95% and 5% cases respectively. Most common foreign body types were plastic beads, pearls, pieces of sponge and small round objects. There were two cases of alkaline battery lodged in the nose. General anesthesia had high success rate. Round shape foreign bodies and younger children are associated with poor outcome with removal attempts made under direct visualization. These cases should be referred directly to otolaryngologists for removal under general anesthesia

Otorhinolaryngological manifestations of tuberculosis

Tuberculosis, one of the oldest disease in man, is even today, a leading cause of human suffering and loss of life. TB has the potential to infect any organ in the body due to lympho-haematogenous dissemination. Therefore, this study was conducted to know the manifestations of the disease in various regions of Otolaryngology. The study was conducted in the ENT department, Khyber Teaching Hospital, Peshawar. Duration of study was two years from January, 2005 to December, 2006. A total of 100 patients presented with primary head and neck TB during the study period. Most of these [97%] had tubercules cervical lymphadenpthy. Age ranged from 8 to 55 years. The mean age was 31.5 years. Thirty six were male and 64 were female. Sixty five patients were diagnosed by FNAC examination and 32 required biopsy and histopathological confirmation. One patient each of laryngeal TB, cervical spine TB and retropharyngeal abscess [TB] were diagnosed by MRI. TB is a challenging disease, its diagnosis requires a high index of suspicion. FNAC is a reliable and easy way to diagnose, however, gold standard is biopsy for histopathology

Non endoscopic predictors of esophageal varices in cirrhotics

To identify non-invasive predictors of esophageal varices in patients in Liver Cirrhosis. First Medical Unit, Nishtar Hospital Multan from January 2004 to December 2005. Sixty five patients diagnosed as Cirrhosis of liver and without any history of hematemesis and/or melena were included in this study. These patients underwent complete clinical, biochemical and ultrasonographic evaluation. Four variables selected to predict the presence of esophageal varices were platelet count, spleen diameter, portal vein diameter and platelet count/spleen diameter ratio. Upper GI endoscopy was done in all these patients to see esophageal varices. Thirty three patients had esophageal varices while varices were not found in 32 patients. Best cut off values of spleen diameter [160 mm, p-value <0.001] and portal vein diameter [13.5 mm, p-value of <0.001] were statistically significant for prediction of presence of varices. Positive and negative predictive values for spleen diameter were 90% and 81% respectively. Positive and negative predictive values for portal vein diameter were 74% and 77% respectively. Best cut off values of platelet count [145 X 10[3]/micro L, p-value-0.486], and platelet count/spleen diameter ratio [1200, p-value-0.153] were statistically not significant for prediction of presence of varice. Spleen diameter [cut off value 160 mm] and portal vein diameter [cut off value 13.5 mm] have very good predictive values [positive and negative] and can be used as predictors for presence of varices in patients of cirrhosis with no past history of bleeding

Stellate ganglion block for the immediate treatment of frostbite of upper limb

The purpose of performing early sympathectomy at high altitude was to get relief of vasoconstriction of frostbitten part so that the progression of the disease might be arrested immediately. Descriptive Interventional Study. This study was done in Northern area from December 1997 to December 1998. In this interventional clinical trial, 23 young soldiers who were the victims of frostbite of upper extremity, were given stellate ganglion block with local anesthetic at army field hospital Goma, situated at altitude of 10,800 feet. All the patients were referred back from the posts at forward areas in high mountains, during one year [Dec 1997-Dec 1998]. The results of the study were very encouraging. Patients having mild to moderate form of disease recovered fully whereas disease progression was arrested in patients with severe form and later on they required less reconstructive surgery. The results noted in this study mandate the purpose of more research in this field so that the morbidity caused by the frostbite may be further decreased

Dyspepsia and upper gastrointestinal endoscopy; Multan experience

To find out causes of dyspepsia on upper gastrointestinal endoscopy. Endoscopy unit of Nishtar Hospital Multan. May 2005 to August 2007. Patients suffering from dyspepsia were referred by consultants of Nishtar Hospital Multan and doctors working in the periphery for endoscopy. 502 patients were scoped for dyspepsia; 254 [50.6%] were male and 248 [49.4%] were female. Mean age was 42.5 years and age range was 7-95 years. Most common lesion was gastroduodenitis [20% cases] followed by gastric ulcer [5.4% cases]. Ratio of duodenal ulcer to gastric ulcer was 1:2.56% patients had no pathology; females were more likely to have normal endoscopy. Gastroduodenitis is the most frequent organic cause of dyspepsia. Functional dyspepsia is more common among females

Percutaneous retrogasserian glycerol rhizolysis in the management of trigeminal neuralgia

To evaluate the outcome and complications of Percutaneous Retrogasserian Glycerol Rhizolysis [PRGR] in intractable trigeminal neuralgia. The patients who were poor risk for anesthesia [e.g. old age] with side effect of medical treatment or with intractable pain despite medical treatment for at least six months underwent PRGR. Forty-one patients were included in the study. They were followed for relief of pain and any complications for at least six months. The mean age of the patients was 59 years with a male to female ratio of 1:1.6. The distribution of pain was most common in V2 territory. The duration of pain was more than one year in 80% of the patients. Prompt pain relief occurred in 34 [83%] patients. Recurrence of pain occurred in 8 [19%]. Six [14%] patients developed Dysesthesia of face. Corneal sensations were affected in five [11%] patients but none developed corneal ulcers. Mastication was affected in two patients and one developed bradycardia, which responded to conservative treatment. None of the patients developed herpes or anesthesia of face. PRGR is an effective procedure in relieving intractable trigeminal neuralgia with few complications, especially in elderly patients and those with intractable pain