The impact of cow dung augmentation on soil restoration and bio-accumulation of metals (Lead and Cadmium) in Pheretima posthuma (Annelida: Clitellata)

Abstract To investigate the role of cow dung in soil reclamation and bio assimilation along with bio accumulation of heavy metals in earthworm (P. posthuma) (N=900) earthworms were used and treatment groups of CD-soil mixture of different proportion of cow dung were designed. Nonlethal doses of lead acetate and cadmium chloride were added in treatment groups. Mature P. posthuma were released in each experimental pot maintaining the favorable conditions. The pH, carbon, nitrogen, phosphorus, exchangeable cations, and heavy metal level of each mixture was evaluated. The results indicated that bio-assimilation of Pb and Cd by P. posthuma were significantly (P 0.01) higher in different soil-CD treatments compared to control. Highest bio-assimilation of both metals was observed in T1 of both groups (Pb = 563.8 mg/kg and Cd = 42.95 mg/kg). The contents of both metals were significantly (P 0.05) lowered in casting. The nutrient concentration in the final castings of all soil-CD treatments were also equally transformed from less or insoluble to more soluble and available for plants, except for carbon level which increased with CD proportion. It is concluded that cow dung as organic matter has a positive effect on soil reclamation and bio-assimilation of metals by P. posthuma.

RESUMO Para investigar o papel do esterco de vaca na recuperação do solo e bioassimilação, juntamente com a bioacumulação de metais pesados em minhocas (P. posthuma) (N = 900), minhocas foram usadas e grupos de tratamento de mistura CD-solo de diferentes proporções de esterco de vaca foram projetados. Doses não letais de acetato de chumbo e cloreto de cádmio foram adicionadas aos grupos de tratamento. P. posthuma maduros foram liberados em cada vaso experimental, mantendo as condições favoráveis. Foram avaliados o pH, carbono, nitrogênio, fósforo, cátions trocáveis e nível de metais pesados de cada mistura. Os resultados indicaram que a bioassimilação de Pb e Cd por P. posthuma foi significativamente (P 0,01) maior em diferentes tratamentos de solo-CD em relação ao controle. A maior bioassimilação de ambos os metais foi observada em T1 de ambos os grupos (Pb = 563,8 mg / kg e Cd = 42,95 mg / kg). O conteúdo de ambos os metais foi significativamente (P 0,05) reduzido na fundição. A concentração de nutrientes nas fundições finais de todos os tratamentos de solo-CD também foi igualmente transformada de menos ou insolúvel para mais solúvel e disponível para as plantas, exceto o nível de carbono que aumenta com a proporção de CD. Conclui-se que o esterco de vaca como matéria orgânica tem um efeito positivo na recuperação do solo e na bioassimilação de metais por P. posthuma.

The impact of cow dung augmentation on soil restoration and bio-accumulation of metals (Lead and Cadmium) in Pheretima posthuma (Annelida: Clitellata) / O impacto do aumento de esterco de vaca na restauração do solo e bioacumulação de metais (chumbo e cádmio) em Pheretima posthuma (Annelida: Clitellata)

Abstract To investigate the role of cow dung in soil reclamation and bio assimilation along with bio accumulation of heavy metals in earthworm (P. posthuma) (N=900) earthworms were used and treatment groups of CD-soil mixture of different proportion of cow dung were designed. Nonlethal doses of lead acetate and cadmium chloride were added in treatment groups. Mature P. posthuma were released in each experimental pot maintaining the favorable conditions. The pH, carbon, nitrogen, phosphorus, exchangeable cations, and heavy metal level of each mixture was evaluated. The results indicated that bio-assimilation of Pb and Cd by P. posthuma were significantly (P ˂ 0.01) higher in different soil-CD treatments compared to control. Highest bio-assimilation of both metals was observed in T1 of both groups (Pb = 563.8 mg/kg and Cd = 42.95 mg/kg). The contents of both metals were significantly (P ˂ 0.05) lowered in casting. The nutrient concentration in the final castings of all soil-CD treatments were also equally transformed from less or insoluble to more soluble and available for plants, except for carbon level which increased with CD proportion. It is concluded that cow dung as organic matter has a positive effect on soil reclamation and bio-assimilation of metals by P. posthuma.

RESUMO Para investigar o papel do esterco de vaca na recuperação do solo e bioassimilação, juntamente com a bioacumulação de metais pesados ​​em minhocas (P. posthuma) (N = 900), minhocas foram usadas e grupos de tratamento de mistura CD-solo de diferentes proporções de esterco de vaca foram projetados. Doses não letais de acetato de chumbo e cloreto de cádmio foram adicionadas aos grupos de tratamento. P. posthuma maduros foram liberados em cada vaso experimental, mantendo as condições favoráveis. Foram avaliados o pH, carbono, nitrogênio, fósforo, cátions trocáveis ​​e nível de metais pesados ​​de cada mistura. Os resultados indicaram que a bioassimilação de Pb e Cd por P. posthuma foi significativamente (P ˂ 0,01) maior em diferentes tratamentos de solo-CD em relação ao controle. A maior bioassimilação de ambos os metais foi observada em T1 de ambos os grupos (Pb = 563,8 mg / kg e Cd = 42,95 mg / kg). O conteúdo de ambos os metais foi significativamente (P ˂ 0,05) reduzido na fundição. A concentração de nutrientes nas fundições finais de todos os tratamentos de solo-CD também foi igualmente transformada de menos ou insolúvel para mais solúvel e disponível para as plantas, exceto o nível de carbono que aumenta com a proporção de CD. Conclui-se que o esterco de vaca como matéria orgânica tem um efeito positivo na recuperação do solo e na bioassimilação de metais por P. posthuma.

Transatrial approach for total correction of tetralogy of Fallot: our centre experience over three years

Background: The objective of this study was to evaluate the early and mid-term outcome of total correction of tetralogy of Fallot (TOF) done through transatrial approach avoiding ventriculotomy with or without transannular patching.Methods: Of 210 patients undergoing total correction for TOF between January 2016 and January 2019, 180 patients were operated via transatrial approach. The ventricular septal defect closure, infundibular resection and pulmonary valvotomy were performed through the right atrium. Age ranged from 12 months to 44 years (mean, 2.6 years), 104 patients were male and 76 patients were females.Results: Three patients (1.67%) died in early post-operative period. Pulmonary complications were seen in 8 (4.44%), septicemia in 1 (0.55%), low output syndrome in 2 (1.10%) and temporary arrhythmias in 6 (3.33%) patients. Reintubation was needed in 3 (1.67%) patients. Early reoperation was needed in 3 (1.67%) patients in view of post-operative bleeding.  There were no mediastinal or deep sternal wound infections. None of our patient had complete heart block. There were no late deaths or late reoperations. Echocardiography before discharge did not reveal significant residual VSD in any patient. The mean right ventricular outflow tract pressure gradient was 28 mmHg (range of 20 to 44 mmHg) which decreased on follow-up echocardiography to 16 mmHg (range of 14 to 24 mmHg) at mean follow up of 23 months. None of our patient had severe pulmonary or tricuspid regurgitation or severe right ventricular dysfunction on follow up.Conclusions: Transatrial repair of TOF is associated with remarkably low morbidity and mortality in our early experience.

Optimization of protein in supplementary feeds for pond raised cyprinids

Labeo rohita, Gibelion catla, Cirrhinus mrigala, Ctenopharyngodon idella and Hypophthalmichthys molitrix were grown together for 365 days in triplicate ponds. Six iso-caloric feeds having varying protein levels i.e. 22, 24, 26, 28, 30 and 32% were prepared and supplemented to fish at 2% fish weight daily. Significantly, higher final average weight [793 +/- 197 g] and total length gain [398 +/- 40 mm] was recorded for Ctenopharyndodon idella. Net fish yield enhanced as the level of digestible protein [DP] in the supplementary diets increased and plateaued at 28% DP level, thereafter significant reduction [P<0.05] in fish weight increments was experienced at any surplus protein level. Among the supplementary feeds, 28% DP level resulted in maximum net fish yield [4304 +/- 33 kg ha-1 year-1] and a significantly higher overall nitrogen conversion ratio [NCR] of 1:5.2 +/- 0.14. Higher level of DP in supplementary feeds resulted in reduced fish growth

Psychosocial assessment of pulmonary functions: a comparative study held on students of 1st and 4th year MBBS at SIMS Lahore

Objectives: To see the pulmonary functions in students of 1st year and 4th year MBBS, SIMS and to compare them with each other considering the Environmental and stress related factors affecting Pulmonary functions on both groups

Methods: 30 students from each 1st and 4th year were taken from Services Institute of Medical Sciences Lahore. Consent in written was taken, participants were questioned and spirometery tests were performed. Data was analyzed using SPSS version 20

Result: Age and BMI of both groups were comparable. The mean values of FEV1 was better in 4th year students [3.2830 +/- 0.7677 V/S 3.2357 +/- 0.8223] and it was not statistically significant [p =0.819]. Values of FVC and FEV1 were better among 4th year students who exercise daily with values of 4.2323 +/- 0.5078 and 4.2343 +/- 0.3070 respectively than those of 1st year students have values of FVC and FEV1 as 4.0057 +/- 0.5022 and 3.7629 + 0.5268. The difference is statistically significant [p= 0.043 and 0.028 respectively]. The mean values of Forced Volume Capacity and Forced Expiratory Volume 1 of students residing in hostels were better in 4th year students [4.0171 +/- 0.8698 and 3.4129 +/- 0.9089 respectively] but it was not statically significant

Conclusion: Pulmonary functions were slightly better in 4th year students. It was due to their resistance to cope up with the environment, stress related to studies and better life styles regarding exercise and less numbers of smokers

Efficacy of ponseti method in management of club foot

Objective: to determine the efficacy of ponseti method in the treatment of club foot

Material and Methods: this descriptive case series was conducted at Department of Orthopaedic Surgery, Services Institute of Medical Sciences [SIMS]/ Services Hospital Lahore. Sample size of 100 was calculated with 95% confidence using non probability purposive sampling technique. Children of age 6 month to 1 year with club foot of either sex were included, while those with any associated congenital anomaly were excluded. Children with idiopathic club foot having skin disease and pressure sore due to POP cast were also excluded. All children had six casts at weekly interval by Ponseti's technique. Prior to the fifth cast percutaneous Achilles tenotomy was done under local anesthesia if dorsiflexion was not possible beyond neutral. Following the removal of the last cast all the feet were placed in a Foot Abduction Orthosis [AFO]. Sixth months after the completion of plaster treatment all feet were assessed by Pirani score

Results: a total of 100 children were included in the study. The mean age was 5.78 +/- 3.21 months. Majority of the patients were between 0-9 months of age i.e. 63% [n=63], and between 10-12 months 37% [n =37]. Male to female ratio was 1.127:1. Percutaneous Achillies tenotomy was done in 82% of cases. Pirani score six months after cast treatment was calculated which showed 88% [n=88] children had good results and 12 % [n=12] didn't have effective results. Efficacy of Ponseti method in the treatment of club foot reveals Pirani score <1 in 88% [n =88] while >1 in 12% [n=12]. Stratification for efficacy of Ponseti method with regards to age before treatment reveals that out of 88 cases 68.18% [n=60] were between 0-9 months of age and 31.82% [n=28] were between 10-12 months of age. Stratification for efficacy of Ponseti method with regards to initial Pirani score before treatment reveals that out of 88 cases 88.64% [n=78] had< 4 and 11.36% [n =10] had >4 Pirani score

Conclusion: we concluded that Ponseti method is highly effective for the management of club foot in children up to 12 months of age and need for extensive corrective surgery is greatly reduced. We recommend the Ponseti method as standard therapy in clubfoot management

Surgical anatomy of the hepatic arteries: a prelude to living donor liver transplantation

In the setting of Liver Transplantation as a new and emerging specialty in Pakistan the need has arisen for exact descriptions of the hepatic vascularization to avoid iatrogenic vascular damage. Exact knowledge of the arterial anatomy is required to plan the best resection as well as to minimize the risks of donor morbidity. We studied variations of extrahepatic arterial anatomy in forty six patients who underwent major hepatobiliary or pancreatic resections with complete exposure and/or skeletonization of the extrahepatic arterial anatomy. The extrahepatic arterial anatomy in twelve cadaveric dissections was also studied. The commonest arterial variant seen in our series was Type 1 i.e. 91.37% . The prevalence of anatomical variants was 8.63% . Knowledge of the variation in the hepatic arterial anatomy will help us in planning and performing the safe procurement of grafts from living donors with less risk of serious ischemic complications

Frequency of osteoporosis in patients with cirrhosis due to hepatitis B and hepatitis C: a study of 100 cases

Osteoporosis is the disease of bone that affected King David of Israel 3000 years ago. This condition is no long considered to be due to aging alone and is increasingly recognized as a major health concern and accounts for about 1.5 million fractures annually in United States. Objective of this study was to see the frequency of osteoporosis in patients with cirrhosis due to Hepatitis B and C, and any correlation between the Bone Mineral Density [BMD] and duration and stage of the liver disease. The study was conducted in the Department of Gastroenterology, Postgraduate Medical Institute, Hayatabad Medical Complex, Peshawar, from January 2008 to December 2008. All patients from the OPD or Ward fulfilling the criteria and consenting were included. Physical examination, with special emphasis on any signs of chronic liver disease was performed. Full blood count, platelet count, prothrombin time and INR, liver function tests including serum albumin, and renal function tests were done on all patients. Viral serology was checked for those patients who were either newly diagnosed as cirrhotic or were cirrhotic but not screened for viral markers. Abdominal sonogram was recorded on all patients. The child's score was calculated for each patient using the clinical and lab parameters. The BMD was calculated for all patients using computer based ultrasound probe. Calcaneum was used for evaluation of BMD. The information collected was entered on structured data collection sheets and was analysed using SPSS version 11. Osteoporosis was found in 26% of subject and osteopenia in 42%, while 32% had BMD in the normal range. The mean T score was -1.483 [ +/- 1.29]. The mean duration of liver disease was 3.77 [ +/- 1.56] year. Majority of the patients [81%] were in Child's Class C, followed by Class B and A [16% and 3% respectively]. Fifty-nine percent of the patients were males with a mean age of 37.65 years, while 41% were females with mean age of 37.76 years. Osteoporosis is a common finding in patients with cirrhosis due to Hepatitis B and C. Osteoporosis is more frequent in patients with long duration of liver disease but there is no significant correlation between the aetiology or severity of liver disease and osteoporosis

Study on ST- segment elevation acute myocardial infarction [STEMI] in diabetic and non- diabetic patients

To compare some epidemiological and other parameters between diabetic and non-diabetic subjects admitted with STEMI. Two hundred and forty patients were included in the study, 76 [32%] were diabetic, and 164 [68%] were non-diabetic. Among diabetic patients 11/76 were newly diagnosed. The male to female ratio in diabetic was 1.5:1 [P=0.02], while in non-diabetic it was 5.8:1 [P=0.001]. At age 55-64 years, STEMI was observed in higher [P=0.001] percentage of diabetic than non-diabetic patients. 82% of the patients reached the hospital within six hours of chest pain. 52.5% of patients were smokers, 40% had long-standing dyslipidaemia, 32.5% were obese, 32% were diabetic and 29% had hypertension. Significant [P = 0.000003] percentage of non-diabetic patients were smokers, while of diabetic patients [P = 0.03] were obese. Dyslipidaemia was the stronger risk factor among diabetics, while it ranked number three in non-diabetic patients. The lateral infarction was more common [P =0.01] in diabetics. Anterior and inferior infarction was more common than inferior + right ventricular and lateral infarction in both diabetic and non-diabetic patients. Trop-T level was low in 46% and high in 54% of diabetic patients, while it was negative in 10%, detectable in 3%, low in 39% and high in 48% of non-diabetic patients. The mean level of various enzymes did not show statistical difference between diabetic and non-diabetics including CK [2008 +/- 785; 1045 +/- 356], CK-MB [211 +/- 75; 157 +/- 23] and Trop-T [1.85 +/- 0.28; 1.77 +/- 0.21]. Irrespective of diabetic status, the mean stay of patients in the hospital was 5.99 +/- 1.04 days. Smoking, dyslipidaemia and obesity are strong risk factor for STEMI. Infarction of anterior site is more frequent. Among diabetics, chances of STEMI are almost equal in male and female, while among non-diabetics it is six male to one female

Complications of total laryngectomy

To find out various complications after total laryngectomy, with reference to their presentation, diagnosis, and management. It was a prospective descriptive study. Otolaryngology, Head and Neck Surgery department, Pakistan Institute of Medical Sciences Islamabad, from 1st July 1999 to 31st June 2001. 25 patients undergoing total laryngectomy for proven carcinoma larynx [Ca larynx] were included in this study. Patients were reviewed after surgery and any complication that occurred was recorded. The presentation, diagnosis, and management of these complications are discussed, along with voice rehabilitation after total laryngectomy. There were 23 males and 2 females. Age of patients ranged from 40 - 65 years. Complications included wound infection [06], pharyngocutaneous fistula [03], pharyngeal stenosis [03], and nodal metastasis [02]. Wound infection and pharyngocutaneous fistula are most common complications after total laryngectomy. Preoperative radiotherapy and low postoperative haemoglobin level are important risk factors for development of pharyngocutaneous fistula in total laryngectomy patients. Postoperative radiotherapy to the neck reduces the risk of nodal metastasis after total laryngectomy

Clinical study on the use of nozovent in a tertiary care setting

To assess the effectiveness of the Nozovent device in Pakistani subjects at Aga Khan University Hospital, Karachi and Sir Ganga Ram Hospital, Lahore from 15 January 2001 to 15 January 2002. Sixty males and 40 females were selected by non probability purposive sampling, from OPD of ENT Department, complaining of nasal obstruction due to various reasons, e.g. vasomotor rhinitis, allergic rhinitis, congestion during pregnancy and menstruation, common cold, traumatic nose and nasal valve problem. All patients benefited subjectively but the degree of relief varied in individuals. The Nozovent provides a unique method to relieve nasal obstruction with no side effects

review of pressure sore treated surgically at a plastic surgery unit

Management of pressure sores has always been a problem across the world but especially in our country due to lack of supporting measures. This study looked at the repair of 34 pressure sores over a period of two years at Plastic Surgery Department in Services Hospital and their outcome. A new reusable flap for reconstruction was found to be effective but rehabilitation program was found to be the ultimate decider of the long-term outcome of these pressure sores

Alien hand syndrome

The alien limb sign includes failure to recognize ownership of one's limb when visual cues are removed a feeling that one body part is foreign, personification of the affected body part and autonomous activity which is perceived as outside the voluntary control. A 65-year old man presented with history of progressive slowness of movements rigidity frequent fall and abnormal movements of the left hand which the patient described as involuntary and not under his own control. Examination revealed bizarre movement of left hand with prominent grasp reflex, groping and apparently purposeful but preservative movements. Patient also had supranuclear ophthamoplegia and rigidity which was more marked on the left side. A magnetic resonance imaging scan of brain and CSF examination was normal. The abnormal movements of the left hand were diagnosed as so called "alien hand" sign and overall clinical picture was consistent with diagnosis of corticobasal degeneration

Psychological problems of children in an orphanage

Maternal deprivation and failures of attachment behaviour during early childhood is a stress which precipitates psychosocial problems in later life. Research work particularly by Bowlby and Rutter clearly indicates that maternal deprivation causes later emotional and conduct disorders. In this paper an attempt has been made to describe the extent and nature of mental health problems of residents of an Orphanage in Lahore. The results of this study support the previous research findings that there is an increase in the prevalence of emotional and conduct disorders in this group of children. And it is recommended that recognition of the psychosocial aspects of orphanages should be a concern of the Management Board of such institutions and steps should be taken to provide better services to these deprived children