Association of family history of cardiometabolic diseases (CMDs) and individual health behaviours: Analysis of CARRS study from South Asia

Objectives: Family history is considered as an important predictor of cardiovascular diseases (CVDs) and diabetes. Available research findings suggest that family history of chronic diseases is associated with perceived risk of disease and adoption of healthy behaviours. We examined the association between family history of cardio-metabolic diseases (CMDs) and healthy behaviours among adults without selfreported CMDs. Methods: Cross-sectional data of 12,484 adults, without self-reported CMDs, from the baseline survey of Centre for cArdiometabolic Risk Reduction in South-Asia (CARRS) cohort study were analysed. Results: Family history was positively associated with non-smoking and high fruits & vegetables consumption in the age group of 45e64 years and moderate to high physical activity in the age group _x0001_65 years after adjusting for sex, education, wealth index, city and body mass index. Conclusions: Understanding perceived risks and cultural or psychological factors related to family history through ethnographic studies may deepen understanding of these associations.

Chromatographic method development and validation for the determination of valsartan in biological fluid

A swift, precise and simple HPLC bioanalytical technique with UV detection was established and validated for quantitative estimation of valsartan in human plasma. The analyte was separated from plasma by protein precipitation with acetonitrile and chromatographically separated on Zorbax SB-C18 [5 micro m, 4.6mm x 15cm] column. The solvent mixture system consisting of acetonitrile, water and glacial acetic acid [40:59:1 v/v], was pumped using isocratic mode at 1mL/min flow rate. Samples' detection of drug was made spectrophotometrically at a wavelength of 264nm. The analyte response was instituted to be linear from 0.06 to 8 micro g/mL with a regression value of 0.999. The accuracy of the proposed method was ranged between 97.2-100.3% with 5% RSD. The analytical recovery [>95%] was consistently observed and satisfactory sample stability was also found at different environmental conditions. In conclusion the reported bio-analytical method is easy and robust that was successfully utilized in estimation of valsartan in a pharmacokinetic study

Comparison of rubber B and ligation versus injection sclerotherapy in second degree haemorrhoids

The objective of this study was to compare the efficacy of rubber band ligation versus injection scierotherapy in second degree haemorrhoids. This randomized control study has been conducted at Surgical O.P.D Nishtar Hospital Multan from 3rd April 2008 to 3[rd] October 2008. The study included 70 patients divided randomly in two equal groups. Patients in group A were subjected to injection sclerotherapy while patients in group B were treated with rubber band ligation. The patients were followed up at two weeks after the treatment and history regarding bleeding and pain was taken and proctoscopy was done to see pile core sclerosis. No patient was below 20 years of age in each category. Males were affected more than females. Only 31.43% of patients complained of mild pain after RBL while 60% of the patients had no pain at all. 91.43% and 88.57% of patients were free from the cardinal symptoms of bleeding and prolapse respectively, after RBL, at the end of 2 weeks of follow up 62.86% and 65.71% of patients were free from the cardinal symptoms of bleeding and prolapse while 34.29% of patients complained of mild pain after injection scierotherapy at 2 weeks. Rubber band ligation showed better results and good efficacy as compared to injection scierotherapy and should be considered as a procedure of choice for outpatient treatment of second degree haemorrhoids

Criteria for Early Laparotomy in abdominal stab wound

Patients with an abdominal stab wound presenting with shock, peritonitis or eviscerarion are usually subjected to early laparotomy, although very few studies have been done to validate the criteria. To validate that early laparotomy for stab wounds is compulsory or other diagnostic methods may be helpful to prevent unnecessary laparotomy in certain cases. The study was carried out in surgical unit-1, Nishtar Hospital, Multan during the period from January 2003 to June 2008. A total of 110 patients with stab wounds of the anterior abdomen, flank or lower chest were evaluated for their accuracy in predicting the presence of significant abdominal organ injury. Overall, 47 patients had a significant abdominal injury [42.7%]. The signs of peritoneal penetration including omental evisceration, air under the diaphragm or free fluid in the abdomen were not the independent predictors of significant injury. Signs of major internal haemorrhage or generalized peritonitis are reliable criteria by themselves for early laparotomy. Peritoneal penetration is a poor indicator of significant organ injury and warrants direct organ specific evaluation, such as computed tomography or laproscopy, to identify, patients who can safely be treated without operation

[Semiquantitative RT-PCR analysis to assess the expression levels of iNOS in chicken macrophages]

iNOS is inducible by a variety of factors related to inflammation and referred to as inducible NOS[iNOS]. It is regulated at the level of gene expression; once expressed, it produces NO at a high rate. iNOS gene-expression profiling is an important tool in understanding molecular markers of the responses of cells and tissues to external factors. In this article a semiquantitative reverse transcription-polymerase chain reaction [RT-PCR] protocol was optimized to extract RNA [ribonucleic acid] from chicken spleen and to measure the expression levels of iNOS mRNAs from each sample. Detailed procedure was described for the analysis of iNOS levels. beta-actin was used as an internal control to normalize for sample to sample variations in total RNA amounts and for reaction efficiency. Co-amplification of the iNOS gene with housekeeping gene [beta-actin] provides a quantitative result. Changes in gene expression level may be monitored, while avoiding sample-to-sample loading variation

Frequency of pulmonary fibrosis in patients with cirrhosis of liver

Background: Cirrhosis of liver and pulmonary fibrosis both are chronic inflammatory disorders. Mediators of chronic inflammation include both cytokines and interleukins. The mediators produced during process of fibrosis in liver reach pulmonary circulation which comes first during the pathway; so these mediators should lead to fibrosis in lungs as well

Material and Methods: 55 patients of age range 16 to 80 year, both males and females having established cirrhosis of liver on ultrasonography, regardless of etiology, visiting the outpatient and inpatient departments for treatment of liver disease were selected. High Resolution Computerized Tomography [HRCT] Scan of chest was performed on each patient to look for pulmonary fibrosis

Results: Out of 55 patients 27 [49%]were found to have pulmonary fibrosis on HRCT

Conclusion: Cirrhosis of liver is associated with pulmonary fibrosis in up to 50% of the patients

Comparison of lidocaine vs lidocaine + ketorolac in intravenous regional anaesthesia [bier's block]

To compare the duration of anaesthesia and degree of analgesia during intravenous regional anaesthesia using Lidocaine alone and Lidocaine with Ketorolac. An international quasi experimental study. This study was carried out in Nishtar Hospital Multan from 01/01/2006 to 30/06/2006 [6 Months]. Results: Patients were divided into two groups A and B. In group A injection Lidocaine 0.5% 40ml was given whereas in group B injection Ketorolac 30mg was add to Lidocaine 0.5% 40ml. The degree of anaesthesia and duration of analgesia were compared in both groups. Haemodynamics were also recorded to see any systemic effects of drugs. We conclude that 30mg Ketorolac added to Lidocaine in IVRA increases degree of anaesthesia and also provide prolonged postop analgesia

Difficult ventilation in a patient after Endotracheal intubation: an unusual manufacturing defect in E.T.T. connecter

Airway resistance depends upon the diameter of endotracheal tube [E.T.T] and other respiratory organs. Actually resistance to flow through a tube increases up to sixteen times if diameter is reduced to half of the original size. Disposable E.T.T which are currently used in anaesthesia practice are made up of P.V.0 with a connecter which is fitted on proximal end of endotracheal tube and proximal end of connector is attached with breathing circuit. Usually the internal diameter of connector should be equal to internal diameter of endotracheal tube. In the market, tubes of different manufacturers and of different sizes are available for all age groups. In developing countries like Pakistan, hospital administration usually purchases the endotracheal tubes and other equipments which are relatively cheaper because of lack of funds. Here we present a case where there was a manufacturing defect in E.T.T connector with a very narrow internal diameter that was causing severe respiratory obstruction in a child undergoing laparotomy. We conclude that the anaesthetists must keep in their mind the possibility of E.T.T connector manufacturing defect if they face problem of increased airway resistance in an intubated patient after excluding other possibilities of high airway resistance

Efficacy of 1% hydrocortisone cream in lichen simplex chronicus

Topical cortlcosteroids are used in different skin conditions. The objective of this study is to assess the efficacy of hydrocortisone in treatment of lichen simplex chronicus, which Is ignored in our population. Forty male and forty female patients suffering from lichen simplex chronicus affecting different parts of the body as nape of the neck, arms, back of the legs and ankle were advised to apply hydrocortisone cream three times a day for four weeks. They were followed up weekly for four weeks. Pruritus and lichenification were scored at 4-grade scale i.e. none, slight, moderate and severe at base line and on each follow up visit. Significant improvement in pruritus was noticed in all groups except Group A2 the results were non significant. Regarding lichenification significant results were observed only in three group [A2, B1, B2] others remained non significant. Assessment shows that hydro-cortisone cream is effective antipruritic and has mostly nonsignificant effect on lichenification

Comparison of risk factors for diabetes in children of different socioeconomic status

To compare the risk factors for diabetes in children of two different socioeconomic status. A cross-sectional analytical study. Visits to one government [low income] and two private [middle income] schools of Karachi in 1999 and 2000. Patients and A total of 260 children; 157 children [mean age 12.10 +/- 4 years] from low-income group and 103 children [mean age 10.6 +/- 0.9 years] from middle-income group were surveyed. Data of physical fitness score [PFS] and BMI was calculated. Dietary records were taken by 24 hours self-reported diet recall charts of two weekdays. Knowledge about health was obtained by a questionnaire given to children and mothers. A significant difference was found in the mean age of low-income and middle-income groups [p-value < 0.001]. Significant association was seen in low-income group compared to middle-income group on the basis of TV viewing [p-value = 0.04]. BMI [p-value = 0.011] and positive family history of diabetes [p-value < 0.001]. Forty-seven percent [n=74] of children from low-income group while 51% [n=53] of middle-income group had poor knowledge about health. The children in both the groups also consumed inadequate amount of calories, the diet being poor in fruit, vegetables and milk and high in the fat content. Although children in both the groups had increased risk factors for diabetes the difference between the two socioeconomic groups was significant in terms of middle-income children having more risk. Thus, changes in lifestyle and behaviour including diet is needed in this high risk group to prevent future generations from developing diabetes