Effect of Leaf Extract of Senna alata on Biochemical Indices of Wistar Rats Infected with Trypanosoma brucei brucei

This study was aimed at determining the effect of leaves of Senna alata extract on biochemical indices of Wistar rats infected with Trypanosoma brucei brucei . Phytochemical screening revealed the absence of steroids in all extracts, absence of saponins in chloroform extracts and the presence of free anthraquinones only in chloroform extract. Post - infection treatment of animals stirred the emergence of parasitaemia by Day 3. Only animals receiving 200 mg/kg b.wt. of chloroform extract survived by day 16. A significant (P<0.05) decrease in ALT for groups receiving methanol (400 mg/kg b.wt.), chloroform and aqueous extracts and significant (P<0.05) increase in unconjugated bilir ubin in the group receiving methanol extract (200 mg/kg b.wt.) compared to infected not treated rats. Significant (P<0.05) decrease in potassium concentration in groups receiving methanol and chloroform, and a significant (P<0.05) increase in sodium concen tration in the group receiving 400 mg/kg b.wt. of aqueous extract compared to the infected not treated rats. These results thereby demonstrate the ameliorative potential of Senna alata leaves against T. brucei brucei .

Seroprevalence of Treponema pallidum Infection among Cohorts of Pregnant Women Attending a Selected Hospital at Northern Nigeria

Background: Syphilis is a multifaceted disease with serious implications for the pregnant women and the foetus. Treponema pallidum, the causative agent of syphilis has been a public health challenge for centuries. Sexually transmitted infections (STIs) among pregnant women are wide spread in the developing countries, and constitute a major public health problem in sub-Saharan Africa. Information regarding the prevalence of syphilis in pregnant women is scanty from the north-west zone of Nigeria.Aims:Evaluation of seroprevalence of Treponema palliduminfection among pregnant women attending a selected hospital at Northern Nigeria was carried out, with view to assess the socio-demographic data and predisposing factors of syphilis among the study population.Methods: Exactly 200 pregnant women, who attended antenatal clinic of the selected hospital at Northern Nigeria, from July to September, 2015 were screened for syphilis using syphilis rapid immunochromatographic test for in-vitrodiagnostic technique. Patients’ demographic data and predisposing factors of syphilis were assessed using a structured questionnaire.Results: The result showed that 2.0% of the 200 pregnant women screened were positive. Basedon age, individuals who were less than or equal 20 years had the highest prevalence of 4.1% followed by those who aged 21-30 with the prevalence of 1.1%. Family type and place of the study subjects were significantly associated with the disease (Fisher’s exact test = 0.014 and 0.008 respectively). Therefore associated risk factors were age, family type and place of residence. While, educational status, employment status, gestational age and blood transfusion were not significantly associated with syphilis in the study area. While seroprevalence of 4(5.7%) was recorded in polygamous individual; no positive case was recorded among those practicing monogamy. Urban dwellers were found to have a prevalence rate of 6.6% with no infection detected among the rural dwellers. Conclusion: Theoverall prevalence of syphilis among the study population was 2.0%. The disease is more prevalent among middle aged, rural dwelling and polygamous pregnant women. Hence in a bid to control syphilis infection, both partners should be evaluated and treated. This study has further provided information on the prevalence of Treponema palliduminfection among pregnant women at Northern Nigeria

Solid Pseudopapillary Neoplasm Of The Pancreas In Sub-Saharan Africa: A Case Report And Review Of Literature

Solid pseudopapillary neoplasm of the pancreas is a rare indolent malignant tumor mostly found in young women in the second and third decades of life. Only about 3000 cases have been reported in English literature, with none in the West African region. Here, we report to the best of our knowledge, the first histologically confirmed case of solid pseudopapillary neoplasm of the pancreas in West Africa. A 29-year-old woman with a slow-growing left upper abdominal mass of 10 months. Abdominal ultrasound and computed tomography scans revealed a cystic-solid mass arising from the tail of the pancreas. She underwent surgical excision of the mass, with post-operative histopathology findings in keeping with solid pseudopapillary neoplasm of the pancreas. This case report highlights the importance of improved abdominal imaging, histopathology and the need for increased awareness as a differential diagnosis of an intra-abdominal tumor, especially in young women

Detection of interleukins-6 and 8 in saliva as potential biomarkers of oral pre-malignant lesion and oral carcinoma: a breakthrough in salivary diagnostics in Pakistan

Oral cancer is at rise in our population due to increasing use of areca nut [Betel nut] with or without tobacco. It is the second frequent malignant tumour for both the gender in Pakistan. This non-interventional case control study was carried out with the aim to explore saliva as diagnostic medium for detecting interleukins [IL] 6 and 8 as biomarkers of pre-malignant lesions [PML] and oral carcinoma. Total 105 subjects were recruited and were divided into three groups "A", "B" and "C" each comprising of 35 subjects. Group "A" comprised of cases with strong clinical evidence of oral PML. Group "B" constitute clinical and histologically proven OSCC and group "C" include disease free subjects as controls. Saliva from all the recruited subjects was procured by drooling method and stored at-20[degree sign]C before further process. All the collected samples were centrifuged at 4500 rpm for 15 minutes at 4[degree sign]C. Supernatant fluid was used in ELISA for detection and quantification of IL-6 and IL-8. Data was analysed by using Chi-square test and multivariate analysis was done by non-parametric test. P-value of 0.05 was taken as standard reference. Significant co-relation was found for qualitative salivary detection of IL-6 and IL-8 among the groups [P<0.001 and <0.0001 respectively]. Regarding quantitative salivary concentration of leukotrienes, no significant co-relation was found in levels of IL-6 among the groups while there was significant association of IL-8 levels between the groups [P<0.0001].On post Hoc multiple comparison, significant co-relation was found among oral PML group and controls [P=0.001] and OSCC group and control [P=<0.0001]. In conclusion salivary detection of IL-6 and IL-8 could be used as probable biomarker for early detection of oral PML and OSCC in etiologically distinct population of Pakistan

role of 320 slice CT angiography in predicting vascular trauma

Objective: To determine the accuracy of multidetector CT angiography [MDCT angiography] as initial diagnostic technique in depicting and characterizing post traumatic vascular injuries, looking for additional injuries and confirming the findings with intervention and follow-up

Study Design: Descriptive analytical study

Place and Duration of Study: Department of Radiology, Shifa International Hospital, Islamabad, from June 2010 to October 2013 Methodology: Patients who underwent MDCT angiography for clinically suspected post traumatic vascular injury were included. All MDCT angiographies were performed on 320 slice CT [Aquilion One[TM]] and were reviewed by two independent consultant radiologists. The sites of injury were intracranial, neck and maxillofacial, chest, abdomen and extremities. The presence and characteristics of vascular injuries were confirmed by post-operative findings or digital subtraction angiography [DSA]. Sensitivity and specificity was calculated

Results: The age of the patients ranged from 7 to 90 years with 94% [48] males and 6% [3] females. Blunt trauma was commoner than penetrating trauma. The site of injury in majority was extremities. Majority of patients had post-traumatic pseudoaneurysm formation followed by arterial occlusion, thrombosis, active extravasation, spasm, arteriovenous malformation and combination injuries. Twenty-one [41%] patients were reported as having vascular injury and confirmed by surgery or DSA. Fifteen [29.5%] patients were reported as normal and had no intervention on follow-up. The sensitivity and specificity of MDCT angiography was found as 100% and 88%, NPV of 100%, PPV of 94% and accuracy of 96%

Conclusion: MDCT angiography can be reliably used as an initial diagnostic technique for the evaluation and characterization of post-traumatic vascular injuries

Salivary detection of human Papilloma virus 16 and 18 in pre-malignant and malignant lesions of oral cavity: Is it feasible in Pakistani context of Socio-Cultural Taboos?

To evaluate salivary detection of HPV-16 and 18 would be feasible and informative biomarker for oral pre-malignant and malignant lesion in our population. This non-interventional, case control study was carried out at department of E.N.T, Head and Neck Surgery, Dow University of Health Sciences, Dow Medical College and Civil Hospital Karachi, Pakistan between July 2011 to December 2012. Total of 105 cases were recruited. These were divided in three groups 'A', 'B' and 'C having 35 subjects each. Group'A' constitutes patients having strong clinical evidence of oral pre-malignant lesions [PML]. Group 'B' includes historically proven oral squamous cell carcinoma [OSCC] and Group 'C' comprised disease free subjects as controls. After taking informed consent, relevant clinical history was recorded on institutional approved performa. Saliva from all subjects was procured by standard 'drooling method'. Samples were stored at +4°C and later transferred to Laboratory to store at-20°C before further process. Samples werKfcentrifuged at 4500 rpm for 15 minutes at 4°C. Cell pellets sediments were used for identification of HPV-16 and 18 by real-time PCR method. Data was entered and analysed using SPSS version 16. P-value of 0.05 was taken as standard. In group 'A', HPV-16 was detected in 3 [8.6%] cases while HPV-18 was not detected in any of the subject. In group 'B', HPV-16 was detected in 07 [20%] while HPV-18 was found in 06 [17.1%] cases. Mixed HPV-16 and HPV-18 were found in 02 [5.7%] cases. In group 'C, HPV-16 was detected in 03 [8.6%] while HPV-18 was not detected in any of the subjects. Significant relationship was observed between the groups for HPV-18 detection [P= 0.002] while for HPV-16, no significant association was found [P= 0.245]. HPV infection for the causation of oral cancer cannot be fully established possibly due to small sample size. More over differences in genetic makeup, environment, indulgence in peculiar risk factor habits, sexual practices and difficult evaluation of the acquisition of viral load due to socio-cultural and religious restrictions could be the reason

Molecular diagnosis of oral pre-malignant lesions and oral squamous cell carcinoma in saliva-a breakthrough in Pakistan

To evaluate salivary detection of interleukin 6 and 8 and high risk HPV-16 and 18 are informative biomarkers of Oral Pre-malignant Lesion [PML] and Oral Squamous Cell Carcinoma [OSCC] in our population. July 2011 to December 2012. Total 105 cases were included. The subjects were divided in three groups 'A', 'B' and 'C' having 35 participants each. Group 'A' comprised of patients having strong clinical evidence of oral PML. Group 'B' constitutes histologically proven OSCC and Group 'C' includes disease free subjects as controls. Relevant clinical history was recorded after informed consent on institutional approved performa. Saliva was collected as per standard drooling method'. Samples were stored at +4oC and later transferred to Dow Diagnostic, Research and Reference Laboratory to store it at -20oC before further process. Samples were subjected to centrifugation at 4500 rpm for 15 minutes at 4oC. Supernatant fluid phase was used in ELISA for detection and quantification of IL6 and IL8. . Cell pellets were used for identification of high risk HPV-16 and 18 by real-time PCR. Data was entered and analyzed on SPSS version 16. P-value of 0.05 was taken as standard reference. In group 'A', IL6 was not detected in almost all the subjects except one case. IL8 was detected in 26/35 [74.3%] subjects and not detected in 09 [25.7%] cases. In group 'B', IL6 was detected in 13 [37.1%] cases and in 22 [62.9%] cases, it cannot be detected. IL8 was detected in 33 [94.3%] and it was not detected in 02 [5.7%] subjects. It is observed that IL8 is consistently found raised in group 'A' and 'B'. In group 'C', IL6 was not detected in any of the subject while IL8 was detected in 10[28.6%] cases. Significant association was found for qualitative salivary detection of IL6 and IL8 between the groups [P= < 0.0001 and < 0.0001 respectively]. Regarding quantitative salivary concentration of IL6 and IL8, no significant co-relation was found in salivary levels of IL6 between the groups while there was significant association of salivary IL8 levels between the groups [P= <0.0001]. On post Hoc multiple comparison, significant co-relation was found in IL8 levels between oral PML group and controls [P=0.001] and OSCC group and controls [P= <0.0001]. In group 'A', HPV-16 was detected in salivary samples of 3 [8.6%] cases while HPV-18 was not detected. In group 'B', HPV-16 was detected in the salivary samples of 07 [20%] cases while HPV-18 was detected in 06 [17.1%] cases. Mixed HPV-16 and HPV-18 were found in 02 [5.7%] cases. In group 'C', HPV-16 was detected in 03[8.6%] cases while HPV-18 was not detected in any of the subjects. Significant relationship was observed between the groups for salivary HPV-18 detection [P= 0.002] while for detection of HPV-16, no significant association was found [P= 0.245]. Salivary concentration of IL6 and IL8 in oral PML and oral cancer are useful biomarkers in our population. Detection of HPV infection for the causation of oral cancer cannot be fully established possibly due to small sample size. More over different genetic makeup, environmental and geographic differences, indulgence in peculiar risk factor habits and different sexual practices compared to west due to socio-cultural and religious restrictions could be the reason

Arterio venous fistula experience at a tertiary care hospital in Pakistan

To evaluate the two year patency rate of functioning arteriovenous fistula. This prospective case series study was conducted at Department of Urology, Jinnah Postgraduate Medical Centre, Karachi, from 1[st] January 2009 to 31[st] December, 2010. Patients were chosen for CBRC arteriovenous fistula at wrist and patients undergoing other types of vascular access or secondary fistula formation were excluded. One hundred and eighty two patients underwent arteriovenous fistula formation. The mean +/- SD age was 63 +/- 13 years and there were 102 [56%] males and 80 [44%] females. 12.6% fistulae failed within first month without dialysis. The primary patency rate was 66.5% at three months and 57.7% at six months. Failing arteriovenous fistula was managed by new arteriovenous fistula in our series. 28.6% patients had redo arteriovenous fistula. This study demonstrated a poor outcome for fistulas in diabetic patients. Fifteen out of 23 [65.2%] who failed primarily were diabetics and out of these diabetics 13 [86.7%] failed in first three months. Infection and burst fistulae were found in nine [4.9%], pseudo aneurysm in 3.2%, fever 4.9%, peri-operative failure 0.55% and burst fistulae 3.2%. One-third of radiocephalic fistulas fail within two years. The outcome is worse for women and diabetic patients. This information may be useful in assessing and counseling patients with end-stage renal failure. Arteriovenous fistula is the better and ideal choice for haemodialysis. A Radiocephalic fistula in forearm seems to have better results as comparison to cubital fossa arteriovenous fistula. End to side anastomosis results are better than side to side anastomosis

Delinquency among street children in Karachi: the challenges to police and forensic medicine

Street Children are homeless, isolated and socially deprived children living in streets, parks or shrines. They are without adequate protection.1 These children, therefore, are at high risk because of their homelessness.2 The objective of this work was to analyse prevailing delinquency among street children [SC] in Karachi, and challenges posed by it to police and forensic medicine experts. It was a descriptive study. The study will be conducted on two hundred SC, at Sadder Town, Karachi. A pre-designed questionnaire will be used by the researcher in simple language. Interview will be conducted at Sadder Town, Karachi in the presence of a social worker from Azad Foundation who remains at Jahangir Park with the SC. Simple random sampling technique will be applied. Inclusion criteria will be SC aged between 12 - 17 years, who sleep in street at night. A minimum three years stay on street will be mandatory. Children who visit home or sleep at work place will be excluded. Interview with respondents who willingly offered to cooperate revealed that the delinquent behaviour among SC is on an increase. Calculated mean age was 14.76 +/- 1.47 years. There are 87% SC who are using a variety of substances while 42.2% prefers Glue Sniffing. It is very difficult to survive alone on street, so 88% SC lives in gangs. Among different gangs 82.8% of SC have physical conflicts with each other or with other gangs. The possession of place is the commonest reason in 41% SC for gang conflict. Street children keep some objects which can be used as weapon when needed. Sharp instruments, like blades are carried by 45% SC. Self - inflicted wounds present in 49.2% of cases while the reason for self - inflicted wound in 39% SC is to kill sweet memories

Pulmonary varices - rare cause of haemoptysis

Haemoptysis has a long list of causes, but pulmonary varices are amongst the rare causes. Pulmonary varices are rare abnormalities of pulmonary veins that may exist either as an isolated malformation or in association with pulmonary venous hypertension. This case report describes pulmonary varices as a cause of hemoptysis in an adolescent boy, which was diagnosed on multislice CT and confirmed on angiography

Characteristics and etiology of radicular cyst - a study

Radicular cyst is one of the late sequelae of untreated pulpal necrosis often caused by dental trauma and caries. It develops slowly and gradually but symptomlessly, and involves many adjacent sound teeth endangering their vitality and even prognosis.The objectives of this study were to determine the site, age and sex distribution as well as to know the ratio of trauma to caries in the occurrence of Radicular cyst. Fifty [50] patients were included in study after taking history, clinical examination, radiological findings, aspiration test and biopsy report. 38 cases occurred in maxilla while 12 in mandible with ratio 3.1:1. In maxilla, the offended tooth was anterior in all 38 cases. So the favoured site was maxillary anterior teeth. The peak frequency was in 3rd decade with mean age of 23 years. There was slight male predilection as like other international studies. The ratio of trauma to caries was 4.3:1 in both jaws, 10:1 in maxilla and 1:1 in mandible. The increased ratio of trauma to caries indicates the neglecting attitude of our patients to dental treatment and demands their awareness and education about the untreated dental trauma.This study will help professionals to know the hazards of untreated dental trauma as well as their consequences. It will also help in early diagnosis and management of radicular cyst to reduce its morbidity

Fine needle aspiration cytology: application to children with neck masses

Fine needle aspiration cytology is widely used to screen neck masses in adult population. Our present series of 40 fine needle aspiration cytology performed during January 2001 to December 2002, on 40 children with clinically significant neck masses. These fine needle aspiration cytology were confirmed by subsequent surgical biopsies, or follow up of patient for 18 months. Out of the 40 aspirations performed 32 required no subsequent surgical biopsy whereas those of 8 tumors identified, 6 were malignant. In 4 of these cases, metastatic tumors were diagnosed and appropriate therapy provided. Two false negative and one false positive result were obtained. No delay in treatment occurred because of false negative result and no radical treatment resulted from the false positive diagnosis. The sensitivity was 93.8% and the specificity was 94.4. The usefulness and cost effectiveness of fine needle aspiration is stressed

Septic arthritis of the hip in childern - Aga Khan University Hospital experience in Pakistan

To present clinical, radiological and bacteriological features and short term outcome of septic arthritis of the hip in children. There were 23 male and 16 female children, including 6 neonates and 10 infants with a mean age of 3.9 years. Diagnosis of septic hip was made on clinical grounds, supplemented by X-rays, leukocyte count and the erythrocyte sedimentation rate [ESR]. Thirty nine patients with 40 hips were followed for a mean time period of 76 weeks. All patients had a positive joint aspirate [pus] and underwent surgical decompression alongwith intravenous antibiotic therapy. Symptoms of pain, fever and restricted range of hip motion were common to all patients. The mean leukocyte count was 14,000 and the mean ESR was 63 mm. Cultures of blood and joint aspirate were positive in 9 and 28 patients respectively. Staphylococus Aureus was the commonest organism [14 patients] identified, and only one patient had Hemophilus Influenzae. Seven patients had a mixed osteoarticular infection. Positive clinical response was noted in the mean time period of 8.6 days. In follow-up, four cases developed myositis ossificans and 2 cases showed signs of partial growth plate destruction. Our findings of the absence of H. Influenzae and the presence of a number of gut organisms are different from the previous studies. Duration of symptoms was an important prognostic factor and correlated well with the final outcome. Early surgical decompression was found to be the treatment of choice. A combined osteoarticular infection should be kept in mind in cases which show a poor response after the initial joint debridement

Comparative study of HB-concentration and platelet-count in relation with stress in adults

114-male student of 1st year and 2nd year M.B.B.S [mean age 24 years], were subjected to mental stress of class test examination and the Hb percent and platelet count were analyzed. The results were compared with the results which were taking after resting period given to them. All the participants were healthy and the selection was based on their well being and consent. The mean and standard deviation of differences in between stress and rest observations for both, the Hb percent and platelet count were calculated. The results were evaluated for level of significance by 95 percent confidence interval and student's paired t-test. There was a significant increase in Hb percent [P<0.001] with 2.08 percent increment during stress and in platelet count [P<0.001] with 17.15 percent increment at the time of mental stress. Our findings were in agreement with most of workers but contradictory to some others who were of the view that the increments were due to the stress induced catecholamine only and were not depending on the type and nature of stress

Treatment of Tibial Diaphyseal Fractures with Closed Flexible Intramedullary Ender Nails: 39 Fractures followed for a Period of Two to Seven Years

OBJECTIVE: To assess the efficacy of flexible intramedullary Ender nails for the treatment of tibial diaphyseal. MATERIALS AND METHODS: This is a retrospective review of patients treated with the Ender Nail for both open and closed tibial shaft fractures. Between January 1989 and December 1994, 43 fractures were treated with these nails. The configuration of each fracture was determined using the Orthopedic Trauma Association classification and the extent of soft tissue damage was assessed using the Gustilo and Anderson's classification. Four patients were excluded from the study due to inadequate follow-up. There were 27 closed and 12 open fractures. The average time to union in 34 out of 39 fractures was 17 weeks. Delayed union and malunion occurred in two patients each and superficial wound infection in 1 patient. Nonunion occurred in 5 fractures that were all located in the distal 1/3 of the tibial diaphysis. We attribute this high rate of non-union to a poor rotational control on the distal fragment by these nails. CONCLUSIONS: The Ender nails provide effective fixation for the OTA stable class of tibial fractures, where they produce good axial and rotational stability by virtue of their three-point fixation. Rotational and angular stability should be improved by a supplementary cast immobilization for fractures with unstable configuration and those located in the distal third of the diaphysis

Variation profile of urea and uric acid in normal and psoriatic subjects

Nowadays, psoriasis is wide spread all over the world and in our country, the rate of this disease is also increasing. There are certain biochemical parameters which vary during this disease indicating the severity, urea and uric acid are one of them. In present study urea and uric acid was determined of total [158] samples which comprises normal blood samples and psoriasis patient blood samples. It was observed that the level of urea and uric acid increased in severe psoriasis condition