Investigation of Cs-137 in the environmental soil segments of the Peshawar and Nowshera districts of Khyber Pakhtunkhwa, Pakistan

Background: Radioactive contamination in soil arises due to various activities of human being, such as nuclear energy generation, use of radioisotopes in industrial applications, science, technology, medicine and release of radiation in nuclear weapon tests

Materials and Methods: The two districts [Peshawar and Nowshera] of Khyber Pakhtunkhwa, Pakistan were selected for the study of anthropogenic Cs-137 assessment. A total of 102 soil samples were collected from different locations of these two districts of Khyber Pakhtunkhwa

Results: The activity concentration of Cs-137 was determined by gamma ray spectrometry using a high purity germanium detector coupled with a PC. The highest values for Peshawar and Nowshera found were 44.1+/- 4.6 Bq/kg and 27.9 +/- 4.3 Bq/kg, respectively

Conclusion: The presence of Cs-137 shows that the areas under study have gained some fallout, however, the activity concentrations of Cs-137 found in the surveyed area were nominal and do not pose any potential health hazard to human beings?

Detection and identification of Malassezia species in domestic animals and aquatic birds by PCR-RFLP

The present study aimed at detection and species-level identification of the Malassezia yeasts in domestic animals and aquatic birds by polymerase chain reaction-restriction fragment length polymorphism [PCR-RFLP]. Samples were collected using tape strips and swabs from 471 animals including 97 horses, 102 cattle, 105 sheep, 20 camels, 60 dogs, 30 cats, 1 hamster, 1 squirrel, 50 aquatic birds and 5 turkeys. Tape-strip samples were examined by direct microscopy. All samples were inoculated on modified Leeming and Notman agar medium. DNA extracted from the yeast colonies was amplified by PCR using primers specific for 26S rDNA. RFLP of the PCR products was performed using Hin6I enzyme, and PCR and RFLP products were visualized by agarose gel electrophoresis. Malassezia yeasts were detected at the following frequencies: 15.46% in horses, 12.74% in cattle, 12.38% in sheep, 28.33% in dogs, 26.66% in cats and 26% in aquatic birds. Eighty colonies of 6 species were isolated: Malassezia globosa 41.25%, Malassezia furfur 22.5%, Malassezia restricta 15%, Malassezia sympodialis 15%, Malassezia pachydermatis 5% and Malassezia slooffiae 1.25%. Therefore different lipophilic Malassezia species are found in a wide diversity of animals and aquatic birds. PCR-RFLP is a suitable technique for identification of different Malassezia species

Assessment of total phenolic content and antioxidant potential of methanol extract of Peltophorum pterocarpum [DC.] Backer ex K Heyne

Plants are rich in a variety of chemical compounds. Many are secondary metabolites including aromatic substances most of them are phenols or their oxygen substituted derivatives. Medicinal plants are also rich in antioxidant constituents such as phenols, tocopherols, ascorbic acid, carotenoids, and flavonoids etc. They are found to acquire free radical scavenging activity and used worldwide for the treatment of various immune system dependent diseases. Peltophorum pterocarpum [DC] Backer ex K. Heyne [Caesalpiniaceae] is a beautiful ornamental tree, widely grown in tropical regions and its parts are used in traditional medicine as an effective therapeutic agent. Fresh pods of Peltophorum pterocarpum was evaluated for its antioxidant potential by using various methods including DPPH, superoxide anion, nitric oxide scavenging, and metal chelating activity. TPC via Folin-Ciocalteau's reagent and anti haemolytic activity red blood cells respectively have also been measured. The methanol extract of pods of Peltophorum pterocarpum was found to possess the significant amount 439.21 +/- 0.17 mg GAE [gallic acid equivalents] / g of TPC. The antioxidant potential of pods extract at mature stage showed potent activity and measured as, free radical scavenging activity 73.29 +/- 0.81%, superoxide anion scavenging activity 89.03 +/- 1.07%, nitric oxide scavenging activity 84.25 +/- 1.18%, and metal chelating activity 64.12 +/- 0.11%. The extract also showed potent anti haemolytic activity 79.09 +/- 75%. Peltophorum pterocarpum exhibited strong but varying level of antioxidant and anti haemolytic activity in various methods along with total phenolic contents

Neovascularization in herniated lumbar disc: a histological study

Inter-vertebral disc is the largest avascular structure in human body, which is primarily a load bearing and stabilizing unit of the human spine. Degenerative disorders and disc herniation causes proliferation or in growth of new blood vessels in this structure. Lumbar disc herniated tissues were studied microscopically in comparison with the cadaveric lumbar disc tissue, to evaluate the changes particularly the formation of new blood vessels. It was a case control study in which 45 lumbar herniated disc tissues [L[4] - L[5] and L[5] - S[1]] and 45 dissected, fresh cadaveric disc tissues of same level and almost of same age groups were collected and in reference to age were divided into groups. Both sets of tissues were processed, sectioned and stained with Hemotoxyllin / Eosin, to observe the architecture of annuli fibrosis and nuclei pulposus parts of disc and the micro-vessels under light microscope. Cadaveric discs, group A, B and C compared with herniated discs A[1], B[1] and C[1], Annuli fibrosi in herniated discs [A[1], B[1], and C[1]] showed significant reduction of cells, disorganized lamellar pattern of collagen, formation of cysts, clefts and numerous new micro-vessels as compared to fresh cadaveric disc tissues [A, B and C]. Disc degeneration and herniation results in the formation of micro-vessels which may not only serve as source of nutrients but also contribute in the healing process of discal tears

Management of Acute Asthma in children using metered dose inhaler and small volume nebulizer

To determine whether the administration of 32 - agonist by Metered Dose inhaler [MDI] with accessory device [AD] is a as effective as the administration of 32 - agonist by small volume nebulizers [SVN] for the treatment of acute asthma. A cross sectional study was conducted at Emergency Room [ER] of National Institute of Child Health [NICH], Karachi, between October 2000 to March 2001. This study included 150 children, 6 months and older with a history of wheeze and presenting with an acute asthma exacerbation. Children were categorized into mild, moderate and severe asthma according to medical scoring system. Children were assigned randomly into group A and B to receive standard dose of 32 - agonist [salbutamol] by MDI/AD [group A] or SVN [group B]. Baseline : characteristics and asthma severity were recorded. All variables [dyspnoea, use of accessory muscles, cyanosis, respiratory rate, heart rate, blood pressure, oxygen saturation, pulsus paradoxus, and wheeze] and Peak Expiratory Flow Rate [PEFR] in children 5 years and older, were determined at pre and post inhalation therapy. Both groups did not differ in demographic characteristics. There were no significant differences in outcome measures. In children treated with MDI/ADs and SVNs. PEFR increased significantly in both the groups after completion of treatment, but PEFR was not statistically significant when compared in between groups. The data suggested that MDI/AD is an effective alternative to nebulizer for the treatment of children with acute asthma exacerbation in the ER

Ultrasonographic diagnosis of intussusception in children

To asses the role of ultrasonography in the diagnosis of intussusception in children. Design: Retrospective review of medical records of the patients presenting with a tentative diagnosis of intussusception. Setting: Paediatric Surgical Units at Queen Mary's Hospital for Children, London and Chelsea and Westminster Hospital, London, UK. Subjects: Children admitted with a tentative clinical diagnosis of intussusception. Main Outcome Measures: The validity of ultrasound scan in confirming or refuting the diagnosis of intussusception. Ultrasound scan was employed in 57 children suspected to have an intussusception. It confirmed the diagnosis in 43 patients, in 39 of whom pneumatic reduction was attempted that successfully reduced intussusception in 34 [87%]. The diagnosis was refuted in 1 4 children, thus obviating the need for any further intervention. No false-positive or false-negative result was observed in this series. This study confirms that ultrasound is a safe, sensitive and specific investigation that may be used as on initial screening procedure, to confirm or refute the diagnosis, in patients in whom intussusception is suspected

Infantile hypertrophic pyloric stenosis the Changing patterns of serum biochemical derangements.

To observe serum electrolyte and acid-base status in infants with hypertrophic pyloric stenosis and identify various factors affecting the magnitude of these biochemical derangements. Design: Retrospective study of medical records of 57 patients with infantile hypertrophic pyloric stenosis [IHPS] admitted during 1992-1994. Setting: The Regional Paediatric Surgical Unit at Chelsea and Westminster Hospital, London, UK. Main outcome measures: Serum electrolytes and acid-base derangements. The degree of alkalosis was directly proportional to the duration of illness and delay in surgical referral. Thirty-seven out of forty patients who were referred for surgery within the first week of their illness were found to have entirely normal electrolyte and acid-base status and required a minimum period of preoperative preparation. The classical "hypochloraemic alkalosis" was observed in the remaining patients, majority of whom presented after first week of their illness. A high index of suspicion of IHPS in a vomiting baby, prompt diagnosis with the help of modern imaging facilities, where indicated, and early referral to paediatric surgical unit is highly recommended. This practice not only reduced the degree of biochemical derangements and associated morbidity but also shortens the hospital stay

Experience with pneumatic reduction of intussusception in children

Intussusception is a frequent cause of intestinal obstruction in infants. The majority of infants who are diagnosed at an early stage and referred to a paediatric surgical unit before the development of an advanced intestinal obstruction are amenable to non-operative reduction of intussusception. Pneumatic enema reduction was employed in 39 infants that successfully reduced intussusception in 34 [87%] of them. No complication resulted from the procedure. One patient developed recurrent intussusception after six months that was again successfully reduced by pneumatic enema. Pneumatic enema was found to be a safe clean, rapid and effective mode of non-operative reduction of intussusception

Congenital hydrocephalus

Hydrocephalus results from an imbalance between the production and absorption of cerebrospinal fluid It is a common major malformation with a multifactorial aetiology. Arnold-Chiari hindbrain deformity and aqueductal stenosis are frequent underlying problems leading to congenital hydrocephalus. It is associated with deleterious long-term effects and high recurrence risk. Prompt diagnosis, adequate treatment and proper genetic counselling remain the key to successful management of this problem in children

Midgut malrotation in children: experience with 33 cases

Midgut marlrotation [MM] typically presents with bilious vomiting with or without abdominal distension. However there is a wide spectrum of associated clinical features that may on occasion lead to a delayed or erroneous diagnosis. In this retrospective study medical records of 33 children with MM were reviewed. Seventeen patients [52%] presented in the neonatal period, seven [21%] in infancy and nine [27%] after the first year of life. Seventy percent of patients presented with bilious vomiting. Although more common in neonates, acute volvulus occurs in all age groups. In patients presenting beyond the neonatal period the features of chronic/intermittent volvulus were more evident. Upper gastrointestinal contrast studies and ultrasound scan were the most commonly used investigations and were almost equally reliable. Awareness of unusual presentations in infants and older children and a high index of suspicion is recommended to avoid delayed diagnosis and surgical referral

Post-operative feeding regimen after pyloromyotomy for infantile hypertrophic pyloric stenosis

Vomiting is the most common post-operative problem and main determinant of the length of hospital stay after pyloromyotomy for infantile hypertrophic pyloric stenosis. The optimal post-operative feeding regimen, to reduce the incidence and severity of vomiting and the length of post-operative hospital stay, has always been a subject of debate. We review, our experience with three types of delayed post-operative feeding regimens employed in 71 babies. These regimens included immediate resumption of normal feeding, an initial 5% dextrose food followed by normal feeding and gradual graded feeding. An immediate resumption of full-strength normal feeds, 12-24 hours post-operatively was found to be associated with shortest hospital stay without any significant increase in the incidence of vomiting

mitrofanoff procedure for uninary incontinence in children

A continent urinary diversion using the Mitrofanoff principle was constructed in 16 children who were incontinent because of severe bladder/urethra] dysfunction secondary to spins bifida [12 patients], exstophy/epispadias complex [3 patients] and limbo-sacral agencies [one patient]. The procedure was combined with bladder augmentation in all patients except for one in whom an autocystoplasty was carried out. The continent conduit was constructed by using the vermiform appendix in 12 patients and the distal ureter in 4 patients. Follow-up period ranged between six months to three years. The capacity of neobladder was good in all patients. All patients were able to catheterise the stoma themselves successfully. Full continence was achieved in 14 patients while the remaining 2 patients had some degree of urinary leakage per urethra. The renal functions remained stable in all patients. We believe that the Mitrofanoff procedure combined with bladder augmentation is the procedure of choice 10 treat refractory urinary incontinence in selected children with bladder/urethral failure

Use of subcuticular absorble sutres in paediatric cases of complicated appendicitis

Modern surgical practice and use of appropriate antimicrobial therapy have rendered earlier methods of wound care in complicated appendicitis unnecessary. We performed primary wound closure with absorbable subcuticular stitches in 51 children with complicated appendicitis. The wound healed nicely in all patients except three who developed infection that was easily managed by simple drainage and did not lead to any major complication. The use of subcuticular absorbable stitches obviates the necessity of traumatic daily dressing changes, leaves an excellent scar and decreases hospital stay and cost