Phytochemical screening and antibacterial activity of different solvent extracted samples of Arisaema jacquemontii

The current research was carried out to assess the antibacterial activities and phytochemical analysis of the methanol, n-hexane, ethyl acetate, n-butanol soluble fractions and aqueous extracts of the tubers of Arisaema jacquemontii. All the extracts were tested for their antibacterial potential at 1, 2 and 3 mg disc-1 concentrations against 6 bacterial strains through disc diffusion suseptibility assay. The data suggested that different extracts showed varying degree of growth inhibition against the tested microbes. Statistical analysis revealed that n-hexane and ethyl acetate soluble fractions significantly inhibited the growth of all the bacterial strains at the tested concentrations. Moderate activities were recorded for n-butanol and methanolic extracted samples at different concentrations against all the tested strains of bacteria. P. aeruginosa, S. aureus and X. campestris showed resistance to all the tested concentrations of the aqueous extract. B. subtilis and K. pneumoniae were resistant at 1 and 2 mg disc-1 concentrations of the aqueous extract and 3 mg disc-1 of the same extract reduced the growth of the same bacteria. Phytochemical analysis of the different solvent extracted samples suggested the presence or absence of various metabolites including alkaloids, saponins, tannins, sterols, flavonoids, protein, carbohydrates and fats

Obstetrical anal sphincter injury - risk factors and outcome of surgical repair by end-to-end re-approximation technique

Objective: To identify the obstetrical risk factors for anal sphincter injury and to review the outcome of our practice of end-to-end reapproximation technique for its repair

Study Design: A prospective observational study

Place and duration: Obstetrics and Gynaecology Unit-A, Khyber Teaching Hospital, Peshawar, from 1[st] January 2011 to 31[st] December 2013

Methodology: All patients with obstetrical anal sphincter injury [OASI] i.e. third and fourth degree perineal tears, after vaginal delivery were included. Data including age, parity, labour characteristics, types of delivery, fetal weight, degree of tear, any previous repair, follow up and outcome were recorded. Primary or secondary repair according to the case was done by end-to-end reapproximation technique. Post operative care was standardized, antibiotics, laxative and pelvic floor exercises were advised. Follow up was done at 6 and then 12 weeks

Results: Thirty two patient had OASI, n = 23 [71.87%] had third degree and n= 9[29.13%] had fourth degree perineal tear. Mean age was 26.07 + 1 S.D [range 19-40 years] including 16[50%] primipara, 12[37.50%] P2-P3 and 4[12.50%] P4 or more. Spontaneous vaginal delivery [SVD] in 21[65.63%], SVD with episiotomy in 5[15.62%] while Breech 1 and instrumental delivery in 5[15.62%]. The risk factors identified were nulliparity, heavier fetal weight [?3.8kg], instrumental delivery, fetal malposition, extension of episiotomy, induction of labour [IOL], oxytocin use and unattended labour. No risk factor could be identified in 6[18.75% patients, more than one factor was identified in 8 women. Seventeen [53.12%] patients with third degree and n= 9[28.13%] with fourth degree tear had primary repair and 9[28.13%] had secondary repair. At 12 weeks follow up over all n=28[87.75%] women were asymptomatic and continent, 1[3.12%] had faecal urgency, 1[3.12%] continence to flatus on physical exersion, in 2[6.25%] repair was unsuccessful with incontinence to stool and flatus. Minor complication were wound infection 2[6.25%] and dyspariuria in 4[12.50%]

Conclusion: Obstetrical risk factors commonly associated with anal sphincter tear were nulliparity, instrumental deliveries, heavier fetal weight, malpositions, prolong labour and delivery by unskilled birth attendants. Our practice of end-to-end approximation technique for repair anal sphincter tears was associated with good outcome in terms of anal continence at 6-12 weeks

Risk factors of congestive heart failure in patients admitted for coronary artery bypass grafting

Background: Congestive heart failure, has high morbidity and mortality outcomes

Objective: To evaluate the association between the risk factors and congestive heart failure in patients admitted for CABG surgery

Subjects and Methods: This comparative cross sectional study includes 102 consecutive patients aged >50 years, admitted for CABG surgery and were classified as with and without congestive heart failure. They were selected from cardiac surgery department of Punjab Institute of Cardiology, Lahore over a period of 6 months from 1[st] January 2014 to 31[st] June 2014. Pre-operative risk factors were recorded while, the data was analyzed by using SPSS Version 20. P-value < 0.05 was taken as significant

Results: Out of 102 patients, 48 were males and 54 were females. Females were older than males. Risk factors i.e. AF, raised creatinine [>1.4 mg/dl], impaired LV function, renal disease, valvular heart disease [VHD], COPD, smoking and hypertension were found to be comparatively higher in heart failure group than non- HF group. [P<0.05]

Conclusion: CHF in patients admitted for CABG surgery leading to increased morbidity. Male gender, age, hypertension, smoking, renal disease, VHD, raised creatinine [mg/dl], impaired LV function, chronic obstructive pulmonary disease [COPD] and artial fibrillation were independently associated with CHF