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Objectives: The objectives were to find out the sociodemographic characteristics, comorbidities, types of CP, level of GMFCS and to determine the association between GMFCS with age, gender, types of CP and topographic distribution among children with cerebral palsy. Methods and Materials: A retrospectives study was done in children with cerebral palsy. Total 384 participants were included in this study. The study setting was Paediatric Department, Centre for the Rehabilitation of the Paralysed (CRP), Savar, Dhaka, Bangladesh. The samples were collected through convenient sampling. The Chi-Square was used to find out the association between GMFCS with age, gender, types of CP and others. Results: Males were affected than female among all participants. The majority participants came from rural area. The children were more in 2 to 4-year age band in GMFCS. The majority participants (81%) had visual problem, 11% hearing and 31% had convulsion. The common levels were II and III. The age bands, topographic classification was associated with GMFCS (p<0.05) but gender and types of CP were not statistically associated (p>0.05). Conclusion: The Gross Motor Function Classification System (GMFCS) has become an important tool to describe motor function in children with Cerebral Palsy (CP).
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Objectives: The study aimed at comparing the therapeuticefficacy of Terbinafine and Itraconazole in terms of clinical curein the treatment of Fluconazole resistant Tinea corporis andTinea cruris.Materials and Methods: A clinical trial with 154 patients’having Tinea corporis and Tinea cruris was performed. All thepatients were treated with fluconazole. The resistant patientswere randomly divided into two groups. The first group wastreated with Terbinafine 250mg daily for 4 weeks, whereassecond group was treated by Itraconazole for 4 weeks. Theparticipants were followed up till the end of treatment and onemonth after treatment.Results: At the end of the trial, terbinafine group developed78.84% clinical response, while Itraconazole treated groupdeveloped only 39.13%.Conclusion: Based on the marked observed difference, it maybe concluded that Terbinafine is more effective in treatingfluconazole resistant Tinea corporis and Tinea cruris.
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Collision tumor is a phenomenon in which two histologically different tumors exist as distinct lesions within the same organ. Occurrence of two different, synchronous, and ipsilateral renal tumors is rare. We present a case of two synchronous tumors of kidney comprising of clear cell renal cell carcinoma [CCRCC] and chromophobe renal cell carcinoma [CRCC]. Grossly, two separate tumor nodules were identified with unremarkable intervening area. Microscopic examination from both tumor nodules revealed two different epithelial malignancies. It is prognostically significant as prognosis in such cases is determined by the more aggressive of the two tumors. In this case, CCRCC is more aggressive with a 5-year survival rate of 50-60 % as compared to CRCC with a 5-year survival rate of 80-90%
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Malignant triton tumor [MTT] is a tumor arising from Schwann cells with divergent rhabdomyoblastic differentiation.It is a relatively rare and aggressive variant of malignant peripheral nerve sheath tumor [MPNST]. We present a case of a 33 years old male with thigh swelling. Surgical excision was done followed by histopathological and immunohistochemical [IHC] workup which revealed a tumor showing two types of cell populations including pleomorphic spindle cells and large cells with pleomorphic eccentric nuclei. Spindle cells showed positivity for S-100 IHC stain confirming their neural origin while large cells with eccentric nuclei showed positivity for desmin and myogenin IHC stains confirming their rhabdomyoblastic origin. Hence, the diagnosis of MTT was made. A 5 years survival rate for MTT is 5-15% compared to 50-60% for MPNST. Considering it is a rare entity with aggressive clinical behavior and poor prognosis, correct diagnosis is essential that can be achieved by careful histological and IHC evaluation
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Background: Prostate cancer incidence is rising leading to a major health problem globally. Infectious complications in TRUS guided prostate biopsy are very common without antibiotic prophylaxis
Objective: To compare the effect of single dose and three day ciprofloxacin prophylaxis regimen for prevention of urinary tract infection after prostatic biopsy
Methodology: This randomized controlled trial involved 130 patients with Prostate cancer which were randomly allocated into 2 groups. Group-A received two ciprofloxacin 500 mg tablets stat while Group-B received 3 days has of ciprofloxacin treatment. Patients were followed up to 5 days to observe any symptoms of UTI. Written informed consent was taken from all the patients. The data was entered and analyzed using SPSS version 19
Results: The mean age of the patients was 56.84 +/- 7.28 years. The mean age of the patients in Group-A was 56.44 +/- 7.10 years while in Group-B it was 57.23 +/- 7.50 years. However, there was no statistically significant difference between groups in terms of age. On follow up at 5 days, 11 patients has UTI. The rate of presence of UTI was similar across different age groups and treatment regimens. Treatment with one-day antibiotic prophylaxis resulted in UTI in 6[9,2%] associated with in comparison to three days' antibiotic treatment, where 5 [7.6%] has UTI. [P=0.64]
Conclusion: The incidence of UTI with one-day antibiotic prophylaxis with ciprofloxacin was comparable to three antibiotic treatments in patients who are candidates for TRUS guided biopsy
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Background: Hypospadias is a congenital abnormality characterized by opening of external urethral meatus on ventral aspect of the penis with an overall incidence of 1:300. Different treatment modalities have been employed in the treatment of distal penile hypospadias with varying degrees of success and complications. A number of studies have compared Mathieu and Snodgrass Techniques but the existing evidence is doubtful owing to small sample size and great variation in their results
Objective: To compare the outcome of Mathieu repair with that of tubularized incised Plate Urethroplasty [Snodgrass] in distal penile hypospadias
Methodology: 90 patients meeting the inclusion and exclusion criteria's were selected and divided into two equal groups randomly using lottery method. Group-A was treated by Mathieu technique and Group-B underwent Snodgrass repair. Operative time was noted in minutes from the start of procedure till the end. Patients were followed post-operatively at 15[th] day, 1 Month and 2 Months and functional recovery and complications were evaluated
Results: The age of the patient ranged from 1 to 25 years in both groups with mean age of 6.67+/-5.74 years in Group-A and 6.65+/-6.06 years in Group-B [p=0.982]. Snodgrass was better in terms of mean operative time [67.37+/-8.85 minutes versus 87.86+/-8.22; p=0.00] as compared to Mathieu technique. The functional outcome in terms of meatal location at tip was better in Snodgrass [93.7% versus 80.2%; p=0.003] with a lower fistula rate [5.4% versus 21.6%; p=0.00] as compared to Mathieu technique
Conclusion: Tubularized Incised Plate Urethroplasty [Snodgrass] is better than Mathieu technique for the treatment of distal penile hypospadias in terms of operative time, success and complication rate
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Foot-and-mouth disease virus is a positive stand RNA virus that causes an acute vesicular disease of bovid wild and domesticated ruminants. Foot-and-mouth disease virus (FMDV) comprises of 7 antigenically distinct serotypes (Type O, A, Asia 1, C and SAT1-3) that do not provide cross-protection against one another. Foot-and-mouth disease (FMD) is a pandemic disease, accounting for a global loss of 6.5-21 billion US$ per annum. The present investigation aimed at the comparison of FMDV in Bangladesh with that of circulatory types in Asian continent. Categorization, estimation and demography of FMD in Asia continent are analyzed. Comparative genome and phylogeography of the FMDV in Asia is discussed. Three serotypes of FMDV are circulating in Asian territory, including mainland Southeast Asia, South Asia and Middle East with predominance of type O, whereas Serotype A and Asia1 are found to be confined to certain geographical regions. Cattle are most susceptible to FMD, whereas Pig serves as mixing vessel that may boost the emergence and re-emergence episode of several lineages/genotypes. Whole Genome and phylogeography analysis revealed that the transboundary movement of FMDVs are responsible for spreading of this disease in Asian regions. In 2013-2015, Saudi Arabia experienced the emergence of Ind-2001 lineage under Middle East South Asia (ME-SA) topotype of FMDV type O and Genotype VII of FMDV type A, which is normally endemic in the Indian subcontinent. Intrusion of type SAT1-3 in Arabian Peninsula occurred due to transboundary animal movement from FMDV enzootic African countries. Transboundary movement of FMDV, inappropriate vaccination and inadequate awareness are the main reasons for FMD spread in most of the Asian Countries.
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The objective of this study was to determine the prevalence of torus palatinus and mandibularis in relation to age and gender among 322 subjects seen at Hill House Kindergarden Students, Mashrek International School and our clinic. Out of the 322 subjects examined only 30[9.3./.] had either TP, TM or both
Subject(s)
Humans , Male , Female , Mandible/abnormalities , Palate, Hard/abnormalities , Prevalence , Child , AdultABSTRACT
Background: Calculus acute renal failure is a urological emergency. Prompt treatment in the form of either temporary urinary diversion, or definite treatment can save the patients from developing chronic renal failure
Objectives: To compare the management of patients with obstructive uropathy with and without percutaneous nephrostomy
Patients and methods: A prospective interventional study conducted at SIMS/ SZMC, 2007-10. Twenty patients of ureteric calculus presenting with acute renal failure were included in our study. Patients were divided into two groups. Age, sex, duration of anuria and biochemical profile like serum creatinine and serum potassium levels were noted in both groups. In group A, a preliminary percutaneous nephrostomy tube was placed as a temporary diversion. On normalization of clinical and biochemical profile, definite treatment in the form of ureterorenoscopy/ lithoclast was performed. In group B, all the patients underwent definite treatment in the form of ureterorenoscopy/ lithoclast without preliminary temporary urinary diversion. The duration of normalization of renal function test, efficacy of URS lithoclast, hospital stay and cost effectiveness in both the groups were noted
Results: A total of 20 patients with 75% male and 25% female were included. Duration of anuria in group A was one day in 1 patients and 2-3 days in 6 patients. The duration of anuria in group B was 102 days in 8 patients. Mean normalization of serum creatinine level in group A was 5.9 days while it was 5.2 days in group B. The mean hospital stay was 10 days in group A while it was 4.7 days in group B. The mean cost of treatment in group A was Rs. 12300 and Rs. 4800 in group B
Conclusion: In patients with deranged renal functions but otherwise clinically normal can be offered definite treatment without temporary diversion in the form of PCN. This not only decreases the morbidity associated with PCN but also comforts the patients in term of shorter hospital stay and cost effectiveness
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The aim of the study was to evaluate the status of cyclin A2 in HPV associated cervical cancer. We analyzed the influence of HPV type 16 on the expression of cell cycle regulatory protein Cyclin A2 and p53 in various grades of cervical dysplasias and infiltrating squamous cell carcinoma. The study was conducted in the Department of Pathology, BMSI, JPMC, Karachi. A total of 50 formalin fixed paraffin embedded blocks were used, which included 18 cases of squamous cell carcinoma and 32 cases of various grades of cervical dysplasias. The blocks were analyzed for the presence of HPV type 16, indirectly by Cyclin A2. Polymerase Chain Reaction was performed on 15 Cyclin A2 positive cases for verification of HPV type 16. Cyclin A2 positivity was detected in all 18 cases of squamous cell carcinoma and 21 cases of various grades of cervical dysplasias. 15 cases positive for Cyclin A2 were analyzed for HPV type 16 by PCR. HPV type 16 was identified in 13 cases out of 15. HPV type 16 identification in majority of the cases showing positivity for Cyclin A2, which could be used as potential indicator for early diagnosis of cervical dysplasias and invasive squamous cell carcinoma
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Objective of the study was to evaluate the efficacy of seeds of Lactuca scariola Linn, on DSM IV defined mixed anxiety depressive disorder. This study was carried out by conducting a 8 weeks, double blind, placebo controlled trial at New Delhi. A total of 54 patients were registered randomly in test group [N=30] and placebo group [N=24]. Symptoms of anxiety and depression were measured using the 14-item Hamilton Rating scale for anxiety and 17-item Hamilton Rating scale for depression respectively. Reduction in the total score was statistically analyzed and adverse event tabulated. The test drug was found to be comparably effective and superior to placebo in reducing anxiety and depressive symptoms. Statistically significant improvement was observed in the test group [p<0.001] in both anxiety and depression. But a marginal significant improvement was observed in anxiety in placebo group
Subject(s)
Humans , Male , Female , Depressive Disorder/therapy , Anxiety Disorders/therapy , Seeds/chemistry , Double-Blind MethodABSTRACT
Hilteet [Asafoetida], an oleo-gum-resin, reported to be anti-convulsant and useful in various types of convulsions, was evaluated for anti-convulsant activity at various doses, in experimental animal model. A potent seizure-inducing model Metrazol test was followed to study the seizure-inhibiting activity of the test drug. The well-known anti-epileptic drug phenobarbitone was used as the standard drug for comparison. LD[50] and autopsy were also carried out to determine the margin of safety and gross changes in vital organs. The test drug showed significant dose dependent anti-convulsant activity without sedative effect as observed in phenobarbitone [Standard] group. The therapeutic index was computed and found to be very large indicating the safety margin of the test drug. Except visceral congestion, no significant histopathological changes were seen in autopsy
Subject(s)
Animals, Laboratory , Plants, Medicinal , Anticonvulsants , Lethal Dose 50 , Mice , Autopsy , PentylenetetrazoleABSTRACT
Sufoof-e-Kulliya [SK] a non-pharmacopocul formulation, reported to be nephro-protectivc and useful in nephrotic syndrome like conditions, was studied for nephro-protective and steroidal activity in experimental models. Gentamicin [40 mg/kg IM] was administered in groups of albino rats twice a day for 7 days to produce the nephrotoxicity and the animals subjected to nephrotoxicity also received the different doses of SK, orally twice a day for 7 days. On the 8th day all the animals were sacrificed and blood samples were collected to estimate the serum urea and serum creatinine levels which were taken as the marker of renal function. In second test, the animals in different groups were administered with the test drug for 3 days while the animals in standard control group were given hydrocortisone in the dose of 200 micrograms by subcutaneous injection for the same period. On the fourth day all the animals were sacrificed and their thymus gland was dissected out. The body weight of thymus gland was recorded to assess the steroidal activity. The test drug was found to have significant nephro-protective and steroidal activity. In addition histopathology was also undertaken to estimate the noxious effect of Gentamicin on kidney and nephro-protective effect of test drug
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Background: Urolothises is one of the most common and oldest diseases of urinary tract. It is endemic Pakistan and the incidence of calculus renal failure is high. This is due to poor initial management
Methods: it is an observational study conducted at the Department of Urology, Services Hospital, Lahore from April 2001 to March 2003. In this study we evaluated the patients with calculus renal failure regard; their preoperative, operative, postoperative management and improvement in renal function after the removal of stones. Twenty patients, 13 male and 7 female were included in this study. The chief presenting symptom was anuria in 20 [100%] of patients. Ultrasonography, X-ray KUB and Ante-grade pyeiogrqahy were the main investigations regarding the site, size of stone, degree of hydronephrosis and echogenicty of the kidneys. Percuta-neous Nephrostomy alone, Acute Peritoneal Dialysis alone and Pereutaneous Nephrostomy with Acute Peritoneal Dialysis were the emergency procedures performed to save the lite ot the patients and to plan for a definite surgical procedure. After the stabilization of the renal function. definite surgical procedure in the tom of pyelo-lithotomy and ureterolithotomy were performed
Results: Results were analyzed by considering the duration of anuria, degree of obstruction [hydrawephmsis] and duration of maximum improvement. Overall thirteen [65%] patients had good result five [25%] patients had satisfactory results and two [10%] patients had poor results. Anuria due to stones in the unnary tract is a urological emergency
Conclusion: Prompt and early interventions can save the patient from developing irreversible renal damage
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Aging is inevitable and getting old in a healthy way is everybody's dream. Loss of memory, osteoarthritis, cataract, benign prostate hypertrophy, psychological disorders and other degenerative changes are few examples of diseases coming as part and parcel with old age. Unani system of medicine offers certain principles known as Asbab-e-sitta zarooriya or six essential requisites of life. These when kept in balance, not only keep one healthy but delay the process of aging. Apart from this there are recommendations of certain Ilaj-bittadabeer [Regimental therapy], and Ilaj-bil-ghiza [Dietotherapy] to rejuvenate the body system. There are certain drugs in Unani system of medicine which are now proven to have antioxidant properties, used for protection of Hararat-e-ghariziya [Vital Power]. In this paper, all this will be presented in a systematic and practical way under the following headings: Asbab-e-sitta zarooriya [Six essential requisites of life] llaj bit tadabeer [Regimental therapy]. Ilaj bil ghiza [Dietotherapy]. llaj bil dawa [Drug therapy]. These when followed will act as a prophylaxis for delaying the process of aging and preventing old age diseases
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Hypertension is a major public health problem in every society throughout the world. It develops dreadful complications such as Cerebrovascular accidents, Angina pectoris, Myocaidial infarction and renal failure leading to cardiovascular mortality and morbidity. If we trace back the historical genesis of hypertension, we come to know that the basic concept of this disease is an ancient one. The ancient Unani physicians like Ibn-e-Sina, Ibn-e-Rushd, Ali Ibn-e- Abbas Majoosi, Abu Bakar Mohammad Bin Zakaria Razi and Ismail Jurjani have described Imtela [Congestion] in their treatises. They have mentioned the types, etiological factors, symptoms and complications of Imtela
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Islam is the religion, which mentions all aspects of life in detail, most of the principles of life are now proved on scientific parameters, and some principles are described in the Holy Qur'an and some in the Hadith. Circumcision is one of the important Sunnah of Prophet Mohammad [and], which has most significance in medical point of view. It is nothing but excision of prepuce of glans penis, it is practically essential for all Muslims and Jews. Circumcision provides local hygiene and prevents from local infective disorders, so that 'it can help in the prevention of sexually transmitted diseases as well as diseases of prepuce or penis e.g. phyrnosis, paraphymosis, balanitis, posthitis prepucial wart, even carcinoma of penis is common in those communities who do not perform circumcisions. By adopting this Sunnah of Mohammad [and], we can prevent from several diseases as mentioned above and this will help mankind. Keeping these facts in mind the present paper will discuss the scientific significance of circumcision with special reference to Islamic concepts
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Ocular trauma [OT] is a common but preventable disease. A total of 102 eyes with OT involving 98 admitted patients were analyzed in a retrospective study spanning over a period from Jan. 2001 to Jan. 2004 in Ophthalmology Unit II of Civil Hospital, Karachi. The aims of the study were to identify etiological factors, to assess the visual outcome and to explore possible methods of reduction of OT in our setting. Out of the 98 patients, 92 [93.88%] were males and the commonest age group involved was 11-30 years with 64 [65.30%] cases. OT most frequently [72.44%] occurred in out-door cases, mostly from sharp objects [68.36%], followed by blunt objects [26.53%] and intra-ocular foreign bodies [3.06%]. Primary enucleation was done in four cases, and the patients were followed-up for a mean period of 20 months. Phthisis bulbi occurred in two patients, but none developed sympathetic ophthalmitis, siderosis bulbi or post-operative infections. Predictors of better visual outcome i.e. visual acuity [VA] 6/12 or better were initial VA of hand movement, wound location anterior to the plane of insertion of recti, wound length of 10mm or less, and sharp injuries. Even blunt trauma when tackled urgently and methodically gives excellent final visual outcome. Major causes of decreased VA were astigmatism, central corneal scar and central retinal injury. This study has identified that OT requiring hospital admission remains a serious problem. Prevention, as the optimum management of trauma, should however remain a priority in order to reduce morbidity and costs
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A prospective study was performed at the Department of the Orthopedic Surgery, Assiut University Hospital, Assiut, Egypt during the period between 1994 and 1996. The age of the patients at the time of surgery ranged between 2.5 and 7 years, with an average of 4 years and 8 months. Clinical and radiological measurements of limb length were performed preoperatively, postoperatively and at follow up for all patients. Colonna hip arthroplasty procedure for non-united femoral-neck fractures has been reported, in which the greater trochanter is placed in the acetabulum and the abductor muscles of the hip are transferred distally on the femoral shaft to improve their function. A modified Colonna procedure has been used for the treatment of pathological dislocation of the hip secondary to pyogenic infection in five children. The modification made in the procedure is its combination with proximal femoral varus osteotomy that is fixed by plate and screws. All patients had full hip extension. No patient had adduction, abduction or flexion contracture of the affected hip at the final follow up. However, compared with the preoperative range of motion, all operated hips decreased the range of motion at a different degree. The average gain in the limb length was 46% of the original discrepancy. Gait was initially improved in all patients. However, in all patients the limp has persisted, for some degree