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Abstract: Olive is grown in semi-arid climatic conditions; however, little is known about mineral changes in olive plant and nutrient requirements during the production period. Hence, the current study was conducted under Pothwar agro-climatic conditions in order to select appropriate stage of macronutrients (N, P, K) application in relation to soil and leaf nutritional status during 2017 and 2018 growing seasons. Soil and leaf analysis were performed at four different phenological stages (i.e. flowering, fruit setting, fruit enlargement and fruit maturity stages). The results revealed that the assessed macronutrient in leaf and soil varied significantly among varieties, phenological stages and growing year. The results revealed also that nitrogen level was found to decrease from fruit set (1.56%) to fruit enlargement stage (1.47%). Leaf and soil N, P and K contents were found higher before the flowering (stage 1) and depleted after fruit harvesting (stage 4), regardless of olive varieties. However, high yielding varieties showed lower nutrients after fruit harvesting (stage 4). Therefore, N content in leaf and soil gradually decreased during fruit growth and development. Whereas, K content in leaf and soil sharply declined from fruit maturity to fruit ripening stage. Overall, the trend of nutrient depletion showed that plants need phosphorus for fruit setting, nitrogen before and after fruit setting, and potash after pit hardening or at oil accumulation stages.
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Objective: To explore potential inhibitors of viral enzymes of SARS CoV-2. Methods: The in-silico docked potential of anti-viral, antibiotic, and analgesic drugs were studied for inhibition of the nonstructural protein (NSP) 9, NSP3, and NSP15 of SARS CoV-2 using recent structural peculiarities of these enzymes, 3D optimized structures of drugs and algorithm-based ligand inhibitory potential. Results: Teicoplanin, azithromycin, and remdesivir potentially inhibited NSP9 (Dock-score 9 620, 5 472 and 6 252, respectively), NSP3 (Dock-score 9 846, 5 604 and 5 548, respectively) and NSP15 (Dock-score 10 960, 6414 and 6 002, respectively). Conclusions: Teicoplanin acts as a significant receptor antagonist and potentially inhibits the SARS CoV-2 enzymes.
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Objective: To find out risk factors of heart failure after ST Elevation Myocardial Infarction [STEMI] and to see the most commonly involved vessels in myocardial infarction responsible for heart failure
Methodology: This cross-sectional study was conducted from June 2013 to November 2013. 225 patients of heart failure [HF] following STEMI who came in the emergency department of the hospital were included. The selected patients were followed till the angiography reporting. Statistical analysis was done in SPSS version 16
Results: Mean age of patients was 51.42 +/-11.78 years. 49.0% patients were hypertensive, 37.3% patients were diabetic, 44.0% were smokers and 18.2% had positive family history. In this study, anterior wall MI was predominant and found in 30.7% patients. 46.7% patients had triple vessel disease [TVD]. There was 33.7% involvement of Left main stem [LMS]
Conclusion: Hypertension and smoking are most common risk factors of heart failure. The patients who present with heart failure are most who have involvement of triple vessel coronary artery disease. Left main stem [LMS] is most commonly involved vessel in these patients
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Objective: To determine the frequency of immunohistochemical expression of Human Epidermal Growth Factor Receptor 2 [HER2] in gastric and gastro esophageal junctional adenocarcinoma
Study Design: Cross-sectional study
Place and Duration of Study: Department of Histopathology, Pakistan Naval Ship [PNS] Shifa Hospital Karachi, from Oct 2014 to Oct 2015
Material and Methods: All specimens of gastric and gastroesophageal adenocarcinoma, irrespective of age of patient, histological type and grade of the tumor were included. Poorly fixed specimens and specimens with scanty tumor tissue were not included
Results: Majority of the patients belonged to 51 to 65 years of age group with mean age of 58.58 [SD +/- 5.56] years. Gender distribution showed that 46 [69.6%] were males and 20 [29.33%] were females. Overall frequency of HER2 expression was 38% [n=25] in cases of gastric adenocarcinoma
Conclusion: Expression of HER-2 receptor in gastric adenocarcinoma in this study was 38% and it was associated with histological grade and type of adenocarcinoma. HER-2 more frequently expressed in well differentiated than undifferentiated carcinomas with non-significant p-value i.e. [0.139] and in intestinal type phenotype with significant p-value less than [0.05]
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Objective: To assess the role of Vitamin E to improve the survival of Wharton's jelly derived mesenchymal stem cells [WJMSCs] in breast cancer conditions
Study Design: An experimental study
Place and Duration of Study: Centre for Research in Molecular Medicine, University of Lahore, from November 2016 to March 2017
Methodology: WJMSCs were obtained from umbilical cord tissue with enzyme digestion method. Isolated cells were characterized for CD90 and CD45 by immunocytochemistry. Pretreatment and conjugation therapies of vitamin E in 50mM and 100mM concentration were used on WJMSCs and breast cancer plasma was provided to mimic the cancer conditions, while WJMSCs provided with normal plasma were considered control. Cells' viability, proliferation and death were evaluated by crystal violet staining, MTT assay and LDH assay, respectively. Oxidative stress was observed by activity of anti-oxidant enzymes [GSH, catalase, SOD] and reactive oxygen species [MDA]
Results: The isolated cells expressed mesenchymal stem cells marker CD90 and lacked hematopoietic marker CD45. Vitamin E improved the viability and proliferation of WJMSCs in normal plasma, in conjugation with breast cancer plasma and in pretreatment groups but conjugation group showed even better results with concentration of 100mM as compared to the pretreatment group and opposite was observed for LDH assay for cells death analysis. Vitamin E also reduced the oxidative stress in 100mM more pronounced in conjugation group as compared to pretreatment group while left no harmful effects on WJMSCs in normal plasma
Conclusion: Vitamin E conjugation with breast cancer conditions significantly improved growth of WJMSCs. Thus vitamin E treated WJMSCs are better therapeutic options for breast cancer
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Objective: To determine the outcome of helicobacter pylori eradication in the treatment of GERD
Methods: A total of 200 patients fulfilling the inclusion and exclusion criteria were enrolled for study. Informed consent was taken from patients for inclusion in the study. Demographic data was collected. Endoscopy for evidence of GERD was done in Medical Unit-1 of Services Hospital, Lahore for evidence of GERD. Outcome of H. pylori eradication on GERD was assessed according to the symptom improvement defined in material and methods of study
Results: A total of 200 patients fulfilling the inclusion and exclusion criteria were enrolled for study. Informed consent was taken from patients for inclusion in the study. Demographic data was collected. Endoscopy for evidence of GERD was done in Medical Unit-1 of Services Hospital, Lahore for evidence of GERD. Outcome of H. pylori eradication on GERD was assessed according to the symptom improvement defined in material and methods of study
Conclusion: The results of the study showed that there was no statistically significant improvement in the symptoms of GERD after H.pylori eradication
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Objective: To study the spectrum of rhabdomyosarcoma, diagnosed at Armed Forces Institute of Pathology [AFIP], Rawalpindi [Pakistan]
Study Design: Descriptive study
Place and Duration of Study: AFIP, Rawalpindi from 1st Jan 2009 to 31st Dec 2013
Material and Methods: The study included all the cases diagnosed as rhabdomyosarcoma from 1st January 2009 to 31st Dec 2013. Records of the malignant tumors of soft tissue that presented during this period were analyzed and out of these spectrums rhabdomyosarcoma was studied. The data analysis included the age, gender, site of tumor and histopathological pattern of Rhabdomyosarcoma
Results: A total of 19140 malignant tumors were diagnosed at AFIP Rawalpindi from 1st Jan 2009 to 31st Dec 2013. Out of these, 512 [2.67%] were malignant soft tissue tumors. Out of these 53 cases were rhabdomyosarcoma with an overall frequency of 0.27% of the malignant neoplasm and 10.3% of soft tissue sarcomas. The age ranged from 1-70 years. Out of these 53 cases 36 were males and 17 were females with a male to female ratio of 2.1:1. The most common subtype of tumor seen was embryonal rhabdomyosarcoma n=22 [41.5%]. The age for embryonal rhabdomyosarcoma ranged from 3 to 71 years with median age of 16 years while most of the patients are effected during 1st decade of life [55%]. Out of 20 cases of rhabdomyosarcoma during the first two decades of life 18 [90%] were embryonal rhabdomyosacoma. Thirty cases of rhabdomyosarcoma encountered during the adult life contained only 4 cases [11%] of embryonal rhabdomyosarcoma. The majority of the tumors originated from lower extremities [41%] and in lower extremities most common site was thigh [27%]. A total of 18% of the tumors originated in head and neck region. Second most common type of the tumor was pleomorphic rhabdomyosarcoma n=21 [39.6%] with age range 40 to 78 years and median age of 60 years. Ten cases were reported during 6th and 7th decade of life. Majority of the cases occurred in lower extremities [47.6%] and thigh was the most common site [42%]. Alveolar rhabdomyosarcoma n=6 [11.32%] was the 3rd most common tumor with age range of 15 to 46 years and median age of 29 years. Four cases [67%] occurred in 3rd and 4th decades of life. The most commonly involved region was lower extremities [50%] followed by upper extremities [17%]. Among lower extremities again thigh was the most common site [33%]. Anaplastic rhabdomyosarcoma n=4 [7.54%] was the least common type of rhabdomyosarcoma with age range of 12 to 45 years and median age of 31 years. Three cases [75%] occurred in the 3rd and 4th decade of life. Two cases [50%] occurred in lower extremities and one case [25%] in the upper extremity
Conclusion: Embryonal rhabdomyosarcoma is the most common rhabdomyosarcoma during the first two decades of life. While pleomorphic rhabdomyosarcoma is the most common rhabdomyosarcoma encountered in adults. Extremities are most common site of involvement by rhabdomyosarcoma followed by the head and neck and abdomen in our setup. This finding needs to be evaluated by a larger scale study
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Objective: to evaluate the frequency of type-2 diabetes mellitus in patients having hepatitis C virus genotype 3[ a] infection, which is the most common type of genotype in our population
Material and Methods: a total number of 200 were enrolled from outpatient department of services hospital Lahore which is a tertiary care hospital. This was a descriptive, cross sectional survey. Both male and female patients fulfilling the inclusion and exclusion criteria were included in the study. The patients having chronic hepatitis C infection with genotype 3[a] were screened for diabetes mellitus according to the operational definition
Results: a total number of 200 patients including 114 males and 86 females were enrolled for study. There ages ranged from 25 to 60 years. Type 2 diabetes mellitus was found in 54.42 %[ n=80] male patients and 45.58 %[ n=67] female patients. Out of 200 patients having HCV genotype 3[a] infection, 147[73.5%] had diabetes mellitus
Conclusion: we concluded that frequency of type-2 diabetes mellitus is high among patients with hepatitis C virus genotype 3[a]. So it is recommended that every patient who present with hepatitis C virus genotype 3[a] infection should be screened for type-2 diabetes mellitus. Furthermore, it is also recommended that every setup should have closed surveillance of their patients in order to know the frequency of the problem
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Primary objective of this study was to evaluate the impact of significant left main stem [LMS] stenosis on the early outcome of coronary artery bypass graft [CABG] surgery. A Retrospective non-randomized analytical study was conducted in Cardiac surgery department, Chaudhary Pervaiz Elahi Institute of Cardiology [CPEIC] Multan, Pakistan. The data of patients who underwent isolated CABG at our institution from February 2008 to March 2014 were analyzed. Two thousand six hundred two [2602] patients of isolated CABG were divided into 2 groups according to the LMS disease. Group I [n=2088]: without significant LMS disease and Group II [n=514]: with LMS disease. Data was analyzed using SPSS V16. The groups were compared using Student's t-test for numeric variables. Chi-square test and Fishers Exact test were used for categorical variables. P-value ? 0.05 was considered as significant difference. Out of two thousand six hundred two, 2088 patients were in Non.LMS group [Control Group] and five hundred fourteen were in LMS Group [Study Group]. Patients with LMS disease were older. In both groups there was no statistically significant difference regarding gender distribution, risk factors of IHD, pre-operative renal function and preoperative CKMB levels. Significant number 50 [9.7%] of patients were unstable in LMS group and they needed urgent surgery [p-value <0.0001]. Need and duration for inotropic support and intra-aortic balloon counter-pulsation support were significantly high in LMS group [p-value <0.0001, 0.002, 0.003 respectively]. Similarly Mechanical ventilation time and hospital stay were higher in LMS group. Incidence of pulmonary complications and operative mortality were significantly higher in LMS group [p-value 0.005 and 0.001 respectively]. Mortality of CABG patients with significant left main coronary stenosis was 13 out of five hundred fourteen [2.5%] as compared to just 17 out of two thousand eighty eight [0.8%] in control group. This study showed that significant LMS disease is an independent risk factor for early cardiopulmonary morbidity and mortality after CABG surgery
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To compare the stylet and the gum elastic bougie in tracheal intubation of a simulated difficult airway. Randomized control trial. The study was conducted in Main Operation Theatre at Rehman Medical Institute, Peshawar from June 2009 to June 2010.6 patients, ASA grades I and II, undergoing elective surgical procedures requiring tracheal intubation were randomly divided in two groups. Difficult intubation scenario was simulated by applying a rigid Philadelphia collar in both groups. Patients in Group-A were intubated with a stylet and patients in Group-B were intubated using a gum elastic bougie. Both groups were then compared in terms of overall success in intubation, and number of intubation attempts. Statistical analysis was done by applying Chi-Square test and Students' T- test. Among the patients of Group-A, only 71.4% patients were successfully intubated using a stylet while 100% patients in Group-B were successfully intubated using a bougie. In the simulated difficult airway, tracheal intubation using a gum-elastic bougie has a higher success rate when compared to stylet assisted intubation and should be preferred in a difficult intubation scenario
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To determine the frequency of meningitis in newborns presenting with neonatal sepsis to Nishtar Hospital, Multan. Descriptive study. This was carried out in the Department of Paediatric Medicine, Nishtar Hospital, Multan from January 2012 to December 2012. A total of 73 newborns were included in the study conducted at Nishtar Hospital, Multan. Out of 73 newborns with sepsis, 20 [27.4%] were diagnosed to have meningitis. Majority of the neonates with sepsis [52.1%] were between 1-7 days of their life, however, mean age of all cases was 10.49 +/- 7.79 days [range 2-25 days]. There were 39 [53%] male, 34 [47%] female babies. 36 [39.3%] neonates having low birth weight [1.5-2.5 kg] however mean weight was 2.55 +/- 0.39 kg [range 1.8-3.6 kg]. Higher rate of meningitis [27.4%] diagnosed in present study shows better diagnostic facilities and on the other hand alarm us to take prompt measures to prevent it
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To describe the clinical presentation and to identify the aetiological agents causing urinary tract infection. Descriptive study. This study was carried out in the Department of Paediatric Medicine, Nishtar Medical College/Hospital, Multan from January 2013 to December 2013. A total of 50 children were included in the study conducted at Nishtar Medical College/Hospital, Multan. Out of 50 children, 38 were female and 12 were male. 28 children were from 1-3 years age group and 22 were of more than 3 years. Most common clinical presentations were fever, urinary symptoms, vomiting and pain abdomen. Aetiological agents in study were Escherichia coli, klebsiella, proteus, staphylococcus saprophyticus, streptococcus fecalis or pseudomonas. four cases of UTI [3 females, 1 male] were associated with nephritic syndrome. Four cases were associated with malnutrition. It is concluded from study that UTI is more common in females between the age of 2-4 years mostly due to problems in their toilet training
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The current study examines attachment styles as determinants of internalizing and externalizing behavioral problems among children, and their academic achievement. The convenient sampling technique was used to collect the sample data comprising of [N=201] school children studying in the 9th and 10th grades; further divided on the basis of gender i.e. boys [n=100] and girls [n=101] with age ranges between 15 to 17 years. Their attachment styles and behavioral problems were measured through the Child Problem Checklist and Attachment Style Scale respectively. Academic achievement was taken from their respective schools. Pearson correlation, multiple regression and independent t-test analyses were computed to verify the hypotheses. Co relational analysis showed that avoidant and anxious attachment styles were negatively correlated and the secure attachment style was positively Co related with academic achievement. Multiple regression analysis demonstrated the secure and anxious attachment styles as significant negative predictors of internalizing behavioral problems whereas the avoidant style was found to be significant positive predictor of internalizing behavior problems. A significant inverse relationship exists between internalizing behavior problems, with externalizing behavior problems and with secure attachment style. Avoidant attachment style predicted externalizing behavioral problems significantly and negatively and non-significantly to internalizing behavior problems. Significant gender differences were demonstrated on the aforementioned constructs except secure attachment style and academic achievement. Further significant school differences were found on all variables except internalizing behavioral problems and the avoidant attachment style
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To determine the diagnostic accuracy of high-resolution MR imaging done at 1.5T in distinguishing bladder-restricted tumor from non-bladder-restricted tumor and compare the mean short axis dimension of metastatic pelvic lymph nodes with benign pelvic lymph nodes. Analytical study. Shaukat Khanum Memorial Cancer Hospital, Lahore, Pakistan, from March 2008 to July 2011. Patients with bladder cancer were enrolled. Based on pathologic T-staging following radical cystectomy, patients were assigned to one of two groups. Patients with stage T1 and T2 disease were assigned to the bladder-restricted tumor [BRT] group and those with stage T3 and T4 disease to the non-bladder-restricted tumor [NBRT]. High-resolution unenhanced MR imaging done prior to cystectomy was reviewed retrospectively [1.5 T MRI unit; GE Healthcare]. Results from MR imaging-based categorization were compared with pathology reports to fulfill the objective. Mean short-axis diameter of largest visible lymph nodes in patients with nodal metastasis was compared with mean short-axis diameter of largest visible lymph nodes in patients with benign lymph nodes. The accuracy of MRI in differentiating distinguishing bladder-restricted tumor from non-bladder-restricted tumor was 67.72%. The mean short axis diameter of metastatic lymph nodes was greater than that of non-metastatic lymph nodes, i.e., 7.4 mm and 5.4 mm respectively. Conventional high resolution 1.5T MRI does not appear to offer advantage over imaging done at low field strength scanners
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Each Year Billions of dollars have been spent on the various programmes for Maternal and child health services in collaboration with international organizations and hundreds of doctors and thousands of skilled [SBAs] birth attendants and lady heal workers have been trained. To evaluate the impact of neonatal resuscitation programs on the prevalence of birth asphyxia in a hospital which drains a large population of Punjab. Cross sectional. Department of Paediatric Medicine, Nishtar Medical College and Hospital, Multan from January 2008-December 2008. All newborns with a H/o failure to initiate or sustain respiration at birth or H/o associated convulsions who were admitted [referred or hospital based] with the diagnosis of Birth Asphyxia and a weight > 1.5 kg were included, still born and those with lethal congenital malformations were excluded. A questionnaire was designed after extensive review of literature and data recorded. The data of past 10 years for Birth Asphyxia was also collected from the hospital record and compared with the present results. In year 1998 a total of 722 Newborns were admitted our neonatal unit out of which 210 [29.0%] were diagnosed as Asphyxia Neonatorum. This number has progressively increased over the past 10 years with a total of 846 out of total 2079 newborns [40.78%] admitted in 2008 with a diagnosis of asphyxia. Out of the total 8461 patients, there were 69% Male and 31% Female with a M:F ratio of 2.2:1.46% were delivered by SVD [17.39% in Nishtar Hospital 15.21% by dais, 32.6% by Private doctors and 34.78% by LHV] and 54% were delivered by caesarian section, out of which 46.29% were delivered in Private hospitals and 54% in Nishtar Hospital. Overall 65% deliveries were in the private sector or at home and 35% in the government hospitals 60% babies had come from Multan and 40% from other town or cities. A H/o one or more antenatal visits was present in 68% of others. Out of total cases of B.A. 26% were in B.A Grade-159% in Birth Asphyxia Grade-II 15% in B.A Grade-lll. Out of this total 45% expired. As we are moving towards the 4[th] MDG and Pakistan strives to improve its health indicators and we claim to decrease the infant mortality, neonatal and perinatal mortality rate. The incidence of birth asphyxia rises with increased burden of, morbidity. Even though the principles of NRPs are recommended for international application, this program widely used in the developed world has not been properly disseminated in communities in the developing countries, especially Pakistan
Subject(s)
Humans , Male , Female , Infant Care , Infant, Newborn/nursing , Cross-Sectional StudiesABSTRACT
The objective of this study was to evaluate the accuracy of reagent strips for diagnosis of spontaneous bacterial peritonitis [SBP] in cirrhotic patients with ascites, taking polymorphonuclear cell count in ascetic fluid as standard criterion. One hundred and fifty patients having cirrhosis of liver and suspicion of SBP admitted in the medical ward of Services Hospital, Lahore were included in the study. Ascetic fluid of the patients was tested in the hospital laboratory for polymorph nuclear cell count and at the same time leukocyte esterase activity of the fluid was assessed by reagent strips. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of reagent strips were calculated. Frequency of SBP in cirrhotic patients with ascites was 28.67%. Specificity, sensitivity, positive predictive value, negative predictive value and diagnostic accuracy of reagent strips for diagnosis of SBP in cirrhotic patients with ascites, taking PMN cell count in ascetic fluid as standard criterion was calculated as 93.02%, 94.39%,86.97%,97.12% and 94% respectively. In view of the results of the current study reagent strip method can be recommended as a rapid and accurate method for diagnosis of SBP in cirrhotic patients
Subject(s)
Humans , Male , Female , Peritonitis/diagnosis , Liver Cirrhosis/complications , Leukocyte Count , Leukocyte Elastase , Peritonitis/etiology , Peritonitis/microbiology , Predictive Value of Tests , Cross-Sectional Studies , Sensitivity and Specificity , Reproducibility of ResultsABSTRACT
To describe the diagnostic yield of USG and CT guided fine needle aspiration cytology/biopsy [FNAC/FNAB] in the bronchogenic carcinoma presenting as localized thoracic mass lesions. Descriptive study. This descriptive study was carried out in the Pulmonology Department, Nishtar Hospital, Multan from March 2011 to Oct 2011. A total of 60 patients were included in the study. All the patients were subjected to bronchoscopy first and then FNAC/B. Out of 60 patients, 40 [66.66%] were males and remaining 20 [33.33%] were females. As regards age of the patients, Most of the [36%] were in the age group 41-50 years. Of the total 60 patients 28 [47%] were smoker. Majority of the patients [72%] belong to urban areas. Chest radiograph showed right lung involvement in 36 [60%] cases. USG guidance was sought in 15 [25%] cases where as CT guidance was taken in 45 [75%]cases [FNAC] was also done in all cases with radiological/USG/CT guidance in all cases. Out of 60 cases, 37 [61.6%] were suffering from primary malignancy of lung [Table-4]. Out of 37 cases of malignancy the squamous cell carcinoma was confirmed in 18 [48.6%] cases. It is concluded from the study that percutaeous aspiration biopsy/cytology of the lung has a definite diagnostic role in lung lesions particularly those situated peripherally. FNAC/FNAB is especially more useful in those lesions not visible through bronchoscopy. FNAC is safe procedure especially when guided by computed tomography [CT] or USG
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The present study aims at exploring the difference between married and unmarried women on the variable of psychological well-being and self esteem and to study these determinants among married women in the cultural perspective of Pakistan. Thus it was hypothesized that there would be a lower level of self-esteem and psychological well-being among unmarried women as compared to married women. Secondly demographic variables will bring some variation on the level of self-esteem and psychological well-being in married women. A Comparative study. Province of Punjab, Pakistan cities Faisalabad, Bahawalpur, Rawalpindi, and Lahore during January 2009 to September 2009. A sample of 200 women was included in the study using purposive convenient sampling technique. Their age range was between 20 to 50 years. Psychological Well Being Scale [CPI] by Chough was used to measure the degree of psychological well-being. Dichotomous scoring 0-1 in response category was used for CPI. Index of Self-Esteem [ISE] by Hudson was applied to test the self-esteem of women. The findings revealed remained consistent to the previous results of research conducted on psychological well-being and self-esteem. Demographic variables like age, education and occupation laid no significant effect on women s psychological well-being and self esteem. The findings suggest that only the marital status of the women can affect the self esteem of the women though no significant effects of marital stats were found on Psychological wellbeing of women. Research concludes with that cultural differences are always there and they affect more in comparison to personal circumstances
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To investigate the type and correlate the appearance of mucocutaneous signs and symptoms with different stages and clinical types of Dengue viral infection. Two hundred patients of dengue virus infection admitted in the dedicated Dengue Unit at Services Hospital, Lahore from 1st September to 31st October 2011 were included in the study. Presenting features were noted. The patients were physically examined for the presence of skin and mucosal lesions and findings were recorded. Serologic tests for anti-dengue immunoglobulin M [IgM] antibodies, Total and Differential Leukocyte Count [TLC and DLC], Platelet count and Liver Function Tests [LFTs] were done in all the patients. Of the 200 patients with dengue infection, 83 [41.5%] were classified as dengue fever [DF], 116 [58%] as dengue hemorrhagic fever [DHF] and one [0.5%] as dengue shock syndrome [DSS]. Cutaneous involvement was seen in 160 [80%] of patients. Of these 160 patients, 130 [81.25%] had single while 30 [18.75%] had multiple manifestations. The most common cutaneous finding was pruritis [47.50%], followed by erythema [37.50%], flushing [23.35%], eccyhmosis [18.13%], petechiae [16.88%], and macular/scarlatiniform eruption [13.7%]. Mucosal involvement was seen in 35.63% of patient, with dry tongue/ cracked lips being the most common [39.7%], followed by mucosal bleed [36.6%], and conjunctival involvement [10.2%]. The most common initial presentation was flushing [27 patients] within 1-3 days followed by mucosal involvement [47 patients] during 4-6 days and cracked lips [30 patients] in 7-10 days. Cutaneous involvement was more common in DF [41.5%] while mucosal involvement was more remarkable in DHF [58%]. This study describes the variety of mucocutaneous features associated with dengue viral infection whichm may evolve during the course of the disease. There is a clear correlation between various skin manifestations and stages of infection. Cutaneous signs and symptoms are more commonly observed in DF and mucosal involvement in DHF
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Measurement of carbon monoxide in the ambient air at 36 locations on the busy roads of Karachi showed peak values of CO at 18 sites to be within the permissible limit of 10 ppm whereas up to 70 ppm at the other 18 sites. The evaluated carboxy haemoglobin [COHb] level was in the range of 1.1 to 15.8%