Seasonal Fluctuations of N, P and K in Leaves Influenced Nutrient Requirement During Fruit Development Stages in Different Olive Genotypes

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.

Genetic diversity and population structure of endangered rosewood from the Peruvian Amazon using ISSR markers

Rosewood, Aniba rosaeodora is an endangered species in Amazon forests and its natural stands have been heavily depleted due to over-exploitation for the cosmetic industry. This study aimed to investigate the genetic diversity and population structure of 90 rosewood accessions from eight localities in the Peruvian Amazon through 11 Inter Simple Sequence Repeats (ISSR) primers. The ISSR primers produced a sum of 378 bands, of which 375 (99.2%) were polymorphic, with an average polymorphism information content (PIC) value of 0.774. The mean effective number of alleles (Ne), Shannon informative index (I), gene diversity (He) and total gene diversity (Ht) were 1.485, 0.294, 0.453 and 0.252, respectively. Analysis of molecular variance (AMOVA) showed the presence of maximum variability within populations (88%). The Structure algorithm, neighbor joining and principal coordinate analysis (PCoA) grouped the 90 rosewood accessions into three main populations (A, B and C). Diversity indices at the inter-population level revealed a greater genetic diversity in population A, due to higher gene flow. The neighbor-joining analysis grouped populations A and B, while population C was found to be divergent at the inter population level. We concluded that population A reflects higher genetic diversity and should be prioritized for future management and conservation plans. (AU)

Correlation of Sit to Stand Test with Six Minute Walk Test in Chronic Obstructive Pulmonary Disease Patients

Introduction: Functional status assessment in patients suffering with Chronic Obstructive Pulmonary Disease (COPD) is the essential component and Six-Minute Walk Test (6MWT) is a valid tool for it. The amount of physical activity possible in patients with chronic obstructive pulmonary disease (COPD) predicts exacerbations, hospital admissions, and mortality. Therefore, guidelines advocate the need to entitle improved physical activity status as a major target of treatment in such patients. Objective: To determine the correlation of sit to stand test with 6-minute walk test in patients with chronic obstructive pulmonary disease. Methodology: An analytical cross-sectional study was done in Chest Medicine department, Jinnah hospital, Karachi during 2015-16. A total of 100 patients with mildto-severe COPD were included in this study. The STST and 6MW Test was performed and compared with each other and with COPD Assessment Test (CAT). Results: Overall 100 patients were recruited for the study with mild-tosevere chronic obstructive pulmonary disease. The mean age of the patients was 60.50 ± 7.03 years. On applying the Correlation coefficient test, a moderate positive correlation was found between Sit to stand test and 6-minute walk test distance (r=0.71, p=0.0005). Mild positive correlation was also found in these patients between the Sit to stand test and chronic obstructive pulmonary disease Assessment Test score (STST and CAT r=0.46, p=0.011). Similarly, moderate positive correlation was found between 6-minute walk test distance and chronic obstructive pulmonary disease Assessment Test score (r=0.58, p=0.001). Conclusion: It is concluded that in COPD patients, the functional capacity can be assessed through STST instead of 6 MW Test having the same results.

Combined intravitreal triamcenolone acetonide and bevacizumab for refractory diabetic macular edema

Objective: To evaluate the effectiveness of combined Intravitreal triamcinolone acetonide [IVTA] and Intravitreal Bevacizumab [IVB] for treatment of refractory diabetic macular edema

Study Design: Quasi-experimental study

Place and Duration of Study: Armed Forces Institute of Ophthalmology [AFIO], Rawalpindi, from January to December 2017

Methodology: Pseudophakic diabetic patients with macular edema refractory to prior treatment were included. Patients having best corrected visual acuity [BCVA] better than 20/40 [6/12] or worse than 20/200[6/60] or the central subfield thickness [CSFT] less than 300 um on spectral domain optical coherence tomography [OCT] were excluded. Effectiveness of treatment was compared in terms of change in BCVA and CSFT on OCT. Intravitreal injection of 2 mg IVTA and 1.25 mg of IVB was given. IVB was repeated on monthly basis in next two months. Follow-up was done after one week of first injection and then monthly for next three months

Results: Fifty eyes of 42 patients were studied. Mean age of the patients was 62.4 years +/- 7.13. Male to female ratio was 2:1. Mean pre op LogMAR visual acuity was 0.708 +/- 0.12 and CSFT was 439.10 +/- 54.64 um. Mean postoperative LogMAR visual acuity was 0.586 +/- 0.13 um and mean post op CSFT was 382.80 +/- 56.12. There is statistically significant difference in improvement of LogMAR BCVA and decrease in CSFT after treatment. [p<0.001, paired t-test]

Conclusion: Eyes with refractory macular edema showed improvement of visual acuity and reduction of CSFT at three months when treated with combined IVTA and IVB

Intravitreal bevacizumab [ivb] for macular edema secondary to branch retinal vein occlusion [brvo]

Objective: To evaluate the effectiveness of intravitreal Bevacizumab in decreasing central macular thickness in branch retinal vein occlusion [BRVO] related macular edema

Study Design: Quasi experimental study

Place and Duration of Study: Armed Forces Institute of Ophthalmology [AFIO], Rawalpindi, Pakistan, from March to August 2017

Methodology: Intravitreal Bevacizumab [1.25 mg/0.05 ml] was given in inferotemporal quadrant under aseptic conditions on monthly basis for consective three months. Post-injection, all the patients were followed up on monthly basis for consecutive three months. CMT [in ìm] was measured by using OCT at baseline and after intravitreal Bevacizumab injections at one month, two months, and finally at three months

Results: Forty eyes of forty patients were included in the study. There were 25 [62.5%] male patients and 15 [37.5%] female patients. Baseline mean CMT +/-SD was 358 +/-36 Mum before IVB injection. Mean CMT was 252 +/-12 Mum at 3 months [after three IVB injections]. At three months, mean percentage decrease in CMT was 29.60%

Conclusion: Intravitreal Bevacizumab is effective and results in decrease in central macular thickness to normal or nearnormal levels in branch retinal vein occlusion [BRVO] related macular edema

Intravitreal bevacizumab [IVB] for macular edema secondary to branch retinal vein occlusion [BRVO]

Objective: To evaluate the effectiveness of intravitreal Bevacizumab in decreasing central macular thickness in branch retinal vein occlusion [BRVO] related macular edema. Study Design: Quasi experimental study. Place and Duration of Study: Armed Forces Institute of Ophthalmology [AFIO], Rawalpindi, Pakistan, from March to August 2017

Methodology: Intravitreal Bevacizumab [1.25 mg/0.05 ml] was given in inferotemporal quadrant under aseptic conditions on monthly basis for consective three months. Post-injection, all the patients were followed up on monthly basis for consecutive three months. CMT [in microm] was measured by using OCT at baseline and after intravitreal Bevacizumab injections at one month, two months, and finally at three months

Results: Forty eyes of forty patients were included in the study. There were 25 [62.5%] male patients and 15 [37.5%] female patients. Baseline mean CMT +/-SD was 358 +/-36 microm before IVB injection. Mean CMT was 252 +/-12 microm at 3 months [after three IVB injections]. At three months, mean percentage decrease in CMT was 29.60%

Conclusion: Intravitreal Bevacizumab is effective and results in decrease in central macular thickness to normal or nearnormal levels in branch retinal vein occlusion [BRVO] related macular edema

Heel pain and its associations

Objective: Heel pain is an everyday increasing problem in young people more commonly in females. It is estimated that about one million people with complaint of heel pain seek medical advice per year. Therefore, it was needed to highlight its clinical associations

Methods: One hundred and thirty-eight cases with heel pain were registered. For comparison, 134 subjects were registered as control. All subjects were segregated into gender groups. Each gender group was further subdivided into young [age < 40] and old [age > 40] groups. Three parameters were considered, i] blood pressure, ii] body mass index [BMI] and iii] serum uric acid level

Results: The overall male to female ratio was 1: 3. There was significant difference [p < .05] in the means of systolic and diastolic blood pressure of old [> 40] cases of both gender groups. The Odds ratio showed association between DBP and heel pain in female group only. There was significant difference [p < .05] in the means of BMI of cases from those of age and gender matched controls. The Odds ratios also showed strong association between increased BMI and heel pain. There was significant difference [p < .05] in the means of uric acid levels of cases from those of controls in female groups only. Similarly, the Odds ratio in this group showed association between hyperuricemia and heel pain. When above parameters were analysed for anindependentrisk factor, increased BMI and hyperuricemia were found to be associated with heel pain as isolated and independent risk factors

Conclusion: In our study, the female cases outnumbered the male cases by 1: 3.The results showing the association between heel pain and increased BMI were well consistent with the international studies. For hyperuricemia, the association with heel pain was also consistent with international studies. Similarly, the hypertension was also found in the cases with heel pain in old groups only. The obesity and hyperuricemia were found to beisolated and independent risk factors associated with the heel pain

Attempted suicide and seriousness of intent

This descriptive research was conducted to estimate the method of suicide and suicidal intent among hospitalised suicide attempters at Pakistan Ordinance Factory [POF] Hospital, Wah Cantt, from December 2012 to June 2013. Data were collected from 49 hospitalised suicide attempters through purposive sampling technique by using Suicidal Intent Scale. Majority of suicide attempters [92%] used self-poisoning as the method of suicide regardless of their gender, age, occupation, past medical history, past psychiatric history, and history of suicide and psychiatric illness in their families. Additionally, most of them [43%] reported high level of suicidal intent, while 16 [33%] reported medium suicidal intent and 12 [24%] reported mild suicidal intent. Keeping in view the fact that majority of suicide attempters used self-poisoning as a method and most of them reported high level of suicidal intent, it is important to plan preventive measures

Histopathological outcome of pancytopenia cases on bone marrow trephine biopsy

Objective: To determine the histological outcome of pancytopenia cases on bone marrow trephine biopsy and to see the frequency of various causes of pancytopenia in our population

Study Design: Descriptive study

Place and Duration of Study: Pathology department, Combined Military Hospital [CMH], Kharian [Pakistan]. One year [Jan 2015-Dec 2015]

Material and Methods: Two hundred bone marrow trephine biopsies were done in one year [2015], out of which 40 were done for evaluation of pancytopenia. The criteria for diagnosis of pancytopenia were; haemoglobin less than 10 g/dl, total leukocyte count [TLC] less than 4.0 x 109/1 and platelet count less than 100,000 x 109/1. Patients with pancytopenia secondary to drugs, chemotherapy and radiotherapy were excluded from the study

Trephine biopsies showing marked crushing and having inadequate material were also excluded from the study. Biopsies were processed, slides made and examined under light microscope by haematologist and histopathologist. Frequencies of various causes of pancytopenia diagnosed on histopathology were calculated. The findings were analyzed by using SPSS version 10.0

Result: Out of 40 cases of pancytopenia, male to female ratio was 3:2. The age range was between 1 year to 75 years. Histopathological analysis of bone marrow trephine biopsies revealed megaloblastic anaemia as the most common cause of pancytopenia [30%], followed by aplastic anaemia [25%] and hypersplenism [15%]

Conclusion: Megaloblastic anaemia is the most common cause of pancytopenia in our population as compared to aplastic anaemia mentioned in most of the international studies. This indicates prevalence of nutritional deficiency in our population and megaloblastic anaemia must be kept at top of list while evaluating pancytopenia cases. Early diagnosis and treatment of megaloblastic anaemia will prevent any further complication of this disease

Histopathological analysis of gastric mucosal biopsies in non ulcer dyspepsia

Objective: To find out the pattern of gastric mucosal histopathological findings in gastric biopsies of patients with non ulcer dyspepsia

Study Design: Prospective descriptive study

Place and Duration of Study: Histopathology department Combined Military Hospital [CMH] Kharian Pakistan from Jan to Dec 2015

Material and Methods: One hundred patients presenting at outpatient gastroenterology department with dyspepsia having no endoscopic lesion were included in the study. Two gastric mucosal biopsies from antrum and two from corpus were taken. The specimens were processed and examined histologically to see the changes

Results: Gastric biopsies of 100 patients including 65 males and 35 females presenting with non ulcer dyspepsia were studied. Most of the patients were between the age group of 31-50 years. Histological examination of gastric biopsies revealed 70% of patients having histological features of gastritis, while 30% having no significant histological finding. Chronic inflammation was seen in 70 cases [70%], activity in 15 cases [15%], glandular atrophy in 2 cases [2%] and intestinal metaplasia in 2 cases [2%]. H.Pylori were identified in 25 cases [25%] based on haematoxylin and eosin [H and E] staining and modified giemsa staining

Conclusion: Most the cases of non ulcer dyspepsia show histological evidence of gastritis, however a significant number of patients showed no gastric mucosal histological abnormality. A significantly low frequency of H. Pylori in gastric biopsies noted in non ulcer dyspepsia cases may be due to more frequent use of antibiotics and acid suppressant drugs used by general practitioners at some stage of disease

Closed reduction and percutaneous pinning in proximal humerus fratures-assessment of results using constant-murley shoulder scoring scale

The aim of the study was to assess the results of closed reduction and percutaneous pinning in proximalhumerus fracture using Constant-Murley shoulder outcome scoring scale. Experimental study. This study was conducted at KMSMC/AIMH and National Bones and JointsHospital Sialkot from July 20 1 3 to Dec 20 1 4. 20 patients having proximal humerus fractures were operated and closedreduction and percutaneous pin fixation was done. Out of 20 patients,1 1 patients [55%] were male and 9female [45%]. Right side was involved in 14 patients [70%] and left side in 6 patties [30%]. Age rangedb/w 30-50 years with an average age of 38.4 years. Mechanismsof injury were RTA in 10patients [50%], fall from height 6 patients [30%], fall while walking/stair climbing 4 patients [20%]. Thefollow up ranged from 6-18 months with an average follow up of 9 months. The patients were assessed postoperatively at the end of follow up using Constant-Murleyshoulder outcome scoring scale.12 patients [60%] had excellent, 5patients [25%] good, 2 patients [10%] fair and 1 patient [5%] had poor result. The mean Constant-Murley score at the end of follow upwas 88.2 points. The complications observed were; pin track infection 3 patients [15%], loosening of pin2 patients [10%], mild fracture displacement 1 patient [5%] and shoulder stiffness 2 patients [10%],Whereas, deep wound infection, avascular necrosis, hetrotophic ossification and neurovascular injurywere not seen in this study. All the fractures unite satisfactorily b/w 8-14 weeks with an average of 10weeks postoperatively. Closed reduction and percutaneous pin fixation in displaced fractures of proximal humerusis safe and effective procedure with negligible complications and should be adopted as the first line oftreatment if facilities are available

Conformational analysis and geometry optimization of apomorphine as an Anti-parkinsonian agent

Apomorphine, a dopamine D[1]/D[2] agonist, is an important drug of choice for the treatment of Parkinson's and related disorders. The present study was designed to perform the conformational analysis and geometry optimization of apomorphine. Resultant optimized structure corresponds to a substance as it is found in nature. This could be used for a variety of experimental and theoretical investigations especially in the field of pharmacokinetics. The results indicate that the best conformation of the molecule is present at minimum potential energy -88702.9595 kcal/mol. At this point molecule will be more active as histamine H[1] receptor agonist

Borneol inhibits TRPA1, a proinflammatory and noxious pain-sensing cation channel

Borneol, a natural product isolated from several species of Artemisia, Blumea and Kaempferia, has a widespread use in traditional medicine. TRP ion channels are a class of nonselective cation channel proteins involved in a variety of physiological and pathological processes in mammals. TRPA1, a member of TRP family of cation channels, is involved in plethora of processes including noxious-cold, noxious-pain sensations, inflammation and the detection of irritant chemicals. Borneol is chemically related to camphor [a known inhibitor of TRPA1 ion channels]; therefore, it is beneficial to investigate the effects of borneol on TRPA1. In the present investigation it was found that borneol inhibits TRPA1 mediated cationic currents in low millimolar range [IC[so] 0.3mM] in heterologous expression systems like Xenopus oocytes and in neurons cultured from trigeminal ganglia. Effects of nicotine, a known chemical irritant and agonist of TRPA1 are also inhibited by borneol in both systems. It is concluded that borneol, being an inhibitor of TRPA1, could be a safer therapeutic-combination in clinical situations where TRPA1 channelopathies like neuropathic-pain, trigeminal neuralgia or nicotine withdrawal treatments are involved

Results of hemiarthoplasty in basicervical fracture neck of femur [gardon type-III and IV]using austin moor prosthesis and their assessment in terms of charnley hip score and harris hip score

Objective: To determine the long term results of Hemiarthoplasty with Austin Moor Prosthesis and to evaluate the results in terms of Harris hip score and Charnley hip score

Study Design: Experimental study

Place and Duration of Study: The study was conducted at Khawaja Muhammad Safdar Medical College/Allama Iqbal Memorial Teaching Hospital, Sialkot from January, 2001 to December, 2011

Materials and Methods: Total 55 patients 40 male [72.72%] and 15 female [27.27%] were selected for study after Hemiarthroplasty with Austin Moor Prosthesis in elderly patients. The age range from 60 to 95 years with an average age of 68 years. 34 patients [61.81%] had Gardon type-III and 21 patients [38.18%] had Gardon type-IV fracture neck of the femur

Results: Post operatively, all patients were assessed radiologically as well as clinically with dual assessment scale using Harris hip score [pain 44 point, function 47 point, deformity 4 point, range of motion 5 point] and Charnley hip score in terms of pain, movement and walking ability with scale of 1 to 6. One being totally disable and six being a normal status. According to H.H.S. we noted 78.18% excellent, 14.54% good and 7.27% poor result at five years follow up and 70.83% excellent, 14.58 good and 14.58% poor results between five to ten years follow up in our study. As per Charnley hip score scale we noted 96.85% satisfactory results and 3.63% poor results at five years follow up and 77.08% satisfactory results at 5 to 10 years follow up in our study. The complications noted during follow up include; infection in 5 patients [9.09%], pain 10 patients [18.18%] shortening in 03 patients [5.45%], scatic nerve injury with foot drop [0%]. According to radiological assessment, we noted dislocation in 1 patient [1.08%], acetabulum protrusia in 2 patients [3.63%], osteolysis 5 patients [9.09%], calcar resorption 5 patients [9.05%], loosening of implant patients [12.72%]

Conclusion: Hemiarthroplasy in type-III and IV Basicervical fracture at the neck of femur with Austin Moor Prosthesis is simple, safe and cost effective method with low incidence of mortality and morbidity in old age patients and gives safely 8 to 10 pain free years to the patients

Audit of beta-thalassemia cases at sheikh Zayed medical college/ hospital, Rahim Yar Khan

Background: Beta-thalassemia is one of the common genetic disorders in our community. Therefore, it is deem necessary to study and probe it to encompass all aspects of this disorder

Objectives: The objective of the study was to find out the distribution of beta-thalassemia in different age groups, prevalence of transfusion related viral infections and serum ferritin levels

Methodology: All cases of thalassemia major and thalassemia intermedia registered with the Centre for Thalassemia Care, Sheikh Zayed Medical College/Hospital, Rahim Yar Khan, were included in the study. The cases were divided into three different age groups, i.e. 0-5 years, 5.1-10 years, 10.1 years and above. The cases were diagnosed as of beta-thalassemia by history and examination, peripheral blood picture, hemoglobin electrophoresis and confirmed by genetic analysis. All cases were screened for HCV, HBV, and HIV. Some of the cases were tested for serum ferritin levels

Results: Two hundred and eighty three [63% males and 37% females] registered cases of beta-thalassemia were included in the study. Two hundred fifty seven [91%] patients were suffering from thalassemia major and 26 [9%] were having thalassemia intermedia. Out of 283 cases, 196 [69%] were belonging to rural areas and 87 [31%] were residing in urban areas. Fifty-five [19.4%] beta-thalassemic patients were found to be positive with anti-HCV antibody and 3[1%] cases were positive for HBV surface antigen. There was a significant difference [p<0.05] between the means of serum ferritin levels in thalassemia major [2775] and thalassemia intermedia cases [1519]

Conclusion: Majority of thalassemic patients were suffering from beta-thalassemia major. Males were predominantly suffering from beta-thalassemia major while in thalassemia intermedia sex distribution was almost equal. The overall prevalence of beta thalassemia in rural areas was comparatively high. Nineteen per cent of beta-thalassemia patients were positive for anti-HCV antibody. There was significant difference in means of ferritin levels among the patients of thalassemia major and of thalassemia intermedia

Prevalence of hepatitis B and hepatitis C carrier state among healthy blood donors in Rahim Yar Khan

Background: The carrier state of hepatitis B and C has been emerging in our community. Thousands of deaths have occurred as the consequences of these viral infections

Objective: To evaluate the prevalence rate of hepatitis B and C among healthy blood donors

Subjects and Methods: A cross-ssectional study was carried out at Sheikh Zayed Medical College Hospital/Rahim Yar Khan. The data was taken from the Blood transfusion Units from the District and Tehsil Headquarter Blood Transfusion Units located at Sadiqabad, Khanpur and Liaqatpur Hospitals

Method: The subjects were the healthy young blood donors. They were screened for HBsAg and anti-HCV using ICT screening kits. The data was collected from the monthly Blood Donor Reports present in the Blood Transfusion Units

Results: A total of 2,17,847 healthy, young blood donors from 1st January 2009 to 31st August 2014 were screened for HBV and HCV. Of these, 5143 [2.4%] were found to be positive for HBsAg and 6407 [2.9%] were positive for anti-HCV. At the District Unit [draining mostly urban areas], 2,03,522 subjects were screened. Of these, 4449 [2.2%] were positive for HBsAg and 5611 [2.7%] were positive for anti-HCV. For Tehsil Units [draining mostly rural areas], total 14,325 subjects were screened, of these 694 [4.8%] were positive for HBsAg and 789 [5.5%] were positive for anti-HCV

Conclusion: Our study showed that prevalence of HBV and HCV infection among healthy blood donors is high and it is comparatively low in urban areas as compared to peripheral rural areas of district Rahim Yar Khan

Conformational analysis and geometry optimization of buspirone-A 5-HT1A receptor agonist

Buspirone, a partial 5-HTiA receptor agonist, is a clinically prescribed anxiolytic

In the present study, conformational analysis and geometry optimization of buspirone were done as per Hartree-Fock [HF] calculation method by Argus Lab 4.0.1 software

The minimum potential energy was calculated by geometry convergence function by Argus Lab software

The results indicate that the best conformation of molecule is present at minimum potential energy of-100679.5513 kcal/mol. At this point, buspirone will be more active

Age-related frequency of triple negative breast cancer in women

Objective: To determine frequency of triple negative breast cancer [TNBC] in Pakistani women with respect to age. Study Design: Observational study. Place and Duration of Study: Armed Forces Institute of Pathology [AFIP], Rawalpindi, from July 2005 to July 2010

Methodology: Pathological records of all specimens of breast cancer were reviewed and data was obtained for estrogen receptor [ER], progesterone receptor [PR] and HER-2 neu receptor proteins. Specimens having complete record of all three proteins were included for analysis. TNBC was defined as those who were ER, PR and HER-2 neu negative. Overall frequency as well as frequency with respect to age was calculated. Descriptive and categorical variables were analyzed using SPSS version 17

Results: Eight hundred and fifteen patients out of 4715 [17.28%] were found to be TNBC. Mean age of diagnosis of TNBC was found to be 46.26 +/- 12.22 years of age while other breast cancers had a mean age 52.90 +/- 9.78 years [p < 0.001]. In the TNBC group, 537 patients [65.88%] were aged < 50 years while 278 patients [34.11%] were aged > 50 years while majority of patients with other breast cancers were elderly females [p < 0.001]

Conclusion: TNBC comprised 17.28% of the breast cancers in Pakistani women diagnosed at the studied centre. A higher frequency of TNBC was noted in significantly younger patients

Should we routinely expose recurrent laryngeal nerve[s] during thyroid surgery?

To compare the frequency of recurrent laryngeal nerve[s] [RLNs] palsy after various thyroid procedures with and without identification of recurrent laryngeal nerve during the operation. Randomized controlled trial. Department of Surgery, Military Hospital, Rawalpindi, from August 2008 to April 2010. Patients undergoing indirect laryngoscopy with normal vocal cords and those with carcinoma and re-do surgery having normal vocal cord were included in the study. Patients with hoarseness of voice, abnormal vocal cord movements and with solitary nodule in the isthmus were excluded. These patients were randomly divided into 2 groups of 50 each using random number tables. RLN was identified by exposing the inferior thyroid artery and traced along its entire course in group-A. Whereas, in group-B, nerves were not identified during the operations. Immediate postoperative direct laryngoscopy was performed by a surgeon with the help of an anaesthesiologist for the assessment of vocal cords. Patients with persistent hoarseness of voice were followed-up with indirect laryngoscopy at 3 and 6 months. Temporary unilateral recurrent laryngeal nerve palsies occurred in 2 [4%] patients in group-A where the voice and cord movements returned to normal in 6 months. In group-B, it occurred in 8 [16%] patients, 2 bilateral [4%] injuries requiring tracheostomy and 6 unilateral injuries [12%]. Among the 2 bilateral recurrent laryngeal nerve injuries, the tracheostomy was removed in one case after 6 months with persistent hoarseness of voice but no respiratory difficulty during routine activities. Tracheostomy was permanent in the other case. Among the 6 cases of unilateral nerve injuries, the voice improved considerably in 4 cases within 6 months but in 2 cases hoarseness persisted even after 6 months. Frequency of recurrent laryngeal nerve palsies was significantly lower in group-A as compared to group-B [p = 0.046]. For safe thyroid surgery, recurrent laryngeal nerve[s] should be routinely exposed in its entire course

Camphor modulates TRPV3 cation channels activity by interacting with critical pore-region cysteine residues

TRPV3 ion channels mediate thermo-transduction, nociception, inflammation and dermatitis in mammals. TRPV1-4 proteins have been shown to have conserved cysteine-residues in the pore-forming regions. These residues participate in channel activation via S-nitrosylation of channel proteins. Camphor is a commonly used ligand for TRPV3 channels. Thus the knowledge about the potential binding/interacting site[s] for camphor will help to design effective and potent analgesic compounds. In an overlap-extension PCR method, following primer-pairs were used to mutate conserved cysteine-residues in the pore-region of TRPV3 channels; GATTGAGAATcCTCCAAGGACAAAAAGGAC, TRPV3-C612S-Fw and GTCCTTGGAGgACTTCTCAATCAGTCAGTGAGG, TRPV3-C612S-Rv primers pair. And for TRPV3-C619S: GGACTCcAGTTCCTATGGCCAGC, TRPV3-C619S-Fw and GCTGGCCATAgGAACTGGAGTCC, TRPV3-C619S-Rv respectively. All cDNA constructs were confirmed by DNA-sequencing and used to make cRNAs. Oocytes expressing mTRPV3-C619S and mTRPV3-C612S mutant channels were challenged with 2-APB [1 mM], camphor [10 mM] and dihydrocarveol [10 mM] either at -40 mV or +40 mV holding potentials in voltage-clamp experiments. Responses of both mutants to 2-APB were similar to wild-type mTRPV3. Interestingly, responses to camphor were totally lost in mTRPV3-C619S mutant, while responses to dihydrocarveol remained intact. In contrast mTRPV3-C612S displayed slightly altered [16 +/- 2% reduction] phenotype with respect to camphor sensitivity. It is concluded that pore-region cysteines play critical role in camphor sensitivity of TRPV3 ion channels