ABSTRACT
Introduction:We aim to investigate ischemic penumbra using Diffusion weighted imaging-Susceptibility weighted imaging mismatch using DWI Alberta Stroke Program Early Computed tomography Stroke Score scoring in patients with multiple co morbid.Methods:From January 2011 to December, 2017; 70 consecutive patients (50 men, 20 women; mean age 64.5; range 45-82 years) with acute infarct on Diffusion weighted imaging (DWI) were selected for the study. Stroke protocol performed including DWI and susceptibility weighted imaging (SWI) on first day and repeat within three days. All initial MR images were interpreted by one Neuroradiologist with more than ten years blind to the clinical findings of each patient. The definition of an acute infarct area was high signal intensity on DWI with dark signal intensity on Apparent diffusion weighted imaging (ADC). The infarct extent was scored using the Alberta Stroke Program Early CT Score (ASPECTS) system. Infarct growth was defined as any new or larger lesion on the second DWI.For correlation with infarct growth, the same topographic system was used to record the extent of the Prominent vessel sign(PVS) on SWI.Spearman’s rank correlation test was used to examine the correlations between PVS score and infarct growth score. Regression was computed, with P<0.05 considered significant.Results:The study included 12 women and 10 men, (mean age 67.1 years).MRI images were initially acquired as stroke protocol (mean 12 hours) in acute stage and the next MRI was done within 3 days after the acute stage.9 patients had right sided and 13 patients had left sided MCA territory infarct, the mean DWI-ASPECTS score was 4.3 (range 0–9). PVS was detected in 15 patients (mean score 4.1, range 0–10).Out of 22 patients 9 patients showed no evolution in infarct however in 13 patients evolution was from (ASPECTS mean score 3.95, range 0–9; mean infarct growth score 7.4, range 0–10).7 patients devoid of PVS in initial MRI, did not exhibited evolution of infarction. Of 15 patients with PVS on initial MRI, 13 (87%) had infarct growth. Correlation between the evolution in infarct size and PVS score was observed (r = 0.86,P<0.001).Conclusion:PVS seen in infarcted territory is related to poor prognosis and this can be reliably used as a surrogate marker of oxygen extraction in penumbra.SWI can predict tissue at risk and can be a replacement for perfusion scan in clinical scenerio of acute ischaemic infarct
ABSTRACT
Biologically, screening of medicinal plants extracts have been since pre-historic to determine the antioxidants and antimicrobial profile. The present study was aimed to investigate and evaluate crude extract and different fractions of Bergenia ciliata Sternb [rhizome] for bioactivity which is most considerable medicinal plants. The chloroform fraction was found to be highly anti-oxidative with the IC50 value [4.15 +/- 0.82] as compare to ethyl acetate and n-hexane fraction. In addition, neither crude extract nor any fraction showed inhibition against fungal strains, i.e. Aspergillus flavus and Aspergillus niger. Furthermore, the crude extract and fractions of B. ciliata [rhizome] exhibiting promising activities against Bacillus atrophoeus, Bacillus subtilis, Kleibsiella pneumonia and Pseudomonas aeruginosa strains. In summary, B. ciliata is recommended as a source of bioactive compounds which might be used against oxidative stress and drug resistance bacteria
ABSTRACT
The current study was designed to check the antioxidant and enzyme inhibition potential of various extracts/fractions of three selected plants. The aerial parts of Conocarpus erectus [Combretaceae], Ficus variegata [Moraceae] and Ficus maclellandii [Moraceae] were extracted with ethanol [95%] and the resulting crude extracts were partitioned with n-hexane, chloroform and n-butanol successively. Folin-Ciocalteu reagent was used to calculate the total phenolic contents, flavonoids contents were calculated with aluminum chloride while antioxidant and enzyme studies were carried out through standard protocols. All extracts/fractions contained reasonable amount of phenolic compounds ranging from 0.58-58.23mg CE/g of DW and 0.43-30.56mg GAE/g of DW. Total flavonoids were determined using rutin and quercetin standards, ranging from 2.65-18.2 mg rutin equivalent/g of dry weight and 0.92-5.41mg quercetin equivalent/g of dry weight. Antioxidant studies such as DPPH inhibition FRAP and total antioxidant capacity [TAC] was checked. The crude ethanolic extract of C. erectus showed maximum antiradical scavenging power [90.43%; IC[50]=7 micro g] and ferric reducing antioxidant power [16.5micro M eq.FeSO[4].7H[2]O], respectively while leave extract of F. variegata [chloroform] was the most active [0.6577] in TAC among other extracts of the selected medicinal plants. Butanolic leave extract of C. erectus exhibited maximum enzyme inhibition activity [91.62% with IC50 40micro g/ml] while other extracts showed significant activity. It was observed from results that all extracts/fractions of under consideration plants, exhibited significant bioactivities especially ethanolic and butanolic fractions, which may be the richest source of such type of activities
Subject(s)
Combretaceae , Antioxidants , Cholinesterase Inhibitors , Plant Components, Aerial , Plant Extracts , Plants, MedicinalABSTRACT
We planned to investigate the rates of Caesarean Section [CS], potential Vaginal Births After previous Caesarean Section [VBAC], and successful VBAC in a secondary care hospital. We conducted an analytical retrospective study at Aga Khan Hospital for Women, Karimabad, Karachi, from October 2011 to September 2012. Data related to total deliveries, Lower Segment CS [LSCS], attempted VBAC and successful VBAC was retrieved from medical records. Total number of deliveries were 3266. Of these, 1021[31.26%] deliveries were conducted by CS. A total of 365[11.1%] had a previous history of one CS and VBAC trial was given to 33[9%] of these pregnancies. The success rate of VBAC was 21[63.6%]. Our results highlight that despite having limited resources, our rates of CS, VBAC trials and successful VBACs were within reasonable limits when compared with international rates
Subject(s)
Humans , Female , Pregnancy , Vaginal Birth after Cesarean , Secondary Care Centers , Retrospective StudiesABSTRACT
To determine the frequency of intra-operative hypotension following induction of Anesthesia in patients continuing their routine dose of angiotensin system inhibitor therapy before surgery. Cross-sectional study. Department of Anaesthesiology, Combined Military Hospital, Quetta. One year from 20-08-2010 to 19-08-2011. Total 92 hypertensive patients were included in this study. Diagnostic criteria for patients was those cases receiving ACEI/ARA therapy for at least 3 months with admission preoperative arterial blood pressure of >150/90mmHg. Mean age of the patients was 47.70 +/- 8.47 years. Out of 92 patients, 38 patients [41.3%] were male while remaining 54 patients [58.7%] were female. Distribution of cases by hypotension after induction of anesthesia shows, hypotension at 30 minute in 55 patients [59.8%] and hypotension at 60 minute in 37 patients [40.2%]. Out of 55 hypotensive patients [at 30 minute] 17 patients [30.9%] had mild hypotension, 32 patients [58.2%] had moderate hypotension and 6 patients [10.9%] had severe hypotension. Out of 37 hypotensive patients [at 60 minute] 8 patients [21.6%] had mild hypotension, 25 patients [67.6%] had moderate hypotension and 4 patients [10.8%] had severe hypotension. Hypertensive patients continuing their routine angiotensin system inhibitors therapy [<10 hr preoperative] have a variable risk of developing moderate hypotension within 30 minutes after induction. This moderate hypotension proved to be of little clinical significance as it responded to conventional therapy