Assessment of land use cover changes, carbon sequestration and carbon stock in dry temperate forests of Chilas watershed, Gilgit-Baltistan

Abstract Land use and land cover change are affecting the global environment and ecosystems of the different biospheres. Monitoring, reporting and verification (MRV) of these changes is of utmost importance as they often results in several global environmental consequences such as land degradation, mass erosion, habitat deterioration as well as micro and macro climate of the regions. The advance technologies like remote sensing (RS) and geographical information system (GIS) are helpful in determining/ identifying these changes. In the current study area, changes in carbon stocks, notably in forest areas, are resulting in considerable dynamics of carbon stocks as a result of climate change and carbon sequestration. This study was carried out in the Diamer district of the Gilgit Baltistan (GB) Pakistan to investigate the change in cover change/land use change (particularly Forest Land use) as well as carbon sequestration potential of the forests in the district during almost last 25years. The land cover, temporal Landsat data (level 1, LIT) were downloaded from the USGS EROS (2016), for 1979-1989, 1990-2000 and 2001-2012. Change in land uses, particularly forest cover was investigated using GIS techniques. Forest inventory was carried out using random sampling techniques. A standard plot of size 0.1 ha (n=80) was laid out to determine the tree density, volume, biomass and C stocks. Simulation of C stocks was accomplished by application of the CO2FIX model with the data input from inventory. Results showed a decrease in both forest and snow cover in the region from 1979-2012. Similarly decrease was seen in tree volume, tree Biomass, dynamics of C Stocks and decrease was in occur tree density respectively. It is recommended we need further more like project such as BTAP (Billion Tree Afforestation Project) and green Pakistan project to increase the forest cover, to control on land use change, protect forest ecosystem and to protect snow cover.

Resumo O uso e as mudanças na cobertura da terra estão afetando o meio ambiente global e os ecossistemas das diferentes biosferas. O monitoramento, relatório e verificação (MRV) dessas mudanças são de extrema importância, pois muitas vezes resultam em várias consequências ambientais globais, como degradação da terra, erosão em massa, deterioração do hábitat, bem como micro e macroclima das regiões. As tecnologias avançadas, como sensoriamento remoto (RS) e sistema de informações geográficas (SIG), são úteis para determinar / identificar essas mudanças. Na área de estudo atual, as mudanças nos estoques de carbono, principalmente em áreas florestais, estão resultando em uma dinâmica considerável dos estoques de carbono como resultado das mudanças climáticas e do sequestro de carbono. Este estudo foi realizado no distrito de Diamer de Gilgit Baltistan (GB), Paquistão, para investigar a mudança na mudança de cobertura / mudança de uso da terra (particularmente uso de terras florestais), bem como o potencial de sequestro de carbono das florestas no distrito durante quase os últimos 25 anos. A cobertura da terra, os dados temporais do Landsat (nível 1, LIT), foram baixados do USGS EROS (2016), para 1979-1989, 1990-2000 e 2001-2012. Mudanças nos usos da terra, particularmente na cobertura florestal, foram investigadas usando técnicas de SIG. O inventário florestal foi realizado por meio de técnicas de amostragem aleatória. Um lote padrão de 0,1 ha (n = 80) foi estabelecido para determinar a densidade das árvores, volume, biomassa e estoques de C. A simulação dos estoques de C foi realizada pela aplicação do modelo CO2FIX com a entrada de dados do inventário. Os resultados mostraram uma diminuição na cobertura florestal e de neve na região de 1979 a 2012. Da mesma forma, diminuição foi observada no volume da árvore, biomassa das árvores, dinâmica dos estoques de C e diminuição na densidade das árvores, respectivamente. É recomendado que precisemos de mais projetos como o BTAP (Billion Tree Afforestation Project) e o projeto Green Pakistan para aumentar a cobertura florestal, controlar as mudanças no uso da terra, proteger o ecossistema florestal e proteger a cobertura de neve.

A retrospective study to assess visual field improvement following augmented trabeculectomy

Purpose: To explore the visual field (VF) changes two years following augmented trabeculectomy. Methods: A retrospective study of patients who underwent augmented trabeculectomy surgery with mitomycin C by a single surgeon at East Lancashire Teaching Hospitals NHS Trust over 3 years. Patients with a minimum of two years postoperative follow?up were included. Baseline characteristics, intraocular pressure (IOP), VF, number of glaucoma medications, and complications were recorded. Results: In total, 206 eyes were included, 97 (47%) patients were female, and the mean age was 73.8 ± 10.3 (range 43 to 93) years. One hundred thirty?one (63.6%) eyes were pseudophakic before trabeculectomy. The patients were divided into three outcome groups according to VF outcome. Seventy?seven (37.4%) patients had stable VF, 35 (17.0%) patients showed VF improvement, and 94 (45.6%) had VF deterioration. The overall mean preoperative IOP was 22.7 ± 8.0 mmHg and postoperative IOP 10.4 ± 4.2 mmHg, with a reduction of 50.2% (P < 0.001). In total, 84.5% of postoperative patients did not require glaucoma medications. A higher number of patients with postoperative IOP ?15 mmHg had deteriorating VF (P < 0.001). Based on preoperative MD distribution, VF improvement or stability was more achievable with patients with a preoperative VF defect up to ?12 dB (n = 41, 59.4%) and in those with greater than ?24 dB (n = 25, 64.1%). Conclusion: Trabeculectomy continues to be an effective means of lowering IOP in patients with uncontrolled glaucoma and is important in stabilizing or improving visual fields. We recommend early trabeculectomy to prevent further VF deterioration. This may help in maintaining VF for driving status and, thus, quality of life

Evaluation of economic loss caused by Indian crested porcupine (Hystrix indica) in agricultural land of district Muzaffarabad, Azad Jammu and Kashmir, Pakistan / Avaliação da perda econômica causada pelo porco-espinho de crista indiano (Hystrix indica) em terras agrícolas dos distritos de Muzaffarabad, Azad Jammu e Caxemira, Paquistão

Abstract The Indian crested porcupine (Hystrix indica) is a vertebrate pest of agricultural lands and forest. The study was aimed to report the damage to local crops by the Indian crested porcupine (Hystrix indica) in the Muzaffarabad District. A survey was conducted to identify the porcupine-affected areas and assess the crop damage to the local farmers in district Muzaffarabad Azad Jammu and Kashmir (AJK) from May 2017 to October 2017. Around 19 villages were surveyed, and a sum of 191 semi-structured questionnaires was distributed among farmers. Crop damage was found highest in village Dhanni where a porcupine destroyed 175 Kg/Kanal of the crops. Regarding the total magnitude of crop loss, village Danna and Koomi kot were the most affected areas. More than half (51.8%) of the respondents in the study area suffered the economic loss within the range of 101-200$, and (29.8%) of the people suffered losses in the range of 201-300$ annually. Among all crops, maize (Zea mays) was found to be the most damaged crop ranging between 1-300 Kg annually. In the study area, porcupine also inflicted a lot of damages to some important vegetables, including spinach (Spinacia oleracea), potato (Solanum tuberosum) and onion (Allium cepa). It was estimated that, on average, 511Kg of vegetables are destroyed by porcupine every year in the agricultural land of Muzaffarabad. It was concluded that the Indian crested porcupine has a devastating effect on agriculture which is an important source of income and food for the local community. Developing an effective pest control strategy with the help of the local government and the Wildlife department could help the farmers to overcome this problem.

Resumo O porco-espinho de crista indiano (Hystrix indica) é uma praga vertebrada de terras agrícolas e florestais. No estudo atual, o dano às plantações locais pelo porco-espinho de crista indiano (Hystrix indica) foi relatado pela primeira vez no distrito de Muzaffarabad. O estudo foi projetado para investigar a perda econômica causada pelo porco-espinho de crista indiano (Hystrix indica) nos distritos de Muzaffarabad, Azad Jammu e Caxemira (AJK) de maio de 2017 a outubro de 2017. Um estudo baseado em pesquisa foi conduzido para identificar as áreas afetadas por porcos-espinhos e avaliar os danos às colheitas para os agricultores locais. Cerca de 19 aldeias foram pesquisadas e um total de 191 questionários semiestruturados foi distribuído entre os agricultores. Os danos às colheitas foram encontrados mais intensamente na aldeia Dhanni, onde um porco-espinho destruiu 175 kg / Kanal das colheitas. Em relação à magnitude total da perda de safra, as aldeias Danna e Koomi Kot foram as áreas mais afetadas. Mais da metade (51,8%) dos entrevistados na área de estudo sofreu perdas econômicas na faixa de 101-200 $, e 29,8% das pessoas sofreram perdas na faixa de 201-300 $ anualmente. Entre todas as culturas, o milho (Zea mays) foi considerado a cultura mais danificada, variando entre 1-300 kg anualmente. Na área de estudo, o porco-espinho também causou muitos danos a alguns vegetais importantes, incluindo espinafre (Spinacia oleracea), batata (Solanum tuberosum) e cebola (Allium cepa). Estimou-se que, em média, 511 kg de vegetais são destruídos pelo porco-espinho todos os anos nas terras agrícolas de Muzaffarabad. Concluiu-se que o porco-espinho de crista indiano tem um efeito devastador na agricultura, que é importante fonte de renda e alimento para a comunidade local. O desenvolvimento de uma estratégia eficaz de controle de pragas com a ajuda do governo local e do Departamento de Vida Selvagem pode ajudar os agricultores a superar esse problema.

Evaluation of economic loss caused by Indian crested porcupine (Hystrix indica) in agricultural land of district Muzaffarabad, Azad Jammu and Kashmir, Pakistan / Avaliação da perda econômica causada pelo porco-espinho de crista indiano (Hystrix indica) em terras agrícolas dos distritos de Muzaffarabad, Azad Jammu e Caxemira, Paquistão

The Indian crested porcupine (Hystrix indica) is a vertebrate pest of agricultural lands and forest. The study was aimed to report the damage to local crops by the Indian crested porcupine (Hystrix indica) in the Muzaffarabad District. A survey was conducted to identify the porcupine-affected areas and assess the crop damage to the local farmers in district Muzaffarabad Azad Jammu and Kashmir (AJK) from May 2017 to October 2017. Around 19 villages were surveyed, and a sum of 191 semi-structured questionnaires was distributed among farmers. Crop damage was found highest in village Dhanni where a porcupine destroyed 175 Kg/Kanal of the crops. Regarding the total magnitude of crop loss, village Danna and Koomi kot were the most affected areas. More than half (51.8%) of the respondents in the study area suffered the economic loss within the range of 101-200$, and (29.8%) of the people suffered losses in the range of 201-300$ annually. Among all crops, maize (Zea mays) was found to be the most damaged crop ranging between 1-300 Kg annually. In the study area, porcupine also inflicted a lot of damages to some important vegetables, including spinach (Spinacia oleracea), potato (Solanum tuberosum) and onion (Allium cepa). It was estimated that, on average, 511Kg of vegetables are destroyed by porcupine every year in the agricultural land of Muzaffarabad. It was concluded that the Indian crested porcupine has a devastating effect on agriculture which is an important source of income and food for the local community. Developing an effective pest control strategy with the help of the local government and the Wildlife department could help the farmers to overcome this problem.

O porco-espinho de crista indiano (Hystrix indica) é uma praga vertebrada de terras agrícolas e florestais. No estudo atual, o dano às plantações locais pelo porco-espinho de crista indiano (Hystrix indica) foi relatado pela primeira vez no distrito de Muzaffarabad. O estudo foi projetado para investigar a perda econômica causada pelo porco espinho de crista indiano (Hystrix indica) nos distritos de Muzaffarabad, Azad Jammu e Caxemira (AJK) de maio de 2017 a outubro de 2017. Um estudo baseado em pesquisa foi conduzido para identificar as áreas afetadas por porcos-espinhos e avaliar os danos às colheitas para os agricultores locais. Cerca de 19 aldeias foram pesquisadas e um total de 191 questionários semiestruturados foi distribuído entre os agricultores. Os danos às colheitas foram encontrados mais intensamente na aldeia Dhanni, onde um porco-espinho destruiu 175 kg / Kanal das colheitas. Em relação à magnitude total da perda de safra, as aldeias Danna e Koomi Kot foram as áreas mais afetadas. Mais da metade (51,8%) dos entrevistados na área de estudo sofreu perdas econômicas na faixa de 101-200 $, e 29,8% das pessoas sofreram perdas na faixa de 201-300 $ anualmente. Entre todas as culturas, o milho (Zea mays) foi considerado a cultura mais danificada, variando entre 1-300 kg anualmente. Na área de estudo, o porco-espinho também causou muitos danos a alguns vegetais importantes, incluindo espinafre (Spinacia oleracea), batata (Solanum tuberosum) e cebola (Allium cepa). Estimou-se que, em média, 511 kg de vegetais são destruídos pelo porco-espinho todos os anos nas terras agrícolas de Muzaffarabad. Concluiu-se que o porco-espinho de crista indiano tem um efeito devastador na agricultura, que é importante fonte de renda e alimento para a comunidade local. O desenvolvimento de uma estratégia eficaz de controle de pragas com a ajuda do governo local e do Departamento de Vida Selvagem pode ajudar os agricultores a superar esse problema.

Evaluation of economic loss caused by Indian crested porcupine (Hystrix indica) in agricultural land of district Muzaffarabad, Azad Jammu and Kashmir, Pakistan

Abstract The Indian crested porcupine (Hystrix indica) is a vertebrate pest of agricultural lands and forest. The study was aimed to report the damage to local crops by the Indian crested porcupine (Hystrix indica) in the Muzaffarabad District. A survey was conducted to identify the porcupine-affected areas and assess the crop damage to the local farmers in district Muzaffarabad Azad Jammu and Kashmir (AJK) from May 2017 to October 2017. Around 19 villages were surveyed, and a sum of 191 semi-structured questionnaires was distributed among farmers. Crop damage was found highest in village Dhanni where a porcupine destroyed 175 Kg/Kanal of the crops. Regarding the total magnitude of crop loss, village Danna and Koomi kot were the most affected areas. More than half (51.8%) of the respondents in the study area suffered the economic loss within the range of 101-200$, and (29.8%) of the people suffered losses in the range of 201-300$ annually. Among all crops, maize (Zea mays) was found to be the most damaged crop ranging between 1-300 Kg annually. In the study area, porcupine also inflicted a lot of damages to some important vegetables, including spinach (Spinacia oleracea), potato (Solanum tuberosum) and onion (Allium cepa). It was estimated that, on average, 511Kg of vegetables are destroyed by porcupine every year in the agricultural land of Muzaffarabad. It was concluded that the Indian crested porcupine has a devastating effect on agriculture which is an important source of income and food for the local community. Developing an effective pest control strategy with the help of the local government and the Wildlife department could help the farmers to overcome this problem.

Resumo O porco-espinho de crista indiano (Hystrix indica) é uma praga vertebrada de terras agrícolas e florestais. No estudo atual, o dano às plantações locais pelo porco-espinho de crista indiano (Hystrix indica) foi relatado pela primeira vez no distrito de Muzaffarabad. O estudo foi projetado para investigar a perda econômica causada pelo porco-espinho de crista indiano (Hystrix indica) nos distritos de Muzaffarabad, Azad Jammu e Caxemira (AJK) de maio de 2017 a outubro de 2017. Um estudo baseado em pesquisa foi conduzido para identificar as áreas afetadas por porcos-espinhos e avaliar os danos às colheitas para os agricultores locais. Cerca de 19 aldeias foram pesquisadas e um total de 191 questionários semiestruturados foi distribuído entre os agricultores. Os danos às colheitas foram encontrados mais intensamente na aldeia Dhanni, onde um porco-espinho destruiu 175 kg / Kanal das colheitas. Em relação à magnitude total da perda de safra, as aldeias Danna e Koomi Kot foram as áreas mais afetadas. Mais da metade (51,8%) dos entrevistados na área de estudo sofreu perdas econômicas na faixa de 101-200 $, e 29,8% das pessoas sofreram perdas na faixa de 201-300 $ anualmente. Entre todas as culturas, o milho (Zea mays) foi considerado a cultura mais danificada, variando entre 1-300 kg anualmente. Na área de estudo, o porco-espinho também causou muitos danos a alguns vegetais importantes, incluindo espinafre (Spinacia oleracea), batata (Solanum tuberosum) e cebola (Allium cepa). Estimou-se que, em média, 511 kg de vegetais são destruídos pelo porco-espinho todos os anos nas terras agrícolas de Muzaffarabad. Concluiu-se que o porco-espinho de crista indiano tem um efeito devastador na agricultura, que é importante fonte de renda e alimento para a comunidade local. O desenvolvimento de uma estratégia eficaz de controle de pragas com a ajuda do governo local e do Departamento de Vida Selvagem pode ajudar os agricultores a superar esse problema.

Global Impact of the COVID-19 Pandemic on Cerebral Venous Thrombosis and Mortality / 대한뇌졸중학회지

Background@#and Purpose Recent studies suggested an increased incidence of cerebral venous thrombosis (CVT) during the coronavirus disease 2019 (COVID-19) pandemic. We evaluated the volume of CVT hospitalization and in-hospital mortality during the 1st year of the COVID-19 pandemic compared to the preceding year. @*Methods@#We conducted a cross-sectional retrospective study of 171 stroke centers from 49 countries. We recorded COVID-19 admission volumes, CVT hospitalization, and CVT in-hospital mortality from January 1, 2019, to May 31, 2021. CVT diagnoses were identified by International Classification of Disease-10 (ICD-10) codes or stroke databases. We additionally sought to compare the same metrics in the first 5 months of 2021 compared to the corresponding months in 2019 and 2020 (ClinicalTrials.gov Identifier: NCT04934020). @*Results@#There were 2,313 CVT admissions across the 1-year pre-pandemic (2019) and pandemic year (2020); no differences in CVT volume or CVT mortality were observed. During the first 5 months of 2021, there was an increase in CVT volumes compared to 2019 (27.5%; 95% confidence interval [CI], 24.2 to 32.0; P<0.0001) and 2020 (41.4%; 95% CI, 37.0 to 46.0; P<0.0001). A COVID-19 diagnosis was present in 7.6% (132/1,738) of CVT hospitalizations. CVT was present in 0.04% (103/292,080) of COVID-19 hospitalizations. During the first pandemic year, CVT mortality was higher in patients who were COVID positive compared to COVID negative patients (8/53 [15.0%] vs. 41/910 [4.5%], P=0.004). There was an increase in CVT mortality during the first 5 months of pandemic years 2020 and 2021 compared to the first 5 months of the pre-pandemic year 2019 (2019 vs. 2020: 2.26% vs. 4.74%, P=0.05; 2019 vs. 2021: 2.26% vs. 4.99%, P=0.03). In the first 5 months of 2021, there were 26 cases of vaccine-induced immune thrombotic thrombocytopenia (VITT), resulting in six deaths. @*Conclusions@#During the 1st year of the COVID-19 pandemic, CVT hospitalization volume and CVT in-hospital mortality did not change compared to the prior year. COVID-19 diagnosis was associated with higher CVT in-hospital mortality. During the first 5 months of 2021, there was an increase in CVT hospitalization volume and increase in CVT-related mortality, partially attributable to VITT.

Strong linear correlation between parasite density and ABO-blood group among patients with malaria parasite infection

Background: Analysis of the dynamics of Plasmodium falciparum infection as it relates to the ABO blood group system could expand our understanding of malaria pathology and further global efforts in addressing the scourge of malaria disease. This study seeks to examine the association between malaria infection and parasite density in relation to the ABO blood group system.Methods: 298 patients (Age Mean±SD = 28.8±9.16) were selected at random and screened for malaria parasite infection and parasite density quantification using the thick blood film method. Pearson correlation analysis was used to determine relationship between parasite density and blood group.Results: 88 (29.5%) patients tested positive to malaria parasite infection. Patients with blood group O recorded the highest number of positive cases (56.81%) and the least was found among those with blood group AB (3.42%). 93.18% of patients that tested positive were rhesus positive while 6.82% were rhesus negative. 40.90% of patients with mild parasitaemia and 10.23% of patients with moderate parasitaemia were of blood group O+. Pearson correlation coefficient was strong, direct and linear (r = 0.9184; r2 = 0.8434).Conclusions: This study has shown that there is a strong correlation between parasite density per microliter of blood in relation to the ABO-blood group type of individuals diagnosed with malaria parasite infection.

Fall-related injuries in a low-income setting: results from a pilot injury surveillance system in Rawalpindi, Pakistan

This study assessed the characteristics and emergency care outcomes of fall-related injuries in Pakistan. This study included all fall-related injury cases presenting to emergency departments [EDs] of the three teaching hospitals in Rawalpindi city from July 2007 to June 2008. Out of 62,530 injury cases, 43.4% [N = 27,109] were due to falls. Children [0-15 years] accounted for about two out of five of all fall-related injuries. Compared with women aged 16-45 years, more men of the same age group presented with fall-related injuries [50% vs. 42%]; however, compared with men aged 45 years or more, about twice as many women of the same age group presented with fall-related injuries [16% vs. 9%, P < 0.001]. For each reported death due to falls [n = 57], 43 more were admitted [n = 2443, 9%], and another 423 were discharged from the EDs [n = 24,142, 91%]. Factors associated with death or inpatient admission were: aged 0-15 years [adjusted odds ratio [aOR] = 1.35], aged 45 years or more [aOR = 1.94], male gender [aOR = 1.15], falls occurring at home [aOR = 3.38], in markets [aOR = 1.43], on work sites [aOR = 4.80], and during playing activities [aOR = 1.68]. This ED-based surveillance study indicated that fall prevention interventions in Pakistan should target children, older adult women, homes, and work sites

Lumbar Morphometry: A Study of Lumbar Vertebrae from a Pakistani Population Using Computed Tomography Scans

STUDY DESIGN: A cross-sectional study. PURPOSE: To describe the characteristics of lumbar vertebrae of Pakistani patients reporting at a tertiary care hospital and compare with studies from other populations. OVERVIEW OF LITERATURE: Several studies have been conducted to determine morphometry of lumbar vertebrae. Most of the studies involve Caucasian populations, still data on other populations still sparse. This is the first study describing lumbar morphometry of a Pakistani population. METHODS: An observational study was conducted based on a review of thin-cut (3 mm) computed topographic images of lumbar vertebrae. Two-hundred and twenty vertebrae from forty-nine patients were studied, and various dimensions were analyzed. RESULTS: Generally, the size of the vertebrae, vertebral canals and recesses were found to be greater in male patients. The difference was statistically significant for transverse and anteroposterior diameters of the vertebral bodies and sagittal diameter of pedicles on the left side (p<0.05). Comparison of populations revealed statistically significant differences in pedicle dimensions between Pakistani population and others. CONCLUSIONS: This study provides anatomical knowledge of the lumbar region in a sample population of Pakistan. There were significant differences in various dimensions of lumbar vertebrae between female and male patients. This would prove to be critical for performing a safe operation.

Natal and neonatal teeth

Natal teeth [teeth present at birth] and neonatal teeth [teeth observed in the first 30 days of life] are uncommon. They may cause feeding problems and ulcerations on the ventral surface of the tongue. They can also be alarming to parents and cause discomfort with breastfeeding. A review of literature was conducted to review their etiology, significance, and clinical features with special emphasis on the complications and management. The opportunity of establishing a dental home through the early dental visits was highlighted. Furthermore, this case report details the examination and management of a 24-hour old neonate with 2 neonatal teeth. Natal teeth, although uncommon, are best referred to pediatric dentists for investigation and management

[Evaluating thrombotic markers in chronic periodontitis with hypertension]

Chronic Periodontitis is accompanied with subacute systemic inflammatory responses and a procoagulant state which manifests in changes of some serological vascular thrombotic markers levels. This study aimed to evaluate several vascular thrombotic markers levels in patients with chronic periodontitis. Study population consisted of 60 individuals ,36 males, 24 females, aged between 30- 48 years, [mean 36.33 years], were divided into 2 groups; the first, [n=20],was the control healthy individuals, and the second, [n=40],was patients with chronic periodontitis. Registration included, systolic blood pressure[sBP], body mass index and the periodontal disease indices; dental plaque[PI], gingival inflammation[GI], bleeding on probing[BOP], pocket probing depth[PPD],clinical attachment loss[CAL]. Blood tests included platelets count[Plt], fibrinogen[Fib], prothrombin time[PT], activated partial thromboplastin [aPTT], and Von Willebrand factor antigen [vWF:Ag]. Statistics, included independent Ttest and Pearson correlation, were performed at [P<0.05] by means of SPSS 19th ed. There were significant differences between the two groups in [sBP] [P=0.022], [Plt] [P=0.004], [Fib] [P=0.001], [vWF:Ag] [P=0.011], and in all of the periodontal indices [P<0.05]. Furthermore, there was a significant moderate positive correlation [r= 0.4, P<0.05] between all of the periodontal indices thrombotic markers, and was more evident in [Plt] with [GI], [Fib] with [PI], [GI], [BOP], [PPD], and [vWF:Ag] with [PI]. Periodontitis was associated with higher values of systolic blood pressure, platelets count, fibrinogen level, Von Willebrand factor activity, and periodontal indices positively correlated with the thrombotic markers. These findings would point out to the role of the periodontal disease as a risk indicator in precipitating a procoagulant state

Herpes Simplex Encephalitis Occurring During Chemo-Radiotherapy in Nasopharyngeal Carcinoma – A Case Report from Saudi Arabia.

Aim: To see possible association between the chemotherapy, radiotherapy or both with the reactivation of Herpes simplex virus 1(HSV1) in brain which merits further dialogue in the field of current evidence based literature. Presentation of Case: We present a case of 46 years old male patient who developed herpes simplex encephalitis (HSE) while receiving radical chemo-radiation for locally advanced nasopharyngeal carcinoma. Full informed consent was obtained for publication of this case. He was treated with protracted course of anti-virals and is currently leading a healthy life. Study Design: The study is a case report of a rare but important side effect of a common chemoradiation procedure. Place and Duration of Study: The study took place at Comprehensive Cancer Center, King Fahad Medical City. It was reported during June 2013. Discussion: HSV1 causes several disseminated primary infections including herpes labialis, gingivostomatitis, and corneal infections. It is particularly notorious for causing potentially fatal encephalitis. Its reactivation is linked to several environmental factors including chemotherapy and radiotherapy. Conclusion: This case report emphasizes on the possible role of chemo-radiation as causation of this life threatening condition, its early detection, prompt and aggressive treatment.

[Studying thrombotic markes in chronic periodontitis with hypertension]

Recent studies has focused on the impact of periodontal disease on the general health like cardiovascular disease and hypertension and their interactions. We aimed to study several vascular thrombotic markers levels in patients with chronic periodontitis and hypertension. Study population consisted of 80 patients aged 30- 68 years, [mean 43.7 years], [53 males, 27 females], were divided into 2 groups; the first, [n=40], had only chronic periodontitis, and the second,[n=40], were hypertensives with chronic periodontitis. Registrations included systolic blood pressure] [sBP], body mass index[BMI], and periodontal disease indices; dental plaque [PI], gingival inflammation [GI], bleeding on probing [BOP], and clinical attachment loss [CAL] Blood tests included; platelets count [Plt], fibrinogen [Fib], prothrombin time [PT], activated partial thromboplastin [aPTT], and Von Willebrand factor antigen [vWF:Ag]. Independent T-test and Pearson correlation, were performed at [P<0.05] by means of SPSS 19th ed. Hypertensives with periodontitis showed higher significant differences in age [P=0.001], [sBP] [P=0.001], [FBG] [P=0.001] [Plt] [P=0.022], [Fib] [P=0.001], and in [PPD] [P=0.008], [CAL] [P=0.001]. Significant moderate positive correlation was found between [Plt] and both of [PPD] and [CAL], while [Fib] correlated with[CAL], [r= 0,3- P<0.05]. Periodontitis in hypertensives was associated with an elevation in platelets count and fibrinogen concomitantly with an increase in blood glucose levels and body mass index,in addition to greater pocket probing depth and clinical attachment loss, compared with periodontitis only.These results shed the light on periodontitis as a risk indicator for hypertension and thrombotic propensity in susceptible individuals

Incidence, types, geographical distribution, and risk factors of congenital anomalies in Al-Ramadi Maternity and Children's Teaching Hospital, Western Iraq

To study the incidence, types, geographical distribution, and risk factors of congenital anomalies [CAs] in a teaching hospital. A total of 5864 neonates were examined for CAs between October 2010 and October 2011 in Al-Ramadi Maternity and Children's Teaching Hospital, Al-Ramadi, Western Iraq. Data include: neonate's name, gender, weight, and type of CAs, mother's age, residence, education, parity, consanguinity, smoking, illness, drugs, and ultrasound [U/S] results, father's age and smoking, and family recurrence of CAs. For every case, 2 controls were selected. Types and incidence of CAs was calculated. Odds ratio and confidence interval was utilized for risk factors evaluation. Overall CA incidences were 40.5/1000 for total births, 40.8/1000 live births, and 270.0/1000 for stillbirths. Twenty percent of CAs was found as multiple, 80% single, 63.8% major, and 36.2% minor. The cardiovascular system was found most affected, followed by genito-urinary system. Low birth weight, male gender, maternal smoking, consanguinity, parity, and CAs family recurrence were found to be significant risk factors, and oligohydramnios, polyhydramnios, and positive CAs by U/S, found as significant co-factors associated with CAs, while parental age, and maternal education were not considered risk factors. Although the incidence of CAs was lower than the Al-Fallujah rate, it is still higher than many developed and developing countries. Amniotic fluid volume changes in U/S may hide an ominous CA, and maternal smoking exposure during pregnancy and consanguinity may expose the family to a congenitally anomalous delivery

Antimicrobial susceptibility patterns of multidrugresistant Pseudomonas aeruginosa and Acinetobacter baumannii against carbapenems, colistin, and tigecycline

To examine susceptibility of Pseudomonas aeruginosa [P. aeruginosa] and Acinetobacter baumannii [A. baumannii] against carbapenems along with colistin and tigecycline as alternative therapeutic options. A total of 117 strains of multidrug-resistant [MDR] non-fermenting Gram negative bacteria isolated from non-duplicate samples were collected consecutively. We included one sample from each patient [84 isolates of A. baumannii and 33 isolates of P. aeruginosa isolated from patients seen at King Khalid University Hospital, Riyadh, Saudi Arabia, from June to December 2010]. Isolates were identified by the MicroScan WalkAway 96 Plus system. The minimum inhibitory concentrations [MICs] were determined by E-test following the Clinical and Laboratory Standards Institute breakpoint recommendations. Most A. baumannii strains were resistant to imipenem [90.5%], meropenem [90.5%], and doripenem [77.4%]. Whereas, a higher percentage of P. aeruginosa was resistant to imipenem [90.9%], and meropenem [81.8%], only 39.4% were resistant to doripenem. Colistin had excellent activity against both A. baumannii [100%] and P. aeruginosa [93.9%], while 89.3% of A. baumannii strains were susceptible to tigecycline. Among the carbapenems, doripenem was found to be the most potent antimicrobial agent against P. aeruginosa, whereas colistin proved to be an effective alternative antimicrobial agent for treatment of A. baumannii or P. aeruginosa. Tigecycline remains the best therapeutic option for MDR A. baumannii

Sedation with Dexmedetomidine versus Propofol during Regional Anaesthesia: Comparing Haemodynamic Parameters, Respiratory Rates and Offset Times

This study aimed to compare dexmedetomidine and propofol, in terms of haemodynamic parameters, respiratory rates and offset times, when used for sedation in patients undergoing elective orthopaedic and surgical procedures under regional anaesthesia. This was a prospective, randomised, single-blind study where 88 patients were recruited. Patients were randomised into two groups to receive either dexmedetomidine or propofol infusion. Central neuraxial blockade (spinal, epidural or combined spinal epidural) was performed. After ensuring an adequate block and stable haemodynamic parameters, dexmedetomidine was infused 15 minutes later at 0.4 μg/kg/hr, and propofol, at a target concentration of 2.5 μg/ml. Both drugs were titrated to achieve a bispectral index score of 70 before surgery commenced. Sedation level was monitored using the bispectral index score and assessed by the Observer Assessment of Alertness Scale score. Drug infusion was adjusted to maintain bispectral index scores ranging between 70-80 during surgery. Both groups showed reductions in mean arterial pressure and heart rate from baseline readings throughout the infusion time. However there was no significant reduction in the first 15 minutes from baseline (p > 0.05). Haemodynamic parameters and respiratory rate between both groups were not significantly different (p > 0.05). No patient demonstrated significant respiratory depression or SpO2 ≤ 95%. Offset times were also not significantly different between both groups (p = 0.594). There were no significant differences in haemodynamic parameters, respiratory rates and offset times between dexmedetomidine and propofol used for sedation in patients undergoing elective orthopaedic and surgical procedures under regional anaesthesia.

Frequency of aberrant expression of CD markers in cases of acute leukemia

In the present study 100 patients of acute leukemia were studied to find out the frequency of aberrant antigens in AML, B-ALL and T-ALL of which 73% cases were of lymphoid lineage and 27% cases were of myeloid lineage. 74% cases showed expression of lineage specific markers and were considered as conventional immunophenotypes while 26% cases showed expression of CD antigens which were not of that lineage upon which they were expressing. Some myeloid lineage associated antigens were present on acute lymphoblastic leukemia cases and lymphoid associated antigens showed their expression on acute myeloid leukemia cases. These cases were considered as aberrant immunophenotypes. The cases of acute lymphoblastic leukemia were further subcategorized as B-cell and T-cell acute lymphoblastic leukemia. The data from this study suggested that either the commonly described myeloid, B-cell and T-cell differentiation pathways are incorrect or blasts from cases of acute leukemia do not represent their normal counterparts. To explain these mixed immunophenotypes it is suggested that leukemic cells may have aberrant markers because of their abnormal genetic programme resulting in lineage infidelity. In this scenario the precursor cells may retain features of one lineage that they should have lost during commitment to another cell line. As a result of the leukemic process cells with aberrant immunophenotypes are immortalized in a precommitment phase of differentiation resulting in lineage promiscuity. This study strengthens the theories of lineage infidelity and lineage promiscuity by taking a critical and comparative approach of frequencies of aberrant antigens in acute leukemia in population of Pakistan

Effects of mobile phone radiation on serum testosterone in Wistar albino rats

To investigate the effects of electromagnetic field radiation generated by mobile phones on serum testosterone levels in Wistar albino rats. This experimental interventional control study was conducted in the Department of Physiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia during the period December 2006 to April 2008. A total of 34 male Albino rats [Wistar strain], 2 months of age, weighing 150-160 gm were used for the experiment. These animals were divided into 3 groups. The first group containing 6 rats was assigned as a control group. The second group containing 14 rats was exposed to mobile phone radiation for 30 minutes daily and the third group containing 14 rats was exposed to mobile phone radiation for 60 minutes daily for the total period of 3 months. At the end of experimental period, blood was collected into the container, and serum testosterone was analyzed using double-antibody radioimmunoassay method by Coat-A-Count. Exposure to mobile phone radiation for 60 minutes/day for the total period of 3 months significantly decrease the serum testosterone level [p=0.028] in Wistar Albino rats compared to their matched control. Long-term exposure to mobile phone radiation leads to reduction in serum testosterone levels. Testosterone is a primary male gender hormone and any change in the normal levels may be devastating for reproductive and general health

Role of modified triple test scoring system for evaluation of palpable breast masses in women under age 40

This prospective analytical clinical study was carried out to determine if a modification of the triple test score in which ultrasonography is substituted for mammography could be developed to rapidly and accurately assess breast mass in women under 40 years of age. Total hundred women were included in this study. Women younger than 40 years with palpable masses were evaluated utilizing modified triple test scoring. Surgical oncologist performed physical examination radiologist performed ultrasonography and cytopathologist did FNAC. All the patients were below age 40; about 50% were between 25-29 years. The youngest patients were of 20 years of age. Seventy-five patients were married and 25 were unmarried. Eleven% of the patients gave history of breast cancer in one of their family members. All the patients have a breast lump; most of the patients found their lumps incidentally while palpating them; however 38% of the patients had associated pain. Weight loss and anorexia was present in 3[3%] cases. Most of the patients 53[53%] presented with breast problem of less than three month duration, 26[26%] presented with complaints of 4-6 months duration while 21[21%] having duration of complaints more than 6 months. Fifty-five cases [55%] of breast lump were found on left side as compared to right 45[45%]. We thus conclude that to minimize delay and, therefore, reduce anxiety in majority of patients presenting to hospital and to avoid unnecessary out patient follow up and open biopsy, a policy of modified triple assessment [where ultrasonography is substituted for mammography especially female under the age of 40 years] with immediate reporting to provide a "one stop" diagnostic service proved highly beneficial for patients. The triple test score thus modified and named as modified triple test score [MTTS]

Clinical evaluation of oral insulin formulation in type-2 diabetic patients

The objective of this study was to assess the clinical efficacy of a single dose of insulin [100 IU] incorporated with a group of additives in enteric-coated, chitosan-coated capsules through its glucose lowering effect over a period of 12 hours. The capsules were administered orally to type-2 diabetic patients. The results were compared to those of oral administration of capsules of the same coating containing only insulin [100 IU] without additives, S.C. insulin injection [average dose 18 IU] and oral placebo. Ten patients with type-2 diabetes were enrolled in this blind, placebo-controlled, four-way crossover study. It was found that, capsules containing, only insulin resulted in a slight decrease in the mean blood glucose levels of the 10 patients compared to control especially in the period from 6 to 12 hours following administration. On the other hand, capsules containing insulin with additives showed a remarkable lowering of the blood glucose levels. Their effect started 3 hours following administration and sustained to the end of the experiment [12 h]. During the first 4 hours following administration was the reduction resulting from S.C. insulin was significantly higher than that produced by capsules containing insulin with additives. In the period from 4-7 hours, the effect of the capsules was comparable to that of S.C. insulin [no significant difference]. Beyond that [7-12 hours], there was a highly significant difference in favor of capsules. The relative bioavailability obtained by capsules containing only insulin was 3.43%, while that obtained by capsules containing insulin with additives was 18.54%