Effects of canola oil supplemented with atherogenic element and Nigella sativa [kalonji] on serum lipids in albino rats - An experimental study

To compare effects of canola oil supplemented with atherogenic element and Nigella sativa serum lipids in albino rats. Study was conducted at Pathology Department of Postgraduate Medical Institute, for 12 weeks. [Laboratory based randomized controlled trials]. Seventy two albino rats were selected and randomly divided into six groups of twelve animals with equal number of male and female in each. Fourteen days after acclimatization to the environment and basal diet, fasting blood samples [zero week] were collected by heart puncture under ether anesthesia and experimental diets were started which were continued for 12 weeks. All parameters were measured using enzymatic colorimetric methods. Estimations of serum lipids showed increase in total cholesterol [TC] and High Density Lipoprotein Cholesterol [HDL-c] levels but fall in LDL-c concentrations in groups fed on canola oil diet. On the other hand, even atherogenic supplemented groups had decrease in cardio-protective HDL-c and raised LDL-c; although statistically non-significant Thus canola oil diets were not hyperlipidaeinic and prevented adiposity. Nigella sativa [NS] diets significantly decreased serum total cholesterol and LDL-c while HDL-c was raised but non-significantly. Thus Nigella sativa prevented deposition of lipids in tissues, thus preventing tendency to obesity and atherogenesis by decreasing LDL-c in serum Nigella sativa produces antilipidaemic and anti-obesity effects by decreasing low density lipoprotein cholesterol level which is statistically significant in two out of the three groups fed on Ns; it also increased high density cholesterol which was however nonsignificant in comparison with canola oil alone

Prevalence of ocular Leishmaniasis in district Chakwal

Cutaneous Leishmaniasis is endemic in Pakistan. The current study was undertaken in District Chakwal to measure the prevalence of ocular lesions in cutaneous leishmaniasis. A 60 years male presented to the Oculoplastic Clinic at Al- Shifa Trust Eye Hospital Rawalpindi, Pakistan, with an isolated chronic non-healing ulcerative lesion of left upper eye lid. Clinically suspected to be squamous cell carcinoma, it underwent total excision followed by Cutler-Beard reconstruction. The histopathology was cutaneous leishmaniasis. A team was dispatched to the health center, Choa Saiden Shah of the area to which the patient belonged [120 km southeast of Islamabad]. The area was found to be endemic for leishmaniasis. A total of 925 patients with known cutaneous leishmaniasis were registered for treatment at the health center and examined for ocular involvement. The prevalence of ocular lesions was found to be about 1%. Most of the lesions involved the skin of the upper eyelid. All the non-ocular patients were undergoing treatment with intralesional injection of Glucantime, while patients with exclusive ocular involvement were treated with intramuscular injections. Ocular involvement in Leishmaniasis is relatively rare, but it should be kept in mind in the differential diagnosis of ulcerative lesions of the eyelid especially in an endemic area

Translation and validation study of the first modified pakistani version of the neck disability index and its revalidation

The purpose of our study was the translation and validation of the Neck Disability Index in our specific cultural background. The Pakistani Urdu version of Neck Disability Index [NDI] was tested for validity and reliability. The Neck Disability Index [NDI] is a valid and reliable tool, designed to measure disability in routine life activities due to neck pain. International standards were followed for the translation strategy comprising forward translations, reconciliation, backward translation and pre-testing steps. The translation of the original questionnaires was performed in accordance with published guidelines and this was adapted to cultural differences in the patient population. These procedures resulted in the Pakistani modified version of the NDI. comparative study. This study was carried out at the Department of Neurosurgery Outdoor Clinics at Benazir Bhurto Shaheed Teaching Hospital Abbottabad from April 2007-March 2009. In the first stage, Fifty five patients [32 men, 23 women] were included over two years period at the Department of Neurosurgery Outdoor Clinics at Benazir Bhutto Shaheed Teaching Hospital Abbottabad attached with Women Medical College Abbottabad. Seventeen patients were suffering from acute phase after a neck sprain, 20 had chronic neck pain and 18 had no neck pain but had other musculoskeletal symptoms. On 3 occasions, the patients completed the Neck Disability Index and other surveys. Levels of sensitivity, test-retest reliability and validity were acceptable. In the next stage, Thirty-eight patients [16 men, 22 women] were included in a study of the modified version, twenty patients with acute neck sprain and 18 with other musculoskeletal symptoms filled out to test the modified version of the Neck Disability Index, which provided a more specific measure of disability due to neck pain. We have accumulated enough evidence to show that the Urdu version of the Neck Disability Index measures disability in activities of daily living in patients with neck pain in a reliable, valid and responsive manner. The questionnaire is considered a useful tool for research and clinical settings in local or international studies since its psychometric properties are comparable with other versions validated in different countries. The Pakistani version of NDI is a reliable and valid instrument to measure psychometric properties and functional status in Pakistani patients suffering from neck disability. Being a simple and fast scale, its use can be recommended in a clinical setting and future outcome studies in Pakistan

Aneurysmal subarachnoid haemorrhage: outcome of aneurysm clipping in elderly patients and predictors of unfavourable outcome

To determine the outcome of treatment of microsurgical clipping in elderly [60 - 70 years] patients with aneurysmal subarachnoid hemorrhage and determine the predictors of poor outcome. Longitudinal analytical study. Nishtar Hospital, Multan, Mayo Hospital, Lahore, Department of Neurosurgery, Lahore General Hospital, Lahore, from January 2000 to January 2010. Elderly patients [60 - 70 years] with ruptured cerebral aneurysm were enrolled and graded on the basis of World Federation of Neurosurgeons Scale [WFNS]. Aneurysm sac obliteration was done in all the patients with microsurgical clipping. Postoperatively, the patients were assessed upto 3 months for outcome parameters i.e., neurological deterioration [based on WFNS grade and modified Rankin scale as favourable [mRS score <-2] and unfavourable [mRS score > 2]. The factors associated with unfavourable outcome were also noted which included age > 65 years, poor initial WFNS grade, and the occurrence of ischaemia. The mean age of the 48 patients was 65 +/- 5.45 years. There were 31 [64.6%] male and 17 [35.4%] female patients. Postprocedural neurological deterioration occurred in 23 patients [47.9%] related to ischaemia in 14 [29.16%], rebleeding in 1 [2%], and hydrocephalus in 8 [16.66%]. At 03 months, the outcome was favourable in 25 patients [52.08%] and unfavourable in 23 [47.91%]. In old patients, careful pre-operative assessment, interdisciplinary approach and meticulous tissue handling during aneurysm clipping may decrease the unfavourable outcome

Effect of benzene extract of Ocimum sanctum leaves on cauda epididymal spermatozoa of rats

Recent studies have shown that benzene extract of Ocimum sanctum [O. sanctum] leaves induces the ultrastructural changes in the epithelial cells of the cauda epididymis, its subsequent recovery in the seminiferous epithelium and fertility of male albino rats. Our aim was to investigate the effect of benzene extract of O.sanctum leaves on the cauda epididymal sperm parameters, morphology and their organelles at the ultrastructural level in albino rats. Wistar male rats [n=20] were allocated into two groups of control [n=10] and test group [n=10]. The test group received benzene extract of O.sanctum leaves [250mg/kg/day] for 48 consequence days. Five animals from each group were used for fertility test. Twenty-four hours after the last dose, the rest of the control [n=5] and treated [n=5] animals were sacrificed by cervical dislocation and then the cauda epididymal plasma was used for sperm analysis, scanning electron microscopy [SEM] and transmission electron microscopic [TEM] studies. Sperm analysis of test group exhibited significant [p

Role of total leukocyte count in diagnosis of acute appendicitis

Acute appendicitis is a common surgical emergency. Diagnosis may be difficult with little help from radiological and laboratory investigations. Total leukocyte count is one of the helpful investigations, being evaluated in this study. The patients presenting with right ower quadrant abdominal pain whom were diagnosed as having acute appendicitis and later underwent appendicectomy were included in the study. The preoperative leukocyte count was compared with histo-pathology findings of removed appendix. Sensitivity and specificity of TLC was calculated by standard formulas. The sensitivity and specificity of TLC as calculated in this study is 76.5% and 73.7% respectively while positive predictive value is 92.5%. TLC although not a diagnostic criteria for acute appendicitis but still is helpful investigation in decision making

Outcome of modified open surgery in tennis elbow

Tennis elbow is a common disorder of upper extremity. It can be treated conservatively in majority of the patients but some resistant cases eventually need surgery. This descriptive study was conducted at Department of Orthopaedics, Ayub Teaching Hospital, Abbottabad, from January 2002 to June 2006. Sixteen patients had surgical release of the extensor tendon origin along with excision of the lateral epicondyle ridge. These patients did not respond to conservative treatment i.e. rest, non- steroidal anti inflammatory drugs [NSAIDS], local steroid injections and physiotherapy. Patients were followed up to six months. Outcome was graded as excellent, good and poor according to pain relief and function of the hand. Sixteen patients [17 elbows] were studied, Thirteen were female [81.25%] and three were male [18.75%]. Fifteen patients [93.75%] had unilateral Tennis Elbow, while one had bilateral involvement [6.25%]. In unilateral disease, right side was affected in eleven patients [68.75%] and left side in four [25%]. Excellent outcome was noticed in eleven patients [68.75%] and good result in five patient [31.25%]. Open surgical technique of releasing extensor tendon origin along with excision of lateral condylar ridge of the humerus is new and simple procedure and yields excellent and good result in patients with resistant Tennis Elbow

Pauwel's osteotomy and osteosynthesis in patients. with non-union of femoral neck fractures

To evaluate the results of Pauwel's ostetotomy and oseosynthesig in patients with non union of femoral neck fractures. This Study was conducted in the Orthopaedic Unit, Nishtar Hospital, Multan during the period of 1989-1998. A total of 30 patients were included in the study. Thirty cases of neglected fracture neck of femur treated in Nishtar Hospital Multan from 1989-1998. Five patients were treated first with traction where greater trochanter migrated a way up to bring it down to the proper level. Then osteotomy was done. In 25 cases Pauwels' osteotomy was primarily done and fixed with 120-degree osteotomy plate. This is a reliable method of dealing with non-union of the Fracture neck of the femur in young adults

Supracondylar fractures; comparison of medial and lateral approach for fixation of humerus in children

To determine the surgical approach most suited in our setup and evaluate the results based on the functional and cosmetic outcome especially in the range of motion, the subsequent deformity, if any, and the carrying angle. Setting Orthopaedic surgery, Nishtar Hospital, Multan. Duration Two years. Study design Quasi experimental type of study. Thirty patients. Sampling technique Non-probability technique. Results The age of the patients included in our study ranged from 4-10 years with a mean age of 5.93 years in group A and 6.66 years in group B. Out of 30 patients in group-A, 3 [20%] males and 4[26.6%] in group-B had fracture on right side where as 12[80%] females in group-A and 11[73.3%] in group-B had fracture on left side. Majority of the patients i.e. 12[80%] in group-A and 11[73.3%] in group-B got injured due to fall from height. One [6.66%] patients from group-A and B had superficial wound infection. Pin tract infection was found in 1[6.66%] in group A and 2[13.33%] patients in group-B. This technique was easy to perform and proved to be safe, although hospitalization time was minimum in both groups. So we recommend medial approach for open reduction and internal fixation of all displaced supra-condylar fractures of humerus in children with appropriate indications

Total arterial myocardial revascularization: analysis of initial experience

Total arterial myocardial revascularization is an attempt to overcome the problems of late vein graft atherosclerosis, occlusion and need for coronary re-operations. Despite increasing evidence of efficacy, the use of arterial conduits has not been accepted as a primary practice in most of the centers in Pakistan for various reasons. We analyze our initial experience to assess the feasibility of total arterial revascularization as a primary strategy in patients requiring first time coronary artery bypass grafting. METHODS: Two hundred patients undergoing first time CABG at our institution, from January 2000 to April 2001, were studied. Group 1 consisted of 100 patients undergoing total arterial revascularization [using bilateral internal thoracic and radial arteries] and Group 2 consisted of 100 patients undergoing conventional CABG [using one internal thoracic artery and supplemental veins]. Thirty-day mortality and early morbidity with particular reference to resternotomy for bleeding, cerebrovascular accidents, renal failure, and sternal dehiscence were the main outcome measures. Patients in Group 1 were younger [56.2 +/- 10.4 vs. 60.3 +/- 9.8 years; P<0.001], had lower Parsonnet scores [4.8 +/- 0.4 vs. 9.6 +/- 1.8; P<0.001], and had better left ventricular function. Both groups received a similar number of grafts. The percentage of patients undergoing total arterial revascularization rose from 20% in the first three months to over 65% in the three later three-month periods. Overall 30-day mortality was 1.5%, one patient [1%] in Group 1 and two patients [2%] in Group 2. There was a similar incidence of postoperative complications and length of median postoperative stay in both groups. Total arterial revascularization can be adopted as a primary strategy in most patients undergoing CABG with no increase in mortality or morbidity

Incidence of gall stones in Carcinoma gall bladder patients

To determine the incidence of Gall stones in cases of Carcinoma Gall bladder.Retrospective descriptive study conducted from June 1999 to August 2002.Surgical B Ward of Khyber Teaching Hospital, Peshawar.All patients who were diagnosed as having Carcinoma Gall BladderThe presence or absence of stones was noted in cases of Carcinoma Gall Bladder, detected on preoperative ultrasonography or per-operatively on macroscopic examination, and later confirmed on histopathology. Out of the 40 patients with Carcinoma Gall Bladder in this series, 37 [924%] had Gall stones. There were 34 [85%] females and 6 [15%] males with an age range from 27 to 65 years. Six [15%] patients were in Stage /, 15 [37.5%] in Stage II, 14 [35%] in Stage III, while 5 [12.5%] cases were in Stage IV In 36 patients simple cholecys-tectomy was performed, whereas in 4 patients only biopsy was taken from liver metastasis.There is a strong association of Carcinoma Gall bladder- with gall stones

Evaluation and management of diabetic foot according to Wagner's classification. A study of 100 cases

Wagner's classification is the most widely utilized grading system for lesions of the diabetic foot. The aim of the study was to evaluate and manage the different lesions of diabetic foot according to Wagner classification. This will help to describe the lesions we treat study and compare outcomes and also identify measures to decrease morbidity and mortality due to diabetic foot disease. The study was conducted in surgical 'c' unit of Khyber teaching hospital, Peshawar from July 2002 to June 2003. 100 patients with diabetic foot disease were included in the study. Detailed history, clinical findings and investigations were recorded. Lesions were graded according to Wagner classification and appropriate medical and surgical treatment carried out. Diabetic foot disease formed 1.04% of total admissions and 0.23% of OPD patients. 62 [62%] were males and 38 were females. Common age group was 40 ' 60 years, 6 patients had grade 0, 14 grade 1, 25 with grade 2, 30 with grade 4 and 4 with grade 5 lesions. 17 patients were managed conservatively with antibiotics alone, 33 had incision drainage and debridement while 48 needed amputation of different types. Staphylococcus aureus was the commonest organism isolated. Majority of the diabetic foot lesions were in grade 2 to 5. Lesser grade lesions responded well to conservative treatment with antibiotics and surgical debridement while those with higher grades needed amputations. Effective glycemic control, timely hospital admissions, approximate surgical / medical treatment along with patient education in foot care can decrease morbidity and mortality due to diabetic foot disease

Myocardial preservation with intermittent aortic cross-clamping technique during coronary artery bypass grafting

To evaluate the safety and efficacy of intermittent aortic cross-clamping technique for myocardial preservation during coronary artery bypass grafting and to compare the results with other published series using the same technique. Design: An institution-based analytical study. Place and Duration of Study: Study was carried out from July 1995 to December 1997 at Punjab Institute of Cardiology, Lahore. Patients and The data of 100 consecutive patients were analyzed who had coronary artery bypass grafting without cardioplegia using intermittent aortic cross-clamping. All the patients who had emergency or concomitant major surgery, reoperations, and aortic disease with calcification were excluded from this study. Despite minor complications there was no mortality, no rhythm disturbance or perioperative infarction. Inotropic support was needed in 8% of patients. Our results compared favourably with other published series using the same technique. These results provide re-assurance that intermittent aortic cross-clamping provides excellent myocardial protection and operative conditions for primary coronary artery bypass. It also provides a simple and safe option for myocardial protection during coronary artery bypass grafting

Diagnostic value of CT scan in paediatric neurological disorders

Computerised tomography [CT] is now an established and widely available neuroimaging teachnique. Data regarding 80 children undergoing CT scan at the Nishtar Hospital. Multan were analyzed. Indications for ordering a CT scan included complicated cases of meningitis, seizure disorders, developmental delay, cerebro-vascular lesions and children with suspected space occupying lesions [SOL]. CT scan provided significant help in diagnosis or management in 100 percent cases of acute hemiparesis and suspected SOL and in 80 percent cases of complicated meningitis. Diagnostic help was provided by CT in 66 percent of children with seizures and in 40 percent with developmental delay. However, in only a very small percentage of children with these disorders, scan findings helped in deciding the course of management. CT scan has been a very significant advance in cranial imaging; however, physicians need to carefully consider relevant clinical findings in children with neurological disorders before considering them a candidate for this costly investigation