Expression of Certain Pulmonary Proteins in the Tracheal Mucosa and Lungs of Pashmina, Bakerwali and Non-Descript Goats of U.T.s of Ladakh and Jammu & Kashmir

Abstract The aim of this present study was to localize alveolar macrophages, Proliferating cell nuclear antigen (PCNA), Smooth muscle actin (SMA), Vimentin and Vasculo-endothelial growth factor (VEGF) in the tracheal epithelium and lung alveoli in three important breeds of goats namely, Pashmina, Bakerwali and non-descript goats by standard immunohistochemical methods. Large pulmonary macrophages were observed in the lung sections of all the three breeds of goat. Macrophages were observed in the alveolar septa and airway epithelium. The mean macrophage count for Pashmina, Bakerwali and non-descript goat were recorded as 23.4±1.47, 27.8±0.68 and 21.4±0.70, respectively. The PCNA activity was intense in the alveolar epithelial cells of lungs in Pashmina and Bakerwali goats and very high in the lung tissue of non-descript goat. The PCNA activity was intense in the bronchial epithelial cells of lungs in Bakerwali goat. Strong reaction of SMA was observed in the submucosa of bronchioles of Pashmina and Bakerwali goats. The submucosa of the tracheal tissue showed a strong reaction of SMA in the non-descript goat and moderate in the submucosa of trachea in the Bakerwali goat. A number of vimentin-positive cells were found in the lung parenchyma in both Pashmina and Bakerwali goats. Also, there was a strong reaction of vimentin mainly in submucosal area in non-descript goat. The VEGF activity was found to be intense in the lung alveoli of Bakerwali goat and strong in Pashmina and non-descript goats. The tracheal epithelium was moderately reactive to VGEF in all the three goats.

Low-light and its effects on crop yield: Genetic and genomic implications

Shade indicates decreased sunlight. The agricultural importance of shade imparts to its deteriorative effect of cropyield. Rice is not only the most widely used food crop by a third of the population of the world, but it has also beenestablished as the model monocot plant for study. This article describes several important aspects of shade on rice yieldwith appropriate examples in other plants such as Arabidopsis. To start with, how different environmental or growthconditions create shade is explained. The morphological, physiological and biochemical characteristics due to differentkinds of shade are selectively explained. The molecular characteristics of rice under shade from genetic, genomic andepigenetic studied are discussed. Signalling components for the manifestation of shade tolerance responses and theirinterconnection with other signalling networks and hormone pathway components are from recent reports. A list ofgenes, micro-RNAs and metabolites that are involved in shade responses is presented. Lastly, implications forsustainable yield under shade is discussed. This review will be useful not only for cutting-edge information on shadetolerance but will also build framework for upcoming new rice varieties with sustainable yield under shade.

Comparative Biometrical Studies on the Trachea and Lungs in Adult Pashmina, Bakerwali and Non-descript Goats of Jammu & Kashmir State

This present study was conducted on the trachea and lungs of adult Pashmina, Bakerwali and non-descript goats to compare the biometrical features of these organs among these breeds. For this, a total of 10 samples from each goat breed were collected. The mean length of the trachea in adult Pashmina, Bakerwali and non-descript goats were recorded as 19.70±0.55 cm, 27.35±0.43 cm and 27.24±1.02 cm, respectively. It was found that the length of the trachea was significantly shorter in case of Pashmina goat as compared to the other two breeds. Also, the width of the middle segment of the trachea was found to be significantly lesser in Pashmina goat. Similarly, the mean weight of the two lungs and their length at various levels in regard to different lobes showed variations among these three breeds and were significant for some biometrical parameters.

Comparision of post operative chronic pain after excision of ilioinguinal nerve in lichtenstein's hernioplasty

Objective: To provide a comparative analysis of mean post-operative pain score after preservation and elective excision of ilioinguinal nerve [UN] using standard Lichtenstein hernia repair [LHR] technique

Study Design: Randomized controlled trial

Place and Duration of Study: Department of Surgery Combined Military Hospital [CMH] Rawalpindi/ Peshawar, from 15 May 2013 to 15 May 2014

Materials and Methods: One hundred and fifty patients with diagnosis of inguinal hernia satisfying inclusion/exclusion criteria were included. Patients were divided into two groups randomly. In group A, UN was carefully protected while excision were done in group B. Demographic as well as data concerning groin pain at 03 months post operatively were collected and analyzed using SPSS

Results: A total of 150 patients were included. Mean age in group A was 37.32 +/- 10.45 years while in group B was 36.56 +/- 10.26 years [p=0.653]. Majority of the patients in both groups were male [group A 89.33% [67], 92% [69] in group-B], while female constituted only minority [8 [10.67%] in group A and 6 [8%] group-B], the difference being statistically insignificant [p=0.571]. Majority of the patients had indirect hernia and mean operation time was similar in both groups. Mean postoperative pain score was 3.76 +/- 1.11 and 2.82 +/- 0.677 in group A and B respectively, the difference being statistically significant [p<0.001]

Conclusion: Mean post-operative pain score is higher in preservation techniques compared to elective excision of UN for the treatment of inguinal hernia

Comparison of Negative Pressure Wound Therapy using Vacuum-Assisted Closure with Advanced Moist Wound Therapy in the treatment of Diabetic Foot Ulcers

Objective: To evaluate the clinical efficacy of Negative Pressure Wound Therapy [NPWT] using Vacuum Assisted Closure [VAC] compared with Advanced Moist Wound Therapy [AMWT] to treat Diabetic Foot Ulcer [DFU]

Study Design: Randomized control trial

Place and Duration of Study: Surgical Department, Combined Military Hospital [CMH] / Military Hospital [MH], Rawalpindi, from November 2010 to June 2012

Methodology: The study consisted of 278 patients, with 139 patients each in Group 'A' and 'B', who were subjected to AMWT and NPWT, respectively. Wound was assessed digitally every week for 2 weeks. Wound dimension and surface area were determined using University of Texas Health Centre at San Antonio [UTHCSA] image tool version 3.0. Efficacies of AMWT and NPWT were compared in terms of reduction in wound area over 2 weeks

Results: Mean age of presentation in group A was 55.88 +/- 10.97 years while in group B, it was 56.83 +/- 11.3 [p=0.48]. Mean duration of diabetes at presentation was 15.65 +/- 4.86 and 15.96 +/- 5.79 years in group A and B, respectively [p=0.74]. Majority of patients had Wagner's grade 2 ulcer [82% in group A and 87.8% in group B, p= 0.18]. Initial wound size in group A was 15.07 +/- 2.92 cm[2] and in group B 15.09 +/- 2.81 cm[2] [p = 0.95]. Wound size measured after 2 weeks, treatment was in group A 13.70 +/- 2.92 cm[2] and in group B 11.53 +/- 2.78 cm[2] [p < 0.001]. Wound area reduction in both groups revealed statistically significant faster healing in group B as compared to group A [p < 0.001]

Conclusion: NPWT using VAC was more efficacious than AMWT in the management of diabetic foot ulcers

Leadership in family planning and reproductive health: a university based capacity building and networking initiative in Pakistan

Pakistan's DHS 2006-07 showed gloomy indicators of reproductive health in the country especially of the women and children. Family planning [FP] and reproductive health [RH] programs date back to late 50's and yet failed to deliver the desired results. Among other weaknesses in the programs, it has been recorded that lack of effective management and good governance have resulted in either questionable quality of FP and RH services and low utilization of services. This dismal state of affairs has left the country with a high growth rate [1.9%], a large unmet need for contraception [33%] with a fertility rate of over 4 children /woman, an unacceptably high maternal mortality ratio [276/100,000], an under 5 mortality of 0.4 million a year, and an ironically strong urban bias of doctors [80%] and that also focusing on curative care. Lack of training and incentives for staff have resulted in a fragile health system and weak human resource management. For redressing this appalling situation in the country, and particularly in RH and Population sector, a new vision has to be thought out through strategic thinking of all the issues. A pilot training course comprising a whole range of pedagogy on 'Leadership in Family Planning and Reproductive Health' was launched and was successfully implemented in 2008 at the Aga Khan University, Karachi with the underlying objectives of capacity building of mid-top level managers, policy makers, advocacy specialist, academia, NGO and civil society representatives to work effectively and acquire leadership positions in family planning and population programs with deeper understanding of RH. This critical mass of trained leaders would work effectively with leadership skills using multi-sectoral approach; and will create and implement a strategic action plan to improve quality of and access to FP/RH services in their respective areas in the wake of achieving the millennium development goals by 2015.

Incidence of liver cirrhosis in infancy and childhood

Cirrohsis is the end result of chronic liver disease caused by the different pathological factors including congenital malformation, inflammation [hepatitis] and metabolic /storage disorders, leading to liver cell damage. To determine the incidence of liver cirrhosis and childhood with chronic hepatitis, we studied 41 biopsies of children for the presence of cirrhosis. To provide an overview of current childhood statistics of hepatitis and liver cirrhosis to facilitate analysis of the impact of past research discoveries on outcome and provide essential information for prioritizing future research directions. Retrospective study. This study was conducted at the Department of Basic Medical Sciences Institute, JPMC, Karachi from Jan.2000 to Dec. 2007. Slides/ paraffin blocks of liver biopsies from patients under 15 years of age. The cases were of two categories i.e. retrospective and prospective. The distribution of 41 cases of hepatitis was according to Age and Sex. Total 22 [53.7%] cases were encountered in the youngest of 0-5 years age group, 13 [13.7%] cases in 6-10 years and only 6 [14.6%] cases in 11-15 years age group. The distribution of 41 cases of cirrhosis of liver, according to age and sex. The maximum 22 [53.7%] youngest case in 0-5 years, 13 [31.7%] cases in 6-10 years and 6 [14.6%] cases were found in 11-15 year age group. It is observed that the tendency of liver inflammation was decreased with increasing age and sexual differentiation shows male predominance with male to female ratio of 2.4:1. Liver cirrhosis discovered with increasing age in children. It is found to be a common cause for enlargement of liver with associated hepatitis and chronic liver diseases in infants and children. It can lead to higher risks of acute or chronic responses in adulthood and will require new treatment paradigms building on an increased understanding of the molecular processes for infancy and childhood liver cirrhosis

Fetal outcome in singleton pregnancies complicated with polyhydramnios from 28 to 36 weeks

To describe the fetal outcome in singleton pregnancies complicated with polyhydramnios from 28 to 36 weeks. Descriptive study. Department of Obstetrics and Gynaecology, Combined Military Hospital, Lahore from July 2007 to July 2008. Fifty pregnant women diagnosed with polyhydramnios were included. They were evaluated on ultrasonography, amniotic fluid index greater than 25cm or a maximum vertical pocket of liquor greater than 8cm confirmed the diagnosis of polyhydramnios and associated congenital abnormality. A total of 50 patients were included in the study. Mean gestational age was 34.2 +/- 1.4. Thirty patients [60%] had vaginal delivery while cesarean section was done in 20 patients [40%]. Forty patients [80%] had live birth whereas 4 [8%] and 6 [12%] patients had stillbirth and IUD respectively. Weight of 56% of the babies was less than 2.5kg and 44% of the babies more than or equal to 2.5kg with mean weight of 2.4 +/- 0.3kg. Normal babies were seen in 40 patients [80%] while 10 babies [20%] had congenital abnormalities. Out of 40 live born babies, 18 [45%] did not require resuscitation while 22 [55%] were shifted to NICU. Two babies [9%] expired in nursery and 20 babies [91%] were discharged healthy. Polyhydramnios carries a higher incidence of adverse perinatal outcomes, such as fetal distress during labor, low Apgar scores, NICU transfer, fetal death, congenital anomalies and neonatal death from the study population

Standardization of symptom checklist-R on psychiatric and non psychiatric sample of Lahore city

The present research was conducted to standardize Symptom Checklist-R on psychiatric and non psychiatric population of Lahore city. Lahore. The research consisted of two stages. At stage one, an indigenous Symptom Checklist developed by Rahman and Sitwat in 1990[1], was reviewed by the research team comprising of 4 trainees of Advanced Diploma in Clinical Psychology and I supervisor. After thorough review, 83 more symptoms were added in that indigenous list of symptoms according to DSM-IV[APA, 1994][2][to make the checklist more comprehensive to use with the psychiatric population. After finalizing the list, Symptom Checklist-R was administered on a sample of 120 subjects residing in different areas of Lahore city from different socioeconomic classes: lower; middle and upper. The analyses of each item revealed that no item /symptom obtained a mean value of more than 7 which clearly show that the non psychiatric respondents did not experience any of these symptoms which were related to different psychopathologies. To determine reliability of SCL-R, 120 subjects from non psychiatric population and 45 subjects from psychiatric population were re-administered the SCL-R within 7-10 days. For the validation of the checklist, 120 psychiatric subjects diagnosed as having different psychopathologies were administered SCL-R along with some other translated instrument. 30 depressed patients were administeredSCL-R and BDI-II[3]; 18 somatic patients were administered SCL-R and two scales: Hysteria and Somatic Anxiety of CCEI[4]; 30 anxiety patients were administered SCL-R and STAI[5], 20 OCD patients were administered SCL-R and Padua Inventory; 32 psychotic patients were administered SCL-R and PANSS[6] and all psychiatric patients were administered LFT scale of SCL-R along with LFT Inventory[7], The psychiatric sample was collected from each of the above mentioned pathologies from different psychiatric units of teaching hospitals: Sir Ganga Ram; Mayo; Services; Punjab Institute of Mental Health [PIMH], Lahore and from out patient clinic of Centre for Clinical Psychology, University of the Punjab, Lahore. The high correlation coefficients between the scores of SCL-R and scores on other instruments clearly indicate that SCL-R is a reliable and valid tool to diagnose psychiatric clients. After determining reliability and validity of SCL-R, the cut offs based on psychiatric and non psychiatric population -were developed separately to use the checklist to diagnose different psychopathologies

Surgical ligation of patent ductus arteriosus in a non-cardiac surgical centre

Surgery for Patent Ductus Arteriosus [PDA] is usually performed in specialized cardiac centres with either open surgery of percutaneous embolisation using different materials and devices. This involves high cost of treatment especially for those poor patients who have grown up to several years of age without seeking any treatment for their disease. The objective of this study is to evaluate the safety of surgery for PDA in a non cardiac paediatric surgical setup. A total of 89 patients of 8 months to 12 years [mean 3 years] age were operated over a period of 13 years [from 1993 to 2006]. Fifty-five cases were females and 34 were males. Investigations included x-ray chest, ECG and echocardiography. All patients with PDA were included in the study except those who had other associated cardiac anomaly and those who had a calcified ductus. The ductus was dissected out and ligated with non-absorbable suture [Silk No. 1 or 2]. The patients were discharged by the 5[th] postoperative day. In majority of the patients the recovery was smooth and uneventful. Eight patients had minor complications which were treated conservatively. There were 3 mortalities in this series; 2 patients were over 10 years of age and had calcified ductus. They died during surgery due to primary haemorrhage and 1 died after 24 hours in the intensive care unit. All patients were reviewed at 1 week, 1 month, 3 months and 1 year after surgery. In majority, the typical machinery murmur disappeared immediately or a soft systolic murmur persisted for up to 4 weeks and then disappeared. With proper patient selection, the procedure can safely be performed in a paediatric surgical setup with facilities for cardiac monitoring. The surgeon needs to receive some additional training in the cardiac institution for safe surgery on these children. This will significantly reduce the cost with minimal complications especially for those poor patients who cannot afford the modern procedures due to monitory constraints. Children older than 10 years are not suitable for open surgery because of calcification of the duct

Urbach-Wiethe disease: experience at a tertiary care hospital in Abbottabad, Pakistan

Urbache-Wiethe disease [Lipoid Proteinosis] is a rare autosomal recessive disorder characterized by the deposition of an eosinophilic hyaline-like material in the skin, larynx, mucous membranes, brain, and other internal organs. A survey of one year duration was carried out prospectively at the Department of Dermatology, Ayub Teaching Hospital Abbottabad to document cases of lipoid proteinosis. Cases were selected from the outpatients department on the basis of clinical presentation and were subjected to detailed examination and investigations after admission. Five cases were diagnosed as suffering from Lipoid Proteinosis over the study period. All had typical features of hoarseness, skin lesions and tongue involvement. All were born of consanguineous parents. Three [60.0%] cases also gave a history of involvement of other family members, particularly cousins. This rare disease occurs in Hazara Division of North West Frontier Province of Pakistan with an as yet undetermined frequency and clinical suspicion is warranted to diagnose cases with the typical presentation

Are unhygienic practices during the menstrual, partum and postpartum periods risk factors for secondary infertility?

This study was aimed at identifying practices during the menstrual, partum and postpartum periods posing possible risk factors contributing towards secondary infertility in women of a selected population in Karachi, Pakistan. A matched case-control study was conducted from April 2003 to March 2004. Four hundred cases were selected from five infertility clinics affiliated with tertiary-care hospitals, and 400 age-matched controls were recruited from the neighbourhood of each case. After taking written consents, trained interviewers conducted interviews using a pretested structured questionnaire. Factors found to be independently associated with secondary infertility were: previous delivery' at an unclean place (adjusted odds ratio [AOR]=1.7, 95% confidence interval [CI] 1.1-2.6), delivery by a birth attendant without washing hands with soap (AOR=4.2, 95% CI 2.36-7.47), use of unclean material for absorption of lochia (AOR=3.1, 95% CI 1.5-6.5), non-washing of perineal area after urination/defaecation (AOR=7.1, 95% CI 1.4-35.7), and insertion of home-made vaginal medications (AOR=2.5, 95% CI 1.3-4.7). Since these factors are preventable/modifiable to a great extent, public-health interventions are, thus, recommended to address these risk factors at various levels.

Health seeking behavior of couples with secondary infertility

To determine the factors affecting the health-seeking behavior of couples with secondary infertility in Karachi. A descriptive case series. The data was collected from women attending infertility clinics in five tertiary care hospitals in Karachi from March to June 2003. All currently married women, between the age of 15-35 years, with at least one previous conception, irrespective of outcome, attending an infertility clinic and consenting to participate in the study, were included. Women with corrective surgery on vagina and uterus, and cases of primary infertility, were excluded. Multiple logistic regression models were used to determine the association of various factors, affecting the health-seeking behavior, with statistical significance set at p < 0.05 for the covariates and the interaction terms between various factors. The women consulted multiple health care providers for treatment of secondary infertility. The main reasons for seeking treatment were couple's wish [54.2%], family pressure [22.6%] and want of a son by husbands or in-laws [20.4%]. The most commonly sought providers were physicians [74.7%], Traditional Birth Attendants [TBA, 39.5%], Spiritual healers [26%], Hakeems [23%] and Homeopaths [17.2%]. Most of the women who consulted non-physicians were illiterate [69.4%] as compared to those who consulted a physician [37.8%, p-value = 0.00]. The non-physicians were more commonly consulted by women belonging to low socioeconomic group. The posttreatment complications were more common among women who consulted non-physicians. Pressure from husbands and in-laws compels women for consulting multiple providers. Health seeking behavior for infertility is affected by the literacy and socioeconomic status of the women

Psycho-social consequences of secondary infertility in Karachi

To explore the experiences of social consequences among women suffering from secondary infertility. Descriptive case series of 400 women with secondary infertility attending tertiary care hospitals in Karachi, Pakistan. More than two thirds [67.7%] of women stated that their inability to give live births or give birth to sons had resulted in marital dissonance. The respondents had been threatened for divorce [20%], husband's remarrying [38%] or to be returned to their parent's home [26%] by their in laws or husbands. Majority [68%] of the women threatened did not have any live births. However, those who had live births [32%] had a girl child only followed by difficulty in conceiving again. Secondary infertility was described as a cause of violence against infertile women. The women reported that they were being physically and verbally abused by husbands [10.5%] and in-laws [16.3%] for being infertile. Nearly 70% of women facing physical abuse and 60% of the women facing verbal abuse suffered severe mental stress. The experience of infertility is a stressful condition itself. This becomes particularly traumatic with previous pregnancies ending up in abortions, stillbirths and neonatal/infant deaths or the live births being daughters only. However, it subjects the woman to contempt and exploitation resulting in severe psychological

quality of care issue: appropriate use and efficacy knowledge of five contraceptive: views of men and women living in low socioeconomic settlements of Karachi, Pakistan

To assess knowledge regarding availability, affordability, appropriate use and efficacy for five non-permanent contraceptive methods.Married Muslim women and men [500 each] were randomly selected from two low socioeconomic settlements in Karachi, Pakistan. Interviews to assess their knowledge on a range of contraceptive and abortion themes were conducted. Four hundred men and 357 women were selected from this larger sample based on their knowledge of condoms, withdrawal, oral pills, injectables and IUDs. Nearly half of the sampled men [56%] and women [48%] were contraceptive users. Knowledge regarding contraception, a specific method, its availability and affordability was high. Appropriate use knowledge for condoms was 73% among men [users 78%, non-users 60%; p-value<0.001] and 5% among women. Efficacy knowledge was generally poor. Low knowledge levels regarding appropriate use and efficacy even among contraceptive users suggests, that quality of family planning services should not be limited to service delivery issues but extend to appropriate use and efficacy knowledge levels among clients

Occurrence of spousal aggression as reported by females in early and later phases of their marriage

The present research investigated the occurrence of spousal aggression [physical and psychological] as reported by females in early and later phases of their marriage. Ex-post facto research design was used. A sample of 30 educated married females was taken. All of them were working women with an average total monthly income of Rs. 20,530 and mean age of 35 years. The sample was reached by the researchers through Legal Aid Center, Lahore; Aurat Foundation, Lahore; Doctors of U.C.H., Lahore; Beacon House School System, Lahore; and Social Welfare Department of the Punjab, Lahore. Each subject was administered Personal History Questionnaire and Scale for Spousal Aggression [Farooqi and Rehman, 1996]. The research findings indicate that the females exposure to spousal Aggression [physical and psychological] decreases with an increase in the marital period