Does gauge of needle effects causation of pneumothorax following ultrasound guided thoracentesis?

Objective: to determine the frequency of pneumothorax following ultrasound guided thoracentesis in our department and its association with gauge of needle in causation of pneumothorax

Methadology: this is descriptive cross sectional study conducted at the Department of Diagnostic and Interventional Radiology, Shifa International Hospital [SIH], Islamabad from January 2010 to April, 2012. A total of 359 ultrasound guided thoracentesis were performed followed by a chest radiograph between January 2010 and April, 2012 fulfilling the inclusion criteria. All procedures were performed by radiology consultants and residents. Generally 18 and 16 G cannulas were used. A few were done with 16 and 18 G spinal needle and 21G syringe needle. Relevant data was collected from hospital data base system on the performa and was analyzed for demographic variables, frequency of pneumothorax, and its association with operator's experience [residents or consultants] and gauge of needle by applying chi square test. P value of < 0.05 was considered significant

Results: 309 patients had thoracocentesis while performed by residents and 50 by consultants. Pneumothorax occurred in 22 of these 359 cases with an overall frequency of 6%. In 219 patients 18 G cannula was used and 8 of these developed pneumothorax [3.6%]. In 94 patients 16 G cannula was used. Pneumothorax occurred in 11 [11.6%]. Statistical analysis confirmed that the frequency of pneumothorax was significantly increased following use of 16G as compared to 18G [p=0.02]

Conclusion: the frequency of pneumothorax following ultrasound guided thoracentesis increases significantly with use of 16G as compared to 18G [p=0.02]

Nutrient evaluation and elemental analysis of four selected medicinal plants of soon valley Khushab, Punjab, Pakistan

To check the nutritional and mineral contents of four medicinal plants viz., Peganum hermla, Solanum nigrum, Mentha longifolia, Achryanthus aspera, which are used as medicine traditionally in Soon Valley Khushab, Pakistan. Proximate analysis of plant sample determined that protein [7.491%] and ash [22.79%] was highest in Mentha longifolia, carbohydrate [75.23%] in Peganum hermla, fats [12.595%] and moisture [6.82%] was highest in Achryanthus aspera. In comparative assessment of the various species, the results showed that Achryanthus aspera. is the most significant species having higher concentrations of fat, fibre values compared to the other species. Absorption Spectrometric method was used for the elemental analysis of essential elements such as Fe, Cd, Cu,Mn, Pb, Cr, Ni and Na in medicinal plants in different range.

Anatomical variations of pulmonary artery and associated cardiac defects in tetralogy of Fallot

To determine pulmonary artery variations and other associated cardiac defects in patients with Tetralogy of Fallot [TOF]. Cross-sectional, descriptive study. The Children's Hospital and the Institute of Child Health, Lahore, from April 2006 to October 2007. All patients with TOF, who underwent cardiac catheterization during this period, were included. Standard cine-angiograms were recorded and pulmonary artery sizing was done using z-scoring. A total of 216 patients with TOF were catheterized. Pulmonary Artery [PA] abnormalities were present in 84 [38.9%] patients. The commonest abnormality was isolated Left Pulmonary Artery [LPA] stenosis [n=27, 32.14%] followed by isolated hypoplasia of Main Pulmonary Artery [MPA] [n=18, 21.43%] and supra-valvular stenosis in [n=11, 13.1%] patients. LPA was absent in one patient, while 2 patients had both absent right and left PA with segmental branch pulmonary arteries originating directly from MPA. Associated cardiac lesions included right aortic arch in 34 [15%], additional muscular VSD vary in 13 [5.5%], Patent Ductus Arteriosus [PDA] in 11 [6%] and Major Aortopulmonary Collateral Arteries [MAPCA] in 2 [1.9%] patients. Significant coronary artery abnormality was present in 10 [4.6%] children. Pulmonary artery abnormalities were present in 38.9% of patients with TOF. Isolated LPA origin stenosis and MPA hypoplasia were the most common abnormalities. Significant associated cardiac lesions were present in one-third of the patients and included PDA, additional muscular VSD, coronary artery abnormalities and MAPCA

Malaria infection: a clinicopathology correlation

Objectives: The hematological changes associated with malaria are well recognized. This study was conducted to assess and compare the incidence and severity of hematological changes in various types of malaria in local population of Gadap city who visited the Fatima Diagnostic Laboratory of Fatima Hospital, Baqai Medical University between Jan. 2007 to Dec. 2008

Methodology: This observational study included 3,263 cases of fever who were suspected for malaria visited Fatima Hospital Laboratory of, Baqai Medical University during January 2007 to December 2008. The age, sex, place of referral and species of malarial parasites were recorded. The total number of male patients was 211 and female was 168 with a mean age group of 21 years. The diagnosis of malaria was confirmed by thick and thin film stained with LeishmanAEuro[™]s staining for malarial parasite. Slides were reviewed by hematologist and Full blood counts were performed using automated Sysmex K-1000

Result: A total of 3,263 patients were subjected for malaria testing during the study period. Three hundred and seventy nine had a positive peripheral smear. There were two hundred and eleven [55.6%] male and one hundred and sixty eight [44.3%] female patients. One hundred and fifty eight [42%] were P falciparum positive, two hundred and three [53%] were P vivax positive and eighteen [5%] patients had mixed infection of both P. falciparum and P. vivax. Two hundred and eighteen [57.5%] patients had thrombocytopenia. Out of this, One hundred and ten [50.4%] patients with thrombocytopenia were P. falciparum positive and one hundred and eight [49.6%] patients with thrombocytopenia were P. vivax positive. One hundred and fifty seven [41%] patients had anemia. Out of this, Thirty seven [23.6%] patients with anemia were P. falciparum positive and one hundred and twenty [76.4%] patients with anemia were P. vivax positive. Sixty 16%] patients had leukopenia. Out of this, Thirty three [55%] patients with leukopenia were P. falciparum positive and 27 [45%] with leukopenia were P. vivax positive

Conclusions: Malaria was found to be one of the most prevalent infections in the surveyed population and the frequency of vivax species was more as compared to falciparum malaria. The majority of falciparum malaria patients develop significant haematological complications with high frequency of thrombocytopenia and anemia as compared to vivax infection while changes in the white blood cells was less dramatic

Role of fissure sealants in the reduction of cariogenic bacteria in 6-8 year old children

Dental caries is a multifactorial bacterial disease affecting the teeth of children and young adults. Fissure sealants are used to prevent bacterial ingress into fissures to minimize decay in children. The aim of this study was to find out role of fissure sealents in reduction of cariogenic bacteria in 6-8 years old children. One hundred [6-8 year old] children/volunteers from Jinnah Foundation Trust School Korangi, Karachi were randomly selected. The oral hygiene and dietary patterns of these volunteers were recorded. The volunteer children were divided into two groups [trial/test and control]. The trial group's fissures were sealed with fissure sealants while control group's fissures were not sealed. The first permanent molar was chosen for sealing as this is the first indicator of caries activity in permanent teeth. All first permanent molars were ensured to be caries-free as fissure sealants are preventive dental materials and are not restorative. The saliva samples of all 100 students were collected in sterilized wide mouth vials. It was then spread on TYCSB and on MRS agar plates for the isolation of Streptococcus mutans and lactobacilli respectively. The plates were incubated for 24 hours at 37°C and then CFU/ml was recorded for each sample. The trial group received fissure sealants while the control group did not. Saliva sampling and isolation procedures were repeated after 4 and 12 weeks of fissure sealant application. The isolated organisms were identified by gram staining, growth characteristics [at different temperature ranges], hemolytic patterns, sugar fermentation, arginine and esculin hydrolysis. The results indicated reduction in the count of cariogenic bacteria in the trial group after the application of fissure sealants on first permanent molars whereas the count remained more or less similar in the control group of all three successive saliva samples. The study was to evaluate the role of fissure sealants in reducing bacterial count of Streptococcus mutans and lactobacilli in the saliva of 6-8 year old children which was found to be significant by the statistical means

Antimicrobial spectrum, production and mode of action of staphylococcin 188 produced by staphylococcus aureus 188

Staphylococcus aureus 188 has been shown to produce bacteriocin-like inhibitory substance known as staphylococcin188. It has a broad-activity spectrum against Micrococcus luteus, Streptococcus pneumoniae, Streptococcus faecalis, Streptococcus viridans, Corynebacterium diphtheriae and several staphylococcus species. The arbitrary unit of staphylococcin 188 against Micrococcus luteus was 1280AU/mL. Its production with simultaneous measurement of activity was monitored and was found to produce maximum amount of staphylococcin after 7 hours of incubation. Mode of action of the staphylococcin 188 on the sensitive cells was bactericidal rather than bacterioloytic