Vitamin D levels in OPD patients in teaching hospital Sukkur

It is well established that low levels of 25 [OH] Vitamin D [<30 ng/dl] are a common finding world over, affecting over a billion of the global population. Aches and pains in joints and muscles are frequently seen in patients with Vitamin D deficiency and patients are misdiagnosed with other diseases. To determine the level of Vitamin D in patients attending outpatient department with aches and pains. Prospective and observational. This study was conducted at Orthopedic department of Ghulam Muhammad Mahar Medical College Hospital [GMMMCH], Sukkur from February 2011 to March 2012. All patients attending orthopaedic OPD of GMMMCH with aches and pains had their Vitamin D level done. They were divided in three diagnostic categories based on their serum 25 [OH] Vitamin D levels. Those with below 8 ng/dl were categorized to have severe deficiency, levels between 8-19ng/dl as moderate deficiency and levels of 20-29 ng/dl as mild deficiency. A total of 400 patients were studied. Minimum age was 15 years and maximum age was 75 years. Serum Vitamin D level was found low [<30 ng/dl] in [92%] patients. Their mean age was 44.3 +/- 18.3 years, with female to male ratio 4:1. Ten percent [10%] had severe, 60% moderate and 30% had mild deficiency. We observed high proportion of patients with aches and pains having low levels of Vitamin D. The specific cause [s] for this observed high prevalence of low 25 [OH] vitamin levels are not clear and need to be investigated further upon

experience of thrombocytopenia in children at Tertiary Care Hospitals Sukkur and Larkana

Thrombocytopenia is the most common cause of bleeding in children. Patients with thrombocytopenia may experience petechiae, epistaxis, gum bleeding, hematuria or gastrointestinal hemorrhage or intracranial bleeding, seizures and unconsciousness. To determine the various causes, and clinical features of thrombocytopenia in children. Prospective descriptive study. This study was conducted at the Paediatric Departments of Shaheed Mohtrama Benazir Bhutto Medical University at Ghulam Muhammad Mahar Medical College Hospital Sukkur and Chandka Medical College Hospital Larkana, from July 2009 to July 2011. This was a prospective descriptive study, include 200 patients1 to 12 year of age, presenting with fever, mucocutaneous bleeding and thrombocytopenia on peripheral smear at both departments. After consent a separate pro-forma was filled for each patient to record demography and data about various causes, clinical presentation and laboratory investigations. Out of 200 thrombocytopenic patients 128 [64%] were males and 72 [36%] females, majority in age group of under 10 years 154 [77%]. The most common cause was the malaria in 50% of cases, followed by ITP 20 [10%], aplastic anemia and thalassemia [hypersplenism] in 7.5% respectively. Dengue fever and Typhoid fever was [5%] of cases. The other minor causes were severe malnutrition, acute leukemia, hemolytic uraemic syndrome 2.5% each. The most common clinical presentation was petechiae and echymosis in 92 [46%], followed by epistaxis and gum bleeding 68 [34%] of cases, subconjuctival hemorrhage in [14%] and hematuria in [08%] of cases. Unconsciousness was present in [9%] of cases. Anemia was found in most of patients [71%]. Splenomegaly was present in 79 [39.5%] and hepatomegaly in 59 [29.5%] of patients. Platelets were less than 50,000/cmm in majority [60%] of patients. The common cause of thrombocytopenia in febrile children was malaria, followed by ITP, Aplastic anemia and thalassemia [hypersplenism], Dengue hemorrhagic fever and enteric fever was less common. The other minor causes were severe malnutrition, acute leukemia, hemolytic uremic syndrome and lymphoma

Polyclonal VDAC3 antibody decreases human sperm motility: a novel approach to male contraception.

Background: Voltage dependent anion channels (VDAC) mediate transport of anions, cations and ATP which play an important role in sperm motility. This study was aimed to examine the effect of polyclonal VDAC3 antiserum to human sperm motility. Methods: Polyclonal VDAC3 antiserum used in this study was produced in rabbits by immunization of VDAC3-specific synthetic peptides. Preimmunserum was collected before immunization and used for control experiment. Recognition of VDAC3 antiserum to antigen in human sperm was performed by western blot. Thirty sperm samples obtained from fertile men which had high quality of sperm motility were washed and collected by Percoll gradient. Sperm motility was assessed by means of evaluation of sperm velocity (seconds per 0.1 mm distance) and the number of unmoved sperm (million per ml) which were observed 0 minute, 30 minutes and 60 minutes after addition of VDAC3 antiserum and preimmunserum as a control. Both data were analyzed by SPSS 13.0 software. Results: VDAC3 antiserum recognized VDAC3 protein in human sperm. Statistical analysis demonstrated that there were increasing numbers of unmoved spermatozoa after addition of anti-VDAC3 antiserum in vitro for 60 minutes observation compared with preimmunserum (control). We found also that sperm velocity decreased signifi cantly after giving anti-VDAC3 antiserum in vitro for 0 minute, 30 minutes, and 60 minutes compared with pre-immunee serum (control). Conclusion: VDAC3 antiserum can decrease motility of human sperm. and may provide a novel principle of male contraception in the future.

Parental attitude toward behavioral management techniques in dental practice with school children in Kuwait

The objective of this study was to evaluate the parental attitude toward different management techniques used during dental treatment of schoolchildren in Kuwait. One hundred and eighteen parents who accompanied their children to the clinics of Hawally School Oral Health Program in Kuwait participated in this study. The parents viewed a videotape which showed scenes of different behavioral management techniques [BMTs] and then completed a questionnaire. Positive reinforcement, effective communication, tell-show-do, distraction, modeling and nonverbal communication were considered was the most approved techniques. Hypnosis and parental separation were moderately approved techniques. Voice control, nitrous oxide sedation, protective stabilization [physical restraint], general anesthesia, hand-over-mouth technique and conscious sedation were the least approved techniques. A majority [99%] of parents regarded the use of various BMTs as a key factor for successful dental care for their children. Acceptance of each BMT was not related to parental age, gender, nationality, educational level or occupation. Most parents preferred the nonpharmacological techniques to pharmacological techniques. Techniques employing drugs and restraint were considered as least acceptable. Further studies comparing the effectiveness of various BMTs are required

Rupture of the common bile duct; a rare cause of biliary peritonitis

A 17-year-old unmarried female complained some pain in the right iliac fossa with associated nausea, vomiting and anorexia. Her examination revealed a conscious and febrile[38[degree sign] C] patient with tenderness in right half. The laboratory findings showed leukocytosis at the time of admission. The patient was admitted to the surgical ward with provisional diagnosis of acute appendicitis. Laparoscopic appendicectomy was planned for the patient on the same day. When we introduced the camera, a sufficient amount of bile was noted in the peritoneal cavity. All other organs including appendix were examined and were found to be normal. Consequently, a diagnosis of perforation in the hepatobiliary system was made and the procedure was converted to open through a mid line laparotomy incision. Gall bladder was collapsed and there was 0.5 cm irregular perforation in the common bile duct. Per operative cholangiogram was unremarkable. A T tube was inserted and peritoneal cavity was washed with normal saline. A drain was placed down to the common bile duct and abdomen closed. The patient made uneventful recovery and was discharged home in a stable condition. Spontaneous Common Bile Duct Injury is extremely rare which should be considered by all physicians dealing with the patients with acute abdomen

Microscopic analysis of epidermal melanocytes in human abdominal skin

Microscopic analysis of epidermal melanocytes in human abdominal skin with respect to age and sex. Design: Cross sectional study. Place and Duration of Study: Department of Anatomy. BMSI, JPMC, Karachi. About one year in 1998. Subjects and Demonstration of epidermal melanocytes in 5mm thick vertical paraffin embedded sections of thirty-eight skin samples from different age and sex groups, using dihydroxyphenyl alanine [Dopa] reagent. The melanocytes count per unit area of skin was significantly higher in the younger than older age groups. No significant difference was noticed between males and females epidermal melanocytes counts. Distribution of epidermal melanocytes was inversely proportional to the advancing age. However, there was no significant gender differences in the distribution of epidermal melanocytes