Assessment of Respiratory Problems in Workers Associated with Intensive Poultry Facilities in Pakistan

Background@#The poultry industry in Pakistan has flourished since the 1960s; however, there are scarce data regarding the impact of occupational exposure on the pulmonary health of farm workers in terms of years working in the industry. The objective of the present study was to assess the effect of poultry environment on the health of occupationally exposed poultry farmers in countries of warm climatic regions, such as Pakistan. This study will also show the effect of exposure to poultry facilities on the health of poultry farmers in the context of low-income countries with a relatively inadequate occupational exposure risk management. @*Materials and methods@#The lung function capacity of 79 poultry workers was measured using a spirometer. Along with spirometry, a structured questionnaire was also administrated to obtain information about age, height, weight, smokersonsmokers, years of working experience, and pulmonary health of farm workers. The workers who were directly involved in the care and handling of birds in these intensive facilities were considered and divided into four groups based on their years of working experience: Group I (3-10 months), Group II (1-5 years), Group III (6-10 years), and Group IV (more than 11 years). The forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and the FEV1/FVC ratio were considered to identify lung function abnormalities. Statistical analysis was carried out using independent sample t test, Chi-square test, Pearson's correlation, and linear regression. @*Results@#Based on the performed spirometry, 68 (86 %) of workers were found normal and healthy, whereas 11 (14 %) had a mild obstruction. Of the 11 workers with mild obstruction, the highest number with respect to the total was in Group IV (more than 11 years of working experience) followed by Group III and Group II. Most of the workers were found healthy, which seems to be because of the healthy survivor effect. For the independent sample t test, a significant difference was noticed between healthy and nonhealthy farmers, whereas Chi-square test showed a significant association with height, drugs, and working experience. Linear regression that was stratified by respiratory symptoms showed for workers with symptoms, regression models for all spirometric parameters (FVC, FEV1, and FEV1/FVC) have better predictive power or R square value than those of workers without symptoms. @*Conclusion@#These findings suggest that lung function capacity was directly related to years of working experience. With increasing number of working years, symptoms of various respiratory problems enhanced in the poultry workers. It should be noted that most of the poultry workers were healthy and young, the rationale being that there is a high turnover rate in this profession. The mobility in this job and our finding of 86% of the healthy workers in the present study also proposed healthy worker survivor effect.

Isolation and identification by 16S rRNA sequence analysis of plant growth-promoting azospirilla from the rhizosphere of wheat

ABSTRACT The main objective of the present study was to isolate phytohormone-producing, phosphate-solubilizing strains of Azospirillum from wheat to be used as inoculants for plant growth promotion. Five Azospirillum strains were isolated from the rhizosphere of field-grown wheat (Triticum aestivum L.), and it was confirmed by BOX-polymerase chain reaction (PCR) that the isolates were different and not re-isolates of the same strain. Sequence analysis of the PCR-amplified 16S rRNA gene indicated that four isolates showed maximum similarity to Azospirillum brasilense and one isolate showed maximum similarity to Azospirillum zeae. This is the first report indicating the presence of an A. zeae like isolate in the wheat rhizosphere in Pakistan. The bacterial isolates were characterized for their plant growth-promoting traits, phosphate solubilization, and indole-3-acetic acid (IAA) production. None of the isolates showed phosphate solubilization activity in the commonly used Pikovskaya medium. However, all strains (except AzoK4) exhibited ability to solubilize tricalcium phosphate (TCP) in modified Pikovskaya medium in which sucrose was replaced by Na-malate, as well as in TCP-supplemented Luria-Bertani (LB) medium. Organic acids, such as acetic, citric, lactic, malic, and succinic acids, were detected in culture supernatants of the tested Azospirillum strains. All strains exhibited ability to produce IAA in the growth medium, except Azospirillum sp. AzoK1. Among the strains tested, the maximum IAA production (30.49 ± 1.04 mg L-1) and phosphate solubilization (105.50 ± 4.93 mg L-1) were shown by a pure culture of Azospirillum sp. AzoK2. In pot experiments, single-strain inocula of Azospirillum sp. AzoK1 and AzoK2 improved wheat plant growth.

Delayed referral of lower limb amputees for rehabilitation; an audit study

To determine the causes of delayed referral of lower limb amputees for rehabilitation. Study Design: Descriptive study. Armed Forces Institute of Rehabilitation Medicine Rawalpindi, from April 2012 to July 2012. Thirty two patient cases of lower limb amputation were included. They were referred cases to AFIRM from operational areas and CMHs all over Pakistan for provision of prosthesis and rehabilitation. A total of 32 lower limb amputees7 male patients with mean age 29 years were included in the study. Transtibial level was the most common amputation 19[57.6%]. Improvised Explosive Device [IED] was the most common mode of injury 19[57.6%]. 34.37% patients were delayed due to leave granted to them at local set ups before referral to AFIRM for rehabilitation. Delayed referral for rehabiltation has poor impact on rehabilitation of an amputee

Frequency of behavioural features among insomniac patients

Background: Insomnia may affect daytime quality of life and have different behavioral symptoms among patients

Objective: To determine the frequency of behavioral and demographic features among insomniac patients

Patients and Methods: A cross sectional study was conducted on patients from southern Punjab, who were insomniac and taking medications from Psychiatric Ward, Nishtar Hospital Multan, from 1[st] January 2010 to 31[st] January, 2011. Data was collected from 417 insomniac patients. A questionnaire was administered targeting insomnia criteria. Confidentiality of information taken was ensured. The data was entered and analyzed by SPSS version 15

Results: A total of 417 patients participated in the study. The age range was 10-80 years, with 52% females, 272 insomniac patients out of 417 [65.2%] were anorexic. 225 [54%] cases were the eldest, among insomnia patients, following were the youngest who were 116 [28%] and the least were in between the eldest and the youngest who were 75 [18%]. 284 [68%] patients complained about the uncontrolled level of anger with destructive behavior

Conclusion: Anorexia, uncontrolled anger, restlessness was found in insomnia. Females, illiterate and elder members of family were more insomniac

Comparison of mean platelet volume in patients with psoriasis and healthy individuals

To compare mean platelet volume in patients with psoriasis and healthy individuals. This case control study was conducted in outpatients department and indoor of department of Dermatology, DHQ Hospital, Faisalabad. The duration of study was six months. Thirty consecutive patients of psoriais, 20 to 60 years of age and thirty age and gender matched healthy individuals were selected. 2cc venous blood sample from each subject was sent to the pathology laboratory of DHQ Hospital. Mean platelet volume [MPV] was measured as a part of blood complete analysis in Medonic M series Haematology analser. MPV was found higher in the patients of psoriasis as compared to the healthy individuals. The mean value of MPV in the case group was 8.24 +/- 1.22 fl, whereas in the control group, it was 7.29 +/- 0.77 fl [p<0.05]. The study demonstrated that mean platelet volume is increased in patients with psoriasis as compared to healthy individuals. Such patients are at an increased risk of cardiovascular complications

Uro-dynamic evaluation

drsaqii1711@hotmail.com To describe the pattern of Urodynamic evaluation at Armed Forces Institute of Rehab Medicine, Rawalpindi. Descriptive study. This study was conducted on 466 patients reporting for urodynamic evaluation at Urodynamic/Incontinence Clinic at A F Institute of Rehab Medicine from Feb 2003 to Dec 2006. We considered the age, gender, etiology, reason for referral, and presenting complaints whereas results were formulated according to Classification of voiding disorders by International society of Incontinence. Data was analyzed using statistical package for Social Science version 10. In all [466] patients, 58% were males and 42% were females. Mean age was 46.8 years. Increased frequency [61%] and incontinence [52%] were the most common presenting complaints, 158[34%] had spinal cord injuries, 58 were cases of myelodysplasias and 128 reported with stress incontinence. Urodynamic studies showed that 152[33%] had hyperactive bladders, 110[24%] had a contractile/hypo-contractile bladders, 104[22%] had stress incontinence and 56[12%] cases had normal results. Urodynamics helps in diagnosis of potentially life threatening urinary problems. The availability of this equipment and trained staff must be encouraged at tertiary care hospital. More research is required in this regard in Pakistan, which shall help in formulating better management protocols in future

Role of physical medicine and rehabilitation intervention for plantar fasciitis

To highlight the role of early physical medicine and rehabilitation. Randomized case control study. Armed Forces Institute of Rehabilitation Medicine Rawalpindi from March 2002 to March 2003. Eighty patients of both sexes between 25-45 years of age were randomly divided into Study and Control group. Group 1 [study] was given standard physiatric therapeutic intervention and Group 2 [control] was given conventional treatment with heel cup and Non Steroid anti inflammatory drugs [NSAIDs]. They were followed up for three months. Pain was assessed by Visual Analog Scale [VAS] and Heel Tenderness Index [HTI]. Mean age of the patients was 35.7 years.Forty percentage cases were male and 60% were female. After three months of treatment, 75% of group 1 and 20% of group 2 showed marked improvement [VAS < 30mm]. On HTI index, 72.5% of patients were in Grade 0 [no pain] and 22.5% were in Grade I while 30% of patients in group 2 were in grade 1 [painful]. Difference was found to be statistically significant i.e. P- value < 0.05. Comprehensive rehabilitation management has shown promising results in the treatment of plantar fasciitis especially when initiated in early stages and may prove to be the mainstay modality in the treatment of plantar fasciitis in future

Bone marrow examination in ITP in children: mandatory?

To determine the need of bone marrow examination in children with idiopathic thrombocytopenic purpura [ITP] at initial presentation. Descriptive study. Pediatric Units of Children Hospital, Islamabad, from January 1 999 to December 2003. All children, clinically suspected to have ITP, who underwent bone marrow examination, were included After reviewing the file records of these patients for history, examination and investigations, a predesigned proforma was filled and data was analyzed, using SPSS version 10 for statistical analysis. The results were reported in the form of frequencies, percentages and mean. A majority of the children were between 48 to 96 months, with a mean age of 54.43 months. Male to female ratio was 1.45:1. Mean platelet count was 33861/mm3. None of the bone marrow results showed the presence of abnormal cells consistent with hematological malignancy. ITP was the final diagnosis in 52 patients. One patient was diagnosed to have megakaryocytic hypoplasia. Bone marrow aspiration in one patient was hypoplastic, and subsequently, he was diagnosed to have aplastic anemia on trephine biopsy. Bone marrow aspiration should not be a part of routine work-up for diagnosing ITP in children and should be reserved for those children having atypical clinical and laboratory features

Down syndrome with Morgagni hernia and hypothyroidism

A rare association of Down syndrome with hypothyroidism and Morgagni type of diaphragmatic defect is described in a one-year-old male child who presented with a history of recurrent chest infections and delayed milestones. He showed obvious features of Down syndrome but was also found to have hypothyroidism on investigations. Morgagni hernia was suspected on lateral chest X-ray and confirmed by CT scan thorax. He responded well to the management, which included surgical repair of the hernia