Efficacy of Probiotics Supplementation on Growth Performance, Carcass Composition and Hematological Parameters of Cyprinus carpio Fingerlings Fed Corn Gluten Meal-Based Diet

Abstract Plant based protein sources are one of the best, cost effective and easily available protein sources being used in fish feed. But due to a lower number of micro-biota in fish gut plant meal based diets cannot be digested and absorbed well in fish body. Probiotics were supplemented at 0, 1, 2, 3, 4 and 5 gkg-1 levels in fish feed for formulating one control and five test diets. In this study, three replicates of each treatment were used and number of fingerlings was 15 in each replicate. The C. carpio (common carp) fingerlings were fed at 5% of live wet weight on their prescribed diet twice daily. The results revealed that supplementation of probiotics in corn gluten meal based diets significantly (p<0.05) improved growth performance, carcass composition and hematological parameters. Most optimum values of growth performance parameters were noted at 2 gkg-1 level of probiotics supplemented diet. C. carpio fingerlings fed corn gluten meal based diet supplemented with 2 gkg-1 level of probiotics indicated significant (p<0.05) improvements in crude protein (17g) crude fat (9g) and gross energy (3 kcalg-1) whereas higher red blood cells (RBCs), white blood cells (WBCs) and hemoglobin (Hb) was also recorded in fish blood when fed 2 gkg-1 probiotics level diet. From these results, it was concluded that 2 gkg-1 probiotics supplementation in corn gluten meal based diet is optimum for improving growth performance, body composition and hematology of C. carpio fingerlings.

Disseminated infection with multiple cold abscesses caused by Rhizopus Arrhizus in an immunocompetent girl

Although infections with fungi, such as Rhizopus species, usually occur in diabetics or immunocompromised patients, they can also rarely affect immunocompetent individuals. We present a case of disseminated infection with multiple cold abscesses in a 13-year, otherwise healthy girl caused by Rhizopus arrhizus

Open globe injuries with intraocular foreign body: surgical outcome

Objective: To determine surgical outcome and residual co-morbidities after surgical intervention in eyes having Open Globe Injury [OGI] with retained Intra Ocular Foreign Body [IOFB]

Methodology: A prospective interventional case series was carried out at the department of Ophthalmology, Khyber Institute of Ophthalmic Medical Sciences [KIOMS], Hayatabad Medical Complex [HMC], Peshawar from 1st September 2012 to 30th November 2013. Patients who were followed post-op-eratively for at least 90 days were included. Eyes having open globe injury [OGI] and intraocular foreign body [IOFB] who had surgical intervention were included in our study. Visual outcome was determined comparing final best corrected visual acuity [BCVA] with initial BCVA. Co-morbidities were noted at final follow up. For data analysis, Snellen's VA was converted to log MAR VA. Data was analyzed by SPSS version 16

Results: Total of 35 patients were included in our study. Male were 94.3% compared to 5.3% females. Mean age was 32.42 years. Bomb blast injury was cause of eye trauma in 60% cases while 40% were doing hammer and chisel work at the time of trauma. IOFB was impacted in anterior segment in 20% cases while it was impacted in posterior segment in 80% cases. IOFB removal was achieved in 33[94.28%] cases; silicone oil was used as temponade in 48.57% cases. Primary repair was required in 40% cases while rest 21[60%] eyes had self sealed wound. Primary surgical intervention in the form of Pars Plana Vitrectomy, IOFB removal with the use of intraocular magnet or forceps was carried out in 71% cases. Mean BCVA log MAR improved from initial BCVA of 2.20 to 1.20. Common comorbidities at final visit were corneal scars, macular scars and cataract

Conclusion: Bomb blast injuries are most common cause of OGI with IOFB in our region. Significant visual improvement occurs in most of the cases after skilled vitreo-retinal surgical interventions. Common ocular co-morbidities are corneal scar, macular scar and cataract

Post-tonsillectomy hemorrhage: an analysis of incidence and risk factors in Kuwait

Introduction: Post-Tonsillectomy Hemorrhage [PTH] remains one of the commonest complications associated with tonsillectomies. Its incidence and risk factors vary widely in literature

Objective: To examine our local experience and assess the incidence of PTH in comparison to that in the literature and to identify factors that contribute in increasing the risk of PTH in our setup. Design: Retrospective study. Setting: Al-Sabah and Zain Hospital, MoH, Kuwait

Methods: A retrospective chart review was conducted on 2,038 patients who underwent tonsillectomy with or without adenoidectomy during a 12-month period [January to December 2010] in Zain and Al Sabah hospitals. Details regarding the patients' age, gender, surgical technique, and level of the operating surgeon were recorded in order to assess any correlation. Intervention: Tonsillectomy. Main Outcome Measure: Incidence of PTH

Results: Out of the 2,038 patients included in this study, a total of 98 patients [4.8%] developed PTH. Thirty-one patients [31.6%] who developed PTH were above the age of 26 years. Out of the 98 patients [4.8%] who developed PTH, 63 patients [64.3%] were male. 'Hot' dissection technique was associated with higher incidence of PTH [71 patients; 72.4%] in comparison to the 'cold' dissection [27 patients; 27.5%]

Conclusion: The incidence of PTH in our institution is 4.8%, which is comparable with that reported in the literature, ranging between 1.5% and 6.68%. Male patients, increasing age and 'Hot' dissection technique were all identified as risk factors for PTH in our setup

Guide wire dilatation of anastomotic strictures secondary to surgical repair of esophageal atresia

To evaluate the efficacy of esophageal guide wire dilatation of stricture after surgical treatment of esophageal atresia. This prospective and descriptive study was carried out at Department of Pediatric Surgery, The children's hospital, Pakistan Institute of Medical Sciences [PIMS], Islamabad from January 2008 to December 2011. It included 23 patients, 15 males and 8 females, aged one month to 3 years with esophageal stricture secondary to esophageal atresia who underwent guide wire esophageal dilatation with savary Gilliard Dilators. All procedures were performed under general anesthesia. Associated gastroesophageal reflux [GER]. was noted in 13 patients. Dilatation relieved the stricture in all patients over a follow-up period varying from 3 months to 3 years. Only two patients developed esophageal perforation, which was treated conservatively. Guide wire dilatation is a safe and effective method of treatment in the management of strictures secondary to surgical repair of esophageal atresia

Unusual cause of upper gastrointestinal tract bleeding in a child

We report a case of gastric teratoma in six years old female child who presented with abdominal pain, vomiting and hematemesis. Child underwent exploratory laparotomy and the mass was excised completely. On histopathology it came out mature gastric teratoma

Analysis of changes in intraocular pressure with changes in body position

To find out the patterns of changes in Intraocular Pressure [IOP] with changes in body position, both in the sitting and lying position. This descriptive study was conducted at Hayatabad Medical Complex, Peshawar from October 2010 to March 2011. All the individuals who voluntarily consented were included in the study. These include individuals without any eye pathologies, glaucomatous eyes, eyes with cataract and both hospitalized and non-hospitalized individuals. While all the individuals who have any corneal pathologies, uveitis, detachment, post operative and post lasered eye were excluded from the study. All the patients were examined with slit lamp. Then Per kins' hand-held applanation tonometer was used to measure the IOP both in the sitting and lying position. The proforma was then filled and data was analyzed by using SPSS v.17. A total of 100 volunteers were included in our study while total number of eyes were two hundred. The mean age of the sample was 49 +/- 15.4 years. There were 110[55%] males and 90[45%] females. Hypertension was present in 50[25%] patients and all of them were taking ant ihyper tensive medications. Thirty five [17.5%] were diabetic and were also on medications. The mean IOP in the sitting position was 13.28 +/- 3.6 mmHg and in lying position it was 16.4 +/- 3.9 mmHg. The difference between lying and sitting position was 3.12 +/- 0.3 mmHg [p<0.001]. A postural IOP change can occur when an individual changes its position from sitting to supine position. Intraocular pressure increases in the lying position as compared to the sitting position

Bacterial spectrum and their sensitivity pattern in patients of chronic suppurative otitis media

The study was conducted from March 2008 to February 2010 in Microbiology Department, Citi Lab, Rawalpindi, to determine the causative microorganisms and their antibiotic sensitivity pattern in patients with chronic suppurative otitis media. One hundred and eighty-three samples received at Citi Lab were included in the study. Pus samples were cultured aerobically. Antibiotic sensitivity testing was done with standard antibiotic discs using modified Kirby-Bauer disk diffusion method. Out of 183 patients, microbiological culture was yielded from 154 specimens [84%]. There were 148 bacterial isolates [96%] and 06 fungi [4%]. Pseudomonas aeruginosa [n=59, 38%] was the most common isolate followed by Staphylococcus aureus [n=34, 22%]. Susceptibility pattern of Pseudomonas aeruginosa showed that 100% isolates were sensitive to Piperacillin/Tazobactam, whereas 98% isolates were sensitive to Imipenem and 76% to Ciprofloxacin. Continuous surveillance of susceptibility pattern is suggestive for effective therapy of chronic suppurative otitis media

Extracorporeal shock wave lithotripsy; can alpha blocker improves stone clearance?

To determine the efficacy of Alpha blocker as adjunctive medical therapy, which increases the stone clearance after extracorporeal shock wave lithotripsy [ESWL] to treat renal stones. Quasi Experimental study. Department of Urology, Liaquat National Hospital, Karachi. September 2010 to March 2011. Ultrasound guided Dornier Alpha Impact lithotripter was used for shock wave lithotripsy. Study was carried out on 60 patients who underwent single session of ESWL for renal calculus. Patients were divided in two groups, Group A [n=30] received conventional treatment and Group B [n=30] received Alpha-1 Blocker in addition to conventional treatment. All patients were evaluated with X-ray and Ultrasound [KUB] after 2 weeks and repeated at the end of month. Failure is defined as unsuccessful expulsion after 4 weeks and patient desire to remove the stone before day 30. Out of 60 patients, 45[75%] were males and 15[257%] were females with male to female ratio was 3:1. The average age of the patients was found 36.32 +/- 14.8 [Ranging from 15 to 75] years. Complete clearance was achieved in 76.7% of those receiving Alpha-1 Blocker and in 46.7% of controls at 1 month [P = 0.001]. This difference was statistically significant. The results of my study demonstrate that Alpha-1 Blocker therapy, as an adjunctive medical therapy after ESWL is more effective than lithotripsy alone for the treatment of patients with large renal stones and is equally safe

Anti vascular endothelial growth factor [bevacizumab] in central retinal vein occlusion: an interventional case series

Vascular endothelial growth factor plays major role in ocular angiogenesis and retinal edema production and is a step forward in the management of ocular neovascularization and retinal edematous pathologies. To determine the efficacy and safety of intra-vitreal Avastin [Bevacizumab] in cases having central retinal vein occlusion. A prospective interventional study. This study was done at Said Anwar Medical Centre, Dabgari Gardens, Peshawar from June, 2007 to September, 2009. All patients with central retinal occlusion occurring in the past 3 months and seen between the study period were included in the study. Diagnosis of central retinal vein occlusion was made clinically by slit lamp biomicroscopy with 78D examination Patients who had received any treatment for and eyes which already had developed Anterior Segment Neovascularization, Neovascularization elsewhere or Neovascularization on disc at presentation were excluded. Dose of 0.05 ml [1.25mg] of Avastin [Bevacizumab] was used as intra vitreal injection every month for 3 months in cases that presented within a month of occlusion and less injections were given in dose presenting later. Follow-up was done at 30th, 60[th], 90[th] and 120[th] day after the onset of disease. Visual outcome was defined as Snellen's or LogMar Best Corrected Visual Acuity at final follow up, of 120[th] day, compared to the visual acuity at presentation. Data were analyzed by SPSS version 17. Total of 17 eyes of 17 patients were included in this study. Eleven [64.7%] patients were males while 6 [35.3%] were females. Total of 40 intra-vitreal injections of Avastin were given to patients with a mean of 2.35 injections per eye. Good visual outcome was achieved in 10 [58.8%]] eyes, while 7[41.2%] had stable visual outcome. Mean initial Best Corrected Visual Acuity [LogMar] in all 17 eyes was 1.79 [SD +/- 0.87] which significantly improved to a mean of 1.18 [SD+0.77] at final follow up. Mean improvement in Best Corrected Visual Acuity [LogMar] after paired sample test in all patients at final follow up on day 120 was 0.61[SD+0.84]. Retinal hemorrhages and macular edema decreased clinically on examination on consecutive follow up visits. No eye developed neovascularization elsewhere, neovascularization on the disc, neovascularization, retinal tears, retinal.detachment, lens trauma, endophthalmitis or anterior chamber activity. Bevacizumab [Avastin] is an effective and safe treatment option for central retinal vein occlusion affected eyes and resulted in improvement in visual acuity. It reduced macular edema and prevented ocular neovascularization at least for short term

Diabetic foot lesions and their management

To find out frequency of different types of diabetic foot lesions and different surgical procedures performed in our setup. The study is a comparative study analyzing the efficacy of various surgical options for the treatment of diabetic foot lesions. The study was done at Combined Military Hospital Rawalpindi from July 2003 to July 2004. A total of 75 patients admitted with diabetic foot lesions were assessed in detail, and the various surgical procedures performed. After admission, history, general physical examinations and examination of the feet were carried out for hygiene, ulcers, gangrene, infection, hair loss, trophic changes in the skin and nails. Sensory and motor assessment and complete neurological examination was done. The patients were graded according to meggit wagner classification. Complete blood picture, serum blood glucose, urine for sugar and proteins, culture and sensitivity of pus, serum urea and creatinine and X-rays of foot in deep ulcer were done. Out of the 75 patients male patients were effected more partly because they are more prone to trauma and mechanical stress of life. Out of 75 patients, 57 [76%] were male and 18 [24%] were female patients. Bulk of the patients were admitted through OPD [26] and emergency [16] total 56%, while other were either referred, transferred from peripheral hospitals, physicians or from other wards. Twenty eight patients were on inj Insulin and 35 were on oral hypoglycemic drugs. The most common infecting agents were staphylococcus [42 patients] and pseudomonas in 28 patients. In majority of the patient incising and drainage of the abscess [12 cases] and toe nail extraction/removal in 11 patients were carried out. The commonest duration of patients in hospital stay was 8-20 days. The commonest lesion seen was infection and gangrene of the toes. Incision drainage, detriment and amputation of the toes were the common surgical procedures done. Most patients admitted for diabetic foot disease were in grade III and IV

Risk factors in development of multi drug resistant tuberculosis in the hospitalized patients

The emergence of multi-drug resistant tuberculosis [MDR-TB] is becoming a global threat. A study was carried out to determine the frequency and risk factors associated in the development of MDR-TB in the hospitalized patients. It was a retrospective study in which five hundred patients of tuberculosis, admitted in the TB wards of Military Hospitals Rawalpindi, were include. Diagnosis of MDR-TB was established based on susceptibility pattern of Mycobacterium tuberculosis by Agar diluted method on Lowenstein Jensen Medium. The isolates which showed simultaneous resistance to INH and Rifampicin either with or without resistance to other drugs were labeled as MDR-TB. Out of 500 diagnosed patients of tuberculosis, 40 [8%] patients developed MDR-TB. Smokers were at high risk to develop MDR-TB [12.9%] as compared to non-smokers [5.6%]. MDR-TB was found more in extra pulmonary tuberculosis [35%], secondary tuberculosis [21.4%] and patients taking irregular anti tuberculosis treatment [36.6%] as compared to pulmonary tuberculosis [6.9%], primary cases [1.8%] and patients taking regular treatment [2.4%] respectively [p<0.05]. smoking, extra pulmonary tuberculosis secondary tuberculosis and poor compliance to the anti-tuberculosis treatment are the main contributing factors in MDR-TB. The development of MDR-TB in community can be reduced by modifying these MDR-TB associated risk factors