Comparison of caffeine versus theophylline for apnea of prematurity

Objective: To make a comparison between standard doses of theophylline and caffeine for the treatment of apnea of prematurity

Methods: A randomised control trail was conducted in Department of Pediatrics Medicine Govt. Khawaja Muhammad Safdar Medical College and Govt. Allama Iqbal Memorial Teaching Hospital, Sialkot over duration of one year from August 2017 to August 2018 after approval from the hospital ethics committee. An informed consent in the form of written document was also taken from the parents of each infant participating in the study. Data was analyzed by using SPSS version 24. Mean and SD was calculated for numerical data like gestational age and mean concentration of caffeine and theophylline. Frequency and percentages were calculated for categorical data like nasal continuous positive airway pressure [CPAP], supplemental oxyen and intrventricular hemorrhage [IVH] grade I. Student t-test was applied in order to determine the significance of results. P value ? 0.05 was considered significant

Results: A total of 100 infants were enrolled in this study. This study was further divided into two equal groups by lottery method i.e. 50% in each, treated with Theophylline and Caffeine respectively. Mean apnea events/day in neonates administrated by theophylline was 1+/-0.1, 2+/-0.12, 2+/-1.1, 1+/-0.10 and 2+/-o.12 for 0, 1-3, 4-7, 8-14 and 15-21 days respectively. While, the mean apnea events/day in neonates administrated by Caffeine was 2+/-0.3, 1+/-0.22, 2+/-1.5, 1+/-0.13 and 2+/-0.14 for 0, 1-3, 4-7, 8-14 and 15-21 days respectively. The differences were statistically significant for 1-3 days and 4-7 days p<0.05 according to student t test

Conclusion: Results of our study revealed that caffeine being more effective than Theophylline for treating apnea of prematurity

The Ability of Baseline Triglycerides and Total Cholesterol Concentrations to Predict Incidence of Type 2 Diabetes Mellitus in Chinese Men and Women: A Longitudinal Study in Qingdao, China / 生物医学与环境科学（英文）

OBJECTIVE@#The purpose of this study was to assess the association between triglycerides (TG), total cholesterol (TC) at baseline, and type 2 diabetes mellitus (T2DM) incidence in a general Chinese population. Further, it aimed to evaluate the ability of TG and TC to predict T2DM incidence.@*METHODS@#Qingdao Diabetes Prevention Program participants recruited between 2006 and 2009 were followed up in 2012-2015. TG, TC, and T2DM status were measured. Cox proportional hazards models were used to estimate the association between TG, TC, and T2DM incidence. The receiver operating characteristic (ROC) curve was used to evaluate the ability of TG and TC to identify T2DM participants.@*RESULTS@#The incidence of T2DM significantly increased with TG in women and TC in both men and women (Ptrend 1.15 and > 1.23 mmol/L in men and women, respectively. For TC, they were > 5.17 and > 5.77 mmol/L in men and women, respectively. The area under the ROCs of TG and TC were 0.54 (0.51-0.57) and 0.55 (0.52-0.58), respectively, in men, and 0.60 (0.58-0.62) and 0.59 (0.56-0.61), respectively, in women.@*CONCLUSION@#Elevated TG and TC were risk factors for T2DM incidence. However, no predictive capacity was found for both factors to identify T2DM incidence in Chinese men and women. Hence, TG and TC levels in both Chinese men and women might be used for decreasing the incidence of T2DM but no clinical predictive capacity for T2DM.

Molecular detection of Leishmania species in human and animals from cutaneous leishmaniasis endemic areas of Waziristan, Khyber Pakhtunkhwa, Pakistan

Objectives:To detect Leishmania species in human patients, animal reservoirs and Phlebotomus sandflies in Waziristan, Pakistan.Methods:Tissue smears and aspirates from 448 cutaneous leishmaniasis (CL) suspected patients were analyzed. To sort out role of the reservoir hosts, skin scrapings, spleen and liver samples from 104 rodents were collected. Furthermore, buffy coat samples were obtained from 60 domestic animals. Sandflies were also trapped. All human, animals and sandfly samples were tested by microscopy, kinetoplastic PCR and internal transcribed spacer 1 (ITS1) PCR followed by restriction fragment length polymorphism for detection of Leishmania species.Results:An overall prevalence of 3.83% and 5.21% through microscopy and ITS1 PCR respectively was found. However, the statistically non-significant correlation was found between area, gender, and number of lesions. The presence of rodents, sandflies, domestic animals and internally displaced people increased the risk of CL. Using ITS1-PCR-RFLP, Leishmania tropica (L. tropica) was confirmed in 106 samples while 25 of the isolates were diagnosed as Leishmania major (L. major). Similarly, 3/104 rodents were positive for L. major and 14 pools of DNA samples containing Phlebotomus sergenti sandflies were positive for L. tropica. None of samples from domestic animals were positive for leishmaniasis.Conclusions:In the present study, L. tropica and L. major are found to be the main causative agents of CL in study area. Movement of internally displaced people from CL endemic areas presents a risk for nearby CL free areas. To the best of our knowledge, we report for the first time L. major infection in rodents (Rattus rattus) and L. tropica in Phlebotomus sergenti sandflies trapped in Waziristan, Pakistan.

Molecular detection of Leishmania species in human and animals from cutaneous leishmaniasis endemic areas of Waziristan, Khyber Pakhtunkhwa, Pakistan

Objectives: To detect Leishmania species in human patients, animal reservoirs and Phlebotomus sandflies in Waziristan, Pakistan. Methods: Tissue smears and aspirates from 448 cutaneous leishmaniasis (CL) suspected patients were analyzed. To sort out role of the reservoir hosts, skin scrapings, spleen and liver samples from 104 rodents were collected. Furthermore, buffy coat samples were obtained from 60 domestic animals. Sandflies were also trapped. All human, animals and sandfly samples were tested by microscopy, kinetoplastic PCR and internal transcribed spacer 1 (ITS1) PCR followed by restriction fragment length polymorphism for detection of Leishmania species. Results: An overall prevalence of 3.83% and 5.21% through microscopy and ITS1 PCR respectively was found. However, the statistically non-significant correlation was found between area, gender, and number of lesions. The presence of rodents, sandflies, domestic animals and internally displaced people increased the risk of CL. Using ITS1-PCR-RFLP, Leishmania tropica (L. tropica) was confirmed in 106 samples while 25 of the isolates were diagnosed as Leishmania major (L. major). Similarly, 3/104 rodents were positive for L. major and 14 pools of DNA samples containing Phlebotomus sergenti sandflies were positive for L. tropica. None of samples from domestic animals were positive for leishmaniasis. Conclusions: In the present study, L. tropica and L. major are found to be the main causative agents of CL in study area. Movement of internally displaced people from CL endemic areas presents a risk for nearby CL free areas. To the best of our knowledge, we report for the first time L. major infection in rodents (Rattus rattus) and L. tropica in Phlebotomus sergenti sandflies trapped in Waziristan, Pakistan.

Prevalence and risk factors for human papillomavirus infection among Chinese ethnic women in southern of Yunnan, China

ABSTRACT Background: Dai is a major Chinese ethnic minority group residing in rural areas of the southern part of Yunnan. However, no data exist on the Human Papillomavirus (HPV) prevalence and genotype distribution among Dai women. Method: A total of 793 participants (Dai = 324, Han = 251, other ethnic = 218) were included in this study. PCR was performed to detect the HPV-positive samples, and genotyping was performed with an HPV Geno-Array. Result: The overall HPV prevalence was very low among Dai women compared to the others. The prevalence of high-risk-HPV infections was significantly higher (p = 0.001) among other ethnic women (22.0%) than that among Han (13.1%) and Dai women (7.1%). The overall HPV, high-risk-HPV, single and multiple infection prevalence among rural women were 12.9%, 12.1%, 12.3%, and 0.5%, respectively. HPV-16 (5.5%) was shown to be the most prevalent genotype, followed by HPV-52 (2.6%) and HPV-58 (2.4%). Urban women had relatively higher rates of overall HPV (16.0%), high-risk-HPV (14.1%), single genotype (11.9%), and multiple genotype (4.1%) infections. In urban women, HPV-52 (3.6%) was the most prevalent genotype, followed by HPV-39 (2.7%) and HPV-16 (1.2%). In the urban area, HPV prevalence was highest in women aged <29 years, but declined with increasing age. However, in rural women, the highest HPV prevalence was observed among women at older age (>50 years). Education and smoking habit were significantly associated with HPV infection among both rural and urban area women (p < 0.001). Conclusion: The prevalence and genotype distribution of HPV varied among ethnic women in urban and rural area of Yunnan Province.

Genotypic Characterization of Methicillin-resistant Staphylococcus aureus Isolated from Pigs and Retail Foods in China / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To investigate the genotypic diversity of Methicillin-resistant Staphylococcus aureus (MRSA) isolated from pigs and retail foods from different geographical areas in China and further to study the routes and rates of transmission of this pathogen from animals to food.</p><p><b>METHODS</b>Seventy-one MRSA isolates were obtained from pigs and retail foods and then characterized by multi-locus sequencing typing (MLST), spa typing, multiple-locus variable number of tandem repeat analysis (MLVA), pulsed-field gel electrophoresis (PFGE), and antimicrobial susceptibility testing.</p><p><b>RESULTS</b>All isolated MRSA exhibited multi-drug resistance (MDR). Greater diversity was found in food-associated MRSA (7 STs, 8 spa types, and 10 MLVA patterns) compared to pig-associated MRSA (3 STs, 1 spa type, and 6 MLVA patterns). PFGE patterns were more diverse for pig-associated MRSA than those of food-associated isolates (40 vs. 11 pulse types). Among the pig-associated isolates, CC9-ST9-t899-MC2236 was the most prevalent clone (96.4%), and CC9-ST9-t437-MC621 (20.0%) was the predominant clone among the food-associated isolates. The CC9-ST9 isolates showed significantly higher antimicrobial resistance than other clones. Interestingly, CC398-ST398-t034 clone was identified from both pig- and food-associated isolates. Of note, some community- and hospital-associated MRSA strains (t030, t172, t1244, and t4549) were also identified as food-associated isolates.</p><p><b>CONCLUSION</b>CC9-ST9-t899-MC2236-MDR was the most predominant clone in pigs, but significant genetic diversity was observed in food-associated MRSA. Our results demonstrate the great need for improved surveillance of MRSA in livestock and food and effective prevention strategies to limit MDR-MRSA infections in China.</p>

GATA1 mutations in a cohort of Malaysian children with Down syndrome-associated myeloid disorder

<p><b>INTRODUCTION</b>Children with Down syndrome (DS) are at increased risk of developing distinctive clonal myeloid disorders, including transient abnormal myelopoiesis (TAM) and myeloid leukaemia of DS (ML-DS). TAM connotes a spontaneously resolving congenital myeloproliferative state observed in 10%-20% of DS newborns. Following varying intervals of apparent remission, a proportion of children with TAM progress to develop ML-DS in early childhood. Therefore, TAM and ML-DS represent a biological continuum. Both disorders are characterised by recurring truncating somatic mutations of the GATA1 gene, which are considered key pathogenetic events.</p><p><b>METHODS</b>We herein report, to our knowledge, the first observation on the frequency and nature of GATA1 gene mutations in a cohort of Malaysian children with DS-associated TAM (n = 9) and ML-DS (n = 24) encountered successively over a period of five years at a national referral centre.</p><p><b>RESULTS</b>Of the 29 patients who underwent GATA1 analysis, GATA1 mutations were observed in 15 (51.7%) patients, including 6 (75.0%) out of 8 patients with TAM, and 9 (42.9%) of 21 patients with ML-DS. All identified mutations were located in exon 2 and the majority were sequence-terminating insertions or deletions (66.7%), including several hitherto unreported mutations (12 out of 15).</p><p><b>CONCLUSION</b>The low frequency of GATA1 mutations in ML-DS patients is unusual and potentially indicates distinctive genomic events in our patient cohort.</p>

Comparison of effectiveness and cost of patent ductus arteriosus device occlusion versus surgical ligation of patent ductus arteriosus

Objectives: Comparison of effectiveness and cost of transcatheter occlusion of patent ductus arteriosus [DA] with surgical ligation of PDA

Methods: This retrospective comparative study was conducted in the pediatric cardiology department of Ch. Pervaiz Elahi Institute of Cardiology Multan, Pakistan. Data of 250 patients who underwent patent ductus arteriosus [PDA] closure either surgical or trans-catheter closure using SHSMA Occluder having weight >5 kg from April 2012 to October 2015 were included in this study. SPSS version 20 was used for data analysis. Quantitative variables were compared using independent sample t-test. Chi-square test and fishers exact was used for qualitative variables. P-value <0.05 was considered statistically significant

Results: There were one hundred and twenty [120] patients who underwent transcatheter occlusion of PDA using SHSMA occluder [PDA Device Group] and one hundred and thirty [130] patients who underwent surgical ligation of PDA [Surgical Group]

Incidence of residual shunting was two [1.5%] in surgical group and 0 [0.0%] in PDA Device group for one month follow up period

There were 4 [3.1%] major complications in surgical group. The rate of blood transfusions were high in surgical group [p-value 0.04]

Hospital stay time was significantly less in PDA Device group [P-value <0.001]

Total procedural cost was 110695+1054 Pakistani rupees in PDA Device group and 92414+3512 in surgical group [p-value <0.001]

The cost of PDA device closure was 16.52% higher than the surgical ligation of PDA

There was no operative mortality

Conclusion: The transcatheter closure of PDA is an effective and less invasive method as compared to the surgical ligation. There is a lower rate of complications and the cost is not much high as compared to surgical PDA ligation

Son preference in Pakistan: M Myth or reality

Objective: To analyze desire for sons/daughters among ladies of Peshawar, Pakistan, with a view to rule out son preference and to study impact of various demographic characteristics on the subject

Methods: Cross-sectional descriptive study conducted at Combined Military Hospital, Peshawar, from August 2015 - January 2016; sampling technique was random/probability/non-purposive. Self-designed questionnaire was utilized; carrying questions pertinent to desire for sons/daughters during marital life, and demographic details. Data analyzed via descriptive analysis [SPSS-21], expressed as frequencies/ percentages and mean +/- standard deviation [minimum/maximum]

Sons and daughters desired [dependent variables] were cross-tabulated with independent variables

Results: Response rate was 63.25% [n-506]

Data revealed following: Sons desired 3.05 +/- 2.061[1/12]; Daughters desired 1.15 +/- 0.767[0/4]; 6.1%[n-31] and 0.6%[n-3] desired infinite number of sons and daughters respectively, 18.2%[n-92] did not desire to have even one daughter, while 2.2%[n-11] considered it immaterial to have daughters or sons

There was a significant relation between sons desired and client's education [p<0.001], husband's education [p<0.001] and socioeconomic class [p<0.001]. There was no significant impact of religion [p-0.142] on desire for sons. Impact of independent variables on daughters desired was similar but less pronounced

Conclusion: There was candid son preference among the respondents. Gender discrimination can be attenuated by adequately addressing son preference at all tiers

Malnourished children with diarrhea; to assess the frequency of serum electrolytes [NA[+], K[+] AND CA[+]] disturbances

"To assess the frequency of serum electrolytes [Na[+], K[+] and Ca[+]] disturbances in malnourished children with diarrhea". Cross-sectional. Pediatrics Department Nishtar Hospital Multan. 01-07-2013 to 31-12-2013. Approval from the institutional ethical committee was taken. Malnourished children with diarrhea admitted to Pediatrics Department Nishtar Hospital Multan were registered. Children meeting the inclusion and exclusion criteria enrolled in the study. In this study there were 90 patients which were found to be malnourished and having diarrhea. The average age of patients was 3.28 +/- 1.2 years and the average duration of diarrhea was 4.67 +/- 0.821 days. There were 58[64.4%] males and 32[35.5%] female patients. Hyponatremia was present in 28[31.1%] patients, Hypokalemia was present in 55[61.1%] while Hypocalcemia was present in 12[13.3%]. Serum electrolyte disturbances in malnourished children are obvious during diarrheal illness particularly in those patients with Grade III malnutrition and measurement of these Serum electrolytes is helpful for immediate therapy to avoid serious life threatening situations

Automatic health care unit

This paper reflects on a novel concept of automation in the health care sector. The idea is to design an automatic system [AHCU] capable of performing remote physical examination with blood glucose estimation, pulse rate measurement, body mass measurement and body temperature measurement. The medical automatic system is consisted of a built-in dispenser to provide front-desk medicines to patient and also prescription in hard copy as well as in soft copy. In the Karachi city, we conducted first focus groups with doctors in order to identify how the remote medical diagnostician system is assessed and conceptualized regarding the examination procedures [activities], communication issues, and the visualization of needed information. The AHCU was found to be very reliable and efficient machine to provide front-desk monitoring, prescription and medication. It takes approximately 20 seconds to examine glucose level in blood, 10 seconds for fever measurement, 5 seconds in pulse rate measurement and 7 seconds for weight measuring. For providing medicines, it takes maximum 60 seconds in all cases. Based on the findings, we has reflected on the technology assessment, i.e., if remote medical services can be a suitable possibility for rural areas where the availability of doctors with various specializations is often a problem, as well as necessities for this novel type of medical treatment from a doctor's point of view [i.e., identified aspects increasing acceptance and adoption by users of the system]

In vitro antibacterial activity of selected medicinal plants from lower Himalayas

The present studies cover antibacterial activity of the crude methanolic extracts of 11 medicinal plants viz. Adhatoda vasica, Bauhenia variegate, Bombax ceiba, Carrisa opaca, Caryopteris grata, Debregeasia salicifolia, Lantana camara, Melia azedarach, Phyllanthus emblica, Pinus roxburghii and Olea ferruginea collected from lower Himalayas against two Gram positive [Staphylococcus aureus, Micrococcus luteus] and two Gram negative [Escherichiacoli, Pseudomonas aureginosa] bacterial strains. The extracts were applied at four different concentrations [120 mg/mL, 90mg/mL, 60mg/mL and 30mg/mL] in dimethyl sulfoxide [DMSO] by using agar well diffusion method. Antibacterial activities against Staphylococcus aureus and Micrococcus luteus were observed formethanolic extracts of all the above mentioned plants. Greater antibacterial activity against Pseudomonas aeruginosa was only exhibited by Phyllanthus emblica, Pinus roxburghii, Debregeasia salicifolia and Lantana camara. Escherichia coli was highly resistant to all the plant extracts at all concentrations. It is inferred that methanolic crude extracts of the above mentioned plantsexhibitantibacterial activities against pathogenic bacteria, which proved the ethnobotanical importance of the selected plants that indigenous people use for cure against various diseases

Comparison of duration of hospitalization and clinical outcome in children infected with methicillin resistant staphylococcus aureus and methicillin sensitive staphylococcus aureus

To compare the duration of hospitalization and clinical outcome in children infected with methicilline-sensitive staphylococcus aureus and methicillin-resistant Staphylococcus aureus. [MRSA and MSSA] comparative cross sectional This Study was carried out at the Paediatrics Department, Nishtar hospital Multan from 14.01.2012 to 13.07.2012 Children meeting the inclusion criteria were selected. Clinical samples were collected before starting antibiotics and sent to microbiology lab for culture. Colony morphology, gram straining and production of catalase and coagulase. confirmed growth of S. aureus. Methicillin resistance was determined by disk diffusion method according to CLSI guidelines. S.aureus with inhibition zone more than 18 mm were taken as methicillin-sensitive and those inhibition zone of less than 18 mm were taken as methicillin-resistant. Adequate information regarding identification of patient, clinical diagnosis, duration of hospital stay and clinical outcome were entered. Aftertaking consent from parents. Lab results were entered in the proforma. Children of all age groups up to 12 years of age and both sexes were included to avoid any bias. All patients clinically diagnosed to be suffering from staphylococcal infection [septicemia, pneumonia, skeletal infection, skin and soft tissue infection, meningitis] who were admitted in pediatric ward were included. Sixty patients with S. aureus infection were included in the study. Thirty patients were of MRSA and 30 were of MSSA. In MRSA group 12 [40%] patients remained in the hospital for less than a week and 18 [60%] patients stayed for more than a week but less than 3 weeks. In MSSA group 23[76.6%] patients were hospitalized for less than one week duration and 7[23.4%] patients were admitted for more than 1 week but less than 3 weeks duration. In MRSA group, 15[50%] patients recovered, 4[13.4%] patients improved, 2[6.6%] patients didn't improved and 9[30%] patients expired. In MSSA group, 22[73.4%] patients recovered completely, 4[13.4%] patients improved, 2[6.6%] patients didn't improved and 2[6.6%] patients expired. Children suffering from MRSA infection have more severe illness as compared to those suffering from MSSA infection. Duration of hospitalization of children suffering from MRSA infection is prolonged as compared to MSSA infection while clinical outcome is better in children suffering from MSSA infection as compared to MRSA infection

Immune response of tuberculin test and diagnostic BCG test in children suffering from tuberculosis

To compare the immunological response of tuberculin test and diagnostic BCG test inoculation given simultaneously to children suffering from tuberculosis. Comparative - Cross sectional. This study was carried out at the Department of Paediatric Medicine, Nishtar Hospital Multan from 6 April 2011 to 5 Oct 2011. Fifty patients with tuberculosis were selected. Relevant data of cases including personal data, presenting complaints, physical examination finding and results of all the relevant investigations were collected. We injected 0.1 ml tuberculin intradermally on ulnar surface of right forearm and 0.1 ml BCG vaccine intradermally on deltoid muscle of left side. Both the BCG and tuberculin tests were performed at the same time by the same doctor. All information was recorded in a specifically designed proforma. 26 patients were male and 24 female. Out of 50 patients; BCG test was positive 36 patients and was negative in 14 patients. Mantoux test was positive in 26 patients and was negative in 24 patients. Both BCG and mantoux tests were positive in 26 patients. Ten patients had a positive BCG test where Mantoux test showed negative results. Both tests were negative in 14 patients. BCG skin test is more superior to Mantoux test as a diagnostic tool in paediatric age group patients suffering from various types of tuberculosis

Hepatitis-B virus infection; to describe the clinical presentation in children

To describe the clinical presentations of hepatitis B virus infection in children. Children presenting with symptoms of liver diseases and other diseases who were found to be HBsAg positive by screening or ELISA method were enrolled. Children suffering from thalassemia, hemophilia and hemolytic anemia, which need multiple transfusions, were excluded. On the basis of history, examination and investigations the clinical presentation of the patient was categorized. Basic demographic data, relevant clinical history, physical examination, lab investigations and clinical presentations category were entered in the predesigned proforma. As this is the descriptive study, no hypothesis were required. Descriptive case series. Paediatric unit-2 Nishtar Hospital Multan. 16[th] May 2012 to 15th November 2012. Study results consist of relative frequencies of different clinical presentations of HBsAg positive patients. Fifty children who were HBsAg positive were enrolled in a six month period. Out of 50 patients, 21 [42%] were of hepatic encephalopathy, 14 [28%] were with acute hepatitis, 12 [24%] were cirrhosis, 2 [4%] were asymptomatic carrier and 1 [2%] was presented with chronic hepatitis B. There were 40 [80%] males and 10 [20%] females. The overall male to female ratio was 4:1. Most common presentation was hepatic encephalopathy which has a very bad prognosis, next comes the acute hepatitis and then cirrhosis. There is another inference that males are more and severely affected by hepatitis-B virus infection

Comparison of real time polymerase chain reaction with microscopy and antigen detection assay for the diagnosis of malaria

To determine the sensitivity of a real time polymerase chain reaction [PCR] for malaria diagnosis and to compare its accuracy with microscopy and an antigen based rapid diagnostic test [OptiMal]. Cross-sectional analytical study. Military Hospital, Armed Forces Institute of Transfusion and Armed Forces Institute of Pathology, Rawalpindi, from July to December 2011. Venous blood samples of 300 clinically suspected patients of malaria were tested for malaria parasite by microscopy and OptiMal; and malaria parasite index was calculated for the positive samples. Plasmodium genus specific real time PCR was performed on all specimens, targeting small subunit rRNA gene. Diagnostic accuracy of three tests was compared and cost analysis was done. Out of 300 patients, malaria parasite was detected in 110, 106 and 123 patients by microscopy, OptiMAL and PCR respectively. Real time PCR was 100% sensitive while microscopy and OptiMal had sensitivity of 89.4% and 86.2% respectively. All methods were 100% specific. The cost per test was calculated to be 0.2, 2.75 and 3.30 US$ by microscopy, OptiMal and PCR respectively, excluding the once capital cost on PCR equipment. Genus specific real time PCR for the diagnosis of malaria was successfully established as a highly sensitive and affordable technology that should be incorporated in the diagnostic algorithm in this country.

Penetrating colonic injuries: primary repair versus colostomy

To compare the primary repair with colostomy in colonic injuries at tertiary care hospital in terms of morbidity and hospital stay. Quasi experimental study. This study was conducted in the Department of Surgery, Unit II BVH Bahawalpur from 27-01-2010 to 31-8-2010. A total of sixty patients fulfilling the inclusion criteria were selected for this study. Patients were randomly allocated in two groups. Group A [Primary Repair] and Group B [Colostomy], 30 patients in each group. Follow up in group A patients was done twice after 2 weeks and after one month. The follow up in group B was done for multiple times. Initially the visit was advised after every two weeks until the patient was called back for colostomy closure. The mean age in group A was 28.9 +/- 8.1 years and in group B was 30.1 +/- 14.0 years. The mean hospital stay in group A was 8.9 +/- 3.65 days and in group B was 11.0 +/- 4.7 days. At two weeks follow up, in group A, there was one [3.3%] patient of abscess, one [3.3%] of suture repair leak, one [3.3%] patient of sepsis and 2 [6.7%] patients of wound infection. In group B, there were 2 [6.7%] patients of abscess, one [3.3%] patient of suture repair leak, 3 [10%] patients of sepsis and 4 [13.3%] patients of wound infection. This is concluded from our study that primary repair was safe and effective treatment modality in the management of colonic injuries as compared to colostomy

Expression and analysis of the glycosylation properties of recombinant human erythropoietin expressed in Pichia pastoris

The Pichia pastoris expression system was used to produce recombinant human erythropoietin, a protein synthesized by the adult kidney and responsible for the regulation of red blood cell production. The entire recombinant human erythropoietin (rhEPO) gene was constructed using the Splicing by Overlap Extension by PCR (SOE-PCR) technique, cloned and expressed through the secretory pathway of the Pichia expression system. Recombinant erythropoietin was successfully expressed in P. pastoris. The estimated molecular mass of the expressed protein ranged from 32 kDa to 75 kDa, with the variation in size being attributed to the presence of rhEPO glycosylation analogs. A crude functional analysis of the soluble proteins showed that all of the forms were active in vivo.

Vaginal delivery versus cesarean section; birth outcome in primi gravdae breech

It is to compare neonatal morbidity in terms of birth trauma, respiratory distress syndrome, APGAR score in Primigravida with breech presentation delivered vaginally and emergency cesarean section. Cross-sectional comparative study. Obstetrics and Gynaecology Unit-l, Bahawal Victoria Hospital, Bahawalpur from 1-5-2007 to 30-4-2008. The study was carried out on all Primigravida with breech presentation reported through emergency in labour delivered vaginally and by emergency cesarean section. The variable analyzed were birth trauma, respiratory distress syndrome and APGAR score at 1 and 5 minutes. Students-t test was used for comparison between means and chi square test for comparison between percentages. Significance was taken at P<0.05. It was found that mean APGAR score at 1 and 5 minutes is 7.31 and 9.066 in vaginal and 8.533 and 9.644 in cesarean group. Respiratory distress syndrome is more in cesarean [4.4%] than vaginal group [2.2%]. Observed neonatal trauma is more in vaginal group [6.7%] than cesarean section [2.2%]. Neonatal morbidity appears to be more in vaginal breech delivery than I cesarean section for Primigravida with breech presentation at term

A new record of Fannia prisca Stein, 1918 (Diptera:Fanniidae) from peninsular Malaysia

Fannia prisca Stein, 1918 is newly recorded from peninsular Malaysia. This record is based on 4 male specimens from Mount Berembun, Brinchang, Cameron Highland, Pahang state, peninsular Malaysia. It is previously recorded from China, Mongolia, Korea, Japan, Taiwan, Bonin Island, Thailand and oriental region. The male of Fannia prisca can be differentiated from male Fannia scalaris by the following features: for F. prisca, mid-coxa without spine; mid-tibia normal or without stout triangular ventral projection; and hind tibia usually with 2 av, while F. scalaris has several stout hook-like spines on the anterior margin; mid-tibia with stout triangular ventral projection and hind tibia usually with 3 av. Both F. prisca and F. scalaris can be differentiated from Fannia leucosticta by looking at its hind tibia, which only has 1 av.