Effect of Integrated Nutrient Management on Growth and Yield of Cauliflower

With the use of integrated nutrient management, cauliflower the growth and yield can be boosted. Due to their complementing effects, the ideal combination of different organic and inorganic sources of nutrients may significantly boost cauliflower growth and yield. The experiment consisted of 13 treatments viz. T1= N120P60K100S20 kg/ha (Recommended dose of NPKS as control), T2= N120P60K100S20 kg/ha + CD (5 t/ha), T3= N120P60K100S20 kg/ha + VC (4 t/ha), T4= N120P60K100S20 kg/ha + MSC (4 t/ha), T5= N120P60K100S20B0.6Mo0.54 kg/ha + CD (5 t/ha), T6= N120P60K100S20B0.6Mo0.54 kg/ha + VC (4 t/ha), T7= N120P60K100S20B0.6Mo0.54 kg/ha + MSC (4 t/ha), T8= N120P60K100S20 kg/ha + CD (5 t/ha) + Bio. (5 kg/ha), T9= N120P60K100S20 kg/ha + VC (4 t/ha) + Bio. (5 kg/ha), T10= N120P60K100S20 kg/ha + MSC (4 t/ha) + Bio. (5 kg/ha), T11= N120P60K100S20B0.6Mo0.54 kg/ha + CD (5 t/ha) + Bio. (5 kg/ha), T12= N120P60K100S20B0.6Mo0.54 kg/ha + VC (4 t/ha) + Bio. (5 kg/ha) and T13= N120P60K100S20B0.6Mo0.54 kg/ha + MSC (4 t/ha) + Bio. (5 kg/ha). The experiment was laid out in a Randomized Complete Block Design (RCBD) having single factor with three replications. Data were recorded on growth, yield components of cauliflower and significant variation was observed for most of the studied characters. Under this investigation, it was revealed that the highest yield (36.34 t/ha) with net return (Tk. 524202) and BCR (3.59) was obtained from T12 (N120P60K100S20B0.6Mo0.54 kg/ha + VC (4 t/ha) + Bio. (5 kg/ha) treatment. On the other hand, the lowest yield (13.50 t/ha) with net return (Tk. 137869) and BCR (2.04) was obtained from T1 (N120P60K100S20 kg/ha) treatment. So, economic analysis revealed that T12 (N120P60K100S20B0.6Mo0.54 kg/ha + VC (4 t/ha) + Bio-fertilizer (5 kg/ha) treatment appeared to be the best for achieving the higher growth, yield and economic benefit of cauliflower.

Mechanical Deformation of Superelastic NiTi Wire at Different Deflections in an Orthodontic Bracket System

@#Introduction: Most patients with malocclusion are given orthodontic leveling therapy with the aim of reducing the vertical discrepancy between teeth. This computational study aims to evaluate the degree of deformation of superelastic NiTi arch wire upon bending at different deflections in a bracket system. Methods: A three-dimensional finite-element model of a wire-bracket system was developed to simulate the bending behavior of superelastic NiTi arch wire in three-brackets configuration. A superelastic subroutine was integrated in the model to anticipate the superelastic behavior of the arch wire. The mid span of the arch wire was loaded to different extent of deflections, ranging from 1.0 to 4.0 mm. The mechanical deformation of the arch wires was accessed from three parameters, in specific the unloading force, the bending stress and the martensite fraction. Results: The superelastic wire deflected at 4.0 mm yielded smaller unloading force than the wire bent at 1.0 mm. The bending stress was highly localized at the wire curvature, with the stress magnitude increased from 465 MPa at 1.0 mm to 951 MPa at 4.0 mm deflection. The martensite volume consistently increased throughout the bending, with a fully transformed martensite was observed as early as 2.0 mm of deflection. The magnitude of bending stress and the volume of fully transformed martensite increased gradually in relation to the wire deflection. Conclusion: The wire-bracket system induced localize wire deformation, hindering complete utilization of superelasticity during orthodontic treatment.

Potential bioactive phytochemicals, antioxidant properties and anticancer pathways of Nymphaea nouchali

Objective: To investigate bioactive phytochemicals and antioxidant activities of Nymphaea nouchali and to explore its anticancer pathways by a network pharmacology approach. Methods: Using a spectrophotometer and high-performance liquid chromatography-diode array detector (HPLC-DAD), we quantified bioactive phytochemicals in methanolic extract of Nymphaea nouchali tuber. The extracts were investigated for in vitro antioxidant properties. Targets of these bioactive phytochemicals were predicted and anticancer-associated pathways were analyzed by a network pharmacology approach. Moreover, we identified the predicted genes associated with cancer pathways and the hub genes in the protein-protein interaction network of predicted genes. Results: Quantitative results indicated the total phenolics, total flavonoids, and total proanthocyanidins in the methanolic extract of Nymphaea nouchali tuber. HPLC-DAD analysis showed rutin (39.44 mg), catechin (39.20 mg), myricetin (30.77 mg), ellagic acid (11.05 mg), gallic acid (3.67 mg), vanillic acid (0.75 mg), rosmarinic acid (4.81 mg), p-coumaric acid (3.35 mg), and quercetin (0.90 mg) in 1 g of dry extract. The extract showed the radical scavenging activities of 2, 2-diphenyl-1-picrylhydrazyl, 2,2'-azino- bis (3-ethylbenzothiazoline-6-sulfonic acid) and N,N-dimethyl-p phenylenediamine. By using network pharmacology, we predicted 130 target genes associated with cancer pathways. The top hub genes (IL6, AKT1, EGFR, JUN, PTGS2, MAPK3, CASP3, and CXCL8) were also identified, which were associated with cancer pathways and interacted with bioactive phytochemicals of the methanolic extract of Nymphaea nouchali tuber. Conclusions: Our study provides insights into the mechanism of anticancer activities of the methanolic extract of Nymphaea nouchali tuber.

Comparison of oral versus intravenous clodronate in patients with skeletal metastasis with respect to bone mineral density and pain score

Background: Clodronate is a bisphosphonate available both in oral as well as intravenous formulations. It is one of the effective drugs painful skeletal metastasis. The present study aimed at comparison of oral vs intravenous formulation with regard to improvement in bone mineral density and pain score among patients having skeletal metastasis

Methods: Two hundred patients having any cancer with skeletal metastasis were included in the study. They were given either oral Clodronate or intravenous Clodronate for six months and a comparison was made between them with regard to improvement in bone mineral density and pain score

Results: Out of 200 patients 135 were males and 65 females with a mean age of 54 years. Mean T score of patients on oral treatment before start of treatment was -2.42 that improved to -2.15 [p<0.005] after 6 months of therapy. Mean T-score of patients on intravenous therapy at baseline was -2.37 also improved to -2.11 [p<0.005] after 6 months of therapy. The two arms of treatment did not show statistically significant difference in pre- and posttreatment T scores. The mean pain score of the patients receiving oral Clodronate at the start of treatment was 7.33 that improved to 3.13 [p<0.005] while among patients on intravenous Clodronate it improved from 7.37 to 3.11 [p<0.005]. The comparative improvement in pain scores in the two arms was not significantly different [p=0.909]

Conclusion: Clodronate improves both T score on DEXAscan and pain score among patients with skeletal metastasis irrespective of the route of administration

Association between hypolipidemias and colorectal carcinoma

Objective: To study association of hypolipidemias and primary colorectal carcinoma in population of patients of colorectal carcinoma presenting to Combined Military Hospital [CMH] Rawalpindi

Study Design: Case control study

Place and Duration of Study: Oncology department, Combined Military Hospital [CMH], Rawalpindi. Material and Methods: Forty one treatment naive patients between ages of 18-75, with histologically confirmed primary colorectal carcinoma were selected and their serum lipid profile was measured after an overnight fast, from Armed Forces Institute of Pathology [AFIP]. These levels were compared with 41 controls, selected from healthier population, using an unpaired T test. Frequency and percentages were computed for variables; sex, age and stage at presentation

Results: Colorectal carcinoma had significant association with triglycerides [p=0.007], total cholesterol [p=0.014] and LDL [p=0.013]

Conclusion: There is an inverse relationship between serum total and LDL cholesterol, and colorectal carcinoma, implying that hypolipidemias may play a role in development of colorectal carcinoma

Efficacy of combination chemotherapy; gemcitabine and docetaxel, in patients with advanced urinary bladder carcinoma

To evaluate the efficacy of combination chemotherapy; gemcitabine and docetaxel, in terms of objective response, in advanced urothelial carcinoma of urinary bladder. Quasi-experimental study. Oncology Department of Combined Military Hospital Rawalpindi, from Oct 2012 to July 2013. Fifty one patients with histologically confirmed urothelialcarcionoma of the bladder were enrolled into this study. Patients were staged and their radiological features were documented before chemotherapy. Four cycles of gemcitabine and docetaxel; combination chemotherapy were administered to the patients. Response was evaluated after 4 courses. Patients with progressive disease were not given further chemotherapy. Patients who could not complete 4 courses were excluded from the study. Remaining patients were given 2 more courses of chemotherapy. Patients were followed up for a period of 1 year after being enrolled for the study to document median survival. Total 46 patients were included in the study out of which 2.2% patients had a complete response, 37% had a partial response, 28.3% patients had a stable disease while 32.6% patients had a progressive disease. The objective response rate was 39.2% while the median survival time was 42 weeks. The results of our study have shown that combination of gemcitabine and docetaxel in patients with advanced urothelial carcinoma of the urinary bladder, has a good therapeutic index and stands as a reasonable first Line option for such patients

Fracture neck of femur; avascular necrosis with cannulated screws

Fracture neck of femur is a devastating injury. One of its main complications is avascular necrosis [AVN] of the femoral head. For the fixation of femoral neck fractures, cannulated screws are now universally used. The aim of the study was to determine the frequency of avascular necrosis in fracture neck of femur fixed with cannulated screws. Descriptive cross sectional study. Orthopedic unit of Ayub Teaching Hospital Abbottabad. 7[th] March, 2011 to 6[th] September, 2011. Recruiting 113 patients of either gender between 15 to 60 years of age with fracture neck of femur who were fixed with cannulated screws. The data was entered and analyzed with the help of SPSS 10. There were 113 patients with an overall mean age of 43.51 years +/- 11.94SD. Maximum number of patients was 56 [49.50%] from the age group of 46 to 60 years. Avascular necrosis was noted in 23 [20.35%] cases. The maximum number of patients with avascular necrosis was 13 [56.52%] belonging to the age group of 15 to 25. Avascular necrosis was high in younger ages in displaced fractures of neck of femur treated with cannulated screws

A Study of Prophylactic Effect Against Diabetes of Two Ayurvedic Drugs ‘Jambadyarista’ and ‘Bohumutrantak Ras’ in Normal as well as Alloxan-induced Diabetic Rats.

Aims: The present study was designed to evaluate the anti-diabetic as well as prophylactic activity of Jambadyarista and Bohumutrantak Ras in alloxan-induced diabetic rats. Study Design: Study the prophylactic and antiglycemic effects against diabetes of two Ayurvedic drugs ‘Jambadyarista’ and ‘Bohumutrantak Ras’ in normal as well as alloxaninduced diabetic rats using in vivo models. Place and Duration of Study: Department of Pharmaceutical Chemistry, Faculty of Pharmacy, University of Dhaka, Dhaka-1000, Bangladesh between December 2013 and March 2014. Methodology: To investigate the activity, 70 Long Evans rats divided into seven (A-G) groups were included in this study. Diabetes was induced by single intraperitoneal injection of alloxan (150mg/kg body weight) while the Ayurvedic drugs Jambadyarista and Bohumutrantak Ras were given orally at a dose of 200mg/kg of body weight. Group A was control group. Groups B and E were allowed to fast for 12 hours. Diabetes was induced by intraperitoneal injection of freshly prepared solution of alloxan (150mg/kg) in normal saline after base line glucose level determination. The alloxan-treated rats were allowed to food over night to overcome drug induced hyperglycemia. After 48 hours, blood glucose level was measured with an Accu-Chek glucometer using blood sample from the tail vein of each rat. Diabetes was established in animals when blood glucose level was raised to 11.1-32.6mmol/L. After the establishment of diabetes, the experiments were carried out. Groups D and G were allowed to induce diabetes by single intraperitoneal injection of alloxan (75mg/kg body weight) in normal saline every day for 5 days. Results: In case of alloxan-induced diabetic rats, Jambadyarista and Bohumutrantak Ras showed prophylactic activity against diabetes as well as also reduced blood glucose level. By statistical analysis of results, it was found that Jambadyarista and Bohumutrantak Ras have prophylactic activity against diabetes in normal and alloxan- induced diabetic rats. Conclusion: It can be inferred that the Ayurvedic drug “Jambadyarista and Bohumutrantak Ras” significantly possess prophylactic activity against diabetes. They also showed antidiabetic effect in alloxan-induced diabetic rats. Further comprehensive cellular and molecular investigations are required to characterize the exact mechanism responsible for its prophylactic and antidiabetic effects.

External fixator in the treatment of open fractures of tibia

To evaluate the outcome of external fixator used as a definitive mean of fixation in open fracture of tibia. This cross sectional study conducted at Orthopaedics Unit District Headquarter Hospital Timergara from December 2005 to September 2008 included 40 patients with grade II, grade IIIA and IIIB open fractures of tibia. Patients with grade I, grade IIIC open fractures and the patients who needed amputation for their injuries were excluded from the study. Patients with insufficient follow up were also excluded. In all these patients an aggressive approach of early initiation of treatment, radical debridement and irrigation was adopted. All the fractures were stabilized with AO external fixator, and early soft tissue coverage was provided in these patients. On removal of the external fixator Sarmiento functional brace was used till the time of union in all these patients. The mean age of the sample was 28.80 +/- 9.87. The most common mechanism of injury in these 40 patients was road traffic accidents. Pin tract infection the commonest complication, noted in 10[25%] patients, deep wound infection in 4[10%] patients, delayed union in 4[10%] patients, and mal union, non union in none of them. Dynamisation of the fixator was done in 12[30%] patients and prophylactic bone grafting was performed in 4[10%] patients. The average time of fracture consolidation was 18 weeks. External fixator can be effectively used as definitive mean of fixation in open fractures of tibia with extensive soft tissue damage

Prevalence of left ventricular diastolic dysfunction in patients with left ventricular hypertrophy

Abnormalities in left ventricular relaxation are indicators of left ventricular [LV] diastolic dysfunction. LV diastolic dysfunction may occur in patients with LV hypertrophy in the absence of systolic dysfunction. The purpose of this study is to assess the prevalence of LV diastolic dysfunction in patients with left ventricular hypertrophy in Pakistani population. 200 consecutive patients age 20 years and above and of either sex with left ventricular hypertrophy were included in this study. LV diastolic function was assessed by pulsed wave Doppler studies measuring transmitted E and A-wave velocities, E/A ratio, deceleration time and Isovolumic relaxation time intervals. LV diastolic dysfunction was diagnosed. Out of 200 patients, 106 [53%] were male and 94 [47%] were female. The average age was 53.66 +11.07 years. The average body surface area of male patients was 1.79 + 0.19 and female patients was 1.59 + 0.16 m2. The average LV mass of male patients was 290.09 + 68.29 and of female patients was 242.23 + 54.34 grams. 92 [46%] patients had LV diastolic dysfunction. 58 [61.70%] of female patients and 50 [47.17%] of male patients had LV diastolic dysfunction [P=0.04]. The average age of patients with LVDD was 55.55 + 10.86 years as compared to 50.27 + 10.38 years in patients without LVDD [P=0.001]. The mean body surface area of patients with LVDD was 1.667+0.202 as compared to 1.738+0.199 of patients without LVDD [P=0.014]. Ejection fraction and LV mass were not different statistically in patients with or without LVDD. LVDD is a frequent finding in patients with left ventricular hypertrophy. It is more frequent ir female patients with advancing age and smaller body surface area

Cardiac arrhythmias and left ventricular hypertrophy in systemic hypertension

Hypertensive left ventricular hypertrophy [LVH] is associated with increased risk of arrhythmias and mortality. Objective was to investigate the prevalence of cardiac arrhythmias and LVH in systemic hypertension. In all subjects blood pressure was measured, electrocardiography and echocardiography was done. Holter monitoring and exercise test perform in certain cases. There were 500 hypertensive patients, 156 [31.2%] men and 344 [69%] women >30 years of age in the study. Among them 177 [35.4%] were diabetic, 224 [45%] were dyslipidemia, 188 [37.6%] were smokers, and 14 [3%] had homocysteinemia. Duration of hypertension [HTN] was >/= 2 years]. Mean systolic BP [SBP] was 180 +/- 20 mm Hg and diastolic BP [DBP] was 95 +/- 12 in male and female patients. Left ventricular mass index [LVMI] was 119.2 +/- 30 gm/m2 in male while 103 +/- 22 gm/m2 in female patients. Palpitation was seen in 126 [25%] male and 299 [59.8%] female patients. Atrial fibrillation was noted in 108 [21.6%] male and 125 [25%] female patients, 30 [6%] male and 82 [16.4%] female patients had atrial flutter. Ventricular tachycardia was noted in 37 [7.4%] male and 59 [11.8%] female patients. Holter monitoring showed significant premature ventricular contractions [PVC'S] in 109 [21.8%] male and 128 [25.69%] female patients while Holter showed atrial arrhythmias [APC'S] in 89 [17.8%] males and 119 [23.8%] females. Angiography findings diagnosed coronary artery disease in 119 [23.8%] with CAD male and 225 [45%] without CAD while 47 [9.4%] females presented with CAD and 109 [21.8%] without CAD. A significant association has been demonstrated between hypertension and arrhythmias. Diastolic dysfunction of the left ventricle, left atrial size and function, as well as LVH have been suggested as the underlying risk factors for supraventricular, ventricular arrhythmias and sudden death in hypertensives with LVH

Door to needle time of streptokinase and ST segment resolution assessing the efficacy of reperfusion therapy at Karachi Institute of Heart Diseases

Early start of treatment including coronary revascularisation has been recognised as crucial variable in the outcome of acute ST-segment Elevation Myocardial Infarction [STEMI]. Objectives of the study were to determine the magnitude of ST-segment resolution after thrombolytic therapy predicts short- and long-term outcomes in patients with an Acute Myocardial Infarction [AMI]. The duration of quasi experimental study was 3 years, from July 2006 to June 2009, conducted at Karachi Institute of Heart Diseases. Total 1,023 patients of STEMI treated with streptokinase [SK] were enrolled in the study. Of the total 1023, 689 [67.3%] patients were males and 334 [32.6%] were females. Six hundred and twenty-nine [61.5%] were successfully resolved after thrombolytic therapy while in 395 [38.5%] patients ST-segment could not resolve into 3 conventional ST-segment resolution categories at 60 minute and 90 minute after thrombolysis. Three hundred and twelve [30%] and 444 [43.4%] with complete resolution, 344 [33.62%] and 325 [31.76%] with partial resolution, 367 [35.8%] and 491 [19.29%] were with no resolution at 60 and 90 minutes respectively. Shock, congestive heart failure, and recurrent angina and ischemia occurred more often in patients with partial or no ST resolution as compare to complete resolution

Per-operative findings and post-operative complications with laparoscopic appendicectomy

To study the per-operative findings and post-operative complications that arise with laparoscopic appendicectomy. Material and Methods: This descriptive study was conducted in Surgical "A" and Surgical "C" Unit of PGMI, Lady Reading Hospital from April 2006 to December 2008. Patients with acute appendicitis, short history, age ranges from 15 to 50 years and recurrent appendicitis were included in this study, while patients with appendicular mass, appendicular abscess, pregnancy and with previous abdominal surgery were excluded. All the data was collected by using a proforma. Data was analyzed by descriptive statistics. Out of 60 patients admitted for Laparoscopic Appendicectomy [LA], 36[60%] were males and 24[40%] were females. Only 6[10%] patients required conversion from laparoscopic to open surgery. Problems and per-operative complications were encountered in 9[15%] patients. These were dense adhesions due to inflammation 4[6.66%], localized perforation 2[3.33%], diffuse peritonitis 2[3.33%] and bleeding during procedure 1[1.66%]. Postoperative complications were seen in 5[8.33%] cases, out of which 2[3.33%] patients developed port site infection, 1[1.66%] patient developed postoperative ileus, 1[1.66%] patient developed partial bowel obstruction and 1[1.66%] patient presented with right iliac fossa abscess. There was no mortality. All patients resumed normal activity within 6-7 days of operation and were well satisfied up to median follow-up of 5-6 months. Majority of the patients were males. Per-operative findings were adhesions, perforation and peritonitis. Post-operative complications were port-site infection, ileus and bowel obstruction. Majority recovered within a week time

Percutaneous coronary intervention of osteal lesions in newly established tertiary care cardiac hospital

To assess the outcome of percutanious Angioplasty in patients with osteal lesions in Coronary artery Diseases. This is a retrospective analysis of all coronary angiograms performed at the catheterization laboratory of Karachi Institute of Heart Diseases [KIHD], a tertiary referral center in Karachi, Pakistan, between the periods August 2006 to August 2008. Fifty patients were enrolled which included thirty-five men and fifteen women and all were >40 years of age. Each patient had a single target osteal lesion: twenty nine patients underwent PCI for ostial LAD lesion [among them twenty males and nine females], six had ostial LCX [five males and one female], and fifteen patients had osteal RCA stenosis [10-male patients and 5- female patients]. After high-pressure balloon dilatation residual stenosis was reduced. Twelve patients were treated with bare metal stents [BMS] while thirty eight with drug eluting stents [DES]. In all cases the procedure was successful without any pre and post procedural complications. A key issue in the treatment of an osteal lesion is to assure that the stent is inserted proximal enough to fully cover the osteal junction. Improvements in technique, equipment, adjunctive drug therapy and better understanding of the procedure have remarkably changed the practice of interventional cardiology

Anatomical position of appendix in emergency care patients

To identify the anatomical position of the appendix in patients presenting at the emergency surgical ward, Lady Reading Hospital Peshawar. This descriptive study was conducted in surgical 'A' Unit, Lady Reading Hospital, Peshawar from January to June 2008. Patients coming to emergency surgical ward were examined after detailed history and investigation; and then operated. Position of appendix along with other findings was noted. 100 patients were admitted and examined. 68% were male and 32% were female. During surgery retrocaecal position was the most common [78%] followed by pelvic position in 16% of patients. Perforated appendix was observed in 06% [all retrocaecal appendixes]. Retrocaecal appendix was the commonest in patients presenting to emergency with acute appendicitis. Less symptoms/signs lead to delay in diagnosis and complications

Experience with the surgical management of fracture penis

To know the etiology, complications and outcome of surgical management of fracture penis. This descriptive study carried out in the surgical departments of Lady Reading Hospital Peshawar from April 2000 to March 2005. Patients with the clinical diagnosis of fracture penis were admitted and operated. All patients except those with haematuria were catheterized. Most of these patients were explored via a circumcoronal incision and the defect in the tunica of corpus cavernosum repaired with 3/0-vicryl suture. No drain was used and a light compression dressing was done in all patients. Catheter was removed on the second postoperative day. Follow up was arranged at 6 and 24 months of operation. During the study period 51 patients were operated for fracture penis. Mean age at presentation was 32 years. The commonest cause of fracture penis was manual fiddling with the organ to overcome an erection [39.2%]. The incidence of associated urethral injury was 1.96% [n=1/51]. The commonest mode of presentation was with a cracking sound, local pain and immediate detumescence [90%, 98% and 94% respectively]. Average hospital stay was 3.4 days. Immediate postoperative complication was urinary retention in 2 patients [3.92%]. Long-term complications were negligible. There was only one readmission at 6 months for urethral stricture that responded well to optical urethrotomy. The commonest cause of fracture penis is manual manipulation to overcome an erection. The best treatment option is immediate surgical repair

Echocardiographic profile of patients with mitral stenosis

Rheumatic heart disease is a common cardiovascular disease in our country. These patients are referred to echocardiography laboratory for the evaluation of valvular lesions. In this study we are presenting the echo-cardiographic data of patients with mitral stenosis referred to our lab during 2006. We have retrospectively analyzed the data of patients with mitral stenosis [MS]. A total of 3393 echo studies were performed during this year. Out of these 70 patients had significant MS. Of these 42[60%] were female and 28[40%] were male patients. The mean age of these patients was 41.13 +/- 12.64 years [Range 17-70 years] and the median age of 40 years. The mean age of patients with mild MS was 48.63 +/- 12.38 years, with moderate MS was 40.33 +/- 12.52 and with severe MS was 34.67 +/- 9.12 years. All patients had dilated left atrium and normal sized left ventricle. The mean diameter of left atrium was 45.65mm. The mean of MVA by planimetry was 1.28 +/- 0.39 cm2 and by pressure half time method was 1.25 +/- 0.35 cm2 [P=0.366]. The mean MVA in female patients was 1.33 +/- 0.31cm2 and 1.21 +/- 0.49 cm2 and in male patients was 1.21 _0.31 cm2 and 1.28 +/- 0.39 cm2 by planimetry and PHT methods respectively. The mean of mean pulmonary artery pressure was 49.26 +/- 26.82 mmHg. In female patients it was 44.49 +/- 22.33 mmHg and in male patients 57.35 +/- 32.0 mmHg [P=0.024]. 19[27.1%] patients had mild MS, 33[47.1%] moderate and severe in 18[25.1%] patients. Mitral regurgitation was present in 36[51.4%] patients, tricuspid regurgitation in 33[49.1%] patients and 13[18.6%] patients had calcification on leaflets or commissures

Large B cell lymphoma-year by year

Non Hodgkin's Lymphoma [NHL] comprises a group of lymphoproliferative disorders the frequency of which continues to rise. Although many classification systems exist for identifying specific histological subtypes, NHL is generally divided into indolent [low-grade] and aggressive [intermediate- and high-grade] forms. Large B Cell Lymphoma [LBCL] is one of the commonest aggressive NHLs. The aim of this review is to provide a general overview of NHL, its clinically practicable cellular classification, epidemiology and in depth overview of the evolution of treatment of LBCL during the past 5 years. Current guidelines from National Cancer Institute [NCI], USA and National Institute on Clinical Excellence [NICE], UK are mentioned and recommendations according to our own set-up are suggested

comparative study of various types of hemorrhoidectomy

To compare the outcome of various operative procedures of hemorrhoidectomy. This comparative study was conducted in Surgical Department, LRH, Peshawar, from March to December 2005. Ninety patients with 2nd and 3rd degree internal hemorrhoids, were randomly divided in to three groups of 30 patients each: "Group A" low ligation and excision with anal stretch. [Group B]: low ligation and excision without anal stretch. [Group C]: closed hemorrhoidectomy. Postoperative pain was present in 4 [13.33%] cases in [Group A] and 3 [10%] cases each in [Group B] and [Group C]. Postoperative bleeding per rectum was present in 2 [6.66%] cases each in Group A and Group B and 1 [3.33%] case in Group C. Postoperative urinary retention was observed in 1 [3.33%] case each in Group A and group B only. Postoperative wound infection and Postoperative peri-anal abscess were recorded in 3 [10%] and 1 [3.33%] patients respectively in Group C only. Postoperative incontinence of flatus was reported in 1 patient [3.33%] of Group A only. Postoperative skin tags were seen in 2 [6.66%] cases of Group A, 1 [3.33%] case in Group B, and none in Group C. Recurrence was not observed in patients during follow up. Mortality was not encountered in the three groups. No statistical significance was found in these three operative procedures with respect to less pain during the early postoperative period and faster wound healing with no recurrence in any group

Ingestion of metallic rods and needles

Foreign bodies in gastrointestinal tract [GIT] are not very rare. This case describes a patient purposefully swallowing metallic objects. These were five iron rods ranging 4-5 inches in length, and two needles. One of the rod perforated duodenum and was found in pelvic cavity upon exploration. The rest of the rods were in small gut and stomach