Evaluation of suspected chronic pesticide poisoning among residents near agriculture fields

The present study was performed to evaluate the incidence of organophosphorus toxicity among agrarian and non agrarian subjects residing near agriculture fields. The location of this study was Nawakot village, Multan. From the cotton producing area of Multan, 225 volunteers [farmers] including 103 females and 122 males were selected. Children <12 years of age constitute 15% of the population. A total of 100 volunteers [non agrarians] from Multan city were taken as control. Blood [4 ml] was drawn from the volunteers to test the level of acetylcholine estrase [Ach E] in plasma. The blood samples were then analysed at the laboratory of National Poison Control Center [NPCC]. Organo-phosphate [OP] and carbamates [CM] both act to block Ach E hydrolysis, necessary for synaptic response in the CNS. Acute illnesses were seen in 6 [2.67%], children [group 1]. They had fever and signs of pulmonary infections. Generalised weakness was found in 9 males and 13 females. Paraesthesia was found in 11 volunteers of group IV. Blood sampling test revealed that 6 volunteers [2.67%] had plasma Ach E below 5300 IU/ml [< 50% reduction], whereas 4 volunteers had Ach E level between 5300 - 5500 IU/ml [< 45% reduction], 81 volunteers fall in group "c", and 126 individuals had an Ach E reduction of at least 25% and 8 volunteers had the serum cholinesterase level above 10000 IU/ml. None of volunteers had the value above 11000 IU whereas plasma Ach E level of control population was between 11500 - 13500 IU/ml. Medical tests of the level of Ach E in plasma suggest that the overall incidence of poisoning from exposure to OP and CM is quite high, and appears to be consistent with the results from other studies in other developing countries

comparative study of kinetic parameters of alprazolam in hepatic and renal insufficient patients

To compare the kinetic parameters of Alprazolam in both hepatic and renal insufficient patients. Jinnah Postgradute Medical Institute, Karachi. Blood samples were collected from three groups of the patients after giving tablet Alprazolam [0.25 mg B.D] for 21 days. These samples were then analyzed for kinetic parameters i.e. Plasma half life, clearance, plasma concentration and volume of distribution. The parameters included plasma concentration of Alprazolam, clearance [cl], serum alkaline phosphate, serum bilirubin and serum glutamate pyruvate transaminase. Patients were divided into three groups i.e. 1] control, 2] suffering from renal insufficiency, 3] suffering from hepatic insufficiency. On day seven and day twenty one, in the same group [both renal], plasma conc. and t 1/2 increased while Vd and cl decreased. On the other hand in the same group [both hepatic], on day 7 and 21, plasma conc. and t 1/2 increased while Vd and cI decreased. When comparative study done on day 7 and 21 in opposite groups [renal vs hepatic], plasma conc., Vd and t 1/2 increased while cI decreased. In hepatic insufficiency, the doses of Alprazolam [benzodiazepines] should be reduced but in renal insufficiency doses should be reduced in only severe forms of renal dysfunction

Snakebite: identification, prevalence and management

Bites from venomous and non-venomous snakes occur throughout the world, but are particularly important in tropical and subtropical regions, where the large number of snake species and the rural lifestyle of the population can lead to significant morbidity and mortality. To determining the goals for reducing the morbidity and mortality as we have tried to explore the every aspect of the incidence. Jinnah Postgraduate Medical Center, Karachi. Clinical confirmation of snakebite with envenoming was by identification of the dead snake brought by victims and by clinical signs and symptoms such as paralysis [krait and cobra] and rapid progressive local edema with active bleeding [viper]. Whole blood clotting test is a simple, rapid and reliable test of coagulopathy. It is also of use in assessing the effectiveness of ASV and is of crucial importance for controlling administration of expensive ASV in relation to restoration of blood coagulability. 130 [57.27%] patients were bitten from cobra and krait whereas 63 [27.76%] individuals were suffered from viper bites. 6 [2.64%] cases were victimized by sea snakes while 28 cases were bitten by some other species labeled as non venomous variety [Graph II]. These 28 cases did not have any signs of systemic envenoming. Among all snakebite victims 33[14.54%] developed complications like severe bleeding, jaundice, acute renal failure, intracranial bleed and respiratory failure. 25 [11.01%] deaths were ensue while remaining 202 were completely recovered. It was observed that Cobra, Krait, Russell's viper commonly called Dabois whereas saw scaled viper locally called as Lundi or Jalebi are responsible for practically all the snakes bite cases. As venom secretion is greater in the months of May to September the incidences of snakebite cases are higher in these months

Does LH/Testo and Testo/LH ratio affect male fertility?

This study was designed to determine the levels of serum LH and Testosterone along with their ratios, among men with varying sperm quality. Two hundred fifty married men, presenting with a complaint of infertility, which had been evaluated for their seminal profile. LH indicated inverse/negative correlation to sperm concentration, while decreased testosterone levels were associated with depleted sperm conc. The mean levels of LH [mlU/ml] and testosterone [nmol/L] for the groups were 13.85 +/- 2.33 and 11.86 +/- 0.70 [azoospermia], 10.92 +/- 3.79 and 11.88 +/- 1.06 [oligozoospermia], 3.92 +/- 1.17 and 16.24 +/- 2.05 [asthenozoospermia], while the levels in normozoospermic men were 7.24 +/- 1.02 and 17.29 +/- 1.02, respect. Similarly, the LH/T and T/LH ratios were 1.17[ +/- 0.28] and 0.86[ +/- 2.70] respectively in azoospermia, 0.92 [ +/- 0.28] and 1.08[ +/- 0.17] in oligozoospermia, 0.30[ +/- 0.10] and 4.14[ +/- 10.4] in asthenozoospermia 0.42 [ +/- 0.08] and 2.34[ +/- 0.48] in normozoospermic men. The present data indicate that disturbance in LH and testosterone ratios also causes infertility, since these hormones act together by maintaining a feedback control system