Role of branched chain amino acids in hepatic encephalopathy

Introduction: Hepatic encephalopathy [HE] or portosystemic encephalopathy is a state characterized by disordered central nervous system functions because of failure of liver to detoxify nitrogenous agents originating from gut because of dysfunction of hepatocytes and portosystemic shunting. Patients with HE often present alteration of mental status varying from minor psychological abnormalities to deep coma. Multiple studies conducted worldwide suggest that the branched-chain amino acids [BCAAs] leucine, isoleucine, and valine may be useful in improving survival and reducing morbidity in patients with HE

Objectives: To compare the efficacy of branched chain amino acids in reversal of hepatic encephalopathy in patients with cirrhosis of liver with placebo

Study Design: Randomized control trial Setting: Medical Unit V, DHQ Hospital Faisalabad

Duration: Study was carried out over a period of 6 months from 1st July 2016 to 30 December 2016

Results: A total of 60 patients [30 in each group] were enrolled, majority of the patients were between 41-50 years in both groups, 36.67% [n=11] in Study and 43.33% [n=13] control group, mean and standard deviation of age was calculated as 43.56+/-5.21 in study and 45.78+/-4.98 years in control group, 70% [n=21]patients were male in study group and 63.33% [n=19] in the control group, 30% [n=9] patients in study group and 36.67% [n=11] in control group were females, comparison of efficacy of BCAAs in reversal of HE with placebo reveals 63.33% [n=19] patients in study group showed reversal of HE and 26.67% [n=8] patients in control group

Conclusion: The results of the study conclude that branched chain amino acids are significantly effective in reversal of hepatic encephalopathy when compared with placebo.

relationship of exposure to sarcastic television political programs and verbal violence at teenagers

Problem: the problem is in the main question: what relation to political satire television verbal violence to teenagers?The objectives of the study: the study aims to identify the role of political satirical publication of verbal violence among adolescents, and the different social and economic and social differences of the University

Type and methodology: the researcher used a sample survey approach to field application on a sample of adolescent age group [18-19] year

Society and the study sample: the sample of the study society in Egyptian universities youth [18-19], who has pulled a random sample [450] itself, partitioned equally to various Egyptian universities youth Katale: Ain Shams University, October 6 University, Al-Azhar University. Study Tools: Questionnaire

Results: Most important differences between the satirical programmes and other programmes from the point of view of adolescents in order to first graetha in dialogue and use the words Street, where it came up 64.18%, II Interesting that they eliminate feeling boring, so came up 37.31%, III breaking routines and improvising her spreader and their guests, where it came up 35.07%, coming in fourth and final arrangement in the diversity of items ordered, and the impact of programmes alsiassih sarcastic teenagers came in first by imitating the speech of adolescents in these programs, where it came up 54.43% and came in second bitbnwa some ideas that change their way of thinking, with a Reached 47.66 percent, came in third by imitating teens announcer in irony and humor, which came up 37.76%, according to the order in the fourth and final negative and indifferent, so came up 23.18%

Frequency of carotid artery stenosis in ischemic stroke

Stroke continues to be a significant cause of morbidity and mortality throughout the world. According to the world health organization, 15 million people suffer stroke worldwide annually. Despite maximal medical management, carotid artery atherosclerosis leading to stenosis continues to portend a poor prognosis. Conservative management frequently fails in this disease, leaving patients at high risk for cerebral infarction and death

Objective: To determine the frequency of carotid artery stenosis in patients with stroke using Doppler Ultrasonography

Study design: cross-sectional analytical study

Setting: outpatient and emergency department of Medical Unit-I, Allied Hospital, Faisalabad

Duration of study: Study was carried out over a period of seven months from 01-03 2014 to 30-09-2014

Subjects and methods: A total of 100 cases were included in this study. Every patient was undergone a list of investigation including lipid profile, electrocardiography [ECG], X-ray chest [PA], computed tomography [CT] scan brain and echocardiography to rule out any cardiac source of embolism

Results: Out of 100 cases, 12 patients [12%] were between 18-40 years old, 34 patients [34%] were 41-60 years of age while 54 patients [54%] were 61-80 years old. Mean age of the patients was 51.9 +/- 5.1. Regarding gender distribution, 62 patients [62%] were male and 38 patients [38%] were female. Of 100 patients, 56 patients [56%] had carotid stenosis on color Doppler Ultrasonography of carotid arteries. 29 patients [51.8%] had mild stenosis, 17 patients [30.3%] had moderate stenosis and 10 patients [17.9%] severe stenosis

Conclusion: It is concluded that carotid artery stenosis is strongly associated with ischemic stroke. Doppler studies are recommended for the high risk patients for the primary as well as secondary prevention of ischemic stroke

Comparison of suprascapular nerve block and intra-articular injection in the treatment of frozen shoulder

The objective of this study was to compare the effect of supra scapular nerve block and intra articular injection to relieve pain and reduce disability in the patients of frozen shoulder. It was a quasi experimental study. The study was conducted at the department of Orthopedics, Pakistan Railway Hospital, Rawalpindi, fromAugust 2011 toSeptember 2012. Patients diagnosed as the cases of frozen shoulder in outpatient department of Orthopedics irrespective of their gender were included in the study. Forty patients and 50 shoulders were divided into two groups by randomization, one group received single suprascapular nerve block and second group received single intra-articular steroid injection. Both groups were advised for physiotherapy after injection. Patients' pain levels and ranges of movement were assessed over a period of twelve weeks. The study included 40 patients and 50 shoulders to a single suprascapular nerve block and intra articular steroid injection. The mean age of the patients was 49.4 + 9.97 and the range was 40-60 years. There were 16 females and 24 male patients. Post injection assessment of patients was done at two, six, eight and twelve weeks. There was a significant decrease in pain and marked improvement in range of movement with supra scapular nerve block than with intra articular injection. Patients' pain levels and ranges of movement were assessed over a twelve week period. Suprascapular nerve block produced a faster and more complete resolution of pain and restoration of range of movement than intra articular injection

Fenton syndrome in an adolescent

Scapho-capitate fracture [Fenton syndrome] is a rare lesion and is even less well-documented in adolescents. The most frequent mechanism is possible forced extension and hyperextension of the wrist. We report a case of 15 years old boy with hyperextension injury to the wrist. The true diagnosis was made 2 weeks later. Treatment involved open reduction and internal fixation with K-wires and Herbert screws. It went on to heal well and at 6 months follow-up, there was no infection or avascular necrosis and wrist function was good

Evaluation of the predisposing factors and causative organisms of chronic osteomyelitis

To determine the important predisposing factors and common organisms responsible for chronic osteomyelitis in our area. Design: It is a descriptive study. Place and Duration: The study was conducted at the Department of Orthopaedic Surgery, Liaquat University Hospital, Jamshoro, Hyderabad between July, 2001 to June, 2002. Subject And All the patients, irrespective of age and sex, admitted in the orthopaedic surgery ward with the diagnosis of chronic osteomyelitis were included in the study. On arrival a thorough history was taken, physical examination and investigations were performed. Radiological examination of the affected part was also done to note the features of chronic osteomyelitis such as sequestra, involucrum and sclerosis etc. The specimens which were sent for culture and sensitivity testing consisted of either or a combination of purulent fluid, sequestra, soft tissue, bone curettings or tissues surrounding an implant. A total of 61 patients were included during one year period. The disease was more common in males around the age of 30 years. Adults were mainly affected by non-hematogenous osteomyelitis as compared to children who were mainly affected by hematogenous osteomyelitis. The commonest predisposing factor was trauma due to road traffic accidents and firearm injuries. Post-operative infection also resulted in chronic osteomyelitis in a number of patients. Staphylococcus aureus was found to be the commonest organism involved. As trauma was found to be the most common type of pre-disposing factor steps should be taken to provide early and proper medical management to victims of trauma, to keep the wounds free of infection. Bacteriological samples should be routinely taken before the start of antibiotic therapy