A simple technique for tracking individual spore and gametophyte development in Adiantum lunulatum Burm. f. using modified extra thin alginate film technique.

A new technique was developed for accurate calculation of percent germination and tracking of individual spores from germination to gametophyte development in Adiantum lunulatum. High percentage of ETAF immobilized spore germination (72.4%) was followed by development of gametophytic clumps. The ETAF immobilized clumps were cut into pieces and multiplied en masse. Apomictic sporophytes developed from the gametophytes. This indicated the potential of ETAF for mass propagation of A. lunulatum without the need to start from spores. Since individual spores can be tracked from germination to gametophyte development, the ETAF technique has the potential to be used for (i) harvesting uniformly developed plants of similar age for extensive experimentations and commercial utilization and (ii) detailed study on developmental and reproductive biology of different ferns and fern allies.

Frequency of various clinical and electrocardiac manifestation in patients with acute organophosphorous compound [OPC] poisoning

Background: worldwide, OPC are the most widely used insecticides in developing countries like Pakistan, where agriculture is the main occupation and easily available everywhere, therefore, the OPC poisoning is very common. WHO recently reports that pesticides poisoning occurs about 3 million/year with mortality > 3 lac/year and 99% belong to developing countries

Objective: to determine the frequency of various clinical and electro cardiac manifestation in OPC poisoning

Methodology: prospective observational study, conducted from Dec 2008 to April 2010 in Department of Medicine and Intensive Care Unit [ICU] at Liaquat University of Medical and Health Sciences, Jamshoro / Hyderabad

Results: out of 70 adult patients, 28[40%] were males and 42[60%] were females. The nature of OPC poisoning was suicidal in 58 [82.86%] and accidental/incidental in 12 [17.14%]. There were 43 [61.43%] farmers, 21 [30%] house-workers and 6 [8.57%] college students. There was a high ratio of insecticides [Melathion, Parathion, and Mite/rat House fly killer Carbamates] by ingestion/ inhalation route. The cardiac manifestations were Sinus Tachycardia in 20[28.6%], Non Cardiac Pulmonary Edema and Sinus Bradycardia 15[21.4%] each, Hypertension in 13[18.6%] and Hypotension in 07[10%]. Common ECG changes noted in our study were prolonged QTc - interval among 28[40%], prolonged P-R interval in 11[15.7%], atrial fibrillation, ventricular Tachycardia and extra systole were found as; 06 [8.6%], 05 [7.1%] and 05 [7.1%] respectively. Common neurological findings were flaccid paralysis in 28[40%] patients with respiratory muscle involvement in 10 cases, delirium in 11[17.5%], impairment of consciousness in 8[11.4%], and extrapyramidal features, fasciculation's, convulsions, and cranial nerve involvement were in 6 [8.6%], 5[7.1. %], 7[10%] and 5[7.1%] respectively

Conclusion: in routine hospital practice, the suicidal cases are very common due to acute OPC poisoning. Many cases are hospitalized with critical condition with predominant involvement of cardiac and neurological features. Early diagnosis with appropriate treatment with specific antidotes and ICU management can minimize the fatal consequences of OPC poisoning. It is further recommended that more studies are required to provide awareness regarding this important public health problem

Frequency of helicobacter pylori among hepatic encephalopathic patients in liver cirrhosis

Objective: to determine the frequency of H. pylori in cases of hepatic encephalopathy with liver cirrhosis

Study design and place: cross-sectional study to observe the role of H. pylori in HE patients of liver cirrhosis, conducted in Department of Medicine with collaboration to Intensive Care Unit [ICU] from January 2009 to December 2009 at Liquate University of Hospital Jamshoro/ Hyderabad

Results: out of 66 patients of HE, 44[66.7%] were male and 22[33.3%] were female, between 20 and 80 years of age. Based on Child-Pough's criteria, severity of hepatic decompensation Grading was as; in grade 1= 07 [10.6%], in grade 2= 21 [31.8%], in grade 3= 20 [30.3%] and in grade 4= 18 [27.3%]. Based on Child-Pough's criteria in class A= 01 [1.5%], in class B= 27 [40.9%] and in class C= 38 [57.6%]. Etiological factors for HE were as; HCV antibodies were positive in 32 [48.48%], HBsAg was positive among 18 [27.27%], HBsAg and HCV antibodies both were positive in 09 [13.64%], Alcoholics were 07 [10.6%] and Frequency of H. pylori was found in 47 [71.2%]

Conclusion: in our study we found that before and after 10 days H. pylori eradication therapy, there was no significant improvement in HE grade and other parameters. While the finding of high frequency of H. pylori in HE patients may be either co-incidence or co-relation that needs further vast studies

Placement of an implantable cardioverter-defibrillator in an infant with congenital long QT syndrome: Anesthetic considerations.

Sudden cardiac arrest (SCA) in children is a rare, but catastrophic event. Children with cardiac pathology at particular risk include those with congenital long QT syndrome (CLQTS) and hypertrophic cardiomyopathy. CLQTS is a genetic disorder of the cardiac ion channels and is associated with significant risk of malignant ventricular arrhythmias and SCA. For symptomatic, untreated patients, the mortality rate is approximately 20% for the first year and 50% at ten years. Use of an implantable cardioverter-defibrillator (ICD) is recommended for the prevention of SCA in this patient population. We report a case of CLQTS, who after successful resuscitation from SCA, underwent ICD placement at our center.

Comparison of transthoracic electrical bioimpedance cardiac output measurement with thermodilution method in post coronary artery bypass graft patients.

Transthoracic electrical bioimpedance (TEB) has been proposed as a non-invasive, continuous, and cost-effective method of cardiac output (CO) measurement. In this prospective, non-randomized, clinical study, we measured CO with NICOMON (Larsen and Toubro Ltd., Mysore, India) and compared it with thermodilution (TD) method in patients after off-pump coronary artery bypass (OPCAB) graft surgery. We also evaluated the effect of ventilation (mechanical and spontaneous) on the measurement of CO by the two methods. Forty-six post-OPCAB patients were studied at five predefined time points during controlled ventilation and at five time points when breathing spontaneously. A total of 230 data pairs of CO were obtained. During controlled ventilation, TD CO values ranged from 2.29 to 6.74 L/min (mean 4.45 ± 0.85 L/min), while TEB CO values ranged from 1.70 to 6.90 L/min (mean 4.43 ± 0.94 L/min). The average correlation (r) was 0.548 (P = 0.0002), accompanied by a bias of 0.015 L/min and precision of 0.859 L/min. In spontaneously breathing patients, TD CO values ranged from 2.66 to 6.92 L/min (mean 4.66 ± 0.76 L/min), while TEB CO values ranged from 3.08 to 6.90 L/min (mean 4.72 ± 0.82 L/min). Their average correlation was relatively poor (r = 0.469, P= 0.002), accompanied by a bias of −0.059 L/min and precision of 0.818 L/min. The overall percent errors between TD CO and TEB CO were 19.3% (during controlled ventilation) and 17.4% (during spontaneous breathing), respectively. To conclude, a fair correlation was found between TD CO and TEB CO measurements among post-OPCAB patients during controlled ventilation. However, the correlation was weak in spontaneously breathing patients.

Women and AIDS Awareness and Attitudes in a peri-urban setting in Punjab.

Women account for 39.3% of HIV/AIDS infection in India. There are many biological and socio-cultural factors which make her highly vulnerable to HIV infection. Knowledge regarding HIV/AIDS can help her in protecting herself from the disease. This study was conducted to the level of awareness of young females with respect to knowledge of the HIV/AIDS, its modes of transmission, methods to prevent it, availability of testing and treatment and attitudes in relation to HIV/AIDS. A cross sectional study was done in a peri-urban setting in Patiala, Punjab among 1044 females in the age group 15-24 yrs using a self designed semistructured questionnaire. 93.9%had heard about AIDS. Television was the most common source of information (79.7%). Knowledge about the different modes of transmission was high (68-78%), but knowledge about preventive methods especially condom use was low (34-54%). Increase in educational status was seen to significantly increase the knowledge of the modes of transmission and preventive methods (p<.001). Knowledge of symptoms of HIV was low. (2-15%). Only 28.5% knew about the availability of HIV testing facility. 33.8% knew about treatment available for HIV. The study subjects were having favorable attitude towards people living with HIV/AIDS. There is a need to focus the education programs and the mass media towards preventive methods rather than just the knowledge of the modes of transmission. Greater emphasis needs to be placed on making people aware about the existence of HIV testing facility and availability of treatment.

Mesenteric fibromatosis with involvement of the gastrointestinal tract.

Primary mesenteric fibromatosis is a rare condition. The aggressive nature of these tumors and the potential for major morbidity secondary to resection makes it a challenging disease for the surgeon. We report a case of mesenteric fibromatosis with involvement of small bowel.

Diet, dietetics and flora of the Holy Bible.

The study of history of medical science from non-medical sources needs no apology. At first the discussion of what was thought in the past rather than what is known now appears to be of merely antiquarian value. The knowledge of Diet, Dietetics, medicinal plants dates back to the remote antiquity of mankind. The Hebrews can be proud of having preserved in the Old Testament many old medical practices and traditions, which throw light on ancient medicine. The Bible is genuinely documented book representing the wisdom, medical knowledge and the culture, of a nomadic race. This article contains information of some medicinal plants, which are useful for treating different kinds of ailments and some with nutritious qualities.

Imaging of congenital anomalies of the gastrointestinal tract.

The radiological imaging plays a vital role in the evaluation of patients with congenital anomalies of the gastrointestinal tract. The evaluation of these patients, most of which present early after birth, frequently requires the use of various imaging modalities for making the correct diagnosis and planning surgical correction. This article reviews the common congenital anomalies of the gastrointestinal tract including obstructive lesions, anomalies of rotation and fixation, anorectal anomalies, and intestinal duplications. The plain radiograph is often diagnostic in neonates with complete gastric of upper intestinal obstruction and further radiologic evaluation may be unnecessary. An upper gastrointestinal series should be performed in all patients with incomplete intestinal obstruction. Sonography is useful in the evaluation of many congenital anomalies affecting pediatric gastrointestinal tract especially hypertrophic pyloric stenosis, enteric duplication cysts, midgut malrotation, meconium ileus and meconium peritonitis. Moreover, CT and MRI has assumed a greater importance as these provide excellent anatomic details which may be necessary for correct diagnosis as well as treatment planning. This is particularly true in evaluation of congenital anomalies such as esophageal/enteric duplications, vascular rings and anorectal anomalies. It is important to be familiar with the role nad usefulness of the various imaging modalities so that these can be used judiciously to avoid unnecessary radiation exposure while minimizing the patient discomfort.

Overexpression of c-erbB-2 oncoprotein and associated pathobiological factors in invasive primary breast cancer.

Breast cancer tissues from 271 cases were analyzed immunologically for c-erbB-2 oncoprotein (HER-2/neu), epidermal growth factor receptor (EGF-R) and estrogen receptor (ER). Overexpression of both c-erbB-2 oncoprotein and EGF-R showed an inverse association with ER and a direct association with metastatic involvement of lymph node and high histological grade. The frequency of c-erbB-2 and EGF-R overexpression was significantly higher among postmenopausal cases in comparison with premenopausal cases. Further, only in postmenopausal patients, c-erbB-2 oncoprotein (chi2 = 6.4, P < 0.05) and EGF-R (chi2 = 6.4, p < 0.05) as well as their concomitant expression (chi2 = 11.5, p < 0.01) revealed a statistically significant association with ER.

Giant cystic lymphangioma of the middle mediastinum.

A middle-aged male presenting with complaint of progressively increasing dysphagia was found to have a large cystic mass lesion in the middle mediastinum on evaluation. A diagnosis of an endo-duplication cyst was considered after exploration, in view of infiltration of the muscular layer of the lower thoracic esophagus, presence of multiple hyperemic nodular lesions on its inner surface and its location in the middle mediastinum. However, the histopathology revealed the lesion to be a cystic lymphangioma.