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Introduction: Psoriasis is a chronic inflammatoryautoimmune disease characterized by hyperproliferation ofkeratinocytes with multifactorial pathogenesis includinggenetic, and environmental factors. The aim of this study wasto evaluate serum ADA, SUA, and ESR in psoriatic patientsand their correlations with PASI score.Material and methods: Our study was a case–control study.The sample size was calculated using the Cochran formulaand 50 patients of psoriasis who attended the out patient clinicat SMHS and Government medical college, srinagar wereincluded in the study. These patients were divided accordingto PASI scores into three groups (mild, moderate, and severe).PASI score <10 defined psoriasis as mild, between 10 and 20as moderate, and >20 as severe. A group of 50 healthy subjectsof matched age and sex were included as a control group whowere taken from amongst volunteering hospital staff andrelatives.Results: This study included 50 psoriatic patients classifiedaccording to PASI score into mild, moderate, and severepsoriatic group and 50 age and sex matched controls. Outof these four patients had mild psoriasis, twelve patients hadmoderate psoriasis and thirty four patients had severe psoriasisaccording to PASI. Fifty healthy subjects were includedas a control group. There were no statistically significantdifferences of age and sex between different patients and thecontrol group.Conclusion: ESR, Serum Uric Acid and serum adenosinedeaminase levels are significantly raised in patients withpsoriasis. However there was no association with severity ofdisease in these patients, however, larger studies are neededto elucidate the mechanism and whether this hyperuricemiapredisposes these patients to gout and increased risk ofcardiovascular disease.
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Background: In this study, our aim was to identify and isolate Candida species from patients admitted in ICU,s of our hospital and to determine their susceptibilities to various antifungal agents so as to find the local resistance pattern and guide for empirical treatment.Methods: In our study 37 strains of candida were isolated (4 Candida albicans, 33 Non-albicans Candida strains). Candida species were identified by conventional, biochemical and molecular methods. Antifungal susceptibility tests for amphotericin B, fluconazole, itraconazole, ketoconazole and voriconazole were performed with broth microdilution method and E- tests as described by National Committee for Clinical Laboratory Standards (NCCLS).Results: Out of 37 Candida strains, the most prevalent species were C. tropicalis (43.2%), C. parapsilosis (24.3%), C. krusei (16.2%), C. albicans (10.8%), and C. glabrata (2.7%). Among all strains four strains (10.8 %) were resistant, two Candida albicans where found resistant to fluconazole one Candida krusei and one Candida parapsilosis were found to be resistant to all azoles.Conclusions: Candidemia continues to be associated with substantial morbidity and mortality and non albicans Candida species are the commonly isolated pathogen from those patients admitted in tertiary care hospitals in Indian scenario. Thus, it is imperative to perform antifungal susceptibility to select appropriate and effective antifungal therapy.
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Background: Ultrasound (USG) guided fine needle aspiration cytology (FNAC) is a simple and cost-effective method for the diagnosis of various peripheral lung lesions. Being radiation free and easily available in most of centres, it has become an important diagnostic modality for early diagnosis of peripheral lung lesions. Besides procedure is simple and complications if occur, can be managed by a pulmonologist effectively. This study was aimed to evaluate the role of Transthoracic ultrasound guided FNAC in diagnosis of peripheral lung lesion.Methods: This prospective observational study was conducted at Government Chest Diseases Hospital Srinagar over a period of one year from January 2018-December 2018. 61 patients who fulfilled inclusion criteria were included in this study. After properly explaining the procedure and taking informed consent, USG guided FNAC was done in patients with peripheral lung lesions under local anaesthesia. Radiological and cytological data of enrolled patients was collected prospectively and analysed.Result: About 61 patients were included in this study comprising of 39 males and 22 females in age range of 17- 90 years. Malignancy was the most common cytological diagnosis (78.57%). while as benign diagnosis was reached in 21.43%. In 8.19% of patients, FNAC was inconclusive. Among the malignant group, adenocarcinoma (47.72%) was most common cytological diagnosis. The overall diagnostic yield of USG guided FNAC in this study was 91.8%.Conclusion: USG guided FNAC of peripheral lung lesions is a simple procedure with high accuracy and less complication rate which can be performed by a pulmonologist for diagnosis.
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Background: Conventional TBNA has been used in the evaluation of intrathoracic lymphadenopathy with varied success rates depending upon size, site and aetiology of the node. Although mediastinoscopy has higher successes but it comes at the cost of general anaesthesia, more complications and limited access to the inferior and posterior mediastinum. Endobronchial ultrasound guided transbronchial needle aspiration has the advantage of real time nodal sampling with good success rates and minimal complications. The aim of our study was to assess the diagnostic yield and safety of EBUS TBNA in the evaluation of intrathoracic lymphadenopathy.Methods: This prospective observational study was conducted at government chest diseases hospital Srinagar over a period of two years from January 2016-December 2018 on 100 consecutive patients who underwent EBUS TBNA procedure for evaluation mediastinal and hilar lymphadenopathy. The data was collected and analysed for diagnostic yield and safety profile.Results: Out of the 100 subjects included in the study 52% were males and 48% were females. Mean age of the study population was 48.5±16.65 years. Most of the nodes sampled were subcarinal in location followed by paratracheal and hilar group. Granulomatous pathology (tuberculosis and sarcoidosis) was present in 41 patients followed by malignancy in 39 patients. Anthracosis was the cause of lymphadenopathy in 4 of the patients. There were no major complications in our study.Conclusions: EBUS TBNA is an effective and safe procedure for evaluation of mediastinal and hilar lymphadenopathy.
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Introduction: Freiberg’s disease, the osteochondrosis of themetatarsal seen in our part of the world, usually at late stages,are refractory to the conservative treatment. Objective:Thepurpose of this study was to evaluate the results of dorsalclosing wedge osteotomy and pin fixation besides debridementand synovectomy.Material and Methods: Twenty patients (14 females,6 Males), mean age 19.3 years; range 14 to 26 years wereevaluated and teated by dorsal closing wedge osteotomy andpin fixation besides debridement and synovectomy, betweenseptember 2016 to 2018 at our institution. The presentingsymptoms were pain on walking or sports, limitation of dailyroutine activities, footwear problems, cosmetic deformitiesof forefoot and failed conservative treatment. Three patientshad a history of trauma. According to Smillies’s classificationtwelve patients were type IV and eight were Type V.Meanfollow-up period was 14.85 months(range 6 months to 24months).Results: Patients were assessed by the lessermetatarsophalangeal interphalangeal (LMPI) scale bykitaokaetal. At the final follow-up, scoring had changed from(44-66) with an average 54.65 to (76-100) with an average85.3. There was no case of infection, avascular necrosis,arthritis or pseudoarthrosis.Conclusion: Treatment of freiberg's disease with dorsalclosing-wedge osteotomy shows satisfactory pain relief andimprovement in quality of life
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Introduction: Incidence of displaced fracture neck of femuris high and there is lack of consensus over the definitivetreatment of such fractures as the incidence of complicationsespecially avascular necrosis remains very high. Objective ofthe study was to evaluate the incidence of avasular necrosisand its pattern in displaced fracture neck of femur managedwith osteosynthesisMaterial and methods: This study was a prospective studyconducted in Bone & Joint Hospital, Srinagar from 2003 to2018 on patients with displaced fracture neck of femur. Closereduction was done on traction table using Whitman’s Methodand reduction was confirmed under C Arm and was labelledsatisfactory using Lowell’s S Method and fixation was doneusing 3 Cannulated Screws of 6.5mm.Results: 118 patients {70 males and 48 females} with meanage 42.5 years {range 18 to 55 years} presented late in ourhospital which resulted in a delay in fixation from 24 hrs to7 days post trauma. Patients were followed till 2018 for aminimum period of 10 years.Conclusion: Our study suggest same AVN rates as of otherstudies if fixation is done within a period of one week.
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Objective: To evaluate the prevalence of novel newly identified periodontal pathogenic strains in subgingival plaque samples and relate it with bleeding on probing, probing pocket depth and age. Material and Methods: 268 chronic periodontitis patients with a mean age of 46.0 ± 6.0 years were included. The following microorganisms were evaluated: Campylobacter gracilis (Cg), Fusobacterium nucleatum (Fn), Porphyromonas gingivalis (Pg), and Tannerella forsythia (Tf). Full mouth examination was registered; the probing pocket depth and clinical attachment level were assessed at six sites per tooth. Dental subgingival plaque samples were taken in the deepest pocket per arch in the maxilla and mandible. DNA analysis was performed using DNA-strip technology. Pearson's correlation coefficient was used for statistical analysis. Results: Porphyromonas gingivalis and Tannerella forsythia were detected at high level of 80% and 82% respectively. F nucleatum revealed a rate of 94%. Bacterial load significantly increased by increasing mean probing depth of the examined sites. Pearson's coefficient was the highest for Pg (r=0.62, p=0.0001) and the lowest for Cg (r=0.08, p=0.04). The bacterial load significantly increased by increasing the number of bleeding sites; Pearson's coefficient varied from r= 0.14 for Pg (p=0.01) to r=0.39 for Tf (p=0.001). Conclusion: It was confirmed the presence of main putative periodontal pathogens detectable in Saudi periodontal subjects, also providing a comprehensive view for correlation of these putative periodontal pathogens with the increase in probing pocket depth to the presence and load of all the bacterial species.
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Humans , Male , Female , Middle Aged , Periodontal Diseases , Periodontal Pocket , Porphyromonas gingivalis , Chronic Periodontitis , Saudi Arabia , Logistic Models , Statistics, NonparametricABSTRACT
The human chronic metabolic disease is predominantly associated with the disturbance in the lipid, proteins and nucleic acid biological balance due to the attack of free radicals generated from oxidative stress. Currently, the available synthetic antioxidants are synthesized by food industries are very effective and inexpensive but as chronic use, it exhibits many toxicological health effects like synthetic drugs. Hence, plant origin antioxidants gained increasing attention all over the world. In this regards, Olive tree (Olea europaea L.) belongs to Oleaceae family and its by-products such as olive leaves and olive oil are highly focused by many researcher due to its potential therapeutic effects in a reversal of various chronic diseases without any side effects. Oleuropein and Oleic acid are the major components in the olive by products and attributes olive as a holly natural remedy and also olive oil considered as a potential food ingredient in the Mediterranean diet. The fat content in olive fruits is higher than olive leaves. Whereas, the protein ratio is higher in olive leaves and more abundance of Oleuropein, which contributes major health benefits as compared to olive oil. Oleic acid with high MUFA ratio contributes to the major health benefits of olive oil to several human chronic diseases.
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The present study was aimed to investigate the analgesic and anti-inflammatory activity of aqueous methanolic extract of Aerva javanica. For measuring analgesic activity, writhing test, hot plate method and formalin test were performed and abdominal writhing was induced by intra-peritoneal injection of 0.2ml of 3% acetic acid. While in formalin test, pain was experimentally induced by injecting 25 micro l of 2.5% formalin in left hind paw. In hot plate method, pain was induced thermally by keeping the animals on a hot plate with temperature of about 51[degree]C. Anti-inflammatory activity was assessed by carrageen an induced mice paw edema. The results showed that the extract had significant analgesic activity [p<0.05- p<0.001] and anti-inflammatory activity [p<0.01-p<0.001]. Therefore, it was concluded from this study that the extracts of Aerva javanica may be used against pain and inflammation
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Animals, Laboratory , Analgesics/pharmacology , Anti-Inflammatory Agents/pharmacology , Phytotherapy , Plant Leaves , Plants, Medicinal , MiceABSTRACT
Objective: To determine neonatal congenital hypothyroidism among neonates born in a tertiary care hospital of Lahore Pakistan
Methods: This cross-sectional study was carried out at Pathology Department of Allama Iqbal Medical College, Lahore in collaboration with Pediatrics and Gynecology and Obstetrics Department, Jinnah Hospital, Lahore Pakistan. A total of 770 babies were included in this study, both male and female. About 2 ml venous blood samples were collected aseptically from the neonates in sterile clotted tube. Serum was separated and serum TSH was determined by ELISA method
Results: Out of total 770 neonates, 48.9% were female and 51.0% were males with the ratio of 1:1.04. Neonatal congenital hypothyroidisim [TSH, >30 mlU/L], was observed in 0.4% [Frequency, 1:257] nenates, with the incidence rate of 1:257. Female to male ratio of hypothyroid neonates was 2:1. The mode of delivery vise distribution showed, among n=251 neonates born by normal delivery, only a single case of hypothyroidism was detected, and among n=519 neonates delivered by cesarean section, only two neonates were belong to hypothyroidism
Conclusion: The frequency of Congenital Hypothyroidism is notably higher in pediatric community than reported in most other countries. This result emphasizes the necessity of a nationwide screening program
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Humans , Male , Female , Infant, Newborn , Infant, Newborn , Tertiary Care Centers , Cross-Sectional Studies , Thyrotropin/bloodABSTRACT
Objective: to compare the outcomes of Desrada repair and Lichtenstein mesh repair of inguinal hernia with respect to operative time, Post-operative pain, hematoma and seroma formation, surgical site infection, early and late recurrence and chronic pain
Methods: 100 patients were admitted throughout patient department and divided into Group D [Desarda repair] and Group L [Lichtenstein repair] with 50 patients in each group. Same surgical team performed the procedure. Early out measures were recorded while patients were admitted in the ward and OPD follow up. Late outcome measures were recorded by telephonic follow up
Results: Mean Operative time was calculated to be 57.84+/-13.07 min in Group D and 60.52 +/- 14.62 min in Group L with a p-value of 0.3362 which is insignificant. No significant difference was found in Post-operative pain in both groups having mean score of 2.11+/- 0.73 in Group D and 2.10 +/- 0.73 in Group L with a p-value of 0.9458. One patient [2%] developed hematoma in Group D and two patients [4%] in Group L suffered from surgical site infection. Seroam formation, early or late recurrence was not reported in any case. 4 patients [8%] complaint of chronic pain in Group L
Conclusion: This study showed that the desarda repair is comparable to Lichtenstein repair for inguinal hernia in respect of post-operative outcomes. Desarda repair is an effective method to replace the use of mesh for the repatr of inguinal hernia. This new repair has the potential to become the gold standard of hernia repair in years to come
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Objective: To determine frequency of different infections in patients with hepaticencephalopathy due to cirrhosis liver
Study Design: Cross sectional descriptive study
Place and Duration of Study: The study was conducted in the Department of Medicine, Combined Military Hospital, Peshawar over six months from April to October 2013
Patients and Methods: All patients with cirrhosis of liver of more than 18 years of age, manifesting signs of hepatic encephalopathy [HE] were included in the study. Detailed history, clinical examination and thorough investigations were done to look for different infections and the findings were recorded on a proforma. Descriptive statistics were used for data analysis
Results: One hundred and eighty five patients [70.81% males and 29.19% females] were enrolled. The mean age of the study subject was 49.2 +/- 3 years. Frequency of infections in the studied population was, spontaneous bacterial peritonitis [31.94%], UTI [25.00%], pneumonia [20.83%], sepsis [8.33%] and others infections [13.90%] like cholangitis, bronchitis, endocarditis, meningitis, and gastroenteritis
Conclusions: This study concluded that a substantial number of patients with hepatic encephalopathy due to cirrhosis liver have infections
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Objective: To determine the frequency of hypertriglyceridemia in newly diagnosed type 2 diabetics presenting to tertiary care hospital
Study Design: Cross sectional descriptive study
Place and Duration of Study: This study was carried out at Department of Medicine, Military Hospital Rawalpindi from Nov 2010 to May 2011
Material and Methods: A total of 193 patients were recruited in this study from medical outpatient department and medical wards. Patients aged more than 30 years and of both sexes who were diagnosed diabetics in the past 6 months were included in the study
Results: Mean age of the patients was 49.1 +/- 7.3 years. Regarding gender distribution, 135 patients [70.0%] were male while remaining 58 patients [30.0%] were female. Out of total 193 patients, hypertriglyceridemia was present in 112 patients [58.0%]. Mean fasting blood glucose was 8.29 +/- 0.69 mmol/l, 2 hours post-prandial blood glucose 14.59 +/- 1.71 mmol/l, fasting serum triglyceride level was 2.27 +/- 0.35 mmol, 2 hours postprandial serum triglyceride level was 3.17 +/- 0.54 mmol
Conclusion: Frequency of hypertriglyceridemia in type 2 diabetics was found to be reasonably high in present study
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Objective: To assess the level of quality assurance in medical education in Pakistan
Study Design: Observational / Descriptive study
Place and Duration of Study: The study was carried out at Frontier Medical College, Abbottabad, from January 2016 to March, 2016
Materials and Methods: No significant research was carried out on this subject earlier in Pakistan. Therefore, an internet search was carried out. Published research [in Pakistan and sub-continent] and documents pertaining to policy were analyzed
Results: Total no of medical schools had risen to 132 in Pakistan, while the no of medical institutes was 314 in India. There are 52 medical and dental colleges in public sector throughout Pakistan while 82 medical and dental colleges in private sector. This shows that the no of medical institutes is considerably high in private sector than in public sector. In public sector, Punjab had the largest no of medical institutes with 22 [18 medical colleges and 4 dental colleges], Sindh has 13 [9+4], Khyber Pakhtunkha [K.P.K] has 10 [8+2], Baluchistan has 2 [1+1] and Azad Jammu and Kashmir [AJK] has 3 [3+0]. In private sector, Punjab had the largest no of medical institutes with 40 [28 medical colleges and 12 dental colleges], Sindh has 26 [14+12], Khyber Pakhtunkha [K.P.K] has 14 [9+5], Baluchistan has 1 [1+0] and Azad Jammu and Kashmir [AJK] has 1 [1+0]. The no of students admitted to medical programs in Pakistan and India in 2014 was 11250 and 35783 respectively
The maximum no of students, about 6250, were in Punjab, followed by 2850 students in Sindh, 1550 in K.P.K, 400 in AJK and 200 in Baluchistan
Conclusion: Quality assurance plays a pivotal role in medical health education. There is a need to establish stringent policy guidelines for accreditation standards
This will help improve level of medical education in Pakistan. It will also ensure that medical graduates will receive good education and public will get highest standards of healthcare services from well-educated doctors
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The purpose of this study was to establish frequency and distribution of different histopathological aspects of biopsies of oral localized benign lesions [fibrous or haemorrhagic]. Ninety-five cases of oral biopsies obtained over a period of one year and 7 months from 1st June 2012 to 31st January 2014 at Government Dental College and Hospital, Srinagar were retrospectively reviewed. The lesions were classified into either fibrous or soft hemorrhagic lesions. Clinical data regarding age, gender, characteristics [site, color, size, surface, consistency and base] of lesions were obtained for each case. Of all the 95 cases studied clinically 69 [72.6%] were histologically diagnosed as fibrous and 26[27.4%] were found to be soft haemorrhagic lesions. Among the fibrous lesions, irritational fibroma was the most frequent [81.2%] and among the hemorrhagic lesions pyogenic granuloma [65.4%] was found to be the most frequent. Majority of the fibrous lesions were located in the buccal mucosa [30.4%] and the greater number of soft hemorrhagic lesions were located on the maxillary gingiva [53.8%]. From the study it can be stated that with regard to frequency and distribution, we found significant differences with respect to gender, age and location between the different oral lesions. The data presented in this study can be used to develop a clinical impression of such lesions frequently faced by the oral physician
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Himalaya is credited all over the world as a treasure of medicinal and aromatic plants, which in turn prove as treasures of bioactive agents. These medicinal plants taking refuge in the sub alpine and alpine zones are facing the brunt of varied threats. Strategies have been proposed by various environmentalists to conserve biodiversity at regional, national and global levels. Assessment of plant populations is one of the basic activities of conservation biology that can be mainly valuable for sustaining species with minor populations. In the present study, threat status of the 6 medicinal plant species (Arnebia benthamiI Wall. Ex G. Don, Meconopsis aculeate Royle, Rheum webbianum Royle, Aconitum heterophyllum Wallish Ex Royle, Podophyllum hexandrum Royle and Aquilegia fragrans Benth.) have been assessed in accordance with IUCN Red List Categories and Criteria 2010 version 8.1 following Guidelines for Application of IUCN Red List Criteria at Regional Levels 2003 version 3.0criteria. Out of 6 species, 2 were categorized as vulnerable, 3 species as endangered and 1 species as critically endangered. The three factors of over exploitation, overgrazing and habitat degradation have been known as main threats to the medicinal plants. Consequently, monitoring of population and habitats, development of conservative protocol and establishment of species in-situ conditions has been proposed.
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Emodin, an anthraquinones component of Rheum palmatun, has been used for anti-inflammatory purposes. However, its underlying molecular effect(s) on target cells remain to be well clarified. our current study was aimed at investigating the regulatory effect of Emodin on lipopolysaccharide induced inflammatory responses in RAW 264.7 macrophages by gelatin zymography . It was found that treatment of LPS(5μg/ml) for 18 h elevates the expression of MMP-9 and MMP-2 proteins in RAW 264.7 cells. It was also found that co-treatment of RAW 264.7 with drug Emodin(6μg/ml) and LPS(5μg/ml) for the period of 18 h reduces the expression level of MMP-9 and MMP-2 protein. Our data suggest that Emodin plays roles in regulating the digestion of Extracellular matrix by down-regulating the expression of MMP-9 and MMP-2 proteins.
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To compare intercostal nerve block before and after rib harvest in terms of mean postoperative pain score and mean postoperative tramadol usage. Randomized controlled trial. Department of Plastic Surgery, Mayo Hospital, KEMU, Lahore, from January 2011 to July 2012. Patients [n = 120] of either gender with ASA class-I and II requiring autogenous costal cartilage graft were inducted. Patients having history of local anaesthetic hypersensitivity and age < 15 years or > 60 years were excluded. Subjects were randomly assigned to pre-rib harvest [group-1] and post-rib harvest [group-2]. Local anaesthetic mixture was prepared by adding 10 milliliters 2% lidocaine to 10 milliliters 0.5% bupivacaine to obtain a total 20 ml solution. Group-1 received local anaesthetic infiltration along the proposed incision lines and intercostals block before the rib harvest. Group-2 received the infiltration and block after rib harvest. Postoperative consumption of tramadol and pain scores were measured at 6 and 12 hours postoperatively using VAS. Mean age was 31.43 A +/- 10.78 years. The mean pain scores at 6 hours postoperatively were 1.033 A +/- 0.609 and 2.4667 A +/- 0.812 in pre-rib harvest and post-rib harvest groups respectively [p < 0.0001]. The mean pain scores at 12 hours postoperatively were 1.45 A +/- 0.565 and 3.65 A +/- 0.633 in pre-rib harvest and post-rib harvest groups respectively [p < 0.0001]. The mean tramadol used postoperatively in first 24 hours was 169 A +/- 29.24 mg and 255 A +/- 17.70 mg in prerib harvest and post-rib harvest groups respectively [p < 0.0001]. Intercostal block administered before rib harvest as preemptive strategy result in decreased postoperative pain scores and narcotic use
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<p><b>OBJECTIVE</b>To test possible antioxidant activity of n-hexane extract of Podophyllum hexandrum under in vitro and in vivo conditions.</p><p><b>METHODS</b>The in vitro antioxidant activity was evaluated by the ability of the extract to interact with the stable free radical DPPH, Superoxide (O2-), Hydroxyl (OH-), Hydrogen peroxide (H2O2) radicals, and reducing power ability of the extract was also evaluated. Under in vivo conditions the extract was evaluated for its hepatoprotective activity by measuring different biochemical parameters, such as serum alanine aminotransaminase, serum aspartate aminotransaminase and serum lactate dehydrogenase and antioxidant enzymes. Antioxidant status was estimated by determining the activities of antioxidative enzymes, glutathione reductase (GR), glutathione peroxidase (GPx), glutathione-S-transferase (GST) and superoxide dismutase (SOD), and by determining the levels of reduced glutathione (GSH) and thiobarbituric acid reactive substances (TBARS).</p><p><b>RESULTS</b>Hexane extract of P. hexandrum exhibited good radical scavenging capacity in neutralization of DPPH, O2-, OH-, and H2O2 radicals in a dose dependent manner. n-hexane extract of Podophyllum hexandrum at the doses of 20, 30, and 50 mg/kg-day produced hepatoprotective effect by decreasing the activity of serum marker enzymes, while it significantly increased the levels of glutathione (GSH), glutathione peroxidase (GPx), glutathione reductase (GR), super oxide dismutase (SOD), and glutathione-S-transferase (GST) in a dose dependant manner. The effect of n-hexane extract was comparable to that of standard antioxidant vitamin E.</p><p><b>CONCLUSION</b>The extract of Podophyllum hexandrum possess free radical scavenging activity under in vitro conditions and could protect the liver tissue against CCl(4) induced oxidative stress probably by increasing antioxidant defense activities.</p>