Effect of solvent polarity and extraction time on in vitro antioxidant properties of Brassica oleracea Convar Capitata Var L. seeds

Effect of solvent polarity and extraction time on antioxidant properties of Brassica oleracea seeds was optimized by response surface methodology using central composite design. A significant linear negative effect of solvent polarity on total extractable components [TEC], total phenolic acids [TPA], linoleic acid reduction capacity [LARC] and hydroxyl radical scavenging capacity [HRSC] and significant positive effect on iron chelating activity [ICA], reducing power [RP] and [DPPH RSC]. Linear effect of solvent polarity on total antioxidant activity [TAOA] was also found to be positive but not significant. Significant linear negative effect of extraction time was observed on ICA and HRSC. Only RP was found to be significantly increased with increase in extraction time. Quadratic effect of solvent polarity was found to be negative on TAOA, DPPH RSC and HRSC. However, quadratic effects of both variables were found to be positive on TEC, TPA, ICA and LARC. The polarity dependent increase in TAOA indicates the extraction of phytochemicals with comparatively stronger antioxidant properties in polar solvents. The decrease in antioxidant properties in response to increase in extraction time may be attributed to the time dependent loss of antioxidant activity of extracted compounds

Anti-psychotics induced sexual dysfunction

Background: Sexual dysfunction associated with the use of antipsychotic drugs is quite prevalent affecting the patients' quality of life and one of the reasons for non-compliance. This important aspect is underestimated and overlooked by the treating professionals, partly because patients rarely talk about their dysfunction. Due to the scarcity of local data on the subject the objective of the present study was to explore and compare the prevalence of sexual dysfunction associated with antipsychotic drugs

Methods: This was a hospital-based cross-sectional study comprising of comparative assessment among five antipsychotics being consumed by 91 male patients under this study

Results: Risperidone, haloperidol and olanzapine collectively as a group were associated with increased incidence of sexual dysfunction [42.43%] compared to quetiapine and aripiprazole group [16%] which was statistically significant. Individually risperidone [48%] and haloperidol [45.81%] were associated with highest incidence of sexual dysfunction followed by olanzapine [29.41%]. Quetiapine [16.67%] and aripiprazole [15.38%] were associated with the lowest incidence of sexual dysfunction

Conclusion: Risperidone and haloperidol are associated with a higher rate of sexual dysfunction compared to olanzapine. Quetiapine and aripiprazole have a significantly lower profile of adverse effects on sexual function

Acoustical behavior of some amino acids in aqueous disodium citrate solutions over temperature range [298.15-313.15] K

Sound velocity, U, and density,Rho, of some amino acids viz. glycine, methionine, phenylalanine and tryptophan were determined in 0.1, 0.2 and 0.3 mol kg[-1]aqueous disodium citrate solutions as a function of concentration at 298-313.15K using DSA 5000M. The experimental data were further used to compute various acoustical parameters such as adiabatic compressibility, beta, apparent molar compressibility, phi[k], partial molar compressibility, phi°[k], transfer adiabatic compressibility, phi[ktr] constant, S[k], and the hydration number, n[h]- The transfer adiabatic compressibility shows the supremacy of hydrophilic-ionic interactions under hydrophobic-ionic interactions. The above-mentioned parameters are relevant for the efficiency of mediation in pharmacology and can be interpreted in terms of structure-making or structure-breaking ability of these amino acids in the solution

Vesico-vaginal fistulae; review of the causes, diagnosis and treatment

To review the causes, diagnosis and treatment of vesico-vaginal fistulae in the department of Gynaecology and Obstetrics, and Urology Department Civil Hospital Quetta. Vesico-vaginal fistula is not life threatening medical disease, but the woman face problems like demoralization, isolation, social boycott and even divorce. The etiology of the condition has been changed over the years and in developed countries obstetrical fistula are rare and they are usually result of gynecological surgeries or radiotherapy. In countries like Pakistan the situation is different, here literacy rate is low, parity rate is high and medical facilities are deficient. People manage delivery at home and usually multi parity. Urogenital fistula surgery doesn't require special or advance technology but needs experienced urogynecologist with trained team and post operative care which can restore health, hope and sense of dignity to women. A retrospective study of 60 patients with different types of vesico-vaginal fistula werereviewed between January 2005 to December 2008. Patients were analyzed with regard to age, parity, cause, diagnosis, mode of treatment and outcome. Patients were also evaluated initially according to prognosis. During the study of four year period 60 patients of vesico-vaginal fistulae were reviewed. Majority of the patients were belonging to middle age group. In 48 patients repair was done through transvaginal route and 12 were operated through transabdominal route. One Ca patient expired and in 4 patients recurrence occurred. Iatrogenic vesico-vaginal fistulae are more common. Difficult and complicated fistulae need experienced surgeon. Establishment of separate fistula surgery unit is suggested to get desired results

Evaluation of carrier added and no carrier added [90]Y-EDTMP as bone seeking therapeutic radiopharmaceutical

The optimum conditions to label ethylenediaminetetramethylene phosphonate [EDTMP] compound with [90]y as a potential candidate for bone metastases therapy were investigated. Yttrium-90 is a pure beta-emitter and can be obtained by 89y [n,gamma] [90]y nuclear reaction in a reactor or from an in-house generator system [[90]sr[rightwards arrow][90]y]. The preparation of [90]y-EDTMPis described using [90]y, which was obtained from neutron irradiation of y2o3 as well as from a laboratory scale organic resin-based [90]sr[rightwards arrow][90]y generator. Because of the radiolabeling yield of [90]y-EDTMP on ligand/metal molar ratio, incubation time and ph was evaluated. Under optimum parameters, the radiolabeling yields of [90]y-EDTMPwere <95% for no-carrier-added as well as carrier-added [90]y. The biodistribution of no-carrier-added and carrier-added [90]yEDTMPcomplexes in rats was identical. The results indicate that [90]y [carrier-added]-edtmp is also an effective bone pain palliation agent because of its rapid blood clearance, greater uptake in bones and little absorption in soft tissues

Comparison of letrozole and clomiphene citrate efficacy along with gonadotrophins in controlled ovarian hyperstimulation for intrauterine insemination cycles

We performed this study to investigate and compare the effects of Letrozole and gonadotrophins versus Clomiphene Citrate and gonadotrophins in women undergoing superovulation for Intrauterine Insemination [IUI]. We performed this prospective cohort study at Australian Concept and Fertility centre, Karachi Pakistan. Women younger than 40 years of age with patent fallopian tubes and infertility of more than 2 years in duration who were undergoing IUI and gonadotrophins therapy were divided into two groups, one received Letrozole for 5 days and another received Clomiphene Citrate for 5 days. All 500 IUI treatment cycles conducted from March 2008 to March 2010 were included. Patients co-treated with Letrozole required fewer gonadotrophins administrations [median difference, 300 IU [95% confidence interval [CI], 225-375 IU], developed more follicles larger than 14 mm [median difference, 1 follicle, 95% CI, 1-2 follicles], and had a thicker endometrium [median difference, 1 mm, 95% CI, 0.4-1.6 mm]. The pregnancy rate was not significantly different between two groups [11% vs. 12.6%]. The addition of Letrozole to gonadotrophins decreases gonadotrophins requirements and improves endometrial thickness, without a significant effect on pregnancy rates. An improved pregnancy rate has been observed in older age group, >35 years with Letrozole

High altitude headache - an etiological based study

To determine the various causes of headache in patients evacuated from high altitude. Descriptive study An observational hospital based study carried out on 50 soldiers evacuated from Northern Areas to Military Hospital Rawalpindi between Sep 2009 to Mar 2010 for evaluation of headache as their major complaint. Necessary investigations including neuroimaging were carried out in coordination with Department of Neurology, Military Hospital and an appropriate diagnosis was made in each case. The data was analyzed accordingly. A total of 50 patients were analyzed .They were all males and the mean age was 25 years. 52% patients had Acute Mountain Sickness, 12% hypertension, 10% High altitude cerebral edema, 8% Tension type headaches, 6% Dural venous sinus thrombosis, 6% migraine, 2% encephalitis, 2% were of Subarachnoid hemorrhage and 2% patients Hydrocephalus. Acute mountain sickness and high altitude cerebral edema accounts for a significant number of patients with high altitude headache

Frequency of headache with stress in adolescent and young adults

Objective of this study was to establish a link between stress as a cause of headache in young adults. Cross sectional study. Department of Neurology Military Hospital [MH] Rawalpindi from September 2009 to March 2010. Thirty young patients, referred for the complaints of headache to the Neurology out patient department, were included in this study. A detailed especially designed, pre tested headache questionnaire was devised which was filled for every patient individually included in the study. Twenty One [70%] of the patients in the study group did have the feeling of stress preceding the headache which sometimes persisted during the episode. Nine [30%] did not report any such feeling of stress before or during the episode. Out of the patients reporting stress 71% [15] were female patients and 29% [6] were males. These key findings suggest that stress and headaches may be related for adolescents and young adults and that this relationship may be reinforced over time. Moreover female patients were far more susceptible to this stressful stimulus as compared to the males

Frequency of axonal variants of guillain-barre syndrome in Pakistan

To determine the frequency of axonal variants in our patients of Guillain-Barre Syndrome. Descriptive study. Department of Neurology, Military Hospital, Rawalpindi and Armed Forces Institute of Rehabilitation Medicine [AFIRM] from 01 Jan 2009 to 30 Jul 2010. Forty adult patients meeting the National Institute of Neurological Disorders and Stroke criteria for Guillain-Barre Syndrome [GBS] were consecutively enrolled in the study. Patient's data, detailed history, examination and electrophysiological studies were carried out and recorded on predesigned proforma. All patients were examined and reviewed by Consultant Physicians and neurologists. Electromyography and Nerve conduction study testing was done by experienced electro-physiologists. Axonal variants of Guillain-Barre Syndrome constituted 16[40%] in our study. The variants of Guillain-Barre syndrome were acute inflammatory polyradiculoneuropathy [AIDP] in 24[60%] patients followed by acute motor axonal neuropathy [AMAN] in 12[30%] and acute motor sensory axonal neuropathy [AMSAN] in 4[10%] patients. We report a high frequency of the axonal variants of Guillain-Barre Syndrome in Pakistan

Frequency of echocardiographic complications of dilated cardiomyopathy at a tertiary care hospital

Background: Dilated cardiomyopathy can lead to a variety of complications recognisable on clinical, echocardiographic, electrocardiographic and radiographic assessment. Among this, transthoracic echocardiography has the dual advantage of being helpful in making the diagnosis of dilated cardiomyopathy as well as an effective tool in early recognition of certain complications for timely management to improve the quality of life of these patients. Methods: This descriptive [case series] study was undertaken at Departments of Medicine, Cardiology, Paediatrics and Obs/Gyn, Ayub Teaching Hospital, Abbottabad from July to December, 2008. Fifty patients of dilated cardiomyopathy without age and gender discrimination were selected by convenience sampling. Those with hypertrophic and restrictive cardiomyopathies, valvular and congenital heart disease, hypertension and ischemic heart disease were excluded. Results: Mean age was 47.12 +/- 17.9 year with male predominance [males=34, females=16]. Mean ejection fraction was 30.6 +/- 6.9%. Complications revealed on echocardiography were intracardiac thrombi [5, 10%], spontaneous echo contrast [5, 10%], pericardial effusion [6, 12%], mitral regurgitation [46, 92%], tricuspid [25, 50%], aortic [5, 10%], pulmonary [2, 4%] multi-valvular regurgitation [28, 56%], and left atrial dilatation [36, 72%]. Conclusion: LV systolic dysfunction, cardiac thrombi, spontaneous echo contrast, mitral and tricuspid regurgitation and left atrial enlargement are important complications of dilated cardiomyopathy. Echocardiography is important tool towards identification of these complications. Keywords: cardiomyopathy, dilated, cardiomyopathy, complications, cardiomyopathy, congestive, echocardiography

Penile fracture: presentation and management

To evaluate the clinical presentation, therapeutic options and outcome of the treatment of penile fracture. Case series. The Department of Urology and Transplantation, Civil Hospital Quetta, between March 1995 and March 2009. One hundred and thirty seven patients of penile fracture were admitted. Detailed history was taken. Physical examination was done in order to get the extent of penile hematoma, sign of blood at the meatus and side of curvature. Patients with rupture of the superficial and deep dorsal vein on the penis were excluded from the study. The operative plan consisted of immediate exploration, debridement and primary repair of the tear in tunica albuginea and urethra via a degloving incision. Data analysis was performed to obtain descriptive statistics. The mean age was 25 years [ranging from 14-50 years]. Causes of fractures were manipulation in 56 [40.87%] cases, sexual maneuver in 39 [28.46%] cases, rolling or fall on bed in 18 [13.13%] and direct blow on erect penis in 11 [8.02%] patients. Injury involved unilateral corpora cavernosa in 126 [87.78%] and bilateral corpora cabernosa plus urethra in 11 [8.02%] respectively. The interval from time of injury to presentation was 4 hours to 45 days. All the patients presented with the typical clinical picture of a characteristic sound at the time of injury, pain, detumescence, and hematoma. In all the patients the tunical and urethral injuries were promptly repaired. Complication occurred in 7 [5.10%] patients. The mean hospital stay was 2 days. Eighty nine [64.96%] patients available for follow-up reported achieving adequate erection for intercourse without erectile or voiding dysfunction. Common clinical presentation were snapping or popping sound, sudden penile pain, detumescence and penile deviation, The aim of surgical repair was to avoid compilations and preserve both sexual and voiding functions which was satisfactorily achieved in the majority

Dual thyroid ectopy in an old woman

Very few cases with dual thyroid ectopy and a normally located thyroid gland have been reported. A 65 years old woman presented with hemoptysis and mild dysphagia 5 years after thyroidectomy. On direct laryngoscopy a supraglotic mass was detected and removed; which on histopathology turned to be an ectopic thyroid tissue. On barium swallow lateral view of the neck demonstrated a mass between trachea and esophagus at C4-6 level. CT scan confirmed a high attenuation, mass posterior to trachea in sub-cricoid area. Suspecting another ectopic thyroid here, Technetium-99 scans were done, while on thyroxine and 4 weeks without it: earlier was inconclusive but the later confirmed another ectopic thyroid in thyroid bed on left side with a tail on right. The diagnosis was dual ectopic thyroid tissue in supraglottic area and the thyroid area [laterally and to the left] extending between trachea and esophagus at C4-6 level producing difficulty in breathing and mild dysphagia. This was a case of dual ectopic thyroid. It emphasizes that thyroid scan should be routinely performed in all thyroid cases and all the suspicious areas studied

Interferon alpha - induced psychotic disorder in patient with chronic hepatitis B

Interferon has remained the mainstay for treating patients suffering from chronic viral hepatitis. However, its efficiency has been limited by the neuropsychiatric side effect profile that it carries; neurotransmitter alterations in the central nervous system [CNS] have been correlated to psychiatric complications of Interferon alpha. Although mood disorders such as depression occasionally develop during Interferon alpha therapy, psychotic disorders have been rarely reported. We present a case of Interferon alpha 2b induced psychotic symptoms in a young male with hepatitis B and review the relevant literature

Juvenile Ewing sarcoma presenting as a pelvic mass

A teen aged girl with rapidly developing pelvic mass, associated with weight loss and left leg weakness, was evaluated and found to have Ewing's sarcoma of non-osseous origin from pelvis, which is a rare situation. She was treated by a multidisciplinary approach by surgery, chemotherapy and rehabilitation by physiotherapy to effective response

Onset of herpes zoster in relation to stressful periods of military service

Stress is a known predisposing factor for the development of herpes zoster. The purpose of this study was to describe the peculiar stressful circumstances of military service which may lead to physical ailments like herpes zoster. The study was conducted at Combined Military Hospitals, Hyderabad and Abbottabad from Oct 2003 to Sep 2004. Serving soldiers of all ranks who were clinically diagnosed to be suffering from herpes zoster during the above mentioned period were included in the study. They were interviewed in detail, in particular regarding physical or mental stress within a period of one month prior to the development of herpes zoster and examined thoroughly. All the findings were recorded on a pre-designed proforma. A separate proforma was filled for each patient. Out of 47 patients, 4 [8.51%] developed herpes zoster during the period which they perceived as stressful. 2 soldiers developed herpes zoster when they were undergoing rigorous imprisonment within the unit, 1 soldier developed the eruption during ration dumping to forward areas and the lesions of herpes zoster appeared in 1 when the patient was overworked and fatigued during the preparation for unit inspection. The eruption in all the 4 patients appeared during 2nd or 3rd week of the stressful period. Stressful periods, peculiar to military service, may lead to various mental as well as physical ailments like herpes zoster. However, the association of occurrence of herpes zoster in relation to stressful periods, peculiar to, military service needs further exploration and methodical studies are required for intervention to limit the incidence of herpes zoster

Benign Prostatic Hyperplsia: mode of presentation and postoperative outcome

To find out various modes of benign prostate hyperplasia [BPH] presentation in our region and their relation to postoperative failure to void after transurethral resection of prostate [TURP]. A study was conducted at Urology Department, Sandeman Teaching Hospital Quetta and Akram Hospital [Private] Quetta from January 2000 to December 2003. All BPH patients in whom the primary mode of presentation was accurately determined and later on underwent TURP were included in the study. Four modes of presentation were defined: [1] lower urinary tract symptoms [LUTS], [2] acute retention, [3] chronic retention and [4] and acute on chronic retention. After relevant investigations all these patients underwent TURP. Postoperatively catheter was removed when the urine was clear, usually within 48 hours of operation. Patients failing to void were recatheterized and given a second trial without catheter [TWOC] at third day of recatheterization. Resumption of spontaneous voiding on either the first or second TWOC was defined as "successful TWOC". Failure to void on second TWOC was defined as "failure to void" and was managed by a six week period of catheterization, followed by an additional TWOC. Statistical analysis was used to see any significant relation of failure to void postoperatively to mode of presentation of BPH, age of the patients and weight of the resected prostatic tissues. A total of 345 BPH patients were included in the study. Of these 270 [78.3%] patients presented with urinary retention and 75 [21.7%] with lower urinary tract symptoms [LUTS]. Patients who presented with retention were acute retention 129 [37.4%], chronic retention 81[23.5%] and acute on chronic retention 60 [17.4%]. The proportion of men failing to void after TURP was significantly higher [P <0.05] in those with [I] acute retention as compared to LUTS [ii] chronic retention compared to acute retention and [iii] acute on chronic retention as compared to acute retention. The proportion of men failing to void postoperatively was highly significant [P <0.005] in those with retention of any type as compared to LUTS. Age of the patients and weight of the resected prostatic tissues were found not significant factors in relation to failure to void postoperatively. BPH patients in our region present very late, most of them [>78%] with complication of urinary retention. Mode of presentation of BPH greatly influences the postoperative outcome of this disease. Patients presenting with complications of chronic and acute on chronic retention have less favourable results regarding postoperative voiding after TURP. Moreover age of the patient and weight of the prostate are not significant factors in relation to failure to void postoperatively

Xanthogranulomatous Pyelonephritis due to calculi: report of 63 cases and review of literature

To examine the relationship between clinical history and results of renal investigations in patients with xanthogranulomatous pyelonephritis. A retrospective review was conducted on 63 cases presenting with histopathological diagnosis of xanthogranulomatous pyelonephritis between 1995 to 2002, at the department of Urology, Bolan Medical College and Sandeman Provincial Teaching Hospital Quetta. There were 26 males and 37 females having an average follow up of two years. Positive findings on examination and investigations at presentation were fever and flank pain in 59 [93.6%] patients and pyuria in 34 [53.9%] patients. All the patients had renal and ureteric calculi with no or severe reduction in the function of the affected kidney on DTPA scan. Hypertrophy of the contra lateral kidney was seen in 56[88.8%] patients. Xanthogranulomatous pyelonephritis is a common entity in this part of the world. Late referral leads to loss of the kidney. Pre-operative diagnosis of the condition is desirable and if surgery is mandatory then all infected tissues have to be removed

Evaluation of low ligation and high ligation procedures of varicocele

To describe the mode of presentation of varicocele and to compare the low ligation [Inguinal approach/Ivanissevich's procedure] and high ligation [Retroperitoneal approach / modified Palomo's procedure] of varicocele repair regarding efficacy and postoperative complications. Design: Institutional-based randomized comparative clinical trial. Place and Duration of Study: This study was conducted at the Urology Department, Bolan Medical College and Sandeman Provincial Teaching Hospital, Quetta from December 1996 to November 2001 [5 years]. Subjects and A total of 213 patients of varicocele who underwent treatment in the department and completed 6 months follow-up were included in the study. The mode of presentation of varicocele was recorded for all patients. For treatment purpose patients were randomly divided into two groups: in group I [n: 115] varicocele was ligated by inguinal approach [Ivanissevich's procedure] while in group II [n: 98] by retroperitoneal approach [modified Palomo's procedure]. The efficacy and postoperative complications of the two procedures were carefully recorded and compared between the two groups. The mean age of the patients of group-I and group-II was 27.2 and 27.5 years respectively. More than 50% patients of both groups presented with feeling of heaviness/ dragging sensation on ipsilateral side. Presentation with infertility/sub fertility in group-I and group-II was 16.5% and 15.3% respectively. Majority of patients of both groups had grade III varicocele with visible deformity. The rate of postoperative complications was very low in both groups of patients. Recurrence of varicocele and postoperative hydrocele formation were slightly more common in group-II as compared to group-I but the difference was statistically not significant [p>0.05]. An extremely significant improvement occurred postoperatively in both sperms density and motility in infertile /sub fertile patients of both groups. Both procedures of varicocele repair are equally effective and have a low rate of complications. There is no significant difference in postoperative complications. An extremely significant improvement occurs in semen parameters of infertile/sub fertile patients postoperatively, irrespective of method / technique of varicocelectomy

Open pyeloplasty: a good option

To assess the Morbidity, Complications and Success rate of different Open Pyeloplasty techniques. This study was carried at the Urology department Bolan Medical College and Sandeman Provincial [Teaching] Hospital Quetta. This is a retrospective study carried out over a period of six years. After complete investigations all the patients were admitted through the out patients department. Kidneys were exposed in standard flank, muscle cutting incision. In short segment uretero pelvic junction obstruction and polar vessels anterior to uretero pelvic junction obstruction, the Anderson - Hynes Pyeloplasty was done. Culp and De-Weered Pyeloplasty was done in patients with long narrow segment at the upper end of ureter, JJ stents and nephrostomy catheters were used in majority of the cases. Patients were discharged on the10th post operative day and were followed-up routinely for six month. In this study 92 Pyeloplasties of different age and sex were done. Majority, 58 [63.4 percent] cases were between the ages 11-30 years. The most common presenting signs and symptoms were pain in 82 [89.13 percent] and loin mass in 61 [66.30 percent] cases. Narrow uretero pelvic junction and high ureteral insertion were the most common causes of uretero pelvic junction obstruction, seen in 62 [67.39 percent] cases. Culp and Anderson-Hynes were the most common surgical techniques used. Open Pyeloplasty is still an excellent procedure for treating uretero pelvic junction obstruction and produce good improvement in function and drainage in majority of patients. If compared with newer techniques open Pyeloplasty is the gold standard