Evaluation of different formulations of IGRs against Aedes albopictus and Culex quinquefasciatus (Diptera: Culicidae)

Objective: To test the relative efficacy of pyriproxyfen and methoprene on mortality, deformity, inhibition and emergence to adult stages of Culex quinquefasciatus and Aedes albopictus. Methods: Serial dilutions (0.01-0.05 mg/L) of methoprene, pyriproxyfen 0.5 water dispersible granules (WDG) and pyriproxyfen 1.0 WDG were used to assess mortality and inhibition of 3rd instar larvae of Aedes albopictus and Culex quinquefasciatus. Each concentration and control was replicated four times in completely randomized design. Data on larval mortality, growth inhibition, deformities and adult's emergence was recorded weekly. On the basis of best comparative performance, the efficacy of pyriproxyfen 1.0 WDG at 0.1 g/m

Hypercholesterolemia; comparison of the efficacy of simvastatin 20mg with atorvastatin 20mg in lowering low density lipoprotein in patients with hypercholesterolemia

To compare the efficacy of Simvastatin with Atorvastatin in lowering Low Density Lipoprotein Cholesterol [LDL-C] in patients with Hypercholesterolemia in a tertiary care hospital. Prospective, observational, single center study. Department of Medicine, Khyber Teaching Hospital, Peshawar. December 2011 to December 2012. A total of 200 cases having base line fasting LDL-C level of >/= 130 mg/dl and meeting the inclusion criteria were included in the study through both outpatient department [OPD] and admitted patient. After detailed history and clinical examination, all patients were divided randomly into two groups, A and B. Patients in Group A were given Simvastatin 20mg/day and Group B received Atorvastatin 20mg/day. Fasting blood samples were taken from the selected patients in the start of study and after 12 weeks. A total of 200 subjects with a serum LDL-C level >/= 130 mg/dL were included in the study. They were divided into 2 groups randomly, 100 in each group. Each group comprised of 75 male and 25 female. The mean age in group A was 52 years and in group B it was 54 years. The age ranges between 40 years and 73 years. Mean base LDL-C level was 165 mg/dl in group A and 170mg/dl in group B. Simvastatin 20 mg/dl reduced LDL-C level by 26% and Atorvastatin 20mg/dl reduced LDL-C level by 33% after 12 weeks of treatment. Atorvastatin is a more effective drug to reduce serum LDL cholesterol than Simvastatin in the same doses

Falciparum malaria; its diverse clinical spectrum: a descriptive study of 150 admitted patients

To determine how Falciparum Malaria can present clinically in various ways. A study conducted on 150 admitted patients. This descriptive case-series, single center study was conducted in Medical B Unit, Khyber Teaching Hospital, Peshawar from November 2012 to June 2013. A total of 150 patients admitted with falciparum malaria were studied. A detailed history and clinical examination was performed. The falciparum malaria was diagnosed by examining peripheral blood film. All patients were thoroughly investigated to find out the complications of falciparum malaria. Out of 150 patients, 95 [63.33%] were males 55 [36.67%] were females with mean age of 30 years. Fever was present in all patients, rigors and chills in 93%, headache and vomiting in 60%, jaundice in 50%, confusion in 37%, abdominal pain in 26% were main presentations. Other presentations were Oliguria, hypotension, cerebral malaria, dyspnea and cough, hypoglycemia and seizures. Clinical examination showed splenomegaly [58%], hepatomegaly [46%], hepato-splenomegaly [22%] of patients. Laboratory investigation showed Hemoglobin < 10gm% in 22% and leukocytosis > 12000/?l in 10% of patients. As Falciparum Malaria presents in multiple ways clinically, it should be considered as a possibility in all febrile illnesses

Clinicopathological study of cutaneous chromoblastomycosis in Pakistan

To recognize commonest clinical presentations of chromoblastomycosis and isolate fungi responsible for causing chromoblastomycosis in our part of the world. The study included all patients with clinical diagnosis of chromoblastomycosis and skin histopathology and fungal culture confirming clinical diagnosis. The disease started in all our patients during their childhood. All presented with psoriasiform plaques and showed infection with Phialophora dermatitidis Psoriasiform plaques can be the clinical presentation of chromoblastomycosis. P. dermatitidis is the fungus commonly seen in our enrolled patients

Spontaneous bacterial peritonitis. Comparison of treatment with ciprofloxacin and ceftriaxone in patients with cirrhosis liver and ascites

To compare the efficacy of ciprofloxacin with ceftriaxone in the treatment of spontaneous bacterial peritonitis in patients with cirrhosis liver and ascites. This hospital based quasi-experimental study. Department of Medicine, Khyber Teaching Hospital Peshawar. October, 2009 to April, 2010. A total of 200 patients were selected by non-probability purposive sampling method after obtaining an informed consent. Sample size was calculated through WHOS statistical calculator. All the selected patients had clinical and biochemical evidence of cirrhosis liver and spontaneous bacterial peritonitis. Both sexes were included in the selected patients had clinical and biochemical evidence of cirrhosis liver and spontaneous bacterial peritonitis. Both sexes were included in the study. They were randomly divided into two groups; group I was treated with ciprofloxacin and group II was treated with ceftriaxone. 200 patients including 124 males and 76 females with spontaneous bacterial peritonitis were included in the study. 100 patients each were treated with ciprofloxacin and ceftriaxone in the two groups. 82% responded favourably to 5 days course of I/V 200 mg ciprofloxacin and 91% were cured with 5 days therapy of I/V 2gm ceftriaxone. Both ceftriaxone and ciprofloxacin are equally effective in the treatment of spontaneous bacterial peritonitis

Double flap patch closure of VSD with elevated pulmonary vascular resistance: an experience at AFIC/NIHD

To determine the 30 days outcome measured in terms of morbidity and mortality in cases of ventricular septal defect [VSD] with increased pulmonary vascular resistance [PVR] managed with double flap patch closure. Case series. Armed Forces Institute of Cardiology [AFIC/NIHD], Rawalpindi, from December 2005 to December 2008. Forty patients with VSD having PVR 9.58 + 4.33 wood units underwent double flap patch closure. The patch was fenestrated as one half of the expected aortic annulus diameter. A separate flap patch 5 mm larger than fenestration was attached to superior upper one third margins of fenestration. The patch was placed with flap to open towards the left ventricular apex. Modified ultra filtration [MUF] was employed in every case and sildenafil was given postoperatively. The age of patients ranged from 1 to 28 years with a mean of 6.66 + 5.70 years. There were 22 males and 18 females. All patients were weaned off from inotropic and ventilatory support as earlier as possible postoperatively with intensive care unit [ICU] stay of 77.15 + 54.56 hours. Postoperative pulmonary artery pressures were reduced to 42.63 + 10.86 mmHg as compared to pre-operative pulmonary artery pressures of 88.3 + 15.2 mmHg. Postoperatively 11 patients with suprasystemic pulmonary artery pressures and desaturation went into pulmonary hypertensive crisis in which immediate 2D echo evidenced the functioning flap valve with right to left shunt. There was only one death [early] out of 40 patients with an overall mortality of 2.5% along with limited morbidity. Double flap patch is an inexpensive, easy to construct technique with low morbidity and mortality in cases of VSD with raised PVR

Experience of Fontan surgery at Armed Forces Institute of Cardiology /National Institute of Heart Diseases [AFIC-NIHD]

To assess the overall outcome and success of Fontan surgery at our institute. AFIC-NIHD Rawalpindi. 01 September 2005 to 31 March 2010. For this retrospective study, institute's cardiac surgery database was used. Patients of single ventricle physiology, who had normal Left Ventricular End-diastolic Pressure and pulmonary artery pressures, were included. Data was analyzed using SPSS version 16. A total of 34 Fontan procedures were done. The mean age at operation was 4.83 +/- 1.37 years. There were 22 [64.7%] males and 12 [35.3%] females. Twenty five [73.5%] had a staged Fontan [successful previous Bidirectional Glenn's shunt, BDG]. Nine [26.5%] were primary Fontan procedures [no successful previous Bidirectional Glenn's shunt, BDG]. Thirty two [94.8%] were Extra Cardiac Conduit Fontan [ECCF] and 2[5.8%] were Intra Cardiac Fontan. Mean Bypass time was 132.65 +/- 48.44 minutes. Aorta was cross clamped in intracardiac Fontan and its mean time was 43.31 +/- 5.85minutes. Fenestration was employed in 14 [41.2%] patients. Mean pre-operative oxygen saturations were 77.41 +/- 10.27%, which significantly increased to 93.94 +/- 3.96% post-operatively [p<0.001]. In-hospital mortality was 2 [5.8%]. Fontan surgery has acceptable morbidity and mortality in our set up

Helicobacter pylori detection in chronic gastritis: a comparison of staining methods

Background: Helicobacter pylori is an important cause of chronic gastritis, gastric ulceration and gastric malignancies as gastric carcinoma and MALT lymphoma. Its definitive diagnosis is based on histopathology. Routine H and E stain is not very effective in its detection, immune-stains and fluorescent stains are costly. Need for simple cheap and sensitive stain has always been a topic of hot debate and extensive research. Method: paraffin embedded blocks of all adult patients diagnosed as chronic gastritis/gastric ulceration with no accompanying gastric pathology as hypertrophic gastropathys, and neoplasias were taken into study. Three sections of 4 micron were cut and stained with routine H and E, Giemsa, and Cresyl fast violet. Results: Total number of patients was 50. Out of these 37 [74%] were males and 13 [26%] were females. Mean age of the patients was 50.4 years. Thirty-four percent [34%] were positive in normal H and E stain, 68% were positive in Giemsa and 76% were positive in Cresyl fast violet. Conclusion: Cresyl fast violet is a good stain for diagnosis of H. pylori gastritis. Keywords: H pylori, chronic gastritis, H pylori staining methods

Diagnostic accuracy of fine needle aspiration of thyroid nodule verses biopsy in thyroid lesions

FNA biopsy of thyroid is a rapid, minimally invasive, and cost effective first line procedure in the evaluation of thyroid nodule. This study was conducted to evaluate the cytological accuracy, sensitivity and specificity of fine needle aspiration [FNA] of solitary thyroid nodules in correlation with post-surgical histological findings. This retrospective study was carried out at Department of Pathology, Abbottabad International Medical College, Abbottabad from January 2009 to December 2010. A total of 81 patients with clinically palpable solitary thyroid nodule were included in the study. Thyroid function tests were initially performed followed by FNA of thyroid nodules later operated and histopathological examination was conducted on the excised nodules. FNA diagnoses were correlated with the histological findings. The accuracy, sensitivity and specificity of the procedure were determined. Out of 81 cases, 5 [6.2%] were unsatisfactory and 76 cases were satisfactory for cytological evaluation. Cytohistopathological correlation was carried out for these cases. The study showed a diagnostic accuracy of 93% with sensitivity and specificity rates of 75% and 96% respectively. Positive predictive value is 81% and negative predictive value is 95%. Fine needle aspiration [FNA] has evolved as an accurate and sensitive diagnostic tool for the initial screening of patients with thyroid nodules, and has reduced the need for unnecessary surgery