A Study on Ventricular Late Potentials by Signal Averaged Electrocardiogram in Myocardial Infarction Patients.

Fifty patients who presented with Myocardial Infarction (MI), diagnosed by history, ECG, enzymes were subjected to late potential analysis between 7-10 days post MI by Signal Averaged Electrocardiography (SAECG). There were 42 male and 8 female patients. 34 had anterior wall MI and 16 had inferior wall MI, and all of them had Q wave infarction. History of previous MI in 12, diabetes in 14, hypertension in 34, smoking in 24 and hypercholesterolemia in 8 was noted. Patients were followed up for one year. Late potentials were positive in 10 patients (62.5%) of inferior wall MI and 6 patients (17.5%) of anterior wall MI. Those with episodes of ventricular tachycardia had increased incidence of late potentials. There was no correlation of late potentials and LV function assessed by echocardiography. Thrombolysed group had decreased incidence of late potentials.

Clinical evaluation of safoof-e-darchini [Cinnamomum zeylanicum blum.] in primary hyperlipidaemia

A single blind standard controlled study was designed to evaluate the efficacy of Safoof-e-Darchini in the management of Primary Hyperlipidaemia. The study was conducted at ZVM College Pune. Before starting study ethical clearance was obtained from Ethical Committee. Sixty diagnosed patients were selected on the basis of inclusion criterion. Patients were randomly divided into two groups 'A' and 'B' comprising 30 patients in each group. In group 'A' test drug was given in a dose of 3 gram twice a day whereas in group 'B' standard drug Atorvastatin 20 mg was given once a day for the period of 60 days. Assessment of efficacy was done on the basis of objective parameters. In this study both test and control group exhibited significant hypolipidaemic activity [P<0.001]

Fabrication, physicochemical characterization and preliminary efficacy evaluation of a W/O/W multiple emulsion loaded with 5% green tea extract

Complex multiple emulsions have an excellent ability to fill large volumes of functional cosmetic agents. This study was aimed to encapsulate large volume of green tea in classical multiple emulsion and to compare its stability with a multiple emulsion without green tea extract. Multiple emulsions were developed using Cetyl dimethicone copolyol as lipophilic emulsifier and classic polysorbate-80 as hydrophilic emulsifier. Multiple emulsions were evaluated for various physicochemical aspects like conductivity, pH, microscopic analysis, rheology and these characteristics were followed for a period of 30 days in different storage conditions. In vitro and in vivo skin protection tests were also performed for both kinds of multiple emulsions i.e. with active (MeA) and without active (MeB). Both formulations showed comparable characteristics regarding various physicochemical characteristics in different storage conditions. Rheological analysis showed that formulations showed pseudo plastic behavior upon continuous shear stress. Results of in vitro and in vivo skin protection data have revealed that the active formulation has comparable skin protection effects to that of control formulation. It was presumed that stable multiple emulsions could be a promising choice for topical application of green tea but multiple emulsions presented in this study need improvement in the formula, concluded on the basis of pH, conductivity and apparent viscosity data.

Emulsões múltiplas complexas possuem excelente habilidade de agregar grandes quantidades de agentes cosméticos funcionais. Este estudo teve por objetivo encapsular grandes volumes de chá verde em uma emulsão múltipla clássica e comparar sua estabilidade com a emulsão múltipla sem o extrato do chá verde. Emulsões múltiplas são desenvolvidas usando cetil dimeticona copoliol como emulsificante lipofílico e o clássico polissorbato-80 como emulsificante hidrofílico. As emulsões múltiplas foram avaliadas por meio de vários aspectos fisico-químicos como condutividade, pH, análise microscópica e reologia. Estas características foram observadas por um período de 30 dias sob diferentes condições de armazenamento. Testes de proteção da pele in vivo e in vitro foram realizados para ambos os tipos de emulsões testadas, i.e. com o ativo em estudo (MeA) e sem ativo (MeB). Ambas as formulações apresentaram características comparáveis no que diz respeito aos diferentes fatores físico-químicos avaliados sob diferentes condições de armazenamento. A análise reológica mostrou que as formulações apresentaram comportamento pseudo-plástico sob contínuo estresse de cisalhamento. Os resultados dos testes in vivo e in vitro sobre a proteção da pele revelaram que a formulação ativa promoveu efeitos comparáveis à formulação controle. Nossos dados mostraram que emulsões múltiplas estáveis poderiam ser escolhas promissoras para a aplicação tópica do chá verde. Entretanto, a fórmula das emulsões múltiplas apresentadas neste estudo precisam ser melhoradas no que diz respeito ao pH, condutividade e viscosidade aparente.

Historical perspective of parkinsonism and ra'asha

Unani classical literature is a rich source of information for various clinical disorders but there is a wide gap between ancient and modern views of elaborating the pathophysiology. As far as Parkinsonism is concerned, it is a syndrome characterized by tremors, muscular rigidity, Bradykinesia and postural instability. After going through literature and historical review it is very much obvious that the description about the Ra'asha and its associated symptoms arise due to CNS disorder that is vividly described by ancient Unani scholars but due to wide gap in ancient and modern knowledge and way of describing pathogenesis of the Parkinsonism and Ra'asha could not be correlated. With the help of this study a thorough review of classical literature along with model concept of extra pyramidal disorders is being incorporated

Assessment of Bone Mineral Density in Elders of Various Socio-economic Status with Special Reference to Osteoporosis

Osteoporosis is a complex heterogeneous disorder of unknown etiology. Why otherwise normal process leads to bone density inadequate to support the body in some people is not known. Although the fracture-precipitating condition of inadequate bone mass is common to all types of osteoporosis, the processes by which this end is reached probably result from etiologies distinctive to each of the types or the many forms of disease. Risk factors for osteoporosis include age, race, sex, body weight, family history, premature menopause, nulliparity, number of lactations, dietary factors, limited exercise, use of cigarette, excessive alcohol consumption, and prolonged use of medications4. Loss of menses at any age is a major determinant of osteoporosis risk in women. Acceleration of bones loss coincides with menopause, either natural or surgical, at which time the ovaries stop producing estrogen. Estrogen and hormone replacement therapy have been shown to conserve Bone Mineral Density [BMD] and reduce the risk following menopause, but young amenorrheic women may also benefit from the use of oral contraceptive agents to promote a normal menstrual cycle. Any interruption of menstruation for an extended period results in bone loss14, 17. Many nutrients and several non-nutrients have been implicated as etiologic risk factors for osteoporosis. At present, safe and effective treatment is not readily available to replace bone that is already lost. It is nevertheless, important to identify women who are at risk of developing osteoporosis as early as possible, so that measures can be taken to prevent further bone loss. Because low BMD is a major risk factor for osteoporosis, its assessment is clinically useful.

Evaluation of effects of clomiphene citrate on serum testosterone and FSH levels and seminal parameters in idiopathic oligospermia

Clomiphene citrate is a synthetic nonsteroidal drug that acts as an antioestrogen and competitively binds to oestrogen receptors in the hypothalamus and pituitary. This blocks the action of the normally low levels of oestrogen on the male hormone axis and results in increased secretion of GnRH, FSH and LH. The enhanced output of these hormones increases testosterone production and sperm production. A non randomised clinical trial was conducted in a sample of 21 idiopathic oligospermic men from local population with a mean age of 27.75 +/- 4.13 years, to evaluate the effects of clomiphene citrate in a dose of 100mg/day for five days, on serum testosterone, serum FSH, semen volume, sperm density, and total sperm motility. After clomiphene citrate therapy, mean serum testosterone level showed highly significant increase [p<0.05], mean serum FSH level showed significant increase [p<0.1]. Semen analyses were done at periodic intervals, 1[st] at day 1 i.e. before the 1[st] dose of clomiphene citrate, 2[nd] at 6[th] day i.e. 24 hours after the last dose of clomiphene citrate, and 3[rd] at 74[th] day of the trial. Clomiphene citrate administration resulted in statistically significant increase in the mean semen volume at day 6 [p<0.05], increase in the sperm density at day 74 [p<0.05], and increase in the total sperm motility at day 6 [p<0.05]

Management of supracondylar fracture of humerus in children by close reduction and immobilization of the elbow in extension and supination

A Supracondylar fracture of the humerus is the most common fracture in children around the elbow and is also called first decade injury. If not treated properly it may lead to disability due to elbow stiffness, and sequel of neuro-vascular injuries like Volkmann ischemic contracture etc. This study was undertaken to determine the outcome of close reduction and immobilization of the elbow in extension and supination in displaced supracondylar fractures of the humerus in children. This Quasi-experimental study was conducted in the Department of Orthopaedics, Postgraduate Medical Institute, Lady Reading Hospital Peshawar, from January 2007 to December 2007. The inclusion criteria was Gartland Type III [completely displaced] supracondylar fractures of the humerus and the exclusion criteria was open or closed Gartland type-III fracture associated with neurovascular injury. Close reduction under general anaesthesia was done and the elbow was immobilized in extension by the application of 2 plaster slabs according. The follow up is based on the overall rating using the modified Flynn global criteria. Out of 70 cases, in 56 cases [80%], reduction was acceptable; while in 14 cases [20%] it was unacceptable. Those with unacceptable reduction, 2nd attempt of close reduction were done but only eight were successful and the other six children required open reduction and internal reduction. Those with acceptable reduction went in to union with the carrying angle +/- 5 of the contra-lateral side and full range-of-motion. Excellent result were achieved in 35 cases [50%], good in 15 cases [21.43%], fair in 4 cases [5.71%] and poor in 6 [8.75%] patients. The extension method of close reduction and immobilisation with two slabs is safe method and give better cosmetic results in uncomplicated type III injures as compared to the flexion method

Career goals of trainee physicians in internal medicine

To survey Internal Medicine trainees' future career choices and factors influencing their decision-making. Cross-sectional study. The Aga Khan University Hospital, Karachi, from November 2006 to January 2007. A standard questionnaire was administered to the residents and Interns working in the Department of Internal Medicine of The Aga Khan University Hospital. The questionnaire covered demographic details, specialty choice, work-time distribution and factors influencing career choice. Descriptive statistics were applied. A total of 49 doctors participated with 57% females; and 43% males, having 33% interns and 67% residents. A minority [22%] opted for internal medicine, while 78% selected sub-specialties with cardiology [20%] being the most sought- after sub-specialty. Majority [69%] wanted to spend more time in clinical activities compared to administration [18%] or research [13%]. Majority [92%] wanted to work in an academic setting. Availability of a structured training program [61%], ability to practice broad area of medicine [41%] and prestige of the specialty [41%] highly influenced their career choices. Forty one [82%] wanted to proceed abroad for further training and 80% wanted to eventually practice in Pakistan. Most of the interviewed under-training physicians wanted to pursue sub-specialty. Clinical work was more attractive compared to research. A structured training program was detrimental in affecting their choices. Majority wanted further training abroad but eventual settlement in Pakistan. The study results can help us create the basis for reforming the current training programs

Pseudomyxoma Peritonei - a rare abdominal tumor

Pseudomyxoma peritonei is a rare abdominal tumor with a reported incidence of approximately 1 per million per year. It is invariably fatal as the space within the abdomen is eventually replaced by mucinous tumor. We report one case of Pseudomyxoma peritonei

surgical treatment of chronic anal fissure: One year's experience with GTN past

Assessment of the efficacy of topical 0.2% glyceryl trinitrate [GTN] paste in the treatment of chronic anal fissure. Sixty two patients were treated with 0.2% GTN paste and reviewed at 3, 6 and 12 weeks interval to assess efficacy and side effects. At 6 weeks, 72% of patients were treated successfully. In 28% of cases treatment was unsuccessful. At 12 weeks follow up there was no early recurrence. The prevalence of headaches was 70%. The use of GTN induces rapid healing of chronic anal fissures with a 72% healing rate in this study. But balance is required between fissure healing and headache intolerance

Young man presenting with chest pain

This is a case report of a young man, who had an acute coronary event followed by angioplasty. On further workup he was found out to have hyper-homocysteinemia

Gender identity disorder: a case report

We report a case of gender identity disorder in a 22 years old male, who confined himself to his house, dressing, walking, talking and behaving like females. His testes were smaller than normal and his breasts were bigger than the normal size. He was taking estrogens and was reluctant to check his sexual hormone levels. He wanted to undergo genital reassignment and was in a regular contact with a transsexual that had already undergone genital reassignment surgery and was aiming to get married to a male. This created a social problem for parents, specially for his father

impact of household contraceptive distribution on breast feeding and pregnancy prevalence in rural Gharbia Governorate Egypt

A total sample of 623 rural married women in the child bearing age [20-49 years] in 3 villages of Gharbia Governorate Egypt; were followed up for a period of 12 months [December 1981 - November 1982] to investigate the influence of household family planning education and contraceptive distribution on patterns of breast feeding and pregnancy status. Results revealed no significant changes in lactation patterns due to household contraceptive education and distribution activities. However, such activities resulted in significant declines in pregnancy prevalences in 2 of the 3 villages studied