Prevalence, Characteristics and Socio-Demographic Correlates of Self-Stigma among Leprosy Affected Persons - A Case Study

This study has determined the prevalence of self-stigma, its characteristics in terms of alienation, stereotype endorsement, perceived discrimination and social withdrawal and stigma resistance among leprosy-affected persons and its relationship and extent of this relationship with various socio-demographic features. This has been done by carrying out a cross-sectional survey of 120 active people affected by leprosy during 2020-21. An internationally validated and standardised instrument (ISMI) was used to measure self-stigma. Statistical techniques such as independent t-test, Pearson’s and point biserial correlation and regression analysis were used for data analysis. The study found significant correlations between ISMI self-stigma scores and socio- demographic variables with moderate to minor deviation across the four components of the ISMI scale. The high to low correlation of various components of the ISMI scale found is discrimination experience, followed by stigma resistance, stereotype endorsement and alienation. Overall, the highest self-stigma was found in disabled people affected by leprosy, followed by those whose age was less than 40 years, followed by unemployed and male people affected by leprosy. It was concluded that alienation was maximum among people affected by leprosy who were either disabled, aged less than 40 years or were males. Discrimination experience was reported mainly by unemployed, disabled, males and younger people affected by leprosy. The findings indicate that proper methodology and components of Cognitive Behavioural Therapy may help reduce self-stigma among leprosy-affected persons

Harnessing Natural Colorants for Sustainable Textile Dyeing an Eco-Friendly Approach Using Sweet Cane (Saccharum Bengalense Retz.) Inflorescence

ABSTRACT The excessive industrial use of dye producing plants has threatened the existence of these species and biodiversity. Exploration of abundantly available natural dye sources not only provide industrial benefits but also share the load of dye yielding plants. In the present study we used the inflorescence of munj sweet cane (Saccharum bengalense Retz.) to extract natural colorant for textile industry. This easily available plant is cheap source of natural colorants and good alternative of synthetic dyes. The munj sweet cane inflorescence extract and fabric was treated with microwave radiations. The dyeing aspects like temperature, time, fabrics to extract ratio, salt type and salt concentrations were optimized. Pre-and post mordanting was carried out and optimized using copper, iron, moringa and turmeric. All the samples were analyzed by spectra flash D65 10 Deg to determine the color strength (%) value. Results proved inflorescence extract of munj sweet cane (RS, two minutes) using aqueous media as a good source of natural dye. Three grams of sodium chloride as exhaustion agent was observed to be the best while 70 0C temperatures gave best colour strength. Among chemical mordants, iron proved to be good one for producing varying shades and better colour strength. Bio mordanting with turmeric was proved to be more beneficial for getting best color strength and new shades.

Effect of seaweeds occurring at Karachi coast on mosquito larvae and liver function in rats

Seaweeds have been consumed as human food from thousands of years. In this study ethanol extract of 16 different seaweeds were tested for mosquito larvicidal activity against 4[th] instar larvae of Aedes aegyptii. The ethanol extracts of Padina pavonia and Sargassum ilicifolium caused 50% mortality at 1200ppm concentration. However other seaweeds Halimeda tuna, Ulva lactuca [Chlorophyta], Dictyota dichotoma var intricata, Jolyna laminariodes, Sargassum binderi [Phaeophyta], Melanothamnus afaqhusainii and Solieria robusta [Rhodophyta] showed LC50 at [almost equal to]1500 ppm concentration. The n-hexane fraction of Padina pavonia was most potent and produced lethality at minimum concentration [LC50 at 250ppm].The effect of ethanol and water extracts of S. binderii was also examined on liver function of healthy rats. The ethanol extract of Sargassum binderi given orally to rats [commercial at] 200mg/kg for 14 days slightly increased the concentration of liver enzymes [ALT, AST, ALP and LDH] and urea level as compared with normal control rats, but did not increase bilirubin, glucose, triglycerides, cholesterol and creatinine. Whereas water extract of S. binderi affected ALT while other biochemical parameters were near normal or slightly decreased as compared to normal control

Isolation and characterization of arsenic resistant bacteria from wastewater

The present study proposed the isolation of arsenic resistant bacteria from wastewater. Only three bacterial isolates (MNZ1, MNZ4 and MNZ6) were able to grow in high concentrations of arsenic. The minimum inhibitory concentrations of arsenic against MNZ1, MNZ4 and MNZ6 were 300 mg/L, 300 mg/L and 370 mg/L respectively. The isolated strains showed maximum growth at 37 ºC and at 7.0 pH in control but in arsenite stress Luria Bertani broth the bacterial growth is lower than control. All strains were arsenite oxidizing. All strains were biochemically characterized and ribotyping (16S rRNA) was done for the purpose of identification which confirmed that MNZ1 was homologous to Enterobacter sp. while MNZ4 and MNZ6 showed their maximum homology with Klebsiella pneumoniae. The protein profiling of these strains showed in arsenic stressed and non stressed conditions, so no bands of induced proteins appeared in stressed conditions. The bacterial isolates can be exploited for bioremediation of arsenic containing wastes, since they seem to have the potential to oxidize the arsenite (more toxic) into arsenate (less toxic) form.

Histomorphometry of preterm and term human placentas / Histomorfometría de placentas de pretérmino y término

The intra-uterine existence of foetus is dependent on placenta, a major organ of nutrition and homeostasis.The present study was carried out to compare morphometric and histological changes in preterm and term human placentas. Eighty placentas collected from Department of Obstetrics and Gynecology, JNMCH, AMU, Aligarh, were divided into group first of preterm placentas up to 36 weeks (n =30) and second group of full term placentas i.e. 37 to 40 weeks ( n = 50) respectively. The samples were fixed in 10 percent formol-saline solution. The gross morphological variables of placentas were studied. There was a significant increase in the placental weight, decidual area and umbilical cord diameter of term placenta as compared to that of the preterm ones. From each placenta whole thickness tissue blocks were taken and processed for paraffin sectioning. Five µ-thick sections were stained with Haematoxylin-eosin and Van Gieson stains and processed for light microscopy. A total of 200 villi were studied in each sample under high power field and occurrence of different features was expressed as percentages for each parameter. The appearance of microvilli and syncytial bud on the syncytium were almost absent in the villi of term placentas. It was concluded that with increasing gestational age there was a gradual increase in the number of capillaries in villi from preterm to term placenta.There was a significant increase in syncytial knot count, fibrinoid necrosis, vasculosyncytial membrane and decrease in the percentage of villi showing cytotrophoblastic cells and number of Hofbauer cells in term group as compared to preterm group.

La existencia intrauterina del feto depende de la placenta, el mayor órgano de nutrición y homeostasis. El estudio se llevó a cabo para comparar los cambios morfométricos e histológicos de la placenta humana de término y pretérmino. Ochenta placentas fueron obtenidas del Departamento de Obstetricia y Ginecología, JNMCH, AMU, Aligarh y se dividieron en grupos, el primer grupo de placentas de pretérmino hasta 36 semanas (n = 30) y el segundo grupo de placentas de término, de 37 a 40 semanas (n = 50 ). Las muestras fueron fijadas en solución de formol-salina al 10 por ciento. Se estudiaron las variables morfológicas macroscópicas de las placentas. Hubo un aumento significativo en el peso de la placenta, el área de decidua y el diámetro del cordón umbilical de la placenta a término en comparación con la de los prematuros. De cada placenta se tomaron y se procesaron bloques de tejido para incluirlos en parafina. Cortes de 5 µm fueron teñidos con HE y Van Gieson para microscopía óptica. De cada muestra fueron estudiadas 200 vellosidades, bajo campo de alta resolución y la aparición de diferentes características se expresó como porcentajes para cada parámetro. La aparición de las microvellosidades y brote sincitial en el sincitio estaban casi ausente en las vellosidades de las placentas de término. Se puede concluir que al aumentar la edad gestacional hubo un aumento gradual en el número de capilares en las vellosidades de la placenta de término. Existe un aumento significativo en el recuento de nudo sincitial, necrosis fibrinoide, membrana vasculosincisial y disminución en el porcentaje de las vellosidades que muestran células citotrofoblástica y número de células de Hofbauer en las placentas del término de grupo en comparación con el grupo de pretérmino.

Pre-auricular sinus and its microsurgical excision

Objectives: to determine the role of operating microscopic magnification in reducing its recurrence after surgical excision of pre-auricular sinus

Methods: all patients who underwent microscopic magnification guided surgical excision of pre-auricular sinus were studied. Follow up was carried out for one year for recurrence and other complications

Results: one year follow up revealed satisfactory results regarding recurrence [ 10,%] and post-operative complications

Conclusions: magnification under operating microscope gives good results regarding recurrence, tissue trauma, wound infection, ugly scar and complete excision

Psychiatric disorders; pattern and trends of patients attending out patient department at govt. Sarhad Hospital for Psychiatric Illnesses, Peshawar

The study was conducted to examine the pattern/trend of psychiatric disorders in a hospital based setting. Conducted at Govt. Sarhad Hospital for Psychiatric Diseases, Peshawar in March-April, 2010. Simple Observational. A Retrospective record review was done to determine the disease pattern for patients examined in the OPD [out patient deptt.]. All the patients who attended OPD in year 2010 and 2004 were included.The diseases were coded and classified according to ICD- 9 and 10. Comparison and Statistical analysis of both years was done. The findings of the study suggested that disease pattern seen at hospital, represents mental diseases prevalent in Distt. Peshawar. It showed the predominance of schizophrenic group and neurotic [31 -35%], stress related disorders [30-31%] group over other diseases. Next were the mode effective disorders [12- 16%] and episodal and paroxysmal disorders group [16-17%]. Drug dependence and mental retardation showed low percentage of 2%. Rest of diseases also showed low percentage. Although similar patterns were observed for both years but there were statistically significant difference between the two years. Hospital utilization pattern is a useful guide to the prevalence of mental diseases in general community.The chronic illnesses consisted of major burden of disease. Major groups were Schizophrenic and Neurotic, and Stress related disorders group. Pattern of psychiatric illness have not changed much from 2004 to 2010. Although the hospital is catering a large number of patients, yet there is a dire need of organizing mental health services at community level to reach undiagnosed patients

Surgical site infections in general surgical wards at a tertiary care hospital

Surgical site infections are important cause of morbidity and mortality in admitted patients world over. To determine the pattern of surgical site infections in General Surgical ward of a tertiary care hospital. Analytical cross-sectional study conducted at Department of General Surgery, Pakistan Institute of Medical Sciences, Islamabad for two years from January 2010 to December 2011. All cases were admitted in surgical ward with various surgical problems either as elective or emergency cases who developed wound infection later were included in the study. Cases of wound infection operated elsewhere, diabetic foot, and abscesses were excluded. Data collected included age, gender, primary diagnosis, mode of admission, comorbid factors, type and duration of surgery, expertise of the surgeon, use of antibiotics and hospital stay. After operation, wound was examined for evidence of infection from third post-op day onward. Any discharge was submitted for bacteriological examination. The wounds were followed till healed. A total of 1913 patients underwent surgery, including 983 cases [51.5 %] operated as elective and 932[48.5 %] as emergency. Postoperative wound infections occurred in 165 cases giving an overall incidence of infection in 8.6% cases. Infection rate in elective cases was lower [4.6%] than that in the emergency [12.7%] cases. Sixty one patients [37%] developed minor infection or stitch abscess, 104[63%] has frank suppuration requiring opening and drainage of wound; while 5[3%] cases developed deep seated infection of intra-abdominal spaces. E. coli was the commonest bacteria for wound infection [39%]. Post operative wound infection rate was 8.6%. The infection was significantly higher in cases who underwent emergency surgery and E. coli was the commonest pathogen to cause infection

Prevalence of bovine tuberculosis in zoo animals in Pakistan

The study was carried out in zoo animals at Islamabad Zoo, Pakistan to know the prevalence of bovine tuberculosis. An overall prevalence of 3.3% was recorded in zoo animals with 3.6% in Bovidae, 3.2% in Cervidae and 0% in Equidae families. The positive animals included spotted deer [1/3; 95% CI = 0.84, 90.57], Chinkara gazella [1/5; 95% CI = 0.51, 71.64] and Blackbuck gazelle [1/30; 95% CI = 0.08, 17.22], while the negative animals were barking deer [0/4], hog deer [0/24], grey gorals [0/2], urial [0/9], mouflon [0/4], nilgai [0/5] and zebra [0/4]. The results revealed significant association of live weight and number of calving with the positive tuberculin test, with 32% higher chances for females to show a positive test. Results also showed that odds of a positive test were 1.19 times higher when animal number was less than 10. The results of haematological parameters showed significant differences in total erythrocyte counts, hemoglobin, total leukocyte counts, eosinophil and basophil percentages between positive and negative animals

study on Acute Myocardial Infarction with special reference to age, sex, type of infarct and associated risk factors

To study the frequency of acute myocardial infarction [AMI] and its types in patients admitted in CCU of Divisional Headquarter Hospital [DHQ], Faisalabad Institute of Cardiology [FIC] Faisalabad and to investigate associated risk factors. It was an observational hospital based study conducted at Cardiac Care Centre, DHQ Hospital Faisalabad and FIC from 30th March 2009 to 30th June 2009. One hundred patients were included in the study at both centers. A Performa was filled with tabulated questions and information was recorded. The data was analyzed on SPSS version 13. It revealed statistically significant difference by patient's age and sex. AMI was higher in males [CI = 75 - 91%] than females [CI = 9 - 25%]. Types of infarction including inferior and anteroseptal were observed in significantly higher number of patients, while extensive anterior, non-STEMI and lateral infarction was observed in significantly less number of patients. Results showed significant association [P<0.05] of fat sources in diet with types of AMI. Hypertension [CI = 36-56], smoking [CI = 30-50], family history of IHD [CI = 26-45] were stronger risk factors than others and 19% patients admitted with AMI had Diabetes Mellitus. AMI was significantly higher in patients between 40 and 50 years of age. Age and sex and fat sources in the diet showed significant association with AMI, while family history of IHD, hypertension and smoking were other stronger risk factors

effect of Cedrus deodara root oil on the histopathology of rat stomach

The aim of this study was to observe the anti-ulcer effects of Cedrus deodara root oil on the rat's stomach and compare it with standard anti-ulcer drugs, femotidine and protonix. The study was conducted on 50 albino Wistar rats in three different doses i.e. 30, 40, and 50 mg/kg. The animals were divided into five groups, each group comprised of 10 rats [5 male and 5 female]. The oil was extracted from the plant root by dry destructive distillation method and the dose was calculated by dissolving 1.25 gms of Cedrus deodara in 25ml of 10% ethanol. The drugs were administered to the treated animals orally through feeding tube for two weeks. Animals received the dose of 50 mg cedar oil only, showed the healing effects on the mucosal epithelium of stomach, decreased inflammatory cells and granulation tissues on the submucosal layer upon histopathological examination. Therefore it may be concluded that Cedrus deodara root oil has anti-ulcerative effects and may be used in the management of gastrointestinal disorders particularly in peptic ulcer

Fine needle aspiration cytology; diagnostic accuracy in thyroid nodules

Goiter is a common problem in southern Punjab and thyroid surgery is frequently performed in surgical units of BVH Bahawalpur. Fine Needle Aspiration Cytology is the investigation of choice in detection of carcinoma thyroid. It is simple and quick to perform and can be readily repeated. The aim of the study was to find out the diagnostic accuracy of FNAC in thyroid nodules. Cross sectional study. June 2009 to November 2009. Department of Surgery, BVH Bahawalpur. Fifty patients of goiter of age ranging from 16 to 60 years, irrespective of gender, presenting with a thyroid nodule and undergoing surgery were included in the study at Department of Surgery, BVH Bahawalpur. Information of each patient was collected on a structural Performa and then analyzed on SPSS to assess the sensitivity and specificity of the FNAC. The sensitivity and specificity of FNAC was 72.2% and 97.8% respectively. FNAC should be performed in all cases of thyroid nodules because of its high sensitivity and specificity to diagnose the benign as well as the malignant lesions of thyroid

Epidemiology of vestibular neurinitis in vertigo presenting at tertiary care health care facility in Pakistan

To determine the frequency of vestibular neuronitis in vertigo patients at a tertiary public health care facility in Karachi Pakistan. It is an epidemiological study conducted at Ear Nose Throat, Head and Neck Surgery Department Jinnah Postgraduate Medical Centre [JPMC], a tertiary care hospital in Karachi, Pakistan. The study duration was from Jan 2007 to Dec 2009. The exclusion criteria included hypertension, diabetes mellitus, hearing loss, other cranial nerves deficits, multidirectional non fatiguing nystagmus, long term medication, Truncal ataxia, inflamed tympanic membrane, mastoid tenderness, high grade fever, and nuchal rigidity. Diagnosis of Vestibular Neuronitis [VN] was made on clinical findings. Patients with sudden onset of vertigo with nausea or vomiting, Clinical signs of unsteadiness, Spontaneous and horizontal nystagmus, Absence of other neurological signs and normal otoscopy and normal hearing were included in the study. Four hundred fifty seven patients reported with vertigo. One hundred sixty five were diagnosed as VN and were enrolled for the study. It was found that patients of VN were increasing yearly; younger male population was found to suffer more than others. Highest incidence was between the age group 16 to 30 years. More patients reported during the months of July - August and March - April every year during the change of season i.e. summer to winter or winter to summer. Vestibular Neuronitis was found more in males than females. Younger population was found to suffer more. Peak incidence was noted during the months of July - August every year. Incidence of VN in younger males and during July - August needs more investigation

Screening mammography for breast cancer in women using Bi-RADS scores

Breast cancer is third order malignancy in women among other malignancies. Various studies showed that incidence of breast cancer can be lower down by early detection of breast cancer. Mammographic screening is considered more effective modality in detecting early stage breast cancer in women who are at elevated risk for breast cancer. The aim of this study is to report the results of mammographic screening of women based on the Breast Imaging Reporting and Data System [BI-RADS] for breast cancer. Five hundred four women aged >40 years with no history of breast cancer, no complaints of breast symptoms during any self or clinical examination were underwent breast cancer screening using MAMMOMATE 1000 [Siemens]. Descriptive analysis is performed for imaging finding and risk factors. The mean age of 504 women was 51 +/- 9.18 years. No family history of breast cancer was present in 418 women [82.9%: 95% CI, 79.4-86.1%]. No cancer [negative and benign] was found in 469 women [93.1%: 95% CI, 90.47-95.12%] with R1/R2 scores. For breast imaging scores, 71.62% of all women were R1, 21.42% were R2, 2.38% were R3 while 4.58% were R4 and above. No association [P>0.05] was found between BI-RADS imaging scores and risk factors. In spite of low prevalence of breast cancer in our participants, still there is a need to educate the women at country level about the risk of breast cancer and significance of screening as a tool of early detection of breast cancer

Prevalence of chronic sinusitis among outdoor psychiatric patients

To assess the prevalence of chronic sinusitis among outdoor psychiatric patients as a number of patients with chronic sinusitis presents with psychiatric symptoms. 5043 cases. Cohort Study. Department of ENT in collaboration with department of Psychiatry, JPMC Karachi. The study duration was six years from January 2002 to December 2007. All cases of psychiatry consultation who agreed, were assessed for history, mental state examination and physical examination with laboratory and radiological investigation. The final diagnosis was based on criteria of ICD-10 for associated psychiatric diagnosis. Out of 5043 cases, 154 [30.05%] cases had chronic sinusitis. Out of 154 cases of chronic sinusitis 85 [55.2%] were male and 69 [44.8%] were female. Majority of the patients 57 [37%] were below primary level of education. As evident from this study, cases with chronic sinusitis can present psychiatric practice as the symptoms resemble or coexist with psychiatric disorders

Etiology and outcome of thrombocytopenia in sick neonates

Enlist risk factors of thrombocytopenia in sick neonates and determine the outcome in sick neonates with thrombocytopenia in relation to risks factors. This descriptive case series study was conducted for a period of 6 months from 2007 to August 2007 in Pediatric Unit-TI, Nishtar Hospital, Multan. A total of 100 sick neonates with thrombocytopenia were included in the study. Neonates with different risks factors were evaluated which were of neonatal infection, birth asphyxia, prematurity, RDS, NEC and others [jaundice, infant of diabetic mother]. Among 100 cases with thrombocytopenia [platelets count< 150,000/ul] were included in this study, Out of 100 cases 35 [35%] were found to have early onset thrombocytopenia and 65cases [65%] were found to have late onset thrombocytopenia. Out of 100 cases, 43 cases were neonatal infection with thrombocytopenia, 23 [67.4%] were with early onset sepsis and 20 cases [46.5%] were late onset sepsis. Out of 100 cases, 17 [17%] cases were of birth asphyxia,11 cases were prematurity with birth weight <2.5 kg and gestational age <37 weeks, 6 cases of prematurity [54.5%] were with hemorrhage skin manifestation and remaining were occult mild thrombocytopenia, 20 cases of RDS with thrombocytopenia, 5 cases with NEC with thrombocytopenia and 4 cases with mild thrombocytopenia. The common manifestations in thrombocytopenic cases were petechiae and bruises followed by gastrointestinal hemorrhages. The leading causes of thrombocytopenia in sick neonates are infections, asphyxia, prematurity, RDS, NEC. Apart from the platelets counts the bleeding manifestations also depend upon underlying ailments

Flexible nasopharyngo-laryngoscopy in comparison with direct laryngoscopy

Flexible nasopharyngo-laryngoscopy is a valuable tool in the diagnosis of nasopharyngeal, laryngeal and hypopharyngeal pathologies. Previously, the same pathologies were detected by doing examination under general anaesthesia which requires admission and theatre involvement in a busy hospital like Jinnah Post Graduate Medical Centre, this results in delay of the procedure and put extra burden on already constraint resources. This study was conducted to determine the accuracy of flexible pharyngolaryngoscopy in recording the site and extent of abnormality in outpatient clinic notes when compared to the findings at direct laryngoscopy. This study was conducted at ENT department, Jinnah Postgraduate Medical Centre from 1[st] January 2006 to 31[st] December 2007. Prospective study. 148 patients included in this study were selected with the complains of hoarseness, dysphagia, odynophagia, difficulty in breathing and neck nodes. Flexible nasopharyngo-laryngoscopy done in all cases than patients were admitted in ENT department had undergone direct laryngoscopy under general anaesthesia. The findings of both procedures were compared. Accuracy was found to be 87% when the readings of flexible endoscopy were matched with that of direct laryngoscopy

Public health problems in low and high socio economic areas of Karachi, Pakistan

Despite many media campaigns by government and private sectors highlighting, water and sanitation treatment plans and policies, the public health problems are still common in different socioeconomic areas. The objective of our study was to explore the major public health problems prevailing in two different socioeconomic areas. The objective of our study was to explore the major public health problems prevailing in two different socio economic areas in Karachi, Pakistan. A cross sectional survey was conducted from January 1, 2008, to June 15, 2008. Convenience sampling was used to select the EVACUE housing situated and model village. From each house selected, interviews were conducted based on one participant per house. The main outcome variables were measure of different qualities of drinking water safety, taste, etc. Problems of waste and sanitation included disposal of solid waste and leakage of drainage system in the area. The results found water quality to be good with safe drinking water and less residents complained in EVACUEE as compared to Model. Health problems of drinking water and sanitation were more prevalent in low socio economic areas as compared to higher socio economic area

Double lumen intubation; reliability of auscultatory method?

Auscultation is well established and most commonly used method for checking of correct placement of Double Lumen Tube[DLT]. Now with widespread availability of fibre optic bronchoscope, confirmation of DLT placement by fibre optic bronchoscope is recommended by many and considered mandatory by some anaesthetist. To discuss method of insertion and reliability of auscultatory method to confirm correct placement of double lumen tubes. Observational. Combined Military Hospital Rawalpindi from 16th Nov 2003 to 13th July 2007. We have performed about one thousand one hundred and fifty double lumen intubation without use of fibreoptic bronchoscope. 85% of patients did not need any tube adjustment during surgical procedure. Only 15% cases required tube adjustment intra-operatively. None of procedures were abandoned due to double lumen tubes problems. We conclude that auscultation is not that unreliable though not perfect method of DLT placement. Use of fibreoptic bronchoscope is recommended but not mandatory for DLT placement. Anatomical malpositioning detected by fibre optic bronchoscope which according to some studies is 70 to 80% does not necessarily translate into physiological malfunctioning

Reciprocity of calcium response in doxorubicin treated heart

Doxorubicin is an important anthracycline which has proven anticancer activity. However its clinical use has been limited by its cardiotoxicity. Many studies have been conducted to explore the mechanism of this untoward effect, but have given conflicting data. This study has been conducted to determine the role of calcium in this regard. Langendroff's technique was used. The data obtained from a significant number of rabbits shows that Doxorubicin suppresses the inotropic activity of heart significantly [p<0.01] while; it does not alter the chronotropic activity significantly [p<0.01] in lower doses, but reduces this activity significantly [p<0.01] at higher doses of calcium. The result clearly supports, the Ca[++] mediated cardio toxic mechanism of heart