Level of vitamin d in Orthopaedic Trauma among adult patients

Background: The evidence on level of vitamin D in trauma patients is scarce in the developing countries

Objective: To determine the levels of vitamin D in trauma patients above 18 years of age

Methodology: This was a cross sectional study conducted on patients admitted in the Orthopedic department of Sheikh Zayed Medical College /Hospital, Rahim Yar Khan, patients included in this study were 340. The duration of study was 21st July to 16th March 2016. Vitamin D level were measured by using vitamin D kits [Roche]. Patients less than 18 years were not included in the study. Data was analyzed by using SPSS version 16

Results: A total of 340 patients admitted in orthopedic department were included in this study. Overall 92.6% patients have deficient or insufficient level of vitamin D. Most of the patients [68.8%] were less than 45 years of age. Majority of the patients were male [71.8%]. Most of the patients [72.4%] were not smokers. Majority belonged to rural areas [56%], and have no history of steroid intake

Conclusion: This study confirmed that majority of the trauma patients were vitamin D deficient or insufficient. This highlights that trauma surgeons should consider vitamin D in the armamentarium of orthopaedic treatment

Outcome of wound coverage around ankle joint with sural artery flap

Background: Trauma is the most common cause of fractures and majority of these fractures involve the foot. So the early coverage is mandatory to prevent the complications, it is challenging to the orthopaedic, plastic and reconstructive surgeons. Sural artery reversible flap is one of the options

Objective: To determine the outcome of sural artery flap for wound coverage around ankle

Methodology: A total of 24 patients were included in this interventional study. All the patients having wound around the ankle due to any cause and of either sex presenting in emergency department of Sheikh Zayed Medical College/Hospital, Rahim Yar Khan from 1st June 2014 to 30th April 2016 were included in this study. Outcome was measured as "Good", "Fair" and "Poor". The data was entered and analyzed by using SPSS version 16

Results: In this study 24 patient were operated, 41.66% were children and 54% were male. In 50% heel region was involved and in 25% melleolar region and 12.5% dorsum of foot and in 12.5% above ankle joint. Outcome noted was "Good" 83.3% "Fair" 8.3% and "Poor" 8.3%

Conclusion: Sural artery flap for the coverage around ankle is simple, safe and can be performed by orthopedic surgeon at any center without the requirement of special instrumentation and special test, with good outcome

Framingham risk score in impaired glucose tolerant population: a sub analysis of diabetes prevention and awareness program of Pakistan

Objective: To assess the 10-year risk of coronary artery disease [CAD] in subjects with impaired glucose tolerance [IGT] using Framingham risk score

Methods:Data for this study was collected from Diabetes Prevention and Awareness Program. Primary prevention team visited different primary health care centers, factories, service organizations and offices within Karachi, Pakistan. IGT was diagnosed according to World Health Organization criteria after taking informed consent. Information regarding social-demography, dietary habits and physical activities were obtained by a designed questionnaire on one-to-one based interview. Framingham risk score [FRS] was used to assess risk of developing CAD

Results:A total of 315 subjects with IGT were recruited for the study. Mean age of subjects was 44.1 +/- 9.8 years and mean BMI was 27.3 +/- 5.0 kg/m[2]. Overall, 31.4% of the participants were at risk of having CAD. Males were 6.4 times and hypertensive subjects were 2.44 times more likely to have CAD in next 10 years

Conclusion:According to the findings of the study, male and hypertensive IGT subjects were more likely to develop CAD in next 10 years. Community based awareness programs are needed to educate people regarding healthy lifestyle in order to reduce the risk of IGT and CAD

Effect of bupivacaine with and without intra peritoneal instillation on postoperative visceral pain after laparoscopic cholecystectomy

Background: Laparoscopic Cholecystectomy is the treatment of choice for symptomatic gallstones disease. Open cholecystectomy results mainly in parietal pain while laparoscopic cholecystectomy causes visceral pain

Objective: To compare post-operative visceral pain at 24 hours in patients undergoing laparoscopic cholecystectomy with and without intra peritoneal instillation of bupivacaine

Methodology: Setting: Surgical Unit II, Sheikh Zayed Medical College/Hospital Rahim Yar Khan. Duration of Study: 1 July to 31 December 2015. Study design: Randomized controlled trial [RCT]. A total of 60 patients having symptomatic gallstones disease were included in this study. Patients were randomly divided into two groups. Thirty patients in group Awere treated with bupivacaine 0.5 % instillation. For the patients in group B, the dose was not instilled in the gall bladder fossa and right and left sub diaphragmatic spaces. Postoperative pain was assessed up to 24hours after surgery using Visual Analogue Scale [VAS]. The data was entered and analyzed by using SPSS version 16

Results: The mean age of the patients was 35 +/- 8 years in group A, and 37 +/- 8 years in Group B. Post operative pain at 24 hours was significantly low in group A than in group B [33.3% vs. 70%; p=0.004]

Conclusion: Intraperitoneal bupivacaine instillation after laparoscopic cholecystectomy reduces pain in the initial postoperative period. It is easy to administer with no adverse effects and may become a routine practice for this procedure

Outcome of closed titanium elastic nailing in paediatric tibial diaphyseal fractures

Background: Tibia fractures in skeletally immature patients are usually treated conservatively but sometimes operative treatment becomes essential

Objective: To determine the outcome of closed titanium elastic nailing in pediatric tibia diaphyseal fractures in terms of union and range of motion at knee and ankle joints

Methodology:Across sectional study was conducted at Orthopedics Department of Lahore General Hospital, Lahore. A total of 35 patients ageing between 6-12 years with unilateral, isolated, closed displaced diaphyseal fractures of tibia were included in this study. Patients were followed in outpatient department after 15 days for operative wound examination and then were followed after every 2 months to determine the progress in union and range of motion. The collected information was entered in PASWStatistics 18 and analyzed

Results: The minimum age was 6 and maximum was 12 years. There were 19[54.3%] males and 16[45.7%] females. According to Hammer classification of fracture healing, at 2nd week post operative all patients has Grade-V. At 2nd Month follow up 12[34.28%] patients has Grade-II and 23 [65.72%] patient has Grade-III fracture healing. At 4th month follow up 30[85.71%] patients has Grade-I and 5[14.2%] patients has Grade-II union. At 6th month follow up all 35[100%] patients has Grade-I fracture healing

Conclusion: Treatment of diaphyseal fractures of tibia in children with closed elastic intramedullary nailing is a rapid and effective method in terms of bone union and range of motion of the ankle and knee joints

Comparison of outcome of fractures of inferior pole of patella

Background: Fractures of patella are common and it constitutes about significant proportion of all skeletal injuries resulting from either direct or indirect trauma

Objective: To evaluate the outcome of inferior pole fractures of patella treated with tension band wiring and resection of avulsed fragment and re-attachment of ligament to patella

Methodology: This was an comparative study, carried out in Department of Orthopaedic surgery of Lahore General Hospital, Lahore from 16[th] June 2012 to 15[th] June 2014. A total of 20 patients were included in this study. These patients were randomly divided into two groups. In Group-A patients were treated with open reduction and internal fixation with tension band wire and in Group-B patients were treated by resection of the avulsed fragment and reattachment of the patellar ligament to the patella. Patients were followed up for surgical site infection and functional outcome at 1[st], 7[th], 15[th], day one month, three months and six months post operatively. Final outcome was assessed by using Bostman criteria. Data entry and analysis was done by using SPSS version 17

Results: Mean age of all 20 patients was 34.20 +/- 12.13 years. Although both treatment groups had statistically same rate of surgical site infection from 1[st] day till 15[th] day post operatively. From 1[st] month till 6[th] months follow up time period none of the patients had surgical site infection in both treatment groups. At 1[st] month and 6[th] month post operatively in Group-B outcome was statistically better as compared to Group-A patients. But at 2[nd] month outcome of patients was statistically same in both treatment groups

Conclusion: Resection of the avulsed fragment and reattachment of the patellar ligament to the patella had good outcome according to the Bostman criteria as compared to open reduction and internal fixation with tension band wire

Outcome of tissue sparing conservative surgery in blast injuries to limbs

Background: Blast injuries are common in countries affected by conflict

Objective: To evaluate the outcome of conservative surgical intervention in the blast injuries of limbs in civilian population

Methodology: Study Design: Cross sectional study. Place and Duration of Study: Department of Orthopedic Surgery, Sheikh Zayed Medical College/Hospital, Rahim Yar Khan from 1[st] September 2011 to 31[st] March 2013. Fifty patients suffering from blast injuries to upper and lower extremities in civilian population regardless of age and sex were enrolled. Those patients who already had been treated after injury at some other centers were excluded from the study. Only clinical evaluation was used to check the vascular status and viability of the remaining attached tissues. Patients were operated either under general or regional anesthesia. Repeated debridement's followed by skin coverage in the form of split thickness skin graft or rotational flaps were the treatment option for soft tissues and exposed bone respectively. Post operative antibiotics were given for a period of one week at least. Rehabilitation exercises were continued up to six months after discharge from the hospital. The data was entered and analyzed by using SPSS version 15

Results: Mean age of the victims in this study was 22 years. Twenty nine patients had some sort of traumatic amputation at presentation resulting from original injury. Original injuries occurred were as follows; loss of limb below knee 7[14%], loss of limb at ankle region 05[10%], mid foot amputations 08[16%], and hemi foot amputation in 05[10%]. In upper limb injuries pattern was as follows; 01[2%] mid palmer amputation, 02[4%] two fingers amputation, and 04[8%] had soft tissue involvement of hand. Infection rate was 22% in patients who did not have wound dressing by the primary physician while it was 10% in patients who had wound dressing by primary physician before presenting to this institution, the collective infection rate was 32%

Conclusion: Conservative wound debridement, early skin coverage, preserving maximum soft tissues and bone results in functionally and cosmetically better limb in blast injuries

Short term outcome of clubfoot correction by Ponseti method

Background: Congenital Talipes Equino Varus [CTEV] is a common complex congenital deformity of the foot. Treatment still continues to challenge the skills of the pediatric orthopedic surgeon as it has a notorious tendency to relapse, irrespective of whether the foot is treated by conservative or operative means

Objective: To evaluate the short term outcome of Ponseti method of serial manipulation and casting in Congenital Talipes Equino Varus [CTEV] in children up to 6 months of age

Methodology: A descriptive case series study was carried from 16[th] February to 15[th] August 2012 in the department of orthopaedic surgery, Sheikh Zayed Medical College/Hospital Rahim Yar Khan. A total of 200 feet were included in this study. The first cast application corrects the cavus deformity by aligning the forefoot with the hind foot, supinating the forefoot to bring it in line with the heel, and elevating the first metatarsal. One week after application, the first cast was removed, and after about 2-3 minutes of manipulation, the next toe-to-groin cast was applied. Manipulation and casting continued weekly for the next 5 to 6 weeks

Results: Mean age of patients was 3.9 +/- 1.7 months. Ninety one patients [62.3%] were male while remaining 55 patients [37.7%] were female. Left foot deformity was seen in 48 [33%] patients, right foot deformity was found in 34 [23%] patients and 64 [44%] patients were suffering from bilateral deformity. Percutaneous tenotomy of Tendo-Achilles was performed in 167 patients [83.5%]. Out of 200 feet, correction was achieved in 177 feet [88.5%] with zero Pirani score

Conclusion: Ponseti's method is simple, easy to learn, effective and reproducible method for correction of Congenital Talipes Equino Varus [CTEV] deformity in children

Frequency of thymoma in thymectomy specimens in myasthenic patients

This study was carried out to determine the frequency of thymoma in different age groups and sexes in thymectomy specimens in Myasthenia Gravis patients. Observational study. The study was carried out in General Surgery Department at PIMS over a period of three years from 2009-2012. PIMS is a tertiary care centre where large population of Islamabad and Surrounding territory, including AJK, Gilgit Baltistan, Hazara division, Peshwar and nearby districts of Punjab gets treatment. A total of 30 patients selected at random, were included in this study. Patients were of different age groups, above 12 and under 52 years of either sex. Patients with poor medical control of disease with no contra indication for surgery. Patients with operable mediastinal mass [thymoma] were included. Generalized myasthenia gravis was diagnosed in patients. Pre-operative plasmaphoresis was carried out in all patients. Transsternal approach was used in all cases although now video assisted thoracoscopic thymectomy is becoming popular. Intraoperative findings were noted with emphasis on gross appearance and an information by histopathological report [frozen section]. In our study 17 % thymectomy specimens turned out to be Thymoma. Male to female ratio was 3:2. Age range was 12 years to 52 years. All patients undergoing thymectomy for Myasthenia Gravis don't have thymoma. Moreover all Thymomas are not associated with Myasthenia Gravis. Ages between 3[rd] to 5[th] decade are affected by thymoma and gender difference is very little

Outcome of surgical treatment of de-quervains disease

Background: De Quervains disease causes significant pain among patients

Objective: The purpose of this study was to evaluate the outcome of surgical treatment of de-Quervains disease

Material and Method: This cross-sectional study was conducted in Sheikh Zayed Medical College/Hospital Rahim Yar Khan from 1[st] January, 2009 to 31[st] December 2011. Patients with de Quervains disease who did not respond to conservative treatment with analgesics, splintage and local steroid injections for four to six months, were operated under local anesthesia. The tendons of abductor pollicis longus and extensor pollicis brevis were released in separate compartments. Patients were followed for a minimum of 4 months to assess the outcome of procedure. The data was analyzed by using SPSS version 15

Results: A total of 20 patients were included in study.Female to male ratio was 8:1. All females were house wives, exposed to manual work, four of them had rheumatoid arthritis. The age range was 35-50 years with mean age of 39 years. Results of surgical treatment were excellent with 94% patients being completely relieved of symptoms

Conclusion: Surgical release of first dorsal compartment [abductor pollicis longus and extensor pollicis brevis] of wrist has excellent results in patients with resistant De-Quervains disease

Reproductive control!; who's responsible? who's decision?

The aim of this study was to assess the frequency of various forms of in-law perpetuated reproductive control asserted on the female and any possible factor such as education level or early age of marriage which might be responsible for it as various studies have demonstrated that violence against women has been documented to be perpetuated not only by male partners but also by the family members of male partners. This multi-centric cross sectional observational study was carried out on 424 consecutive patients in 6 hospitals. The mean age [+ S.D] was 33.7+7.8 years and age of marriage [+S.D] was 21.3+2.8 years. 116[27.4%] were uneducated, 142[33.5%] had obtained education till primary level, 124[29.2%] had secondary education and 42[9.9%] had higher level of education. Upon asking about any life time in-law perpetuated reproductive control 205 [48.3%] of the females answered one or more than question as yes and 142 [33.5%] of the participating females said that the in-laws advised their husbands to go for a second marriage if they did not become pregnant. The more uneducated the participants of the study were, more abuse was faced at the hands of her in-laws [p-value <0.005]. The most common form of reproductive control asserted by the in-laws was telling the husband to go for a second marriage if the female did not become pregnant and this was most commonly seen in the less educated females [p-value <0.005].In conclusion increased efforts are needed to involve the in-laws in programs that seek to improve women's reproductive health

Outcome of sural and lateral supramalleolar flap in patients with exposed distal tibia and heel

Background: Soft tissue defects around ankle is a challenge for reconstructive surgery

Objective: To compare the outcome of sural and lateral supramalleolar flap for soft tissue coverage in patients with exposed distal tibia and heel

Patients and Methods: This comparative cross-sectional study was conducted in Department of orthopedic surgery, Bahawal, Victoria Hospital, Bahawalpur from 1 st January, 2008 to 31 st March, 2009. We included 32 patients which were randomly divided into group A, in whom soft tissue defect was managed by distally based Sural flap and group B, managed by lateral supramalleolar flap. All patients were discharged on 5[th] post operative day after flap surgery. First follow up in outpatient department was scheduled 10 days after discharge and skin sutures were removed, then all patients were followed on every 5[th] day for two months. The data was entered and analyzed in SPSS

Results: Mean age of patients in group A was 36 years and in group B was 31 years. It was noted that 21 [65.6%] patients were having soft tissue defect of heel region while 11 [34.3%] cases were having soft tissue defect of distal tibia. In 30 [93.7%] cases, cause of soft tissue defect was trauma while in 2 [6.6%] patients, chronic osteomyelitis was causing soft tissue defect. Flap survived in all cases of group A while success rate was 94% in group B. Marginal necrosis occurred in 1 [6.6%] patient of group A and 4 [23.5%] patients of group B. Flap was debrided and advanced in all cases. Flap edema occurred in 2 [13.3%] patients of group A and 6 [35.2%] patients of group B that resolved spontaneously by elevating the limb

Conclusion: It is concluded that distally based sural flap is a better choice for soft tissue coverage of distal tibia and heel region because it is much reliable and covers a larger area than lateral supramalleolar flap

Pattern of stroke in diabetics and non-diabetics

Diabetes mellitus has been established as a risk factor for stroke. Diabetes increases the risk of stroke in younger patients and diabetics are more likely to have an ischemic stroke. There are numerous studies on microvascular complications but there are only a few studies on strokes in diabetics. Therefore, this study was conducted to assess the impact of diabetes on the pattern of stroke in our population. This descriptive study was carried out in Department of Medicine, Ayub Teaching Hospital, Abbottabad from September 2011 to February 2012. Forty diabetics and 40 nondiabetics stroke patients were included in the study. Risk factors were noted and their distribution in both groups was analysed. The difference in age and gender distribution in both groups was not significant. Thirty-four [85%] of diabetics, and 25 [62.5%] non-diabetics suffered from ischemic stroke. Six [15%] of diabetics and 15 [37.5%] of non-diabetics suffered from haemorrhagic stroke. The differences between the distribution of ischemic stroke were significant [p<0.02]. In the diabetic group 32.5% of the individuals suffered from lacunar infarcts and in the non-diabetic group 10% suffered from lacunar infarctions [p<0.02]. There was no significant difference in distribution of risk factors. Diabetics are more likely to have an ischemic stroke and lacunar infarctions

Orthopedic injuries among elderly persons; frequency and assessment of the risk factors

Pakistan is experiencing a rise in its elderly population leading to increase burden of orthopedic injuries. With meager resources and a poor understanding of elderly health problems; Pakistan faces many challenges in caring for its elderly population. The objectives of this study were to, "Assess the frequency of orthopedic injuries among elderly persons and the associated risk factors at Sheikh Zayed Medical College Hospital Rahim Yar Khan". This was an analytical observational study conducted among the elderly patients above the age of 60 years, admitted in the Orthopedic Department of Sheikh Zayed Medical College Hospital Rahim Yar Khan. The data was collected regarding the frequency, causes and pattern of orthopedic injuries in elderly patients admitted in the Orthopedic Department of Sheikh Zayed Hospital I Medical College Rahim Yar Khan. The data regarding age, sex, education, occupation, geographical origin, and mechanism of injury were obtained by questionnaire. The data was analyzed on SPSS version 16. There were total 1589 patients admitted in the Orthopedic Unit during the study period. The elderly persons above the age of 60 years were 291[18.31%]. There were 184[63.24%] males and 107[36.76%] females. The average age was 64.52 years in urban residents and 66.34 years in rural residents' patients. Among the frequency of injuries, the femoral neck and inter-trochanter region were most commonly involved. The proportion of injuries in males it was 44.02% and in females it was higher that was 49.53%. The majority [68.29%] of the elderly persons was dependent and was not satisfied with socio-economic condition and status in the family [p<0.000]. Elderly patients who have experienced trauma are at increased risk of subsequent injury. Interventions to reduce the likelihood of trauma recurrence should focus on those with chronic illnesses and functional impairments

Flood devastated the barriers of epidemics at district Rahim Yar Khan

Back ground: Natural disasters are catastrophic events with atmospheric, geologic, and hydrologic origins. Disasters include earthquakes, volcanic eruptions, landslides, tsunamis, floods and drought. Pakistan faced floods in 2010 that began following heavy monsoon rains in the Khyber Pakhtunkhwa, Sindh, Punjab and Balochistan regions of Pakistan

Objectives: To evaluate the prevalence of infectious diseases in the flood affectee persons at Bhung, District Rahim Yar Khan in southern Punjab

Patients and Methods: This cross sectional study was conducted among the flood affectee at the flood relief camp of Sheikh Zayed Hospital / Medical College, Rahim Yar Khan located at Bhung, Rahim Yar Khan, during the month of September 2010. The data regarding age, sex, education, occupation, geographical origin and nature of disease were obtained from the patients attending flood relief medical camp for health care and was analyzed on SPSS version 14

Results: During the study period, 8074 patients were examined. Patients of all ages and both sexes were included. Male to female ratio was 1 to 1.01.The patients ranged from neonates to more than 70 years of age. The children under the age of ten years were 40.99%. Among the flood affectee, the most common diseases in decreasing order of frequency were diarrhoea, RTI, skin infection, eye infection, ear infection and bone trauma

Conclusion: Clean water, environmental hygiene and health education with proper and timely medical cover can reduce mortality and morbidity

FNAC of thyroid nodule; diagnostic accuracy of fine needle aspiration cytology [FNAC]

Clinically, solitary thyroid nodules are common, being present in up to 50% of the elderly population. The majority are benign with thyroid cancer representing an uncommon clinical problem. If euthyroid, then fine needle biopsy provides direct specific information about the cytology of the nodule from which the histology can be inferred. To determine the accuracy of fine needle aspiration cytology [FNAC] in the diagnosis of solitary thyroid nodule and to avoid unnecessary surgery. This study was conducted in the Department of Surgery, Sheikh Zayed Medical College/ hospital Rahim Yar Khan. September 2008 to August 2009 [one year]. Fifty patients were included in the study. Prospective analytical study. The results obtained were compared with histopathology and efficacy of FNAC was checked by calculating sensitivity, specificity, positive predictive value and negative predictive value. Out of 50 cases, FNAC showed 43 cases as benign and 7 cases as malignant lesions, while histopathological examination revealed 42 benign and 8 malignant lesions. FNAC was able to correctly pick 41 benign lesions, while 2 cases of benign lesion turned out to be malignant on histopathology [False negative].Out of total 8 cases which turned out to be malignant on histopathology, FNAC was able to pick 6 cases, while one benign lesion was misdiagnosed as malignant [false positive]. The analysis of study showed a sensitivity of 75% and specificity 97.6% of FNAC in detecting malignancy in solitary thyroid nodule. This study concluded that FNAC is highly effective in detecting thyroid malignancy in solitary thyroid nodule with a sensitivity of 75% and specificity of 97.6%

Hirschsprungs disease; modified duhamel [martin modification], a procedure of choice [a study at Sheikh Zayed Hospital Rahim Yar Khan

Hirschsprung's Disease is one of the most common congenital anomalies that Pediatric Surgeons manage. In spite of the various modifications of pull through procedures available, the long term functional results are less than ideal. However, Modified Duhamel Procedure is one which has relatively good functional results and that is the reason we have selected this procedure for Hirschsprung's disease in Sheikh Zayed Hospital, Rahim Yar Khan. To evaluate the outcome of patients after Modified Duhamel Procedure for Hirschsprung's Disease. This is case series study. Department of Pediatric Surgery Sheikh Zayed Medical College/ Hospital Rahim Yar Khan. Seventeen cases were studied over a period of two year i.e. from November 2006 to December, 2008. Seventeen [1 7] cases from both sexes were operated for Hirschsprung's Disease over a period of one year and Modified Duhamel Procedure was adopted for all these cases. All patients were diagnosed cases of rectosigmoidal aganglionosis and follow up was done over a period of one year according to a comprehensive Proforma. Four parameters like normal stool evacuation, abdominal distension, soiling and stool incontinence were followed and then the results were compared with other national and international studies. Fever 19.4% [n=04], wound infection 19.4% [n=04], vomiting 9.52% [n=02], abdominal distension 4.76% [n=01], and bleeding per rectum 4.76% [n=01], were the immediate post operative complications. Fourteen patients [82.35%], used to pass stool once daily. Abdominal distension was observed occasionally in six patients [28.57%]. Soiling was seen in five patients [29.41%]. Out of Seventeen, stool incontinence was seen in only three patients [1 7.64%]. Modified Duhamel Procedure with the help of linear cutter stapler device is quite safe, easy and less time consuming. Infact Modified Duhamel is a procedure of choice for Hirschsprung's Disease

Growth of albizia lebbeck [L.] Benth, and leucaena leucocephala [LAM.] De-wit, in different soil compositions of karachi university campus soil

The growth of Albizia lebbeck [L.] Benth, and Leucaena leucocephala [Lam] de-Wit, were studied in soils collected from Karachi University area under natural ecological circumstances. Various growth variables of A. lebbeck and L. leucocephala were reduced from different soil composition [25, 50 and 75%] of Karachi University soil [sandy soil] as compared to Garden soil. Growth of L. leucocephala in comparison of A. lebbeck was significantly decreased in all of the proportions of University soil. 50% University soil caused diminution in a large number of growth parameters of A. lebbeck, particularly considerable inhibition was observed in plant height, plant cover, seedling length, root length, shoot length, leaf area, shoot dry weight and total plant dry weights than Garden soil. 75% soil markedly retarded leaves growth and leaflets numbers, whereas root and leaf dry weights were substantially lessened by 50 and 75% soils. Root/shoot ratio and leaf weight ratio were manifestly stunted in the treatment of 25% soil. In the case of L. leucocephala, almost cumulative growth properties except shoot dry weight were depleted using all ratios of University soil comparatively to Garden soil. 75% University soil especially showed more pronounced declination in plant height, plant cover, numbers of leaves and leaflets, leaf area, root, leaf and total plant dry weights, root/shoot, leaf weight and leaf area ratios of L. leucocephala as related to Garden soil. 25% soil exhibited appreciably regretting growth in root, shoot and seedling length while, specific leaf area was adversely affected from application of 50% soil

Peltophorum pterocarpum [DC.] Baker ex K. Heyne growth in soils of Korangi and Landhi Industrial areas of Karachi, Pakistan

The growth of Peltophorum pterocarpum [DC.] Baker ex K. Heyne were studied in soils collected from Khan Towel, Tanveer Garment, One Tech Rubber and One Tech Ply Board factories in the vicinity of Korangi and Landhi industrial areas under natural environmental conditions. Various growth variables of P. pterocarpum were reduced from industrial areas soils particularly of One Tech Rubber factory soil exhibited decrease in many plant growth parameters than a control soil of Karachi University Campus. Reduction was pronounced in plant height, leaves numbers, plant cover, leaflets numbers, leaf area and dry weights of root, shoot, leaf and total plant in One Tech Rubber factory soil as compared to University soil. Tanveer Garment factory soil inhibited apparently shoot, seedling length, specific leaf area and leaf area ratio while root length and root/shoot ratio was retarded by One Tech Ply Board factory soil. Khan Towel factory soil stunted the root/shoot ratio of P. pterocarpum as correlated to University soil

Body ache and pain in school children associated with school bag carriage in Multan - Pakistan

In Pakistan anecdotal evidence of shoulder, back pain in school children is alarming but no scientific studies have been carried out yet. This study was carried out to find out any association between pain and school bag carriage in students, since almost all school management including public and private in Pakistan putting extra loads on the children in the form of heavy school bags. Children and in the phase of growth and development. So there is continuous endanger of growth and developmental retardation due to growth due to pulling heavy school bags load not only but also some sort of body aches and pains occur. This study was carried at four different schools in Multan. Schools were selected by convenience sampling. Two hundred children between the ages of 11 and 14 years correctly filled out a questionnaire with open ended and closed ended questions. Each child also had his/her body and bag weight measures. In this study, most of the children experienced shoulder and a combination of shoulder and other bodily pain. The majority of the children carried school bags over two shoulders. The type of bag carried was significantly related to pain experienced. A significantly larger number of female students experienced pain. The shoulder and other bodily pain experienced by the students are strongly related to the type of bag and the gender of the children