Traditional knowledge about medicinal plant in the remote areas of Wari Tehsil, Dir Upper, Pakistan / Conhecimento tradicional sobre plantas medicinais nas áreas remotas de Wari Tehsil, Dir Upper, Paquistão

Abstract Traditional medicine is cheaper and easily available to local people, to care for most frequent diseases in the Northern parts of Pakistan. Our study aimed at inventorying medicine from local plants, documenting their uses, and assessing their market value in 2015-2018 during spring, summer, and winter seasons. A total of 15 trips were made, 5 in each season. Semi-structured interviews with 165 inhabitant's age range between 20-80 years were conducted, analyzed the data is analyzed using Relative frequency of citation(RFC), Use Value(UV), Fidelity Level(FL), Informants consensus factor(ICF), and Jaccard index(JI) to find the most frequent and well-known used species in the area. A total of 86 species belonging to 39 vascular plant families, 33 genera were documented as medicinally important. Family Asteraceae was observed as the dominant family among all the families with 10 species, the leaf was the most used parts and decoction 36% was the most preferred preparation type. Herb was the predominant life form (67%). The maximum UV (0.92) was demonstrated by J. adhatoda L. species, while A. sativum L. shows maximum RFC (0.58), the highest ICF value represented by diarrhea and dermatitis 0.92, and high FL value is recorded 100%. According to our collections, wild species were 45%, invasive species were 38% and cultivated 17% recorded, dicots species were recorded more 81%. Seven 7 medicinal species is being economically important and export to the local and international market of the world, whereas P. integrima L. species were the most exported species according to the local dealers. The investigated area is rural and the local people depend on the area's plants for their health needs, and other uses like a vegetable, fuelwood, fodder, etc. The current result of RFC, UV, ICF, FL, and JI shows that medicinal flora needs to be pharmacologically and phytochemically investigated to prove their efficacy. The documentation of medicinal knowledge is important to preserve this precious old knowledge before it is lost forever, due to technological and environmental changes in the world.

Resumo A medicina tradicional é mais barata e facilmente disponível à população local para cuidar das doenças mais frequentes nas áreas do norte do Paquistão. Nosso estudo teve como objetivo inventariar medicamentos de plantas locais, documentar seus usos e avaliar seu valor de mercado em 2015-2018 durante as temporadas de primavera, verão e inverno. Foram feitas 15 viagens, 5 em cada temporada. Foram realizadas entrevistas semiestruturadas com 165 moradores na faixa etária de 20 a 80 anos, com dados analisados ​​por meio de frequência relativa de citação (RFC), valor de uso (UV), nível de fidelidade (FL), fator de consenso de informantes (CIF), e o índice de Jaccard (JI) para encontrar as espécies utilizadas mais frequentes e conhecidas na área. Um total de 86 espécies pertencentes a 39 famílias de plantas vasculares, 33 gêneros foram documentados como medicamente importantes. A família Asteraceae foi observada como a família dominante entre todas as famílias com 10 espécies, a folha foi a parte mais utilizada e a decocção 36% foi o tipo de preparação mais preferido. A erva foi a forma de vida predominante (67%). O UV máximo (0,92) foi demonstrado pelas espécies de J. adhatoda L., enquanto A. sativum L. mostra RFC máximo (0,58), o maior valor de ICF representado por diarreia e dermatite 0,92, e alto valor de FL é registrado 100%. De acordo com nossas coleções, as espécies selvagens foram 45%, as espécies invasoras 38% e as cultivadas 17% registradas, as espécies dicotiledôneas foram registradas mais 81%. Sete espécies medicinais estão sendo economicamente importantes e exportadas para o mercado local e internacional do mundo, enquanto as espécies de P. integrima L. foram as espécies mais exportadas de acordo com os comerciantes locais. A área investigada é rural e a população local depende das plantas da área para suas necessidades de saúde e outros usos como vegetal, lenha, forragem etc. O resultado atual de RFC, UV, ICF, FL e JI mostra que a flora medicinal precisa ser investigada farmacológica e fitoquimicamente para comprovar sua eficácia. A documentação do conhecimento medicinal é importante para preservar esse precioso conhecimento antigo antes que se perca para sempre, devido às mudanças tecnológicas e ambientais do mundo.

Traditional knowledge about medicinal plant in the remote areas of Wari Tehsil, Dir Upper, Pakistan

Abstract Traditional medicine is cheaper and easily available to local people, to care for most frequent diseases in the Northern parts of Pakistan. Our study aimed at inventorying medicine from local plants, documenting their uses, and assessing their market value in 2015-2018 during spring, summer, and winter seasons. A total of 15 trips were made, 5 in each season. Semi-structured interviews with 165 inhabitants age range between 20-80 years were conducted, analyzed the data is analyzed using Relative frequency of citation(RFC), Use Value(UV), Fidelity Level(FL), Informants consensus factor(ICF), and Jaccard index(JI) to find the most frequent and well-known used species in the area. A total of 86 species belonging to 39 vascular plant families, 33 genera were documented as medicinally important. Family Asteraceae was observed as the dominant family among all the families with 10 species, the leaf was the most used parts and decoction 36% was the most preferred preparation type. Herb was the predominant life form (67%). The maximum UV (0.92) was demonstrated by J. adhatoda L. species, while A. sativum L. shows maximum RFC (0.58), the highest ICF value represented by diarrhea and dermatitis 0.92, and high FL value is recorded 100%. According to our collections, wild species were 45%, invasive species were 38% and cultivated 17% recorded, dicots species were recorded more 81%. Seven 7 medicinal species is being economically important and export to the local and international market of the world, whereas P. integrima L. species were the most exported species according to the local dealers. The investigated area is rural and the local people depend on the area's plants for their health needs, and other uses like a vegetable, fuelwood, fodder, etc. The current result of RFC, UV, ICF, FL, and JI shows that medicinal flora needs to be pharmacologically and phytochemically investigated to prove their efficacy. The documentation of medicinal knowledge is important to preserve this precious old knowledge before it is lost forever, due to technological and environmental changes in the world.

Resumo A medicina tradicional é mais barata e facilmente disponível à população local para cuidar das doenças mais frequentes nas áreas do norte do Paquistão. Nosso estudo teve como objetivo inventariar medicamentos de plantas locais, documentar seus usos e avaliar seu valor de mercado em 2015-2018 durante as temporadas de primavera, verão e inverno. Foram feitas 15 viagens, 5 em cada temporada. Foram realizadas entrevistas semiestruturadas com 165 moradores na faixa etária de 20 a 80 anos, com dados analisados por meio de frequência relativa de citação (RFC), valor de uso (UV), nível de fidelidade (FL), fator de consenso de informantes (CIF), e o índice de Jaccard (JI) para encontrar as espécies utilizadas mais frequentes e conhecidas na área. Um total de 86 espécies pertencentes a 39 famílias de plantas vasculares, 33 gêneros foram documentados como medicamente importantes. A família Asteraceae foi observada como a família dominante entre todas as famílias com 10 espécies, a folha foi a parte mais utilizada e a decocção 36% foi o tipo de preparação mais preferido. A erva foi a forma de vida predominante (67%). O UV máximo (0,92) foi demonstrado pelas espécies de J. adhatoda L., enquanto A. sativum L. mostra RFC máximo (0,58), o maior valor de ICF representado por diarreia e dermatite 0,92, e alto valor de FL é registrado 100%. De acordo com nossas coleções, as espécies selvagens foram 45%, as espécies invasoras 38% e as cultivadas 17% registradas, as espécies dicotiledôneas foram registradas mais 81%. Sete espécies medicinais estão sendo economicamente importantes e exportadas para o mercado local e internacional do mundo, enquanto as espécies de P. integrima L. foram as espécies mais exportadas de acordo com os comerciantes locais. A área investigada é rural e a população local depende das plantas da área para suas necessidades de saúde e outros usos como vegetal, lenha, forragem etc. O resultado atual de RFC, UV, ICF, FL e JI mostra que a flora medicinal precisa ser investigada farmacológica e fitoquimicamente para comprovar sua eficácia. A documentação do conhecimento medicinal é importante para preservar esse precioso conhecimento antigo antes que se perca para sempre, devido às mudanças tecnológicas e ambientais do mundo.

Effect of Solvents Fractions of Cucurbita maxima Cuticular Lipids on Metabolic Biomarkers of Cardiovascular Disease

This study was aimed at studying the effect of solvents (n-hexane, chloroform and methanol) fractions of Cucurbita maxima (pumpkin) cuticular lipids on metabolic biomarkers of cardiovascular disease using L-NAME induced hypertensive rats. A total of thirty-six (120-150 g) albino rats were randomly selected and placed into twelve groups of three rats each were used for this study. Each rat was weighed and tagged and thereafter weighed weekly for five weeks of the experiment. Rats were induced with hypertension using 40mg/Kg body weight/24hours. Other rats were placed on normal feeds and water while biomarkers were assayed and recorded on weekly basis. Group I served as normal control, Group II were hypertensive control, Group III were induced with hypertension and administered with standard drug while Groups IV-XII were induced with hypertension and administered with varying doses of n-hexane, chloroform and methanol fractions. A slight alteration on metabolic biomarkers between the normal control group and hypertensive control group was recorded, which was reversed by the administration of methanol fraction. Thus, cuticular lipids from Cucurbita maxima might have some anti-hypertensive potentials.

Nutritional Contents of Two Varieties of Sweet Potatoes (Ipomoea batatas (L.) Lam ) Cultivated IN North Western Nigeria

Background and Objectives: Food shortages and nutritional imbalances are among the main food security problems in many countries around the world. In this study, the nutrients content of the yellow and red-fleshed sweet potatoes varieties cultivated in Nigeria were assessed. Materials and Methods: The proximate composition, mineral elements analysis, phytochemicals, and vitamins content of the red and yellow-fleshed sweet potatoes were determined using the standard methods of analysis. Results: The proximate analysis has shown that, the moisture (17.927%) and fat (2.703%) content of the yellow sweet potato were significantly (p<0.05) higher than in the red potato with a content of 16.68% and 1.693% respectively. The protein and fiber content of the red potato are 14.280% and 14.572% respectively, this is quite higher than in the yellow cultivar having 12.987% and 10.443% of the nutrients respectively. The ash and carbohydrate content were same in both. The red potato exhibits high level of sodium (11.420 mg/l), potassium (1.206 mg/l), and magnesium (8.468 mg/l) in contrast to the red potato containing 10.270 mg/l, 1.035 mg/l and 6.127 mg/l of the respective elements. Iron and zinc content were comparable in both cultivars while the calcium content (1.444 mg/l) of the yellow cultivar is significantly higher than in the red variety (1.144 mg/l). The vitamin A, B and E content of the red potato are 8.740 µmol/L, 2.977 mg/dl, and 13.267 mg/dl respectively. These values are significantly (p<0.05) higher than in the yellow potato containing 6.047 µmol/L, 1.680 mg/dl, and 11.110 mg/dl of the respective vitamins. There is no significant difference with respect to the vitamin C content of both yellow (11.850 mg/dl) and red potato (12.520 mg/dl). The phytochemicals: tannins, flavonoids, phenols, terpenes, and anthocyanins content of the red sweet potato are 0.967 mg/g, 1.577 mg/g, 1.867 mg/g, 6.590 mg/g and 2.660 mg/g respectively. Terpenes and anthocyanins were not found in the yellow cultivar. However, saponins (0.823 mg/g) were found in the yellow variety but not in the red potato. Amount of the tannins, flavonoids and phenols observed in the yellow-fleshed potato are 0.667 mg/g, 1.027 mg/g and 1.287 mg/g respectively. These values are lower than in the corresponding red potato. Conclusion: In this study, the nutritional contents of sweet potato varieties have been assessed which will immensely contribute to reducing the menace of malnutrition bedeviling the Northwestern part of Nigeria.

Correlation Analysis of Toxic Metals Distribution and Pollution Indices in Soil, Beans and Maize Samples of Kano State, Nigeria

Correlational study and evaluation of pollution indices of toxic metals distribution in soil and crops of a population are imperative for assessing the risk of chronic diseases associated with these metals. Correlational analysis for the distribution of; lead (Pb), cadmium (Cd), chromium (Cr) and mercury (Hg) in soil (S), bean (B) and maize (M) was conducted around Bunkure (BKR), Danbatta (DBT), Gwarzo (GRZ), Ungogo (UGG) and Wudil (WDL) as sampling zones around Kano State, Nigeria. The samples were collected from farm harvests in each of the sampling zones. The metal concentration was determined using atomic absorption spectrometry (AAS). Results in mg/kg across the local governments indicate respective ranges for Hg, Pb, Cd, and Cr of; 0.33 - 3.13, 0.14 - 0.84, 0.02 - 0.05 and 0.01- 0.49 in soil, 0.04-4.23, 0.06-0.23, 0.02-0.04 and 0.00-0.10 in maize and 0.20-4.23, 0.16-0.19, 0.03-0.04 and 0.00-0.03 in beans. Although with the exception of mercury, the ranges of the toxic metals are within the tolerable range set by International Standard Tolerable Limits and European Regulatory Standard. Potential hazard may be speculated because the detected levels are on higher tolerable ranges. A higher level of mercury in almost all the samples indicates potential hazards associated with human activities in those areas. A strong positive correlation between soils samples in respect to the level of some of the toxic metal may suggest a common nature of the soil, while the negative correlation may be due to variation in agrochemicals in-use. For the pollution load index, Wudil had the highest soil pollution load index for Hg (3.13 ± 0.16), Cd (1.6×10-2 ± 0.01) and Cr (4.9×10-3 ± 0.01), while Ungogo had the highest pollution load for Pb. Also, all grains within the study zones exhibited a positive transfer factor, except Cr in Bunkure, Danbatta and Gwarzo. It may be concluded that crops grown in those areas may bioaccumulate some of these toxic metals, thereby incorporating them into the food chain, hence potential health risk.

Poverty-associated emerging infection of Cystic Echinococcosis in population of Northern Pakistan: A hospital based study

@#Cystic Echinococcosis (CE) is one of the most important zoonotic parasitic diseases in human, livestock, and wildlife globally. The prevalence of CE depends upon human behavioral risk factors, the diversity and ecology of animal host interactions and the genetic diversity within Echinococcus species which differ in their zoonotic potential and pathogenicity. It is a neglected, economic and socio-cultural problem in Pakistan. The available data about the incidence of CE is very limited and no extensive study has been reported in Pakistan. The current study was aimed to analyze the hospital reported cases of CE and the associated risk factors related to the incidence of CE. The hospital-based data of CE for the time period of January 2012-December 2017 was collected from Islamabad, Rawalpindi and Peshawar. The data covered demographic characteristics including age, gender, and cyst localization of infected individuals and socioeconomic determinants. The data was analyzed based upon different risk factors along with the different socioeconomic parameters that has an important impact on the distribution of disease. A total of 228 cases were presented in the selected hospitals of different cities during the study period. Out of total 228 patients, 59.21% were males and 40.78% were females (P<0.001). Most infections have been recorded in young adults (>20-30) showing 22.8% of total infected individuals followed by children (0-10) showing 10.5% (n=24), respectively (P<0.001). Liver was the most vulnerable organ (58.77%, n=134) followed by lungs (14.47%, n=33) (P<0.001). The infection was higher among rural communities (84.2%) than urban (12.8%) (P<0.001). Socioeconomic and demographic factors had an important impact on the intensity of disease (P<0.001). The occurrence of cases in children and young adults was an important finding as it indicated an active transmission of the parasite in Pakistan along with the poverty index. Emergence of echinococcosis in Pakistan showed that emerging health issues in Pakistan could bring the disease to limelight for future research. This finding, together with the fact that 1 hospital reported 214 cases over 6 years 325 underlines the need for a program for prevention/control of this disease in Pakistan. The timely measure needs to be taken to hamper the disease development and establishment. In order to control the disease, complete surveillance should be done which in turn weighs down the disease progress.

In vitro antiplasmodial and antioxidant activities of bisbenzylisoquinoline alkaloids from Alseodaphne corneri Kosterm

Objective: To study antiplasmodial and antioxidant activities of the isolation of alkaloids from the active dichloromethane extract of Alseodaphne corneri. Methods: Phytochemical studies of the crude extract led to the isolation of six alkaloids using recycle high performance liquid chromatography and preparative thin layer chromatography. The antiplasmodial activity of the isolated compounds was evaluated using the histidine-rich protein II assay. The isolated alkaloids were also tested for their antioxidant activity using three different assays; DPPH, ferric reducing ability of plasma and metal chelating assays. Results: Malaria infection caused the formation of free radicals which subsequently led to oxidative stress and apoptosis. The antioxidant properties of the alkaloids under investigation revealed that in addition to the antiplasmodial activity, the alkaloids could also prevent oxidative stress. (+)-laurotetanine and (+)-norstephasubine exhibited strong antiplasmodial activities with IC

In vitro antiplasmodial and antioxidant activities of bisbenzylisoquinoline alkaloids from Alseodaphne corneri Kosterm

OBJECTIVE@#To study antiplasmodial and antioxidant activities of the isolation of alkaloids from the active dichloromethane extract of Alseodaphne corneri.@*METHODS@#Phytochemical studies of the crude extract led to the isolation of six alkaloids using recycle high performance liquid chromatography and preparative thin layer chromatography. The antiplasmodial activity of the isolated compounds was evaluated using the histidine-rich protein II assay. The isolated alkaloids were also tested for their antioxidant activity using three different assays; DPPH, ferric reducing ability of plasma and metal chelating assays.@*RESULTS@#Malaria infection caused the formation of free radicals which subsequently led to oxidative stress and apoptosis. The antioxidant properties of the alkaloids under investigation revealed that in addition to the antiplasmodial activity, the alkaloids could also prevent oxidative stress. (+)-laurotetanine and (+)-norstephasubine exhibited strong antiplasmodial activities with IC50 values of 0.189 and 0.116 μM, respectively.@*CONCLUSIONS@#Interestingly, the two most potent compounds that exhibit antiplasmodial activity also exhibit good antioxidant activities. The crude dichloromethane extract and the isolated compounds exert substantial antiplasmodial and antioxidative activities which in turn suppress oxidative stress and cause less damage to the host.

Therapeutic Implication of Terfezia claveryi Extract on Corneal Ulcer of Rabbit’s Eye.

Aims: The aim of this study was to investigate the antimicrobial activity of Terfezia claveryi crude extract on induced corneal ulcer in rabbit’s eye. Study Design: Study was carried out in Rabbits eye. Place and Duration of the Study: This study was conducted in the experimental laboratories at College of Applied Medical Sciences of Qassim University during the period from March to June 2013. Methodology: Crude aqueous extract of this truffle, in different concentrations, was introduced through intraperitoneal injection to rabbits for their safety dose. Corneal epithelial wound was induced in different groups of rabbit’s eye with sodium hydroxide and later this wound was contaminated with some selected bacteria like Staphylococcus aureus and Escherchia coli to produce iatrogenic infection. The healing power of different concentrations of T. claveryi crude extract was observed by different clinical findings. Results: We observed that 1.5% crude extract of this desert truffle significantly healed the corneal ulcer almost within 9 days. Delayed response in healing was observed with 3% T. claveryi, while 5% extract developed some extra corneal complications. The healing response of corneal ulcer to topical application of different concentrations of T. claveryi extract was compared with a synthetic antibiotic (Vigamox 0.5%) as a reference standard drug. Conclusion: It was concluded that aqueous extract of T. claveryi has no significant toxic effects against liver and kidney function parameters. The antibacterial activity of this desert truffle recommends as an alternative medicine for some corneal infections. However, the therapeutic role of some specific ingredients present in this truffle needs further investigations.

Formulation and in-vitro bioequivalence evaluation of verapamil hydrochloride matrix tablets with Calan SR.

The purpose of the current work was to formulate Verapamil Hydrochloride (VH) sustained release matrix tablets by using natural polymers and comparison with leading national brand Calan SR of Searle Pharmaceuticals. Tragacanth and pectin were used in various concentrations. Pre compression studies i.e. angle of repose, bulk density, tapped density, Carr’s compressibility index and Hausner’s ratio were also performed and found within the Pharmacopoeial limits. Eight formulations (F1-F8) of (VH) were prepared by direct compression method. Post compression studies i.e. Thickness, Hardness, Diameter, Friability and Dissolution studies were conducted. Different kinetic models i.e. zero order, first order, Highuchi model and Korsmeyer Peppas were applied to study release patterns and similarity index was calculated. Dissolution studies were carried out in phosphate buffer of pH 6.8 showed that formulations (F4 and F8) formulated with higher polymers concentration showed comparatively better drug retardation. F5 was the most comparable with the reference product. Verapamil hydrochloride released was observed non-fickian as diffusion following Higuchi model.

Formulation and in-vitro bioequivalence evaluation of verapamil hydrochloride matrix tablets with Calan R.

The purpose of the current work was to formulate Verapamil Hydrochloride (VH) sustained release matrix tablets by using natural polymers and comparison with leading national brand Calan SR of Searle Pharmaceuticals. Tragacanth and pectin were used in various concentrations. Pre compression studies i.e. angle of repose, bulk density, tapped density, Carr’s compressibility index and Hausner’s ratio were also performed and found within the Pharmacopoeial limits. Eight formulations (F1-F8) of (VH) were prepared by direct compression method. Post compression studies i.e. Thickness, Hardness, Diameter, Friability and Dissolution studies were conducted. Different kinetic models i.e. zero order, first order, Highuchi model and Korsmeyer Peppas were applied to study release patterns and similarity index was calculated. Dissolution studies were carried out in phosphate buffer of pH 6.8 showed that formulations (F4 and F8) formulated with higher polymers concentration showed comparatively better drug retardation. F5 was the most comparable with the reference product. Verapamil hydrochloride released was observed non-fickian as diffusion following Higuchi model.

GC-MS analysis and antifungal activity from galls of Guiera senegalensis J F Gmel (Combretaceae).

Guiera senegalensis is a well known medicinal plant which is used as a drug in Burkina Faso. The aim of this study was to investigate the chemical composition and antifungal activity from galls of Guiera senegalensis against different kinds of fungi in vitro. The chemical composition of the Guiera senegalensis volatile compounds obtained from the galls was analysed using gas chromatograph (GC)-flame ionization detectors (FID) and GC-MS. Thirteen (13) components were identified for hexane-acetone (50:50) column fraction of hydroacetone extract and twenty one (21) compounds for hexane-acetone (50:50) column fraction of aqueous decoction extract. This composition differed according to the kind of extract. The ethyl acetate fraction extract from hydroacetone extract (EAF/HAE) exhibited the highest of flavonol content (0.56 ± 0.01 mg QE/100 mg of fraction). The G senegalensis exhibited an interesting antifungal activity against all strains tested.

Incidence and risk factors of bacteria causing infectious keratitis

To study the incidence and risk factors of the bacteria causing infectious keratitis among patients in Qassim province of Saudi Arabia. This is a cross sectional study conducted at the Department of Optometry, College of Applied Medical Sciences, Qassim University, Qassim, Kingdom of Saudi Arabia from December 2010 to May 2011. One hundred patients suspected of keratitis were subjected to clinical examinations. A total of 115 corneal swabs from these cases were collected under aseptic conditions for bacteriological examinations. Culture of the corneal swabs revealed Pseudomonas aeruginosa [25.2%], Staphylococcus aureus [15.7%], and unclassified bacteria [13.9%]. However, 52 swabs of infectious keratitis cases [45.2%] were negative to bacteria. Contact lens wearing [44.4%] was the most common risk factor among the examined patients, followed by corneal trauma [21.7%], ocular surface disease [11.3%], and corneal surgery [7%]. No significant correlation was observed between systemic risk factor and clinical presentation. It could be concluded that infectious keratitis was mostly due to Pseudomonas aeruginosa and Staphylococcus aureus. Therefore, strict measures are recommended to control and treat infectious keratitis to avoid visual complications

p53 expression in synovial sarcoma and its association with prognostic factors.

Background: Synovial sarcoma is an aggressive tumor and has two common histological subtype, biphasic and monophasic. It has SYT-SSX gene fusion that decreases expression of p53 tumor suppressor. The prognosis is associated with mitosis and tumor diameter. Therefore this study conducted to know the pattern of p53 expresion and its association with mitosis, histological subtype, and other prognosis factors. Methods: Twenty synovial sarcoma cases consisted of 4 monophasic and 16 biphasic cases from Cipto Mangunkusumo Hospital – Faculty of Medicine, Universitas Indonesia (CMHospital-FMUI) 2005-2011 were analyzed for association of p53 expression and mitosis as prognostic factor. Haematoxylin-eosin slides were used to count mitosis. Paraffin block materials were used to analyze p53 expression by immunohistochemistry and to detect SYT gene translocation by FISH (Fluorescein in situ Hybridization). Results: The Fisher’s exact test showed that positive p53 expression was associated with tumor diameter <5 cm although it was not associated with mitosis. The histological subtype has no association with p53 expression and mitosis. Unfortunately, only 7/19 cases were positive for FISH-SYT gene translocation. Conclusion: In synovial sarcoma, p53 expression is associated with tumor diameter.

Management of appendiceal abscess. a 10-year experience in central Saudi Arabia

To study the outcome of patients with appendiceal abscess [AA] following immediate operative and non-operative management in terms of complications and hospital stay. Medical records of all adult patients treated for AA between July 2002 and June 2011 in the Department of Surgery, King Saud Medical City, Riyadh, Kingdom of Saudi Arabia were reviewed. We identified 2 main groups of patients with the diagnosis of AA. The first group of patients were managed by CT-guided percutaneous drainage and parenteral antibiotics [non-operative management [NOM group]]. The second group were patients who underwent surgical intervention [operative management [OM]]. The outcome was determined in terms of complications, recurrence rate, and hospital stay. Eighty AA patients were managed during the study period. Forty-two patients [52.5%] received NOM, while 38 patients [47.5%] underwent immediate OM. The complication rate was significantly higher in the OM group compared with the NOM group [44.7% versus 11.9%; p=0.0012]. Successful NOM was achieved in 92.8% of patients. The overall mean hospital stay of the NOM group was 8.54 +/- 2.25, and the OM group was 10.86 +/- 4.32 days [p=0.003]. Non-operative management is associated with significantly lower complication rate and shorter hospital stay than OM

Polyclonal VDAC3 antibody decreases human sperm motility: a novel approach to male contraception.

Background: Voltage dependent anion channels (VDAC) mediate transport of anions, cations and ATP which play an important role in sperm motility. This study was aimed to examine the effect of polyclonal VDAC3 antiserum to human sperm motility. Methods: Polyclonal VDAC3 antiserum used in this study was produced in rabbits by immunization of VDAC3-specific synthetic peptides. Preimmunserum was collected before immunization and used for control experiment. Recognition of VDAC3 antiserum to antigen in human sperm was performed by western blot. Thirty sperm samples obtained from fertile men which had high quality of sperm motility were washed and collected by Percoll gradient. Sperm motility was assessed by means of evaluation of sperm velocity (seconds per 0.1 mm distance) and the number of unmoved sperm (million per ml) which were observed 0 minute, 30 minutes and 60 minutes after addition of VDAC3 antiserum and preimmunserum as a control. Both data were analyzed by SPSS 13.0 software. Results: VDAC3 antiserum recognized VDAC3 protein in human sperm. Statistical analysis demonstrated that there were increasing numbers of unmoved spermatozoa after addition of anti-VDAC3 antiserum in vitro for 60 minutes observation compared with preimmunserum (control). We found also that sperm velocity decreased signifi cantly after giving anti-VDAC3 antiserum in vitro for 0 minute, 30 minutes, and 60 minutes compared with pre-immunee serum (control). Conclusion: VDAC3 antiserum can decrease motility of human sperm. and may provide a novel principle of male contraception in the future.

Extraskeletal osteosarcoma, telangiectatic variant arising from the small bowel mesentery

Extraskeletal osteosarcoma [EOS] is a highly aggressive and rare malignant soft tissue tumor, characterized by the production of neoplastic osseous tissue without attachment to the bone or periosteum. It rarely involves the visceral organs. Only 3 cases of mesenteric EOS have been reported in English literature. Here, we describe a male patient of 40 years, who was diagnosed to have EOS arising from small bowel mesentery This patient presented with lower gastrointestinal [GI] bleeding. Upper GI endoscopy and colonoscopy were normal. Computed tomography scan demonstrated a well defined multi-loculated mixed density mass lesion measuring about 13x7x7 cm in lower abdomen adjacent to small bowel loops with liver metastasis. Palliative en bloc resection of tumor with adjacent small bowel was performed. The histopathology revealed a telangiectatic type osteosarcoma of mesentery. Diagnosis of EOS, its management and the outcome in context of the current literature are discussed

Operative management of liver trauma: a 10-year experience ib Riyadh, Saudi Arabia

To analyze our experience and the outcome of operative management of liver trauma, and to suggest ways to improve the management of such patients. This retrospective study was conducted on patients admitted with liver trauma to King Saud Medical Complex, Riyadh, Kingdom of Saudi Arabia between January 1997 and December 2006. Only patients who underwent operative management were included in this study. Sixty-four out of 138 patients with liver injury were treated surgically. Most of the patients were young [mean 29.4 years], and male [84%]. Fifty-six patients sustained blunt trauma. Eight patients had grade I, 17 had grade II, 21 had grade III, 12 had grade IV, and 6 patients had grade V liver injuries. Hepatorrhaphy [n=28] was the most common surgical technique used followed by peri-hepatic packing [n=12], simple hemostatic measures [n=9], and non-anatomical hepatic resections [n=8]. Laparotomy was non-therapeutic in 7 patients [11%]. Liver injury related morbidity was 19%, and mortality was 11%. Hepatorrhaphy was the most common surgical modality employed to control bleeding. Peri-hepatic packing was used in unstable patients. In 25% of patients, bleeding had either stopped from the injured liver or needed only simple hemostatic measures

Extremity vascular trauma. A 7-year experience in Lahore, Pakistan

To determine the outcome of various techniques of vascular repair in terms of repair related complications and limb salavagibility. From January 1999 to December 2005, this retrospective study was conducted in the Department of General Surgery, Lahore General Hospital, Lahore, Pakistan. The patients, who underwent various surgical interventions for extremity vascular trauma, were included in this study. Those, who underwent primary amputation due to non-salvageable injuries or who presented with late complications of vascular injuries were excluded. Ninety-three patients underwent different surgical procedures for extremity vascular trauma. Majority of the patients were young, mean, 29.4 years male 91.3%. Penetrating trauma was the most common mode of injury 77.4%. The median time interval between injury and repair was 4.5 hours. Superficial femoral artery was the most frequently injured artery 26.8%. Graft repair was carried out in 41 patients 46.6%, while 34.1% of the patients had end-to-end anastomosis. Wound infection was the most common complication 18.2%. Seven patients 7.5% had secondary amputations and 3 3.2% died from other injuries. Vascular reconstruction was successful in 89.3% of the patients. Early revascularization by employing simple repair or interposition autogenous vein graft repair results in successful limb salvage with acceptable complication rate

Evaluation of prognostic value of adhesion molecules in septic critically Ill patients

Septic shock is the most frequent cause of death in intensive care units. Despite major advances in antimicrobial therapy, critical care and surgical techniques, there has been little improvement in morbidity or mortality due to sepsis or septic shock. The aim of this study was to evaluate the role of vascular cell adhesion molecule-1 [VCAM-1] and intercellular adhesion molecule-1 [ICAM-1] in sepsis, septic shock, haemodynamic changes and outcome. Thirty intensive care unit patients suffering from sepsis with or without shock were subjected to blood culture, culture from the site of infection if possible, blood gases analysis, acute physiology and chronic health evaluation score [APACHE II] at baseline, multiple organ failure score on day one [MOF1], cummulative organ failure score [MOFC] on day 5, haemodynamic measurements, as well as serum VCAM-1 and ICAM-1 levels for 5 days after admission. Ten healthy control subjects were also included in the study. The most common site of infection was the chest, the isolates were mostly Gram negative [60%of cases], 9 patients [30%] had positive blood cultures. Serum ICAM-1 and VCAM-1 levels gradually increased from a baseline till day 5 of the study and were significantly higher in patients on admission [62 +/- 20.21, 404.67 +/- 130.85 ng/ml, respectively] than in the control group [14.0 +/- 4.71, 128.0 +/- 34.9 ng/ml respectively], [P=0.00]. They were higher in shocked than in non-shocked patients, and significantly so in non-survivors than in survivors and in patients with positive blood cultures than in those with negative blood cultures, throughout the study period [P=0.00]. A significant positive correlation was observed between serum ICAM-1 and VCAM-1 levels on one hand, and APACHE II as well as both organ failure scores for the 1st day or cumulative on the other hand. We conclude that these adhesion molecules could be measured in critically ill septic patients to predict prognosis and guide therapy