Antibacterial Effects of Cinnamon Extract, Clove Oil and Antibiotics against Helicobacter pylori Isolated from Stomach Biopsies

Abstract Helicobacter pylori is a pathogenic bacterium causing gastric problems such as, peptic ulcers and stomach cancer. H. pylori were isolated from the stomach biopsy specimens (n = 100) of gastric patients by performing polymerase chain reaction (PCR) against cagA (cytotoxin associated gene A) and ureC (Urease subunit alpha) genes. Furthermore, antibiogram studies of the H. pylori isolates were evaluated against the common antibiotics. The overall detection rate of H. pylori was 71% in biopsy specimens of gastric patients. The antimicrobial susceptibility test revealed the resistance rate of H. pylori isolates against metronidazole (50%), clarithromycin (28.33%), tetracycline (21.66%), amoxicillin (18.33%), and ciprofloxacin (11.66%). However, the H. pylori isolates were completely resistant to vancomycin, erythromycin and nalidixic acid antibiotics. Clove oil showed a remarkable antimicrobial effect against H. pylori whereas, mild inhibition (10 mm) was observed in case of curcumin extract. Due to increase incident of resistance and high prevalence of H. pylori in gastric patients, natural antimicrobial like clove oil can be explored as an alternative treatment.

Abdominal myomectomy and its morbidity

Background: Abdominal myomectomy has classically been viewed as a procedure associated with high intra operative and postoperative morbidity. This study was designed to review the experience with abdominal myomectomy and to assess morbidity associated with the procedure

Methodology: This study was conducted at Azad Jammu and Kashmir Medical College, Muzaffarabad. The hospital records of 116 women who underwent abdominal myomectomies from January 2012 to December 2016 were reviewed retrospectively. Particular attention was paid to blood loss and the febrile conditions. Blood loss was reckoned from surgeons' operative notes. It was calculated by subtracting total irrigation fluid used from the total amount of fluid in the suction, the suction container at the end of surgery, then adding the amount of blood on the sponges, determined by weight. Ethical approval for article was obtained from Hospital Ethical Committee. The data collected was analyzed using SPSS-17. Chi-square test was applied and p<0.05 was taken as statistically significant

Results: The mean estimated intraoperative blood loss was [320+/-25 ml]. Three [2.6%] had an estimated blood loss >1,000 ml and 1 [0.9%] had estimated blood loss of >1,500 ml. Febrile morbidity occurred in 26 [22.5%] patients, wound infection in 6 [5.3%], haemorrhage in 3 [2.7%] patients, and postoperative antibiotics were used in 66 [56.9%] cases. There was no re-admission and no mortality associated with the procedure

Conclusion: Myomectomy may be an attractive alternative to hysterectomy in selected women with uterine leiomyomata, with an added advantage of preservation of women's sexual and reproductive functions. Women with very large uterine size should not be denied this procedure for safety concerns

Comparison of 23 gauge transconjunctival releasable suture vitrectomy with standard 20 gauge vitrectomy

Objective: To compare effectiveness of releasable transconjunctival sutures in 23 gauge vitrectomy and standard 20 gauge vitrectomy

Methods: This prospective comparative study was conducted in Department of Vitreoretinal Surgery, Al Ehsan Eye Hospital, Lahore from June 2016 to March 2017. It included 84 patients in total [Group-A: 42 patients underwent 23 gauge releasable suture vitrectomy; Group-B: 42 patients who underwent standard 20 gauge vitrectomy]. Pre operative and post operative best corrected visual acuity, surgical duration, pre and post operative intraocular pressure and complication profile was compared between two groups

Results: The leading cause for vitrectomy was vitreous haemorrhage. [Group-A; n=15 ;35.71%; Group-B; n=17; 40.47%]. There was statistically significant improvement in preoperative and postoperative BCVA in both groups [Group A: P-value < 0.05; Group B P-value < 0.05] but there was no significant difference in post operative BCVA between two groups at 3 months [P-value > 0.05]. Surgical time for 23G vitrectomy Group was statistically less than 20 G vitrectomy Group [51 +/-18 minutes for Group-A versus 78 +/- 13 minutes for Group-B; p-value < 0.05]. Visual analog score for pain / discomfort was also significantly less for Group-A than Group-B. There was no significant difference in intraocular pressures between the two groups

Conclusions: Releasable suture technique for small gauge vitrectomy is a safe and easily adaptable technique that has certain significant advantages over 20G absorbable suture vitrectomy

Supernumerary tooth: a common odontostomatologic anomaly of number of teeth

Supernumerary tooth [ST] is a developmental disturbance of number of teeth characterized by teeth present in excess of normal dental formula of deciduous or permanent dentition.[1, 2, 3, 4] It may occur in either dental arch, maxillary or mandibular.[5] Literature has shown marked predilection in maxilla over mandible.[6, 7] The first documented report of supernumerary teeth has been revealed in human fossils that are approximately 11,000 years old.[8]

giant asymptomatic submandibular salivary gland calculus reported at Bahria university dental hospital

Sialolithiasis is a common salivary gland disease which has highest predilection rate in submandibular followed by parotid and sublingual glands. It results in mechanical obstruction of the salivary gland duct. The unique anatomy of the submandibular gland duct facilitates the deposition of mineral salts and leads to the formation of stones. We are presenting a unique case of submandibular calculus which was completely asymptomatic. On 2[nd] day after a mandibular incisor tooth extraction, patient presented with some hard object in her mouth. The stone was removed intraorally through the duct opening under local anaesthesia

Frequency and pattern of removal of teeth in a sample of population of southern Punjab

Removal of non-restorable teeth is a routine cost-effective procedure. A cross-sectional study was conducted in the Department of Oral and Maxillofacial Surgery, Nishtar Institute of Dentistry, Multan, Pakistan from 1[st] April 2016 to 30[th] October 2016 to find out frequency and pattern of teeth removal in southern Punjab population. Both genders were included and causes of extraction were categorized. Chi square test applied to assess the significance of association. Two thousands and seventy two teeth were extracted from 1700 patients [786 male 45.2%, and 932 female 54.8%] presented to oral surgery department. Mean age of the sample was 40 +/- 15.01. A total of 1339 [64.6%] were extracted due to advanced dental caries, the leading cause of tooth extraction followed by periodontal disease 217 [10.5%]. Molars [45%] were most common teeth extracted. It was concluded that there was strong need for directing more financial resources to community awareness programs to prevent premature teeth loss

Frequency and shape of torus palatinus in relation to age and gender in karachi

Objective: The aim of this study was to determine the frequency and shape of torus palatinus and to assess its gender and age-related differences in the population of Karachi, the metropolitan city of Pakistan

Methodology: This was a cross sectional study with non-probability convenience sampling method conducted at Bahria University Medical and Dental College [BUMDC], Karachi. The presence of tori was observed by clinical examination and palpation. The shape was also investigated by presence or absence and classified as flat, spindle and nodular shaped tori. The data was analyzed by using Statistical Package for Social Science version 23. The Chi-square test was used to test for group differences of sex and age association with the prevalence of tori. Difference between groups with P <0.05 was considered significant

Results: A total of 1203 patients were screened in which torus palatinus was found in 141 [11.7%] patients. Present study findings showed torus palatinus was more prevalent in males 76 [53.9%]. It was dominant in 31-60 years of age group [47.5%] with significant P=0.000. Shapes of torus palatinus were compared with gender in which flat shape was more frequent in both male and female with significant P-value of 0.015

Conclusion: Torus Palatinus is a rare bony exostosis of the oral cavity. Even though, it is an asymptomatic anatomical variation it expresses itself in unique shapes and patterns. The prevalence varies with respect to age and gender

Frequency of Beta Thalassemia trait among the healthy individuals: a single centre study

Objective: To determine the frequency of beta thalassemia trait among the asymptomatic healthy individuals

Study Design: Cross sectional study

Place and Duration of Study: This was carried out at Pakistan Air Force [PAF] Hospital Lahore from Jan 2016 to Jun 2017

Patients and Methods: The subjects were both male and female who came from all over Pakistan for central medical board for selection in Pakistan Air Force. Their ages were between 18 and 28 years. Their complete blood counts were measured on Sysmex KX 21 hematology analyzer. Candidates with microcytic hypochromic indices without anaemia were screened for beta thalassemia trait. Haemoglobin [Hb] electrophoresis was done on cellulose acetate paper at alkaline PH. HbA2 estimation was done by measuring the absorbance of elute on spectrophotometer. Beta thalassemia was diagnosed if the subject had HbA2 more than 3.5 percent. The data was analyzed using statistical package for social sciences [SPSS] software version 17

Results: A total of 2279 individual were enrolled in the study. Among them 2061 [90.4 percent] were males and 218 [9.6 percent] were females. Out of 2061 males, 91 [4.41 percent] were found to have beta thalassemia trait whereas among females only 6 [2.75 percent] out of 218 had beta thalassemia trait. The overall frequency of beta thalassemia trait was found to be 4.25 percent

Conclusion: The overall frequency of beta thalassemia trait in our study was found to be 4.25 percent. Thalassemia screening should be carried out along with normal health screening tests at least once in lifetime

Frequency of hepatitis B and C virus among the healthyblood donors, a single centre study

Objective: To determine the frequency of hepatitis B and C virus among the healthy blood donors

Study Design: Cross sectional study

Place and Duration of study: This was carried out at Pakistan Air Force [PAF] Hospital Islamabad from January 2015 to April 2017

Patients and Methods: The blood donors were both male and female came from Islamabad and surroundings. A detailed medical history and examination was carried out by medical officer. All donors were provided questionnaire and consent Performa. The blood donors negative for previous history of viral hepatitis and other contraindications for blood donation were included in study. All donations were screened for HBV surface antigen [HBsAg] and anti-HCV antibodies by ELISA

Results: A total of 2185 healthy blood donors were enrolled. Out of them, 2137 [97.8%] were male and 48[2.2%] were female. In female donors, HBsAg was negative in all donors and anti-HCV antibodies was positive in 2[4.16%]. Whereas, in males HBsAg was positive in 34[1.59%] and anti-HCV antibodies was positive in 81[3.79%]

Conclusion: The prevalence of HCV among blood donors was high as compared to HBV. Hepatitis B and C are one of major sources of transfusion transmitted diseases. Prevention of transfusion transmitted diseases is possible with vigilant donor selection and strict screening process

Astroblastoma in a Young Female Patient: A Case Report and Literature Review of Clinicopathological, Radiological and Prognostic Characteristics and Current Treatment Strategies

Astroblastoma is an uncommon glial tumor with predominant manifestation in the young age. Herein, we report a case of 18-year-old astroblastoma female patient who presented with history of two months headache. Magnetic resonance imaging (MRI) of the brain demonstrated well circumscribed, intra-axial abnormal signal intensity lesion (size=5×4 cm²) in the right parieto-occipital region of the brain. The patient underwent complete surgical resection of the gross tumor, as confirmed by an early post-surgical MRI (i.e., within 24 hours of surgery). Histopathological examination revealed neoplastic lesion exhibiting perivascular pseudo-rosettes with centrally hyalinized blood vessel and focal nuclear pleomorphism. Immunohistochemistry staining illustrated reactivity for glial fibrillary acidic protein and integrase interactor 1 (INI-1). These features rendered the diagnosis of astroblastoma. A comprehensive review of the current literature to summarize the clinicopathological and radiological characteristics, prognostic factors and current treatment strategies of astroblastomas is also presented. Our study would expand the pool of this uncommon tumor towards its better understanding and optimal treatment.

Evaluation of albumin, fibrinogen levels with orthopedics traumatic patients' outcome after massive transfusion in tertiary care hospital at Peshawar

Objective: Objective of study was assessment of fibrinogen and albumin levels association with orthopedics traumatic patients' outcome who received massive transfusion

Study Design: Observational / cross sectional study

Place and Duration of Study: This study was carried out at orthopedic department of a tertiary care Hospital, Peshawar from March 2014 to July 2015

Materials and Methods: In all patients, the initial resuscitation was performed as soon as admitted to the emergency room. Blood samples were obtained at admission and after 24 h. Part of the serum was frozen and stored at -70°C for determination of fibrinogen and albumin by an immunoturbidometric assay. Electrolytes, hemoglobin, and hematocrit levels were measured on admission. For early restoration, normal saline or ringer was used, clinical events were recorded thereafter until death or hospital discharge

Result: We were studied forty six traumatic patients with severe limb injuries and result showed that 20 patient [41.3%] and 27 [58.7%] were alive

There was significant difference outcome observed in fibrinogen level after 24 h and in case of albumin levels, there was no significant difference observed

Conclusions: When orthopedics traumatic patients received massive transfusion, fibrinogen level play significant role in determination of these patients, while serum albumin is not important factor

cardiac electrical activity model based on a cellular automata system in comparison with neural network model

Cardiac Electrical Activity is commonly distributed into three dimensions of Cardiac Tissue [Myocardium] and evolves with duration of time. The indicator of heart diseases can occur randomly at any time of a day. Heart rate, conduction and each electrical activity during cardiac cycle should be monitor non-invasively for the assessment of "Action Potential" [regular] and "Arrhythmia" [irregular] rhythms. Many heart diseases can easily be examined through Automata model like Cellular Automata concepts. This paper deals with the different states of cardiac rhythms using cellular automata with the comparison of neural network also provides fast and highly effective stimulation for the contraction of cardiac muscles on the Atria in the result of genesis of electrical spark or wave. The specific formulated model named as "States of automaton Proposed Model for CEA [Cardiac Electrical Activity]" by using Cellular Automata Methodology is commonly shows the three states of cardiac tissues conduction phenomena [i] Resting [Relax and Excitable state], [ii] ARP [Excited but Absolutely refractory Phase i.e. Excited but not able to excite neighboring cells] [iii] RRP [Excited but Relatively Refractory Phase i.e. Excited and able to excite neighboring cells]. The result indicates most efficient modeling with few burden of computation and it is Action Potential during the pumping of blood in cardiac cycle

To determine frequency of cardiovascular complications in patients with thyroid disorder presenting at divisional head quarters hospital Mirpur Azad Kashmir

Objective: To determine frequency of cardiovascular complications in patients with thyroid disorder presenting at Divisional Head Quarters Hospital Mirpur Azad Kashmir

Study Design: A descriptive study

Place And Duration: This study was done at Kashmir Institute of Cardiology DHQ. Teaching Hospital Mirpur AJK, over 3 years from 1st January 2010 to 31st Dec 2012

Methodology: 103 consecutive patients with different Thyroid disorders were studied. Only lab confirmed patients whose Thyroid functions tests done were considered. All the values were computed using SPSS version 20. T3,T4 ,TSH were collected from each study participant

Results: Most of the patients were hyperthyroid .Tremors, palpitations, atrial fibrillation were observed as most common presenting symptoms followed by heart failure and dyspnoea. A high prevalence of Diabetes Mellitus and Ischemic heart diseases were also observed, similarly Atrial Fibrillation and heart failure were also observed particularly in admitted patients

Conclusion: Thyroid disorders are important cause of cardiovascular morbidity and mortality. General public and patients diagnosed as thyroid disorders should know about cardiovascular complications of thyroid disorder through electronic and print media. Community awareness aggressive and early identification and management is needed to reduce morbidity and mortality

Tracheostomy; complications in upper air way management as compared to endotracheal intubation

This study involves the review of management of patients who required temporary airway support and were treated either with tracheostomy or endotracheal intubatione in ear, nose, throat. Department and intensive care unit of Multan Medical and Dental College Ibne Sina Hospital Multan. Another important aspect of the study is to compare the results of tracheostomy with endotracheal intubation. Retrospective and descriptive. Multan Medical and Dental College Ibnae e Sina Hospital Multan. From 2012 to 2013. Twenty consecutive patients who had operation of tracheostomy whether emergency or elective, and were admitted in ENT ward of Ibne Sina Hospital Multan and twenty patients were intubated with endotracheal tube in the intensive care unit of the hospital. The main indications of tracheotomy were upper air way obstruction [80]% and mechanical respiratory insufficiency [20]%. Indications of endotracheal intubation were mechanical respiratory failure[80]% and ventilatory insufficiency due to retention of secretions [20]%. Tracheostomy is better choice in prolonged air way control more than three 3 weeks. But endotracheal intubation is found to be better choice in early and quick management of short term airway control up to 3 weeks

Extra nasal manifestations of fungal sinusitis in children

Objectives: To portray the extra nasal features of fungal sinusitis in children in southern Punjab [Pakistan]

Study design: A retrospective descriptive study

Place and duration: Conducted at two tertiary care hospitals Ibn-e-Sina Hospital Multan, teaching hospital affiliated with Multan Med and Dental College, CMH Multan and one private ENT hospital Javeria ENT hospital Mianchanu. Period of study was three years [Jan 2010-Dec 2012]

Methodology: Thirty children with age range of 5-12 years fulfilling the diagnostic criteria of fungal sinusitis treated within 3 years [Jan 2010 - Dec 2012] were evaluated retrospectively. Nineteen patients were referred from ophthalmology and pediatric units of different hospitals located in Multan region for otorhinological opinion. Eleven patients reported directly to ENT department with nasal symptoms. Clinical presentation, radiological, laboratory and operative findings were studied

Results: Mean age determined was 10.2. Males were affected more than female and majority of them belonged to underprivileged group. Most frequent extra nasal features were epiphora, proptosis, telecanthus and headache

Conclusion: Fungal sinusitis is misjudged in children. In absence of or minimal nasal symptoms diagnosis gets delayed leading to dreadful disease with poor outcome

Atrial septal defect coexistent with sjogren's syndrome

Pulmonary hypertension is frequently associated with atrial septal defect and various connective tissue disorders. This case describes a 74-year-old woman who presented with symptoms of heart failure and concomitant involvement of salivary glands and keratoconjunctivitis. An echocardiogram demonstrated ostium secundum atrial septal defect with left to right shunt and severe pulmonary hypertension. Laboratory investigations confirmed the diagnosis of Sj?gren's syndrome [SS] with positive anti-nuclear factor and centromere SS-A/Ro pattern. Anti-Ro [SS-A] was found positive. Atrial septal defect was closed through transcatheter route with significant improvement in clinical outcome. This case report suggests a possible association of atrial septal defect with primary Sjogren's syndrome in an adult patient

low cost digital infant incubator

In modern times the care of new born, especially the premature, the small for dates, or otherwise vulnerable infant has been greatly improved by the invention of the isolette incubator. However the cost of an infant care incubator is prohibitively high for poor and low income countries. We set out to develop an economical machine which should not only have the usual features, but also should have the ability to run, if electrical power fails.Our design required that it should be, safe to use and be run on 12 volt batteries to make it immune to frequent power breakdowns, it should be a sturdy, shock proof and a durable machine. It should have the provision of its own light source to provide for an emergency light for observation of the baby in case of power failure or during transport. Design should be such that it should be easy to repair with conveniently available parts. The design has a microcontroller, at its heart receiving input from Analog to Digital Convertor [ADC]. It provides the efficient functional control of temperature and humidity simultaneously. It will send signals to keep the heating and humidity in control at the same time feeding signals to LCD display.The product has turned out to be a very well functioning machine as shown in the figure. The prototype is economical to make and meets our initial aims. But we intend to improve upon it in our next model and make it a commercially viable and a more useful machine

Homocysteine as a risk factor in coronary heart disease

To study Homocysteine as a risk factor in coronary heart disease [CHD] patients. Design: Cross sectional observational study. All the cases taken from 1st November 2002 to 31st October 2003 were included in the study from the Department of Cardiology, KRL Hospital Islamabad. Total 93 subjects below the age of 45 were taken. Thirty normal healthy subjects [group I], remaining 63 Myocardial Infarction patients were further divided into two groups, 33 cardiac and non diabetic subjects [group II], 30 cardiac and diabetic subjects [group III]. Biochemical analysis include Serum Cholesterol, Glucose, Lipid Profile and Homocystene levels. The data about total Serum Cholesterol, TG,HDL, Homocystens level was analyzed in all three groups and studied in tabulation, cross tabulation and SPSS was applied for significance. The mean values of homocystene in groupl [normal healthy subjects] is 12.3 +/- 1.46 in group2 [cardiac and non diabatic] 14.3 +/- 4.09 and in groups [cardiac and diabatic] is 15.1 +/- 4.8. Homocystene was found raised in group3 as compared with groupl and group2. High levels of Homocysteine is a risk factor in CHD

Dacryocystorhinostomy; a comparative study of the results with and without silicon intubation in Pakistani patients of chronic dacryocystitis

To compare the results of standard dacryocystorhinostomy with the results of dacryocystorhinostomy done with silicon tube stentting of the lacrimal canaliculi. This is a hospital based, prospective, comparative and interventional study. Department of Ophthalmology, Allied Hospital Punjab Medical College Faisalabad. January 2006 to December 2006. Twenty seven patients of chronic dacryocystitis fulfilling the inclusion criteria were selected and divided in two groups. Group A consisted of 15 patients who underwent standard dacryocystorhinostomy and Group B consisted of 12 patients who underwent dacryocystorhinostomy along with intubation of the lacrimal canaliculi with silastic tubes. All the patients were followed up for at least six months post-operatively. Success of the procedure, defined as the symptomatic relief of epiphora and infection was assessed at the end of follow-up period. Of the total 27 patients of chronic dacryocystitis 23 [85%] were female and 4[15%] were male. The mean age of the patients was 45 years. The success of the procedure was recorded in 14 [93.33%] patients in group-A and in 10 [83.33%] patients in group B. Quite a few and simple complications were recorded during the study period. 1. Standard external dacryocystorhinostomy is a simple and cost effective procedure for the management of chronic dacryocystitis. 2. Silicon tube stentting of the lacrimal canaliculi does not have any extra advantage in the management of chronic dacryocystitis without canalicular obstruction

Assessing polynomial approximation for AT

The time based on the rotation of the earth around its own axis is known as Universal Time [UT], it is not a uniform time scale. Another time scale based on the revolution of earth in its orbit around the sun, called Terrestrial time [TT]. The difference between TT and UT is known as delta T [Delta T]. Delta T varies slowly but rather irregularly. The exact value of Delta T cannot be predicted because the rate at which earth's rotation is slowing down is not known. Therefore, delta T can only be deduced form observations. The knowledge of the exact value of Delta T is essential for predicting the correct time of astronomical event or to confirm the time of Historical events. If Delta T is not considered the result may contain an error of several seconds. The value of Delta T can be found in almanacs, where it is given in seconds of times at January 1 for each year but for some calculation of the astronomical events we require its values at any date of the year. In such cases an approximate formula can make the life simple. This paper discuss a polynomial approximation to Delta T for the range of 1620 to 2000 AD published by Jean Meeus and Larry Simons and gives a modified version of this approximation which is much more accurate