Safety of fenbendazole in common peafowl [Pavo cristatus]

The present study was undertaken to find out the safety levels of fenbendazole in common peafowl. This bird, raised on aviaries and zoos, can be severely parasitized with Ascaridia galli [enteric worms] and Syngamus trachea [gapeworm] along with other parasitic worms. Fenbendazole is a highly effective benzimidazole-class anthelmintic in animals. The objective of this work was to provide target animal safety data in young peafowl and to demonstrate reproductive safety in adult birds. During the experimental study, diets containing fenbendazole at 0, 100, 200 and 300 ppm were fed for 21 days [three times the normal treatment duration]. Data for feed consumption, feed conversion rate, and body weights were recorded for each bird in each group. Drug concentrations in different tissues of birds were determined to correlate concentrations with clinical observations, clinical pathology, and histologic findings. There were no morbidities or mortalities after study day 21. Additionally, there were no statistically significant treatment-related differences among above mentioned parameters. Analysis of fenbendazole concentrations in kidney, liver, leg/thigh, and breast muscle and skin with associated fat revealed that, even at the highest dose level used and with no feed withdrawal, fenbendazole concentrations were relatively low in these tissues. These findings indicate that fenbendazole has a relatively wide margin of safety in young peafowl and that the proposed dose of 100 ppm in the feed for 7 consecutive days is well within the margin of safety. In the reproductive safety study, five breeder peafowl farms fed fendbendazole at 100ppm for 7 days and collected data on hatching percentage of peahen eggs before and after treatment. Reproductive performance in peahen was not adversely affected

Lower gasrtointestinal bleeding; etiologic spectrum in Nishtar Hospital Multan

To determine the etiology of lower GI bleeding based on colonoscopic findings Retrospective study. This study was conducted at gastroenterology unit of Nishtar Hospital Multan from Feb 2013 to August 2014. Two hundred and fifty four patients, >/= 14 years old who presented with history of lower GI bleeding to the gastroenterology unit of Nishtar Hospital Multan out of 254 patients, 59.05% were males and 40.95% were females. Mean age of patients was 37.22 +/- 10.68 years. Most common findings were haemorrhoids [40.9% cases], ulcerative colitis [35.4%], no abnormality [8.2%], solitary rectal ulcer [7.5%], growth [7.1%], proctitis [3.5%], polyps[2%], rectal varix [1.2%], infective colitis [0.8%], uremic colopathy [0.8%], rectal prolapse [0.8%], multiple polyposis coli [0.8%], petechiae [0.8%], stricture [0.8%], diverticula[0.4%]and fissure [0.4%]. Colonoscopy is the investigation of choice for patients of lower gastrointestinal bleeding. More common colonoscopic findings in our study were haemorrhoids, ulcerative colitis, solitary rectal ulcer, malignancy and proctitis. Polyps and diverticula which are common in the west were uncommon in our patients. Rectal prolapse, petechiae, stricture, uremic colopathy and multiple polyposis coli were rare causes

Assessment of anti-inflammatory, anti-ulcer and neuropharmacological activities of Cyperus rotundus Linn.

This article reports the assessment of anti-inflammatory, antiulcer and neuropharmacological activities of crude extract of Cyperus rotundus. The plant exhibited significant property to act as an anti inflammatory agent. In experimental design, inflammation was produced by carrageenan in rats and compare with saline treated and Aspirin treated group. Simultaneously the drug was also observed for its antiulcer response and found effective enough [these two activities were observed at the dosage of 300mg/kg and 500mg/kg]. The anti ulcer activity was observed 41.2% as a dosage of 500mg/kg. Neuropharmacological activities [open field, head dip, rearing traction and forced swimming test] were also observed at 300 and 500mg/kg of C. rotundus extract. The crude extract showed mild decreased in all test and exhibited slight muscle relaxant effect. Powder drug studies and FTIR analysis were performed for the authentication of C. rotundus

Variation in bioactive principles of Artemisia amygdalina Decne. in wild and tissue culture regenerants

Wild and tissue culture raised regenerants of Artemisia amygdalina, a critically endangered and endemic plant of Kashmir and North West Frontier Provinces of Pakistan were screened for the amount of bioactive principles and in particular antimalarial compound artemesinin. Phytochemical screening of extracts revealed the presence of terpenes, alkaloids, phenolics, tannins [polyphenolics], cardiac glycosides and steroids in wild [aerial, inflorescence] and tissue culture regenerants [in vitro grown plant, callus and green house acclimatized plants]. HPLC of Artemisia amygdalina revealed the presence of artemesinin in petroleum ether extracts of wild aerial part, tissue culture raised plant and green house acclimatized plants. Acetonitrile and water in 70:30 ratios at flow rate of 1ml/min was standardised as mobile phase. Retention time for standard chromatogram was 6.7. Wild inflorescences and callus does not produce artemesinin. This is the first report of phytochemical screening and artemesinin estimation of wild and tissue culture raised regenerants of Artemisia amygdalina

Frequency of urethrocutaneous fistula following snodgrass hypospadias repair in children

To determine the frequency of urethrocutaneous fistula over a period of three months following snodgrass hypospadias repair for the treatment of distal penile hypospadias in children. This descriptive study was conducted in the pediatric surgery unit, Lady Reading Hospital, Peshawar over a period of eight months from June 2009 to February 2010. Patients with distal penilehypospadia without chordee between 2 and 14 years were included and patients were excluded who had previous repair for hypospadias. All those patients fulfilling the inclusion and exclusion criteria whose parents gave informed consent after explanation of the whole protocol were admitted through outpatient department for the said procedure and data was analyzed. A total of 52 patients were included in the study. All patients were in the range of 2 to 10 years and underwent Snodgrass Tubularized Incised Plate [TIP] urethroplasty for hypospadias repair. The overall rate of urethrocutaneous fistula was 9.6% [5 out of 52 patients]. Mean operative time noted in minutes was 57.52 minutes. No major morbidity or mortality was noted in this study. TIP urethroplasty is simple, single stage operation in the management of hypospadias and has good functional and low complication rate

Backache due to alkaptonuria in a middle aged man

Alkaptonuria is a rare cause of backache. A 55 years old gentleman, a retired army personal had been having pain and stiffness in the spine for the last 15 years, accompanied by bluish black discolouration of face and hands. Kyphosis and reduced movement of spine were present. Other joints were spared. Osler spots were visible on the sclera. X-rays revealed calcification of intervertebral discs. Asymptomatic renal stone was identified. There was no cardiac involvement. Symptomatic care was provided.

Lipoma in perineum- an unusual location

Subcutanoeus lipomas are rarely seen in the perineum. We describe a 55 years old man with four years history of a 10cm long soft lobulated mass between the scrotum and anus.This was successfully excised and was shown to be a lipoma on histopathological exam

Gastro esophageal reflux: an over investigated entity in neonates and infants

To determine the outcome of clinically suspected gastro esophageal reflux in neonates and Infants. To find a protocol for evaluation of these patients in order to reduce unnecessary radiation to neonates and infants. Fifty three neonates and infants of up to 1 year of age with clinical suspicion of gastro esophageal reflux [GER] were referred for Upper gastro intestinal barium studies. This retrospective descriptive case study was carried out over a period of one year starting from October, 2006 to September, 2007. Positive cases were followed for another one year to see the final outcome. The neonate and infants of upto one year of age, referred from Neonatal intensive care unit [NICU], Paediatric ward and Out Patient Department [OPD] were included in this study. Out of 53 cases 32 were positive for G.E.R and no reflux could be identified in rest of the patients. Out of these positive cases only 4 had massive or severe G.E.R. These patients were prescribed conservative and medical treatment and were advised to follow up in the O.P.D where on subsequent follow ups the medical treatment was stopped as there were no further complaints These patients showed normal weight gain on subsequent O.P.D visits. Other positive cases only had mild to moderate G.E.R and they were managed conservatively. These patients showed normal weight gain on subsequent O.P.D visits with complete resolution of symptoms. Regurgitation or gastro esophageal reflux is a common finding in the first 3 months of life [especially in preterm infants] and usually resolves by 6-12 months of age and should not be over investigated

Integration of sexual and reproductive health in the medical curriculum in Pakistan

To assess the knowledge of medical practitioners regarding management of selected reproductive tract infections, diagnosis of sexual dysfunction and identification of sexual abuse and to assess the attitudes and practices of health care providers regarding sexual and reproductive rights in order to recommend areas that need to be incorporated in a sexual and reproductive health curriculum. A cross-sectional survey. From March to August 2003 in the District Turbat of Balochistan, Pakistan. Selected indicators of knowledge, attitudes and practices regarding sexual and reproductive health of primary care physicians were assessed using a pre-tested questionnaire and formal/informal interviews. Variables were identified from the literature and previous in-depth interviews, and then formulated into respective questions. A Lichert scale marked from 1 to 5 was used for categorizing responses into agreed, neutral and disagreed. Descriptive statistics were computed using SPSS version 10 for windows. Qualitative interviews were translated and transcribed and analyzed according to pre-judged and emerging themes Out of 45 physicians interviewed, nearly half scored less than 50% in the knowledge section. Attitudes and practices assessed suggested a tendency to be judgmental, gender/rights discriminatory and with little provision for enabling clients to make their own decisions, so essential for quality sexual health service provision. Keeping in view the importance of the sexual health issues and a lack of ability of health care providers to handle it effectively, deficient areas of sexual health must be integrated into the medical curriculum. Medical educators have the responsibility to train physicians and other health professionals in the core competencies to improve the sexual and reproductive health of their communities

Outcome of patient referral made by the lady health workers in Karachi, Pakistan

The outcome and consequences of referral made by the Lady Health Workers [LHWs] are largely unknown. This cross sectional study was conducted as part of a larger study and aims to assess outcome of patients' referrals made by the LHWs in Karachi, Pakistan. Only 4% of patients referred visited government facilities, the rest having visited private physicians and in-formal practitioners. The median cost of the treatment was 200 Pakistani Rupees [PKR] and 1230 PKR as out -patient and in-patient respectively with almost half the patients [41.3%] borrowed money to finance their treatment. Seventy-eight [31.6%] patients were not satisfied with the management they received from the referral health facilities. Major reasons cited were non-improvement in their condition, expensive, long waiting time and rudeness of the health facility staff. Factors identified in this study should be taken into account to ensure continuity and quality of care and to provide efficient, effective and equitable health services to all.

Recommenndations to strengthen the role of lady health workers in the national program for family planning and primary health care in Pakistan: the helath workers perspective

This study was planned to assess the strengths and weakness of the National Program for Family Planning and Primary from the Lady Health Workers [LHW] perspective. We conducted this study in order to develop recommendations for strengthening LHW's role in Primary Health Care [PHC] in Pakistan in consultation with the health workers. A qualitative study, based on key informant interviews, was carried out in Karachi, Pakistan. A total of 20 workers were interviewed. Analysis was carried out by grouping similar responses in a matrix and then analysis with reference to context. Motivations for joining program included financial benefits, convenient timings and an opportunity to serve humanity. Training was deemed satisfactory but clinical training was resented because of doctors' attitudes. Further training needs identified included basic information about common ailments, reproductive issues and basic clinical skills. Major strengths of the program mentioned included provision of survices at grass root level, reinforcement of health messages and the community acceptability of workers. Weaknesses mentioned included the contractual nature of job, low- salaries, irregularity' of payment, no career development and poor logistical support. Giving LHWs permanent government employee status and a raise in salary may strengthen the workers functions. Eligible LHWs should be given incentives [skills, career development, financial]. The community must be educated about assigned role and responsibilities of LHWs and patient referral system by the LHW needs to be strengthened. The valuable role of LHWs in PHC in Pakistan must be acknowledged and further improvements pursued

Red cell alloimmunization in repeatedly transfused thalassemia major patients

Thalassemia major patients managed by regular transfusion regimen may develop anti-red cell alloimmunization. If the alloantibodies are hemolyzing in nature, transfusion reaction may occur, and provision of blood thereafter requires matching of the relevant blood group in addition to "ABO" and Rh 'D' matching. We investigated 75 cases of multiply transfused thalassemia major patients for development of alloantibodies against red cells by indirect antiglobulin test, using 3-red cell panel, and when required 11-red cell panel. Anti-red cell alloantibodies were detected in 17 [22.7%] patients. Anti-Kp[a] antibodies were the commonest, followed by Anti-e, anti-E and anti-K antibodies, respectively. Anti-k, -C[W], -Fy[b], -Kp[b], -Rh 'D' and -c were detected in one patient each. It is concluded that in multiply transfused patients, alloantibodies develop in a significant number of patients. The hemolyzing nature of antibodies should be determined in patients who develop these antibodies, and transfusion should be arranged accordingly

Hepatitis C virus seropositivity in repeatedly transfused thalassemia major patients

Multiple transfusions in patients of thalassemia major who are conventionally treated by a regular transfusion regimen, are at a risk of developing Transfusion Transmitted Infections [TTIs], including HCV-hepatitis. Strict criteria of safe donor selection have to be adopted in order to minimize the risk of TTIs. The present study was conducted to evaluate the seropositivity of anti-HCV antibodies in multiply transfused thalassemia major patients. A total of 75 patients of thalassemia major who had received at least 10 transfusions were tested for anti-HCV antibodies, using third generation ELISA kits. Amongst these patients, 42% were seropositive for anti-HCV antibodies. This is a high prevalence rate and calls for a critical look into the prevailing transfusion practices and adoption of stricter donor selection criteria

Drug resistance staphylococcus aureus

Staphylococcus aureus is known to be one of the most antibiotic resistant bacteria. In the present study one hundred and fifty hospital isolated from various sites were studied. Were from abcesses and subacute otitis media. The most effective drugs are quinolones and aminoglycosides

Isolates from ear swab specimens in chronic ear infections, and antibiotic sensitivity pattern

A total of one hundred and four [104] ear swab specimens were investigated in Rawalpindi General Hospital. Of isolated were found to be Pseudomonas aeruginosa [43%], next were stapylo-coccus aureus [35%] and Proteus Spp. [13%]. Amioglycosides and third generation cephalosporins seen to be the best choice for treatment of ear infections