Adrenaline; the effects in presence of beta blocker in isolated mammalian heart

There is no doubt that the effects of the catecholamines of the heart are mainly due to the stimulation of beta-adrenoceptors but in the mid 1960' s the first evidence was presented that a-adrenoceptors mediating positive inotrpoism exists also in the myocardium beside well established beta -adrenoceptors. In our observation adrenaline shows a positive inotropic response. The response of adrenaline in presence of metoprolol [beta1blocker] showed negative inotropic effect

H[2] receptor activity; effect in isolated rabbit heart

Histamine can stimulate the heart by directly interacting with cardiac histamine receptors. In the present study we have investigated the H[2] receptor activity in isolated rabbit heart. Cimetidine, a specific H[2] receptor antagonist was used. The isolated heart was mounted in langendroff apparatus. The heart was perfused at a constant pressure with oxygenated Ringer's Locke solution. H[2] receptor antagonist produces negative inotropic effect in the presence of histamine. This indicates that H[2] receptors are present in rabbit heart, and plays a role in mediation of positive inotropic effect produced through CAMP by histamine

Scrotal pathologies; role of high resolution and Doppler ultrasound in evaluation

To assess common presenting complaints and the role of Grey Scale and Doppler ultrasound in evaluation of scrotal pathologies. Cross sectional study, Khyber X rays, Khyber Medical Centre, Peshawar. July 2011 to December 2011. Data from patients presenting for evaluation of scrotal pathologies was analyzed for presenting complaints and ultrasound findings according to objectives of the study. In total 210 cases were included in the study. The age wise categorization included pediatric population [14.3%] adult population [80.9%] and geriatric population [4.3%]. Pain was the most common presenting feature in all age. Other major presenting complaints included swelling, absent testis, history of trauma, lower urinary tract symptoms [LUTS], and infertility. Hydrocele was the most common finding overall. Other major ultrasound finding included varicocele, epididymo-orchitis, spermatocele, atrophic testis, undescended testis tumors and complications of trauma. Scrotal pathologies are among the frequently encountered problems in our region. Ultrasound is a sensitive and useful tool for evaluation of scrotal pathologies

Early Nasogastric Enteral Nutrition in Acute Pancreatitis

To evaluate the effectiveness and safety of early Nasogastric Enteral Nutrition in patients with Acute Pancreatitis. Randomized controlled trial. The study was conducted at IIMC Hospital Islamabad, and Railways Hospital Rawalpindi from June 2008 to April 2011. A total of 26 patients were studied over the course of 34 months who were admitted with the diagnosis of acute pancreatitis. Patients were divided randomly in two equal groups by consecutive sampling method. One group was given enteral nutrition [EN] through nasogastric tube beginning within 24 hours of admission [group-I], and the other group was provided nutrition through parenteral route [PN] only [Group-II]. Outcome in the two groups such as length of hospital and ICU stay, infective complications, nutrition related complications, metabolic and catheter related complications were compared. Baseline of the study regarding infective complications and mortality were comparable. Average hospital stay was shorter by 22.3% in enterally fed group. ICU stay was also shorter in group-I patients. Significant difference was seen in relief of abdominal pain amongst the two groups, enterally fed [group-I] patients had earlier relief of pain starting on the 3[rd] day, compared to 5[th] day in group-II. Majority of the patients in group-I [84.5%] had pain relief between 4[th] and 9[th] day, while in group-II, 76.8% had pain relief between 7[th] and 12[th] day. Mean pain relief in enterally fed patients was in 7.5 days and in parenteral nutrition group in 10.2 days. Nutrition related complication of diarrhoea was noted in 2 enterally fed patients. Metabolic complications [hyperglycaemia], and catheter related septic complications were seen only in parenterally fed patients. Acute pseudocyst formation occurred in one patient of enterally fed group as noted on follow up. Early enteral nutrition is safe and effective in the management of acute pancreatitis. Enterally fed patients show advantage of shorter hospital and ICU stay, and earlier relief of symptoms compared to patients managed on parenteral nutrition. Our study considers early enteral nutrition feasible and desirable

Plasma exchange in patients with the diagnosis of Guillain-Barre syndrome: an experience in intensive care unit

To assess the effectiveness of plasma exchange in patients with Guillain-Barre syndrome. This descriptive study was conducted at Intensive Care Unit Lady Reading Hospital Peshawar from March 2008 to July 2010. Twenty eight patients were included in study after fulfilling inclusion criteria. All the diagnosed cases of Guillain-Barre syndrome were admitted in Intensive care Unit Post Graduate Medical Institute Lady Reading Hospital Peshawar and 4 sessions of plasma exchange therapy was initiated in every patient after informed written consent. Out of 28 patients 19 were male [67.85%] and 9 were female [32.14%]. Mean age was 32.32 years and mean duration of stay in Intensive Care Unit was 6.32 days. Out of these 28 patients, 60.71% [17] recovered and 39.3% [11] expired despite treatment and 2 patients developed adverse events secondary to Plasma Exchange. In 25 [89.29%] patients breathlessness was reported as their major symptom beside motor weakness, while in 19 [67.85%] patients, pain was also reported. Early referral to Intensive Care Unit, management of complications, good nursing care and specific therapy with Plasma Exchange within seven days of onset of symptoms improve prognosis and Plasma Exchange has proved beneficial to supportive treatment alone in Guillain-Barre syndrome with minimal side effects