Evaluating a murine model of endometritis using uterine isolates of Escherichia coli from postpartum buffalo

Ascending infection of the uterus with Gram-negative bacteria is responsible for postpartum endometritis in cattle and buffalo and can adversely affect fertility. Development of a laboratory animal model for bovine endometritis would facilitate the understanding of the pathogenesis as it is difficult to conduct controlled experimentation in the native host. In the present study, 30 virgin Swiss Albino mice [5-8 weeks old] were used to evaluate the pathogenic potential of Escherichia coli, isolated from the normally calved postpartum buffalo to induce endometritis. Mice in the diestrus phase of the estrous cycle were randomly allotted to one of the following four intravaginal inoculation [100 microL] treatments: EG [experimental group]-1: sterile normal saline; EG-2, -3 and -4: E. coli@ 1.5 × 104, 105 and 106 CFU/ml, respectively. The animals were then scarified 36 h post-inoculation to study gross and microscopical lesions. Gross changes were confined to EG-4. Acute endometritis was recorded in 50% of the EG-3 and 66.7% of the EG-4. The rate of acute endometritis development was significantly higher in EG-4 [P<0.05] as compared to the other groups. The present study demonstrated that the animal model for bubaline endometritis can be developed in mice by intravaginal inoculation of E. coli@ 1.5 × 106 CFU/ml at diestrus. Ease of intravaginal inoculation, apparent absence of systemic involvement and high infective rate are the advantages of the model over other studies

Siriraj score as a tool for clinical diagnosis of stroke

Siriraj stroke score is a diagnostic tool to differentiated ischemic from haemorrhagic shock. This study was carried out to access SSS accuracy as compared to CT scan. This study was carried out in the Department of Medicine and Neurology of Mayo Hospital, Lahore. Thirty two patients were included in the study who had stroke SSS was applied as well as CT scan was done. Out of them 6% were misdiagnosed. Overall predictive accuracy was 87.5%. Siriraj stroke score is not 100% accurate. CT scan should be advised before starting definitive stroke therapy

Management of faecal fistula

To share our experience of management of faecal fistula so as to establish management protocol. A descriptive study. Department of surgery ward-2 of Jinnah Postgraduate Medical Center Karachi, from July 2002 to June 2005. Twenty seven patients with a diagnosis of faecal fistula were studied. Demographic variables cause and outcome were observed and recorded. A three staged strategy was employed in the management. Conservative management of fistula was based on TPN and bowel rest. There were 16 males and 11 females. Mean age was 36 years. Small bowel was the commonest site of fistulation [22] and intestinal tuberculosis was the most common cause. Eighteen were high output fistulas and 9 were of low output. One fistula was complex others were simple. Sixteen responded to the conservative management and their fistulae closed spontaneously. Eleven of them had small bowel fistulas with high output, 5 had large bowel fistulas with low output. Six patients underwent surgery after 4 weeks of conservative management. All had small bowel fistulas with high output. In 2 patients definitive surgery was done in the form of repair of intestinal leak and by-pass of obstructed segment. In 2 cases laparotomy and peritoneal lavage was done. Primary repair was done in 2 patients for high output fistula but lead to anastomotic leak. They were re-explored and exteriorization of loop was done but both died due to sepsis. Two patients underwent surgery after 6 weeks of conservative management 1 due to peritonitis secondary to anastomotic leak and exteriorization of loop was done and other operated for intra-abdominal collection. One patient was operated after 10 weeks of conservative management but deteriorated despite of all measures. There were five deaths 3 after surgery and 2 without any intervention, both of them were outside referrals. The outcome of faecal fistula depends on a host of factors. We recommend proper timing of intervention for a good outcome

outcome of darning method of inguinal hernia repair using polypropylene in Sir Ganga Ram Hospital, Lahore

To valuate the darning method of inguinal hernia repair with polypropylene. 300 patients of unilateral inguinal hernia were admitted. After thorough investigations, all patients were operated for hernia repair by standard procedure using No.1 polypropylene. Patients were operated under, spinal or general anesthesia. Patients were followed up at one week, six weeks and six months after operation for wound healing and complications. Out of 300 patients, ranging in age from 20 to 70 years, 250 patients were given spinal anaesthesia, 45 patients [20%] were operated under local anesthesia. 196 patients were discharged from the hospital on the following day. 3 patients went into urinary retention and one patient had large haemotoma requiring exploration. Recurrence rate was 1% [n=3]. Darning method of inguinal repair with polypropylene is a safe and cheaper method of hernia repair

Genetic and biochemical effects of Ginkgo Biloba on somatic and germ cells of mice

Ginkgo biloba has immense folkloric significance in the treatment of Alzheimer's disease and age-related dementia. The present study on the genetic and biochemical effects of Ginkgo biloba was undertaken, in view of the reports on the carcinogenic effects of the dietary supplements containing Ginkgo biloba. the cytotoxic and mutagenic potentials of its constituents and a paucity of literature on the genotoxicity. The protocol included the oral treatment of mice with different doses [100. 200 and 400 mg/kg] of Ginkgo biloba for 7 consecutive days. The following experiments were conducted: [i] cytological studies on micronucleus test. [ii] cytological analysis of spermatozoa abnormalities, [iii] quantification of proteins and nucleic acids in hepatic and testicular cells and [iv] estimation of malondialdehyde [MDA] and nonprotein sulihydryl [NPSH] in hepatic and testicular cells. The results obtained in this study clearly demonstrate lack of any effect of Ginkgo biloba on the frequency of micronuclei, ratio of polychromatic erythrocytes [PCE]/normochromatic erythrocytes [NCE], spermatozoa abnormalities and hepatic concentrations of nucleic acids, while the nucleic acid levels of testicular cells were significantly depleted. The results on testicular nucleic acids failed to reflect our data on spermatozoa abnormality. The discordance might be related to the role of excurrent duct system in eliminating morphologically abnormal spermatozoa during transit from testis to vas deferens and caudac epididymis. The observation on MDA and NP-SH showed Ginkgo biloha to cause genesis of lipid peroxides. This study indicates that the changes observed in the somatic and germ cells were independent of the Ginkgo biloba-induced genesis of lipid peroxides. The observed changes of Ginkgo biloba might be related to its effect on the increase of MDA and depletion of NP-SH. In view of the observed oxidant potentials, our study warrants careful use of Ginkgo biloba

Pharmacological and safety evaluation studies on cardamom elettaria cardamomum: an important ingredient of gahwa [arabian coffee]

An aqueous suspension of cardamom, Elettaria cardamomum was tested for its ability to inhibit gastric secretion and to protect gastric mucosa against the injuries caused by pylorus ligation, indomethacin and cytodestructive agents [80% ethanol, 0.2 M NaOH and 25% NaCI] in rats. The cardamom suspension at doses [250 and 500 mg/kg] exhibited significant decrease in basal gastric secretions and ulcers induced by Shay rats and indomethacin in rats. The suspension also significantly protected gastric mucosal against necrotizing agents. Histopathological evaluation revealed no significant pathological changes in the stomach of rats after 80% ethanol challenge. The LD[50] of cardamom was found to be 26.0 g/kg in mice. A large margin of safety was observed in animals in acute and chronic toxicity tests. Treatment with cardamom suspension did not induce any significant changes in the micronucleated polychromatic erythrocytes [PCE] and the ratio of PCE and normochromatic erythrocytes [NCE] at both doses used as compared to control group. In conclusion, cardamom showed a significant antisecretory and antiulcer activities without causing any deleterious effects in acute, prolong administration and genotoxicity in the animals

current susceptibility patterns of methicillin resistant staphylococcus aureus to conventional anti staphylococcus antimicrobials at Rawalpindi

Objective: To evaluate current susceptibility of MRSA to commonly used anti-staphylococcus antimicrobials at Rawalpindi. Design: An observational study

Place and duration of study: Pathology Laboratories, Army Medical College, Rawalpindi during the period January 2001 to January 2004

Material and Methods: One hundred eighty five consecutive, non-duplicate strains of Methicillin resistant Staphylococcus aureus [MRSA] isolated from different clinical samples were identified by standard microbiological methodology between January 2001 and January 2004. They were studied for their susceptibility to co-trimoxazole, erythromycin, tetracycline, gentamicin, chloramphenicol, ciprofloxacin, and vancomycin by disc diffusion technique using modified Kirby-Bauer method

Results: All the MRSA were sensitive to vancomycin. Approximately 38.3% strains revealed resistance to chloramphenicol, 77.2% to co-trimoxazole, 89.7% to erythromycin, 88.6% to tetracycline, 97.8% to gentamicin and 98.9% to ciprofloxacin

Conclusion: Most of the MRSA were multidrug resistant. These strains revealed higher degree of resistance [>75%] to routine anti-staphylococcus antimicrobials in comparison to the previous study of 1985- 87. The p-values have been highly significant in case of erythromycin, tetracycline, gentamicin, fluroquinolone and vancomycin. The p-values in case of chloramphenicol has not been significant. Vancomycin is yet a life saving anti-staphylococcus antimicrobial in MRSA infections in Rawalpindi

FNAC and core needle biopsy - A comparison in space occupying lesions of liver

A prospective analysis was conducted on 110 FNAC and results were compared with histologicul reports of patients with intrahepatic focal defects. Cytology permitted a diagnosis of the lesion in 98% cases. When aspirates with insufficient material were excluded [4], the diagnostic accuracy of FNA was 94%. Among the 106 patients who underwent both procedures, FNAC and CNB had the some diagnostic accuracy 94% i.e., sensitivity 96% and specificity 93% of FNAC. There were no complications during the execution of FNAC and CNB. FNAC is an effective and safe method in the diagnosis of focal hepatic lesions, with diagnostic accuracy almost similar to that of CNB. When the two techniques are combined, the accuracy of the diagnosis of malignancy of focal liver lesions increases

Neonatal intestinal perforation secondary to congenital segmental agenesis of intestinal muscularis

Congenital segmental absence of intestinal musculature is a rare disorder of unknown etiology. It is a rare cause of intestinal obstruction or perforation in newborns which may resemble necrotizing enterocolitis [NEC]. The diagnosis is confirmed histologically by segmental absence of the muscularis propria, normal intact mucosa, submucosa and serosa. The absence of inflammation, hemorrhage and necrosis helps to distinguish it from NEC. A case of an infant boy with intestinal perforation secondary to segmental absence of intestinal musculature is presented, the literature is reviewed and possible etiologies are discussed

Reaven's quartet [metabolic syndrome X]: a potent predictor of coronary events

Reaven's syndrome of the deadly quartet [Metabolic Syndrome X] of risk factors for coronary artery disease continues to attract attention. Whether or not insulin is atherogenic and hyperinsulinemia is the major link in this association, it subserves the importance of identifying and treating patients with varying degrees of glucose intolerance. This study confirms the presence of an adverse risk factor profile, and a clustering of risk factors in diabetics. Out of a total of 400 patients with coronary artery disease diabetes was present in 40 patients, hypertension in 120 patients, hypercholestrolemia in 100 patients and obesity in 96 patients. But the incidence of hypertension, dislipidemia and obesity in diabetics ranged from 70% to 90%. A similar profile was seen in the patients with impaired glucose tolerance. This clustering of adverse risk factors suggest that is a common link accounting for this cluster