Histopathological changes induced in liver, kidney, heart and pancreas of rabbits by prolonged oral cyanide exposure

The aim of the present study was to determine the deleterious effects of prolonged oral cyanide insult on various organs and tissues in rabbits. For this purpose, 12 locally bred adult male rabbits were allocated into two groups of 6 viz. control and experimental. Rabbits in control group were offered feed only while the rabbits in experimental group received feed plus potassium cyanide [KCN] at 3 mg/kg body weight orally for a period of 40 days. None of the rabbit in both the groups demonstrated any of the gross changes in any organ on postmortem examination. Liver was normal in size, shape, texture and color. Kidneys were also normal in size and color. Histopathological examination revealed severe hepatocyte vacuolation and degeneration in liver of rabbits in experimental group. There was also excessive congestion in liver and bile duct of rabbits in experimental group. Kidneys of rabbits in experimental group demonstrated severe glomerular and tubular necrosis and congestion. In the tubular epithelial cells, pyknotic nuclei were also present. On the other hand, heart and pancreas of rabbits in both control and experimental group did not show any histopathological change in microscopic structures. In conclusion, prolonged oral cyanide administration could have harmful effects on liver and kidney functions

Comparison of single-dose nalbuphine versus tramadol for postoperative pain management in children: a randomized, controlled trial / 대한마취과학회지

BACKGROUND: Acute postoperative pain control in children is an essential component of postoperative care, particularly in daycare procedures. Giving patients continuous narcotic analgesics can be risky; however, a single dose may be sufficient. METHODS: This study used a prospective, randomized controlled design and was conducted at the Pediatric Surgery Unit, Services Hospital, Lahore. In total, 150 patients who underwent inguinal herniotomy (age range: 1–12 years) were randomly assigned to two groups: group A (nalbuphine) and group B (tramadol). Patients were given a single dose of either nalbuphine (0.2 mg/kg) or tramadol (2 mg/kg) immediately after surgery and pain was measured at 0, 1, 2, 4, and 8 h. RESULTS: The demographic characteristics were similar between the two groups. The mean pain score was lower in group A than in group B at 0 and 1 h (P < 0.05). However, at 4 h and 8 h, the pain scores in group A were still lower, but not significantly. In all, 9 patients (12.0%) required rescue analgesics in group A compared to 16 patients (21.3%) in group B (P = 0.051). The mean time for requirement of rescue analgesics was 6.5 ± 0.5 h in group A and 5.3 ± 1.7 h in group B (P = 0.06). CONCLUSIONS: A single dose of nalbuphine is sufficient, and superior to tramadol, for postoperative pain management in children who have undergone daycare procedures.

Evaluation of furazolidone, sulfadimidine and amprolium to treat coccidiosis in beetal goats under field conditions

Coccidiosis is a protozoal and occasionally fatal diarrheic disease of goats imposing heavy economic losses to farming community. This study aimed to evaluate the efficacies of Furazolidone, Sulfadimidine and Amprolium against coccidiosis in Beetal goats. Twenty-four [24] Beetal goats naturally infected with coccidiosis were randomly divided into four groups of 6 [A-D]. Goats in groups A, B and C were treated orally with Furazolidone [10mg/Kg], Sulfadimidine [100mg/Kg] and Amprolium [55mg/Kg], respectively for 7 days. Goats in-group D served as positive control. Oocysts per gram [OPG] of feces counts of individual goats in each group were performed on Days; 0 [pre-treatment] 7, 14 and 21 [post-treatment]. OPG counts amongst goats in all groups at day 0 were not significant [P>0.05]. On days 7, 14 and 21, OPG values decreased significantly [P<0.05] in groups A, B and C compared to group D. The efficacy of Furazolidone, Sulfadimidine and Amprolium was 98.6, 98.0 and 99.6 percent, respectively on Day 21 [end of trial]. Statistically, the efficacies of three drugs were not significantly different [P>0.05]. In conclusion, Furazolidone, Sulfadimidine and Amprolium are well-tolerated and any one of these may be recommended to effectively treat coccidiosis in Beetal goats

Duplication cyst presenting as hydrocoele in a child

Enteric duplication cyst can occur anywhere in Gastrointestinal Tract [GIT], from oropharynx to rectum. Their presentation depends upon the portion of GIT involved. The most common site of GIT involved is small intestine, in 50% of cases. Small intestinal duplication cyst usually present with abdominal pain or mass and rarely as intussusception, volvulus or small bowel obstruction. It may also present very rarely as inguinal hernia of which only 2 cases have been reported yet. We report a 3 years child presenting as hydrocoele of the cord which turned to be duplication cyst which is very rare presentation

Relaparotomies in abdominal trauma, systematic review

Treatment of a number of complications that occur after abdominal trauma surgeries may require that Urgent Abdominal Re-explorations, the life-saving and obligatory operations, are performed. To evaluate the reasons and incidence of re-operations in abdominal trauma cases and their outcomes in our centre, so that more preventable morbidity can be avoided. A retrospective study of all trauma victims who sustained laparatomies and relaparatomies in the Emergency Department of Al-Imamain Al-kadhymain Medical City, Baghdad, over a 2 years period. A review of the case sheets of these victims has been reviewed to identify the various circumstances of trauma cases and the detailed operative findings and definitive causes of relaparatomies were noted. The study included 21 relaparatomy cases out of 244 laparatomy for various abdominal trauma reasons ; 180 patients [74%] males and 64 [26%] females, with a male to female ratio of about [3:1]. The commonest causative accidents were missile inury 97pt [39%], gunshot injuries 58 [24%], road traffic accidents 43pt [18%], stab wound 32 pt[13%], and. Fall from height 14 pts [6%] . Reoperations were performed in 21 cases Incidence [8.6%], finding in reoperation including second look operation [which constituted 4 patients] were as the followings: Bleeding 11 pts [52%], peritonitis from missed bowel injuries and anastomosis leak 5 pts [24%], small bowel obstruction one pt [5%], IAC[abscess] 2pt [9.5%] and prolonged ileus and peritonism 2 Pts [9.5%]. Overall mortality in the reexplored patients was 8 patients[38%]. Incidence of missed injuries 24% of reoperation and 1.6% of total trauma cases. Many pt can be saved from repeat laparatomy by avoiding missed injuries. The main reason for immediate reoperation is bleeding and lately is peritonitis and sepsis

Pakistamide C, a new sphingolipid from Abutilon pakistanicum

The Abutilon genus from the Malvaceae family is of medicinal importance, and members of this genus are distributed in the tropical and subtropical regions of Asia and other parts of the world. Abutilon pakistanicum Jafri & Ali is mainly found in Pakistan. It has been used by different systems of traditional medicines to treat different diseases. Pakistamide C, a new sphingolipid, has been isolated from the ethyl acetate soluble fraction of the methanolic extract of A. pakistanicum. Different spectroscopic techniques such as NMR (1H, 13C, COSY, NOESY, HSQC, HMBC) and Mass spectrometry (EI-MS, and FAB-MS experiments) were used to elucidate the structure of pakistamide C.

Alveolar clefts reconstruction: a comparison of autogenous bone graft versus autogenous combined with alloplasts

Alveolar cleft reconstruction is a major challenge in cleft lip and/or palate [CLP] patients and golden standard protocol is to perform bone grafting [BG] before canine eruption and subsequent orthodontic closure. Objective of this study was to compare the post operative morbidity of two procedures in terms of complications i.e. the average operation time, intra-operative blood loss, postoperative pain and to demonstrate the surgical procedure and clinical outcome in terms of preservation of the grafted alveoli. This was a prospective comparative study conducted at the Department of Oral and Maxillofacial Surgery, Children Hospital, Lahore on twenty patients with residual alveolar clefts. The patients were randomly divided into two groups A and B. In group A, the cancellous bone graft was harvested from the anterior iliac crest while in group B, the cancellous bone was harvested from the anterior iliac crest and mixed with Synthetic bone substitutes in 1:1 by volume. The patients in group B recovered from walking uncomfortably statistically faster than those in group A. The duration of the hospital stay was significantly shorter in group B than in group A. The average bone graft densities of both groups significantly reduced within 6 months after grafting then seemed to be stable until month 24. The bone graft heights gradually decreased with time, in both groups by 24 months postoperatively. It was concluded that efficacy of hydroxylapatite is comparable with that of autogenous bone alone in terms of bone remodeling and tooth eruption, either spontaneous or orthodontically assisted

Prolonged oral cyanide effects on feed intake, growth rate and blood parameters in rabbits

Twelve adult rabbits bred locally were divided into two equal groups of 6; experimental and control groups. Rabbits in the experimental group were orally dosed with KCN at 3mg/kg body weight for 40 consecutive days. Members in control group were given placebo [distilled water] for the same period. Animals in both groups were offered feed at 90gm/kg/day while ample drinking water was available ad lib. Feed consumption and body weight of rabbits in both the groups were recorded. Blood samples were also drawn to determine various hematological parameters. Statistical analysis revealed a non-significant difference of total and daily feed intakes in rabbits of experimental and control groups. Whereas the feed efficiency of rabbits in the experimental group were significantly reduced [P<0.05] compared to controls. Likewise a significant decrease in body weight gain of rabbits in experimental group [P<0.05] was observed. A non-significant difference [P>0.05] was observed in leukocyte count, differential leukocyte count and platelets of rabbits in both the groups. Erythrocyte count, hemoglobin concentration, packed cell volume and mean corpuscular hemoglobin were significantly decreased in treated rabbits. It was concluded that chronic cyanide intake had a deleterious effect on feed efficiency, growth rate and blood components of rabbits

Laparoscopic cholecystectomy for acute cholecystitis an experience of 64 cases

To evaluate the feasibility and safety of laparoscopic cholecystectomy in severe acute cholecystitis, and to assess the incidence of complications. A prospective study included Sixty four patients with a confirmed diagnosis of acute cholecystitis at Al-Kadhimyia Teaching Hospital, over a period of 18 months from march 2009 to August 2010. Sixty four patients with diagnosis of acute cholecystitis were enrolled in our study. All of cases underwent laparoscopic cholecystectomy during the first 72 hours of their admission. Of the 64 patients there were 48 female and 16 male with a female to male ratio of 3:1. The age of our patients ranged from 19 years to 63 years with mean age of 35.6 years in female and 49.8 years in male. Cholecystectomy was completed successfully in 52 patients [81%], conversion to open conventional surgery was necessary in 12 patients [19%]. The main reasons were obscured anatomy [calot's triangle], excessive bleeding and dense adhesions. Data on presenting symptom, ultrasound findings, operative findings, hospital stay and complications were recorded. In the presence of severe acute cholecystitis laparoscopic cholecystectomy is feasible in most patients, with minimal risk of injury to surrounding structures, shorter hospital stay and considerable benefits. It is recommended that laparoscopic cholecystectomy should be attempted in these patients when appropriate surgical skill is available

Acute abdominal pain in Iraqi children: causes and management

Acute abdominal pain is the most frequent gastrointestinal complaint that brings children and adolescent to physicians and the one that frequently requires urgent evaluation in the office or emergency department. The challenge for the clinician is to identify those patients with abdominal pain who have either serious, potentially life-threatening conditions, such as appendicitis or bowel obstruction. The difficulty in this problem resides in the great diversity of underlying pathologies and poor localization of pain. To study different etiologies' of acute abdominal pain in children and their incidence in our locality to offer a clinical issue helping relevant doctors in management of their child patients. In this study, we enrolled children with age ranged from 4 months to 12 years, from April 2007 to April 2009 during which every child visit outpatient clinic or emergency unit complaining of acute abdominal pain was included; full clinical evaluation and necessary laboratory tests was obtained. Follow up data of these children in the emergency room, pediatric and surgical ward and after discharge were obtained. The study include 566 child with age range from 4 month to 12 years with overall mean age was 5.8+2.4 years, female children were 58% while male were 42%. 36% of children sustained emergency surgical operation [surgical group], the other 64% were treated conservatively [conservative group]. The commonest pathologies in surgical group were acute appendicitis 73%, intussusceptions 13%, primary peritonitis 5% and incarcerated hernias 2%. While that in conservative group, they were non-specific abdominal pain 44%, gastroenteritis 23%, UTI16% and ML 8%. The incidence of acute abdominal pain in relation to the age group was as following: Group l [age of 1 year and below] was 45 cases [8%], Group2 [2-5 years] was 294 cases [52%], Group 3[6 - 12 years] were 227 cases [40%].The commonest medical cause of acute abdominal pain is nonspecific abdominal pain followed by gastroenteritis while the surgical cause is acute appendicitis followed by intussusceptions. The age is fundamental clinical factor in assessing any child with acute abdominal pain and the underlying pathologies are closely related to the child's age. The repetitive gentle clinical examination is superior to most sophisticated investigations and it is considered a cornerstone in pediatrics' clinical practice

Pattern of intestinal obstruction in children - a review of 200 consecutive cases

To identify the various causes of intestinal obstruction in children. Retrospective study. Department of Paediatric Surgery, Allied Hospital, Faisalabad from July 1995 to June 2009. The record of all children, between the age of 1 to 14 years, who presented with intestinal obstruction during the study period was reviewed. Two hundred children presented with intestinal obstruction. It was not an uncommon cause for admission from the emergency department [12.1%] and constituted 7.4% of the children operated in the unit. They were predominantly males [75%]. Average duration of symptoms was 3 days. The commonest causes were adhesions [31%], Meckel's diverticulum with band [15.5%], volvulus [12%] and incarcerated inguinal hernia [11.5%]. Wound infection [11%] and wound dehiscence [4%] were the common complications. Mortality rate was 2.5%. Intestinal obstruction is seen not infrequently in children and is associated with significant morbidity. Adhesions especially post operative have emerged as a leading cause. Early recognition and prompt treatment are needed

Adult mortality in medical, sociodemographic and healthcare perspective

Statistics on causes of deaths can help in determining the pattern and burden of disease and devise measures for planning and controlling unwanted deaths. To assess the pattern of mortality in adult patients in a public sector tertiary care hospital at Rawalpindi during the year 2005. This retrospective study was done through search of hospital records of all deaths in adults during the year 2005 in a public sector tertiary care hospital. Information on pertinent variables was obtained on a proforma. Cause of death in each case was ascertained as it was documented. Important Lab. Investigations, where available were also recorded. Diseases were grouped according to World Health Organization classification [International Classification of Diseases-10]. Causes deaths were analyzed under various medical, sociodemographic and healthcare parameters according to available records. A total of 529 adult deaths occurred during study period. The mean age of the deceased was 54 years. There were 58% males with 13% being unmarried. More than 75% cases belonged to lower socioeconomic status while 55% belonged to urban areas. Almost all [97%] were admitted through casualty department. Hospital stay was less than one hour in 34% and 1-7 days in 52% cases. Death due to diseases of circulatory system was ranked first [33%]. A total of sixty deaths occurred due to liver diseases and hepatitis C virus was positive in 39 [64%] cases. Proportion of female who died of hypertensive disorders was significantly high [p < 0.01]. Both infectious and non infectious diseases are bringing a major death toll in our health setting with circulatory system and liver disease as the leading causes of death in adults. Adult mortality can be reduced by controlling infectious and non infectious diseases

Knowledge about leprosy in doctors of teaching hospitals of Rawalpindi

To assess the knowledge of doctors about leprosy. This was a qualitative study. Specially designed questionnaire based interviews were carried out in three teaching hospitals [Holy Family Hospital, Rawalpindi General Hospital and District Head Quarter Hospital of Rawalpindi Medical College] over 2 months [May-June 2008]. Doctors were interviewed irrespective of their qualification and experience using convenience sampling. A total of 136 doctors were included in the study, out of which 96 were simple MBBS, 34 had done FCPS-I and 6 were FCPS-II. Of the total 68 doctors, 38.2% had seen a case of leprosy whereas 61.8% had never examined a case of leprosy. Majority knew the commonly used drugs for leprosy and only 2.9% did not know them. Eighty two percent doctors knew the management of a suspected case of leprosy. Doctors had adequate knowledge about leprosy that was independent of their qualification and experience. Though leprosy has been eradicated from Pakistan but students and doctors still need to educated on this subject to keep them abreast about the subject

Incidence of homicide by sharp edged weapon at Lahore

To find out the most frequently targeted site of the body in sharp force homicidal injuries, defence wounds, age, associated weapon use, gender incidence and cause of death. Department of Forensic Medicine and Toxicology, King Edward Medical University, Lahore. 2002, 2003 and 2004. Proforma was designed for retrospective study, relevant information was gleaned from the available record .A three year period was selected, spreading over 2002, 2003 and 2004, was scrutinised for 232 cases autopsied at this facility. Male to female ratio was 2.26: 1. Maximum number of victims belonged to the 20-29 years age group. Single injuries were present in 18.54% of the cases and multiple were present in 81.46% cases. The commonest associated weapon used was blunt. Death was caused by haemorrhage in 46.5% cases and damage to vital organs proved to be the cause of death in 53.5% cases. Defence injuries were seen in 26.7% cases. The commonest infliction site was the neck in females while the area most targeted in male victims was the chest. The most targeted site is neck. Approximately one in four victims had defence injuries. Most injuries are on trunk [chest and abdomen]. Commonest regions for males was chest and in females. Damage to vital organs was the major cause of death. Amongst females teenager are more vulnerable, as this group had the maximum number of victims

Management of hypothermia in neonates with a locally made resuscitation trolley system

Hypothermia is associated with large number of serious complications. We face a lot of problems while treating babies with preoperative and post operative hypothermia. Hypothermia is preventable if proper measures are taken. In our set up we do not have proper warming system in neonatology units. We managed hypothermia successfully in neonates preoperatively and post-operatively with the help of a locally made resuscitation trolley system designed and made by the authors. To asses the outcome of the neonates with preoperative and postoperative hypothermia a locally made resuscitation trolley system was used. Retrospective study. All neonates with hypothermia were shifted to the automatic resuscitation trolley system. A four hourly record of axillary temperature of all the babies under study was kept. The warmer rods were operated at 750 watts maximum till the surface temperature of the babies was normal. A total of 510 neonates were managed during the period from July 2005 to June 2007. Out of these 108 neonates suffered hypothermia during some phase of pre-operative period. Eighty seven hypothermic babies were managed post-operatively. Fifteen normothermic babies were also managed on this automatic system. All the neonates with hypothermia preoperative and post operative were managed successfully on this system. Of the fifteen normothermic neonates who were also managed on this resuscitation system, only two developed hypothermia of 1 degree C. Proper warming system can prevent hypothermia in neonates and many lives can be saved

Ano-rectal malformations

OBJECTIVE: To assess the type of anorectal anomalies among the patients presenting to us and to compare our results with other published series. DESIGN: Retrospective study. PERIOD: July 1995 to December 2001. SETTING: Department of Paediatric Surgery, Allied Hospital, Faisalabad. PATIENTS AND METHODS: All patients presenting to the Department of Paediatric Surgery, Allied Hospital, Faisalabad for management of anorectal anomalies were included in the study. The patients presented either for the initial management, for the definitive procedure, colostomy closure or management of complications. A total of 365 patients were managed during the study period. Of these 265 patients presented for the initial management. The majority [60.37%] came within 72 hours. M:F ratio was 1.85: 1. High and intermediate anomalies constituted 56.1%. Initially Colostomy was done in 160 cases and Anoplasty/ Cut Back in 93. Of the 160 patients in whom an initial colostomy was performed to date only 43 have had the definitive procedure done. Posterior Sagittal Anorectoplasty [PSARP] was done in 30 cases and Anterior Sagittal Anorectoplasty [ASARP] in 11 cases. Colostomy closure was done in 27 patients. Among postoperative complications wound infection was the commonest. Continence rate on follow up is within the acceptable range. Recorded mortality was low but we noted a significant percentage of hidden' mortality. Colostomy performed in patients with anorectal malformations is a major cause of the 'hidden' mortality associated with the management of this condition. Proper care of the colostomy needs to be achieved to reduce this

Hair tourniquet strangulation of penis

Strangulation of the penis by coil of hair is very uncommon. Left as such it can produce varying grades of injury to skin, urethra.and glans. Simple removal of hair coil at early stage can prevent the dreadful complication. The author describes a series of 9 boys who presented with hair coil strangulation of penis. Four boys had superficial skin injury. The rest five presented with urethral fistula at the corona glandis. One stage repair was done in all cases with good results for repair of fistula. Overview of the literature and surgical technique is discussed