Lethal toxic Dose [i.p LD50], total protein contents and comparative hemolytic potential of [99mTc labeled and non-labeled] Naja naja karachiensis venom

Recent recognition about snake bite envenomation on June, 2017 as neglected tropical disease under categoryA by World Health Organization advocated again its undeniable importance. Present circumstances reasoned to work on a neglected subspecies of Naja naja, i.e., Naja naja karachiensis [N. n. karachensis] has been documented for frequent deaths in Pakistan. In this study median lethal toxic dose [LD50] was determined intraperitoneally in Swiss albino mice and was found to be 2.0microg/g [2.0mg/kg] equal in potency to Naja pallida [red spitting African cobra]. Total protein contents [188+/-0.011microg / 200microg of dry weight] were high enough [94%] to represent an arsenal of proteins. Furthermore, 99mTc was labeled 99.9% with venom and didn't find to alter hemolytic activity of venom in dose dependent manner at 125 microg/ml [p<0.5], 250 microg/ml [p<0.1] and 500 microg/ml [p<0.1] when compared with its crude form. Present work will pave the way for proteomics study in effective production of antidote against specific species of snakes as dare demand of it has been felt since long period of time in Pakistan

Complete Heart Block in Association with Dengue Hemorrhagic Fever

Dengue virus infection affects the heart structurally and functionally. Clinical manifestations of cardiac complications secondary to dengue virus infection vary from self-limiting arrhythmias to severe myocardial infarction, leading to hypotension, pulmonary edema, and cardiogenic shock. However, we report a case of dengue hemorrhagic fever (DHF) complicated by a complete heart block. A female with DHF due to dengue virus serotype 2, presented to the emergency department with fever, headache, rash, and fatigue followed by an episode of syncope. She was found to have a third-degree atrioventricular block, with pulseless polymorphic ventricular tachycardia. Patient was resuscitated and a temporary trans-venous pacemaker was placed. She reverted back to normal sinus rhythm after 4 days of syncope and was subsequently discharged from the hospital after complete resolution of symptoms, without the need for a permanent pacemaker. Physicians are warranted to have high index of suspicion for dengue virus infection as an etiology in patients with acute cardiovascular compromise, especially in tropical areas.

Phytochemical screening, antiglycation and antioxidant activities of whole plant of Boerhavia repens L. from Cholistan, Pakistan

Present study was aimed to explore a traditionally used indigenous medicinal plant Boerhavia repens [Nyctaginaceae family] of the Cholistan desert, Pakistan. Crude aqueous and methanolic extracts of the whole plant were investigated in vitro for preliminary phytochemical screening, antioxidant and antiglycation activities. Antioxidant activities were determined by total phenolic contents, 1,1-diphenyl-2-picrylhydrazyl [DPPH] free radical scavenging and inhibition of lipid peroxidation. For antiglycation activities browning production was noted and thiobarbituric acid [TEA] technique was used to determine glycation level. Boerhavia repens expressed considerable amounts of phytochemicals. Extract yield was found to be 4.59%-7.85% g/100g of dry matter with total phenolics ranging from 47.9- 190.77mg/GAE per g for aqueous and methanol extract respectively. Strong inhibitory effect was exhibited by methanolic extract in linoleic acid per oxidation system [86.11%, EC[50]=0.99mg/mL] and DPPH assay [88.65%, EC[50] =212.33 Lig/ml]. In term of browning maximum inhibition [81.50%] was exhibited by methanolic extract at 37°C at third week of incubation. Both extracts expressed significant [P>0.05] and comparable inhibition of glycation level. In conclusion, Boerhavia repens showed promising antioxidant and antiglycation activities validating its therapeutic potential

Assessment of early childhood caries [ECC] and its relationship with feeding practices - a study

Early childhood caries remains a problem in both developed and developing countries and has been considered to be in an epidemic proportion in developing countries. The aim of this study was to asses the prevalence of Early Childhood Caries and its relationship with feeding practices. It was carried out at Khyber College of Dentistry Hospital. It was spread over a period of three months. This was cross sectional analytical study children of 2-6 years old formed the study group. Sample size was 194 children and sampling technique was convenience purposive. Children were examined on dental unit by the principal author and caries were detected using dft index. A parent or care giver, after taking the informed consent, was asked to complete a self-designed questionnaire regarding information about the child's pattern of feeding, mother education level, socio economics status age of starting brushing, having snack between meals and dft status. The study showed prevalence of ECC was 55.2%. In this study breast, fed children were 84% and bottle-fed were 16%. Pecentage of ECC in breast-fed children was 51.6%, which was less than the percentage of ECC in bottle-fed children, which was 72.25%. Those children who took bottle at nighttime had more carries [72.5%] as compared to those who did not [50%]. Caries in children was 89% who took milk with sugar at night as compared to those who did not. Incident of carries was more in the children of illiterate mothers [56%] than those of educated mothers [10%]. This study documented high prevalence of ECC among 2-6 year olds children. Prevalence of ECC was more in bottle fed children specially in those children who were given milk with sugar in bottle at night. Results reveal an urgent need of increased awareness among the public about ECC and their attitude towards the importance of primary teeth. This is high time to institute preventive strategies to control ECC

survey of awareness regarding diabetes and its management among patients with diabetes in Peshwar, Pakistan

To determine and compare the level of awareness regarding diabetes mellitus, its complications and management in male and female diabetic patients of Peshawar, Pakistan. A cross sectional study conducted in Peshawar, from February to July 2013. A well organized questionnaire was used, having fourteen items. The participants were interviewed and the questionnaire was filled by trained persons [Diabetes Educators]. The correct answers were marked as aware and incorrect as unaware, and made conversions to percentage. Total 561 diabetic patients were assessed. The data was analyzed using SPSS v.16 software and excel 2007. The level of awareness regarding diabetes and its management was found inadequate. Amongst, 36.3% male and 13% female diabetics were aware that why glycemic control is important, 63% male and 32.4% females were aware that diabetes could produce some complications. Similarly 23.7% male and 10% female respondents know importance of blood glucose monitoring. Only 181 male and 31 female diabetics were aware of hypoglycemia symptoms and management. Over all level of awareness in female patients as compared to male patients was found low. The overall level of awareness in both male and female diabetics was found low; and comparatively female patients have poorer awareness.

Neovascularization in herniated lumbar disc: a histological study

Inter-vertebral disc is the largest avascular structure in human body, which is primarily a load bearing and stabilizing unit of the human spine. Degenerative disorders and disc herniation causes proliferation or in growth of new blood vessels in this structure. Lumbar disc herniated tissues were studied microscopically in comparison with the cadaveric lumbar disc tissue, to evaluate the changes particularly the formation of new blood vessels. It was a case control study in which 45 lumbar herniated disc tissues [L[4] - L[5] and L[5] - S[1]] and 45 dissected, fresh cadaveric disc tissues of same level and almost of same age groups were collected and in reference to age were divided into groups. Both sets of tissues were processed, sectioned and stained with Hemotoxyllin / Eosin, to observe the architecture of annuli fibrosis and nuclei pulposus parts of disc and the micro-vessels under light microscope. Cadaveric discs, group A, B and C compared with herniated discs A[1], B[1] and C[1], Annuli fibrosi in herniated discs [A[1], B[1], and C[1]] showed significant reduction of cells, disorganized lamellar pattern of collagen, formation of cysts, clefts and numerous new micro-vessels as compared to fresh cadaveric disc tissues [A, B and C]. Disc degeneration and herniation results in the formation of micro-vessels which may not only serve as source of nutrients but also contribute in the healing process of discal tears

Effects of seat belts use on the severity of maxillofacial injuries in Khyber Pakhtunkhawa sample

The aim of the study was to know the effects of the seat belts on the severity and pattern of facial injuries in road traffic accidents. Sixty patients with road traffic accidents in four wheel vehicles were investigated for mild-moderate and severe facial injuries with and without seat belt usage during driving. This study was carried out in the Department of Oral and Maxillofacial Surgery, Khyber College of Dentistry, Peshawar. These patients with maxillofacial injuries and associated fractures were studied for age, gender distribution, severity of facial injuries and their association to restrained or unrestrained with seat. Among 60 patients only 12 were wearing seat belts when accidents occurred. Male were dominant and most RTA occurred in patient in 20s. The mean age of the patient in the present study was 21.9 years SD +/- 3.5. The age range was 6 - 50 years. The most commonly involved age group was the 3rd decade [32.25%] followed by 1[st] decade [25%] and 4[th] decade [18.25%]

Lipid lowering effect of Cinnamomum zeylanicum in hyperlipidaemic albino rabbits

The purpose of the present study was to investigate the lipid lowering effect of Cinnamomum zeylanicum [Cinnamon] in hyperlipidaemic albino rabbits. For this purpose, forty eight albino rabbits were randomly divided into eight equal groups; untreated control on normal routine feed, untreated control on butter and cholesterol, treated control on synthetic cholesterol lowering drug simvastatin [Tablet survive[R] 20 mg], three treated groups on three respective doses of C. zeylanicum bark powder and two treated groups on water and methanol extracts of C. zeylanicum bark powder. Butter ad lib and cholesterol powder 500 mg/kg body weight were used to induce experimental hyperlipidaemia in all groups except untreated control group. The results suggested that C. zeylanicum bark powder at the rate of 0.50 g/kg, 0.75 g/kg and methanol extract equivalent to 0.75 g/kg powder produced respective percent reductions in total lipids by 45, 49 and 64; triglycerides by 38, 53 and 60; total cholesterol by 53, 64 and 69 and LDL-cholesterol by 50, 59 and 62. However, at these dosage levels HDL-cholesterol showed respective percent increase of 42, 48 and 53. Nonetheless, C. zeylanicum bark powder at the level of 0.25 g/kg and C. zeylanicum extract in water could not significantly reduce lipid profile indicators. Based on these studies, it can safely be said that C. zeylanicum bark powder methanol extract equivalent to 0.75 g/kg bark powder and simvastatin [0.6 mg/kg b. wt.] were equieffective in treating hyperlipidaemia

Frequency and site distribution of oroantral fistula - a study

The objective of the study was to determine the most vulnerable sites and side involved in oroantral fistula creation. Oroantral communication [OAC] and subsequent formation of oroantral fisturla is a common complication of dental extraction of maxillary molars. Chronic oroantral fistula may complicate into chronic sinusitis and its sequelae. The study was carried out on 60 patients with oroantral fistula reported to the Department of Oral and Maxillofacial Surgery, Khyber College of Dentistry Peshawar from Aug 2004 to Aug 2007. diagnostic criteria were history, clinical examination, Periapical views, orthopantomogram and paranasal air sinuses [PNS] view. Maxillary first molar was involved in 60% cases, second molar in 30%, last molar in 6% and premolars in 4% cases. Right side was involved [52%] and left side [48%]

Post management complications of fracture mandible at the angle-an analysis

The aim of the study was to investigate post management complications of the fracture of mandible at the angle. Age and sex distribution was also studied. 750 patients who suffered maxillofacial trauma were seen during the period 1991-97 at Khyber College of Dentistry, Peshawar. 546 had mandibular fractures, 125 of these showed fracture at the angle. 20 [16%] suffered from some kind of complications. Break up showed five [25%] suffered from infection, seven [35%] had delayed union, one [5%] non-union, two [10%] showed malunion/malocclusion, two [10%] trismus and three [15%] anesthesia/paraesthesia. Study subjects from 21-30 years showed highest [46%] prevalence of management complications. Males dominated females 4:1. RTA remained highest causative factor in the fracture [65.20%]

Dental ailments among low and high socioeconomic status school children aged 11-12 years

A cross sectional study was undertaken to compare the dental ailments in school children's among low and high socioeconomic status. The data was randomly collected from children, of two schools one in Private sector [High socioeconomic status, Group A] and one in Public sector [Low socioeconomic status, Group B] from Sep 2011 to Oct 2011. School going children boys and girls were selected, and the final sample size was 216, one hundred and eight from each group with ages 11-12 years and with mean of 11.57 and SD of +/- .659, the levels of DMFT were identified by clinical examination only, using WHO standardize forms for data collection. There was high percentage [62.06%] of DMFT with SD +/- 1.84 and with mean 1.44 in the low SES group compared to the [50%] of DMFT with high SES group. The oral hygiene status was good in high SES compared to low SES

Third molar position as predisposing factor for mandible angle fracture

The aim of the study was to assess the position of 3rd molar as a predisposing factor in the fracture of the mandible at the angle. Age and sex distribution was also studied. Out of 125 mandibular fractures at the angle, during a study from 1991-97 at Khyber College of Dentistry, Peshawar, 108 [86.4%] cases had 3rd molar present while in 17 [13.6%] cases it was absent. In 108 angle fractures, 23[18.4%] were fully erupted, 42[33.6%] were partially vertically erupted, 3[2.4%] were partially erupted distoangular, 15[12%] partially erupted mesioangular, 13[10.4%] were unerupted vertically, 7[5.6%] were unerupted mesioangular and 5[4%] were unerupted horizontally. High prevalence was seen in the third decade i.e.46%. Male to female ratio was 4:1

Frequency of mandibular fractures at the angle as a result of maxillofacial trauma

The aim of this study was to determine the vulnerability of the angle of mandible to fracture in maxillofacial injuries. The etiological factors, distribution of age and gender of the patients with mandibular fracture were investigated. 750 patients were seen for maxillofacial trauma during the period 1991-97 at Khyber College of Dentistry, Peshawar. Out off 750, 546 suffered from mandibular fracture. 412 were males and 134 females. Regarding etiology of the fracture of the mandible road traffic accident [RTA] was the most common cause accounting 356 followed by fall 78, interpersonal violence [IPV] 47, firearm injuries [FAI]29, sports 23 and industrial injuries 13. Fracture of the body of mandible came out to be the frequent site [185 patients] suffered. Angle of the mandible was second most common site and accounted for 125 injuries. Other sites were symphysis [97], condyle [82], dentoalveolar process [38], ramus 16 while coronoid was the rare site [3] patients. Out of the 125 fractures cases at the angle 3[rd] molar were present in 108 cases. Among the total fractures at the angle 102 were favorable while 23 were unfavorable

Assessment of knowledge and practice regarding HIV/aids and its magnitude among truck drivers

It is estimated that 70,000 to 80,000 persons, or 0.1 percent of the adult population in Pakistan, are infected with the HIV virus, according to UNAIDS. Only 1,972 HIV cases and 231 AIDS cases had been reported to the government's National AIDS Control Program. Under reporting is attributable to social stigma, ill-developed surveillance, lack of screening and as well as lack of knowledge among the population and practitioners. Our country is highly vulnerable to an escalating epidemic due to a number of prevalent risk factors. To assess the knowledge, attitude and practice of truck drivers regarding AIDS and to calculate the magnitude of AIDS among truck drivers. It was a descriptive study, carried out as KAP survey of truck drivers. The truck drivers were interviewed at the truck agency "adda" or midway driver's hotels "charpai hotel" at eight different sites during December 2004 to January 2005. A total of 129 truck drivers were conveniently selected and information was obtained. There 104 in Lahore and 25 in Hyderabad were interviewed. Out of total subjects, 104 respondents [interviewed at Lahore] were tested for HIV antibodies by ELISA / CAPILLUS technique. The drivers were aged 19-56 years, 74% of the drivers were married with families and engaged in driving job for a mean duration of 13 years. Eighty nine [74.4%] of drivers were aware of AIDS and 61% admitted having multiple heterosexual partners, including prostitutes, and 5% admitted to have regular homosexual sexual encounters. Thirty two percent knew most of the correct sources of HIV spread. It was found that 9% of promiscuous drivers used condoms regularly, none admitted taking IV drugs, 35% reported histories of either urethral discharge or genital ulcers, and none of the 104 men tested were found to be infected with HIV. The truck drivers were adequately familiarized with AIDS but the knowledge regarding spread of disease through sexual transmission was found to be poor. No single subject was tested positive for HIV in this study. Although, literacy was found to be significantly associated with awareness of AIDS but attitude and practices were found to be unaffected