Potential of botanical driven essential oils against Haemonchus contortus in small ruminants / Potencial de aceites esenciales botánicos contra Haemonchus contortus en pequeños rumiantes

The livestock sector is continuously facing problems in controlling parasitic diseases especially Haemonchosis due to emergence of anthelminthic resistance and failure in vaccination control programmes. Therefore, to increase milk and meat production and emerging demand of meat free from drug residues development of new alternative approaches are appealing for prevention and control of Haemonchosis in small ruminants. Among alternatives, plants driven essentials oils have shown promising results in control of Haemonchus contortus infection at various concentrations by different assays including egg hatch assay, larval development assay, larval exsheathment assay and adult motility assay. Essential oils are complex mixtures of various impulsive or volatile compounds which have potential to control Haemonchosis. The current study reviews the therapeutic effects of essential oils of plants against Haemonchus contortus and to be used them against Haemonchus contortus for future perspectives.

El sector ganadero enfrenta continuamente problemas para controlar las enfermedades parasitarias, especialmente la hemoncosis, debido a la aparición de resistencia antihelmíntica y al fracaso en los programas de control de vacunación. Por lo tanto, para aumentar la producción de leche y carne, y la demanda emergente de carne libre de residuos de medicamentos, el desarrollo de nuevos enfoques alternativos es atractivo para la prevención y el control de la hemoncosis en pequeños rumiantes. Entre las alternativas, los aceites esenciales producidos por las plantas han mostrado resultados prometedores en el control de la infección por Haemonchus contortus a diversas concentraciones mediante diferentes ensayos, incluido el análisis de eclosión de huevos, el desarrollo de larvas, el análisis de vaciado de larvas y el ensayo de motilidad en adultos. Los aceites esenciales son mezclas complejas de varios compuestos impulsivos o volátiles que tienen potencial para controlar la hemonchosis. Este estudio revisa los efectos terapéuticos de los aceites esenciales de las plantas contra Haemonchus contortus y evalúa sus perspectivas futuras como agentes para combatir las enfermedades causadas por este parásito.

SSR based Characterization of Indigenous Harnai Sheep Breed of Balochistan

This study was on the molecular characterization of Harnai sheep breed in Balochistan. A set of (n=16) ovine specific SSR markers, recommended by FAO, was used on (n=50) blood samples from unrelated animals of Harnai sheep breed from their breeding tract. Various genetic parameters were observed using Pop gene software. A total of 74 alleles were found on 13 loci. The finding values for observed number of alleles (Na), effective number of alleles (Ne) and Shannon’s Information index (I) the average values were found along with standard deviation to be 2.448±0.869, 1.7050.604 and 0.5890.357 respectively, further more, the mean values of observed heterozygosity (Obs_Het) expected homozygosity (Exp._Hom), expected heterozygosity (Exp_Het), effective number of allele (Ne) average Heterozygosity (Ave Het) were found to be 0.598±0.299, 0.366±0.284, 0.602±0.238, 0.363±0.219, 0.347±0.209 and 0.347±0.209, respectively. The value of F-statistic ranged from 0.2851 to 0.9132 for different microsatellite markers with an average of 0.515±0.021. Majority of the markers showed higher than average expected reduction in heterozygosity. The standard errors were generally low, which indicated that homozygosity prevails in the population under study. This might be due to intense inbreeding in this flock of Harnai sheep.

Acaricidal and insecticidal effects of essential oils against ectoparasites of veterinary importance / Efectos acaricidas e insecticidas de los aceites esenciales contra los ectoparásitos de importancia veterinaria

Ectoparasitism in animals has become an issue of great concern that needs to be resolved to prevent huge economic losses occurring to livestock industry all over the world. Synthetic adrugs have been playing a major role in controlling ectoparasites, but their frequent and irrational use has resulted in drug resistance to routinely used chemicals and their residual effects on food and environment. Therefore, this approach of using chemical acaricides and insecticides is losing its popularity and effectiveness in controlling ectoparasites. So, the development of alternative approaches in ectoparasite management is currently required. Among alternative protocols, plants and their essential oils have played remarkable role in controlling different ectoparasites (ticks, flies, mites, lice) of veterinary importance. Essential oils have been proved to be cheaper, more effective and safer therapeautic agents against different ectoparasites of livestock importance.

En los animales el ectoparasitismo se ha convertido en un tema de gran preocupación que debe resolverse para evitar que se produzcan grandes pérdidas económicas para la industria ganadera en todo el mundo. Los aditivos sintéticos han desempeñado un papel importante en el control de los ectoparásitos, pero su uso frecuente e irracional ha dado como resultado la resistencia a los fármacos utilizados habitualmente y efectos residuales sobre los alimentos y el medio ambiente. Por lo tanto, el enfoque basado en el uso de acaricidas e insecticidas químicos está perdiendo popularidad y efectividad en el control de los ectoparásitos. Por lo tanto, actualmente se requiere el desarrollo de enfoques alternativos en el manejo de ectoparásitos. Entre los protocolos alternativos, las plantas y sus aceites esenciales han jugado un papel notable en el control de diferentes ectoparásitos (garrapatas, moscas, ácaros, piojos) de importancia veterinaria. Se ha demostrado que los aceites esenciales son agentes terapéuticos más baratos, más efectivos y más seguros contra diferentes ectoparásitos de importancia ganadera.

Purification and Characterization of a recombinant beta-Xylosidase from Bacillus licheniformis ATCC 14580 into E. coli B121

Present research work is aimed to purify and characterize a recombinant beta-xylosidase enzyme which was previously cloned from Bacillus licheniformis ATCC 14580 in to Escherichia coli BL21. Purification of recombinant enzyme was carried out by using ammonium sulphate precipitation method followed by single step immobilized metal ion affinity chromatography. Specific activity of purified recombinant beta-xylosidase enzyme was 20.78 Umg-1 with 2.58 purification fold and 33.75% recovery. SDS-PAGE was used to determine the molecular weight of recombinant purified beta-xylosidase and it was recorded as 52 kDa. Purified enzyme showed stability up to 90degree C within a pH range of 3-8 with and optimal temperature and pH, 55degree C and 7.0, respectively. The enzyme activity was not considerably affected in the presence of EDTA. An increase in the enzyme activity was found in the manifestation of Mg+2. Enzyme activity was also increased by 6%, 18% and 22% in the presence of 1% Tween 80, beta-mercaptoethanol and DTT, respectively. Higher concentrations [10 - 40%] of organic solvents did not show any effect upon activity of enzyme. All these characteristics of the recombinant enzyme endorsed it as a potential candidate for biofuel industry

Antihyperglycemic effect of methanol extract of Tamarix aphylla L. Karst (Saltcedar) in streptozocin–nicotinamide induced diabetic rats

Objective To evaluate the antihyperglycemic potential of Tamarix aphylla (T. aphylla) leaves in STZ–NIC induced diabetes in Wister Albino rats. Methods Acute toxicity study was done to check the toxicity of T. aphylla (L. Karst) methanol extract. T. aphylla leaves extract was administered intraperitoneally (100 mg, 250 mg and 400 mg/kg body weight per day) to diabetic Wister rats for 21 days. The various parameters were studied including fasting blood glucose levels, haemoglobin and glycosylated haemoglobin. Results The treatment groups with the extract at three dose levels expressively abridged the intensities of blood glucose and Glycosylated Haemoglobin. The earlier detected reduced level of plasma haemoglobin of the diabetic rats was raised to near normalcy with treatment of extract. Conclusions The results of the current study confirm that the leaves extract of T. aphylla are nontoxic and have antidiabetic nature.

Hashimoto's thyroiditis: not uncommon in simple benign goiter. A review of 1102 thyroidectomies for simple benign goiter

Objective: To see the frequency of Hashimotos Thyroiditis [HT] in patients operated with the diagnosis of simple goiter

Study Design: A retrospective multicenter study

Place and duration: From 1[st] January 1999 to 31[st] March 2011 at three tertiary care hospitals

Methodology: All patients with simple benign goiter irrespective of age and sex are included in the study. Patients already diagnosed for hashimotos thyroiditis, recurrent goiter, abnormal thyroid hormone profile, diagnosed congenital thyroid pathology or non availability of postoperative histopathology were excluded from the study. Histopathology of all patients reviewed to see the frequency of hashimotos thyroiditis in patients operated for benign simple goiter

Results: Among a total of 1102 patients, 91.28% [n=1006] were female and the majority were in 5[th] decade [35.48%, n=391] of life. Histopathology review of all patients operated for benign simple goiter showed that 2.81% [n=31] were having Hashimoto's thyroiditis and majority [87.09%, n=27] were female. Hashimoto's thyroiditis were common in patients who was in the 3[rd] decade of life followed by 4[th] decade, i.e. 35.48% [n=11] and 32.26% [n=10] respectively

Conclusion: Hashimotos thyroiditis is not uncommon and due to its varied clinical presentation it should be ruled out in simple benign goiter before surgery

Wife battering trends in Pakistani population

Objective: to study the present trends about wife battering in Pakistani population

Material and Methods: two hundred cases of battered wife were selected from Emergency and OPD of Islam Hospital Sialkot, OPD and Emergency of Fouji Foundation Hospital Rawalpindi, PD and Emergency Department of Railway Hospital Rawalpindi, OPD and Emergency Department of Services Hospital, Lahore, and OPD and Emergency Department of Shahina Jamil Hospital Abbottabad. The data was collected on preform with relation to age, socio economic status, literacy rate, occupation, addiction, joint family system and residential area with the permission of authorities of the hospitals. The data was analyzed for results statistically

Results: in this study the victims of battered wife were maximum at the age range 21 30 years 33 % [66 cases] as compared to age range 71 80 years 02 % [04 cases]. The house wives were the maximum victims of battered wife 25 % [50 cases] as compared to belonging to business community wives 05 % [10 cases]. In the lower class the victims of battered wife were 56 % [112 cases]; in middle class 24 % [48 cases] and in high gentry 20 % [40 cases] victims of battered wife were recorded. Among the addicted couples the battering of wife was higher 83 % [166 cases] as compared to non-addicted couples 17 % [34 cases]. The battered wives were 73 % [146 cases] in case of more than one wife as compared to single wife 27 % [54 cases]. Where there was sickness of the wife or husband the victims were 83 % [166 cases] as compared to healthy couple which were 17 % [34 cases]. In illiterate families the victims of battered wife were 63 % [126 cases] as compared to literate families 37 % [74 cases]. In joint family system the victims of battered wife were 67 % [134 cases] as compared to nuclear family system 33 % [66 cases] were seen. The victims of battered wife were maximum from rural area 67 [134 cases] as compared to urban area 33 % [66 cases]

Conclusion: the tendency of battered wife is a global problem. It is increasing day by day in developed/ under developed countries and nations. This trend is even going to be increased in Muslims countries where battering to the wife is prohibited [Haraam]

Increasing tendency of rape with females in Pakistan

To study the increasing tendency of rape with females in Pakistan. Observational study. This study was conducted at the Emergency Departments of Gangaram Hospital Lahore, Mayo Hospital Lahore, Services Hospital Lahore., Shahina Jamil Hospital Abbottabad from 1[st] January 2012 to 31[st] May 2013. The cases of rape were selected from Services hospital Lahore, Mayo hospital Lahore, Shahina Jamil leaching hospital Abbottabad and Gangaram Hospital Lahore. The data of rape with female was collected on proforma and analyzed for results. The incidence of rape was maximum at the age range 21 30 years [39%] as compared to age range 60 and above [1 2%]. It was seen that incidence of rape was maximum in labor class of women as compared to house wives and business man wives 5-9% which was minimum. In this study the incidence of rape with women was 55% [55 cases] it] lower class, 30% in middle class [30 cases] but the victim of rape in high gentry was IS% [15 cases]. The Rape victims were 64 o [64 cases] in unmarried women and 36% [36 cases] in married women. The incidence of rape was 41% in urban area [4! cases] and 59% [59 cases] in rural area. In this study 37% [37 cases] were semen positive and 63% [63 cases] were of semen negative. The injuries of private parts and rest of the body were present in 83% victims of rape [83 cases] and 17% [17 cases] were those victims in which the injuries were absent. At the last 91% [9lcases] were brought by the police for medico legal examination / certification and 9% [9 cases] were come on their self request. The tendency of rape with females is a global problem/sex assault due to, 1] internet use for sex stimulation, 2] Indian sexy movies. 3] the female mixing with males, 4] Co education, 5] Joint possession of offices, 6] Sexy Movies on cable, 7] Non religious gatherings and 8] Unawareness of Islamic teaching

Increasing tendency of "target killing" in Pakistan

To determine the increasing tendency of target killing in Pakistan. Retrospective study. This study was conducted at the Emergency Departments of Services Hospital Lahore, Gangaram Hospital Lahore, Mayo Hospital Lahore and Shahina Jamil Hospital Abbottabad from 01-01-2012 to 31-05-2013. 100 cases of Target Killing were selected from Emergency Deptt of services Hospital Lahore, Emergency Deptt of Gangaram Hospital Lahore, Emergency Deptt of Mayo Hospital Lahore and Emergency Deptt of Shahina Jamil Hospital Abbottabad. The data was collected from above said hospitals on proforma and analyzed for results. In our study the incidence of target killing was maximum at the age of 21-30 years [33%] and minimum at the age of 71-80 years as show in Table No.1. The incidence of target killing was 20% in lower class, 34% in middle class, 56% in upper class as shown in Table No 2. Addict people had 83% incidence of target killing and 17% in non addict people as shown in Table No 3. The incidence of target killing was 83% in people having mental / physical sickness has compared to healthy people [17%] as shown in Table No 4. The incidence of target killing was 37% in literate people and 63% in illiterate people as shown in Table No 5. The incidence of target killing was high 67% in people living in non joint family system as compared to people living in joint families [33%] as shown in Table No 6. The incidence of target killing was 37% in literate people as compared to illiterate people [63%] as shown in Table No 7. The trend of target killing was 67% in rural area and 33% in urban area as shown in table No. 8. Target Killing is a global problem. This problem is due to 1]Mental /physical or both Sickness of the people, 2] Frustration of people due to economical/ political/ sectarian disputes, 3] Far Away from Islamic teachings, 4] Out spread of addiction in Pakistan

Increasing trend of homicidal drone attacks in Pakistan

To study the increasing trend of Homicidal Attacks in Pakistan. Retrospective study. This study was carried out at 1. Benazir Civil Hospital Rawalpindi, 2. Forensic Medicine Deptt. General Hospital PGMI Lahore, 3. Civil Hospital Sialkot, 4. DHQ Benazir Hospital Abbottabad 5. DHQ Hospital Gujrat from 01.01.2012 to 31.05.2013. The data of Homicidal drone attacks and mortality was collected from news papers, internet and medical journals of Forensic Medicine. The Bureau of Investigative Journalism estimates the following cumulative statistics about US drone strikes: [As of March 2013]. Total strikes: 366. Total reported killed: 2,537 - 3,581. Civilians reported killed: 2000 - 3000. Children reported killed: 368 - 997. Total reported injured: 1,174-1,465 . Strikes under the Bush Administration: 52. Strikes under the Obama Administration: 314. The trend of Homicidal drone attack was increased in Pakistan in President Pervaiz Musharaf time in favour of Americans by giving our National Airports. The people of Waziristan are also responsible for these attacks as they give information about Taliban to their centers by giving signals in a cost of dollars

Increasing trend of domestic violence with women in Pakistan

To study the increasing trend of domestic violence with women in Pakistan, Retrospective study. This study was carried at Emergency Departments of four hospitals namely Services Hospital, Lahore, Shahina Jamil Hospital Abbottabad, Gangaram Hospital Lahore and Mayo Hospital Lahore from 1[st] January 2012 to 31 May 2013. The cases of domestic violence with women were selected from aforementioned hospitals. The data was collected on proforma ad analyzed for results. In our study the incidence of Domestic violence with women was maximum at the age of 21 - 30 years [33%] and minimum at the age of 71 - 80 years as show in Table No. 1. The incidence was maximum with house wife [25 %] and minimum in wives of business man [0.5 %] as shown in Table No.2 The incidence of Domestic violence with women was 56 % in lower class, 34 % in middle class in 20 % in high gentry as shown in Table No 3. Addict member of family had 83 % incidence Domestic violence with women of and 17 % in non addict people as shown in Table No 4. The incidence of Domestic violence with women was 73 % in unmarried and 27 % in married as shown in Table No 5. The incidence of Domestic violence with women was 83 % in people having mental / physical sickness as compared to healthy people [17 %] as shown in Table No 6. The incidence of Domestic violence with women was 37 % in literate people and 63 % in illiterate people as shown in Table No 7. The incidence of Domestic violence with women was high 67 % in couples living in joint family system as compared to couple living in non joint families [33 %] as shown in Table No 8 The trend of Domestic violence with women was 67 % in rural area and 33 % in urban area as shown in table No.9. The tendency of domestic violence with women is a global problem It is increasing day by day in developed / under developed countries and nations. This trend is even going to be increased even in Muslims countries where domestic violence with women is prohibited [Haraam]

Laparoscopic cholecystectomy in acute gall bladder

To look for the feasibility and results of laparoscopic cholecystectomy in acutely inflamed gall bladder, gangrenous cholecystitis and empyema gall bladder. It was a prospective observational case series. As an institutional policy early laparoscopic cholecystectomy was performed in all the patients with diagnosis of acute cholecystitis. The incidence of gangrenous cholecystitis and empyema gall bladder was noted and laparoscopic intervention was preferred in all these patients. The demographic profile, clinical records, operative details, complications and follow up details were prospectively gathered on a performa. Early laparoscopic cholecystectomy was performed in 142 patients. 103 patients had simple acute cholecystitis, 13 patients had empyema gall bladder and 26 patients had gangrenous cholecystitis. The incidence of comorbids such as diabetes mellitus, hypertension and ischemia heart diseases was 28.1%, 61.5 and 80.75 in patients with simple acute cholecystitis, empyema gall bladder and gangrenous cholecystitis respectively. Male gender was predominating in patients with complicated cholecystitis. The open conversion rate was 3.88% in simple acute cholecystitis, 15.38% in empyema gall bladder and gangrenous cholecystitis combined. There were 2 major complications in patients with simple acute cholecystitis and 2 major complications in patients with gangrenous cholecystitis. There was one mortality in a patient with simple acute cholecystitis. Laparoscopic cholecystectomy is a safe and effective option in acute gall bladder. Based on our experience we recommend an early laparoscopic gall bladder removal, provided expertise and gadgets are available

Road traffic accidents fatality and disability in D.I. Khan N.W.F.P

Road traffic accidents are important cause of death and disability in the world. More than 3000 people die on road everyday and 10 million are disabled or injured every year. The present study is an attempt to visualize the menace in D.I. Khan. The study is based upon the data of autopsies and medico legal cases examined at DHQ Hospital, D.I. Khan and Forensic Medicine Department of Gomal Medical College, D.I. Khan during year 2007 and 2008. The data was analysed for assessment of traffic accident victims. During period of study 341 cases of unnatural deaths were subjected to autopsy examination. Out of these 59 cases [22.7%] were of accidental deaths and all were male. A total of 225 injuries were recorded. The head and face sustained the highest number of injuries [42.6%] followed by the lower extremities [21.8%]. The total no. of Medico legal cases was 2153 and out of which 495 [23%] were injured due to accidents. Majority were males [99.4]. A total of 1208 injuries were found in various body areas. The maximum number of injuries [39.4%] was on head and face and next were lower extremities sustaining 28.4% injuries. The situation is alarming one and it requires immediate measures to be taken for ensuring safe traveling. Accidental death and disability can be minimized by improving roads condition, making separate pathways for cyclists and motor cyclists and adopting precautionary measures during driving

experience with retrosternal Goiter: analysis of 89 cases

To determine the frequency of retrosternal goiter, clinical presentation and post operative complications among the patients presenting with goiter. It is a prospective, crossectional study conducted at Department of Surgery, Fauji Foundation Hospital, Rawalpindi from January 1997 to December 2008. All patients with goiter were evaluated for retrosternal extension of thyroid, clinical presentation, and post operative complications. Among 978 patients, 89 [9.10%] patients had retrosternal extension of thyroid. Majority of the patients were female [94.51%] and euthyroid [91.02%]. Among all the patients, [39.33%] were in the 5th decade. Retrosternal extension of both lobes was found in 83.15% and one lobe in 16.15% patients. Dysponea was the commonest complaint by all patients, followed by headache [30.33%] and dysphagia [25.84%]. Recurrent laryngeal nerve palsy was seen in 4.49% patients and 3.37% patients developed hypocalcaemia and wound infection after surgery. Retrosternal extension of thyroid is not uncommon. Surgery can be easily done through cervical approach

autopsy study of asphyxial deaths

The study includes autopsy examination of 132 cases of asphyxial deaths, brought by the police at Department of Forensic Medicine, K.E.M.U., Lahore during the year 2002, 2003 and 2004. The study revealed that the female to male ratio was 2:3 and individuals in the third decade of life are maximally involved. The ligature was a single loop in 77.7% of the cases and multiple in 22.3% of the cases. The most frequent non-specific asphyxial signs were congestion [72.7% of the cases] and petecheal haemorrhages [78%] cases. The hyoid bone was fractured in 22.7% cases. The associated injuries found were, physical and sexual in nature in 65% of the cases examined

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

Nd: yag laser capsulotomy and complications

To evaluate the complications of Nd: Yag laser when applied on postoperative posterior capsule opacification [PCO], following extra capsular cataract extraction [ECCE] with intraocular lens [IOL]. Analytical and descriptive study. Eye OPD of DHQ Hospital, PMC and Clinic of Professor Zia ud Din Ahmad, Faisalabad. From Jan 2006 to Jan 2007. There were 120 patients; age ranged from 15 years to 80 years with post operated extra capsular cataract extraction with posterior capsular opacification. A Proforma was made which included detailed history of diabetes, hypertension, time period of cataract extraction, other relevant surgical or medical history, and examination e.g. Visual acuity, slit lamp examination, intraocular pressure measurement [applanation tonometry] dilated posterior capsule examination and slit lamp biomicroscopy etc. The patients were kept under observation for 5 hour and called for follow up after one week. Out of 120 patient s 70 eyes showed visual improvement from 6/18 to 6/6 [58.34%], while 30 Shown visual acuity improvement from count figures to 6/24 [25%], mild anterior uveitis occurred in 8 cases [6.67%], corneal damage in 2 cases [1.6%] while transient raised Intraocular Pressure [IOP] in 7 cases [5.83%]. The damage to IOL observed in 3 [2.5%], the corneal damage was seen in 2 cases [1.67%]. The Nd; Yag Laser is very effective, cheap and easy mode of treatment for PCO with minimal post laser complications

Urological complications of intrauterine contraceptive device

To elucidate the urological complications of Intrauterine contraceptive device [IUCD]. This study was conducted in Fauji Foundation Hospital Rawalpindi to elucidate. The urological complications of IUCD presenting to Urology department from January 2002 to December 2006. During this period 12 ladies having IUCDs presented with lower urinary tract symptoms [LUTS]. After thorough work up, 6 patients were managed surgically and the remaining 6 were managed conservatively. In all cases the IUCDs were inserted by paramedics. Out of six cases managed surgically, 3 patients had developed complete intravesical migration of device with stone formation. While in two other patients there was partial migration of the IUCD and stone formation over the migrated component of the device. One patient had simultaneously two IUCDs, one in uterus and another in bladder. We successfully performed cystolitholapaxy and retrieved four IUCDs in these patients endoscopically. A large vesical stone and the entombed IUCD in one of our patients were also removed endoscopically. The patient who presented with two IUCDs also got the vesical IUCD removed endoscopically. In remaining six cases, the IUCDs were in proper location and the cause of LUTS in these patients was urinary tract infection. These patients were successfully managed conservatively. Insertion of IUCD necessitates regular follow-up to confirm its correct position. Migration of an IUCD warrants prompt removal, even in asymptomatic patients. Cases presenting with UTI with undisplaced IUCD should be managed with appropriate antimicrobial therapy

Flexible cystoscope: a useful aid to difficult male catheterization

To assess usefulness of flexible cystoscope in difficult male urethral catheterization. Fauji Foundation Hospital and Maryam Memorial Hospital, Rawalpindi during a period of four years. In a consecutive series of thirty patients with acute urinary retention and initial difficulty in urethral catheterization, a flexible cystoscope and a guide wire was used to insert the Foley's catheter. Ten patients [33.3%] presented with acute urinary retention due to benign enlargement of prostate. Five patients [16.6%] required re-catheterization following unsuccessful trial after transurethral resection of prostate. Four patients [13.3%] had carcinoma of prostate. This technique was used five times [16%] to catheterize prior to intravesical instillation of cytotoxic drugs. Two patients [6.6%] had bladder neck distortion due to transitional cell carcinoma of bladder, one [3.3%] had an extravesical haematoma and another one [3.3%] had massive post traumatic clot retention. The procedure was successful in 86.7% of the cases. Difficulty to negotiate the urethra was faced in cases of urethral strictures [6.6%]. Flexible cystoscope is a safe, quick and effective method for difficult urethral catheterization in male patients

Audit of medical record documentation of patients admitted to a medical unit in a teaching hospital NWFP Pakistan

To audit the medical record documentation of patients admitted to a medical unit in year 2005 at a teaching hospital NWFP Pakistan. The retrospective audit was conducted in the Medical [C] Unit of Government Lady Reading Hospital Peshawar from 1st January 2005 to 31st December 2005. Out of 3944 patients admitted during 2005, 200 case notes were randomly selected and subjected to audit. The clinical notes were broadly analysed for documentation of six parameters. Each parameter's documentation was to be graded as very good, good, average, poor, or not documented. Personal bio-data was documented good in 194 [97%] cases; history and examination were good in 22 [11%] cases; diagnosis was very good in 48 [24%] cases; Investigation were documented very good in 18 [9%] cases and good in 134 [67%] cases; Progress notes were good in 156 [78%] cases and treatment was documented good in 186 [93%] cases. In 82 [41%] charts, one or more of the six selected items were not documented at all. Investigations were not written in 20%, progress notes in 12%, history and examination in 9%, diagnosis in 6%, treatment in 3% and bio-data in 1% of the case notes. Documentation of important clinical information is poor even in the hospital charts of patients admitted in tertiary care hospital. Poor documentation in medical records might reduce the quality of care and undermine analyses based on retrospective chart reviews