Antidiabetic Activity of Hydroalcoholic Extracts of Nardostachys jatamansi in Alloxan-induced Diabetic Rats.

A review of literature indicates that diabetes mellitus was fairly well known and well conceived as an entity in India with complications like angiopathy, retinopathy, nephropathy, and causing neurological disorders. The antidiabetic study was carried out to estimate the anti hyperglycemic potential of Nardostachys Jatamansi rhizome’s hydro alcoholic extracts in alloxan induced diabetic rats over a period of two weeks. The hydroalcoholic extract HAE1 at a dose (500mg/kg) exhibited significant antihyperglycemic activity than extract HAE2 at a dose (500mg/kg) in diabetic rats. The hydroalcoholic extracts showed improvement in different parameters associated with diabetes, like body weight, lipid profile and biochemical parameters. Extracts also showed improvement in regeneration of β-cells of pancreas in diabetic rats. Histopathological studies strengthen the healing of pancreas by hydro alcoholic extracts (HAE1& HAE2) of Nardostachys Jatamansi, as a probable mechanism of their ant diabetic activity.

Serum anti-thyroid peroxidase antibodies in patients with endogenous depression

A total of 80 subjects were divided into two groups. Groups A included 20 normal healthy control subjects and group B included 60 subjects with endogenous depression Anti-TPO antibodies were performed by commercially available kits. Results were analysed by using students T test and level of significance was done. Anti-TPO antibodies were significantly raised in patients with endogenous depression

Diagnostic value of automated haematology analyzer in the diagnosis of malaria

To evaluate the diagnostic utility of a haematology analyzer in malaria cases in which the analyzer failed to give a differential leukocyte count. It was an observational study carried out at Pathology Department, Rehman Medical Institute Peshawar, from August 2006 to Jan 2009. During this period a total of 96,865 blood counts were done using Sysmex XT 2000i, haematology analyzer, In 310 consecutive cases, in which the instrument failed to give any differential, 225/310 [73%] were suspected as having blasts or nucleated red cells by the analyzer. In 80/310 [26%] cases in which the instrument did not suspect any blasts or nucleated red cells, some type of malaria was detected on slide examination. Out of the 80 malaria cases, Plasmodium vivax trophozoites were seen in 99% cases with or without ring forms. It included 5% cases of mixed malaria. Using this analyzer, if there is no White Blood Cells differential and no flagging or suspicion, there is a strong possibility of finding trophozoite forms of Plasmodium vivax malaria in peripheral blood

Penile fracture: role of early surgical intervention on postoperative outcome

Fracture of penis is relatively uncommon but grave urological emergency, which needs urgent surgical intervention to achieve good postoperative outcome

Objective: To determine the outcome of early surgical repair in patients presenting with fracture of penis

Patients and Methods: This retrospective study comprises 13 patients with fracture of penis, presenting in emergency of Services Hospital, Lahore from 2000-2007. Diagnosis was made clinically. No radiological investigation was carried out. All patients had primary suturing of the tunica tear and were followed up for 2-6 months postoperatively

Results: Mean time interval between accident and arrival to hospital was recorded. Eight patients [61.5%] had fracture due to sexual intercourse. Three patients [23.08%] bending of penis. Masturbation and fall on to an erect penis each accounted for 1 [7.70%] of the total cases. There were no significant complications except necrosis of penile skin in one patient. Erectile function was preserved in all patients postoperatively

Conclusion: Early surgical intervention for penile fracture has good postoperative outcome with acceptable complication rate. Early diagnosis and surgical repair are instrumental in ensuring good outcome and minimal complications

Lateral epicondylitis; steroid injections for the management

To find out effectiveness of steroid injection for early management of lateral epicondylitis. One hundred and twenty Patients of both genders presenting with unilateral lateral epicondylitis of less than two weeks duration reporting at Outpatient Department at Armed Forces Institute of Rehabilitation Medicine, Rawalpindi. Quasi experimental study. Out patient department of Armed Forces Institute of Rehabilitation Medicine, which is the largest rehabilitation facility in the country at present offering a multidisciplinary approach in the management of disability and musculoskeletal disorders17. 01 yrs. Both groups had sixty cases each with a mean age of 35.1 +/- 6.22 and 36.08 +/- 5.98 respectively. There were 54[45%] males and 66[55%] females. At four weeks and three months follow up assessments there was significant improvement in pain relief and pain free grip strength in the Group A[steroids] as compared to Group B [NSAIDs]. Local steroid injection is an effective treatment with an advantage over nonsteroidal anti-inflammatory drugs [Diclofenac]. It results in a rapid and better relief of symptoms, which is sustained over a period of three months

Frequency of complications during hemodialysis in patients of chronic renal failure

To determine the frequency of various complications occurring during hemodialysis in patients of chronic renal failure undergoing maintenance hernodialysis. A descriptive prospective study. The study was conducted at Department of Nephrology, Military hospital Rawalpindi Pakistan, from 21st July 2005 to 21st Jan 2006 One hundred subjects fulfilling inclusion criteria [Patients suffering from chronic renal failure [CRF] who were on maintenance hemodialysis for at least 03 months] during the above-mentioned period were enrolled in this study with non-probability sampling technique after taking informed consent. One hundred patients of end stage renal disease of maintenance hemodialysis were studied The major causes of renal disease were diabetes mellitus [24.0%] and hypertension [22.0%] The most frequent complication was hypotension seen in 12% of dialectic treatment followed by muscular cramps [10%], chest pain [09%], vomiting [08%] and headache 06% of patients. Other complications like membrane hypersensitivity reactions, pruritis and complications of access route disequilibrium syndrome were uncommon. In the patients with chronic renal failure on maintenance hemodialysis, hypotension was the most frequent complication. So assessment of patient for hernodynamic status and general condition is important to reduce the incidence of complications

Frequency of hepatitis B and C infections in the general population of Lahore, Pakistan

In the recent times, viral hepatic infections [HBV and HCV] have become common and the most important cause of liver disease. It is posing a great health problem especially in the developing world. The importance of hepatitis B and hepatitis C is illustrated by the fact that these infections are imposing a heavy burden on national economy and individual families due to considerable morbidity and mortality from both acute infection and chronic sequelae including chronic active hepatitis, cirrhosis and hepatocellular carcinoma. The present study was carried out to determine the frequency of HBV and HCV infections in the general population of Lahore and to highlight the magnitude of the problem. The study was conducted during the 'Free Hepatitis Camp' held at Services Hospital, Lahore - Pakistan for a period of one week from May 18 to May 25, 2007. It is a descriptive / cross sectional study. Blood specimens were collected using approved medical techniques and tested for HBsAg and anti-HCV on 3rd generation ELISA system. This study was conducted in the general population of Lahore and a total of 992 subjects were screened for both hepatitis B and C. Sero-positivity for hepatitis B and C were detected in 30.94% of the subjects. The prevalence of HCV among the total subjects studied was 21.7%, hepatitis B, 8.06% and hepatitis B and C [dual infection] 1.31%. Sero-prevalence in females and males of HBsAg was 1.61% and 6.45% and of anti HCV antibodies 10.38% and 11.19% respectively. It is concluded that about 1/3rd of the studied population is sero-positive for hepatitis B or hepatitis C or both infections and this figure is alarmingly high. It further concludes that the frequency of HCV infection is much more common than that of HBV. It raises concern about the increasing disease burden in future and effectiveness of preventive programs/methodologies. Practical implementation of recommended preventive measures in true sense is crucial to prevent or at least reduce the consequences of viral hepatitis in risk groups. There is considerable HCV and HBV threat to our population and require a genuine need for strict adherence to preventive measures

Pit falls in stroke rehabilitation: a Pakistani perspective

To identify short comings in the stroke rehabilitation referral and consultation in Pakistan. Observational study. Stroke Clinic at Armed Forces Institute of Rehabilitation Medicine [AFIRM] Rawalpindi from March 2005 to September 2005. 171 patients of stroke fulfilling the inclusion criteria were enrolled in the study. Detailed history was obtained and a thorough examination with emphasis on neurological and musculoskeletal system was performed. Medical records and radiological investigations were reviewed. There were 132 [77.2%] males and 39 [22.8%] female patients. Radiological investigations were not available in some patients. In the remaining patients the frequency of Ischemic vs Hemorrhagic was 82% and 18% respectively .Involvement of right and left cerebral hemisphere was almost equal with 53% and 47% respectively. Majority, i.e 153 [89.5%] of the patients were referred as OPD cases while indoor rehabilitation consultation was made only for 18 [10.5%] patients. Only 04 [2.3%] patients were seen within 48 hours of stroke onset. In 39 [22.8%] cases consultation was made between one week to one month and for 116 [67.8%] between one to six months, while it was delayed beyond six months in 12 [7%] patients. Important shortcomings identified were non availability of physicians in rehabilitation medicine, late/ no referrals, inadequate referrals, long term placement of indwelling catheters and lack of patient and family education. Stroke is an important cause of long-term disability. Timely and comprehensive stroke rehabilitation minimizes the impairments and leads to successful reintegration of individual into the society. It is a poorly understood concept in Pakistan. Physicians are either not aware of the concept and significance of stroke rehabilitation or often confuse it with physiotherapy alone. There is a need to improve the stroke rehabilitation services in the country

Clinical outcome of modified thiersch duplay urethroplasty for proximal hypospadias

To report the functional results, complications and cosmesis by using Thiersch Duplay urethroplasty repair for hypospadias. Between years 2006 to 2007, 30 patients underwent repair of proximal hypospadias [penoscrotal] with chordee. Two stage repair was performed in all cases. 1[st] stage consisted of chordee correction by excising fibrous cord between ectopic meatus and corona along with incision of glans. The grafting of the dorsal hood skin was made on ventral aspect of tunica albuginea. In second stage repair U shaped incision was made around hypospadiac meatus and a ventral skin flap was dissected superficially to allow tubularization around a suitable size silicon Foley catheter [5 -8 Fr in children, 10-12 Fr adolescence and 14-16 Fr in adults] without tension. The Thiersch Duplay tube was constructed using 5/0 vicryl. A subcutaneous fascial layer was closed over tube to support neourthra. The Foley catheter was left for 10-12 days. Age range was 3-25 years with mean +/- SD of 12.7 +/- 5.09. Total hospital stay was 10-12 days with mean +/- SD of 11.9 +/- SD 0.85. Twenty five patients [80.2%] could void on standing and had a good caliber straight single stream of urine in forward direction. The cosmetic appearance of a natural vertical slit glanular meatus situated at the normal position on the glans achieved in twenty five patients. Period of follow up was 4-8 month mean with mean +/- SD of 6 +/- 1.43. Main complications seen were urethrocutaneous fistulae in three [9.9%], meatal stenosis in three [9.9%], hematoma in one [3.3%], complete disruption in one [3.3%] infection in two [6.6%] and painful bladder spasm in two [6.6%]. These seen in five [16.5%] patients. Staged urethroplasty for proximal hypospadias results in a normal penis with good functional, minimum complications and excellent cosmesis, with short hospital stay

Uro-dynamic evaluation

drsaqii1711@hotmail.com To describe the pattern of Urodynamic evaluation at Armed Forces Institute of Rehab Medicine, Rawalpindi. Descriptive study. This study was conducted on 466 patients reporting for urodynamic evaluation at Urodynamic/Incontinence Clinic at A F Institute of Rehab Medicine from Feb 2003 to Dec 2006. We considered the age, gender, etiology, reason for referral, and presenting complaints whereas results were formulated according to Classification of voiding disorders by International society of Incontinence. Data was analyzed using statistical package for Social Science version 10. In all [466] patients, 58% were males and 42% were females. Mean age was 46.8 years. Increased frequency [61%] and incontinence [52%] were the most common presenting complaints, 158[34%] had spinal cord injuries, 58 were cases of myelodysplasias and 128 reported with stress incontinence. Urodynamic studies showed that 152[33%] had hyperactive bladders, 110[24%] had a contractile/hypo-contractile bladders, 104[22%] had stress incontinence and 56[12%] cases had normal results. Urodynamics helps in diagnosis of potentially life threatening urinary problems. The availability of this equipment and trained staff must be encouraged at tertiary care hospital. More research is required in this regard in Pakistan, which shall help in formulating better management protocols in future

Living donor renal transplantation our experience in SIMS/Services Hospital, Lahore

Kidney transplantation is the treatment of choice for end stage renal disease [ESRD] patients. However organ shortage remains the central problem in kidney transplantation. To deal with the widening gap between supply and demand of organ for renal transplantation, efforts to expand the organ donor pool have received increased attention. To solve this problem, we have initiated a living related and unrelated living donor programe using emotionally related persons, friends and well motivated volunteers as organ donors. A total of 18 patients with live donor underwent kidney transplantation in Sims /Services Hospital over a period from March 2006 to December 2006. The aim of study is to highlight the problems and identification of factors limiting the number of transplantation and further prospects of renal transplantation in Pakistan. The cause of ESRD was HTN 7 [38.89%], Chronic Glornerulonephritis 4 [22.22%], Calculus Renal failure 4 [22.22%], and Diabetic Nephropathy 3[16.67%].The donor age ranged between 20-55 years [mean 28.39].The recipient age ranged 17-56 years [mean32.73]. Relationship of donor to recipient was sister 1 [5.56%], 1st degree relatives 3 [16.7%], friends 4[22.22%], unrelated 10[55.56%]. In our study graft survival was 88.89%, patient survival 94.45%, mortality 5.56%. Transplanted patient has to be better motivated to take medication regularly and get the investigations. It was observed that 1st degree relation are very limited source of donors in this part of the world and unrelated donors certainly encourage, transplantation

Evaluation of sealing ability of three root canal sealers

The purpose of this study was to determine the sealing ability of three different sealers and to compare the sealing ability of three sealers. Thirty single rooted mandibular first premolar teeth were used. The crowns were removed at the cemento - enamel junction and root canals were prepared to a # 35 K-file. The teeth were randomly divided into three groups, A, K and R. Each group consisted of 10 specimens. In group A, AH Plus sealer, group K, Ketac-endo sealer and group R, Roth 801 sealer were used and obturated with gutta percha using lateral condensation technique. After storage in 100% humidity at 37°C for one week, the root surfaces were coated with nail polish [except at the apex] and suspended in 2% methylene blue dye solution for one week. The roots were sectioned longitudinally to determine the following mean values of dye penetration, group A - 2.675 mm, group K - 2.346 mm, group R - 4.929 mm. This study shows that Ketac-endo gave better seal than Roth 801 sealer

Role of therapeutic exercises in neurogenic thoracic outlet syndrome

Neurogenic Thoracic Outlet Syndrome [TOS] is a set of signs and symptoms existing due to compression of brachial plexus in the cervical area. We performed the study to highlight the role of therapeutic exercises on patients with neurogenic thoracic Outlet Syndrome. This quasi-experimental study was carried out at Armed Forces Institute of Rehabilitation Medicine [AFIRM], Rawalpindi. Fifty consecutive patients of neurogenic TOS of both genders and all ages were selected. Patients were diagnosed clinically and the diagnosis was confirmed by electrodiagnosis. These patients were asked to follow a therapeutic exercises program for 6 months. Outcome measures included Visual Analogue Scale [VAS] and Ulnar Nerve Conduction Velocity across neck. Results were compared by applying relevant tests of significance on follow up visits at 3 and 6 months. Mean age was 39.1 +/- 7.79 years. Thirty seven [74%] cases were females and thirteen [26%] were males. On each visit, statistical analysis showed significant improvement with therapeutic exercises. After 6 months of conservative treatment, 17 [34%] of patients showed full recovery, 14 [28%] had marked improvement, 16 [32%] had partial improvement while 3 [6%] patients reported with persistent severe symptoms. Current study shows that a trial of therapeutic exercises provides relief of symptoms of Neurogenic Thoracic Outlet Syndrome in majority of patients

Accuracy of ultrasonography in detection of severe liver fibrosis/cirrhosis in chronic liver disease

To determine the accuracy of three ultrasonographic [US] signs; liver surface nodularity, caudate lobe hypertrophy and hepatic vein flow pattern on Doppler ultrasound, in detecting severe liver fibrosis in chronic liver disease. Descriptive study. Department of Diagnostic Radiology, PNS Shifa Karachi. Duration of the study was 6 months -SEPTEMBER 2005 TO MARCH 2006. The study included 50 patients of both sexes [20-60 yrs], presenting with chronic liver disease to department of Ultrasound. TOSHIBA [NEMIO- 20] Doppler Ultrasound Machine with Doppler 3.5 and 5.0MHz probes was used to look for liver surface nodularity, caudate lobe hypertrophy and pattern of hepatic vein flow. After performing US, liver biopsy on these patients was performed under US guidance and sent for histopathology findings; taken as gold standard. On US, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy were highest for liver surface nodularity in detecting severe liver fibrosis. However, the above-mentioned values were relatively higher when the three ultrasound signs were collectively considered; compared to single US sign. US determination of liver surface nodularity is a significantly accurate method for identifying severe liver fibrosis or cirrhosis. The accuracy of ultrasound further increases when hepatic vein flow pattern and caudate lobe hypertrophy are also taken into account

Inflammatory pseudotumour of urinary bladder

A young patient with gross haematuria was evaluated radiologically which revealed a solid mass measuring 7x7 cm in the urinary bladder. Cystoscopy showed a big solid mass at bladder dome. Biopsy was taken endoscopically. Histologically it turned out to be inflammatory pseudotumour. Later partial cystectomy was done with 1 cm healthy margins. Repeat biopsy confirmed the findings of previous histopathological examination

Percutaneous Nephrolthotomy [PCNL]

Background: SIMS/Services Hospital Urology department presented its initial experience of Percutaneous Nephrolithotomy [PCNL] with promising results

Aim: To assess the efficacy and safety of PCNL in the management of Renal stones

Methods: Prospective study of 40 patients who underwent PCNL. Procedure performed in General Anasthesia. Placement of ureteric catheter in Lithotomy position to visualize the collecting system. Ureteric catheter and Foley catheter retained in a sterilized bag. Patient shifted to prone position with C-Arm at 0[degree]. Nephrostomy needle placed over desired calyx and tract dilated with metallic dilators. Stone crushed with swiss lithoclast and fragments removed with stone graspers. Foley catheter placed at the end of procedure percutaneously. X-Ray KUB done post operatively and both Foley and ureter removed subsequently

Results: In total 40 patient 27 [67.5%] male and 13 [32.5%] female the success rate with PCNL as monotherapy was 72.5%. It was 82.5% when combined with ESWL

Conclusion: Percutaneous Nephrolithotomy [PCNL] is effective monotherapy for renal stones and gives excellent results when combined with ESWL

Lymphatic filariasis in a young girl

Lymphatic filariasis known as Elephantiasis put more than a billion people at risk. Over 120 million have already been affected by it; out of which over 40 million are seriously incapacitated and disfigured by the disease 1.2. Elephantiasis is a complication that occurs due to repeated infections caused by three species of filarial worms. Wuchereria bancrofti, Brugia malayi are the most common and Brugia timori is rarely implicated 2. In its most obvious manifestations, lymphatic filariasis causes enlargement of the entire leg or arm, the genitals, vulva and breasts. In endemic communities, 10-50% of men and up to 10% of women can be affected 3. The psychological and social stigma associated with these aspects of the disease arc immense. In addition, even more common than the overt abnormalities is hidden, internal damage to the kidneys and lymphatic system caused by the filariae 4.5. One-third of the people infected with the disease live in India. A primary cause of this increase is the rapid and unplanned growth of cities, which creates numerous breeding sites for the mosquitoes that transmit the disease

Relationship of ABO blood group in patients with oral cancers

Present study was designed to find the association of ABO blood groups with oral cancers. In this study 50 diagnosed cases of oral cancers and 50 healthy controls were selected. ABO blood grouping, complete blood examination was performed in all these subjects. Out of 50 patients 16 were blood group A, 11 group 'B', 8 group 'AB' and 15 belong to group 'O' as compared to controls who were, 14, 15, 3, 18 for blood groups A, B, AB and O respectively. Conclusions: No relationship is found between Oral Cancers and ABO Blood groups

Changes in serum lipid profile of albino rats fed on canola oil supplemented with atherogenic elements: 18 weeks study

Amongst lipid lowering factors, the dietary intervention for treating hyperlipidaemia and atherosclerosis associated ailments is physiological and gratifying. Canola is rich in monounsaturated fatty acids and is locally cultivated and cost effective. The criterion of the study was to determine the status of serum lipid profile in albino rats fed on canola oil diets for prolonged period of 24-weeks and to compare the same with those fed on canola oil supplemented with atherogenic elements. Results demonstrate that moderate amounts of canola oil [2.9% in diet] has triglyceride and cholesterol lowering effects. Both moderate and high amounts of canola oil [20%] decrease serum LDL-c profiles and resist lowering of HDL-c levels in rats fed with canola oil alongwith atherogenic elements. Conclusions: These findings reveal canola oil amongst the important supplement of monounsaturated fatty acids in animals and these findings may be generalized for humans

Coagulation profile in patients with breast cancer

Fifty subjects with breast cancer patients and 25 healthy control were included in this study. Routine hematological investigations i.e. Hb, TLC, platelets count were done by hematology analyzer and specific investigations like prothrombin time [PT], activated partial thromboplastin time [APTT] and fibrinogen level were performed by using commercially available kits. Results obtained were analyzed by using Student's 't' test and level of significance was done. Platelets count and fibrinogen levels were increased in breast cancer patients but PT and APTT were comparable with control group