Pain management: an overview

Pain is an unpleasant sensory and emotional experience caused by actual or potential tissue damage. This damage is nature's warning that something is not well within the body. This condition causes loss of workforce and also affects the patients family members in socio-economical and psychological terms. There is an increase in knowledge regarding pain management in recent years. These developments in pain management may provide different opportunities to the patient and their families to lead a more comfortable and productive life. Managing pain is not about making it disappear rather it is about keeping it under control. The aim is not to stop pain in its stride, but to avert the damage caused by it. Prolonged pain is demoralising and debilitating and should be controlled as fast as possible and with all possible means. For this reason in addition to pharmacological treatment now a days non pharmacological treatment options are on rise

Visceral Leishmaniasis Eradication is a Reality: Data from a Community-based Active Surveillance in Bangladesh

More than 20 million people in Bangladesh are considered at risk of developing visceral leishmaniasis (VL). A community-based active surveillance was conducted in eight randomly selected villages in a highly endemic area of Bangladesh from 2006 to 2008. A total of 6,761 individuals living in 1,550 mud-walled houses were included in the active surveillance. Rapid rK39 dipstick tests were conducted throughout the study period to facilitate the case diagnosis. Individuals with previous or current clinical leishmaniasis were identified on the basis of the case definition of the VL elimination program. Untreated cases of suspected VL were referred to the hospital for treatment. Socioeconomic and environmental information including bed net use was also collected. In 2006, the annual incidence of clinical leishmaniasis in the study area was 141.9 cases per 10,000 population, which was significantly increased by the following year owing to community-based active surveillance for case detection and reporting. However, early case detection and early referral for treatment led to a significant decrease in incidence in 2008. This study suggests that community-based active surveillance using a simple diagnostic tool might play a role in achieving the goal of the VL elimination program.

Preliminary study on the prevalence of Campylobacter in childhood diarrhoea in north Lebanon

Campylobacter species are a major cause of human diarrhoeal disease worldwide. In Lebanon, the true prevalence of Campylobacter infections and the species distribution in childhood diarrhoea are not known. This study in 2010 investigated the prevalence of Campylobacter species and its possible etiologic role in childhood diarrhoea in north Lebanon. A total of 90 stool samples from children [aged 1 month to 10 years] presenting with diarrhoea were collected from 5 hospitals. A polymerase chain reaction technique [PCR] was used for each sample for the amplification of all Campylobacter species followed by 5 PCR reactions for the amplification of C. jejuni, C. hyointestinalis, C. coli, C. fetusand C. upsaliensis. Of the 90 samples, 10 were positive for Campylobacter species [11.1%]: 1 for C .coli, 1 for C. jejuni, 2 for both C. jejuni and C. coli, and 6 could not be identified to the species level with the available primers. Campylobacter species is frequently associated with childhood diarrhoea in north Lebanon but Campylobacter infection may be significantly underdiagnosed because the search for Campylobacteria not part of the routine stool culture

Genetic and biochemical studies on hepatocytes of young and old heat-stressed rats

Heat stress was shown to cause impairments in hepatocytes and result in oxidative damage, which can lead to cytotoxicity; thus, we carried out this study to investigate the age tolerance to oxidative stress caused by heat stress in young and old female Wistar rats and whether this effect varied with different postexposure periods. Heat stress-induced injury in hepatic cells was evaluated in young [6 months] and old [24 months] female Wistar rats by exposing them at an ambient temperature of 42[degree sign]C for 1 h. Livers were harvested at several time points [6, 24, and 72 h] after application of the heat stress protocol. The level of DNA damage assessed using the comet assay, percentage of fragmented DNA, quantitative changes in nucleic acid and protein contents, activity of liver enzyme marker, level of superoxide dismutase, and lipid peroxidation were determined. The results showed that exposure to heat stress significantly increased the oxidative DNA damage, percentage of DNA fragmentation, and activities of liver enzyme marker and stimulated the process of lipid peroxidation in liver cells of young and old rats. Further, it decreased total nucleic acid and protein contents and superoxide dismutase activities. In addition, it was observed that the damage from heat stress was more serious in old animals than in young ones and they needed more time to return to control values. It was concluded that aging and heat exposure instigate oxidative stress, which can contribute to cellular dysfunction and age-related reductions in stress tolerance

Hair Lead Content In Car Radiator Repairers and Printing Shop Workers in Khon Kaen, Thailand

 The  descriptive  study  utilized  hair  lead analysis  measure  past  lead  exposure in  car  radiator  repairers  and  printing shop  workers.  Hair  samples  and  questionnaires  were  taken  from  163 workers at  7 car  radiator  repair  businesses  and  21 printing  shops  in  Khon  Kaen,  Northeast  Thailand.  Hair  samples  were  analysed  by  inductively  coupled  plasma spectrometry  (ICP). Hair  lead  (PbH)  content  of  all  radiator  repairers (n = 15)  showed  severe  past  exposure  (\>25 mg/kg), Observation  of  work  practices  in  the  repair  shops  revealed  the  source  of  contamination.  The  radiator  repair industry  is  a  high  risk  activity  for  lead  exposure.  In  the  printing  shops (n = 148) hair  lead  levels  randiator  repair industry is  a  high risk  activity  for  lead  exposure.  In  the  printing  shops  (n= 148)  hair  lead levels  ranged  from 0.6 to  307 mg/kg.  There   were 64 workers over normal limit for hair lead content (normal level is 25 mg/kg. These  14 workers had  heterogeneous  jobs  within the printing shop. Explanations  for  the  findings were researched  by evaluating  each  worker  according  to  their  primary  work  task  and  whether  they  responded  positively  to  confounding  variables  in  the  question naire  such  as  living  on  work  premises,  eating  in  the  workplace. Conclusive  answers  could  not  be  found  in  all  cases  but  certain  work  activities  and  hygiene  practices  within  the  industry  increase the  likelighood  of  lead  contamination.

review of medicinal plants exhibiting potential anti-ulcer activity

Plants have been used for medicinal purposes from the time immemorial. Medicinal plants are an indispensable source of new chemical substances with potential therapeutic effects. Their chemical compounds may serve as lead for the development of new drugs. In the present communication a review of the plants exhibiting antiulcer activity is presented

Evaluation of the genotoxicity and pathological changes induced by the prolonged bromuconazole triazole fungicide exposure in rats

Bromuconazole, is a triazole fungicide used in enclosed commercial greenhouses was evaluated for its potential toxic effects in rat liver. Sprague-Dawley male rats were treated orally at daily doses of 36.5 and 18.25 mg/kg b. wt [1/10 and 1/20 LD[50], respectively] Bromuconazole for 3 months. Measurements include potential DNA fingerprinting using random amplified polymorphic DNA [RAPD-PCR] analysis, total nucleic acids content, total protein as well as histopathological alteration in the liver were performed. The results revealed that, Bromuconazole fungicide had genotoxic and toxicopathological effects in rat liver. The genotoxic effects were indicated by appearance of some changes in polymorphism band patterns including deletion of stable bands or insertion of new bands. The effects on the liver were also manifested by different histopathological lesions including severe necrobiotic and proliferative changes with the appearance of hepatoma at high dose. In addition, the liver tissue DNA, RNA and protein contents were significantly increased with increasing the dose of Bromuconazole. Using of Bromuconazole fungicide should be reconsidered due to its possible cytotoxic. clastogenic and mutagenic effects

Antimicrobial activity of parmelia perlata

Petroleum ether, chloroform and alcoholic extracts of lichen Parmelia perlata showed inhibitory activity against both gram positive and gram negative bacteria namely Streptococcus aureus and Escherichia coli, respectively and fungus Malassezia furfur

Association of ABO and Rh blood group systems with blood pressure in a population sample from Peshawar, NWFP, Pakistan

Abundant literature is available on the association of blood groups to various diseases. It was thus hypothesized that similar linkage may also exist between blood groups and Hypertension, which prompted me to work on this project. This study was carried out from June 2001 to September 2003 on 1304 subjects out of which 756 were male and 548 were females. Age ranged from 18-65 years. The blood groups and blood pressure were determined in PMRC Research Center KMC Peshawar, by using standard methods. Out of 1304 subjects distribution of blood groups was such that blood group B [30.1%]> O [29.7%] >A [28.5%]>AB [10.1%]. No significant difference in systolic and diastolic blood pressure was found among the all groups. However significant differences existed between the two sexes within blood group B and O for systolic BP and A and O groups for diastolic BP. Significant differences in systolic BP were found between A+ve and O+ve phenotypes only. A-ve males had lower systol ic BP than O-ve males. Substantially more conspicuous Rh factor associated differences became evident among the ABO phenotypes. Nearly similar trends were evident for systolic and diastolic blood pressure as age of both genders of the A, B and AB phenotypes advanced. Statistically significant [P<0.05] increase above the age of 16-20 years group was noticed at least as far as the 41-50 years age groups. Especially highly significant increase in systolic and diastolic Blood pressure in Group A [both males and females] and in Group B and AB [females only] was noticed. It is advisable that the males having blood group O-ve and females having AB-ve should be aware of their blood pressure and maintain it with in the normal limits especially by changing their lifestyle

impact of immune response to schistosoma hematobium infection on the outcome of HCV in patients with concomitant HCV and Schistosoma hematobium infection in El-Minya governorate in Egypt

Patients with schistosoma haematobium display immune response may alter the outcome of HCV in-patients with concomitant HCV and schistosoma haematobium. This study was aimed at evaluation of the effect of immune response to schistosoma haematobium on the outcome of HCV in-patients with concomitant infection [HCV and schistosoma haematobium]. This study was conducted on 70 subjects 59 of them were infected with HCV and/or schistosomiasis selected form the outpatient clinic of El-Minya University Hospital while the remaining eleven subjects were healthy control volunteers with no history and negative serology to both HCV and schistosomiasis. The patients were grouped into three groups. Group [I] it included 24 patients with concomitant HCV and schistosomal infections. Group [II] it included 19 patients with schistosoma haematobium infection. Group [III] it included 16 patients with HCV infection alone and control group. It included 11 healthy subjects. All groups were subjected to history taking, clinical examination, abdominal ultrasonography and rectal snip were done for all groups and liver biopsy was done for HCV +ve patients. Routine laboratory investigations and ELISA assessed hepatitis markers [A, B, C] antibodies and Special investigations, CD3, CD4, CD8, and estimation of CD[4]/CD[8] ratio and detection of ant-bilharzial antibody titer. Absolute CD4 was highly significant higher in group 3 when compared to control group [p- value < 0.001] and was highly significant lower in group 1 when compared to control group [p- value < 0.001]. As regard to absolute CD4 between different groups of patient it was high in group 3 then less in group 2 and much lower in group 1 and these differences were highly significant [p- value <0.001]. Absolute CD8 was highly significant higher in group 3 when compared to control group [p- value < 0.001] and was highly significant lower in group 1 when compared to control group [p- value < 0.001]. As regard to absolute CD8 between different groups of patient it was high in group 3 then less in group 2 and much lower in group 1 and these differences were highly significant [p- value <0.001]. Absolute CD4 / CD8 ratio was highly significant lower in group 1, 2 and 3 when compared to control group [p-value < 0.001] and was highly significant lower in group 1 when compared to group 3 [p- value < 0.001]. As regard to absolute CD3, CD4, CD8 and CD4/ CD8 ratio absolute CD4 and CD4/CD8 ratio were higher in-patients treated with praziquantel versus those not receiving this medication. While CD8 was higher in-patients not received this medications versus those received the medications. This study has documented that schistosoma haematobium display a suppressive effect on the immune system so that a concomitant infection with HCV will present with a more protracted disease with severe sequel and adverse complications. Also this study has documented that CD4, CD8, and CD4/CD8 ratio may be good indicators of the disease activity. It is recommended that strict control and treatment of schistosomiasis may ameliorate the problem of HCV induced chronic liver disease in Egypt

In vitro Inhibition Effect of Plant Extracts, Urine, Fertilizers and Fungicides on Stem Rot Pathogen of Sclerotium rolfsii

Twenty plant extracts were tested against mycelial growth, sclerotium formatiom and dry weight of mycelium with sclerotia of Sclerotium rolfsii Sacc. The highest(90 mm) mycelial growth was measured in Adhatoda vasica, Tegetes erecta, Allium cepa, and Curcuma longa. The lowest(25 mm) was in Azadirachta indica. No mycelial growth was found in any concentration of cow, buffalo, and goat urine. The highest(90 mm) and the lowest(15 mm) mycelial growth were measured in Biomil and Urea, respectively. No mycelial growth was observed in Zinc. The highest(60 mm) and the lowest(2 mm) mycelial growth were recorded in Macuprex(Dodine; 65% WP) and Boron(100% Boric acid and 17% Boron) respectively. Mycelial growth was totally inhibited in Rovral(Iprodione; 50% WP).

In Vitro Effect of Fungicides, Plant Extracts and Smoke on Conidial Germination of Fusarium oxysporum Root Rot Pathogen of Piper betle

Five fungicides such as rovral, bavistin, cupravit, dithane M-45 and thiovit were tested against conidial germination of Fusarium oxysporum. Dithane M-45 was the most effective against the fungus. Rests of the fungicides were more or less effective in the inhibition of conidial germination after 5~30 minutes immersion in 500~2500 ppm concentration. Five plant extracts(leaf extracts of Ocimum sanctum, Lantana camera, Calotropis procera, Azadirachta indica and Vinca rosea) found to be more or less effective against the fungus. 'Dhup' somke have good inhibitory effect on conidial germination of F. oxysporum.

Association of ABO, Rh blood groups systems with lipids and other anthropometric co variables as predictors of cardiovascular risk in NWFP, Pakistan

Aims and Objects: The present study was carried out to find the possibility of association of lipid profile with ABO/Rh blood groups and other anthropometric co- variables as cardiovascular risk. Material and A community-based investigation was carried out on lipid profiles and blood groups of selected population of rural and urban areas of Peshawar. NWFP on total of 1304 subjects out of which 548 were females and 756 were males. Age ranged from 16-75 years. Due emphasis was laid in the study on anthropometric parameters [age, height, body weight and body mass index] blood pressure and dietary parameters. Blood grouping revealed distribution of various blood groups in the order of their predominance being B>O>A>AB. The Rh- positive subjects were 94.6% of the total. Sex wise analysis of anthropometric data, blood pressure including pulse rate and lipid profiles prior to partitioning by Rh factor revealed only sporadic significant differences among the various ABO blood phenotypes. When the ABO phenotypes were partitioned according to Rh factor and gender, substantially more significant Rh factor associated differences were seen among the ABO phenotypes. Most of the lipid profile parameters for the sample do not provide enough evidence of hyperlipidemia and cardiovascular risk. The A and A B Phenotypes show lesser long term risk if any. The B and 0 phenotypes have relatively higher tendency of adverse lipid/lipoprotein metabolism and hence invite greater attention from therapeutic point of view. There is no evidence of predisposition of phenotype A as a co marker of risk of cardiovascular disorders

Effects of Plant Extracts on Conidial Germination, Mycelial Growth and Sporulation of Fungi Isolated From Poultry Feed

Effect of ethanolic extracts of Lawsonia inermis, Azadirachta indica, Vinca rosea, Tagetes patula, Ocimum sanctum, Colocasia antiquorum, Adhatoda vasica, Moringa oleifera, Datura metel and Curcuma longa leaf on conidial germination, mycelial growth and sporulation of Aspergillus flavus, A. niger and A. fumigatus were examined. The conidial germination of A. flavus and A. fumigatus were most inhibited by the extract of L. inermis, while that of A. niger was inhibited by A. indica. Other tested plant extracts have a good effect on conidial germination on the selected fungi. The highest mycelial growth of A. flavus (37 mm) was found in V. rosea, but in case of A. niger and A. fumigatus it (38 and 39 mm) was found in D. metel. The lowest (4, 9 and 6 mm) respectively mycelial growth of these fungi found in L. inermis. The highest sporulation (75 x 10(4)/ml) of A. flavus was counted in V. rosea, but in case of A. niger and A. fumigatus those (45 x 10(4) and 55 x 10(4)/ml) were in D. metel and the lowest (5 x 10(4), 12 x 10(4) and 9 x 10(4)/ml) respectively sporulation of these fungi counted in L. inermis plant extract medium.

Mesenteric vasculitis A diagnostic dilemma

Mesenteric vasculitis is a rare diagnosis. Although it has been described more than a century ago, clinicians still face difficulties in making an early diagnosis. We report a case who presented with symptoms of severe rheumatoid arthritis [RA] and abdominal pain and subsequently twice developed intestinal perforation within a period of one week. Laparotomy on both occasions disclosed multiple subserosal small bowel ulcers, histopathology of which was reported as polyarteritis nodosa. While early surgical intervention might be life saving in a localised small bowel vasculitis, its efficacy in progressive involvement of multiple segments is doubtful

Use of Leu M1 monoclonal antibody for the diagnosis of Hodgkin's

Monoclonal antibody to LeuM1, a granulocyte-related differentiation antigen, represents a highly effective reagent for detection of diagnostic [Reed-Sternberg] cells and variants in paraffin-embedded tissues of Hodgkin's disease. The [Reed Sternberg] cell in all the cases of Hodgkin's disease except lymphocyte predominance variety revealed positive intracytoplasmic/paranuclear granular staining with LeuM1 marker. The R-S cells in lymphocyte predominance variety contain probably sialylated LeuM1 antigen. All the cases of non-Hodgkin's lymphoma and reactive lymphadenitis showed no staining with LeuM1 monoclonal antibody. Therefore this antibody represents a potentially helpful diagnostic discriminant in the assessment of Hodgkin's disease and its distinction from non-Hodgkin's lymphomas and morphologically similar reactive lymphoid lesions