Effect of aqueous extract of walnut leaves on lipid profile and atherogenic ratio in hypercholesterolemic rats

To determine the effect of aqueous extract of walnut leaves on lipid profile i.e. serum total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol triglycerides, LDL/HDL and atherogenic ratio [Total Cholesterol/HDL] ofhypercholesterolemicrats. Study Design: An experimental randomized control study. The study was conducted at Islamic International Medical College, Riphah International University, with assistance from National Institute of Health, Riphah Institute of Pharmaceutical Sciences and Citilab, Islamabad, Pakistan. The duration of study was one year from April 2014 to March 2015. A total of 30 male Sprague Dawley rats were included in the study. They were divided into 3 groups i.e. ten rats in each group. Group l [Control group], Group 2 [Hyper-cholesterolemic control], Group 3 [Aqueous group] treated with aqueous extract of walnut leaves after induction of hypercholesterolemia in a dose of [200mg/kg] through gavage needle once daily, for four weeks. Blood sampling was done at the beginning [baseline], end of week 8, and end of week 12 to perform lipid profile, LDL/HDL and atherogenic ratios TC/HDL-cholesterol. Statistical analysis was applied by using SPSS version 17. All data was shown as mean +/- SD and Student t test was applied between groups, p value of < 0.05 was considered as statistically significant. Hyper-cholesterolemic rats after treatment with aqueous extract [Group 3] had significantly lower levels [p<0.001] of serum cholesterol, low density lipoprotein and triglycerides while significantly high [p<0.001] levels of HDL-Cholesterol with significantly reduced [p<0.001]TC/HDL-Ch. Aqueous extract of walnut leaves has hypo-lipidemic effect on serum total cholesterol, LDL-Cholesterol and triglycerides. It reduces TC/HDL, LDL/HDL ratios whereas it significantly increases the level of HDL-Cholesterol

Effect of Body Mass Index on Intracytoplasmic Sperm Injection Outcomes

To determine the effects of increased BMI on ICSI outcomes. It was an analytical cross sectional study. Islamabad Clinic Serving Infertile Couples, Islamabad, Pakistan. Duration of the study was one year, from January 2013 to December 2013. Total of 150 females were classified into three groups on the basis of BMI. Those with BMI ranging from 18.5 - 24.9 kg/m2 /were placed in normal group [n=50], those with BMI ranging from 25 - 29.9 kg/m2/were placed in overweight group [n=50] and those with BMI ranging more than 30kg/ m2 were placed in obese group [n=50]. Serum levels of FSH, LH, Te, TSH, T3 and T4 were done in all three groups and their effects on oocyte and embryo quality were observed during controlled ovarian stimulation and after ICSI procedure. Obese group had significantly decreased ICSI outcomes due to increased levels of testosterone [p value< 0.05]. Increased BMI leads to decreased ICSI outcomes

Frequency of wound infection in open mesh inguinal hernioplasty

Objective: To analyze the frequency of surgical site infection in mesh open inguinal hernioplasty with single prophylaxis dose antibiotics and to find out organisms and its sensitivity

Study design: A Prospective interventional study

Place and duration: Jacobabad institute of medical sciences [JIMS], previous name of District head quarter hospital Jacobabad Sindh from 1st June 2009 to 30th April 2012

Methodology: The study comprises of 215 cases who underwent open mesh inguinal hernioplasty. Preoperative assessment was done for fitness of anesthesia before mesh repair. A single dose i/v antibiotic used, and early post operative surgical site infection examined. Wound site edema, redness, seroma, and pus discharge data collected. Culture was done to identify common organisms in wound infected cases. The data was collected and analysis done to see frequency of wound infection and sensitivity of infecting organism

Results: The frequency of surgical site wound infection was observed in 3.2%, and in these pus culture report showed that staphylococcus aures was commonest and E-coli organism was second common cause of superficial surgical site infection

Conclusion: The frequency of surgical site wound infection is low in Open inguinal mesh hernioplasty with single dose antibiotic prophylaxis and the Staphylococcus aueres was the common culprit organism

Psychological morbidity amongst infertile couples

To assess psychological morbidity amongst infertile couples. Cross-Sectional study. This study was carried out at MAS Infertility Clinic, Rawalpindi from August 2010 to January 2011. A total of 30 subjects [15 couples] were included in the study. After taking an informed consent, they were asked to complete a questionnaire. Depression, Anxiety and Stress Scale [DASS] questionnaire was used for this study. Data was analyzed using SPSS version-14 and t-test was applied to see the significance in differences. Majority of couples were over 30 years of age and were married for more than 5 years. Vast majority [73.3%] were living in joint family system. Psychological morbidity, particularly anxiety and depression affected significantly [p=0.05] female partner. However no significant relationship was observed between the cause of infertility or duration of infertility and psychological manifestations. This study presents pragmatic evidence regarding the psychological health of infertile couples in our society. Findings suggest that high levels of stress and depression exist in these couples, which not only affects their physical health, but also their psychological well being. It highlights the importance of providing psychotherapeutic help along with treatment for the cause of infertility

Pattern of gynaecological malignancies in tertiary hospital

To analyze the pattern of genital tract tumour in terms of their age, mode and stage of presentation, histological subtypes and treatment modalities. Gynae Unit-1 Jinnah Hospital/Allama Iqbal Medical College, Lahore from Oct 2007 to Oct 2009. All cases of genital tract malignancy admitted through OPD, emergency or referred to the unit were included in the study. A proforma was designed for each type of genital tract cancer and its details entered through history, examination and investigations. The staging and grading systems as designed by FIGO[7] were used. The data was collected and analysed through SPSS version 10. During the two years, 63 cases of genital tract malignancies were recorded. The most frequent cancer was ovarian seen in 35 [55.6%] with mean age 48 years. Among them two third of cases were with stage 3 and 4 disease. Epithelial ovarian cancer was seen in 26[41.3%] and abdominal hysterectomy and bilateral salpingoophrectomy and nodal dissection was carried out in 16 patients. Fertility preserving surgery was done in young patients with germ cell tumors and were given chemotherapy post-operatively. Cervix cancer was seen in 14 [22.2%], with mean age of 45 years. Among them five patients [35.7%] presented with stage 2 were given radio chemotherapy. Endometrium cancer was seen in 12[19%], with mean age of 50 years. Among them nine patients [75%] presented with stage 1 and 2, and were treated by radical surgery followed by radiotherapy and three patients [25%], in stage 3 and 4 were treated with radiotherapy. One patient [1.6%] of vulval carcinoma was 55 years of age with stage 2 squamous cell carcinoma. She was given radiotherapy. One patient [1.6%] of choriocarcinoma was 40 years of age and was given chemotherapy. Ovarian cancer was the most frequent gynaecological malignancy, which presented at an advanced stage due to late referral. A strong referral system should be developed between primary, secondary and tertiary health centres for screening of general population and high risk group and treatment of affected cases. Awareness about modification of risk factors, and management guidelines also need to be adopted

Early prediction of severity and outcome of acute severe pancreatitis

To establish the value of APACHE II scoring system, C-reactive Protein [CRP] level and C.T Severity Index [CTSI] in predicting the severity of acute pancreatitis. A prospective study was done in the Department of General Surgery, Jinnah Postgraduate Medical Centre, Karachi, over a period of one year i.e. from January to December 2007. Fifty patients of acute pancreatitis were taken and their outcome and severity was assessed by using APACHE II score, CRP level and CTSI. At the end of the study results showed that thirty eight [76%] patients were young females, most of which had gall stone pancreatitis, twenty-one patients [42%] had severe acute pancreatitis, twenty two [44%] patients had length of hospital stay of two or more than two weeks, in 21 patients [42%] patients APACHE II score was more than 8, in 21 patients [42%] CRP level was more than 120mg/l, CTSI showed that eighteen [36%] had three points and three [6%] had four points. Three patients [6%] expired within 72 hours of admission due to advanced age, uncontrolled sepsis and co-morbids. The seventy markers used in this study showed significant importance in prediction of severity of acute pancreatitis. Particularly Apache II scoring system and CTSI

Prevalence of functional GI disorder in the adult population of Arafat town, Karachi

To find out the prevalence of functional gastrointestinal disorders in the adult population of a low socioeconomic community in Pakistani population. A sample of 500 adult individuals was selected through a simple random sampling technique using simple random table. The Study conducted in 2004 based on a questionnaire comprising of 38 close ended questions as per ROME II criteria. The diagnosis established through the same criterion after analyzing the data on SPSS 10.0. The Study on 500 individuals revealed that a major proportion of the studied population 80.2% [401/500] were having one or more than one functional gastrointestinal disorders ranging from mild to server conditions, while only 19.8% [99/500] of them were free from any disorder. Out of these diseased individuals, the majority 77.8% [312/401] suffering from Multiple Gastrointestinal Symptoms, while 22.2% [89/401] were with that of Single Gastrointestinal Symptoms. Functional gastrointestinal disorders are prevalent in our community. These disorders found in individuals are of both Single and Multiple in nature. Although these are not fatal but may cause discomfort ranging from inconvenience to deep personal distress which may lead to great decline in their quality of life

experience of total mesorectal excision in surgery for rectal cancer

To evaluate the results following total mesorectal excision in rectal cancers. Place and Duration of Study: Surgical Ward 2, Jinnah Postgraduate Medical Centre [JPMC], Karachi. From January 2003 to December 2005. Fifty consecutive patients with histological diagnosis of rectal cancer were included in this study. In all cases tumor staging was carried out with ultrasound [US] and CT scan. Carcino-embryonic antigen [CEA] level was also done. They underwent surgery in the form of abdomino-perineal resection [APR], low anterior resection, ultra low anterior resection and Hartmans procedure. Total mesorectal excision [TME] was done in 42 patients and their postoperative morbidity and mortality were recorded. Out of 50 patients 6 were irresectable. These patients had evidence of disseminated disease on US and CT scan. Forty two were resectable. Age range was 14-60 years. Thirty patients were between 20-40 years. Male to female ratio was 4:1. Thirty three patients had tumor at anorectal junction, four patients had tumor at 7 cm from anal verge, in five the tumor was not palpable as it was in the mid rectum. APR was carried out in thirty-three patients, low anterior resection in the four, ultra low anterior resection in four, with covering ileostomy in all cases of low and ultra low anterior resection. One patient had Hartmans procedure. In 42 patients curative surgery was done. With limited follow up over a period of two years one patient who had APR developed local recurrence. Total mesorectal excision in rectal cancer surgery is known to give less postoperative morbidity and good local disease control. Appropriate training in total mesorectal excision should be given to surgeons under training in order to achieve standard surgical outcome