Tree species composition, growing stock and biomass carbon dynamics of the major timber species in Hindu Kush regions of Pakistan / Composição de espécies de árvores, estoque em crescimento e dinâmica de biomassa de carbono das principais espécies madeireiras nas regiões de Indocuche no Paquistão

Using inventory data, this study evaluates the species composition, growing stock volume (GSV), and biomass carbon (BMC) of the five major timber species in the sub-tropical, and temperate/sub-alpine regions of Pakistan. It was found that the stem density varies between 50 and 221 trees ha -1, with a mean of 142 trees ha-1 (13.68 million trees for entire forest area). Among the species, Pinus wallichiana showed a high species composition (27.80%) followed by Picea smithiana (24.64%). The GSV was found in the range of 67.81 to 425.94 m3 ha-1, with a total GSV value of 20.68 million m3 for the entire region. Similarly, The BMC ranged from 27.04 to 169.86 Mg ha-1, with a mean BMC value of 86.80 Mg ha-1. The total amount of stored carbon was found at 8.69 million tons for a total of 95842 ha of commercially managed forest. Furthermore, the correlation analysis between the basal area (BA) and GSV and BMC showed that BA is the best predictor of GSV and BMC. The findings provide insights to the policy makers and forest managers regarding the sustainable commercial forest management as well as forest carbon management in the recent global carbon management for climate change mitigation.

Usando dados de inventário, este estudo avaliou a composição de espécies, volume de estoque crescente (GSV) e carbono de biomassa (BMC) das cinco principais espécies madeireiras nas regiões subtropicais e temperadas/subalpinas do Paquistão. Constatou-se que a densidade do caule variou entre 50 e 221 árvores ha-1, com média de 142 árvores ha-1 (13,68 milhões de árvores para toda a área florestal). Entre as espécies, Pinus wallichiana apresentou alta composição de espécies (27,80%), seguida de Picea smithiana (24,64%). O GSV foi encontrado na faixa de 67,81 a 425,94 m3 ha-1, com um valor total de 20,68 milhões de m3 para toda a região. Da mesma forma, o BMC variou de 27,04 a 169,86 mg ha-1, com valor médio de 86,80 mg ha-1. A quantidade total de carbono armazenado foi de 8,69 milhões de toneladas para um total de 95.842 ha de floresta manejada comercialmente. Além disso, a análise de correlação entre área basal (BA), GSV e BMC mostrou que BA é o melhor preditor de GSV e BMC. As descobertas fornecem insights para os formuladores de políticas e gestores florestais sobre o manejo florestal comercial sustentável, bem como o manejo florestal de carbono no recente gerenciamento global de carbono para a mitigação das mudanças climáticas.

Tree species composition, growing stock and biomass carbon dynamics of the major timber species in Hindu Kush regions of Pakistan

Abstract Using inventory data, this study evaluates the species composition, growing stock volume (GSV), and biomass carbon (BMC) of the five major timber species in the sub-tropical, and temperate/sub-alpine regions of Pakistan. It was found that the stem density varies between 50 and 221 trees ha -1, with a mean of 142 trees ha-1 (13.68 million trees for entire forest area). Among the species, Pinus wallichiana showed a high species composition (27.80%) followed by Picea smithiana (24.64%). The GSV was found in the range of 67.81 to 425.94 m3 ha-1, with a total GSV value of 20.68 million m3 for the entire region. Similarly, The BMC ranged from 27.04 to 169.86 Mg ha-1, with a mean BMC value of 86.80 Mg ha-1. The total amount of stored carbon was found at 8.69 million tons for a total of 95842 ha of commercially managed forest. Furthermore, the correlation analysis between the basal area (BA) and GSV and BMC showed that BA is the best predictor of GSV and BMC. The findings provide insights to the policy makers and forest managers regarding the sustainable commercial forest management as well as forest carbon management in the recent global carbon management for climate change mitigation.

Resumo Usando dados de inventário, este estudo avaliou a composição de espécies, volume de estoque crescente (GSV) e carbono de biomassa (BMC) das cinco principais espécies madeireiras nas regiões subtropicais e temperadas/subalpinas do Paquistão. Constatou-se que a densidade do caule variou entre 50 e 221 árvores ha-1, com média de 142 árvores ha-1 (13,68 milhões de árvores para toda a área florestal). Entre as espécies, Pinus wallichiana apresentou alta composição de espécies (27,80%), seguida de Picea smithiana (24,64%). O GSV foi encontrado na faixa de 67,81 a 425,94 m3 ha-1, com um valor total de 20,68 milhões de m3 para toda a região. Da mesma forma, o BMC variou de 27,04 a 169,86 mg ha-1, com valor médio de 86,80 mg ha-1. A quantidade total de carbono armazenado foi de 8,69 milhões de toneladas para um total de 95.842 ha de floresta manejada comercialmente. Além disso, a análise de correlação entre área basal (BA), GSV e BMC mostrou que BA é o melhor preditor de GSV e BMC. As descobertas fornecem insights para os formuladores de políticas e gestores florestais sobre o manejo florestal comercial sustentável, bem como o manejo florestal de carbono no recente gerenciamento global de carbono para a mitigação das mudanças climáticas.

Echocardiographic Wall Motion Abnormalities in Hypertensive Patients with Electrocardiographic Left Ventricular Hypertrophy

Background: During the cardiac cycle with the effect on cardiac function, Echocardiographic wall motion abnormalities are kinetic alterations in the cardiac wall motion. It can be characterized as per their grades and their distribution pattern like segmental or global. It can be attributed to a coronary territory or follow a non-coronary distribution. Aim of the study: The aim of the study was to evaluate the patterns of echocardiographic wall motion abnormalities among hypertensive patients with electrocardiographic left ventricular hypertrophy.Material & Methods:This was prospective observational study which was conducted in the Department of Cardiology, Ibrahim Cardiac Hospital & Research Institute, Dhaka, Bangladesh from January 2020 to January 2021. In total 76 hypertensive patients with electrocardiographic left ventricular hypertrophy were included as the study subjects for this study. This study was approved by the ethical committee of the mentioned hospital. A predesigned questioner was used in data collection. All data were collected, processed and analyzed by using MS Office and SPSS version 23 programs as per necessity.Results:In this study, in analyzing the status of wall motion abnormalities (WMA) among the participants we observed that, 22% of the patients were with segmental wall motion abnormalities, 18% were with global dysfunction and 59% were fully free from any type of WMA. Among patients with global dysfunctions, 71% were with mild and 12% were with moderate-to-severe dysfunction whereas this ratio was 47:24 in segmental abnormality patients. On the other hand, in analyzing the severity and location of patients with segmental WMA we observed that 47%, 24%, 53%, 41%, 18%, 24%, 29%, 47%, 35%, 53% and 41% were with mild dysfunction, moderate-to-severe dysfunction, inferior wall dysfunction, antero-septal dysfunction, anterior wall dysfunction, lateral wall dysfunction, posterior wall dysfunction, posterior septal dysfunction, LV base dysfunction, LV mid-cavity dysfunction and LV apical dysfunction respectively.Conclusion:In this study, majority of the participants were found free from any type of wall motion abnormality. ‘Mild dysfunction’, inferior wall dysfunction, anterior wall dysfunction, lateral wall dysfunction, posterior septal dysfunction, LV base dysfunction, LV mid-cavity dysfunction and LV apical dysfunction are found as some more frequent dysfunctions among patients with WMA.

Three point fixation is superior to two point fixation technique for zygomatic complex fracture

Background:Isolated zygomatic or malar bone fractures are second most common fracture among facial skeletal injuries. It has been reported that three point fixation is appropriate for isolated zygomaticbone fracture. The objective of current study was to compare the mean difference in terms of malar height outcome by using different fixation techniques (two point and three point)in patients with zygomatic complex fracture.Methods:This randomized controlled trial was conducted at Department of Oral and Maxillofacial Surgery, MMDC, Multan, during a period of six months from 1st June 2017 to 30th November 2017. A total 182 patients of both genders were included in this study. Two point fixation techniques were used in Group-A patients. While 3 point fixation was used in Group-B patients. After 6 weeks follow-up, patients were assessed for malar height. Outcome was measured by comparing the mean difference of pre and postoperative malar height of both techniques. Data were analyzed using computer program SPSS-21. P≤0.05 was taken as significant in all analysis.Results:Among patients in two pointfixation group, the mean malar height was 67.55±2.98 mm and in three pointfixation group, meansmalar height was 71.55±2.36 mm. The difference of malar height among two treatments was highly significant with p<0.01. Conclusions: Using three point fixation results better as compared to two point fixations in terms of malar height outcome

Biochemical changes in subjects with fatty liver: Is there a link?

Objective:To evaluate the biochemical markers including serum triglycerides, ALT, and fasting plasma glucose in detection of fatty liver disease

Methodology:This cross-sectional analysis was carried out at the department of radiology and pathology, PNS Rahat hospital,Karachi between March-2010 to February-2011.Sixty-two subjects with an ultrasonographic diagnosis of fatty liver were compared with thirty-seven subjects with normal ultrasound for fatty liver, after excluding all other abnormalities on history and examination. The comparison included measurement of biochemical abnormalities including fasting blood glucose, triglycerides, total cholesterol and alanine transaminase [ALT]

Results:The results of fasting blood glucose[[Fatty liver group=7.06 +/- 3.51mmol/L][Without fatty liver disease=5.12 +/- 0.56 mmol/L] [p = 0.002]], serum triglycerides [[Fatty liver group=2.56 +/- 1.33 mmol/L ] [Without fatty liver disease=1.68 +/- 0.97 mmol/L ] [p = 0.001]] and ALT[[Fatty liver group=36.37 +/- 18.12 IU/L] [Without fatty liver disease=28.15 +/- 13.95 IU/L] [p = 0.026]] were significantly higher in subjects with fatty liver disease. The Receiver Operating Curve [ROC] analysis showed fasting blood glucose and serum triglycerides to have the most area under the curve [AUC] as 0.747 [95% CI: 0.647-0.847] and 0.731[95% CI: 0.622-0.840]; while the other parameters have AUCs as: Serum ALT-0.650 [95% CI: 0.532-0.767] and total cholesterol-0.509 [95% CI: 0.389-0.629]

Conclusion: Hyperglycemia and hypertriglyceridemia are associated with an ultrasonographic diagnosis of fatty liver. Raised transaminase levels in subjects with fatty liver disease also suggest underlying hepatocyte damage

Mitral valve replacement in systemic lupus erythematosus associated Libman-Sacks endocarditis

Libman-Sacks endocarditis, first discovered in 1924, is a cardiac manifestation of systemic lupus erythematosus [SLE]. Valvular involvement has been associated with SLE and antiphospholipid syndrome [APS]. Mitral valve, especially its posterior leaflet, is most commonly involved. We report a case of a 34 year old woman with antiphospholipid antibody syndrome and SLE, who presented with mitral valve regurgitation. The patient underwent a prosthetic mitral valve replacement, with no followup complications. We suggest mechanical valve replacement employment in the management of mitral regurgitation in Libman- Sacks endocarditis, in view of the recent medical literature and our own case report

Resection of posterior mediastinal tumors by video assisted thoracic surgery

This case report illustrates successful Video Assisted Thoracic Surgery [VATS] performed on a 45-year-old woman and 52-year-old man presenting with a mass in left and right paravertebral space on the CT scan respectively. VATS has many benefits over traditional open operation [thoracotomy], resulting in less pain and shorten recovery time. However, VATS has higher equipment cost but when an experienced surgeon performs the surgery, better outcomes are achieved. VATS is not common in Pakistan's surgical setup as it is an expensive method of eradicating mediastinal pathologies and not every patient undergoes VATS. The primary objective of presenting these cases is to promote the use of VATS specifically for removal of posterior mediastinal tumors and improve the surgical outcomes

Strangulated paraesophageal hiatus hernia: a case report

Strangulation of hiatus hernia is a rare event and difficult to diagnose in emergency. We are reporting a case of 14 year old girl who was diagnosed sliding hiatus hernia since childhood but due to delayed treatment presented in emergency with perforation of stomach and generalized peritonitis. She was treated successfully

Massive retroperitoneal mass - giant schawanoma

Schwannoma are usually solitary, slow growing, and non-aggressive neoplasms usually found in head and neck region. Retroperitoneal Schawanoma especially large sized are rare and difficult to diagnose clinically. We are discussing a 43 years old lady, who presented with huge reteroperitoneal mass of left side, treated successfully

Characteristics and in Hospital Clinical Outcome of Patients with Non St-Segment Elevation Myocardial Infarction with Chronic Kidney Disease.

Background: Nearly 40% of patients presenting with Non ST-Segment Elevation Myocardial Infarction (NSTEMI) have Chronic Kidney Disease (CKD). CKD is a powerful predictor of adverse events among NSTEMI patients. The purpose of the present study was to evaluate the in-hospital outcome of patients with Chronic Kidney Disease presenting with Non ST-Segment Elevation Myocardial Infarction. Methods: In this prospective observational study a total of 128 patients with NSTEMI were enrolled. They were divided equally in group I (NSTEMI with CKD) and group II (NSTEMI with normal renal function) on the basis of estimated glomerular filtration rate. Patients were considered to have CKD if he/she had documented history of CKD or estimated glomerular filtration rate <60 mL/min/1.73 m². Presence of inhospital complications was identified. Results: Patients with CKD were significantly older, with a greater prevalence of hypertension, diabetes mellitus, lower left ventricular ejection fraction, and lower haemoglobin level compared with those without CKD. CKD patients had more atypical presentation during admission. In-hospital complications were significantly higher in CKD patients presenting with NSTEMI. Conclusion: CKD strongly predicts adverse in-hospital outcome among NSTEMI patients.

Effect of bleaching on shear bond strength of orthodontic brackets

The purpose of this in vitro study was to determine the effect of bleaching on shear bond strength of orthodontic brackets. This randomized control trial was performed over a period of 6 months in the department of orthodontics, de,Montmorency College of Dentistry, Lahore. A total of one hundred and forty extracted premolar teeth were included which were further divided into two groups. Group A was assigned as control group without bleaching and Group B as study group with bleaching. The teeth in both groups were embedded individually in acrylic placed in rubber moulds using a mounting jig so that the labial surfaces would be parallel to the applied force during the shear test. Group B was bleached with Pola office advanced tooth whitening system and were stored in a solution of 0.9% saline till they were bonded. The bonding process for both groups was then performed in a standard manner. After bonding bracket was properly positioned on its respective tooth. An occluso-gingival load was applied to the bracket producing a shear force at the bracket tooth interface using a computerized shear bonding testing machine. The results showed that there was no statistically significant difference between the shear bond strength of unbleached teeth and that of bleached teeth following a two weeks interval after bleaching

Role of newspapers in health policy making in Punjab

This paper looks at the role of newspapers in health policy making in Punjab, the largest province of Pakistan in terms of population, with nearly 56% of the country's entire population. For the inclusive progress of socio-economic facet of the general public, government should give top priority to the investment in the health sector. Health is the second biggest public sector when it comes to physical infrastructure and human capital in Punjab. Health sector of Punjab is faced with numerous anomalies and the government has been undertaking reforms with intervals. Announcement of health policy is an important initiation for government's plan for the advancement of health sector, in this regard how the media and in case of this study, newspapers, impact health policy making. Newspapers provide a channel which is used by the policy makers to make promises and deliver intentions. Public's Feedback is an essential part of this process and is under investigation in this study. Newspapers can set the direction for public's welfare by covering a specific matter and overlooking the other. With regard to this function of the newspapers this research endeavors to discover the role newspapers in health policy making by adopting the technique of content analysis of four sampled newspapers for the period of six months

Diagnostic accuracy of saline hysterosonography in cases of abnormal uterine bleeding

To evaluate diagnostic accuracy of saline hysterosonography in diagnosing endometrial hyperplasia taking histopathology as gold standard. Validation study. Radiology Department MH/CMH Rawalpindi form 10th July 2006 to 10th January 2007. Fifty cases of Abnormal Uterine Bleeding comprising both pre and post menopausal patients were included. They were selected on non probability convenience sampling technique. Saline hysterosonography was conducted in the Radiology Department and results compared with histopathological findings. Among 50 patients who underwent saline hysterosonography, 40 patients were diagnosed to have positive findings while 10 did not show any abnormality on saline hysterosonography. Of the 10 patients whose endometrium did not show any abnormality on saline hysterosonography, 8 were found to be normal on histopathology and 2 cases showed abnormality. One case was of endometrial hyperplasia and the other showed a benign endocervical polyp which was missed on saline hysterosonography. This showed that Saline hysterosonography has a sensitivity of 94.7%, specificity of 66.7%, and an overall diagnostic accuracy of 88%. Saline hysterosonography is highly accurate in the diagnosis of endometrial pathologies. It is cost effective, well tolerated by patients and can be performed as an outpatient procedure

Rare Case of Ruptured Sinus of Valsalva: Ruptured Into Left Ventricular Cavity.

Rupture sinus of Valsalva is a relatively rare condition. We report a rare case of ruptured left sinus of valsalva with aneurysm, presenting with acute left ventricular failure. Transthoracic echocardiography showed an aneurysmal dilatation of the base of interventricular septum and part of the aortic root and a marked turbulent flow from the aortic root to the left ventricle with a continuous systolodiastolic shunting. The patient underwent successful repair of ruptured sinus of valsulva with closure of fistula. During Ventriculotomy the defect was repaired using pledgeted 5/ 0 prolene interrupted sutures and pericardial patch.

Pheochromocytoma with hypertensive crisis due to glucocorticoid administration: a case report and review of the literature.

We report a patient who presented with single episode of severe hypertension after intramuscular injection of betamethasone which was given to treat acute exacerbation of bronchial asthma. Episode of severe arterial hypertension was associated with pulmonary edema, acute renal failure and hyperkalemia. Further evaluation by appropriate diagnostic tests revealed that the patient is a case of phaechoromocytoma. This neoplasm was excised successfully and the patient is presently asymptomatic.We believe that this episode was initiated by glucocorticoid injection.

Relationship of C · reactive protein with essential hypertension at 1st presentation and effect of antihypertensive treatment on micro inflammation

Objective: to determine the relationship of C- reactive protein with essential hypertension at 1st presentation and effect of angiotensin-11 receptor blockade on micro-inflammation

Material and Methods: twenty healthy controls and forty patients of stage 1 and stage 2 essential hypertension diagnosed at their 1st presentation at outpatient department of Services Hospital Lahore was studied. Blood of all patients was checked for CRP at 1st presentation and at the end of twelve weeks. Patients were divided in two groups A and B, group A received valsartan 80 to 160 mg per day and group B received amlodipine 5 to 20 mg per day. None of the patients required additional antihypertensive therapy

Results: the mean change in hsCRP was 0.09 mg/L among those allocated to amlodipine compared with 0.08 mg/L among those allocated to valsartan. When the means of hsCRP were compared in three groups, it was found that initial hsCRP levels were high in hypertensive group and after twelve week treatment with antihypertensive medicines there was significant drop in hsCRP levels [p<0.05]. Within the groups neither amlodipine nor valsartan showed the individual benefit on each other [p>0.05], both of them were equally effective in reducing hsCRP. No relationship was observed between hsCRP change and change of blood pressure

Conclusion: it is concluded that C-reactive protein is high in hypertensive patients and adequate control of blood pressure is required to prevent the vasculature from atherosclerotic damage

Ductal variations in the Calot's triangle seen on laparoscopic cholecystectomy

To describe the frequency and pattern of ductal variations seen in the Calot's triangle on laparoscopic cholecystectomy. Descriptive study. This study was conducted in the Surgical Unit 1, Fauji Foundation Hospital, Rawalpindi from December 13, 20008 to February 22, 2011. 200 patients with a diagnosis of biliary colic, cholelithiasis, acute cholecystitis, empyema gall bladder and mucocele gall bladder were included in this study. Patients with age less than 15 years were excluded. Careful dissection of the Calot's triangle was carried out. The anatomical variations of the cystic duct and other anomalous variations in the region were noted and data analyzed on SPSS 10. The age range was 19 to 88 years with a mean of 48 years. The majority [88%] of the patients presented with a clinical diagnosis of biliary colic. The cystic duct was of normal size in 88%, short in 7%, and long in 5% of the cases. The cystic duct terminated laterally into the common hepatic duct in 94% of the cases, anteriorly into the common hepatic duct in 5% and posteriorly into the common hepatic duct in 1% of the cases. Each Calot's triangle differs from the other. Ductal variations are the hallmark of this region and their knowledge is mandatory for a safe laparoscopic cholecystectomy

comparison between open and closed hemorrhoidectomy

Haemorrhoidectomy is associated with complications including pain, bleeding and wound infection which can result prolonged hospital stay. Haemorrhoidectomy is considered to provide a better outcome in terms of postoperative pain and wound healing. Aims were to compare postoperative pain, bleeding, operating time and wound healing in patients undergoing open and closed haemorrhoidectomy. This comparative study was conducted in the surgical department at Fauji Foundation Hospital, Rawalpindi from December 13, 2006 to December 31, 2011. Consecutive patients, both male and female, presenting with 3[rd] and 4[th] degree haemorrhoids in the surgical Outpatient Department were included in this study. Half of the patients were assigned to the open haemorrhoidectomy group while the other half was put in the closed haemorrhoidectomy group. Each patient was evaluated by detailed history and examination. Both digital rectal examination [DRE] and proctoscopy were done to confirm the diagnosis. A total of 260 patients were assessed, 130 in each group. In the open group, 52 patients experienced mild pain and 78 moderate while in the closed group, 30 patients experienced mild pain, 87 moderate and 13 patients severe pain. All 130 patients in the closed group showed complete wound healing after 2 weeks as compared to only 66 patients in the open group with a p<0.001. Early and late postoperative bleeding was similar in both groups. The closed technique provides a better outcome in terms of less postoperative bleeding and complete wound healing, but it is associated with more pain

Vascular variations in the calot's traingle seen on laparoscopic cholecystectomy

To describe the frequency and pattern of vascular variations seen in the Calot's triangle on laparoscopic cholecystectomy. Descriptive study. From December, 2008 to February, 2011. Surgical Unit 1, Fauji Foundation Hospital, Rawalpindi. Two hundred patients with a diagnosis of biliary colic, cholelithiasis, acute cholecystitis, empyema gall bladder and mucocele gall bladder were included. Patients with age less than 15 years were excluded. Careful dissection of the Calot's triangle was carried out. The anatomical variations of the cystic artery and other anomalous variations in the region were noted and data analyzed on SPSS 10. The age range was 19 to 88 years with a mean of 48 years. The majority [88%] of the patients presented with a clinical diagnosis of biliary colic. The cystic artery was single in 91%, branched in 6% and absent in 3% cases. The cystic artery was supero-medial to the cystic duct in 88%, anterior in 6%, and posterior in 3% of the cases. Other arterial variations included Calot's arteries [2%], Moynihan's Hump [3%] and gall bladder arterial supply from liver bed [3%]. Each Calot's triangle differs from the other. Vascular variations are the hallmark of this region and their knowledge is mandatory for a safe laparoscopic cholecystectomy

Management of congenital club foot

Aims and Objectives: To determine the effectiveness of Ponseti technique with the kite method in the management of congenital club foot

Study Design: It was a prospective interventional study

Place and Duration of Study: The study was conducted in the department of Orthopedic Surgery Foundation University Medical College and Fauji Foundation Hospital Rawalpindi from 1st October 2009 to 31st June 2010

Results: Total of 46 patients with grade 2 deformity was included in the study who meets the inclusion criteria. Patients were randomly divided into two groups of 23 each. Majority of the patients [65%] were between 05-09 weeks of age. The mean age was recorded as 7.7 weeks with S.D of 5.21. TEV is a predominantly male's disease as 65% patients in this study were males, while 35% were females in group-A. Similarly in group-B, males were 78% and 22% were female. Outcome of both the procedures was recorded at three months follow up. In group-A success rate was recorded 74% as compared to group-B in which 87% patients were found in satisfactory range with more than 25 passive range of dorsiflexion at ankle joint

Conclusion: Conservative Ponseti method is the best option for the management of Congenital Talipes Equino Varus [clubfoot] for grade 2 deformity, when starts early. This not only corrects the deformity, preventing surgical intervention but also lessens the financial burden over the parents as well as on the health system