Phytochemical, antibacterial and antioxidant screening of Artemisia santolinifolia various parts

The current study was carried out to explore the phytochemical, antioxidant potential and antibacterial activities of the crude methanolic extract of A. santolinifolia Turcz. Ex Besser. The antioxidant activity was carried out by using 1,1-diphenyl-2-picrylhydrazyl (DPPH) and 2,2'-azino-bis-3-ethylbenzthiazoline-6-sulphonic acid (ABTS) assay, while methanolic extract displayed the highest scavenging activity (DPPH) was 61.31µg/ml on Artemisia santolinifolia root and the lowest (51.05µg/ml) was record for their leaves. Similarly, in (ABTS) the highest activity (89.16µg/ml) was recorded for roots of A. santolinifolia followed by leaves (68.14µg/ml). In low inhibitory concentration assay, the crude methanolic extracts showed significant inhibition against all tested microbes on different concentrations like 25 µg/ml, 50 µg/ml, and 100 µg/ml. The leaves extract of A. santolinifolia AsL showed MIC of 12.5µg/ml for B. subtilis, a gram-positive bacterium, 50µg/ml for gram positive bacteria S. aureus and 37.5 µg/ml for gram negative bacteria P. aeruginosa that is almost equal to the response of standard ciprofloxacin. Our current study revealed that Artemisia santolinifolia root (AsR) exhibited a significant antioxidant potential while AsL showed good antibacterial effect which is suggested to be used for treatment and management of different infectious diseases.

The Effect of Nutritional Status on the Occlusion of Primary Dentition among Iraqi Preschool Children

Background: Nutritional status of children might affect the jaws growth. Aim of the study: This study aimed to investigate the relationship between the malnutrition and the malocclusion. Patients and methods: A total sample of 135 preschool children of 5 years was collected. The body mass index was calculated for each child. The primary terminal plane occlusal relationship was assessed in this study. Results: The flush terminal plane showed the highest percent among normal weight than overweight and obese children with a statistically non-significant difference (Pearson Chi-Square=4.562(a) p<0.335). While the mesial and distal terminal plane showed the highest percent among overweight children than normal weight and obese children. Conclusion: There was no relationship between the malnutrition and the malocclusion.

Anterior technique in spinal deformity correctional surgery

The aim of this review is to classify spinal deformities, provide knowledge in correctional surgery of spinal deformities and highlight the anterior technique. PubMed and Medline database search was performed for published articles up to October 2017 related to surgical techniques for spinal deformities. Spinal deformity may be the pathology of one vertebra or may develop with pathologies of multiple vertebras, ribs or the pelvis. The spine must be analyzed in different planes before starting the treatment because it can be accompanied by multiple organ pathologies. Different surgery types can be used and anterior method is one of them, which can give better result in cases with advanced kyphosis. The therapy of serious spinal deformity is challenging and needs a careful analysis of the patient by the orthopedic surgeon, anesthesiologist, pulmonologist, and neurologist especially when neurologic deficits are existing

Frequency and pattern of congenital heart defects in a tertiary care cardiac hospital of Karachi

Objective: To determine the current frequency and pattern of distribution of congenital heart defects [CHD] at National Institute of Cardiovascular Diseases [NICVD], with the age at which initial diagnosis of CHD was made and the age at which the participant first visited the study center

Methods: This is a descriptive and prospective hospital based study conducted in the pediatric cardiology unit outpatient department of NICVD. This study included all the patients, irrespective of age, having confirmed diagnosis of CHD on the basis of echocardiographic report. The collected data was entered and analyzed by using Statistical Package for Social Sciences v 20.0

Results: Out of 1100 cases of congenital heart defects 1003 could be analyzed. There are 565 males [56.3%] and 438 females [43.6%]. Total 609 cases [60.6%] were of simple acyanotic lesions and 387 [38.6%] were complex cyanotic lesions. In simple lesions septal defects constitute 64.9% and obstructive lesions were 11.0%. Tetralogy of fallot[TOF] was the commonest CHD and cyanotic lesion accounted for 24.4% of the total 1003 cases followed by Ventricular septal defect[VSD] 21.5%, Atrial septal defect [ASD] 9.3% and Patent ductus arteriosus [PDA] 8.6%. Pulmonary stenosis[PS] was the most common obstructive lesion making 3.1% of the CHD. In 147 [14.5%] cases combination of simple defects were encountered and the commonest combination was ASD with VSD in 34 cases

Conclusion: Congenital Heart Defects are very common in our setup and early detection of CHD is increasing. Overall burden of CHD is also increasing therefore a proper population based study on a large scale is needed to estimate the prevalence accurately

Research design and statistical methods in Pakistan Journal of Medical Sciences [PJMS]

Objective: This article compares the study design and statistical methods used in 2005, 2010 and 2015 of Pakistan Journal of Medical Sciences [PJMS]

Methods: Only original articles of PJMS were considered for the analysis. The articles were carefully reviewed for statistical methods and designs, and then recorded accordingly. The frequency of each statistical method and research design was estimated and compared with previous years

Results: A total of 429 articles were evaluated [n=74 in 2005, n=179 in 2010, n=176 in 2015] in which 171 [40%] were cross-sectional and 116 [27%] were prospective study designs. A verity of statistical methods were found in the analysis. The most frequent methods include: descriptive statistics [n=315, 73.4%], chi-square/Fisher's exact tests [n=205, 47.8%] and student t-test [n=186, 43.4%]. There was a significant increase in the use of statistical methods over time period: t-test, chi-square/Fisher's exact test, logistic regression, epidemiological statistics, and non-parametric tests

Conclusion: This study shows that a diverse variety of statistical methods have been used in the research articles of PJMS and frequency improved from 2005 to 2015. However, descriptive statistics was the most frequent method of statistical analysis in the published articles while cross-sectional study design was common study design

Evaluation of anti-streptolysin o titers in rheumatic heart disease patients

Background: Anti-streptolysin O titer is related to rheumatic heart disease

Objective: To assess anti-streptolysin O titer in rheumatic heart disease patients at Punjab Institute of Cardiology Lahore

Methodology: It was a cross-sectional study, 130 consecutive patients of rheumatic heart disease admitted at Punjab Institute of Cardiology Lahore between 1[st] January to 31[st] December, 2014, fulfilling the inclusion and exclusion criteria were enrolled. Their laboratory findings were taken; CRP and ESR levels were measured. ASO titer was measured by latex agglutination test. ASO Titer more than 200IU/ml was taken as significant

Results: It was found that 81[62.31%] patients of rheumatic heart disease has ASO levels more than 200IU/ml and 49[37.69%] patients has ASO less than 200IU/ml. Fifty two percent study subjects were female and 60% were between 4-15 years of age

Conclusion: Majority of the patients admitted with RHD has raised level of ASOT

Cut throat injury: one year study

To evaluate the cause and pattern of cut throat injury. Prospective study. This study was conducted in Abbasi Shaheed Hospital and Karachi Medical and Dental College from 01.09.2012 to 31.08.2013. Total number of patients with cut throat were 42 patients, in which 33 were selected in this study. During this period, those patients who came in emergency room in Abbasi Shaheed Hospital with cut throat injury were included in this study. In this study male were 24 patients [72.72%] and female were 9 [27.27%]. Male female ratio was 2.66:1. Maximum incidence of age was between 21-30-years 9 cases [27.27%]. Accidental cause was the main cause of cut throat with 19 patients 57.57%. In 9 [27.27%] cases of suicidal, 7 [77.77%] patients was history of psychiatric illness. Zone II was the commonest site which was 20 cases [60.60%] Skin and soft tissue is the commonest structure involved which was 20 cases [60.60%]. 26 patients [78.78%] were discharge from ward after treatment. Proper assessment the cause and accurate treatment may prevent complication

Acute toxicity and antispasmodic activities of achillea wilhelmsii C. Koch

Since Achillea wilhelmsii is used as antispasmodic in traditional medicine, we conducted our current work to investigate its rationale on scientific grounds. Acute toxicity studies of crude methanol extract of Achillea wilhelmsii [Aw. CMeOH] is also performed. Effect of Aw. CMeOH and its fractions were tested on isolated sections of rabbits' jejunum at test concentrations 0.01, 0.03, 1.0, 3.0, 5.0 and 10mg/ml. The test extracts, in similar concentrations, were also tested on KCl-induced contractions. Calcium chloride curves were constructed for those fractions which relaxed KCl induced contractions in the absence and presence of the test samples to investigate its possible mode of action through calcium channels. Aw. CMeOH tested positive for flavonoids, saponins, tannins, glycosides, terpenoids, sterols, phenols, carbohydrates and proteins. LD[50] for acute toxicity studies is 2707 +/- 12.6 mg/kg. Mean EC[50] values for Aw. CMeOH on spontaneous and KCl-induced contractions are 3.41 +/- 0.18 [2.56-3.8, n=6] and 0.68 +/- 0.05 [0.6-0.85, n=6] mg/ml, respectively. Respective EC[50] values for n-hexane fraction on spontaneous and KCl-induced contractions are 3.06 +/- 0.08 [2.8-3.3, n=6] and 1.68 +/- 0.8 [1.4-1.9, n=6] mg/ml, respectively. Corresponding EC[50] [mg/ml] values for chloroformic, ethylacetate and aqueous fractions of Achillea wilhelmsii on spontaneous rabbits' jejunum preparations are 4.8 +/- 0.2 [4.41-5.63, n=6], 5.07 +/- 0.15 [4.7-5.58, n=6] and 5.2 +/- 0.13 [4.91-5.64, n=4], respectively. Constructing calcium chloride curves, in the presence of 0.1 mg/ml of Aw. CMeOH, mean EC[50] value [log molar [Ca[++]]] is-1.98 +/- 0.03 [-1.89-2.05, n=6] vs. control EC50 [log molar [Ca[++]]]-2.41 +/- 0.02 [-2.32-2.44, n=6]. Mean EC50 value [log molar [Ca[++]]] for 0.3 mg/ml n-hexane fraction is-1.76 +/- 0.05 [-1.70 -1.93, n=6] vs. control EC50 [log molar [Ca[++]]] value-2.18 +/- 0.07 [-2.0-2.46, n=6]. While in the presence of chloroformic fraction [3 mg/ml], mean EC50 [log molar [Ca[++]]] value is -2.4 +/- 0.1 [-2.78 - 2.9, n=6] vs. control EC50 [log molar [Ca[++]]] value-2.70 +/- 0.05 [-2.5-2.8, n=6]. Mean EC50 value [log molar [Ca[++]]] for ethyl acetate fraction [1 mg/ml] is-1.94 +/- 0.07 [-1.75-2.05, n=6] vs. control EC50 [log molar [Ca[++]]] value-2.69 +/- 0.04 [-2.57-2.79, n=6]. Mean EC50 [log molar [Ca[++]]] value for residual aqueous fraction [3 mg/ml] is-1.8 +/- 0.3 [-1.71-1.84, n=6] vs. control EC50 [log molar [Ca++]] -2.6 +/- 0.04 [-2.59-2.76, n=6]. Whereas, the verapamil [0.1 micro M] EC[50] value [log molar [Ca[++]]] is-1.7 +/- 0.1 [-1.6-1.8, n=6] vs. control EC50 value [log molar [Ca[++]]]- 2.4 +/- 0.09 [-2.3-2.47, n=6]. The present research work confirms that the intestinal relaxation effect of Achillea wilhelmsii is supporting its traditional use as antispasmodic. The plant species can be a source for calcium antagonist[s], which can preferably be isolated from n-hexane fraction

Lack of awareness about safe blood in Pakistani population

Blood transfusion is a life saving procedure in various transfusion-dependent life threatening conditions and donation of safe blood is a prerequisite for achieving this goal. This study was designed to evaluate the awareness regarding [safe blood] in Pakistani population. This study was conducted at a large scale through a population survey. The test population was divided into two groups i.e. general population and students. The Performa was designed for a general and student population and included 20 questions related to awareness of safe blood. A total of 4900 individuals belonging to different ethnic groups were included in this population survey. Results of social survey were analyzed by using Usman and Moin awareness chart. Results of this study revealed profound unawareness about safe blood in Pakistani population. This study found lack of awareness about safe blood as a major factor that is playing a vital role in the propagation of blood borne diseases in Pakistan. To secure the recipients from blood borne complications through blood donation, it is necessary to create effective awareness about safe blood in Pakistani population

Pathological findings of chronic supparative otitis media in tertiary care hospital

Objectives: To see the clinico-pathological pattern of findings in the chronic supparative otitis media [CSOM] during surgery

Study Design: A prospective observational study

Place And Duration: This study was conducted in Karachi Medical and Dental College and Abbasi Shaheed Hospital during the period of October 2006 to October 2010

Methodology: For this study, 288 patients were selected. After complete history, examination and relevant investigations surgery was performed and intra-operative findings of middle ear cleft were noted

Results: Total number of patients selected were 288, in which female were dominating slightly with 54.1%. Maximum incidence was noted between the ages of 16-30 years of age in 180 patients [62.5%]. 140 cases [48.61%] had no ossicles damage while 148 cases[51.38%] had one or more ossicles damage. Granulation tissue found in 99 patients [34.37%], while cholesteatoma found in 77 patients [26.73%]

Conclusion: Pathological changes varies from simple mucosal edema to extensive destruction of the middle ear cleft

Typhoid fever in paediatric patients in Quetta, Balochistan, Pakistan

To determine the seropositivity of typhoid fever in febrile pediatric patients presenting to tertiary care center. This observational study was conducted at Children Hospital Quetta [CHQ] from July 2011 to March 2012. The children with three or more days fever, no obvious focus of infection and clinically suspected of typhoid fever were screened. Sterile Blood samples were obtained from febrile patients and Widal and Typhidot [Trade Mark] tests were performed for the diagnosis of Typhoid fever in the suspected populations. Total of 2964 clinically suspected patients were screened for typhoid fever. Of these, 550 [18.6%] patients were positive serologically. The higher prevalence of the disease in hot summer season and increasing pattern of the disease was observed in summer days. The disease was higher in school age children under 5-10 years. Although non-significant association was observed on sex basis. The findings highlight the considerable burden of typhoid fever in pre-school and school-aged children. The variation in the disease pattern has also been observed under seasonal variation and different age groups, all of which need to be considered in deliberations to control the typhoid fever

Pattern of ossicular damage in chronic supparative otitis media

The aim of this study is to determine pattern of ossicular damage in chronic supparative otitis media. Prospective study. This study and was conducted in Karachi and Medical and Dental College and Abbasi Shaheed Hospital during the period of October 2006 to October 2010. 288 patients were selected in this study and intra-operative findings of ossicles were noted. Total numbers of patients was 288, in which female was slight domination with 54.1%. Maximum incidence was noted between the ages of 16-30 years of age which was 180 patients. 209 patients presented with central perforation. 140 cases had no ossicles damages of ossicles damage. Ossicles damage can be prevented by early diagnosis and proper management

Spectrophotometric analysis of cefepime through its Hg [I] complex

A spectrophotometric procedure -was developed for determination of cefepime depending on the complexation of the drug with Hg[2][NO[3]]2 in acid medium [pH 3.5] and measuring the absorbance at 263 nm. Different variables affecting the reaction were studied and optimized. Under the optimized conditions, linear relationship with good correlation coefficient [0.999] was found between the absorbance and the concentration in the range of 3.65-40 microg ml[1] . The limits of detection and quantitation were 1.20 and 3.65 microg mt[1] respectively. The stoichiometry of the reaction was studied using Yoe and Jones method and was found to be 1:2 ratio for cefepime: Hg [I]. The method was successfully applied for determination of cefepime in its vial with average percentage recovery of 98.95 +/- 1.079. The results were favorably compared with those of reference method. The IR study of the formed complex was done and different probabilities of the formed complexes were suggested

Device-associated infection rates in adult and pediatric intensive care units of hospitals in Egypt. International nosocomial infection control consortium [INICC] findings

To determine the rate of device-associated healthcare-associated infections [DA-HAIs] at a respiratory intensive care unit [RICU] and in the pediatric intensive care units [PICUs] of member hospitals of the International Nosocomial Infection Control Consortium [INICC] in Egypt. A prospective cohort DA-HAI surveillance study was conducted from December 2008 to July 2010 by applying the methodology of the INICC and the definitions of the NHSN-CDC. In the RICU, 473 patients were hospitalized for 2930 d and acquired 155 DA-HAIs, with an overall rate of 32.8%. There were 52.9 DA-HAIs per 1000 ICU-days. In the PICUs, 143 patients were hospitalized for 1535 d and acquired 35 DA-HAIs, with an overall rate of 24.5%. There were 22.8 DA-HAIs per 1000 ICU-days. The central line-associated blood stream infection [CLABSI] rate was 22.5 per 1000 line-days in the RICU and 18.8 in the PICUs; the ventilator-associated pneumonia [VAP] rate was 73.4 per 1000 ventilator-days in the RICU and 31.8 in the PICUs; and the catheter-associated urinary tract infection [CAUTI] rate was 34.2 per 1000 catheter-days in the RICU. DA-HAIs in the ICUs in Egypt pose greater threats to patient safety than in industrialized countries, and infection control programs, including surveillance and guidelines, must become a priority

Fibrolamellar hepatocellular carcinoma- a rare clinical variant

Fibrolamellar type is a rare variant of hepatocellular carcinoma [FLHCC]. A 20 year old boy presented with pain and mass in the epigastric region for the last six months. Early diagnosis and confinement of the lesion to a lobe made it possible to perform complete resection of tumour along with subtotal gastrectomy. Patient recovered well and was sent to oncologist for further treatment

Comparison of three different ceruminolytic agents [soda-bicarbonate, almond oil and normal saline] with respect to their efficacy

To compare the efficacy of three ceruminolytic agents for cerumen impaction with respect to its ease of complete removal via suctioning or probe. A comparative prospective study. This study was conducted carried out at the outpatient department of ENT, Abbasi Shaheed hospital, Karachi from November 2010 to March 2011. A comparative prospective study of 75 adult patients with cerumen impaction in either or both of the ears carried out at the outpatient department of ENT, Abbasi Shaheed hospital, Karachi. The study was done after taking the consent of the patients. All the adult patients of age 18 years or greater, of either sex with the symptoms in the ear[s] because of cerumen which was hard/dry and difficult to remove were included in the study. Those of age less than 18 years and not having any symptomatology because of the cerumen or with soft wax which was easy to clear were not included in the study. The study was carried out from November 2010 till March 2011. the patients with problematic, difficult to remove cerumen or cerumen impaction with symptoms were divided in to three groups: Groups A, Group B and Group c; all having equal number of cases that is 25 each. In group A they were given soda-bicarbonate in glycerin based ear drops; in group B almond oil and group C the normal saline for instillation in ear. The doses and timings for drops were equal in all the group and it was 3 drops in the affected ear every 6-hourly for 1-week. They were councilled that the dose should not be missed and they have to lay down for 5 minutes so that drops are absorbed and does not come out of the ear. After one week they were called in the OPD, was compared with completeness of removal of impacted cerumen for the three groups. Ease and completeness of cerumen removal was 80% in group A, followed by 60% for group C and 20% for group B. We found soda-glycerin to be superior to almond oil and normal saline as ceruminolytic agent

Spasmogenic and spasmolytic activities Onosma griffithii Vatke

Methanolic extract of Onosma grifflthii and its fractions were evaluated for possible effects on rabbits' jejunum preparations. Rabbits of either sex [weight 1.5-2.0 kg] were used in experiments. Studies were carried out on rabbits' jejunum preparations. Crude methanolic extract of Onosma griffithii [Meth.OG] was tried in concentrations of 0.01, 0.03, 0.1, 0.3, 1.0, 3.0, 5.0 and 10.0 mg/ml on rabbits' jejunum preparations. Meth.OG was also tried on KCl-induced contractions to explain its possible mode of actions in the presence and absence of atropine [0.03 microM]. Fractions of Meth.OG were tried in similar manner. Calcium chloride curves were constructed for Meth.OG treated tissues that were compared with curves constructed for verapamil in same fashion. Preliminary phytochemical screening of the plant was also performed. Meth.OG increased the amplitude of spontaneous activity of rabbits' jejunum preparations at concentrations of 0.1, 0.3 and 1.0 mg/ml. However, spasmolytic effects were observed at higher concentrations 3.0, 5.0 and 10.0 mg/ml. Mean EC[50] values [mg/ml], respectively, in absence and presence of atropine were 7.5 +/- 0.25 [6.9-8.4, n=6] and 3.0 +/- 0.17 [2.3-3.5, n=6, P<0.05]. Mean EC[50] values, respectively, for effects on spontaneous and KCl-induced contractions were 7.5 +/- 0.25 [6.9-8.4, n=6] and 7.3 +/- 0.35 [6.25-8.2, n=6, p<0.05]. rc-Hexane, chloroform and ethyl acetate fractions showed their respective EC[50] values [mg/ml] 9.7 +/- 0.25 [8.6-10.2, n=6], 4.0 +/- 0.2 [3.5-4.6, n=6] and 1.07 +/- 0.093 [0.78-1.5, n=6]. EC[50] values for calcium chloride curves in presence of 0.3 mg/ml Meth.OG were - 2.27 +/- 0.038 [- 2.4 to - 2.10, n=6] vs. control - 2.78 +/- 0.04 [-2.9 to - 2.6, n=6,P<0.05] Log [Ca[++]]M. Comparing with curves of calcium chloride constructed in presence of 0.1 juM verapamil, the EC[50] [log [Ca[++]] M] values were - 1.82 +/- 0.087 [- 2.0 to - 1.65, n=6] vs. control - 2.64 +/- 0.089 [- 2.9 to - 2.4, n=6] demonstrated a right shift [p<0.05]. Meth.OG tested positive for terpenes, saponins, sterols, flavonoids and carbohydrates. We concluded that the relaxant effect of Meth.OG is exerted through blocking of calcium channels. However,

butanolic and aqueous fractions produced spasmogenic effects that require further work for isolation of pharmacologically active substances

Post tonsillectomy quality of life in adults

Objective: to determine the health related quality of life benefits derived from tonsillectomy in adult patients of chronic or recurrent tonsillitis

Patients and methods: a cross sectional study of 85 adult patients carried out in ENT department of Abbasi Shaheed Hospital, Karachi from January 2010 to February 2011 with the written and informed consent of patients. All were of age 18 years or greater and of either sex with the diagnosis of chronic tonsillitis or recurrent tonsillitis. There complete correspondence addresses with phone numbers were noted and they all were called back again after a lapse of 6-months post-operation to fill in the questionnaire, Glasgow Benefit Inventory [GBI]. Analysis of data was done by SPSS version 11.0

Result: good scores were noted on the Glasgow Benefit Inventory. Total score was +45.29 [p-value <0.0001]. The subscale scoring was general subscale score +44.10 [p-value <0.0001]; social subscale score, no change i.e. 0 and physical health subscale score +79.62 [p-value <0.0001]

Conclusion: the result thus proves that post-tonsillectomy the HRQOL is improved and the procedure of tonsillectomy is beneficial in terms of improved quality of life

Relapsing fever, a rare disease in Saudi Arabia

Background: relapsing fever is an acute febrile illness caused by blood spirochetes belonging to genus borrelia. This spirochete can be acquired through the bite of an infected soft tick [Ornithodoros species] or contact with an infected louse [Pediculus humanus] and thus constituting two types of relapsing fever [RF] depending upon the responsible vector i.e. Tick borne relapsing fever [TBRF] and Louse-borne relapsing fever [LBRF]. It is characterized by recurrent cycles of pyrexia which are separated by intervals of apparent recovery. During pyrexia, organisms are found in blood. While during afebrile period, organisms hide themselves in spleen, liver and even central nervous system

Methods: one hundred and thirteen patients presenting with high grade fever were studied for disease pattern. They underwent routine and special investigations for meningitis, malaria, dengue, enteric fever, HBV, HCV and HIV on quality control maintained analyzers by standard methods

Results: all the 113 patients after diagnosis were classified as enteric fever [41], malaria [37], meningitis [20], dengue fever [14] and a patient of relapsing fever i.e. Borrelia recurrentis. This patient was brought in unconscious state, looked jaundiced, dehydrated, had hepatosplenomegaly. His CBC showed WBC 10. 7X1 0A9/L, Hb 10.5g/dl, Platelet count 35x10"9/1. Giemsa stained blood film showed multiple number of spiral shaped organisms- borrelia recurrentis. He had signs of splenic rupture; he underwent splenectomy. Histopathology of spleen for spirochetes confirmed spiral shaped organisms [borrelia recurrentis]

Conclusions: there is very little information about borrelia infection in Saudi Arabia. The prevalence or incidence in Saudi Arabia is unknown. Its apparent rarity may be due to under diagnosis and under reporting. A high index of suspicion in appropriate clinical situations will lead to its early recognition and treatment