Level of Organochlorine Pesticide in Prediabetic and Newly Diagnosed Diabetes Mellitus Patients with Varying Degree of Glucose Intolerance and Insulin Resistance among North Indian Population

Background@#Organochlorine pesticides (OCPs) exposure may induce an endocrine disruption which may lead to the risk of developing diabetes through alteration and disturbance of glucose metabolism, insulin resistance, and destruction of β-cells. The present study determines the recent trend of OCPs residue in blood samples and their association with the known risk factors responsible for developing the risk of diabetes among the North Indian population. @*Methods@#Blood sample of 300 patients (100 each of normal glucose tolerance [NGT], prediabetes and newly detected diabetes mellitus [DM]) between the age group of 30 to 70 years were collected. OCPs residue in whole blood samples was analyzed by using gas chromatography equipped with a 63Ni selective electron capture detector. @*Results@#Significantly higher levels of β-hexachlorocyclohexane (HCH), dieldrin, and p,p’-dichloro-diphenyl-dichloroethylene (DDE) were found in the prediabetes and newly detected DM groups as compared to NGT group. Insulin resistance showed to be significantly positive correlation with β-HCH and dieldrin. Also, fasting and postprandial glucose levels were significantly positively correlated with levels of β-HCH, dieldrin, and p,p’-DDE. Further, when OCPs level was adjusted for age and body mass index (BMI), it was found that β-HCH, dieldrin, and p,p’-DDE levels in blood increases the risk of diabetes by 2.70, 2.83, and 2.55 times respectively. Moreover, when we adjust OCPs level based on BMI categories (BMI 25 kg/m2); β-HCH and p,p’-DDE showed a significant risk of developing newly detected DM with BMI >25 and ≥23 and ≤25 kg/m2. @*Conclusion@#The OCPs level present in the environment may be responsible for biological, metabolic, and endocrine disruptions within the human body which may increase the risk of developing newly detected DM. Hence, OCPs exposure can play a crucial role in the etiology of diabetes.

Level of Organochlorine Pesticide in Prediabetic and Newly Diagnosed Diabetes Mellitus Patients with Varying Degree of Glucose Intolerance and Insulin Resistance among North Indian Population

Background@#Organochlorine pesticides (OCPs) exposure may induce an endocrine disruption which may lead to the risk of developing diabetes through alteration and disturbance of glucose metabolism, insulin resistance, and destruction of β-cells. The present study determines the recent trend of OCPs residue in blood samples and their association with the known risk factors responsible for developing the risk of diabetes among the North Indian population. @*Methods@#Blood sample of 300 patients (100 each of normal glucose tolerance [NGT], prediabetes and newly detected diabetes mellitus [DM]) between the age group of 30 to 70 years were collected. OCPs residue in whole blood samples was analyzed by using gas chromatography equipped with a 63Ni selective electron capture detector. @*Results@#Significantly higher levels of β-hexachlorocyclohexane (HCH), dieldrin, and p,p’-dichloro-diphenyl-dichloroethylene (DDE) were found in the prediabetes and newly detected DM groups as compared to NGT group. Insulin resistance showed to be significantly positive correlation with β-HCH and dieldrin. Also, fasting and postprandial glucose levels were significantly positively correlated with levels of β-HCH, dieldrin, and p,p’-DDE. Further, when OCPs level was adjusted for age and body mass index (BMI), it was found that β-HCH, dieldrin, and p,p’-DDE levels in blood increases the risk of diabetes by 2.70, 2.83, and 2.55 times respectively. Moreover, when we adjust OCPs level based on BMI categories (BMI 25 kg/m2); β-HCH and p,p’-DDE showed a significant risk of developing newly detected DM with BMI >25 and ≥23 and ≤25 kg/m2. @*Conclusion@#The OCPs level present in the environment may be responsible for biological, metabolic, and endocrine disruptions within the human body which may increase the risk of developing newly detected DM. Hence, OCPs exposure can play a crucial role in the etiology of diabetes.

Foot Reflexology Therapy for Non-Specific Low Back Pain Condition: A Protocol for a Randomized Controlled Trial

Background: Non-specific low back pain is one of the most common physical ailments affecting millions of people worldwide. This condition constitutes a significant public health problem and was listed as a prevalent health complaint in most societies. Even though there are many anecdotal claims for reflexology in the treatment of various conditions such as a migraine, arthritis and multiple sclerosis, but very little clinical evidence exist for reflexology on the management of low back pain per se.Objectives: This study aim to evaluate the effects of foot reflexology therapy as an adjunctive treatment to the Malaysian low back pain standard care in relieving pain and promoting health-related quality of life among people with non-specific low back pain. Methods and analysis: This is parallel randomized controlled trial with pre and post-treatment study design. The study setting for the intervention located at Penawar Reflexology Center, Kuala Terengganu, Malaysia. Total of 100 people with non-specific low back pain will be allocated into one of two groups, using a randomization computer program of Research Randomizer. The control group will receive low back pain standard care, while the intervention group will receive standard care plus eight sessions of foot reflexology therapy. The pain intensity and health-related quality of life scores will be measured using visual analog scale and Euro-quality of life scale respectively in both groups.Measurements: Outcome measures will be undertaken at pre-intervention (week 1), post-intervention (week 6) and follow-up (week 10).Conclusion: This will be the first trial to compare the foot reflexology therapy with control group among people who medically diagnosed with non-specific low back pain in Malaysia. The result of this study will contribute to better management of this population especially for Malaysia healthcare setting.Trial registration: The study was approved by the Human Research Ethics Committee of University Sultan Zainal Abidin (UHREC/2016/2/011). The study protocol was registered at ClinicalTrials.gov, with the ID number of NCT02887430

Anemia and thrombocytopenia in malaria: an observational study of 115 patients in Mardan Pakistan

Objective: the aim of present study was to evaluate hematological changes in malaria in Mardan, Pakistan

Methods: this prospective observational study was conducted at O.P.D of Mardan MedicalComplex Mardan from July to September 2015. A total of 115 patients were divided to age groupsof< 15 and > 15 years old. Malaria parasite was examined using thick and thin smears stained with Giemsa stain and also cross-checked by ICT. Those patients with a confirmed diagnosis of malaria were investigated for platelets, hemoglobin and total leukocyte count on Automatic hematology analyzer [Mindray] and studied by hematologist. Data was tabulated, descriptive statistics analyzed; the chi-square test was applied to evaluate statistical significance of the studied variable between groups on SPSS version 20. A p-value of 0.05 or less was used for statistical significance

Results: a total of 115 patients were included in the study. Male were 56[48.7%] and females 59[51.3%], the mean age of study group was 10.62[3.89]. According to age group, patients were divided into two groups; those <15 years comprised of 102[88.7%], while> 15 years were found 13[11.3%]. P. vivax was seen in 108[93.9%] and P. falciparum 7[6.1%] patients. Out of total population 70[60.9%] were found anemic, 79[68.7%] had mild thrombocytopenia and 4[3.5%] with moderate thrombocytopenia and sever leucopenia were found 2[1.7%], mild leucopenia 24[20.9%], mid leucocytosis 1[0.9%]. Patients with P.vivax aged <15 years had found anemia 59[62.1 %] with p=0.56, moderate thrombocytopenia 4[4.2%] [p=0.05], sever leucopenia 2[2.11 %], mild leucopenia 13[13.7%] and mild leukocytosis 1 [1.1 %] with p=0.001

Conclusions: the present study concludes that thrombocytopenia and anemia are common hematological findings in patient with Plasmodium infection particularly vivax species infection in Mardan region. Therefore, malaria should be a consideration in febrile patients with low platelets and haemoglobin

Cross-species amplification of microsatellite markers in Mycteria leucocephala Pennant 1769: Molted feathers as successful DNA source.

DNA from molted feathers is being increasingly used for genetic studies on birds. However, the DNA obtained from such non-invasive sources is often not of enough quantity and quality for isolation of new microsatellite markers. The present study examined the potential of shed feathers of near threatened Painted Stork as a source of its DNA for cross-species amplification of microsatellites. Thirty-one shed feathers of varying conditions (‘good’ and ‘deteriorated’) and sizes (‘large’, ‘intermediate’ and ‘small’) collected in a north Indian population were used to isolate DNA by a standard isopropanol method and 11 microsatellite markers already developed in the Wood Stork were screened for amplification. Nine plucked feathers from two dead Painted Storks were also used to compare the DNA yield and amplification success. The DNA yield of feathers varied significantly in relation to the calamus size and condition. Among molted feathers, ‘good’ and ‘large’ samples provided more DNA than ‘deteriorated’ and ‘small’ ones, respectively. ‘Large’ plucked feathers yielded more DNA than ‘large’ molted feathers. DNA was almost degraded in all the samples and ratio of absorbance at 260/280 nm varied from 1.0 to 1.8, indicating impurity in many samples. Independent of DNA yields, all microsatellites were cross-amplified in all kinds of feathers, with >80% success in different feather categories. It is concluded that the shed feathers can be successfully used to isolate DNA in the Painted Stork and for cross-species amplification of microsatellites.

Successful pregnancy following resection of recurrent retroperitoneal liposarcoma

Retroperitoneal liposarcoma is rare in pregnancy. Management of recurrent disease following surgical resection remained a challenge especially when it is associated with pregnancy. A 30-year old primigravida conceived spontaneously four months following a second laparotomy for resection of recurrent RPLS. The primary surgery was performed four years earlier with optimum postoperative course in the absence of need for postoperative adjuvant treatment Histology of the recurrent tumor confirmed a well differentiated liposarcoma. She was monitored closely for any worsening of symptoms and underwent a MRI and an ultrasound at 12 and 22 weeks gestation respectively. The pregnancy continues to be uneventful and she safely delivered vaginally at 41 weeks gestation. Small RPLS during pregnancy do not pose great obstetrics management challenges. Early detection with multidisciplmary team management would anticipate possible complications to ensure both maternal and fetal wellbeing

Short Review Of Fourteen Years Maternal Mortality In Achieving Mdg5 In UKMMC

Worldwide maternal mortality rate had reduced tremendously including Malaysia. At the 2000 Millenium Summit, eight Millenium Development Goals (MDGs) were established with target for the year 2015. Three years remained until the dateline to achieve MDG5, which comprised of two targets and one being reducing the maternal mortality ratio by 75%. This review compared the trend of maternal mortality and its causes in our centre to the national data. The national data had shown a reduction from 44 to 27.6 in 100 000 live births in1991 and 2008 respectively. The subsequent rate had stabilized for the past seven years. In contrast the UKM Medical Centre (UKMMC) data in the past 15 years had not been stable. The target of MDG5 seemed to be achievable by our country but may require longer time as we have yet to find ways to overcome medical care inadequacy in remote areas.

Pattern of diseases among visitors to Mina health centers during the Hajj season, 1429 H [2008 G]

While performing the Hajj, hajjis face different risks related to the environment, their behaviors and their health conditions that can result in a variety of diseases. The objective of this study was to determine the pattern of diseases among pilgrims seeking medical services in Mina primary health care centers [PHCCs] during the Hajj season in 1429 [2008]. This is a descriptive study based on the medical records of a random sample of 4136 patients who attended 13 randomly selected Mina PHCCs from 8 to 12 Dhu-Alhijja, 1429 H [6-10 December 2008]. The majority of the patients were men [70.7%], and most of the patients were between 45 and 64 years of age [42.8%]. One-fifth [20.2%] of the patients suffered from multiple diseases. Respiratory diseases were the most common [60.8%], followed by musculoskeletal [17.6%], skin [15.0%] and gastrointestinal [13.1%] diseases. Diabetes, asthma and hypertension each constituted less than 3% of the total diseases. Respiratory diseases were the most common independent of nationality or the day of visit, while the frequency of the other diseases varied according to nationality and the day of visit. The most frequently prescribed drugs were analgesics, antipyretics, antibiotics and cough syrups. This study describes the pattern of diseases among pilgrims attending Mina PHCCs, which may aid in providing the best possible health care services to pilgrims. 2011 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved

Case Review: Post Partum Vulvo-vaginal Haematomas and Options of Management

Vulvo-vaginal haematomas are not an uncommon obstetric complication. Despite advances in obstetric care, practice and technique, vulvo-vaginal haematomas do occur especially in complicated vaginal deliveries. Various management options are available for vulvo-vaginal haematomas. We describe three cases of vulvo-vaginal haematomas with different severity and presentations which were managed in different manners i.e. local haemostasis control, laparotomy with hysterectomy, and transarterial embolisation. The choice of treatment options would mainly depend on the clinical presentations, availability of expertise as well as facilities. Early identification is crucial.

Data on services available to HIV/AIDS patients in two tertiary care hospitals of Peshawar

To identify services available to HIV / AIDS patients in two tertiary care hospitals of Peshawar. Descriptive observational survey. Khyber teaching hospital [KHT] and Postgraduate Medical Institute, Hayatabad Medical Complex Peshawar [PGMI, HMC]. September 2005 to February 2006. A questionnaire was designed in accordance with the objectives of the study. Questionnaire contained information about the medical services available to HIV/AIDS patients, clinic pathological aspects of the disease, risk behaviors, preventive and precautionary measures, diagnosis and treatment of HIV/AIDS. A total of 100 medical faculty were selected, 64 from KHT and 36 from HMC. Voluntary counseling and testing [VCT] is available in these centers [76%]. Preliminary tests for HIV testing were done on site [70%]. Pre and post-test counseling [68%] and space to ensure privacy [60%] were available. No confidentiality testing, trained counselors and quality control for HIV testing were recorded. Services for special and vulnerable groups were available only for pregnant women [90%]. Distribution of laboratory tests or medical procedures that are part of the routine HIV-treatment follow-up were: complete blood count [100%], liver function tests, Hbs Ag, and HCV antibodies [100%], syphilis serology [68%], toxoplasmosis serology [38%] and MTb culture [65%] etc. No facilities for CD4 cell count, viral load testing; cryptococcal Ag, anergy testing and PAP smear were available. Drugs used for treatment of opportunistic infections associated with HIV / AIDS were available [74%]. Drugs used for treatment of malignancies associated with HIV/AIDS were available on site/city [56%]. Antiretroviral therapy availability [on order only] were nucleoside reverse transcriptase inhibitors [NRTI] [n: 16%] and protease inhibitors [n: 4%]. Medical services available in two tertiary care centers of Peshawar are not satisfactory. There is need for further action, more collaboration, leadership, community involvement, UN assistance and government support to improve the quality of life of people living with HIV / AIDS

Maternal practices regarding acute respiratory tract infections in an urban slum of lahore

Acute Respiratory tract infections [ARI] are responsible for 26.5% of all deaths under five yeras of age in Pakistan. To determine the knowledge and practices of the mothers regarding management of acute respiratory tract infections, 256 randomly selected mothers, having at least one child below 5 years of age where interviewed in an urban slum of Lahore. Seventy five% children were suffering from ARI at the time of interview. 25% children had suffered during the last two months preceding the interview but were free from any symptom of ARI at the time of interview. Seventy% mothers consulted private general physicians, 10.9% consulted Government health facility while 23% mothers used various types of home remedies for the management of ARI in their children. In home management, 44.1% mothers used allopathic drugs, 27.1% used Joshanda, 22% vicks rub, 22% honey, 20.3% soanf [aniseed] water, 15.2% tea, 11.9% kept the child warm and 8.5% gave eggs to their children. Majority of mothers 71.2% intiated the home based treatment on their own. Eight four% mothers said that allopathic medicines should not be used without consulting a qualified doctor, 19.5% mothers considered that the consultation from the doctor for the last episode of ARI in their children was delayed