Association between serum concentration of vitamin D and development of pneumonia

Background: Pneumonia is a common disease with significant morbidity and mortality. There is evidence that vitamin D deficiency can be associated with an increased incidence of lower respiratory illness requiring hospitalization. The objective of this study investigated the impact of vitamin D status on the susceptibility of pneumonia in children the design is Case - Control study, Duration of this study is One year (October 2016 -November 2017) and Setting is Niloufer Hospital, Hyderabad, India. In this study participants are 50 children aged 5 months to 5 years with pneumonia and 50 healthy children of the same age were studied.Methods: In this case-control study, children aged 5 months to 5 years with pneumonia were compared with healthy children of the same age as the control group. Serum levels of vitamin D in both groups were measured by chemiluminescence method. Mean serum levels of vitamin D in patients with pneumonia and control groups were compared using t test.Results: The mean serum levels of vitamin D in the group with pneumonia and the control group were 25.98'14.8 ng/mL and 31.18'15.81 ng/mL, respectively. The difference between the two groups was significant. However, this difference was more significant in the age group of 24 to 60 months.Conclusions: According to findings, a low level of Vitamin D is associated with a higher incidence of pneumonia and more severe disease. It is recommended to pay more attention to vitamin D deficiency in infectious diseases, particularly in pneumonia patients.

Modifiable cardiovascular risk factors in rheumatoid arthritis

Objective: To determine the frequency of modifiable cardiovascular risk factors in Rheumatoid Arthritis patients at tertiary care hospital

Methods: During this study 246 patients of Rheumatoid Arthritis were enrolled from outpatients department of Medicine of Central Park Medical College Hospital, Lahore from July 1, 2016 to January 31, 2017. Demographic data and questions related to study were noted. After 14 hours of fasting 5ml of venous blood was drawn for Cholesterol, triglycerides, HDL and blood sugar level. Blood tests were performed on COBAS c III [ROCHE], Framingham 10 year Risk score was calculated for every individual

Results: The mean age of male population was [50.2 +/-7.5] and females [48.4+/-7.6] and female gender was common. Seventy eight [78%] of study population has one modifiable risk factor. Most frequent risk factor found in this study was BMI >30 in 48.4% [n=119], High LDL 43.5% [n=107], moderate to high FRS score 40.2% [n=99], Hypertension 37.4% [n=92], Diabetes Mellitus was present in 22.8% [n=56], while smoking was least frequent risk factors with frequency of 15.9% [n=39]. Framingham cardiovascular risk score was significantly different, males were having higher mean 10 year risk score [19.7%] and females [8.7%] with [p<0.01]. Regression analysis revealed that older patients of Rheumatoid Arthritis with disease duration of more than seven years are four times more likely to have High Framingham risk score, moderate to high LDL and diabetes mellitus with significant high Odds ratio [p-value <0.05]

Conclusion: Rheumatoid Arthritis patients are having increased chances of developing cardiovascular risk factors leading to cardiovascular events with male sex, increasing age and disease duration

Cardiovascular risk score in Rheumatoid Arthritis

Objective: To determine the 10-year Cardiovascular risk score with QRISK-2 and Framingham risk calculators in Rheumatoid Arthritis and Non Rheumatoid Arthritis subjects and asses the usefulness of QRISK-2 and Framingham calculators in both groups

Methods: During the study 106 RA and 106 Non RA patients age and sex matched participants were enrolled from outpatient department. Demographic data and questions regarding other study parameters were noted. After 14 hours of fasting 5 ml of venous blood was drawn for Cholesterol and HDL levels, laboratory tests were performed on COBAS c III [ROCHE]. QRISK-2 and Framingham risk calculators were used to get individual 10-year CVD risk score

Results: In this study the mean age of RA group was [45.1 +/- 9.5] for Non RA group [43.7 +/- 8.2], with female gender as common. The mean predicted 10-year score with QRISK-2 calculator in RA group [14.2 +/- 17.1%] and Non RA group was [13.2 +/- 19.0%] with [p-value 0.122]. The 10-year score with Framingham risk score in RA group was [12.9 +/- 10.4%] and Non RA group was [8.9 +/- 8.7%] with [p-value 0.001]. In RA group QRISK-2 [24.5%] and FRS [31.1%] cases with predicted score were in higher risk category. The maximum agreement scores between both calculators was observed in both groups [Kappa=0.618 RA Group; Kappa=0.671 Non RA Group]

Conclusion: QRISK-2 calculator is more appropriate as it takes RA, ethnicity, CKD, and Atrial fibrillation as factors in risk assessment score

Bioconversion of low quality lignocellulosic agricultural waste into edible protein by Pleurotus sajor-caju (Fr.) Singer / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Pleurotus sajor-caju (Fr.) Singer was cultivated on selected agro wastes viz. cotton stalks, groundnut haulms, soybean straw, pigeon pea stalks and leaves and wheat straw, alone or in combinations. Cotton stalks, pigeon pea stalks and wheat straw alone or in combination were found to be more suitable than groundnut haulms and soybean straw for the cultivation. Organic supplements such as groundnut oilseed cake, gram powder and rice bran not only affected growth parameters but also increased yields. Thus bioconversion of lignocellulosic biomass by P. sajor-caju offers a promising way to convert low quality biomass into an improved human food.

Prophylactic role of epidural saline injection for post dural puncture headache: a pilot study

This pilot study was designed to judge the Prophylactic role of epidural injection for prevention of post dural puncture headache [PDPH] in patients with accidental dural puncture during the setting up of epidural anaesthesia. Ten patients who sustained accidental dural puncture during routine epidural anaesthesia for various gynaecological and obstetrical surgical procedures carried out in [Iynae Block of Services Hospital Lahore between 16-03-05 to 15-04-06 were included in the study. All patients had ASA I to ASA III status. The age range was 25 to 50 years and weight range was 45 to 70. Kg. A 16 gauge Touhy needle was used for epidural anaesthesia. In case of dural puncture, epidural anaesthesia was given one space above or below the site of puncture. The study was approved by hospital ethical committee. After completion of surgery, 30 ml of normal saline [0.9%] was injected in the epidural space. All patients were observed for three days for occurrence of post dural puncture headache. Two out of ten patients [20%] complained of post dural puncture headache. One patient had to undergo repeat surgery under general anaesthesia for a surgical complication but did not complain of post dural puncture headache. Prophylactic epidural saline injection is associated with low frequency of post dural puncture headache in patients with accidental dural puncture during setting up of epidural anaesthesia

phase II study of gemcitabine concurrent with radiation in locally advanced squamous cell carcinoma of head and neck: a trial of the cancer research group Pakistan

To evaluate the efficacy and toxicity of weekly gemcitabine as a radiosensitizer concurrent with radical radiotherapy in locally advanced carcinoma of head and neck. From August 2001 to January 2002, thirty-nine patients with stage III or IV B inoperable carcinoma of head and neck were enrolled. Patients with histopathologically confirmed squamous cell carcinoma with at least one bidimensionally measurable lesion, no prior chemotherapy or radiotherapy, and a KPS of 60 or above were included. Patients with nasopharyngeal, glottic or sub-glottic cancer were excluded. Gemcitabine 150mg/m2 or a total dose not exceeding 200 mg was given on day 1, 8, 15, 22, 29, and 36 during radiation treatment. Radiation was delivered with conventional fractionation to a total dose of 66-70Gy. Miller's criteria was used for response evaluation. RTOG/EORTC acute radiation [and chemotherapy] morbidity scoring system and WHO grading of acute and sub acute toxicity criteria were used for documentation of toxicity. All 39 patients were evaluable for toxicity but only 35 patients were evaluable for response. An overall response rate of 94.3% [95% CI; 80.8-99.3] was seen with a partial response rate of 71.4% and complete response rate of 22.9% [95%CI; 10.4-40.1]. Grade 3 mucositis was seen in 28 patients [71.8%]. Grade 4 mucositis was seen in 2 patients [5.1%]. Pharyngeal toxicity was the second-most common toxicity. Grade 2 toxicity was seen in 12 patients [30.8%] and grade 3 in 6 patients [15.4%]. Despite vigorous symptomatic and supportive care acute toxicities led to treatment interruption in 40% of patients. A high overall response rate and a high rate of acute toxicity are seen at a weekly gemcitabine dose of 150mg/m2 concurrent with radiation. This shows that gemcitabine is a potent radiosensitizer with a marked tumor and normal tissue radio sensitization