Effect of smoking on serum xanthine oxidase, malondialdehyde, ascorbic acid and alpha-tocopherol levels in healthy male subjects

To examine the effect of smoking on serum xanthine oxidase, malondialdehyde, alpha- tocopherol and ascorbic acid levels in healthy adult male subjects. This cross-sectional comparative study was carried out at Isra University Hyderabad from July 2012 to December 2012. One hundred and twenty apparently healthy adult male subjects [60 smokers and 60 non-smokers] included in present study, were recruited from Jaindal kot, a small village located midway between Hyderabad and Matiari. Serum samples from smokers and non-smokers were analyzed for xanthine oxidase and malondialdehyde levels by standard kit methods, while for ascorbic acid and alpha- tocopherol by spectrophotometric methods. The mean xanthine oxidase and malondialdehyde levels measured in healthy smokers were 0.30 +/- 0.05 mg/dl and 37.50 +/- 4.05 micromoles/l respectively as against 0.25 +/- 0.04 mg/dl and 19.86 +/- 2.21micromoles/l in non-smokers. Both xanthine oxidase and malondialdehyde levels were significantly [p<0.001] raised in healthy smokers than in non-smokers. Likewise, mean vitamin E and vitamin C levels were respectively 0.69 +/- 0.37 mg/dl and 0.80 +/- 0.16 mg/dl in healthy smokers compared to 1.14 +/- 0.43 mg/dl and 1.22 +/- 0.29 mg/dl in non-smokers. The concentrations of both these vitamins were significantly [p<0.001] lower in smokers than in non-smokers. The results of present study demonstrate that smoking had significantly increased xanthine oxidase and malondialdehyde levels and decreased vitamins C and E [antioxidants] levels. These findings suggest that smokers have to take additional amounts of vitamins C and E in order to avoid deleterious effects of smoking on their health

Mid-term follow-up of the transcatheter closure of Perimembranous Ventricular Septal defects in children using the amplatzer

Background: The ventricular septal defect [VSD] is the most common form of congenital heart defects. The purpose of this study was to evaluate the results of the early complications and mid-term follow-up of the transcatheter closure of the VSD using the Amplatzer VSD Occluder

Methods: Between April 2012 and October 2013, 110 patients underwent the percutaneous closure of the perimembranous VSD. During the procedure, the size and type of the VSD were obtained via ventriculography. A device at least 2 mm larger than the VSD diameter measured via ventriculography was deployed. The size of the VSD, size of the Amplatzer, and devicesize to VSD-size ratio were calculated. After the confirmation of the suitable position of the device via echocardiography and left ventriculography, the device was released. Follow-up evaluations were done at discharge as well as at 1, 6, and 12 months and yearly thereafter for the VSD occlusion and complete heart block

Results: The study population comprised 62 females and 48 males. The mean age and weight of the patients at procedure were 4.3 +/- 5.6 years [range: 2 to 14] and 14.9 +/- 10.8 kg [range: 10 to 43]. The average device size was 7.0 +/- 2.5 mm [range: 4 to 14]. The VSD occlusion rate was 72.8% at the completion of the procedure and rose up to 99.0% during the follow-up. The most serious significant complication was complete atrioventricular block, which was seen in 2 patients. The mean follow-up duration was 10.9 +/- 3.6 months

Conclusion: The transcatheter closure of the perimembranous VSD was a safe and effective treatment with excellent closure rates in our study population. This procedure had neither mortality nor serious complications

comparative study of sciatic nerve block for leg and foot surgery in elderly patients with the help of nerve locator vs paraesthesia elicitation technique

Commonly used methods of performing peripheral nerve blocks include elicitation of paresthesia and motor response to an electrical stimulus. The objective of this study was to compare the efficacy and reliability of these two methods in performing sciatic nerve block for lower limb surgery in elderly patients. Sixty patients, 60 - 90 years of age were randomly divided into two groups in this observer blinded study. In Group I Sciatic nerve block was established with a nerve locator and in group II paraesthesia elicitation technique was used. 20 ml of 0.5% bupivacine was administered in both groups. Haemodynamic parameters were recorded before and after the sciatic nerve block. We recorded the time of onset and extent of both sensory and motor blocks. The severity of pain was also noted in both groups. Statistically significant differences were seen in depth of sensory and motor blocks and degree of pain between groups [P < 0.05]. The time of onset of block was same in both groups and haemodynamics remained stable before and after the block. The use of nerve locator is more effective and successful in performing peripheral nerve blocks in comparison to paresthesia elicitation technique

Comparative study of granisetron versus combination of granisetron with dexamethasone in the prevention of postoperative nausea and vomiting in the patients undergoing elective plastic surgical procedures in head and neck region

Postoperative nausea and vomiting is a major challenge with an incidence of 70% to 80%. This study evaluated the efficacy of Granisetron with or without Dexamethasone in reducing postoperative nausea and vomiting in patients undergoing elective plastic surgery procedures in Head and Neck region. A prospective, randomized, double blinded study of 90 patients undergoing plastic surgery procedures in Head and Neck region under general anesthesia with prophylactic Granisetron alone or combination of granisetron and dexamethasone or placebo was done. The main outcome measures were the occurrence of vomiting and severity of nausea up to 24 hours postoperatively. There was statistically significant difference in occurrence of postoperative nausea and vomiting when prophylaxis of granisetron alone or in combination with dexamethasone was given versus no prophylaxis. Although addition of dexamethasone further decreased the incidence of nausea and vomiting but the difference was not statistically significant It was concluded that in patients undergoing plastic surgery procedures in Head and Neck region, the addition of dexamethasone to granisetron decreased the incidence of postoperative nausea and vomiting up to 24 hours

Double blind placebo controlled study on "efficacy of lignocaine pretreatment in reducing pain during injection of propofol" in patients undergoing elective maxillofacial surgeries

This study was undertaken to evaluate the incidence and severity of pain on Injection of Propofol and to find the efficacy of lignocaine pretreatment in reducing such pain. 150 patients undergoing different Maxillofacial Surgeries with American Society of Anesthesiologists class 1 and 2 [ASA 1 and 2] were randomly allocated in two groups, Group A [Saline group] and Group B [Lignocaine group] who received saline and lignocaine as pretreatment respectively. Another anesthetist who was blinded to study recorded pain on a 4-point pain scale. The incidence of pain on giving Propofol was 57.33%. There was reduction of pain by 32% in the patient group who received Lignocaine pretreatment. It was concluded that lignocaine is an effective measure to decrease the incidence and severity of pain on injection of Propofol

Evaluation of exercise-induced hypertension post endovascular stenting of coarctation of aorta

Coarctation of the aorta [COA] is a defect that accounts for 5-8% of all congenital heart diseases. Balloon angioplasty as a treatment for COA is increasingly performed, with endovascular stents having been proposed as a means of improving the efficacy and safety of the procedure. The aim of this study was to evaluate the systolic blood pressure gradient at rest and during maximal exercise at follow-up in patients post endovascular stenting of COA. Thirteen patients [4 native and 9 re-coarctation cases of COA after surgery or balloon angioplasty] with a mean age of 11.1 +/- 4.7 years underwent endovascular stenting between November 2007 and December 2009 via standard techniques for native COA as an alternative to surgical repair. Doppler echocardiography was performed pre and post stenting. Resting and exercise assessment of blood pressure was performed at follow-up. Post stent implantation, no angiographic major complications were evident. Systolic blood pressure gradient decreased from 42 +/- 8.8 mm Hg before stent placement to 7 +/- 10 mm Hg at follow-up [p value < 0.001]. Peak Doppler pressure gradient decreased from 30 +/- 14 mm Hg to 14 +/- 10 mm Hg at follow-up [p value < 0.007]. One case of exercise-induced hypertension was seen in patients. Endovascular stenting for native COA in older children and post-surgical COA repair in patients with residual COA and re-coarctation is a reasonable alternative to surgical correction. During early follow-up, stenting effectively alleviates the aortic arch obstruction with normalization of the systemic blood pressure both at rest and during maximal exercise

Chronic gastritis and helicobacterpylori: a histopathological study of gastric mucosal biopsies

The aim of this study was to observe the histological features of chronic gastritis and associated effects due to Helicobacter pylori infection in 176 randomly selected antral biopsy specimens of chronic gastritis cases. The specimens were reviewed for the presence or absence of H.pylori. The activity [neutrophilic infiltration] of gastritis and the presence or absence of mucosa-associated lymphoid tissue [MALT] were also noted. Chi-square test [Pearson value] was used to analyze categorical variables. H.pylori was detected in 110 [62.5%] cases of chronic gastritis. There was a significant association between H.pylori infection and activity of chronic gastritis [p=0.002]. Lymphoid aggregates were significantly more frequently noted in H pylori-positive patients [68.2%] vs. H.pylori negative group [47%], [p=0.005]. It is concluded that H.pylori is significantly associated with active chronic gastritis and with formation of mucosa-associated lymphoid tissue [MALT], which may develop into gastric lymphoma [MALT type]

Pneumonia; frequency of under nutrition in children under 5 years of age

To find out an association between undernutrition and severity of pneumonia in children under five years of age. The study was carried out at paediatric department of Military Hospital Rawalpindi. From August 2003 to January 2004. Cross sectional analytical study. Children of either gender from 2 to 59 months of age with the clinical diagnosis of pneumonia made according to WHO guidelines were classified into various grades of nutritional status with referrence to the NCHS standards for weight for age. Five hundred children, including 280 [56%] boys and [220] 44% girls with the mean age 20.36 [ +/- 14.26] months were evaluated. One hundred and ninety five [39%] had pneumonia, 158 [31.6%] had severe pneumonia, whereas 147 [29.4%] had very severe pneumonia. Two hundred and eighty six [57.2%] children were normally nourished whereas 214 [42.8%] were undernourished; 133/214 [62.1%] had moderate and 81/214 [37.9%] had severe undernutrition. Fever [81%], cough [77%], nasal flaring [76%], tachypnoea and chest indrawing [61%] were the commonest presentations. The mean hospital stay was 6.9 [ +/- 2.65] days. Thirteen [2.6%] patients including 5 [38.5%] boys and 8 [61.5%] girls, who all were undernourished, expired. The relative risk of death in undernourished children was 1.065 times [95%CI= 1.029 to 1.102] that of normally nourished children [p<0.0001]. Younger age, severity of pneumonia and undernutrition are significant risk factors for morbidity, prolonged hospitalization and mortality in young children with pneumonia

Evisceration, enucleation, and exentration: painful but life saving surgical procedures

To determine the indications for Evisceration, Enucleation and Exentration in patients operated at the eye department. It was a prospective study done at Khyber Teaching Hospital, Peshawar, from May 2001 to October 2003. A total of 110 cases comprising of 50 enucleations, 34 evisceration, and 26 exentration were seen. Ocular malignancy was the commonest cause for eneucleation while postoperative panophthalmitis and trauma were the reasons for evisceration and for exentration the indication was squamous cell carcinoma involving lid and conjunctiva followed by basal cell carcinoma. Only a minority of cases of eye globe surgery are preventable and/or treatable, while rest are due to malignancy. Early diagnosis in these cases is likely to make surgery easy with promising postoperative cure

Incidence of cancer esophagus in Quetta and Karachi, Pakistan.

OBJECTIVE: To study the differences in the incidence of cancer esophagus in Karachi and Quetta, Pakistan. METHODS: Incident cases of cancer esophagus registered from January 1, 1995 to December 31, 2000 were included for Karachi South, and those registered from January 1, 1998 to December 31, 2000 were included for Karachi Division and Quetta. RESULTS: In Quetta, cancer esophagus had age-standardized incidence rate (ASIR) of 25.5/100,000 population in males and 23.4/100,000 population in females, and it was the commonest malignancy in both genders. In comparison, in Karachi South and Karachi Division, cancer esophagus ranked 7th among cancers in males (ASIR 6.2/100,000 and 5.0/100,000 population, respectively) and 5th in females (7.0/100,000 and 4.9/100,000 population, respectively). The ASIR was similar among males and females in all data sets. CONCLUSION: The incidence of cancer esophagus in Quetta is comparable to that in high-incidence regions, whereas the incidence in Karachi is similar to that in moderate-incidence zones. In contrast to other world regions, cancer esophagus was equally common in males and females in Pakistan. The high risk in Quetta warrants investigation for risk factors and a targeted cancer control program.

Cancer of the oral cavity and pharynx in Karachi--identification of potential risk factors.

The objective of the study was to provide an overview of the demographics of cancer of the oral cavity and pharynx in Karachi South (1995-2001), and identify potential risk factors. Cases recorded for Karachi South, at Karachi Cancer Registry during 1(st) January 1995 to 31(st) December 2002 were analysed. For maximum completion of data cancer cases, recorded from 1(st) January 1995 to 31(st) December 2001 were included for final analysis. The age standardized incidence rates per 100000 population (ASIRs) for cancer of the oral cavity (excluding salivary gland) in Karachi South were 17.1 and 16.5 in males and females whereas the ASIRs for cancer of the pharynx (excluding nasopharynx) were 7.1 and 2.4 in males and females, respectively. The oral pharyngeal ratios were 2.4 and 6.9 for males and females and gender ratios (M F) were 1.04 for the oral cavity and 3.0 for the pharynx. The mean ages were 51 years (95% CI 49.6; 52.2) and 56.1 years (95% CI 54.4; 57.8) respectively. Cancer of the oral cavity ranked 2(nd) in Karachi in both genders. Cancer of the pharynx ranked 7(th) in males and 14(th) in females. Approximately 97% of the oral cavity and pharyngeal cancers were histologically confirmed. The majority of the oral (47.1%) and pharyngeal (51.9%) cancer cases presented as grade II lesions, and were discovered at advanced stages. Of the cancers reported during 1995-2001, 60.4% of the oral and 78.1% of the pharyngeal lesions had spread to a distant site at the time of diagnosis. Squamous cell carcinoma comprised 96.5% and 91.8% of the totals. The incidences of these cancers are comparable to the highest risk regions of the world. As distinct from other geographical areas oral cancer is as common in females as in males, which may reflect the pattern of exposure to known risk factors such as betal quid, arecanut and tobacco and the absence of alcohol as a risk factor in both genders. Apergillus contamination of arecanut could also be a risk factor but no confirmation studies or quantification is available. Despite the common risk factors, incidence of pharyngeal cancer is three times higher in men as compared with women. The keys to reducing the incidence and mortality due to oral and pharyngeal cancers are prevention and control, emphasizing cessation of tobacco use and cancer screening. However a targeted cancer and tobacco control program does not presently exist in Pakistan.