Effect of Socio-economic Status, Quality of Hygiene, Nutritional Status on Helminthic Infection Among School Going Children

Background: Helminthic infections have been major publichealth burdens. Some isolated helminths include Ascarislumbricoides, the whipworm Trichuris trichuira, the hookwormAncylostoma duodenale, Necator americanus andStrongyloides stercoralis. The present study was conducted tostudy the effect of socio-economic status, quality of hygiene,nutritional status on helminthic infection among school goingchildren aged between 5 to 13 years.Materials and Methods: A cross-sectional study on 352children at Govt. Primary school, Rajapur was conducted fromJanuary 2007 to June 2008. Children were interviewed usingpre-tested proformas to identify the risk factors and prevalenceof Helminthic infestation. Stool examination was done by usingthe formal ether concentration technique in microbiologylaboratory at M. R. Medical college. Statistical analysis wasdone by using the percentage, chi-square, SPSS statisticalsoftware.Results: Out of 352 children 162 tested positive for variousintestinal helminth’s in the age group 5 to 13 years. The overallprevalence of Helminthic infestation was 46.02% thepredominant parasites were Ascaris Lumbricoides 48.77%followed by Hymenolepsis Nana 27.16% Ancylostomaduodenale 11.73%, Trichuris Trichiura 9.88% & Enterobiusvermicularis 2.46%. 4.94% cases were of mixed infection. Thepresent study found that Socio-economic class, nutritionalstatus and pallor was significantly associated with prevalenceof Helminthic infestation. Habit of digit sucking or nail bitting,Storage of food and water were not significantly associatedwith Helminthic infestation (p>0.05). The association betweenHand wash before eating food, Status of Nails, practice of openair defecation and hand wash with soap after defecation,footwear use, eating mud or pica, drawing water for drinking,source of water, eating of raw vegetables or fruits, eating offood sold by vendor and prevalence of Helminthic infestationwere found to be significant (P<0.05). The association betweenprevalence of Helminthic Infestation and KAP of children wasalso found to be Significant.Conclusions: In the present study the prevalence ofhelminthic infestation in school children are on the higher sidewhich requires due attention and consideration despitehelminthic control programme in school for all children.

Association Between Age, Sex, Religion and Helminthic Infection Among Children Aged Between 5 to 13 Years: An Institutional Based Study

Background: Worm infestation is a major Health problem inchildren of developing countries, its effective prevention andcontrol requires identification of local risk factors particularlyamong high risk groups. The present study was conducted tostudy t various factors like age, sex, religion and helminthicinfection among children aged between 5 to 13 years.Material and Methods: A cross-sectional study on 352children at Govt. Primary school, Rajapur was conducted fromJanuary 2007 to June 2008. Children were interviewed usingpre-tested proformas to identify the risk factors and prevalenceof Helminthic infestation. Stool examination was done by usingthe formal ether concentration technique in microbiologylaboratory at M. R. Medical College. Statistical analysis wasdone by using the percentage, chi-square, SPSS statisticalsoftware.Results: Out of 352 children 162 tested positive for variousintestinal helminth’s in the age group 5 to 13 years. The overallprevalence of Helminthic infestation was 46.02% thepredominant parasites were Ascaris Lumbricoides 48.77%followed by Hymenolepsis Nana 27.16% Ancylostomaduodenale 11.73%, Trichuris Trichiura 9.88% & Enterobiusvermicularis 2.46%. 4.94% cases were of mixed infection.Helminthic infestation among males was 48.33% and females43.60%. Religion, Sex, Type of family were not significantlyassociated with Helminthic infestation (p>0.05). Theassociation between prevalence of Helminthic Infestation andKAP of children was also found to be Significant.Conclusion: This study concluded that the prevalence ofHelminthic infestation among primary school children were highand need to be addressed.

Pattern of hepatitis C virus genotypes and subtypes circulating in war-stricken Khyber Pakhtunkhwa, Pakistan: Review of published literature

Infection due to hepatitis C virus (HCV) is a major cause of fibrosis and hepatocellular carcinoma in Pakistan. In the current review, pattern of HCV genotypes and subtypes in Khyber Pakhtunkhwa province was ascertained in light of the available literature. After thorough analysis, genotype 3 (58.27%) was determined to be the leading HCV genotype, followed by genotypes 2 (12.39%), 1 (9.54%) and 4 (0.86%). The proportions of genotypes 5 and 6 were recorded as 0.09% and 0.22% respectively. Subtype wise, 3a accounted for 48.67%, followed by subtype 2a (10.91%), 3b (9.43%), 1a (5.84%), 1b (3.66%), 2b (1.45%) and genotype 4 with its undefined subtypes contributed a portion of 0.86%. The cumulative share of subtypes 1c, 2c, 3c, 5a and 6a was less than 1%. In 11.51% cases, the subtype was untypeable while in 7.17% cases mixed subtypes were recorded. Gender wise, proportions of most HCV subtypes were marginally higher among males as compared to females. On the basis of studied groups, 3a was pervasive among all groups except in intravenous drug users where 2a was the major HCV subtype. Similarly, based on various geographical locations (provincial divisions), subtype 3a revealed a ubiquitous distribution. Conclusively, HCV 3a persists to be the principal subtype across the province of Khyber Pakhtunkhwa. The considerable number of untypeable subtypes in most studies urges for an improved genotyping system on the basis of local sequence data and practice of sequencing for determination of underlying subtype in untypeable cases. Further, studies on identification of subtypes transmission pattern are imperative for assessment of transmission origin and reinforcement of efficient control strategies. In addition, the current review emphasizes the need of attention toward HCV risk groups and ignored southern side of Khyber Pakhtunkhwa province for better holistic understanding of HCV genotype distribution pattern in the province.

Pattern of hepatitis C virus genotypes and subtypes circulating in war-stricken Khyber Pakhtunkhwa, Pakistan: Review of published literature

Infection due to hepatitis C virus (HCV) is a major cause of fibrosis and hepatocellular carcinoma in Pakistan. In the current review, pattern of HCV genotypes and subtypes in Khyber Pakhtunkhwa province was ascertained in light of the available literature. After thorough analysis, genotype 3 (58.27%) was determined to be the leading HCV genotype, followed by genotypes 2 (12.39%), 1 (9.54%) and 4 (0.86%). The proportions of genotypes 5 and 6 were recorded as 0.09% and 0.22% respectively. Subtype wise, 3a accounted for 48.67%, followed by subtype 2a (10.91%), 3b (9.43%), 1a (5.84%), 1b (3.66%), 2b (1.45%) and genotype 4 with its undefined subtypes contributed a portion of 0.86%. The cumulative share of subtypes 1c, 2c, 3c, 5a and 6a was less than 1%. In 11.51% cases, the subtype was untypeable while in 7.17% cases mixed subtypes were recorded. Gender wise, proportions of most HCV subtypes were marginally higher among males as compared to females. On the basis of studied groups, 3a was pervasive among all groups except in intravenous drug users where 2a was the major HCV subtype. Similarly, based on various geographical locations (provincial divisions), subtype 3a revealed a ubiquitous distribution. Conclusively, HCV 3a persists to be the principal subtype across the province of Khyber Pakhtunkhwa. The considerable number of untypeable subtypes in most studies urges for an improved genotyping system on the basis of local sequence data and practice of sequencing for determination of underlying subtype in untypeable cases. Further, studies on identification of subtypes transmission pattern are imperative for assessment of transmission origin and reinforcement of efficient control strategies. In addition, the current review emphasizes the need of attention toward HCV risk groups and ignored southern side of Khyber Pakhtunkhwa province for better holistic understanding of HCV genotype distribution pattern in the province.

Outcomes of intravitreal bevacizumab and macular photocoagulation for treatment of diabetic macular edema in a tertiary care eye hospital at Karachi

Objective: To study the outcomes of intravitreal injection of Bevacizumab and laser photocoagulation in the treatment of diabetic macular edema [DME]

Methods: Seventy-two eyes of 59 patients with diabetic macular edema were divided into two groups of 41 eyes [Group-A] and 31 eyes [Group-B]. Subjects in group-A were treated with three intravitreal injections of Bevacizumab [IVB], and that of group-B with macular photocoagulation. Duration of study was 9 months. Follow up pattern for both groups was 1,2,3 and 6 months. Best Corrected Visual acuity on log AAAR [BCVA] for distance as well as near in each visitwas recorded. Retinal OCT for central macular thickness [CMT] was performed on baseline. SPSS version 20.0 was used to analyze the data

Results: Mean age of the patients was 53.76 +/- 8.82 ranging to 36-71 years. Out of 59 patients, 40 [67.8%] were male and 19 [32.2%] female. It was observed that the difference of results among both groups was not significant. Fig.2 documents visual acuity recorded as Improved; Stable and Worse. in BCVA has been almost similar between both the treatment groups although it was noted that JVB group showed early improvement in BCVA at follow-ups of 1 and 3 months. A long term follow-up is required in these cases to see the effect of both these treatment strategies

Visual outcome after phacoemulsification with lens implant in diabetic and non-diabetic patients; a comparative study

Objective: To compare the visual outcomes of phacoemulsification surgery with intraocular lens [IOL] in persons with and without diabetes at end of follow-up

Methods: This was a comparative, cross sectional, observational study with Non-probability, purposive sampling. After approval from "Research Ethical Committee of Isra Post-graduate Institute of Ophthalmology Karachi, 92 patients with cataract in one eye were selected. Patients were divided into two groups. Group A consisted of 48 diabetics and group B consisted of 44 non- diabetics with or without diabetes in the age group >/= 30 years were included. Patients with small Pupil, Pseudo exfoliation Syndrome, Diabetic Retinopathy, and positive history of Uveitis, Glaucoma, and Macular Degeneration were excluded. Data analysis was performed by SPSS Version 20.0

Results: Best Corrected Visual Acuity [BCVA] in diabetic patients improved from 0.813 +/- 0.181 Log MAR pre operatively to 0.183 +/- 0.143 after the period of six months post-operatively. Corresponding results in non-diabetics were 0.66 +/- 0.31 and 0.08 +/- 0.092 Log Mar [P value = 0.001]. If WHO criteria was considered, 87.5% diabetics and 92% non-diabetics achieved normal vision [Log Mar 0 to 0.5; >/= 6/12,] on the first postoperative day. Remaining 12.5% diabetics and 8% non-diabetics achieved moderate vision [0.6 to 1 Log MAR] on first post-operative day improving to normal vision within a week

Conclusion: Visual outcomes in diabetics after phacoemulsification with intra ocular lens implant is almost as good as that in non-diabetic patient if the diabetics have no retinopathy and have good glycemic control

Protective effects of rice bran oil in haloperidol-induced tardive dyskinesia and serotonergic responses in rats

Effect of administration of Rice bran oil [RBO] was evaluated on haloperidol elicited tardive dyskinesia in rats. Albino Wistar rats treated with haloperidol in drinking water at a dose of 0.2mg/kg/day and RBO by oral tubes at a dose of 0.4 mL/day for 5 weeks. Motor coordination, VCMs and 8-hydroxy-2-[di-n-propylamino] tetraline][8-OHDPAT] _syndrome were monitored. Striatal serotonin [5-hydroxytryptamine; 5-HT] and 5-hydroxyindolacetic acid [5- HIAA] levels were determined by high performance liquid chromatography [HPLC-EC]. Rats treated with haloperidol orally at a dose of for a period of 5 weeks developed VCMs, which increased progressively as the treatment continued for 5 weeks. Motor coordination impairment started after the 1[st] week and was maximally impaired after 3 weeks and gradually returned to the 1[st] week value. Co-administration of RBO prevented haloperidol_induced VCMs as well impairment of motor coordination. The intensity of 8-OH-DPAT_induced syndrome and decreased 5-HT metabolism were greater in water + haloperidol treated animals than RBO + haloperidol treated animals. The present study suggested that involvement of free radical in the development of TD and point to RBO as a possible therapeutic option to treat this hyperkinetic motor disorder

Frequency of anomalies associated with chest deformity in physically fit male candidates reporting for military recruitment

To identify the frequency of anomalies associated with chest deformity in physical fit male candidates reporting for military recruitment. Observational. Department of Thoracic Surgery, CMH Rawalpindi from 1[st] Jan 2008 to 31 Dec 2011. Normal healthy physically fit young adolescents being recruited for army were scrolled and those exhibiting chest deformity were isolated and subjected to evaluation. Convenience sampling was carried out. All cadidates of chest wall deformity thereafter underwent a thorough physical checkup, pulmonary function tests and echocardiography. A total of 3735 candidates of chest deformity reported at our center for evaluation over this duration. Single deformity patients 3380 [90.5%], mixed deformity patients 355 [95%]. We found that none of the candidates had any derangement of the lung function tests or electrocardiographic abnormality despite their deformity. However echocardiography detected an abnormality in 161 [4.3%] individuals who were otherwise asymptomatic. Chest deformity should be excluded before physical tests, in all the male candidates reporting for enrolment. If slightest of doubt exists that a candidate has chest deformity then he should be evaluated with echocardiography to exclude cardiac abnormality. Although the associated frequency is only 4.3% but this can subsequently result in a grave event like death

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

Ultrasonographic appearance and measurement of epiphyseal ossification centres of fetal peripheral long bones for assessment of gestation age

To determine the ultrasonographic appearance and size of epiphyseal ossification centers of fetal peripheral long bones for assessment of third trimester gestational age. Descriptive, Observational study. This study was carried out at Department of Radiology, Dow University of Health Sciences/Civil Hospital Karachi, from February 2009 from July 2009. 200 pregnant females were examined having gestational age of 28 or more weeks. Obstetrical ultrasound was done using 3.5 MHz convex transducer on Toshiba ultrasound scanner model Nemio-17. Measurement of Biparietal Diameter, [BPD], femur Length [FL] and abdominal Circumference [AC], placental localization and assessment of liquor was done as per standard protocol. The distal femoral, proximal tibial and proximal humeral ossification centers were identified and measured. Gestational age correlated well with appearance and size of distal femoral, proximal tibial and the proximal humeral epiphyseal ossification centers but even better with the sum of the three ossification centers. Ultrasonographic visualization of the epiphyses ossification centers may be a useful marker of fetal gestational age

Neurochemical and behavioral effects of green tea [Camellia sinensis]: a model study

Being rich in polyphenolic compounds such as flavonoids, green tea is suggested to be a potential candidate for the treatment of obesity, stress, depression, Parkinson's and other disorders. Since serotonin has an important role in the pathophysiology of these disorders, present study was designed to monitor the effects of green tea in rats. Green tea extract was provided to the male Albino Wistar rats for 5 weeks, and effects on behaviors were monitored. Results show a decrease in food intake after 5th week but not before. An increase in locomotive activities of the animals was observed, as monitored in novel as well as in familiar environment. Anxiolytic effects were observed in elevated plus maze but not in light dark activity box. An increase in dopamine and serotonin turnover was observed. Our results suggest that beneficial effects of green tea drinking might be due to alteration of serotonin and/or dopamine metabolism. We thereby propose that in further experiments, green tea should be administered in animal model of learned helplessness and effects on the development of adaptation to stress should be monitored. Neurochemical estimations of catecholamine and indoleamine in these animal models of stress exposed to green tea would help in understanding the anxiolytic effects of green tea

Identification of sulfamoylbenzamide derivatives as selective cathepsin D inhibitors

Aspartic proteases play very important role in post translational processing of proteins and several of them are essential for organism's viability. Here we present the enzyme inhibition activities of different Sulfamoylbenzamide derivatives against two aspartic proteases cathepsin D and plasmepsin II. Cathepsin D is an aspartic protease that degrades proteins at acidic pH in the lysosomes, or extracellular matrix. It is overexpressed by epithelial breast cancer cells and hence hyper-secreted. On the other hand plasmepsin II is an essential enzyme of Plasmodium falciperum. Cathepsin D and Plasmepsin II are pivotal drug targets for treatment of breast cancer and malaria respectively. Virtual screening of Sulfamoylbenzamide compounds followed by enzyme inhibition assays revealed these compounds as selective Cathepsin D inhibitors while inactive against Plasmepsin-II. IC[50] values of five Sulfamoylbenzamide compounds tested are in range of 1.25-2.0 microM. N-[3-chlorophenyl]-2-sulfamoylbenzamide is identified as the most potent of all tested Sulfamoylbenzamide compounds with IC[50] 1.25 microM. It was also noted that the docking score of theses compounds was better in case of Cathepsin D as compared to Plasmepsin-II. Docking score ranges from -29.9 +/- 1.16 to -35.1 +/- 0.13 in case of Cathepsin D, while from -24.0 +/- 0.10 to -29.5 +/- 0.10 in case of Plasmepsin-II

Use of harmonic scalpel in laparoscopic cholecystectomy

To determine the effectiveness and safety of the Harmonic Scalpel in laparoscopic cholecystectomy. Quasi Experimental Study. Surgical Unit -1 Combined Military Hospital Rawalpindi. From January to December 2009. A total of 110 consecutive patients undergoing laparoscopic cholecystectomy in which the procedures were performed exclusively with the Harmonic Scalpel were included. Patients were of either sex and of different age groups. Only three patients were operated in emergency and all other under went elective surgery. Ease of dissection and clarity of operative field [as determined by definition of dissection planes, need for using irrigation/suction and need for clearing the smoke by evacuation of gas], haemostasis and control of vascular pedicles, rate of complications, rate of conversion to open surgery and dissection time were analysed. Data was analyzed by SPSS. Frequencies and percentages were calculated. There were 65 females and 40 males. Age range was 24-72 years with mean age 45 years. Irrigation with saline and suction was needed in only 5 cases. There was practically no or minimal whitish smoke and none required evacuation of gas to clear the operative field from it. No patient had hemorrhage of any extent. Cystic artery was clipped in 40 [36.36%] patients and in all others [54.54%] it was secured by harmonic coagulation. None had CBD or bowel injury or post op sepsis. Two [1.82%] cases required conversion to open surgery due to dense adhesions and obscure anatomy. Cystic duct was dissected out with the same device but was clipped in all the cases. Average dissection time was 40 minutes [range, 17-75 minutes].There was no mortality. The Harmonic scalpel is safe and a surgeon friendly instrument for laparoscopic cholecystectomy

Video assisted thoracoscopic surgery [VATS] lung biopsy for non-responsive patients of interstitial lung disease [ILD]

To study the results of VATS [Video Assisted Thoracoscopic Surgery] Lung Biopsy in Interstitial Lung Disease [ILD] case series. Department of Thoracic Surgery, CMH Rawalpindi from Jan 2009 to Mar 2010. All those patients of ILD [Interstitial Lung Disease] were included who failed to improve after a period of observation including those on empiric therapy, all patients in which BAL [Bronchoalveolar Lavage] and TBLB [Transbronchial Lung biopsy] was inconclusive and all those patients fit to undergo thoracoscopic surgery. Patients excluded were elderly patients, those with systemic disorders frequently associated with ILD and those with known neoplasm likely to have lymphangitic dissemination. We used three thoracoscopic ports, all biopsies were sent for histopathology examination, single chest tube was placed in all cases and it was removed once the airleak ceased. All complications encountered were noted. Fourteen patients were registered during study period. Biopsy showed that 9 had ILD, and 5 did not have ILD. Only complication was a prolonged airleak for 2 days in 2 patients. No mortality was encountered. Thoracoscopic surgical biopsy can be accomplished safely in most cases where there is a diagnostic dilema for interstitial lung disease

Vesico-vaginal fistula abdominal repair versus repair via vaginal route

To evaluate the outcome of Vesico-vaginal Fistulae [VVF] repair by abdominal and vaginal route. Interventional / clinical trial. Department of Urology, Chandka Medical College Teaching Hospital and Almas Medical Centre Larkana. Feb; 2005 to Nov; 2010. After routine clinical examination and investigation, patients having Vesico-vaginal Fistulae [VVF] were selected for repair. All patients had under gone examination those anesthesia [EUA] and cystoscopy. The patients having complex fistulae or associated with urethral, ureteric and colonic involvement or with preexisting malignant pelvic pathology were excluded from the study. Patients were divided in to 02 groups on the basis of the site of the fistula and the method of repair. Group-I comprised of those patients who had low type or uncomplicated fistulae and were operated by vaginal approach. Group-II consisted of those patients who had high type or large fistulae and were operated by abdominal approach. Postoperative follow up was carried out on weekly basis for 03 to 06 months. Our study included 32 cases. Group-I and II comprised of 18 and 14 patients respectively. The mean age was 34 years [ranged from 22 to 45 years]. The main cause of vesico-vaginal fistulae was obstetrical in 28[87.5%] and iatrogenic gynecological [hysterectomy] in 04 [12.5%] patients. No major difficulty was experienced except in 01[0.83%] case in group-1 who had a previous failure history of repair. The mean operative time was 95 minutes [range 80 to 125 minutes] and 145 minutes [range 110 to 175 minutes] in group-1 and group-2 respectively. Peroperative blood transfusion was required in 06 [33.33%] and 13 [93%] patients of group-1 and group-II respectively. Statistically significant difference was found between these two groups [P< 0.05]. Postoperative complications like wound infection occurred in 01[7.15%] of group- 1 and haematuria was present for few days in o4 [22.22%] and 05[35.5%] in group-1 and group-2 respectively. The mean hospital stay was 07 [range 5-10] days. Foleys catheter was removed at 02 week time in all cases. The success rate was achieved 15[83.33%] and in all 14 [100%] cases for group-1 and group-2 respectively and statistically no significant difference was found between two groups [P=NS]. All the patients were followed up regularly except 03 [16.5%] and 05 [35.5%] patients of group-1 and group-II respectively. Long term complications like urinary stress incontinence was observed in 2 [11.1%] patients of group-I, where as small capacity bladder and stone formation was observed in 02[14.3%] of group-11 cases. Birth trauma is still a major cause of vesico vaginal fistula in our region. Although, there is no significant difference in outcome of different technique but interposition of tissue between suture lines have a vital role to achieve a high success rate. Further more, best chance of success achieved with first attempt of repair. Strategic approach and proper training of medical and paramedical staff is recommended

Management of primary spontaneous pneumothorax by video assisted thoracoscopic surgery [VATS]

To evaluate the outcome of treatment of primary spontaneous pneumothorax by VATS. Case Series. Dept. of thoracic Surgery Combined Military Hospital Rawalpindi between April 2007 to Dec 2009. This study included 20 patients with primary spontaneous pneumothorax who were treated by VATS apical stapling and pleural abrasion/ pleurectomy. All patients were operated under one lung ventilation. Three ports of 10mm were used and apical stappling / bullectomy was done with linear cutting stapler [ethicon, autosuture]. This was combined with pleural abrasion/ pleurectomy, Chest was drained via a single chest tube. We had 21 procedures on 20 patients. There were 18 males and 2 females [9:1]. Mean age was 26.4 years. Indications included persistent air leak 7, recurrent attack 12, contralateral recurrence 1 and professional hazard 1. Mean hospital stay was 3.2 days. Complications included minor port site infection 5, intercostals neuralgia 3, delayed lung expansion 2 cases and persistent apical space in 1 case. There is no recurrence. VATS was a reliable approach for managing primary spontaneous pneumothorax with low morbidity

Giant aneurysm of the extracranial internal carotid artery

Aneurysm of the extracranial internal artery is a rare condition with incidence of 0.8-1% of all aneurysms. It can give rise to serious complications like; haemorrhage due to rupture, stroke and thrmboembolism. Its treatment is technically challenging. One such case of giant aneurysm of extracranial internal carotid artery was found in 70 years old lady. The aneurysm was treated by proximal and distal ligation of the internal carotid artery and excision of the aneurysm with excellent postoperative recovery and early follow-up

[Comparison of physical, chemical, rheological and baking properties of some local and imported wheat varieties]

This study was conducted to compare Physical, Chemical, Rheological, and Baking characteristics of some local [Pawni and Samra] and imported [Australian and U.S.] wheat varieties. All grains were cleaned and subjected to Physical tests and then ground and subjected to Chemical, Rheological, and Baking tests. Results of physical characteristics showed high humidity in Australian and U.S. wheat grains, and lower in local wheat grains of both Samra and Pawni varieties. Thousand-grain weight of local wheat Samra and Pawni recorded high values, while American wheat showed the lowest values. Imported wheat showed higher specific weight and had the highest average value of Particles Size Index [PSI%] as compared to local wheat varieties. Results of chemical characteristics of local wheat flour Samra and Pawni showed higher percentage of lipid, protein, ash, damaged starch granules, total Pentosans and water soluble Pentosans contents as compared to imported varieties, while the proportion of crop flour and wet gluten were higher in imported wheat compared with local wheat flour. All wheat varieties, particularly Samra and Australia showed lower activities of amylases enzymes as compared to best value. Farinograph results indicated that water absorption of local wheat flour [Pawni and Samra] was higher than imported wheat flour especially U.S. wheat flour. Australian wheat flour showed high dough development and stability time compared with local wheat flour; however, imported American wheat flour recorded lower value. There was no significant difference [P?0.05] between the two types of local wheat flour on the average values of development and stability time. Results of baking characteristics and sensory evaluation indicated that imported Australian wheat flour showed the highest specific loaf volume, followed by American; however, local wheat flour had the lowest volume. The results of sensory evaluation agreed with the results of baking characteristics regarding to baking quality factors

Experience of upper urinary tract stones with dornier mpl 9000 lithotripter

To report our experience with Dornier MPL9000X Lithotripter in terms of safety, efficacy and complications in the management of upper urinary tract stones. Retrospective study. From 19[th] April 1998 to 15 August 2007 in the department of Nephrology, Chandka Medical College, Larkana. All patients who had renal calculi up to 2.5cm in size were selected for extra corporeal shock wave lithotripsy with Dornier MPL 9000 on the basis of clinical examination, laboratory investigations, X-Ray, intravenous urography and ultrasonography. Simple analgesics /sedation were used before the procedure, except in children where general anesthesia was used. A total of 1965 patients were treated with 3930 sessions [Average 4.1 sessions per patients]. Male to female ratio was 1.8:1. Average age of the patients was 35.3 years. The average stone burden was 1.8cm in diameter. Stone did not break in 3.3% cases, where as in 53 [2.69%] cases partial fragmentation had occurred. Over all success rate was 84%. About 10.2% cases were lost to follow up. Complications like colic pain, transient haematuria and stein Strasse was observed in 33%, 17% and 2.5% respectively. Extra corporeal shock wave lithotripsy for renal calculi was simple, safe and effective in selected group of patients

Per-operative findings and post-operative complications with laparoscopic appendicectomy

To study the per-operative findings and post-operative complications that arise with laparoscopic appendicectomy. Material and Methods: This descriptive study was conducted in Surgical "A" and Surgical "C" Unit of PGMI, Lady Reading Hospital from April 2006 to December 2008. Patients with acute appendicitis, short history, age ranges from 15 to 50 years and recurrent appendicitis were included in this study, while patients with appendicular mass, appendicular abscess, pregnancy and with previous abdominal surgery were excluded. All the data was collected by using a proforma. Data was analyzed by descriptive statistics. Out of 60 patients admitted for Laparoscopic Appendicectomy [LA], 36[60%] were males and 24[40%] were females. Only 6[10%] patients required conversion from laparoscopic to open surgery. Problems and per-operative complications were encountered in 9[15%] patients. These were dense adhesions due to inflammation 4[6.66%], localized perforation 2[3.33%], diffuse peritonitis 2[3.33%] and bleeding during procedure 1[1.66%]. Postoperative complications were seen in 5[8.33%] cases, out of which 2[3.33%] patients developed port site infection, 1[1.66%] patient developed postoperative ileus, 1[1.66%] patient developed partial bowel obstruction and 1[1.66%] patient presented with right iliac fossa abscess. There was no mortality. All patients resumed normal activity within 6-7 days of operation and were well satisfied up to median follow-up of 5-6 months. Majority of the patients were males. Per-operative findings were adhesions, perforation and peritonitis. Post-operative complications were port-site infection, ileus and bowel obstruction. Majority recovered within a week time