Allelopathic potential of 73 weed species in Pakistan

Introduction: Use of allelochemicals as inexpensive, biodegradable and eco-friendly substitutes for the management of weeds in crops is a central topic nowadays. Objective: The current study represented the comprehensive screening of allelopathic activity of 73 weeds in Pakistan by the Sandwich method and dish pack method. To investigate the allelochemical compound in top most allelopathic weed. Methods: Allelopathic effects of selected weeds leaves leachate were determined through sandwich technique, while volatile allelopathic effects through dish pack techniques. Qualitative and quantitative phytochemical techniques were applied to investigate allelochemical potential of Melilotus indicus. The statistical analysis of the data described the allelopathic effect of 73 weed plants on lettuce seedling growth in terms of radicle and hypocotyl elongation. Results: Elongation percentage of radicle and hypocotyl ranged 0-74 % to 0-148 % and 0-75 % to 0-84 % respectively at 10 mg concentration of dry plant powder in sandwich method while it was 2-234 % and 7-150 % at in Dish Pack method. Among the plants screened for phytotoxic activity, M. indicus contained the strongest allelochemicals. Qualitative and quantitative analysis of M. indicus showed the presence of flavonoids and phenolic compound along with other allelochemical. Conclusions: Selected weeds may have strong allelochemical potential that can help in the development of bioactive compounds from plant species to be used as natural herbicides and pesticides for sustainable management of weeds and pest.

Introducción: El uso de aleloquímicos como sustitutos baratos y amigables con el ambiente para el manejo de hierbas en plantaciones es un tema central actualmente. Objetivo: En el presente estudio se midió la actividad alelopática de 73 hierbas en Pakistán a través de los métodos "sandwich" y "dish pack", con el fin de investigar los compuestos aleloquímicos más importantes en las hierbas analizadas. Métodos: A través del método "sandwich" se determinaron los efectos alelopáticos de los lixiviados de hojas en las hierbas analizadas, mientras que el efecto alelopático volátil a través de la técnica "dish pack". Para investigar el potencial aleloquímico de Melilotus indicus se aplicaron técnicas fitoquímicas tanto cualitativas como cuantitativas. El análisis estadístico de los datos describió el efecto alelopático de 73 especies de hierbas sobre el crecimiento radicular y del hipocótilo en plántulas de lechuga. Resultados: El porcentaje de elongación radicular y del hipocotilo varió entre 0-74 % hasta 0-148 % y 0-75 % hasta 0-84 % respectivamente, con una concentración de 10 mg de polvo de planta seca con el método "sandwich". Además, fue entre 2-234 % y 7-150 % con el método "dish pack". Entre las plantas analizadas para actividad fitotóxica, M. indicus presentó los aleloquímicos más fuertes. Los análisis cualitativos y cuantitativos de M. indicus mostraron la presencia de flavonoides y compuestos fenólicos, junto con otros aleloquímicos. Conclusiones: Las hierbas seleccionadas pueden tener un potencial aleloquímico fuerte que ayude al desarrollo de compuestos bioactivos de plantas, para usar como hierbicidas y pesticidas naturales en el manejo sostenible de plagas y malas hierbas.

Learning the pelvic examination by clerkship medical students: evaluating skills by standardized patient model

To compare the effectiveness of training of pelvic examination [PE] of medical students on standardized patients [SPs] with the training on regular patients [RPs] during clinical rotations. A prospective controlled study. Obs/Gynae Unit I and II, Pakistan Railway Teaching Hospital, Islamic International Medical College - Rawalpindi; from April 1[st], 2013 to December 31[st], 2013. The fifth year MBBS students, doing their clerkship in Obs/Gynae department were included in the study through simple random sampling [probabilistic sampling]. Sixty seven medical students participated in the study. Group I comprised of 35 students who were trained on RPs. However 3 students of this group did not appear for assessment by OSCE so finally 32 students were left for OSCE assessment and data collection. Group II comprised of 35 students who were trained on SPs. After the completion of training, PE skills of both the groups were assessed through OSCE. The average assessment scores, technical skill scores, and communication skill scores of both the groups were calculated and standard deviation was obtained. After applying t-test, p-value was calculated, p-value less than 0.05 was considered to be statistically significant. The OSCE based average assessment scores of combined modular examination of Group I and Group II was 6.0 and 7.7 respectively. The p-value was <0.001, which was statistically significant. Similarly the average assessment score for group I and II for Technical skills in combined modular examination was 6.0 and 7.75 respectively. The average assessment scores of group I and II for communication skills was 6.25 and 8.0 respectively. Statistically significant p-value of <0.001 was calculated. It was significantly found that the students trained on SPs were more competent in technical as well as communication skills of pelvic examination as compared with the students trained on RPs. To conclude, SPs are a much more useful and efficient alternative to RPs for the clinical training of medical students of PE

Comparison of the efficacy of subtenon with peribulbar local anesthesia without hyaluronidase in patients undergoing cataract surgery

To compare the efficacy of subtenon with peribulbar local anesthesia without hyaluronidase in patients undergoing cataract surgery. A randomized controlled trial. Eye [B] Unit, Khyber Teaching Hospital, Peshawar, from October 2009 to October 2010. Patients undergoing cataract surgery were divided into two groups. Group A received subtenon anesthesia and group B received peribulbar anesthesia. Pain score, akinesia and intraocular pressure were compared in the two groups. Statistical Package for Social Sciences-14.0 was used for data analysis. There were 304 patients, 152 patients in each group. At the time of injection, there was less pain in group A as compared to group B [p < 0.001]. At the time of surgery and till 90 minutes after administration of anesthesia, there was no significant difference in pain between the 2 groups [p = 0.999 and 0.59 respectively]. Group A had better akinesia as compared to group B [p = 0.04]. There was a greater rise in mean intraocular pressure just after injection in group B as compared to group A [p < 0.001]; in both groups, the intraocular pressure declined to its base level 10 minutes after the injection [p = 0.52]. Subtenon anesthesia is less painful at the time of its administration, provides better akinesia and leads to smaller rise in intraocular pressure just after the injection than peribulbar anesthesia

Emergency Peripartum Hysterectomy in Pakistan Railway Teaching Hospital Rawalpindi: Eleven Years Review

Emergency Peripartum Hysterectomy [EPH] is a major surgical procedure. There appears to be a rise in the rate of emergency peripartum hysterectomy [EPH] in the developed world. Peripartum hysterectomy is high risk but a life saving operation. It is usually associated with significant maternal and fetal morbidity and mortality. Obstetricians should identify patients at risk and anticipate the complications, as early intervention and proper management results in optimal outcome. To determine the incidence, indications, risk factors, complications and management of EPH over the last eleven years. A descriptive study. All cases of EPH performed in the period between January 2001 and December 2011 were included in the study. Study was conducted at Railway Teaching Hospital, Rawalpindi [in northern Pakistan]. Data of all the cases of EPH cases operated during the study period was collected from the hospital obstetric record. Data of basic demographics, mode of delivery, maternal and fetal outcome along with associated complications was collected and entered into the Statistical Package for Social Sciences version 14.0 [SPSS Inc., Chicago, IL, USA] for further analysis. Indications, pre-op planning, type of operation, emergency decision, blood loss, transfusion, complications, were compared and cross-tabulated. Statistical analysis included: Chi-square and Fisher exact tests, where appropriate, and two-sample t test. Total deliveries were 13560 in 11 years. Twenty Six EPH cases were performed among deliveries, giving an incidence of 1.8 per 1000 deliveries i.e. one in 566 deliveries. The indications were uterine atony [34.61%], ruptured uterus [23.07%] and cervical/vaginal tears [11.53%], placenta praevia [11.53%], invasive placental adhesion [accreta, increta, percreta [11.53%]]. A significant association between previous uterine surgery and abnormal placentation was shown [p=0.02], especially those with previous caesarean [p=0.003]. One maternal and six perinatal mortalities were recorded. Four perinatal deaths were of non-booked patients, handled by traditional birth attendants/private clinics. Out of two perinatal deaths of booked patients, one was pre-term and other was delivered by forceps. Maternal morbidity was prevalent, including twenty three intensive care admissions, three disseminated intravascular coagulopathies, three bladder injuries, three re-explorations, multiple blood, FFPs and platelet transfusions, two pulmonary embolism and one cardio- respiratory failure. Maternal death was of non-booked patient with previous scar, home delivery, uterine rupture and brought to hospital with un-recordable BP and very weak pulse. Incidence of peri-partum hysterectomy is increasing. It is a major operation, and almost always an emergency with significant blood loss. An early decision should be made to save life of the patient and prevent complications. The most important risk factor for peripartum hysterectomy in our patients is hemorrhage, most notably caused by uterine atony, uterine rupture, placenta previa and abnormally adherent placenta

Patients' Attitude towards Medical Students in a Teaching Hospital of Pakistan

To study patient's attitude towards medical students on clinical clerkship rotation in a hospital Descriptive Cross Sectional Study. Medical, Surgery and Gynae/Obs Departments of Pakistan Railway Teaching Hospital, Rawalpindi from March 30, to May 30, 2013. Two hundred and seventy five patients were included in the study through non probability purposive convenient sampling. A questionnaire was prepared to interview the patients participating in the study. Data collected was entered into Statistical Package for Social Sciences [SPSS Version 17]. Descriptive statistics were applied for all the variables to present the frequencies and percentages. For history taking, a larger preference was shown by the patients to the students' involvement irrespective of the gender; 55% patients recommended the presence of both male and female students, 50% patients were willing to allow medical students of either gender to take their medical history in the doctor's presence and 43% patients were willing to permit without a doctor's supervision. For medical examination by the medical students, patients were more inclined to the presence of a doctor but much more patients became gender conscious. 36% preferred the presence of both male and female students, 31% patients were willing to allow medical students of either gender in the doctor's presence and only 22% to permit medical students to carry out their examination without a doctor's supervision. Patients' preference to students' involvement while a medical procedure is carried out on them, in general, around 50% of the patients were reluctant; 48% patients would not allow medical students to be present as observers, 57% were reluctant to allow the students to carry out a procedure on them in the presence of a doctor and 68% patients were unwilling to let medical students to carry out a procedure on them in the absence of doctors. For gender conscious patients, a significantly larger preference was shown towards female students over male in all the three situations. It is concluded that the attitude of patients' towards the involvement of medical students in their clinical health care is related to the extent of students' involvement, the presence of a doctor[s] and the gender of the students and the patients

Psychiatric disorders; pattern and trends of patients attending out patient department at govt. Sarhad Hospital for Psychiatric Illnesses, Peshawar

The study was conducted to examine the pattern/trend of psychiatric disorders in a hospital based setting. Conducted at Govt. Sarhad Hospital for Psychiatric Diseases, Peshawar in March-April, 2010. Simple Observational. A Retrospective record review was done to determine the disease pattern for patients examined in the OPD [out patient deptt.]. All the patients who attended OPD in year 2010 and 2004 were included.The diseases were coded and classified according to ICD- 9 and 10. Comparison and Statistical analysis of both years was done. The findings of the study suggested that disease pattern seen at hospital, represents mental diseases prevalent in Distt. Peshawar. It showed the predominance of schizophrenic group and neurotic [31 -35%], stress related disorders [30-31%] group over other diseases. Next were the mode effective disorders [12- 16%] and episodal and paroxysmal disorders group [16-17%]. Drug dependence and mental retardation showed low percentage of 2%. Rest of diseases also showed low percentage. Although similar patterns were observed for both years but there were statistically significant difference between the two years. Hospital utilization pattern is a useful guide to the prevalence of mental diseases in general community.The chronic illnesses consisted of major burden of disease. Major groups were Schizophrenic and Neurotic, and Stress related disorders group. Pattern of psychiatric illness have not changed much from 2004 to 2010. Although the hospital is catering a large number of patients, yet there is a dire need of organizing mental health services at community level to reach undiagnosed patients

Use of circumferential fasciocutaneous penile skin flap in the reconstruction of complex urethral strictures

To find out stricture free rate of penile circumferential fasciocutaneous skin flap use in complex urethral strictures Descriptive case series. Surgical Unit Khyber Teaching Hospital and Hayatabad Medical Complex Peshawar, from January 2000 to December 2009. All patients with complex urethral strictures, more than 4 cm long, were included. Patients were followed-up for two years and on each visit ascending urethrogram was performed. A total of 48 patients with complex urethral strictures were managed. The average length of the stricture was 06 cm [range 04-12cm]. Total operation time was 01-03 hours [mean 02 hours]. Late postoperative complications included recurrent strictures [25%], urethrocutaneous fistula [4.2%], erectile dysfunction [8.3%] and mild postmicturition dribbling [8.3%]. The overall success rate at the end of two years follow-up was 75%[n=36]. Circumfrential fasciocutaneous penile skin flap for urethroplasty is a good option for managing complex urethral strictures with acceptable postoperative morbidity

Frequency of incidental gallbladder carcinoma following cholecystectomy for symptomatic gallstone disease

To determine the frequency of incidental carcinoma of the gallbladder in specimens following routine cholecystectomy. Descriptive case series. Department of Surgery, Hayatabad Medical Complex Peshawar, from February 2008 to January 2011. All patients with symptomatic gallstone disease of either gender having age range between 12-70 year were included. Patients with diagnosed gallbladder malignancy, gallbladder mass, empyema gallbladder and gallstones associated with obstructive jaundice were excluded. Following cholecystectomy all the specimens were sent for histopathological examination. Two hundred and sixty patients including 65 males and 195 females [M: F ratio 1:4] aged 12-70 year and having a mean age of 41.7 year [ +/- SD 2.4], were studied. Commonest presentations were pain right hypochondrium and a positive Murphy's sign [87.71%] followed by dyspepsia[55%], nausea, vomiting [40%], pyrexia [31.92%] and weight loss [05%]. Eleven [4.23%] patients had a diagnosis of malignancy of gallbladder at histopathology examination. Mean age for patients with malignancy was 55.25 year with a male to female ratio of 01:10. Well differentiated adenocarcinoma was reported in 45.45% cases, moderately differentiated in 36.36%, poorly differentiated in 09.09% and undifferentiated in 09.09% patients. Routine histopathology of gallbladder following cholecystectomy is helpful in early detection of carcinoma gallbladder

Open haemorrhoidectomy versus rubber band ligation

To assess the results of open haemorrhoidectomy and rubber band ligation in terms of post operative pain and bleeding in 3rd degree haemorrhoids. A comparative study. Surgical unit Hayatabad Medical Complex Peshawar, from July 2009 to June 2010. A total of 100 patients were included. These were randomly divided in two groups; A and B and each group had 50 patients. Group A patients underwent open haemorrhoidectomy while group B patients had rubber band ligation procedure. Post operative complications like pain and bleeding between the two groups were compared. Out of 50 patients in group A, 72% [n=36] had pain and 20% [n=10] had post operative bleeding, while in group B pain was present in 08% [n=4] and post operative bleeding in 04% [n=2] patients. P values for pain [0.007] and bleeding [0.04] were significant in favour of group B. Rubber band ligation is a safe and quick procedure. It is associated with less intensity postoperative pain and bleeding as compared to open haemorrhoidectomy

Abdominal transpubic perineal urethroplasty for complex posterior urethral strictures: an experience of 10 years

To document the outcome of abdominal transpubic perineal urethroplasty for complex posterior urethral strictures. Descriptive case series Surgical unit Hayatabad Medical Complex and Khyber Teaching Hospital Peshawar, from March 1999 to February 2009. Abdominal transpubic perineal urethroplasty is an acceptable surgical approach in patients with complex posterior urethral stricture. Patients with complex posterior urethral stricture were included in this study. Pre operative evaluation included history, physical examination and laboratory investigations. Antegrade/retrograde urethrograms and cystourethroscopy were performed to evaluate bladder neck, and stricture site and length. Surgery was performed in lithotomy position through lower abdominal and perineal approaches. Patients were followed for 2 years. At each visit, ascending and descending urethrograms were performed and post operative complications were recorded. Results were graded as successful and failure based on stricture free rate at the end of 2 years A total of 28 patients were managed The age range was 14-36 year with a mean age of 27.3 + 2.4 year. Urethral stricture was associated with false passages in 17.88% cases, periurethral cavity in 10.71% and urethrocutaneous fistula in 7.14% cases. Mean operation time was 3.5 hours and mean hospital stay was 6 days. Postoperative complications were recurrent stricture [17.86%], urethrocutaneous fistula [7.14%], perineal haematoma [7.14%], impotence [10.71%] and wound infection [10.71%]. During follow up 89.29% patients were stricture free at the end of 2 years Abdominal transpubic perineal urethroplasty is an acceptable surgical approach in patients with complex posterior urethral stricture

Surgical management of carcinoma caecum

To determine the magnitude of carcinoma caecum and its surgical management in the department of Surgery, Hayatabad Medical Complex Peshawar-Pakistan. This case series study was conducted at surgical Unit Hayatabad Medical Complex Peshawar from July 2006 to June 2009. A total of 32 patients of carcinoma of caecum were included that were admitted either through OPD as elective cases [22 patients] or in emergency [10 patients]. In elective cases, diagnosis was made on colonoscopic biopsy while those who presented in emergency either with intestinal obstruction or with the suspicion of acute appendicitis, were diagnosed on the resected specimen histopathology. Out of 32, 25 patients [78%] were male and 7 [22%] female, with a male to female ratio of 3.6:1. Their mean age at the time of presentation was 65 +/- 2.8 years. Right hemicolectomy with side to side or end to end ileotransverse anastomosis was performed in 23 cases [71.89%]. In 3 cases [9.37%] ileotransverse bypass without resection was carried out as the tumour was locally advanced. In 3 other cases [9.37%], only omental biopsy was taken as the carcinoma was so advanced that any curative or palliative resection was not possible. In emergency situation, right hemicolectomy with exteriorization of bowel ends was done in 3 cases [9.37%]. Postoperative morbidity included wound infection 12.50%, faecal fistula 9.37% and intraabdominal collection 6.25%. Majority of the patients were having operable disease, however late presentation is very common. Surgical intervention may prove to be a better option in such cases

Postoperative outcome of mesh hernioplasty under local anaesthesia as a day case procedure

To evaluate the outcomes of inguinal hernia mesh repair under local anaesthesia as a day case surgery. Descriptive case series. Surgical unit, Hayatabad Medical Complex Peshawar, from September 2007 to August 2008. Patients having direct/indirect inguinal herniae of either side who underwent Lichtenstein repair under local anaesthesia as a day case procedure were included. Patients below 20 years of age were excluded. Similarly those patients having acute complications of hernia like obstruction and strangulation were also excluded. Patients were followed up in the OPD for 02 years and any positive findings noted during this time period, recorded. All 135 patients were male with mean age of 52.5 years [ +/- 2.4 years SD]. Fifty-eight [42.96%] patients had direct inguinal hernia [right side 35 cases and left side 23 cases]. Seventy-seven had indirect inguinal hernia [right side 45 cases and left side 32 cases]. Postoperative complications included urinary retention in 08 [5.93%] cases, seroma formation in 06 [4.44%], wound infection in 10 [7.41%], scrotal oedema in 07 [5.19%] and chronic neuralgic pain in 02 [1.48%] cases. Three [2.94%] patients developed recurrence during the follow up period. Inguinal hernia mesh repair can be performed safely and effectively under local anaesthesia with minimal postoperative complications and acceptable results

Post operative outcomes of open versus closed haemorrhoidectomy

To compare the therapeutic results of open haemorrhoidectomy with closed one in terms of post operative pain, bleeding and wound healing. This experimental study was carried out in the surgical unit, at Hayatabad Medical Complex Peshawar from March to August 2009. Fifty patients of 2[nd], 3[rd] and 4[th] degree haemorrhoids having no systemic illnesses were included in this study. Patients were randomly divided in two equal groups. Group A included patients undergoing open haemorrhoidectomy and group B catered for patient with closed haemorrhoidectomies. Post operatively these patients were followed up in the OPD for 02 months and were evaluated for post operative pain, bleeding and wound healing in addition to other complications like urinary retention and anal fissure. The mean age of the sample was 45.5 +/- 2.3 years. In group B, 08 [32%] patients had mild pain, 10 [40%] had moderate and 02 [08%] had sever pain post operatively as compared to 13 [52%] patients with mild, 11[44%] with moderate and 06 [24%] with severe pain in group A [p < 0.05]. Similarly early post operative bleeding was noted in 15 [60%] patients in group A and 06 [24%] patients in group B [p < 0.05]. Wound healing time was just over 02 weeks in group B as compared to more than 04 weeks in group A [p < 0.05]. Closed haemorrhoidectomy technique is much better than open technique for 2[nd], 3[rd] and 4[th] degree haemorrhoids

Comparison of wide open excision and karydakis procedure for pilonidal sinus disease

To compare the outcomes of wide open excision and Karydakis procedure in terms of postoperative complications, hospital stay and recurrence rate. Comparative interventional study. Surgical unit Hayatabad Medical Complex Peshawar, from April 2006 to March 2009. A total of 40 patients with pilonidal sinus were admitted through OPD. Patients with osteomyelitis of sacrum, fistula with anal canal or rectum, and those who were lost during follow up, were excluded. Patients were divided into 2 groups. In group A [20 patients] wide open excision was done whereas in group B [20 patients] Karydakis procedure performed. Patients were followed up in OPD for 6 months and postoperative outcomes were recorded. Out of 40 patients, 36 [90%] were males and 4 [10%] females [M:F = 9:1]. Age range was 15 to 40 year with mean age of 26.5 year +/- 2.4 year. In group A, postoperative complications encountered were pain [75%], bleeding [10%], wound infection [25%], scar pain [30%] and numbness [15%] at the site of surgery. While in group B, postoperative morbidity included pain [25%], hematoma/seroma formation [10%], wound infection [15%], scar pain [15%], numbness [20%] and wound dehiscence [10%]. Average hospital stay was 5.6 days in group A and 2.5 days in group B. Recurrence rate was 25% following wide open excision and 5% after Karydakis procedure. Karydakis procedure is better than wide open excision in terms of less postoperative complications, reduced hospital stay and low recurrence rate

Causes of mechanical intestinal obstruction in adults

To investigate the causes of mechanical intestinal obstruction in adults at surgical C unit Lady Reading Hospital Peshawar. This case series study was conducted at surgical C unit, of Lady Reading Hospital Peshawar, Pakistan from July 2006 to June 2007. In this study a total of 93 patients were included; who underwent exploratory laprotomy. These patients were diagnosed on the basis of clinical history, examination and radiological findings. After resuscitation, exploratory laprotomy was performed to confirm the diagnosis and relieve the obstruction. Laprotomy findings were recorded and where necessary specimen was sent for histopathology for definitive diagnosis. In this study of 93 cases, 100% patients presented with pain and abdominal distension. Other symptoms were less frequent. Males were 50 [53.76%] and females 43 [46.24%] with a male to female ratio of 2:1. 72. Tuberculosis [36.55%] was the leading cause of mechanical intestinal obstruction followed by carcinoma of the large gut [22.58%] and postoperative adhesions [21.51%]. Five [5.37%] patients had obstructed herniae and four [4.31%] had malignancy of the small gut. Three [3.22%] patients were with Meckle's diverticulum while 2 [2.15%] each had appendicular adhesions, intussusception and sigmoid volvulus. The causes of intestinal obstruction are variable in different parts of the world. Tuberculosis was the leading cause of dynamic intestinal obstruction in this study

Temperature monitoring and perioperative heat loss

To assess the temperature fall at various stages in the perioperative period and identification of contributing factors. This observational study was carried out at Blackpool Victoria Hospital, UK from August 2005-January 2006 on 32 patients undergoing major lower limb vascular surgery. Semistructured data collection form was designed to record the time and tympanic temperature at different stages in perioperative period and the warming methods used. A median fall of 0.1°C [0-0.5°C] in core temperature was recorded in ward and theatre reception area. The median fall of temperature in the anaesthetic room was 0.3°C [0-.8°C]. Patients [n=16] spending more than 0.5 hour in the anaesthetic room had a significant [p=0.002] temperature drop recorded at 0.4°C as compared to 0.2°C for those spending less than 30 minutes. During operation, a median fall of temperature by 0.8°C [0.3-2.1°C] was recorded. Operations lasting for 2.5 hours or more [n=16] resulted 2 in a 1°C temperature fall as against 0.5°C for the rest. Seven patients, in whom a warming mat was used, had a temperature drop of 0.6°C compared to 0.35°C in patients who received warm touch. In the recovery unit, 23 patients had a further drop of 0.3°C, while 9 patients who were actively warmed gained 0.6°C. Significant heat loss occurs in the anaesthetic room relevant to the length of time consumed in anaesthetising the patient. Furthermore active warming measures in the perioperative period have a positive impact on maintaining core temperature

Successful resuscitation of prolonged hyperkalemic cardiac arrest following succinylcholine administration in possibly undiagnosed myopathy

We report a 3 years old male with undiagnosed myopathy, who developed cardiac arrest secondary to hyperkalemia following succinylcholine administration.The patient underwent prolonged cardiopulmonary resuscitation [CPR], which ended successfully after applying external pace maker. He was discharged home eleven days after the cardiac arrest for follow up of his myopathy

Low amniotic fluid index in high-risk pregnancy and poor apgar score at birth

To determine the accuracy of antepartum Amniotic Fluid Index [AFI] of 5 cm was labeled as predictor of good outcome at birth. The subjects in both the groups were demographically matched and fulfilled the inclusion and exclusion criteria. The Apgar score was calculated at 5 minutes of birth. The newborns, with Apgar score 6 were labeled as healthy. AFI was compared with Apgar score, using Chi-square and a p-value was calculated to determine the statistical significance. Sensitivity, specificity, efficiency and the predictive values of AFI at a cut off point of

Two successful cases of root perforation repair using mineral troxide aggregate

Root perforation repair has historically been an unpredictable treatment modality with an unacceptably high rate of clinical failure. Inadequacy of the repair materials has been a contributing factor to the poor outcome of repair procedures. Mineral trioxide aggregate [MTA] is a relatively new material that is being successfully used to repair perforations. This article reports the findings of research done on MTA used as material to repair root perforations and presents two clinical cases where MTA was successfully utilized to repair root perforation