Acute Limb Ischemia Due to Cardiac Thromboembolismin a Young Patient without Myocardial Infarction or Cardiomyopathy

Acute limb ischemia secondary to systemic arterial embolism from left ventricular thrombus is a rare life threatening emergency. Peripheral arterial thrombosis superimposed on an atherosclerotic disease or thromboembolism from cardiac or aortic source are the two most common causes of acute limb ischemia. We present a case of a young healthy female who had recurrent admissions with acute lower extremity ischemia secondary to embolism from intra cardiac thrombus diagnosed by bedside doppler and computed angiogram, managed by surgical thromboembolectomy and discharge on anticoagulation.

Pakistamide C, a new sphingolipid from Abutilon pakistanicum

The Abutilon genus from the Malvaceae family is of medicinal importance, and members of this genus are distributed in the tropical and subtropical regions of Asia and other parts of the world. Abutilon pakistanicum Jafri & Ali is mainly found in Pakistan. It has been used by different systems of traditional medicines to treat different diseases. Pakistamide C, a new sphingolipid, has been isolated from the ethyl acetate soluble fraction of the methanolic extract of A. pakistanicum. Different spectroscopic techniques such as NMR (1H, 13C, COSY, NOESY, HSQC, HMBC) and Mass spectrometry (EI-MS, and FAB-MS experiments) were used to elucidate the structure of pakistamide C.

Effectiveness of halo-tolerant, auxin producing Pseudomonas and Rhizobium strains to improve osmotic stress tolerance in mung bean (Vigna radiata L.)

Halo-tolerant, auxin producing bacteria could be used to induce salt tolerance in plants. A number of Rhizobium and auxin producing rhizobacterial strains were assessed for their ability to tolerate salt stress by conducting osmoadaptation assay. The selected strains were further screened for their ability to induce osmotic stress tolerance in mung bean seedlings under salt-stressed axenic conditions in growth pouch/jar trials. Three most effective strains of Rhizobium and Pseudomonas containing ACC-deaminase were evaluated in combination, for their ability to induce osmotic stress tolerance in mung bean at original, 4, and 6 dS m-1 under axenic conditions. Results showed that sole inoculation of Rhizobium and Pseudomonas strains improved the total dry matter up to 1.4, and 1.9 fold, respectively, while the increase in salt tolerance index was improved up to 1.3 and 2.0 fold by the Rhizobium and Pseudomonas strains, respectively. However, up to 2.2 fold increase in total dry matter and salt tolerance index was observed due to combined inoculation of Rhizobium and Pseudomonas strains. So, combined application of Rhizobium and Pseudomonas strains could be explored as an effective strategy to induce osmotic stress tolerance in mung bean.

Association of hepatitis [B, C and D] viral infection to gallstones in cirrhosis of liver

To observe the association between hepatitis viral [B, C and D] infection to gallstones in liver cirrhosis. A cross-sectional and hospital based study. This study was carried out at the Hepatology Clinic of CMC, Larkana during January 2011 to December 2011. 913 patients of cirrhosis of liver presenting at Hepatology Clinic of CMC, Larkana during January 2011 to December 2011 were enrolled for study. After informed written consent, blood samples were drawn for HBsAg, anti -HCV antibodies, and anti-HDV Antibodies by ELISA. Ultrasound of all cases was performed to detect gallstones and study the related radiological features. The data was transferred and analyze using SPSS version 17. Means of numeric response variables and categorical response variables were compared by chi-square test and odd ratios calculated when and where applicable. P value less than 0.05 was taken as statistically significant. HBsAg, Anti-HCV Ab and Anti-HDV Ab were documented in 272 [42.2%], 253 [39.3%] and 178 [27.6%] patients respectively. HCV co infection with HBV and HDV was documented in 56 [8.7%] and 44 [6.8%]. Gallstones were detected in 269 [29.5%] cirrhotic patients, of these 136 [14.9%] were multiple. Statistically significant association was observe between gallstones and HBsAg seropositivity with odd of 2.17 [95% CI: 1.62 - 2.90] and p value less than 0.001. There was no statistically significant association between Anti-HCV Ab and Anti-HDV Ab seropositivity with gallstones in cirrhosis of liver. HBV infection is documented more frequently in cirrhosis with gallstone. Female were more likely to be infected. HBV infection may be one of the risk factor for development of gallstones in cirrhosis of liver

Strangulated obturator hernia - an unusual presentation of intestinal obstruction

An 81-year-old Caucasian emaciated female presented with 3 days history of colicky abdominal pain nausea, projectile vomiting and abdominal distension. A pre-operative diagnosis of mechanical bowel obstruction was made. The absence of characteristic clinical signs in this thin elderly woman with a small bowel obstruction failed to provide a pre-operative diagnosis. She underwent a midline laparotomy and resection and anastomosis of small bowel and repair of the strangulated right obturator hernia. The high mortality rate associated with this type of abdominal hernias requires a high index of suspicion to facilitate rapid diagnosis and prompt surgical intervention if the survival rate is to be improved