Comparative histological analysis of cerebellum of representative species of elasmobranchii

SUMMARY: In elasmobranch fishes, variations in gross structural organization of cerebellum has been extensively explored. The basic histological features of cerebellum although conserved in the group but the comparative account on subtle cellular variations is largely underestimated. The present study aims to explore the histological and cellular variations in different layers of cerebellar cortex of the representative elasmobranchs' species belonging to different habitat. Our findings showed that the histological architecture of cerebellar granular layer between the examined species varies noticeably. By and large increase cellular density were observed in all the layers of cerebellum in the representative species of shark compared to ray. The findings were then compared and discussed with reference to their habitat and behavior.

En los peces elasmobranquios, las variaciones en la organización estructural general del cerebelo se han explorado ampliamente. Las características histológicas básicas del cerebelo, aunque se conservan en el grupo, pero la descripción comparativa de las variaciones celulares sutiles es limitada. El presente estudio tiene como objetivo explorar las variaciones histológicas y celulares en diferentes capas de la corteza cerebelosa de las especies representativas de elasmobranquios pertenecientes a diferentes hábitats. Nuestros hallazgos mostraron que la arquitectura histológica de la capa granular del cerebelo entre las especies examinadas varía notablemente. Se observó un gran aumento de la densidad celular en todas las capas del cerebelo en las especies representativas de tiburón en comparación con la raya. Luego, los hallazgos se compararon y discutieron con referencia a su hábitat y comportamiento.

Determinants of the willingness of the general population to get vaccinated against COVID-19 in a developing country

Purpose@#Vaccination is a cost-efficient intervention to slow the spread of the coronavirus disease 2019 (COVID-19) pandemic. This study aims to assess the population's willingness to take the COVID-19 vaccine in Jordan and investigate potential determinants of their acceptance @*Materials and Methods@#This study used an online survey distributed in November 2020, before introducing the vaccine, with items investigating socio-demographic characteristics, seasonal flu vaccination history, COVID-19 vaccine acceptance once available, and factors affecting their decision-making. Also, “COVID-19 risk perception” and beliefs toward COVID-19 vaccine benefits and barriers were assessed. @*Results@#A total of 2,208 participants completed the survey with a participation rate of 13.1%. The mean±standard deviation age was 33.2±13.5, and 55.7% were females. Study participants were almost equally distributed between willingness, unwillingness, and indecision to take the COVID-19 vaccine (30.4%, 36.4%, and 31.5%, respectively). Younger adults, males, and those who were not married, do not have children, have a bachelor or higher education, employees or being students, healthcare workers, and those who reported receiving flu vaccine had higher rates of COVID-19 vaccine acceptance compared to their counterparts (p<0.001 for each category). COVID-19 risk perception, and perceived vaccine benefits, and barriers were significant predictors of intention. Among those undecided or unwilling to take the COVID-19 vaccine, its safety and side effects were the most common concerns. @*Conclusion@#The low rate of COVID-19 vaccine acceptance in a developing country is alarming, and a significant proportion are indecisive. Interventions to elevate vaccine acceptance by addressing its safety and efficacy and targeting vulnerable groups are recommended.

Prédisposition génétique à la néphropathie diabétique: rôle du polymorphisme I/D du gène ACE / Genetic Predisposition to Diabetic Nephropathy: Role of I/D ACE Gene Polymorphism

Introduction - La néphropathie diabétique est la principale cause de la maladie rénale chronique et représente la complication la plus fréquente et la plus grave du diabète. Sa pathogénie exacte est complexe et noncomplètement élucidée. Plusieurs facteurs et mécanismes contribuent au développement et à l'issue de cette pathologie. Les objectifs de notre travail sont de déterminer la fréquence du polymorphisme Insertion(I)/Délétion (D) du gène ACE (angiotensin-converting enzyme) chez des patients diabétiques avec et sans néphropathie et d'établir la relation entre ce polymorphisme et la néphropathie diabétique dans une population de l'Est algérien. Matériel et Méthodes - Nous avons recruté à cet effet, vingt neuf sujets diabétiques avec néphropathie et trente témoins diabétiques sans néphropathie. L'extraction de l'ADN a été réalisée sur du sang frais par la méthode au NaCl et le polymorphisme I/D du gène ACE a été déterminé par PCR (polymérase Chaine Réaction). Un consentement éclairé a été obtenu de l'ensemble des participants. Résultats - La durée moyenne du diabète chez noscas est de 19,21 ± 9,31ans ; celle des témoins est de 10,67 ± 7,66 ans. Le diabète de type 1 est plus fréquent chez les néphropathes (72,41%), chez les témoins la fréquence du diabète de type 2 est plus importante (73.33%). Les complications macro-angiopathiques sont plus prévalentes chez les néphropathes. De plus l'association de deux ou plusieurs complications est fréquemment retrouvée. Les fréquences des allèles I et D sont respectivement 13,79 % et 86,21 % chez les sujets témoins alors que les fréquences alléliques chez les sujets avec néphropathie sont respectivement 19,64 % et 80,36 %. Conclusion - Aucune association significative entre ce polymorphisme et la néphropathie diabétique n'a été démontrée.

Comparison of protective effects of carvedilol and ?-tocopherol on doxorubicin-induced cardiotoxocity

Background: Doxorubicin, an effective anticancer drug used to treat multiple solid tumours and childhood malignancies since many decades but its cardiac adverse effects limits its use in full therapeutic dose. The mechanism involved in cardiotoxicity is apoptosis of cardiomyocytes due to reactive oxidative stress. The study was conducted to compare the cardioprotective effects of carvedilol and ?-Tocopherol and to detect myocardial injury at early stage.Methods: Cardiotoxicity was produced in a group of rabbits by single intravenous injection of doxorubicin; control group was treated with normal saline only. Third and fourth groups were pretreated with carvedilol 30 mg/kg bodyweight and ?-Tocopherol 200 mg/kg bodyweight respectively for ten days before injection of doxorubicin.Results: Doxorubicin produced marked cardiotoxicity represented by raised levels of serum biomarkers (cTnI, LDH and CK-MB) and severe necrosis of cardiomyocytes on microscopic examination. Carvedilol and ?-tocopherol pretreatment resulted in decreased serum levels of biomarkers and improved the histological picture of heart tissue.Conclusions: The outcome of doxorubicin chemotherapy can be made successful with the concurrent use of carvedilol or ?-tocopherol. Although carvedilol has more pronounced cardioprotective effects perhaps due to its antioxidant activity in addition to antiapoptotic, antiproliferative and anti-inflammatory effects. Furthermore the quantitative cTnI estimation for detection of cardiotoxicity at early stage can lead to significant economic impact in management of cancer.

La fonction thyroïdienne au cours du premier trimestre de la grossesse / Thyroid function in the first trimester of pregnancy

Introduction : Les dysthyroïdies représentent les secondes pathologies les plus fré-quentes après le diabète chez la femme enceinte. La thyroïde subit de nombreux changements physiologiques pendant la grossesse et son activité fonctionnelle augmente de 50%. Les hormones thyroïdiennes jouent un rôle im-portant dans les premiers stades du développement du cerveau. Au cours du premier trimestre, le fœtus est dépendant de la production d'hormones thyroïdiennes mater-nelles. Il est donc important de détecter, typer et éventuellement traiter toute anomalie thyroïdienne au début de la grossesse; l'idéal étant bien évidemment une prise en charge de ces pathologies avant la conception.Patients et méthodes - Dans ce travail, nous avons étudié les variations des concen-trations plasmatiques des paramètres du bilan thyroïdien à savoir l'hormone thyréos-timulante (TSH), la thyroxine libre (fT4) et tri-iodothyronine libre (fT3) chez cinquante gestantes au 1ertrimestre de la grossesse.Résultats - Parmi les cinquante femmes enceintes au 1er trimestre concernées par notre étude, 11 étaient au 1er mois, 19 au 2ème et 20 au 3ème mois de grossesse. L'âge moyen de nos gestantes était de 30±6,76 ans avec des extrêmes allant de 17 à 45 ans. Le dosage de la TSH a révélé une valeur moyenne chez nos gestantes de 2,37± 4,01mUI/L avec des extrêmes allant de 0,031 à 26,37mUI/L. La prévalence de l'hypothyroïdie dans notre série était de 8 %. Les deux autres paramètres du bilan thyroïdien (fT3, fT4) ont présenté une élévation de leurs concentrations au premier mois puis une stabilisation au 2ème et 3ème mois de grossesse.Conclusion - Les dysthyroïdies sont fréquentes dans notre population d'étude, elles doivent être systématiquement recherchées chez toute femme enceinte et correcte-ment prises en charge afin de prévenir les complications à la fois maternelles et fœtales.

Introduction - Dysthyroidism represents the second most frequent pathologies after diabetes in pregnant women. The thyroid undergoes many physiological changes during pregnancy and its functional activity increases by 50%. Thyroid hormones play an important role in the early stages of brain development. During the first trimester, the fetus is dependent on the production of maternal thyroid hormones. It is therefore important to detect, type and possibly treat any thyroid abnormality at the start of pregnancy; ideally, of course, taking care of these pathologies before conception. Patients and methods - we studied the variations in the plasma concentrations of the parameters of the thyroid balance, namely the thyroid stimulating hormone (TSH), the free thyroxine (fT4) and the free tri-iodothyronine (fT3) in fifty pregnant women in the 1st trimester of pregnancy. Results - Among the fifty pregnant women in the 1st trimester concerned by our study, 11 were in the 1st month, 19 in the 2nd and 20 in the 3rd month of pregnancy. The average age of our pregnant women was 30 ± 6.76 years with extremes ranging from 17 to 45 years old. The TSH assay revealed an average value in our pregnant women of 2.37 ± 4.01 mUI/L with extremes ranging from 0.031 to 26.37 mUI/L. The prevalence of hypothyroidism in our series was 8%. The other two parameters of the thyroid balance (fT3, fT4) showed an increase in their concentrations in the first month and then stabilization in the 2nd and 3rd month of pregnancy. Conclusion - Dysthyroidism is frequent in our study population, it must be systematically sought in any pregnant woman and properly managed in order to prevent complications both maternal and fetal.

Relationship of sociodemographic factors with serum levels of vitamin D in a healthy population of Pakistan

Background: High prevalence of vitamin D deficiency has been reported from Pakistan. Association of sociodemographic factors with vitamin D status has received little attention in this region. Therefore, we embarked on investigating the relationship of sociodemographic factors with vitamin D levels in a healthy Pakistani population. Venous blood from 226 healthy participants [age range 19-69 years] was collected and analyzed for serum concentrations of 25[OH] vitamin D [25[OH]D] and other related biomarkers. Demographic characteristics of the study participants were collected. Vitamin D deficiency [25[OH]D levels less than 20 ng/ml] was found to be 75% in this cohort. Gender, sunlight exposure and monthly household income emerged as predictors of hypovitaminosis D. Mean serum 25[OH]D levels in the groups with monthly household income less than Pakistani Rupees [PKR] 20,000, between PKR 20,000-50,000 and above PKR 50,000 were found to be 11.0+/-7.5, 13.9+/-9.6 and16.9+/-11.7 ng/ml, respectively. Using logistic regression the odds of having vitamin D deficiency was 3.22 [95% CI, 1.65-6.28] in the group with household income less than PKR 50,000 per month compared to the group with household income more than PKR 50,000 per month when the model was adjusted for gender and exposure to sunlight. There is an association between household income and hypovitaminosis D in a healthy Pakistani population

Lack of association of statin use with vitamin D levels in a hospital based population of type 2 diabetes mellitus patients

Objective: To investigate the relationship of statins [drug given to reduce serum levels of LDL-cholesterol] on vitamin D levels of Pakistani type 2 diabetes mellitus [DM] patients in a hospital in Karachi

Methods: In a cross-sectional survey, 312 consecutive patients with type 2 DM [219 males and 93 females, age 22-70 years] were recruited with informed consent. A questionnaire was administered to find out whether they were statin users or non-users. Serum was analyzed for concentrations of 25[OH] vitamin D [25[OH]D] and other related biomarkers such as serum cholesterol, triglycerides, HDL-cholesterol, LDLcholesterol, phosphate and calcium using kit methods. Multiple Linear Regression was used to evaluate association of statin use with serum levels of vitamin D while adjusting for related covariates including duration of statin use, duration of type 2 DM and smoking

Results: Mean concentrations of serum cholesterol, and LDL-cholesterol were lower among statin users compared to statin non-users [P < 0.01], while HDL-cholesterol levels were higher [P<0.01]. No relationship was observed between statin use and serum levels of vitamin D [P=0.768], when adjusted for age, gender, BMI, duration of type 2 DM, smoking, serum cholesterol and LDL-cholesterol. The adjusted regression coefficient [beta] and standard error [SE[beta]] for statin use duration were 0.012 [0.042], when serum levels of vitamin D was taken as an outcome

Conclusion: Lack of association was found between statin use and vitamin D levels in a hospital-based population of Pakistani patients with type 2 DM

Primary postpartum hemorrhage and maternal outcome

Background: Primary postpartum hemorrhage [PPH] is a significant cause of maternal morbidity and mortality. The value of reviewing the care of women with severe PPH is to improve the obstetric practice

Objective: To evaluate maternal outcome after postpartum hemorrhage

Design: A Retrospective Data Analysis

Setting: Bahrain Defence Force Hospital, Bahrain

Method: Data analysis of PPH from 1 January 2015 to 31 December 2016 was performed. Data were obtained from all patients who delivered during this period including born before arrival [BBA], home deliveries and stillborns. All relevant maternal complications, including postpartum events, morbidities correlation of maternal outcomes with Hb drop, blood transfusion, length of hospital stay, ICU admission, coagulopathy, organ failure, hysterectomy and management were recorded. The data were analyzed using StatDirect. A P-value of less than 0.05 was considered statistically significant

Result: During the study period, 8,449 women had given birth. Seventy-two [0.85%] cases of PPH were identified. A significant correlation between estimated blood loss [EBL] and the need for blood transfusion and length of hospital stay was discovered, P-value<0.0001 and P-value<0.0001, respectively. However, no correlation was discovered between EBL and hemoglobin drop, P-value= 0.12. Receiver Operating Characteristic [ROC] curve analysis of morbidities associated with PPH pointed to the bleeding cutoff point of 2L for morbidity to occur

Conclusion: PPH is significantly related to maternal need for transfusion and hospital stay. Morbidity occurs once EBL reach 2000 ml

Evaluation of blood glucose concentration in patients with diabetes undergoing tooth extraction after administration of local anesthesia with or without adrenaline

The aim of this study was to determine the mean blood glucose concentration in patients with dia-betes undergoing tooth extraction after administration of local anesthesia with or without adrenaline. A Randomized control trial [RCT] study was carried out from October 2015 to June 2016 in the De-partment of Oral and Maxillofacial Surgery of Islamic International Dental Hospital [IIDH] Islamabad on 60 diabetic patients undergoing tooth extraction requiring administration of local anesthesia. All patients were randomly divided into two equal groups that is group A [lignocaine without adrenaline] and group B [lignocaine with adrenaline]. Blood glucose concentration measurements were taken 10 minutes before, 10 minutes and 20 minutes after administration of local anesthesia. Data were analyzed through SPSS version 17.Patient's age ranged from 25-75 years. Average age of patient was 64.5+/-9.86. There were 37% males and 23% females in both groups. The mean blood glucose concentration was increased in group B when compared to group A from 154 to 163.2mg/dl at 10 minutes. This increase in blood glucose concentration was statistically not significant [P ? 0.05]. There was statistically significant [P<0.05] increase in blood glucose concentration in group B when compared to group A from 155.0 to 176.16 mg/dl at 20 minutes.It was concluded that though 2% lignocaine with adrenaline is widely used local anesthetic, it should be cautiously used in type 2 diabetics

Adult granulosa cell tumor: a small mass producing troublesome morbidity to a woman

Granulosa cell tumors are sex-cord stromal tumor ofovary, a rare neoplasmaccounting for approximately 3-5% of all ovarian malignancies. Hormone producing tumor, a total of 95% of all GCTs are adult type and of large size. A majority of women present with abdominal mass and diagnosis made on histopathology. While small size symptoms producing Granulosa cell tumors are rare and it's a rare virilizing tumor of adolescents. Adult Granulosa cell tumor is a clinically and molecularly unique subtype of ovarian cancer. The present case study reports on a case of a small size Granulosa cell tumor producing postmenopausal bleeding in 56-year-old woman

relationship of authoritarian parenting style and academic performance in school students

The purpose of the present study was to demonstrate the predictive relationship between authoritarian parenting style and academic performance in school students. The sample of 100 school students [50 male and 50 female] with an age range 9 to 17 years with mean age of 14.6 [±SD= 3.69] were recruited from various educational institutions of Karachi, Pakistan. The Authoritarian Parenting Style was assessed through subscale of Parental Authority Questionnaire [PAQ; Buri, 1991] whereas he Academic performance was assessed through last class achieved grade point. The Linear Regression analysis was employed for statistical analysis of the data. Results reveal authoritarian parenting style as a significant predictor of academic performance in school students. The authoritarian parenting style accounted for 38% variance in scores of academic performance. The implications and avenues for future studies are discussed

Intestinal barrier integrity and function in infants with cholestasis

BACKGROUND/AIMS: The safety of the human body is maintained by effective monitoring of the mucosal surface integrity and protection against potentially harmful compounds. This function of the gut called intestinal barrier function can be affected by cholestasis and the absence of bile in the intestinal lumen. We aimed to determine whether the gut barrier integrity is impaired in infants with cholestasis by evaluation of the intestinal fatty acid binding proteins (I-FABP) and ileal bile acid binding protein (I-BABP) as markers of intestinal epithelial cell damage and plasma D-lactate level as a marker of gut wall permeability. METHODS: This case-control study included 53 infants with cholestasis and 29 controls. Serum levels of I-FABP, I-BABP, and D-lactate were measured in all subjects. RESULTS: Both groups of patients with neonatal hepatitis and biliary atresia showed significantly higher levels of I-FABP and I-BABP than the controls. There were no differences in the serum D-lactate level between the cases and controls. There was no difference between the two groups of patients (I and II) regarding any of the parameters studied. No significant correlations between serum levels of I-FABP, I-BABP, or D-lactate and total or direct bilirubin levels were found in the cholestatic infants. CONCLUSIONS: The intestinal epithelial barrier integrity is breached nearly in all parts of the intestine in infants with cholestasis. Further research is recommended to determine the impact of this finding on the management of these infants. The relationship between physical intestinal barrier damage and its functional failure remains subject for further research.

Association of Vitamin D deficiency and VDBP gene polymorphism with the risk of AMI in a Pakistani population

Objective: To investigate the relationship of vitamin D deficiency and risk of AMI in a Pakistani population, and to find out any association between vitamin D binding protein [VDBP] genotypes and risk of AMI in this population

Methods: In a comparative cross-sectional study, 246 patients [age: 20-70 years; 171 males and 75 females] with first AMI were enrolled with informed consent. Similarly, 345 healthy adults [230 males and 115 females] were enrolled as controls. Their fasting serum samples were analyzed for 25 [OH] vitamin D, lipids and other biomarkers using kit methods, while DNA was analyzed for VDBP genotypes using PCR-RFLP based methods. Chi-squared test and logistic regression were used for association of vitamin D deficiency and VDBP genotypes with AMI

Results: Mean serum concentration of 25[OH] vitamin D was significantly lower in AMI patients compared to healthy subjects [p=0.015] and percent vitamin D deficiency was higher in AMI patients compared to healthy subjects [p=0.003]. VDBP IF-IF genotype was positively associated with the risk of AMI in subject above 45 years after adjusting for potential confounders [OR = 9.86; 95% CI=1.16 to 83.43]

Conclusion: Vitamin D deficiency and VDBP IF-IF genotype are associated with AMI in Pakistani adults

Cornual ectopic pregnancy: a threat to the life of mother

Cornual [interstitial] ectopic pregnancy, an uncommon variant of ectopic pregnancy often poses a diagnostic and therapeutic challenge with a significant risk of rupturing and bleeding. Early diagnosis and treatment of interstitial ectopic pregnancy is very crucial, as they carry a very high risk of morbidity associated with the rupture. If they continue without diagnosis, a life-threatening situation may occur even when surgical intervention with laparotomy is performed. We present a case who reported with lower abdominal pain and 2 months amenorrhea. The patient was diagnosed with a cornual ectopic pregnancy and managed timely

Evaluation of changes in serum albumin level during different stages of pregnancy

Objectives: 1.To determine changes of serum albumin level during progression of pregnancy. 2. To assess hypoalbuminaemia as an early indicator of pregnancy induced hypertension

Study Design: Comparative cross sectional study

Place and Duration of Study: The study was conducted at Biochemistry department of Liaquat University of Medical and Health Sciences, Jamshoro with the collaboration of Gynecological and obstetric department of Liaquat University Hospital, Jamshoro/Hyderabad from 1.8.2008 to 31.7.2009

Materials and Methods: One hundred and twenty pregnant women of different gestational stages were selected through convenient sampling. The women suffering from any systemic disease were excluded from the study. The data regarding subjects was collected on a prtested questionnaire. The blood samples were collected through sterilized disposable syringes from the anterior cubital vein by venipuncture and were transferred into test tube and allowed to clot and then centrifugeted and the readings were noted for each blood sample. Results were analyzed by SPSS version 14. Continuous predictor variable and its relationship to the outcome variable was examined to ensure its modeling as a linear term. where possible. The independent effect of each variable significantly associated with serum albumin level was assessed at significance level of P tilde. 05. Students t -test was applied to compare levels of serum albumin in case and control subjects

Results: The women of 25 years had highest percentage of 22%; the highest percent of 12% were in their 28th weeks of pregnancy. At the significant level of P= 0.05 Pearson's coefficient was -0.267 and p-value was 0.003. As the duration of pregnancy advanced, level of serum albumin decreased in our study subjects

Conclusion: Appropriate measures should be taken to prevent fluctuation in serum albumin level which ultimately cause high maternal and neonatal mortality

Polymorphisms in MTHFR, MS and CBS genes and premature acute myocardial infarction in a Pakistani population

High prevalence of premature coronary heart disease in Pakistanis compared to other populations points towards the genetic predisposition of this population to develop this disease. Since no investigations have been carried out in Pakistan to study the relationship of polymorphisms in genes involved in homocysteine cycle, the objective of the present study was to find out if there is any association of methylenetetrahydrofolate reductase [MTHFR] C677T, A1298C; methionine synthase [MS] A2756G; cystathionine-beta-synthase [CBS] 844ins68, G919A polymorphisms with premature acute myocardial infarction [AMI] in a population of Pakistani patients with this disease. In a cross-sectional study, DNA samples of 143 AMI patients [age <45 years] and 153 healthy controls were genotyped for the above mentioned polymorphisms using PCR-RFLP methods. Plasma/serum samples of both patients and healthy controls were screened for homocysteine, folate and vitamin B12. One way ANOVA and chi-squared test were used for analysis of data. Mean plasma homocysteine levels in premature AMI patients and healthy controls were found to be 23 +/- 17.2 and 23 +/- 13.4 micro mol/l, respectively which are higher than the upper normal limit of this biomarker [15micro mol/l]. MTHFR 677 CT genotype in healthy controls and MTHFR 677 TT genotype in AMI patients were found to have significantly increased levels of plasma homocysteine [p value <0.05], while all other polymorphisms did not show any significant difference in mean levels of homocysteine between AMI patients and healthy controls. Moreover, no association was observed between MTHFR C677T, A1298C; MS A2756C; CBS844ins68 polymorphisms and premature AMI in this population. This indicates that common polymorphisms in MTHFR, MS and CBS genes have no role in premature AMI in Pakistani population

Early detection of doxorubicin-induced cardiotoxicity and its prevention by carvedilol.

Background: The objective was to detect doxorubicin (Dox) - induced myocardial injury at early stage by quantitative estimation of cardio specific protein, cardiac troponin I (cTnI) and to explore the cardioprotective effects of carvedilol. Methods: The study design was lab-based randomized controlled in-vivo in rabbits conducted from January to August 2012. Cardiotoxicity was produced by single intravenous injection of 12 mg/kg body weight (BW) of Dox in a group of rabbits, control group was treated with normal saline only and the rabbits of third group were pre-treated with carvedilol 30 mg/kg of BW for 10 days before injecting Dox. Results: Dox induced cardiotoxicity was depicted by markedly raised serum levels of cTnI, creatine kinase-MB, lactate dehydrogenase, and Grade 3 necrosis of the heart tissue in rabbits. The pre-treatment with carvedilol resulted in improved serum levels of these biomarkers and the histological picture of heart tissue. Conclusions: Quantitative serum estimation of cTnI detects the presence of cardiotoxicity much before cardiac dysfunctions can be revealed by any other diagnostic technique. It can lead to significant economic impact in the management of cancer patients because the troponin-negative subjects can be excluded from long-term cardiac monitoring programs that involve high costs imaging techniques. The outcome of Dox chemotherapy can be made successful with the concurrent use of carvedilol.

Haemorrhoidectomy with internal sphincterotomy: a useful method to relieve post operative pain

OBJECTIVE: This study was designed to compare short term outcome of post operative pain in patients operated for haemorrhoidectomy alone and haemorrhoidectomy with internal sphincterotomy

METHODOLOGY: This comparative observational study conducted at Liaquat University Hospital Jamshoro during August 2012 to July 2014. One hundred and sixteen patients of 3rd or 4[th] degree hemorrhoids were enrolled in the study. Patients were divided into two comparable groups. Group A underwent open haemorrhoidectomy along with lateral sphincterotomy whereas group B was operated for open haemorrhoidectomy alone. Postoperative pain was analyzed by using visual analogue score at 24 hours, 48 hours and on 10th post operative day

RESULTS: Total 116 patients were included in the study. Fifty eight patients in each group

The mean age of the patients was 42+/- 10.2. Male were 77 [66.4%] and 39 [33.6%] were female. Male to female ration was 2:1. During follow-up periods, patient in group A experienced less postoperative pain as compared to group B [p value is

CONCLUSION: Lateral internal sphincterotomy combined with haemorrhoidectomy significantly reduces postoperative pain without increasing morbidity

Variation in admission rates of acute coronary syndrome patients in coronary care unit according to different seasons

Environmental stresses, especially extreme cold and hot weathers, have tendency to have more admissions for acute coronary syndromes. Due to scarcity of local data, we studied the variation in patient admission rates with acute coronary syndrome according to different seasons. Descriptive study. Coronary Care Unit, Civil Hospital and Pakistan Steel Hospital, Karachi, from January 2011 to December 2011. The study group comprised consecutive patients with acute coronary syndrome [unstable angina, Non STElevation Myocardial Infarction [NSTEMI], ST-Elevation Myocardial Infarction [STEMI] admitted to the coronary care unit. Patients with stable angina and valvular heart disease were excluded. Data was analyzed for admission according to different seasons, [winter, spring, summer and autumn]. The mean age of the 428 cases was 48.5 +/- 10.4 years [range 27 to 73 years]. Among the study group, 261 [61%] and 167 [39%] cases were male and female respectively. ST-elevation myocardial infarction, non ST-elevation myocardial infarction and unstable angina were present in 206 [48%], 128 [30%] and 94 [22%] respectively. Among the 428 patients, 184 [43%] cases had hypertension, 133 [31%] cases were smokers, 103 [24%] cases had dyslipidemia and diabetes mellitus and 08 [2%] cases had history of premature coronary artery disease. The number of patients admissions with acute coronary syndrome tended to change with sudden change in season. It increased in Winter 158 [36.9%] and Summer 130 [30.3%] in comparison to Spring 80 [18.69%] and Autumn 60 [14.02%] season. It was found variation in admission rates of acute coronary syndrome patients according to different seasons. The number of admissions not only increased in the cold season [winter] but also in hot season [summer] with sudden changes in temperature

Obstructed labor; risk factors and outcome among women delivered in a tertiary care hospital

The women of developing countries are at risk of pregnancy-related complications including pre-eclampsia/ eclampsia, obstructed labor, sepsis etc. Obstructed labor results due to three delays while woman is full term and is in labor. If detected and managed early and correctly, the pregnancies can be made safe and may result in birth of healthy babies. [1] To assess frequency of obstructed labor among pregnant women. [2]To determine socio-demographic risk factors associated with obstructed labor among study population. [3]To determine outcomes of obstructed labor among pregnant women. It was a hospital based descriptive cross sectional study. Two months. Department of Gynaecology and Obstetrics units I, II and III of Liaquat University Hospital [LUH] Hyderabad. To estimate the frequency, risk factors and outcomes of obstructed labor as of third trimester adverse pregnancy outcomes and to seek association of this adverse pregnancy outcome with the socio-demographic characteristics of the pregnant women i.e. their age, residence, parity, level of education and socio economic class. Out of total six hundred and nine women enrolled in the study, only 22 [3.61%] were in obstructed labor. 63.64% of them were of age > 30 years. More than 60% women in obstructed labor had reported from rural areas; and more than eighty percent of them were illiterate and belonged to lower socio-economic class. Only 4.55% of the women in obstructed labor were the booked cases. All the cases of obstructed labor were at full term. Cesarean section was done on 90.90% women. Not a single maternal mortality was reported among women enrolled in the study as obstructed labor. Neglected obstructed labor is a major public health issue. It can be avoided by addressing various socio-demographic determinants of pregnant women