Preventive role of gum Arabic administration on STZ induced diabetic kidney disease in rats; renal antioxidant and histopathological evidence / Función preventiva de la administración de goma arábiga en la enfermedad renal diabética inducida por STZ en ratas; antioxidante renal y evidencia histopatológica

This study was set to investigate the effect of gum Arabic (G.A.) on diabetic kidney disease. We divided sixty male Sprague rats randomly into six groups. Normal control, normal rats treated with G.A., untreated diabetic rats, diabetic rats treated with insulin, diabetic rats treated with G.A., and diabetic rats treated with both insulin and G.A. Diabetes was induced by a single intraperitoneal injection of STZ. Forty eight hr post injections. Insulin was injected subcutaneously (1.6/IU/100g/day). We provided G.A. in drinking water (10 %w/ v).). At the end of the twelve weeks, blood was drawn for measurement of blood glucose, glycosylated hemoglobin (HbA1C), serum lipids, serum creatinine, and blood urea. Renal tissue oxidative stress (O.S.) was assessed by measuring the activities of superoxide dismutase (SOD) and catalase (CAT), and the concentrations of reduced glutathione (GSH) and malondialdehyde (MDA). For histological assessments, sections from segments of kidneys were processed and stained with hematoxylin and eosin (H&E) for assessment under the light microscope. STZinduced diabetes caused an elevation of blood glucose, HbA1c, urea and creatinine, triglycerides LDL and cholesterol, MDA with reduction of HDL, GSH level, and CAT and SOD activities. Histologically, kidneys from diabetic rats showed marked glomerular and tubular changes. Administration of G.A. alone to diabetic rats had a significant hypoglycemic, hypolipidemic, and antioxidant effect, although the levels achieved remained significantly abnormal compared with the untreated group with no effect on urea and creatinine levels. Co-administration of G.A. with insulin reversed the impact of D.M. on all parameters evaluated including the histological changes and led to normal urea and creatinine levels. We concluded that G.A., in combination with insulin, improves chemically-induced diabetes and its renal complications, possibly by modulation of oxidative stress.

En este estudio se evaluó el efecto de la goma arábiga (GA) en la enfermedad renal diabética. Dividimos sesenta ratas macho Sprague Dawley al azar en seis grupos. Control normal, ratas normales tratadas con GA, ratas diabéticas no tratadas, ratas diabéticas tratadas con insulina, ratas diabéticas tratadas con GA y ratas diabéticas tratadas con insulina y GA. La diabetes fue inducida por una sola inyección intraperitoneal de STZ. Cuarenta y ocho horas después se inyectó insulina por vía subcutánea (1,6 / UI / 100 g / día). A los animales se les dió GA en agua potable (10 % p / v)). Al final de las doce semanas, se extrajo sangre para medir la glucosa, la hemoglobina glicosilada (HbA1C), los lípidos en suero, la creatinina en suero y la urea en sangre. El estrés oxidativo del tejido renal (SO) se evaluó midiendo las actividades de la enzima superóxido dismutasa (SOD) y la catalasa (CAT), y las concentraciones de glutatión reducido (GSH) y malondialdehído (MDA). Para las evaluaciones histológicas, se procesaron secciones de segmentos de riñones y se tiñeron con hematoxilina y eosina (H & E) para análisis bajo microscopio óptico. La diabetes inducida por STZ causó una elevación de la glucosa en sangre, HbA1c, urea y creatinina, triglicéridos LDL y colesterol, MDA con reducción de las actividades de HDL, GSH y CAT y SOD. Histológicamente, los riñones de ratas diabéticas mostraron marcados cambios glomerulares y tubulares. La administración de GA solo en las ratas diabéticas tuvo un efecto hipoglucémico, hipolipidémico y antioxidante significativo, aunque los niveles alcanzados permanecieron significativamente anormales en comparación con el grupo no tratado, sin ningún efecto sobre los niveles de urea y creatinina. La dministración conjunta de GA con insulina revirtió el impacto de DM en todos los parámetros evaluados, incluidos los cambios histológicos y condujeron a niveles normales de urea y creatinina. Concluimos que GA en combinación con insulina, mejora la diabetes inducida químicamente y sus complicaciones renales, posiblemente mediante la modulación del estrés oxidativo.

Toxicity of Zinc at sublethal exposure to rainbow trout (Oncorhynchus mykiss) / Toxicidad de zinc por exposición subletal en trucha arco iris (Oncorhynchus mykiss) / Toxicidade por exposição ao zinco em trutas arco-íris (Oncorhynchus mykiss)

Abstract Zinc (Zn), can alter different physiological processes in fish such as growth and serum parameters. The objective of this study was to investigate the toxicity of Zn on sublethal exposure to rainbow trout (Oncorhnychus mykiss). Fish exposed to higher levels of Zn grew slower than fish exposed to lower levels of Zn. Weight gain and SGR (Specific Growth Rate) decreased linearly as the Zn level in the water increased. The CF (Condition factor) of fish grown in water with a high concentration of Zn also decreased significantly compared to the low concentration of Zn, whereas the Food Conversion Ratio (FCR) increased with the concentration of Zn in water. Both AST (Aspartate Transaminase) and ALT (Alanine Transaminase) activities were significantly altered by Zn and showed a linear pattern and decreased after 30 days, while ALP (Alkaline Phosphatase) levels showed a remarkable increase from a mean level of control. This study suggests that biochemical parameters of growth and serum could be used as important and sensitive biomarkers to monitor heavy metal toxicity on fish health status.

Resumen TZinc (Zn), puede alterar diferentes procesos fisiológicos en peces, tales como, el crecimiento y los parámetros séricos. El objetivo de este estudio fue investigar la toxicidad de Zn en la exposición subletal de la trucha arco iris (Oncorhnychus mykiss). Los peces expuestos a niveles más altos de Zn crecieron más lentamente que los peces expuestos a niveles más bajos de Zn. El aumento de peso y la SGR (tasa de crecimiento específica) disminuyeron linealmente a medida que aumentó el nivel de Zn en el agua. El CF (factor de condición) de los peces cultivados en agua con una alta concentración de Zn, también disminuyó significativamente en comparación con la baja concentración de Zn, mientras que el índice de conversión de alimentos (FCR) aumentó con la concentración de Zn en el agua. Las actividades AST (Aspartate Transaminase) y ALT (Alanine Transaminase) fueron significativamente alteradas por el Zn y mostraron un patrón lineal y disminuyeron después de 30 días, mientras que los niveles de ALP (Fosfatasa Alcalina) mostraron un aumento notable desde un nivel medio de control. Este estudio sugiere que los parámetros bioquímicos de crecimiento y suero podrían usarse como biomarcadores importantes y sensibles para controlar la toxicidad de metales pesados en el estado de salud de los peces.

Resumo O TZinc (Zn) pode alterar diferentes processos fisiológicos em peixes, como parámetros de crescimento e soro. O objetivo deste estudo foi investigar a toxicidade do Zn na exposição subletal à truta arco-íris (Oncorhnychus mykiss). Os peixes expostos a níveis mais altos de Zn cresceram mais lentamente do que os peixes expostos a níveis mais baixos de Zn. O ganho de peso e a SGR (Taxa de Crescimento Específico) diminuíram linearmente à medida que o nível de Zn na água aumentou. O CF (fator de condição) de peixes cultivados em água com alta concentração de Zn também diminuiu significativamente em comparação com a baixa concentração de Zn, enquanto a tax on de conversão alimentar (FCR) aumentou com a concentração de Zn na água. As atividades de AST (Aspartate Transaminase) e ALT (Alanine Transaminase) foram significativamente alteradas pelo Zn e mostraram um padrão linear e diminuíram após 30 dias, enquanto os níveis de ALP (Fosfatase Alcalina) mostraram um aumento notável em relação ao nível médio de controle. Este estudo sugere que parâmetros bioquímicos de crescimento e soro podem ser usados como biomarcadores importantes e sensíveis para monitorar a toxicidade de metais pesados no estado de saúde dos peixes.

Synthesis, characterization and enzyme inhibitory activity of new pyrazinamide iron complexes

The present paper deals with synthesis, characterization and amylase inhibitory activity of pyrazinamide [PYZ] with iron in its both [II] and [III] oxidation states. The synthesized complexes were characterized on the basis of IR, UV, [1]H-NMR, [13]C-NMR, elemental analysis and SEM. Changes in IR data shows that PYZ form complex with octahedral geometry and binding sites are ring nitrogen and carbonyl group, wherein two sides are satisfied with two chloride ions. SEM images indicate the crystalline state and surface morphology of PYZ and its complexes. Elemental analysis proves the composition of complexes. Pyrazinamide and the complexes showed no significant effect on amylase activity but the activity was inhibited in the presence of ferrous chloride

A report on the molecular detection and seasonal Trypanosoma brucei in Dromedary Camels from Dera Ghazi Khan District in Southern Punjab (Pakistan)

The present study was designed for molecular detection of Trypanosoma brucei through PCR, by using kinetoplast DNA (kDNA) maxicircle primers, on seasonal basis and to demonstrate the effect of this parasite on complete blood count and selected parameters of serum biochemistry in camels from Southern Punjab (Pakistan). A total of 291 camel blood samples (61 male, 230 females) were collected from Dera Ghazi Khan District in Pakistan during March 2012 till February 2013 for Trypanosoma brucei detection by blood smear screening, micro hemato centrifugation and Polymerase chain reaction techniques. Twenty eight out of 291 blood samples (9.62%) produced a 164 bp DNA fragment specific for T. brucei . Only 6 blood samples (2.06%) were found parasite positive by microscopic examination and 13 (4.46%) were positive for microhematocrit centrifugation technique. Seasonal PCR based prevalence of trypanosomiasis was 6.9%, 13.7%, 9.7% and 8.1% during spring, summer, autumn and winter seasons respectively. T. brucei prevalence was not restricted to a particular age group or and gender of the studied animals (P > 0.05). A significant increase in WBC (P = 0.001), neutrophils (P = 0.004), ALT (P = 0.028) and decreased RBC (P < 0.000), hemoglobin (P < 0.000) and packed cell volume (P < 0.000) were detected in parasite positive as compared to the parasite negative blood samples. In conclusion, PCR is a more reliable and sensitive technique than conventional microscopic blood screening and microhematocrit centrifugation for the detection of T. brucei in camel blood. We recommend the use of PCR for the effective prophylactic detection of T. brucei in livestock in order to reduce economic losses.

Pancreas divisum

Objective: To evaluate the complications, technical success, diagnostic evaluation and various endoscopic management options in patients with pancreas divisum

Study Design: Descriptive study

Place and Duration of Study: Endoscopy Suite, Surgical Unit 4, Civil Hospital, Karachi, from January 2007 to December 2013

Methodology: All Endoscopic Retrograde Cholangio-pancreatography [ERCPs] procedure performed in patients with pancreas divisum were analyzed. Success was defined as having authentic diagnostic information or a successful endoscopic therapy for the condition

Results: During the study period, 3600 patients underwent 4500 ERCP procedures. Pancreas divisum was found in 17 patients [0.47%]; 7 ERCPs [41.2%] were performed for diagnostic and 10 [58.8%] for therapeutic purposes. Sixteen [94.1%] had complete PD and one [5.9%] had incomplete PD. Male and Female ratio was 1:1.83 with a mean age of 26.3 years and median symptom duration of 11 months. A total of 23 procedures were performed in 17 patients; 2 had ERCP done thrice, 2 underwent the procedure twice, while the rest had single procedure done. Six [35.3%] patients had chronic pancreatitis, 7 [41.2%] had acute recurrent pancreatitis and 4 [23.5%] had acute pancreatitis. Endoscopic minor papillotomy was performed. There was no procedure-related mortality. ERCP affected management in 88.2% [15/17 procedures]

Conclusion: ERCP is a safe and feasible procedure for pancreas divisum patients

Pneumatic balloon dilation of Achalasia Cardia

Objective: To find out frequency of improvement of symptoms and complications rate following endoscopic esophageal balloon dilation in patients with achalasia cardia

Study design: Case series

Place and duration of study: Department of Surgery Dow University of Health Sciences and Civil Hospital Karachi, from January 2006 to September 2013

Methodology: Patients in whom diagnosis of esophageal achalasia was made on investigations [barium swallow and / or manometry] were included. These patients were subjected to balloon dilation. The procedure was performed using Olympus achalasia balloon dilators. All patients were followed up and their responses were noted. Excellent response was defined as improvement of dysphagia for both solids and liquids. In good response category those patients were included who had improvement of dysphagia for both solids and liquids but problems with food intake persisted. In poor response category patients there was no improvement following balloon dilation. Time to recurrence of symptoms and complications were also noted

Results: A total of sixty patients were included. There were 31males [51.7%] and 29 [48.3%] females. Male to female ratio was 1.07:1. The age of the patients ranged from 13 to 65 year. The mean age was 35.48 +/- 13.36 year. Seventy five dilations were performed [mean 1.25 +/- 0.54]. In 35 [58.33%] patients excellent response was obtained while 19 [31.67%] patients had good response. In 6 [10%] patients no improvement was seen. These were put into poor response category. In one [1.7%] patient esophageal perforation occurred. In six patients [10%] surgery was advised as no improvement following multiple sessions of balloon dilation occurred

Conclusion: Achalasia cardia can be managed effectively with balloon dilation under fluoroscopy

Early breast cancer in females presenting with palpable breast lumps

To determine the frequency of early breast cancer in women presenting with palpable breast lumps. Prospective cohort study. Surgical Unit - IV Civil Hospital Karachi, from December 2011 to June 2012. All female patients 13 year and above with palpable breast lumps were recruited in this study after seeking their consent. Triple assessment was carried out and core biopsies taken. Histopathology reports were recorded. Two hundred and eighty two females between 15 to 80 year [mean= 36.5 year] presented with breast lumps. Of the total 72% [n=199] lumps were benign on histopathology while 29% [n=83] showed malignancy. There were 19 [7%] cases of breast abscess. The frequency of breast cancer was 29% in present group of patients presenting with breast lumps

Laparoscopic cholecystectomy with and without prior ERCP

To find out operative difficulties in patients undergoing laparoscopic cholecystectomy after ERCP in comparison with those without prior ERCP. Comparative study. Surgical Unit IV Civil Hospital Karachi, from June 2011 to June 2013. Patients were divided into 2 groups. Group 1 consisted of 40 patients with choledocholithiasis, who underwent ERCP followed by laparoscopic cholecystectomy while in Group 2 there were 40 patients with uncomplicated gallstones who had no intervention prior to laparoscopic cholecystectomy. A total of 80 patients underwent laparoscpic cholecystectomy. Male: female ratio was 8:32 and 5:35 and mean age was 40.20 +/- 11.27 year and 39.58 +/- 11.29 year in Groups 1 and 2 respectively. Statistically significant difficulties were encountered during operation between the groups. Such difficulties were found in 29 [72.5%] and 3 [7.5%] patients in Group 1 and 2 respectively [p<0.0001]. The laparoscopic procedure was converted to open in eight [20%] patients in Group 1 and 1 [2.5%] patient in Group 2 [p=0.01]. Patients with difficult laparoscopic cholecystectomy had a mean ERCP frequency of 1.34 +/- 0.74 while those with no difficulty encountered had a mean ERCP frequency of 1.15 +/- 0.38 [p=0.05]. Statistically significant difference was found when comparing the operative difficulties encountered in patients who underwent ERCP and surgery in the same settings and in those where surgery was delayed after ERCP [p<0.001]. Laparoscopic cholecystectomy after ERCP was difficult and challenging. To minimize the complications and conversion, these patients should be operated in same sitting as for ERCP

Spontaneous bacterial peritonitis in egyptian cirrhotic patients with nucleotide-binding oligomerization domain containing 2 [NOD2] gene variants

Background: Spontaneous bacterial peritonitis [SBP], a common and severe complication in patients with advanced liver cirrhosis, assumed that can result from bacterial translocation from the intestine. Mutations in the Nucleotide-binding oligomerization domain containing 2 [NOD2] genes contribute to bacterial translocation and subsequently increased susceptibility to spontaneous bacterial peritonitis. Aim: The aim of this study was to investigate the association between the NOD2 gene variants and SBP in Egyptian patients with post-HCV cirrhotic as cites

Patients and Methods: Overall, 90 patients with post-HCV cirrhotic ascites were genotyped for the three common NOD2 variants, 1007fs, R702W and G908R and underwent diagnostic paracentesis, the ascitic fluid was analyzed for polymorphonuclear leucocytic count [PMN] and bacterial culture results

Results: NOD2 risk alleles were detected in 13 patients [14.4%] and all patients were heterozygous for one NOD2 polymorphism. Patients with SBP were more often carriers for NOD2 risk alleles than patients without SBP [Odds ratio [OR] = 4.7, P= 0.027]. The NOD2 risk variant R702Wwas significantly higher in patients with SBP than other variants [OR= 6.2, P=0.021]. Univariate analysis revealed that predictors of SBP were a previous episode of SBP, recent variceal hemorrhage and the presence of a NOD2 risk allele. Multivariate analysis confirmed NOD2 polymorphism [OR = 3.7, p = 0.03] as independent predictor of SBP

Conclusion: NOD2 risk variants specifically R702W are associated with SBP susceptibility in the Egyptian patients with cirrhosis

Frequency and risk factors in the post-ERCP pancreatitis in a tertiary care centre

To evaluate the frequency and associated factors in the post-endoscopic retrograde cholangiopancreatography [ERCP] pancreatitis. Cross-sectional analytical study. Endoscopy Suite of Surgical Unit IV, Civil Hospital, Karachi, from December 2009 to November 2010. Patients undergoing ERCP were included. Patients who had presented with pancreatitis or raised amylase levels before procedure or patients who had previous history of surgery on the biliary or pancreatic systems were excluded from the study. Pearson chi-square and Fisher's exact test were used for qualitative data and t-test for quantitative data. Significance was taken as p

Cartilage tympanoplasty: the outcome in 35 patients

This is a retrospective analysis of the cases that underwent cartilage tympanoplasty for the last 4 years. Thirty-five patients with perforated ear drums and chronic otitis media were included in the study. Twenty patients were females and 15 were males. The age ranged from 12-65 with a mean of 30.37 years. Three patents had bilateral ears operated on making the number of procedures 38 tympanoplasties. All patients except one had type1 tympanoplasty. One patient had tympanoplasty after a previous mastoid surgery [type 3]. One operation was done on a recently infected ear. Follow up periods were from 6-42 months with a mean of 15 months. All patients had both pre- and post-operative audiograms. The graft take occurred in 30 patients [85.71%].This paper discusses the operative procedure adopted and the outcome of these surgeries

Detection of multidrug-resistant tuberculosis using PCR compared to the conventional proportional method

To evaluate the PCR technique for the rapid defection of Multidrug-Resistant [MDR] Mycobacterium tuberculosis compared to the conventional proportional drug sensitivity testing. Cross sectional laboratory based study. Alshaab Teaching Hospital, Abu-Angah Hospital and the National Health Laboratory, Sudan. One hundred thirty tuberculosis suspected individuals of both sexes and of different ages were included in the study. Sputum samples were cultured on Lowenstein-Jensen [LJ] medium. Resistant strains were tested for the presence of mutations conferring resistance using molecular techniques to amplify 315 base pair [bp] rifampicin [RIF] and 146 bp isoniazid [INH], as markers for MDR among Mycobacterium tuberculosis. One hundred nineteen [91.5%] showed Mycobacterium tuberculosis-like colonies, 65 of which were randomly subjected to PCR and examined for the presence of IS6110 insertion sequences. Fifty-six [86.2%] were confirmed members of the Mycobacterium tuberculosis. The result of antibiotics susceptibility testing revealed that 32/56 [57.1%] of the strains were resistant to RIF, 36/56 [64.3%] to INH and 30/56 [53.6%] were resistant to both drugs [MDR]. The conventional method showed 21/56 [37.5%] were resistant to RIF, 32/56 [57.1%] to INH and 16/56 [28.6%] were resistant to both drugs [MDR]. Not all resistant strains detected by conventional were detected by PCR method; 14 [25%] were missed for RIF, 9 [16.1%] for INH and 4 [7.1%] for both. This represents a significant lack of sensitivity of the PCR technique, which could be due to the presence of other types of mutations that needs other primers and PCR protocol

Awareness of DOTS regarding management of pulmonary tuberculosis, among resident doctors and final year medical students in tertiary level health care facility

To assess and compare the awareness level regarding management of pulmonary tuberculosis including DOTS among resident doctors of JHL and final year medical students of AIMC and to find weak areas regarding it which need interventions according to WHO recommendations, at tertiary care level hospitals. It is a cross sectional comparative, study carried out from May 2010 to Sept. 2010, of Jinnah Hospital Lahore. In this study regarding awareness of DOTS strategy among doctors and medical students, doctors had designation as SRs 8, PGs 36, SHOs 56 and final year students were 110 [Total 210]. A semi - structured questionnaire was filled by the trained medical students. Regarding sputum microscopy for AFB as standard test for diagnosis of new case of pulmonary TB, 50% resident doctors and 51% students answered in favour of it, while 20% doctors and 12% students preferred x-ray chest as 1[st] choice and rest 15% preferred isolation by culture, mycodot and severity of symptoms [P = 0.04]. Regarding the knowledge about time taken for growth of AFB on culture media 70% doctors and 61% students answered correctly [P = 0.2122], whereas 83.8% students and 89% residents knew what 'DOTS' stands for? Both 84% doctors and students gave multiple reasons in favour of "why DOTS" as it is cost effective, better patient's compliance and stops MDR. Only 10% said that it is WHO'S recommended strategy [P = 0.002]. Only 30% doctors follow the complete standard management regime as described by DOTS for different categories of patients with pulmonary tuberculosis while only 16% 5th year medical students were able to classify patients according to drug regimen and category. Sixty% doctors 34% SRs, 20% PGs and 6% house officers chose "sputum microscopy" as best tool to monitor the progress of case 3 under treatment for pulm. TB. while 20% preferred chest X-ray for this purpose. There are multiple weak areas about knowledge and practices of doctors in tertiary care level hospitals about DOTS and its strategies for patients of pulmonary tuberculosis. Majority of the doctors were not awared that DOTS facility is available in JHL. Hence education of hospital doctors is important because private practitioners [pps] generally tend to follow the prescription written by doctors in the teaching hospitals

Gestational diabetes mellitus

Gestational diabetes mellitus is common disorder in pregnancy. It is associated with adverse pregnancy out come. There is no consensus regarding the optimal approach to screening of gestational diabetes mellitus. The present study has tried to observe the value of fasting blood glucose in screening of gestational diabetes. To determine the frequency of patients in whom fasting blood glucose and 100gm glucose tolerance show agreement for screening of gestational diabetes mellitus at 24-28 wks. Comparative cross sectional study. The study was conducted at Gynecology and Obstetrics department Shaikh Zayed Federal Post Graduate Institute Lahore. 6 months from 12 Nov 2010 to 11 May 2011. The study included 135 booked patients with positive family history of diabetes mellitus. All patients underwent fasting blood glucose at 24-28 weeks of gestation, regardless of results of fasting blood glucose on next visit they underwent 100g oral glucose tolerance test [OGTT]. The agreement between fasting blood glucose and 100g oral glucose tolerance test was calculated in frequency and percentages. The mean age of women in studied population was 27.15 +/- 3.70. Out of 135 patients 86.7% [117] showed agreement between results of fasting blood glucose and 100g OGTT while 13.31% [18] showed no agreement between both of the tests. Fasting blood glucose is a good screening option for gestational diabetes mellitus along with positive history. It provides a simple, cheap and more practical test for screening of gestational diabetes mellitus. However diagnostic confirmation with 100g OGTT should be done

Hysterectomy comparison of laparoscopic assisted vaginal versus total abdominal hysterctomy

Abdominal hysterectomy, the procedure by which almost 90% of hysterectomies are currently being done. Laparoscopic assisted vaginal hysterectomy has been introduced as an alternative to abdominal hysterectomy, and is thought to allow a more rapid return to normal activity. Laparoscopic assisted vaginal hysterectomy has less postoperative morbidity and quicker recovery than abdominal hysterectomy. To compare the laparoscopic assisted vaginal hysterectomy with total abdominal hysterectomy in term of operative time, per operative blood loss and post-operative wound infection. Randomized trial. This study was carried out in the department of obstetrics and gynaecology, Shaikh Zayed Hospital, Lahore. Six months [15th September, 2008 to 15th March 2009]. Eighty patients fulfilling the inclusion criteria were selected for this study. Patients were equally divided in two groups; group A [laparoscopic assisted vaginal hysterectomy] and group B [total abdominal hysterectomy]. Operative time [in minutes], blood loss [in ml] as estimated and post-operative wound infection was assessed by presence or absence of wound discharge, redness and edema around the incision on 3rd, 5th and 7th post-operative day. The mean ages of women in group A was 49.13+4.26 and 45.68+4.54 years in group B. The maximum number of parity between 3-4 was 19 in group Aand 20 in group B. Mean weights of cases in group A was 65.60+10.45 kilograms and 70.77+15.59 kilograms in groups B. The per-operative time in group Awas 105.13+6.55 minutes and 83.38+14.82 minutes in group B. The mean blood loss in group Awas 178.0+43.51 ml and 228.25+72.49 ml in group B. The wound discharge was not found in group A, while in group B, 4 cases [10%] on 3rd post-operative day, 6 cases [15%] on 5th post-operative day and 11 cases 27.5% on 7th post-operative. Laparoscopic assisted vaginal hysterectomy has a quicker post-operative recovery but at the expense of a bit long duration of surgery. Laparoscopic vaginal assisted hysterectomy is a feasible option in a selected group of patients who would otherwise require an abdominal hysterectomy. The drug requirement to control pain and level of pain experienced by patients were also significantly less

Flexible sigmoidoscopic findings in patients with fresh rectal bleeding

Flexible sigmoidoscopy can diagnose majority of pathologies in patients with rectal bleeding and is less demanding than colonoscopy. Frequency of different findings in patients with rectal bleeding on flexible sigmoidoscopy was considered. Out of a total of 215 patients, 133 [61.9%] were males and 82 [38.1%] were females. The most common findings were hemorrhoids in 49 patients [22.8%] and polyps in 37 [17.2%] patients. The mean duration of bleeding was 57.4 +51.8 months. Seventeen [7.1%] were found to have malignancy on sigmoidoscopic biopsy. Flexible sigmoidoscopy was able to determine the cause of bleeding in majority of patients with rectal bleeding

Sero-prevalence of HCV and associated infections with HIV and HBV among prisoners in Lahore

Hepatitis C Virus [HCV] infection and its co-infection with HIV or HBV is associated with an accelerated course of the disease and may result in more rapid progression of either or both, but knowledge on these dynamics in the imprisoned is scarce particularly in the developing world. Hence in this study we evaluated the prevalence of HCV infection and its associated co-infections with HBV or HIV in the prison population of Lahore. This was a descriptive cross-sectional study aimed to estimate the prevalence of HCV infection in prisons of Lahore [Pakistan] between May and November 2009. In this study, 4915 prisoners participated; 91.5% of them were males, and 8.5% females. Median age of prisoners was 28 years. Jail inmates were tested for serological markers-HBsAg, HCV antibodies and HIV antibodies-by chromatographic immunoassay. Initially reactive sera were retested for HBV and HCV with ELISA and for HIV with another rapid method. In total, 783 [15.93%] prisoners were positive for HCV and 105 [2.13%] of all prisoners were registered having co-infection with HIV, HBV or both. Among 783 HCV positive prisoners 72 [9.19%] had HIV co-infection, HCV/HBV co-infection was observed in 30 cases [3.83%] and triple co-infection [HCV/HBV/HIV] in three cases [0.38%]. The prevalence rate of HCV infection is quite high in the prison population of Pakistan and is mainly complicated with HIV co-infection. It is imperative that HCV, HIV and HBV prevention strategies be intensified in this community

Health seeking behavior of the people; knowledge, attitudes and practices [KAP] study of the people of urban slum areas of Karachi

The aims and objectives were, to know about the approach of people towards seeking medical advice with different options of healers, to observe thinking, feeling and various actions of people including level of self medication, and to know perception of people regarding various practices done by the healers. People living in urban slum areas of Karachi. Cross sectional Karachi. July to October 2008. Subjects and It was Knowledge, attitudes and practices [KAP] study carried out on a sample of 300 permanent household members aged>/=16 years of middle and poor class living in urban slum areas of Karachi. The mean age of the study participants was 38.27 with standard deviation of 17.57. 182 [61%] were male while 118[39%] were female. Out of 300 study participants [n=300] 260 [86.6%] consult allopathic healers including 169 [56.33%] MBBS general practitioners and 91 [30.3%] non qualified or quacks,25 [8.3%] consult homeopaths, 11 [3.6%] Hakims, and only 4 [1.33%]consult faith healers [P<0.05].148 [49.33%], participants belong to middle class group, while 152 [50.66%] were from poor class. 50% study participants do self medication at home prior to consultation for heath. Health seeking behavior is a complex phenomenon in developing countries like Pakistan where poverty overrides all other factors in decision of selecting a healer. It is recommended that people should be educated in choosing a healer which should be a qualified one

Antibiobitc susceptibility pattern of bacterial isolates from patients admitted to a tertiary care hospital in Lahore

To determine the antimicrobial sensitivity pattern of bacterial isolates from patients admitted in a tertiary care hospital of Lahore. The study was carried out in Department of Pathology, Postgraduate Medical Institute, Lahore from January 2010 to June 2010. The samples from the hospital were sent to microbiology laboratory for bacteriological examination. They were cultured onto Blood and MacConkey agar plates; organisms were identified by their colonial morphology, Gram Staining and appropriate biochemical tests using standard recommended protocol. Antimicrobial susceptibility pattern of the bacterial isolates recovered from different clinical specimens against penicillins,, cephalosporins, fluoroquinolones, carbapenems, aminoglycosides and trimethoprim sulphmethoxazole was determined using modified Kirby Bauer method. Among the 925 different clinical samples, 379 organisms were isolated. Escherichia coli and Klebsiella species were the most prevalent isolates followed by Pseudomonas and Staphylococcus spp. High degree of resistance was observed among gram negative organisms to all groups of antibiotics. Resistance to amikacin ranged from 12- 18% among different species of Gram negative isolates whereas the range of carbapenem resistance was 1.4 - 9.5%. The percentage of oxacillin resistance among staphylococcal isolates was 33.1%, but all were sensitive to vancomycin. High frequency of resistance observed in the present study indicates that antibiotic resistance among nosocomial isolates is a serious problem. There is a continuous need of surveillance of sensitivity patterns of antimicrobial agents in our set up to know about the trend of this problem

Association of blood group types to Hepatitis B and Hepatitis C virus infection

Frequency of Hepatitis B Surface Antigen [HBsAg] and Hepatitis C Virus Antibodies [Anti-HCV] among blood donors of Lahore and their association with blood group types. To study the frequency of Hepatitis B Surface Antigen [HBsAg] and Hepatitis C Virus Antibodies [Anti-HCV] in blood donors of Lahore and to assess the association with blood group types. The design of study will be cross sectional descriptive study. It was held in the Pathology Department, Nawaz Sharif Social Security Hospital, Lahore, during the period January, 2006 to December, 2008. A total of 16695 blood donors were screened for HBsAg and Anti-HCV by rapid test devices based on immuno-chromatographic technique following the instruction given by the manufacturer. In the present study, devices manufactured by Acon, USA were used. The specimens reactive on screening by devices were confirmed on ELISA. The results were subjected to chi-square analysis for determination of statistical difference between the values among different categories. Among 16695 blood donors, 467 [2.79%] were positive for HBsAg and 1326 [7.94%] were positive for Anti-HCV. The frequency of HBsAg was seen to decrease significantly [p < 0.01] from 2006 to 2008 [4.23% to 2.31%]. However, frequency of anti-HCV was seen to rise significantly [< 0.01] from 2006 [6.69%] to 2008 [7.82%]. Comparison of HBsAg and anti-HCV positivity among RhD positive and RhD negative donors showed that there was no significant difference for HBsAg positivity [2.79% vs 2.85%]. However, significantly higher number of RhD positive donors had HCV infection as compared to RhD negative donors [8.25% vs 3.66%]. High frequency of HCV infection in blood donors need implementation of strict screening policy for donors and public awareness campaigns about preventive measure to reduce the spread of this infection as well as other transfusion transmissible infections. Association of HCV infection with blood group types needs more studies to get more knowledge about this aspect