Efficacy of Ibuprofen after Total Hip Arthroplasty to Prevent Heterotopic Ossification: Systematic Review and Meta-Analysis / Eficácia do ibuprofeno após artroplastia total de quadril para prevenção de ossificação heterotópica: Revisão sistemática e metanálise

Abstract The objective of this study was to conduct a systematic review and meta-analysis of relevant randomized control trials (RCTs) to determine the role of ibuprofen, as well as the optimum dose and duration of therapy, in preventing the incidence of heterotopic ossification (HO) after primary total hip arthroplasty (THA). A literature search was performed using the PubMed/MEDLINE and Cochrane Library databases for RCTs that compared the use of ibuprofen versus placebo as prophylaxis for HO in patients after THA. The main outcomes for this study were overall occurrence of HO, occurrence according to the Brooker classification, and gastrointestinal complications. A total of 27 potential articles were identified from the database. Eventually, four trials with 1,153 patients were included in the final analysis. When compared with placebo, the use of ibuprofen is associated with a reduction in the incidence of HO at the 3- and 12-month follow-up appointments, as well as the incidence of Brooker II and III HO (p < 0.05). However, there was no significant difference between the ibuprofen and placebo groups in terms of treatment discontinuation due to gastrointestinal complications or the incidence of Brooker I and IV HO (p > 0.05). The existing data indicates that ibuprofen is safe and efficacious in reducing the total incidence of HO along with Brooker II and III HO at follow-up. However, due to the small number of studies, the conclusions are limited; therefore, more high-quality clinical trials are required to develop guidelines for optimal dose and duration of therapy.

Resumo O objetivo deste estudo foi realizar uma revisão sistemática e metanálise de estudos clínicos randomizados (ECRs) relevantes para determinar o papel do ibuprofeno, sua dose ideal, e a duração do tratamento na prevenção de ossificação heterotópica (OH) após a artroplastia total primária do quadril (ATQ). Uma pesquisa bibliográfica foi feita nos bancos de dados PubMed/MEDLINE e Cochrane Library para a obtenção de ECRs quecomparassem ouso de ibuprofeno edeplacebo como profilaxiaparaOHem pacientes submetidos à ATQ. Os principais desfechos deste estudo foram ocorrência geral de OH, classificação de Brooker da OH, e complicações gastrintestinais. No total, 27 artigos foram identificados nos bancos de dados e 4 estudos, com 1.153 pacientes, foram incluídos na análise final. Em comparação ao placebo, o uso de ibuprofeno reduziu a incidência de OH aos 3 e 12 meses de acompanhamento e a incidência de OH Brooker II e III (p < 0,05). No entanto, não houve diferença significativa entre os grupos que receberam ibuprofeno e placebo em termos de interrupção do tratamento devido a complicações gastrintestinais ou da incidência de OH Brooker I e IV (p > 0,05). Os dados existentes indicam que o ibuprofeno é seguro e eficaz na redução da incidência total de OH e de OH Brooker II e III durante o acompanhamento. No entanto, as conclusões são limitadas devido ao pequeno número de estudos; logo, mais estudos clínicos de alta qualidade são necessários para o desenvolvimento de diretrizes em relação à dose e duração ideal da terapia.

Prevalence and factors associated with symptoms of psychological distress among students of Allied Health Sciences in a Nigerian University

BACKGROUND@#A student enrolled in Allied Health Sciences has a curriculum and academic standards that are different compared to a student enrolled in a medical programme. Nevertheless, little is known about the psychological distress of this population. Our objective was to determine whether psychological distress is prevalent in students enrolled in an Allied Health Sciences programme, as well as factors that contribute to it. @*METHODS@#Three hundred and thirty-three (333) undergraduates studying Allied Health Sciences, ages 18-30, were included in this cross-sectional study. A representative sample of students from nursing, physiotherapy, medical laboratory science, medical radiography, and optometry programmes were selected through a stratified sampling technique. A 21-item Depression Anxiety and Stress Scale (DASS-21  10) was used to collect data on psychological distress indicated by depression, anxiety, and stress. We fitted a multivariate logistic regression to identify factors associated with psychological distress among the participants.@*RESULTS@#As a result of the study, 58.9% reported depression, 66.1% reported anxiety, and 45.1% reported stress. Depression (AOR= 3.23; 95% CI: 1.33- 7.81), anxiety (AOR= 3.33;95% CI:1.34- 8.26) and stress (AOR= 2.58;95% CI: 1.14- 5.85) were associated with family history of mental illness. Poor academic performance was associated with anxiety (OR=2.75; 95% CI: 1.35- 5.61) and stress (OR=2.00; 95% CI: 1.05-3.81).@*CONCLUSIONS@#The prevalence of psychological distress among allied health sciences students is high, especially among students with poor academic performance and those with a family history of mental illness. Psychological distress can be prevented with early detection and awareness programmes.

Combination Treatment With Proton Pump Inhibitor Plus Prokinetic for Gastroesophageal Reflux Disease

no abstract available.

Acute Gastrointestinal Bleeding in COVID-19 Patients: A Systematic Review and Meta-Analysis

Background/Aims@#More than 100 million people to date have been affected by the coronavirus disease-2019 (COVID-19) pandemic. Patients with COVID-19 have a higher risk of bleeding complications. We performed a systematic review and meta-analysis to evaluate the outcomes of COVID-19 patients with signs and symptoms of acute gastrointestinal bleeding (GIB). @*Methods@#A systematic literature search was carried out for articles published until until November 11, 2020, in the Embase, MEDLINE, Web of Science, and Cochrane Library databases. We included studies on COVID-19 patients with signs and symptoms of GIB. @*Results@#Our search yielded 49 studies, of which eight with a collective 127 patients (86 males and 41 females) met our inclusion criteria. Conservative management alone was performed in 59% of the patients, endoscopic evaluation in 31.5%, and interventional radiology (IR) embolization in 11%. Peptic ulcer disease was the most common endoscopic finding, diagnosed in 47.5% of the patients. Pooled overall mortality was 19.1% (95% confidence interval [CI]; 12.7%-27.6%) and pooled mortality secondary to GIB was 3.5% (95% CI; 1.3%–9.1%). The pooled risk of rebleeding was 11.3% (95% CI; 6.8%–18.4%). @*Conclusion@#The majority of COVID-19 patients with GIB responded to conservative management, with a low mortality rate associated with GIB and the risk of rebleeding. Thus, we suggest limiting endoscopic and IR interventions to those with hemodynamic instability and those for whom conservative management was unsuccessful.

Molecular detection and characterization of ovine herpesvirus-2 using heminested PCR in Pakistan

Background@#Malignant catarrhal fever (MCF) is a highly fatal lymphoproliferative disease of cattle, deer, bison, water buffalo, and pigs caused by the gamma-herpesviruses alcelaphine herpesvirus-1 (AlHV-1) and ovine herpesvirus-2 (OvHV-2). @*Objectives@#This study aimed to determine the prevalence of OvHV-2 in sheep, goats, cattle, and buffalo in Rawalpindi and Islamabad, Pakistan, by applying molecular and phylogenetic methods. @*Methods@#Blood samples were aspirated from sheep (n = 54), goat (n = 50), cattle (n = 46) and buffalo (n= 50) at a slaughterhouse and several farms. The samples were subjected to heminested polymerase chain reaction (PCR), followed by sequencing and phylogenetic analysis of the OvHV-2 POL gene and the OvHV-2 ORF75 tegument protein gene. @*Results@#The highest percentage of MCF positive samples was in sheep (13%), whereas goat, cattle, and buffalo had lower positive percentages, 11%, 9%, and 6.5%, respectively. Four OvHV-2-positive PCR products obtained from sheep samples were sequenced. The sequences obtained were submitted to the NCBI GenBank database (MK852173 for the POL gene;MK840962, MK852171, and MK852172 for the ORF75 tegument protein gene). Phylogenetic analysis revealed a close similarity of study sequences with those of worldwide samples. @*Conclusions@#This study is the first cross-sectional study on the prevalence and molecular detection of OvHV-2 in apparently healthy cattle and buffalo that could be carrying OvHV-2 acquired from OvHV-2-positive sheep and goats. The results indicate that OvHV-2 is circulating in Pakistan. Further studies are needed to characterize OvHV-2 and elucidate further its prevalence.

Acute Gastrointestinal Bleeding in COVID-19 Patients: A Systematic Review and Meta-Analysis

Background/Aims@#More than 100 million people to date have been affected by the coronavirus disease-2019 (COVID-19) pandemic. Patients with COVID-19 have a higher risk of bleeding complications. We performed a systematic review and meta-analysis to evaluate the outcomes of COVID-19 patients with signs and symptoms of acute gastrointestinal bleeding (GIB). @*Methods@#A systematic literature search was carried out for articles published until until November 11, 2020, in the Embase, MEDLINE, Web of Science, and Cochrane Library databases. We included studies on COVID-19 patients with signs and symptoms of GIB. @*Results@#Our search yielded 49 studies, of which eight with a collective 127 patients (86 males and 41 females) met our inclusion criteria. Conservative management alone was performed in 59% of the patients, endoscopic evaluation in 31.5%, and interventional radiology (IR) embolization in 11%. Peptic ulcer disease was the most common endoscopic finding, diagnosed in 47.5% of the patients. Pooled overall mortality was 19.1% (95% confidence interval [CI]; 12.7%-27.6%) and pooled mortality secondary to GIB was 3.5% (95% CI; 1.3%–9.1%). The pooled risk of rebleeding was 11.3% (95% CI; 6.8%–18.4%). @*Conclusion@#The majority of COVID-19 patients with GIB responded to conservative management, with a low mortality rate associated with GIB and the risk of rebleeding. Thus, we suggest limiting endoscopic and IR interventions to those with hemodynamic instability and those for whom conservative management was unsuccessful.

Molecular detection and characterization of ovine herpesvirus-2 using heminested PCR in Pakistan

Background@#Malignant catarrhal fever (MCF) is a highly fatal lymphoproliferative disease of cattle, deer, bison, water buffalo, and pigs caused by the gamma-herpesviruses alcelaphine herpesvirus-1 (AlHV-1) and ovine herpesvirus-2 (OvHV-2). @*Objectives@#This study aimed to determine the prevalence of OvHV-2 in sheep, goats, cattle, and buffalo in Rawalpindi and Islamabad, Pakistan, by applying molecular and phylogenetic methods. @*Methods@#Blood samples were aspirated from sheep (n = 54), goat (n = 50), cattle (n = 46) and buffalo (n= 50) at a slaughterhouse and several farms. The samples were subjected to heminested polymerase chain reaction (PCR), followed by sequencing and phylogenetic analysis of the OvHV-2 POL gene and the OvHV-2 ORF75 tegument protein gene. @*Results@#The highest percentage of MCF positive samples was in sheep (13%), whereas goat, cattle, and buffalo had lower positive percentages, 11%, 9%, and 6.5%, respectively. Four OvHV-2-positive PCR products obtained from sheep samples were sequenced. The sequences obtained were submitted to the NCBI GenBank database (MK852173 for the POL gene;MK840962, MK852171, and MK852172 for the ORF75 tegument protein gene). Phylogenetic analysis revealed a close similarity of study sequences with those of worldwide samples. @*Conclusions@#This study is the first cross-sectional study on the prevalence and molecular detection of OvHV-2 in apparently healthy cattle and buffalo that could be carrying OvHV-2 acquired from OvHV-2-positive sheep and goats. The results indicate that OvHV-2 is circulating in Pakistan. Further studies are needed to characterize OvHV-2 and elucidate further its prevalence.

Frequency of Impairment of Executive Functioning among Patients having Obsessive-Compulsive Disorder

Introduction: Obsessive-compulsive Disorder (OCD) isa highly debilitating neuropsychiatric condition with anestimated lifetime prevalence of 2-3 percent. Executivefunction refers to the ability to use high level oversightfunctions to modulate memory, sensory information,cognition, and affect as a situation evolves, and use ofstrategies that must shift to maintain performance. Impairmentof nonverbal memory has been reported in studies of patientswith OCD. The objective of present study was to determinethe frequency of impairment of executive functioning amongpatients having obsessive-compulsive disorder.Material and methods: A total of 150 patients fulfillingselection criteria were enrolled through the OutpatientsDepartment of Psychiatry, Services hospital Lahore. Aftertaking informed consent, the demographic data i.e. name, age,gender and duration of OCD were noted. All patients werescreened using the frontal lobe assessment battery (FAB) bythe researcher himself. Impaired executive functioning wascategorized as a calculated FAB score <12.Results: The study revealed that, out of 150 cases of OCD,frequency of impairment of executive functioning amongpatients was calculated as 22.67%(n=34). 65.33%(n=98)participants were between 18-30 years of age (M=30.05,S.D+5.83 years), 54.67%(n=82) were male and 45.33%(n=68)were females.Conclusion: Thus, it is concluded that executive functioningis impaired frequently among patients having obsessivecompulsive disorder. So, it is recommended that executivefunctioning should be monitored among patients who presentwith OCD. However, it is also required that every setup shouldhave their surveillance in order to know the frequency of theproblem.

Toxicological Evaluation of Nelumbo Nucifera Fruit Ethanol Extract

Nelumbo nucifera fruit (NNF) is frequently used for the treatment of many diseases in Asian countries withoutproper scientific evidence of its safety. The purpose of this study was to determine the toxicological effects ofNNF. Toxicity study was conducted on 28 male Wister rats weighing 180-230 g that were allocated equally to 4treatment groups; a control and 3 test groups. Parameters assessed were clinical signs, body weight,hematology, blood biochemistry and histopathology after administration of NNF to rats for 13 weeks. No majortoxicity was revealed throughout the study, though some biochemical changes were observed in hepatic andrenal tissues but these changes did not correspond with histopathology findings. There was no mortality andevidence of systemic toxicity following 13 weeks administration of NNF. Hematology and blood biochemistrydid not reveal any toxicity at any dose; however, histopathological evaluation of hepatic tissues of few animalstreated with 200 mg/kg showed areas of necrosis at lesser extent in few animals after 13 weeks exposure of fruit.Histopathology of renal tissues of group treated with 200 mg/kg revealed areas of moderate tubular disruptionand few foci of tubular necrosis. Although only few adverse effects were observed but NNF administration ifnecessary for a prolonged period, then it may be used in a dose rage of 50-100 mg/kg in order to avoidintractable effects. Additional studies are required to clinically evaluate the safety profile of NNF.

The Effect of Nigella Sativa, and Metformin on the Changes in Liver, Heart, and Kidney Caused by DM in Experimental Animals

Metformin is a biguanide oral hypoglycemic drug used primarily in the treatment of DM. Nigella sativa (Activeingredient, Thymoquinone) has been found effective in lowering serum glucose levels and has protective effectspreventing the complications of Diabetes Mellitus. Diabetes Mellitus causes several complications, affectingalmost every organ of the body. The objective of this study was to investigate the effects of DM on liver, heartand kidney and to observe the protective as well as curative effects of Metformin and Nigella sativa from thosecomplications. The results obtained indicate that DM causes inflammation in liver and kidney and also leads tohydropic changes. While no significant changes could be observed in the heart during the study, it was observedthat Both Nigella sativa and Metformin decrease the early inflammatory changes caused by STZ induced DM inthe rat liver and kidneys but the hydropic changes continue.

SSR based Characterization of Indigenous Harnai Sheep Breed of Balochistan

This study was on the molecular characterization of Harnai sheep breed in Balochistan. A set of (n=16) ovine specific SSR markers, recommended by FAO, was used on (n=50) blood samples from unrelated animals of Harnai sheep breed from their breeding tract. Various genetic parameters were observed using Pop gene software. A total of 74 alleles were found on 13 loci. The finding values for observed number of alleles (Na), effective number of alleles (Ne) and Shannon’s Information index (I) the average values were found along with standard deviation to be 2.448±0.869, 1.7050.604 and 0.5890.357 respectively, further more, the mean values of observed heterozygosity (Obs_Het) expected homozygosity (Exp._Hom), expected heterozygosity (Exp_Het), effective number of allele (Ne) average Heterozygosity (Ave Het) were found to be 0.598±0.299, 0.366±0.284, 0.602±0.238, 0.363±0.219, 0.347±0.209 and 0.347±0.209, respectively. The value of F-statistic ranged from 0.2851 to 0.9132 for different microsatellite markers with an average of 0.515±0.021. Majority of the markers showed higher than average expected reduction in heterozygosity. The standard errors were generally low, which indicated that homozygosity prevails in the population under study. This might be due to intense inbreeding in this flock of Harnai sheep.

Preventive and Curative Effects of Metformin, Nigella sativa, Punica granatum and Zingiber officinale on Male Reproductive Dysfunction in Diabetic Rats

Diabetes mellitus is a metabolic disorder, that affects almost all the cells of the body. Well documented complications of DMinclude, neuropathy, nephropathy, microangiopathy, and retinopathy. The negative impact of the disorder is also found inother cells, including male reproductive system. In this study, fifty adult Wistar albino male rats were used. The rats weredivided into 10 groups, each group comprised of 5 rats. Diabetes was induced by intraperitoneal injection of STZ, effects ofDM were observed on the sperm producing cells then preventive as well as curative effects of Metformin, Punica granatum,Nigella sativa and Zingiber officinale were observed. It was found that all the substances prevent as well as repair/cure thedamage caused by DM to the seminiferous tubules and other structures. The results of this study show that Metforminthough prevented and caused repair to the damaged cells as well, but was not as effective as Punica granatum, Nigellasativa and Zingiber officinale.

Antiviral, embryo toxic and cytotoxic activities of Astragalus membranaceus root extracts

Antiviral activity of Astragalus membranaceus aqueous and methanol root extracts was determined against Avian influenza H9 virus. Toxicity profile of extracts was evaluated using chicken embryos and BHK-21 cell line. Different concentrations [400, 200, 100, 50, 25. 12.5, 6.25 and 3.12µg/mL] of both aqueous and methanol extracts were mixed with standard virus inoculum [4HAunits] and incubated for 30minutes at 37oC prior to inject the chicken embryos. Chorioallantoic fluid harvested 72 hours post inoculation and evaluated for virus growth using hemagglutination assay. Same concentrations of both extracts without virus were injected in chicken embryos to evaluate embryo toxic activity as well. The cytotoxic activity of aqueous and methanol extracts was determined by MTT colorimetric assay using BHK-21 cells. Three concentrations [400, 200 and 100µg/mL] of aqueous and five concentrations [400, 200, 100, 50 and 25µg/mL] of methanol extract showed antiviral activity. None of the tested concentrations of aqueous and methanol A. membranaceus root extracts caused chicken embryo mortality. Cell survival percentage of aqueous extract was higher than 50 at all of the tested concentrations except 400µg/mL. Two concentrations [400 and 200µg/mL] of methanol extract showed cytotoxicity. It was concluded that aqueous and methanol roots extracts of A. membranaceus have antiviral activity and concentrations which were safe may be used for treatment of Avian influenza H9 virus infections

Scenario of dengue infection & its control in Pakistan: An up-date and way forward

Dengue fever is one of the major health problems in tropical and subtropical areas throughout the world. The causative agent of dengue fever is the dengue virus which is an enveloped single stranded RNA virus belongs to the family Flaviviridae and has five distinct serotypes (DENV-1, DENV-2, DENV-3, DENV-4 and DENV-5). Dengue virus is transmitted to human via bite of Aedes aegypti and Aedes albopictus mosquitoes. The clinical symptoms of dengue fever ranging from mild to severe form as dengue hemorrhagic fever and dengue shock syndrome. Pakistan is dengue endemic since 1994 but from 2006, Pakistan faced the worst condition regarding dengue in which thousands of people affected by the disease and hundreds of people lost their lives. DENV-2, DENV-3 and DENV-1 are the prevalent serotypes in Pakistan. Common diagnostic techniques are being used in Pakistan such as enzyme-linked immunosorbent assay, polymerase chain reaction and rapid diagnostic tests, while differential diagnosis, limitations of diagnostic methods and poor health care system are the real challenges in dengue diagnosis. Favorable climatic conditions, unplanned urbanization, travelling etc., are major factors responsible for dengue epidemics in Pakistan. This presentation provides update about dengue circumstances in Pakistan and also describes the way how to improve dengue situation in Pakistan.

Structural and functional annotation of citrate synthase from Aspergillus niger ANJ-120

Citrate synthase [CS] is involved in citric acid biosynthesis which is a well-established metabolic pathway. The condensation of acetyl-CoA with oxaloacetate is catalyzed by CS. Citric acid [CA] has a number of applications in pharmaceutical industry. CA in combination with bicarbonates is used as an effervescent in the preparations of tablets and powders. It has also been used as an anticoagulant and acidulant to form mild astringent. In current study, detailed structural and functional analyses of CS protein were carried out using various bioinformatics tools. Structural modeling was also done by building 3D model of CS from Aspergillus niger ANJ-120 using Modeller 9.16 software. The 3D Model was then evaluated using different online approaches. Furthermore, superimposition of query and template structures, Root Mean Squared Deviation and visualization of generated model were done through UCSF Chimera 1.5.3. Even though various roles of CS protein were already known and verified experimentally, here we presented a structural analysis of CS protein. The structural investigation of CS protein will be helpful for protein engineering strategies and understanding the interactions among proteins. Due to large number of applications, the production of citric acid by A. niger and its bioinformatics studies will offer substantial improvement in commercial scale intensification of this useful product

Association of in-hospital outcome of acute kidney injury [AKI] with etiology among newborns at a tertiary care unit

Objective: To determine association of in-hospital outcome of AKI with etiology in newborns at a tertiary care hospital

Methods: This descriptive cross-sectional study was conducted at Department of Pediatric Neonatology, The Children's Hospital and Institute of the Child Health, Multan by using non-probability purposive sampling technique from June 2016 to June 2017. A total of 101 newborns diagnosed with acute kidney injury were registered. Etiological factors were assessed and these patients were followed till discharge to monitor in-hospital outcomes

Results: Of these 101 newborns, 75 [74.3%] were boys while 26 [25.7%] were girls. Mean age of these newborns was 7.59 +/- 6.13 days [range; 1 day to 28 days]. Mean age of the boys was 5.73 +/- 7.20 days while that of girls was 6.77 +/- 6.16 days. [p=0.515]. Mean weight of these neonates was 2545.05 +/- 600.42 grams [range; 1000 grams to 4000 grams]. Mean serum potassium level was 4.94 +/- 0.92 mgEq/L ranging from 3.1 mgEq/L to 7.0 mgEq/L. Mean urea level was 73.35 +/- 27.65 mg/dl ranging from 18 mg/dl to 206 mg/ dl. Mean serum creatinine level was 1.98 +/- 0.27 mg/dl, ranging from 1.6 mg/dl to 2.8 mg/dl. Mean serum sodium level was 145.72 +/- 12.64 mgEq/L ranging from 126 to 166 mEq/L. Eighty one [80.2%] were term babies while 20 [19.8%] were pre-term babies. Of these 101 study cases, 29 [28.7%] delivered vaginally while 72 [71.3%] through cesarean section. Delayed crying was noted in 48 [47.5%], dehydration 13 [12.9%], sepsis in 36 [35.6%] and renal malformation in only 4%. Neonatal mortality in these patients was 15 [14.9%] while 86 [85.1%] were discharged from hospital after recovery

Conclusion: Acute kidney disease in newborns is associated with significant disease morbidity and mortality with asphyxia and sepsis are the main etiological factors responsible. It is predominantly more common in boys compared with girls. Mortality rate was high in our study and it was significantly associated with female gender. Mortality was also associated with elevated serum sodium and urea level

Outcomes of gastric pull-up reconstructive surgery following laryngopharyngoesophagectomy in hypopharyngeal and upper esophageal carcinomas

Objective: To determine the commonest stage of hypopharyngeal and upper esophageal carcinoma at presentation, common complications after surgery, perioperative mortality, and one-year survival rate after surgery. Study Design: A descriptive prospective study. Place and Duration of Study: Combined Military Hospitals, Rawalpindi, Lahore, and Malir, from Oct 2008 to Oct 2016

Material and Methods: Through consecutive sampling, 25 individuals were sampled after staging disease through TNM classifications provided by the 1983 American Joint Committee on Cancer Classification for hypopharyngeal cancers. Total laryngopharyngoesophagectomy and gastric pull-up reconstructive surgery was performed by two teams. The total operation time in hours and the approximate blood loss in ml during the procedure was documented. The patients were monitored post-operatively for pulmonary [respiratory failure requiring ventilatory support, atelectasis, pneumonia, pulmonary embolism, pleural effusion/hemothorax, etc.], cardiac [arrhythmias, myocardial infarction, and congestive cardiac failure], and surgical complications [wound infections, anastomotic leak, and fistula formation]. The patients were also followed-up for survival at 1[st], 6[th], and 12[th] month

Results: There were 18 males and 7 females [mean age: 53 +/- 14 years]. Majority presented with T4N2M0-stage disease. The operation lasted for a mean time of 7.7 +/- 1.3 hours [range: 6.3-11 hours] and a mean 1218 +/- 338 ml [range: 590-2020 ml] blood was lost during the operation. The patients remained in the hospital for a mean 26 +/- 16 days [range: 1-56 days]. The commonest complication following operation was pleural effusion/hemothorax present in 72% of the patients. The perioperative mortality was 12% and one-year survival rate was 36%

Conclusion: Majority of our sampled patients presented with T4N2M0-stage disease. The mean operation time in our sample was longer with an increased incidence of anastomotic leaks when compared to the international data. The other complications and perioperative mortality were comparatively similar while one-year survival rate was lower

Ameliorating role of methanolic leaves extract of Fraxinus xanthoxyloides against CCl4-challanged nephrotoxicity in rats

Roots, bark, stem/twigs, and leaves of Fraxinus xanthoxyloides are being used regionally for the cure of malaria, jaundice, internal injuries, pneumonia, pain, rheumatism and also in fracture of bones. Our objective was to assess the methanolic leaves extract of F. xanthoxyloides for its antioxidant capability against oxidative stress induced by carbon tetrachloride [CCl[4]] in the kidney of Sprague-Dawley rats. Duration of this experiment was 30 days and doses were given on alternative days. Urine of rats was assessed for kidney function and renal tissues for antioxidant enzymes activity, biochemical markers, comet assay and histopathology. Enhanced urinary creatinine, urobilinogen levels and decreased creatinine clearance, protein contents, and albumin levels were observed by CCl[4] administration when matched to controls. CCl[4] injection also decreased the level of reduced glutathione, catalase, super oxide dismutase, peroxidase, glutathione s-transferase, glutathione reductase, and tissue protein while elevated the levels of thiobarbituric acid reactive substances, DNA damages and H[2]O[2] in renal tissues of experimental animals. Co-treatment of FXM and silymarin, lead to the restoration of all the above tested parameters of kidney. Through this study we affirmed the ameliorating role of F. xanthoxyloides in oxidative stress affiliated disorders of kidney

Comparative evaluation of antibacterial activity of foot muscle extracts from genus Physa and genus Ceciloides [Mollusca: Gastropoda]

The aim of this study is to explore the presence of antimicrobial bioactive agents in the foot muscle extracts of snails belonging to genus Physa and Ceciloides. Antibacterial activity of foot extracts belonging to species named as P. fontinalis, P. gyrina, P. acuta, C. acicula, C. eulima, C. petitiana, was checked and compared against three bacterial strains i.e. E.coli, P. auroginosa, S. aureus by using disc diffusion method. The results were highly significant with maximum zone of inhibition of 20.10 mm in the P. fontinalis acetone extract and the least was 12.97 mm of C. eulima diethyl ether extract. The microdilution method was employed to observe MIC to evaluate antimicrobial resistance pattern of snails foot muscle extract against three mentioned strains. MIC of foot extracts was ranging from 0.03ug/ml-5 ug/ml for six species. TLC was carried out for profiling of extracts with positive results. Foot extracts from species of both genera eluted in different fractions of compounds with a good resolution in 100% n-hexane and ethyl acetate each. The plates developed in solvent system showed purple and yellow spots indicating the presence proteins and organic compounds showing it a promising canditadate for the therapeutic purposes

Outcome of peroneus brevis tendon transfer for augmentation of repair of old complete tear of achilles tendon

Background: Repair of complete tear achilles tenden is a challenge for orthopedic surgeons

Objective: To assess the outcome of peroneus brevis tendon transfer for augmentation of repair of the old tear of the Achilles tendon

Methodology: Study Design: Prospective case series study. Place of Study: Orthopaedic Complex, Quaid e Azam Medical College/ B. V. Hospital, Bahawalpur, Pakistan. Study duration: 1st October 2013 to 30th September 2017. A total of 52 patients [42 males and 10 females], age range 38 to 52 years who underwent repair of old tear of Achilles tendon augmented by peroneus brevis tendon transfer, were included. All patients were having closed rupture. Postoperative follow up evaluation was done for a period of 12 months by using modified Rupp score. Data analysis was done by using SPSS version 17

Results: 52 patients were operated of which 5 suffered minor skin complications which recovered subsequently. No patient suffered repeat tear of the repaired tendon. Subjective postoperative evaluation was done by modified Rupp score questionnaire while objective follow up evaluation was done on the basis of ankle range of movements, ability for raising over the tip toes and sensory/motor status over the foot. At 12 months follow up 25 [48%] patients has excellent, 16 [30.7%] patients has good, 7 [13.4%] patients has fair while 4 [7.10%] patients had poor functional outcome

Conclusion: The peroneus brevis tendon transfer for augmentation of repair of old tear of Achilles tendon achieved good to excellent functional outcome in majority of the patients