Synthesis of 2-Furyl [[4-aralkyl]-1-piperazinyl] methanone derivatives as suitable antibacterial agents with mild cytotoxicity

The aim of the present research work was synthesis of some 2-furyl [[4-aralkyl]-1-piperazinyl] methanone derivatives and to ascertain their antibacterial potential. The cytotoxicity of these molecules was also checked to find out their utility as possible therapeutic agents. The synthesis was initiated by reacting furyl[-1-piperazinyl] methanone [1] in N,N-dimethylformamide [DMF] and lithium hydride with different aralkyl halides [2a-j] to afford 2-furyl[[4-aralkyl]-1piperazinyl] methanone derivatives [3a-j]. The structural confirmation of all the synthesized compounds was done by IR, EI-MS, 1H-NMR and 13C-NMR spectral techniques and through elemental analysis. The results of in vitro antibacterial activity of all the synthesized compounds were screened against Gram-negative [S. typhi, E. coli, P. aeruginosa] and Gram-positive [B. subtilis, S. aureus] bacteria and were found to be decent inhibitors. Amongst the synthesized molecules, 3e showed lowest minimum inhibitory concentration MIC = 7.52 +/- 0.[micro]g/mL against S. Typhi, credibly due to the presence of 2-bromobenzyl group, relative to the reference standard, ciprofloxacin, having MIC = 7.45 +/- 0.58[micro]g/mL

Use of penile skin flap in complex anterior urethral stricture repair: our experience

Objective: To present our experience of treatment of complex anterior urethral strictures using penile skin flap

Study Design: Descriptive, case series

Place and Duration of Study: Department of urology Combined Military Hospital Malir Cantonment, Karachi and Armed Forces Institute of Urology, Rawalpindi from Jan 2012 to Feb 2014

Material and Methods: Total 18 patients with complex anterior urethral strictures and combined anterior and bulborurethral strictures were included. Patients underwent repair using Orandi or circularfacio-cutaneous penile skin flap depending upon the size and site of stricture. First dressing was changed after two days and an in dwelling silicone two way foleycatheter was kept in place for three weeks. Graft was assessed with regards to local infection, fistula formation and restricturing. Re-stricture was assessed by performing uroflowmetery at 6 months and 1 year. Ascending urethrogram was reserved for cases with less than 10 ml/sec Q max on uroflowmetery. Repair failure was considered whenthere was a need for any subsequent urethral procedure asurethral dilatation, dorsal visual internal urethrotomy, or urethroplasty

Results: Overall success rate was 83.3%. Of all the patients operated 1[5.6%] had infection with loss of flap, 3[16.7%] had urethral fistula and none had re stricture confirmed by uroflowmetery

Conclusion: In our study the excellent results of the penile skin flap both in anterior urethral strictures and combined anterior and bulbar urethral strictures are quite encouraging. It is easy to harvest and seems anatomically more logical

Multiple pesticide residues; in spinach and associated health risk

In past, no work has been done regarding the pesticide residues in spinach targeting peri-urban area of district Faisalabad. Keeping in view the persistent nature and cumulative behavior as well potential toxic effects of pesticides as a result of consumption of vegetable this is planned. Food safety is a major public concern worldwide. This is serious problem in the whole world especially in economically poor countries like Pakistan. The production of safe food is an important aspect of food quality assurance as well as human health. The people are demanding fresh, hygienic and quality food. To study the level of pesticide residues in spinach grown in peri-urban area of district Faisalabad and compare the level of contaminants respective their maximum residues limits [MRLS]. Ten farmers were selected randomly for spinach in the peri-urban area of district Faisalabad and vegetable samples were collected at optimum maturity in triplicate and transported to the laboratory of National Institute of Food Science and Technology, University of Agriculture, Faisalabad for further processing. The residues of pesticide were determined by GC-ECD. The results regarding pesticide residues in different spinach samples showed variations and residues varied as deltamethrin 0.024 to 0.143 mg Kg[-1], permethrin 0.159 to 0.573 mg Kg[-1], cypermethrin 0.098 to 0.503 mg Kg[-1], profenofos 0.016 to 0.425 mg Kg[-1], chlorpyrifos 0.009 to 0.212 mg Kg[-1], bifenthrin 0.012 to 0.623 mg Kg[-1], endosulfan 0.043 to 0.103 mg Kg[-1], dimethoate 0.077 to 0.515 mg Kg[-1], respectively. The chlorpyriphos has no residues in any sample of spinach. The spinach samples are found to be contaminated with a number of different pesticides and these pesticides are not applied judiciously according to good agricultural practices and recommended doses. The farmers are unaware of pesticide use and other agricultural practices due to lack of extension as result causes of serious problems to all community

Prolonged oral cyanide effects on feed intake, growth rate and blood parameters in rabbits

Twelve adult rabbits bred locally were divided into two equal groups of 6; experimental and control groups. Rabbits in the experimental group were orally dosed with KCN at 3mg/kg body weight for 40 consecutive days. Members in control group were given placebo [distilled water] for the same period. Animals in both groups were offered feed at 90gm/kg/day while ample drinking water was available ad lib. Feed consumption and body weight of rabbits in both the groups were recorded. Blood samples were also drawn to determine various hematological parameters. Statistical analysis revealed a non-significant difference of total and daily feed intakes in rabbits of experimental and control groups. Whereas the feed efficiency of rabbits in the experimental group were significantly reduced [P<0.05] compared to controls. Likewise a significant decrease in body weight gain of rabbits in experimental group [P<0.05] was observed. A non-significant difference [P>0.05] was observed in leukocyte count, differential leukocyte count and platelets of rabbits in both the groups. Erythrocyte count, hemoglobin concentration, packed cell volume and mean corpuscular hemoglobin were significantly decreased in treated rabbits. It was concluded that chronic cyanide intake had a deleterious effect on feed efficiency, growth rate and blood components of rabbits

Pheochromocytoma: a rare cause of childhood hypertensive encephalopathy

Pheochromocytomas are rare neuroendocrine tumours of chromaffin tissues. They are catecholamine secreting tumours which cause severe hypertension and other systemic disturbances. Of all the causes of childhood hypertension, pheochromocytoma constitutes less than 1%. We report the case of a 12 years old child who presented with hypertensive encephalopathy, confirmed histologically to be secondary to pheochromocytoma, and cured with meticulous critical care and surgical resection

Multiple angiosarcomas of the gut (duodenum, appendix and cecum) - a case report

Angiosarcoma is a rare soft-tissue neoplasm that occurs most often in the skin and the subcutaneous tissues but very rarely in the gastrointestinal tract. We present a case of angiosarcoma involving small and large intestine

audit of cholecystectomy

To evaluate the results of Cholecystectomy in our practice. Prospective, descriptive study from January 2006 to December 2006. Hamdard University Hospital and private hospitals. A total of 150 patients who underwent cholecystectomy were included in this study. The dats of all the patients who underwent cholecystectomy was entered on a proforma and analyzed. Out of the total 150 patients, 75% were females and 25% males, with an age range of 20 to 76 years. The duration of symptoms was from one day to three years. Laparoscopic Cholecystectomy was attempted in 118 [78.66%] patients and completed in 104 [88.13%] patients; 13 [11.11%] patients required conversion, while in one case the procedure was abandoned due to abdominal tuberculosis. The remaining 32 patients underwent planned open cholecystectomy for various reasons. The comparison of our work with national and international studies showed that Laparoscopic Cholecystectomy in our set up is up to the accepted standard. More emphasis is needed to properly train young surgeons in the field of Laparoscopic surgery

Tubularized incised plate urethroplasty for various types of hypospadias

To report out short term results of hypospadias repair using Tubularised Incised Plate [TIP] Urethroplasty as described by Snodgrass for various types of hypospadias. A cohort of 62 patients comprising various types of hypospadias [62% distal penile, 30% mid penile and 8% proximal penile] underwent Snodgrass repair by one surgeon [F.A.] from June 2001 to November 2005. Age of the patients ranged from 1 to 20 years, the modal age being 3.2 years. There was no chordee in 90% of the cases whereas mild to moderate chordee was present in the remaining 10%. Urethroplasty was done by tubularization of the incised urethral plate as described by Snodgrass with coverage of the suture line by vasclarized dartos layer for water proofing. Chordee, if persisted after degloving of the penis, was corrected by dorsal placation. Patients were followed postoperatively on day 5, one month and subsequently on three monthly basis for a year. On the mean follow up of six months 46 patients [74%] achieved good functional and cosmetic results, with normal looking penis and ability to void urine with good forwardly directed stream. Complications were observed in 16 patients [26%]. The most common complication was urethrocutaneous fistula in 14 [22%]. Out of these 8 patients had minor leak which closed without requiring any further surgical intervention by regular urethral dilatation. The remaining 6 patients required re-operation for closure of the fistula. 2 patients had glans dehiscence which required re-operation 6 months later. Another 2 patients developed meatal stenosis which settled with regular post-op dilatation. So, the complications requiring surgical intervention was seen in 8 patients only. TIP Urethroplasty is a simple single stage procedure applicable for the majority of the hypospadias including mid and proximal hypospadias and redo cases where urethral plate is intact. It provides excellent functional neo-urethra, cosmetically normal looking glans and vertically oriented slit like meatus with lesser complication as compared to other single stage procedures

Aspartate aminotransferase alanine aminotransferase ratio predicts cirrhosis in patients with chronic hepatitis C

To confirm the usefulness of aspartate aminotransferase - alanine aminotransferase ratio [AST/ ALT ratio] in predicting cirrhosis in patients with chronic hepatitis C. A prospective non interventional study. Combined Military Hospital, Kharian. Fifty Five patients with chronic hepatitis C were included in the study. Groups included were the patients admitted with sign and symptoms of chronic liver disease due to hepatitis C, blood donors found incidently to be Anti - HCV positive and the persons rejected from embassies duet to Anti-HCV postitive serostatins. The sera of the patients were tested for AST and ALT. Liver biopsy of each patient was performed. Histological Activity Index [HAI] of the specimens was scored on the basis of Knodell score. AST/ALT ratio was correlated with the histological stage [i.e. degree of fibrosis], and the histological grade [i.e. inflammatory activity]. The mean AST/ALT ratio in 17 cirrhotic patients [1.11 +/- 0.18] was higher than in 38 noncirrhotic patients [0.72 +/- 0.23; p < 0.05]. A ratio 1 had 97.36% specificity and 93.75% positive predictive value in distinguishing cirrhotic from noncirrhotic patients with 88.23% sensitivity and 94.87% negative predictive value. The ratio correlated positively with histological stage but not with the grade. Two Patients out of 17 cirrhotic patients [12%] had no clinical or biochemical features suggestive of chronic liver disease except for an AST/ ALT ratio more than one. It is concluded that AST/ALT ratio 1 is highly specific for the presence of cirrhosis in patients with chronic hepatitis C. This ratio reflects the fibrosis stage in these patients. This ratio can be considered as a dependable marker of fibrosis in patients with chronic hepatitis C

Assessment of hypothyroidism in diffuse nonscarring alopecia

Alopecia, clinically as well as etiologically, is a heterogeneous group. Several hormonal etiologies may cause alopecia including hyperthyroidism, hypothyroidism etc. Thyroid diseases show a wide range of clinical signs in skin, hair and nails. Several reports document a significant correlation between thyroid diseases especially hypothyroidism with alopecia. Thyroid function test is one of the useful indices to assess the cause of alopecia. The aim of our study was to evaluate the frequency of alopecia in hypothyroid cases by performing the thyroid function tests [T3, T4, TSH]. Twenty diagnosed patients of hypothyroidism were assessed for alopecia [according to the Hamilton and Norwood grading scale] and thyroid function tests. 20 healthy controls were recruited for comparison. Out of 20 hypothyroid patients, 10 [50%] showed alopecia of variable grades. On laboratory investigations, significantly decreased levels of T3 and increased levels of TSH were noticed. Alopecia is quite frequent in hypothyroid patients. Similarly, thyroid profile is one of the useful diagnostic index for screening patients with alopecia

Inverted Papilloma: experience at Allama Iqbal Medical College and King Edward Medical College

Purpose: In this study, the surgical management of an inverted papilloma of the nose and paranasal sinuses at our institutions [Allama Iqbal Medical College and King Edward Medical College Lahore-Pakistan] is reviewed

Methods: Nine patients diagnosed with an inverted papilloma and treated at the Ear Nose and Throat Departments of Allama Iqbal Medical College and King Edward Medical College Lahore-Pakistan from 1995 to 2003 were retrospectively reviewed. One patient after the complete work up left without surgery. Eight patients were treated with lateral rhinotomy and medial maxillectomy

Results: The patients had a mean follow up of 4 years and eight months [8 years to 2 years 3 months]. The overall recurrence rate was 12%. The patient with recurrence on biopsy showed presence of squamous cell carcinoma

Conclusions: All unilateral nasal masses must be biopsied. Lateral rhinotomy with medial maxillectomy is an effective way of treating sinonasal inverted papilloma in our set up

Comparison between serological testing and biopsy examination of helicobacter pylori

This study was conducted at the gastroenterology department of the MH Rawalpindi to compare the sensitivity and specificity of serological assay for H .Pylori with the histopathological tests. A total of 50 patients were included. 32 cases were found to have H. Pylori on the histological examination. Out of these 32 patients 28 cases were found to have anti H. Pylori antibodies. 2 cases were found to have false positive anti H. Pylori antibodies in serum. The sensitivity and specificity of tests were 87.5% and 88.8% respectively with negative predictive value of 80% and diagnostic efficacy of 88%

Endoscopic assessment of dyspepsia

This study was conducted to identify the spectrum of diseases causing dyspepsia and to find out relative prevalence of individual diseases in our society. A number of 510 patients between ages of 10-70 years with dyspepsia were selected after fulfilling a definite criterion for the study. The results indicated that 261 [51.17%] had no endoscopic abnormality suggesting that a large majority of patients suffer from non-ulcer dyspepsia. The prevalence of peptic ulcer was 10%. About 20% had esophagitis and 13% suffered from gastritis/duodenitis. It was concluded that majority of patients with dyspepsia had no peptic ulceration, though they may present with ulcer like symptoms

Critical pathway, cardiac surgery in the third world

To set up a protocol in order to provide an efficient, cost effective system for Cardiac Surgery and to reduce the waiting list in straight forward Cardiac Surgical Operations. A prospective study in all patients with Patent Ductus Arteriosus [PDA] following the Critical Care Methodology. Department of Cardiac Surgery, Punjab Institute of Cardiology, Lahore. Main outcome measures: Effectiveness of critical care methodology, reduction of cost to hospital and patient and reduction in waiting list time for PDA surgery. From June 1994 till June 1999, one hundred and fifty consecutive patients of PDA had their operation planned as day case cardiac surgery. There were 90 females and 60 males. Their mean age was 6.55 +/- 0.56 years. 134 patients were less than 18 years, mean age 4.9 +/- 0.39 years. These patients were seen in the outpatient and were accessed by the surgeon, anesthetist and intensive care sister. The parents of the children were fully briefed about the preoperative preparation, operation and post operative course. The patients were admitted on the day of the operation and kept in the ICU for 6 hours and then shifted to the high dependency unit [HDU] and discharged on the second post operative morning. We found this method of day case surgery beneficial for the patient. In that it reduced the cost of the hospital stay, surgery and led to a reduction in the waiting list time for PDA. This did not lead to an increase in the morbidity as the patients were sent home to the community early. In third world countries like Pakistan where resources are limited this method is ideal provided everyone is willing to participate

Carcinoma Gall bladder with situs inversus totalls

We report a case of carcinoma gall bladder with situs inversus totalis in a 65 years old lady. She presented very late with obstructive jaundice and gastric outlet obstruction. Different imaging tests were done to accurately outline vital structures. At laparotomy the carcinoma was inoperable, hence a palliative percutaneous external biliary drainage and gastrojejunostomy was done. She survived for three months but ultimately died of disseminated cancer