Hepatoprotective and hepatocurative effects of Spilanthes acmella Murr against paracetamol induced hepatotoxicity

Hepatotoxicity is appreciably escalating health dilemma worldwide and the degree of the problem has encouraged importance in the exploration for hepatotherapeutic agents from plants. In the current research work, the hepatoprotective/hepatocurative activity of methanolic extract of Spilanthes acmella Murr aerial parts in paracetamol induced hepatotoxicity was investigated in rabbits by the analysis of different liver enzymes including ALT, AST, ALP along with histopathological investigations. In first phase of the study, paracetamol toxicated rabbits were treated with extract and standard drug jatepar TM. The hepatotoxicant [paracetamol] significantly increased the levels of aspartate transaminase, alanine transaminase, alkaline phosphatase compared to normal control. Spilanthes acmella Murr at [400 mg/kg] reversed the elevation in the level of ALP, AST and ALT caused by the hepatotoxicants and jetepar[R] TM [standard] also reversed the deleterious effects of the hepatotoxicants. In second phase of this study, extract of Spilanthes acmella Murr was given to rabbits for ten days then paracetamol was administered in one group and level of liver parameters was paralleled with regular control group and the group that was receiving the extract. It is concluded that methanolic extract of Spilanthes acmella Murr aerial parts possesses hepatocurative and hepatoprotective activity

Presentation and management of neglected developmental dysplasia of hip [DDH]: 8-years'experience with single stage triple procedure

Objective: To document the clinical presentation of neglected DDH and evaluate the outcome of triple procedure

Methods: It was a descriptive case series study, conducted at the Department of Orthopedic Surgery, National Institute of Rehabilitation Medicine [NIRM], Islamabad over a period of 8-years. It included children aged >1 and <9 years who underwent the triple procedure of open reduction, femoral shortening and Salter's osteotomy. Clinical evaluation was performed using McKay's criteria. Tonnis classification and Severin's scoring system were employed for the radiological evaluation

Results: There were 193 children with 213 DDH affected hips. The mean age was 3.31+/-1.6 years. The preoperative severity of the femoral head dislocation per Tonnis classification was Grade-I in 7.98%[n=17], Grade-II in 48.35%[n=103] and Grade-III in 43.66% [n=93] hips. The postoperative MacKay criteria was 'Good' to 'Excellent' in 193[90.61%] hips. The postoperative Severin's class was I in 113[53%] hips, II in 48[22.53%] hips, III in 43[20.18%] and IV in 9[4.22%] hips. The preoperative acetabular index ranged from 39 degree to 51 degree with a mean of 43.91+/-3.69 degree. The mean postoperative AI was 18.42+/-2.99 degree. The postoperative centre edge angle ranged from 21 degree to 26 degree with a mean 23.18 +/-1.35 degree

Conclusions: The single stage triple procedure offers the surgical remedy of choice with favourable results for managing neglected and late diagnosed DDH among children aged 1-8 years

ex vivo up-take of levamisole molecules by cestode [Monezia expensa] of goat [Capra hirsa] and its detection through RP-HPLC

Detection of various molecules of drugs remained a prime issue especially in tissues of animals, humans and in their target parasites. The cestode/tapeworms pose a dilemma because of their weird body composition and uptake pattern of nutrients and medicines especially through absorption by tegument. We selected levamisole; thought to be potent antiparasitic/ ani-cestodal drug. The uptake of levamisole [LEV] through cestodeal tissues is studied through HPCL in this paper. High performance liquid chromatography technique has been utilized to know the uptake of levamisole in tissues of cestodes of Goat [Monezia expensa] in small ruminants. The drug was exposed to M. expensa by in vitro till its death or a parasite ceases its movement. The tissue/ part of proglattids of the M. expensa were homogenized with some modifications and levamisole extraction was performed with liquid phase extraction method. The evaporation of solvent was done and the residual cestodal tissues were cleaned by solid phase. After the solid phase extraction method, the recovery of drug, detection and quantification of levamisole from cestodal tissues was determined through Reverse Phase Column High Performance Liquid Chromatography [RP-HPLC]. Levamisole [LEV] molecules assay was obtained on a C18 reverse-phase [20um, 6mm x 150mm] column at flow rate of 1ml/min using acetonitrile and ammonium acetate as mobile phase and UV detection was done at 254nm. The development of method of Levamisole [LEV] detection from cestodal tissues by HPLC in vitro samples has been demonstrated first time in Pakistan, which can provide the solution of parasitic control and provide in sight in to the uptake of anti cestodal drugs either against human or livestock parasites

DPPH, ABTS free radical scavenging, antibacterial and phytochemical evaluation of crude methanolic extract and subsequent fractions of Chenopodium botrys aerial parts

We investigated antioxidant, antibacterial potentials and secondary metabolites of Chenopodium botrys aerial parts to rationalize its effectiveness in free radicals induced disorders and infectious diseases. Antioxidant activity of plant extracts were investigated using DPPH and ABTS free radicals scavenging assays. Antibacterial potential was studied using well diffusion method. Phytochemical analysis was performed for the presence of secondary metabolites. In DPPH assay chloroform fraction [CHF], ethyl acetate fraction [EAF] and n-hexane fraction [NHF] were most active causing average inhibition of 65.9, 59.2 and 55.9% at concentration of 1mg/ml with IC[50]values of 140, 30 and 590 micro gml respectively. EAF, CHF and aqueous fraction [AQF] revealed highest scavenging effect against ABTS free radicals causing 85.46, 82.73 and 68.80% inhibition with of IC[50]of 75, 94 and 530 micro g/ml respectively. In antibacterial assay, CHF was found most effective against S. aureus presenting an inhibitory zone of 19 mm whereas; EAF, CHF and NHF were most active against K. pneumoneae with inhibitory zones of 27.1 mm, 25.4 and 18.7 mm respectively. C. botrys was tested positive for flavonoids, anthraquinones, saponins and tannins. Current findings revealed that that C. botrys is rich source of natural antioxidant and antibacterial bioactive compounds and may be further investigated

Frequency of stillbirths in a tertiary care hospital of Karachi

Background and Objective: Pakistan accounts for the highest stillbirth rate in the world. Therefore, this observational study was planned to determine the prevalence of stillbirths and its associated demographic characteristics in the given context. Hence our objective included: To determine the frequency of stillbirths with reference to parity and gestational age in a tertiary care public hospital, Karachi. To determine the socio-demographic characteristics of families with stillbirths

Methods: All pregnant mothers who delivered stillbirth babies at Gynaecology and Obstetrics ward of Jinnah Postgraduate Medical Center, Karachi a tertiary care facility were prospectively enrolled from October 2012 to September 2013. Deliveries occurred before 28 weeks of gestational age were excluded. Gestational age was confirmed from hospital record and attending physicians. Data was collected on predesigned proforma and analyzed using descriptive statistics

Results: Among 7708 registered deliveries, 137 were stillbirths. A total of 84 mothers were primiparous and 12% of mothers were below 20 years at the time of delivery. Majority of stillbirths were macerated type [80.3%] and 20% were fresh stillbirth. About 55% of still births occurred between 33-37 weeks and 20% between 28-32 weeks. Almost 80%[109] of stillbirths were low birth weight and only 20%[28] were normal birth weight

Conclusion: This study shows that stillbirths are more common in primiparous mothers in a given context. Conducting awareness sessions with special focus on antenatal and obstetrical care of primiparous may be helpful to reduce still births

Functional and structural abnormalities of the kidney and urinary tract in severely malnourished children - A hospital based study

Objectives: The association of malnutrition and systemic diseases like chronic kidney disease [CKD] is well known. Various urinary tract abnormalities may be associated with malnutrition. So objective of current study was to determine the frequency of functional and structural urinary tract abnormalities in severely malnourished children admitted in Nutritional Rehabilitation Unit [NRU] of a tertiary care facility, Karachi

Methods: This descriptive cases series of 78 children was conducted in NRU from October 2014 - March 2015. All newly admitted children aged 2-60 months, diagnosed as Severe Acute Malnutrition [SAM] were studied and children with known kidney and urinary tract disorders were excluded. Detailed history, examination and investigations like serum creatinine, ultrasound kidney and urinary tract in addition to routine tests for SAM, were done. A proforma was used to collect demographic data, clinical history, physical findings, and radio-imaging and biochemical investigations. Glomerular filtration rate [GFR] was calculated using Schwartz equation. Data was analyzed using descriptive statistics

Results: Among 78 children, male to female ratio was equal. Mean age was 18+/-15.53 months and majority [79.48%] of children were below 24 months. Majority [82%] of children with SAM had marasmus whereas 18% had edematous malnutrition. Out of 78, 57 [73%] children had either functional [80.7%] and or structural [19.3%] abnormalities whereas 21[36.84%] had normal functional and structural status. Most common functional abnormality was subnormal GFR [<90ml/min/1.73 m[2]] found in all 46 children. Functional abnormities were more common in children below 24 months. Other functional disorders were Bartter syndrome, renal tubular acidosis and urinary tract infection [UTI] found in two cases each. Common structural abnormalities were echogenic kidneys [n=4, 36%], hydronephrosis [n=3, 27%], hypoplastic kidneys [n=3, 27%] and calculi [n=1, 9%]. Subnormal GFR was also found in all cases with structural abnormalities. UTI was observed exclusively in two children among 11 with structural abnormalities

Conclusion: A high frequency of functional abnormalities and noticeable proportion of structural abnormalities of urinary tract were detected in children with SAM. Current finding suggest that multicenter study at national level may be undertaken to generate better data about prevalence of renal diseases in SAM

Comparison of HO:YAG laser and pneumatic lithotripsy in the treatment of proximal ureteral stones

Objective: To evaluate the effectiveness and safety of treatment for proximal ureteral stones with pneumatic lithotripsy compared to holmium: yttrium-aluminum-garnet [HO: YAG] laser therapy

Study Design: Randomized control study

Place and Duration of Study: Armed Forces Institute of Urology, Rawalpindi from Sep 2014 to Mar 2015

Material and Methods: This randomized control trial was conducted at Armed Forces institute of Urology Rawalpindi. A total of 73 patients who underwent treatment between Sep 2014 and Mar 2015 were included in the study. Of the patients, 37 had pneumatic lithotripsy [PL group] and 36 had ureteroscopic HO: YAG laser lithotripsy [LL group] using rigid 8 Fr-ureteroscope for the fragmentation of the ureteric stones. Patients were evaluated for stone clearance after 3 weeks, with X-ray KUB, ultrasound and plan CT KUB [where indicated]. All the data were recorded in a proforma and analyzed in SPSS version 11

Results: There was a difference between the two groups according to overall stone clearance rate 83.8% for PL group vs. 86.5% for LL group. Proximal stone migration was seen in 16.2% of cases in PL group while in only 5.5% of cases in LL group. The overall complication rate was 35.1% in PL group while 30.5% in LL group. The mean procedure time was 28.8 +/- 4.5 minutes for PL group while it was 35.5 +/- 8.6 minutes for LL group

Conclusion: The pneumatic and holmium: yttrium-aluminum-garnet laser lithotripsy both are established choices for treatment of ureteral stone but in terms of stone clearance rate and decrease incidence of proximal stone migration HO: YAG lithotripsy is better than pneumatic lithotripsy

Phytochemical screening and standardization profile of adansonia digitata L. - a universal remedial plant

Globally, the significance of medicinal plant in the cure of variety of illnesses has been increasing the expansion of science of phytopharmaceuticals and desire for treatment in chronic and acute diseases which initiates new enthusiasm to develop herbal medicine. The present study was conducted on mature leaves of Adansonia digitata L. used in traditional system of medicine for curative and preventive treatment of asthma, dysentery, fever, hemorrhoids, insect bites, malaria, measles, sores trypanosomiasis, ulcers, etc. This plant is used as a staple food because it has nutritional value too. The present investigation describes phytochemical screening and standardization profile of mature leaves of A. digitata. Various extracts of leaves were prepared and subjected to phytochemical screening using different solvents and detailed microscopic and fluorescence studies were also carried out

Medico-genetics of oculocutaneous albinism; An updated study with Pakistani perspective

Albinism is a rare genetic disease associated with reduced melanin pigment biosynthesis in eyes, skin or hair. Clinically it is categorized, based on the affected tissue, into two types i.e ocular albinism [OA]; when hypopigmentation influence the retinal pigment epithelium leaving skin and hair unaffected, and oculocutaneous albinism [OCA]; when hypopigmentation occur in hair, skin and eye. Various genetic studies to date identified six genes [TYR, TYRP1, OCA2, SLC45A2, SLC24A5, C10orf11] and a locus [OCA5] for whom the candidate gene is yet to be known. All these reported genes, at the molecular level, are involved in melanin pigment biosynthesis. Among these reported genes, TYR and OCA2 are the most prevalent genetic factors of OCA in Pakistani population. The study will assist in understanding the molecular factors of OCA and melanin synthesis pathway to reduce its prevalence rate. The review aims to systematically reread and analyze the oculocutaneous albinism and its various types in the context of developed world as well as Pakistani community

Comparative evaluation of in vitro cytotoxic effects among parent abietyl alcohol and novel fatty acid ester derivatives against MCF7 and hepatocellular carcinoma cell lines

Synthesis of twelve hitherto unreported esters of abietyl alcohol and screening of these esters against four cancer cell lines including one breast cancer line MCF7 and four hepatocellular carcinoma cell lines [HCC] Huh7, Hep3B, Snu449 and Plc has been determined using SRB assay. The Cell cycle progression showed changes in cellular behaviour after 48 and 72 hours in MCF7 and Huh7 cell lines. Abietyl alcohol was obtained from the reduction of abietic acid, a tricyclic diterpene, isolated from oleoresin of Pinus longifolia Roxberghii

Negative regulatory approaches to the attenuation of Toll-like receptor signaling

Toll-like receptors (TLRs) are pivotal components of the innate immune response, which is responsible for eradicating invading microorganisms through the induction of inflammatory molecules. These receptors are also involved in responding to harmful endogenous molecules and have crucial roles in the activation of the innate immune system and shaping the adaptive immune response. However, TLR signaling pathways must be tightly regulated because undue TLR stimulation may disrupt the fine balance between pro- and anti-inflammatory responses. Such disruptions may harm the host through the development of autoimmune and inflammatory diseases, such as rheumatoid arthritis and systemic lupus erythematosus. Several studies have investigated the regulatory pathways of TLRs that are essential for modulating proinflammatory responses. These studies reported several pathways and molecules that act individually or in combination to regulate immune responses. In this review, we have summarized recent advancements in the elucidation of the negative regulation of TLR signaling. Moreover, this review covers the modulation of TLR signaling at multiple levels, including adaptor complex destabilization, phosphorylation and ubiquitin-mediated degradation of signal proteins, manipulation of other receptors, and transcriptional regulation. Lastly, synthetic inhibitors have also been briefly discussed to highlight negative regulatory approaches in the treatment of inflammatory diseases.

Medical Education: a Preference by Parents for their Children in a Private Medical College

Occupations which require high educational attainment, are well-compensated and are held in high public esteem such as physicians, lawyers, engineers, scientists and professors are largely considered to be upper middle class. Education serves as perhaps the most important value and also the most dominant entry barrier of the upper middle class This article examines some of the factors or determinants which enable the parents for choosing medical profession for their children specially the females. To see the social determinants [profession, occupation] of parents for choice of medical profession by gender In Private Medical College for their children. A descriptive study. This study was conducted from 2009 to 2011 at Islamic International Medical College, Rawalpindi. This was a descriptive study. Sampling was universal as all the students of year 2009, 2010 and 2011 who succeeded in getting admission were included in the study. Data was collected through a questionnaire from the record mentioning Class year' Gender, Fathers Occupation. Data was entered and analyzed in SPSS version 17.0. Tables and graphs were made for data presentation and percentages and cross tabulation was done among variables. The ratio of female to male students is on continuous increase. The main segments of the society who opted for the private medical education for their children during these three years were, government servants and businessmen i.e., 33.3% each, Doctors 15%, Miscellaneous 10%, Engineers 8% Agriculturist 2.5% and advocates/Judges 1%. There is progressive increase of female students from 2009 to 2011. It was 65% in 2009, 70% in 2010 and 75% in 2011. Medical profession and medical education is cherished more by the parents for females. All segments of the educated and affording class of society whether government employees' business man, doctors, engineers, are investing in female human resource

Biosafety intervention and follow up assessment in laboratory workers of Karachi, Pakistan

Regular trainings and capacity building are required for all health care workers to ensure that they follow the laid down standard operating procedures and thus avoid any mishap. Delays in such trainings and improper supervision results in their reverting back to their old habits. Post intervention assessment of laboratory workers of public and private sector hospitals of Karachi on adherence to biosafety practices. Quantitative-qualitative cross-sectional survey done from August-November, 2012 using simple random sampling. Study population comprised of 253 laboratory workers of public and private sector hospital laboratories of Karachi. An initial KAP survey on biosafety practices in the laboratories and their workers followed by training and a post intervention evaluation was done in 2008. Four years later these workers were re-evaluated using an anonymous closed ended questionnaire to assess how many are following the training and the standard guidelines. Data was entered and analyzed using SPSS 13.0. Mean and percentages were calculated for quantitative variables and x[2] - test was applied for significance. A total of 253 participants [168 males and 85 females] returned the filled questionnaire Almost all [98.8%] laboratory workers had correct concept on use of personal protective equipment, 85% were neither practicing mouth pipetting for chemical and biological samples, nor using laboratories for eating and drinking purposes while importance of SOP/BOP and laboratory accident record maintenance was acknowledged by over 95%. Knowledge about discarding the used syringe was present in only 68%. A comparison between public and private sector laboratory workers revealed that 37% public sector workers were still discarding syringes in the dustbin as opposed to 3% from private sector. Educational interventions performed almost 4 years ago were still followed by laboratory workers indicating the importance of at least one training every 2-3 years to sensitize them on biosafety

Pattern of diseases, reason of visiting and waiting time at various stages of tertiary hospital

Objectives: To determine the frequency of diseases in children, reasons of visiting out patients department of tertiary care children, hospital and to evaluate the waiting time of patients at different stages of treatment

Study Design: Descriptive observational study

Place And Duration: National Institute of Child Health, Karachi from October 2007 to July 2008

Methodology: Patients up to 13 years of age attending OPD were recruited in to study using simple random sampling procedure. Sample size was 400

Results: Children were selected from three OPDs of NICH, Karachi. Majority of patient were below 5 years of age [69.7% [n=279]]

Mean age was 3.53years + 3.3 with range 155 months [1-156]. The main diseases in medical OPD were respiratory problem 19.43 % [n=34], followed by renal problems 17.7% [n=31], and GIT problem 13.7% [n=24]. In surgical OPD, trauma and fracture 23.2% [n=36], hernia 17.42 % [n=27], and urology 15.5 % [n=24] were important problems in children. Respiratory distress 31.43% [n=22], sepsis 18.61% [n=13], NNJ+ 17.1% [n=12], and constipation 11.43% [n=8], were theicommon disorders in infants attending well baby clinic. Mean number of visits per patient was 2.5 +1.9 [range 1-20]

Conclusion: Most frequent disorders in medical OPD were respiratory problem, trauma and fracture in surgical OPD, and respiratory distress, sepsis and neonatal jaundice at well baby clinic. Availability of free of cost facilities was the main reason for attending the OPD

Optimized antimicrobial peptide [Bacitracin] production by immobilized and free cells and of bacillus Spp GU215 using wood chips and silicon polymer beads

The immobilization of bacillus spp. GU215 on silicon polymer beads, wood chips was performed and antibiotic peptide [bacitracin] production, optimization of parameters were investigated. The immobilized cells presented elevated levels of activity than free cells. The silicon polymer based cells showed widest zones of inhibitions [18mm] in 72 hours and 4% concentration of glucose, PH 8 and 30°C, whereas a marginal decrease in the activity [14mm] was noticed in case of wood chips based immobilization systems and least stable immobilization in 72 hours incubation time, 4% glucose concentration, PH 8 and 30°C. This study illustrates that the silicon polymer based beads facilitate a strong interactions with bacitracin producing cells and render them suitable for excessive and long time production of antibiotic

To evaluate the efficacy and reliability of commonly available tests for the diagnosis of dengue fever in children in Karachi

Diagnosis of dengue fever in financially constraint countries like Pakistan is usually made on immunochromatographic [ICT] based serological tests. To compare the diagnostic accuracy of commercially available dengue rapid immunochromatographic tests [ICT] with dengue ELISA in acute dengue infection in children. This retrospective study was carried out at the National Institute of Child Health, Karachi in the Department of Pathology from October 2010 to January 2011. Hospitalized children who fulfilled the WHO and CDC definition of probable dengue fever i.e. fever of 2 to 7 days with two or more than two of the associated symptoms like headache, retro orbital pain, myalgia, arthralgia, rash, hemorrhagic manifestation, leucopenia, thrombocytopenia and supporting serology were included in the study after taking informed consent from their parents / care givers. Malarial parasite positive cases were excluded from the study. Dengue ICT based IgG, IgM, IgA antibodies were done using rapid devices, dengue NS[1] was done on ICT rapid device and dengue IgM was done using enzyme linked immunosorbent assay [ELISA] by micro titer well plate. Data entered and analyzed on SPSS version 16. Out of 80 suspected cases [being a retrospective study it would be better that we give number of all suspected cases and then delete the numbers that did not have complete tests], 39 fulfilled the criteria of suspected dengue fever patients. Ages of these children ranged from 6 months to 13 years. There were 18 males and 21 females. Mean haemoglobin was 8.7g/dl and mean haematocrit was 26.3%. Elevated haematocrit was seen in 7.5% cases only. Mean WBC count was 6164/cmm, with leucopenia seen in 33.3% and leucocytosis in 5.12% cases. Thrombocytopenia was present in all cases except one. Positivity rate of dengue IgG was 25.64%, IgM 15.4%, IgA 43.59%, rapid antigen by ICT method 20.5% and ELISA IgM [by micro titer well- plate] was 76.9%. Sensitivity / specificity of dengue IgG, IgM, IgA and rapid antigen by ICT were compared with ELISA IgM [gold standard] and these were 33.3/100%, 16.67/88.89%, 50.0/77.78%, 23.3/88.8% respectively. ELISA IgM antibody [by micro titer well-plate] test was most reliable as compared to ICT tests. Among the ICT tests, dengue IgA antibody was superior to other tests

Production of peptide antibiotics by Bacillus sp: GU 057 indigenously isolated from saline soil

A total of 112 soil samples were taken from differents areas of district D.I.Khan and Kohat (KPK) Pakistan and screened for production of antibiotics against the Micrococcus luteus and Staphylococcus aureus. Widest zone of inhibition (18mm) was produced by microorganism isolated from saline soil. The strain was later identified as Bacillus GU057 by standard biochemical assays. Maximum activity (18mm inhibition zone) was observed against Staphylococcus aureus after 48 hours of incubation at pH 8 and 4% concentration of glucose. The antibiotic was identified by autobiography as bacitracin. The Bacillus strain GU057 was confirmed as good peptide antibiotic producer and can effectively be indulged as biocontrol agent.

Complete elimination of indigenously isolated agrobacterium tumefaciens strains by quinolone and metallo beta-lactam antibiotics

The present study aimed to isolate Agrobacterium tumefaciens strains from lycoperiscum esculantum [Tomato] galls and investigate in vitro the potential killing activities of various antibiotics. Seven Agrobacterium tumefaciens strains namely WF2, WF7, WF7d, WF11, WF12, WF14 and WF15 were isolated from galls of different lycoperiscum esculantum from various fields in district D.I.Khan. The isolated strains were assayed for their ability to initiate tumors by using a carrot and potato disc assay. Primarly six antibiotics were screened for susceptibility against Agrobacterium tumefaciens by a disc diffusion assay. The antibiotic with the widest zones of inhibition were used for determination of the minimum inhibitory concentration [MIC] and minimum bactericidal concentrations [MBC].The MIC and MBC of meropenem against almost all strains were the same [0.025mg/ml] except for WF14, [MIC/MBC 0.05mg/ml]. The ciprofloxacin was reported as the second most active antibiotic against A. tumefaciens. Suppression of the growth of all strains occurred at 0.0031mg/ml except for WF7 and WF14 with MIC 0.0062mg/ml. The MBCs of all strains are the same as the corresponding MICs. However, the strain WF15 was two times higher [0.0093mg/ml]. The amoxicillin also represented comparatively lower MIC/MBC [0.2mg/ml] except WF14 [MIC 0.4mg/ml, MBC 0.8mg.ml] without clavulanic acid. It is concluded that both meropenem and ciprofloxacin were highly effective in eliminating the Agrobacterium tumefaciens in a low concentration. These findings prove the effective use of ciprofloxacin and meropenem in agrobacterium mediated transformation in plants

Adolescent's perspective on reproductive health: a study from Karachi

To determine the existing knowledge, attitude and behavior about reproductive and sexual health in adolescents of Karachi and seek their opinion about reproductive health education. Study type, settings and duration: A cross sectional study was conducted on adolescents [17-19 years] of both gender studying in colleges of Karachi during 2010. Subjects and Methods: Using stratified sampling procedure, a cross sectional study was carried out. After informed consent and ensuring confidentiality an anonymous quantitative questionnaire was completed to ascertain the knowledge of adolescents on reproductive health. A total of 912 adolescents [470 males and 442 females] of 12 public and private sector colleges of Karachi participated in the study. Acquaintance to reproductive health was present in 75% males and 71% females and most participants confirmed discussing reproductive health issues with friends. About 81% males and 91% females affirmed for a need for enhanced reproductive health education and awareness while over 50% of the respondents were of the opinion that the right age for reproductive health education was 16 to 18 years. Confining sexual activity to one partner and avoiding exposure to blood and needles for the prevention of AIDS was known to 38% males and 44% females but the prevention of sexually transmitted infections using condoms, was known to only 1/3 rd of the respondents. Although 70% of the respondents of both genders knew that pregnancy can be avoided but only 20% knew about contraceptives. Most adolescents' knew about the reproductive cycle but were not well aware of how to avoid exposures to sexually transmitted infections and pregnancies. Policy message: Reproductive health education is insufficient in adolescents should be gender specific and socio culturally sensitive

Intestinal tuberculosis presenting as acute abdomen

To study the outcome of intestinal tuberculosis presenting as acute abdomen. Descriptive Study. Bolan Medical Complex Hospital [BMC] Quetta and Combined Military Hospital [CMH] Quetta from Nov 2003 to Nov 2005 from Bolan Medical Complex and from Nov 2005 to Nov 2006 in CMH Quetta. Thirty seven patients of acute abdomen presenting with intestinal obstruction were admitted; 28 from emergency department and 9 from out patient department. Twenty seven patients were from BMC and 10 from CMH Quetta. Patients were diagnosed as having abdominal tuberculosis on the basis of operative findings and histopathological reports. Out of 37 patients presenting with acute abdomen due to intestinal obstruction, 54% were male and 46% were female with M: F ratio of 1: 1.2. Age of the patient ranged from 20 to 50 years, with maximum frequency between 30 to 40 years. Abdominal pain was the commonest presenting feature in all patients followed by constipation in 81.1% patients. Peritonism was seen in 27% patients. Different operative procedures performed were adhesionolysis 65.8%, segmental resection 7.9%, right hemicolectomy 10.5%, stricturoplasty 7.9% and ileostomy 1.3%. Mesenteric lymph node biopsy 40.8%.Intestinal tuberculosis is still a very important surgical problem in our country presenting as acute abdomen. A suspicion must always be kept during laparotomy and adequate tissue histopathology should supplement the diagnosis.