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Abstract Today, global focus of research is to explore the solution of energy crisis and environmental pollution. Like other agricultural countries, bulk quantities of watermelon peels (WMP) are disposed-off in environment as waste in Pakistan and appropriate management of this waste is the need of hour to save environment from pollution. The work emphasizes the role of ethanologenic yeasts to utilize significant sugars present in WMP for low-cost bioethanol fermentation. Dilute hydrochloric acid hydrolysis of WMP was carried out on optimized conditions employing RSM (response surface methodology) following central composite design (CCD). This experimental design is based on optimization of ethanologenesis involving some key independent parameters such as WMP hydrolysate and synthetic media ratio (X1), incubation temperature (X2) and incubation temperature (X3) for maximal ethanol yield exploiting standard (Saccharomyces cerevisiae K7) as well as experimental (Metchnikowia cibodasensisY34) yeasts. The results revealed that maximal ethanol yields obtained from S. cerevisiae K7 was 0.36±0.02 g/g of reducing sugars whereas M. cibodasensisY34, yielded 0.40±0.01 g ethanol/g of reducing sugars. The yeast isolate M. cibodasensisY34 appeared as promising ethanologen and embodies prospective potential for fermentative valorization of WMP-to-bioethanol.
Resumo Hoje, o foco global da pesquisa é explorar a solução da crise energética e da poluição ambiental. Como em outros países agrícolas, grandes quantidades de cascas de melancia (WMP) são descartadas como resíduos no meio ambiente no Paquistão, mas a gestão adequada desses resíduos é a mais recente solução para salvar o meio ambiente da poluição. O trabalho enfatiza o papel das leveduras etanologênicas para utilizar açúcares significativos presentes no WMP para fermentação de bioetanol de baixo custo. A hidrólise de ácido clorídrico diluído de WMP foi realizada em condições otimizadas empregando RSM (metodologia de superfície de resposta) e seguindo o projeto de composto central (CCD). Este projeto experimental é baseado na otimização da etanologenesis envolvendo alguns parâmetros independentes importantes, como hidrolisado de WMP e razão de meio sintético (X1), temperatura de incubação (X2) e temperatura de incubação (X3) para rendimento máximo de etanol explorando o padrão (Saccharomyces cerevisiae K7) também como leveduras experimentais (Metchnikowia cibodasensis Y34). Os resultados revelaram que os rendimentos máximos de etanol obtidos a partir de S. cerevisiae K7 foi de 0,36 ± 0,02 g / g de açúcares redutores, enquanto M. cibodasensis Y34 rendeu 0,40 ± 0,01 g de etanol / g de açúcares redutores. O isolado de levedura M. cibodasensis Y34 apareceu como um etanologeno promissor e incorpora um potencial prospectivo para a valorização fermentativa de WMP em bioetanol.
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Cucurbitaceae , Etanol , Saccharomyces cerevisiae , Água , Biotransformação , Estudos Prospectivos , FermentaçãoRESUMO
Abstract Today, global focus of research is to explore the solution of energy crisis and environmental pollution. Like other agricultural countries, bulk quantities of watermelon peels (WMP) are disposed-off in environment as waste in Pakistan and appropriate management of this waste is the need of hour to save environment from pollution. The work emphasizes the role of ethanologenic yeasts to utilize significant sugars present in WMP for low-cost bioethanol fermentation. Dilute hydrochloric acid hydrolysis of WMP was carried out on optimized conditions employing RSM (response surface methodology) following central composite design (CCD). This experimental design is based on optimization of ethanologenesis involving some key independent parameters such as WMP hydrolysate and synthetic media ratio (X1), incubation temperature (X2) and incubation temperature (X3) for maximal ethanol yield exploiting standard (Saccharomyces cerevisiae K7) as well as experimental (Metchnikowia cibodasensisY34) yeasts. The results revealed that maximal ethanol yields obtained from S. cerevisiae K7 was 0.36±0.02 g/g of reducing sugars whereas M. cibodasensisY34, yielded 0.40±0.01 g ethanol/g of reducing sugars. The yeast isolate M. cibodasensisY34 appeared as promising ethanologen and embodies prospective potential for fermentative valorization of WMP-to-bioethanol.
Resumo Hoje, o foco global da pesquisa é explorar a solução da crise energética e da poluição ambiental. Como em outros países agrícolas, grandes quantidades de cascas de melancia (WMP) são descartadas como resíduos no meio ambiente no Paquistão, mas a gestão adequada desses resíduos é a mais recente solução para salvar o meio ambiente da poluição. O trabalho enfatiza o papel das leveduras etanologênicas para utilizar açúcares significativos presentes no WMP para fermentação de bioetanol de baixo custo. A hidrólise de ácido clorídrico diluído de WMP foi realizada em condições otimizadas empregando RSM (metodologia de superfície de resposta) e seguindo o projeto de composto central (CCD). Este projeto experimental é baseado na otimização da etanologenesis envolvendo alguns parâmetros independentes importantes, como hidrolisado de WMP e razão de meio sintético (X1), temperatura de incubação (X2) e temperatura de incubação (X3) para rendimento máximo de etanol explorando o padrão (Saccharomyces cerevisiae K7) também como leveduras experimentais (Metchnikowia cibodasensis Y34). Os resultados revelaram que os rendimentos máximos de etanol obtidos a partir de S. cerevisiae K7 foi de 0,36 ± 0,02 g / g de açúcares redutores, enquanto M. cibodasensis Y34 rendeu 0,40 ± 0,01 g de etanol / g de açúcares redutores. O isolado de levedura M. cibodasensis Y34 apareceu como um etanologeno promissor e incorpora um potencial prospectivo para a valorização fermentativa de WMP em bioetanol.
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Objective@#Polycystic ovary syndrome is a diverse endocrine disorder characterized by hyperandrogenism and ovulatory dysfunction. Hyperandrogenism affects body morphology, resulting in excess weight (overweight or obesity). This study aimed to evaluate the efficacy of high-intensity interval training on serum testosterone levels, body fat percentage, and level of physical activity among women with polycystic ovary syndrome. @*Methods@#Fifty participants were enrolled in the study and randomly allocated into two groups. Group A performed highintensity interval training on alternate days per week (total of 12 weeks) and group B performed strength training on alternate days per week (total of 12 weeks). Baseline and 12th-week assessments included serum testosterone levels, body fat percentage using the skinfold method, and level of physical activity assessed using the International Physical Activity Questionnaire. @*Results@#After 12 weeks of intervention, both groups showed significant improvements in all the outcomes. However, group A (high intensity interval training) showed statistically significant results compared to group B (strength training) in lowering serum testosterone levels (P=0.049) and body fat percentage (P=0.001) and increasing physical activity levels (P=0.006). @*Conclusion@#After 12 weeks of exercise, both exercises benefited the participants; however, high-intensity interval training specifically was found to be a more effective exercise regimen than strength training in reducing serum testosterone levels and body fat percentage and enhancing levels of physical activity in women with polycystic ovary syndrome.
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Objective: To assessthe fracture union in patients of subtrochanteric femoral fractures managed with dynamic condylar screw system and its association with type of fracture. Material and methods: This was case series study and was conducted at Department of Orthpaedic Surgery DHQ Hospital Vehari. Total 80 patients with closed subtrochanteric fractures (within the 1 week of fracture) either male or female having age from 20 years to 70 years were recruited. Patients were managed with dynamic condylar screw system. Union of fracture was assessed after 8 weeks of surgery. Results: Mean age of the patients with subtrochanteric femoral fractures was 38.75±14.33 years and mean duration of fracture was 4.33±1.42 days. Total 80 patients were managed with dynamic condylar screw system and after 8 weeks, all the patients were assessed for union of fracture and union was found in 55 (69%) patients. Union of fracture was noted in 4 (26.27%) patients, 33 (89.19%) patients and 18 (64.29%) patients respectively in type A, B and C fracture. Highly significant association between union and type of fracture was noted with p value 0.000. Conclusion: Findings of present study showed high rate of union in patients of subtrochanteric femoral fractures treated by fixation with dynamic condylar screw system. Union of fracture is significantly associated with type of fracture and duration of fracture.
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Objective: Comparison between Methyldopa and combination of Methyldopa and Nifedipine in terms of mean change in blood pressure in pregnancy induced hypertension. Material and methods: This randomized controlled was conducted at Depart Obstetrics and Gynecology DHQ Okara. Total 80 women with pregnancy induced hypertension having age range from 20-40 years and with gestational age 20-40 weeks were selected. Results: Mean age of the patients was 30.81 ± 5.670 years, mean age of patients of group A was 31.50 ± 5.809 years and mean age of group B was 30.13 ± 5.515 years. Mean gestational age was 30.17 ± 5.981 weeks, mean gestational age of patients of group A was 29.70 ± 6.329 weeks and mean gestational age of patients of group B was 6.329 ± 5.650 weeks. In group A, mean diastolic blood pressure was decrease from 101.2250 ± 4.97938 to 84.5000 ± 3.26599 and in group B from 107.7750 ± 7.18434 to 82.5000 ± 2.25320. Comparison of mean decrease in diastolic blood pressure between group A (High dose Methyldopa) and group B (Low dose Low dose Methyldopa with Nifedipine) was done. Mean decrease in diastolic blood pressure in group A was 16.72 ± 3.935 and in group B was 25.28 ± 6.876. Statistically significant difference of mean decrease in diastolic blood pressure between the both groups was noted with p value 0.000. Conclusion: Results of this study showed that Low dose Methyldopa with Nifedipine combination is more effective as compared to High dose Methyldopa to reduce diastolic blood pressure in pregnant women suffering from pregnancy induced hypertension.
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Purpose: To assess the Correlation of obesity and other factors with presence of extrahepatic disease among the patients presenting with fatty liver at CMH Rawalakot, Azad Kashmir. Study design: Correlational Study. Setting: Gastroenterology department CMH//Sheikh Khalifa Bin Zayad Al Nahyan Hospital Rawalakot. Duration of study: Six months, from 01-09-2018 to 01-03-2019. Patients and methods: A prospective study was conducted on 51 patients of fatty liver diagnosed on ultrasound by consultant radiologist of own hospital. The demographic profile included age, gender, presence of obesity, triglyceride levels and total cholesterol levels. Common extra-hepatic conditions which were looked for in this study included Diabetes mellitus (DM), Hypertension (HTN), Ischemic heart disease (IHD) and Osteoarthritis (OA) which were diagnosed with the help of detailed history taking, relevant physical examination and laboratory investigations. Results: Out of 51 patients included in the final analysis 31 were male and 20 were female. Twenty-seven participants had one or more co-morbid illnesses while 24 had no such diseases at the time of study. DM was the commonest comorbid illness while OA was least reported. Twenty four patients were obese while 27 had BMI less than 30. The presence of obesity and raised total cholesterol levels had a significant relationship with presence of extra-hepatic illness among the patients presenting with fatty liver. Conclusion: Patients presenting with fatty liver have high prevalence of extrahepatic diseases. Routine screening of common illnesses should be done on all the patients who have been diagnosed as having a fatty liver. Special attention should be given to the patients who had BMI more than 30 or raised total cholesterol levels.
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Objective: To evaluate key corneal tomography parameters for screening refractive surgery patients in Pakistani population
Study Design: Cross-sectional, observation study
Place and Duration of Study: Armed Forces Institute of Ophthalmology AFIO, National University of Medical Sciences, Rawalpindi, Pakistan, from August 2013 to December 2016
Methodology: Myopic patients were evaluated by two separate observers on Allegro OculyzerII [Wavelight] for normal ocular examination. A total of 20 tomographic parameters, used for pre-refractive surgical evaluation, were included. Normality of data was evaluated using Kolmogorov-Smirnov test. Results for outliers were displayed as 2.5%, 5%, 95% and 97.5% percentiles
Results: The sample of 451 patients [895 eyes], comprised of 61% [n=277] females and 39% [n=174] males [39%]. The mean age was 26 +6.4 years [range of 18-62 years, M=F]. Normal mean anterior segment values included; flat simulated keratometry [K1] 42.9 +/-1.44 diopters [D], steep K2 43.9 +/-1.52 D, K mean 43.4 +/-1.43 D, K maximum 44.6 +/-1.56 D, astigmatism -0.96 +/-0.97 D, anterior chamber depth [ACD] 3.19 +/-0.28 mm, front elevation at the thinnest point 4.11 +/-2.44 um, and that at the back was 7.56 +/-4.52 um progression index [PI] maximum 1.14 +/-0.17, Ambrosio relational thickness maximum [ART max] 487.5 +/-89.0 and pachymetry at thinnest point 542.2 +/- 31.1 um
Conclusion: The study demonstrates key corneal tomography parameters, which can be useful for screening refractive surgery patients in Pakistani population
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Objective: To determine median values of biochemical maternal serum markers during second trimester maternal screening to rule out chromosomal anomaly, Down syndrome. Study Design: Cross sectional study. Place and Duration of Study: Department of Chemical Pathology and Endocrinology, Armed Forces Institute of Pathology [AFIP], from Nov 2016 to May 2017
Patients and Methods: Non-probability consecutive sampling technique was used. All healthy pregnant women with single pregnancy were included. As non-parametric statistics was used, the sample size was collected to be 155. Blood sample for serum human chorionic gonadotropin [HCG] was analyzed on random access immulite 2000, alpha-fetoprotein [AFP] was analyzed on ADVIA Centaur, unconjugated estriol [uE3] and Inhibin A measured by Enzyme-Linked Immunosorbent Assay [ELISA] method by PR 4100 Micro plate Reader
Results: Total 155 women were enrolled in this study. Mean maternal age was 33.46 +/- 2.35 years and mean maternal body weight was 54.98 +/- 2.88 kg. Median value of quadruple markers, calculated from 15-18[th] week of gestation, was used for calculation of multiple of median [MoM] for screening of trisomy 21 in this gestational age. Median values at 15 week of gestation: hCG 36650 mIU/ml, AFP 23.3 IU/ml, uE3 3.5 nmol/l, Inh A 198 ng/l, at 16 week of gestation: hCG 29050 mIU/ml, AFP 35.4 IU/ml, uE3 4.1 nmol/l, Inhibin-A 179 ng/l; at 17 week of gestation: hCG 28450 mIU/ml, AFP 36.0 IU/ml, uE3 6.7 nmol/l, Inhibin-A 175 ng/l and at 18 week of gestation: HCG 25200 mIU/ml, AFP 38.2 IU/ml, uE3 8.2 nmol/l, Inhibin-A 190 ng/l
Conclusion: In this study we were able to get median values of quadruple markers for regional population, which will be used in future to calculate MoM for the screening purpose of Down syndrome. It will help to rule out Down syndrome by non-invasive test and at early stage of pregnancy
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The objective of the study was to determine level of dental anxiety related to dental procedures in dental students and comparing the dental anxiety between male and female undergraduate dental students of Rawal Dental College. This cross-sectional study was conducted at Rawal Dental College, Islamabad, Pakistan during October 2016. A validated Corah Dental Anxiety Scale [DAS] questionnaire were distributed among dental students in first, second, third and fourth year students present at the day of study. There were four questions with five options in this scale that assess level of anxiety. Total score ranged from 4-20. This was total of all points of scale items. The score 8 or below 8 showed no anxiety, 9-12 showed moderate level of anxiety, 13-14 showed high level of anxiety and 15-20 showed severe level of anxiety. Chi-Square Test used to determine level of anxiety and Mean Anxiety Score between male and female students. Mean and Standard Deviation of gender was calculated by independent T test and that of Academic classes of dental students were calculated by one-way ANOVA. Results showed female students presented with higher mean anxiety score as compared to male students. The difference was statistically insignificant [P-value = 0.10]. Dental anxiety reduced from first year to final year. Female students had more high to severe level of anxiety as compared to male students. Mean and standard deviation of Mean anxiety score was calculated i.e. 9.11 +/-3.15
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The objective of this study was to determine the confidence level of house officers in performing root canal treatment. This cross-sectional study was conducted at Rawal Institute of Health Sciences and Islamic International Dental Hospital from june 2017 to January 2018. An anonymous questionnaire was distributed among house officers of both hospitals. The questionnaire utilized scaled response to determine the level of confidence while performing various steps of root canal treatment. The level of confidence was categorized using 5-point Likert's scale as 1=not at all confident, 2=not very confident, 3=neutral, 4=confident and 5=very confident. Data were entered and analyzed in SPSS version 17.0. Counts and percentages were measured for various parameters of respondent's confidence level. Chi- square test was used to compare confidence level between the two genders and also between the two institutes. Majority of house officers were not confident in placement of rubber dam [44%], working length determination using apex locator [36%] and management of flare-ups [40%]. Male gender was found more confident than female regarding various steps of root canal procedure. House officers of Rawal institute of health sciences were more confident in some steps of root canal than house officers of Islamic international dental hospital. Overall it was concluded that though house officers were confident in performing root canal, however, they were found to have low confidence in performing difficult steps like rubber dam application, use of electronic apex locator and management of flare-ups
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Objective: is an endemic disease. This study was done to compare the efficacy of intralesional meglumine antimoniate [MA] with combination of 50% trichloroacetic acid [TCA] and intralesional meglumine antimoniate in patients of cutaneous leishmaniasis [CL]
Methods: it was a randomized controlled trial conducted in department of dermatology, Military Hospital, Rawalpindi over six months i.e. 02-08-2016 to 01-02-2017. A total of 210 patients [105 in each group] were taken in this study. Group A received 50% TCA fortnightly with intralesional meglumine antimoniate and group B was treated with intralesional meglumine antimoniate alone
Results: efficacy was observed in 91 [86.7%] patients of group A and in 78 [74.3%] patients of group B [p=0.024]
Conclusion: combination therapy with TCA 50% and intralesional MA accelerated the resolution of CL lesions with significant difference in complete resolution rate in comparison to the patients treated with intralesional MA alone
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Abstract In the study presented here, a new series of 2-furyl(4-{4-[(substituted)sulfonyl]benzyl}-1-piperazinyl)methanone derivatives was targeted. The synthesis was initiated by the treatment of different secondary amines (1a-h) with 4-bromomethylbenzenesulfonyl chloride (2) to obtain various 1-{[4-(bromomethyl)phenyl]sulfonyl}amines (3a-h). 2-Furyl(1-piperazinyl)methanone (2-furoyl-1-piperazine; 4) was then dissolved in acetonitrile, with the addition of K2CO3, and the mixture was refluxed for activation. This activated molecule was further treated with equi-molar amounts of 3a-h to form targeted 2-furyl(4-{4-[(substituted)sulfonyl]benzyl}-1-piperazinyl)methanone derivatives (5a-h) in the same reaction set up. The structure confirmation of all the synthesized compounds was carried out by EI-MS, IR and 1H-NMR spectral analysis. The compounds showed good enzyme inhibitory activity. Compound 5h showed excellent inhibitory effect against acetyl- and butyrylcholinesterase with respective IC50 values of 2.91±0.001 and 4.35±0.004 µM, compared to eserine, a reference standard with IC50 values of 0.04±0.0001 and 0.85±0.001 µM, respectively, against these enzymes. All synthesized molecules were active against almost all Gram-positive and Gram-negative bacterial strains tested. The cytotoxicity of the molecules was also checked to determine their utility as possible therapeutic agents.
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Simulação por Computador/estatística & dados numéricos , Anti-Infecciosos/análise , Piperazinas/análise , Ensaio de Atividade Hemolítica de Complemento , Colinesterases/farmacologiaRESUMO
The aim of this study was to assess the frequency of VAP [ventilator associated pneumonia] after strict implementation of ventilator bundle in PICU. Medical records of all children [age 1 month - 16 years] were retrospectively reviewed, who were on mechanical ventilation [MV] for more than 48 hours and received all key components of "ventilator bundle" from January 2012 to December 2014. Out of 1050, 565 [54%] patients were enrolled. The mean age was 4.02 SD 4.29 years and 62 [69%] were male. The indications of MV were respiratory illness [54%], neurological illness [31%], shock [9%], and postoperative care [6%]. The mean duration of MV was 7.05 SD 5.4 days. Only 4 patients [0.7%] developed VAP. The incidence-density of VAP was 1.6 per 1000 ventilator days. The strict implementation of simple, inexpensive interventions [ventilator bundle] in care of mechanically ventilated children can decrease significantly VAP even in resource-limited country
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Objective: To compare the effectiveness of functional electrical stimulation [FES] versus conventional electrical stimulation in gait rehabilitation of patients with stroke for finding the most appropriate problem-oriented treatment for foot drop patients in a shorter time period. Study Design: Randomized controlled trial. Place and Duration of Study: Armed Forces Institute of Rehabilitation Medicine, Rawalpindi, from July to December 2016
Methodology: Subjects with foot drop due to stroke were allotted randomly into 1 of 2 groups receiving standard rehabilitation with Functional Electrical Stimulation [FES] or Electrical Muscle Stimulation [EMS]. FES was applied on tibialis anterior 30 minutes/day, five days/week for six weeks. EMS was also applied on the tibialis anterior five days/week for six weeks. Outcome measures included Fugl-Meyer Assessment Scale, Modified Ashworth Scale, Berg Balance Scale [BBS], Time Up and Go Test [TUG] and Gait Dynamic Index [GDI]. They were recorded at baseline, after 3 and 6 weeks. Pre- and post-treatment scores were analyzed between two groups on SPSS-20
Results: After six weeks of intervention, significant improvement was recorded in Fugl-Meyer Assessment score [p<0.001], modified Ashworth Scale score [p=0.027], Berg Balance Scale score [p<0.001], Time Up and Go Test [p<0.001] and Gait Dynamic Index [p=0.012] of the group subjected to FES
Conclusion: Gait training with FES is more effective than EMS in improving mobility, balance, gait performance and reducing spasticity in stroke patients. The research will help clinicians to select appropriate treatment of foot drop in stroke patients
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Objective: To determine the frequency of different levels of amputations in type-2 diabetics. Study Design: Cross sectional study. Place and Duration of study: Department of Surgery Combined Military Hospital, Peshawar, from 27 Aug 2012 to 27 Feb 2013
Material and Methods: Non probability consecutive sampling technique was used to enroll 158 type-2 diabetics undergoing amputations satisfying inclusion/exclusion criteria. Data regarding level of amputation, glycosylated Hb% and duration of diabetes mellitus [DM] was recorded followed by analysis using SPSS version 17
Results: Total 158 patients were enrolled, 102 [64.5%] male and 56 [35.44%] female, with male female ratio of 1.8:1. Mean age of presentation was 54.99 +/- 7.84 years in males and 55.14 +/- 8.99 years in females respectively, the difference being statistically insignificant [p=0.912]. Mean duration of DM was found 10.88 +/- 3.16 years in males and 10.03 +/- 2.50 years in females while mean level of glycosylated hemoglobin was 7.54 +/- 0.68 and 7.35 +/- 0.63 in males and females respectively, both values statistically insignificant. Below knee amputation [BKA] was done in 55 [34.8%] patients, above knee amputation [AKA] 34 [21.5%], Toe amputation [TA] 42 [26.6%] and foot amputation [FA] in 27[17.1%]
Conclusion: Majority of the patients underwent major amputations and most frequent level of amputation was below knee amputation
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Dengue infection is prevailing among the people not only from the developing countries but also from the developed countries due to its high morbidity rate around the globe. Hence, due to the unavailability of any suitable vaccine for rigorous dengue virus [DENY], the only mode of its treatment is prevention. The circumstances require an urgent development of efficient and practical treatment to deal with these serotypes. The severe effects and cost of synthetic vaccines simulated researchers to find anti-viral agents from medicinal plants. Flavonoids present in medicinal plants, holds anti-viral activity and can be used as vaccine against viruses. Therefore, present study was planned to find anti-viral potential of 2500 flavonoids inhibitors against the DENVNS2B/NS3 protease through computational screening which can hinder the viral replication within the host cell. By using molecular docking, it was revealed that flavonoids showed strong and stable bonding in the binding pocket of DENY NS2B/NS3 protease and had strong interactions with catalytic triad. Drug capability and anti-dengue potential of the flavonoids was also evaluated by using different bioinformatics tools. Some flavonoids effectively blocked the catalytic triad of DENY NS2B/NS3 protease and also passed through drug ability evaluation. It can be concluded from this study that these flavonoids could act as potential inhibitors to stop the replication of DENY and there is a need to study the action of these molecules in-vitro to confirm their action and other properties
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Dengue , Doenças Negligenciadas , Inibidores de Proteases , Simulação de Acoplamento Molecular , Plantas Medicinais , Extratos Vegetais , Fitoterapia , Vacinas , Vírus da DengueRESUMO
Background: Acute Kidney Injury is not a single disease but rather a syndrome comprising of multiple clinical conditions. The high rate of morbidity associated with AKI poses a burden on both the public as well as private sector. Small changes in serum creatinine concentrations associated with a substantial increase in the risk of morbidity. Therefore, detection of even small changes in kidney injury has an important prognostic value to avoid chances of hemo-dialysis and the associated risks which can result in both better outcomes as well as lowering financial burden on the patient as well as the state
Methods: A sample size of 100 patients was included as calculated by taking reported incidence of 36%. Patient's baseline and maximum creatinine was taken during ICU stay together with urine output monitoring during first 48 hours. Staging of acute kidney injury [AKI] was done by Acute Kidney Injury Network [AKIN] criteria. Outcome of renal failure was assessed on the basis of full, partial and no recovery
Results: Out of 100 patients, 52% were in stage 1, 32% were in stage 2 and 16% were in stage 3. AKI was common in females; present in 37 males and 63 females; [p value <0.05]. Full renal recovery was achieved in 62 patients [62%] of AKI; 25 patients [25%] were partial recovered, and in 13 patients [13%] recovery could not be achieved. Recovery was significantly lower [25%] and potentially greater in stage1 [79%].The chi square between outcome and acute kidney injury revealed statistical significant value [p value <0.001]. Hemodialysis requirement was significantly higher in AKI stage3 [62%] than AKI stage1 [4%]; [P < 0.001]. There were no significant differences in duration of ICU stay, age and mortality
Conclusion: Our study showed the morbidity and mortality associated with rising creatinine with increasing stages of acute kidney injury. Recovery in stage 1 was significantly higher and lower in stage 3 and therefore emphasis is required on early diagnosis and timely management of AKI that can prevent patients from distressing and life threatening problems
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Objective: To explore the mentoring program on a subset of Pakistani medical students in a private medical college
Method: Total students targeted were 300 MBBS students of 1[st] Year [group B], 2[nd] Year [group C] and 3[rd] Year [group D], of these 256 students filled the self-reported questionnaire. The questionnaire was based on Likert Scale. The statements in the questionnaire are designed in a positive manner so that if the students agree to them the level of satisfaction with the mentoring program was considered significantly good. Open-ended questionnaires were also given so as to have a clearer concept of the students' perception. This study is a mixed method study catering to both quantitative and qualitative domains
Results: The overall results reported that the junior students of group B and group C showed higher satisfaction in being mentored as compared group D [p-value=0.001]. All three groups were compared with each other to check the response of every statement by applying Tukey's test. Analysis of the result showed that majority of the students considered mentoring program a beneficial tool for their academic and non-academic lives. The students of all three years have reported that the mentor is mostly available and helps to reconcile internal conflicts. They also confirmed that their mentor keeps records but most of the students have reported that communication via email is limited
Conclusion: Majority of students of Bahria University Medical and Dental College are able to carry on with their academic and non-academic routine due to the presence of mentoring. The medical students appreciated the presence of a mentor during thick and thin; they have also accepted that it is due to the presence of this guide that they are able to continue with their difficult studies in these difficult times
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Object: to determine the frequency of symptomatic osteoarthritis in general population of Karachi presenting with joint pain
Introduction: people easily get tired due to heavy duty occupations to keep pace with the society. Arthralgia commonly called as "Joint pain" is one of the most frequently observed complain, especially in individuals aged 50 above
Methods: a cross-sectional study was conducted at Jinnah Postgraduate Medical Centre [JPMC] from 1[st] November 2013 to 25[th]November 2013. The data was collected from 316 patients presenting to the department of rheumatology and orthopedics with joint pain. A structured questionnaire was designed based on the clinical symptomatology of osteoarthritis. It was administered to the participants aged above 18 yrs. old. 17.7% of males and 82.3% of females participated in the study
Result: out of 316 patients with joint pain, 71.2% [n=225] was diagnosed osteoarthritis on the basis of symptoms present with a high prevalence in females than males. The most common joints to be involved in osteoarthritis were found to be knee joint [90.2%] and hip joint [55.7%]. The majority of the patients [n=109] had an X-ray of their joint and n=125 was getting analgesics as an effective therapy for osteoarthritis
Conclusion: the frequency of osteoarthritis is increasing in Karachi with globalization due to high level occupational stress along with recreational activity stress and other contributive factors. Female predominance as compare to that of man is quite alarming that needs to be controlled for maintaining future quality of life and providing ease for daily activities
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A high performance liquid chromatographic method for the simultaneous determination both qualitative and quantitative of cholesterol lowering statin drugs in pharmaceutical formulations has been developed. The most important advantage of developed method is that all seven statin drugs can be determined on a single chromatographic system without modification in detection wavelength. An organic modifier addition [25% v/v methanol] in the presence of buffer [20mM ammonium acetate; pH 4.0 adjusted with dilute acetic acid] played a key role in the resolution of statin drugs in gradient elution with acetonitrile. The drugs were separated on a Purospher Star 4.6mm x 25cm, Sum, Qg column maintained at 25°C with ImLmin"1 flow rate using ultra violet detection at 240nm. Good separation [Rs > 2.5] was achieved in a short analysis allowing simultaneous determination of all seven statins. The effect of variation in flow rate, detection wavelength and column oven temperature was also studied. The proposed method was statistically validated in terms of precision, accuracy, linearity, specificity and robustness. The newly developed method proved to be specific, robust and accurate for the quantification of seven statins in commercial pharmaceutical formulations