Analysis of NT-proBNP and uric acid due to left ventricle hypertrophy in the patients of aortic valve disease

Objective: To evaluate the concentration of N terminal proBNP [NT-proBNP] and partially the serum uric acid in the severe condition of aortic valve dysfunction for assessment of left ventricle hypertrophy

Methods: The study was conducted in the signal transduction lab department of biochemistry Quaid-I-Azam University, Islamabad from September 2013 to February 2017. NT-proBNP and serum uric acid were measured in one hundred patients of aortic valve dysfunction. The patients were divided into three main groups: 1] Aortic stenosis, 2] Aortic regurgitation, and 3] Aortic stenosis with Aortic regurgitation. The results were compared between disease and controls groups

Results: High level of plasma NT-proBNP was detected in all the three disease groups of aortic valve [stenosis, p<0.001], [regurgitation, p<0.001] and [stenosis with regurgitation, p<0.001]. In addition, non-significantly increased level of serum uric acid was also observed in left ventricle hypertrophy in all the three respective disease groups of aortic valve

Conclusion: Increased secretion of NT-proBNP during cardiac remodeling can be related to the severity of left ventricle hypertrophy due to aortic valve abnormality in all the disease groups of severe stenosis, severe regurgitation, and combine disease condition of severe stenosis and severe regurgitation. However, non-significant increase in uric acid concentration is also identified which may be due to one of the factors involved in left ventricle hypertrophy in all the three disease groups of aortic valve. The interaction of uric acid with NT-proBNP during cardiac remolding due to aortic valve dysfunction is still not clear

Seroprevalence and Spatial Distribution of Toxoplasmosis in Sheep and Goats in North-Eastern Region of Pakistan

Toxoplasmosis is a protozoan disease that is caused by Toxoplasma gondii in livestock and humans. Due to its medical and veterinary importance, it is essential to study the seroprevalence of T. gondii infection among humans and animals in various parts of the world. The major objective of this study was to determine the seroprevalence and spatial distribution of toxoplasmosis in small ruminants (sheep and goats) of north-eastern region, Pakistan. A total of 1,000 animals comprising of sheep (n=470) and goats (n=530) were examined for T. gondii infection by using ELISA. An epidemiological data was collected in the form of questionnaire. A surface has been generated by using method of interpolation in Arc GIS with the help of IDW (inverse distance weight). The results showed higher seroprevalence of T. gondii in goats (42.8%) as compared to sheep (26.2%). The seroprevalence was higher in females as compared to males in all examined ruminants. Similarly, there is a wide variation in the seroprevalence of T. gondii in different breeds of sheep and goats showing higher seroprevalence in Teddy (52.8%) and Damani breed (34.5%) of goat and sheep's, respectively. The geographical and spatial distribution of T. gondii shows that it is widely distributed in different parts of the north-eastern region of Pakistan. Our results suggest widespread environmental contamination with T. gondii oocysts. It suggests us that small ruminants could be a potentially important source of T. gondii infection if their infected meat is consumed undercooked.

Efficacy of cervical spine mobilization versus peripheral nerve slider techniques [neurodynamics] in cervicobrachial pain syndrome

The objective of this study was to compare the efficacy of cervical spine mobilization versus peripheral nerve slidertechniques [neurodynamics] incervicobrachial pain syndrome. The study design was arandomized interventional study. This study was conducted at the Armed Forces Institute of Rehabilitation Sciences [AFIRM], Rawalpindi from August 2014 to January 2015. Forty patients [n=40] were included by using purposive sampling technique. Patients of Age 30 to 60 years with Radiating neck pain, Limited ROM of neck and Pain persisting for more than 2 months, were included in study. Then randomly divided into two groups, each group contains 20 participants. One group was treated with neck mobilization and other was treated with neurodynamic treatment protocol. Pain and Active Range of Motion [AROM] was measured by Visual analog scale [VAS] and Inclinometer respectively. Neck Disability Index was also used. Patients were assessed before and after six week intervention. Data was analyzed on SPSS 20 and Independent t Test was used to compare the results of two groups. Pain was measured on VAS, the mean of Mobilization and Neurodynamics were [2.0+1.892 vs.4.8+2.397] respectively. There is significant [p<0.05] difference between two groups. There is also significant [p<0.05] difference for Range of Motion between two groups. The mean value for NDI of both groups were [14.5+7.564 vs 26.80+11.484]. It also shows better treatment is mobilization. The results of this comparison between two single interventions indicate that cervical mobilization treatment in neck pain is more useful than anneurodynamic treatment. For daily practice, we can recommend treatment according to the expert guidelines investigated

Salivary gland tumours: a tertiary care hospital experience

To study demographic, clinical and histopathological features of salivary gland tumours in a tertiary care hospital. Prospective cross sectional study. This study was carried out in the Department of ENT, Head and Neck surgery, Postgraduate Medical Institute, Lady Reading Hospital Peshawar from June 2010 to May 2014. This prospective cross sectional study of 4 years was carried out in the Department of ENT, Head and Neck surgery, Postgraduate Medical Institute, Lady Reading Hospital Peshawar. All the patients qualifying inclusion criteria were evaluated in terms of detailed history, thorough examination and relevant investigation. After performing required surgery specimen was examined for histopathology. In this study 123 patients were included with mean +/- SD age of 40 +/- 5.1 years [age range 7–76 years]. Males were 81 and females were 42 with male: female ratio of 1.9:1. Most of the patients presented in 4th decade [28.45%, 35]. Lump was the commonest clinical feature lasting for 1-5 years [66.66%, 82]. Among the tumours 77.23% were benign while 22.76% were malignant. Benign tumours were commonly noticed in parotid gland [53.65%]. Pleomorphic adenoma was the commonest benign tumour [65.04%, n-80], affecting parotid gland in 52.03%. Mucoepidermoid carcinoma is the commonest malignant tumour [12.19%] predominantly found in minor salivary gland of palate [6.50%]. Salivary gland tumours predominantly affecting middle aged male population. Benign tumours are the commonly occurring salivary gland tumours. Pleomorphic adenoma is commonly occurring benign tumour affecting predominantly parotid gland while mucoepidermoid carcinoma is the commonest malignant tumour of salivary glands

Efficacy of topical clotrimazole in treatment of otomycosis

Otomycosis is a common condition affecting external ear and ears with chronic suppurative otitis media, and has a tendency for recurrence. Objective of this study was to determine the efficacy of topical clotrimazole in the treatment of otomycosis. This descriptive study was conducted at the outpatient department of ENT, Ayub Teaching Hospital Abbottabad, from Jul 2012 to Dec 2012. A total of 101 patients were included in this study. The results were compared and analysed regarding age, gender, presenting complaints and efficacy of clotrimazole. A total of 101 patients of otomycosis were included in the study. Male to female ratio was 0.71:1. Patients of 15 years and above were included in the study. Adults were more affected by otomycosis than the younger age group. The efficacy of clotrimazole in treatment of otomycosis was observed in 89 [94.12%] while in 12 [5.88%] patients no efficacy was seen. Age and gender have no role in efficacy of Clotrimazole in treatment of Otomycosis. Topical clotrimazole is effective in the treatment of Otomycosis

Polycythemia vera: Essential management protocols

Primary polycythemia [polycythemia vera] is a hematopoeitic stem cell disorder giving rise to proliferation of a clone of hematopoietic precursors leading to an excess production of erythrocytes with thrombocytosis and leukocytosis

The optimum management of polycythemia vera remains elusive. Patients requiring surgery are at increased risk of both perioperative thrombosis and hemorrhage

On one hand, thrombosis can lead to multi organ ischemia and infarction while on the other, bleeding diathesis can lead to profuse perioperative hemorrhage; both posing considerable risk to the patient's health and stress to the anesthesiologist concerned directly with perioperative management of the patient

Hence, management guidelines for polycythemia vera needs to be clearly understood and tailored to each patient individually and appropriate management protocols need to be de Ned accordingly

Role of clean intermittent self catheterisation [CISC] in the prevention of recurrent urethral strictures after internal optical urethrotomy

Background: Urethral stricture is one of the oldest diseases Urethral dilatation Internal optical urethrotomy, were the only treatment. Clean Intermittent Self Catheterisation was introduced by Lapides has greatly decreased the recurrence of stricture. Objectives were to determine the role of Clean Intermittent Self Catheterisation [CISC] in the prevention of recurrence of urethral strictures after Internal Optical Urethrotomy and to study the frequency of any postoperative complications and tolerability for the patients associated with this procedure. Methods: A randomised controlled study conducted in the department of urology and renal transplantation, Institute of Kidney Diseases Hayatabad Medical Complex, Peshawar from June 2007 to June 2010. Total of 60 patients with mean age 48 years [range 20–73] were selected and randomly divided into Treatment Group [30 patients] and Control Group [30 Patients]. Eight "drop out" occurred in the treatment group and four "drop out" occurred in the controlled group. All the patients were treated with Internal Optical Urethrotomy using Sachse method followed by indwelling catheter for 5 days. The treatment group was then taught to perform Clean Intermittent Self Catheterisation by inserting a Classic Neleton Catheter [No. 16 or 18] twice a day for 1 week, then once a day for another 4 weeks and then once weekly continued for one year. All the patients were followed up regularly at 1 month intervals during the first 6 months and then every 2 months for the next 6 months. Results: Total of 48 patients completed the study, 22 in the treatment group and 26 in the control group. Within the first year, 4 patients [22%] in the treatment group developed urethral stricture. In the control group, 12 patients [46%] developed urethral stricture within the first year, showing a significant difference [p<0.01]. In the treatment group four patients developed simple UTIs while in the control group three patients developed UTIs, one with concomitant epididymitis. No other complications were noted up to one year follow up. Conclusion: Clean Intermittent Self Catheterisation is a simple and effective way of reducing stricture recurrence after Internal Optical Urethrotomy and is associated with less morbidity and is cost effective. CISC is an important modality for maintaining the normal urethral calibre. Keywords: Urethral Strictures, Optical Urethrotomy, Clean Intermittent Self Catheterisation, Recurrence, Complications

Effect of variable degrees of jejunal resection upon different clinico-biochemical parameters in dogs / 대한수의학회지

Dogs are considered to be the best companions of human beings due to their loyalty, obedience and pleasant disposition. Jejunum is the largest part of small intestine mainly involved in absorption of nutrients. Jejunal resection up to 80% allows normal weight gain while resection up to 90% increased morbidity and mortality. In the present study, 20 dogs were divided into 4 groups based on the degree of jejunal resection i.e. A (70% resection), B (80% resection) and C (100% resection) while group D served as control. Dogs in the 70% and 80% jejunal resection group showed normal growth and function while 100% jejunal resection resulted in weight loss and alteration of hematological and biochemical parameters.

Spectrum of common childhood skin disease: a single centre experience

To assess the pattern of childhood skin diseases and to analyze the attitude towards consultation and self-treatment. Children with complaints of skin diseases visiting outpatient department of Jinnah Postgraduate Medical Centre and National Institute of Child Health were enrolled in this study during the period of May 2002 to July 2003. A detail performa was filled in, for all the patients. 250 cases were finally analyzed in 15 months duration. The diseases were sub-classified on etiological basis e.g. infectious [bacterial, fungal, viral, parasitic] immune mediated, congenital, allergic and miscellaneous. The children's sex, race, age, duration, history of previous treatment and family and past history for skin or systemic diseases were noted. Of all the patients visiting the outpatient department [OPD], 31% were children with skin diseases. Infectious skin diseases were the commonest [60%]. Among the infections, fungal were maximum [20.6%], followed by bacterial diseases [12%]. Eczemas constituted 21% of skin diseases and 6.4% children had congenital skin conditions. Previous treatment history was present in 43.6% patients. Antibiotics [topical and/or systemic] were taken by 28.4% of patients; whereas history of steroids [topical and/or systemic] was present in 15.2% of patients. Most children [550] had a normal weight and 13.6% were severely malnourished. Skin diseases are fairly common in children especially infectious skin diseases. Eczematous and allergic skin diseases are also frequently encountered in children. Self medication is a common practice. Topical steroids were the most commonly used medications