Reduction of testicular volume of albino rats in lead induced toxicity and reversal of IT with high dosages of vitamin C

Lead toxicity is a common industrial hazard. It affects all systems of the body. The study was conducted to see reduction in volume of the testes of albino rats and reversal of it with high dosages of vitamin C. Experimental study. The study was conducted in the Department of Anatomy, Post Graduate Medical Institute [PGMI], Lahore from May 2007 to April 2009. 90 albino rats were divided into five groups A, B, C, D and E. Each group was comprised of 18 animals and divided into 3 subgroups 1, 2 and 3 sacrificed after 5[th], 6[th] and 7[th] weeks. Groups A was given normal saline, group B was given lead acetate 10 mg/kg body weight, group C was given lead acetate with 250 mg/kg body weight of vitamin C, group D was given lead acetate with vitamin C 500 mg/kg body weight and group E was given vitamin C 1000 mg/kg body weight with lead acetate intraperitoneally. The animals sacrificed after the 5[th] week in subgroups A1, B1, C1, D1 and E1 showed insignificant changes while in subgroup A2, B2, C2, D2 and E2 sacrificed after 6[th] week, P value was 0.015 which was significant. The P value of subgroup 3 sacrificed after 7[th] week was 0.002 which was significant. This study showed that lead toxicity brought caused a significant reduction in the volume of the testes. The testes regained their normal size after heavy dosage of vitamin C

Asthmatic children; knowledge, attitude and practices among caregivers

To assess the knowledge, attitude and practices among caregivers of asthmatic children and to describe their clinical and biographic features. A descriptive cross-sectional study was conducted in asthma clinic and medical wards of children hospital P.I.M.S.100 diagnosed asthmatic children and their caregivers were enrolled. Two questionnaire one comprising clinical aspects and other regarding knowledge attitude and practices among caregivers were administered. 100 asthmatic children and their caregivers participated. Among children, 77% were breastfed, 95% were immunized, only 13% were receiving controller medications and 62% were having >5 acute exacerbations per year. Diagnosis of asthma was accepted by 76% of caregivers, of which 67% recognized correct etiology. Multiple food items were blamed for acute exacerbations, while respiratory infections were most commonly recognized triggering factor. 50% of study population was ignorant of aerosol therapy and only 26% prefer it. Cough suppressants are most popular home medications. Asthma awareness is inadequate. Controller medications and aerosol therapy is underused and unnecessarily blamed. Asthmatic children are deprived of nutritious food considering them as triggering factors. Awareness raising strategies are needed in community

Prevention of post spinal hypotension; comparison between preloading with and without intramuscular ephedrine in elderly patients undergoing inguinal hernia surgery

Objective of the study is to evaluate the efficacy of intramuscular ephedrine along with preloading in prevention of post spinal hypotension in elderly patients undergoing inguinal hernia surgery. This is a quasi experimental study. The study was conducted at the department of Anaesthesia and Intensive Care Combined Military Hospital, Peshawar over a period of one year. In a double-blind, randomized study, 80 elderly patients undergoing inguinal hernia surgery under spinal anaesthesia divided into two equal groups of A and B. Forty patients received i/m inj of ephedrine 45mg deep in the paravertebral muscles immediately after injection of bupivacaine, and 40 received an equal volume of saline. Patients in both groups were given the same volumes of fluid before anaesthesia. The incidence of hypotension [Systolic arterial pressure <90mmHg or <80% of baseline] were recorded. and incidence of fall in the heart rate was recorded. Systolic arterial pressure during the first 60 min after anaesthesia remained significantly more stable in the ephedrine-treated group, and there was also a significantly smaller number of patients in this group who had decreases in pressure of more than 30% of pre-block levels and fewer required rescue i.v. Ephedrine. An increase in heart rate or systolic pressure of > 20% from baseline was found in two patients in the ephedrine group and in one patient in the placebo group. We conclude that ephedrine 45mg administered in the paravertebral muscles immediately after plain bupivacaine spinal anaesthesia is a simple and effective means of reducing the incidence of hypotensive episodes in the elderly patient

Spectrum of ocular injuries presenting at emergency department of pakistan institute of medical sciences

To determine the proportion, pattern and burden of eye injuries presenting at emergency department [A and E] of Pakistan Institute of Medical Sciences [PIMS], Islamabad. Study Design: Observational case series. The study was carried out of all cases of ocular trauma presenting in PIMS via emergency department during a 1 year period. After presentation in the emergency department the detailed history of the patient was taken with particular reference to age, sex, mode of injury. Initial examination was carried out by using torch, slit lamp examination. Relevant investigations including X-ray orbit, B-scan of the orbit, X-ray skull and C.T-scan were also done where needed. Patient with superficial injuries were discharged after management, while those with serious injuries were admitted. 209 cases were enrolled in the study. Most were males [83.7%] between 16 and 30 years of age. The commonest place of injury was work place [30.6%] followed by home [30.1%]. 194 patients [92.8%] presented in emergency within 24 hours and only 15 patients [7.2%] came after one day. 202 patients [96.7%] presented directly to emergency and only 7 [3.3%] were referred by other hospitals. Visual acuity was 6/6 in 31.6% of patients while five patients [2.4%] had no light perception. Most of the patients were treated without hospitalization and only 58 patients [27.8%] were admitted in the hospital. The current burden of eye injuries presented to A and E department of PIMS had been estimated. Ocular trauma remained an important cause of blindness, particularly among younger age groups

Efficacy of peribulbar [Sub-Tenon] versus retrobulbar local anesthesia in cataract surgery

To evaluate the efficacy of peribulbar [sub-Tenon] versus retro bulbar local anesthesia in cataract surgery by comparing analgesia, akinesia and effect on intraocular pressure. Comparative Consecutive Interventional Case series. One hundred patients undergoing surgery for uncomplicated cataract at Munawwar Memorial Hospital Chakwal. Patients were selected on the basis of convenience sampling. Patients were divided in two equal groups of 50 each. One group received retrobulbar block and other group received sub-Tenon's block. Before starting the surgery complete systemic and ocular examination was done. Efficacy was compared in terms of analgesia, akinesia and effect on intraocular pressure. Out of total 100 patients, 60% were male and 40% were female with a ratio of 3:2. In retrobulbar anesthesia, 30 [65.2%] patients experienced pain free surgery as compared to sub-Tenon's local anesthesia where 49 [98%] patients experienced pain free surgery. Complete akinesia was achieved in 26 [56.52%] cases of retrobulbar anaesthesia group as compared to 5 [10%] cases in sub-Tenon's anaesthesia group. There was a significant elevation of intraocular pressure immediately after administrating the local anesthesia in retrobulbar group as compared to sub-Tenon's group. Conclusion: Sub-Tenon's anaesthesia is a safe and effective technique for patients undergoing day cataract surgery as compared to retrobulbar local anesthesia. It prevents sight and life threatening complications

Role of preoperative B-scan to detect posterior segment pathologies in eyes with age related mature cataract

To determine the role of B-scan ultrasonography [USG] in pre operative assessment of eyes with age-related mature cataract by documenting the frequency and nature of posterior segment intraocular pathologies detected by it. A hospital based descriptive observational study Two hundred nine [209] eyes with age related mature cataract of the patients presenting at the outpatient department of Al-Shifa Trust Eye Hospital, Rawalpindi from May to August 2003 A detailed ocular and medical history was taken keeping in view the inclusion and exclusion criteria. Eyes of these patients were divided into four groups on the basis of their age. All patients underwent a comprehensive ocular evaluation including visual acuity assessment, slit-lamp examination, pupil reactions and applanation tonometry. B-Scan USG of these patients was performed at both high [58-61 db] and low [42-44db] instrument sensitivity settings. By compiling data obtained by these various scanning approaches, a three dimensional concept of the lesion was developed and its topography adequately documented. SPSS software [Ver.10.0] was used for statistical analysis of results. It was observed that out of 209 eyes considered for simple mature cataract, USG revealed that 29 [13.87%] of them also had some other ultrasonically detectable posterior segment pathologies. 10 [4.78%] eyes out of 209 had vitreous haemorrhage [VH], 9 eyes [4.30%] had PVD, 3 eyes [1.43%] had asteroid hyalosis, 4 eyes [1.91%] had membranes in anterior and mid-vitreous, 2 eyes [0.96%] had chorioretinal layer thickening while one eye [0.48%] had optic disc edema. Pre operative B-Scan ultrasonography of cataract patients, when posterior segment examination is not possible by conventional methods, helps in diagnosis of additional posterior segment pathologies. Knowledge of these hidden posterior segment pathologies will then help the surgeon in explaining prognosis and expected outcome of surgery to patients. Surgeons can modify their plan of surgery and can also take measures to combat various predictable complications. In addition many legal and technical problems can also be avoided