Diagnostic accuracy of surgeon-performed focused assessment sonography in trauma patients with blunt abdominal injury

Background: computerized tomography [CT] Scan is the gold standard for imaging in blunt abdominal trauma. Focused Assessment Sonography in Trauma [FAST] is a quickly performed screening technique aimed to detect collections of free fluid

Objective: to determine the diagnostic accuracy of surgeon-performed Focused Assessment Sonography in patients with blunt abdominal Trauma by taking operative findings as gold standard in detecting hemoperitoneum

Methodology: this cross sectional study was conducted in Department of Emergency and Trauma, Sheikh Zayed Hospital, Rahim Yar Khan from 1[st] January to 30[th] June 2015. A total of 167 patients with blunt abdominal trauma within 24 hours were included in this study. Surgeon performed Focused Assessment Sonography in Trauma[FAST] was done in all patients with Ultrasound Machine for detection of hemoperitoneum. All the patients were undergone through exploratory laparotomy and compared the findings of FAST. All this information was entered on Proforma. Data was entered and analyzed using SPSS version 16

Results: the sensitivity, specificity, positive and Negative predictive value as well as accuracy of surgeon performed FAST in detecting hemoperitoneum were 83.8%, 92%, 90.5%, 86% and 88% respectively

Conclusion: FAST has a high accuracy. It can be included in the initial evaluation of adult patients with Blunt abdominal trauma [BAT] and it will assist in rapidly identifying the need for laparotomy

Prevalence of electrolyte disorders among cases of diarrhea with severe dehydration and correlation of electrolyte levels with age of the patients

Objective: To find out the prevalence of electrolyte disorders among children with severe dehydration, and to study correlation between age and electrolyte, urea and creatinine levels

Study Design: Prospective, analytical study

Place and Duration of Study: Outdoor and indoor of Fazle-Omar Hospital, Rabwah, Pakistan, from January to December 2012

Methodology: All patients from birth to 18 years age, presenting with diarrhea and severe dehydration were included in the study. Urea, creatinine and electrolyte levels of all patients included in the study were checked and recorded in the data form with name, age and outcome. The prevalence of electrolyte disorders were ascertained and correlation with age was determined by Pearson's coefficient

Results: At total of 104 patients were included in the study. None of the patients died. Hyperchloremia was the commonest electrolyte disorder [53.8%], followed by hyperkalemia [26.9%] and hypernatremia [17.3%]. Hyponatremia, hypokalemia and hypochloremia were present in 10.6%, 7.7%, and 10.6% cases, respectively. Weak negative correlation was found between age and chloride and potassium levels

Conclusion: Different electrolyte disorders are common in children with diarrhea-related severe dehydration

Aetiology of epistaxis: a retrospective study of 87 cases at Bolan medical complex hospital, Quetta

To objective of this study was to describe the aetiology of epistaxis. Retrospective, descriptive study. This study was carried out at the Department of Otorhinolaryngology and Head and Neck Surgery, Bolan Medical Complex Hospital, Quetta from December 2011 to December 2013. This study included 87 patients of epistaxis of the afore-said period. Medical records of patients were reviewed retrospectively and results were analyzed. The mean age of the patients was 26.70 +/- 18.10 [SD] years and male to female ratio was 2:1.Trauma [32.18%] was the commonest cause of epistaxis, followed by idiopathic group [22.99%] and hypertension [14.94%]. Other causes were nasal and nasopharyngeal tumours [10.34%], inflammatory diseases of nose and sinuses [8.05%], blood dyscrasias [6.90%] and miscellaneous causes [4.60%] which included one case of aspirin induced epistaxis, one case of hereditary hemorrhagic telangiectasia, one patient of typhoid fever and one case of liver cirrhosis. Nasal trauma is the most common cause of epistaxis. Idiopathic group is the second in which exact cause of epistaxis is not known, followed by hypertension, while other causes are rare

Platelet counts, MPV and PDW in culture proven and probable neonatal sepsis and association of platelet counts with mortality rate

To determine frequency of thrombocytopenia and thrombocytosis, the MPV [mean platelet volume] and PDW [platelet distribution width] in patients with probable and culture proven neonatal sepsis and determine any association between platelet counts and mortality rate. Descriptive analytical study. NICU, Fazle Omar Hospital, from January 2011 to December 2012. Cases of culture proven and probable neonatal sepsis, admitted in Fazle Omar Hospital, Rabwah, were included in the study. Platelet counts, MPV and PDW of the cases were recorded. Mortality was documented. Frequencies of thrombocytopenia [< 150000/mm[3]] and thrombocytosis [> 450000/mm[3] were ascertained. Mortality rates in different groups according to platelet counts were calculated and compared by chi-square test to check association. Four hundred and sixty nine patients were included; 68 [14.5%] of them died. One hundred and thirty six [29%] had culture proven sepsis, and 333 [71%] were categorized as probable sepsis. Thrombocytopenia was present in 116 [24.7%], and thrombocytosis was present in 36 [7.7%] cases. Median platelet count was 213.0/mm[3]. Twenty eight [27.7%] patients with thrombocytopenia, and 40 [12.1%] cases with normal or raised platelet counts died [p < 0.001]. Median MPV was 9.30, and median PDW was 12.30. MPV and PDW of the patients who died and who were discharged were not significantly different from each other. Thrombocytopenia is a common complication of neonatal sepsis. Those with thrombocytopenia have higher mortality rate. No significant difference was present between PDW and MPV of the cases who survived and died

Andrographia paniculata a Miracle Herbs for cancer treatment: In vivo and in vitro studies against Aflatoxin B1 Toxicity

The history of natural products used in ancient times and in folk medicine these days, around the world, is the basis for the use of many therapeutic drugs in modern day medicine. Andrographia paniculata belongs to the family Acanthaceae or Kalmegh and is commonly known as 'king of bitters'. It is extensively used as home remedy for various diseases in Indian traditional system as well as in tribal system in India for multiple clinical applications. In our present work, extracts of these ayurvedic plants were tested for their anticlastogenic, and anticarcinogenic properties against Aflatoxin Bl induced toxicity. We used the in vitro method i.e. human lymphocytes culture and in vivo method in bone marrow cells of albino mice, while the parameters studied included chromosomal aberrations [CA], sister chromatid exchanges [SCEs] and cell growth kinetics [RI] both in the presence as well as in the absence of exogenous metabolic activation system for in vitro studies, whereas total aberrant cells and the frequencies of aberrations were used for in vivo methods A. paniculata extracts significantly reduced chromosomal aberrations from 35.0%, 62.0% and 69.0% level [at 24, 48, and 72 h due to Aflatoxin B1] to 21.72%, 44.0% and 52.0%, similarly sister chromatid exchanges were reduced from 14.60 per cell to 7.50 per cell at 48 h of treatments and replication index was enhanced in vitro for each concentration and duration of treatment. In conclusion A. paniculata extracts significantly reduced the number of aberrant cells and frequencies of aberration per cell at each concentration and duration of exposure in vivo; similarly it reduced chromosomal aberrations and sister chromatid exchanges and replication index was enhanced in vitro that was statistically significant at < 0.05 level

Terminalia arjuna, a herbal remedy against environmental carcinogenicity: An in vitro and in vivo study

Medicinal plants have been a major source of therapeutic agents from ancient times to cure diseases. The evaluation of rich heritage of traditional medicine is essential. The bark of Terminalia arjuna is rich in polyphenols [60-70%] including flavonoids and tannins. The aim of the present investigation is to highlight the anticarcinogenic and antimutagenic potential of extracts of T. arjuna. In this experiment we have used human lymphocyte culture and bone marrow cells of albino mice as assay system. The parameters studied included chromosomal aberrations [CA], sister chromatid exchanges [SCEs] and cell growth kinetics [RI] both in the presence and in the absence of exogenous metabolic activation system for in vitro experiment, whereas total aberrant cells and the total frequencies of aberrations were taken for in vivo study. The role of T. arjuna extracts in reducing metaphase aberrations due to aflatoxin B[is quite significant, the reduction varying from 23.49%, 42.47%, and 59.65% down to 12.32%, 28.00%, and 36.88% respectively at the highest dose [TA[4]] for the three different durations viz., 24, 48 and 72 h. Similarly the number of sister chromatid exchanges got reduced from a higher level of 15.00 +/- 1.40 per cell to 7.70 +/- 0.50 per cell with S9 mix at 48 h of treatment. The replication index was enhanced from 1.33 to 1.55 in vitro. Similar trends were noticed in the in vivo experiments i.e., effective reductions in clastogeny ranging from 15.22% to 54.82% from the mutagen treated positive control and the total frequencies in aberrant cells got reduced from 429 due to AFB1 to 141 due to 5th concentration of Terminalia extracts at 32 h of exposure. The ameliorating potential of Terminalia extracts was dose and time dependant

Does caesalpinia bonducella ameliorate genotoxicity? An in vitro study in human lymphocyte culture and in vivo study in albino mice

Most of the world's populations residing in developing countries depend on alternative medicine and use of plant ingredients. The plant Caesalpinia bonducella belongs to the family of Caesalpiniaceae and it is commonly known as Natakaranja in Hindi. It contains bonducin and two phytosterols namely sitosterol and hepatsane. The twigs and young leaves of C. bonducella are rationally used for curing tumors, inflammation and liver disorders. In our present work alcoholic extracts of this ayurvedic plant were tested for their antimutagenic and anticarcinogenic properties. The aim of the study is to investigate the antimutagenic and antigenotoxic potential of alcoholic extracts of C. bonducella against methyl methane sulfonate [MMS] induced genotoxicity. In this experiment we have used in vitro method i.e., human lymphocyte culture and in vivo method in bone marrow cells of albino mice, while the parameters studied included chromosomal aberrations [CA], sister chromatid exchanges [SCEs] and cell growth kinetics [RI] both in the presence as well as in the absence of exogenous metabolic activation system for in vitro studies whereas total aberrant cells and the frequencies of aberrations were used for in vivo methods. Alcoholic extracts of C. bonducella significantly reduce chromosomal aberration from 42.75%, 44.25%, and 51.75% levels [at 24, 48, and 72 h due to methyl methane sulfonate [MMS]] to 28.50%, 30.25%, and 35.10%, respectively similarly sister chromatid exchanges were reduced from 7.70 +/- 1.50 to 5.20 +/- 1.50 at 48 h of treatment and replication index was enhanced in vitro for each concentration and duration of treatment and their ameliorating potential was dose and duration dependent. Similarly these extracts significantly reduced the number of aberrant cells and frequency of aberrations per cell in in vivo

Blood glucose levels in neonatal sepsis and probable sepsis and its association with mortality

To determine the blood glucose levels among patients with neonatal sepsis and probable sepsis and evaluate their association with the mortality rate. Analytical study. Fazle Omar Hospital, Rabwah, Pakistan from July 2007 to December 2008. Neonates with culture proven and probable neonatal sepsis were included. The glucose levels at the time of admission and outcomes were recorded. The patients were divided in four groups according to their glucose levels i.e. < 40 mg/dl, 40-100 mg/dl, 101-200 mg/dl and > 200 mg/dl. The patients were divided in two groups according to weight i.e. < 2.5 kg and >/= 2.5 kg. There were a total of 502 cases. The glucose levels were below 40 mg/dl in 50 patients [9.9%], between 40 mg/dl to 100 mg/dl in 322 [64.1%], between 101 mg/dl to 200 mg/dl in 95 [18.9%] and above 200 mg/dl in 35 patients [6.9%]. Among these four groups, 16 [32%], 32 [9.9%], 22 [23.2%] and 17 [48.6%] neonates died respectively [p < 0.001]. The difference in glucose levels among the two groups according to weight was significant [p=0.002]. Majority of patients with neonatal sepsis and probable sepsis had glucose levels between 40 and 100 mg/dl at admission. Those with the levels below 40 mg/dl and above 200 mg/dl had higher mortality rates

Catheter as a therapeutic agent in the treatment of cardiovascular diseases

In summary, the cardiac catheter has undergone a remarkable transition. What was originally a diagnostic tool is rapidly becoming a therapeutic modality for many interventional procedures and in many replacing surgery altogether