Association of 25-hydroxyvitamin D with hematological profile and anthropometry in patients with glioma

SUMMARY OBJECTIVE: Gliomas are immune system suppressive tumors, and the role of vitamin D is pivotal in the immune system. This study aimed to observe if there is any significant association between the serum levels of 25-hydroxyvitamin D with hematological indices and anthropometric measurements. METHODS: A total of 75 glioma patients were included, and the information was collected on gender, age group, area, socioeconomic status, intake of vitamin D and calcium in food and supplements, skin color, sunlight exposure, body mass index, and muscle strength. A nonparametric Kendall's tau-b correlation test was performed to find a correlation between 25-hydroxyvitamin D levels and blood counts, body mass index, and muscle strength. RESULTS: The majority of patients (72%) were having low lymphocytes followed by high granulocytes and high white blood cells. The majority were having low levels of both 25-hydroxyvitamin D (84%) and calcium (73%). Patients were mainly from urban areas, and the majority belonged to middle-class families having sedentary lifestyles. The majority of patients were not taking vitamin D supplements. An insufficient amount of sunlight exposure was found in most of them. The majority of the patients were although had normal weight but weak muscle strength (74.6%). An insignificant correlation was found between 25-hydroxyvitamin D levels with the hematological indices or anthropometric measurements in brain tumor patients. CONCLUSION: Vitamin D is a powerful immune modulator, and there is a great need for sufficient amounts of sunlight exposure and vitamin D-enriched diets to prevent cancer.

Anomalous aortic origin of a coronary artery (AAOCA): A case report

@#Anomalous Aortic Origin of a Coronary Artery (AAOCA) is a rare anomaly of the coronary artery with a considerable risk of sudden cardiac death due to ischaemia of the heart. Symptoms may include chest pain on exertion, breathlessness or dizziness. We encountered a case of a 46- year-old female who complained of exertional chest pain with a positive-stress test and subsequently diagnosed with AAOCA through CT angiography (CTA). She successfully underwent a coronary artery bypass graft (CABG) surgery using a saphenous vein graft with uneventful recovery. Right internal mammary artery (RIMA) was not used as it was flimsy and the flow was very poor.

Motivational profiles and study strategies among medical students

Background: Medical profession requires a deep insight regarding its extensive curriculum for competency in field. Motivation is a contributing factor. Objective: To determine the types of motivational profiles and study strategies among medical students

Methodology: Study design: Cross Sectional study. Study Setting: Sheikh Zayed Medical College Rahim Yar khan

Duration of Study: 1st July to 30th September 2017. Sample Size: A total of 120 subjects were included in the study. Sampling Technique: Two stage stratified systematic random sampling. Study Subject: Students of all classes. Inclusion Criteria: Students of MBBS classes from 1st Year to Final Year from either sex. Exclusion Criteria: People not willing to participate in study. Motivational profiles and study strategies, study hours, and learning methods to memorize were assessed. Data was entered and analyzed by using SPSS version 20

Results: Most common motivational profile was high intrinsic high controlled 52 [43%]. Most common learning method was understanding and repetition 89 [74%]. Daily study hours were non specific among 66 [55%] of students

Conclusion: High intrinsic high controlled was most common profile and understanding and repetition was most common way of learning

Knowledge and practices regarding colostrum feeding among pregnant mothers in rahim yar khan

Background: Colostrum is important for promoting health, growth and development of newborn and fighting the infections

Objective: To assess the knowledge and practices about Colostrum feeding among pregnant mothers in Rahim Yar Khan

Methodology: Study Design: Cross Sectional study. Duration and Setting: This Study was conducted from 8th March to 22th August 2017, in Sheikh Zayed Medical College/Hospital, Rahim Yar Khan. A sample of 105 mothers was taken from Pediatrics department, Gynecology department and EPI center of Hospital that were selected by convenient sampling. A pre-designed questionnaire having variables like age of mothers, Education of mother, Occupation of mother, Residence area of mothers, knowledge about colostrum feeding, Source of information, Knowledge about importance of colostrum, Knowledge about prelacteal feeding, Practices about colostrum feeding, Practices about prelacteal feeding was filled by interviewing these women. Data was analyzed by using SPSS 16

Results: In our study, mean age of mothers was 27.85 +/-5 years, 42.9% study subjects were illitetrate 77.1% were house wives. 76.2% women has information about colostrum 45.7% of study subjects mentioned that the source of information was friends and family. 42.9% of mothers acknowledged colostrum as nutritious milk. 69.5% study subjects had misconception that prelacteal feeds are necessary for child health. 28.6% women has started breast feeding within 1st hour and 73.3% has given prelacteal feeds to their newborn babies

Conclusion: Majority of mothers had good knowledge about colostrum feeding and they thought that it was nutritious milk and good for newborn health. But on the other hand, three fourth mothers practiced prelacteal feeding for their kids. There is a big gap between knowledge and practice about colostrum feeding. Health education programme should be started to cover this gap

Comparison of recurrence of low risk superficial bladder cancer in patients with and without single dose intravesical doxorubicin instillation

Introduction: Urinary bladder Cancer [UC] is second most common cancer among patients with genitourinary malignancies. Because of high recurrence rate the patients with Non-muscle-invasive bladder cancer [NMIBC] requires a lifelong surveillance. Doxorubicin has been shown to decrease recurrence rate on long term follow up. However, evidence on its efficacy on short term follow-up is limited. The purpose of the current study was to find out early recurrence rate after Doxorubicin treatment. If found low, this study will reduce the costs and hospital burden for patients needing Re-TURBT

Objective: The study objective was to compare the frequency of recurrence in patients with low risk superficial bladder cancer receiving a single dose intravesical Doxorubicin instillation with placebo

Study Design: Randomized Controlled Trial

Setting: Department of Urology, Khawaja M Safdar Medical College, Sialkot

Duration: One year from 10-03-16 to 09-03-2017

Methodology: 70 patients with Non-muscle-invasive bladder cancer were randomly allocated into 2 groups. Group-A received Doxorubicin treatment while Group-B received Placebo. Patients were followed after 3 months on cystoscopy. All the patients were informed about the procedure

Results: The mean age of the patients was 56.84+/-7.28 years and majority [n=58, 82.85%] of the patients were male and only 12 [17.14%] patients were female giving a male to female ratio of 4.38:1. The mean age of the patients in Group-A was 56.44+/-7.10 years while in Group-B it was 57.23+/-7.50 years. Among Group-A 80% patients were male and 20% were female while in Group-B 82.9% were male and 17.1% were female. However, the difference in term of age and gender was not significant statistically. On follow up at 3 months, 19 [27.14%] patients had recurrence while 51[72.85%] patients were clear of disease. The rate of recurrence was similar across different age groups and gender. Doxorubicin treatment was associated with decreased frequency of recurrence [18.6% vs. 35.7%; p=.023] as compared to Placebo

Conclusion: This comparative randomized control trial showed that intravesical Doxorubicin instillation within 6 hours of TURBT is effective in reducing recurrence in patients with NMIBC

Role of iron supplements on pregnancy outcomes

Background: Anemia is one of the most widely recognized nutritional deficiencies for the duration of pregnancy in underdeveloped countries. It is a risk factor for preterm delivery and consequent low birth weight new born, and subsequent ill effects on neonate and infant health. Further research and sufficient data in different setting is required for determining the extent to which maternal anemia might contribute to maternal morbidity, mortality and impact on pregnancy outcomes

Objective: To assess the effects of iron supplements on pregnancy outcomes

Study Design: Cross-sectional study in which women delivered in hospital were questioned for history of intake of iron supplements during ante-natal period and new born was examined for any adverse effects of iron deficiency anemia

Setting: Hilal-E-Ahmar Maternity Hospital Faisalabad

Results and Discussion: 400 respondents were included in study that was regular in attending ante-natal clinic in the hospital during different gestational period. No significant adverse effects/outcomes were seen in women and newborn irrespective of frequency of iron supplementation already taken during these gestational periods

Conclusion: Majority of the newborn delivered full term and without any complication of pregnancy in this study as well as most of them had normal birth weight. This finding is linked with intake of iron supplements taken by majority of pregnant women during antenatal care. Incidence of low birth weight new born, abortion [spontaneous and therapeutic] and fetal deaths were almost negligible

Effect of drawing microscopic images on students' retention of knowledge of histology

Background: a move towards integrated curriculum questions the desirability and application of image sensitive disciplines like histology. It calls for redefining the role of drawing in learning

Objective: to determine the effect of drawing microscopic images on retention of knowledge of histology

Study design, settings and duration: the quasi experimental study was conducted at the histology laboratory of Anatomy department, Shifa College of Medicine [SCM], Shifa Tameer-e-Millat University, lasting from January 2017 to September 2017

Subjects and Methods: the second year MBBS students were selected by purposive sampling technique. The study was conducted during an eight week duration module of endocrine and reproductive system. The class of 100 students was divided into group A and group B, comprising of 50 students each. During the first four weeks, students in group A were required to draw the histological image. The students in group B did not draw the microscopic image. During the next four weeks, the two groups were flipped over by a cross-over design. The group A became the no drawing group and group B became the drawing group. The MCQ test was taken at the end of four and eight weeks respectively

Results: the students scored better when they drew the images compared to when they did not draw. The results are statistically significant [p <0.05]

Conclusion: drawing is an effective teaching strategy for knowledge retention

Liver histology in asymptomatic Hepatitis-C virus positive blood donors

Objective: To assess the Histological alteration of liver in asymptomatic HCV PCR positive family blood donors

Methods: This is a prospective cross sectional study carried out at Blood Transfusion Services, Clinical and Molecular Laboratory and Pakistan Health Research Council, Jinnah Postgraduate Medical Centre, Karachi from January 2011 to December 2016. One hundred thirteen [113] Anti HCV and HCV RNA positive family blood donors with normal or slightly raised ALT during three consecutive bimonthly visits were included. After taking consent liver biopsy was done to see the histopathological changes in these study participants. The software program SPSS for windows [Ver.19] was utilized for all statistical analysis

Results: One hundred thirteen blood donors who were Anti HCV and HCV RNA positive were included. Ninety eight were male and 15 Female with a mean age of 32.3 +/- 6.94 years. Nineteen [16.8%] had significant inflammation of grade 2-3. Nine [8.0%] had significant fibrosis and steatosis was seen in 65 [57.5%] cases. Cirrhosis or advanced liver disease was not found in this series

Conclusion: HCV infected individual with normal ALT level having good physical health, without any sign of advanced liver disease on ultrasonography and routine laboratory investigation like AST, Gamma GT, Alkaline Phosphatase, serum albumin, A/G ratio, platelet count and PT, INR might be highly helpful to predict mild or progressive liver disease. Ultimately it reduces the need of liver biopsy, an invasive procedure having significant complications

Effectiveness of the ligation of intersphincteric fistula tract in the treatment of high lying perianal fistula

Background: Intersphincteric fistula may be ligated during surgery of high lying perianal fistula

Objective: To evaluate the effectiveness of the Intersphincteric ligation technique of the fistulous tract in the treatment of high lying anal fistula

Methodology: Study Design. Quasi Experimental study. Study Setting: Surgical deptt- II BVH Bahawalpur. Sampling Technique: Non-probability purposive sampling. Duration: 1 February to 31 July 2016. A total of thirty patients were recruited for this study, of high lying perianal fistula, and transsphincteric variety. Diagnosis verified by EUA, fistulogram and by MRI. They were subjected to ligation of Intersphincteric fistula tract on elective operation list. All these patients were observed in ward meticulously for 5 days then discharged and follow up done on OPD basis for 3 month for recurrence of fistula and for development of complications like incontinence. The data was entered and analyzed by using SPSS version 20

Results: Twenty five patients were cured. Only 5 patients were declared of recurrence of fistula, all 5 patients were having abscess cavity and that's why fistula tract have not healed. No patient presented with incontinence. The effectiveness of LIFT procedure remained about 83% in this model

Conclusion: The Ligation of Intersphincteric Fistula Tract [LIFT] technique in mid-term evaluation is effective for the treatment of high lying anal fistula

Delayed diagnosis of neural signs of leprosy

Leprosy is a chronic granulomatous disease caused by Mycobacterium leprae. It mainly affects the peripheral nerves and skin. Neural symptoms often precede the appearance of skin lesions but in many cases leprosy is not considered as a cause, leading to a delay in diagnosis. Ensuing nerve damage leads to deformity and disability. We herein, describe two adult males who first presented with neural symptoms, but in both the cases the diagnosis of leprosy was delayed by several years. The outcome in both was a visible deformity

Evaluation of dyslipidaemia in type 2 diabetes mellitus patients

Objective: This study is aimed to evaluate the correlation of raised levels of Non-high-density lipoprotein cholesterol [Non-HDL-C] in Type 2 Diabetic patients

Study design: Cross sectional study

Place and duration of study: Department of Chemical Pathology and Endocrinology, PNS SHIFA hospitalKarachi, from 20.5.2014 to 20.11.2014

Materials and Methods: Diabetic patients between 30-70 years age, of either gender and having diabetes for more than five years were included in the study. Patients with co-existing Hypothyroidism, Chronic renal failure, Nephrotic syndrome, Familial hypercholesterolaemic syndromes, already on lipid lowering drugs, anti-hypertensive drugs, using beta blockers or thiazide diuretics, obese patients with BMI greater than 30 and those using alcohol were excluded. Blood samples after overnight 10 hours fasting were taken for fasting plasma glucose, serum total cholesterol and HDL-cholesterol

Results: The average age of the patients was 48.75 +/- 11.02 years. Out of 232 patients, there were 124[53.45%] males and 108[46.55%] females. Raised levels of non-high-density lipoprotein cholesterol [>3.33 mmol/L] in type 2diabetic patients was observed in 80.6% [187/232] cases

Conclusion: Raised level of non-high-density lipoprotein cholesterol in diabetes mellitus patients is reasonably high. Appropriate therapeutic interventions should be carried out on basis of simple test such as non-HDL-C in type2 diabetics to avoid risk of cardiovascular, cerebrovascular and renal disease complications, thereby reducing mortality and morbidity in these patients

Effect of ketamine and nalbuphine on shivering after spinal anesthesia

Objective: To compare the effect of ketamine and nalbuphine on shivering after spinal anesthesia

Methodology: Study design: Quasi experimental study. This study was conducted in operation theater phase 2 of Sheikh Zayed Hospital, Rahim Yar Khan

Duration: From 6[th] September 2016 to 13[th] February 2017. The patients under going non obstetrical surgery under spinal anesthesia were included in this study. The data was collected from 67 patients on which we compared the effect of ketamine [group A] and nalbuphine [group B] on shivering after spinal anaesthesia. The patients undergoing gynaecological and obstetrics procedures were excluded from this study. The data was entered and analyzed by using SPSS 20

Result: In our study, total 67 non-obstetrical patients were included undergoing spinal anesthesia. Age range was 15 to 80 years. Out of 67 patients ketamine was given to 34[82.9%] males and 7[17.1%] females and nalbuphine was given to 21[80.8%] males and 5[19.2%] females. In group A shivering stopped by ketamine was 90.2% and in group B shivering stopped by nalbuphine was 69.2%

Conclusion: Ketamine showed better effect on shivering after spinal anesthesia as compared to nalbuphine in non-obstetrical patients undergoing elective surgical procedures

Neovaginoplasty in congenitally absent vagina with bilateral pudendal thigh fasciocutaneous flaps

Background: Vaginal agenesis repair technique expensive and demanding in terms of expertise

Objective: To evaluate functional and aesthetic outcome of vaginal reconstruction using pudendal-thigh fasciocutaneous flaps

Methodology: Our case series was conducted at departments of plastic surgery and Obstetrics and Gynecology, Sheikh Zayed Hospital, Rahim Yar Khan from 1[st] September 2012 to 31[st] August 2015. Vaginal reconstruction was done with bilateral island pudendal thigh flaps in 08 consecutive female patients with congenital absence of vagina. Each flap was raised just lateral to labia majora and then after passing under the labia majora both flaps were sutured together to form a neovaginal tube. This neovaginal tube was then inserted into a newly created space between the rectum and bladder

Results: Out of 8, three patients [37.5%] were diagnosed with Mayer Rokitansky Kauser Hauser Syndrome and 5 [62.5%] with isolated vaginal atresia. One patient [12.5%] developed necrosis of distal part of a unilateral flap followed by severe infection that was managed conservatively. The same patient also developed excessive hair growth in the neovagina. In rest of the seven patients all the flaps survived comletely and the neovaginal length and width was adequate. The mean vaginal length was 9.5 cm and width was 3.8 cm one year post operatively

Conclusion: Neovaginoplasty using bilateral islanded pudendal-thigh flaps is suggested as one of the best methods of vaginoplasty. This technique is very simple and reliable and has shown satisfactory functional and cosmetic results. The neovagina was sensate and has a natural angle for intercourse. No postoperative stenting or dilatation was required. The donor site was closed primarily and the resulting scar was in the groin crease with little secondary deformity

comparison of the efficacy of topical adapalene gel 0.1% with tretinoin gel 0.025% in mild acne vulgaris

Objective To compare the efficacy of topical adapalene with topical tretinoin in the treatment of mild acne vulgaris

Methods This randomized controlled trial was conducted over a period of 6 months in outpatient department of dermatology, Lady Reading Hospital, Peshawar. 101 patients were taken after nonprobability consecutive sampling in each group. Topical adapalene 0.1% gel was given to group A while topical tretinoin 0.025%

Results Out of 202 patients, male and female patients were 91 and 111, respectively with male to female ratio 0.8:1. The age of the patients ranged from 15-25 years. Mean age in group A was 19.79 +/- 2.24 years while in group B, it was 20.11 +/- 2.53 years. Overall efficacy in adapalene group was 84.2% as compared to 39.6% of tretinoin group [p=0.000]

Conclusion Topical adapalene has a better efficacy than topical tretinoin in the treatment of mild acne vulgaris

Frequency of HCV seropositivity in lichen planus

Objective To determine the frequency of Hepatitis C [HCV] seropositivity in patients of lichen planus [LP]

Methods This observational cross-sectional study was conducted over a period of 6 months, at Dermatology Department PNS Shifa hospital Kaitachi. Eighty-two [n=82] patients with a diagnosis of LP fulfilling the inclusion and exclusion criteria were enrolled using non-probability consecutive sampling technique. Detailed history, physical examination and biochemical measurements were recorded. Outcome variable i.e. HCV seropositivity was determined in laboratory with third generation ELISA technique. All data were entered and analyzed using SPSS Version 20.0

Results The mean age of study population was 39.32+/-13.212 years. On analysis of demographics data it was observed that 25 [30.5%] were below 30 years of age and 57 [69.5%] were of age 30 years and above. 39 [47.6%] were males and 43 [52.4%] were females. On analysis of frequency of outcome variable, 15 patients [18.3%] were HCV positive out of 82 patients irrespective of gender, morphological pattern and site of disease

Conclusion HCV positivity is common in patients with lichen planus in Pakistani population. Age, gender, morphological pattern and site of involvement have no effect of HCV positivity

Haematological parameters in different African populations: an experience from united nations level 3 hospital

Objective: To evaluate hematological parameters in African population to estimate normal reference intervals for these tests

Study Design: Cross sectional observational study

Place and Duration of Study: Department of Pathology, United Nations level 3 hospital, Nyala, Darfur from 1st Mar to 30th Dec 2014

Material and Methods: There were 396 healthy African male and female volunteers selected between 18-65 years of age, belonging to different countries. Fresh whole blood was used to measure haemoglobin [Hb] concentration, haematocrit [Hct], total red blood cell [TRBC] count, mean corpuscular volume [MCV], mean corpuscular haemoglobin [MCH], mean corpuscular haemoglobin concentration [MCHC], platelet count, total leucocyte count [TLC] and differential white blood cells count. Data were analysed using SPSS version 19

Results: Mean Hb of study group was 13.81 +/- 1.99 g/dl. Mean TLC was 5.50 +/- 1.96 x 103/ul. Mean lymphocyte count was 2.58 +/- 0.95. Mean platelet count was 234 +/- 92 x103 /ul. Mean values for Hb Concentration, TRBC, Hct Ratio, MCV, MCH and MCHC were all higher for African Males than Females; this difference was statistically significant [p<0.05]

Conclusion: This multi-national African population based study confirms the variations in haematological parameters previously described in single nation African studies. The commonly observed variations in normal adults are low RBC indices, relative neutropenia and lymphocytosis

Frequency of group d streptococci isolated from UTI cases among hospitalized patients and their antibiotic sensitivity pattern

Objective: To determine the frequency and antibiotic susceptibility pattern of Enterococci obtained from UTI patients

Methods: A total of 2653 urine samples have been received for culture and sensitivity during the study period, 1387 were culture positive and 117 urine specimens have recovered Enterococci. The repeated urine cultures recovering Enterococci from the same patient and with mix growth were excluded from the study. The patients were asked to wash the perineal area with clean tap water. Females patients were instructed to apart the labia majora and minora to wash the area before collecting sample to avoid vaginal contamination.. Sterile plastic, wide mouthed containers were used to collect early morning, clean catch, mid-stream urine samples, and the samples were processed as soon as possible within 30 min. In case of delay, the samples were refrigerated. The urine samples were inoculated on Cysteine Lactose Electrolyte Deficient [CLED] media [Oxoid, England] and incubated at 37 degree C for 24 hours. Bacterial growth was taken significant as per count [single species count > 105 organisms]. The growth appeared was identified by colonial morphology, Grams Staining, Catalase Test, Bile Esculin test and growth in nutrient broth with 6.5 % NaCl. The antibiotic sensitivity pattern was determined by modified Kirby Bauer disc diffusion method

Results: The eighty six [73.50%] samples showed salt tolerance as growth appeared and turned out as Group D Enterococci whereas 31 [26.50%] did not show salt tolerance as no growth was observed and labelled as group D non Enterococci. The antibiotic sensitivity of the Group D Enterococci by Kirby bauer disk diffusion mehod with Penicillin 81[82.65%], Ampicillin 73[74.49%], Gentamicin 61[62.24%], Vancomycin 90 [91.84%], Linezolid 98[100%], Ciprofloxacin and Levofloxacin 55 [56.12%] and 57 [58.16%], Nitrofurantoin and Fosfomycin is 42 [42.86%] and 34 [34.69%]. While antibiotic sensitivity of Group D non Enterococci with Penicillin 18[68.71%], Ampicillin 9[47.36%], Gentamicin 10[52.63%], Vancomycin 19 [100%], Linezolid 19 [100%], Ciprofloxacin and Levofloxacin is 9 [47.36%] and 9 [47.36%], Nitrofurantoin and Fosfomycin is 11 [57.89%] and 14 [73.68%]

Conclusion: The frequency of the Group D Enterococci is 86 [73.50%] while that of Group D non Enterococci is 31 [26.50%]. The Enterococci are most susceptible to Linezolid, Vancomycin, Penicillin, Ampicillin, Nitrofurantoin, Levofloxacin, Ciprofloxacin, Gentamicin and Fosfomycin in descending order while the non Enterococci are most susceptible to Linezolid, Vancomycin, Fosfomycin, Penicillin, Nitrofurantoin, Gentamicin, Ciprofloxacin and Levofloxacin in descending order

Association of serum ferritin and CRP levels with development and severity of diabetic retinopathy

Background: Diabetes mellitus is a global health issue. Chronic hyperglycaemia induces endothelial dysfunction and metabolic derangements which are postulated to be the cornerstone for the pathogenesis of diabetic microangiopathic complications. The interplay of oxidative stress, endothelial dysfunction and inflammation in this regard has led to investigation of role of inflammatory biomarkers as adjuncts to routine diagnostic testing. This study was designed to elucidate the association between serum ferritin and high sensitivity CRP levels and diabetic retinopathy

Methods: The study was carried out at Department of Physiology and Centre for Research in Experimental and Applied Medicine [CREAM], Army Medical College, in collaboration with Armed Forces Institute of Ophthalmology, Rawalpindi for a period of one year. A total of 90 subjects were recruited into three equal groups; healthy subjects, diabetics and patients with diabetic retinopathy. Serum high sensitivity C-reactive protein [hs-CRP] was estimated by Enzyme Immunoassay [EIA] and serum ferritin levels were carried out by enzyme linked immunosorbent assay

Results: The mean age was 48.50+/-5.32, 50.90+/-3.83 and 50.83+/-3.54 years respectively. Insignificant differences in height, weight and BMI were found across the groups. Highly significant difference was noted in the mean CRP levels in normal subjects. The mean ferritin levels were also found to be significantly different. Univariate multinomial regression revealed that variance in CRP levels could account for 91.1% of variance in status of patients and that in ferritin levels could account for 96.7%

Conclusion: These prognostic markers correlate well with diabetic retinopathy and have an independent predictive ability as well. This may in future be inculcated into screening and surveillance of diabetic microangiopathic complications

Synthesis, characterization and biological evaluation of some 5-methylpyrazine carbohydrazide based hydrazones

Pyrazine carbohydrazide based hydrazones were synthesized starting from 5-methylpyrazine-2-carboxylic acid. The acid was first converted to its methyl ester, which on further treatment with hydrazine hydrate transformed to carbohydrazide. The carbohydrazide was treated with differently substituted aromatic carbonyl compounds giving hydrazones. Characterization of the synthesized compounds was carried out using modern spectroscopic techniques and unambiguously confirmed through X-ray crystallographic studies of compound 3d. The purity of the compounds was verified using elemental analysis. The target molecules were evaluated for urease inhibition, antioxidant and antimicrobial activity

Knowledge and practices of rural mothers about diarrhea among infants

Background: Diarrhea is one of the most common cause of morbidity and mortality in children

Objective: To assess knowledge and practices of rural mothers about diarrhea among infants

Methodology: Study design Cross-sectional sutdy. Place and Duration: This study was conducted at EPI center of OPD and diarrheal unit of children ward Sheikh Zayed Hospital Rahim Yar Khan, from 15th March to 15 May 2016. A total of 224 rural mothers of infants were included in the study by non probability consecutive sampling technique. Before commencing with the data collection, informed consent was taken. The performa was designed and pretested and it contained variables like age, mother's education, mothers occupation, family income per month, knowledge about definition of diarrhea, causes of diarrhea, signs of dehydration, consequences of diarrhea, prepration of market available ORS sachet, continuation of breast feeding during diarrhea, consultation with doctor during diarrhea, time of consultation with the doctor, diet preferences during diarrhea and preventive measures applied by mothers during diarrhea. All the data collected was recorded on the performa, entered and analyzed by using SPSS version 16

Results: Mean age of mothers was 27 +/- 5 years. In our study [49.10%] months were illiterate. Regarding mothers occupation 74.11% were housewives. Regarding Knowledge of the mothers on definition of diarrhea 46.43% told loose watery stool, 3.57% told increased frequency and 36.61% told both loose watery stool and increased frequency. As regards causes of diarrhea, [24.11%] pointed out contaminated water, [9.82%] eating mud and [26.78%] told both contaminated water and eating mud. Regarding signs of dehydration [9.82%] sunken eyes, [6.25%] dry skin and [25%] considered both Sunken eyes and Dry skin. Regarding practices during diarrhea, 68.76% continued breast feeding during diarrhea, 92.86% consulted doctor but before consulting the doctor, 21.88% did self medication and 65.62% consulted the doctor when condition of child was not improving. 33%] gave diet preferences to both ORS and khichree, 26.79% ORS and 6.69% khichree only. 40.89% applied boiling the water, covering the food and keeping child and environment clean as preventive measure during diarrhea whereas 22.32% did boiling the water and covering the food only, whereas, 3.57% boiling the water only and 2.67% covering the foods only

Conclusion: Majority of the mothers has good knowledge and practices about diarrhea but still many of them do not have clear idea about prevention and ideal practices to be adopted during diarrhea and they should be focused. There is a need of health education program to be started in the rural areas of Rahim Yar Khan