Use of multi-strain probiotics in linseed meal based diet for Labeo rohita fingerlings / Uso de probióticos multi-cepas na dieta à base de farinha de linhaça para alevinos de Labeo rohita

Unavailability of probiotics in fish digestive system fingerlings is unable to digest and absorb their food properly. The current research was conducted to investigate the influence of probiotics added Linseed meal based (LMB) diet on hematology and carcass composition of Labeo rohita juveniles. Hematological parameters are essential diagnostics used to estimate the health status of fish. The usage of probiotics for fish health improvement is becoming common due to the higher demand for environment-friendly culture system in water. Linseed meal was used as a test ingredient to prepare six experimental test diets by adding probiotics (0, 1, 2, 3, 4 and 5 g/kg) and 1% indigestible chromic oxide for seventy days. According to their live wet weight, five percent feed was given to fingerlings twice a day. Fish blood and carcass samples (Whole body) were taken for hematological and carcass analysis at the end of the experiment. The highest carcass composition (crude protein; 18.72%, crude fat; 8.80% and gross energy; 2.31 kcal/g) was observed in fish fed with test diet II supplemented with probiotics (2 g/kg). Moreover, maximum RBCs number (2.62× 106mm-3), WBCs (7.84×103mm-3), PCV (24.61), platelets (63.85) and hemoglobin (7.87) had also been reported in the fish fingerlings fed on 2 g/kg of probiotics supplemented diet. Results indicated that probiotics supplementation has a critical role in improvement of fingerlings' body composition and hematological indices. Present findings showed that probiotics supplementation at 2 g/kg level in linseed by-product-based diet was very useful for enhancing the overall performance of L. rohita fingerlings.

A indisponibilidade de probióticos em alevinos do sistema digestivo de peixes faz com que ele seja incapaz de digerir e absorver seus alimentos adequadamente. A presente pesquisa foi conduzida para investigar a influência de probióticos adicionados à dieta à base de farelo de linhaça (LMB) na hematologia e na composição da carcaça de juvenis de Labeo rohita. Os parâmetros hematológicos são diagnósticos essenciais usados para estimar o estado de saúde dos peixes. O uso de probióticos para a melhoria da saúde dos peixes está se tornando comum devido à maior demanda por sistemas de cultivo em água que não agridam o meio ambiente. Farinha de linhaça foi usada como ingrediente para preparar seis dietas de teste experimentais adicionando probióticos (0, 1, 2, 3, 4 e 5 g/kg) e 1% de óxido crômico indigestível por 70 dias. De acordo com seu peso úmido vivo, 5% de alimento eram dados aos alevinos duas vezes ao dia. Amostras de sangue e carcaça de peixes (corpo inteiro) foram coletadas para análise hematológica e de carcaça no final do experimento. A maior composição da carcaça (proteína bruta, 18,72%; gordura bruta, 8,80%; e energia bruta, 2,31 kcal/g) foi observada em peixes alimentados com a dieta teste II suplementada com probióticos (2 g/kg). Além disso, os números máximos de RBCs (2,62×106 mm-3), WBCs (7,84×103 mm-3), PCV (24,61), plaquetas (63,85) e hemoglobina (7,87) também foram relatados em alevinos alimentados com 2 g/kg de dieta suplementada com probióticos. Os resultados indicaram que a suplementação de probióticos tem um papel crítico na melhoria da composição corporal dos alevinos e índices hematológicos. As descobertas atuais mostraram que a suplementação de probióticos no nível de 2 g/kg em dieta à base de subproduto de linhaça foi muito útil para melhorar o desempenho geral de alevinos de L. rohita.

Use of multi-strain probiotics in linseed meal based diet for Labeo rohita fingerlings

Abstract Unavailability of probiotics in fish digestive system fingerlings is unable to digest and absorb their food properly. The current research was conducted to investigate the influence of probiotics added Linseed meal based (LMB) diet on hematology and carcass composition of Labeo rohita juveniles. Hematological parameters are essential diagnostics used to estimate the health status of fish. The usage of probiotics for fish health improvement is becoming common due to the higher demand for environment-friendly culture system in water. Linseed meal was used as a test ingredient to prepare six experimental test diets by adding probiotics (0, 1, 2, 3, 4 and 5 g/kg) and 1% indigestible chromic oxide for seventy days. According to their live wet weight, five percent feed was given to fingerlings twice a day. Fish blood and carcass samples (Whole body) were taken for hematological and carcass analysis at the end of the experiment. The highest carcass composition (crude protein; 18.72%, crude fat; 8.80% and gross energy; 2.31 kcal/g) was observed in fish fed with test diet II supplemented with probiotics (2 g/kg). Moreover, maximum RBCs number (2.62× 106mm-3), WBCs (7.84×103mm-3), PCV (24.61), platelets (63.85) and hemoglobin (7.87) had also been reported in the fish fingerlings fed on 2 g/kg of probiotics supplemented diet. Results indicated that probiotics supplementation has a critical role in improvement of fingerlings body composition and hematological indices. Present findings showed that probiotics supplementation at 2 g/kg level in linseed by-product-based diet was very useful for enhancing the overall performance of L. rohita fingerlings.

Resumo A indisponibilidade de probióticos em alevinos do sistema digestivo de peixes faz com que ele seja incapaz de digerir e absorver seus alimentos adequadamente. A presente pesquisa foi conduzida para investigar a influência de probióticos adicionados à dieta à base de farelo de linhaça (LMB) na hematologia e na composição da carcaça de juvenis de Labeo rohita. Os parâmetros hematológicos são diagnósticos essenciais usados para estimar o estado de saúde dos peixes. O uso de probióticos para a melhoria da saúde dos peixes está se tornando comum devido à maior demanda por sistemas de cultivo em água que não agridam o meio ambiente. Farinha de linhaça foi usada como ingrediente para preparar seis dietas de teste experimentais adicionando probióticos (0, 1, 2, 3, 4 e 5 g/kg) e 1% de óxido crômico indigestível por 70 dias. De acordo com seu peso úmido vivo, 5% de alimento eram dados aos alevinos duas vezes ao dia. Amostras de sangue e carcaça de peixes (corpo inteiro) foram coletadas para análise hematológica e de carcaça no final do experimento. A maior composição da carcaça (proteína bruta, 18,72%; gordura bruta, 8,80%; e energia bruta, 2,31 kcal/g) foi observada em peixes alimentados com a dieta teste II suplementada com probióticos (2 g/kg). Além disso, os números máximos de RBCs (2,62×106 mm-3), WBCs (7,84×103 mm-3), PCV (24,61), plaquetas (63,85) e hemoglobina (7,87) também foram relatados em alevinos alimentados com 2 g/kg de dieta suplementada com probióticos. Os resultados indicaram que a suplementação de probióticos tem um papel crítico na melhoria da composição corporal dos alevinos e índices hematológicos. As descobertas atuais mostraram que a suplementação de probióticos no nível de 2 g/kg em dieta à base de subproduto de linhaça foi muito útil para melhorar o desempenho geral de alevinos de L. rohita.

Antibacterial activity of plant essential oils against indigenously characterized methicillin-resistant Staphylococcus aureus (MRSA)

@#Plant essential oils were evaluated for antimicrobial activity against Methicillin-resistant Staphylococcus aureus (MRSA). The isolates (n=03) were procured from Institute of Microbiology, UVAS Lahore, Pakistan. After biochemical and 16S rRNA gene-based PCR characterization, accession numbers were retrieved from NCBI i.e. MW344063.1, MW344064.1 and MW344065.1. These isolates exhibited molecular positivity by multiplex PCR for mecA, coa and eta toxin genes. Moreover, these isolates exhibited resistance to cefoxitin, ampicillin, amoxicillin, penicillin, amoxicillin clavulanate, ciprofloxacin, erythromycin and gentamicin. The antibiotic resistant isolates were evaluated for antimicrobial activity of plant essential oils. The highest zone of inhibition (mean ZOI±S.D.) was measured for Cinnamomum verum (22.67±1.52 mm) followed by Eucalyptus globulus (18.67±2.51 mm) and Syzygium aromaticum (12.67±2.51 mm). Lowest mean MIC value (0.33±0.11 mg/mL) was recorded for E. globulus. Eucalyptus globulus was processed for fractionation by column chromatography and n-hexane, chloroform, n-hexane + chloroform and ethyl-acetate fractions were evaluated for antibacterial activity. Lowest mean MIC (10.04±5.80 mg/mL) was recorded for E. globulus n-hexane fraction. Cell survival percentage of BHK21 cell line was 51.7% at 54.87mg/mL concentration of E. globulus n-hexane fraction. Through gas chromatography-mass spectrometry (GC-MS) analysis of n-hexane fraction, benzene was found abundant (29.9%) as active compound. It was concluded that E. globulus n-hexane fraction exhibited significantly promising results against MRSA.

Evaluation of Contrast-Induced Acute Kidney Injury (CI-AKI)

Background: The risk of contrast-induced acute kidney injury (CI-AKI) has been accepted lately by medicalliterature and practice since it is the third leading cause of acute kidney injury in hospitalized patients. Differentmeasures in practice are being used to prevent the incidence of CI-AKI. Objective: In this review, we aimed todiscuss the different methods of prevention of CI-AKI mentioned in the literature. Methods: A comprehensivesearch was done using biomedical databases including Medline, and PubMed, for studies concerned with theassessment of Contrast-Induced Acute Kidney Injury. Keywords used in our search through the databases were“Contrast-Induced Kidney Failure” and “Diagnosis & Management”. Conclusion: Intravenous (IV) fluidhydration is the mainstay of practice in the prevention of CI-AKI. Intravenous administration of sodiumbicarbonate has also gained notable importance in the prevention of CI-AKI, but it is still not confirmed. Despitethat the application of N-acetyl cysteine to prevent CI-AKI is controversial, N-acetyl cysteine remains a commonlyutilized agent even without solid scientific evidence. The application of statins for the prevention of CI-AKI afterintravascular contrast medium administration revealed some promising results but it is still premature toimplement their application in daily clinical practice. Therefore, there is a need for additional well designed andsufficiently powered randomized controlled trials to clarify these issues and to assess the risk vs benefit of allother methods for the purpose of CI-AKI prevention

Evaluation of Osteopontin in Combination with Bone Turnover Markers for the Assessment of Osteoporosis in Postmenopausal Women.

Aims: Osteoporosis, a disease characterized by low bone mass and microarchitectural deterioration of bone tissue, has an important impact on the lives of postmenopausal women, owing to the increased risk of fractures. Although bone mineral density (BMD) is the standard criteria used for the diagnosis of osteoporosis, but BMD provides a slow and static picture of skeleton whereas, the biochemical markers of bone turnover (BTM) can provide dynamic status of bone remodeling and rapid measurement of skeletal metabolism. Osteopontin (OPN), a glycoprotein has been implicated in bone remodeling by activating the resorption process. Combination of osteopontin with classical bone turnover markers can enhance the confidence of detecting osteoporosis and predicting fracture risk. Study Design: Cross-sectional study. Place and Duration of Study: Department of Pathology, Quaid-e-Azam Medical College, Pakistan from 1st July 2015 to 15th September 2015. Methodology: We included 120 females (60 postmenopausal, age >45 years and 60 from childbearing age 25-45 years) and excluded all conditions affecting bone metabolism. Enzyme-linked immunosorbent assay technique was used to measure levels of bone markers in serum. Results: Bone markers were significantly higher in postmenopausal group of patients. Osteopontin was found to be positively correlated with osteocalcin (r=0.82), bALP (r=0.76), CTX (r=0.62) and DPD (r=0.49) and it was negatively correlated with BMD lumbar spine (r= -0.71) indicating a significant correlation (p<0.0001). The osteopontin and osteocalcin combination showed highest sensitivity (94%) and specificity (88%), closely followed by that of osteopontin and bone alkaline phosphatase combination. Conclusion: High levels of osteopontin in postmenopausal women are associated with low BMD, raised levels of bone turnover markers and fractures. When used in combination with other bone turnover markers, it can provide an accurate assessment of osteoporosis and fracture risk.

miR-139 modulates MCPIP1/IL-6 expression and induces apoptosis in human OA chondrocytes

IL-6 is an inflammatory cytokine and its overexpression plays an important role in osteoarthritis (OA) pathogenesis. Expression of IL-6 is regulated post-transcriptionally by MCPIP1. The 3' untranslated region (UTR) of MCPIP1 mRNA harbors a miR-139 'seed sequence', therefore we examined the post-transcriptional regulation of MCPIP1 by miR-139 and its impact on IL-6 expression in OA chondrocytes. Expression of miR-139 was found to be high in the damaged portion of the OA cartilage compared with unaffected cartilage from the same patient and was also induced by IL-1beta in OA chondrocytes. Inhibition of miR-139 decreased the expression of IL-6 mRNA by 38% and of secreted IL-6 protein by 40%. However, overexpression of miR-139 increased the expression of IL-6 mRNA by 36% and of secreted IL-6 protein by 56%. These data correlated with altered expression profile of MCPIP1 in transfected chondrocytes. Studies with a luciferase reporter construct confirmed the interactions of miR-139 with the 'seed sequence' located in the 3' UTR of MCPIP mRNA. Furthermore, miR-139 overexpression increased the catabolic gene expression but expression of anabolic markers remained unchanged. Overexpression of miR-139 also induced apoptosis in OA chondrocytes. Importantly, we also discovered that IL-6 is a potent inducer of miR-139 expression in OA chondrocytes. These findings indicate that miR-139 functions as a post-transcriptional regulator of MCPIP1 expression and enhances IL-6 expression, which further upregulates miR-139 expression in OA chondrocytes. These results support our hypothesis that miR-139-mediated downregulation of MCPIP1 promotes IL-6 expression in OA. Therefore, targeting miR-139 could be therapeutically beneficial in the management of OA.

Influence of tourniquet application; on selected chemical analytes

The objective of the study was to determine the mean change in selected chemical analytes with and without application of tourniquet. Blood samples were collected from all persons irrespective of age and gender visiting pathology laboratory, Quaid-e-Azam Medical College, Bahawalpur. The study was a Quasi experimental study. The study was carried out in Pathology Laboratory, Quaid-e-Azam Medical College, Bahawalpur on Selectra XL and Easy lyte. October 2011 to April 2012. Blood samples were taken from both arms of 265 volunteer with one difference that standardized external pressure of 60 mm Hg was applied by using a sphygmomanometer for one minute on one arm and on other arm blood sample was collected without application of tourniquet. Samples with tourniquet application showed statistically significant mean increase in serum concentration of protein [p =0.001], cholesterol [p=0.03], calcium [p =0.007] and potassium [p=0.0001]. The mean concentration of serum sodium and chloride showed no statistically significant change after one minute of tourniquet application. The tourniquet application of one minute influence certain laboratory parameters, so its use should be kept to a minimum

Anesthetic considerations in Leigh disease: case report and literature review

Leigh disease is an extremely rare disorder, characterized by a progressive neurodegenerative course, with subacute necrotizing encephalomyelopathy. It usually presents in infancy with developmental delay, seizures, dysarthria, and ataxia. These patients may also develop episodes of lactic acidosis that usually lead to respiratory failure and death. Due to the rarity of the condition, the most appropriate anesthetic plan remains unclear. We present a patient with Leigh disease, who required general anesthesia. The pathogenesis of the disease is discussed and previous reports of perioperative care from the literature are reviewed

Benign lesions in abdominal hysterectomies in women presenting with menorrhagia

Menorrhagia is a common and debilitating problem. It is one of the major causes leading to hysterectomy in women all over the world. Menorrhagia is most commonly associated with benign pathologies like uterine fibroids, adenomyosis and pelvic infection. Rarely it is secondary to malignant pathology like endometrial carcinoma. Hysterectomy specimens form a major component of histopathological work in Pathology laboratories. The present study was undertaken in Pathology department, Allama Iqbal Medical College, Lahore to find out the morphology and frequency of different benign histopathological lesions in total abdominal hysterectomy specimens in patients presenting with menorrhagia. A descriptive case series study of one hundred total abdominal hysterectomies of patients presenting with menorrhagia carried out. Patients' data and detailed gross examination of specimens were recorded on a proforma. Representative sections were taken for microscopic examination and findings were recorded. The ages of the patients ranged from 30- 59 years with maximum number [73%] of cases in 40 - 49 years age group. Macroscopically fibroids were seen in 69% cases in myometrium. Microscopic examination of cervix revealed features of chronic cystic cervicitis in 100% cases. Endometrial histology showed disordered proliferation [41%] followed by hyperplasia [25%] as the commonest finding. Myometrium revealed foci of adenomyosis in 49% cases. The commonest neoplastic lesion was leiomyoma [69%]. In patients with menorrhagia the commonest neoplastic lesion was leiomyoma [69%], and commonest histopathological cervical lesion as chronic cervicitis [100%]. Endometrial hyperplasia was the most common lesion [41%] on endometrial histology. Myometrium revealed foci of adenomyosis in 49% cases

Effect of hypertension on body mass index and total cholesterol levels as risk factors in ischemic heart diseases

Dyslipidaemia and hypertension are important predisposing factors leading to cardiovascular diseases. Obesity also increases the risk of hypertension, coronary artery disease and dyslipidaemia. Purpose of this study was to find out a relationship between body mass index and total cholesterol levels in 100 hypertensive patients. Study was performed in Chemical Pathology Department of Army Medical College, Rawalpindi in collaboration with Department of Medicine, Combined Military Hospital, Rawalpindi. It is a cross-sectional study and simple non-probability random sampling was used. Hundred hypertensive patients were included in the study. Data was recorded using a detailed proforma and analysis was done on SPSS version 17. Of the 100 hypertensive patients included in the study, there were 39 males while 61 were females. The mean age was 60.1 +/- 11.5 years. The mean blood pressure was 171 +/- 13.1/105.2 +/- 6.6 mm of Hg. Mean body mass index was 28.6 +/- 3.97. Mean of total cholesterol was 5.7 +/- 0.7 mmol/L in all the patients. Hypertension, dyslipidaemia and increased BMI increase go hand in hand with the risk of cardiovascular disease. Treatment strategies should be adopted to treat hypertension and dyslipidemia aggressively and lifestyle modifications are necessary for reducing BMI

High prevalence of the cardiovascular risk factors in Al-Ain, United Arab Emirates. An emerging health care priority

In the United Arab Emirates [UAE] cardiovascular mortality is a leading cause of death. Yet, there is a dearth of data on its risk factors. A cross-sectional community based study on established cardiovascular risk factors carried out between February 2004 - February 2005 in Al-Ain City, UAE. Subjects were interviewed, blood pressure, weight, height, fasting blood sugar, and lipid profile measured. Framingham risk scores were used for risk assessment. Eight hundred seventeen subjects [403 males and 414 females] completed the survey, of these 28.4% had a Framingham risk assessment score of more than 20%, 23.3% had diabetes mellitus, 20.8% hypertension, 37.3% obesity, 22.7% metabolic syndrome, and 19.6% of male smoked. Coronary heart disease was reported in 2.4%. Lipid profiles were abnormal in 64% of the males, and in 53.9% of the females, mostly due to low high-density lipoproteins or high triglycerides levels. The overall cardiovascular risk assessment of the population screened calls for targeted interventions

relationship between helicobacter pylon infection and childhood idiopathic thrombocytopenic purpura

Idiopathic thrombocytopenic purpura, a disorder characterized by autoantibody mediated platelets destruction causing decreased number of circulating platelets manifest as bleeding tendency. Since the discovery of Helicobacter pylon [H. pylon] several studies have been published concerning a hypothetical role of this bacteria in idiopathic thrombocytopenic purpura. Evaluate the pathogenic correlation between H. pylori infection and idiopathic thrombocytopenic purpura. A cross sectional study was done on 30 cases of idiopathic thrombocytopenic purpura admitted to the Pediatric Hemato-Oncology unit in ALKadhimiyia Teaching Hospital and 20 cases of sex and age matched healthy children asa control io determine the relation between H. pylon infection and idiopathic thrombocytopenic purpura. The peak age for idiopathic thrombocytopenic purpura was between [6-10 years] of age, [43.33%]. Male: female ratio equal to 2:1. ELIZA test was used to measure the serum IgG antibody titer against H. pylon, 5 cases of idiopathic thrombocytopenic purpura was found to be positive for H.pylori [16.67%]while the test was negative in all of the control group [100%] a result which is statistically highly significant, p - value < 0. 05. Of the positive cases 3 [60%] was chronic idiopathic thrombocytopenic purpura and two cases [40%] was acute idiopathic thrombocytopenic purpura. Patients with positive test were older than those with negative test. The mean platelet count was less in the positive than those with negative test. A weak inverse correlation was found between platelet count and H. pylori serum antibody titer [r- value equal to -0.13437]. The test was sensitive in [20%] and speicific in [100%] of cases H. pylori infection may play a role in the initiation of idiopathic thrombocytopenic purpura and eradication of H. pylori infection can cure idiopathic thrombocytopenic purpura specially in chronic and resistant cases. The ELIZA test can be used as a screening test to detect H.pylori infection in children with idiopathic thrombocytopenic purpura

Leiomyosarcoma of the bladder in a 16-year-old girl with a history of cyclophosphamide therapy for bilateral retinoblastoma during infancy

A 16-year-old female with bladder leiomyosarcoma had a history of bilateral retinoblastoma at 6 months of life. She received cyclophosphamide chemotherapy after surgical enucleation. In this report, we discussed the possible role of retinoblastoma or cyclophosphamide as a target for the development of bladder leiomyosarcoma

Etiology of community - acquired pneumonia in hospitalized patients in Jordan

To ascertain the causative organisms of community acquired pneumonia [CAP] in Jordanian patients requiring hospital admission. A prospective study of both adults and children admitted to Princess Basma and Princess Rahma Teaching Hospitals in Irbid, Jordan with a diagnosis of CAP over a 6-month period from April to October 2002. A total of 35 adult patients were admitted with a mean age of 47 years, and 63 children with a mean age of 3 years. A pathogen was isolated from 25 [71%] adults, and from 17 [27%] children, and sputum cultures gave the best diagnostic yield. In adults Streptococcus pneumoniae was the most common isolate [26%], followed by Chlamydia pneumoniae [23%], Haemophilus influenzae [17%], Mycoplasma pneumoniae [9%], and Legionella pneumophila and Klebsiella pneumoniae [6%] each. Seven of the 9 gram negative isolates were from patients with some co morbid illness. While in children, Chlamydia pneumoniae was the most common [14%], followed by Mycoplasma pneumoniae [6%], and Streptococcus pneumoniae, Haemophilus influenzae, and Pseudomonas aeruginosa [3%] each. Streptococcus pneumoniae and atypical microorganisms are the most common cause of CAP in previously healthy adults; while in those with associated co morbid illness, gram negative organisms are the likely cause. In children, the overall detection rate of causative organisms was low with atypical microorganisms being the most common

Rapid assessment of cataract surgical services in age group 50 years and above in lower DIR district Malakand, Pakistan

To assess the rapid assessment of cataract blindness and surgical services in age group 50 years and above. Design: A cross-sectional survey. Place and Duration of Study: This survey was conducted in District Lower Dir, Malakand Division, NWFP, Pakistan, from March 9-23, 2003. Patients and A community-based survey was carried out with systematic cluster random sampling. The survey was preceded by a pilot study in which the proforma and operational methods were field-tested and refined. One thousand, one hundred and fifty eligible adults of 50 years and older were selected by systematic random sampling from the whole lower Dir district of Malakand, Pakistan. A total of 1076 subjects [93.6%] were examined. The visual acuity of each eye was assessed using tumble Snellen's E Card method at 6 and 3 meters. Any subject having visual acuity <3/60 with or without obvious lens opacity or with aphakia [removal of lens] or pseudophakia [removal of cataract lens and implantation of artificial lens] was examined in detail. The surgical services were assessed by measuring the prevalence of pseudophakia, surgical outcome of visual acuity and also the effect of place of surgery on outcome. Prevalence of total bilateral blindness was 2.6%, and unilateral blindness 2.46%.Total prevalence of aphakia was 2.4%, which was almost equal in both sexes, male 2.3% and female 2.4%. Prevalence of unilateral aphakia was 0.3% in females being slightly higher than males, 0.16%.The prevalence of bilateral aphakia was 2.2% and 2% in males and females respectively. Prevalence of total pseudophakic eyes was 2.74%. Surgical outcome showed good, borderline and poor visual acuity of 40.5%, 22% and 14.3% respectively. Surgical outcome was also seemed to be better in private hospitals as compared to field camps. It is concluded that to reduce the prevalence of blindness there was a need to improve the quality of services in mobile camps and fixed facilities. At the same time the visual outcome of surgery could be improved by expanding the number of Intraocular lens procedures and routine monitoring of cataract outcome

Pattern of eye diseases in children of 5-15 years at Bazzertaline area [South Karachi] Pakistan

To assess the prevalence and pattern of eye diseases in children aged 5-15 years. Population based cross-sectional survey. Bazzertaline area of Karachi [South] from July to August, 2003. A community-based survey was carried out at the Bazzertaline Area, South Karachi, Pakistan on 5110 children 5-15 years of age. The socioeconomic status of the area was low, with many living below the poverty line. The survey used the WHO definitions of visual impairment as criteria for classification. St and ard Snell's literate and illiterate charts were used for assessing the visual acuity. An anterior segment examination with a torch light and loupe was carried out and the posterior segment examined with a direct ophthalmoscope, initially without pupil dilation. Suspected cases of amblyopia, albinism, traumatic cataract and squint, etc. were examined with pupil dilatation. Refractive error of 2% was found to be the primary ocular morbidity, followed by conjunctivitis 1.2%, and squint was found as third ocular morbidity with the prevalence of 0.6%. Those diseases that were less than 0.5% included unilateral amblyopia, corneal ulcer/opacity, cataract, aphakia, trauma, blepharitis, albinism, stye, chalazion and unilateral/bilateral blindness. Bilateral blindness was present in 2.7/1000 children, the major causes being cataract and corneal diseases. Low vision was found in 2.2%, the leading cause being uncorrected refractive error. Visual acuity according to 2.42%. Gender showed higher visual impairment in girls as compared to boys 1.72%. Only one case of vitamin-A deficiency was seen. Provision of spectacles would address the most commonly found problem of uncorrected refractive error. Lack of trained personnel and facilities for low vision services in addition to lack of advocacy and awareness in the community contribute to the pattern of eye disease in the area

abnormal chest radiograph in a 6-year-old boy

An unexpected finding in a chest radiograph of a child with upper respiratory symptoms is presented as a clinical quiz. The condition is discussed, and the relevant literature is reviewed and summarized

Incidence of circulating antinuclear antibodies in cancer patients.

The following study was conducted to know the incidence of antinuclear antibody [ANA] in various types of cancers in different age groups of both sexes. Results revealed that an overall level of ANA in female is higher than males. This study also showed that out of 50 only 20 cancer patients had raised level of ANA. Whereas in control group only one was positive for antinuclear antibody. Of these 20 positive cases, 4 were having very high titer of ANA, 13 showed high titer and 3 samples were moderately high titer of ANA. The high prevalence of autoantibodies found in aged cancer subjects could be attributed to several cellular and humoral immunological aberrations, which occur with the aging process. The results of this study confirm the earlier observation of necrosis of tumour tissue could be an important contributing factor for production of autoantibodies.

Diabetes mellitus. Prevalence of retinopathy

OBJECTIVE: To study the prevalence of retinopathy in association with duration of the disease, age at the onset, treatment, haemoglobin [Hb] levels, obesity and glycemic control as measured by means of glycosylated [HbAlc] levels. STUDY DESIGN: A cross-sectional study comprising 1340 diabetic patients was carried out. Retinopathy was evaluated by means of direct and indirect ophthalmoscopy and retinal photographs. It was calculated that the prevalence of retinopathy was significantly higher in early diabetics [p<0.006]. The prevalence of severity of retinopathy was higher in patients with HbALC >12% [p<0.01]. It was found out that frequency of retinopathy was twice in those that had the Hb levels <12g/dl as compared to Hb levels >12g/dl. Diabetic retinopathy had a positive association with the duration of the disease. With an age at the diagnosis <30 years, the prevalence of retinopathy was 62% whereas with an age of diagnosis >30% years, the prevalence of retinopathy was 54% in insulin treated and 22% in non-insulin treated patients. CONCLUSIONS: Early diagnosis with good glycemic control decreases the risk of developing diabetic retinopathy