bluuebunny/crossref_metadata_2025 huggingface dataset:
Rumen Microbial Community and Functions of Rumen Bacteria under Different Feeding Regime
Authors: Chen Dong
Published: August 2021

The aim of the study was to evaluate the variations in the rumen ecosystem at genus level and predicted functions of rumen bacteria by using whole crop corn silage (WCS), whole crop rice silage (WRS) or rice straw (RS) as forage sources in beef cattle ration. Ruminal digesta samples from 10 bulls per treatment were collected at day 60 of experimental period. The PCoA plots based on the Bray-Curtis distance matrix (BDM) expressed separation between WRS and WCS , WRS and RS using PC1 (P<0.05, 45.56%). The PCoA plots based on BDM also expressed separation among WRS, WCS and RS group using PC2 (P<0.05, 11.95%). Microbiota composition resutls at genus level showed that the most abundant genera were Prevotella (13.37%) and Ruminococcus (4.00%). Comparison of treatments represented that Prevotella, Treponema and Anaerostipes were higher in bulls fed WCS forage. Clostridium, Anaeroplasma and RFN20 were higher in bulls fed RS forage than animals fed WCS and WRS. Butyrivibrio was higher in WRS and RS treatments than WCS treatment group. Pseudobutyrivibrio was higher in bulls fed WRS forage than animals fed RS and WCS forage. Fibrobacter was higher in RS and WCS as compared to WRS. The results of functional alteration of rumen microbiota in different experimental groups represented that the leading modified function of the microbiome was the transporter. Based on findings of current study, it is concluded that microbial community at genus level in the rumen of bulls was highly altered by forage type.
Seroprevalence of Camels Listeriosis, Brucellosis and Toxoplasmosis from Kirkuk Province-Iraq
Authors: Yawoz Mohammed
Published: August 2021

This study was conducted to diagnose the seroprevalence of Listeriosis, Brucellosis, and Toxoplasmosis in camels from Kirkuk province in Iraq. Seventy-six serum samples were randomly collected and analyzed from camels from April to September 2018. Three serological diagnostic methods were used; Osebold agglutination test (OAT), Serum tube agglutination test (SAT) and Sabin- Feldman dye test (SFDT). From all serum samples that were collected, 42(55.26%) showed infections with Listeria, Brucella, and Toxoplasma as following 15(19.7%), 7(9.2%), and 20(26.3%) respectively. Additionally, the study revealed a highly significant relationship between aborted camels and their infection with Brucellosis and Toxoplasmosis (58.3%). In contrast, infections with these pathogens have no significant relationship with the sex and age of the camels. Risk factors of abortion were related to the high prevalence of Brucellosis and Toxoplasmosis in camels' herds. Furthermore, this study found out that the camels in Kirkuk city might be the source of these infectious agents and disseminated the diseases to the human through their contaminated dairy products and meat.
Evaluation of the PBMC Proliferation, Apoptosis and Cytokines Profiling in Cattle Infected with Mycoplasma bovis Strain 07801
Authors: Askar Hussam
Published: August 2021

Bovine respiratory diseases are widespread and too costly disease impacting contributes to economically essential diseases like mastitis and pneumonia worldwide. The present study aimed to explore the influence of M. bovis field strain 07801 on the status of PBMCs in the challenged cattle group and the immunized one. For this aim, the PBMCs proliferation, apoptosis, and cytokine profile changes were determined. In this study, M. bovis strain Mb 07801 and reference strain PG45 were used; ten calves (2-3 months old) were arranged into two groups (5 calve each): 1) PBS-challenged group (with M. bovis 07801 at about 1010 CFU/ml), and 2) immunized group (by Inactivated M. bovis 07801); both groups were treated nasally and intra-tracheal. Blood samples were obtained from both groups and examined for PBMCs proliferation and apoptosis, as well as serum cytokine profile, before infection and at day zero and days 7, 14, 21, and 36 post bacterial treatment. The results revealed that M. bovis strain (07801and PG45) antigen increased the proliferative response of the stimulated PBMC compared with the unstimulated cells and ConA-alone stimulated. The PBMC apoptosis showed a non-significant increase in both challenged and immunized groups compared to the negative and positive control (treated with apoptosis inducer) groups. Besides, the levels of cytokines profile showed a significant up-regulation in IFN-γ, IL-4, IL-2, IL-18, TNF-α, IFN-α, IL-6, IL-10 IL-1β, and IL-13, in both groups, except IL-4 and IL-18 those recorded a down-regulation in the immunized group at days 7,14, 21, and 36 post-M. bovis infection. In conclusion, immunization markedly ameliorated the immune deterioration induced by M. bovis strain 07801.
Antimicrobial Resistance and Virulence Genes Distribution in Trueperella pyogenes Isolated from Dairy Cows with Clinical Mastitis in Liaoning of China
Authors: Guo Yuru
Published: August 2021

Trueperella pyogenes is considered as a causative agent of many infections, such as mastitis, endometritis, pneumonia, liver abscessation. T. pyogenes can express several virulence genes such as plo, fimA, cbpA, nanH and nanP contributing to its pathogenicity. The aim of this study was to provide an investigation about antimicrobial resistance, as well as virulence genes distribution and gene cassettes among T. pyogenes isolates from dairy cows with clinical mastitis. The susceptibility to different antimicrobial agents was determined by the Broth Microdilution Method, and virulence genes and gene cassette was detected by polymerase chain reactions (PCRs). There are 10.49% (17/162) of milk samples from dairy cows with mastitis were positive for T. pyogenes. High levels of resistance were found to clindamycin (23.53%), oxytetracycline (23.53%), ciprofloxacin (47.06%), sulfamethoxazole/trimethoprim (100%). Moreover, all isolates carried class I integrons, and gene cassette arrays were aadA9 (2/17) or aadA5-dfrA17 (3/17). Finally, all isolates harbored plo nanH and fimA genes, but other genes encoding virulence genes including fimC, fimE, nanP and cbpA are ranged from 47.06% to 88.23%. Our study showed T. pyogenes isolates from dairy cows with clinical mastitis were susceptible to β-lactams. In addition, all seven virulence genes occurred in isolates, and plo, nanH, and fimA gene showed a significantly higher frequency in T. pyogenes of the Liaoning Province, China.
EMERGENCY ABDOMINAL SURGERY;
Authors: SULTAN JUNAID , BILAL HARIS BIN , KIRAN HUMAIRA , Bilal Badar Bin , Yusuf Azam
Published: August 2021

Intra-abdominal (I.A) sepsis is widely recognized as the leading cause of death in patients following emergency abdominal surgery. Objective To determine the incidence of intra-abdominal sepsis after emergency abdominal surgery. To study the predisposing factors which lead to post-op. I.A sepsis. To determine the micro flora involved in I.A sepsis Study design: A quantitative cross sectional study.. Place of study: Surgical unit-l General Hospital Rawalpindi. Period: March 1999 to August 2000. Material & methods:565 patients) were followed after emergency abdominal surgery and incidence determined. Results: These 565 patients included 400 patients of acute appendicitis, 140 patients of emergency laparotomy and 25 patients of obstructed/strangulated hernias. The incidence of I.A sepsis after emergency abdominal surgery was found to be 10.6% with incidence of generalized I.A sepsis of 6.6%. Different risk factors predispose to the development of post-op. I.A sepsis. Aerobic microflora of the I.Asepsis consists predominantly of E.coli. Overall mortality rate was 7.6% with 4% cases due to post-op. I.A sepsis. Mortality rate in patients with post-op. I.A sepsis was 38.33% with mortality rate of 78% in patients with post-op, generalized I.A sepsis and of 20% in patients with I.A abscesses. Conclusion: IA sepsis continues to be one of the major challenges in general surgery. A successful outcome depends on early diagnosis, rapid and appropriate surgical intervention, prompt administration of broad spectrum antibiotics and aggressive supportive care in ICU remains the therapeutic strategy for these patients. It is important first to determine the risk status of these patients and then to apply proper and sound surgical technique and do timely decision.
BACTERIOLOGY OF SPONTANEOUS BACTERIAL PERITONITIS
Authors: MUHAMMAD DILSHAD , Husain Aamir , JAVED MASOOD , Qayyum Abdul , IQBAL MUHAMMAD NAEEM
Published: August 2021

Cirrhosis is a major cause of mortality worldwide and is the most common non neoplastic cause ofdeath among hepatobiliary and digestive diseases. Ascites is often among the first signs of de-compensation in patientswith chronic liver disease. Spontaneous Bacterial Peritonitis (SBP) (with out any source of infection) occurs in 30% ofpatients with ascites. Common causative organisms include escherichia coli, pneumococcus, Klebsiella and anaerobes.It has a 25% mortality and recurs in 70% of patients within a year. Objective: To determine the pathological agentscausing SBP in patients with liver cirrhosis. Design: Descriptive study. Setting: Medical Ward Allied and K.M. HospitalsFaisalabad. Period: From 17 Nov 2004 to 15 May 2005. Patients & Materials. Fifty patients of either sex havingcirrhosis of liver and ascites were included according to the criteria i.e ascitic fluid leukocyte count of >500 cells/L or>250 PMN, while results of bacterial cultures of ascitic fluid were pending. Results: Out of 50 patients, 27 (54%) weremales and 23 (46%) females. Mean age of whole the population was found to be 51±12.49) yrs. Classical spontaneousbacterial peritonitis was present in 27 patients and Culture Negative Neutrocytic Ascites (CNNA) in 23(46%) patients.Out of 50 patients, 27(54%) samples of ascitic fluid showed positive culture reports. E Coli was isolated in 9(18%)cases. Klebsiella pneumoniae in 6(12%), streptococcus pneumoniae 4(8%), staphylococcus aureus 2(4%),pseudomonas aeruginosa 2(4%). Acinobacter 2(4%) and proteus mirabilis 2(4%). E.Coli is the commonest organismfollowed by klebsiella pneumoniae.
ACUTE CHOLECYSTITIS
Authors: CH TARIQ HASSAN , ALI ASGHAR
Published: August 2021

Introduction: Gallstones are common biliary pathology. The Vast majority of subjects are asymptomatic. About 0.2% of the population suffering from gallstones develop acute cholecystitis every year. In case of acute calculous cholecystitis, cholecystectomy can be performed early i.e during the same admission or interval i.e after 6 weeks of conservative management. Objective: To compare the early and interval cholecystectomy in acute calculous cholecystitis for morbidity, postoperative hospital stay, total hospital stay and complications. Study Design: Quasi-experimental study. Setting: Department of Surgery Bahawal Victoria Hospital Bahawalpur. Duration of Study: Two year study from December 2007 to December 2009. Subject and Methods: Sixty patients fulfilling the inclusion criteria were selected for this study. The patients were divided into two groups. Group A patients were managed by early cholecystectomy and group B patients by intervalcholecystectomy. Postoperatively patients were evaluated for postoperative hospital stay, total hospital stay and postoperative complications. Results: The mean age of the patients in group A was 42.2 + 10.7 years and in group B was 42.2+ 10.7 years. The Male to female ratio was 1:4 in both groups. The mean postoperative hospital stay in group A was 4.0+ 1.8days and in group B was 3.8+ 1.4 days. The mean total hospital stayin group A was 6.5 + 1.7 days and in group B was 10.2 + 1.3 days. The P value was less than 0.001, which was significant. In distribution of postoperative complications, in group A there were 1(3.3%) injury to biliary tree, 4(13.3%) wound infection,1(3.3%) wound haematoma, 3 (10%) seroma and 1(3.3%) wound dehiscence. While in group B there were 1(3.3%) injury to biliary tree, 3(10%) wound infection,2 (6.7%) woundhaematoma, 2(6.7%) & no patient of wound dehiscence. Conclusion: Our study suggests that early cholecystectomy is a better treatment option than interval cholecystectomy because it has less total hospital stay, needs single hospital visit and has no risk of developing complications during wait for surgery.
POSTDURAL PUNCTURE HEADACHE
Authors: SOHAIL BEHZAD , SHARIF ASJAD , ADNAN AHMED , Iqbal Rashid , Zahoor Umer
Published: August 2021

Objective: To evaluate the role of needle diameter in causing postdural puncture headache (PDPH) in patients undergoing elective caesarian section. Study Design: Comparative cross-sectional study. Place and Duration of Study: This study was conducted in Department of Anaesthesia and Intensive care PNS Shifa Karachi over duration of six months. Patients and Methods: It was a cross sectional study of 100 patients, which were divided into two separate groups. Group I and Group II were given spinal anaesthesia with 25 gauge and 27 gauge Quincke needles respectively. In both the groups the patients were randomly selected and were blind to size of the spinal needle used. Results: The data was analyzed using Chi-square test. A P value of <0.05 was considered statistically significant. Two patients in 25-G group and one in 27-G group required additional general anaesthesia because of inadequate spinal anaesthesia. Thus, a total of three patients were excluded from the study. Five out of forty-eight patients in group 1 and one out of forty-nine patients in Group II suffered from post spinal headache. Conclusions: The proportion of patients with post spinal headache with 25 G needle is significantly more than those with 27 G.
RABBIT SEMINIFEROUS TUBULES
Authors: REZIGALLA ASAAD ALI , - TINGARI , - MAKAWI
Published: August 2021

Objective: The aim of this article was to study the ultrastructure of the boundary tissue of rabbit seminiferous tubule. Design:Experimental study. Period: During July 2010 to July 2011. Material: Eight sexually mature male rabbits (Oryctolagus cuniculus) were used inthis study. Rabbit maturity was determined by age and semen samples. Method: Ultrastructure observations by electron microscopetransmission of normal rabbit testes. Setting: Samples processing were done in both university of Khartoum (Sudan) and then Assiut university(Egypt). Results: The boundary tissue is formed of three lamellae, inner fibrous, inner and outer cellular lamellae. The inner fibrous lamellaconsists of three strata; internal and external homogenous enclosing a middle stratum of collagenous fibers. The internal homogenous stratumof the inner fibrous lamella is subdivided into four layers of moderate electron density. Conclusions: The general structure of the seminiferoustubule of rabbit is similar to that of hamster and mouse, but the internal homogenous stratum is formed of four layers.
GROWTH HORMONE THERAPY;
Authors: AHMAD, COL NAYYAR , NADEEM, COL. MOHAMMAD TARIQ , NAYYAR, MAJ. ZAMEER AHMAD
Published: August 2021

Objective: To detect growth hormone deficiency in short stature children and to observe the response of growth hormonereplacement therapy in isolated GH deficient. Design: An interventional descriptive study. Place and Duration of Study: The study wascarried out in the Department of Pediatrics at Military Hospital Rawalpindi in collaboration with Armed Forces Institute of PathologyRawalpindi over a period of two years from Jan 2007 to Dec 2008. Patients and Methods: Thirty short children between three to fourteenyears of age having isolated growth hormone deficiency confirmed by laboratory investigation were included in the study prospectivelyand retrospectively. Growth hormone replacement therapy with recombinant GH was given to all children at the dose of 0.14iu/kg, sixdays a week subcutaneously. Each patient was assessed and evaluated after every three months. Results: The mean chronologic agewas 8.05 +/- 2.74 years with a height age of 4.02 years. The male to female ratio was 1.72:1. They were treated with recombinant GH in adose of 0.14iu/kg, six days a week, subcutaneously at evening. Response to GH was excellent and the mean growth speed had gone upfrom 2.53 +/- 0.87 cm per year before the treatment to 8.94 +/- 3.18 cm / year in the first twelve months of treatment and 6.8 +/- 1.6cm / year during the second year of treatment. During the first twenty four months of treatment, height standard deviation score increasedby 1.0 +/- 0.4 SD (p < 0.0001) The height velocity increased, the bone age / chronological age ratio and height SDS for chronologicalage decreased, while height SDS for bone age increased. There were no adverse reactions. Conclusion: Short stature with classic growthhormone deficiency is not uncommon. Early diagnosis and prompt treatment with growth hormone replacement has a very goodoutcome and the child attains a reasonable height.
PATHOGENS FROM DRINKING WATER
Authors: Din Mohammad , Ahmad Zafar , Aleem Abdul , Pirkani G.S. , Mohammad Amir , Ahmad Nazeer
Published: August 2021

… Objectives: Main objective was to check drinking water for pathogenic bacterialload, their resistance to antimicrobials and to create awareness among the people of Quetta cityabout safe drinking water. Place and Duration of Study: The study was conducted inDepartment of Microbiology Bolan Medical Complex Hospital Quetta during the hot season inQuetta City (June- September 2013). Methodology: One hundred and twenty five (125) tapewater samples were collected aseptically in 200 ml sterile caped glass bottles from differentlocalities of Quetta city. Samples were passed through mille pore assembly containing 0.45 μmpore-sizecellulose nitrate sterile membrane filter (MF).Viable count technique was used forenumeration of water samples having high bacterial burden. Serological tests and analyticalprofile index API-20E (Biomerieux France) were used to identify pathogens according to themanufacturer’s directions. Standardized antibiotic sensitivity test was performed on MuellerHinton agar using disc diffusion Kirby Bauer technique and McFarland Turbidity Standardmethod 0.5 following CLSI protocols. Results: Out of hundred and twenty five (125) tape watersamples 110 (88 %) showed highly pathogenic bacterial load, in which the most prominentorganism was E.coli 36 (28.8 %), followed by Enterobacter 35 (28 %), Klebsiella 24 (19.2 %),Pseudomonas, 10 (08 %), and Salmonella 05 (04 %). All pathogens in this study expressed a highlevel of resistance to antimicrobials that are commonly used in clinical medicine i.e. Tetracycline,Gentamycin, Sulphamethaxazole, Piperacillin, Ampicillin, Augmentin and Imipenam etc. Only 15(12 %) samples were pathogens free. Conclusion: Among drinking water samples the presenceof pathogenic bacteria (88%) is alarming for public health authorities. The emergence ofresistance and decreasing level of susceptibility of pathogens to a wide spectrum ofantimicrobials is a matter of great concern, because it may limit the availability of antimicrobialsfor clinical management of water born outbreaks in future.
RISK FACTORS FOR HEPATITIS;
Authors: CHAUDHRY MUHAMMAD ASHRAF , GHULAM BUSHRA , KHALID LAILA , Ahmed Marryam Shaheen , - Amnah
Published: August 2021

Background: Infections with Hepatitis B Virus (HBV) and Hepatitis C virus (HCV) are worldwide public health problem. Thisis related to the continued occurrence of new infections and the presence of a large reservoir of chronically infected persons. Objective:To determine the frequency of risk factors (causes of transmission) for HBV and HCV infections in hospitalized patients of CMH, Lahoreand Sheikh Zayed hospital, Lahore. Design: Descriptive (cross sectional). Setting: The study was carried out in CMH, Lahore and SheikhZayed hospital, Lahore from January, 2012 to July, 2012. Methods: The patients were selected by consecutive (non-probability)sampling technique. The data was collected through questionnaire. Informed written consent was obtained SPSS version 16.0 was usedto calculate the descriptive statistics. Results: Out of total of 100 subjects, 50 were cases and 50 were controls. Out of 50 cases, 26%were HBV positive and 74% were HCV positive with female preponderance. The history of injections was very high in both the groups,making a total of 64% (14% HBV; 16% HCV) the important contributors for different types of hepatitis were blood transfusion (HBV =10%; HCV = 28%; controls = 14%). Surgical procedures (4% HBV, 28% HCV; 8% controls). History of piercing in the last six months(HBV = 6%; HCV = 22% and control = 8%). History of dental procedures in the last six months was higher in HCV patients (18% HCV and4% HBV). History of HBV or HCV positive patients or relatives at home. (HBV 18%; HCV 36%; control 30%). Conclusions: In Pakistan thereis an urgent need to raise the public awareness about importance of properly screened blood transfusion, use of disposable needles andusing new blades for shaving and haircuts especially at barber shops. In our study, the important contributors for different types ofhepatitis were blood transfusion, surgical procedures and history piercing in the last 6months.
SALVADORA PERSICA;
Authors: Hoor Talea , Farooqu Riffat , Shaikh Jan Mohammad , Karim Nasim
Published: August 2021

Objective: To evaluate anti-inflammatory activity of Salvadora persicain rats.Materials & methods: The anti-inflammatory activity of Salvadora persica was assessed in 63albino rats of both sexes, weighing 400 gm. They were divided into three groups, A (control), B(crude drug), C (standard drug) with twenty one animals. Each group was divided into threesubgroups with seven animals. Groups B &C were given crude drug and aspirin diluted in one mlof distilled water once daily orally, in doses of 300, 500, & 700 mg/kg body weight respectively,prior to induction of edema and Group A was given same volume of saline. Inflammation wasinduced in hind paw of rat by sub-planter injection of 0.1ml of 1% carrageenan. Paw volume wasmeasured in terms of milliliters using plethysmometer, immediately before injection & then hourlyup to 5 hours& mean was calculated. The inhibition of edema was calculated for each subgroupwith respect to control group. Results: After carrageenan injection mean paw volume of controlgroup was 5.43 ml, while that of drug treated subgroup was 4.32 ml & standard group was 4.49 mlat the dose of 700 mg/kg body weight. Comparison of crude drug with the control was found to bestatistically significant only at 700 mg/kg & was comparable with the standard drug aspirin.Conclusions: Salvadora persica has shown anti-inflammatory activity by decreasing the pawvolume of carageenan induced edema.
CANCER TYPES;
Authors: Qaisar Abdul Matin , Sirhindi Ghazanfar Ali , Mandokhel Shamayal
Published: August 2021

Introduction: This study attempts to highlight the relation of various types ofcancers to abnormalities in liver and renal function tests. Objectives: Correlation of derangedrenal and liver function tests to different types of cancers in industrial workers who are exposed toindustrial chemicals and carcinogens. Patients and Methods: This non-interventional studyincluded 100 hundred confirmed cases of cancer were selected and studied from July 2011 toDecember 2011. The study was conducted at Fatima Memorial Hospital/College of Medicine &Dentistry, Lahore . Results: Out of these 100 patients, 21 had CA lung, 19 had lymphoma, 14 hadsarcoma, 13 had CA breast, 6 had CA prostate, 4 had CA liver, 3 had CA colon, 3 had CA ovary, 3had CA testis, 2 had leukemia, 2 had multiple myeloma, 2 had CA gall bladder, 2 had CA stomach,1 had CA esophagus, 1had CA tongue, 1had CA parotid, 1 had CA rectum, 1 had CA cervix and 1had CA larynx. Among lymphoma, non-Hodgkin lymphoma was more than Hodgkin lymphoma(out of 19 patients, 13 had non-Hodgkin and 6 had Hodgkin lymphoma). Out of 14 patients ofsarcomas, 5 had Ewing sarcoma, 4 had chondrosarcoma, 3 had fibrosarcoma and 2 hadliposarcoma. Similarly the serum bilirubin levels in liver cancer, ovarian cancer, multiplemyeloma, stomach and gall bladder cancer were 1.50±0.31, 1.17±0.10, 1.46±0.15 and1.40±0.50 mg% were 32.38±18.81, 37.73±4.35, 34.43±4.35, 45.00±46.17, 31.33±44.70,65.25±31.14, 33.67±80.90, 99.00±73.08, 50.00±98.49, 33.50±75.0, 36.50±85.0 and49.0±11.0 μ/l respectively which were statistically significantly higher (p<0.05) then controlindividuals. respectively which were significantly higher (p<0.05) than the control individualsSimilarly the ALT levels in lung cancer, lymphoma, sarcoma, breast cancer , prostate cancer, livercancer, leukemia, ovarian cancer, cancer of colon, multiple myeloma, cancer of testis andstomach. The mean serum creatinine levels in lung cancer, liver cancer and cancer of colon were0.89±0.05, 0.90±0.16 mg% respectively which were significantly higher than the controlindividuals (p<0.05). Conclusions: The renal and liver function tests should be frequentlymonitored in cancer patients from industrial back grounds.
OPERATIONS
Authors: Jawaid Masood , Moosa Foad Ali , Jaleel Farhat , Khalique Abdul
Published: August 2021

Objective: To find out reasons for cancellation of operation on the day of surgeryin the Surgical Department of Civil Hospital Karachi. Design: Observational study. Setting &Period: All operation theatre bookings of the Civil Hospital Surgical Department from July 2010 toOctober 2010 have been studied by using the ‘daily operating theatre lists’. Frequency ofcancellation, type of surgeries cancelled and their reasons studied. Results: Out of total 455cases, 97 (21%) surgical operations were cancelled on the day of surgery, highlighting patients’non-compliance as a major contributing reason, followed by the lack of operating room time andother causes. Among the less contributing factors were patient expiry on table, failure toadminister anesthesia and delay in operation due to exams (engagement of patients inundergraduate exam in the college). Conclusions: Patients non-compliance is a majorchallenging factor that causes a large number of cancellations of operations in the Civil HospitalKarachi.
ENDOSCOPIC THIRD VENTRICULOSTOMY (ETV)
Authors: Haq Mian Iftikhar ul
Published: August 2021

Objective: To know the surgical outcome of endoscopic third ventriculostomy(ETV) in non communicating hydrocephalous. Design: Cross sectional descriptive study.st Setting: Neurosurgery department of Hayatabad Medical Complex, Peshawar. Period: 1 March2010 to 1st march 2011. Materials and methods: A total of 41 patients with non-communicatinghydrocephalous, irrespective of gender discrimination were included in this study. Patientsbelow two years of age and hydrocephalus with infected CSF or hemorrhage were excluded.Hydrocephalous was diagnosed on CT scan brain. The information regarding patientdemographical details, causes of hydrocephalus and complications of procedure wasdocumented in patient’s Performa. The data was analyzed by SPSS version 16. Frequency andpercentage was calculated for categorical variables. Mean ± SD was calculated for age. Resultswere presented as tables. Results: A total of 41 patients with non-communicatinghydrocephalous were included in the study. Out of 41 patients, there were 26(63.41%) males and15(36.58%) females. The mean age was 21 years. Etiologically tuberculous meningitis was thecommonest cause of non communicating hydrocephalous. Post-operatively CSF leakage waspresent in 4(9.75%) patients, pseudomeningocele in 2(4.87%) patients, transient memory loss in2(4.87%) patients and pneumocephalous in 1(2.43%) patient. Conclusions: The complicationsof endoscopic third ventriculostomy are transient. Those patients who meet the criteria,endoscopic third ventriculostomy offers the possibility of freedom from shunt dependency.
OVERT HYPOTHYROIDISM;
Authors: Lohano Ashok Kumar , Siaya Noor Nabi , Samie Adnan
Published: August 2021

Objective: To assess the frequency of common presentations of the overthypothyroidism. Study design: Cross sectional study. Setting: This study was conducted at allOPD’s of peoples’ medical college hospital nawab shah, a tertiary care hospital, from 01-10-2012to 31-03-2013. Material and methods: This study was conducted at all OPDs of Peoples’medical college hospital Nawabshah, a tertiary care hospital, from 01-10-2012 to 31-03-2013.Patients visiting outpatient department (OPD) meeting the inclusion criteria were involved instudy. Inclusive criteria were diagnosed cases of overt hypothyroidism, age 18-60 years and bothgender. Exclusion criteria were age less than 18 years and more than 60 years and pregnantwomen. The collected data was entered and analyzed by using Statistical Package for SocialSciences (SPSS) software, Version 17. Results: Among 126 patients that had hypothyroidism,there were 46 males(36.5%) and 80 females(63.5%). Mean age of patients was 37.60 ± 7.54years. Most of the patients presented with symptoms of cold intolerance (62.7%) dry skin(61.9%), pedal edema (57.1%), weight gain(56.3%) while rest presented with hair loss (20.6%),bradycardia (29.4%) & delayed tendon reflexes (27.8%). Overt hypothyroidism was presented inonly 21 (16.7%) patients. Conclusions: The frequency of Hypothyroidism vary in different areas,and is affected by Socio-demographic, nutritional status, illiteracy level and personal self-care.
CANCERS
Authors: Muhammad Noor , Rafique Muhammad , Baloch Saud , Raza Syed Hyder , Khan Hina , Quresh Saeed
Published: August 2021

Objective: To calculate the prevalence of common types of cancer in SINDHbased on Civil Hospital Karachi (CHK) database. Type of Study: Retrospective ObservationalStudy. Place & Duration of Study: Clinical Oncology Department Civil Hospital Karachi, fromJanuary, 2004 to December 2011(8 Years). Methods: All the Patients attending the oncologydepartment CHK were selected for study. After completing data the cancer registry patients werecategorized according to their diagnosis and this data was recorded on Microsoft Excel sheet.Results: During period of January 2004 to December 2011, the total number of patients includedin the study was 5504 out of which 2638 were males and 2866 females. The list of prevalence ofdifferent types of cancer was created and according to the statistical analysis based on CHK database, the increasing trend was seen in breast, oral cavity, lymphoid tissue, blood, colorectal, liver& biliary tract, faciomaxillary, lung, uterus, esophagus, gastrointestinal stromal tumor, larynx,ovary, male genital system, Nasopharynx, urinary system and brain cancers. Conclusions: It isconcluded that the registration of cancer patients is highly beneficial for the evaluation of cancerprevalence and incidence. This registration is also helpful for calculating the comparativeincidence and prevalence of cancers on national and international levels. The recorded data willalso help to improve the quality of life of cancer patients as this data is very much helpful toidentify the etiology and risk factors of cancers which will improve health prevention andmanagement plans by higher authorities.
EARLY CHOLECYSTECTOMY
Authors: Sajid Muhammad , Azim Khalid , Rehman Sajid , Saqib Khurram
Published: August 2021

Background: This study was conducted to evaluate results of earlycholecystectomy in acute cholecystitis in terms of procedural safety. Methods: In this study 50consecutive cases of acute cholecystitis who underwent early laparoscopic cholecystectomy(within 03 days of attack) were included. Patients with symptoms of more than 03 days durationor those with associated diseases were excluded. Evaluation of results was done by analyzingthe data in SPSS V-17. Results: Out of 50 patients operated 46 (92%) were female and 4 (8%)were male. Most of the patients were received within 24 hours after the onset of symptoms. Theage of patients ranged from 30-70 years with the median age of 45 years. Ultrasound revealedoedematous gall bladder with pericholecystic fluid in 38 (76%) patients. In 8 (16%) patients, gallbladder was small, shrunken and thick walled, there was empyema in 2 (4%) patients &mucocele with stone impacted at hartmann’s pouch in 2 (4%) patients. Average operation timewas 40 minutes. All patients were operated within 72 hours of onset of symptoms. Per operativelysevere inflammation was noted in 32 (64%) patients, adhesions with colon/stomach/omentum in10 (20%) patients, adhesions with CBD in 3 (6%) patients, distorted anatomy at Calot’s triangle in5 (10%) patients. 6 (12%) patients had bleeding from liver bed, but controlled with diathermy. In46 (92%) patients laparoscopic cholecystectomy was completed successfully. In 4 (8%) patients,laparoscopic procedure was converted to open cholecystectomy. Reasons of conversion wereacute cholecystitis with severe adhesions which caused bleeding in 2 (4%) patients, obscureanatomy of Calot's triangle in 2 (4%) patients. Post operatively, there was bile leak in 1 (2%)patient which was due to minor injury of CBD, which required re-exploration & suturing of defect.No patient developed post operative jaundice. There was no major bleed post operatively. 3 (6%)patients developed wound infection. Conclusions: Laparoscopic cholecystectomy is aneffective and safe technique of treating symptomatic gallstones even in cases of acutecholecystitis because of accelerated recovery couple with less postoperative pain and shorthospital stay.
SNAKE VENOM
Authors: Mahmood Hamid , Afaridi Nazar , Mashoori Abdullah , Waqar Ammara , Rehman Mujadid-ur-
Published: August 2021

Introduction: Viperidae venoms contain toxins that are direct or indirectanticoagulants that inhibit the clotting pathway, therefore increasing the risk of bleeding. Severalvenoms from the families Viperidae contain proteolytic enzymes that exercise some effect on theblood coagulation process. Snake venom toxins which delay blood coagulation are proteins orglycoprotein with molecular weights ranging from 6 kDa to 350 kDa. These factors inhibit bloodcoagulation by different mechanisms.Some snake venoms contain toxins that are direct orindirect anticoagulants, which inhibit the clotting process, thus increasing the risk of bleeding.Snake venom toxins that prolong blood coagulation are proteins or glycoproteins with molecularmasses ranging from 6 to 350 kDa. Methods: The crude venom of E. carinatuswas obtained fromthe Venomous Animals from department of microbiology Hazara University, Mansehra(Pakistan). Sephadex G-75 and DEAE-Sepharose columns were purchased from Pharmacia(Sweden). CaCl2 and PT kit was purchased from Fisher Diagnostics (USA). Protein markers wereobtained from BioRad (Hercules, USA). Other reagents and chemicals were of analytical gradefrom Fluka and Merck. Results: The anticoagulant fractions (F2C and F2D) isolated in thepresent work were characterized as proteases, since a photolytic effect was observed on casein,BAPNA or human plasma. Our results showed that the PT value significantly increased in the F2Cand F2D fractions as compared with PT value of the crude venom. Conclusions: Inthe presentstudy, the venom of Echiscarinatuswas fractionated by chromatography and each fractionevaluated by PT test. These fractions showed enzymatic activity. Their main components wereproteins of molecular weights of about 42, 50 and 79 kDa. . Further studies are needed to verifythis hypothesis.
ACUTE MALNUTRITION
Authors: Shah Syed Muhammad Hussain , Shaikh Farzana , Memon Shazia , Siyal Abdul Rehman , Nizaman Muhammad Akbar
Published: August 2021

Objective: To determine the frequency of low mid upper arm circumference(MUAC) of children with acute malnutrition. Patients and methods: This study was conducted inthe department of paediatrics at Liaquat University Hospital Hyderabad from 01-06-2012 to 30-11-2012. All the children with features of malnutrition, of either gender were recruited andevaluated for their mid upper arm circumference which was measured through plastic measuringtape. Result: During six month study period, total 135 children with acute malnutrition werestudied for their mid upper arm circumference (MUAC), of which 95(70%) were males and40(30%) were females. The mean age ±SD of overall population was 30.24±10.57 month whilethe mean age of male children was 32.88±11.76 and the female child was 31.62±10.97 months.Regarding the MUAC, was low in 93(68.9%) children with acute malnutrition. The mean age ±SDof child with low MUAC was 28.99±12.52 while the mean ±age of male and female child with lowMUAC was 27.63±10.73 and 29.85±11.64 respectively. The mean MUAC in children of acutemalnutrition with low MUAC was 8.85±3.93 while it was 8.66±3.96 and 8.93±3.31 in male andfemale child with low MUAC respectively. Conclusions: The present study suggested that MUACis appropriate and good tool for identifying severe malnutrition in children.
INTRAOCULAR PRESSURE
Authors: Ahmad Munir , Ahmed Iftikhar , Ahmed Waqar , Syed ZulfiqarUddin
Published: August 2021

Objective: To assess the incidence of steroid induced rise in intra-ocular pressurein different group of patients. Place and duration of study: The study was conducted in thedepartment of ophthalmology Akhtar Saeed Trust Teaching Hospital of Akhtar Saeed Medicaland Dental College Lahore and Continental Medical College Lahore from Jan 2009 to Oct 2010.Material and Methods: Three groups were formulated in which group A comprised of normalpopulation with no ocular disease, group B included patients with vernal keratoconjunctivitiswhile group C comprised of chronic simple glaucoma patients with controlled intraocularpressure. Dexamethasone 0.1% eye drops were used four times daily for four weeks and patientswere evaluated weekly in terms of IOP monitoring after which they were labeled as either low ornon-responders, moderate responders or high responders. Results: In group A 40% of thepatients showed rise in IOP, group B showed 95% rise in IOP and the response in group C caseswas 100%. Conclusions: Topical steroids result in significant rise in IOP therefore carefulmonitoring should be done in all patients on corticosteroids.
POLYCYSTIC OVARIAN SYNDROME
Authors: Yasin Misbah , Yasmeen Fouzia
Published: August 2021

Objectives: The objective of this study is to: describe the pattern of disease inpatients with polycystic ovarian syndrome. Data Source: Medline Data Base. Design Of Study:Descriptive case series study. Settings: Gynaecological Outpatient Department of Ghurki trustteaching hospital Lahore. Duration: 6months period, from 8th October 2012 to 7th April 2013.Materials & Methods: Sixty cases of polycystic ovarian syndrome as diagnosed on ultrasoundwere selected. These cases were examined for height, weight, body mass index, hirsutism, acne,acnthosis nigricans, breast examination (galactorrhoea). These cases were investigated forblood sugar (random), Fasting Insulin, pelvic ultrasound, LH, FSH and serum prolactin. Results:The mean age of the patients were 24.93±5.67 years. There were 28 (47%) patients of menstrualdisturbance, 18 (30%) patients of subfertility, 9 (13%) of obesity. There were 13 (21.7%) patients2of BMI level of equal to or less than 25 kg/m and 47 (78.3%) patients of BMI level more than 252kg/m . There were 25 (41.7%) patients of hirsuitim, 14 (23.3%) patients of acne and 17 (28.3%)patients of acanthoris nigricans on physical examination. There were 28 (46.7%) patients of LHlevel of more than 10 IU/L (raised) and 1 (1.7%) patient of more than 350 mU/L prolactin (raised).The mean right ovary volume of the patients was 12.08±3.04 and mean left ovarian volume of thepatients was 11.86±4.83. Conclusions: Hirsutism and cycle disturbances are the major clinicalfeatures of polycystic ovarian syndrome patients. Obesity seems to be more prevalent inpolycystic ovarian syndrome patients. The ratio between LH and FSH as a diagnostic tool waslow in our patients.
FRUCTOSE;
Authors: Naz Zehra , Naveed Abdul Khaliq , Raza Mehdi
Published: August 2021

Objectives: To study and compare the effects of fructose and galactose on, bloodglucose, insulin, HbA and lipids and anthropometric measurements. Data Source: Ninety, 1chealthy adult male rats of Sprague-Dawley strain. Design: Experimental study. Setting:Department of Biochemistry and Molecular Biology, A.M.C, Rawalpindi, in collaboration withN.I.H, Islamabad. Period: Twelve months. Subjects and Methods: Rats weighing 180-350 gramswere selected by random sampling and were divided into three groups, 30 each. Group I wasgiven standard diet, Group II was given high fructose diet (HFD), i.e., 1.5gms/Kg body weight/dayof fructose, along with standard diet for two weeks and Group III was given high galactose diet,i.e., 0.83gms/Kg body weight/day, along with standard diet for two weeks. Results: There was asignificant increase in height of galactose group while fructose group has significant weight loss;BMI decreased in both but more in former. The blood levels of cholesterol, HDL-c, LDL-c, TG, andinsulin were significantly higher in fructose group than in galactose group. There was nosignificant difference between blood glucose and HbA among these groups yet their higher 1clevels indicate the chances of developing insulin resistance. Conclusions: Fructose due to itsless hyperglycaemic effects should not be used in diet and must not be prescribed in diabetes, asin the long run it can lead to obesity, hypertension and cardiovascular risk. Non-significant effectsof galactose on above parameters (except lipoproteins), does not mean that it can be used as analternative to fructose and this area needs exploration.
DENGUE FEVER
Authors: Naeem Muhammad , Shaheen Aneela , Batool Saima , Rubab Sara , Saba Tehmina , Riaz Tooa , Mahmood M. Arshad
Published: August 2021

Background: Dengue is the most prevalent mosquito-born viral illness in theworld. Clinically dengue ranges from asymptomatic, non-febrile illness, classic dengue todengue hemorrhagic fever/dengue shock syndrome. Objective: Subjects & Methods: Thisstudy was included 79 patients conducted at Nawaz Sharif Social Sevurity Hospital, Lahoreduring the epidemic of dengue in Lahore from September 2011 to Dec 2011. Results: Twenty outof 79 patients suspected of dengue fever were dengue IgM positive. Male to female ratio was1.19: 1. Our study included 79 patients suspected of having dengue fever. Fever was the mostcommon symptom in these patients. Conclusions: Early identification of dengue with risk ofdeveloping hemorrhage is an important clinical objective. The morbidity and mortality can bereduced by appropriate and judicious treatment of dengue patients.
BREAST CANCER
Authors: Shaikh Naseer Ahmed , Rajput M. Jawaid Aqeel , Samo Rukhsana , Soomro Rasheed Ahmed
Published: August 2021

Object: Evaluation & distribution of established etiological risk factors in patientsof breast cancer in our local population. Study Design: Institution based non-interventionaldescriptive & prospective study Place & Duration: Department of Pathology, Liaquat Universityof Medical & Health Sciences, Jamshoro from January 2009 to December 2011. Material &Methods: One hundred & two cases of breast cancer diagnosed on HE staining were selected forthe study. Results: More than 50% were in 4th and 5th Decades of life. 94% were married and06% were un-married. 65% were in pre-menopausal group and 35% in post-menopause group.93% had positive history of breast feeding. None of them had ever taken oral contraceptive.Smoking history was present only in 9.80 % cases. 27% cases had family history of breast cancerin first degree relative & 13% in 2nd degree relatives. Majority (66.66%) were belongs to lowermiddle socioeconomic class. Conclusions: Surprisingly in this study marital status, parity, andbreast feeding not proved as protective factors against breast cancer.
SERUM LIPOPROTEINS AND CHRONIC HEPATITIS C INFECTION;
Authors: Liaquat Jahangir , Bawany . Muhammad Adnan , Ansari Shuaib , Khahro Adnan Ali , Naz Falak , Khanzada Shereen Rahat
Published: August 2021

Objectives: To determine the serum lipid profile in patients with chronic HCVinfection and correlation between serum lipid levels and liver histology. Material and methods:Descriptive study was carried out in Medical Unit I of Liaquat University Hospital JamshoroHyderabad, from September 2007 to August 2009. Convenience sampling was used and 30patients were selected. Positive PCR test for HCV, non diabetic patients and non cirrhotic patientswere included in this study. All the patients were selected from the medical OPD. Clinicalexamination performed and then blood tests were done. Serum lipid profile were determined inall participants after an overnight fast of 12 h. TC, TG, and HDL-C was measured enzymaticallywith commercial kits (Olympus System Reagent, Hamburg, Germany) by the use of anautomated analyzer. The body mass index (BMI) was calculated in accordance with the formulaof weight (kg) divided by height2 (m2). Selected patients were called in the ward and biopsy wasdone via Trucut needle and the specimen was fixed in formalin. The biopsies were used tocalculate the degree of steatosis (0-3) and fibrosis by METAVIR score. Results: A total of 30patients were selected for this study. Out of these 19 were males and 11 females. The patientswere divided in three groups. Patients with chronic HCV infection were found to have significantlylower levels of serum TC, HDL-C and LDL-C than normal adults values. Steatosis was present insignificant number of patients (36.67%). However, steatosis was not correlating with fibrosis(p>0.005). Conclusions: Hypolipoproteinemia and steatosis are important factors which areassociated with chronic hepatitis C
ANEMIA;
Authors: Hashim Nazia , Farooqi Munira , Naqvi Sonia , Jaffery Hassan Fatima
Published: August 2021

Background: Moderate to severe anemia during pregnancy is associated withincreased maternal and fetal morbidity and mortality. Therefore moderate to severe maternalanemia is a high risk group and it is imperative that all cases of anemia should be identified andtreated to ensure adequate hemoglobin level before labour. Different countries have shownconsiderable variations in the prevalence of moderate to severe anemia during pregnancy.Objective: To determine the frequency of moderate to severe anemia during pregnancy and itsassociation with socio-demographic and obstetric characteristics. Study Design: Crosssectionaldescriptive study. Place and duration of Study: This study was conducted from 1stOctober 2011 to 31st March 2012, in the obstetrics and gynaecology department of Sir SyedHospital, a tertiary care hospital in Karachi. Methodology: The patients attending the antenatalOPD between the gestational age of 20 to 41weeks who were moderate to severely anemic (according to WHO criteria based on Hb level) were selected for the study. A self-designedproforma was then utilized to obtain relevant information. This proforma covered sociodemographicas well as patient’s obstetric characteristics. Result: The frequency of anemia wasfound to be 42% (633/1507).Patients with moderate to severe anemia after 20 weeks till 41 weekswere 323. Patients with moderate anemia were 268/323 (83%), while 55/323 (17%) women hadsevere anemia. Majority of women with moderate anemia were multiparous between 26-32 yearsof age and presented between 35-41 weeks gestation. Majority of women with severe anemiawere primigravidas between 18-25 years and presented in late third trimester. Conclusions: Ourstudy revealed multiparity, illiteracy, poverty and late antenatal booking as the factors responsiblefor the severity of anemia during pregnancy. Therefore, anemia should be recognized as aserious public health problem. The adverse effects of anemia can be avoided by counseling onbirth spacing and early antenatal booking.