Journal of Ayub Medical College Abbottabad

Journal of Ayub Medical College Abbottabad

Basic info

  • Publisher:
  • Country of publisher: pakistan
  • Date added to EuroPub: 2019/Nov/23

Subject and more

  • LCC Subject Category:
  • Publisher's keywords:
  • Language of fulltext: english

Publication charges

  • Article Processing Charges (APCs): No
  • Submission charges: No
  • Waiver policy for charges? No

Editorial information

Open access & licensing

  • Type of License:
  • License terms
  • Open Access Statement: No
  • Year open access content began:
  • Does the author retain unrestricted copyright? False
  • Does the author retain publishing rights? False

Best practice polices

  • Permanent article identifier:
  • Content digitally archived in:
  • Deposit policy registered in:

This journal has '55' articles

IMPROVEMENT PROPOSALS FOR CULTURE METHODS TO DIAGNOSIS OF PROSTHETIC JOINT INFECTIONS IN LATIN AMERICA

IMPROVEMENT PROPOSALS FOR CULTURE METHODS TO DIAGNOSIS OF PROSTHETIC JOINT INFECTIONS IN LATIN AMERICA

Authors:
( 0 downloads)
Abstract

Different diagnostic and treatment algorithms for prosthetic infections of the hip and knee are available and widely used in North America. However, for the best of our knowledge, the sampling methodology in Latin American countries is not protocolized varying among the members of the region. In conclusion, we recommend that samples should aim to screen for aerobic, anaerobic, mycobacterial, fungal, and intracellular bacteria. These recommendations are based on experience, especially in Latin America. Further research is necessary for the realization of an international consensus.

Keywords: Latin America; Intraoperative cultures; Surgical site infection; Arthroplasty
NEW DELHI METALLO-BETA-LACTAMASE PRODUCING CARBAPENEM-RESISTANT GRAM-NEGATIVE BACILLI: MICROBIOLOGICAL AND GENOTYPIC ANALYSES AT A TERTIARY CARE HOSPITAL IN PAKISTAN

NEW DELHI METALLO-BETA-LACTAMASE PRODUCING CARBAPENEM-RESISTANT GRAM-NEGATIVE BACILLI: MICROBIOLOGICAL AND GENOTYPIC ANALYSES AT A TERTIARY CARE HOSPITAL IN PAKISTAN

Authors:
( 0 downloads)
Abstract

Background: Metallo-beta-lactamases (MBL) catalyze the hydrolysis of beta-lactam antibiotics including carbapenems. A novel MBL subtype, New Delhi MBL (NDM), poses a serious public health problem. The aims of this study were to determine the frequency of NDM producers among the Carbapenem-resistant gram-negative bacilli (GNB) in hospitalized patients and carrying out the molecular analysis of the NDM genes as reliable data on this is not available in Pakistan. Methods: We carried out a cross-sectional study on prospectively collected clinical samples from 113 patients hospitalised at Shaikh Zayed Hospital Lahore, Pakistan. All the samples that were carbapenem-resistant on routine sensitivity testing were selected for this study. Various microbiological and genotypic analyses of the samples were performed. Results: The mean age of the patients was 47.8±20.8 years. About a quarter (25.7%) of the samples was from the urology ward and 43% were urine samples. Around two-third of the samples (n=74, 65.5%) tested positive for Non-Enterobacteriaceae GNB. Pseudomonas spp was the most common isolate among the Non-Enterobacteriaceae and E-coli amongst the Enterobacteriaceae. NDM gene was detected in 22 patients (19.5%). We did not find any association of the NDM gene with the demographic and clinical characteristics. Conclusion: NDM-positive GNB are present in our hospitalized patients, which is worrisome as these bacteria can disseminate globally and lead to an extensive and uncontrollable spread of pandemic clones for which efficient antibiotic therapy is currently not available. Systemic surveillance network and infection control strategies should be established to curtail dissemination of NDM-producing GNB in Pakistan.

Keywords: Gram-Negative Bacteria; Extended Spectrum Beta Lactamase; New Delhi metallo-beta-lactamase; Carbapenem-Resistant Enterobacteriaceae; Health Care Associated Infections; Pakistan
C1Q NEPHROPATHY: A MULTIFACETED DISEASE WITH INFREQUENT DIAGNOSIS

C1Q NEPHROPATHY: A MULTIFACETED DISEASE WITH INFREQUENT DIAGNOSIS

Authors:
( 0 downloads)
Abstract

Background: C1q nephropathy (C1qN) is a rare glomerulopathy, with a very low prevalence world wide varying from 0.2 to 2.5%. Even though more than three decades have passed since this entity was first explained, still, it remains a dilemma for many due to the rarity of this lesion. This study was carried out principally to determine the clinical presentation, morphologic features and distribution of C1qN in our region based on renal biopsies studied by light microscopy (LM), and immunofluorescence (IF) so that this entity is better understood both by nephrologists and pathologists as no such study has ever been conducted in Pakistan to our knowledge. Methods: It was a cross-sectional study carried out from 1st January 2012 to 30th December 2016 in Histopathology department, Shifa International Hospital. All cases diagnosed as C1q nephropathy were retrieved from the hospital’s computerized database. Their clinical profiles, morphology and immunohistochemical profiles were studied. Results: Over this period a total of 31 cases were diagnosed with C1qN. Mean age of the patients was 32.09±18.66 years. The most common clinical presentation was nephrotic syndrome seen in 22 (71%) patients. The most frequent morphological pattern seen was minimal change disease (MCD) in 13 (41.9%) cases. All cases showed dominant 22 (71%) or codominant 9 (42.9%) mesangial±membranous C1q deposition. No correlation was found (p-value >0.05) between morphological pattern and clinical presentation of the disease or immunofluorescence findings. Conclusion: C1qN is a rare entity which is primarily diagnosed on the basis of immunofluorescence findings with a dominant or codominant fluorescent intensity for C1q. It is recommended that C1qN is sought for preferably with immunofluorescence staining of biopsies for immune reactants, especially for C1q. Studies from this part of the world are strongly recommended to predict clinical outcome and treatment options.

Keywords: C1q nephropathy; Immunofluorescence; Immune reactants; Histopathological patterns
SURVIVAL AND PROGRESSION AFTER RADICAL NEPHRECTOMY IN A COHORT OF NON-METASTATIC RENAL CELL CARCINOMA TREATED WITH CURATIVE INTENT

SURVIVAL AND PROGRESSION AFTER RADICAL NEPHRECTOMY IN A COHORT OF NON-METASTATIC RENAL CELL CARCINOMA TREATED WITH CURATIVE INTENT

Authors:
( 0 downloads)
Abstract

Background: Radical nephrectomy (RN) is a standard treatment of cure for non-metastatic renal cell carcinoma (NMRCC). Long-term outcome data are limited for Pakistani population. Our aim was to assess the long-term outcomes of RCC treated with curative intent with radical nephrectomy (RN) and to study the 5 & 10years survival outcomes in patients with NMRCC who underwent radical nephrectomy. Methods: This is a retrospective review and analysis of the data between December 2006 and February 2017. We included all the adult patients (age ≥18 years) with NMRCC from both genders irrespective of their histologic subtypes who underwent radical nephrectomy (RN) with a curative intent. The data was analysed for overall survival and recurrence rates at 5- and 10-years using Kaplan-Meier survival analysis. Multivariate analysis was performed using Cox-regression to identify risk factors associated with poor overall outcome in terms of recurrence and mortality. Results: Three hundred and forty-four patients with 195 (55.5%) males and 149 (44.2%) females with a mean age of 53.5±14.1 years were monitored for a mean follow-up of 31.1±26.77 months (range: 3–132 months). Overall there were 46 (13.4%) deaths. Forty-nine 14.2%) cases had disease recurrence with 33 (9.5%) deaths from disease progression. The 5-year progression-free survival was 37% (95% CI: 49.04–72.76) with the median time to recurrence of 33 months (95% CI: 27.6–38.4) and the median overall survival was 103.7 months (95% CI: 95.7–111.7). The 5-year overall survival was 76.1% (95% CI: 75.2–77) while 10-year survival was 70.8%. There was a significant median survival difference for cases with and without recurrence (log-rank χ2: 117.5, p<0.001), T stage, Fuhrman’s grade, and early postoperative recurrence. Conclusion: Radical nephrectomy offers the best survival for non-metastatic renal cell carcinoma patients with excellent postoperative survival and progression-free profile. Although renal cell cancer presents in younger age group but the long-term survival after radical nephrectomy in Pakistani population is similar to the rest of the world.

Keywords: Renal cell carcinoma; Radical nephrectomy; Recurrence; Survival
EARLY ACTIVE MOBILIZATION VS IMMOBILIZATION FOLLOWING MODIFIED KESSLER REPAIR OF EXTRINSIC EXTENSOR TENDONS IN ZONE V TO VII

EARLY ACTIVE MOBILIZATION VS IMMOBILIZATION FOLLOWING MODIFIED KESSLER REPAIR OF EXTRINSIC EXTENSOR TENDONS IN ZONE V TO VII

Authors:
( 0 downloads)
Abstract

Background: The long-disputed issue of rehabilitation of extensor tendon repairs in zones V–VII has been treated with either complete immobilization or mobilization within the constraints of splint. In recent times, most authors have preferred some mobilization. Many studies have shown good results with early mobilization techniques; however, these studies have limitations. Most of these are retrospective observations. Some prospective studies are without proper controls. This study was conductive to compare the functional outcome of early active mobilization versus immobilization following repair of extensor tendons in zone V–VII. Methods: Functional outcome was determined by total active motion, pain and complications during rehabilitation. Total active motion (TAM) was graded by scores of the American Society for Surgery of Hand as TAM=total active flexion (MCP+PIP+DIP)–total extension deficit (MCP+PIP+DIP). A randomized control trial was conducted including 50 subjects of with extensor tendon injury exclusively in zone V–VII. Patients were divided randomly in two groups. All extensor tendon repairs (zone V to VII) were performed with modified Kessler's method. The pain and TAM was assessed during all visits in both groups except TAM in group B that was assessed after four weeks. Results: We found that outcome of 12% cases in Group A as excellent and no patient fell in category of fair results. While, in comparison, there was no case of excellent result in Group B. 4% cases showed fair results that were treated with immobilization. The pain score at the end of treatment, i.e., at 12 weeks were same in both the groups but, generally the score remained higher in group of EAM. There was significant difference in adhesion formation that was more in patients of immobilization group. The overall suture dehiscence was insignificant and was only 8% in each group. Conclusion: EAM has better outcome in terms of pain and range of motion.

Keywords: Extensor tendon injury; Zone V; Zone VI; zone VII; Early active mobilization
EFFECT OF THREE PAKISTANI DATE-SEED VARIETIES ON LIPID PROFILE OF DIET INDUCED HYPERLIPIDEMIC RABBITS

EFFECT OF THREE PAKISTANI DATE-SEED VARIETIES ON LIPID PROFILE OF DIET INDUCED HYPERLIPIDEMIC RABBITS

Authors:
( 0 downloads)
Abstract

Background: Hyperlipidemia is one of the major risk factors of cardiovascular diseases. In addition to current therapeutic strategies, a lot of work is being done on nutraceutical management of this condition. This study was designed to assess the effect of date seed powder on lipid profile of diet induced hyperlipidemic rabbits. Methods: Thirty male rabbits were divided into five groups, having six animals in each. One group was given normal rabbit chow throughout the study period of eight weeks. The remaining four groups were fed high fat diet (4% coconut oil and 1% cholesterol powder) for first four weeks in order to induce hyperlipidemia. After first four weeks, 2% date seed powder of three Pakistani varieties namely Dhakki, Khudrawi and Desi was added to the diet of three experimental hyperlipidemic groups for the next four weeks. Body weight and blood samples were taken at zero, 4th and 8th week of study. Serum was analyzed for total cholesterol, LDL-cholesterol, HDL-cholesterol and serum triglycerides. LDL/HDL ratio and AIP were calculated. Results: It was observed that date seed powder of the three varieties significantly decreased total cholesterol, serum triglycerides and AIP. There was no significant change in body weight, HDL-cholesterol, and LDL/HDL ratio. LDL cholesterol was decreased significantly only by Khudrawi date seed powder Conclusion: It was concluded that date seed powder has marked antihyperlipidemic properties. However, the difference in appearance, taste and price of different dates does not affect their lipid lowering capacity.

Keywords: Hyperlipidemia; Date-seed, P.Dactylifera; Lipid profile
SURGICAL MANAGEMENT OF MALE INCONTINENCE, WITH PROLENE MESH FIXING WITH PROLENE SUTURES; A PROSPECTIVE NOVEL STUDY FOR THE TREATMENT OF MALE INCONTINENCE AT TERTIARY CARE HOSPITAL

SURGICAL MANAGEMENT OF MALE INCONTINENCE, WITH PROLENE MESH FIXING WITH PROLENE SUTURES; A PROSPECTIVE NOVEL STUDY FOR THE TREATMENT OF MALE INCONTINENCE AT TERTIARY CARE HOSPITAL

Authors:
( 0 downloads)
Abstract

Background: Urinary incontinence is an uncommon problem in males but has major impact on daily living. This study aimed to highlight the outcome of surgical treatment in terms of safety, efficacy and cost-effectiveness in the management of urinary incontinence. Methods: A Total of 48 patients, prospective experimental study, in the duration of 4 years conducted at Department of Urology, Liaquat National Hospital & Medical College. Patients having moderate to severe urinary incontinence for 1 year after transurethral resection of prostate, radical prostatectomy, road traffic accident with pelvic fracture causing neurologic damage were included in this study. Patients having mild incontinence, having multiple co-morbid conditions were excluded from this study. Outcome of surgery was noted during follow up visit after 13 month (median). The data was obtained and analysed by using SPSS version 20. Mean and standard deviation for quantitative data, frequency and percentage for categorical variables were presented. Results: Out of 48 patients having urinary incontinence, 28 (58.3%) had severe urinary incontinence while 20 (41.7%) had moderate incontinence. After surgery, 28 (58.3%) patient had no leakage all day, 12 (25%) had some leakage while bending and 8 (16.7%) had no improvement in symptoms. On ultrasound recorded after voiding in post-surgery patients, 40 (83.3%) had no residual found in bladder while 8(16.7%) could not be assessed due to persistence of urinary incontinence. Conclusion: Our study predicted that in patients having moderate to severe urinary incontinence, Prolene Mesh repair anchoring with Prolene suture can be an efficient and cost-effective treatment for the urinary incontinence with least complications.

Keywords: Urinary incontinence; Prolene Mesh repair surgery
EFFICACY OF MICRO-NEEDLING ON POST ACNE SCARS

EFFICACY OF MICRO-NEEDLING ON POST ACNE SCARS

Authors:
( 0 downloads)
Abstract

Background: Acne effects 80–90% of teenage population all around the world. Resulting scars can lead to facial disfigurement and psychological issues in affected population. To counter this problem many treatment options have been tried including resurfacing lasers, dermabrasion, peeling, fillers, platelet rich plasma therapy etc. All have shown variable results. Among these modalities, micro needling is showing promising results in treatment of acne scars due to collagen induction. This study was conducted to assess efficacy and safety of micro-needling on acne scars. Methods: In this cross-sectional study a total of 50 patients (female 35, male 15) underwent treatment for post acne scarring, 4 sessions of micro-needling were done under local anaesthesia 3 weeks apart over the span of 2 months. Initial and follow up qualitative assessment was done. Photographs were taken of each patient on their subsequent visit, they were analysed and compared for final results. Grading was done by using Goodman Baron scale. Results: 70% (35) were females and 30% (15) were males with mean age of 27.31±4.41 ranging from 19–35 years. After the treatment of scars, 73% (08) of Grade 4 scars have showed improvement by 2 grades, remaining 27% (03) showed improvement to Grade 3. In 20 patients with Grade 3 scars, 30% (06) showed improvement by 1 grade. Remaining 70% (14) improved by 2 grades. All patients with Grade 2 scar downgraded to grade 1 after treatment. Chi-square test was used to assess pre-treatment and post treatment grading improvement among subjects and was statistically significant. (X2=30.010 p=000). Conclusion: Micro needling is an effective tool for aesthetic improvement of post acne scarring.

Keywords: Acne; Acne scarring; Micro-needling
RESULTS OF IMMEDIATE FACIAL NERVE RECONSTRUCTION IN PATIENTS UNDERGOING PAROTID TUMOUR RESECTION

RESULTS OF IMMEDIATE FACIAL NERVE RECONSTRUCTION IN PATIENTS UNDERGOING PAROTID TUMOUR RESECTION

Authors:
( 0 downloads)
Abstract

Background: Facial nerve is usually sacrificed in total parotidectomy. The objective of this study is to present results of immediate reconstruction of facial nerve in total parotidectomy cases where facial nerve is sacrificed. Methods: This is a prospective study done in patients who had total parotidectomy including facial nerve and immediate reconstruction was done with inter-positional nerve grafts (sural n=12 and greater auricular n=10) from December 2017 till February 2018 by single surgeon (MR). Wounds were closed primarily (n=15), local flap (n=2) and free flap (n=5). Clinical evaluation was done at four months minimum follow up (those operated in January to February 2018) and eight months maximum follow up (those operated in December 2017), for facial nerve functional recovery using House and Brackmann grading system by single author (MR). Results: Total of 22 (male n=7, female n=15) patients included in study from December 2017 till February 2018. Sural nerve grafts were used in 54% (n=12) and greater auricular nerve grafts in 45% (n=10) patients for reconstruction of facial nerve. On clinical evaluation using House and Brackmann grading system, showed grade V (n=4), grade IV (n=7), grade III (n=8) and grade II (n=3) repairs. Conclusion: Although primary end to end facial nerve repair is ideal but in situation where a significant segment of nerve is lost or where the repair is under tension, inter-positional nerve grafting is a simple and reliable reconstructive technique with good outcomes.

Keywords: Facial nerve immediate reconstruction; Total parotidectomy; Sural nerve grafts; Facial nerve palsy; House and Brackmann grading; Facial reanimation
INCREASE IN HEPATIC QUINOLINIC ACID CONCENTRATIONS IN ALCOHOL WITHDRAWN RATS

INCREASE IN HEPATIC QUINOLINIC ACID CONCENTRATIONS IN ALCOHOL WITHDRAWN RATS

Authors:
( 0 downloads)
Abstract

Background: Behavioral associated disturbance involves excitotoxic quinolinate in alcohol withdrawal syndrome in man due to increase availability of tryptophan. In present study we investigated alcoholism related clinical features in relation to tryptophan and 5-HT levels in rat’s model. Methods: Locally bred male Wistar rats, weighing 200–250 g were housed separately into 6 animals/ group with 12 h light: dark cycle at room temp 22±3 °C. They were given diet ad libitum, for three days then alcohol 8% (v/v) was added into the liquid diet. Matched control rats of each group were given maltose-dextrin as a substitute of alcohol. Alcohol withdrawal syndrome was assessed after 7 hours by replacing the alcohol-containing liquid diet with tap water. Results: Alcohol withdrawal group showed significant increase (p<0.001) in holo, apo, and total tryptophan 2, 3 dioxygenase enzyme activities, no significant change in brain tryptophan and 5HIAA however significant decrease (p<0.001) in brain 5HT was observed when compared with chow controls. Both alcohols administered and withdrawal groups showed significant rise in serum corticosterone by p<0.05 and p<0.001 respectively. Liver quinolinic acid concentrations were increased significantly (p<0.01) with robust increase in alcohol withdrawn rats. Conclusion: We conclude that the excitotoxin tryptophan metabolite quinolinic acid of peripheral origin plays significant role in the behavioral manifestation of the alcohol withdrawal syndrome. Tryptophan metabolites should be targeted to develop new strategies in the progress of pharmacological interventions related to alcoholism.

Keywords: Ethanol; Quinolinic acid; Tryptophan metabolism; Alcohol withdrawal; tryptophan 2,3 dioxygenase; 5–hydroxytryptamine; Rats
IS THERE ANY IMPROVEMENT IN EFFICACY OF EXTRACORPOREAL SHOCKWAVE LITHOTRIPSY THERAPY FOR TREATING RENAL STONES WITH INVENT OF NEW SHOCKWAVE MACHINES?

IS THERE ANY IMPROVEMENT IN EFFICACY OF EXTRACORPOREAL SHOCKWAVE LITHOTRIPSY THERAPY FOR TREATING RENAL STONES WITH INVENT OF NEW SHOCKWAVE MACHINES?

Authors:
( 0 downloads)
Abstract

Background: Renal stone disease is a very common medical problem in general population. As with invent of newer therapeutic modalities, ESWL is already losing its popularity. But we believe it as an effective way of treating renal stones. This study was conducted to evaluate any improvement in success rate of ESWL therapy for treating renal stones with latest shockwave lithotripsy machines. Methods: Study conducted from June 2016 until November 2017 in Alkhor hospital, Hamad Medical Corporation, Qatar. All patients undergoing ESWL for renal stones in mentioned period were included. Total 197 patients underwent ESWL using newer machines. Factors already studied to affect the success rate like stone size, location, consistency (measured by Hounsfield units on CT), presence of stent were taken in consideration. After a period of 3 months either complete stone clearance or stone fragments smaller than 4 mm were considered as a treatment success. These results were compared to the results from literature. Results: Patients were followed until 3 months after treatment. 170 patients (86.29%) had complete stone clearance. Eleven patients (5.58%) had residual stone less than 4 mm, thus achieving an overall success of 181 patients (91.88%). 42 patients (21.32%) needed repeat session of ESWL with a maximum number of 3 sessions. 16 patient’s (8.12%) required auxiliary procedures like flexible ureteroscopy. Post-ESWL complications were recorded in 12 patients (6.09%). Success rate was affected mainly by stone size with negligible effect of stone location. Presence of stent affected the number of sessions but has no impact on stone clearance. Conclusion: Although the stone size and to a negligible extent, the stone location and presence of stent may affect the stone clearance, nevertheless a significant improvement in success rate has been observed by use of new shockwave lithotripsy machines.

Keywords: Kidney; Extracorporeal shockwave lithotripsy; Stone
OUTCOME OF USE OF 1% SILVER NITRATE IN PATIENTS WITH LOW LYING PERIANAL FISTULA

OUTCOME OF USE OF 1% SILVER NITRATE IN PATIENTS WITH LOW LYING PERIANAL FISTULA

Authors:
( 0 downloads)
Abstract

Background: Anorectal fistula is a common illness which is seen among the middle-aged male patients. Various surgical procedures have been proposed and are associated with the recurrence of the fistula, repeated surgery and in some cases incontinence which may reach up to 43% in complicated fistulas. The purpose of this study was to assess and formulate a non-surgical procedure for fistula in ano through irrigation of the fistula tract with 1% of silver nitrate solution in healing the low perianal fistula. Methods: Seventy-nine patients presenting to the outpatient department of Ward 3, Surgical unit 1 in Jinnah Postgraduate Medical Centre during a period of 8 months from April to November 2017 with complain of perianal pain and pussy discharge were included in the study. Three patients of the total 79 patients lost to follow up. Outcome measure were cessation of the symptoms for consecutive 10 weeks. Results: Seventy-six patients were assessed and underwent irrigation using this 1% of silver nitrate solution. Out of 76 patients, 58 (76.3%) patients showed complete clinical healing while 18 (23.68%) of patients showed failure to clinical healing. Patients with continuous discharge had a significantly higher rate of complete clinical healing than those with intermittent discharge. Conclusion: From this study it can be concluded that cauterizing and corrosive properties of silver nitrate are effective in treating the patients with low lying perianal fistula. We suggest that this method should be used as a first line treatment option for all the patients presenting with low lying anal fistula since it is simple, can be easily performed on an OPD basis is minimally invasive and avoids any complication.

Keywords: Silver nitrate; Perianal fistula; Low lying perianal fistula; Nonoperative management
EFFECT OF LIGNOCAINE ADDITION ON THE PROPERTIES OF IRREVERSIBLE HYDROCOLLOID IMPRESSION MATERIAL

EFFECT OF LIGNOCAINE ADDITION ON THE PROPERTIES OF IRREVERSIBLE HYDROCOLLOID IMPRESSION MATERIAL

Authors:
( 0 downloads)
Abstract

Background: Irreversible hydrocolloid impression materials have been a staple in dentistry and useful for the fabrication of dental prosthesis. Gagging is most commonly experienced during maxillary impression making, which may affect the clinical management of the patient. Different techniques have been described to alleviate this problem. One of them is mixing lignocaine local anesthetic solution in irreversible hydrocolloid impression material before making the impression. The objective of this study was to evaluate the effect of lignocaine addition in irreversible hydrocolloid impression on the properties of irreversible hydrocolloid impression materials. Methods: Irreversible hydrocolloid was mixed with water (Control group) or water and adrenalin (Lidocaine hydrochloride) (Experimental group). Compressive strength, tear strength and setting time were measured according to ISO1567 and ANSI/ADA specifications 18. The structural analysis of both groups was also evaluated by Fourier Transform Infrared Spectroscopy (FTIR). Results: In the experimental group, insignificant decrease was observed in compressive and tear strength of irreversible hydrocolloid (p >0.05). There was significant (p <0.05) increase in setting time of irreversible hydrocolloid impression material. FTIR analysis indicated no change in chemistry of irreversible hydrocolloid before and after setting. Conclusion: Addition of lignocaine in irreversible hydrocolloid impression material may result in control of gag reflex without affecting its mechanical and chemical properties.

Keywords: Irreversible Hydrocolloid; Lignocaine; Gag reflex; Dental prosthesis; FTIR
FREQUENCY OF ELEVATED TROPONIN T IN PATIENTS OF CHRONIC RENAL FAILURE WITHOUT CLINICALLY SUSPECTED ACUTE MYOCARDIAL INFARCTION

FREQUENCY OF ELEVATED TROPONIN T IN PATIENTS OF CHRONIC RENAL FAILURE WITHOUT CLINICALLY SUSPECTED ACUTE MYOCARDIAL INFARCTION

Authors:
( 0 downloads)
Abstract

Background: Cardiac Troponins are established markers of myocardial injury; however, they may be elevated in chronic renal failure (CRF) patients even in absence of acute myocardial infarction. The objective of the study was to determine the frequency of elevated Troponin T in patients of chronic renal failure without clinically suspected acute myocardial infarction. Methods: This cross-sectional study was conducted at Medical B Unit of Ayub Teaching Hospital, Abbottabad from 16th December 2013 to 16th June 2014. A sample of 117 patients of chronic renal failure was included in the study without any gender discrimination. The patients were defined as known chronic renal failure when renal failure was reported in their past medical history and by estimation of glomerular filtration rate (GFR). Those patients who had raised Troponin T due to any other reason like acute myocardial ischemia (chest pain, electrocardiographic changes and greater than 20% elevation in Troponin T from baseline), sepsis, heart failure and those who were receiving cardiotoxic chemotherapy were excluded. The subjects were enrolled by non-probability consecutive sampling. Results were analysed by SPSS 16.0 Results: Out of 117 participants, 72 (61.5%) were males and 45 (38.5%) were females. The mean age of the study participants was 52.08±14.21 years. Elevated Troponin T was found in 45 (38.5%) of the patients. There is statistically significant association between the stage of CRF and elevated levels of Troponin T. Statistically significant negative correlation (r=-0.213,p=0.021) was found between the Glomerular Filtration Rate and serum levels of Troponin T. Conclusion: A high proportion of CRF patients have elevated Troponin T and the rise is significantly associated with the stage of chronic renal failure.

Keywords: Chronic renal failure, Troponin T, Acute myocardial infarction
HEPATIC GLYCOGENOSIS IN CHILDREN: SPECTRUM OF PRESENTATION AND DIAGNOSTIC MODALITIES

HEPATIC GLYCOGENOSIS IN CHILDREN: SPECTRUM OF PRESENTATION AND DIAGNOSTIC MODALITIES

Authors:
( 0 downloads)
Abstract

Background: Objectives of the study were to determine the clinical spectrum of presentation and various modalities helpful in the diagnosis of liver glycogenosis short of genetic analysis. Methods: All patients under 18 years of age presenting to Paediatric Gastroenterology unit of Children's Hospital, Lahore with suspicion of hepatic glycogen storage disease (GSD) were enrolled over a period of 18 months. Demographic profile and various factors under observation were recorded. Collected data was analysed using SPSS version 22. Results: Among 89 enrolled patients F:M ratio was (1.28:1). The most common GSD was type I (71, 79.7%) followed by III (13, 14.6%), II (3, 3.3%), IV (1, 1.1%) and IX (1, 1.1%). The Abdominal distension was the most common presentation in 89.5% followed by hepatomegaly in 86.5%, diarrhoea in 41.6%, doll’s like appearance in 31.5% and vomiting, acidotic breathing with convulsions in about 20% of children in GSD I. Hepatomegaly (100%), failure to thrive (85%), developmental delay (69%) and splenomegaly (92.3%) were leading presentation in GSD III. Elevated triglycerides (77.5%) followed by transaminesemia (56%), hypercholesterolemia (63%), hyperuricemia (32%) and hypoglycaemia (14%) were significant biochemical findings in GSD I. Consistently raised liver enzymes (92%) and creatinine phosphokinase (100%) in addition to hypertriglyceridemia (69%) were seen in GSD III. The presence of enlarged hepatocytes with clearing of cells favour GSD1 showed in 79% of children while fibrosis and steatosis usually seen in GSD-III (14.6%). Conclusion: Hepatic glycogen storage diseases are serious health issues and should be excluded in any patient who present with hepatomegaly, short stature and hyperlipidaemia to decrease the disease mortality and morbidity.

Keywords: Glycogen storage disease; Children; Presentation

About Europub

EuroPub is a comprehensive, multipurpose database covering scholarly literature, with indexed records from active, authoritative journals, and indexes articles from journals all over the world. The result is an exhaustive database that assists research in every field. Easy access to a vast database at one place, reduces searching and data reviewing time considerably and helps authors in preparing new articles to a great extent. EuroPub aims at increasing the visibility of open access scholarly journals, thereby promoting their increased usage and impact.