Adult onset Stills disease in a tertiary care hospital of Pakistan.

Objective: To study the clinical characteristics of Stills disease in a tertiary care hospital of Pakistan and compare it with similar published studies. Materials and Methods: (Retrospective descriptive study) Thirteen patients with Adult onset stills disease were identified by chart review of last ten years from 1995 to 2005 at Aga Khan University Hospital (AKU), a tertiary care private medical university in Karachi Pakistan. Demographic and other specific information was recorded on standardized data sheet and analyzed by SPSS 11.5 software. Results: Mean age of patients was 26.54±10.34 years, of which 8 (61.5%) were males. The most common presenting features were fever (100%), arthralgias and myalgias (100%) with large joint involvement (91.7%), significant weight loss (30.8%), sore throat (53.8%). None of the patients had skin rashes with fever, chest and abdominal pains. One patient had cervical lymph node swelling and 4 (33.3%) patients had splenomegally. The common laboratory findings were: leukocytosis and anaemia (100%), elevated ESR and C reactive protein (100%). Thrombocytosis (56.2%) and elevated Liver function tests (62%). Seven patients had serum ferritin checked which was in the range of 1872 to 16652 iu/l. None of the patients had positive ANA, Anti-DNA or RA factor. Twelve patients had a chest x-ray done, among them 11 were normal, one had pleural effusion. The clinical course of the patients who were followed for three months, was monocyclic (53.8%), polycyclic (30.8%) and persistent (15.4%). Conclusion: Clinical characteristics of Stills disease in our country are mostly similar to those seen in other regions, suggesting that same pathogenetic factors may be implicated in patients from different genetic back grounds and geographic location

Septic arthritis in a tertiary care hospital

Objectives: To study the epidemiological features of septic arthritis in the adult population and to identify the risk factors for mortality in septic arthritis.Methods: A five year reterospective study was performed on cases with septic arthritis admitted in our hospital between January 1999 and December 2004. Patients were identified according to ICD codes, 711.00. Data was recorded on a standardized data sheet and analyzed by SPSS 11.5 software.Results: A total of 116 patients were identified, 69 were male (59.5%) and 47 female (40.55%). Mean age of patients was 49.22 years. The most common presenting clinical features were joint swelling (99.1%) and fever (60.3%), Knee joint was the most common joint involved (65.5%) followed by hip (11.2%). Gram stains of synovial fluid was done in 67.2% of cases out of which 22.4% had positive stains. Staphylococcus aureus was the most common organism isolated from blood as well as synovial fluid (18.8%). Mean haemoglobin was 10.83gm/dl and 57.8% of patients had total leukocyte count less than 11,000/cumm. Platelet count was greater than 150,000/cumm in 90.5% patients. Hypertension, renal failure, chronic liver disease and elevated ESR were identified as some of the potential risk factors for higher mortality in a cohort with septic arthritis.CONCLUSION: Septic arthritis is associated with significant morbidity and mortality. These results highlight the importance of obtaining cultures before starting any treatment

Knowledge about osteoporosis among healthy women attending a tertiary care hospital

INTRODUCTION: To determinate the knowledge on osteoporosis-risk factors and disease in three age groups of Pakistani women.METHODS: In this exploratory cross-sectional study, an osteoporosis knowledge assessment questionnaire (OKAT) was used to collect data and it was delivered through a face-to-face interview. Questions were asked about symptoms of osteoporosis, knowledge of risk factors, preventive factors and treatment. A convenience sample (n =320) comprising of three groups of healthy women aged 25-35 years, 36-45 years, and over 45 years was taken. The scoring range was 0 to 20. Among-group comparisions of means were analyzed by two-way ANOVA. To determine the overall influence of osteoporosis-risk factors, the multivariate analysis was used.RESULTS: The knowledge on osteoporosis in younger women was very poor compared to relatively older females. However, women belonging to higher socioeconomic status and better education had slightly more knowledge about osteoporosis compared to those with a low education level, regardless of age.CONCLUSION: The majority of women had modest knowledge on osteoporosis. Younger women were at increased risk for low bone mass and premature osteoporosis

Recent technologies for nutrient removal and recovery from wastewaters: A review

Water scarcity and its pollution has become a concern in recent times. The disposal of nutrient-rich (nitrogen and phosphorous) wastewater is also one of the main cause of water pollution through eutrophication, reduced dissolved oxygen that poses threat to aquatic ecosystems. As a result, nutrient removal has become a mandate apart from the removal of organics. However, the removal of nutrients from sewage is a challenging task. Conversely, conventional biological treatment processes provide little relief in nutrient removal. The treated effluents from conventional biological processes do not achieve the stringent nutrient removal disposal standard limits and become primary cause of pollution in the receiving water bodies. This has stressed upon the need for eco-friendly, low-energy and cost-efficient nutrient removal treatment technologies. Various biological treatment combinations or variants are in use for the efficient removal of nutrients. The biological processes in itself or in combination with chemical processes are preferred over technologies based solely on physico-chemical processes for its treatment performance at lower cost. This review summarizes the existing treatment processes and their possible up-gradation with the aim to accomplish the marked effluent standards for the nutrients. The concept of conventional systems and advanced systems for nutrients (nitrogen and phosphorous) removal which are already developed or under development are deeply discussed. Further, the challenges of each treatment systems are abridged. Finally, the possible suggestions for the modification/retrofitting of existing treatment systems for achieving stringent disposal standards are pointed out

Genetic diversity among tomato accessions based on agro-morphological traits

It is of great importance to know about the genetic diversity, conservation and classification for further utilization of tomato germplasm resources. Therefore, 40 tomato accessions were evaluated on the basic of agro-morphological traits for genetic diversity in 2014. The experiment was conducted at Agricultural Research Farm, University of Haripur and farmer field in Swabi, Khyber Pakhtunkhwa, Pakistan. Principal component analysis showed that five out of 27 principal components with an eigenvalue above 1.0 were considered for 74.10% of the total variance. The major contributing traits in variations were days to flowering (DFL), days to fruiting (DFR), fruit size (FS), fruit weight plant-1 (FW), yield plot-1 (YPP), yield hectare-1 (YPH), leaf length (LL), predominant fruit shape (PDFS), fruit length (FL), fruit width (FWidth), clusters plant-1 (CPP), fruits plant‑1 (FPP) and plant height (PH). The scattered plot of the PC’s revealed that the accessions were scattered in all the quarters, which is also a representative that high level of genetic variability was present. FW and FL were positively correlated with YPH. However, the remaining yield components indirectly contributed YPH. Cluster analysis divided 40 accessions into four main clusters (I, II, III and IV), each of which having 12, 11, 07 and 10 accessions. The accessions in clusters I and II were statistically similar and performed better in terms of yield and yield related traits. Grouping into different clusters was associated with their agro-morphological differences. These results could be serving as a useful resource for further characterization, preservation and breeding programs

Acute sarcoid arthropathy

A case of middle aged female with acute arthritis, mediastinal lymphadenopathy and diabetes mellitus is described. The patient underwent mediastinal lymph node biopsy and was diagnosed as having acute sarcoidosis (Lofgrens syndrome). She was treated with systemic steroids and responded well

Kinetic and equilibrium studies for cadmium biosorption from contaminated water using Cassia fistula biomass

Cadmium (Cd) contamination of the water resources is one of the serious environmental issues. The present study aims to (1) evaluate the biosorption potential of Cassia fistula biomass for the removal of Cd from contaminated water and validate the experimental results with kinetic and equilibrium sorption models, (2) assess the removal of Cd from groundwater samples in the presence of other competing ions in the solution. The C. fistula biomass was characterized using Fourier transform infrared spectroscopy, Brunauer–Emmett–Teller technique and scanning electron microscopy to understand the role of its physical properties in Cd biosorption and removal. The effects of biosorbent dose, initial Cd concentrations, contact time and presence of competing cations in groundwater samples at constant pH and temperature (27 ± 1.5 °C) were studied. At equilibrium (90 min), Cd removal (98–16%) and biosorption (6.26–0.34 mg/g) were recorded depending on the experimental conditions. The Langmuir model yielded a better approximation of the experimental data at equilibrium (Formula presented.) rather than Freundlich model. The pseudo-second-order kinetic model explained well the kinetic behavior of Cd biosorption. Results revealed a decline in the Cd removal (12.7 and 6% at 0.25 and 1.0 g/100 mL, respectively) in the presence of cations in the water samples. The results proved that C. fistula is a very effective and environment friendly alternative adsorbent for the removal (98%) of Cd from the aqueous system