Motor and Somatosensory Evoked Potential Monitoring Without Wakeup Test during Scoliosis Surgery

Background: Available evidence suggests that Transcranial electric motor evoked potentials and somatosensory evoked potential are safe methods to check the integrity of the spinal cord during spine deformity correction surgery. We compare the efficacy of Transcranial electric motor evoked potentials and somatosensory evoked potential to detect the nerve injury during Scoliosis surgery. Objectives: To demonstratethe advantages of combined motor and sensory evoked potential monitoring during Scoliosis surgery. Methods: We analyzed records of 65 (48 female and 17 male) Scoliosis surgery cases of Transcranial electric motor evoked potential and Somatosensory evoked potential.Mean age was 15.6 years. Patients who showed significant (at least 55%) of unilateral or bilateral amplitude loss , for at least five to ten minutes during the intervention in scoliosis surgery under total intravenous anesthesia will be included. Results: From 65 patients during surgery seventeen patients have a significant or complete drop of baseline amplitude on transcranial electric motor evoked potentials. Thirteen patients have the complete return of baseline amplitude by surgeon intraoperative intervention, whereas four patients havea reversal of motor response after 8 hours post-operatively. Transcranial electric motor evoked potential monitoring was 100% specific and 100% sensitive, whereas Somatosensory evoked potential was 100% specific and 85% sensitive. Conclusions: SSEPs and MEPs , in combination give accurate and quick information of nerve or spinal cord insult intraoperatively

Simultaneous Determination of Dimethomorph and Chlorothalonil in Pesticide Formulation: HPLC Method Development and Validation

The identification and accurate quantification of pesticides is important to verify the recommendedconcentration of active content of each pesticide in formulated products to avoid adverse effects on human life due toover dosage. In this study, method of quantitative determination of Dimethomorph and Chlorothalonil in pesticideformulation was developed and validated by using ICH guidelines. Chromatographic separations with good resolutionwere performed on Beckman C-18 column (5 µm x 150 mm x 4.6 mm), using 80:20, v/v – (CH3CN:H2O) as mobilephase in isocratic mode at 230 nm. The retention time for Dimethomorph and Chlorothalonil at flow rate 1.2 mL/minwas 6.21 and 9.63 minutes, respectively. Calibration curves of both studied fungicides (Chlorothalonil andDimethomorph) were linear showing coefficient of determination greater than 0.996. %RSD value of inter-dayprecision was found to be less than 3 for both pesticides and for intra-day precision these values were less than 2. Interlaboratory comparison (ILC) method was applied to evaluate the accuracy of the proposed method and Z-score valueswere found to be less than 2. The proposed method is therefore efficient, accurate, and cost-effective and can suitablybe used for simultaneous quantitative determination of Dimethomorph and Chlorothalonil in pesticide formulatedproducts

Comparison of efficacy of Moxifloxacin and Ceftriaxone in acute exacerbation of chronic obstructive pulmonary disease

Objective: The aim was to compare the efficacy of Moxifloxacin and Ceftriaxone in acute exacerbation of the chronic obstructive pulmonary disease. Methodology: This randomized trial was conducted in the Pulmonology Department, PIMS, Islamabad between August 2018 to February 2019. Ethical approval was granted by the hospital ethics committee and patients were enrolled after written informed consent. Patients were screened from the OPD department and before randomization their sputum was collected over a 24-h period in strong sterile plastic (60 mL) bottle at room temperature. They were randomized equally into two treatment groups using a lottery method. Group A received Moxifloxacin 400 mg orally once daily for five days and group B received Ceftriaxone 1 g (IV infusion) once daily for five days. All the measurements (dyspnea grading, sputum volume, and character) were taken after 5 days of antibiotics therapy.  Results: The mean age was 60.79 ± 13.34 years in Moxifloxacin and 59.86 ± 12.72 years in the Ceftriaxone group. In Moxifloxacin group, there were 49(68.06%) male and 23(31.94%) females and in the Ceftriaxone group, there were 49(68%) males and 23(31.94%) female cases. In Moxifloxacin a total of 68(94.4%) cases recovered while 4 (5.6%) cases did not achieve efficacy whereas in the Ceftriaxone group 54 (75.0%) cases achieved efficacy and 18 (25.0%) were therapy failures. The efficacy of the oral Moxifloxacin group was significantly better than the oral Ceftriaxone group (p-value, < 0.05). Conclusion: The efficacy of Moxifloxacin was better than Ceftriaxone in acute exacerbation of chronic obstructive pulmonary disease

Role of HRCT for Rapid Triage of Patients with COVID-19 Pneumonia

Background:   To assess the diagnostic performances of HRCT for COVID 19 pneumonia for efficient triage of patients, in comparison with RT-PCR reverse transcription polymerase chain reaction test.   Method:   It is retrospective comparative study conducted in Benazir Bhutto hospital affiliated with Rawalpindi medical university from March 25th to April 25th, 2021.  HRCT of 500 patients were selected from central computer server and their RT-PCR results were also obtained from the HMS system of the hospital. HRCT were reported as “Definitely COVID positive”, “Possible COVID positive” or “COVID negative” by experienced radiologists. Sensitivity, Specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated using the final RT-PCR test as standard of reference. Results:   RT-PCR test of 207 patients was positive, whereas 293 were reported negative. HRCT was reported as “Definitely COVID positive” in 222 cases (44.4 %), “Possible COVID positive” in 24 cases (4.8%) and “COVID negative” in 254 cases (50.8%). Comparing only Definitely COVID positive category with RT-PCR results sensitivity, specificity. PPV and NPV were 90.3%, 88%,84.2% and 92.8%   Conclusion:   CT chest is the most reliable, sensitive and rapid tool for triaging of patients as COVID positive or negative in busy emergency departments as compared to RT-PCR which is time consuming and has limitations such as faulty sampling technique, limited kits and variable sensitivit

Hepatocellular Carcinoma in Pakistan: National Trends and Global Perspective

Hepatocellular carcinoma (HCC) ranks second amongst all causes of cancer deaths globally. It is on a rise in Pakistan and might represent the most common cancer in adult males. Pakistan contributes significantly to global burden of hepatitis C, which is a known risk factor for HCC, and has one of the highest prevalence rates (>3%) in the world. In the absence of a national cancer registry and screening programs, prevalence of hepatitis and HCC only represents estimates of the real magnitude of this problem. In this review, we present various aspects of HCC in Pakistan, comparing and contrasting it with the global trends in cancer care. There is a general lack of awareness regarding risk factors of HCC in Pakistani population and prevalence of hepatitis C has increased. In addition, less common risk factors are also on a rise. Majority of patients present with advanced HCC and are not eligible for definitive treatment. We have attempted to highlight issues that have a significant bearing on HCC outcome in Pakistan. A set of strategies have been put forth that can potentially help reduce incidence and improve HCC outcome on national level

Persistence and Degradation of Imidacloprid in Wheat Crop

Present study was conducted to investigate the levels and persistence of imidacloprid residues in wheat grains and straw of field crop samples grown from treated seed and foliar application. Objective of the study was to assess the best practices that may be used to produce safe grains and straw. Residual uptake of imidacloprid was measured after seed treatments at four dosage levels of seed. Each sample of 25g treated seed was sown in a separate 5ft2 plot.The absorption of imidacloprid residues was investigated by spraying the crops with 1ml and 5ml of 6 mgmL-1 solution of 200SL Confidor (imidacloprid). The results helped in determining the maximum allowable limits of imidacloprid application (foliar or seed treatment) on wheat, which would prevent the residues from exceeding the MRL. The quantitative determination of imidacloprid suggested that the lowest seed treatment level (i.e. 0.015g/25g seed) may be used to produce a residues-free crop

Persistence and Degradation of Imidacloprid in Wheat Crop

Present study was conducted to investigate the levels and persistence of imidacloprid residues in wheat grains and straw of field crop samples grown from treated seed and foliar application. Objective of the study was to assess the best practices that may be used to produce safe grains and straw. Residual uptake of imidacloprid was measured after seed treatments at four dosage levels of seed. Each sample of 25g treated seed was sown in a separate 5ft2 plot.The absorption of imidacloprid residues was investigated by spraying the crops with 1ml and 5ml of 6 mgmL-1 solution of 200SL Confidor (imidacloprid). The results helped in determining the maximum allowable limits of imidacloprid application (foliar or seed treatment) on wheat, which would prevent the residues from exceeding the MRL. The quantitative determination of imidacloprid suggested that the lowest seed treatment level (i.e. 0.015g/25g seed) may be used to produce a residues-free crop