Congenital pyloric atresia and epidermolysis bullosa

Congenital pyloric atresia with epidermolysis bul­losa is recognized as a rare but distinct entity which is uniformly fatal1,2. Until 1990 only 20 cases have been reported in the English literature3,4. We present an additional case managed at the Aga Khan University Hospital to demonstrate the difficulties encountered in the management of such infants

The abdominal cocoon: An unusual cause of intestinal obstruction in adolescents

The abdominal cocoon is a rare cause of intestinal obstruction in adolescent girls caused by encasement of the small intestine in fibrous tissue. Only 15 cases have been reported in the English literature so far. This is a report of another two patients managed at the Aga Khan University Hospital. The correct diagnosis is often not suspected, resulting in delays in the treatment of this condition. Following simple surgical release of the entrapped bowel, these patients do well

Awareness about reproductive health and rights among students of a public university in Karachi, Pakistan: a cross sectional study

Objective: To determine the knowledge, attitude and practices of Karachi University students about reproductive health and rights. Design: Cross sectional study Methods: A survey was conducted from February to May 2005 to determine the understanding and knowledge related to reproductive health and rights among the students of the department of Biochemistry, University of Karachi, Pakistan. A pre-coded questionnaire was developed and pre-tested. The questionnaire was introduced to those students, who agreed to participate in the study. Data collected was double entered and analyzed on SPSS and Epi-info latest version. Results: Fifty five percent (55%) of participants believed the reproductive rights to be as important as other human rights. About 80% of participants thought that proper birth spacing can improve maternal and child health but very few Pakistani women have birth spacing rights. Quality of life of women and men can be improved by knowing their reproductive rights in view of 71 % and 63 % of respondents respectively. Conclusion: Although one third of participants claimed to be aware of their reproductive rights but majority were unable to identify what exactly comes under the domain of reproductive rights. Majority knew that appropriate use of contraception and birth spacing can have positive impact on maternal and child health. The study recommends that awareness sessions should be conducted at all levels of society and more efforts should be made to improve reproductive health and increase awareness and the implementation of reproductive rights

Acute Administration of Clozapine and Risperidone Altered Dopamine Metabolism More in Rat Caudate than in Nucleus Accumbens: A Dose-Response Relationship

The present study compares the extrapyramidal and neurochemical effects of clozapine and risperidone in rat caudate (corpus striatum) and nucleus accumbens (ventral striatum) dose-dependently. Animals injected with clozapine (2.5, 5.0 and 10.0 mg/kg IP) or risperidone (1.0, 2.5 and 5.0 mg/kg IP) in acute were sacrificed 1 h later to collect brain samples. Extrapyramidal side effects (EPS) in terms of locomotor activity and catalepsy were monitored in each animal after the drug or vehicle administration. Maximum cataleptic potentials were found only at high doses of clozapine (10.0 mg/kg; 60%) and risperidone (5.0 mg/kg; 100%). Neurochemical estimations were carried out by HPLC-EC. Both drugs at all doses significantly (p<0.01) increased the concentration of homovanillic acid (HVA), a metabolite of DA, in the caudate nucleus and decreased in nucleus accumbens. Levels of Dihydroxyphenylacetic acid (DOPAC) significantly (p<0.01) increased in the caudate by clozapine administration and decreased in the nucleus accumbens by the administration of both drugs in a dose-dependent manner. 5-Hydroxyindoleacetic acid (5-HIAA), the predominant metabolite of serotonin significantly decreased in the caudate and nucleus accumbens in a similar fashion. Levels of tryptophan (TRP) were remained insignificant in caudate and nucleus accumbens by the injections of two drugs. In caudate, clozapine and risperidone administrations significantly (p<0.01) decreased HVA/DA ratio and increased DOPAC/DA ratio in nucleus accumbens at all doses. The findings suggest the evidence for DA/5-HT receptor interaction as an important link in the lower incidence of EPS. The possible role of serotonin1A receptors in the pathophysiology of schizophrenia is also discussed

Diagnostic Validity Of Low Dose CT KUB In Demonstration Of Genitourinary Tract Calculi Compared To Normal Dose Ct Kub: A Provisional Study

Objective: Renal colic is a common clinical condition. Our objective is to evaluate the diagnostic accuracy of low dose CT KUB for detection of urinary stones, to minimize radiation dose to the patients, and to analyze diagnostic accuracy of LDCT KUB in comparison to standard dose CT KUB. We speculate the LDCT KUB may reduce patient radiation dose while maintaining diagnostic value. Materials and Methods: This comparative cross sectional validation study was conducted at Department of Radiology in Benazir Bhutto Hospital, Rawalpindi June 2021 to Feb 2022. After approval of hospital ethical committee, a sample of 49 kidneys of 31 patients was collected by non-probability consecutive sampling technique. Included were the patients diagnosed with renal calculi referred from other departments. All the included patients were scanned by Toshiba Aquilion 16 slices, using automated tube current modulation, without any oral or IV contrast. CT scan started from diaphragm down to pubic symphysis with standard dose CT (SDCT) followed by low dose CT (LDCT). After the data was recorded, statistical package for social sciences, version 20.0 (SPSS Inc., Chicago, Illinois, USA) was used to analyse the data and generate results. Mean + standard deviation was calculated for qualitative data while frequency and percentage for qualitative variables. The means were compared by independent sample t test while the agreement between standard and low dose was depicted by kappa value. Results: A total of 49 kidneys of 31 patients with renal stones was included in this study. The mean age of the patients ranged from 27 years to 48 years with a mean of 36.42 + 9.97 year. In gender distribution, 75.5 % (37) were male while 24.5 % (12) were females. More than half 59 % (29) were right while 41 % (20) were left kidneys. Conclusion: This study demonstrated that LDCT was a productive and effective technique in the detection of urothelial stones despite considerable reduction in radiation dose and exposure as seen in SDCT

O dozi ovisni učinci klozapina i risperidona na metabolizam serotonina i dopamina u pojedinim područjima mozga i na ekstrapiramidalne nuspojave u štakora

The present study was designed to evaluate the behavioral and neurochemical profiles of clozapine and risperidone in rats in a dose-dependent manner. Animals injected intraperitoneally (i.p.) with clozapine (2.5, 5.0 and 10.0 mg kg1) or risperidone (1.0, 2.5 and 5.0 mg kg1) were sacrificed 1 h later to collect brain samples. Hypolocomotive effects (home cage activity and catalepsy) were successively monitored in each animal after the drug or saline administration. Both drugs significantly (p < 0.01) decreased locomotor activity at high doses and in a dose-dependent manner. Maximum (100 %) cataleptic potential was achieved at a high dose (5.0 mg kg1) of risperidone. Neurochemical estimations were carried out by HPLC with electrochemical detection. Both drugs, at all doses, increased significantly (p < 0.01) the concentration of homovanillic acid (HVA), a metabolite of dopamine (DA), in the striatum. Dihydroxyphenylacetic acid (DOPAC) levels increased in the striatum and decreased in the rest of the brain, particularly in clozapine-injected rats. 5-Hydroxyindoleacetic acid (5-HIAA), the predominant metabolite of serotonin, decreased significantly (p < 0.01) in the striatum. 5-Hydroxytryptamine (5-HT) was significantly (p < 0.01) increased by risperidone and decreased by clozapine in the rest of the brain. Striatal tryptophan (TRP) was significantly (p < 0.01) decreased by risperidone and increased in the rest of the brain. The striatal HVA/DA ratio increased and the 5-HT turnover rate remained unchanged in the rest of the brain. Results suggest that the affinity of the two drugs towards D2/5-HT1A receptor interaction is involved in lower incidence of extrapyramidal side effects. Role of 5-HT1A receptors in the treatment of schizophrenia is discussed.Cilj rada bio je procjena ponašanja i neurokemijskog profila klozapina i risperidona u ovisnosti o dozi nakon primjene na štakorima. Pokusnim životinjama intraperitonealno je injiciran klozapin (2,5, 5,0 i 10,0 mg kg1) ili risperidon (1,0, 2,5 i 5,0 mg kg1). Nakon jednog sata životinje su žrtvovane i uzeti su uzorci mozga. Nakon primjene lijeka ili fiziološke otopine praćeni su hipolokomotorički učinci (aktivnost u kavezu i katalepsija). Oba lijeka su pri visokim dozama značajno smanjila (p < 0,01) lokomotoričku aktivnost, a smanjenje je ovisilo o dozi. Maksimalni (100 %) kataleptički učinak postignut je visokom dozom risperidona (5,0 mg kg1). Neurokemijske procjene provedene su pomoću HPLC s elektrokemijskom detekcijom. Oba lijeka su pri svim dozama značajno (p < 0,01) povećala koncentraciju homovanilinske kiseline (HVA), metabolita dopamina (DA), u striatumu. Koncentracija dihidroksifeniloctene kiseline (DOPAC) u striatumu bila je povećana, a u ostatku mozga smanjena, posebno nakon primjene klozapina. Koncentracija 5-hidroksiindol octene kiseline (5-HIAA), najvažnijeg metabolita serotonina, značajno (p < 0,01) se smanjila u striatumu. 5-Hidroksitriptamin (5-HT) značajno se povećao (p < 0,01) nakon risperidona, a smanjio nakon klozapina u ostalim dijelovima mozga. Risperidon je značajno smanjio triptofan (TRP) u striatumu (p < 0,01), a povećao njegovu koncentraciju u ostalim dijelovima mozga. Također je povećao omjer HVA/DA u striatumu, dok je metabolizam 5-HT ostao nepromijenjen u ostalim dijelovima mozga. Rezultati upućuju na to da je interakcija ispitivanih lijekova s D2/5-HT1A receptorima uključena u nisku incidenciju ekstrapiramidalnih nuspojava. Razmatrana je uloga 5-HT1A receptora u terapiji šizofrenije

Caffeine – An Invisible Addiction

Caffeine, an alkaloid, is a stimulant of the central nervous system and is the most popularly consumed psychoactive drug worldwide. This stimulant can have both positive and negative effects on health. The objective of this study was hence to determine the common side effects associated with consumption of caffeinated drinks along with any symptoms stated by the participants that indicate withdrawal. A questionnaire-based descriptive epidemiological study was conducted at three major universities of Lahore, Pakistan. Among the target population that fell in the age ranging from 18-28 years, 35% started consuming caffeinated drinks between the ages 10-15, while tea was consumed by 60% of the sample population. 50% consume caffeinated drinks once or twice a day whereas 60% could refrain from consuming a single drink per day. 38.5% stated to suffer from increased urination while 22% suffered from increased blood pressure upon consumption. Caffeine addiction is one of the most prevalent and ever-expanding addictions in the world which must be either eliminated from diet or replaced by a healthier alternative

Analyzing the Maturity wise Interest Rate Pass Through in Pakistan

This paper examines the degree of pass through and adjustment speed of maturity wise deposit rates in response to changes in the discount rate in Pakistan during the time period from 1978 to 2019. The study finds evidence of a long run relationship among maturity wise deposit rates and discount rate. However, the estimates of long run model proposed by Philips &amp; Loretan (1990) and short run Error Correction Model indicate that pass through is incomplete and slow. This study confirms asymmetric adjustment of pass through and upward rigidity in deposit rates. Overall, the finding of less than complete and asymmetric pass through suggests limited efficiency of monetary policy in Pakistan