Co-existing spinal intradural ependymal cyst and sacral tarlov cyst in adult-onset tethered cord syndrome with syringomyelia: Case report and literature review

Background: Synchronous spinal intradural ependymal cysts and sacral Tarlov cysts in adult onset tethered cord syndrome are extremely rare.Case description: A 23-year-old male presented with back pain radiating into both lower extremities, accompanied by acute onset of gait difficulty and sphincter dysfunction. Magnetic resonance imaging identified a low lying conus medullaris, syringomyelia with septations extending from T12 to S1, a tethered cord, and a thickened filum terminale with a sacral Tarlov cyst. The patient underwent a L3-4 laminectomy for decompression of syringomyelia and excision/biopsy of a space occupying lesion along with S1-2 laminectomy for cord untethering and Tarlov cyst fenestration. Postoperative histopathology confirmed that the lesion was an ependymal cyst. Clinically, patient showed marked improvement in the neurological status.Conclusion: Simultaneous decompressive laminectomy of L3-4 and S1-2 effectively decompressed the syringomyelia while allowing for excision/biopsy of a space occupying lesion at the former and untethering and Tarlov cyst fenestration at the latter levels

A comparative study of job satisfaction in public and private school teachers at secondary level

AbstractThe present study was conducted to investigate a comparative study of job satisfaction in public and private school teachers. ‘Job satisfaction’ refers to the attitudes and feelings people have about their work. Positive and favorable attitudes towards the job indicate job satisfaction. Negative and unfavorable attitudes towards the job indicate job dissatisfaction. Researches support that teacher's job satisfaction has been found one of the very important variable related to positive teaching behavior toward their job. There has also been considerable interest in the complex relationship between an individual's job satisfaction and satisfaction with other aspects of his or her life. It was hypothesized that a comparative study of job satisfaction in public and private school teachers. To test this hypothesis the researcher conducted this study to investigate the sense of teacher's job satisfaction. For this purpose the researcher developed a questionnaire of 25 items and 5 options. A sample of 150 public and private school teachers was conveniently selected for the study. Data analysis was conducted through ‘t-test’ and ‘ANOVA’ Which shoed that there is no significance difference between teacher's job satisfaction in public and private schools

Blindness in children at the Ida Rieu school for the blind and deaf

Objective: To identify the causes of blindness at the Ida Rieu school for the blind and deaf, Karachi, Pakistan.Methods: A cross sectional study was conducted at the Ida Rieu School for the blind and deaf. The data collected from medical record of students was entered into the WHO/PBL eye examination form for children with blindness and low vision.Results: Records of 144 pupils aged between 4-30 years were reviewed, including 67% males and 33% females. One third (31%) children had visual impairment (\u3c 6/18-6/60) and 69% were blind (\u3c 3/60-NPL). The commonest anatomical site was retina (41%) and whole globe (20%). The etiology was unknown in 49% cases. In 33% of cases, the data suggested hereditary cause as the etiology, 40% of cases were preventable and 13% treatable.CONCLUSION: Avoidable causes of blindness were seenin 53% of children, 58% of which were preventable and 19 were treatable

Does academic assessment system type affect levels of academic stress in medical students? A cross-sectional study from Pakistan

Introduction Stress among medical students induced by academic pressures is on the rise among the student population in Pakistan and other parts of the world. Our study examined the relationship between two different systems employed to assess academic performance and the levels of stress among students at two different medical schools in Karachi, Pakistan. Methods A sample consisting of 387 medical students enrolled in pre-clinical years was taken from two universities, one employing the semester examination system with grade point average (GPA) scores (a tiered system) and the other employing an annual examination system with only pass/fail grading. A pre-designed, self-administered questionnaire was distributed. Test anxiety levels were assessed by The Westside Test Anxiety Scale (WTAS). Overall stress was evaluated using the Perceived Stress Scale (PSS). Results There were 82 males and 301 females while four did not respond to the gender question. The mean age of the entire cohort was 19.7±1.0 years. A total of 98 participants were from the pass/fail assessment system while 289 were from the GPA system. There was a higher proportion of females in the GPA system (85% vs. 59%; p \u3c 0.01). Students in the pass/fail assessment system had a lower score on the WTAS (2.4±0.8 vs. 2.8±0.7; p=0.01) and the PSS (17.0±6.7 vs. 20.3±6.8; p \u3c 0.01), indicating lower levels of test anxiety and overall stress than in students enrolled in the GPA assessment system. More students in the pass/fail system were satisfied with their performance than those in the GPA system. Conclusion Based on the present study, we suggest governing bodies to revise and employ a uniform assessment system for all the medical colleges to improve student academic performance and at the same time reduce stress levels. Our results indicate that the pass/fail assessment system accomplishes these objectives

Comparative analysis of pedicle screw versus hybrid instrumentation in adolescent idiopathic scoliosis surgery

Introduction: Adolescent idiopathic scoliosis is the most common type of scoliosis. A Cobb angle of 50° will progress beyond the age of spinal maturity. Surgery over bracing is advised at a Cobb angle above or equal to 50°. The aim of surgery is to bring the Cobb angle down below 50° to prevent reprogression as well as improve the quality of life. The objective of the study is to analyze the efficacy and significance in lifestyle improvement of pedicle screw-only fixation system versus the more common hybrid instrumentation system used for the surgical treatment of adolescent idiopathic scoliosis. Materials and Methods: A prospective cohort study was conducted involving two groups of patients were included in the study. One group was operated with pedicle screw-only method while the other with hybrid instrumentation system. The pre- and post-operative Cobb’s angles were taken across a follow-up of 4 years. An SRS-30 questionnaire was given in a yearly follow-up to assess the lifestyle improvement of the patient. Results: Pedicle screw-only method was significantly more effective in reducing Cobb’s angle (P = 0.0487). It was showed less loss of correction (P = 0.009) pedicle screw-only surgery was also better at reducing thoracic curves (P = 0.001). There seemed a better recovery time with pedicle screw surgery (P = 0.003). Conclusion: Pedicle screws are more effective and durable than hybrid systems at when treating adolescent idiopathic scoliosis

Relative weight-age in textbook and examination of secondary school chemistry-implications for selective study among students

AbstractThis research paper aims at the relationship between the examination and the textbook. It will also explore the limitations of the current evaluation methods in examination system and find the validity of the examination papers. For this purpose five years(from 1998 to 2002) of Chemistry papers of SSC (Secondary School Certificate) level were taken from the Board of Intermediate and Secondary Education, Lahore and analyzed. Analysis was done by calculating the standard weight-age of each paper and by also calculating number of questions selected from text book in the each year of examination. Pearson product moment correlation was employed to examine the relationship between content coverage and the standard weight-age given of each chapter. The value of correlation showed that the paper setter tried to follow the standard weight-age of textbook. The value of correlation in the paper of Chemistry between the standard weight-age of textbook and ten examination papers of BISE, Lahore is 0.01 to 0.91. This shows that in annual paper of 1999 the paper setter did not follow the table of specification and in 1999 supplementary examination he tried to follow the table of specification. Wide range of the value of correlation also shows that no proper paper pattern has been followed by the paper setters

Ionic liquid functionalized nano-zerovalent cerium for catalytic degradation of carbamazepine and colorimetric sensing of H\u3csub\u3e2\u3c/sub\u3eO\u3csub\u3e2\u3c/sub\u3e

© 2021 Elsevier Ltd This study reported the chemical reduction method based synthesis of ionic liquid (IL) functionalized nano-zerovalent cerium (nZVCe) for the degradation of carbamazepine (CBZ) and colorimetric detection of H2O2. Carbamazepine is an important class of emerging water pollutants while H2O2 is produced as a major by-product by living organisms during metabolism. The synthesized IL-nZVCe showed high efficiency towards CBZ degradation and H2O2 detection. The use of advanced characterization techniques showed the prepared material to be highly crystalline and of high surface area, i.e., 85 m2/g. The IL-nZVCe caused 56% removal of CBZ, however, the use of H2O2 and IL-nZVCe promoted the removal of CBZ to 85% under 80 min treatment time using [IL-nZVCe]0, [CBZ]0 and [H2O2]0 as 0.5 g/L, 10 mg/L and 40 mg/L, respectively. IL-nZVCe/H2O2 yielded ●OH which showed high reactivity of 5.40 × 109 (M s)–1 with CBZ and played active role in CBZ degradation. Removal of CBZ was inhibited in the presence of ●OH scavengers. The IL-nZVCe/H2O2–mediated removal of CBZ was promoted under the conditions of high [H2O2]0, high [IL-nZVCe]0 and low [CBZ]0. IL-nZVCe/H2O2 was also highly effective in TOC removal of CBZ. The IL-nZVCe showed high reusability than nZVCe. The acute and chronic toxicities of CBZ degradation products identified by LC–MS analysis were estimated. The conversion of CBZ into non-toxic acetate suggests high potential of the IL-nZVCe/H2O2 into remediation and detoxification of CBZ

Polyaxial screws for lumbo-iliac fixation after sacral tumor resection: experience with a new technique for an old surgical problem.

Background:Although numerous reports have been published about various methods for reconstruction after sacrectomies, there are still biomechanical and technical dilemmas that are unaddressed. This report describes the experience at authors\u27 institution of five cases in which polyaxial pedicle screws construct has been successfully used for lumbo-iliac fixation after sacral tumor resection. Methods: Five cases of sacral tumors, two of Ewing\u27s sarcoma and three of giant cell tumor (GCT) underwent surgical resection and then reconstruction was done with hardware using vertical rods placed alongside the spine bilaterally, transfixing monoaxial and polyaxial pedicle screws in lower lumbar levels and polyaxial screws into the ilium bilaterally. Cross links were also used to connect the two vertical members, thus enhancing biomechanical stability of the construct. Use of autologous bone grafts was relied upon to fill the gap created by sacral resection. Results: No instrumentation failure was noted and the continuity of the spine and pelvis was well established with the instrumentation and auto grafts. In follow up of these Patients (1-3 years), no complications were seen. Conclusions: Polyaxial pedicle screws fixation is an effective technique to transmit axial load from spine to the appendicular bone and can be used safely in Patients in whom sacral integrity is compromised after surgical resection. However, the long term benefits of this technique need to be evaluated

Aflatoxin contamination of milk produced in peri-urban farms of Pakistan: Prevalence and contributory factors

Aflatoxin M1 contamination of milk in Pakistan, like many developing countries, is poorly understood. The present study was therefore conducted to determine AFM1 contamination of milk and its contributory factors in Pakistan. We sampled milk and feedstuffs from 450 peri-urban dairy farms in seven major cities following a cross-sectional study design. Analysis of milk using ELISA revealed high contamination with an overall average of 3164.5 ng of AFM1/L, and significant differences (p < 0.001) between cities. The milk sampled from Gilgit, in northern hilly areas, had an average AFM1 level of 92.5 ng/L. Milk from other cities had 3529.7 ng/L average contamination, with only 5.7% samples qualifying the maximum tolerable limit of 500 ng of AFM1/L. Heavy mean aflatoxin contamination was found in bakery waste (724.6 μg/kg), and cottonseed cake (600.8 μg/kg). Rest of the other feedstuffs had moderate to low mean aflatoxin contamination, ranging from 66.0 μg/kg in maize stover to 3.4 μg/kg in wheat bran. The mean aflatoxin level in commercial dairy concentrates was 32.7 µg/kg. About 80% of the total aflatoxin intake of dairy animals was contributed by cottonseed cake alone due to its high aflatoxin contamination and proportion in dairy rations. On-farm storage time of oilseed cakes varied (p < 0.01) in different cities but was not associated with aflatoxin contamination. The exceptionally high AFM1 contamination suggests that milk from peri-urban dairy farms is a serious public health threat in Pakistan. This situation can be mitigated by reducing aflatoxin contamination in cottonseed cake and promoting the use of commercial concentrates and other feedstuffs with low contamination