Minimally invasive plate osteosynthesis for tibial plateau fractures.

Purpose:To evaluate radiological and clinical outcome of minimally invasive plate osteosynthesis (MIPO) for tibial plateau fractures. Methods: 35 men and 6 women aged 19 to 75 (mean, 40, standard deviation [SD], 14) years underwent MIPO for displaced tibial plateau fractures. According to the Schatzker system, the tibial plateau fractures were classified as types I (n=3), II (n=9), III (n=11), IV (n=6), V (n=7), and VI (n=5). Six Patients had open fractures, 2 of them underwent debridement before MIPO. 10 Patients needed additional bone grafting. Radiological (at immediate postoperation) and clinical (at the 12-month follow-up) assessments based on the Rasmussen anatomic and functional scoring system were recorded using a proforma. Patients with acceptable and unacceptable outcomes were compared in terms of age. Results: The mean Rasmussen anatomic score was 15.1 (SD, 2.2, range, 10-18), the mean Rasmussen functional score was 25.3 (SD, 3.2, range, 14-29), and the mean range of knee motion was 118 (SD, 10, range, 90-140) degrees. Anatomic outcome was excellent in 10, good in 28, and unacceptable in 3 Patients (one each had Schatzker type-I, -II, and -III fractures). 27 (71%) of the 38 Patients with acceptable anatomic outcome were aged 45 years or younger, whereas 2 (67%) of the 3 Patients with unacceptable anatomic outcome were aged 60 years or older (p=0.001). Functional outcome was excellent in 18, good in 19, and unacceptable in 4 Patients (2 had Schatzker type-III and another 2 had Schatzker type-I or -II fractures). 37 of the Patients had a range of knee motion of 120 degrees or more, 27 (73%) of them were aged 45 years or younger, whereas 3 (75%) of the 4 Patients with unacceptable functional outcome were aged 60 years or older (p=0.001). Conclusions: MIPO for tibial plateau fractures achieved good outcome with minimal soft-tissue complications. Older age was the predictor of unacceptable outcome

Effect of early release of tourniquet in total knee arthroplasty

Objective: To evaluate whether tourniquet release intraoperatively is better than postoperative release in reducing overall blood loss, duration of surgery, duration of tourniquet, length of hospital stay, wound related complications and transfusion requirement. Study Design: Comparative study. Place and Duration of Study: Department of Surgery, The Aga Khan University Hospital, Karachi, from January 2004 to June 2007. Methodology: One hundred and thirty patient files were reviewed retrospectively. Patients were divided into two groups. Group-A consisted of 65 patients with early deflation of tourniquet and group-B comprised of 65 patients with the release of tourniquet after applying compressive dressing. Total blood loss (determined by Gross method) and other study variables were noted as per objective and computed.Results: There were 22 males and 108 females with comparable BMI. All had undergone posterior stabilized cemented total knee replacement. Calculated blood loss was 1.208 L and 1.108 L in group-A and B respectively (p = 0.27). Significant increase in duration of surgery was noted in group-A patients. Four patients in group-B showed complication related to wound with 3 being minor and 1 requiring additional operation room visit. Mean length of hospital stay was 9 days. Transfusion frequency was higher in group-B despite comparable postoperative haemoglobin values. Conclusion: Intraoperative tourniquet release does not reduce overall blood loss with no effect in conserving blood after total knee replacement, however, this group had relatively shorter hospital stay

Transfusion practice in orthopedic patients: do we really need it?

Abstract OBJECTIVE: To determine the proportion of inappropriate transfusions in patients undergoing orthopaedic surgery at a tertiary care university hospital, and factors associated with inappropriate transfusions. METHODS: The prospective study was conducted at Aga Khan University Hospital, Karachi, from December 2008 to September 2009, and comprised patients admitted to the Orthopaedic Department and received transfusion of at least one packed cell. Patients were divided into four groups: A, those with haemoglobin \u3c 7, B, haemoglobin 7.1-10 without ischemic heart disease, C, haemoglobin 7.1-10 with ischemic heart disease, and D, haemoglobin \u3e10. Variables recorded were, pre-transfusion haemoglobin level, co-morbids, symptoms of hypovolemia, pre-transfusion volume replacement with fluids, transfusion reactions, and haemoglobin after 48 hours. Indications of transfusion were assessed in accordance with available data. RESULTS: Of the 126 patients, 65(52%) were males and 61(48%) were females. There were 18(14%) patients in group A, 88(70%) in group B, 12(10%) in group C, and 8(6%) in group D. Overall, Overall, 44(35%) were transfused appropriately according to the criteria, and 82(65%) were inappropriate. CONCLUSIONS: The number of inappropriate transfusion was quiet high and demands revision of institutional policy of packed cell transfusion in accordance with available guidelines

Electrokinetic Desalination of Compound Building Materials by Applying Electric Field

Damaging of building materials is directly connected to the salt crystallization. The present research is based on removal of NaCl from compound building materials, where a direct current (DC) electric field was applied to the mortar plus bricks system. The main objective of this work is to investigate the electrokinetic desalination methodology that can provide sufficient removal of salts. pH neutralization in the surrounding of mortar plus bricks system is crucial to obtain sufficient desalination. For this purpose, the electrodes across the brick were inserted in kaolin clay mixed with buffer agents to suppress the pH changes. Most of the experiments were performed with kaolin clay and sponge. The concentration of chloride ions and sodium ions in all the segments and clay poultice was measured using argentometric titration method and flame photometer, whereas the pH variations in the entire system was measured by using pH indicator papers. The electrokinetic desalination was found to be an efficient method as 86 % removal of chloride and 80 % removal of sodium was achieved

Functional evaluation of the urinary tract by duplex Doppler ultrasonography in patients with acute renal colic

Purpose: To determine the role of duplex Doppler ultrasonography (DDU) in Patients with acute unilateral renal obstruction. Subjects And Methods:A total of 161 Patients with suspected renal colic due to urolithiasis were evaluated by DDU followed by intravenous urography (IVU). The mean intra-arterial resistive index (RI) and the difference of mean resistive index between both kidneys (delta RI) were determined for each person. An RI value of ≥0.70 and a delta RI value of ≥0.06 were taken as the discriminatory threshold for obstruction. IVU results were considered the reference standard against which renal DDU findings were compared. Results: IVU showed both kidneys to be normal in 51 Patients and with unilateral ureteric obstruction in 110 Patients. The mean RI for obstructed kidneys was 0.67 (0.048), which was significantly higher (P-value Conclusion: Delta RI is more sensitive and specific than RI in acute renal obstruction. However, due to relatively low sensitivity for detection of partial obstruction, DDU cannot replace IVU as the standard imaging technique

Chemical Control of Codling Moth, Cydia pomonella L. (Lepidoptera: Tortricidae) in Relation to Pheromone Trap Catches and Degree Days in Upland Balochistan

Abstract.-The present study was aimed to protect apple crop from codling moth (Cydia pomonella) attack and to expand its production in the region. Study was conducted over two years (2010 and 2011) in apple field to evaluate number and proper time of pesticides application to kill maximum larvae of moth. Three chemicals, Lorsban (Chlorpyrifos), Match (Lufenuron) and Talstar (Bifenthrin) were used. Pheromone traps together with degree days (°DD) were utilized to monitor moth population and to time pesticides sprays. °DD was calculated using 10 °C as lower developmental threshold (base temperature) to examine their effect on flight activity of the moth. Result of analyzed data showed highly significant differences between generations and treatments at P-value < 0.01 in 2010 and 2011. All the three chemicals significantly controlled infestation compared with control (un-treated). A significant difference was observed between Lorsban and Talstar for three timely sprays in 2010. Treatments with Lorsban at 80% petal fall gave efficient control than peak emergence and 5 moths trapped per week methods in both years of this study. Flight activity of first and second generation moths in pheromone trap was observed at 97.04 and 663.04 °DD in 2010 respectively. First flight of the successive two generations in 2011 was recorded at 97.66 and 707.93 °DD respectively. The overall population of moth captured in pheromone traps was higher in the first year than in the second year. The results of the two years study demonstrate that application of 3 to 4 timely sprays (combined with monitoring moth traps and °DD) per year effectively control the larval infestation of C. pomonellat in field

Epidemiological Data of Neurological Disorders in Pakistan and Neighboring Countries: A Review

Neurological disorders are the impairments of nervous system and are an important and growing cause of morbidity, mortality, and disability. In addition to health costs, those suffering from these conditions are also frequently victimized of stigmatization and discrimination. Stigmatization further minimizes the patients\u27 access to treatment and social activities. These disorders, therefore, require special attention particularly in developing countries where unfortunately, the burden of these disorders remains largely unrecognized. Moreover, the burden imposed by such chronic neurological conditions in general can be expected to be particularly devastating in poor populations. These conditions are emerging as severe public health concerns in the developing countries due to the facts such as unawareness, Illiteracy, large numbers of people who are untreated, and unavailability of inexpensive but effective interventions. Regrettably, reliable population-based data from developing countries including Pakistan on the epidemiology of neurological disorders are extremely limited. Although, some information on epidemiological aspects of neurological diseases are available from some developing countries (Pakistan, Iran, India, Sri Lanka, Saudi Arabia and China) but disease prevalence and pattern are based on geographical, social, cultural, religious, and ethnic factors. In this review, w e critically analyzed data of 209 studies regarding the burden and prevalence of hypertension, depression, Stroke, Alzheimer\u27s disease (AD), epilepsy, and Parkinson\u27s disease (PD) in Pakistan and neighboring countries

Ferula asafoetida Linn. is effective for early functional recovery following mechanically induced insult to the sciatic nerve of a mouse model

Purpose: To evaluate the effect of Ferula asafoetida (oleo gum resin powder) on sensory and motor functions retrieval on an induced sciatic nerve injury in a mouse model.Methods: A mechanical crush was inserted in the sciatic nerve of all the experimental mice after acclimatization. The mice were allocated to four groups; one normal chow group (control, n = 7) and three Ferula asafoetida chow groups (each n = 7) of different doses (50, 100 and 200 mg/kg). Muscle grip strength, muscle mass, and sciatic functional index were measured to evaluate the motor function regain, while sensory function regain was assessed by hot plate test. Oxidative stress and glycemic levels were measured by biochemical assays.Results: The findings of this study indicate that Ferula asafoetida 200 mg/kg has a highly significant (p≤ 0.001) ameliorating effect in terms of improved grip strength (77.7 ± 5.4 % for 200 mg/kg vs. 46 ± 5.1 % for control), reversal of SFI towards normal ( -34 ± 8.1 for 200 mg/kg group vs. –61 ± 6.1 for control), decrease in paw withdrawal latency (7.10 ± 0.06 s for 200 mg/kg group vs. 15 ± 0.5 s for control) on day 12 post-injury, as well as restoration of skeletal muscle mass towards normal. Interestingly, F. asafoetida chow 50 mg/kg and 100 mg/kg groups also impacted significant (p < 0.01) improvement in the ameliorative effect. However, the differences among all treatment groups in ameliorating recovery were not significant (p > 0.05). Moreover, comparatively improved (p < 0.0001) total antioxidant capacity along with reduced total oxidant status (p = 0.01) in the Ferula asafoetida chow (200 mg/kg) group, indicate the antioxidative effect of this plant. Furthermore, the treated mice (200 mg/kg) also expressedan improved glycemic level (p = 0.0005).Conclusion: Ferula asafoetida supplementation helps to accelerate both sensory and motor function retrieval following sciatic nerve injury. This  improvement is thought to be correlated with the antioxidant capacity of the plant. However, further investigations are required to identify the therapeutic principles responsible for the observed actions. Keywords: Sciatic nerve injury, Ferula asafoetida, Function recovery, Oxidative stress, Biochemical analysi

Effect of electrokinetic treatment time on energy consumption and salt ions removal from clayey soils

Electrokinetics effectively removes contaminants, but its field-scale applications are limited mainly due to its high energy cost. In previous studies, the energy consumption was determined either by changing the soil’s specimens initial salt concentration while keeping the treatment time fixed or by changing the treatment time and keeping the same initial salt concentrations for all the specimens. Since both the initial salt concentration and treatment time are important parameters in determining reclamation cost, therefore, in this study, the soil specimens intentionally contaminated with different concentrations of sodium chloride (NaCl), i.e., varying from 3.7 to 15.5 g kg−1, were exposed to a constant DC electric field of 1 V cm−1 for different time durations, i.e., varying from 6 to 72 h. The results show that electroosmotic flow (EOF) was directed from the anode to the cathode and higher for specimens contaminated with relatively low salt concentration, i.e., up to 7.6 g kg−1. Therefore, for these specimens, due to the combined effect of electroosmosis and electromigration, the removal of Na+ was higher than the Cl−. However, for the specimen contaminated with a higher salt concentration, i.e., 15.5 g kg−1, the Cl− removal exceeded Na+ due to the marginalization of EOF. Regardless of initial salt concentration, the electroosmotic flow and salt ions removal rates decreased with increasing treatment time, which might be attributed to the development of acidic and alkaline environments in soil. The collision of acidic and alkaline fronts resulted in a large potential gradient in a narrow soil region of pH jump, diminishing it everywhere else. This nonlinearity in the electric potential distribution in soil reduced the EOF and electromigration of salt ions

Battling arid adversity: unveiling the resilience of cotton in the face of drought and innovative mitigation approaches

Climate change has had significant impacts on agriculture, particularly on cotton production, where drought has emerged as a major threat worldwide. Long and intense dry periods in cotton-growing regions have become more frequent and severe. Drought stress severely affects various aspects of cotton plants, including chlorophyll pigments, carbohydrate metabolism, and enzyme activities related to fiber development, such as vacuolar invertase and sucrose synthase. Furthermore, drought stress disrupts the movement of nutrients toward the reproductive tissues in cotton, resulting in compromised pollen function, propagative failure, and fiber characteristics. To tackle these issues, scientists have made advancements in creating drought-resistant cotton varieties through transgenic methods or molecular breeding techniques, genome editing, CRISPR/Cas9, utilizing quantitative trait loci (QTL). Moreover, the application of plant growth regulators and mineral elements has displayed the potential to improve cotton’s ability to endure drought stress while also enhancing fiber yield and quality. These approaches activate stress-responsive signaling pathways, which could contribute to mitigating reproductive failure and improving fiber characteristics. While the impact of drought stress on cotton plants has been extensively studied, the variations in fiber quality resulting from drought stress are not yet completely understood. Current research has been focused on unraveling the mechanisms underlying these changes, including the physiological, biochemical, and molecular alterations during the multiplicative growth phase that contribute to poor fiber development. Understanding these mechanisms will facilitate the development of novel strategies to alleviate the adverse impact of worldwide weather changes on cotton growth and fiber quality. This research focuses on the drought stress in cotton cultivation and explores its different effects on cotton morphology, physiology, crop yield, and fiber characteristics as well as mechanisms by which cotton exhibits drought tolerance and highlights innovative strategies to mitigate drought stress