Correlation of Red Cell Distribution Width with Severity of Cardiovascular Diseases

Objectives: To determine the correlation of red cell distribution width (RDW) with severity of cardiovascular diseases. Methodology: This study was conducted at the Department of Pathology, Aziz Fatima Medical and Dental College, Faisalabad, over a period of one year from October 2019 to September 2020. A total of 150 participants were included in the study consisting of 75 patients of cardiovascular disease in case group and 75 participants without any cardiovascular disease in control group. All patients in the study underwent trans radial or transfemoral rout coronary angiography using 5F optitorque catheter for trans radial rout or 6F Judkins catheters for transfemoral rout. All the patient had angiography within 24 hours of admission in the hospital. Results: The patients who were diagnosed with Coronary artery Disease (CAD) had significantly higher mean age (51.45 ± 11.29 years) as compared (44.56 ± 9.45 years) to group B without out CAD. There were 53 (70.67%) males in group A, and 42 (56%) males in group B. The rate of hypertension (61.33%) was significantly higher among patient who diagnosed with CAD. The mean value of RDW CV was found significantly (p-value < 0.05) raised among patients of CAD (14.36 ± 1.02vs. 13.52 ± 0.89). The RDW SD was also significantly higher in group A (43.67 ± 4.39 vs. 41.65 ± 3.46, p-value = 0.002) in comparison to group B. Age and male gender were found to be a significant (p-value < 0.05) contributor for CVD with an odds ratio of 1.18 and 3 respectively. Conclusion: RDW is an effective easily available marker for the assessment of severity of coronary artery disease and helps in risk stratification of CAD patients for further events

Comparative analysis of hyoscine in wild-type and in vitro grown Datura innoxia by high performance liquid chromatography

Purpose: To compare the hyoscine contents of Datura innoxia plant grown in the wild and that grown in vitro.Methods: For callus induction from leaf explants, 15 combinations of 2,4-dichlorophenoxy acetic acid, gibberellic acid, benzyl amino purine and kinetin were used. For regeneration of shoots, 8 combinations of BAP, kinetin and indole butyric acid (IBA) were tested. Different concentrations of IBA were used for rooting. The hyoscine contents of the wild and in vitro samples was initially identified by TLC and subsequently quantified by high performance liquid chromatography using hyoscine N-butyl bromide as standard.Results: For callus induction, 2,4-D at 2 mg/L produced maximum calli (96 %). Maximum shoots regeneration was obtained with 2 mg/L BAP and 1 mg/L kinetin. IBA at 0.5 mg/L induced good rooting. Substantial amount of hyoscine was detected in the extracts of in vitro grown plants through TLC and HPLC. Wild root, stem and leaves exhibited higher amounts (approx. 2 μg/mL) of hyoscine than the parts of in vitro grown plants. Green callus grown in vitro contained a maximum concentration of hyoscine (1.01 μg/mL) followed by leaf (0.82 μg/mL) and brown callus (0.432 μg/mL).Conclusion: The callus cultures of D. innoxia are capable of yielding good amounts of hyoscine, and therefore can be exploited to increase hyoscine production using chemical/hormone treatments on a large scale. Thus, this study provides a sustainable and efficient way for the sustainable production of a natural hyoscine product via in vitro-grown D. innoxia cultures.Keywords: Datura innoxia, Hyoscine, Callus, Hyoscine, Explant, Gibberellic acid, Benzyl amino purine, Kineti

Helmet wearing saves the cost of motorcycle head injuries: A case study from Karachi, Pakistan

Purpose: To estimate the difference in healthcare cost of head injuries among motorcycle helmet users and non-users.Methods: Motorcycle crash victims with head injuries that were brought to a public, tertiary care emergency room in Karachi were studied through a descriptive cross-sectional design. A standard questionnaire was used to collect data on demographics, injury pattern, helmeting practice, length of hospital stay, out-of-pocket payments (OOPs), and healthcare service utilization at the facility to estimate total healthcare and other costs applying micro-costing methods during the hospitalization period.Results: A total of 323 motorcyclists involved in crash were brought to a public tertiary care ER, 112 patients had head injuries and were enrolled in the study. The helmeted motorcyclists had a significantly lower median total healthcare cost of PKR 10,796 ($69) [IQR 9851 ($63)-PKR 12,581 ($80)] compared to higher cost of PKR 12,113 ($77) [IQR 10,431 ($66)-50,545 ($322)] (p value = 0.046) in non-helmeted. Helmet users expended significantly less cost on laboratory tests, PKR 365 ($2) [IQR 365 ($2)-548 ($3)] compared to PKR 3650 ($23) [IQR 365 ($2)-5840 ($37)] (p value =0.027) among non-users. Furthermore, cost of radiological investigations was also low among helmeted patients compared to non-helmeted ones, median PKR 4096 ($26) [IQR 3166 ($20)-5678 ($36)] vs 4750 ($30) [3166 ($20)-11,358 ($72)] (p value =0.049). The out-of-pocket payments (OOPs) for healthcare services were lower among helmet users as compared to non-users, with cost of PKR 17,750 ($113) [IQR 16,650 ($106)-18,000 ($115)] vs PKR 19,800 ($126) [IQR 12,300 ($78)-30,900 ($197)] (p value =0.03), respectively.Conclusion: The result of this study demonstrates that helmet use among motorcyclists significantly reduced healthcare costs and healthcare resource utilizations during hospitalization for head injuries in Pakistan. Thus, it is important to implement strict helmet wearing laws to decrease head injuries and the cost burden on the healthcare facility and patients

Floods and flood management and its socio-economic impact on Pakistan: A review of the empirical literature

Flood is one of the most damaging natural disasters as the recent floods have shown their serious impact on Pakistan. Flood control and regulation policies are essential to reduce the risks of economic downturn, a threat to human existence, and to sustain the ecology. The severity of flood catastrophe activities represents a constant and severe issue in the world. Floods are rising year by year in severity and duration, causing negative impacts on the social and economic conditions of the nation concerned. While the frequency of floods cannot be avoided, their adverse impacts can be considerably reduced by adopting careful planning and efficient training. This paper reviews the socioeconomic impact of floods, and the existing condition of flood control policies outlines the flood protection problems and discusses opportunities for successful and efficient flood control in Pakistan. The paper also intends to propose several suggestions for efficient and sustainable flood control in Pakistan

Methyl 4-hy­droxy-2-meth­oxy­carbonyl­methyl-1,1-dioxo-1,2-dihydro-1λ6,2-benzothia­zine-3-carboxyl­ate1

There are two independent mol­ecules in the asymmetric unit of the title compound, C13H13NO7S, which have almost identical geometries. The thia­zine ring adopts a sofa conformation in both mol­ecules and the mol­ecular conformations are stabilized by intramolecular O—H⋯O hydrogen bonds. Inter­molecular C—H⋯O hydrogen bonds stabilize the crystal packing

Public exposure from I-131 hospitalized isolated patients in NIMRA Jamshoro Pakistan

Purpose/ Background: To treat the cancerous tissues the unsealed radioisotopes are being in clinical practice since 7 decades. From these unsealed sources, I-131 is the choice of treatment for the treating thyroid cancers. Orally administered I-131 patients are to be kept isolated in hospital for some period until captured activity in the body reaches to national and international limits for the avoidance of unacceptably high radiation exposures to patients' family members and the general public to keep ALARA (as low as reasonably achievable) principal in mind. The main rationale of this study was to calculate the exposure/dose of the general public. Material and Methods: This work presents the exposure rate and dose to the general public in the corridor and the non-radioactive patients admitted in adjacent room from I-131 administered isolated patients treated at NIMRA (Nuclear Institute of Medicine and Radiotherapy) Jamshoro Pakistan. In this study exposure from 23 thyroid cancer patients treated with different activities of I-131 (50 to 200 mCi) from January 2011 to December 2012 were included. Results: The average exposure rate in the corridor was about 5.17 µSv/hr (2.14 µSv/hr to 8.15 µSv/hr) and the cumulative dose to nonradioactive patients residing in an adjacent room was 0.647 mSv (0.192 mSv to 1.664 mSv). Conclusion: This study concludes that the exposure rate to the general public especially the admitted non-radioactive patient in the adjacent room is almost within the limits of 1 mSv as specified in national and international standards.-----------------------------------------Cite this article as: Memon SA, Laghari NA, Qureshi ST, Ahmad A, Khan AA, Hussain MM. Public exposure from I-131 hospitalized isolated patients in NIMRA Jamshoro Pakistan. Int J Cancer Ther Oncol 2014; 2(2):020214. DOI: 10.14319/ijcto.0202.1

“Takotsubo cardiomyopathy presenting with QT prolongation: an atypical presentation.”

Takotasubo Cardiomyopathy (TCM), also known as broken heart syndrome, is a syndrome of transient and reversible cardiac dysfunction in the absence of obstructive coronary artery disease following an unpleasant emotional event. TCM commonly presents as chest pain mimicking acute coronary syndrome (ACS) in character. The most common electrocardiogram (EKG) findings associated with TCM are ST-segment elevation or T wave inversion. Herein, we present a case of TCM in an individual who presented with a sudden onset chest pressure following a stressful event. She was found to have QT interval prolongation on EKG and elevated troponins. Initially thought to have non-ST elevation myocardial infarction (NSTEMI). Cardiac catheterization did not reveal coronary artery disease. The ventriculography suggested apical ballooning and the diagnosis of TCM with atypical EKG presentation. Our case is unique as we describe an atypical electrocardiographic presentation of TCM. Our case emphasizes that physicians should refrain from prescribing QT-prolonging drugs to patients with TCM, to avert potential QT prolongation and progression to torsade de pointes (TDP)