Surgical Management and Outcome of Lumbosacral Disc Herniation (Study of 100 Cases)

Objective:  To discuss the surgical management and outcome of lumbosacral disc herniation. Material and Method:  The study was conducted in BMCH and Akram Hospital Quetta from April 2005 to November 2006, 100 patients of both gender included in study. Age range was 30 – 25 years. MRI lumbosacral spine done in all cases. Results:  Excellent result was observed in 80% of patients while fair result in 12% and results were same in 6% of patients. Poor result in 2%. Key word:  Lumbosacral Disk, Herniation.   &nbsp

'Lactobacillus fermentum' 3872 genome sequencing and analysis

In recent years, there has been a rise in antimicrobial-resistant bacteria caused by overdependence on, and misuse of, antibiotics. This has led to an increase in research for identifying alternatives to combat pathogens. One promising means of combating pathogenic bacteria, particularly for those residing in the gastrointestinal tract (GIT), is the use of probiotics. This thesis focuses on a potential probiotic strain Lactobacillus fermentum 3872, the genome sequence of which was circularised during the study, identifying genes that may contribute to probiotic activity. Several genes involved in GIT survival, such as acid symporters were discovered, along with genes that encode adhesion proteins such as those involved in mucus, fibronectin and collagen binding. The genes mentioned above may contribute to L. fermentum 3872 survivability within the GIT and have an antagonistic effect on enteric pathogens via competitive exclusion. Other interesting genes identified in L. fermentum 3872 were potentially involved in bacterial aggregation, exopolysaccharide and vitamin synthesis, along with four prophage encoding regions. Genes that encode a class III bacteriocin was also identified. An additional gene encoding a collagen binding protein (CBP) of a newly discovered plasmid pLF3872, was recognised. The chromosomal sequence also had a partial CBP encoding gene. pLF3872 has a toxin-antitoxin gene pair that ensures stable maintenance of the plasmid, along with conjugation-related genes. Functional analysis of the recombinant CBP via ELISA experiments found that the protein had the ability to bind to collagen I, a protein present on the epithelial lining of cells of the GIT. ELISA experiments also demonstrated that a common gastrointestinal pathogen, Campylobacter jejuni, can bind to collagen I in a concentration-dependent manner. In addition, mass spectrometry analysis identified that C. jejuni strains 11168H and 81-176 may utilise flagellar components (FlaA and FlaB) for adhesion. Furthermore, C. jejuni 11168H and 81-176 binding to collagen I was inhibited in the presence of either L. fermentum 3872 or CBP, thus reducing C. jejuni adherence via competitive exclusion. Using an in vitro assay, it was also demonstrated that L. fermentum 3872 cell-free supernatant could inhibit the growth of C. jejuni, due to the acidic environment brought about by L. fermentum 3872. During the completion of the genome sequence of L. fermentum 3872, comparison of various sequence assembly techniques which focused on the quality of the genome assembly was conducted. The results showed that further extension of the genome sequence during sequence assembly may lead to assembly errors when over-relying on a commonly-used sequence quality indicator, referred to as read mapping. It is suggested that care must also be taken when using long read technology to complete the genome sequence of a bacteria, as this may result in nucleotide sequence redundancies

EFFECT OF HIGH AND LOW FLEXIBILITY ON AGILITY, ACCELERATION SPEED AND VERTICAL JUMP PERFORMANCE OF VOLLEYBALL PLAYERS

This study aimed to assess the effect of high and low levels of flexibility on key performance indicators of volleyball performance. Eighty-four volleyball players (n=84; mean±SD; decimal age: 16.57±1.51; height (cm): 176.23±8.77; body mass (kg): 66.14±11.79) were selected for the study. The design of the study was cross-sectional and to measure selected variables i.e. agility, lower body muscular power, and acceleration speed; 6×10 m shuttle run, countermovement jump (with arm swing) test and 20 m sprint test (standing start) were used. To measure the flexibility level of the players, sit and reach test was used. Shapiro-Wilk normality test was conducted to check the distribution of data and the Levine test was applied to check homogeneity of the variance in data. Participants were divided into two groups i.e. High Flexibility Group (HFG) and Low Flexibility Group (LFG) using k-means cluster analysis and independent t-test was applied to find the differences between HFG and LFG. The level of significance was set at p < 0.05. Results showed statistically significant difference between HFG and LFG in agility, acceleration speed and lower body muscular power and, based on the results, it was concluded coaches should include flexibility training in the regular training programme. The results obtained supported the rationale that baseline flexibility may influence the performance of volleyball players. Article visualizations

Clinical Presentation and Surgical Management of Brain Abscess

Objectives:&nbsp;&nbsp;To determine the clinical presentation, surgical management and outcome of patients with Brain Abscess in our locality. Study Design:&nbsp; Descriptive study. Place and Duration of Study:&nbsp;&nbsp;Bolan Medical complex, Sandeman Provincial Hospital and Akram Hospital, Quetta. Duration from January 2003 to July 2004. Subject and Methods:&nbsp;&nbsp;Study conducted on twenty patients with Brain Abscess confirmed on CT Scans. Patients of both gender and all age group were included in the study. Those managed conservatively were excluded from the study. Results: &nbsp;Surgery was performed on all patients with the mortality rate of 20% (4) in this study. Conclusion:&nbsp;&nbsp;Appropriate microbial coverage and surgical management of Brain Abscess reduced the mortality and neurological deficits. Key Works: &nbsp;Brain Abscess, Neurological deficit, Mortality

Management and Outcome of Compound Depressed Skull Fracture

Objectives:&nbsp;&nbsp;To determine the clinical presentation, management and outcome of patients presenting with compound depressed skull fracture. Study Design:&nbsp; Descriptive study. Place and Duration of Study:&nbsp;&nbsp;Bolan Medical Complex Hospital Duration from May 2003 to March 2006. Materials and Methods:&nbsp;&nbsp;Study conducted on sixty patients with compound depressed skull fracture. Patients of both gender and all age group were included in the study, those with major life threatening injuries to other organs were excluded. Results:&nbsp;&nbsp;Out of total of 60 patients, 42 (70%) patients were male and 18 (30%) were female. Majority were in the first (33%) second (25%) decade of life (child and young patients). Most of patients were injured as a result of road traffic accidents 32 (53%), fall from height in 16 patients (27%) and assault in 12 (20%). Seventy percent of patients in fall group fell from roof while 30% from electric pool. Patients presented with various signs and symptoms like headache, vomiting (70%), loss of consciousness (33%), ear, nose and throat bleed (40%), CSF rhinorrhea (17%) and fits. Seventy percent of patients in this study presented with sings of raised intracranial pressure. Temporal region was the most frequently affected area in 30 (50%) cases.&nbsp; Conclusion:&nbsp;&nbsp;Children and yuoung adults and males are most commonly affected. Road traffic accidents and falls from height are the most common modes of head injury. If treated properly most cases of compound depressed fracture will reveal good results. &nbsp

Outcome of Microvascular Decompression (MVD) for Trigeminal Neuralgia

Objective: To assess the outcome of patients of Trigeminal Neuralgia after Microvascular Decompression (MVD).Design: Case Series.Place and Duration of Study: Bolan Medical Complex Hospital, Quetta from July 2008 to July 2015.Materials and Methods: Patients of all age group and both gender were included. Those patients were included in study that was not relieved by conservative treatment.Results: 40 patients included in study, 30 patients were male and 10 patients were female. Male to female ratio 3:1. The majority of the patients were over 50 years of age. Duration of symptoms in all the patients was more than one year. All of patients were not responding to medical treatment (Anticonvulsant, Antispasmodic and Pain Killers) after one year treatment. All of patients were operated. Procedure was microvascular decompression. They were followed for the period of one year. Most of the patients were pain free after surgery and few patients develop minor complications.Conclusion: Micro vascular decompression is treatment of choice in those patients who stop responding to the conservative treatment

Impact of Time Taken on the Surgical Outcome of Epidural Hematoma in Patients with Road Traffic Accidents

Introduction: Traumatic epidural hematoma is a neurosurgical emergency and timely surgical intervention is the standard treatment. The rationale of this study is to highlight the importance of time of surgery on the surgical outcome of epidural hematoma particularly in patients with history of road traffic accidents.Objectives: To determine the impact of time taken on the surgical outcome of epidural hematoma in patients with road traffic accidents.Study Design: Descriptive Case Series.Place and Duration of Study: Bolan Medical Complex Hospital and Sandeman Provincial Hospital, Quetta. From April 2010 to July 2011.Patients and Methods: Sixty adult patients of either gender with H/O road traffic accident with epidural hematoma on axial images of CT scan brain were included. All patients were allocated into three groups with 20 patients in each group. Patients in group I were those in whom time from the occurrence of trauma to the surgical evacuation of hematoma was &lt; 1 hour, 1 to 6 hours in group II and &gt; 6 hours in group III.Results: In group I, 18 (90%) showed favorable and 2 (10%) showed unfavorable outcome. In group II, 14 (70%) showed favorable and 06 (30%) showed unfavorable outcome. In group III, 10 (50%) showed favorable and 10 (50%) showed unfavorable outcome. Significant association was found between outcome and time of surgery (P &lt; 0.05).Conclusions: Frequency of favorable outcome after surgical evacuation was significantly higher in patients in whom surgery was performed within one hour after the trauma