Etiology, functional status and short term outcome of patients with pituitary lesions. An experience from a developing country

OBJECTIVE: To describe the etiology, functional status and short term outcome of patients with pituitary lesions (PL). METHODS: Brain or pituitary MRI reports of 3753 patients were analyzed for PL over the period of 2000 to 2007, done at the Aga Khan University Hospital (AKUH), Karachi, Pakistan. MRIs with reported PL and all those ordered by Endocrinologists with or without pituitary abnormalities, were included in the analysis. This made a total of 338 (9%) MRI reports. PL were defined as pituitary tumors, cysts, haemorrhage, hypoplasia; and empty sella. Patients with these PL, were analyzed for symptoms, hormonal profile and short term outcome in the hospital retrospectively. RESULTS: In the analysis of 338 MRI reports, 23% had normal pituitary gland on MRI examination. Hypogonadotrophic hypogonadism was the commonest (38.5%) endocrine abnormality seen with normal pituitary MRI, followed by hypopituitarism (5.1%). Most common PL identified were macroadenoma (38.7%), empty sella (16.5%) and microadenoma (12.7%). Patients with macroadenoma had 58% of non-functional tumours while 19.1% had hypopituitrism, 17.6% had acromegaly and 17.5% had prolactinoma. Majority of these lesions were causing headache and visual symptoms (42.7%) and were treated with surgery (75.5%). Patients with microadenoma included 39.5% prolactinomas, 18.6% cushing disease, 14% acromegaly, 4.7% hypogonadotrophic hypogonadism and 2.3% hypopituitrism. Majority of these lesions were treated with drugs and 37.3% were treated with surgery. In empty sella patients, 32% patients had endocrine abnormalities among which 21.4% had hypopituitrism, 2% had hypogonadotrophic hypogonadism, and only 6% patients had normal endocrine workup. A significant number of patients (62.5%) never had endocrine hormonal checkup. CONCLUSION: Although PL are less common entities (9% in 3,753 reports) but they are associated with significant endocrinal abnormalities and need prompt treatment. Empty sella, which is not considered as a distinct abnormality, is also associated with significant endocrine deficiencies

Effects of temperature and water purity on germination and yield of mungbean sprouts

Mungbean (Vigna radiata L. Wilczek) is a popular pulse crop, producing protein-rich food and nitrogen-rich residues. Mungbean sprouts were grown at different temperature levels of 10, 20 and 30°C in various water purities of 30 (distilled water), 100, 400, 700 and 1000 TDS (ppm). After keeping them in the germination chamber for 72 h, the percentage of germination, stem length and yield along with proximate composition were determined. The temperature was kept as main factor and water purity as the second. The experiment was replicated four times and the data obtained were analyzed using two factorial completely randomized design. The results showed that both the factors had significant (p<0.05) effect on the germination, stem length, yield as well as proximate composition. A temperature of 30°C and water with high purity of 30 TDS resulted in high emergence (69%), stem length (3.14 cm) and yield (70.1 g) as compared to the other treatments. Minimum germination (2.1%), stem length (0.11 cm) and yield (12.11 g) were recorded in samples kept at low temperature of 10°C and water purity with 1000 TDS. The mungbean seeds showed a very low plasticity to water purity, and that they were very susceptible to water impurities. It is concluded that, to prepare sprouts from mungbeans, it is necessary to germinate mungbean seeds them in water having high purity and temperature of 30oC for maximum germination, stem length and yield

Phenological and yield components response of major exotic maize varieties to different levels of soil bulk densities

Maize is the second staple food and a major cereal crop in Pakistan, but its actual yield is 25-30% less than the potential because of high soil bulk densities. Three exotic maize varieties (Baber, Pioneer-30P45, and Syngenta-6621) were evaluated under the three different soil bulk densities of 1.00 - 1.30, 1.30 - 1.60, and 1.60- 1.90 g.cm-3. Nine treatments were replicated three times, making 27 pots experiments under complete randomized design were tested. Results showed that bulk density significantly (α < 0.05) affected all the parameters of the crops except the number of days to emergence. The fewest number of days to emergence (8.4), tasseling (60.9), silking (66.9), maturity (91.9), leaves per plant (6.3), as well as the lowest shoot thickness (0.49 cm) were obtained under the 1.00 - 1.30 g.cm-3 density. This density also produced the tallest plants (174.7 cm), highest stover (5938.7 kg ha-1), grain yields (1551 kg ha-1), and harvest index (21.9 %). Conversely, most days to emergence, tasseling, silking, and maturity occurred at the bulk density of 1.60 - 1.90 g.cm-3, which also produced the shortest plants and the lowest grain stover and grain yields as well as the harvest index. It was concluded that increasing bulk density levels increase the number of days to tasseling, silking, maturity, and leaves per plant and shoot thickness. Syngenta 6621 was found late in maturity among the hybrids but produced superior stover and grain yields

ANTIMICROBIAL SCREENING OF SELECTED FLORA OF PAKISTAN

Abstract -ethanolic extracts of Ferula assafoetida resin, Grewia asiatica leaves, Ipomoea hederacea seeds, Lepidium sativum seeds, Nigella sativa seeds and Terminalia chebula fruits were tested in vitro for their antibacterial and antifungal activities. The antibacterial study performed against eight bacterial species viz., Escherichia coli, Citrobacter, Staphylococcus aureus, Pseudomonas aeruginosa, Salmonella typhi, Micrococcus luteus, Proteus mirabilis and Bacillus subtilis indicated that the investigated plants have potent activity against all the tested microorganisms. The antifungal activity of these extracts was performed against nine fungal strains, viz., Aspergillus parasiticus, Aspergillus niger, Yersinia aldovae, Candida albicans, Aspergillus effusus, Fusarium solani, Macrophomina phaseolina, Saccharomyces cerevisiae and Trichophyton rubrum. The extracts showed moderate as well as significant activity against the different fungal strains

Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomised, double-blind, placebo-controlled trial

Background: Tranexamic acid reduces surgical bleeding and reduces death due to bleeding in patients with trauma. Meta-analyses of small trials show that tranexamic acid might decrease deaths from gastrointestinal bleeding. We aimed to assess the effects of tranexamic acid in patients with gastrointestinal bleeding. Methods: We did an international, multicentre, randomised, placebo-controlled trial in 164 hospitals in 15 countries. Patients were enrolled if the responsible clinician was uncertain whether to use tranexamic acid, were aged above the minimum age considered an adult in their country (either aged 16 years and older or aged 18 years and older), and had significant (defined as at risk of bleeding to death) upper or lower gastrointestinal bleeding. Patients were randomly assigned by selection of a numbered treatment pack from a box containing eight packs that were identical apart from the pack number. Patients received either a loading dose of 1 g tranexamic acid, which was added to 100 mL infusion bag of 0·9% sodium chloride and infused by slow intravenous injection over 10 min, followed by a maintenance dose of 3 g tranexamic acid added to 1 L of any isotonic intravenous solution and infused at 125 mg/h for 24 h, or placebo (sodium chloride 0·9%). Patients, caregivers, and those assessing outcomes were masked to allocation. The primary outcome was death due to bleeding within 5 days of randomisation; analysis excluded patients who received neither dose of the allocated treatment and those for whom outcome data on death were unavailable. This trial was registered with Current Controlled Trials, ISRCTN11225767, and ClinicalTrials.gov, NCT01658124. Findings: Between July 4, 2013, and June 21, 2019, we randomly allocated 12 009 patients to receive tranexamic acid (5994, 49·9%) or matching placebo (6015, 50·1%), of whom 11 952 (99·5%) received the first dose of the allocated treatment. Death due to bleeding within 5 days of randomisation occurred in 222 (4%) of 5956 patients in the tranexamic acid group and in 226 (4%) of 5981 patients in the placebo group (risk ratio [RR] 0·99, 95% CI 0·82–1·18). Arterial thromboembolic events (myocardial infarction or stroke) were similar in the tranexamic acid group and placebo group (42 [0·7%] of 5952 vs 46 [0·8%] of 5977; 0·92; 0·60 to 1·39). Venous thromboembolic events (deep vein thrombosis or pulmonary embolism) were higher in tranexamic acid group than in the placebo group (48 [0·8%] of 5952 vs 26 [0·4%] of 5977; RR 1·85; 95% CI 1·15 to 2·98). Interpretation: We found that tranexamic acid did not reduce death from gastrointestinal bleeding. On the basis of our results, tranexamic acid should not be used for the treatment of gastrointestinal bleeding outside the context of a randomised trial

COPPER ORE FLOTATION PARAMETERS OPTIMIZATION USING STATISTICAL TECHNIQUES

Mathematical simulation has been used in mineral processing system design, optimization and control for more than 30 years. Presently a new set of simulation tools based on the physics of the underlying processes were developed. Because these models provide accurate micro scale simulations of equipment and process behavior, these high-fidelity simulation (HFS) tools are deemed to constitute a radical innovation of great importance to the mineral processing industry.This research study deals with the development of a mathematical model based on the parameters processes developed both at laboratory and pilot scale of North Waziristan copper ore. In the mathematical model the effect of four process parameters (parameters are denoted by X1, X2. X3 and X4) will be tested individually on grade (YG) (enrichment) of copper in the final product of North Waziristan. When the value of NaPX is 200 gm/ton, pH is 11.5, Na2S is 22 gm/ton and the value of NaCN is 58 gm/ton

Gastric Schwannoma in a Female Patient with Pulmonary Tuberculosis — A Clinicopathological Assessment and Diagnosis

Schwannomas, or neurinomas, are generally benign, slow-growing, asymptomatic neoplasms originating from the Schwann cells of a nerve sheath. As a part of spindle cell mesenchymal tumours, schwannomas arising from the gastrointestinal tract (GIT) are unusual; however, when they occur, the most common site involved is the stomach, which represents 0.2% of all gastric tumours. We report the case of a 35-year-old female patient with a history of pulmonary tuberculosis presenting with a large palpable abdominal mass reaching up to the peritoneal cavity. The initial clinical impression was a tuberculous abdominal mass, a cyst, or a teratoma. However, intra-operative findings during a subtotal gastrectomy revealed an exophytic gastric serosal mass, which suggested a gastrointestinal stromal tumour (GIST). Post-operative histopathological findings showed a fascicular arrangement of neoplastic spindle cells with pallisading nuclei that showed intense positivity for S-100 protein, and were negative for CD117 and desmin in immunohistochemistry studies. These results confirmed the final diagnosis of a gastric schwannoma