Indo- US Strategic Objectives in Afghanistan: Security Calculus of Pakistan

Washington and New Delhi have converged interests in Afghanistan. US aspires a greater Indian role in Afghanistan in the wake of its withdrawal from Afghanistan and India, in order to pose itself an international power, seeks in Afghanistan a deeper involvement. Although both of the states, India and the US, have devised a commonality of interests since 9/11, yet since the current US Administration bilateral ties have been intensified to the extent where Pakistan have severe implications. US President Trump‟s verdict of regionalization of Afghan issue has implied concerns for Islamabad. Pakistani authorities relate the terrorist activities in the country, particularly insurgency in Baluchistan with the role of various powers‟ role in Afghanistan. Strategic and security related objectives and concerns would be discussed in this article

ASSOCIATION OF VARICEAL BLEED WITH SEVERITY OF LIVER CIRRHOSIS AT A TERTIARY CARE HOSPITAL

Background; A major cause of cirrhosis-related morbidity and mortality is the development of variceal bleeding, a direct consequence of portal hypertension. Each episode of active variceal bleeding is associated with 30 percent mortality. This study was planned to determine frequency of variceal bleeding in patients with liver cirrhosis and frequency of in-hospital mortality of these patients in our population. Objective; To determine the frequency of variceal bleed in hospitalized patients with cirrhosis of liver and its outcome in terms of in-hospital mortality. Material and Methods; Consecutive 139 Patient diagnosed with cirrhosis of liver were included in this cross-sectional study from department of Medicine, Bahawal Victoria hospital Bahawalpur. Complete history and physical examination was assessed to document duration of duration of liver disease, ascites, Hepatic encephalopathy, Previous GI bleed and systemic coagulopathy. All the patients had undergone diagnostic upper GI endoscopic examination to document varices. Results; Of these 139 study cases, 77 (55.4 %) were male and 62 (44.6 %) were female. Mean age of our study cases was 45.50 ± 10.81 years. Mean duration of disease (liver cirrhosis) was 3.25 ± 2.32 years. Majority of our study cases i.e. 94 (67.6%) were having liver cirrhosis for the duration of less than 5 years. Child-Pugh class C was more prevalent i.e. 77 (55.4%) of our study cases. Variceal bleeding was observed in 100 (71.9 %) of our study cases. Frequency of mortality was 35 (25.2%) in our study cases with liver cirrhosis, while frequency of mortality in patients with variceal bleeding was seen in 31 (31%). Variceal bleeding was significantly associated with disease severity (p<0.001). Conclusion; Very high frequency of variceal bleeding was observed in patients with liver cirrhosis. In-hospital mortality was significantly more prevalent in patients with variceal bleeding than without bleed. Variceal bleeding was significantly more seen in patients with increasing age, duration of disease and with more severe level of disease (Child Pugh class C). There was no statistically significant difference of bleeding with regards to gender. Keywords; Liver Cirrhosis, Variceal bleeding, Mortality. DOI: 10.7176/JMPB/62-13 Publication date: December 31st 201

OUTCOME OF INTRAVENOUS ACETAMINOPHEN IN PAIN RELIEF AMONG UNDERGOING ABDOMINAL HYSTERECTOMY

Objective; To determine the efficacy of intravenous acetaminophen for postoperative pain after abdominal hysterectomy. Material and Methods; A total of 114 women undergoing abdominal hysterectomy were taken in this study. The study was conducted from June 2018 to May 2019 at department of Anesthesiology, Nishtar Hospital, Multan. Results; Our study comprised of 114 ladies undergoing abdominal hysterectomy, mean age of the study cases was 54.13 ± 6.89 years (with minimum age of the patients was 39 years while maximum age was 68 years). Majority of our study cases i.e. 92 (80.7 %) had parity more than 3 and American Society of Anesthesiology (ASA) score level 1 in 93 (81.6%). Sixty one (53.1%) belonged to rural areas, while mean duration of surgery was 72.80 ± 11.32 minutes. Mean BMI level in our study cases was noted to be 23.98 ±4.17 Kg/m2 and obesity was present in 34 (29.8%) of our study cases and Efficacy in terms of pain reduction was 73.7%. Conclusion; Our study results support the use of intravenous acetaminophen (IVA) for pain management in patients undergoing abdominal hysterectomy. Intravenous acetaminophen is safe, reliable and effective for the pain management in postoperative abdominal hysterectomy patients which was associated with shorter hospital stay and cost effective for the suffering families. No adverse reactions were noted in this study with the use of intravenous acetaminophen. Keywords; Intravenous acetaminophen, pain relief, Abdominal Hysterectomy. DOI: 10.7176/JMPB/62-10 Publication date: December 31st 201

Histopathological Effects and Element Concentration Of Body Tissues Of Ranid Frog Inhabiting Polluted Water Sites

Freshwater or wetlands are being polluted on regular basis due to the release of domestic sewage and most importantly industrial effluents that include chemicals, organic pollutants and heavy metals, and run-off from land-based activities containing leached fertilizers. Pollutants are such substances that reduce quality of water that effect directly and indirectly. The present study was carried out on Korang River Islamabad/Rawalpindi. Two different locations were selected along the Korang River. The data were collected two times during the current study period; March 2012, and October 2012. Ranid frogs (n=10) were captured from all selected sites, which were dissected to collect blood and body tissue samples. During the month of March and October the concentration of heavy metals in water samples increase and decrease significantly at both sites of Korang River. The continuous leaching of contaminants may cause abnormal tissue damage in amphibians making them more vulnerable to predation and competition and also decreased reproductive success

Helicobacter pylori infection among type 2 diabetics: a case control study

Background: Helicobacter pylori infection has been associated with hyperglycemia among type 2 diabetics. The objective of this study was to compare the H. pylori infection frequency in diabetic and non-diabetic patients.Methods: This case-control study was done at Al-Tibri Medical College and Hospital from May 2019 to August 2019. After written and informed consent, patients between 18-75 years with epigastric burning, dyspepsia, regurgitation were included and with history of eradication therapy, antibiotic or NSAID use in the last 6 months or surgery of upper GI tract months were excluded. Type 2 diabetics were placed in one group and non-diabetic individuals in another. Both groups were compared for presence of H. pylori infection. Data was analysed using SPSS. Demographic variables included age, gender and status of H. pylori infection. Quantitative data was expressed as frequency and percentages. Chi-square test was applied to test for significance keeping p-value of <0.05 statistically significant.Results: From 480 patients, 355 patients showed positive H. pylori, among them 282 were diabetic and 73 non-diabetic (p-value <0.001). Amongst the 355 diabetics, 55% were male Among 73 non-diabetics, 64% were male. All the patients in the study had dyspeptic symptoms and complained of dyspepsia, epigastric burning and regurgitation.Conclusions: A substantial relationship between H. pylori infection among type 2 diabetes mellitus patients was observed compared to non-diabetics. As a result, diabetic patients having active dyspeptic symptoms should undergo further confirmatory tests for diagnosing H. pylori infection

Insight of Tp53 Mutations and their effect on Protein in Different Feline and Canine Neoplasms

Background: Mutations in the Tp53 gene, a tumor suppressor gene, may cause dysfunction in growing cells and hinder the phenomenon of apoptosis, an alleged cause of tumorigenesis. It is involved in conservation of the genome and DNA repair, mutations of this gene may cause the damaged cells to grow continuously.Methods: The type of molecular changes in Tp53 gene and their effects on physiochemical and structural properties of this protein in various Canine and Feline cancers were observed in this study by using online bioinformatics tools.Results: Our results indicated that lymphomas and perianal adenocarcinomas (PAC) have the same mutation at c. 104, while mammary tumors and canine transmissible venereal tumor (CTVT) contain different mutations. Referring to changes in protein, synonymous mutations in granulomas were observed while certain mutations in squamous cell carcinoma (SCC) and head & neck tumors were detected in Canis familiaris. In Felis catus, the mutant protein was similar to wild type protein with exception of mutant 5 of mammary tumor, which had a deletion at the 287 amino acid position.Conclusion: The insight gathered on the p53 mutant proteins in both species aided our understanding of the in-vivo fate of the p53 protein and its isoforms and the effects that morphological changes can have on the fate of cells. Furthermore, isolation of this protein may augment our understanding about the structural biology of these proteins

Preparation of cellulosic Ag-nanocomposites using an ionic liquid

© 2019, © 2019 Informa UK Limited, trading as Taylor & Francis Group. Cellulose-based nanocomposites have gained much attention due to their remarkable biological properties such as biodegradability, biocompatibility, and low toxicity. In this research work, 1-h-3-methylimidazolium hydrogen sulfate ionic liquid was employed as an efficient solvent for preparation of cellulosic Ag-nanocomposites (CRC/AgNPs composite) from Neem plant. Ionic liquid plays a dual role in obtaining cellulose-rich compound (CRC; removing lignin and hemicellulose components) and plant’s extract (phenolic compounds such as flavonoids, tannins, etc.) that reduces the AgNO 3 into AgNPs for preparation of CRC/AgNPs composite. The prepared CRC/AgNPs composite was characterized using XRD, FTIR and SEM techniques. The XRD and FTIR spectral analysis showed the characteristic peaks assigned to cellulosic constituent and AgNPs. SEM analysis revealed the particles in the range from 26 to 56 nm. The CRC/AgNPs composite was evaluated for its antibacterial and mechanical properties. The antibacterial activity against S. aureus and E. coli for CRC/AgNPs composite was observed in comparison to CRC. Cell viability and morphology were performed on MC3T3-E1 cells which showed no as such toxicity for the prepared CRC/AgNPs composite. Moreover, the addition of CRC/AgNPs composite as a filler increased the compression strength of polymeric materials

National guidelines for the diagnosis and treatment of hilar cholangiocarcinoma

©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.Peer reviewe

Strategic Dimensions of CPEC: Role of Regional and International Powers

Indian Ocean, along with its chokepoints and Sea Lanes of Communications, is considered to be the significant strategic maritime arena. The area has remained under the influence of the US. India, being a largest littoral state of the said ocean, has a strong say here. Sino- Pakistan strategic collaboration and convergence over the construction of Gwadar and CPEC would not only serve the commercial interests of both of the states, rather it would also strengthen their strategic and defense position in the region. On the Beijing’s part, China would, to a considerable extent, neutralize its “Malacca Dilemma”. And on Islamabad’s part, it would serve to be a deterrent to any aggressive design of her arch rival India. It is because on the one hand it would enhance the strategic depth of Pakistan, and on the other hand integrity of Pakistan would be indispensible for China. And any attempt to destabilize Pakistan could provoke China, so Pakistan’s integrity would be sine qua non for China

Realignment of Power Patterns in Indian Ocean: Role of Regional and Global Actors

Purpose: Purpose of study is to analyze the impact of changing strategic patterns and priorities of various regional and international actors on the Indian Ocean Region. Geo-political contestation for hegemony among these actors i.e. US, India, Japan, Australia, China and Pakistan is examined. Measures and counter-measures taken by the said states too are evaluated. Design/Methodology/Approach: Analytical study based on qualitative descriptive analysis is formulated in inductive way. Findings: Indian Ocean has been evolving to be the center-stage of Global power politics. US, UK, Australia, Japan and India are pursuing the goal of containment of China. China too has initiated economic partnerships with various states of the Indian Ocean Region i.e. Pakistan, Myanmar and Sri Lanka. Implications/Originality/Value: Keeping in view the pace at which international and other concerned actors are inclined towards alliances formulation and militarization of the Indian Ocean Region, naval arms to acquire naval second strike capability is anticipated to be initiated in the near future, Indian ambitions to achieve the naval based second strike capability can be analyzed with the same lens