Frequency of Morbidity and Mortality Associated With Meconium Aspiration Syndrome

AbstractObjective: The objective was to find out frequency of morbidity and mortality associated withmeconium aspiration syndrome (MAS) and to compare morbidity and mortality with APGAR Score,gestational age and weight of neonates.Methodology: A total of 112 patients with a gestational age of 37 weeks or more, diagnosed withMAS and a history of meconium-staining of amniotic fluid were included. The research was carriedout at the Department of Neonatology, Children's Hospital and Institute of Child Health in Lahorefrom 1st September, 2020 till 1st September 2021. Non probability consecutive sampling was used.Statistical analysis was performed using SPSS version 25.Results: The average gestational age observed was 38.66±1.21 weeks, while the average duration ofcomplaint was 15.92±8.69 hours and the mean weight of infant was 2.87±0.52 kg. Male gender was thepredominant sex, accounting for 67.9% of the cases. Morbidity affected half of the patients, withpneumothorax occurring in 3.6%, hypotensive shock in 9.8%, hypoxic ischemic events in 17.9%, persistentpulmonary hypertension in 6.3%, chemical pneumonitis in 3.6%, and myocardial dysfunction in8.9% of the cases. Mortality was observed in 30.4% of the patients.Conclusion: Approximately 75% of infants diagnosed with meconium aspiration syndrome (MAS)experienced one or multiple complications. MAS cases presenting with the combination of pulmonaryhypertension and chemical pneumonitis exhibited the poorest prognosis, characterized by anextended hospitalization period and elevated mortality rates.Keywords: APGAR Score, Gestational Age, Meconium Aspiration Syndrome, Morbidity

Attenuation of Chemically Induced Diabetes in Rabbits with Herbal Mixture (Citrullus colocynthis and Cicer arietinum)

The present study was carried out to investigate the hypoglycemic potential of herbal mixture (Citrullus Colocynthis and Cicer arietinum) in normal and alloxan induced diabetic rabbits. Hypoglycemic potential was evaluated through curative and preventive modes of treatments. Blood glucose and lipid level was measured in serum of experimental rabbits. Significant (P<0.05) increase was observed in glucose level (466.33+9.07 mg/dl) in diabetic control group after the injection of alloxan (120 mg/kg) as compared to normal group (103.67±4.51 mg/dl). Treatment of diabetic rabbits with herbal mixtures at the dose of 150 mg/kg for three weeks significantly decreased (126±9.17 mg/dl) glucose level of the alloxan induced. The oral administration of herbal mixture in curative and preventive groups showed significant reduction in plasma glucose, and low density lipoprotein (LDL), total cholesterol levels, and significant (P<0.05) increased was observed in the level of high density lipoprotein (HDL). The phytochemical studies revealed the presence of alkaloids, flavonoids, saponins and steroids in herbal mixture. The results of this study indicated that antidiabetic potential of herbal mixture (Citrullus Colocynthis and Cicer arietinum) may be due to presence of bioactive phytochemical constituents. It can be concluded that herbal mixture has strong hypoglycemic and antilipidemic potential which is comparable with standard drug

Clinical audit to assess delays in chemotherapy administration at daycare oncology center at a tertiary care hospital in Karachi, Pakistan

Aim: There were delays reported by patients in chemotherapy administration in daycare oncology. Therefore, we decided to audit all processes which are involved in chemotherapy administration. The objective was to improve our service by decreasing the time between admission and initiation of chemotherapy and identify the reasons for delays. Materials and Methods: The audit was conducted in three parts. In Review I, audit tool was developed and information documented of 109 patients receiving chemotherapy at daycare center from April 14 to May 13, 2015. Five processes were assessed out of which delay in initial assessment by the nurse was the only factor identified leading to delay in chemotherapy. Review II was done from March 1 to 31, 2016 of 208 patients after increasing the number of nurses and Review III from June 7 to August 25, 2016 of 287 patients by dividing the initial assessment process at two different areas to decrease delay in initial assessment. Results: Seventy-two percent of patients had their initial assessment done within 15 min of arrival in daycare in the first audit. In the second part of audit this percentage decreased to 55%, and finally, in the third part of the audit, percentage was improved and increased to 75% after separating initial assessment process into two areas (P \u3c 0.001, Kruskal-Wallis test). Conclusion: After separating initial assessment process into two different areas, delays in chemotherapy administration were reduced

Cardioprotective and Metabolomic Profiling of Selected Medicinal Plants against Oxidative Stress

In this research work, the antioxidant and metabolomic profiling of seven selected medicinally important herbs including Rauvolfia serpentina, Terminalia arjuna, Coriandrum sativum, Elettaria cardamom, Piper nigrum, Allium sativum, and Crataegus oxyacantha was performed. The in vivo cardioprotective potential of these medicinal plants was evaluated against surgically induced oxidative stress through left anterior descending coronary artery ligation (LADCA) in dogs. The antioxidant profiling of these plants was done through DPPH and DNA protection assay. The C. oxyacantha and T. arjuna showed maximum antioxidant potential, while the E. cardamom showed poor antioxidative strength even at its high concentration. Different concentrations of extracts of the said plants exhibited the protection of plasmid DNA against H2O2 damage as compared to the plasmid DNA merely treated with H2O2. The metabolomic profiling through LC-MS analysis of these antioxidants revealed the presence of active secondary metabolites responsible for their antioxidant potential. During in vivo analysis, blood samples of all treatment groups were drawn at different time intervals to analyze the cardiac and hemodynamic parameters. The results depicted that the group pretreated with HC4 significantly sustained the level of CK-MB, SGOT, and LDH as well as hemodynamic parameters near to normal. The histopathological examination also confirmed the cardioprotective potential of HC4. Thus, the HC4 being safe and inexpensive cardioprotective herbal combination could be considered as an alternate of synthetic drugs

Uterine Artery Doppler Pulsatility Index in the First Trimester as a Forecaster of Pre-Eclampsia in Primary Gravida

Objective: To uncover a correlation between a high uterine artery pulsatility index on Doppler ultrasound and the early onset of pre-eclampsia to reduce maternal and fetal morbidity and mortality. Study Design: Quasi-experimental study. Place and Duration of Study: Department of Gynecology and Obstetrics, Combined Military Hospital, Multan Pakistan, from Jun 2020 to Dec 2021. Methodology: After Ethical Approval and informed consent, the umbilical artery pulsatility (UAPI) of the patients was measured by a transabdominal scan(TAS) between 75 and 100 days. Raised UAPI was correlated with early onset preeclampsia. Results: One hundred and sixty pregnant women were included in the study, out of which 34(21.3%) women developed preeclampsia, and 126(78.8%) were normal patients. Maternal weight (p=0.001), maternal BMI (p=0.002), gestational age and weight at delivery (p=0.001), and uterine artery doppler pulsatility index (p=0.001) had statistically significant differences with pre-eclampsia and regular patients among the target population. Conclusion: First-trimester uterine artery pulsatility index on Doppler ultrasound is a beneficial technique to recognize the women by risk status and target them to prevent pre-eclampsia

Epigenetic and breast cancer therapy : promising diagnostic and therapeutic applications

The global burden of breast cancer (BC) is increasing significantly. This trend is caused by several factors such as late diagnosis, limited treatment options for certain BC subtypes, drug resistance which all lead to poor clinical outcomes. Recent research has reported the role of epigenetic alterations in the mechanism of BC pathogenesis and its hallmarks include drug resistance and stemness features. The understanding of these modifications and their significance in the management of BC carcinogenesis is challenging and requires further attention. Nevertheless, it promises to provide novel insight needed for utilizing these alterations as potential diagnostic, prognostic markers, predict treatment efficacy, as well as therapeutic agents. This highlights the importance of continuing research development to further advance the existing knowledge on epigenetics and BC carcinogenesis to overcome the current challenges. Hence, this review aims to shed light and discuss the current state of epigenetics research in the diagnosis and management of BC.The authors acknowledge Qatar National Library fund for supporting the publication

Audit on incidents and knowledge of nurses regarding chemotherapy extravasations at day care oncology of a tertiary care hospital in Karachi, Pakistan

Purpose: Extravasations of cytotoxic agents after intravenous administration results in serious damage to the tissues leading to local injury and tissue necrosis. Worldwide incidence of extravasation ranges from 0.1% – 6%. Patient education, early identification and management can reduce morbidity associated with chemotherapy extravasation.Method: This audit was conducted at day care oncology of Aga Khan University Hospital to assess the knowledge of nursing staff regarding identification, management and teaching to the patients about of chemotherapy extravasations before and after teaching (intervention) sessions. These sessions were conducted monthly, for a year (July 2016 till June 2017). We also recorded incidents of extravasation reported before (February till June 2016) and after (July till November 2017) intervention.Results: A total of twelve nurses were audited before and after the intervention. Their mean age was 36.08 years ±3.35 (range 32-42 years). They had median 5 years’ (range 1-13 years) experience at Daycare Oncology. Overall, 63% and 96% had demonstrated and answered the steps of identification and management correctly in audit before and after intervention respectively (P\u3c0.001). Incidence of chemotherapy extravasation was 0.128% (7/5461) and 0.054% (3/5546) before and after intervention. In total, vinorelbine was the most common drug associated with such incidence (50%). Most had grade II reaction (50%) and history of chemotherapy (70%) was the most common risk factor.Conclusion: Our hospital based incidence of chemotherapy extravasation is comparable to international data. This may be reduced further by improving knowledge of nurses regarding prevention, prompt identification, management and education of patients

Synergistic Effect of Urease and Nitrification Inhibitors in the Reduction of Ammonia Volatilization

Nitrogen (N) is deficient in more than 90% of soils of Pakistan mainly because of low organic matter contents. The use of nitrogenous fertilizers is a common practice for sustainable and profitable crop yields. A significant portion of added fertilizers is lost through volatilization, leaching, and denitrification. Low use efficiency of these fertilizers in our climate is a serious concern because of high costs and environmental issues. The present study evaluated the novel synergistic effect of urease and nitrification inhibitors such as ammonium thiosulfate (ATS) and 2-Chloro-6-(trichloromethyl)pyridine (Nitrapyrin) to reduce the urea hydrolysis in the soil of Faisalabad, Gujranwala, and Sheikhupura to manage the ammonia as well as N loss. Three different combinations such as A1, A2, and A3 of both inhibitors were prepared with different ratios of 1:1, 0.25:0.75, 0.75:0.25, respectively. Results showed that the minimum urea hydrolysis of about 2.41, 2.79, and 4.68 IU/g soil with A1 combination after 4th-day observation with the rate of 0.50% concentration for Faisalabad, Gujranwala, and Sheikhupura, respectively. In addition, results showed the better urease activity at a pH value of 6.50, incubation time of 30 min, and temperature of 37 ℃ for all A1, A2, and A3 combinations with 0.50% concentration. Moreover, inhibitors treated urea showed the plant maximum height of 111, 101, and 101 cm, and root length of 15, 11, and 5 cm, number of tillers of 14, 16, and 19 per panicle, and number of spikes of 37, 21 and 38 per panicle with A1, A2, and A3 combination at 0.50% dose respectively in Faisalabad soil. Overall, it is concluded that 0.50% inhibitor concentration showed the much impressive urease inhibition results followed by 0.25 and 0.10%. However, the application of inhibitors was a good practice to reduce the N loss from soil.</p

Antioxidant and Gastroprotective Activity of <i>Suaeda fruticosa</i> Forssk. Ex J.F.Gmel

Suaeda fruticosa Forssk. Ex J.F.Gmel is traditionally used for inflammatory and digestive disorders, as a carminative, and for diarrhea. This plant is widely distributed in Asia, Africa, and the Mediterranean region. Aqueous methanolic extract of S. fruticosa (Sf.Cr) was prepared and screened for phytoconstituents through qualitative and GC-MS analysis. Quantification of total phenolic and flavonoid contents was performed, while antioxidant capacity was determined by DPPH, CUPRAC, FRAP, and ABTS assays. The gastroprotective activity was assessed in an ethanol-induced ulcer model. Gastric secretory parameters and macroscopic ulcerated lesions were analyzed and scored for ulcer severity. After scoring, histopathology was performed, and gastric mucus contents were determined. Oral pre-treatment of Sf.Cr demonstrated significant gastroprotection. The gastric ulcer severity score and ulcer index were reduced while the %-inhibition of ulcer was increased dose-dependently. The Sf.Cr significantly elevated the pH of gastric juice, while a decrease in total acidity and gastric juice volume was observed. Histopathology demonstrated less oedema and neutrophil infiltration in gastric mucosa of rats pre-treated with the Sf.Cr in comparison to ethanol-intoxicated animals. Furthermore, the gastric mucus contents were increased as determined by alcian blue binding. Sf.Cr showed marked gastroprotective activity, which can be attributed to antioxidant, antisecretory, and cytoprotective effects