Comparison of Post-operative Mean Opioids Consumption in Patient given Preoperative Gabapentin and Placebo Undergoing Major Laparotomies for Lower Abdomen and Pelvis

Objective:- To compare the efficacy of lignocain with lignocain and magnesium sulfate for intravenous regional anesthesia. Material and methods:- This Ranodomized controlled trial was conducted at Bahawal Victoria Hospital, Bahawalpur and Nishtar Hospital Multan. The patients were divided in two equal groups. In group L, 55 patients received Lignocain alone and in group M, 55 patients received lignocaine with magnesium sulfate. The two groups were compared for the efficacy. Results:- Mean VAS was 4.36 + 2.40 in group L and 3.55+ 2.47 in group M (p>0.05). The efficacy of lignocaine alone was observed in 21 (38.2%) patients while efficacy of lignocaine with magnesium was seen among in 32 (58.2%) patients. p-value > 0.05. Conclusions:- The use of magnesium along with lignocaine is found to be more effective than lignocaine alone for IVRA.   Key words:- Intravenous regional anesthesia; lignocaine; magnesium sulfat

FREQUENCY AND RISK FACTORS ASSOCIATED WITH THE TRANSMISSION OF HEPATITIS B AND HEPATITIS C VIRUS INFECTION IN PREGNANT WOMEN OF SOUTH PUNJAB.

Objective:- To see the frequency of Hepatitis B and Hepatitis C virus infection and associated risk factors  in pregnant women. Study design:- Cross-sectional study. Setting:- Outpatient departments of Gynaecology and obstetrics, Nishtar hospital Multan and Bahawal Victoria Hospital (BVH) Bahawalpur. Patients and methods:- A total of 500 pregnant women attending outpatient departments of Gynaecology and Obstetrics were included in this study. Informed consent was taken. A specially designed proforma was filled in. HBsAg and Anti-HCV were tested by device method. Data were analyzed on SPSS-20. Results:- Out of 500 pregnant women 35(7.00%) were found to have Anti-HCV positive and 23(4.60%) were positive for HBsAg. Mean age of the study cases was 26.7± 4.8 years. Majority of the patients 263(52.60%) were from age group 26-35 years. In this study 138 (27.60%) of women were nulliparous and 282 (56.40%) were para 1-4 and Hepatitis B and C were common in this parity group. Only 80 (16.00%) women were para 5 or more. All Hepatitis B and C positive women were house-wives. Most of them were belonging to rural areas and with poor socio-economic status.  Among 35 anti-HCV positive women, 20 (57.14%) had history of previous surgery while 13 (37.14%) had history of multiple injections, 5 (14.28%) received blood transfusion, 4 (11.42%) had ear/nose piercing while tattooing was seen in only 2 (5.71%). Among 23 HBsAg positive women, 10 (43.47%) had history of previous surgery. History of Multiple injections was present in 6 (26.08%) patients, 4 (17.39%) patients had history of blood transfusion, Tattooing, Ear/nose piercing, history of dental procedure, history of sharing needles was observed in 1 each. Conclusion:- HCV infection is more common than HBV infection in our study population. Previous History of surgery, multiple injection therapy and blood transfusion are major risk factors. Keywords:- Hepatitis B, Hepatitis C, Risk factors,  Pregnancy

Transfusion transmitted malaria in three major blood banks of Peshawar, Pakistan

Malaria is one of the most important transfusion associated infections in many parts of the world, particularly the developing countries where it is endemic. This study estimates the risk of acquiring malaria from a single unit of blood in North of Pakistan. A prospective study was conducted to investigate transfusion transmitted malaria in three major blood banks of Peshawar, Pakistan. A total of 1558 (1534 males and 24 females) healthy volunteer blood donors were screened for the presence of malarial parasites in thick and thin smears using microscopy. Nine donors (0.577%) were found positive for malarial parasite, with trophozoites and gametocytic stages of Plasmodium falciparum (1) and Plasmodium vivax (8). Majority of the donors (82.09%) belonged to age group 15 - 30 years. Donors who suffered from malaria in recent years were 28 in number and 3 of them were found positive for malaria in the present study. The results of the present study indicated that transfusion transmitted malaria is a risk in malaria endemic regions like Pakistan. Further research on this aspect using more sophisticated and advanced diagnostic techniques like enzyme-linked immunosorbent assay (ELISA) and polymerase chain reaction (PCR) are required for proper assessment of actual situation and control of transfusion transmitted malaria in Pakistan.Keywords: Transfusion, malaria, blood-borne infections, screening, microscopy, blood banksAfrican Journal of Biotechnology Vol. 9(33), pp. 5445-5449, 16 August, 201

Comparison of outcome in medical versus expectant management in unruptured tubal pregnancy with β-hCG 1000-3000 IU/L

Background: Ectopic pregnancy (EP) is an important cause of maternal morbidity as well as mortality in the 1st trimester. This study was done to compare outcome in medical versus expectant management in patients with unruptured tubal pregnancy having β-hCG 1000-3000 IU/L.Methods: In this randomized controlled trial, 82 (41 in each group) women with tubal ectopic pregnancy (TEP) having β-hCG levels between 1000-3000 IU/L and 18 to 40 years of age were enrolled. Women having non-tubal pregnancy, ruptured ectopic pregnancy, heterotopic pregnancy, hypersensitivity to methotrexate were excluded. Included women were randomly assigned to either Group-A (expectant management) or Group-B (medical management). Outcome was measured after one week and considered successful if patient had β-hCG levels negligible i.e. <10 IU/L and complete resolution on ultrasonography (absence of adnexal mass, pelvic free fluid, gestational sac).Results: Overall mean age was 30.65±6.37 years. The mean gestational age in Group-A was 7.12±2.12 weeks and 7.63±2.41 weeks in Group-B. The mean β-hCG levels in Group-A was 1984.63±515.81 IU/L and 1937.33±519.68 IU/L in Group-B. Outcome was successful in 90.24% in Group-A and 63.41% in Group-B (p-value=0.004).Conclusions: Expectant management is associated with better outcome as compared to medical management in tubal ectopic pregnancy having β-hCG between 1000-3000 IU/L

Efficacy of Phytochemicals of Cassia Angustifolia in Chronic Myeloid Leukaemia – An In-silico Analysis

Objective: To discover the compounds of Cassia having activity against the BCR-ABL fusion protein involved in the pathogenesis of CML and to compare it with previously developed inhibitor, nilotinib using in-silico molecular docking. Methodology: The 3D structure of Human BCR-ABL fusion protein was obtained from PDB (RSCB). The SMILES and Chemical Structures of the ligands were obtained from PubChem. They were prepared in Mol SDF format by the Chem Bio Draw and then converted to PDBQT format using PyRx tool for generating the atomic coordinates for molecular docking. &nbsp;Molecular docking of Nilotinib, Quercimeritin, and Scutellarein with Human ABL Kinase was performed using Autodock4. The ADMET properties were described using Swiss ADME, a web-based tool. Results: All the three compounds under study bind and make stable complexes with wild-type BCR ABL with the global energies of -12.46, -16.17kCal/mol and -15.41kCal/mol for Nilotinib Scutellarein and Quercimeritin respectively which means that these compounds can act as selective inhibitors of BCR-ABL fusion protein. Quercimeritin, also form Hydrogen bonds with GLU 286 and Asp 381, Conclusion: The binding energies of the phytochemicals of Cassia are higher in comparison with Nilotinib which has a binding energy of -12.46kCal/mol which suggests a better inhibitory potential of these compounds. Quercimeritin also forms Hydrogen bonds with Glutamine 286 and Aspartate 381, hence its potential to be a potent inhibitor of the BCR- ABL fusion protein is more promising Nilotinib. Further in vitro and in vivo studies are suggested to elaborate the anti-neoplastic potential of Quercimeritin in CML

Psychological Morbidity in patients with Idiopathic Hirsutism presenting for Laser Treatment at a Tertiary Care Hospital

Objective: The objective of our study was to determine the frequency of depression, anxiety, and stress in females presenting for laser treatment of hirsutism at a dermatology clinic. Materials and Methods: This was a cross-sectional descriptive study. 152 female participants of all ages presenting for laser treatment of hirsutism to the dermatology department –removed for blind review--from June 2019 to Dec 2019, were included using a consecutive convenient sampling technique. Patients having an FG (Ferriman and Gallwey) score of 8 or more, were included whereas those having any underlying cause (as assessed by history and examination and laboratory investigations where required) for both hirsutism and psychological disorder were excluded. The participants were given an Urdu version of the DASS 21 (depression, anxiety, and stress scale) to complete. Results: The participants had a mean age of 30.22 (SD = 9.17). The prevalence of depression, anxiety, and stress in the sample was found to be 13.2%, 23.7%, and 17.8%, respectively. Mean depression, anxiety, and stress scores on DASS 21 were 4.43(SD=4.87, Cut-off= 10), 4.34(SD=5.12, Cut-off= 8), and 8.21(SD=6.26, Cut-off=15), respectively, indicating that the scores were within the normal range. Anxiety was the most common illness in the sample and both depression and stress showed a decline with advancing age up till 45years of age. No statistically significant association was found between the severity of hirsutism and depression, stress, and anxiety scores. Conclusion: Psychological morbidity was found to be lower in patients of idiopathic hirsutism presenting for laser treatment. The long-term efficacy of laser treatment needs further evaluation in future research

Stereological Evidence of Non-Selective Hippocampal Neurodegeneration, IGF-1 Depletion, and Behavioral Deficit following Short Term Bilateral Adrenalectomy in Wistar Rats

The development of animal models to study cell death in the brain is a delicate task. One of the models, that was discovered in the late eighties, is the induction of neurodegeneration through glucocorticoid withdrawal by adrenalectomy in albino rats. Such a model is one of the few noninvasive models for studying neurodegeneration. In the present study, using stereological technique and ultrastructural examination, we aimed to investigate the impact of short-term adrenalectomy (2 weeks) on different hippocampal neuronal populations in Wistar rats. In addition, the underlying mechanism(s) of degeneration in these neurons were investigated by measuring the levels of insulin-like growth factor-1 (IGF-1) and β-nerve growth factor (β-NGF). Moreover, we examined whether the biochemical and histological changes in the hippocampus, after short-term adrenalectomy, have an impact on the cognitive behavior of Wistar rats. Stereological counting in the hippocampus revealed significant neuronal deaths in the dentate gyrus and CA4/CA3, but not in the CA2 and CA1 areas, 7 and 14 days post adrenalectomy. The ultrastructural examinations revealed degenerated and degenerating neurons in the dentate, as well as CA4, and CA3 areas, over the course of 3, 7 and 14 days. The levels of IGF-1 were significantly decreased in the hippocampus of ADX rats 24 h post adrenalectomy, and lasted over the course of two weeks. However, β-NGF was not affected in rats. Using a passive avoidance task, we found a cognitive deficit in the ADX compared to the SHAM operated rats over time (3, 7, and 14 days). In conclusion, both granule and pyramidal cells were degenerated in the hippocampus following short-term adrenalectomy. The early depletion of IGF-1 might play a role in hippocampal neuronal degeneration. Consequently, the loss of the hippocampal neurons after adrenalectomy leads to cognitive deficits

Exacerbation of N-nitrosodiethylamine Induced Hepatotoxicity and DNA Damage in Mice Exposed to Chronic Unpredictable Stress

Psychological stress contributes to increased susceptibility to a number of diseases including cancer. The present study was designed to assess the effect of chronic unpredictable stress on N-nitrosodiethylamine induced liver toxicity in terms of in vivo antioxidant status and DNA damage in Swiss albino mice. The animals used in this study were randomized into different groups based on the treatment with N-nitrosodiethylamine or chronic unpredictable stress alone and post-stress administration of N-nitrosodiethylamine. The mice were sacrificed after 12 weeks of treatment, and the status of major enzymatic and non-enzymatic antioxidants, liver function markers, lipid peroxidation and the extent of DNA damage were determined in circulation and liver tissues of all the groups. The N-nitrosodiethylamine treated group showed significantly compromised levels of the antioxidant enzymes, lipid peroxidation, and the liver function markers with enhanced DNA damage as compared to chronic unpredictable stress or control groups. A similar but less typical pattern observed in the chronic unpredictable stress treated mice. All the measured biochemical parameters were significantly altered in the group treated with the combination of chronic unpredictable stress and N-nitrosodiethylamine when compared to controls, or chronic unpredictable stress alone and/or N-nitrosodiethylamine alone treated groups. Thus, exposure to continuous, unpredictable stress conditions even in general life may significantly enhance the hepatotoxic potential of N-nitrosodiethylamine through an increase in the oxidative stress and DNA damage