ASSOCIATION OF UNSAFE ABORTIONS WITH COMPLICATONS

Background; Unsafe abortion is a persistent, preventable pandemic. WHO defines unsafe abortion as a procedure for terminating an unintended pregnancy either by individuals without the necessary skills or in an environment that does not conform to minimum medical standards, or both. This study was conducted in our local population of southern Punjab to ascertain magnitude of the problem in terms different maternal complications after unsafe abortions. Objective: To determine the frequency of complications of unsafe abortions at a tertiary care hospital. Material and Methods; All the study cases (n=169) who met inclusion criteria of my study were taken from Department of Gynecology and Obstetrics, Bahawal Victoria Hospital, Bahawalpur, Pakistan from June 2015 to June 2016 in this descriptive cross – sectional study . Once registered, these study case had undergone required investigations like blood tests (TLC count to determine sepsis and serum urea and creatinine levels to ascertain ARF). These blood tests were performed by a trained pathologist. These patients were also arranged for X – Ray chest (PA view) to diagnose perforation and complications such sepsis, hemorrhage, ARF and perforations were noted in the proforma by the researcher. Data was analyzed by using SPSS Version 20. Results; Mean age of our study cases was 29.39 ± 4.12 years (with minimum age of our study cases was 24 years while maximum age was 37 years) and majority of our study cases i.e. 93 (55 %) belonged to age group 20 – 30 years of age. Of these 169 study cases, 104 (61.5%) were from rural areas, 113 (66.9%) were poor, 141 (83.4%) were illiterate, 111 (65.7%) spouses were illiterate and most of them i.e. 112 (66.3%) belonged to joint family system. Mean body mass index of our study cases was 24.78 ± 3.24 kg/m2 and obesity was present in 27 (16 %) patients. Hemorrhage was noted in 94 (55.6%), sepsis in 74 (43.8%), acute renal failure in 39 (23.1%) and perforations in 19 (11.2%) of our study cases. Conclusion; Our study results indicate that unsafe abortion is a major cause of maternal morbidity with hemorrhage was commonest complication followed by septicemia, mostly because the procedure was performed by untrained health care providers under unhygienic conditions.  Majority of the patients had multiple complications. There is urgent need to improve quality of services offered by family planning programs and provision of safe abortion services to decrease significant morbidity among targeted population. This will improve their quality of life and also provide relief to health authorities in terms of more investments due to prolonged hospitalizations. Keywords; Unsafe abortion, hemorrhage, sepsis

IN-HOSPITAL MORTALITY AMONG PATIENTS OF LIVER CIRRHOSIS WITH VARICAL BLEED

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%). 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.

Effectiveness of Fromkein Model for Analysis of Blend and Exchange Speech Errors in Urdu Language

The study aims to examine the speech errors made by the speakers of Urdu language. Paper also identifies the types and most frequently used errors in the Urdu language. Speaking is one of the major forms of language production. It involves the process of how a speaker translates information and intention in a given language. It is an active procedure of the human mind and strictly governed by phonological syntactic and semantic rules. Error analysis is defined as a way of identifying, organizing and systematically interrupting the improper forms produced by someone speaking the native language, using any of the principles and procedures provided by linguistics (Crystal, 2003). There exist tremendous difficulties in natural speeches uttered by the speakers unconsciously. Due to the trend of English medium in schools as we use English as our official language that’s why most of the students face problem while reading the Urdu language so when they switch their language into Urdu they commit so many errors. So to identify those errors which we commit while speaking the Urdu language. The method of the study includes 30 participants randomly selected from the undergraduate level. The data was collected through the audio recordings of the participants for the investigation of speech errors. Fromkein’s classification scheme has been used to analyze the errors and their frequencies in a speech. The result identified the specific type of speech error and their occurring frequencies in speech production. The results of the study identified the types of speech errors which committed most are blend and exchange error. Moreover, the findings of the study also checked the frequency of the errors committed in speech production. Keywords: Speech errors, analyze, Data collection, Recordings, Percentage DOI: 10.7176/JEP/11-24-07 Publication date:August 31st 202

Primary signet-ring cell carcinoma of vermiform appendix: a rare case report

Appendiceal primary signet ring cell carcinoma is an extremely rare neoplasm considered to be more aggressive than other appendiceal tumour. Primary appendiceal carcinoma is diagnosed in only 0.9%–1.4% of appendectomy specimens and signet-ring cell carcinoma (SRCC) of vermiform appendix is accounting 0.43% of all appendiceal malignancies. Patients of SRCC usually present clinically as acute appendicitis. Preoperative imaging detection of appendiceal adenocarcinoma have limited benefit due it has minimal change like appendicitis or wall thickening without any obvious growth. We reported an extremely rare case of primary signet ring cell carcinoma of the vermiform appendix in a 55 year old man. Patient had abdominal pain, anorexia and nausea. He underwent appendectomy for appendicitis and histopathologically diagnosed as appendiceal signet ring cell carcinoma with lymph node metastasis

Nitrofurantoin and Fosfomycin, effective oral empirical treatment options against multidrug resistant Escherichia coli

ObjectiveThe present study is designed to monitor antibiotic susceptibility pattern of Escherichia coli to assist in forecasting empirical therapy of urinary tract infection.MethodologyIt is a retrospective cross sectional study. It was carried out at Dow Diagnostic Research and Reference Laboratory for a period of 3 months from February 2017 to April 2017. A data of total 5000 urine culture and sensitivity test reports was taken from the medical record. The data was analyzed by SPSS version 16.ResultsOut of 5000 urine samples processed, 1565 showed significant bacterial growth. Escherichia coli was the most common pathogen isolated. Meropenem, Amikacin, Fosfomycin and Nitrofurantoin respectively were found to be the most sensitive antibiotics against Escherichia coli.Conclusion Fosfomycin and Nitrofurantoin are effective oral antibiotics against Escherichia coli causing urinary tract infection. The present study may help clinicians in making rational choice of empirical treatment of the patients

Prevalence of Polycystic Ovarian Syndrome, Its Associated Conditions And Complications: an Experience from a Low Socio-Economic Population of Sikandrabad, Karachi, Pakistan

OBJECTIVES To study the prevalence of polycystic ovary syndrome, its associated conditions and complications in the low socio-economic population of Sikandrabad, Karachi. METHODOLOGY This cross-sectional study was conducted in a primary health care centre of Ziauddin University, Sikandrabad-Karachi, Pakistan, from January-June 2021. The ethical committee of the university approved this study. All female patients with gynaecological complaints having an age between 18 to 49 years were included. Females with a history of unilateral oophorectomy, uterine abnormality and abnormal karyotype or known malignancies were excluded from the study. A sample size of 118 was calculated using open-epi software. A performed questionnaire was used to collect data from females with gynaecological complaints. PCOS was diagnosed using Rotterdam criteria. Routine examination tests were done at the Primary Health Care Clinic (PHCC) of Ziauddin Hospital, and obesity was labelled through BMI calculation. RESULTSOf 118 females in the reproductive age group screened, 55.93% reported PCOS as a major gynaecological problem, followed by endometriosis at 16.94%, uterine fibroid at 14.46% and urinary tract infections at 9.32% respectively. Patients had infertility as a major complaint, with 54.54% cases followed by menstrual abnormalities at 21.21%, obesity at 16.66% and others at 7.57%. Most patients (38%) were obese, and 34% were overweight. CONCLUSION PCOS is a prevalent complicated endocrine disorder in women in the reproductive age group, and it presents with varying gynaecological complications like infertility, menstrual disturbances, hirsutism, and acne. Obesity, hormonal imbalance and poor dietary intake affect the disease outcomes further. More multi-centred studies are needed to know the exact prevalence and causal relations

Bacterial Shoot Apical Meristem Inoculation Assay

© Springer Science+Business Media, LLC, part of Springer Nature 2020. By virtue of their sessile nature, plants may not show the fight-and-flight response, but they are not devoid of protecting themselves from disease-causing agents, attack by herbivores, and damages that are caused by other environmental factors. Plants differentially protect their life-sustaining organs such as plant apexes from the attack by microbial pathogens. There are well-established methods to inoculate/infect various plant parts such as leaves, roots, and stems with various different pathogens. The plant shoot apical meristems (SAM) are a high-value plant target that provides niche to stem cell populations. These stem cells are instrumental in maintaining future plant progenies by giving birth to cells that culminate in flowers, leaves, and stems. There are hardly few protocols available that allow us to study immune dynamics of the plant stem cells as they are hindered by various layers of the SAM cell populations. Here, we describe a step-by-step method on how to inoculate the Arabidopsis SAM with model plant pathogen Pseudomonas syringae pv. tomato DC3000

Frequency Of Bacterial Co-Infections Isolated from Covid-19 Positive Patients From Tertiary Care Hospital Of Karachi

Objective: This study aims to determine the frequency of bacterial co-infections in COVID-19-positive patients. Methodology: A prospective cross-sectional study was conducted in the Department of Microbiology, Pakistan, from November 15, 2021, to April 15, 2022. Blood and respiratory tract samples were collected, including sputum, bronchial lavage, and tracheal aspirate. Clinical specimens were inoculated onto a Sheep blood agar plate, Chocolate agar plate (aerobic with 5% CO2), and MacConkey’s agar. Identification was followed by specific and standard microbiological protocols. COVID-19 was confirmed by qualitative PCR. Antimicrobial susceptibility testing was performed using the Kirby Bauer disc diffusion method. Results: A total of 202 clinical samples, including blood, sputum, tracheal aspirates, and bronchial lavage, were collected from COVID-19-positive patients. Male patients were more common in sputum and tracheal aspirates, while female patients were more common in blood cultures. The majority of patients were over 60 years of age. Acinetobacter baumannii was predominantly isolated from blood and tracheal aspirates, exhibiting multidrug resistance, but showing complete sensitivity towards Colistin. Klebsiella pneumonia exhibited high prevalence in sputum, with complete resistance observed in Cephalosporins and Co-trimoxazole. Conclusion: The study concludes a high frequency of superadded bacterial co-infections, caused most prominently by Acinetobacter baumannii, Klebsiella pneumonia, and Pseudomonas aeruginosa. The majority of these are multidrug-resistant pathogens, therefore, urgent action is required to control the spread of nosocomial infections by resistant strains, which are responsible for the high mortality rate among COVID-19 critical patients