Heterotopic pregnancy: A case Report.

Heterotopic pregnancy (HP) is a rare phenomenon. It is defined as simultaneous presence of intrauterine and extrauterine pregnancy. A case of HP is discussed. A young patient presented initially with two months amenorrhea and lower abdominal pain. Initial ultrasound showed only 6 weeks intrauterine pregnancy. But, due to increasing severity of pain ultrasound was repeated showing heterotopic pregnancy, which was later confirmed by histopathology. Keywords: Tubal pregnancy, Ectopic pregnancy, Heterotopic pregnancy .   &nbsp

Biocompatibility and Physiological Thiolytic Degradability of Radically Made Thioester-Functional Copolymers: Opportunities for Drug Release

Being nondegradable, vinyl polymers have limited biomedical applicability. Unfortunately, backbone esters incorporated through conventional radical ring-opening methods do not undergo appreciable abiotic hydrolysis under physiologically relevant conditions. Here, PEG acrylate and di(ethylene glycol) acrylamide-based copolymers containing backbone thioesters were prepared through the radical ring-opening copolymerization of the thionolactone dibenzo[c,e]oxepin-5(7H)-thione. The thioesters degraded fully in the presence of 10 mM cysteine at pH 7.4, with the mechanism presumed to involve an irreversible S–N switch. Degradations with N-acetylcysteine and glutathione were reversible through the thiol–thioester exchange polycondensation of R–SC(═O)–polymer–SH fragments with full degradation relying on an increased thiolate/thioester ratio. Treatment with 10 mM glutathione at pH 7.2 (mimicking intracellular conditions) triggered an insoluble–soluble switch of a temperature-responsive copolymer at 37 °C and the release of encapsulated Nile Red (as a drug model) from core-degradable diblock copolymer micelles. Copolymers and their cysteinolytic degradation products were found to be noncytotoxic, making thioester backbone-functional polymers promising for drug delivery applications

Prevalence of Black Quarter in Association with Patho-Morphological Alterations in Affected Tissues at Different Zones of Punjab-Pakistan

Background: Blackleg or Black Quarter (BQ) is a serious bacterial disease caused by Clostridium chauvoei. It causes edematous and gaseous changes in skeletal muscles of animals. The study was designed to find prevalence of BQ in 6 districts of Punjab, Pakistan from June 2018 to June 2019.Methods: Animals were randomly monitored, and selected in each union council regardless of age, sex and species, but lameness and hyperthermia were the selection parameters. A proforma was used to record the experimental readings of each animal. A total of 1500 swab samples from bovines (cattle and buffaloes) were processed through conventional PCR and culture sensitivity tests to examine the comparative diagnostic efficacy and suitability of the test.Results: Sensitivity and specificity of culture tests were 87.6% and 34.19% respectively, whereas PCR demonstrated 81% and 47.3% results for the said aspects, respectively. Alpha toxin gene (Ccta) was amplified at 52.2oC yielding an amplicon size of 1400 base pairs. Area wise and season wise prevalence of each animal was also determined. The prevalence of BQ in cattle was significantly higher (P 0.05) in Lahore (0%) and Nankana Sahib (8%) which belonged to the canal irrigated zones.Conclusion: There was higher prevalence of BQ in different areas of Punjab, Pakistan that show the higher risk of disease transmission. A systematic surveillance system is essential to regularly monitor the disease incidence and prevalence in these areas of Pakistan.Keywords: Black Quarter; Prevalence; Pathological; Ruminants;  Zone

ASSESSING STAFF REQUIREMENTS AND WORKLOAD PRESSURE AMONG DOCTORS WORKING IN OBSTETRICS & GYNECOLOGY DEPARTMENT OF A PUBLIC SECTOR HOSPITAL IN PAKISTAN USING THE WORLD HEALTH ORGANIZATION’S WORKLOAD INDICATORS OF STAFFING NEEDS

OBJECTIVE: To assess the doctors’ requirement/workload pressure in Department of Obstetrics and Gynecology (DObGyn) of a public sector hospital for effective planning and management of human resources. METHODS: World Health Organization's Workload Indicators of Staffing Needs (WISN) tool was used in assessing the staffing requirements for doctors working in the DObGyn of a public sector hospital Khyber Pakhtunkhwa, Pakistan. Information on working conditions and staffing was acquired by reviewing relevant documents and interviewing key informants. We obtained workload statistics from the hospital from January 1 to December 31, 2015. We assisted a senior technical expert working group in identifying workload components and activity standards, as well as validating both. RESULTS: The average working time needed by the doctors to perform ‘health service activities' was 1952 hours, for which 32 doctors are needed, while there are 36 doctors in the department. ‘Support activities’ accounted for about a fifth of the doctors' annual working hours (-category allowance standards=18.54%), for which 7 doctors were additionally needed. The ‘additional activities' required 3566 hours for which 2 additional doctors were needed. To perform all the three activities, there was a total need of 41 doctors. The workload pressure was also found to be high (WISN ratio: 0.87) on doctors. CONCLUSION: The health services, support and additional activities take up about significant part of the doctors’ time annually. This may require recruitment of a low-cost skill-mix of healthcare personnel to cope with the current workload and/or a health system thinking perspective to reduce the workload indirectly

Strategic priorities for hematopoietic stem cell transplantation in the EMRO region

The World Health Organization-designated Eastern Mediterranean region (EMRO) consists of 22 countries in North Africa and Western Asia with a collective population of over 679 million. The area comprises some of the wealthiest countries per capita income and some of the poorest. The population structure is also unique and contrasts with western countries, with a much younger population. The region sits in the heart of the thalassemia belt. Many countries have a significant prevalence of sickle cell disease, and cancer is on the rise in the region. Therefore, the strategic priorities for the growth and development of hematopoietic stem cell transplantation (HSCT) differ from country to country based on resources, healthcare challenges, and prevalent infrastructure. Thirty-one reporting teams to the Eastern Mediterranean Blood and Marrow Transplantation Group have active HSCT programs in 12 countries; allogeneic transplants outnumber autologous transplants, and the proportion of allotransplants for non-malignant conditions is higher in the EMRO region than in Western Europe and North America. The vast majority (99%) of allotransplants are from matched related donors. Matched unrelated donors and other alternate donor transplants are underutilized. The chance of finding a matched related donor for allografts is higher, with a significant chance of finding matched donors among non-sibling related donors. Reasons for relatively lower rates of transplants compared with other countries are multifactorial. Capacity building, development of newer centers, innovative funding, and better utilization of information technology are required to make transplantation as an accessible modality to more patients. Cost-effectiveness and cost-containment, regulation, and ensuring quality will all be priorities in planning HSCT development in the region

Pseudoaneurysm of left proximal common carotid artery following penetrating trauma

A 33-year male with history of penetrating trauma to left upper chest in 2006, presented through Medical unit to Radiology Department with complain of hemoptysis. Chest X-ray showed a soft tissue lesion in left upper lobe with a linear metallic foreign body. Contrast enhanced CT scan of chest and later CTA was performed which showed a saccular aneurysm arising from mediastinal part of left common aortic artery surrounded by thrombosis with a cylindrical linear metallic foreign body. He was planned for endovascular repair with stenting which he could not afford due to financial constraints. He is currently on conservative follow up. Vascular lesions can be serious complications resulting from blunt or penetrating trauma, when presenting with hemoptysis due to pseudaoneurysms formation even after so many years of trauma

Comparative Numerical Study of Spline-Based Numerical Techniques for Time Fractional Cattaneo Equation in the Sense of Caputo–Fabrizio

This study focuses on numerically addressing the time fractional Cattaneo equation involving Caputo–Fabrizio derivative using spline-based numerical techniques. The splines used are the cubic B-splines, trigonometric cubic B-splines and extended cubic B-splines. The space derivative is approximated using B-splines basis functions, Caputo–Fabrizio derivative is discretized, using a finite difference approach. The techniques are also put through a stability analysis to verify that the errors do not pile up. The proposed scheme’s convergence analysis is also explored. The key advantage of the schemes is that the approximation solution is produced as a smooth piecewise continuous function, allowing us to approximate a solution at any place in the domain of interest. A numerical study is performed using various splines, and the outcomes are compared to demonstrate the efficiency of the proposed schemes

Fully degradable polymer networks from conventional radical polymerization of vinyl monomers enabled by thionolactone addition

We report the preparation of degradable polymer networks by conventional free radical copolymerization of n-butyl acrylate with a crosslinker (1 mol%) and dibenzo[c,e]oxepane-5-thione (DOT) as a strand-cleaving comonomer. Addition of only 4 mol% of DOT imparts the synthesized networks with full degradability by aminolysis, whereas gels with less DOT (2-3 mol%) cannot be degraded, in excellent agreement with the recently proposed reverse gel-point model. Importantly, even though DOT significantly slows down the polymerization and delays gelation, it has a minimal effect on physical properties of the networks such as shear storage modulus, equilibrium swelling ratio, glass transition temperature or thermal stability

The Impact of Bypass Fat on Milk Contents And Yield in Indigenous Buffalo (Bubalus Bubalis) of Sindh, Pakistan

Introduction: Buffalo and cow milk have a great affinity for strong bones, healthy teeth and in various heart diseases. The study was carried out on Kundi buffalo to assess the outcomes of bypass fat on dry matter, milk output, milk contents, body mass gain, nutrient digestibility, and production costs. Methodology: 12 buffaloes of early third and fourth lactation were selected, divided into two groups (six each) for ninety days experiment. In the test animals, additional 300 mg bypass fat was given with balance ration containing 16% of crude proteins, while in control group only balance routine ration was provided. The data was statistically evaluated using a one-way analysis of variance in a completely randomized design (CRD), and differences were assessed using a t-test. Results: The results indicated that mean values in group-A regarding the dry matter intake (DMI) was significantly elevated (P<0.05) (14.29±1.42 kg) as compared to control group (13.65 ± 2.174 kg). At the end of experiment the mean of daily milk production (7.73±1.115 liters/day) was also reported higher (P<0.05) in group-A. The milk yield of Group-A was raised up to 15.39% than the control group. Though, the buffaloes under bypass fat treatment were not found significantly higher in weight gain, but the milk contents in context of solids not fat, fat and total solids presented as P<0.05 between the treatments. Conclusion: Therefore, it is concluded from the conducted study that, bypass fat can be employed to produce milk both quantitatively and qualitatively at a reasonable cost