A review of comparison of complications of vaginal hysterectomy with and without concomitant surgery for SUI: A 5 years’ experience at a tertiary care hospital of Pakistan

Objective. The study was performed to review the complications of surgery for POP with or without surgery for SUI. This included the need for second procedure two years after the primary surgery. Study Design. We conducted a retrospective cross-sectional comparative study at the Aga Khan University, Karachi, Pakistan. International Classification of Diseases, 9th revision, Clinical Modification (ICD-9-CM) was used to identify women who underwent vaginal hysterectomy with anterior/posterior repair alone and those with concomitant tension-free vaginal tape surgery for urodynamic stress incontinence. Results. The 28 cases of VH/repair combined with TVT were compared for complications with 430 cases of VH with repair alone. The basic characteristics like age, BMI, and degree of prolapse showed no statistical difference among two groups. The main comorbidities in both groups were hypertension, diabetes, and bronchial asthma. We observed no significant differences in intraoperative and postoperative complications except for cuff abscess, need for medical intervention, and readmission following discharge from hospital, which were higher in cases with vaginal hysterectomy with concomitant TVT. Conclusions. Vaginal hysterectomy is an efficient treatment for uterovaginal prolapse with a swift recovery, short length of hospital stay, and rare serious complications. The addition of surgery for USI does not appear to increase the morbidity

Comparison of Outcomes of Topical Anesthesia with Peribulbar Anesthesia in Vitrectomy for Unresolving Vitreous Hemorrhage

OBJECTIVES: To compare the Surgeon's ease level and duration of surgery in topical anesthesia with peribulbar anesthesia for vitrectomy without sedation in patients with unresolving vitreous hemorrhage of duration greater than 3 months. METHODOLOGY: A randomized controlled trial was carried out at the Department of Ophthalmology, Lahore General Hospital, Postgraduate Medical Institute, Lahore from October 2017 to September 2018. A total of 110 patients were equally divided (n=55) in group A (topical anesthesia) and group B (peribulbar anesthesia) by lottery method. In group A, 0.5% proparacaine hydrochloride eye drops were instilled into the conjunctival sac every 3 minutes preoperatively 5 times before surgery. For group B patients, 5cc injection consisting of 2.5ml of 0.5% bupivacaine and 2.5ml of 1% lidocaine was injected thirty minutes before surgery. Surgical time was noted from first incision to enter the eye for vitrectomy till application of last closing suture. Surgeon ease was recorded with a 4 Grade scale. All data was recorded, entered, and analyzed by SPSS version 25.0. Continuous variables were presented as mean, standard deviation and independent t-test was applied. RESULTS:  The mean age of the patient was 43.83±9.76 years. Male cases were 78 (70.9%) and female cases were 32 (29.1%). Mean duration of surgery was 30.32±7.07 minutes and the surgeon’s ease was 2.30±0.98. There was a significant difference (P<0.05) with respect to mean duration of surgery and surgeon’s ease level in patients who were given topical anesthesia (28.12±6.57 minutes and 3.11±0.90) versus peribulbar anesthesia (32.52±6.92 minutes and 2.67±0.90). CONCLUSION: Topical anesthesia without sedation is better than peribulbar anesthesia for vitrectomy without sedation in patients with unresolving vitreous hemorrhage of duration greater than 3 months

Optimization of single step multiplex PCR for detection of Eimeria tenella and Eimeria necatrix from commercial broilers

Multiplex polymerase chain reaction (PCR) was optimized for detection of 2 important species of Eimeria (Eimeria tenella and E. necatrix). This optimized protocol was used to screen 100 fecal samples collected from broiler birds in Lahore periphery. Out of 100 samples we found 6 tenella and only 1 E. necatrix positive by this method. The detection limit of oocysts by this method was as leastas 16 oocysts. This optimized multiplex PCR method can be used as routine diagnostic tool for detection of E. tenella and E. necatrix and can be extended up to the detection of 7 Eimeria species in future

Comparative evolutionary and structural analyses of the TYRP1 gene reveal molecular mechanisms of biological functions in mammals

Molecular mechanisms underlying adaptation to the environments are still challenging in evolutionary biology. This study conducted a comparative analysis of tyrosine protein across different mammalian species to gain insight into the molecular mechanisms of adaptive evolution in response to oxidative stress. By examining tyrosine protein's structural and evolutionary patterns, the study identified specific amino acid residues that may have played a role in adaptive evolution in response to oxidative stress. We examined this protein's structural and evolutionary patterns and identified specific amino acid residues that may have played a role in adaptive evolution. Our results suggest that changes in the tyrosine protein may have contributed to the evolution of antioxidant defense mechanisms in mammals. We also reconstructed the evolutionary history of tyrosine protein in mammals and identified key events and lineages that may have contributed to the observed patterns of adaptation. These findings provide valuable insights into the molecular mechanisms that underlie adaptive evolution in response to environmental stressors and highlight the importance of the tyrosine protein in the evolution of antioxidant defense systems in mammals. The results suggest that changes in the tyrosine protein may have contributed to the evolution of antioxidant defense mechanisms in mammals. These findings provide a deeper understanding of the molecular mechanisms that underlie adaptive evolution in response to environmental stressors.The authors extend their appreciation to the Researchers Supporting Project number (RSP2023R165), King Saud University, Riyadh, Saudi Arabia.Peer reviewe

Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial

Background Post-partum haemorrhage is the leading cause of maternal death worldwide. Early administration of tranexamic acid reduces deaths due to bleeding in trauma patients. We aimed to assess the effects of early administration of tranexamic acid on death, hysterectomy, and other relevant outcomes in women with post-partum haemorrhage. Methods In this randomised, double-blind, placebo-controlled trial, we recruited women aged 16 years and older with a clinical diagnosis of post-partum haemorrhage after a vaginal birth or caesarean section from 193 hospitals in 21 countries. We randomly assigned women to receive either 1 g intravenous tranexamic acid or matching placebo in addition to usual care. If bleeding continued after 30 min, or stopped and restarted within 24 h of the first dose, a second dose of 1 g of tranexamic acid or placebo could be given. Patients were assigned by selection of a numbered treatment pack from a box containing eight numbered packs that were identical apart from the pack number. Participants, care givers, and those assessing outcomes were masked to allocation. We originally planned to enrol 15 000 women with a composite primary endpoint of death from all-causes or hysterectomy within 42 days of giving birth. However, during the trial it became apparent that the decision to conduct a hysterectomy was often made at the same time as randomisation. Although tranexamic acid could influence the risk of death in these cases, it could not affect the risk of hysterectomy. We therefore increased the sample size from 15 000 to 20 000 women in order to estimate the effect of tranexamic acid on the risk of death from post-partum haemorrhage. All analyses were done on an intention-to-treat basis. This trial is registered with ISRCTN76912190 (Dec 8, 2008); ClinicalTrials.gov, number NCT00872469; and PACTR201007000192283. Findings Between March, 2010, and April, 2016, 20 060 women were enrolled and randomly assigned to receive tranexamic acid (n=10 051) or placebo (n=10 009), of whom 10 036 and 9985, respectively, were included in the analysis. Death due to bleeding was significantly reduced in women given tranexamic acid (155 [1·5%] of 10 036 patients vs 191 [1·9%] of 9985 in the placebo group, risk ratio [RR] 0·81, 95% CI 0·65–1·00; p=0·045), especially in women given treatment within 3 h of giving birth (89 [1·2%] in the tranexamic acid group vs 127 [1·7%] in the placebo group, RR 0·69, 95% CI 0·52–0·91; p=0·008). All other causes of death did not differ significantly by group. Hysterectomy was not reduced with tranexamic acid (358 [3·6%] patients in the tranexamic acid group vs 351 [3·5%] in the placebo group, RR 1·02, 95% CI 0·88–1·07; p=0·84). The composite primary endpoint of death from all causes or hysterectomy was not reduced with tranexamic acid (534 [5·3%] deaths or hysterectomies in the tranexamic acid group vs 546 [5·5%] in the placebo group, RR 0·97, 95% CI 0·87-1·09; p=0·65). Adverse events (including thromboembolic events) did not differ significantly in the tranexamic acid versus placebo group. Interpretation Tranexamic acid reduces death due to bleeding in women with post-partum haemorrhage with no adverse effects. When used as a treatment for postpartum haemorrhage, tranexamic acid should be given as soon as possible after bleeding onset. Funding London School of Hygiene & Tropical Medicine, Pfizer, UK Department of Health, Wellcome Trust, and Bill & Melinda Gates Foundation

Selfhood and Creativity in Taufiq Rafat’s “Reflections”

Reconstruction of selfhood is a central theme of post-colonial writers. They strived hard to decolonize their lost identity through creative works. They consider revival of selfhood an elemental source for creative consciousness. It is a base for developing a pure creative thinking. In fact, a desire for reshaping selfhood and identity gave birth to post-colonial writings. Frantz Fanon emphasized on the need of complete rejection of colonial influence in order to attain autonomous self. He lays this responsibility of reviving selfhood on writers and most importantly on poets as they enjoy direct access to masses. Pakistani post-colonial writers particularly poets also tried to revive their splendid self through their writings. Taufiq Rafat coined “Pakistani idiom” to entitle a distinguished identity to Pakistani literary world as well as its dazzling culture. He sublimed Pakistani culture through his influential works. The present study also focuses on Taufiq Rafat‘s efforts to recover selfhood and a distinguished creative expression through his seminal poem “REFLECTIONS”. The analytical framework is borrowed from Fanon’s notion of reviving selfhood for autonomous expression by rejecting the colonial influence and by meticulously concentrating on indigenous culture. The close study of a poem ‘Reflections’ will highlight distinguished Pakistani culture and identity. It will also open new vistas for young researchers to explore in the area of selfhood and creative expression

Language Localization of Foreign Dramas in Pakistan: Transmogrifying Cognizance Against Zealotry and Bigotry

Language localization codes modern world to dilate trade and surplus. Capitalists approach far off markets by localizing their products to tantalize autochthonous consumers. Creative arts are immensely influenced by dubbed localization. Films and dramas are dubbed and localized in target cultures and languages to amplify the global market. This is proliferating a hybrid popular culture. Localization can be adapted as a tool to educate people and to broaden their approach towards life. This paper is exploring positive impact of localized foreign dramas in conservative and hidebound societies. This study presents a basic survey of culturally and linguistically sensitive localization of foreign dramas and its clout on Pakistani society. Three dramas from different cultures and ethnicities have been selected to analyze the power of localized visual arts to influence the thought of masses. The Korean drama “Dae Jang Geum, A Jewel in the Palace”, The Iranian drama “Roz e Hasrat” and the Turkish drama “Fatima Gul Mera kasur kia ha” are part of this study. This paper focuses on two basic questions. How localization influence a target culture in this global \capitalist world? How can we apply this power of localization to reduce bigotry in Pakistani society? &nbsp

Curriculum Overload at College level: Probing its Repercussions on EFL Learners and Academics

English language is considered the core of success in Pakistani education system. The most important task of English teachers at college level in Pakistan is to develop competence and better understanding of English language in students. However, curriculum overload is the biggest hurdle in enhancing language proficiency because it keeps teachers and students under pressure. J.B McDonald elucidates curriculum as a fount of quality teaching and better learning experience for students by identifying an apt syllabus and assessing their learning outcomes. This paper looks into the causes and consequences of curriculum overload on English teachers at college level in particular and on students in general. This study helps in understanding the issue through teachers and students’ point of view. Data were collected through questionnaires based on close and open-ended questions. These questionnaires were filled by the English teachers and students of public and private colleges of Faisalabad city. Macdonald's Model has been adapted to understand the role of curriculum in education. He takes curriculum as a social and cognitive system for proper planning and instruction in academia. This study recommends certain measures to overcome the overload of curriculum on teachers and students. It will open new vistas of research as less work has been done in this regard particularly at college level. &nbsp

The Consciousness and Urdu Ghazal

According to psychological study poetry belongs to those dreams of poet that he watches in awaking condition. Freud explains poetry as language of dreams. The atmosphere that we find in Urdu ghazal is approximately similar to all those atmospheres (condition) that is present in human's sub –conscious

The Consciousness and Urdu Ghazal

According to psychological study poetry belongs to those dreams of poet that he watches in awaking condition. Freud explains poetry as language of dreams. The atmosphere that we find in Urdu ghazal is approximately similar to all those atmospheres (condition) that is present in human's sub –conscious