Dietary practices and beliefs of patients with chronic liver disease

Objective: To study of the dietary practices and beliefs of patients suffering from chronic liver disease. Setting: Two private tertcary care hospitals. Method: Fifty patients presenting to the Gastroenterology Clinics at the Aga Khan University Hospital and Baqai Hospital, with compensated liver disease and no other co-morbid condition which required dietary modifications, were enrolled in the study. Patients were interviewed regarding their current dietary practices using an open-ended questionnaire. Results: The mean age of the patients was 48 years and the majority were in relatively poor nutritional status. Four had BMI\u27s \u3c 18; 58% had Hb \u3c 12 g/dl and 36% had albumin levels \u3c 3 gm/dl. The percentage of patients avoiding various foods is as follows: meats 72%, fats and oils 64%, salt 42%, spices 34%, milk and milk products 28%, rice 20%. Conclusion: The most commonly cited reason for avoiding a given food was the advice of the family doctor, followed by advice by gastroenterologists, family and friends. Concepts from alternative medicine and continuation of dietary restrictions imposed during a decompensated phase also influenced intake. Compromised nutritional status is a poor predictor of clinical outcome in liver disease therefore it is important that gastroenterologists be proactive regarding nutritional counseling and both patients and their primary care physicians understand the importance of not imposing unnecessary restrictions on dietary intake

A roadmap to develop dementia research capacity and capability in Pakistan: a model for low- and middle-income countries

Objective To produce a strategic roadmap for supporting the development of dementia research in Pakistan. Background While global research strategies for dementia research already exist, none is tailored to the specific needs and challenges of low- and middle-income countries (LMIC) like Pakistan. Methods We undertook an iterative consensus process with lay and professional experts to develop a Theory of Change-based strategy for dementia research in Pakistan. This included Expert Reference Groups (ERGs), strategic planning techniques, a “research question” priority survey, and consultations with Key Opinion Leaders. Results We agreed on ten principles to guide dementia research in Pakistan, emphasizing pragmatic, resource sparing, real-world approaches to support people with dementia, both locally and internationally. Goals included capacity/capability building. Priority research topics included raising awareness and understanding of dementia, and improving quality of life. Conclusion This roadmap may be a model for other LMIC health ecosystems with emerging dementia research cultures

A young boy with abdominal pain

At times, acute diffuse abdominal pain can be a diagnostic dilemma, especially when the symptoms appear to be out of proportion to the findings on physical examination. The case of a young boy with abdominal pain is presented

Peculiar histopathological features of giardiasis in distal duodenal biopsies

Histological changes in 20 Giardia positive duodenal biopsies (Group A) were compared with 50, Giardia negative duodenal biopsies (Group B), taken during the same period. Stool examinations in Group B were negative for Giardia. Surface epithelium, villous and crypt architecture and cellular infiltrates were examined and compared between the groups. Atrophic changes in the villi were more common in Group A as compared to B(P \u3c 0.0001). Intraepithelial neutrophil infiltration (P \u3c 0.001), infiltration of the lamina propria with plasma cells (P \u3c 0.5), and presence of eosinophils in the lamina propria (P \u3c 0.001) were significant findings in group A. Some of the changes were related to the density of Giardia colonization e.g., the goblet cell depletion (P \u3c 0.05) and the density of plasma cell infiltration in lamina propria (P \u3c 0.01). Erosions and ulcerations were less commonly seen in group A. Thus we conclude that giardiasis manifests its peculiar features in the distal duodenal mucosa and a biopsy of this region is an important diagnostic tool for detection of this disease

ILAJ BIL HIJAMAH (TERAPIJA PUŠTANJEM KRVI) U MEDICINSKOM SUSTAVU UNANI: OD ANEGDOTALNE PRAKSE DO TERAPIJE TEMELJENE NA DOKAZIMA

Background: Cupping (Hijamah) therapy is very well documented as a result of several thousand years of clinical experiences in Unani medicine. In this procedure, suction is created by various means either with or without bloodletting. Though this therapy is being widely practiced across the globe for treating many chronic and intractable ailments but many reports reveal its unscientific and improper practices which results in many complications. Therefore to develop standard operative procedures and to propose protocols of cupping therapy in various diseases is the need of hour. Materials and methods: A thorough literature review of relevant journals and textbooks was performed to gather the maximum available data on cupping therapy. Conclusion: This paper seeks to introduce the general concepts of cupping therapy in Unani medicine and other traditional systems of medicine, shortcomings and limitations of the currently published studies and suggest ways to improve these technical/methodological flaws. In addition, the authors have also attempted to provide the cupping related materials, hypotheses, observations which will provide the researchers the base for evaluating their usefulness in future clinical trials.Uvod: Terapija puštanjem krvi (hijamah) vrlo je dobro dokumentirana kao posljedica nekoliko stotina godina kliničkih iskustava medicine Unani. U tom je postupku sukcija ostvarena različitim sredstvima s ispuštanjem krvi ili bez njega. Iako se ova terapija primjenjuje širom svijeta za liječenje mnogih kroničnih i teško lječivih bolesti, mnoga izvješća otkrivaju neznanstvene i nepravilne prakse koje rezultiraju mnogim komplikacijama. Stoga je nužno čim prije razviti standardnu proceduru te predložiti protokole za terapiju puštanjem krvi kod različitih bolesti. Materijali i metode: Kako bi se prikupila maksimalna količina podataka o terapiji puštanjem krvi, učinjen je pregled relevantnih časopisa i udžbenika. Zaključak: Ovaj rad nastoji predstaviti osnovni koncept terapije puštanjem krvi u medicini Unani kao i u drugim tradicijskim medicinama, nedostatke i ograničenja objavljenih aktualnih studija te predložiti na koje načine poboljšati ove tehničke/metodološke nedostatke. Osim toga autori su također pokušali odrediti materijale koji se koriste pri puštanju krvi, hipoteze i opažanja koja će istraživačima omogućiti temelj za evaluaciju njihove korisnosti u budućim kliničkim ispitivanjima

Efficacy of octreotide in diarrhoea due to Vibrio cholerae: a randomized, controlled trial

Although octreotide, a long-acting analogue of somatostatin, is currently used in the treatment of chronic secretory diarrhoea due to various causes, its role in the management of acute secretory diarrhoea is not well established. In the present study, therefore, the therapeutic value of octreotide in the management of cholera, a classical example of acute secretory diarrhoea, was investigated. During an outbreak of cholera, patients admitted with acute secretory diarrhoea of \u3c or = 24 h duration and a purging rate \u3e 100 ml/h were enrolled on the study and randomly assigned to octreotide (N = 17) and control (N = 16) groups. All 33 patients received intravenous fluid replacement and antibiotic treatment (200 mg ofloxacin twice daily for 3 days, by mouth). Each patient in the octreotide group was also given a subcutaneous injection containing 100 micrograms octreotide every 8 h for a maximum of six doses. The stool output of each patient was recorded every hour until there had been none for an hour, which was taken as the endpoint. Mean (S.D.) total stool output was lower [6.56 (3.7) v. 9.7 (6.5) litres] and the mean (S.D.) duration of diarrhoea after admission was shorter [32.9 (15.6) v. 47.8 (22.3); P \u3c 0.05] in the octreotide group than in the control group. However, as both groups generally had similar purging rates, the higher volume of stools from the control group was simply the result of the longer period of diarrhoea in this group. Octreotide therefore only decreased the duration of diarrhoea in the cholera patients

Tunable Pinning of Burst-Waves in Extended Systems with Discrete Sources

We study the dynamics of waves in a system of diffusively coupled discrete nonlinear sources. We show that the system exhibits burst waves which are periodic in a traveling-wave reference frame. We demonstrate that the burst waves are pinned if the diffusive coupling is below a critical value. When the coupling crosses the critical value the system undergoes a depinning instability via a saddle-node bifurcation, and the wave begins to move. We obtain the universal scaling for the mean wave velocity just above threshold.Comment: 4 pages, 5 figures, revte

Pelatihan Perawatan Pompa Hidram untuk Kelompok Tani Utama Di Daerah Baumata

Dry land agriculture is a crop cultivation activity carried out in moderate to severe drought conditions during most of the growing season. As a result, special cultivation techniques, types of crops and farming systems are needed to enable sustainable production. The partner involved in the Program Kemitraan Masyarakat (PKM) is a farmer group called the main farmer group. The main farmer group is located in Baumata village, Taebenu sub-district, Kupang district. This farmer group has used appropriate technology in the form of a hydram pump. The Hydram Pump, which is located in Baumata village is a product of the LP2M through the Mechanical Engineering Study Program, Faculty of Science and Engineering in 2018and is still running and is still being used by farmer groups. Based on the survey and coordination of the implementation team to the location until December 2019, it was concluded that there was a need for field activities in the context of training activities for members of farmer groups on how to repair, maintain and deal with pump problems which decrease productivity and aspects of pump work functions accordingly with a description of the report of the members of the Farmer Group