To Know the Effectiveness of Disc Excision in the Treatment of Herniated Lumbar Intervertebral Disc

OBJECTIVES To evaluate the effectiveness of disc excision in the treatment of herniated lumbar intervertebral disc.METHODOLOGY METHODOLGY This study was conducted in the Department of Neurosurgery, Lady Reading Hospital, Peshawar. A total of 62 patients had moderate to severe radicular pain due to Prolapsed intervertebral disc at L4/5 or L5/S1. All the enrolled patients were subjected to disc excision surgery. Postoperatively the patients were kept for 48 hours for observation and then discharged. All the patients were advised to come after 2 weeks for the follow-up to check effectiveness. RESULTS The mean age of patients was 34.59± 7.49 years. There were 64.5% male and 35.5% female. 53.2% of patients had L4-L5, 33.9% of patients had L5-S1 and 12.9% of patients had both L4–L5 and L5–S1 level disc herniation. 85.5% of patients had no pain, 8.1% had mild pain and 04.8% had moderate pain. Postoperatively 79.0% of patients were satisfied. CONCLUSION As compared to conservative care limited disc excision is safe, effective, and reliable in terms of pain. Disc excision technique provides immediate relief from radicular pain

Potentials of Educational Technology Used In in-Service Teachers Training Programs at Secondary School Level In Khyber Pakhtunkhwa Pakistan

The study investigated in to descriptive research to evaluate the potentials of educational technology usedin-service teachers training programmed in KPK (Pakistan). The study has defined the potentials ofeducational technology used in services training, provision of a new educational technology in in-servicetraining and the effectiveness of in- service training at secondary level. The main objectives of the studywere, to determine the role of educational technology, needs, usefulness, status and emerging trends ofeducational technology, educational technology used in-service teachers training. The following resultswere drawn by the researcher in the light of the analysis of the data:-It was found that the in-service trainingschedule is not followed; educational technology is helpful for professional development but not properlyused. Executive district officer makes the nomination of the teachers for in service training. In-servicetraining venue is not accessible for the teachers and result oriented teaching methods are used at secondarylevel.Keywords: Use of educational technology, provision of ET, in-service training, emerging technologiesand professional development

Immediate postoperative complications of sellar suprasellar lesions operated via pterional approach

Objective:  In neurosurgical facilities, lesions that occur in the sella turcica and suprasellar area are frequently encountered. Different complications have been documented in the past studies following surgical management of sellar suprasellar lesions. This study's rationale was to get data from our local population on complications related to the transcranial approach for sellar suprasellar lesions. The study aimed to determine the immediate (within one week) postoperative complications of sellar suprasellar lesions operated via a pterional approach Material and Methods:  This descriptive case series study was conducted from June 2019 to June 2020 at the neurosurgical facility lady reading hospital Peshawar. A total of 117 patients, meeting inclusion criteria irrespective of gender, diagnosed with the sellar suprasellar lesion between 18 to 60 years of age operated through a pterional approach. Post-op patients were followed for seven days to access main outcome measures such as CSF leak and diabetes insipidus. Results:  CSF leak found in 7.7% (n = 9) of patients while diabetes insipidus was detected in 14.5% (n = 17) patients. Gender and age-based stratification showed no statistically significant difference for both postoperative complications. Conclusion:  Diabetes insipidus was a more frequent postoperative complication in patients undergoing the pterional approach for sellar suprasellar lesions followed by CSF leak. However, no statistically significant correlation was observed between different age groups and gender for all these complications

Surgical Outcome of Anterior Cervical Decompression and Fusion in Patients with Cervical Spondylotic Myelopathy and Radiculopathy in Terms of Improvement of Pain

Objective: Cervical spondylosis is a common degenerative condition leading to compression of nerve roots or spinal cord, causing radiculopathy or myelopathy. Anterior cervical decompression and fusion (ACDF) techniques are commonly recognized procedures in treating axial cervical spine pain and upper extremity radicular discomfort. The study analyzed the surgical outcome of anterior cervical decompression and fusion (ACDF) in cervical spondylotic myelopathy (CSM) and radiculopathy patients in terms of pain improvement. Material and Methods: This descriptive case series analysis was performed at the Neuro Surgery department, Lady Reading Hospital Peshawar. A total of 146 patients between age 18 – 65 years meeting the inclusion criteria underwent anterior decompression &post-procedure improvement in pain of neck and arm/shoulder was determined using patient reported outcome (PRO) measure, namely visual analog scale (VAS) of 0-10 and a final outcome that is an improvement of pain, i.e., Mild to no pain (VAS score ≤3) was considered after 12 months. Results: The mean age was 52 years ± 8.273. As regards gender distribution, 78% of patients were male, while 22% were female. The mean baseline VAS score was 6.5 ± 2.37, mean postoperative VAS score was 3.5 ± 1.161 with a mean point improvement in pain of 3.0 points (p-value < 0.05). 80% of patients had shown improvement in reducing pain, while 20% did not have shown any improvement. Conclusion: This study revealed that independent of symptoms duration and presentation, patients reported dramatic improvements in neck and arm pain after ACDF

In vitro and in vivo evaluation of different measures to control Ascochyta blight in chickpea

Ascochyta blight, an infection caused by Ascochyta rabiei is a destructive disease in many chickpea growing regions and it caused significant yield losses. To minimize the impact of Ascochyta blight, 5 fungicides viz., Aliette, Cabrio Top, Thiovit Jet, Cymoxanil and Difenoconazole, 5 plants extracts namely Azadirachta indica, Azadirachta azedarach, Datura stramonium, Chenopodium album and Allium sativum L. and two strains T-22 and E58 of bio-control agents (BCAs) Trichoderma viride and Aspergillus flavus were evaluated on the growth of A. rabiei under in vitro conditions by using the food poison technique. The colony growth of Ascochyta rabiei was inhibited at all concentrations of fungicides @ 0.07, 0.15, 0.21%, plants extracts @ 4, 6, 9% and bio-control agents @ 105, 106 and 107 conidia ml-1 respectively. Among all applied treatments, maximum inhibition colony growth of pathogen was recorded in the case of Aliette (83.4%), followed by Cabrio Top (74.3%), Azadirachta indica (50.3%) and Trichoderma viride (60.3%) at their high concentrations. Field trials showed that Aliette and Cabario Top significantly reduced the disease severity to 10 % and 24% respectively, followed by Azadirachta indica and Allium sativum which reduced the disease severity to 40% and 50% respectively. Bio-control agent Trichoderma viride proved less effective in controlling Ascochyta bight severity under field conditions. The present study showed that systemic and sulphur containing fungicides, plant extracts and bio-control agents (BCAs) have the potential to control Ascochyta blight in both in vitro and in vivo conditions

Community-based social and demographic assessment of knowledge, attitudes, practices and medical conditions related to vitamin D deficiency in Gilgit Baltistan, Pakistan.

Vitamin D is an important nutrient for bone health, and vitamin D deficiency increases the risk of various diseases. Gilgit Baltistan, the northern-most area of Pakistan, has a high prevalence of vitamin D deficiency, despite many nutritional and food safety programmes. The present study aimed to find how knowledge, attitudes and practices associated with vitamin D related to the prevalence of vitamin D deficiency among people residing in different areas of Gilgit Baltistan. The cross-sectional study was descriptive and used data from a survey carried out between February 2019 and December 2020 on individuals of both sexes aged 10 years or over in Gilgit Baltistan. Of the 575 survey participants, 306 (53.2%) had experienced signs and symptoms of vitamin D deficiency, i.e. tiredness, fatigue and bone weakness. Approximately 64.8% had some general knowledge of vitamin D and its relation to health. Participants aged 19-25 years had the highest scores on knowledge of vitamin D. Only 22.7% of interviewees had ever taken any supplements and only 25.6% often exposed themselves to sunlight. Females' mean knowledge score (28.7; SD 7.02) was higher than that of males (24; SD 9.01). A lack of consistency was observed between attitude towards daylight exposure and knowledge of vitamin D. There was a large correlation between knowledge and attitude (p = 0.001), while a non-significant association was demonstrated between knowledge and practices (p = 0.1). Better knowledge, attitude and practices by people living in cities or more-developed regions indicates that education can be an effective way to provide awareness regarding micronutrient deficiencies. More emphasis is needed on enhancing knowledge, awareness and practices associated with vitamin D deficiency in rural areas of Pakistan. It is strongly recommended that an awareness campaign on micronutrients is launched in both rural and urban areas of Pakistan, concentrating on poor socioeconomic settings

Osmotin-loaded magnetic nanoparticles with electromagnetic guidance for the treatment of Alzheimer's disease

Alzheimer's disease (AD) is the most prevalent age-related neurodegenerative disease, pathologically characterized by the accumulation of aggregated amyloid beta (Aβ) in the brain.</p

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

SummaryBackground Azithromycin has been proposed as a treatment for COVID-19 on the basis of its immunomodulatoryactions. We aimed to evaluate the safety and efficacy of azithromycin in patients admitted to hospital with COVID-19.Methods In this randomised, controlled, open-label, adaptive platform trial (Randomised Evaluation of COVID-19Therapy [RECOVERY]), several possible treatments were compared with usual care in patients admitted to hospitalwith COVID-19 in the UK. The trial is underway at 176 hospitals in the UK. Eligible and consenting patients wererandomly allocated to either usual standard of care alone or usual standard of care plus azithromycin 500 mg once perday by mouth or intravenously for 10 days or until discharge (or allocation to one of the other RECOVERY treatmentgroups). Patients were assigned via web-based simple (unstratified) randomisation with allocation concealment andwere twice as likely to be randomly assigned to usual care than to any of the active treatment groups. Participants andlocal study staff were not masked to the allocated treatment, but all others involved in the trial were masked to theoutcome data during the trial. The primary outcome was 28-day all-cause mortality, assessed in the intention-to-treatpopulation. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936.Findings Between April 7 and Nov 27, 2020, of 16 442 patients enrolled in the RECOVERY trial, 9433 (57%) wereeligible and 7763 were included in the assessment of azithromycin. The mean age of these study participants was65·3 years (SD 15·7) and approximately a third were women (2944 [38%] of 7763). 2582 patients were randomlyallocated to receive azithromycin and 5181 patients were randomly allocated to usual care alone. Overall,561 (22%) patients allocated to azithromycin and 1162 (22%) patients allocated to usual care died within 28 days(rate ratio 0·97, 95% CI 0·87–1·07; p=0·50). No significant difference was seen in duration of hospital stay (median10 days [IQR 5 to >28] vs 11 days [5 to >28]) or the proportion of patients discharged from hospital alive within 28 days(rate ratio 1·04, 95% CI 0·98–1·10; p=0·19). Among those not on invasive mechanical ventilation at baseline, nosignificant difference was seen in the proportion meeting the composite endpoint of invasive mechanical ventilationor death (risk ratio 0·95, 95% CI 0·87–1·03; p=0·24).Interpretation In patients admitted to hospital with COVID-19, azithromycin did not improve survival or otherprespecified clinical outcomes. Azithromycin use in patients admitted to hospital with COVID-19 should be restrictedto patients in whom there is a clear antimicrobial indication