Comparative analysis of non-descent vaginal hysterectomy versus total abdominal hysterectomy in benign uterine disorders

Background: Hysterectomy is the most common operation performed by gynecologist, next to caesarean section. Currently, there are three main types of hysterectomy operations in practice for benign diseases-Abdominal hysterectomy (AH), vaginal hysterectomy (VH) and Laparoscopic hysterectomy (LH). Vaginal route for non-descent uterus is an acceptable method of hysterectomy. The objective of present study was to compare the operating time, intraoperative and postoperative complications between VH and TAH in non-descent uterus.Methods: The study was conducted in the Postgraduate department of Gynaecology and Obstetrics for a period of 18 months between April 2013 to October 2014 in the Government Lalla Ded Hospital - an associated hospital of Government Medical College, Srinagar; which is the sole tertiary care referral centre in the valley.Results: Over the study period 100 patients were taken, 50 patients underwent non-descent vaginal hysterectomy and labelled as group A and 50 patients were under went total abdominal hysterectomy and labelled as group B. It was seen that intraoperative complications and postoperative complications were less in group A patients and operating time is also less with group A patients when compared with group B patients.Conclusions: From the present study, it was concluded that NDVH is associated with less blood loss during surgery, quicker recovery, and early mobilization, less operative and less postoperative morbidity when compared to TAH. NDVH is a less invasive technique with shorter hospital stay and faster convalescence

Study of amniotic fluid and its co-relation with pregnancy outcome in high risk pregnancies

Background: Amniotic fluid is an important part of pregnancy sac and helps in fetal development. There is a consistent association between low AFI and conditions like pregnancy induced hypertension, postdated pregnancy and IUGR resulting in poor fetal outcome. In fact, high risk patients with low amniotic fluid index need to deliver quickly. So, an assessment of amniotic fluid volume has become an important component of antenatal testing for the high risk pregnancy. The objective was to study the correlation between Amniotic fluid index less than 5 cm (AFI˂5) and adverse perinatal outcome in high risk pregnancies.Methods: It was a hospital based prospective, comparative study. 150 high risk patients were selected from inpatient department of obstetrics and Gynecology Government Medical College Srinagar, Jammu and Kashmir, India over a period of one and half year. High risk pregnancies belonging to study group with AFI˂5 were demographically matched with high risk pregnancies with AFI >5 serving as comparison group. Perinatal outcome, rate of caesarean section and early intervention need were compared between the two groups.Results: 77.3% women in study group underwent caesarean section as compared to 28% in control group to prevent adverse perinatal outcome. 60% babies in study group had APGAR score less than 6 at 1 minute compared to only 8% in control group. 61.4% babies in study group needed NICU admission compared to 10.7% in study group.Conclusions: AFI is predictor of adverse outcome for high risk pregnancies. The early recognition alerts an obstetrician to prevent perinatal catastrophe if timely intervention is done along with antepartum and intrapartum fetal monitoring

The Diagnostic Value of Biochemical Cardiac Markers in Acute Myocardial Infarction

Cardiovascular disease is the leading cause of death worldwide. The role of cardiac markers in the diagnosis, risk stratification, and treatment of patients with chest pain is vital. Patients with elevated cardiac troponin levels but negative CK-MB who were formerly diagnosed with unstable angina or minor myocardial injury are now reclassified as non–ST-segment elevation MI (NSTEMI) even in the absence of diagnostic ECG changes. CK-MB is both a sensitive and specific marker for myocardial infarction. Cardiac troponin T is a cardio-specific, highly sensitive marker for myocardial damage. Cardiac troponin I is a contractile protein exclusively present in the cardiac muscle. The absolute cardiospecificity of cTnI allows the diagnosis of myocardial infarction distinct from muscle lesions and non-cardiac surgery. In 2000, the European Society of Cardiology and the American College of Cardiology redefined AMI with a particular advocacy on troponin. The 2002/2007 American College of Cardiology (ACC) and the American Heart Association (AHA) Guideline Update for the management of these patients strongly recommend to include cTnI. Specifically, with rare exception, the diagnosis cannot be made in the absence of elevated biomarkers of cardiac injury

ETHNOMYCOLOGICAL KNOWLEDGE OF SOME WILD MUSHROOMS OF NORTHERN DISTRICTS OF JAMMU AND KASHMIR, INDIA

  Objective: Mushrooms are known for their nutritional and medicinal importance from ancient times throughout the world. The use of mushrooms as valuable tonic, food, and ethnomedicines has also been reported from India. However, information on the ethnomedicinal use of mushrooms is not available from the surveyed area of Kashmir valley. Therefore, the objective of this work is to study the ethnomedicinal use of wild mushrooms from the Northern districts of Jammu and Kashmir.Materials and Methods: Different remote areas of Northern districts, Baramulla and Kupwara of Kashmir Valley were surveyed to document the indigenous use of various mushrooms growing in the area by local tribal people and local herbalists. Mushroom hunters, local Hakims, herbalists and aged people from tribal communities and nomads were consulted, interviewed and taken as guides to collect various mushroom species.Results: The mushroom samples collected from the study area were used as a source of food and medicines for different ailments. The specimens collected were photographed by Sony cyber shot 12.1 megapixel camera in their natural habitats and were identified on the basis of macro and microscopic characters, expert mushroom taxonomists, field guides and standard related literature. The study revealed that 33 mushroom species belonging to Ascomycetes and Basidiomycetes were used for their nutritional and medicinal values. These mushrooms were used by the local hakims against various ailments ranging from respiratory, blood and heart ailments, arthritis, nervous and urogenital diseases either alone or in combination with some herbs.Conclusions: It was concluded from this study that all the mushrooms used by the local tribal people and local herbalists for different ailments can be further evaluated for medicinal value and for bioactive constituents

Medicinal Plants Used for Treatment of Prevalent Diseases in Northern Pakistan of Western Himalayas

In this research study, we have scientifically assessed medicinal species and herbal preparations used by inhabitants of Northern Pakistan to treat joint pain, hypertension, skin diseases and glottis infections. The aim of the study is to document and highlight the ethnopharmacological significance and compare the uses of medicinal herbs for curing prevalent ailments in Northern Pakistan. Ethnomedicinal data were collected from 180 informants using semi-structured interviews and group meetings. A total of 80 plant species in 54 families were reported for the treatment of various health conditions. Heliotropium lasiocarpum, Geranium wallichianum, Parkinsonia aculeata, Rubia cordifolia and Salvadora persica were the favored plants for curing these diseases. Highest RFC was recorded for Neolitsea chinensis (0.956), Rubia cordifolia (0.928). The similarity of the informer’s knowledge about used medicines was found in Aesculus indica and Abies pindrow with high UV. Cuscuta reflexa and Lawsonia inermis had 98–99% fidelity level for management of joint pain, skin diseases, glottis infection and hypertension respectively. In Northern Pakistan, a rich diversity of medicinal plants was used in curing various diseases. The results of this study help us in screening of herbal plants for further phytochemical and pharmacological study which leads to discovery of natural drug and development with global interest for cure of various ailments

Implication of Connexin 43 as a Tumor Suppressor in Pathogenesis of Breast Cancer

Breast cancer (BC) is a global public health burden, constituting the highest cancer incidence in women worldwide. Connexins 43 proteins propagate intercellular communication, gap junction intercellular communication (GJIC), remarkably expressed in several tumor types including liver, prostate, and breast. This domain of Cx43 possesses functionally critical sites identical to those involved in gating of channel and phosphorylation sites for various kinases. However, the mechanism by which Cx43 down regulation occurs in breast cancer is far from clear. Several mechanisms like Cx43 promoter hyper-methylation or a cancer-specific reduction of Cx43 expression/trafficking by the modulation of various components of the Cx43 life cycle give the idea to be involved in the down regulation of Connexins in mammary glands, but irreversible mutational alterations have not yet been proved to be among them. Summarily, the efficacy or specificity of these drugs can be increased by a combinatory approach considering an effect on both the Connexins and their regulatory molecules. This chapter will summarize the knowledge about the connexins and gap junction activities in breast cancer highlighting the differential expression and functional dynamics of connexins in the pathogenesis of the disease

Efficacy of Intra Articular Steroid Injection and Platelet Rich Plasma in Patients with Osteoarthrithis

Objective: To compare the efficacy of intra-articular steroid injection and Platelet rich plasma in patients with Osteoarthrithis. Methodology: A randomized controlled trail study was conducted at Rheumatology Division of the Department of Medicine, Pakistan Institute of Medical Sciences, Islamabad after the acceptance of synopsis from  . A total of 122 adult patients with unilateral or bilateral osteoarthritis of knee and were randomized into two treatment groups. In Group I, patients received intra-articular steroid injections and in Group II, patients received platelet rich plasma (PRP). WOMAC score was calculated at baseline and was subsequently assessed after 06 weeks and 3 months. Results: Age and gender distribution and mean WOMAC and VAS scores were similar in both groups at baseline (p>0.05).  At six weeks, mean WOMAC score in steroid group was 32.1 ± 24.1 and it was 24.9 ± 21.3 in PRP group (P=0.084).  Mean VAS in steroid group was 4.5 ± 2.5 and it was 3.9 ± 2.6 in PRP group (P=0.0.158).  At three months, mean WOMAC score in steroid group was 39.1 ± 24.3 SD and it was 27.1 ± 21.9 SD in PRP group (P=0.005).  At three months, mean VAS in steroid group was 5.6 ± 2.6 and it was 4.1 ± 2.7 in PRP group (P=0.003).  Conclusions: The study outcomes were better in patients treated with PRP as compared to intra-articular steroid injection. Mean WMOAC and VAS scores were significantly lower after three months in PRP group as compared to steroid group

Phenotypic Diversity among Fennel (Foeniculum Vulgare) Germplasm of Pakistan

Fennel is facing continuous challenge with reference to biotic and abiotic stresses that can be solved with the knowledge of available germplasm of fennel in the country or worldwide. Selection of fennel genotype on the basis of research interest can never been accomplished without gene pool. The aim of the present study was to explore the phenotypic diversity among selective fennel accession and identify lines having high yielding potential. In the present study thirty fennel accessions were sown in PGRI, NARC. Irrigation practice was carried out during the growing period. Data was recorded during different growth stages and after harvesting. Nine morphological parameters under study include plant height, number of umbels/plant, umbel diameter, rays produced/umbel, fruits produced/umble, fruit color and fruit shape. Statistical analysis was performed using ANOVA, Tukey Honest Significance Test and Multivariate cluster Analysis using Minitab Software version 20.0. High diversity was observed among the quantitative traits of thirty accessions. Qualitative traits of accessions from similar region had considerable resemblance. Fennel germplasm collected from Punjab gives outstanding performance with reference to phenotypic traits. Accessions were identified as potential sources including: 21293 (maximum plant height, Punjab, Jhang, Chiniot), 21209 ( great height, Punjab, Faisalabad), 21737 (short height, Punjab, Layyah, Karore Chak-84) 21699 (maximum number of rays/umbel, Punjab, Pakpattan) and 21722 (maximum number of umbels , Punjab, Narowal, Talwandi Bhandran in short 21722 due to high yield was identified as potential sources to be included in future breeding programs for the improvement of fennel varieties

The Selection of Maxillary Anterior Teeth Width in Kashmiri Population

Introduction: Determining the width of maxillary anterior teeth is a difficult aspect in complete denture fabrication. The width of maxillary anterior teeth is determined by taking various anatomical landmarks on the face as a guide, such as the interpupillary, interalar, intercommissure and interzygomatic distance, etc. The present clinical study was carried out to evaluate the relationships between maxillary anterior teeth measurements (canine to canine and central incisor width) and various horizontal facial parameters. Materials and methods: The facial and dental measurements were obtained directly from 60 Kashmiri  undergraduate dental students by using vernier calliper and dental floss. Result: Correlation analysis was done using Pearson’s correlation analysis and it was determined that the incisor width and canine to canine distance show positive correlation with some of the facial measurements. Conclusion: This study inferred that while most of the measurements showed a positive correlation with the incisor width and canine width in the different face forms none of them were found to be significant.&nbsp

Genetic Divergence in Advanced Lines of Oilseed Rape (Brassica napus ssp oleifera L.)

A field experiment was conducted with 22 Brassica napus L. advanced lines at the experimental farm of Sher-e-Bangla Agricultural University, Dhaka from November 2008 to March 2009 to asses genetic diversity among advanced lines of Brassica napus L. Different multivariate analysis techniques were used to classify 22 Brassica napus genotypes. The genotypes were grouped into four clusters. The highest inter-cluster distance was observed between clusters II and IV whereas the maximum intra-cluster distance was found in cluster II. Therefore, the genotypes belonging to cluster I and cluster II, cluster II and cluster III and cluster III and cluster IV have been selected for future hybridization program. The role of number of secondary branches per plant and number of siliqua per plant in both vectors were important components for genetic divergence in these materials. Considering group distance and other agronomic performance the inter-genotypic crosses between G1 and G2, G2 and G6; G6 and G7; G6 and G8 and G7 and G8 might be suggested for future hybridization program