Isospectral orbifold lens spaces

Spectral theory is the study of Mark Kac's famous question [K], "can one hear the shape of a drum?" That is, can we determine the geometrical or topological properties of a manifold by using its Laplace Spectrum? In recent years, the problem has been extended to include the study of Riemannian orbifolds within the same context. In this thesis, on the one hand, we answer Kac's question in the negative for orbifolds that are spherical space forms of dimension higher than eight. On the other hand, for the three-dimensional and four-dimensional cases, we answer Kac's question in the affirmative for orbifold lens spaces, which are spherical space forms with cyclic fundamental groups. We also show that the isotropy types and the topology of the singularities of Riemannian orbifolds are not determined by the Laplace spectrum. This is done in a joint work with E. Stanhope and D. Webb by using P. Berard's generalization of T. Sunada's theorem to obtain isospectral orbifolds. Finally, we construct a technique to get examples of orbifold lens spaces that are not isospectral, but have the same asymptotic expansion of the heat kernel. There are several examples of such pairs in the manifold setting, but to the author's knowledge, the examples developed in this thesis are among the first such examples in the orbifold setting

Clinical presentations of colorectal cancer at initial presentation to hospital and its site specific correlation

Background: Colorectal cancer is one of the leading cause of death all over the world. It progresses slowly and may be asymptomatic for as many as 5 years. Aim of this study was to find the incidence and the initial clinical presentations of patients with colorectal cancer and its site specific correlationMethods: This was a prospective hospital-based study conducted over a period of two years from August 2015 to September 2017 in the postgraduate department of surgery, Government medical college, Srinagar. Total of fifty three patients in the age group of 10 years to 80 years were included in the study. Colorectal tumors were divided into right colon growths (caecum, ascending colon and hepatic flexure), left colon growths (splenic flexure, descending colon and sigmoid colon) and rectal growths. Data was collected from their hospital records and analysed using SPSS computer program.Results: In present study incidence of colorectal cancer was 0.2 per 100,000 people. Thirty percent of our patients were found to be in the sixth decade of their life with male preponderance in almost every age group. Mean age of presentation being 46.44 years (males= 48.5years, females= 43.76years). Out of 53 patients, rectal growths constituted 36%, left colonic growths 36% followed by 28% cases of right colonic growths. More than one symptom was present in several patients. Maximum number of patients (43%) presented with anemia (microcytic hypochromic) with Hb of <9gm% followed by constipation 38% and bleeding per rectum 28%. Pain abdomen was present in 23% of patients. Loss of weight and diarrhoea was equally seen in 19% of patients. Diarrhoea was seen in 6 males and 4 females and was statistically significant (p<0.05).Conclusions: Colorectal cancer was found to affect the Kashmiri patients at younger age (38% were 40 years or less) with peak incidence at sixth decade. Males were affected more than females. Anaemia, constipation and bleeding per rectum were the most common predominant clinical features in right colon, left colon and rectal growths respectively

Three port versus four port laparoscopic cholecystectomy: a prospective comparative clinical study

Background: Although, traditional laparoscopic cholecystectomy is performed using four-port technique, various modifications were made to further enhance the advantages of laparoscopic cholecystectomy. Aim of the study is to compare the results of three-port and four-port laparoscopic cholecystectomy at single center in terms of technical feasibility, safety of the procedure, operative time, intra-operative complications, postoperative pain and post-operative analgesia requirementMethods: It was a  prospective comparative study conducted  in the department of surgery Skims Medical college Srinagar, India from July 2015 to March 2017. The study was performed on all adult patients with ultrasound documented cholelithiasis and gall bladder Polyposis. The total number of patients studied was 100 which were divided into two groups of 50 each.Results: The average operative time in three port group was 29.2 minutes (range, 15-37) compared to 30.66 minutes (range, 15-42) in four port group, which was statistically insignificant. The final visual analog scores for pain in the postoperative period was 2.30 vs 2.86 in three port and four port group respectively, with a P value=0.008, which was statistically significant.Conclusions: The three-port technique is as safe as the standard four-port technique and can be a viable alternative to four port cholecystectomy with an advantage of less pain and less analgesic requirement and better cosmetic results

Effects of different forms of docosahexaenoic acid supplementations on human neuronal cells

My study showed that Docosahexaenoic Acid (DHA), a major dietary omega-3 polyunsaturated fatty acid, inhibited cell death and promoted electro-physiological activity in cultured neuronal cells. The free fatty acid form was more effective than DHA-phospholipids and DHA-nanoliposomes. This study provides insights into the beneficial effects of dietary omega-3 fatty acids

Outcome of albendazole therapy in the management of hepatic hydatid disease

Background: The treatment modalities for managing patients with hepatic hydatidosis include surgical treatment and non-surgical treatments. The non-surgical methods include albendazole therapy and percutaneous management. Use of albendazole as an adjuvant therapy to surgery has been found to significantly reduce the viability of daughter cyst and recurrence of hydatid disease. The aim of the study was to understand the effect of albendazole therapy on the viability of protoscoleces and recurrence rate of hydatid disease of liver.Methods: The study was conducted at Sher-i-Kashmir Institute of Medical Sciences and Medical College, Srinagar, Kashmir India, from March 2010 to February 2012 with further follow up of 3-4 years and the total of 64 patients were studied. ; Patients were divided into two groups, Group A and Group B, each comprising of 32 patients. In group A, patients were given albendazole for 12 weeks preoperatively followed by further postoperative course for 12 weeks. In group B, patients were first taken for surgery followed by postoperative course of albendazole for 12 weeks. The two main outcome measures studied and compared during present study were the viability of the hydatid cysts and the recurrence rate in two groups.Results: Out of those, patients who received preoperative albendazole, 9.37% had viable cysts at the time of surgery as compared to 96.87% of patients who did not receive any preoperative albendazole. In those patients who received only postoperative albendazole therapy, recurrence rate was 18.75% while as there was no recurrence was in patients who received both preoperative and postoperative albendazole therapy.Conclusions: Study concludes that albendazole is safe and effective adjuvant therapy in the treatment of hydatid liver disease.

Study on baseline characteristics and lipid profile abnormalities among type 2 diabetic patients attending urban diabetic care hospital, Bangladesh

Background: Altered levels of serum glycated hemoglobin (HbA1c) and lipid profile are prevalent in patients having type 2 diabetic mellitus (T2DM). Aim of the study was to investigate the relationship between serum HbA1c and lipid profile in T2DM to predict diabetic dyslipidemia.Methods: A structured questionnaire was filled up by each study subject to collect data according to study protocol including age, gender, BMI, BP, residential status, socio-economic status, educational status, physical activity, dietary habit, smoking and duration of diabetes. We collected blood samples from 270 type-2 diabetes mellitus (T2DM) patients aged 30-65 years after overnight fasting (10-12 hours). Then blood samples collected from T2DM patients were used to measure serum levels of HbA1c, fasting blood glucose (FBG), total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL) and high-density lipoprotein (HDL) were estimated by standard laboratory methods.Results: In this study, increased levels of fasting blood glucose (8.61 mmo/l), HbA1c (7.86%), TC (226.15 mg/dl), TG (193.34 mg/dl) and LDL (147.37 mg/dl), and decreased levels of HDL (40.36 mg/dl) were observed in T2DM patients. Moreover, the strong positive correlation of HbA1c levels with FBG, TC, TG, and LDL levels were found in this study. Besides, a very strong and significant negative correlation (R2=0.1822) between the serum levels of HbA1c and HDL were noted in this study.Conclusions: This study revealed a strong correlation between dyslipidemia and serum levels of HbA1c in T2DM patients

Cutaneous Leishmaniasis of the Lid: A Report of Nine Cases

Leishmaniasis is a parasitic disease caused by Leishmania species and is classified into three forms; cutaneous, mucocutaneous, and visceral. The eyelid is a rare site involved by leishmaniasis and only makes up 2.5% of cases with cutaneous leishmaniasis (CL). Although CL can affect both upper and lower lids on either their outer or inner aspects, the lateral canthus is most often affected. The most common aspect of lid leishmaniasis is chalazion-like lesions but ulcerous, phagedenic, cancer-like forms, and unilateral chronic granulomatous blepharitis may be observed. When the lid is involved, the disease is usually self-limiting; healing usually takes up to one year, hence early diagnosis and treatment are important. The diagnosis is based on a high index of suspicion regarding the endemicity of the disease in the region. Response to treatment in lid CL cases is quite satisfactory. In this article, we report nine cases of lid leishmaniasis with satisfactory responses to intralesional meglumine antimoniate

Isolation, characterization, pharmacological evaluation and in silico modeling of bioactive secondary metabolites from Ziziphus oxyphylla a member of Rhamnaceae family

Purpose: To investigate the pharmacological properties of the medicinally active metabolites of Ziziphus oxyphylla. Methods: Compound I-IV were isolated form the root of Ziziphus oxyphylla (compound I = Stigmasterol, II = Betulinic acid, III = 1,2,3 benzene triol and IV = 5-Pentadecanoic acid). Various spectroscopic techniques were used to identify and characterize the isolated compounds. DPPH (2,2-diphenyl-1- picrylhydrazyl) and ABTS (2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) assays were employed to determine the antioxidant potentials of these compounds. The acetylcholinesterase (AChE) and butyrylcholinesterase (BChE) inhibition potential of the isolated compounds were also evaluated. Results: Amongst the isolated compounds, compound IV was the most potent antioxidant against DPPH and ABTS free radicals, exhibiting half-maximal concentration (IC50) values of 64 and 65 μg/mL, respectively. All the compounds exhibited good inhibition of acetylcholinesterase and butyrylcholinesterase. However, stigmasterol was more potent than the other isolated compounds, showing IC50 of 85.10 ± 1.45 and 84.81 ± 1.17, respectively, against AChE and BChE. Conclusion: Although, all isolated compounds inhibited the selected free radicals (DPPH and ABTS) and cholinesterases, stigmasterol and 5-penatadecanoic acid were more potent than other two compounds. Thus the former can potentially be used to treat oxidative stress and neurodegenerative diseases. Keywords: Ziziphus oxyphylla, Stigmasterol, 5-Pentadecanoic acid, Antioxidant, Acetyl Cholinesterase, Butyryl cholinesteras

Traumatic carotid-cavernous fistula: Clinical presentation and outcome

Objective:To evaluate the presentation, clinical course and outcome of traumatic carotid-cavernous fistula (CCF) withendovascular treatment at our institution during the last five years. Design: Retrospective descriptive study. Setting: The study included patients seen at Aga Khan University Hospital from January 2000 to December 2005. Methods: Retrospective analysis based on data retrieval from medical records using ICD coding system. Only those cases who had traumatic CCF and underwent endovascular treatment were included in the study. Results: A total of 8 patients were diagnosed with post-traumatic CCF and 11 procedures were done. Mean age at presentation was 35.6 years; mean duration of symptoms was 23 weeks after trauma; 6 patients were male and 2 female. Patients presented from 1 week to 2 years after the trauma; 7 had high-flow fistulas and 1 had low-flow fistula. Proptosis was the most common symptom (6 patients); decreased vision was present in 3 patients; 4 patients had an accompanying skull base fracture; and 1 patient had bilateral CCF. All patients were treated by endovascular procedures; 2 patients had recurrences, seen within 1 month of initial treatment and subsequently successfully treated. In 1 patient, the procedure failed due to the small size of the fistula. Conclusion: High success rate with minimal complications as seen in our series supports endovascular treatment as the leading option for CCF managemen