Hepatic or Cystic Artery Pseudoaneurysms Following a Laparoscopic Cholecystectomy : Literature review of aetiopathogenesis, presentation, diagnosis and management

Pseudoaneurysms (PSAs) of the hepatic and/or cystic artery are a rare complication following a laparoscopic cholecystectomy (LC). Generally, PSA cases present with haemobilia several weeks following the procedure. Transarterial embolisation (TAE) is considered the optimal management approach. We report a 70-year-old woman who presented to the Sultan Qaboos University Hospital, Muscat, Oman, in 2016 with massive hemoperitoneum two weeks after undergoing a LC procedure in another hospital. She was successfully managed using coil TAE. An extensive literature review revealed 101 cases of hepatic or cystic artery PSAs following a LC procedure. Haemobilia was the main presentation (85.1%) and the mean time of postoperative presentation was 36 days. The hepatic artery was involved in most cases (88.1%), followed by the cystic artery (7.9%) and a combination of both (4.0%). Most cases were managed with TAE (72.3%), with a 94.5% success rate. The overall mortality rate was 2.0%

Comparative Efficacy of Various Antiviral Agents against Avian Influenza Virus (Type H7N3/Pakistan/2003)

Abstract.-Highly pathogenic avian influenza (H7 type) is of greater importance due to its economic impact and public health significance. Drugs available to vanish this pathogens are very limited and having high prices. Therefore a study was planed to check the comparative efficacy of the Herbs' extract as compared to the standard available drug in the market. There were used three different concentrations (2%, 4% and 8%) of each of amantadine HCl, extracts of fresh leaves of opuntia herb, papaya and dried powdered leaves of green tea in distilled water and were evaluated for their antiviral activity, by injecting through chorioallantoic sac route into 10 days old live embryonated broiler chicken eggs. Group A is negative control with no haemagglutination activity and group B as positive control with positive Haemagglutination activity. For each drug to be tested, 40 eggs were assigned to 8 groups (i.e. A, B, C1, C2, C3, D1, D2, D3) with 5 eggs in each group. Embryonated eggs in each of C1, C2 and C3 subgroups were treated only with 3 different concentrations of each compound to evaluate toxicity respectively. Whereas embryonated eggs of SUB-GROUPS D1, D2 and D3 were treated with suspensions of three different concentrations of each compound with 4HA titer of Avian Influenza Virus (AIV) type H7N3/Pakistan/2003, to check antiviral efficacy respectively. Positive and negative controls were also run side by side under similar experimental conditions. In case of amantadine HCl out of 50, 500 and 1000 µg/ml concentrations, only 500ug/ml was found to be an ideal concentration, as in addition to stop virus growth it also did not kill the embryos. In case of Opuntia dellinii all the 3 concentrations used were not toxic for embryos, but antiviral effect was observed only at 4g and 8g/100ml concentrations. Green tea extract was found to be effective against AIV only at 8g/100ml concentration with no damage to chick embryos. Papaya leaves extract as a whole failed to check virus replication at all the three concentrations used in this experiment i.e. 2, 4 and 8g/100ml. All these dose levels were not lethal for chick embryos

Infekcija vrstom Ornithobacterium rhinotracheale u crvenolikih vivaka (Vanellus indicus) u Pakistanu - prikaz slučaja

Respiratory infections are of major concern in the poultry industry in Pakistan. Previously, wild birds have been reported to transmit respiratory infections. The Red Wattled Lapwing (RWL) is a wild bird prevalent in the Indus basin and the wetlands of Punjab, Pakistan. Out of total of eighteen RWL birds housed at Lahore Zoo, Pakistan, three birds died after showing signs of respiratory distress and paralysis, in August, 2014. Postmortem examination revealed air sacculitis and pneumonia. Microbiological examination revealed Ornithobacterium rhinotracheale (ORT) as the causative agent, which was later confirmed by Polymerase Chain Reaction (PCR). The isolate was found to be susceptible to amoxicillin, erythromycin, tetracycline and enrofloxacin, and resistant to gentamycin, neomycin and sulfamethoxazole/trimethoprim. All the remaining birds were treated with long acting tetracycline, and diseased birds eventually recovered. No further mortality was declared. This is the first report of its kind which demonstrates ORT infection in RWL in Punjab, Pakistan.Dišne infekcije od velike su važnosti za peradarsku industriju u Pakistanu. Znano je da ih mogu prenositi divlje ptice. Crvenoliki vivak nastanjuje bazen Indus i močvarna područja Pendžaba u Pakistanu. Od ukupno 18 crvenolikih vivaka iz Zoološkog vrta Lahore, tri su uginula nakon pojave znakova dišnog poremećaja i paralize u kolovozu 2014. Razudbom je utvrđen sacculitis i pneumonija. Mikrobiološkom pretragom dokazan je Ornithobacterium rhinotracheale što je bilo potvrđeno lančanom reakcijom polimerazom. Izolat je bio osjetljiv na amoksicilin, eritromicin, tetraciklin i enrofloksacin, a otporan na gentamicin, neomicin i sulfametoksazol/trimetoprim. Sve preživjele ptice bile su liječene tetraciklinom s produženim djelovanjem i ozdravile. Novi slučajevi uginuća nisu bili primijećeni. Ovo je prvo izvješće o pojavi infekcije vrstom Ornithobacterium rhinotracheale u crvenolikog vivka u Pendžabu u Pakistan

Municipal solid waste generation and its compositional assessment for efficient and sustainable infrastructure planning in an intermediate city of Pakistan

It is imperative to design and operate sustainable solid waste management (SWM) systems in cities based on the results of waste amount and characterization study (WACS). In this work, WACS was conducted and results were used to design an SWM system for an intermediate city of Pakistan. The study revealed that about 110 tons of solid waste per day is generated with a per capita rate of 0.337 kg/day. Around 51.2% of mixed municipal solid waste (MSW) is organic in nature and its non-scientific disposal is resulting in higher greenhouse gas (GHG) emissions. It was also found that more than 80% of valuables are taken away by the informal sector during the transfer of MSW from the generation source to the dumping site. Ultimate analyses showed that the moisture content (MC) and carbon to nitrogen (C:N) ratio were 64.23% and 51.14%, respectively. Proximate analysis revealed that moisture and calorific values were 57 % and 3505 BTU/lb., respectively. Based on these results, a material sorting facility (MSF) was proposed, with an estimated investment cost of US $3.64 million. However, the efficiency of the existing collection system is limited to 32$1.638 million was estimated with an operations and maintenance (O&M) cost of US $19.25 per ton. Existing non-scientific MSW disposal practices contribute 32,079.61 CO(2)e tons/year of GHG emissions. The proposed MSF followed by composting is estimated to reduce GHG emissions by 38% to 19,722.38 CO(2)e tons/year

Assessment of Microbial Load of Milk Shakes Available in Various Educational Institutes of Lahore

Background: A milkshake is a delicious and non-carbonated refreshment produced using dairy, frozen flavour related item. The growth of microbes is inevitable in milk shakes when proper hygienic conditions were not maintained. These microbes may produce toxins which are harmful and may lead to food poisoning. This study was established to calculate total plate count (Staphylococcus aureus, Total coliform and Salmonella) present in Apple and Banana milk shakes. Study Design: The samples from 25 different public and private educational institutes were collected to analyse using pour plate method to determinate total microbial load in apple and banana milk shake. Results and Discussion: Total plate count in August was significantly higher than in November. In August TPC range of banana shake was between 2.3x107-7.2x107 cfu/ml and respectively in November range between 2.1 x107-6.7 x107cfu/ml. In August TPC range of apple shake between 2.2x107-7.5x107 cfu/ml and respectively in November range between 2.08 x107-6.5 x107cfu/ml. The S. aureus in banana milk shake were positive 19 (76%) in the month of August and 15 (60%) were also positive in the month of November. The S. aureus in apple milk shake were found to be positive 18 (72%) during August and 16 (64%) were also positive during November. The Total coliform count in apple milk shake was positive 16 (64%) in August and 14 (56%) were also positive in November. The total positive coliforms were 15 (64%) in August and 14 (56%) were also positive in November. Conclusion: The findings of the present study showed a much higher prevalence of microbial load in banana and apple. We suggested that in most of the samples, the total bacterial load was much higher than recommended by the Gulf standard. So these drinks are not fit for consumption

Role of Wheat Based Diet on the Pathology of Necrotic Enteritis in Turkeys

The study was conducted to investigate the effects of wheat based diet on the pathology of necrotic enteritis in turkeys. Turkeys were divided into four groups. Groups A and B were kept as noninoculated and fed normal commercial diet while groups C and D were challenged orally with C. perfringens and fed wheat based diet to promote the development of experimental disease. Infected turkeys showed clinical signs of depression, ruffled feathers, and dark yellowish faeces showing the most prominent disease signs in turkeys of group D with 30% mortality. Similarly, turkeys of group D showed more striking gross and histopathologic lesions as compared to turkeys of group C. The most severe gross lesions comprised intestinal distension, small necrotic spots and haemorrhages on intestine, fragile intestinal wall, and gas bubble formation in the small intestine. Histologically, inoculated turkeys showed patchy necrosis, desquamation of intestinal epithelium, and intense leukocyte infiltration in the intestine. Microscopic examination showed significant decrease in the height of intestinal villi of inoculated birds. Haematological studies showed significant influence of necrotic enteritis on the blood profile of turkeys in group D. The findings revealed that simultaneous feeding of wheat enhanced the pathology of necrotic enteritis in turkeys

Markets in crises: the 2010 floods in Sindh, Pakistan About the authors Acknowledgements

. This study would not have been possible without the active engagement of these researchers, including foundational support from Mr Leghari and Mr Shah in Sukkur in setting up the field work in Sindh. We would also like to acknowledge the support of Pakistan Hands, a local NGO which helped to enable access to flood-affected communities in Sindh during the initial phase of this project. Participants in a February 2010 roundtable discussion in Islamabad at SDPI also provided insightful comments based on their experience not only with the 2010 floods but also with the 2005 Kashmir earthquake and with other crises in Pakistan. The proceedings of this roundtable can be found a