OUTCOME OF INTRAVENOUS ACETAMINOPHEN IN PAIN RELIEF AMONG UNDERGOING ABDOMINAL HYSTERECTOMY

Objective; To determine the efficacy of intravenous acetaminophen for postoperative pain after abdominal hysterectomy. Material and Methods; A total of 114 women undergoing abdominal hysterectomy were taken in this study. The study was conducted from June 2018 to May 2019 at department of Anesthesiology, Nishtar Hospital, Multan. Results; Our study comprised of 114 ladies undergoing abdominal hysterectomy, mean age of the study cases was 54.13 ± 6.89 years (with minimum age of the patients was 39 years while maximum age was 68 years). Majority of our study cases i.e. 92 (80.7 %) had parity more than 3 and American Society of Anesthesiology (ASA) score level 1 in 93 (81.6%). Sixty one (53.1%) belonged to rural areas, while mean duration of surgery was 72.80 ± 11.32 minutes. Mean BMI level in our study cases was noted to be 23.98 ±4.17 Kg/m2 and obesity was present in 34 (29.8%) of our study cases and Efficacy in terms of pain reduction was 73.7%. Conclusion; Our study results support the use of intravenous acetaminophen (IVA) for pain management in patients undergoing abdominal hysterectomy. Intravenous acetaminophen is safe, reliable and effective for the pain management in postoperative abdominal hysterectomy patients which was associated with shorter hospital stay and cost effective for the suffering families. No adverse reactions were noted in this study with the use of intravenous acetaminophen. Keywords; Intravenous acetaminophen, pain relief, Abdominal Hysterectomy. DOI: 10.7176/JMPB/62-10 Publication date: December 31st 201

ASSOCIATION OF VARICEAL BLEED WITH SEVERITY OF LIVER CIRRHOSIS AT A TERTIARY CARE HOSPITAL

Background; A major cause of cirrhosis-related morbidity and mortality is the development of variceal bleeding, a direct consequence of portal hypertension. Each episode of active variceal bleeding is associated with 30 percent mortality. This study was planned to determine frequency of variceal bleeding in patients with liver cirrhosis and frequency of in-hospital mortality of these patients in our population. Objective; To determine the frequency of variceal bleed in hospitalized patients with cirrhosis of liver and its outcome in terms of in-hospital mortality. Material and Methods; Consecutive 139 Patient diagnosed with cirrhosis of liver were included in this cross-sectional study from department of Medicine, Bahawal Victoria hospital Bahawalpur. Complete history and physical examination was assessed to document duration of duration of liver disease, ascites, Hepatic encephalopathy, Previous GI bleed and systemic coagulopathy. All the patients had undergone diagnostic upper GI endoscopic examination to document varices. Results; Of these 139 study cases, 77 (55.4 %) were male and 62 (44.6 %) were female. Mean age of our study cases was 45.50 ± 10.81 years. Mean duration of disease (liver cirrhosis) was 3.25 ± 2.32 years. Majority of our study cases i.e. 94 (67.6%) were having liver cirrhosis for the duration of less than 5 years. Child-Pugh class C was more prevalent i.e. 77 (55.4%) of our study cases. Variceal bleeding was observed in 100 (71.9 %) of our study cases. Frequency of mortality was 35 (25.2%) in our study cases with liver cirrhosis, while frequency of mortality in patients with variceal bleeding was seen in 31 (31%). Variceal bleeding was significantly associated with disease severity (p<0.001). Conclusion; Very high frequency of variceal bleeding was observed in patients with liver cirrhosis. In-hospital mortality was significantly more prevalent in patients with variceal bleeding than without bleed. Variceal bleeding was significantly more seen in patients with increasing age, duration of disease and with more severe level of disease (Child Pugh class C). There was no statistically significant difference of bleeding with regards to gender. Keywords; Liver Cirrhosis, Variceal bleeding, Mortality. DOI: 10.7176/JMPB/62-13 Publication date: December 31st 201

N′-(2,4-Dinitro­phen­yl)acetohydrazide

In the title compound, C8H8N4O5, the nitro groups ortho and para to the hydrazone group are twisted by 10.0 (2) and 3.6 (2)°, respectively, relative to the aromatic ring. The structure exhibits an intra­molecular N—H⋯O hydrogen bond between the hydrazide and ortho-nitro groups. There is a strong inter­molecular C=O⋯H—N hydrogen bond, giving rise to chains, and weaker ONO⋯NO2 [2.944 (2) Å] and C—H⋯O—N inter­actions linking the mol­ecules into a three-dimensional network

Age related clinical manifestation of acute bacterial meningitis in children

Objective: To determine the signs and symptoms of acute bacterial meningitis (ABM) in different age grops of a paediatric population. Methods: The retrospective study comprised patients who had been admitted through the Emergency Department of Aga Khan University Hospital, Karachi with the relevant diagnosis from September 2009 to September 2011. Case record forms were used to collect data from patient files. Data was collected using variables such as age, gender, presenting complaints, clinical signs and symptoms, computed tomography scan findings and final outcome of patients. There was a minimal risk of breach in patient confidentiality. SPSS 19 was used for data analysis. Results: A total of 192 patietns were enrolled. The presenting complaint in 165 (86%) patients was fever; vomiting in 93 (48.43%); and 49 (52.68%) of them were more than 5 years old. Irritability was present in 54 (28.12%) children, of whom 27 (50%) were less than one year. Fits were present in 47 (24.47%) cases out of which 21 (44.68%) were less than one year. Neck stiffness and signs of meningeal irritation, Kerning\u27s sign and Brudzincski\u27s sign, were present in 53 (27.60%) patients; 26 (13.54%); and 18 (9.3%) respectively. These signs were more common in children over 5 years of age, reflected by 29 (54.7%), 16 (61.5%) and 11 (61.11%) patients respectively. On presentation, headache was found in 77 (40.10%) children among whom 56 (72.72%) were over 5 years. Besides, 151 (78.6%) patients required admission to the ward, while 40 (20.8%) were admitted in High Dependancy Unit/critical care units. Adverse outcome was observed in 6 (3.12%) patients. Conclusion: Younger children with acute bacterial meningitis presented with non-specific signs and symptoms. Headache and signs of meningeal irritation were common findings in children over 5 years

Fungal pathogens associated with branch and trunk cankers of nut crops in Iran

[EN] Branch and trunk canker diseases have become prevalent on nut crops in Iran. During 2015 to 2018, extensive field surveys were conducted on 58 almond, 43 pistachio and 80 walnut orchards in Iran to study fungal pathogens associated with symptomatic trees. One hundred and fifty-six representative fungal isolates were selected and identified based on morphological characteristics and by phylogenetic comparison of DNA sequence data. Fungal species found were Collophorina hispanica, Pleurostoma richardsiae, nine species of Phaeoacremonium (namely P. angustius, P. cinereum, P. italicum, P. fraxinopennsylvanicum, P. minimum, P. parasiticum, P. scolyti, P. tuscanum and P. viticola), 11 species of Botryosphaeriaceae (namely Botryosphaeria dothidea, Diplodia gallae, D. mutila, D. seriata, Dothiorella plurivora, Do. sarmentorum, Do. viticola, Lasiodiplodia citricola, L. mahajangana, L. theobromae and Neofusicoccum parvum), four species of Diatrypaceae (namely Cryptosphaeria pullmanensis, Diatrype whitmanensis, Eutypella citricola and E. vitis) and two non-identified Eutypella spp. (Eutypella sp. 1 and Eutypella sp. 2). Some of these species represent new reports in Iran and/or are reported for the first time in their respective hosts. Pathogenicity tests demonstrated that most of these fungi were pathogenic to inoculated almond, pistachio and walnut shoots. 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Association between Gly460Trp Polymorphism of αAdducin Gene and Risk Factors in Hypertensive Pakistani Population

Objective: To determine possible association between αadducin gene G460W polymorphism and risk factors like age & BMI in hypertensive Pakistani population. Material & Methods: Deoxyribonucleic acid (DNA) samples from 200 patients with essential hypertension and 200 normotensive healthy individuals from Pakistani population were genotyped for G460W polymorphism by Polymerase Chain Reaction and Restriction Fragment Length Polymorphism. Logistic regression analysis was used to find association between ADD1 gene G640W polymorphism and risk factors like age and BMI (Body mass index) in hypertensive Pakistani population. Results: No significant association was found between G640W polymorphism and risk factors like age and obesity. Conclusion: This study showed that there is no significant association between ADD1 gene G640W polymorphism and risk factors in our selected samples from Pakistani population

Adaptive and survivable trust management for Internet of Things systems

Abstract The Internet of Things (IoT) is characterized by the seamless integration of heterogeneous devices into information networks to enable collaborative environments, specifically those concerning the collection of data and exchange of information and services. Security and trustworthiness are among the critical requirements for the effective deployment of IoT systems. However, trust management in IoT is extremely challenging due to its open environment, where the quality of information is often unknown because entities may misbehave. A hybrid context‐aware trust and reputation management protocol is presented for fog‐based IoT that addresses adaptivity, survivability, and scalability requirements. Through simulation, the effectiveness of the proposed protocol is demonstrated

2-(3,4-Dimethyl-5,5-dioxo-2H,4H-pyrazolo­[4,3-c][1,2]benzothia­zin-2-yl)acetic acid

In the title mol­ecule, C13H13N3O4S, the heterocyclic thia­zine ring adopts a half-chair conformation in which the S and an adjacent C atom are displaced by 0.919 (3) and 0.300 (4) Å, respectively, on the same side of the mean plane formed by the remaining ring atoms. The mean planes of the benzene and pyrazole rings are inclined at a dihedral angle of 18.32 (12)° with respect to each other. The acetate group is oriented at 80.75 (8)° with respect to the pyrazole ring. The crystal structure is stabilized by O—H⋯N and C—H⋯O hydrogen bonds, resulting in fused eight- and seven-membered rings with R 2 2(8) and R 2 2(7) graph-set motifs, respectively

N′-(3-Methoxy­benzyl­idene)-4-nitro­benzohydrazide monohydrate

There are two independent formula units in the asymmetric unit of the title compound, C15H13N3O4·H2O. The C=C—N—C torsion angle of the methyl­idenehydrazide group is 174.3 (2)° in one mol­ecule and 178.6 (2)° in the other. The dihedral angles between the two benzene rings in the two mol­ecules are 4.17 (12) and 3.58 (12)°. In the crystal structure, inter­molecular O—H⋯O, N—H⋯O and O—H⋯N hydrogen bonds link the components into a two-dimensional network and additional stabilization is provided by weak inter­molecular C—H⋯O hydrogen bonds

1-(4-Hydr­oxy-2-methyl-1,1-dioxo-2H-1,2-benzothia­zin-3-yl)ethanone

In the title compound, C11H11NO4S, the thia­zine ring adopts a distorted half-chair conformation. The enolic H atom is involved in an intra­molecular O—H⋯O hydrogen bond, forming a six-membered ring. Mol­ecules are linked through weak inter­molecular C—H⋯O hydrogen bonds, resulting in chains lying along the b axis