Operative management of unstable thoracolumbar burst fractures

Operative management of unstable burst vertebral fractures is challenging and debatable. This study of such cases was conducted at the Aga Khan Hospital, Karachi from January 1998 to April 2003. All surgically managed spine injuries were reviewed from case notes and operative records. Clinical outcome was assessed by Hanover spine score and correction of kyphosis was measured for radiological assessment. The results were analyzed by Wilcoxon sign rank test for two related samples and p-value \u3c 0.05 was considered significant. Ten patients were identified by inclusion criteria. There was statistically significant difference between mean pre-and postoperative Hanover spine score (p=0.008). Likewise, there was significant difference between mean immediate postoperative and final follow-up kyphosis. (p=0.006). Critical assessment of neurologic and structural extent of injury, proper pre-operative planning and surgical expertise can optimize the outcome of patient

Factors Affecting Water Absorption Of Hydrophilic Polymeric Membrane Based On Crosslinked Empty Fruit Bunch And Polyvinyl Alcohol

The hydrophilic polymeric membrane (HPM) was made up from treated empty fruit bunch (EFB) fibers impregnated with polyvinyl alcohol (PVOH) solution which contains citric acid (CTR). The production of HPM involved 3 steps which was step 1 (EFB treatment process using prehydrolysis and alkali treatment), step 2 (formation of crosslinked PVOH film), and step 3 (impregnation of treated EFB fiber with PVOH solution contains CTR). In step 1, the EFB fibers were treated by pre-hydrolysis process with 20 min, 40 min, 60 min, and 80 min, then was continue with alkali treatment process at condition 17 % NaOH, 22 % NaOH, 27 % NaOH, and 32 % NaOH. Based on the results, treated EFB fibers with 60 min prehydrolysis and 27 % NaOH alkali treatment was found as the optimum conditioned for HPM production

Genetic Diversity and Screening of Rice Germplasm Lines against Grain Discoloration Disease

Background: The research was conducted to screen out the diverse rice germplasm lines against grain discoloration disease by using 10 SSR primer pairs and on the basis of various morphological characters to evaluate the diversity of the genotypes at Faculty of Agricultural sciences, University of the Punjab, Lahore. Methods: Seed morphological traits were measured and recorded under Randomized Complete Block Design (RCBD) experiment. DNA extraction and PCR analysis was done to measure the genotypic characteristics of rice. Genotypic and phenotypic variability was measured by using ANOVA and correlation. Microsatellite markers, also called simple sequence repeats (SSR) were used for screening and to check the genetic diversity of rice.Results: The PIC values ranged from 0.204 of RM-07 to 0.640 of primer RM-22 along with other genetic characters i.e., number of alleles, percentage of polymorphism chromosomal location etc. The higher PIC (polymorphism information content) value showed the greatest genetic diversity among the genotypes. The polymorphic SSRs produced 3-5 alleles with an average unit of 3.3. The PIC values ranged from 0.204 to 0.640 with an average mean of 0.51. All the genotypes showed significant differences in all the studied traits which gave the significant results and non-significant results at significance level of p<0.05= *; p<0.01=** respectively.  A significant association was also observed between seed length with length width ratio, 1000 grain weight (r= 0.1251*; r= 0.1922**) and seed thickness with 1000 grain weight (r=0.1205*). All these traits showed higher variations for different rice lines.Conclusions:  From the study it was concluded that some rice found to be highly resistant (Blue Nile, IR 50, Line 9 (4×15) and Line 12 (4×23) against grain discoloration that could be more useful for the production new rice lines with diverse genetic characteristics.Keywords: Oryza sativa; DNA; SSR; Germplasm; Traits; Diversity   

Alleviation of Boron Stress through Plant Derived Smoke Extracts in Sorghum bicolor

Boron is an essential micronutrient necessary for plant growth at optimum concentration. However, at high concentrations boron affects plant growth and is toxic to cells. Aqueous extract of plant-derived smoke has been used as a growth regulator for the last two decades to improve seed germination and seedling vigor. It has been established that plant-derived smoke possesses some compounds that act like plant growth hormones. The present research was the first comprehensive attempt to investigate the alleviation of boron stress with plant-derived smoke aqueous extract on Sorghum (Sorghum bicolor) seed. Smoke extracts of five plants, i.e. Cymbopogon jwarancusa, Eucalyptus camaldulensis, Peganum harmala, Datura alba and Melia azedarach each with six dilutions (Concentrated, 1:100, 1:200, 1:300, 1:400 and 1:500) were used. While boron solutions at concentrations of 5, 10, 15, 20 and 25 ppm were used for stress. Among the dilutions of smoke, 1:500 of E. camaldulensis significantly increased germination percentage, root and shoot length, number of secondary roots and fresh weight of root and shoot while, boron stress reduced growth of Sorghum. It was observed that combined effect of boron solution and E. camaldulensis smoke extract overcome inhibition and significantly improved plant growth. Present research work investigated that the smoke solution has the potential to alleviate boron toxicity by reducing the uptake of boron by maintaining integrity of plant cell wall. The present investigation suggested that plant derived smoke has the potential to alleviate boron stress and can be used to overcome yield losses caused by boron stress to plants

Comparative physicochemical and histo-anatomical study of vague traditional and magical herb Lavandula stoechas L. with Lavandula officinalis Chaix.

723-730Lavandula stoechas L. (Lamiaceae) is a medicinal plant of traditional Unani, Iranian and Tunisian systems of medicine. It has a unique attribute to expel out and remove all impurities and obstructions and reinvigorate the brain power, honored as broom of brain in classical Unani literatures. To establish clear identification between L. stoechas (LS) and L. officinalis (LO) standard operating parameters, TLC fingerprinting and physicochemical and histo-anatomical studies were done. LS exhibited significantly higher physical values for their standardization and quality parameters with respect to LO. Histoanatomical disquisition and chemo-microscopic studies of the drug revealed that presence of substantial and marked diagnostic feature to LS having large bract, brown colored flexible peduncle, presence of exorbitant number of uniseriate and multi seriate covering and uniseriate glandular trichomes leading to soft stem and peduncle. It has distinguished and well-developed phloem, centrally filled with parenchymatous cells, with camphoric stench along with bitter in taste while LO has lesser hairs, hard stem and peduncle, greenish color, presence of centrally hollow pith, indiscriminate bract, and flowers are without stalks with pleasant aroma. Seeds of LS are yellowish brown, frivolous weight and very small in size while LO have blackish seeds and are comparatively larger in size and weight

Mortality and pulmonary complications in patients undergoing surgery with perioperative sars-cov-2 infection: An international cohort study

Background The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (740%) had emergency surgery and 280 (248%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (261%) patients. 30-day mortality was 238% (268 of 1128). Pulmonary complications occurred in 577 (512%) of 1128 patients; 30-day mortality in these patients was 380% (219 of 577), accounting for 817% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 175 [95% CI 128-240], p&lt;00001), age 70 years or older versus younger than 70 years (230 [165-322], p&lt;00001), American Society of Anesthesiologists grades 3-5 versus grades 1-2 (235 [157-353], p&lt;00001), malignant versus benign or obstetric diagnosis (155 [101-239], p=0046), emergency versus elective surgery (167 [106-263], p=0026), and major versus minor surgery (152 [101-231], p=0047). Interpretation Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P &lt; 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Mechanical Properties And Thermal Characteristics Of Sandwich Composite Panel From Spent Mushroom Substrate And Empty Fruit Bunch Fibers Towards Heat Insulation Application

The growing demand for eco-friendly products and materials has prompted several studies on the potentials of natural waste fiber such as coconut husk and sugarcane bagasse as composite panels towards heat insulation application. However, research on composite panels fabricated of the spent mushroom substrate (SMS) and empty fruit bunch (EFB) fibers for insulating purposes is limited properties and thermal characteristic, controlled by a range of parameters. Thus, only a few research have looked at the impact parameters of fiber ratio and fibrillation degree. There are less researcher concentrated on the fabrication process using sandwich composite approach. Therefore, this study aimed to characterize the physico-chemical properties of SMS and EFB fibers towards sandwich composite panel fabrication process; to evaluate the properties and thermal characteristic of the sandwich composite panel at different SMS and EFB fibers ratios and; to assess the effect of EFB fiber fibrillation degree on its properties and thermal characteristic. To achieve these objectives, the SMS and EFB fibers physico-chemical properties in terms of chemical composition, particle size and thermal degradation temperature were characterized and compared with fresh rubberwood sawdust (FRS) fibe

Pulmonary tuberculosis and its management in classical Unani literature

143-149Tuberculosis is the leading cause of death in the world from a single infectious disease and represents more than a quarter of the world's preventable deaths. Mycobacterium tuberculosis is the etiologic agent of tuberculosis (TB) in humans. Transmission of TB occurs primarily by the aerosol route but can also occur through the gastrointestinal tract. Coughing by people with active TB produces droplet nuclei containing infectious organisms which can remain suspended in the air for several hours. Infection occurs if inhalation of these droplets results in the organism reaching the alveoli of the lungs. Since administration of a single drug often leads to the development of a bacterial population resistant to that drug, effective regimens for the treatment of TB contain multiple drugs to which the organisms are susceptible. Tuberculosis is usually treated with four different antimicrobial agents. The paper reviews the disease and treatment known to ancient Unani physicians. Pathophysiology and pathogenesis of pulmonary tuberculosis have been elaborately discussed. Attempts have been made to correlate and interpret the views of ancient Unani physicians with the modern concept