Iliopsoas Abscess in a 24-Months-Old Child: Management in Absence of an Identifiable Organism

Iliopsoas abscess presents with vague and variable symptoms and is less commonly encountered in a clinical setting. The most common causative agent is staphylococcus aureus. In our case, a 2-year-old boy presented with high-grade fever, difficulty in walking, and pain in the right leg near the hip joint. Psoas sign was positive but his blood cultures were negative and CT scan showed a necrotic mass with peripheral enhancement measuring 7.0x4.2x2.6 cm in all three dimensions in right Psoas muscle. Biopsy of the abscess was denied and the patient was managed conservatively with intravenous ceftriaxone and metronidazole. This case highlights the importance of clinical examination and then co-relating it radiologically and focuses on the importance of broad-spectrum antibiotics when necessary investigation (biopsy in our case) is denied

Effect of aescin on β-cell physiology in fructose fed rat model

Objective: To determine the effects of Aescin on blood glucose homeostasis in fructose fed Diabetic albino Wistar rats Methodology: This Quasi Experimental study was conducted at the Department of Physiology from July 2018 to January 2019. Sixty albino (Wistar) rats were equally divided into five groups according to diet as; Group A (normal diet) and Group B (Fructose 10 g/kg/day) and all the other experimental groups were given Fructose (10 g/kg/day) with the administration of aescin as; Group C (0.9 mg/kg/day), Group D (1.8 mg/kg/day) and Group E (3.6 mg/kg/day). After four weeks body weight was calculated and blood samples were taken from all animals to assess the blood glucose level and serum insulin level. All the data was recorded in self-made proforma. Results: Mean of blood glucose in control group A (165.0±14.29 mg/dL) was significantly lower in contrast to experimental groups B, C and D (357.17±21.73, 246.08±21.73 and 235.67±25.73 respectively); p-0.001, while the mean difference was insignificant as compared to experimental group E (194.0±22.16 mg/dl); p=0.078. Serum insulin level was significantly lower in experimental group B (17.45± 5.17) as compared to control group A (16.88± 4.78); p-0.001, while Aescin administered groups C and D showed serum insulin level (19.05± 5.81 and 25.08± 2.42 respectively) almost equal to control group A; p-0.092. Mean serum insulin level in Aescin (3.6 mg/kg/day) administrated group E was significantly higher (29.10± 1.64 IU/L) as compared control and other experimental groups; p-0.001. Conclusion: The Aescin showed exerts ameliorating effects on glucose homeostasis in fructose fed Diabetic albino Wistar rats. By Aescin administration, serum insulin level can be increases to control the diabetes

Isolated cryptococcal osteomyelitis in an immunocompetent patient

bstract Cryptococcosis is a rare infection in HIV-negative individuals. While the lungs and the central nervous system are most commonly infected, skeletal cryptococcosis is uncommon and isolated osteomyelitis due to Cryptococcus neoformans is quite rare. To our knowledge, only 47 cases of isolated cryptococcal osteomyelitis have been reported from 1974 to 2005. We report a case of isolatedcryptococcal osteomyelitis in an immunocompetent patient, who received 12 weeks of fluconazole with complete recovery

Positive Data Visualization Using Trigonometric Function

A piecewise rational trigonometric cubic function with four shape parameters has been constructed to address the problem of visualizing positive data. Simple data-dependent constraints on shape parameters are derived to preserve positivity and assure smoothness. The method is then extended to positive surface data by rational trigonometric bicubic function. The order of approximation of developed interpolant is

Comparison of foeto-maternal outcome in pregnant women with hepatitis E - A review of 12 years.

Objective: To compare adverse maternal and foetal outcome in pregnant women with hepatitis E immunoglobulin M reactive versus non-reactive.Methods: This retrospective study was conducted at the Aga Khan University Hospital, Karachi, and comprised records of pregnant patients at any gestational age with clinical and biochemical evidence of hepatitis E from January 2002 and December 2014. . Maternal and perinatal outcome of the subjects were analysed. SPSS 20 was used for data analysis.Results: Out of the 200 subjects, 168(84 %) were hepatitis E immunoglobulin M reactive and 32(16%) were non-reactive. The overall mean age was 26.7±4.5 years. Also, 12(7%) patients in the immunoglobulin M reactive group were admitted to intensive care unit compared to no one from the non-reactive group. Similarly fulminant hepatic failure was seen in 12(7.1%) patients in the immunoglobulin M reactive group compared to no one in the other group. Post-partum haemorrhage was more frequent in the immunoglobulin M reactive group compared to the non-reactive group. There were 5(3%) maternal deaths in the reactive group compared to no death in the other group.Moreover, 34(20.2%) neonates of the immunoglobulin M reactive group needed neonatal intensive care unit admission compared to none in the non-reactive group. There were 4(2.4%) neonatal deaths in the reactive group.Conclusion: Participants in the immunoglobulin M reactive group had a higher percentage of adverse foeto-maternal outcomes compared to the non-reactive group

Comparison of Quality of Life of Medical Students in Annual and Modular System in Public Sector Medical Colleges in Karachi, Pakistan

Background: Curriculum structure in medical education in Pakistan includes an annual system which is based on subject wise learning and clinical rotations, and a modular system, with the basic and clinical sciences taught cohesively. The effect of curriculum designs in the quality of life (QoL) of medical students has not been assessed in Pakistan. We aimed to compare these two curriculum structures focused on QoL. Methods: Cross-sectional study of medical students from three different medical schools in Karachi, Pakistan, comparing QoL based on their curriculums. QoL was measured using the WHOQOL-BREF questionnaire. Through random sampling students from each year (1st-5th year) in each institution were selected. Kruskal Wallis test and Mann-Whitney U test were used to compare scores among different years of medical training and between curricular systems. Results: Response rate was 85%. Out of 404 participants, 81.3% were females, and age average was 21±1 years. According to the year of study, significant differences were observed in physical health and overall QoL domain, with 3rd-year students having the highest scores. Overall QoL of students in clinical years was found to be significantly higher than those in preclinical years. The modular system was found to have a better but not significantly higher QoL when compared to the annual system (mean 83.34±11.41 vs. 82.32±10.27, respectively). Conclusion: Overall QoL in the modular system was slightly higher than the annual system, but a significant difference was noted only in the environmental domain. QoL of students in clinical years was higher than preclinical years

Body Dysmorphic Disorder: a Comprehensive Review

DergiPark: 889274tmsjBody dysmorphic disorder is psychiatric morbidity that comes under the spectrum of obsessive-compulsive disorders. Individuals suffering from body dys- morphic disorder are incredibly concerned about their minor or so-called defects to such an extent that their lives may be affected drastically. As a result of continuously thinking about the asserted defect, the individuals end up suffering from major depression, anxiety, and self-harm. Diagnosis of body dysmorphic disorder is based on the Diagnostic and Statistical Manual of Mental Disorders, fifth edition criteria. The management of body dysmorphic disorder consists of psychotherapeutic and pharmacological interventions. Body dysmorphic disorder is a hidden disorder and is often under-reported. It has been linked to muscle dysmorphia, substance abuse, and major depressive disorder. The lack of studies in different countries and populations has made this a topic that requires sub- stantial input from researchers

Monotone Data Visualization Using Rational Trigonometric Spline Interpolation

Rational cubic and bicubic trigonometric schemes are developed to conserve monotonicity of curve and surface data, respectively. The rational cubic function has four parameters in each subinterval, while the rational bicubic partially blended function has eight parameters in each rectangular patch. The monotonicity of curve and surface data is retained by developing constraints on some of these parameters in description of rational cubic and bicubic trigonometric functions. The remaining parameters are kept free to modify the shape of curve and surface if required. The developed algorithm is verified mathematically and demonstrated graphically

Comparison of Radiation Dose in CT Examinations At PIMS with European Commission Reference Doses

OBJECTIVE - The purpose of this study was to assess the radiation dose levels from common computed tomography (CT) examinations performed in Radiology Department of Pakistan Institute of Medical Sciences (PIMS), and evaluate these according to diagnostic reference levels (DRLs) proposed by European Commission (EC) guidelines, and thus contributing towards the establishment of local and national DRLs. To the best of our knowledge, this is the first study of its kind to explore radiation doses from CT examinations in Pakistan. STUDY DESIGN - This was a quantitative study conducted at PIMS, Islamabad, spanning a duration of eight weeks. Scan parameters and dose profile data of 1506 adults undergoing examinations of head, neck, chest and abdomen-pelvis regions, comprising of single- and multi-phase, contrast-enhanced and unenhanced studies. Dose indicators utilized by EC guidelines for DRLs include volume CT dose index (CTDIvol) and Dose Length Product (DLP) for single slice and complete examination radiation doses, respectively. METHOD - Values of CTDIvol, DLP and scan lengths were extracted from the CT operators console. Other control variables included gender, contrast enhancement and phasicity of study. IBM SPSS package was used to obtain descriptive statistics such as mean and quartiles. RESULTS - DRLs calculated as 75th percentile of CTDIvol, DLP for various anatomical regions are by and far comparable to European DRLs. CONCLUSION – This study describes institutional diagnostic reference levels for common CT exams in Islamabad and provides benchmark values for future reference. Our DRL values are mostly comparable to European and international DRLs. Similar, albeit large scale, surveys are recommended for establishment of local and national DRLs, eventually contributing towards development of regional DRLs. KEYWORDS: CTDIvol, DLP, Diagnostic Reference Levels, Computed Tomography, Radiation Monitoring, Scan lengt