الملخص
Nanoparticles (NPs) are insoluble particles with a diameter of fewer than 100 nanometers. Two main methods have been utilized in orthodontic therapy to avoid microbial adherence or enamel demineralization. Certain NPs are included in orthodontic adhesives or acrylic resins (fluorohydroxyapatite, fluorapatite, hydroxyapatite, SiO2, TiO2, silver, nanofillers), and NPs (i.e., a thin layer of nitrogen-doped TiO2 on the bracket surfaces) are coated on the surfaces of orthodontic equipment. Although using NPs in orthodontics may open up modern facilities, prior research looked at antibacterial or physical characteristics for a limited period of time, ranging from one day to several weeks, and the limits of in vitro studies must be understood. The long-term effectiveness of nanotechnology-based orthodontic materials has not yet been conclusively confirmed and needs further study, as well as potential safety concerns (toxic effects) associated with NP size.
Nanopartículas (NPs) são partículas insolúveis com diâmetro inferior a 100 nanômetros. Dois métodos principais têm sido utilizados na terapia ortodôntica para evitar a aderência microbiana ou a desmineralização do esmalte: NPs são incluídas em adesivos ortodônticos ou resinas acrílicas (fluoro-hidroxiapatita, fluorapatita, hidroxiapatita, SiO2, TiO2, prata, nanopreenchimentos) e NPs são revestidas nas superfícies de equipamentos ortodônticos, ou seja, uma camada fina de TiO2 dopado com nitrogênio nas superfícies do braquete. Embora o uso de NPs em ortodontia possa tornar acessível modernos recursos, pesquisas anteriores analisaram as características antibacterianas ou físicas por um período limitado de tempo, variando de 24 horas a várias semanas, por isso devem ser compreendidos os limites dos estudos in vitro. A eficácia de longo prazo de materiais ortodônticos com base em nanotecnologia ainda não foi confirmada de forma conclusiva, o que exige mais estudos, bem como potenciais preocupações de segurança (efeitos tóxicos) associadas ao tamanho da NP.
الموضوعات
Orthodontics , Demineralization , Dental Enamel , Nanoparticles , Anti-Infective Agentsالملخص
Abstract Nanoparticles (NPs) are insoluble particles with a diameter of fewer than 100 nanometers. Two main methods have been utilized in orthodontic therapy to avoid microbial adherence or enamel demineralization. Certain NPs are included in orthodontic adhesives or acrylic resins (fluorohydroxyapatite, fluorapatite, hydroxyapatite, SiO2, TiO2, silver, nanofillers), and NPs (i.e., a thin layer of nitrogen-doped TiO2 on the bracket surfaces) are coated on the surfaces of orthodontic equipment. Although using NPs in orthodontics may open up modern facilities, prior research looked at antibacterial or physical characteristics for a limited period of time, ranging from one day to several weeks, and the limits of in vitro studies must be understood. The long-term effectiveness of nanotechnology-based orthodontic materials has not yet been conclusively confirmed and needs further study, as well as potential safety concerns (toxic effects) associated with NP size.
Resumo Nanopartículas (NPs) são partículas insolúveis com diâmetro inferior a 100 nanômetros. Dois métodos principais têm sido utilizados na terapia ortodôntica para evitar a aderência microbiana ou a desmineralização do esmalte: NPs são incluídas em adesivos ortodônticos ou resinas acrílicas (fluoro-hidroxiapatita, fluorapatita, hidroxiapatita, SiO2, TiO2, prata, nanopreenchimentos) e NPs são revestidas nas superfícies de equipamentos ortodônticos, ou seja, uma camada fina de TiO2 dopado com nitrogênio nas superfícies do braquete. Embora o uso de NPs em ortodontia possa tornar acessível modernos recursos, pesquisas anteriores analisaram as características antibacterianas ou físicas por um período limitado de tempo, variando de 24 horas a várias semanas, por isso devem ser compreendidos os limites dos estudos in vitro. A eficácia de longo prazo de materiais ortodônticos com base em nanotecnologia ainda não foi confirmada de forma conclusiva, o que exige mais estudos, bem como potenciais preocupações de segurança (efeitos tóxicos) associadas ao tamanho da NP.
الملخص
Background@#Alopecia areata (AA) is the most common cause of non-scarring alopecia.1 Many studies reported decreased serum vitamin D levels in patients with AA compared to healthy subjects.1-8 This study aimed to assess the prevalence of vitamin D deficiency in patients with AA compared to patients without AA. The secondary objective was to determine the correlation between vitamin D deficiency with disease severity and the pattern of AA.@*Methods@#This research was a case control study involving patients with AA from the dermatology clinic in Hospital Raja Permaisuri Bainun. All the subjects and controls were age, sex and Fitzpatrick skin type matched. Serum vitamin D (25-hydroxyvitamin D) (25 OHD) levels were obtained and analysed by the chemiluminescence immunoassay method. AA severity was assessed by Severity of Alopecia Tool (SALT) score.@*Results@#A total of 50 subjects, out of which 25 patients with AA and 25 controls, were recruited. The median serum vitamin D level was 54.15 nmol/L (IQR 139) in the AA group and 53.79 nmol/L (IQR 64.47) in the control group. However, the difference was not statistically significant (p=0.823). The prevalence of vitamin D deficiency was higher in the AA group (12%) compared to the control group (4%), but it was not statistically significant (p=0.304). There was no statistical significance in serum vitamin D levels with disease severity (SALT score) (p=0.171) and pattern of AA (p=0.657).@*Conclusion@#There was no statistical difference in the prevalence of vitamin D deficiency between patients with and without AA. There was no correlation between serum vitamin D levels with disease severity and pattern of AA. Further studies using a larger sample size is needed to justify measuring serum vitamin D levels in patients with AA.
الموضوعات
Alopecia Areata , Vitamin Dالملخص
Objective: To investigate the modulatory effects of bitter gourd extract on the insulin signaling pathway in the liver and skeletal muscle tissues of diabetic rats. Methods: The ethanolic extract of bitter gourd was prepared and its contents of total polyphenols and flavonoids were assayed. A neonatal streptozotocin-induced diabetic rat model was established and the diabetic rats were assigned into different groups and were treated with different doses of bitter gourd extract (100, 200, 400, or 600 mg/kg) or with glibenclamide (0.1 mg/kg) for 30 d. Fasting blood glucose, insulin, and lipid profile were evaluated and the insulin signaling pathway in the liver and skeletal muscle of rats was investigated. The correlations between homeostasis model assessment (HOMA) and the components of insulin signaling pathway were also evaluated. Results: Different doses of bitter gourd extract significantly ameliorated fasting blood glucose level and HOMA index for insulin resistance. Moreover, bitter gourd extract increased serum insulin and improved disrupted serum lipid profile. The levels of insulin receptor substrate-1 (IRS-1), p-insulin receptor β (p-IR-β), protein kinase C (PKC), GLUT2, and GLUT4 were improved by treatment with bitter gourd extract. The best results were obtained with 400 mg/kg dose of the extract, the effect of which was equivalent to that of glibenclamide. HOMA in the bitter gourd treated rats was negatively correlated with p-IR-β, IRS-1 and PKC in hepatic and skeletal muscle. HOMA was also negatively correlated with skeletal muscle GLUT4. Conclusions: Bitter gourd extract improves glucose homeostasis and lipid profile in diabetic rats via enhancement of insulin secretion and sensitivity. Therefore, bitter gourd can be used as a potential pharmacological agent for the treatment of type 2 diabetes mellitus.
الملخص
Objective: To investigate the modulatory effects of bitter gourd extract on the insulin signaling pathway in the liver and skeletal muscle tissues of diabetic rats. Methods: The ethanolic extract of bitter gourd was prepared and its contents of total polyphenols and flavonoids were assayed. A neonatal streptozotocin-induced diabetic rat model was established and the diabetic rats were assigned into different groups and were treated with different doses of bitter gourd extract (100, 200, 400, or 600 mg/kg) or with glibenclamide (0.1 mg/kg) for 30 d. Fasting blood glucose, insulin, and lipid profile were evaluated and the insulin signaling pathway in the liver and skeletal muscle of rats was investigated. The correlations between homeostasis model assessment (HOMA) and the components of insulin signaling pathway were also evaluated. Results: Different doses of bitter gourd extract significantly ameliorated fasting blood glucose level and HOMA index for insulin resistance. Moreover, bitter gourd extract increased serum insulin and improved disrupted serum lipid profile. The levels of insulin receptor substrate-1 (IRS-1), p-insulin receptor β (p-IR-β), protein kinase C (PKC), GLUT2, and GLUT4 were improved by treatment with bitter gourd extract. The best results were obtained with 400 mg/kg dose of the extract, the effect of which was equivalent to that of glibenclamide. HOMA in the bitter gourd treated rats was negatively correlated with p-IR-β, IRS-1 and PKC in hepatic and skeletal muscle. HOMA was also negatively correlated with skeletal muscle GLUT4. Conclusions: Bitter gourd extract improves glucose homeostasis and lipid profile in diabetic rats via enhancement of insulin secretion and sensitivity. Therefore, bitter gourd can be used as a potential pharmacological agent for the treatment of type 2 diabetes mellitus.
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Two spectrophotometric methods were used to determine two substances simultaneously in a binary mix whichare diosmin (DSM) and hesperidin (HSP). First, we used the derivative spectrophotometry by the zero-crossingmeasurements based on the elaboration of the linear calibration graphs of first derivative values, which are plottedat 269 nm for HSP and 262.5 nm for DSM. Then, for the second method, we opted for the calculation of the peakabsorbance ratio λmax of both drug substances (DSM-HSP) in a binary mixture, and the percentage of drugs wasdetermined. Two different ratios were selected.The two methods presented are simple, selective, and reliable, providing satisfactory accuracy. The recoveriesobtained in both cases are good and agreed well with the reported values. The results confirmed that the methodscan be considered as a good alternative to other costly techniques, in particular, chromatographic techniques. Thesemethods can be used easily and effectively for simultaneous dosing of two active ingredients mixed in pharmaceuticalforms with precision. Furthermore, we can use them for monitoring the synthesis of DSM from HSP. Considering thetime saved by these methods presented in the brief period of the analysis, we can use them for daily quality assurance.
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Background: The pathways that are involved for the duration of pregnancy and type of parturition are extremely complex, involving maternal as well as fetal systems. The objective of this study was to determine the frequency of types of parturition and their relationship with maternal characteristics among pregnant female patients.Methods: A cross-sectional survey using a non-probability convenient sampling technique was conducted among 195 healthy pregnant females at Obstetrics and Gynaecological Department of Hamdard Hospital, Karachi, from 1st March 2019 to 31st August 2019. After taking written informed consent from the participants, the relevant data were gathered with the help of a structured questionnaire designed specifically for the study. Statistical package for social sciences was used for data entry while the chi-square test was applied for inferential analysis. The duration of the study was six months. Data were entered and analyzed using Statistical Package for Social Sciences version 20.0. Descriptive analysis was performed by generating means and standard deviations for continuous variables while frequencies and percentages for categorical variables. A Chi-square test was applied to perform the inferential analysis while the significance level was set at 0.05.Results: A total of 195 pregnant females were included in the study, whose mean age was 29.29±5.22 years. The study results showed that BMI before pregnancy (p=0.021), rest is taken during pregnancy (p=0.034) and gravida status (p=0.047) were all significantly associated with the type of parturition among the study participants, but spacing in pregnancies and parity were not.Conclusions: Maternal characteristics were found to be significantly associated with the type of parturition among pregnant females. For gynecologists the maternal characteristics identified in this study may serve as a useful indicator of the type of parturition expected in their patients.
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Background: Urinary tract infection (UTI) is a common clinical issue among pediatric population and might progress into renal scaring, hypertension as well as end stage kidney disease. This study was aimed at finding clino-pathological features of UTI and antibiotic sensitivity against most common causative agents involved at a tertiary care hospital of South Punjab, Pakistan.Methods: This descriptive case series study was conducted at department of Paediatric Medicine, Nishtar University Hospital Multan from July to December 2019. A total of 100 children fulfilling the inclusion criteria, presenting in outpatient department or emergency section of paediatric medicine department, having positive urine culture and sensitivity were selected. Their detailed history, clinical examination and relevant investigations were done.Results: Out of the 100 children, 73 (73.0%) were female and 27 (27.0%) were male. There were 57 (57.0%) children from 1 year to 4 years age group and 43 (43.0%) were of more than 4 years. Most common clinical presentations were fever 83 (83.0%), urinary symptoms, vomiting 52 (52.0%) and pain abdomen 48 (48.0%). Most common aetiological agents were Escherichia coli 74 (74.0%) and Klebsiella pneumoniae 9 (9.0%).Conclusions: UTI is more common in female children. Most common presentation observed was fever and/or urinary symptoms while most common aetiological agent was E. coli.
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Background: Pregnancy is a very crucial time in a woman’s life. In this period of time, not only multiple physiological alterations effect the usual health status but also makes women more vulnerable to contract infection and face negative sequalae. Hepatitis C, a blood borne viral infection serve the similar fate when encountered by pregnant ladies. This study is based on exploring the prevalence of the Hepatitis C virus seropositivity among pregnant population. Moreover, we also evaluated the major risk factors leading to the infection in these mothers. Besides this, infected mothers were studied for their pregnancy outcomes.Methods: In this study 114 pregnant females were observed for this cross-sectional study. It was conducted in Gynecology Unit- 1, Liaquat University Hospital Hyderabad, for the period of January 2017 to July 2017. Chi square test was applied for statistical analysis on SPSS version 16. The criteria for enrollment in the study was set to be a pregnant lady belonging to age group 20-35 years; having singleton pregnancy; was a booked case at the hospital with compliant to antenatal follow ups; admitted to the labor room for delivery. All the non-pregnant ladies, whom had co morbid conditions such as hypertension or diabetes or had infected with hepatitis B or D were excluded from the study. Furthermore, pregnant ladies with multiple gestion or those who were either diagnosed of hepatitis C prior to conceive or had a previous history of hepatitis C were also excluded.Results: Present study revealed that out of 114, 10(8.8%) pregnant ladies were found seropositive for Hepatitis C virus. Prior history for transfusion of blood was the Foremost risk factor discovered, with 60.5% women reported this. History of surgery was the 2nd commonest factor and 43.9% had this in their medical records. On the other hand, only 8.8% women gave the history for previous evacuation. While observing pregnancy outcomes, we found 48.2% neonates had low birth weight, 41.2% were born preterm and 21.1% had low APGAR score.Conclusions: In a nutshell hepatitis c is prevalent in the pregnant population of this region and showing its effects in the form of compromised pregnancies. History of blood transfusion and previous surgery were found to be chief risk factors in the study.
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ABSTRACT American bollworm (ABW), Helicoverpa armigera (Hubner), is considered as a major pest of cotton, Gossypium hirsutum, all over the globe. Due to its destructive feeding nature and continuous consumption of the same chemicals, it devolved resistant against many insecticides. Therefore, a combined application of bio- and synthetic-pesticide need to evaluate against this pest. The entomopathogenic viruses like nuclear polyhedrosis virus (NPV), a member of baculoviruses, can be the potential candidates for better control against ABW. The present study was conducted to assess the comparative efficacy of NPV and Spinosad 240SC (with the concentration of 250 mL · ha-1) against ABW in the controlled environment. The ABW was treated with different concentrations of NPV and Spinosad separately and in a combination of NPV with 0.1% Spinosad. The results revealed that highest concentrations showed highest mortality (95%) followed by 95%, 92%, 84%, 82% and 78% mortality at 1 × 109, 1 × 108, 1 × 107, 1 × 106 and 1 × 105 POBs, respectively. Spinosad when mixed in diet give 100% mortality at 0.8% followed by 50.87%, 42.10%, 29.82%, 26.31% and 22.80% mortality at 0.4%, 0.2%, 0.1%, 0.5% and 0.025% respectively. The results of this study revealed that microbial control of ABW through NPV is an effective tool. The repeated use of synthetic pesticides caused the resurgence of many insect pests, and this study results would provide useful insight to build a framework for future investigations for the management of many major insect pests.
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Aim: Infection control is crucial in any clinical setting. It is vital that all dentists must follow the infection control protocols in their clinics to prevent cross-infection. In a dental clinic, even simple dental procedures including extractions, scaling and root planning, dental crown preparations and root canal treatment, have a high risk of exposure to blood, which may cause transmission blood-borne diseases. Dentist’s compliance with these guidelines and recommendations have been recently studied in different parts of the world. Hence this study was performed to evaluate the knowledge, attitude, and practice regarding infection control measures among private dental practioners in Karachi, Pakistan.Study Design:Cross-sectional study.Place and Duration of Study:This study was conducted for a period of four months in Karachi, Pakistan. Materialsand Methods: Present cross–sectional study was performed by interviewing 234dentists via a questionnaire based upon various questions regarding infection control. Sample were collected using convenience sampling, from private dental clinics in Karachi, Pakistan. Setting:Questionnaire were sent to 400 general dentist in Karachi,out of which 234 replied.Results: Mostly (69%) dentists who took part in the study were males. Regarding infection control, most of the individuals had a comprehensive understanding of infection control techniques. Isolation was considered to play a vital role in cross-infection prevention by 97.3% of the dentists. 93.2% used autoclave for sterilization and majority had thorough knowledge of the process involved. Regarding preventive measures, 66.7% of the dentists were vaccinated against major infectiousagents in our society and 92.2% took protective measures required to prevent cross-infection.Conclusion: Knowledge, attitudes and practices regarding infection control of dentists in private clinic of Karachi, Pakistan are satisfactory.
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Background: The aim of this study was to determine the disturbances in the levels of mineral in the body due to hemodialysis at different levels of parathormone levels and to assess its association with the calcium levels.Methods: Study was a cross sectional for the period of 6 months taking ethical approval. Total 255 cases were registered in this study after taking their informed consent. The cases were divided into three groups according to PTH level. Group 1 has 87 subjects with PTH level <250, group 2 has 102 subjects with PTH level 250-650 and group 3 has 66 cases with PTH level >650. The cases were taking hemodialysis for greater than 6 months and have the ages more than 18 years were included in this study. The demographic data includes age, sex dialysis related data like duration of hemodialysis, levels of calcium, phosphorus, albumin, PTH, ALP were observed.Results: Hemodialysis duration were recorded in respective three groups as 7.28±5.71, 6.26±5.56 and 6.15±4.30 days respectively (P=0.319). Calcium was found in group 1, 8.70±0.81, in group 2, 8.39±0.89 and in group 3, 8.76±0.82 (P=0.01). PTH level in three respective group were recorded to be 123.46±74.15, 418.47±115.49 and 1314.67±1188.63 (P <0.001).Conclusions: Present study showed that significant difference was found in mineral levels in patients on hemodialysis with PTH level as well as with alkaline phosphatase level. Nevertheless, no significant difference was found with duration of dialysis and with parameter of albumin.
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Background: Hypertension is defined as a systolic blood pressure of 140 mmHg or more, or a diastolic blood pressure of 90 mmHg or more or taking anti-hypertensive medication. The clinical presentation of high blood pressure may depend upon several factors such as age, gender, severity and duration of hypertension. There is a paucity of data exploring the role hypertension duration may play in shaping the relationship between blood pressure and signs and symptoms of hypertension. To evaluate the effect of hypertension duration on relationship between blood pressure and signs and symptoms in hypertensive patients.Methods: A cross-sectional study was carried out among 250 patients, aged 18 or above, with self-reported history of hypertension and on anti-hypertensive medication. Data were collected by means of a structured questionnaire whereas the blood pressure level was measured with the help of sphygmomanometer using stethoscope. Inferential analysis was performed by applying chi-square test whereas the significance level was set at 0.05.Results: The study results revealed that among patients with ≥5 years duration of hypertension headache history (P=0.021), edema (P=0.034), increased urinary frequency (P=0.031), sleep apnoea (P=0.016), palpitation (P=0.005) and confusion (p=0.021) were significantly associated with systolic whereas only increased urinary frequency (P=0.009) was significantly associated with diastolic blood pressure. Moreover, among patients with <5 years duration of hypertension vision problems (P=0.03), sleep apnoea (P=0.015) and palpitation (P=0.035) were significantly associated with systolic whereas sleep apnoea (P=0.048) and palpitation (P=0.028) were significantly associated with diastolic blood pressure.Conclusions: The study results showed that patients with higher blood pressure were more likely to have the signs and symptoms of hypertension. Also, patients with longer duration of hypertension had greater number of signs and symptoms associated with systolic hypertension.
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Background: The aim of this study was to determine the disturbances in Calcium and other mineral levels in patients on hemodialysis at Tabba Kidney Institute, Karachi, Sindh, Pakistan.Methods: A cross sectional observational study through convenient sampling technique was conducted from January 2017 to August 2017 at Tabba Kidney Institute, Karachi after obtaining ethical approval. 255 patients, all above 18 years of age and on hemodialysis were included in the study. Multi-organ failure patients on dialysis, other systemic diseased patients on hemodialysis were excluded. Demographic variables, mineral levels, symptoms and supplementations were recorded. SPSS version 20.0 was used for data analysis.Results: A total of 255 patients on hemodialysis were selected and divided into groups depending upon median years of hemodialysis below and above 5 years of hemodialysis. Median and IQR of calcium were 8.8 and 8.2-9.1 mg/dl for below 5 years, 8.6 and 8.1-9.1 mg/dl for above 5 years (P value=0.44). Median and IQR of phosphate were 4.9 and 3.9-5.7 mg/dl for below 5 years and 4.6 and 3.7-5.5 mg/dl for above 5 years (P value=0.21). Median and IQR of parathyroid hormone were 393 and 212-699 pg/ml for below 5 years and 329 and 128-657 pg/ml for above 5 years. (P value=0.13) Median and IQR of albumin were 4.0 and 3.6-4.2 mg/dl for below 5 years and 4.0 and 3.8-4.3 for above 5 years (P value=0.30). Total of 18 (10.9%) had para thyroidectomy.Conclusions: Present study showed that significant difference in mineral levels did not exist in patients on hemodialysis as regards to the duration of dialysis. However clinical features had a tendency to decrease as duration of dialysis increased to above 5 years. Para thyroidectomy and itching were two main significant findings in this study.
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Background: Hypertension is estimated to affect about 40% of adults above 25 years of age globally. While many of the risk factors of hypertension are well known, such is not the case with smoking. Pertinent published literature is heterogeneous, with a dearth of relevant local data. Objectives was to study the relationship between smoking and blood pressure levels in hypertensive patients and to assess the effects of gender, age and hypertension duration on such a relationship.Methods: A cross-sectional study was carried out on a total of 298 conveniently sampled patients, aged 18 or above, from the medical outpatient department of a secondary care hospital of Karachi. The relevant data were collected by means of a structured questionnaire whereas the blood pressure level was checked using sphygmomanometer with stethoscope. Mann Whitney U test was used for inferential analysis whereas the significance level was set at 0.05.Results: Overall, both the systolic and diastolic blood pressure levels were significantly associated with smoking history (p<0.05 for both) where they were found to be higher in smokers than in non-smokers. Furthermore, after gender, age and hypertension duration based stratifications; both the systolic and diastolic blood pressure levels were still significantly associated with smoking history in patients who were male, were ≥35 years old and had <5 years hypertension duration (p<0.05 for both) where they were again found to be higher in smokers than in non-smokers.Conclusions: The study results showed a significant association of positive smoking history with higher mean systolic and diastolic blood pressure levels, though after stratifying for gender, age and hypertension duration, this relationship persisted only in patients who were male, were ≥35 years old and had <5 years hypertension duration.
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Objectives: This study aimed to throw some light on knowledge, attitude and the histological changes in human placenta exposed to passive smoking. Methods: Hospital-based studies were conducted to assess the knowledge and attitude of passive smoking in pregnant women and non-smoker controls (n=50) were selected. A structured questionnaire was used for data collection. Differences between the 2 groups were determined by the Chi-square test and the significance level was set at p<0.05. Total 50 placentas were collected immediately from interviewed pregnant women after delivery (38-40 weeks of gestation) from the Department of Obstetrics and Gynecology. According to the result yielded from the questionnaire 20 out of 50 placentas, showed no history of exposure to tobacco smoke, or consumption of tobacco in any form, and were labeled as controls. About 30 placentas were collected from passive smokers mostly exposed to smoke. The pregnant mother exposed to tobacco used by a chain-smoking husband or very close relative in a nuclear family was designated as a passive smoker. Results: The study indicated that there are significant statistical differences found among the pregnant women’s on their knowledge, attitude in term of pregnancy outcome and adverse effect on labor. The placenta exposed to passive smoking showed an increase in the connective tissue stroma in chorionic villi (intravillous fibroid) and some of them lost their trophoblastic covering. Also, the lumen of blood capillaries appeared obliterated and irregular. Conclusion: Our findings suggested that quantitative parameters of the placenta significantly showed changes in placenta from the passive smoker group compared to the controls. These changes can probably be associated with pregnancy complications in smoking mothers and may affect the development and survival of the fetus and even it’s future.
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BACKGROUND: Metaplastic breast carcinoma (MBC) is a rare disease with incidence of less than 1%. MBC present with a larger tumor size, less number of nodes involved, mostly undifferentiated triple negative tumors. We aimed to determine progression-free and overall survival and reported hospital-based incidence of MBC. MATERIAL AND METHODS: A retrospective closed Cohort study elicited data of 42 patients with MBC from January 2008 to December 2013; followed till August 2016. Kaplan-Meier method was applied to compute overall and progression-free survival analysis. Cox Proportional hazard ratios were computed to assess associations between survival and independent variables. RESULTS: Hospital-based incidence of MBC was 1.92% (42/2187), 95% CI [1.41-2.56]. The median age at tumor diagnosis was 54 years (range, 25–81 years). Thirty-nine (92.9%) patients had Grade III tumor. The most common histopathology was squamous (69%). The median tumor size was 4.5 cm (range, 0.8–17 cm). Nineteen (45.2%) patients had nodal involvement at diagnosis. Four patients (9.5%) had metastatic disease at presentation. Hormone receptors were positive in 19 (45.2%) patients. Her-2 neu receptor was positive in 9 (19%) patients. Sixteen (38.1%) patients had triple negative disease. Neoadjuvant and adjuvant chemotherapy was received by 10 (31.25%) and 19 (45.2%) patients respectively. Both median progression-free and overall survival was 38 months. CONCLUSION: Five-year progression-free and overall survival was 79.5% and 76.3%, respectively. We report better survival outcomes when compared to series described earlier despite our patient population presenting mostly with high grade, large tumors, and half of them exhibiting nodal and hormonal involvement.
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Objective: To evaluate the utilization of the pharmacist-operated Drug and Poison Information Center (DPIC) services in Pakistan. Methods: All queries from 2015-2017 were retrieved from PharmAssist DPIC database and were retrospectively analyzed. The variables obtained for analysis were call types (drug or poison), type of callers, type of drug queries, and type of poison queries. Results: A total of 2209 queries were analyzed. The highest queries in the year 2015, 2016 and 2017 came from general public as 44.0%, 56.3%, and 80.6%, followed by consultants as 11.4%, 7.3%, 4.4%, general physicians as 7.20%, 3.40%, and 3.85%. Students and interns show least usage with students 2.20%, 2.30%, 0.29% and interns 0.27%, 0.23%, 0.09% in the year 2015, 2016 and 2017 respectively. The most frequent queries received at PharmAssist DPIC were related to miscellaneous queries (14.7%), indications (13.6%), strength (13.4%) and drug availability (12.1%). The majority of poison calls were for ingestion (80.3%), followed by animal bite (6.6%), dermal contact (5.5%), injection (2.2%) and inhalation (2.2%). Conclusion: It was concluded that as the awareness of our service enhanced, the utilization also increased. In order to have enhanced usage of the service, more frequent awareness activities need to be performed to have improved patient care.
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The effect of composite endomycorrhizal inoculums was studied on the strawberry plant growth under greenhouse conditions. After six months, a significative effect was observed. Leaves number, fruits number, fresh roots weight and fresh fruits weight under greenhouse conditions compared to controls were 28.9/11.2, 58/1, 12.59g/9.62g and 367g/230g. Mycorrhizal intensity, arbuscular content and spores number in mycorrhized and non mycorrhized strawberry seedlings were respectively 54.1, 28.3 and 220. The spores detected belong to eight species and four genera: Glomus, Rhizophagus, Gigaspora and Scutellospora.
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Mixed connective tissue disease (MCTD), or overlap syndrome, is a multisystem autoimmune disease characterized by a combination of clinical features similar to those of polymyositis, systemic sclerosis, and rheumatoid arthritis. MCTD patients present with a distinct rise (high titers) of anti-U1 ribonucleoprotein antibody in serum. Here, we present the case of a 45-year-old female who presented with subacute onset weakness on all four limbs and later on diagnosed as overlap syndrome with severe myositis