Biodiversity, distributions and isolation of microplastics pollution in finfish species in the Panjkora River at Lower and Upper Dir districts of Khyber Pakhtunkhwa province of Pakistan / Biodiversidade, distribuição e isolamento de poluições por microplásticos em espécies de peixes no rio Panjkora nos distritos de Lower e Upper Dir da província de Khyber Pakhtunkhwa do Paquistão

The basic aim of this study was aimed to determine the ichthyofaunal diversity of River Panjkora in both upper and lower Dir districts in Khyber Pakhtunkhwa province of Pakistan.Fish samples were collected by using fishnets from March to September 2020. A total of 724 specimens were collected and classified into 5 families, 14 genera, and 18 species. The overall results revealed that most fish fauna of river Panjkora contains 8 species of family Cyprinidae (56.49%) followed by 4 species of Nemacheilidae (24.44%), 2 species of Channidae (10.63%), and Sisoridae (7.04%), and 1 species of Mastacembelidae (1.38%), respectively. Among all kinds of fish species, Schizothorax plagiostomus (16.57%) was highly dominated and followed by Carassius auratus (11.87%) and Racoma labiata (9.66%) and were reported as highly abundant, especially during April, May, and June. The least abundant species were Glyptothorax punjabensis, Glyptothorax sufii, and Mastacembelus armatus, that constituting 2.48%, 2.20%, and 1.38% of the total fish samples. The Overall Simpson's diversity (1-D= 0.919) and Simpson's Reciprocal index values (1/D= 12.3876), and Shannon's index (H= 2.68) were indicating that river Panjkora contains a quite rich and diverse group of fish species. The highest microplastics observed in site 7 compared to other study area. Conservation steps should be taken as a top priority to protect and conserve the marine environment and natural heritage from further loss, extinction and stop or minimize losses incurred through irresponsible fishery practices

O objetivo básico deste estudo foi determinar a diversidade ictiofaunística do rio Panjkora nos distritos de Lower e Upper de Dir, na província de Khyber Pakhtunkhwa, no Paquistão. Amostras de peixes foram coletadas com redes de arrasto de março a setembro de 2020. Foram coletados 724 espécimes, classificados em 5 famílias, 14 gêneros e 18 espécies. Os resultados gerais revelaram que a maioria da ictiofauna do rio Panjkora contém 8 espécies da família Cyprinidae (56,49%), seguidas por 4 espécies de Nemacheilidae (24,44%), 2 espécies de Channidae (10,63%) e Sisoridae (7,04%) e 1 espécie de Mastacembelidae (1,38%). Entre todas as espécies de peixes, Schizothorax plagiostomus (16,57%) foi altamente predominante, seguida por Carassius auratus (11,87%) e Racoma labiata (9,66%), e elas foram relatadas como altamente abundantes, especialmente nos meses de abril, maio e junho. As espécies menos abundantes foram Glyptothorax punjabensis, Glyptothorax sufii e Mastacembelus armatus, que constituíram 2,48%, 2,20% e 1,38%, respectivamente, do total de peixes amostrados. O índice de diversidade de Simpson (1-D = 0,919), o índice recíproco de Simpson (1/D = 12,3876) e o índice de Shannon (H = 2,68) indicaram que o rio Panjkora contém um grupo bastante rico e diversificado de espécies de peixes. Os microplásticos mais altos foram observados no local 7 em comparação com outra área de estudo. Medidas de conservação devem ser tomadas como prioridade máxima para proteger e conservar o ambiente marinho e o patrimônio natural de novas perdas e extinção e para parar ou minimizar as perdas ocorridas por práticas de pesca irresponsáveis.

Biodiversity, distributions and isolation of microplastics pollution in finfish species in the Panjkora River at Lower and Upper Dir districts of Khyber Pakhtunkhwa province of Pakistan

Abstract The basic aim of this study was aimed to determine the ichthyofaunal diversity of River Panjkora in both upper and lower Dir districts in Khyber Pakhtunkhwa province of Pakistan.Fish samples were collected by using fishnets from March to September 2020. A total of 724 specimens were collected and classified into 5 families, 14 genera, and 18 species. The overall results revealed that most fish fauna of river Panjkora contains 8 species of family Cyprinidae (56.49%) followed by 4 species of Nemacheilidae (24.44%), 2 species of Channidae (10.63%), and Sisoridae (7.04%), and 1 species of Mastacembelidae (1.38%), respectively. Among all kinds of fish species, Schizothorax plagiostomus (16.57%) was highly dominated and followed by Carassius auratus (11.87%) and Racoma labiata (9.66%) and were reported as highly abundant, especially during April, May, and June. The least abundant species were Glyptothorax punjabensis, Glyptothorax sufii, and Mastacembelus armatus, that constituting 2.48%, 2.20%, and 1.38% of the total fish samples. The Overall Simpsons diversity (1-D= 0.919) and Simpsons Reciprocal index values (1/D= 12.3876), and Shannons index (H= 2.68) were indicating that river Panjkora contains a quite rich and diverse group of fish species. The highest microplastics observed in site 7 compared to other study area. Conservation steps should be taken as a top priority to protect and conserve the marine environment and natural heritage from further loss, extinction and stop or minimize losses incurred through irresponsible fishery practices

Resumo O objetivo básico deste estudo foi determinar a diversidade ictiofaunística do rio Panjkora nos distritos de Lower e Upper de Dir, na província de Khyber Pakhtunkhwa, no Paquistão. Amostras de peixes foram coletadas com redes de arrasto de março a setembro de 2020. Foram coletados 724 espécimes, classificados em 5 famílias, 14 gêneros e 18 espécies. Os resultados gerais revelaram que a maioria da ictiofauna do rio Panjkora contém 8 espécies da família Cyprinidae (56,49%), seguidas por 4 espécies de Nemacheilidae (24,44%), 2 espécies de Channidae (10,63%) e Sisoridae (7,04%) e 1 espécie de Mastacembelidae (1,38%). Entre todas as espécies de peixes, Schizothorax plagiostomus (16,57%) foi altamente predominante, seguida por Carassius auratus (11,87%) e Racoma labiata (9,66%), e elas foram relatadas como altamente abundantes, especialmente nos meses de abril, maio e junho. As espécies menos abundantes foram Glyptothorax punjabensis, Glyptothorax sufii e Mastacembelus armatus, que constituíram 2,48%, 2,20% e 1,38%, respectivamente, do total de peixes amostrados. O índice de diversidade de Simpson (1-D = 0,919), o índice recíproco de Simpson (1/D = 12,3876) e o índice de Shannon (H = 2,68) indicaram que o rio Panjkora contém um grupo bastante rico e diversificado de espécies de peixes. Os microplásticos mais altos foram observados no local 7 em comparação com outra área de estudo. Medidas de conservação devem ser tomadas como prioridade máxima para proteger e conservar o ambiente marinho e o patrimônio natural de novas perdas e extinção e para parar ou minimizar as perdas ocorridas por práticas de pesca irresponsáveis.

Transcutaneous oxygen tension and ankle brachial pressure index as predictors of outcome in diabetic foot

Background: Diabetic foot ulcer poses a serious threat to patients with Diabetes as the presence of an ulcer further significantly increases the risk of an amputation. Aim and Objectives: The present study was undertaken to assess: Correlation of transcutaneous oxygen tension (TcpO2) and ankle brachial pressure index (ABI) in outcome of diabetic foot and severity of neuropathy by grades. Materials and Methods: About 30 patients of Type 2 Diabetes Mellitus with foot lesions and 30 healthy controls were selected after obtaining informed consent and ethical committee clearance. Subjects were recruited taking into consideration various inclusion and exclusion criteria. The subjects were assessed for the following parameters: Vibration perception, hot, and cold perception along with TcpO2 and ankle brachial pressure index (ABI). The test results were compared within the two groups of cases, that is, Group I: Healed ulcer and Group II-Non-healed ulcer. The results of the two groups were compared with 30 healthy controls also. Results: Males were predominant (66.67%) compared to females (33.33%) in the diabetic foot patients. Severe derangements in the sensory modalities were found as observed by the bilaterally reduced values of vibration perception, hot perception and cold perception tests when diabetic foot patients were compared to controls. The values, however, were not significantly different between the two groups of patients of diabetic foot. The values of TcPO2 and ABI were bilaterally reduced in the cases as compared to controls and amongst the Group I and Group II comparison these values showed a significant difference. A highly significant positive correlation was observed between the TcPO2 and ABI test results in the diabetic foot patients that indicates both are complimentary tests for diabetic foot outcome prediction. Conclusion: Increased duration of diabetes, high value of Hba1c and presence of neuropathy were found to be important risk predictors for diabetic foot. Early and severe derangement of vibration perception indicated early involvement of large nerve fibers. Heat and cold perception is affected late and less severely, indicating late involvement of small nerve fibers in diabetic polyneuropathy. The positive correlation between TcPO2 and ABI indicates both are complementary tests for predicting the outcome of diabetic foot. However, TcPO2 being a better predictor maybe incorporated as a routine screening test for diabetic foot risk and outcome predictor in the diabetic foot clinic.

Prevalence of rhabdochoniasis in snow trout of river Swat and river Panjkora, Khyber Pakhtunkhwa province, Pakistan / Prevalência de rabdoconíase em trutas das neves do rio Swat e do rio Panjkora, província de Khyber Pakhtunkhwa, Paquistão

This research was aimed to explore the helminth parasitic diseases in Schizothorax plagiostomus (the snow trout) from river Swat and river Panjkora, Pakistan. Collection of 360 fish specimens have done from the lower, middle and upper reaches of both the rivers through gill nets, cast nets, dragon nets and hooks. All the samples were examined in the University of Malakand, Zoology Department for helminth parasites during the months from January 2015 to December 2016. Of the total examined fish samples 21.9% (n=79) were infected with Rhabdochona spp including 17.7% (n=32/180) in river Swat and 26.6% (n=47/180) in river Panjkora. Highest month-wise prevalence (p=0.09878,p<0.05) was reported in May (30%), then by February and October each (26.6%) while the lowest during August (13.3%). Highest prevalence (p=0.9723, p<0.05) was reported in summer season (26.6%), while lowest in the winter season (20%). Adults were highly infected (p=< 0.0001) in prevalence (63.7%) followed by sub-adults (13.2%) while no infection was found in juvenile specimens. Females fish samples had higher (p=0.0277, p>0.05) prevalence (28.8%) than males (16.6%). Fishes of the lower reaches had highest (p=0.0029, P>0.05) prevalence (31.7%) followed by middle reaches (16.5%) while the lowest prevalence was observed in samples of fish collected from upper reaches (9.87%). Present study address that Rhabdochona spp in the intestine of snow trout has a long term relationship and call as a natural infection in cyprinids and zoonotic risk to human.

Esta pesquisa teve como objetivo explorar as doenças parasitárias por helmintos em Schizothorax plagiostomus (a truta das neves) do rio Swat e do rio Panjkora, Paquistão. A coleta de 360 espécimes de peixes foi feita nos trechos inferior, médio e superior de ambos os rios por meio de redes de emalhar, de lançamento, de dragão e anzóis. Todas as amostras foram examinadas na Universidade de Malakand, Departamento de Zoologia, para helmintos parasitas durante os meses de janeiro de 2015 a dezembro de 2016. Do total de amostras de peixes examinadas, 21,9% (n = 79) estavam infectados com Rhabdochona spp, incluindo 17,7% (n = 32/180) no rio Swat e 26,6% (n = 47/180) no rio Panjkora. A maior prevalência no mês (p = 0,09878, p <0,05) foi relatada em maio (30%), depois em fevereiro e outubro cada (26,6%), enquanto a menor em agosto (13,3%). A maior prevalência (p = 0,9723, p <0,05) foi relatada no verão (26,6%), enquanto a menor no inverno (20%). Os adultos foram altamente infectados (p = <0,0001) na prevalência (63,7%), seguidos por subadultos (13,2%), enquanto nenhuma infecção foi encontrada em espécimes juvenis. As amostras de peixes do sexo feminino tiveram maior (p = 0,0277, p> 0,05) prevalência (28,8%) do que o masculino (16,6%). Os peixes do curso inferior tiveram maior (p = 0,0029, P> 0,05) prevalência (31,7%) seguida do curso médio (16,5%), enquanto a menor prevalência foi observada em amostras de peixes coletados do curso superior (9,87%). O presente estudo aborda que Rhabdochona spp no intestino da truta das neves tem uma relação de longo prazo e pode ser considerada uma infecção natural em ciprinídeos e risco zoonótico para humanos.

Prevalence of rhabdochoniasis in snow trout of river Swat and river Panjkora, Khyber Pakhtunkhwa province, Pakistan / Prevalência de rabdoconíase em trutas das neves do rio Swat e do rio Panjkora, província de Khyber Pakhtunkhwa, Paquistão

This research was aimed to explore the helminth parasitic diseases in Schizothorax plagiostomus (the snow trout) from river Swat and river Panjkora, Pakistan. Collection of 360 fish specimens have done from the lower, middle and upper reaches of both the rivers through gill nets, cast nets, dragon nets and hooks. All the samples were examined in the University of Malakand, Zoology Department for helminth parasites during the months from January 2015 to December 2016. Of the total examined fish samples 21.9% (n=79) were infected with Rhabdochona spp including 17.7% (n=32/180) in river Swat and 26.6% (n=47/180) in river Panjkora. Highest month-wise prevalence (p=0.09878,p0.05) prevalence (28.8%) than males (16.6%). Fishes of the lower reaches had highest (p=0.0029, P>0.05) prevalence (31.7%) followed by middle reaches (16.5%) while the lowest prevalence was observed in samples of fish collected from upper reaches (9.87%). Present study address that Rhabdochona spp in the intestine of snow trout has a long term relationship and call as a natural infection in cyprinids and zoonotic risk to human.

Esta pesquisa teve como objetivo explorar as doenças parasitárias por helmintos em Schizothorax plagiostomus (a truta das neves) do rio Swat e do rio Panjkora, Paquistão. A coleta de 360 espécimes de peixes foi feita nos trechos inferior, médio e superior de ambos os rios por meio de redes de emalhar, de lançamento, de dragão e anzóis. Todas as amostras foram examinadas na Universidade de Malakand, Departamento de Zoologia, para helmintos parasitas durante os meses de janeiro de 2015 a dezembro de 2016. Do total de amostras de peixes examinadas, 21,9% (n = 79) estavam infectados com Rhabdochona spp, incluindo 17,7% (n = 32/180) no rio Swat e 26,6% (n = 47/180) no rio Panjkora. A maior prevalência no mês (p = 0,09878, p 0,05) prevalência (28,8%) do que o masculino (16,6%). Os peixes do curso inferior tiveram maior (p = 0,0029, P> 0,05) prevalência (31,7%) seguida do curso médio (16,5%), enquanto a menor prevalência foi observada em amostras de peixes coletados do curso superior (9,87%). O presente estudo aborda que Rhabdochona spp no intestino da truta das neves tem uma relação de longo prazo e pode ser considerada uma infecção natural em ciprinídeos e risco zoonótico para humanos.

Prevalence of rhabdochoniasis in snow trout of river Swat and river Panjkora, Khyber Pakhtunkhwa province, Pakistan

ABSTRACT This research was aimed to explore the helminth parasitic diseases in Schizothorax plagiostomus (the snow trout) from river Swat and river Panjkora, Pakistan. Collection of 360 fish specimens have done from the lower, middle and upper reaches of both the rivers through gill nets, cast nets, dragon nets and hooks. All the samples were examined in the University of Malakand, Zoology Department for helminth parasites during the months from January 2015 to December 2016. Of the total examined fish samples 21.9% (n=79) were infected with Rhabdochona spp including 17.7% (n=32/180) in river Swat and 26.6% (n=47/180) in river Panjkora. Highest month-wise prevalence (p=0.09878,p 0.05) was reported in May (30%), then by February and October each (26.6%) while the lowest during August (13.3%). Highest prevalence (p=0.9723, p 0.05) was reported in summer season (26.6%), while lowest in the winter season (20%). Adults were highly infected (p= 0.0001) in prevalence (63.7%) followed by sub-adults (13.2%) while no infection was found in juvenile specimens. Females fish samples had higher (p=0.0277, p>0.05) prevalence (28.8%) than males (16.6%). Fishes of the lower reaches had highest (p=0.0029, P>0.05) prevalence (31.7%) followed by middle reaches (16.5%) while the lowest prevalence was observed in samples of fish collected from upper reaches (9.87%). Present study address that Rhabdochona spp in the intestine of snow trout has a long term relationship and call as a natural infection in cyprinids and zoonotic risk to human.

Resumo Esta pesquisa teve como objetivo explorar as doenças parasitárias por helmintos em Schizothorax plagiostomus (a truta das neves) do rio Swat e do rio Panjkora, Paquistão. A coleta de 360 espécimes de peixes foi feita nos trechos inferior, médio e superior de ambos os rios por meio de redes de emalhar, de lançamento, de dragão e anzóis. Todas as amostras foram examinadas na Universidade de Malakand, Departamento de Zoologia, para helmintos parasitas durante os meses de janeiro de 2015 a dezembro de 2016. Do total de amostras de peixes examinadas, 21,9% (n = 79) estavam infectados com Rhabdochona spp, incluindo 17,7% (n = 32/180) no rio Swat e 26,6% (n = 47/180) no rio Panjkora. A maior prevalência no mês (p = 0,09878, p 0,05) foi relatada em maio (30%), depois em fevereiro e outubro cada (26,6%), enquanto a menor em agosto (13,3%). A maior prevalência (p = 0,9723, p 0,05) foi relatada no verão (26,6%), enquanto a menor no inverno (20%). Os adultos foram altamente infectados (p = 0,0001) na prevalência (63,7%), seguidos por subadultos (13,2%), enquanto nenhuma infecção foi encontrada em espécimes juvenis. As amostras de peixes do sexo feminino tiveram maior (p = 0,0277, p> 0,05) prevalência (28,8%) do que o masculino (16,6%). Os peixes do curso inferior tiveram maior (p = 0,0029, P> 0,05) prevalência (31,7%) seguida do curso médio (16,5%), enquanto a menor prevalência foi observada em amostras de peixes coletados do curso superior (9,87%). O presente estudo aborda que Rhabdochona spp no intestino da truta das neves tem uma relação de longo prazo e pode ser considerada uma infecção natural em ciprinídeos e risco zoonótico para humanos.

The First 100 Cases of Endoscopic Combined Intrarenal Surgery in Korea: Matched Cohort Analyses versus Shock-Wave Lithotripsy

Purpose@#This study presents our initial experience with endoscopic combined intrarenal surgery (ECIRS) for large renal stones and compares the results of a propensity score-matched cohort of patients undergoing shock-wave lithotripsy (SWL). @*Materials and Methods@#A total of 100 adults underwent ECIRS for renal stones between August 2017 and January 2019. For comparison, 2172 patients who underwent a first session of SWL between January 2005 and May 2018 were included in the SWL cohort.Propensity score matching was performed using maximal stone length (MSL), mean stone density (MSD), and stone heterogeneity index (SHI) scores. Stone-free rate (SFR) and success rate were compared between ECIRS and SWL. @*Results@#In the ECIRS group, the mean MSL, mean MSD, and mean SHI were 28.7±15.2 mm, 1013.9±360.0 Hounsfield units (HU), 209.4±104.0 HU, respectively. The SFR was 70%, and the success rate was 82.0% in this group. Although the ECIRS group had larger, harder, and more homogeneous stones than the SWL group, ECIRS showed a higher SFR and success rate than SWL. After propensity-score matching, SFR and success rate remained higher with ECIRS than with SWL (both, p<0.001). In multivariate logistic regression, smaller stone size [odds ratio (OR): 0.947, 95% confidence interval (CI): 0.913–0.979, p=0.002] and lower Seoul National University Renal Stone Complexity score (OR: 0.759, 95% CI: 0.610–0.935, p=0.011) were independent predictors of successful ECIRS. @*Conclusion@#ECIRS showed a higher SFR and success rate than SWL for large renal stones. Smaller stone size and lower complexity of stones were associated with a higher likelihood of successful ECIRS.

ROLE OF REAL TIME PCR (RT-PCR) IN CLINICAL DIAGNOSIS FOR COVID-19 REVIEW

The pandemic of Coronavirus Disease 2019 (COVID19) has compelled scientists to create highly reliable diagnostic tools quickly in order to successfully and properly diagnose this pathology and thereby prevent infection transmission. Even though structural and molecular properties of the severe acute respiratory syndrome coronavirus 2 (SARSCoV2) were previously unknown, private research institutes and biomedical firms quickly developed numerous diagnostic procedures beneficial for making a correct detection of COVID19. Rapid antigen or antibody testing, immunoenzymatic serological tests, and RT-PCR based molecular assays are the most frequently used and validated procedures now available. The PCR has grown in popularity in molecular diagnostics to the point where it is still considered the gold standard for finding nucleotides from a variety of sources becoming an indispensable tool in the research lab. Because of its improved speed, sensitivity, reproducibility, and lower likelihood of carry-over contamination, real-time PCR has gained greater popularity. Currently, five different chemistries are employed to detect PCR product during real-time PCR. The self- fluorescing amplicons, DNA binding fluorophores, 5? endonuclease, neighbouring linear and hairpin oligoprobes, and self-fluorescing amplicons are all detailed in depth. We also go through the problems that have hampered the development of multiplex real-time PCR and the importance of real-time PCR in nucleic acid quantification.

A PATH TO EFFECTIVE E-LEARNING IN MEDICAL EDUCATION: BARRIERS AND THEIR SOLUTION

Online learning in medical education is a relatively new concept and one which is rapidly expanding. Recently, due to the global widespread of COVID-19 pandemic, e-learning became the mainstreaming mode of teaching all over the world. Thus, it is critical to assess and work upon the potential challenges, drawbacks and barriers of effective implementation of successful e-learning. The general barriers to e- learning are often encountered as institutional or teaching method norms and technological drawbacks and behavior change in both the learner and the instructor is essential for successful implementation of e- learning in medical education. Although online course delivery has probably eliminated certain barriers that exist in face-to-face classrooms, such as geographic location, transportation issues, architectural and physical impediments, and social contexts which lead to inaccessible learning environments. Thus, it is the responsibility of the medical educators and administrators to look into these challenges and incorporate the solutions which can make begin a new era of better teaching-learning mode of education in medical education in the future This review article analyzes the prominent barriers to e-learning and solutions amongst medical educators to the implementation of online learning in medical education.

Septic sacroiliitis post gluteal intramuscular injection

We report an unusual case of septic sacroiliitis resulting as a complication of a previous gluteal intramuscular injection. A previously healthy young man presented with fever and severe pain in the right hip, with swelling and reduced range of movement. Imaging showed inflammatory changes suggestive of septic sacroiliitis. After treatment, the symptoms completely resolved and a follow-up computed tomography confirmed the complete resolution of the sacroiliitis. We identified that the patient took a gluteal intramuscular injection one week before his symptoms. This case highlights the possible association between septic sacroiliitis and the intramuscular injection and the importance of aseptic technique

Clostridium difficile infections in HIV-positive patients with diarrhoea.

Background. Patients with HIV/AIDS are at a high risk of being infected with toxin-producing strains of Clostridium difficile (C. difficile) because of frequent hospitalization, exposure to antibiotics and antibiotic prophylaxis for opportunistic infections. There are little data from India on the prevalence of C. difficile infection in such patients. Methods. We assessed the occurrence of C. difficile infections in HIV-positive patients with diarrhoea by looking for the presence of its toxin as well as by culturing. Enzyme immunoassay (EIA, Premier toxins A and B; Meridian Diagnostic Inc.) was used to detect toxin from 237 fresh stool samples collected from HIV-positive patients with diarrhoea. Culture was done on cycloserine–cefoxitin–fructose agar and brain– heart infusion agar. Results. C. difficile was found in 12 of 237 (5.1%, 95% CI 2.64%–8.68%) HIV-positive patients with diarrhoea (9 patients were positive by EIA and 3 by culture). The presence of C. difficile in patients who had received antiretroviral therapy (7/66 [10.6%]) was significantly higher (p<0.016) compared with those who had not (5/171 [3%]). Of the 12 patients positive for C. difficile, 7 were on antiretroviral therapy for a mean (SD) of 34.4 months with mean CD4+ count of 186 (98.81) cells/cmm and 5 patients were anti-retroviral-naïve with mean CD4+ count of 181 (68.7) cells/cmm. All the 12 patients were on antibiotics for previous 2 months and 4 of 12 had been hospitalized in the previous 30 days. Conclusion. C. difficile infections occurred more frequently in patients who had received antiretroviral therapy. Our study population had a lower frequency of C. difficile infections compared to previous studies.

Serum cortisol and testosterone levels in idiopathic central serous chorioretinopathy.

Context: The preferential occurrence of idiopathic central serous chorioretinopathy (ICSC) in males with a typical Type A personality and behavior and a relative absence in females is a possible indicator towards the role of serum cortisol and /or the male sex hormone testosterone. Aims: To study levels of cortisol and testosterone in ICSC. Settings and Design: Case-control study in a tertiary care teaching hospital. Materials and Methods: The study was conducted on 23 cases of ICSC. Twelve patients with unilateral sudden painless loss of vision of less than one month duration served as controls. Serum cortisol and testosterone levels at 8.00 a.m. were estimated by radioimmunoassay in both groups. Statistical analysis used: Statistical analysis was done using SPSS 13.0 software. Independent Sample t-test was applied to analyze statistical significance between the two groups. Results: Mean age of patients with ICSC was 37.1 ± 9.7 years and 96% of the patients were males. Mean serum cortisol levels were significantly higher (P=0.002) in patients with ICSC i.e., 495.02 ± 169.47 nano moles/liter (nmol/L) as compared to controls i.e., 362.25 ± 51.54 nmol/L. Mean serum testosterone levels were 3.85 ± 1.81 nano grams/ml (ngm/ml) and 4.23 ± 1.89 ngm/ml in cases and controls respectively and the difference was not statistically significant (P=0.58). Conclusions: ICSC is associated with elevated 8.00 a.m. serum cortisol levels. However, mean serum testosterone levels in both patients of ICSC and controls were within normal range.

Inflammatory markers, insulin resistance and carotid intima-media thickness in North-Indian type 2 diabetic subjects.

OBJECTIVE: To study the interrelationship of the inflammation, insulin resistance and atherosclerosis in recently diagnosed type 2 diabetes. METHODOLOGY: Eighty-one newly diagnosed type 2 diabetic patients were compared with 81 healthy age, sex and BMI matched controls. Plasma glucose and insulin (fasting and after 2 hours of 75 gm of oral glucose), lipids and serum levels of C-reactive protein (CRP), fibrinogen and Tumour Necrosis Factor (TNF)-alpha were measured. Carotid (Intima-Medial Thickness) IMT was measured using high "resolution B-Mode ultrasonography. Insulin resistance was calculated using HOMA-IR model. Electrocardiogram (ECG) and exercise ECG were recorded for the evidence of coronary heart disease (CHD). RESULTS: Carotid IMT was significantly thicker in diabetic patients than in control group across the whole age range (p < 0.01). In merged group of diabetes, composite IMT was significantly correlated with LDL-cholesterol, fasting insulin, serum cholesterol, BMI and HOMA-IR (p < 0.01). After controlling for age and sex, all glycaemic parameters were correlated with IMT in both diabetic and control group. HOMA-IR, waist hip ratio, serum triglycerides, serum cholesterol, fasting serum insulin and CRP were significant predictor of IMT. Concentrations of inflammatory markers were significantly higher in diabetic patients than in control group. Serum levels of CRP (p < 0.05) were found to be higher in diabetic patients with CHD than without CHD. CRP was significantly correlated with IMT (r = 0.603, p < 0.01) in diabetic subjects with and without CHD after controlling for age and sex. CONCLUSION: Inflammatory markers are associated with type 2 diabetes but only CRP is associated with development of accelerated atherosclerosis and subsequent CHD.

Firearm injuries, a review of 135 cases at King Hussein Medical Center-Jordan

This is a retrospective study of 135 cases of non fatal firearm injury in various age and sex, who attended the Emergency Department at King Hussein Medical Center, in two years duration 1/1/2002 - 31/12/2003. Data are presented with reference to age, sex, anatomical location of injury, duration of hospitalization and long-term complication. The age range of all firearm injuries in the study period was 2 to 62 years with a median age is 32.2 years. The majority were in the groups aged 10-19 years [47%] and aged 20-29 years [37%], 97 [72%] were male and 38 [28%] were female [male: female ratio is 2.5:1]. The length of stay in Hospital ranged from one day to 98 days, the mean stay was 13 days. Lower extremities were the most common site of injury [62.46%], followed by the abdominal injury accounting for 23 [17.5%]. Chest injury and thoraco-abdomen injuries were 33 [24.5%]. Resection of one organ or more was done for 15 patients [11%], lower limb weakness was seen in 9 cases [6.6%], pneumonectomy done just for one patient out of 37 patients having thoracic injury and only one patient out of 135 cases of non fatal injury to head and neck complicated by paraplegia. The economic costs of acute and long-term care of debilitating injuries and their complications and the lost productivity are serious and important problems for these non-fatal and "preventable in injuries" especially in young age group

Seroprevalence of hepatitis C infection in healthy children from the western region of Saudi Arabia

Community-acquired HCV infection was re garded as the main pattern of HCV infection especially after the implementation of the blood screening program in the Kingdom. Our aim was to determine the seroprevalence of community-acquired HCV infection in a group of healthy children from the western region of Saudi Arabia. Blood samples were collected from children attending the surgical clinics for minor surgery at King Abdulaziz University Hospital in Jeddah in the period between November 2001 to October 2003. Sera were tested for HCV antibody using a third-generation enzyme-linked immunosorbent assay. 1059 children screened, mean age +/- SD [7.4 +/- 3.7 years], range [1-18 years], 630 were males [60%]. Four children tested positive with a mean age +/- SD [7 +/- 3.1 years], range [4-11 years]. Giving a seroprevalence of 0.38%. There was no difference in seropositivity according to age groups, p values was 0.9. The seroprevalence of HCV infection in healthy children residing the western region of Saudi Arabia is loss, which may reflect the general improvement in the standard of living

Study of white blood cells changes in mice infested with gamma rays radiant and not radiant fertile protoscolices of echinococcus granulosus

Cystic echinococcus is a chronic zoonotic parasitic disease. To investigate the white blood cells changes in mice following the infestation with gamma rays radiant [and not radiant] fertile protoscolices. 120 mice were divided into six equal groups: groups A. B, C, D and E were administered intraperitoneal gamma rays radiant fertile protoscolices 5, 10, 15, 20 and 25 Gray. After a month with the challenge dose, blood picture were measured and compared to those of the natural infection or the control. The differential white blood cells count for the groups A and B with 5 and 10 Gray, showed increase of neutrophil, but decrease of Lymphocytes from the first week to the eighth week. The study showed that there was no change in the number of monocytes and eosinophils during the same period for all groups. Groups C and D [20 and 25 Gray] showed the increase of Lymphocytes, but decrease of neutrophil. Controls showed increase of neutrophlis, monocytes, eosinophils, but decrease of Lymphocytes

Kidney functions in newly diagnosed type 2 diabetic subjects: role of glycemic control.

BACKGROUND: The increased urinary albumin excretion (UAE) found at the diagnosis in type 2 diabetes may at least be functional and, thus reversible, as in type 1 diabetes. Furthermore, a positive correlation has been found between the glycemic control and UAE in type 2 diabetic subjects. MATERIAL AND METHODS: The impact of glycemic control after achieving three months of continuous normo-glycemia was studied in 26 (including 16 males and 10 females) newly diagnosed type 2 diabetic patients to assess renal size/volumes, various renal functions and UAE. RESULTS: A significant reduction was seen in glomerular filtration rate (GFR), UAE and fractional albumin clearance after achieving near normoglycemia (p < 0.01). A decrease in the kidney size/volume, though statistically insignificant, was also observed. Besides a decline in GFR of 4.8% was also noted after three months of stable normoglycemia. UAE normalized in six of these subjects. A statistically significant correlation was also found between the changes in mean fasting plasma glucose and the decline in UAE (r=0.56 and p < 0.01). CONCLUSION: The study emphasizes the necessity to correct the apparently reversible increase in microabuminuria that accompanies hyperglycemia prior to patients recruitment for intervention therapy.

Goiter in rural area of Aligarh district.

The survey of iodine deficiency disorder (IDD) and an inquiry about intake of goitrogenic items in two villages of the Aligarh District with a population of 1819 was done. Out of 1152 subjects examined, 348 had goiters but no other abnormality related to the IDD could be found in these subjects. The goiter positivity was 30.2% with visible goiter (grade II & III) rate 8.5%. Six of the subjects had multi nodular goiter of grade III. Urinary iodine levels in 316 of the goitrous subjects were lower (4.939 +/- 1.593 micrograms/dL, M +/- SD, P < 0.001, Median 4.9 micrograms/dL) than 50 urban inhabitants (6.638 +/- 1.372 micrograms/dL). Through in most of the cases (83.9%) T3, T4 and TSH were within normal range, in 35% of the 69 from whom the blood samples were drawn, T3 levels > 150 ng/dL and in 41% of the cases TSH levels > 3.5 mU/L was seen. As in most of the goitrous subjects T3, T4, TSH levels were within normal limits, only iodine deficiency could not be the causative factor for the goiter in 30.2% (severe endemia) of the total population of these two villages. Consumption of millets by the villagers, known to contain goitrogens along with the iodine deficiency in the food and drinking water appears to be responsible for the higher goiter rate in these villagers.