Married to the Pacemaker: An Autobiographical Case Report of Sick Sinus Syndrome.

I, the author of this case report, was on beta blockers, initially atenolol and later on nebivolol, for my "systemic hypertension" illness. After attending the National Pulmonary Conference, I fell during the return journey on the express highway, became unconscious, and reached the tertiary care hospital of the medical college at the end of the day. The electrocardiogram was suggestive of a "complete heart block.". They immediately implanted a temporary pacemaker and transferred me to the cardiac care unit. I was discharged after five days of stay in the hospital, as the Holter study concluded to be normal. After about two weeks, I felt lightheadedness and giddiness for a fraction of a second. An eminent senior cardiologist in my hometown advised Holter's study; this time, it was suggestive of long pauses. A permanent pacemaker was implanted with the diagnosis of sick sinus syndrome. This autobiographical case report hopes to shed light on more advanced cardiac screening in the search for the etiology of clinical symptoms.

The Role of Continuous Positive Airway Pressure (CPAP) Therapy in Obstructive Sleep Apnea With Metabolic Syndrome: Does It Affect the Outcomes?

Background Of all fatalities occurring globally each year caused by noncommunicable diseases, obstructive sleep apnea (OSA) and obesity are associated with an increased risk of sudden death and cardiovascular mortality. Metabolic syndrome and its comorbidities are linked to OSA. The three essential elements of the metabolic syndrome are improper lipid metabolism, hypertension, and insulin resistance. The effect of continuous positive airway pressure (CPAP) on metabolic syndrome elements and related symptoms and whether CPAP therapy helps reverse the syndrome was studied. Methods The present study is prospective pre-post research conducted at a tertiary care center in Nagpur, Hingna, India. The cases included were of moderate to severe or worse OSA, older than 18 years, willing for CPAP therapy with no previous or current CPAP therapy. They had a history of excessive drowsiness during the day. The cases excluded from the study were those with an active, persistent breathing ailment requiring treatment, intervention, or diagnosis of dyslipidemia, diabetes mellitus, or hypertension, past or present, or evidence of damage to the vital end organs. Components of the metabolic syndrome were assessed at the beginning and end of three months of CPAP therapy. Findings Eighty-five cases were enrolled in the study, of which 79 completed it. The majority of cases were male, comprising 48 individuals, accounting for 60.8% of the total cohort. Additionally, 54 cases, representing 68.4% of the group, had hypertension. The average age of the participants was 53.95 years ± 6.84 years. The BMI mean was 30.4 kg/m2 ± 4.642, with a waist-hip ratio of 0.964 ± 0.056 and a neck circumference of 40.66 cm ± 3.37. The study population scored 12.53 ± 2,616 on the Epworth Sleepiness Scale. The study population's apnea-hypopnea index/respiratory disturbance index ratio was 16.118 ± 4.868, a moderate risk score. After three months of CPAP therapy, there was a significant improvement in glycated hemoglobin (HbA1c), tetraiodothyronine (T4), high-density lipoprotein (HDL), and oxygen desaturation, and they were also statistically significant. In the study group, there was a decrease in systolic and diastolic blood pressure of 2.21 mm Hg and 0.26 mm Hg, respectively. Other indicators, including HbA1c, fasting and post-meal blood sugar, triglycerides, and HDL cholesterol, were significantly lower. We observed in the less than 50-year-old age group better improvement in systolic blood pressure of 0.49 mm Hg, diastolic blood pressure improvement of 0.32 mm Hg, and fasting blood sugar improvement of 14.59 mg/dl, and in the age group of more than 50, better improvements in post-meal blood sugar of 9.7 mg/dl, along with a statistically significant change in triglyceride with an improvement of 16.26 mg/dl, P value less than 0.05. Interpretation After three months of CPAP therapy, there was a significant improvement in HbA1c, T4, HDL, and oxygen desaturation, and they were also statistically significant. Fourteen (17.72%) cases of post-CPAP therapy no longer met the requirements for the syndrome. There was an improvement in the blood pressure's diastolic and systolic values, fasting and post-prandial sugar levels, HbA1C, and triglyceride levels. Patients over 50 years old showed better improvement in post-meal and triglyceride levels. Females improved blood pressure and triglycerides, whereas males responded better to blood sugar levels.

Lipoid Pneumonia Secondary to Diesel Aspiration: An Occupational Hazard.

Lipoid pneumonia is defined as a type of pneumonia that occurs as a result of inhalation of either endogenous or exogenous lipid-containing products in the lungs. We present the case of a 55-year-old male patient who presented with chief complaints of cough with blood-tinged sputum, right-sided chest pain, dyspnea, and fever for two days. The patient gave a history of working as a mechanic in an automobile garage and reported an episode of accidental aspiration of diesel during diesel siphoning at the workplace. A chest X-ray and computed tomography (CT) scan of the chest were done, which revealed right-sided lower lobe consolidation. The patient was admitted and started on intravenous antibiotics, corticosteroids, and inhaled bronchodilators, along with oxygen support. A bronchoscopy was done, which revealed the presence of thick mucoid secretions in the right lower lobe bronchus. The patient was discharged after 10 days with stable vitals and was advised to have regular follow-ups to monitor for any long-term pulmonary complications.

Post-tubercular Unilateral Lung Destruction: A Complicated Case.

Pulmonary tuberculosis is associated with long-term complications that affect both the respiratory and cardiovascular systems. We present the case of a 65-year-old male patient who presented with chief complaints of productive cough and breathlessness for the last four years. Further radiological investigations revealed a left-sided destroyed lung with left lung collapse and deviation of the mediastinum towards the left side. The patient responded well to treatment with broad-spectrum antimicrobial drugs and mucolytics.

Chronic Tubercular Mediastinitis: A Rare Case Presentation With Subcutaneous Emphysema.

Tuberculosis, histoplasmosis, various fungal infections, malignancy, and sarcoidosis are the most common causes of chronic or slowly progressing mediastinitis. Chronic mediastinitis of tubercular origin with subcutaneous emphysema is exceptionally uncommon, and the majority of cases are caused by trauma. Here we report the case of a 35-year-old chronic alcoholic male who presented to the Outpatient Department (OPD) with complaints of cough, chest pain, loss of weight, and intermittent low-grade fever for three months with no significant past medical history or family history for any respiratory diseases. He was admitted and all routine investigations were performed, which were normal including his chest X-ray, except erythrocyte sedimentation rate (ESR) which was raised. The patient's high-resolution Computed Tomography (HRCT) of the thorax was done which showed multiple pleural-based nodular lesions with few showing central cavitary nodules along with ground glass appearance. It also showed two fistulous tracks of 3.4-millimeter diameter, arising from the trachea at the T1 - T2 vertebral level and at the carina which led to the presence of air in the subcutaneous plane extending from the neck up to visualized abdomen suggestive of chronic mediastinitis with tracheal fistula, along with subcutaneous emphysema. This fistula was confirmed by video bronchoscopy as well as three-dimensional (3D) virtual bronchoscopy. A biopsy was taken, which was positive for acid-fast bacilli (AFB) stain, polymerase chain reaction (PCR) for tuberculosis, and positive tuberculin skin test. The patient was started on anti-tubercular treatment and on a follow-up visit upon completion of the intensive phase, his HRCT and video bronchoscopy showed fibrosing scarring with fistula closure.

Miliary Tuberculosis with Acute Respiratory Distress Syndrome: A Deadly Combination.

A unique and deadly presentation of miliary tuberculosis is acute respiratory distress syndrome. In this case report, we present the case of a 22-year-old male patient who presented with a history of weight loss, appetite loss for eight months, and rapidly worsening dyspnea for 15 days, for which he was admitted to the intensive care unit. Chest X-ray and computed tomography (CT) of the thorax revealed bilateral miliary opacities. Routine blood tests revealed hyponatremia and leukocytosis. The patient was started on non-invasive ventilatory support, intravenous corticosteroids, and anti-tubercular therapy on clinical and-radiological suspicion of miliary tuberculosis. The patient was admitted for one month and started to show rapid recovery after initiating anti-tubercular and corticosteroid therapy.

Enterotoxigenic methicillin resistant Staphylococcus aureus contamination in salted fish from Gwadar Balochistan / Contaminação de Staphylococcus aureus resistente à meticilina enterotoxigênica em peixes salgados de Gwadar Balochistan

Staphylococcus aureus is an important foodborne pathogen associated to food intoxication and other multiple infections in human being. Its presence in salted food is a serious issue due to its salt tolerance potential. A study was conducted to analyze the presence of enterotoxins producing drug resistance S. aureus in salted sea fish from Gwadar. Freshly persevered samples (n=50) of salted fish were subjected to analyze the presence of S. aureus using 16S rRNA and Nuc genes primers. The isolates were then evaluated for drug resistance and enterotoxins producing potential using specific primers for MecA (methicillin resistance gene), (SEA) staphylococcal enterotoxin A and (SEB) staphylococcal enterotoxin B genes. Total 13/50 (26%) of the samples were found positive for the presence of S. aureus, preliminary confirmed with biochemical profiling and finally with the help of target genes presence. The isolates were found showing 100% resistant to methicillin, which were molecularly confirmed by the presence of MecA gene present in genome. The isolates 5/13 (38%) were positive for SEA and 3/13 (23%) for SEB genes, whereas 2/13 (15%) were confirmed having both SEA and SEB genes in its genome. It was also confirmed that all the isolates were capable to form biofilm over the glass surfaces. It was concluded that the study confirmed the presence of enterotoxigenic methicillin resistance Staphylococcus aurous (MRSA) in salted fish product, that poses gross food safety concern. Preventive and control measures are necessary to handle this serious food safety concern.

Staphylococcus aureus é um importante patógeno de origem alimentar associado à intoxicação alimentar e outras infecções múltiplas em seres humanos. Sua presença em alimentos salgados é um problema sério devido ao seu potencial de tolerância ao sal. Um estudo foi realizado para analisar a presença de enterotoxinas produtoras de resistência a drogas S. aureus em peixes salgados do mar de Gwadar. Amostras recém-perseveradas (n = 50) de peixes salgados foram submetidas à análise da presença de S. aureus usando os primers dos genes 16S rRNA e Nuc. Os isolados foram então avaliados quanto à resistência a drogas e potencial de produção de enterotoxinas usando primers específicos para os genes MecA (gene de resistência à meticilina), (SEA) enterotoxina A estafilocócica e (SEB) enterotoxina B estafilocócica genes. Um total de 13/50 (26%) das amostras foi considerado positivas para a presença de S. aureus, confirmadas preliminarmente com perfis bioquímicos e finalmente com a ajuda da presença de genes-alvo. Os isolados foram encontrados com 100% de resistência à meticilina, os quais foram confirmados molecularmente pela presença do gene MecA no genoma. Os isolados 5/13 (38%) foram positivos para SEA e 3/13 (23%) para genes SEB, enquanto 2/13 (15%) foram confirmados tendo os genes SEA e SEB em seu genoma. Também foi verificado que todos os isolados foram capazes de formar biofilme sobre as superfícies de vidro. Concluiu-se que o estudo confirmou a presença de Staphylococcus aurous resistente à meticilina enterotoxigênica (MRSA) em produtos de peixe salgado, o que representa uma grande preocupação para a segurança alimentar. Medidas preventivas e de controle são necessárias para lidar com essa grave preocupação com a segurança alimentar.

Enterotoxigenic methicillin resistant Staphylococcus aureus contamination in salted fish from Gwadar Balochistan

Abstract Staphylococcus aureus is an important foodborne pathogen associated to food intoxication and other multiple infections in human being. Its presence in salted food is a serious issue due to its salt tolerance potential. A study was conducted to analyze the presence of enterotoxins producing drug resistance S. aureus in salted sea fish from Gwadar. Freshly persevered samples (n=50) of salted fish were subjected to analyze the presence of S. aureus using 16S rRNA and Nuc genes primers. The isolates were then evaluated for drug resistance and enterotoxins producing potential using specific primers for MecA (methicillin resistance gene), (SEA) staphylococcal enterotoxin A and (SEB) staphylococcal enterotoxin B genes. Total 13/50 (26%) of the samples were found positive for the presence of S. aureus, preliminary confirmed with biochemical profiling and finally with the help of target genes presence. The isolates were found showing 100% resistant to methicillin, which were molecularly confirmed by the presence of MecA gene present in genome. The isolates 5/13 (38%) were positive for SEA and 3/13 (23%) for SEB genes, whereas 2/13 (15%) were confirmed having both SEA and SEB genes in its genome. It was also confirmed that all the isolates were capable to form biofilm over the glass surfaces. It was concluded that the study confirmed the presence of enterotoxigenic methicillin resistance Staphylococcus aurous (MRSA) in salted fish product, that poses gross food safety concern. Preventive and control measures are necessary to handle this serious food safety concern.

Resumo Staphylococcus aureus é um importante patógeno de origem alimentar associado à intoxicação alimentar e outras infecções múltiplas em seres humanos. Sua presença em alimentos salgados é um problema sério devido ao seu potencial de tolerância ao sal. Um estudo foi realizado para analisar a presença de enterotoxinas produtoras de resistência a drogas S. aureus em peixes salgados do mar de Gwadar. Amostras recém-perseveradas (n = 50) de peixes salgados foram submetidas à análise da presença de S. aureus usando os primers dos genes 16S rRNA e Nuc. Os isolados foram então avaliados quanto à resistência a drogas e potencial de produção de enterotoxinas usando primers específicos para os genes MecA (gene de resistência à meticilina), (SEA) enterotoxina A estafilocócica e (SEB) enterotoxina B estafilocócica genes. Um total de 13/50 (26%) das amostras foi considerado positivas para a presença de S. aureus, confirmadas preliminarmente com perfis bioquímicos e finalmente com a ajuda da presença de genes-alvo. Os isolados foram encontrados com 100% de resistência à meticilina, os quais foram confirmados molecularmente pela presença do gene MecA no genoma. Os isolados 5/13 (38%) foram positivos para SEA e 3/13 (23%) para genes SEB, enquanto 2/13 (15%) foram confirmados tendo os genes SEA e SEB em seu genoma. Também foi verificado que todos os isolados foram capazes de formar biofilme sobre as superfícies de vidro. Concluiu-se que o estudo confirmou a presença de Staphylococcus aurous resistente à meticilina enterotoxigênica (MRSA) em produtos de peixe salgado, o que representa uma grande preocupação para a segurança alimentar. Medidas preventivas e de controle são necessárias para lidar com essa grave preocupação com a segurança alimentar.

Pulmonary Manifestations in Rheumatological Diseases.

Pulmonary involvement complicates the various aspects of care in patients suffering from autoimmune disorders. The epidemiological data generated over the last 10 to 15 years have improved the overall understanding of the risk factors and pathophysiological mechanisms involved in pulmonary involvement in rheumatological conditions. Recent advances in genetics have provided superior insight into the pathogenesis of autoimmune diseases and the underlying pulmonary involvement. This review article provides a concise overview of the four most common rheumatological conditions associated with pulmonary involvement: systemic lupus erythematosus (SLE), dermatomyositis/polymyositis, rheumatoid arthritis (RA), and systemic sclerosis (SSc). The clinical, epidemiological, and genetic aspects of these diseases are summarized in this article with particular emphasis on the characteristic patterns of pulmonary involvement in radiological imaging and various treatment options for each of these autoimmune diseases and their lung manifestations.

Elucidating antiviral activity of Curcuma longa against H9 N2 influenza virus using embryonated chicken egg model.

Curcumin is a potent antimicrobial herb used traditionally as a spice in culinary. This study was designed to evaluate the antiviral effects of curcuma longa extract against H9 influenza virus. A total of 60 embryonated eggs were equally divided into 5 groups with 12 eggs in each group. Group 1 (G1) served as uninfected negative control. Whereas Group 2 (G2) was kept as positive control infected with known virus @ 0.2 ml with 10-9.3 EID50. Group 3 (G3) was offered Curcuma longa @ 0.2 mg/0.2 ml and H9N2 virus (@ 0.2 ml with 10-9.3 EID50. Similarly, Group 4 (G4) was inoculated with extract of Curcuma longa @ 0.2 mg/0.2 ml per egg, whereas Group 5 (G5) was given Ribazole @ 0.2 ml/ egg. The crude extract and virus were administered on the 15th day of incubation and were checked after every 24 hours up to 96th hour post inoculation by random selection of 3 eggs. Death and survival rate were noted in all groups. Gross and histopathological lesions were also observed. Results revealed that Curcuma longa extract had significantly (p<0.05) reduced the mortality rate of embryos infected with H9N2 virus. In G3, increased lymphocytes and mild fatty changes were seen in liver. Whereas, mature RBCs, plasma cells and some lymphoblast's were observed in Spleen. Similarly, the bursa follicles were with lymphocytic aggregation. The G4 (Curcuma longa) and G5 (Ribazole) were with maximum embryo survival after 48 and 72 h post inoculation. This study revealed potential antiviral activity of Curcuma longa against H9N2 influenza viruses and can be opted as alternative to antibiotics and antiviral drugs to minimize the antimicrobial resistance in human and animal population.

Enterotoxigenic methicillin resistant Staphylococcus aureus contamination in salted fish from Gwadar Balochistan.

Staphylococcus aureus is an important foodborne pathogen associated to food intoxication and other multiple infections in human being. Its presence in salted food is a serious issue due to its salt tolerance potential. A study was conducted to analyze the presence of enterotoxins producing drug resistance S. aureus in salted sea fish from Gwadar. Freshly persevered samples (n=50) of salted fish were subjected to analyze the presence of S. aureus using 16S rRNA and Nuc genes primers. The isolates were then evaluated for drug resistance and enterotoxins producing potential using specific primers for MecA (methicillin resistance gene), (SEA) staphylococcal enterotoxin A and (SEB) staphylococcal enterotoxin B genes. Total 13/50 (26%) of the samples were found positive for the presence of S. aureus, preliminary confirmed with biochemical profiling and finally with the help of target genes presence. The isolates were found showing 100% resistant to methicillin, which were molecularly confirmed by the presence of MecA gene present in genome. The isolates 5/13 (38%) were positive for SEA and 3/13 (23%) for SEB genes, whereas 2/13 (15%) were confirmed having both SEA and SEB genes in its genome. It was also confirmed that all the isolates were capable to form biofilm over the glass surfaces. It was concluded that the study confirmed the presence of enterotoxigenic methicillin resistance Staphylococcus aurous (MRSA) in salted fish product, that poses gross food safety concern. Preventive and control measures are necessary to handle this serious food safety concern.

A 15-year study of death in custody in Tuanku Ja'afar Hospital Seremban.

Death-in-custody refers to the occurrence of death, while a person is under the custody of any enforcement agency. Their incidence often creates overwhelming public and media attention. Currently, there is no standardised definition of 'death-in-custody' in Malaysia and internationally. A crosssectional descriptive study was performed in the Department of Forensic Medicine Hospital Tuanku Ja'afar Seremban (HTJS) for a period of 24 months. Information on all custodial deaths registered at HTJS from January 2001 till December 2015 was selected from the in-house hospital death registration system. The definition of 'death-in-custody' used was guided by the recommendation by the 'Australian Royal Commission into Aboriginal Deaths in Custody' 1991 with few adjustments. Four custodial settings of interest (the police, prison, immigration depot for the illegal immigrant, and army custody) were studied. A total of 172 deaths-in-custody were collected, in which the majority of cases were natural deaths (84.88%), predominantly infective in nature (65.07%). Less than 1/6th of cases were unnatural deaths with more than 80% died from legal intervention. All custodial deaths were dominated by males (96.51%) with a mean and median age of 37 years. In terms of nationality, 52.91% of the deaths involved Malaysian citizens in which the 'Malay/Bumi' race outnumbered the other two main races. The most documented custodial deaths occurred in prison (44.19%) followed by immigration depots (38.37%) and police lock-ups (17.44%). This study provides a general overview of the pattern including the causes and the demographic profile involving death in custody in the Seremban district registered at HTJS.

The ameliorative effect of curcumin on cryptorchid and non-cryptorchid testes in induced unilateral cryptorchidism in albino rat: histological evaluation.

BACKGROUND: Cryptorchidism, one or both hidden testes, is the most common abnormality of male sexual development. Subfertility or infertility is associated with both unilateral and bilateral cryptorchidism. In this study, we investigate the possible ameliorative effect of curcumin (Cur) on the induced-unilateral cryptorchidism testicular injury in both cryptorchid (Cryp) and non-cryptorchid (non-Cryp) scrotal testes through histological, immunohistochemical and morphometrics. MATERIALS AND METHODS: Forty adult male albino rats were divided into: control group, Cur control group, Cryp group, and Cryp+Cur group. The rat model was surgically established by fixing the left testis in the abdomen. The treated groups were subjected to surgically induced-unilateral cryptorchidism on the left side then were given Cur (80 mg/kg) orally, for 20 days. Histological analysis using haematoxylin and eosin and periodic acid Schiff's reaction was done. Immunohistochemistry was performed for proliferating cell nuclear antigen (PCNA); to estimate the proliferation in the germinal epithelium, and vimentin; to evaluate Sertoli cells. The results were confirmed by statistical evaluation of the spermatogenic epithelium height, the seminiferous tubules diameter, the basement membrane thickness, the number of PCNA immunostained cells and the area per cent of vimentin immunostaining. RESULTS: Distorted seminiferous tubules, substantial degeneration of the germinal epithelium, thickening of the basement membrane with a significant decrease in PCNA and vimentin immunostaining were observed in Cryp group; mainly in the cryptorchid testis. These structural changes were significantly reversed in Crypt+Cur group. CONCLUSIONS: Curcumin proved to be an important and effective medical line for protecting against the unfavourable sequels of cryptorchidism in a rat model.

Elucidating antiviral activity of Curcuma longa against H9 N2 influenza virus using embryonated chicken egg model

@#Curcumin is a potent antimicrobial herb used traditionally as a spice in culinary. This study was designed to evaluate the antiviral effects of curcuma longa extract against H9 influenza virus. A total of 60 embryonated eggs were equally divided into 5 groups with 12 eggs in each group. Group 1 (G1) served as uninfected negative control. Whereas Group 2 (G2) was kept as positive control infected with known virus @ 0.2 ml with 10-9.3 EID50. Group 3 (G3) was offered Curcuma longa @ 0.2 mg/0.2 ml and H9N2 virus (@ 0.2 ml with 10-9.3 EID50. Similarly, Group 4 (G4) was inoculated with extract of Curcuma longa @ 0.2 mg/0.2 ml per egg, whereas Group 5 (G5) was given Ribazole @ 0.2 ml/ egg. The crude extract and virus were administered on the 15th day of incubation and were checked after every 24 hours up to 96th hour post inoculation by random selection of 3 eggs. Death and survival rate were noted in all groups. Gross and histopathological lesions were also observed. Results revealed that Curcuma longa extract had significantly (p<0.05) reduced the mortality rate of embryos infected with H9N2 virus. In G3, increased lymphocytes and mild fatty changes were seen in liver. Whereas, mature RBCs, plasma cells and some lymphoblast’s were observed in Spleen. Similarly, the bursa follicles were with lymphocytic aggregation. The G4 (Curcuma longa) and G5 (Ribazole) were with maximum embryo survival after 48 and 72 h post inoculation. This study revealed potential antiviral activity of Curcuma longa against H9N2 influenza viruses and can be opted as alternative to antibiotics and antiviral drugs to minimize the antimicrobial resistance in human and animal population.

Seroprevalence of Bluetongue Virus in small ruminants in Balochistan province, Pakistan.

Bluetongue (BT), caused by bluetongue virus (BTV), is a vector-borne disease of small ruminants that has the potential to spread across international borders. Despite large populations of susceptible animals and borders with BTV endemic countries, little is known of the disease burden and prevalent serotypes in the province of Balochistan in Pakistan. We conducted a cross-sectional study to determine seroconversion and prevalent serotypes in selected districts of the province using a competitive enzyme-linked immunosorbent assay (cELISA) and real-time polymerase chain reaction (RT-PCR). Sera (n = 876) were collected from clinically healthy sheep and goats originating from the districts of Quetta (n = 300), Mastung (n = 201), Killa Saifullah (n = 75) and Kech (n = 300). None of the study herds (n = 97) were seronegative for BTV, and at the individual level, the overall prevalence of BTV seroconversion was 47.26% (n = 414/876, 95% CI = 43.92%-50.63%). A higher percentage of goats (50.87%, 95% CI = 45.99%-55.73%) were seropositive for anti-VP7 immunoglobulins (IgG) than sheep (44.21%, 95% CI = 39.81%-48.70%). Odds ratios of seroconversion for goats were associated with breed type (χ2  = 16.84, p = .01), parity (χ2  = 23.66, p = .00) and presence of vector (χ2  = 2.63, p = .10), whereas for sheep, it was associated with breed type (χ2  = 13.80, p = .01) and parity (χ2  = 53.40, p = .00). Serotype 8 was the most prevalent (26.82%, 95% CI = 14.75%-43.21%) followed by an equal prevalence of serotypes 2 and 9 (7.31%, 95% CI = 1.91%-21.01%). To the best of our knowledge, this is the first study conducted in Balochistan province and the results indicate that there is a necessity to initiate intervention strategies to control BT disease burden not only in this region of Pakistan but also in adjacent areas of the neighbouring countries, Iran and Afghanistan.

Molecular evidence shows that the liver fluke Fasciola gigantica is the predominant Fasciola species in ruminants from Pakistan.

Fascioliasis is an important disease affecting livestock, with great costs to producers worldwide. It has also become a serious issue for human populations in some endemic areas as an emerging zoonotic infection. There are two Fasciola species of liver fluke responsible for this disease, which occur worldwide, Fasciola hepatica and Fasciola gigantica. Identifying these two species on the basis of adult or egg morphology requires specialist knowledge due to the similarity of characters, and may misidentify putative intermediate or hybrid forms. In this study we sequenced the internal transcribed spacer 2 (ITS-2) rDNA of liver flukes collected from multiple species of hosts from seven localities in the Punjab and Baluchistan provinces of Pakistan, to determine the distribution of these two species. All 46 flukes processed in this study, collected from seven sites, showed the rDNA ITS-2 genotype corresponding to F. gigantica, contradicting previous reports, based on adult and egg morphology, that both species are present in Pakistan, with F. hepatica being the more common.

Seroprevalence of pediatric malaria in quetta, balochistan, pakistan.

BACKGROUND: Malaria is one of the most devastating protozoal diseases in under developing countries like Pakistan where health facilities are scarce. It is the second most frequently reported disease with 4.5 million suspected cases in Pakistan. The current study was designed to determine the incidence of pediatric malaria in Quetta, Balochistan. METHODS: The study was conducted at Children Hospital Quetta (CHQ) during July 2011march 2012. Blood samples were collected from 3418 clinically suspected and were evaluated using thin and thick blood films stained with Giemsa stain. RESULTS: Out of 3418 total of 230 (6.72%) children were found positive for any of the malarial parasitic infestation. Plasmodium vivax was observed to be more common 54.34% (n= 125/230) than P. falciparum 44.78% (n = 103/230). Male children were 65.21% (150/230) i.e. two times more commonly affected than female 34.78% (80/230) children. The prevalence among age groups was 7.41% (n = 89/1200) in preschool-aged children aged 1-5 years, 7.11% (n = 75/1054) in school-aged children aged 6-10 years while 6.78% (n = 46/678) in 11-15 years-old children, and 6.66% (n = 20/300) in >15 year-olds children. Peak prevalence was noted in summer and mild in winter. Mixed infection of (0.86%: 2/230) P. vivax and P. falciparum was also observed in two cases although no case of P. malariae or P. ovale infection was seen during entire study. CONCLUSION: The results reflect the higher prevalence of malaria in Quetta, Pakistan that poses a significant health threat and requires urgent attention of high-ups to launch programme to control the disease in the area.

Prevalence of coronary risk factors in a rural community of Andhra Pradesh.

A community based cross sectional survey was carried out to study the prevalence of the risk factors for CHD and identify the high-risk groups in the rural community. 924 subjects of 30 years and above were investigated using structured, pre-tested schedule. Coronary risk factors were assessed. Statistical analysis was done by using Chi square test for prevalence of coronary risk factors in the age and sex groups. The prevalence of coronary risk factors ranged from 5.4 to 41.3%. Tobacco use, alcohol consumption, truncal obesity and sedentary life style were significantly prevalent among males. Whereas truncal obesity and hypertension among females. Behaviour change communication strategies targeting these high risk factors need to be emphasized to lower CHD related morbidity burden in the community.

Arthroscopy alone or in association with open cystectomy: in treatment of lateral meniscal cysts.

We retrospectively the results in 27 knees (26 patients) with cysts of the lateral meniscus. All patients had a meniscal tear (20 horizontal, 7 transverse) and pain over the lateral joint line with a palpable mass. The pathology was in the middle or anterior one-third of the meniscus. Arthroscopic surgery was performed in 22 knees, consisting of partial excision of meniscal tear, leaving a peripheral rim, coupled with débridement of the cyst; open cystectomy was performed in the remaining 5 knees. Average follow-up was 58 months (range 9-110). All patients but two were satisfied with the results.

The clinical value of cathepsin-D and TNF-alpha in bladder cancer patients.

This study included 34 normal healthy controls, 35 patients with urinary tract bilharziasis and 93 bladder cancer patients (62 were operable cases and 31 non-operable). Serum tumor necrosis factor alpha (TNF-alpha) was determined using the enzyme immunoassay reagents supplied by Medgenix Diagnostics, Belgium. Cytosol Cathepsin-D was estimated using the immunoradiometric assay supplied by CIS BIO International, France. The results revealed that at 100% and 90% specificities, cytosol Cathepsin-D had 35.7% and 59.5% sensitivity in bladder cancer patients. Serum TNF-alpha showed sensitivity of 17.0% and 55.0% at 100% and 90% specificities in operable bladder cancer patients and 48.0% and 77.0% in non-operable cases respectively. Cytosol cathepsin D and TNF-alpha did not show prognostic values like positive correlation with tumor stages, grades or association of tumors with bilharzial ova or lymph node involvement.