[en] Sixty-six patients with nonpalpable suspicious breast lesions at mammography underwent mammographically directed fine-needle aspiration biopsy (FNAB) and needle localization with use of a prototype coaxial breast localization and fine-needle biopsy system (18/20 gauge in most instances) and a retractable nitinol hook wire for stabilization during repositioning. Twelve malignancies were diagnosed histologically and ten were diagnosed cytologically (FNAB). There were no false-positive results with FNAB. Two false-negative results were obtained, in two cases of lobular carcinoma in situ. The results thus far are comparable to published results for a stereotaxic biopsy technique, with a sensitivity of 83%, a specificity of 100%, and an overall diagnostic accuracy of 96.7%

[en] Full text: We study the properties of leptons in hot and dense media. We also investigate the lepton properties in the magnetized media. We also show that the first order radiative corrections to the leptonic processes in the real-time formalism could be evaluated without going into the resummation of thermal loops. It is also shown that the light particle cross-sections could be estimated, approximately, in terms of the corresponding decay rates in the real time formalism. The leading order contribution comes out to be proportional to T²/E² in the usual notation

[en] Metal ions interference in the quantitative determination of Hg/sup 2+/ by cold vapor atomic absorption spectrophotometry has been investigated. The results show that the measured values of the Hg/sup 2+/ content of the samples are less than the actual values of measured in presence of Ni/sup 2+/, Co/sup 2+/, Cu/sup 2+, etc. (author)

[en] Objective: To assess the current understanding of treatment and management protocols for adult diabetic in-patients at a tertiary care hospital. Methods: This cross-sectional study, conducted at the Civil Hospital Karachi from July to September 2009, involved 450 participants, who were interviewed through a well-structured questionnaire regarding the patient's demography, clinical features, past medical history, type of diabetes mellitus, duration, associated complications, and also involved patient notes for laboratory tests and management. SPSSv15.0 was used for descriptive analysis. Results: The study population of 450 diabetics had 144 (32%) males and 306 (68%) females. Of the total, 435 (96.7%) patients had type 2 diabetes. There were 231 (51%) patients using insulin, 168 (37.3%) oral hypoglycaemic drugs, and 51 (11.3%) using both. Among patients using insulin, regular insulin usage stood at 30% followed by a combination of regular insulin and NPH (26.7%) and NPH alone at 6%. The most popular drug used was metformin (27.3%) and the least used drug was glitazones (4%). In the study population, 73.3% patients controlled their diabetes with diet, and 24.7% with regular exercise. Conclusion: Majority of the study population had type 2 diabetes with a female preponderance. Insulin was prescribed for half the patients. Metformin was the most frequently used oral hypoglycaemic drug. (author)

[en] Background: Chorionic Villus Sampling (CVS) is the technique of choice for prenatal diagnosis prior to 12 weeks gestation. The objective of this study was to determine the feasibility, and pattern of complications following first trimester Trans-abdominal Chorionic Villus Sampling (TA-CVS). Methods: This was a descriptive study conducted in the Obstetrics and Gynaecology Department Military Hospital (MH) Rawalpindi from Jan 2007 to July 2008. Couples at risk of giving birth to a child with genetic disorder were identified and counselled. Trans-abdominal Chorionic Villus Sampling was done using double needle technique under ultrasound guidance. Immediate and late complications were followed up. Data was analysed using SPPS-10. Results: On 200 cases chorionic villus sampling was done as an outdoor procedure. Most common indication was thalassaemia trait 75 (37.5%). Most procedures were done between 12-13 weeks. All placental positions including 104 (52%) posterior and 71 (35.5%) anterior were approachable. Most aspirations were easy, however, in 30 (15%) the aspiration was difficult. Overall success rate was 100%. In 158 (79%) of the cases sample yield was good. One (0.5%) patient had vaginal bleeding and three (1.5%) had placental haematoma formation. Most patients (84%) experienced mild pain during the procedure. The procedure related miscarriage occurred in 2 (1%) patients while another patient developed this complication after 6 weeks. Conclusion: First trimester TA-CVS is an accurate and safe invasive prenatal diagnostic procedure. Placentas in almost any position can be approached without any significant risk to mother and the foetus. (author)

[en] Objectives: This study was planned with an aim to find out the effectiveness of oral versus vaginal micronized progesterone for the treatment of threatened miscarriage. Methods: This randomized controlled trial was conducted at The Department of Obstetrics and Gynaecology, Nishtar Hospital Multan, from August 2019 to January 2020. A total of 136 pregnant women, aged 18 to 45 years having vaginal bleeding were included and divided into two groups (68 women in each group). Participants in the Group-A were given oral micronized progesterone as 200mg twice a day while Group-B participants were given vaginal progesterone suppository 400mg once a day. All women were followed up until 20th week of their pregnancy. Outcome was labeled as prevention of miscarriage if woman had no bleeding per vagina and pregnancy went beyond 20th weeks of gestation. Results: In a total of 136 women enrolled, mean age was noted to be 30.85+3.34 years. Overall, mean gestational age was noted to be 9.3+2.7 weeks. A total of 98 women (49 in each group) completed the follow up and were included in the final analysis regarding outcome. Among Groups-A, 45 (91.8) had prevention of miscarriage while 4 (9.2%) had miscarriage in comparison to 36 (73.5%) in Group-B had prevention of miscarriage whereas 13 (26.5%) had miscarriage and this difference was statistically significant in between the both study groups as women in Group-A had significantly better outcome in terms of prevention of miscarriage. (P value = 0.0164). Conclusion: The use of oral micronized progesterone was found to be significantly more effective than vaginal progesterone in women with threatened miscarriage. (author)

[en] Objective: To determine the factors, management and outcome of colorectal tumors presenting at Emergency Department, Mayo Hospital, Lahore. Study Design: Observational study. Place and Duration of Study: Accident & Emergency Department, Mayo Hospital, Lahore, from August 2017 to July 2019. Methodology: Conducted on 40 consecutive patients who presented in the Accident and Emergency Department, Mayo Hospital, Lahore; determined to have colon or rectal cancer as the cause of intestinal obstruction or perforation, were studied. Data was abstracted from patient charts. Studied variables included patient’s demographic data, indication for admission, surgical procedure done, complications, histopathology and mortality rate. Results: Forty patients underwent operations of colon and rectum during the study period. Mean age at presentation was 37.8 ± 16.7 years. Intestinal obstruction (75%) was the main presenting symptom. Ascending colon was the main site involved (50%), followed by recto-sigmoid mass (15%) and rectal mass (12.5%); 80% patients subjected to the stoma formation. Electrolyte imbalance and wound infection were the most common medical and surgical complications. Adenocarcinoma was the most common tumor on histopathology (92.5%). After surgery 87.5% patients survived and 12.5% patients expired. Factors significantly associated with worse outcome were greater ASA score (p=0.004), absence of screening colonoscopy in the past (p=0.013) and postoperative medical complications (p<0.001). Conclusion: Colorectal tumor cases continue to present in emergency in a high number. Male gender, young age and ascending colon cancers were more frequent among such cases. Most patients had to undergo stoma formation in emergency. Mortality is significantly associated with higher ASA score, absence of screening colonoscopy and postoperative medical complications. (author)

[en] Objectives: To determine and current the current trends in managing trigeminal neuralgia among oral maxillofacial surgeons and neuro-physicians in Sindh - Pakistan. Study design: Descriptive cross-sectional study. Place and duration: This survey was conducted in the Altamash Institute of Dental Medicine, Karachi. The survey was initiated on the 30 November 2017 and was concluded on the 20th March 2018. Materials and Method: A total of 110 practitioners from all over Karachi have participated in the study. A questionnaire was used to evaluate the current trends in the management of trigeminal neuralgia Results: According to the results attained oral maxillofacial surgeons preferred plain radiograph for their investigation while neuro-physicians found MRI as their first choice for a patient with suspected trigeminal neuralgias. While the data showed that oral maxillofacial surgeons opted for a conservative pharmacological treatment, mostly carbamazepine. Neurophysicians used Gabapentin most commonly in their practice. Majority of the patients were refractory who previously had undergone alcohol injections were encountered by both oral maxillofacial surgeons and neuro-physicians. The use of Gamma knife was rare to none due to non-affordability on the patient's part and non-availability on the doctor's side. Conclusions: The management of trigeminal neuralgia (TN) is a challenge both for neuro physicians and oral maxillofacial surgeons. The lack of a full comprehension of the complex pathogenesis at the basis of trigeminal neuralgia remains a key factor. (author)

[en] Background: Breast feeding is a physiological phenomenon, nonetheless, this act is a learned behaviour that requires continuous active support to make it successful. This study determines the frequency of mothers practicing successful breast feeding according to the WHO ten steps at tertiary care hospital. Methods: A descriptive cross sectional study was conducted in the Obstetrics department of Military Hospital, Rawalpindi over six month duration from July to December 2014. Booked mothers aged 15-49 years, having given birth to healthy, singleton baby were included in the study. Questions were asked after taking written informed consent from the mothers after delivery. Data was entered and analysed on SPSS version 20. Results: Out of 148 mothers, 35 (23.7 percentage) mothers were following successful breast feeding, i.e., knew 7 or more steps. A total of 100 (67.6 percentage) mothers received support for breast feeding by healthcare staff during their stay in hospital while 19 (12.8 percentage) mothers started breast feeding within one hour. About 71 percentage had started formula milk along with breast feeding. About 127 (85.8 percentage) reported that they fed their children on demand and 144 (97.3 percentage) did not use dummies. Statistically significant difference was observed as housewife mothers gave no top feed (p=0.005) and multiparous mothers started breast feeding within one hour of delivery (p=0.04). Conclusion: The steps to achieve successful breast feeding are followed to a small extent among mothers. Delayed initiation of breast feeding and increasing trend towards use of formula feed was observed. Employed, primiparous mothers are the most sensitive group to be focused during antenatal period. (author)

[en] Turmeric (Curcuma longa) is a well known condiment of the Asian cuisine and also used as ayurvedic medicine in the content, since ancient times due to its potential therapeutic properties. Main colouring constituent of Curcuma longa is curcumin and curcuminoids. In the present work natural yellow dye was extracted from rhizome of turmeric using an effective low cost method of solvent extraction. The developed natural yellow dye was assessed for physico-chemical analysis, toxicity, polyphenolic content and antioxidant activity. Physico-chemical assay showed good nutritional profile of the extracted natural yellow dye and quite safe at dose level 3.5g/Kg body wt. Significant phenolic content was found to be 63.32 mg GAE/100g, and also showed potent antioxidant capacity (% inhibition) ranging from 5.1-20.4 at 1-5 mg/mL concentration. Animal trials showed no mortality in the mice. (author)