Notes

Initial of the Adipose Muscle NLRP3 Inflammasome Walkway inside Cancers Cachexia.
Objective To find out the frequency of ZAP-70, CD38 and CD49d in patients diagnosed with CLL in our population. Methods This is a cross sectional study conducted in Army Medical College in collaboration with Armed Forces Institute of Pathology and Military Hospital Rawalpindi from 1st January 2018 to 30th November 2018. Permission from Institutional Ethical Committee was obtained. Blood samples were collected by non-probability consecutive sampling technique and analyzed for blood counts and flow cytometry was done for ZAP-70, CD38 and CD49d. Manufacturer's instructions for the kits were strictly followed. Results Fifty-one newly diagnosed patients with CLL were studied for the prognostic markers in CLL. CD 38 was expressed in 25(49%) and CD49d in 21(41.2%). ZAP-70 expression was not detected in our series of patients. Conclusion We conclude that CD38 and CD49d expression was detected in almost half of the patients of CLL in our series. CD49d showed statistically positive correlation with CD38, showing that it is a more pragmatic choice for reliable prognostication of CLL along with CD38. Copyright © Pakistan Journal of Medical Sciences.Objective To observe presentation of Pediatric congenital cardiac defects to the Emergency Department (ED) of a tertiary care hospital in Pakistan. Methods This is a retrospective chart review of patients under the age of 16 years with congenital cardiac defects presenting to the Emergency Department of Aga Khan University Hospital over a period of eighteen months, from January 2012 to June 2013. Study population was divided into two groups; first group constituted children with undiagnosed congenital cardiac defects, whereas second group constituted children with diagnosed congenial cardiac defects presented to ED. In previously diagnose cases each visit was counted as a separate encounter. Results Out of 133 children, 44 (33.5%) were diagnosed congenital cardiac disease for the first time (Group-1) in ED, while 89 (66.5%) children were diagnosed cases of congenital heart disease (Group-2). Among Group-1; main reasons for ED visits were cyanosis, cardiac failure, murmur evaluation and cardiogenic shock where as in Group-2; main presentations were cardiac failure, hyper cyanotic spells, gastroenteritis, lower respiratory tract infection, and post-operative issues. There were total 13 deaths. Conclusion High index of suspicion is necessary for early diagnosis and management of children with congenital heart disease in the pediatric emergency department. Copyright © Pakistan Journal of Medical Sciences.Objective To explore the impact of Blackboard (Bb) formative assessment on the final score in the endocrine module and determine the medical students' perception of the impact and effectiveness of Bb. Methods This exploratory case study was carried out at the King Abdulaziz University (KAU), Jeddah, Saudi Arabia (SA). Blackboard was used in the course management and formative assessment of third-year medical students and three years of data was collected (2016, 2017, 2019). In the last week of the module before the final exam, a formative assessment test that comprised of 50 Multiple Choice Questions (MCQs) was posted on Bb each year. All the students filled a questionnaire regarding their perception about the impact and effectiveness of Bb. Results Overall, summative exam scores were significantly higher than the scores in formative assessment (p less then 0.001). A substantial positive correlation was observed between students' marks in the online (Bb) MCQ exam and their final exam marks (p less then 0.001). Regarding the features of Bb, most often used by the students' were course resources uploaded on the Bb, assignments, online quizzes, and others. Majority of the students were satisfied with the use of Bb in this module. Conclusions The majority of the students liked this blended learning (BL) method and conceded the impact and effectiveness of Bb. The formative online assessment on Bb improved the students' performance in the final exam and a positive correlation was noted between students' marks in online (Bb) exams with their final exam marks. Copyright © Pakistan Journal of Medical Sciences.Objective To compare and analyze the clinical efficacy of brain radiotherapy combined with targeted therapy and concurrent radiotherapy and chemotherapy in the treatment of non-small cell lung cancer (NSCLC) with brain metastasis. Methods Fifty-eight patients with NSCLC with brain metastasis who were admitted to our hospital between October 2016 and October 2017 were randomly divided into a control group and an observation group, 29 cases in each group. The control group was treated with concurrent radiotherapy and chemotherapy, while the observation group was treated with whole brain radiotherapy plus targeted therapy. The disease control rate, adverse reactions and survival condition were compared between the two groups. Results The disease control rate of the observation group was 68.97%, significantly higher than 41.38% of the control group (P less then 0.05); the total incidence of adverse reactions in the observation group was 6.90%, significantly lower than 24.14% of the control group (P less then 0.05); the median survival time of the observation group was (16.81±5.32) months, significantly longer than that of the control group ((9.76±3.25) months). The one-year and two-year survival rates in the observation group were significantly higher than those in the control group (P less then 0.05). Conclusion Whole brain radiotherapy combined with targeted therapy is superior to concurrent radiotherapy and chemotherapy in the treatment of NSCLC with brain metastasis and has high safety. It can effectively prolong the life span of patients and is worth clinical promotion and application. Copyright © Pakistan Journal of Medical Sciences.Background and Objective Open partial nephrectomy (PN) is still considered gold standard procedure for T1 localized renal tumors. Conventional technique involves clamping of the renal artery with or without vein however, renal ischemia produces a certain level of damage to the kidneys. This study aims to investigate potential effect of off-clamp vs. hilar clamping PN on renal function. Methods This is a retrospective cohort study of patients who underwent unilateral, open partial nephrectomy for renal tumors b/w January 2009 December 2016 at our institution. A total of 90 partial nephrectomies were performed of which 65 cases were eligible for analysis. Non clamping technique was used in 43 while clamp was applied in 22 patients. Variables studied were patients' demographics, clinical variables, the laterality, tumors size and location, R.E.N.A.L nephrometry score, blood loss, tumor histology and surgical margins. Patients' renal function (serum creatinine and eGFR) were determined pre-operatively, at 3 and 12 months follow up. Data was analyzed on SPSS v. 22. Results Both the groups were comparable with regards to pre-operative renal function. Mean radiological size of tumor was 4.71±1.31 and 3.81±1.0 (0.003) in two groups respectively. Mean R.E.N.A.L nephrometry score was 6.1±1.5 in off-clamp group compared to 7.05 ± 1.7 in clamp group (p=0.04). No statistically significant difference was found in operative duration, blood loss, positive surgical margins and intra/ peri-operative complications. At three months and one year, renal function was better preserved in non-clamp group compared to clamp group (p=0.001 and 0.007 respectively). Conclusion Off clamp open partial nephrectomy is safe and feasible option leading to less decline in renal function. Copyright © Pakistan Journal of Medical Sciences.Objective To determine the morphological variations and location of pterion in Pakistani male population. Methods This retrospective observational study was carried out in the Department of Radiology, Shifa International Hospital from December 2018 to June 2019. The sample size was calculated by Open Epi web-based calculator. Fifty-three cranial CT scans with slice thickness of 0.5mm; consecutive scans of males were randomly selected. The patients with no craniofacial fracture and ages from 25 to 45 years were included. The dataset was obtained from Toshiba Aquilion One, 360-slice MDCT. The images were imported into the imaging software PACS (WFM), and analyzed in maximum intensity projection mode with three dimensional multiplanar reconstruction viewers. Measurements were taken in lateral projections of skull in Frankfurt plane, as horizontal and vertical distance from the posterolateral margin of frontozygomatic suture to center of pterion. Vertical distance from the superior border of zygomaticotemporal arciences.Objective To find out the outcome of management of brain abscess in children. Methods This is prospective observational study conducted in the Department of Paediatric Neurosurgery at Children's Hospital and Institute of Child Health, Multan from July 2014 to June 2017. Children up to the age of 14 years suffering from brain abscess were admitted. After taking clinical history, general and systemic physical examination and necessary investigations, abscess was evacuated and abscess wall excised after performing craniotomy. Data was collected on a predesigned performa. Results were analyzed and compared with national and international literature through statistical package for social sciences (SPSS-20). Results Twenty five patients up to 14 years of age were included. Seventeen (68%) were male and eight (32%) female. Fever and vomiting were present in all 25 (100%) patients. Paranasal sinusitis was predisposing causative factor in 9(36%) followed by otitis media in 7 (28%). Abscess was present in frontal lobe in 9 (36%), temporoparietal region in 8 (32%), posterior fossa in 5 (20%) and multiple abscesses in 3 (12%). Craniotomy was performed, pus evacuated and abscess wall excised in all 25 (100%) patients. Three (12%) patients expired. Conclusion Incidence of brain abscess can be decreased by treatment of its predisposing causes as sinusitis and otitis media. YK-4-279 cell line Small abscess less than 2cm can be treated with antibiotics. Complete evacuation of pus and excision of abscess wall after performing craniotomy along with appropriate antibiotics is gold standard management of brain abscess in children. Copyright © Pakistan Journal of Medical Sciences.When subjected to stress, terminally differentiated neurons are susceptible to reactivate the cell cycle and become hyperploid. This process is well documented in Alzheimer's disease (AD), where it may participate in the etiology of the disease. However, despite its potential importance, the effects of neuronal hyperploidy (NH) on brain function and its relationship with AD remains obscure. An important step forward in our understanding of the pathological effect of NH has been the development of transgenic mice with neuronal expression of oncogenes as model systems of AD. The analysis of these mice has demonstrated that forced cell cycle reentry in neurons results in most hallmarks of AD, including neurofibrillary tangles, Aβ peptide deposits, gliosis, cognitive loss, and neuronal death. Nevertheless, in contrast to the pathological situation, where a relatively small proportion of neurons become hyperploid, neuronal cell cycle reentry in these mice is generalized. We have recently developed an in vitro system in which cell cycle is induced in a reduced proportion of differentiated neurons, mimicking the in vivo situation.
Here's my website: https://www.selleckchem.com/products/yk-4-279.html