Notes

Throughout vitro exercise in the anti-microbial peptides h-Lf1-11, MSI-78, LL-37, fengycin 2B, and magainin-2 towards scientifically important germs.
8 months. The mean±SD haemoglobin level, TLC and platelet counts were 7.2±2.3 g/dl, 30,913±63,573 per cm and 58.6±52.3×103 per cm. The blast cell (%) count was 69.6±19.8. FLT-3 mutation was present in 18.9%.

We conclude that FLT-3 mutation to be present in only a minority of patients with Acute Myeloid Leukaemia having no significant association with age, sex, haemoglobin, WBCs and blast counts.
We conclude that FLT-3 mutation to be present in only a minority of patients with Acute Myeloid Leukaemia having no significant association with age, sex, haemoglobin, WBCs and blast counts.
In patients of non-ST-elevation acute coronary syndrome (NSTEACS), the global longitudinal peak systolic strain (GLPS) has been used to detect the presence of coronary artery disease (CAD) before left ventricular ejection fraction (LVEF) is affected. We tried to find out the correlation between the GLPS and severity of CAD in such patients.

A descriptive correlational study was conducted from March 2018 to January 2020 at Jinnah Hospital Lahore. Two hundred and sixteen patients of NSTEACS with EF of ≥60% were included. Patients were divided according to angiographic results into those having non-significant, one-vessel, two-vessel or three-vessel disease. These four groups were compared regarding left ventricular end-systolic dimension (LVESD), left ventricular end-diastolic dimension (LVEDD), LVEF, global longitudinal peak systolic strains in apical long axis view (GLPS-APLEX), in apical 4-chamber view (GLPS-A4C), in apical 2-chamber view (GLPS-A2C) and average of these (GLPS-AVG). All these parameters waction.
Global longitudinal peak systolic strain has a significant negative correlation with severity of coronary artery disease in non-ST-elevation acute coronary syndrome having normal ejection fraction.
The Triple D score is a novel and easy to use nomogram to predict shock-wave lithotripsy (SWL) outcomes. It is based on Computed Tomography (CT scan) parameters including stone density, skin-to-stone distance, and stone volume. However, its use has not been validated much as studies are sparse regarding its use. Our aim was to validate and evaluate accuracy of the Triple D scoring system in predicting SWL success rates.

It was a prospective study of 277 patients who had undergone SWL procedure for renal stones. They were evaluated by using non-contrast tomography, before undergoing SWL. CT scan-based parameters including distance of stone to skin (SSD), stone volume (SV), stone density was assessed. Computation of Cut off values was done with receiver operating characteristics analysis. Score was assigned on the basis of these cut-off values and success rate of SWL was determined. This score ranged from 0 (least favourable score) to 3 (most favourable score).

Stone-free status was attained in 160 patients (57.7%), and 117 (42.3%) patients were labelled to have failed the procedure. Differences between these two groups in terms of Stone volume, stone density and skin to stone distance were significant. Triple D scores of zero,1, 2, and 3 had stone-free rates of 3.6%, 52.56%, 53.3%, and 93.1% respectively (p-vaue<0.001).

Shock-wave lithotripsy outcomes can be predicted with use of Triple D score and hence, it's externally corroborated. It may help urologist in appropriate patient selection and hence decision making and patient counselling.
Shock-wave lithotripsy outcomes can be predicted with use of Triple D score and hence, it's externally corroborated. It may help urologist in appropriate patient selection and hence decision making and patient counselling.
Magnetic resonance imaging (MRI) has been commonly used in the assessment of preoperative pelvic organ prolapse to evaluate anatomical defects prior to surgery. This study aimed at evaluating the dynamic MRI reliability in the determination of pelvic organ prolapse and to assess its compliance with the physical examination for preoperative planning of women.

A prospective cross-sectional study was performed at the radiology department of the Jinnah Postgraduate Medical Centre Karachi from April-October 2019. selleck chemicals All women irrespective of age and parity status having obstructed defecation, constipation, organ prolapse, pelvic pain, or stress urinary incontinence undergoing dynamic pelvic MRI were consecutively enrolled. A brief history was obtained followed by a physical examination for pelvic organ prolapse followed by MRI examination. Kappa coefficient was applied to see the agreement of physical examination with MRI finding.

A total 38 women were included. A significantly moderate agreement was observed between MRI and physical exam findings with respect to the presence or absence of cystocele (K=0.554, p<0.001), rectocele (K=0.632, p<0.001), and enterocele (K=0.587, p<0.001). However, agreement with respect to the MRI and physical examination findings on uterine descent was non-significant (K=0.130, p 0.421).

MRI examination is an effective diagnostic modality in determination of the pelvic organ prolapse in suspected symptomatic patients. MRI could add value primarily in research areas, taking into account its ability to examine the entire pelvis.
MRI examination is an effective diagnostic modality in determination of the pelvic organ prolapse in suspected symptomatic patients. MRI could add value primarily in research areas, taking into account its ability to examine the entire pelvis.Within the last few years, advances in CT coronary imaging has revolutionised the diagnostic flow of suspected coronary artery disease. CT coronary angiogram has a high diagnostic accuracy and negative predictive value for diagnosis of coronary disease. Its non-invasive nature makes it a lower risk and lower cost procedure compared to conventional invasive coronary angiogram. However, there is restricted value in anatomical evaluation without input regarding the functional significance of each lesion identified with cross-sectional imaging. The gold standard to assess whether a lesion is haemodynamically significant has been the assessment of FFR (fractional flow reserve). Fractional flow reserve is the ratio between maximum coronary flow in the presence of stenosis and in the hypothetical absence of stenosis. This is measured invasively by introducing a pressure wire across the lesion involving intracoronary nitro-glycerine as well as intravenous infusion of adenosine. However, the introduction of FFR CT provides information on functional significance of a lesion only using the CT data set of CT CA. Through complex non-linear equations and supercomputing, it produces a three-dimensional model of the coronary artery giving FFR values at multiple point along every major coronary vessel. It is non-invasive, involves no extra dose or contrast and does not require adenosine stress. A lesion that may appear moderate to severe on CT CA with FFR values above 0.80 can be managed by optimal medical management alone. Together FFR Ct and CTCA provide a comprehensive assessment for CAD leading to a reduction in downstream testing and unnecessary revascularisation procedures.
COVID-19 pandemic has severely affected the entire world. However, its severity and mortality rate are lesser in developing countries, including Pakistan. This study aims to determine the association of prior pulmonary tuberculosis with COVID-19 pneumonia.

This cross-sectional study was conducted at two centres of Sindh, Pakistan. 521 HRCT chest performed from 1st May to 31st July 2020 were included and marked as "COVID-19 group". 761 HRCT chest performed during the first six months of 2019 were retrospectively evaluated to determine the prevalence of prior pulmonary tuberculosis and marked as the "pre-COVID-19 group". Previous pulmonary tuberculosis was documented as evidenced by clinical history, ATT intake and HRCT findings. Chi-square test was used to determine the association of prior pulmonary tuberculosis with COVID-19 pneumonia. A p-value of ≤0.01 was considered statistically significant.

In the "COVID-19 group", 4.9% (n=26) patients had prior pulmonary tuberculosis. In the "pre-COVID-19 group", 9.8% (n=75) patients had prior pulmonary tuberculosis with a confirmed history of tuberculosis in 8.9% (n=68) and without documented history in 0.9% (n=7) cases. A significant p-value of 0.001 was obtained with a confidence interval of 99%.

Prior pulmonary tuberculosis might have a protective effect against COVID-19 pneumonia which could be due to developed antibodies secondary to exposure to prior tuberculosis or BCG vaccination. Our results warrant further consideration due to the potential public-health benefits that can be achieved in our fight against the novel pandemic.
Prior pulmonary tuberculosis might have a protective effect against COVID-19 pneumonia which could be due to developed antibodies secondary to exposure to prior tuberculosis or BCG vaccination. Our results warrant further consideration due to the potential public-health benefits that can be achieved in our fight against the novel pandemic.
Pulmonary exacerbations (PEx) are major contributor of significant morbidity and mortality in CF patients. Managing PEx needs standardization and without standard local practice guidelines there will be significant variation in practice in managing these children. The aim of this study is to analyse the clinical management of PEx in our setup and to document variation in practices among physicians.

Children and adolescents ≤18 years with CF pulmonary exacerbations admitted at high dependency unit (HDU) or wards were included in the study. Frequencies of different intravenous antibiotic combinations were documented along with use of different inhaled antibiotics and inhalation therapy. Practices of different physician were further studied with regards to use of systemic steroids, oral azithromycin and inhaled antibiotics. One way ANOVA was used to assess differences between physicians' practices.

Fifty-seven patients were selected according to the inclusion criteria for 114 different exacerbations. Mean pulmonary exacerbation (PEx) for a patient (events/person-year) over five years was 3.16±1.41 per year and average length of stay was 5.7±4.4 days. Combination of intravenous ceftazidime and amikacin was the most frequently used regimen (28.07%). Five different physicians dealing with majority of the exacerbations (n=74) were studied further. Variability among consultants was significant in using systemic steroids (21.42-92.30%), use of maintenance oral azithromycin (0- 80%) and inhaled antibiotics (0-86.6%).

Significant variation exists in practices of physicians dealing with CF PEx. Variability observed in our study will definitely provide openings for local CF experts to come up with standardized inpatient exacerbation guidelines.
Significant variation exists in practices of physicians dealing with CF PEx. Variability observed in our study will definitely provide openings for local CF experts to come up with standardized inpatient exacerbation guidelines.
Chest wall tuberculosis is a rare disease, and although incidence has decreased further with advances in antituberculosis chemotherapy, it remains prevalent in developing countries. Diagnosis is difficult because pus smears or bacterial cultures of aspirate frequently fail to yield tuberculous bacilli. To discuss the characteristics of this rare disease and suggest an optimal strategy for management, we share our experience with 32 patients managed surgically and with antituberculosis chemotherapy.

In this descriptive case series we retrospectively reviewed the medical records of 32 patients managed from May 2006 to May 2016.

Out of 32 cases of chest wall tuberculosis, 59.4% (n=19) patients had a current or previous history of tuberculosis. Presenting complaints were chest pain, a palpable mass and pus discharge in most patients. A preoperative bacteriologic diagnosis was positive in only 3 patients. Generous abscess debridement was done in 21 (65.63%) cases, abscess debridement and partial rib resection in 11 (34.
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