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Existing position and unique tools in Native indian Chilika zoysia grass with regard to edition to brackish water ecology.
89%) were aged 26-30 years. Major risk factor was urinary tract infection in Nowshera 30(29%) and Mardan 5(26.3%), while no major factor was identified in Peshawar. Patients in the first trimester were 59(57.28%) in Nowshera, 19(100%) in Mardan and 19(83.3%) in Peshawar, and primigravidas were 19(18.4%), 6(25%) and 8(42%) respectively. Overall, 119(81.5%) patients had no history of abortion. CONCLUSIONS The prevalence of hyperemesis gravidarum was high in Nowshera, Mardan and Peshawar, predominantly during the first trimester of pregnancy.OBJECTIVE To evaluate microbiological and clinical characteristics of acute cholangitis along with their impact on mortality, and to compare the role of early versus late biliary drainage in the management of cholangitis. METHODS The retrospective study was conducted at the Shaukat Khanum Memorial Cancer Hospital Research Centre, Lahore, Pakistan, and comprised records of all patients presenting with acute cholangitis from June, 2012, to June, 2017. The risk factors, presence of bacteremia, resistance pattern of microbial pathogens and severity were assessed according to Tokyo guidelines in addition to associated mortality and recurrence at 3 months. Data was analysed using SPSS 20. RESULTS Of the 230 patients, 137(59.6%) were male. The overall mean age was 56±13 years. The most common isolated organism was Escherichia coli 54(70.1%). Clinical severity (p=0.001), late biliary drainage (p=0.001) and use of multiple stents (p=0.03) were associated with increased mortality. However, in multivariable analysis, only high body mass index (p=0.01) and Tokyo severity grades II (p=0.04) and III (p=0.001) were significant factors associated with mortality. CONCLUSIONS Early identification of risk factors, administration of appropriate antibiotics and establishing early biliary drainage were found to be the key management steps to reduce cholangitis-related mortality.Objective To compare half-thickness tragal cartilage graft with temporalis fascia graft in terms of graft take-up and acoustic outcomes in type-I tympanoplasty. METHODS The randomised control trial was conducted at Lady Reading Hospital, Peshawar, Pakistan, from January to December 2017, and comprised patients aged 16-60 years undergoing tympanoplasty. The patients were divided into two equal groups using systemic random sampling method. In Group A, tympanoplasty type-I was done using half-thickness tragal cartilage graft, while in Group B, it was done using temporalis fascia graft. Data was analysed using SPSS20. RESULTS Of the 40 patients, there were 20(50%) in each of the two groups. Overall, there were 24(50%) males and 16(40%) females. The mean age of Group A was 28.57±8.00 years, and in Group B it was 27.14±6.18 years. The graft success rate in Group A was 19(95%) and in Group B it was 18(90%) (p>0.05). Conclusion The graft success rates for half-thickness tragal cartilage and temporalis fascia were statistically non-significant.OBJECTIVE To assess the impact of a partnership between a nursing school and a large-scale urban hospital on healthcare education, practice and research. METHODS The qualitative study was conducted from April 2013 to January 2014 at a nursing school and an urban hospital at University of Pennsylvania, Philadelphia in the United States, and comprised health professionals including nursing faculty members, nurse clinicians and nurse managers from the two institutions. Data was collected through in-depth interviews using an open-ended questionnaire. Data was subjected to qualitative content analysis. RESULTS Of the 16 health professionals, 8(50%) were faculty members at the school of nursing, and 8(50%) were nurse clinicians/manager at the hospital. Major themes that emerged were mutual gains and benefits; clinical educators as the cornerstones of the partnership; leaders as key actors; and roadblocks to sustaining collaboration. The partnership benefitted both parties, particularly those in clinical practice, despite some challenges to long-term sustainability. The roles of clinical educator and team leader were critical in both settings. CONCLUSIONS The partnership between academics and practice carried critical importance in terms of enhancing quality patient care, student training, professional development and increasing research capacity.OBJECTIVE To compare the outcome of induction-remission in acute lymphoblastic leukaemia patients treated according to two different guidelines. METHODS The descriptive retrospective cohort study was conducted at The Children's Hospital Lahore, Pakistan, and comprised clinical information sheets of acute lymphoblastic leukaemia patients from September 2014 to August 2015. Data regarding demographics, risk categorisation, rapid early response and induction-remission assessment was collected separately for Group 1 patients treated with Lahore protocol and Group 2 patients using United Kingdom acute lymphoblastic leukaemia-2011 interim guidelines. Data was analysed using SPSS version 20.0. RESULTS Of the 98 patients who had a median age of 6.4 years (interquartile range 1.5-16 years), 48(49%) were in Group 1 and 50(51%) in Group 2. see more There were 14(29%) patients with standard risk in Group 1 while 34(71%) were high-risk. The corresponding numbers in Group 2 were 30(60%) and 20(40%) in Group 2. Rapid early response was noted in 18(37.5%) patients in Group 1 and 11(28%) in Group 2. Remission was achieved in 38(79%) patients in Group 1 and 36(72%) in Group 2. There was significant association of rapid early response with induction-remission in Group 2 (p0.05). CONCLUSIONS Induction-remission rate was comparable in the two treatment groups, but significant association of rapid early response with induction-remission was observed only in patients treated using United Kingdom acute lymphoblastic leukaemia-2011 interim guidelines.Objectives To examine whether Ephrin type A receptor 2 gene polymorphisms are associated with susceptibility to age-related cataract. METHODS The case-control study was conducted from January to May 2014 in Multan, Pakistan, and comprised patients of age-related cataract enrolled from Nishtar Hospital, Multan, and age-matched healthy controls without any type of cataract from the local population. A questionnaire was used to gather clinical and epidemiological data. Deoxyribonucleic acid was extracted from blood samples, and analysis of rs11260867, rs3568293 and rs7543472 single nucleotide polymorphisms was performed by using tetra amplification-refractory mutation system polymerase chain reaction protocol. Data was analysed using SPSS 17. RESULTS Of the 230 subjects, 129(%) were patients and 101(%) were controls. Among the three polymorphisms analysed, rs7543472 was associated with age-related cataract. Among the epidemiological and clinical factors, age, diabetes, blood pressure, smoking, radiation exposure, steroids usage and use of tranquilisers were associated with age-related cataract (p less then 0.
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