LIAQUAT MEDICAL RESEARCH JOURNAL

Evaluation of outcome of systemic tranexamic acid injection in drain output in ventral hernia repair

Sun, 31 Mar 2024 00:00:00 +0500

The primary objective of the study was to determine the mean drain output after systemic tranexamic acid injection in patients undergoing ventral wall hernia repair. This was a descriptive cross-sectional study conducted in the Department of General Surgery, Hamdard University Hospital Karachi, Pakistan for a period of six months from Oct 2020 to April 2021. The patients undergoing ventral hernia repair were included. Injection tranexamic acid 1gm intravenous twice a day for 1st post-operative day and then capsule Tranexamic acid 500mg per oral three times a day for two consecutive days was given and drain output was measured for 3 days. A total of 63 patients with ventral hernia were included, mean age of patients was 41.476 (±SD= 8.693). There were 41 male patients (65.1%) and 22(34.9%) females. The mean drain output on first day, second and third day was 115.047+14.678 ml/day, 91.919+9.947 ml/day, 66.914+7.070 ml/day and 273.254+29.165 ml/day respectively. The results showed overall reduction in postoperative drain output after oral and intravenous tranexamic acid for 72 hours. However further large scale randomized controlled trials are recommended for confirmation of these findings.

Negative Air ions induced amelioration of biochemical parameters in Cerebral Palsy patients

Ammara Rafique — Sun, 31 Mar 2024 00:00:00 +0500

Cerebral palsy (CP) is an umbrella term for a group of neurological abnormalities that impair a person's ability to stand, balance, walk, and maintain posture. It is caused by injury or anomalies in the developing brain, which tend to happen before or soon after birth or in early childhood. The study aimed to explore the influence of negative air ions (NAIs) on biochemical parameters in CP-inflicted patients and was conducted from February 1st to March 30th, 2021. Ethical permission from the Institutional Bioethics Committee (Ref: IBC-2017) and the Al-Umeed Rehabilitation Association (AURA) was obtained before the study. Thirty-one structured sessions of exposure to NAIs were conducted at AURA for six weeks after randomly allocating CP-inflicted participants into control (n=12; Median age: 14±5 years) and intervention groups (n=16; M age: Median age=14.5±7.1 years). Biochemical parameters included blood urea nitrogen, calcium, creatinine, electrolytes (bicarbonate, chloride, potassium, and sodium), liver function tests (alkaline phosphatase, alanine aminotransferase, aspartate transaminase, bilirubin total, direct bilirubin, and ?-glutamyl transpeptidase), protein tests (albumin, globulin, A/G ratio, and total proteins), and random blood sugar. For all tests, a trained phlebotomist collected blood samples from the premises of the rehabilitation center at baseline and sixth week. Paired t-tests were performed for within-group comparisons using SPSS v28. The biochemical parameters were normal in both groups at baseline and sustained normality in assessment at the sixth week. The NAI intervention showed no negative effects, indicating that it can be a progressive, non-pharmacological, cost-effective, and effective method to improve the quality of life of CP-inflicted patients.

Antioxidant and phytochemical analysis of different date palm (Phoenix dactylifera l.) Seed varieties: An in vitro assessment

Sun, 31 Mar 2024 00:00:00 +0500

The date palm (Phoenix dactylifera L.) fruit contains variety of bioactive constituents including phenolic compounds. This research aimed to analyze the phenolic constituents and antioxidant potential of crude methanol extract samples from seeds of different date varieties, Aseel (As), Ambar (Am), Ajwa Saudi (AJS), Ajwa Khairpur (AJK), Khipro (KP) and Karblyan (KB). Date seeds are regarded as waste product. However, it contains secondary chemicals of biomedical significance. Colorimetric methods were used for the evaluation of phytochemical and antioxidant capacity. The Folin-Ciocalteu method was used for the assessment of phenolic content. The antioxidant potential was evaluated through phosphomolybdenum test, potassium ferricyanide test, and 2,2-diphenyl-1-picryl-hydrazyl-hydrate scavenging test methods. All samples differ significantly in terms of antioxidant activities and quantity of secondary metabolites (phenolic and flavonoid contents). When all samples were compared, As was shown to have the highest amount of phenolic and flavonoids, while AJ(S) had the lowest content. The KP sample had the highest overall antioxidant and reducing potential, while the AJ(K) and Am samples showed the lowest, respectively. Significant DPPH scavenging capacity has been demonstrated in all samples. In order to extend the shelf life of food products, date seeds may consequently provide ideal material for the bio-functional food industry.

Titanium clips for vascular control of renal vessels during laparoscopic nephrectomy: a safe and cost effective tertiary care center experience

Sun, 31 Mar 2024 00:00:00 +0500

This study aimed to evaluate the safety and cost-effectiveness of practice of titanium clip application on renal vessels in laparoscopic nephrectomy (LN) in a tertiary care hospital. A total of 143 patients were included in our study undergoing laparoscopic nephrectomy from January 2018 to April 2023. In our study, 3 titanium clips were applied on each renal artery and vein 1-2 mm apart from each other in order to achieve vascular control of the renal pedicle. This data was obtained retrospectively through medical records. We reported 31 (22%) patients in our study with malignant conditions and 112 (88%) patients with benign diseases. Of these, 4 (3 %) patients required blood transfusion. There were four cases where laparoscopic nephrectomy was converted to open procedure. No incidence of slippage of titanium clips used for vascular ligation was reported in our study neither did we encounter any clip dislodgement during or after the surgery. No significant post-operative complications pertaining to clip application were seen. Cost analysis revealed that most cases required a total of 6 titanium clips costing around 8 USD (4 USD per cartridge of 6 titanium clips) in total for vascular control. Titanium clip application for securing renal vessels during laparoscopic nephrectomy is a safe and cost-effective approach.

Analysis of pattern of salivary gland cancers: Descriptive analysis from a single center

Sun, 31 Mar 2024 00:00:00 +0500

Salivary gland carcinomas are the malignant tumours arising from major or minor salivary glands, accounting for 5% of all head and neck cancers. There is scarce data available regarding pattern of presentation and clinical outcome of salivary glands in Pakistan. Thus this retrospective analysis of the patients presenting with salivary gland tumours was designed. A total of 305 patients were diagnosed with salivary gland cancers from 2008 till 2023, including 127 (41.6%) of females and 178 (58.4%) of male patients. There were 191 (62.6%) patients with parotid gland cancer and 114(37.4%) with submandibular and other minor glands. Mucoepidermoid carcinoma was the most prominent histological type followed by Adenoid Cystic carcinoma. Grade 2 (44.1%) was most frequently reported followed by Grade 1 (33.9%) and 3 (22.0%). These cancers did not show any significant association with age or gender. Salivary gland cancers are relatively rare cancer. Further studies to explore biological characteristics and long term clinical outcome are recommended.

Cancer Immunotherapy: Advances and Challenges

Binafsha Manzoor Syed — Sun, 31 Mar 2024 00:00:00 +0500

Cancer immunotherapy has emerged as a transformative approach in cancer therapeutics, offering new hope to patients by harnessing the power of the immune system to target and eliminate cancer cells. It falls under the category of targeted therapy where an immune target i.e. molecule is identified and then immunotherapy i.e. antibodies are given to target it. Recent advances have brought a number of novel therapeutic options but they are also tagged with various challenges. These challenges include but not limited to the identification of appropriate target, later resistance to the therapy and most importantly the cost of the treatment.

Successful management of Aspergillosis in post renal transplant patient: A case report

Sun, 31 Mar 2024 00:00:00 +0500

This case describes a 60-year-old man with a history of diabetes and hypertension who underwent a kidney transplant in September 2023. The patient presented with fever, cough for 5 days, empirical antibiotics were started but complaints were not resolved so fungal markers were sent, which showed elevated galactomannan levels, necessitating the initiation of voriconazole therapy. X Ray chest showed patch along with cavitatory lesion which was further confirmed by CT Scan Chest which confirmed a cavitatory lesion. This case report emphasizes the importance of considering fungal infection as a differential diagnosis in immunocompromised patients and achieving good results with appropriate treatment.

Autoimmune complexity: A case report of immune thrombocytopenia (ITP) with coexistent positive autoimmune markers and multidisciplinary challenges

Tariq Ali, Salma Rattani, Faheem Shaikh — Sun, 31 Mar 2024 00:00:00 +0500

This case study explores a complex clinical presentation of an 85-year-old male diagnosed with immune-mediated thrombocytopenia (ITP) with coexistent positive autoimmune markers. A multidisciplinary approach was crucial in managing the patient, involving hematology, rheumatology, urology, and respiratory specialists. Despite tailored treatments, including platelet transfusions, immunosuppressive therapies, and antibiotics, the patient developed complications including hospital-acquired pneumonia, pulmonary infection, and acute kidney injury. Extensive discussions with the family led to the decision to transition the patient to comfort care, emphasizing the challenges in managing complex cases and the importance of a comprehensive care plan.

Transplant glomerulopathy: A brief narrative review in the light of informed literature

Muhammad Tassaduq Khan, Rashid Bin Hamid, Naranjan Lal — Sun, 31 Mar 2024 00:00:00 +0500

Transplant glomerulopathy is characterized by a post-transplant morphologic insult. It occurs as a consequence of chronic, periodic injury of endothelial cells triggered by chronic hepatitis C virus (HCV) infection, donor-specific antibodies (DSA), cell-mediated injury or thrombotic microangiopathy. The disease might not be overt; however, it often presents with obvious symptoms, such as proteinuria (nephrotic range), hypertension, and deteriorating glomerular filtration rate (GFR). Histopathology is the mainstay diagnostic tool for transplant glomerulopathy patients and electron microscopy serves the purpose to early diagnosis. The classic histopathological feature of the disease is glomerular basement membrane thickening with reduplication on light or electron microscopy without immune complex deposits. Conventional therapeutic regimens include intravenous immunoglobulins (IVIG), plasmapheresis and splenectomy, and lately rituximab, eculizumab and bortezomib. Transplant glomerulopathy patients usually have positive history for acute rejection, resulting mostly in antibody-mediated rejection. DSAs against class II is specifically linked with transplant glomerulopathy. Unfortunately, the prognosis of kidney allografts is dismal even under existing immunosuppressive regimens.

Influence of variants mutations on the progression and outcome of COVID-19 in Pakistan

Sun, 31 Mar 2024 00:00:00 +0500

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing the coronavirus disease 2019 pandemic (COVID-19) has put millions of people at risk in an increasing number of countries, suggesting a serious threat to global public health. The first identification in late 2019, the strain has undergone several changes that have resulted in several genetically different variations that are cause for concern. By comprising the Delta, Gamma, Beta, and Alpha variations, each of which has shown evidence of increased virulence, transmissibility, or capacity for immune evasion as compared to ancestral strains. Their advancement over ancestral strains in transmission was discovered by genomic surveillance, highlighting the vital necessity for monitoring the evolution of SARS-CoV-2. Remdesivir and other treatments showed promising results in reducing the duration of the disease; however, the development of antivirals to prevent the emergence of new variations is still an important goal. The vaccine also provides hope, although its effectiveness against new genotypes needs to be evaluated. Pakistan is also facing the implications of COVID-19. The months-long closing of colleges and universities affected education as well. As SARS-CoV-2 continues to evolve, creating efficient antiviral therapies and guaranteeing vaccination accessibility continue to be critical concerns.