Enhancing Documentation Precision in Ophthalmic Surgery: A Quality Improvement Project.

Background Effective clinical documentation, particularly operative notes, is essential for maintaining healthcare standards and fostering interdisciplinary communication. This study focuses on improving the quality of ophthalmic operative notes by adopting the Royal College of Surgeons (RCS) guidelines for good surgical practice. Methodology A retrospective cross-sectional audit at Khyber Teaching Hospital, Pakistan, assessed 138 operative notes against the RCS criteria.

Neurotrophic Keratopathy and Topical Insulin Therapy: A Case Report.

Neurotrophic keratopathy is a rare disorder caused by the loss of corneal sensation. It is characterized by persistent epithelial defects, corneal ulceration, and, ultimately, corneal perforation if not managed in a timely manner. The management includes aggressive lubrication, prophylactic topical antibiotics, therapeutic contact lenses, tarsorrhaphy, and amniotic membrane transplantation.

FK506-Binding Protein 2 Participates in Proinsulin Folding.

Apart from chaperoning, disulfide bond formation, and downstream processing, the molecular sequence of proinsulin folding is not completely understood. Proinsulin requires proline isomerization for correct folding. Since FK506-binding protein 2 (FKBP2) is an ER-resident proline isomerase, we hypothesized that FKBP2 contributes to proinsulin folding.

Defective Proinsulin Handling Modulates the MHC I Bound Peptidome and Activates the Inflammasome in β-Cells.

How immune tolerance is lost to pancreatic β-cell peptides triggering autoimmune type 1 diabetes is enigmatic. We have shown that loss of the proinsulin chaperone glucose-regulated protein (GRP) 94 from the endoplasmic reticulum (ER) leads to mishandling of proinsulin, ER stress, and activation of the immunoproteasome. We hypothesize that inadequate ER proinsulin folding capacity relative to biosynthetic need may lead to an altered β-cell major histocompatibility complex (MHC) class-I bound peptidome and inflammasome activation, sensitizing β-cells to immune attack.

Epidemiology of Drowning Incidents among Children at Sultan Qaboos University Hospital Oman.

Objectives: We sought to study the epidemiology of drowning among children reported at Sultan Qaboos University Hospital in Oman.

Methods: We conducted a retrospective study of the patients who presented to the emergency department with a history of drowning over 10 years from January 2008 to December 2017. Patients with children aged one to 18 years old were included in the study.

Emergency Department Changes to Combat COVID-19 in Oman.

Our hospital is one of the tertiary care hospitals in Oman receiving coronavirus disease (COVID-19; C19) patients. To meet the expected surge of patients, a number of changes was made to the emergency department (ED), especially regarding capacity building and patient flow. At first, few changes were made to the main ED, which mainly includes the addition of a COVID suspect room with the use of a separate resuscitation area.

Clinical Presentations and Outcomes of Industrial Chlorine Gas Exposure Incidence in Oman.

Objective: The main objective was to study different clinical presentations and outcomes of patients after acute industrial chlorine gas exposure in Oman with evaluation of overall incident management to help develop a chemical exposure incident protocol.

Methods: This was a retrospective observational study of 15 patients exposed to chlorine gas after an accidental chlorine gas leak in a metal melting factory in Oman.

Results: Six (40%) patients were admitted and nine (60%) patients were discharged from the emergency department (ED) after initial management.

The inducible β5i proteasome subunit contributes to proinsulin degradation in GRP94-deficient β-cells and is overexpressed in type 2 diabetes pancreatic islets.

Proinsulin is a misfolding-prone protein, and its efficient breakdown is critical when β-cells are confronted with high-insulin biosynthetic demands, to prevent endoplasmic reticulum stress, a key trigger of secretory dysfunction and, if uncompensated, apoptosis. Proinsulin degradation is thought to be performed by the constitutively expressed standard proteasome, while the roles of other proteasomes are unknown. We recently demonstrated that deficiency of the proinsulin chaperone glucose-regulated protein 94 (GRP94) causes impaired proinsulin handling and defective insulin secretion associated with a compensated endoplasmic reticulum stress response.

The intermediate proteasome is constitutively expressed in pancreatic beta cells and upregulated by stimulatory, low concentrations of interleukin 1 β.

A central and still open question regarding the pathogenesis of autoimmune diseases, such as type 1 diabetes, concerns the processes that underlie the generation of MHC-presented autoantigenic epitopes that become targets of autoimmune attack. Proteasomal degradation is a key step in processing of proteins for MHC class I presentation. Different types of proteasomes can be expressed in cells dictating the repertoire of peptides presented by the MHC class I complex.

Endoplasmic Reticulum Chaperone Glucose-Regulated Protein 94 Is Essential for Proinsulin Handling.

Although endoplasmic reticulum (ER) chaperone binding to mutant proinsulin has been reported, the role of protein chaperones in the handling of wild-type proinsulin is underinvestigated. Here, we have explored the importance of glucose-regulated protein 94 (GRP94), a prominent ER chaperone known to fold insulin-like growth factors, in proinsulin handling within β-cells. We found that GRP94 coimmunoprecipitated with proinsulin and that inhibition of GRP94 function and/or expression reduced glucose-dependent insulin secretion, shortened proinsulin half-life, and lowered intracellular proinsulin and insulin levels.

Inhalation of Ketamine in Different Doses to Decrease the Severity of Postoperative Sore Throat in Surgeries under General Anesthesia Patients.

Context: Postoperative sore throat (POST) occurs in 21%-65% of patients. Nebulization of ketamine reduces POST.

Aims: The aim of this study is to see the effectiveness of nebulized ketamine in different doses to reduce POST and observe adverse effects, if any.

Differential effects of experimental hyperthyroidism on declined immunity of broiler chicken.

Thyroid hormones (THs) are involved in the development of lymphoid organs and regulation of immune function in birds. However, their role as an immune-modulator in the hyperthyroid state is still debatable. To explore the interrelationship of thyroxine (T ) and the immune system, chicks were divided into three groups.

Effects of dietary chromium supplementation on muscle and bone mineral interaction in broiler chicken.

The study was conducted to ascertain the effects of dietary chromium chloride (CrCl·6HO) supplementation on mineral interaction in blood serum, leg muscles and bones of broilers at 35 day of age. For this purpose, ninety male broiler chicks were divided into three groups. One served as control (group I) while, the other two groups were supplemented with CrCl (group II-12.

Seat Belt Compression Appendicitis following Motor Vehicle Collision.

Appendicitis and trauma both present in emergency department commonly but their presentation together in the same patient is unusual. We present a case of a middle-aged man brought by emergency medical services (EMS) to the emergency department with complaints of abdominal pain after he was involved in motor vehicle collision. He was perfectly fine before the accident.

Radiation-Induced Cardiovascular Disease.

Purpose Of Review: Thoracic radiation therapy is an effective treatment for several malignancies, such as Hodgkin's lymphoma and breast cancer. Over the years, however, the incidence of cardiovascular events has increased in these patients, notably in younger survivors who do not have traditional risk factors. This review summarizes the pathology, incidence, clinical presentation, and management of cardiac events after radiation therapy.

Spontaneous Arachnoid Cyst Rupture with Subdural Hygroma in a Child.

Arachnoid cyst of the brain is common in children but its association with spontaneous subdural hygroma is rare. A case of a nine-year-old boy, without any preceding history of trauma, is presented here who came to the emergency department of a tertiary care hospital with complaints of headache, nausea, and vomiting for the last two weeks but more for the last two days. Examination showed a young, fully conscious oriented boy with positive Cushing's reflex and papilledema of left eye.

Primary Peritonitis-A Forgotten Entity.

Primary peritonitis is a rare phenomenon in modern antibiotic era. A case of pediatric primary peritonitis is presented here, in which a child presented with complaints of abdominal pain, vomiting for one day. Abdominal examination showed marked tenderness and guarding, diagnosis of appendicitis was made and laparoscopic appendectomy done.

Ontogenic development of corticotrophs in fetal buffalo (Bubalus bubalis) pituitary gland.

To evaluate the subpopulation of corticotrophs in developing buffalo (Bubalus bubalis) fetus, recovered pituitary glands (n=6 per group) from late first, second and third gestational female buffalo dams. The corticotrophs were identified by using specific antibodies against proopiomelanocortin (POMC) and adrenocorticotrophic hormone (ACTH) through immunohistochemistry. There was a significant (P≤0.

Supratentorial extraventricular anaplastic ependymoma in a child.

A young child presented to the emergency department of a tertiary care hospital with on and off headache, focal seizures involving the left side of the body, weakness of left upper and lower limbs and vomiting for 2 weeks. Examination showed an alert child with grade 4/5 powers in left upper and lower limbs. Blood investigations were normal.

Genotoxicity evaluation of chlorpyrifos: a gender related approach in regular toxicity testing.

The oral intubation of chlorpyrifos, an extensively used organophosphate insecticide, was tested for its capability to induce in vivo genotoxic upshot in blood lymphocytes of 24 male and female Wistar rats using biomarker of genotoxicity. Rats were orally administered with daily doses 3 and 12 mg/kg body weight (BW) of chlorpyrifos (CPF). The blood lymphocytes were harvested after 7 and 14 days of treatment and subjected to bi-nucleus (BN), multi-nucleus (MN) and single cell gel electrophoresis (comet assay) to evaluate the extent of DNA damage.

Morphological and quantitative features of mitral cells in the rat olfactory bulb after administration of propranolol.

Objective: To determine the cytoplasmic morphological changes in the mitral cells and quantitative changes (number of mitral cells and thickness of mitral cell layer in microns) in the rat olfactory bulb after administration of propranolol.

Study Design: Experimental study.

Place And Duration Of Study: The Department of Anatomy, University of Health Sciences, Lahore, from January 2006 to January 2007.

Purification and partial characterisation of a bovine kidney aminotripeptidase (capable of cleaving prolyl-glycylglycine).

An enzyme was purified 163-fold in an 8.2% yield from bovine kidney. The specific activities of the pure preparation against L-prolyl glycylglycine and L-alanyl glycylglycine were found to be 244.

The purification of a bovine kidney enzyme which cleaves melanocyte-stimulating hormone-release inhibiting factor.

An enzyme which catalyzes the hydrolysis of L-prolyl-L-leucylglycinamide, the factor which inhibits the release of melanocyte-stimulating hormone, was purified 189-fold from bovine kidney in a 5% yield. The molecular weight of the enzyme on gel filtration was estimated to be 300 000 and its isoelectric point was found to be pH 4.1.