Mid-term clinical outcomes and cardiac function in patients receiving cardiac contractility modulation.

Objectives: To describe the mid-term clinical and functional cardiac contractility modulation therapy (CCM) recipients in an urban population with heart failure.

Background: CCM is a non-excitatory electrical therapy for patients with systolic heart failure with NYHA class III symptoms and ejection fraction (EF) 25-45%. How CCM affects a broad range of clinical measures, including diastolic dysfunction (DD) and weight change, is unexplored.

An Unusual Presentation of Infective Endocarditis.

Introduction: Leukocytoclastic vasculitis is the inflammation of small blood vessels due to leukocyte migration that comprises a wide range of differentials. It can be caused by autoimmune disorders, infections, neoplasms, or certain medications and warrants prompt recognition and therapy for optimal patient outcomes.

Case Presentation: Here we present a case of a 37-year-old male who presented with a painful, petechial rash on his torso and extremities.

Posterolateral plating is a safe alternative for the treatment of distal tibial fractures.

Introduction: We assessed the outcome and safety of posterior plating of distal tibial fractures.

Methods: We conducted a retrospective case series at a Level I trauma center. Seventy-four consecutive patients with distal tibial fractures treated with anatomically contoured 3.

Vomiting in Neuromyelitis Optica: An Atypical Presentation.

Neuromyelitis Optica (NMO), also known as Devic's disease, is a demyelinating disorder of the central nervous system (CNS) that majorly involves the optic nerves and the spinal cord. It is an idiopathic and an autoimmune disorder. The patient typically presents with symptoms pertaining to the eye or spinal cord, such as a decrease in visual acuity, visual field defects, pain in the eyes, loss of vision, numbness, and weakness of the limbs with or without bladder dysfunction.

FREQUENCY OF AUTONOMIC NEUROPATHY IN PATIENTS WITH ERECTILE DYSFUNCTION IN DIABETES MELLITUS.

Background: Among diabetic patients autonomic neuropathy (AN) is one of the most frequent complications. This affects peripheral nervous system and thus results into erectile dysfunction (ED). The main objectives of the study were to determine the frequency of autonomic neuropathy (AN) in diabetic patients with ED and to find out the associated risk factors.

HBA1C AS AN INDIRECT MARKER OF HYPERTRIGLYCERIDEMIA IN TYPE-2 DIABETES MELLITUS.

Background: Diabetes is usually accompanied by dyslipidaemia, and among these triglyceride levels are related to the insulin resistance in type 2 diabetes. HbAlc which is an indicator of diabetes control can depict the severity of hypertriglyceridemia. The objective of this study was to determine the correlation between HbAlc and Triglyceride levels in type 2 Diabetes mellitus.

Greenhouse gas emissions from production chain of a cigarette manufacturing industry in Pakistan.

This study quantified greenhouse gas (GHG) emissions from the Pakistan Tobacco Company (PTC) production using a life cycle approach. The PTC production chain comprises of two phases: agricultural activities (Phase I) and industrial activities (Phase II). Data related to agricultural and industrial activities of PTC production chain were collected through questionnaire survey from tobacco growers and records from PTC manufacturing units.

Coverage, timeliness, and determinants of immunization completion in Pakistan: evidence from the Demographic and Health Survey (2006-07).

Background:  Immunization coverage data and determinants for completion are not well described for Pakistan. This study determines immunization coverage rates and timeliness based on the 2006-07 Pakistan Demographic and Health Survey (DHS) and identifies determinants for completion of immunizations.

Methods:  DHS data from 9177 randomly selected households from across Pakistan were analyzed to assess immunization coverage and timeliness for children aged 0-5 years, and to investigate determinants of immunization completion through logistic regressions.

Geographic variation in access to dog-bite care in Pakistan and risk of dog-bite exposure in Karachi: prospective surveillance using a low-cost mobile phone system.

Background: Dog-bites and rabies are under-reported in developing countries such as Pakistan and there is a poor understanding of the disease burden. We prospectively collected data utilizing mobile phones for dog-bite and rabies surveillance across nine emergency rooms (ER) in Pakistan, recording patient health-seeking behaviors, access to care and analyzed spatial distribution of cases from Karachi.

Methodology And Principal Findings: A total of 6212 dog-bite cases were identified over two years starting in February 2009 with largest number reported from Karachi (59.

HPLC and HPTLC methods by design for quantitative characterization and in vitro anti-oxidant activity of polyherbal formulation containing Rheum emodi.

Safoof-e-Pathar phori (SPP) is a traditional polyherbal formulation and has been used since long time for its anti-urolithiatic activity. It contains three plant constituents Didymocarpous pedicellata, Dolichous biflorus and Rheum emodi. Emodin and chrysophanic acid were selected as chemical markers for SPP and quantified using simultaneous HPTLC and RP-HPLC methods in R.

MRI evaluation of the contralateral breast in patients with recently diagnosed breast cancer.

Introduction: Contralateral breast cancer can be synchronous and/or metachronous in patients with cancer of one breast. Detection of a synchronous breast cancer may affect patient management. Dynamic contrast-enhanced MRI of the breast (DCE-MRI) is a sensitive technique for detecting contralateral lesions occult on the other imaging modalities in women already diagnosed with cancer of one breast.

Perceptions of anti-smoking messages amongst high school students in Pakistan.

Background: Surveys have provided evidence that tobacco use is widely prevalent amongst the youth in Pakistan. Several reviews have evaluated the effectiveness of various tobacco control programs, however, few have taken into account the perceptions of students themselves regarding these measures. The aim of this study was to determine the most effective anti-smoking messages that can be delivered to high-school students in Pakistan, based on their self-rated perceptions.

Stability-indicating ultra-performance liquid chromatography method for the estimation of thymoquinone and its application in biopharmaceutical studies.

Thymoquinone (THQ) is known for its neuroprotective and anti-convulsant properties in preclinical studies. We herewith describe a simple, rapid, selective, sensitive and stability-indicating UPLC method for the estimation of THQ and its application to biopharmaceutical studies such as in vitro release from nanoparticulate system and in vivo pharmacokinetic study. The method employed gradient elution using a Waters Acquity HSS-T3 C(18) (100 × 2.

Factor VII deficiency and pregnancy: a case report and review of literature.

Factor VII deficiency is one of the 'rare inherited disorders of coagulation.' Few cases of Factor VII deficiency have been reported during pregnancy, a state which could potentially cause fatal haemorrhage. Here we report a case of a pregnant lady with a history of heavy menorrhagia and multiple first pregnancy failures.

Quantitative analysis of safranal in saffron extract and nanoparticle formulation by a validated high-performance thin-layer chromatographic method.

Introduction: Safranal is an effective anticonvulsant shown to act as an agonist at GABA(A) receptors. Nose to brain delivery via nanoparticle formulation might improve its brain delivery. A selective and sensitive analytical method is required for evaluation of safranal-based novel drug delivery systems.

CNS drug delivery systems: novel approaches.

The brain is a delicate organ, and nature has very efficiently protected it. The brain is shielded against potentially toxic substances by the presence of two barrier systems: the blood brain barrier (BBB) and the blood cerebrospinal fluid barrier (BCSFB). Unfortunately, the same mechanisms that protect it against intrusive chemicals can also frustrate therapeutic interventions.

Oxidative stress-induced inhibition of adrenal steroidogenesis requires participation of p38 mitogen-activated protein kinase signaling pathway.

Previous studies from this laboratory identified excessive oxidative stress as an important mediator of age-related decline in steroid hormone production. Here, we investigated whether oxidative stress exerts its antisteroidogenic action through modulation of oxidant-sensitive mitogen-activated protein kinase (MAPK) signaling pathways. To accomplish these studies, we employed a highly responsive mouse adrenocortical cell line, Y1-BS1 cells that secrete large quantities of steroids when stimulated with lipoprotein plus hormone.

Congenitally corrected transposition of great arteries with ischemic symptoms in middle age.

Congenitally corrected transposition of the great arteries CCTGA is a rare congenital disease first described by Von Rokitansky in 1875. Transposition of the great arteries comprises 2.6 - 7.