An Unusual Presentation of a Patient with Leg Ulcers: A Case Report.

Leg ulcers have been a common presentation in clinics; disruptions in the mechanism of ulcer healing are vascular insufficiency, anemia, metabolic disturbances, neuropathy, and autoimmunity. The term 'non-transfusion-dependent thalassemia' encompasses the milder forms of thalassemia traits that require intermittent or no transfusion at all, and are mostly associated with leg ulcers. We present the case of a 19-year-old female with beta-thalassemia major who presented with non-healing leg ulcers and anemia.

Efficacy and tolerability of sofosbuvir and daclatasvir for treatment of hepatitis C genotype 1 & 3 in patients undergoing hemodialysis- a prospective interventional clinical trial.

Background: There is paucity of data using direct anti-viral agents (DAA) in patients on maintenance hemodialysis (MHD) infected with HCV-genotype 1 & 3. Aim of the study was to evaluate DAA therapy in patients infected with HCV-genotype 1 & 3 on MHD.

Methods: A prospective open label, parallel, non-randomized interventional trial was conducted in patients with Hepatitis-C on maintenance hemodialysis.

Failure rates of miniscrews inserted in the maxillary tuberosity.

Introduction: Anchorage conservation in orthodontics has always been a challenge.

Objective: The aim of this current study was to find out the failure rate of miniscrews inserted in the maxillary tuberosity (MT) region.

Methods: This pilot study consisted of 40 patients (23 female, 17 male; mean age = 20.

Impacts of intake of bakery food chemicals, degraded water and psychiatric drugs on liver & renal functions of brain tumor patients.

A chemically preserved food has raised mental health issues. Abnormalities in liver and kidney functions have been reported from mentally imbalanced individuals. This study was focused on finding anxiety issues and biochemistry alterations in brain tumor patients and in controls.

Barriers to Women Entering Surgical Careers: A Global Study into Medical Student Perceptions.

Background: Barriers to female surgeons entering the field are well documented in Australia, the USA and the UK, but how generalizable these problems are to other regions remains unknown.

Methods: A cross-sectional survey was developed by the International Federation of Medical Students' Associations (IFMSA)'s Global Surgery Working Group assessing medical students' desire to pursue a surgical career at different stages of their medical degree. The questionnaire also included questions on students' perceptions of their education, resources and professional life.

Formulation, characterization and in vitro evaluation of antifungal activity of Nystatin micro emulsion for topical application.

The current research aims at development and assessment of o/w nystatin microemulsion. The pseudoternary phase diagrams were developed to determine microemulsion existence regions by water titration method. Nystatin was liquefied in the blend of oil phase, surfactant and cosurfactant.

Frequency of Depression in Patients with Type 2 Diabetes Mellitus and its Relationship with Glycemic Control and Diabetic Microvascular Complications.

Introduction Various clinical studies have reported that clinical depression is a common co-morbidity in patients with type 2 diabetes mellitus. Depression can badly affect the lifestyle of diabetic patients and impair the proper management of diabetes mellitus. Therefore, there exists a need to identify risk factors of depression in diabetic patients especially in relation to various clinical parameters, glycemic control and diabetic microvascular complications.

Factors affecting the outcome of hospitalization among liver cirrhosis patients.

Objectives: To determine the factors affecting the outcome of hospitalization in patients suffering liver cirrhosis hospitalized to tertiary care hospital, Gujranwala, Pakistan.

Methods: After informed consent, the data of liver cirrhosis patients with age >12 years hospitalized from June 2016 to May 2017 was collected by purposive sampling. The outcome of the hospitalization in term of 'death' and 'no death' was noted.

Treatment of cardiac nocardiosis in a post-renal transplant patient of systemic nocardiosis.

In general, nocardia infects immunosuppressed patients, however, sometimes it can also infect immunocompetent individuals. Nocardia infection can disseminate to any organ system of the body but the pulmonary system is the most commonly involved system. In some rare cases, the heart can also be involved and the resulting cardiac mycetoma can be treated successfully with antimicrobials without the need of surgery, unlike fungal cardiac mycetomas wherein surgery may be required in addition to antimicrobial therapy.

Efficacy of a Novel Food Supplement (Ferfer®) Containing Microencapsulated Iron in Liposomal Form in Female Iron Deficiency Anemia.

Introduction Iron deficiency anemia (IDA) is a highly afflicting condition which affects young children of growing age and reproductive age women in countries of lower economies. Conventional oral iron salts have poor absorption and gastrointestinal side effects. Microencapsulated liposomal iron pyrophosphate is a novel compound with enhanced palatability, higher bioavailability, and consequently increased adherence among people with IDA.

Gallbladder Perforation Secondary to Enteric Fever: An Interesting Case of Acute Abdomen.

Enteric fever is a common infectious disease, especially in countries with poor sanitation and in the tropics. It is caused mainly by Salmonella typhi and accounts for nearly 27 million cases worldwide and 200,000 deaths annually. Enteric fever involves the reticuloendothelial system such as bone marrow, spleen, and liver.

Diagnostic Accuracy of Doppler Ultrasonography in Predicting Presence of Esophageal Varices in Patients with Hepatitis-C Induced Cirrhosis.

Objective: To determine the diagnostic accuracy of Doppler ultrasonography in predicting presence of esophageal varices in patients with hepatitis-C induced cirrhosis.

Study Design: Descriptive analytical study.

Place And Duration Of Study: Department of Radiology, Jinnah Hospital, Lahore, from May 2016 to October 2016.

Altered expression of vascular endothelial growth factor, vascular endothelial growth factor receptor-1, vascular endothelial growth factor receptor-2, and Soluble Fms-like Tyrosine Kinase-1 in peripheral blood mononuclear cells from normal and preeclamptic pregnancies.

Preeclampsia (PE) is the leading cause of maternal and fetal morbidity and mortality. It complicates around 2%-10% pregnancies worldwide due to imbalance between proangiogenic and anti-angiogenic factors, leading to incomplete placentation, ischemia, and endothelial dysfunction. The study was aimed to analyze the mRNA expression of vascular endothelial growth factor (VEGF) and its receptors, i.

Distribution of , , and genes in Extended-spectrum--lactamase-producing Clinical isolates: A three-year multi-center study from Lahore, Pakistan.

Background: Frequency of extended-spectrum--lactamase-producing clinical isolates is increasing worldwide. This is a multi-center study which was aimed to check the frequency of third-generation cephalosporin resistance and distribution of the key genetic determinants of Extended-spectrum-β-lactamase-producing Clinical isolates in Pakistan.

Methods: A total of 2372 samples were processed in three tertiary care hospitals and one diagnostic research center of Lahore, Pakistan during Aug-2014 to Sep-2017.

Factors Increasing the Risk of Recurrence in Fistula-in-ano.

Anal fistula, or fistula-in-ano, is a condition involving the anal region that is common yet debilitating. Surgery is the mainstay of treatment for an anal fistula and the chances of recurrence are quite high even after corrective surgical procedures. The risk factors for recurrence can be broadly classified into four categories: 1) risk factors related to the fundamental anatomy of the fistula and presence of comorbidities, 2) lack of proper preoperative assessment of the fistula, which includes failure to recognize the internal opening and overall structure of the fistula and not supplementing the proctologic examination with sufficient imaging, 3) intraoperative loopholes that include improper procedure selection, inexperience of the surgeon, and failure to get rid of the entire tract along with its ramifications, and 4) lack of proper postoperative care in the early and late periods following the surgery.

Ophthalmic Manifestations of Acute Leukemia.

Introduction Ocular involvement in leukemia may occur because of direct leukemic infiltration or because of secondary ophthalmic involvement as a result of abnormalities related to blood like anemia, thrombocytopenia, and leukocytosis. In some patients with leukemia, ophthalmic signs can precede the systemic features and can help in early diagnosis of systemic leukemia. Due to the scarcity of data on this topic from Pakistan, we conducted this study to determine the pattern of ocular involvement in patients with leukemia presenting in our settings.

Variability in the therapeutic response of Metformin treatment in patients with type 2 diabetes mellitus.

Objective: To assess the glycemic response of metformin in patients with Type-2 Diabetes Mellitus (T2DM) as well as to see its association with reductions in BMI and GIT intolerance.

Methods: This Quasi, Experimental study was conducted at Jinnah-Allama Iqbal Institute of Diabetes and Endocrinology (JAIDE) Jinnah Hospital, Lahore from 1 March 2016 to 30 September 2016. Newly diagnosed T2DM patients were given metformin for duration of three months and later on they were categorized into Responders and Non-Responders on the basis of HbA1c (A1C) reductions, which were estimated by Hemoglobin (A1C) analyzer (TD4611A TAIDoc Tech.

Modified Nutrition Risk in Critically Ill (mNUTRIC) Score to Assess Nutritional Risk in Mechanically Ventilated Patients: A Prospective Observational Study from the Pakistani Population.

Purpose Typical nutritional assessment criteria and screening tools are ineffective in mechanically ventilated patients who are often unable to report their food intake history. The Nutrition Risk in Critically Ill (NUTRIC) score is effective for screening mechanically ventilated patients. This prospective observational study was conducted to identify nutritional risk in mechanically ventilated patients using a modified NUTRIC (mNUTRIC) score (without using interleukin-6 values).

Differential Expression of Placental Growth Factor, Transforming Growth Factor-β and Soluble Endoglin in Peripheral Mononuclear Cells in Preeclampsia.

Objective: To measure the peripheral blood mononuclear cells (PBMCs) mRNA expression of placental growth factor (PlGF), Transforming growth factor beta (TGF-β), and soluble Endoglin (sEng) in the blood of preeclamptic and normotensive pregnant women.

Study Design: Cross-sectional analytical study.

Place And Duration Of Study: Department of Physiology and Cell Biology, University of Health Sciences, Lahore, from November 2016 to April 2018.

Giant Right Coronary Artery Aneurysm: A Case Report.

Coronary artery aneurysms are not very uncommon but 'giant' coronary artery aneurysms are rare, with a reported prevalence of 0.02% to 0.2%.

Acute Dystonia Secondary to Domperidone in a Pediatric Patient.

Domperidone is a dopamine-2 receptor (D2) antagonist. It is used as an antiemetic and has an excellent safety profile. We present a case of acute dystonia secondary to domperidone use in an 11-year-old girl.

Solitary Fibrous Tumor of Pleura Invading into the Left Atrium via Pulmonary Vein.

A 67-year-old woman came to the hospital because of difficulty in breathing. After an initial clinical assessment, contrast-enhanced computerized tomography (CT) of the chest revealed a well-circumscribed heterogeneous mass arising from the pleura adjacent to the superior and medial left pulmonary artery. The mass was invading the pulmonary vein and entering the left atrium.

Migratory Gossypiboma: An Unusual Presentation Of A Rare Surgical Complication.

Gossypiboma is a rare surgical complication associated with significant patient morbidity and even mortality. Migratory gossypiboma is a rarer subset of these cases, representing the erosion of surgical sponge into the intestine with consequent complications. A 40 years old female presented with a surgical sponge that had eroded into the caecum and subsequently moved with peristalsis up to the anal canal from which it was protruding out at the time of presentation.

Role Of 0.2% Bio-Adhesive Chlorhexidine Gel In Reducing Incidence Of Alveolar Osteitis.

Background: Alveolar osteitis is a frequent postoperative complication of third molar surgery. A number of preventive methods have been tried. Chlorhexidine is most widely used antiseptic which is thought to be helpful to prevent alveolar osteitis.