The present study was designed for molecular detection of Trypanosoma brucei through PCR, by using kinetoplast DNA (kDNA) maxicircle primers, on seasonal basis and to demonstrate the effect of this parasite on complete blood count and selected parameters of serum biochemistry in camels from Southern Punjab (Pakistan). A total of 291 camel blood samples (61 male, 230 females) were collected from Dera Ghazi Khan District in Pakistan during March 2012 till February 2013 for Trypanosoma brucei detection by blood smear screening, micro hemato centrifugation and Polymerase chain reaction techniques. Twenty eight out of 291 blood samples (9.62%) produced a 164 bp DNA fragment specific for T. brucei . Only 6 blood samples (2.06%) were found parasite positive by microscopic examination and 13 (4.46%) were positive for microhematocrit centrifugation technique. Seasonal PCR based prevalence of trypanosomiasis was 6.9%, 13.7%, 9.7% and 8.1% during spring, summer, autumn and winter seasons respectively. T. brucei prevalence was not restricted to a particular age group or and gender of the studied animals (P > 0.05). A significant increase in WBC (P = 0.001), neutrophils (P = 0.004), ALT (P = 0.028) and decreased RBC (P < 0.000), hemoglobin (P < 0.000) and packed cell volume (P < 0.000) were detected in parasite positive as compared to the parasite negative blood samples. In conclusion, PCR is a more reliable and sensitive technique than conventional microscopic blood screening and microhematocrit centrifugation for the detection of T. brucei in camel blood. We recommend the use of PCR for the effective prophylactic detection of T. brucei in livestock in order to reduce economic losses.

A massive goiter may constrict the trachea resulting in shortness of breath. Recurrent laryngeal nerve compression may cause vocal cord paralysis. We highlight a case of a 62- year-old female with a 30 year history of an anterior neck swelling gradually increasing in size. She presented with acute symptoms of upper airway obstruction and voice changes. Emergency thyroidectomy was performed by dividing the middle part of the gland using ultrasonic scissors. The recovery was uneventful and the patient regained normal vocal cord function post operatively.

Ganoderma lucidum is a fungus usually used in traditional Chinese medicine. The high value of G. lucidum is related to its polysaccharides content. Crude polysaccharides from G. lucidum (GLCP) were obtained using hot water extraction method. There is about 0.57 g of GLCP in 1 g crude of G. lucidum. The prebiotic potential of GLCP was tested against probiotic bacteria namely: Bifidobacterium longum BB536, Bifidobacterium pseudocatenulatum G4, Lactobacillus acidophilus and Lactobacillus casei Shirota. The prebiotic potentials were studied in 10 mL basal Trypticase Phytone Yeast (abbreviated as bTPY) medium (without glucose) supplemented with various concentrations of GLCP (abbreviated as bTPYglcp) (0.5%, 1.0%, 1.5% and 2.0%). bTPY medium supplemented with glucose (abbreviated as bTPYglu) and inulin (abbreviated bTPYinu) were used as comparison. Viable cell counts of the bacteria and the pH of the medium were determined during anaerobic incubation period of 0 h, 12 h, 24 h and 48 h at 37 °C. In the presence of carbohydrate source, cultures showed various degree of growth increment. With regards to the growth supporting property: bTPYglu, bTPYglu+glcp, bTPYglcp and bTPYinu were ranked first, second, third and fourth respectively. Interestingly, in bTPYglcp medium, bacterial growth increased with increasing GLCP concentrations when incubated until 24 h. B. longum BB536 was ranked first (10.53 log cfu/mL) in term of their growth in this medium. Growth of B.pseudocatenulatum G4 was ranked second with 10.40 log cfu/mL. This study shows that, GLCP could support the growth of the bacteria tested.

· AIM: To evaluate the optic disc parameters in the three main ethnic groups of Malaysia (Malay, Chinese and Indian). Possible relationships between optic disc parameters and gender, intraocular pressure and axial length of eye were also studied. · METHODS: The study included 244 eyes of 122 subjects (61 cases with open angle glaucoma and 61 non- glaucomatous individuals) with clear ocular media. Magnification corrected measurements of optic disc diameters and area were done using Zeiss FF450 Plus fundus camera. Differences between the three ethnic groups were tested by using ANOVA. The association between factors such as gender, intraocular pressure and axial length of the eye, and the optic disc size was tested through Pearson's bivariate correlation analysis. · RESULTS: The overall mean vertical optic disc diameter as (1.96 ± 0.20) mm, horizontal optic disc diameter was (1.84±0.20)mm and optic disc area was (2.84±0.56)mm2. Indians had larger optic disc area compared to Malay and Chinese. However, the difference was not statistically significant. · CONCLUSION: Optic disc size is larger in Malaysian population than Caucasians, Among the three ethnic groups, Indians have the largest optic disc size without any statistical difference.

AIM: To report the usefulness of a new parameter (maximum cross sectional area) in the measurements of B-scan ultrasonography to evaluate the progress of choroidal metastatic tumour size during the follow-up of patient.METHODS: Case report-the B-scan ultrasonographic measurements of height, base and maximum cross sectional area during the follow-up of the patient are presented.RESULTS: A 62-year-old Chinese lady, known case of non-small cell lung carcinoma, presented with painless blurring of vision in the right eye. She was diagnosed to have bilateral choroidal metastasis (advanced in the right eye and early in the left eye) with good vision in both eyes. The tumour size in the right eye reduced significantly after the first chemotherapy; but increased again 6 weeks after the end of last cycle of chemotherapy. She was given radiotherapy and another course of chemotherapy. The tumour size in the right eye did not respond much later on. However, the tumour size in the left eye was static through out the follow up period of 2years. The patient maintained best corrected visual acuity in both eyes (6/9 in right eye and 6/6 in left eye). The progress of tumour size in right eye was evaluated with serial B-scan ultrasonographic measurements.CONCLUSION: The ultrasonographic measurements were reproducible all through the follow up period and coincided well with clinical appearance of the tumour in right eye. We suggest the use of B-scan ultrasonography in the follow up of patients with elevated choroidal masses for quantitative assessment of progression/regression in their size during the treatment period.

Objective: This case control study was undertaken to ascertain the frequency of subclinical and overt hypothyroidism in patients with various types of primary headache disorders in Kashmir, North India. Methods: The study was conducted in a tertiary care (university of Kashmir) hospital of North India. The study subjects consisted of 250 patients with primary headache disorders. This was compared with an age-sex matched control of 500 subjects. Thyroid function tests were performed by new automated immunochemiluminometric assay. Results: Among patients with primary headache disorders, subclinical hypothyroidism was present in 22% and overt hypothyroidism in 7.2%. On the other hand, subclinical hypothyroidism was observed in 11.2% and overt hypothyroidism in 1.2% of cases in the control group, the differences between primary headache and control group was statistically significant (p<0.05). Frequency of hypothyroidism was more in chronic headache disorders (chronic tension-type headache and migraine). The frequency of hypothyroidism in patients with primary headache disorders was higher among females than males, but this was not statistically significant (p> 0.05). Conclusion: Hypothyroidism is found to be a co-morbidity or predisposes to the development of chronic headache (tension-type headache and migraine) in this North Indian study.
Headache Disorders ; Hypothyroidism ; Migraine Disorders

BACKGROUND/AIMS: The T-helper 1 (TH1) immune reaction is essential for the eradication of hepatitis C virus (HCV) during pegylated interferon alpha (PEG-IFN-alpha)- and ribavirin (RBV)-based therapy in chronic HCV patients. Secreted phosphoprotein 1 (SPP1) was shown to be a crucial cytokine for the initiation of a TH1 immune response. We aimed to investigate whether SPP1 single nucleotide polymorphisms (SNPs) may influence sustained virological response (SVR) rates. METHODS: Two SNPs in the promoter region of SPP1 at the -443 C>T and -1748 G>A loci were genotyped in 100 patients with chronic HCV genotype 4 infection using a TaqMan SNP genotyping assay. RESULTS: Sixty-seven patients achieved a SVR, and 33 patients showed no SVR. Patients carrying the T/T genotype at the -443 locus showed a significantly higher SVR rate than those carrying the C/T or C/C genotype (83.67% vs 50.98%, p<0.001). At the -1748 locus, the SVR rate was significantly higher in patients with the G/G genotype than in those with the A/A genotype (88.89% vs 52.63%, p=0.028) and in patients with the G/A genotype than in those with the A/A genotype (85.29% vs 52.63%, p=0.001). CONCLUSIONS: SPP1 SNPs at -443 C>T and -1748 G>A loci may be useful markers for predicting the response to PEG-IFN-alpha-2b plus RBV therapy in Egyptian patients with chronic HCV genotype 4 infection.
Adult ; Antiviral Agents/*therapeutic use ; Biomarkers/blood ; Drug Therapy, Combination ; Egypt ; Female ; Genotype ; Hepacivirus/drug effects/genetics ; Hepatitis C, Chronic/*drug therapy/virology ; Humans ; Interferon-alpha/*therapeutic use ; Male ; Middle Aged ; Osteopontin/*genetics ; Polyethylene Glycols/*therapeutic use ; Polymorphism, Single Nucleotide/genetics ; Predictive Value of Tests ; *Promoter Regions, Genetic ; Recombinant Proteins/therapeutic use ; Ribavirin/*therapeutic use ; Treatment Outcome

Methods: We assessed 23 patients with a mean age of 57.3±15 years. According to the Japanese Orthopedic Association (JOA) scale; eight patients had grade 0, nine had grade I, and six had grade II. All patients underwent plain radiography and magnetic resonance imaging of the cervical spine. The foramen magnum was involved in 10 patients, C1–2 in seven, C2–3 in four, and C3–4 in two. All patients were operated via the far-lateral approach. Results: Gross total resection was achieved in 21 patients. Sixteen lesions were psammomatous, five were fibroblastic, and two were meningothelial meningiomas. The mean operative duration was 135±40 minutes, while the mean operative blood loss was 450±210 mL, and the mean hospital stay was 4.3±2.2 days. At the final follow-up that was conducted at 27.6±21 months and as per the JOA score; 16 patients were classified into grade 0 and 7 into grade II. The condition of none of our patients deteriorated postoperatively. There was no significant correlation of the clinical outcome with tumor level, pathological subtype of the tumor, symptom duration, age, and sex. There was no significant correlation of tumor resection completeness with tumor level, tumor pathological subtype, or tumor topography (ventral or ventrolateral). Conclusions The far-lateral approach is a safe and effective access for ventral and ventrolateral cervical meningiomas. It allows direct access to tumor with no spinal cord or nerve roots traction, and thus may yield a fairly better outcome than the standard posterior approach.

Excretion of urinary N-acetyl beta-D-glucosaminidase (NAG) and its isoenzyme patterns were studied in two groups of patients with rheumatoid arthritis (RA) and in normal control subjects. Urine samples were collected from 30 seropositive RA patients, 19 seronegative RA patients, and 15 normal healthy subjects. All the patients and normal subjects were assessed to have normal liver and kidney functions. A small portion of the urine sample was dialyzed against 0.01 M phosphate buffer, pH 7.0 and NAG activity was monitored. Mean +/- SD values of urinary NAG in seropositive RA patients, in seronegative RA patients and in normal healthy subjects were found to be 4.20 +/- 3.73 U/g creatinine, 2.96 +/- 2.11 U/gm creatinine, and 1.71 +/- 0.6 U/g creatinine, respectively. The mean urinary, NAG value in RA patients was found to be significantly higher (P < 0.05) in seropositive RA compared to the mean NAG value in normal healthy subjects and patients with seronegative RA when analyzed by one way ANOVA and Tukey-HSD test. The mean proportion of isoenzyme form B to isoenzyme form A in seropositive RA patients was also found to be significantly different (P < 0.05) from the mean proportion of these forms in normal healthy subjects and seronegative RA patients. There also appears to be a correlation between the concentration of urinary NAG and severity of the disease in seropositive RA.
Acetylglucosaminidase/urine* ; Adult ; Arthritis, Rheumatoid/urine* ; Arthritis, Rheumatoid/immunology ; Arthritis, Rheumatoid/enzymology* ; Chromatography, Liquid/methods ; Comparative Study ; Female ; Human ; Isoenzymes ; Male ; Predictive Value of Tests ; Severity of Illness Index

Type III radical hysterectomy reported in 1974 by Piver, Rutledge, and Smith is considered worldwide by many as the standard surgical therapy for invasive cervical carcinoma stage IB and IIA. With the increasing number of robotic surgeries being performed for early stage cervical cancer worldwide, the purpose of the paper is to present our personal perspective of the 21st century role of Piver-Rutledge type III radical hysterectomy for stage IB cervical cancer in the era of robotic surgery using the da Vinci robot.
Humans ; Hysterectomy ; Uterine Cervical Neoplasms