Epiphora, or pathological overflow of tear due to obstruction in the nasolacrimal drainage system, is a common problem encountered in ophthalmology. The ophthalmologist relies mainly on symptoms to guide further diagnosis and therapy. However, there appears to be a discrepancy between the degree of discomfort experienced by the patient and the severity of pathological finding. The purpose of this study was to determine the clinical utility of dacryoscintigraphy in the assessment of nasolacrimal duct (NLD) obstruction. We retrospectively reviewed the records of 27 patients who underwent dacryoscintigraphy between July-January 2007. Thirty-six eyes in these patients had epiphora. Three eyes (8%) showed partial obstruction. On the other hand, 33/36 eyes (92%) had complete obstruction in different areas of the NLD system. Patients with complete obstruction were treated by dacryocystorhinostomy and silicon tube insertion. Patients with partial nasolacrimal duct obstruction were treated medically. Dacryoscintigraphy is a simple, non-invasive, safe and non-traumatic procedure in assessing NLD obstruction. It demonstrates anatomical pathway of tear by physiological drainage. This can aid the surgeon in localizing the site of obstruction and guide him in choosing the appropriate treatment.

Human ; Male ; Female ; Sense Organs ; Eye ; Lacrimal Apparatus Diseases ; Eye Diseases ; Dacryocystorhinostomy ; Lacrimal Duct Obstruction ; Nasolacrimal Duct ; Ophthalmologists ; Ophthalmology ; Retrospective Studies ; Silicon ; Surgeons ; Tears

Pre-operative localization of abnormal parathyroid tissue helps in deciding whether surgery begins with a neck or mediastinal exploration. In this study we aimed to evaluate the usefulness of parathyroid scintigraphy in pre-operative localization of parathyroid adenomas and treatment. From February 2006 to October 2008, patients with signs and symptoms of hyperparathyroidism were recruited to join the study. The study group consisted of 3 males and 8 females. All subjects had a pre-operative parathyroid scintigraphy with Tc99m Sestamibi followed by parathyroidectomy. Ten patients had a positive scintigraphic finding which correlated to the actual location of the adenoma determined during the operation. Almost all patients (10 out of 11) underwent minimally invasive parathyroidectomy (MIP) while only one patient underwent bilateral neck dissection. The average incision length was 3.73 + 0.65 cm. Only one patient had an adverse event (transient hypocalcemia and bleeding necessitating a drain) which resolved later. The average hospital stay was 2.5 + 0.7 days. Parathyroid Tc99m-sestamibi scan is a reliable, non-invasive, and cost effective imaging modality in pre-operative localization of parathyroid adenomas for first time parathyroidectomy. This can help and guide surgeons to perform focused parathyroid surgery with minimal incision, successful localization, less complications, and shorter hospital stays.

Human ; Male ; Female ; Adenoma ; Hyperparathyroidism ; Hypocalcemia ; Length Of Stay ; Neck Dissection ; Parathyroid Glands ; Parathyroid Neoplasms ; Parathyroidectomy ; Surgeons ; Technetium Tc 99m Sestamibi ; Endocrine Gland Neoplasms

Malaria is a life-threatening disease caused by the Plasmodium sp. parasite. Infection results in heightened pro-inflammatory response which contributes to the pathophysiology of the disease. To mitigate the overwhelming cytokine response, host-directed therapy is a plausible approach. Glycogen synthase kinase-3β (GSK3β), a serine/threonine kinase plays a pivotal role in the regulation of inflammatory response during pathogenic infections. The present study was conducted to investigate the chemo-suppressive and cytokine-modulating effects of insulin administration in malaria-infected mice and the involvement of GSK3β. Intraperitoneal administrations of 0.3 and 0.5 U/kg body weight insulin each for four consecutive days into Plasmodium berghei NK65 (PbN)-infected mice resulted in chemo-suppression exceeding 60% and improved median survival time of infected mice (20.5 days and 19 days respectively compared to 15.5 days for non-treated control). Western analysis revealed that pGSK3β (Ser9) intensity in brain samples from insulin-treated (0.3 and 0.5 U/kg body weight) infected mice each were 0.6 and 2.2 times respectively than that in control. In liver samples, pGSK3β (Ser9) intensity from insulin-treated infected mice were significantly higher (4.8 and 16.1 fold for 0.3 and 0.5 U/kg bw respectively) than that in control. Insulin administration decreased both brain and liver pNF-κB p65 (Ser536) intensities (to 0.8 and 0.6 times for 0.3 U/kg bw insulin; and to 0.2 and 0.1 times for 0.5 U/kg bw insulin respectively compared to control). Insulin treatment (0.5 U/kg bw) also significantly decreased the serum levels of pro-inflammatory cytokines (TNF-α (3.3 times) and IFN-γ (4.9 times)) whilst significantly increasing the levels of anti-inflammatory cytokines (IL-4 (4.9 fold) and IL-10 (2.1 fold)) in PbN-infected mice. Results from this study demonstrated that the cytokinemodulating effects of insulin at least in part involve inhibition of GSK3β and consequent inhibition of the activation of NF-κB p65 suggesting insulin as a potential adjunctive therapeutic for malaria.

Dogs can act as a reservoir of canine leishmaniasis disease, which is caused by Leishmania species. The study aimed to identify and document the genotype of cutaneous leishmaniasis (CL) in the stray dogs in Riyadh Province using kinetoplast DNA (kDNA) as a target gene by using nested polymerase chain reaction (nPCR). This cross-sectional investigation was conducted over the course of two years, from March 2016 to July 2018, in different districts of Riyadh Province, Saudi Arabia. A total of 237 dogs were examined, only 18 of the dogs were suspected clinically of cutaneous leishmaniasis due to the presence of cutaneous nodules and cutaneous lesion. Biopsy tissue collections were performed and DNA was extracted. CSB2XF and CSB1XR primers were used to amplify the Leishmania kDNA regions. The Leishmania species were detected by specific 13Z and LIR primers by applying nested PCR assay. Nine dogs were found to be positive for Leishmania major. The examined dogs were negative for other Leishmania spp. The phylogenetic analysis and blast results of kDNA showed that the 9 isolates L. major is closely related (99.9%) to the L. major isolate CMG_irfan5, accession number HQ727556.1 from human, Pakistan. This is the first molecular study on dog leishmaniasis from Saudi Arabia confirmed that dogs have a L. major infection. Further epidemiological and molecular investigations are required to study domestic and wild canine infections with L. major and other Leishmania spp in endemic and nonendemic areas of Saudi Arabia as part of leishmaniasis control

A series of new 2,5-disubstituted-1,3,4-oxadiazole derivatives (5a-j and 6a-j) have been designed and synthesized in four-steps. Sixteen compounds among the twenty compounds are reported for the first time. The compounds were characterized and confirmed by the FTIR, 1D- and 2D-NMR and HRMS analyses, and were tested against Mycobacterium smegmatis and Mycobacterium tuberculosis H37Ra. Compound 5d was the most active against M. smegmatis with MIC value of 25 µM, and exhibited cidal activity with MBC of 68 µM, respectively. The time-kill assay showed the good killing rate at 77% with the combination of isoniazid (INH). In addition, checkboard assay confirmed the interaction of compound 5d was categorised as additive. Docking simulation has been performed to position 5d into the pantothenate synthetase active site with binding free energy value –8.6 kcal mol-1. It also occupied the same active site as that of standard native ligand with similar interactions, which clearly indicate their potential as pantothenate synthetase inhibitor.

Cystic Echinococcosis (CE) is one of the most important zoonotic parasitic diseases in human, livestock, and wildlife globally. The prevalence of CE depends upon human behavioral risk factors, the diversity and ecology of animal host interactions and the genetic diversity within Echinococcus species which differ in their zoonotic potential and pathogenicity. It is a neglected, economic and socio-cultural problem in Pakistan. The available data about the incidence of CE is very limited and no extensive study has been reported in Pakistan. The current study was aimed to analyze the hospital reported cases of CE and the associated risk factors related to the incidence of CE. The hospital-based data of CE for the time period of January 2012-December 2017 was collected from Islamabad, Rawalpindi and Peshawar. The data covered demographic characteristics including age, gender, and cyst localization of infected individuals and socioeconomic determinants. The data was analyzed based upon different risk factors along with the different socioeconomic parameters that has an important impact on the distribution of disease. A total of 228 cases were presented in the selected hospitals of different cities during the study period. Out of total 228 patients, 59.21% were males and 40.78% were females (P<0.001). Most infections have been recorded in young adults (>20-30) showing 22.8% of total infected individuals followed by children (0-10) showing 10.5% (n=24), respectively (P<0.001). Liver was the most vulnerable organ (58.77%, n=134) followed by lungs (14.47%, n=33) (P<0.001). The infection was higher among rural communities (84.2%) than urban (12.8%) (P<0.001). Socioeconomic and demographic factors had an important impact on the intensity of disease (P<0.001). The occurrence of cases in children and young adults was an important finding as it indicated an active transmission of the parasite in Pakistan along with the poverty index. Emergence of echinococcosis in Pakistan showed that emerging health issues in Pakistan could bring the disease to limelight for future research. This finding, together with the fact that 1 hospital reported 214 cases over 6 years 325 underlines the need for a program for prevention/control of this disease in Pakistan. The timely measure needs to be taken to hamper the disease development and establishment. In order to control the disease, complete surveillance should be done which in turn weighs down the disease progress.