Medicine

Background: Schizophrenia is a mental disorder characterized by persistent defects in the perception, thinking or the expression of reality. The term “schizophrenia” translates roughly as “shattered mind,” and comes from the Greek (schizo, “to split” or “to divide”) and (phrēn, “mind”). Material and Methods: The study was designed to be a prospective control study. Schizophrenic patients taking Olanzapine and Haloperidol were selected and follow up at three weeks and six weeks was done. Results: In this prospective control study, Olanzapine and Haloperidol were associated with an increase in Blood Glucose Levels. The mean changes in Glucose remained within clinically normal range in this six week study. Conclusion: Antipsychotic treatmemt leads to the development of Diabetes mellitus in a significant 10.1% of patients within 6 weeks. Given the serious implications for morbidity and mortality attributable to diabetes mellitus, clinicians need to be aware of these risk factors when treating patients with chronic schizophrenia

Agricultural land of Amreli district of Gujarat state in india is the study area of this paper and in present study total 396 samples were collected from different fourteen sites in the year 2012-2013. Under the soil health card programme of Government of Gujarat, all soil samples were collected by trained farmers and brought for analysis to approved Soil Test laboratory.  All soil samples were analyzed for pH, (EC)Electrical conductivity, (P)Phosphorus, (K)Potassium, (OC)Organic Carbon, (Fe)Iron, (Cu)Copper, (Zn)Zinc, (Ca)Calcium, (Mg)Magnesium and (S)Sulfur. The purpose of present paper is to study soil fertility status and correlation of Electrical conductivity with micro-macro nutrients. Present work concludes that the electrical conductivity is strong soil health indicator as well as ‘correlation analysis’ and discriminate analysis can give scientific basis for managing the recent tillage system. 

A distinctive novel characterized by an exploration of the relationship between history and fiction, Chaman Nahal’s Azadi expresses a strong consciousness of the fictiveness of all discourse about history and reality. The paper is an attempt to study Azadi in the postmodern perspective and to attempt the application and utility of the post-modern critical concepts like historiographic metafiction to historical novels. It is not only a recreation of a historical event but an imaginative revisioning of a historical epoch. Indian freedom movement and the consequent emergence of the two states, Pakistan and India, acquired a huge dimension in the history of South Asia. The focus of the novel is the socio-political concerns of the era. It leaves an impact of  being more than a historical novel in which historical sense and reality enter into the sphere of art imperceptibly.

Diseases caused by body fat accretion are alarming among Malaysian population. This study aims to determine the level of obesity (BMI) and abdominal fat among 210 students, ten to twelve years old (93 boys and 117 girls) from Vagesar Primary school, a rural Tamil School, in Malaysia. This ex post facto study was conducted using Omron Karada Scan HBF-375 Body Composition Monitor with Scale and Waist to Hip Ratio (WHR) protocol to measure abdominal fat. Research outcome showed that 46 boys (49.5%) and 72 girls (61.5%) are prone to the risk of cardiovascular diseases based on the level of abdominal fat using WHO (1998), Asian norm. However, it is clear from the result, that about 102 students (49 boys and 53 girls) 48%, were underweight according to WHO (2004) Asian BMI norm. This describes an unfavourable environment in which the corresponding respondents could possibly suffer from deficiency in minerals and vitamins. Therefore, the rural Tamil school students must be offered sufficient awareness on issues of body fat accretion and deficiency in nutrition. Based on these study, respondents especially female students needs to take preventive measures to reduce abdominal fat, in addition to control of diet and at the same time increase physical activities. Appropriate action must be taken by the teachers and parents to ensure the quality of life with proper nutrients

OBJECTIVE: To investigate the relative differences in outcomes among microdissection testicular sperm extraction (micro-TESE), conventional testicular sperm extraction (cTESE), and testicular sperm aspiration (TESA) in men with nonobstructive azoospermia.
DESIGN: Systematic review and meta-analysis.
SETTING: A variety of outpatient academic and private urology clinics.
PATIENTS(S): Men with nonobstructive azoospermia.
INTERVENTION(S): Micro-TESE, cTESE, or TESA.
MAIN OUTCOME MEASURE(S): Sperm retrieval (SR).
RESULT(S): Fifteen studies with a total of 1,890 patients were identified. The weighted average age of the patients was 34.4 years, the follicular stimulating hormone level was 20.5 mIU/mL, the T was 373 ng/dL, and the testicular volume was 13.5 mL. In a direct comparison, performance of micro-TESE was 1.5 times more likely (95% confidence interval 1.4-1.6) to result in successful SR as compared with cTESE. Similarly, in a direct comparison, performance of cTESE was 2.0 times more likely (95% confidence interval 1.8-2.2) to result in successful SR as compared with TESA. Because of inconsistent reporting, evaluation of other procedural characteristics and pregnancy outcomes was not possible.
CONCLUSION(S): Sperm retrieval was higher for micro-TESE compared with cTESE and for cTESE compared with TESA. Standardization of reported outcomes as well as combining all available SR data would help to further elucidate the SRs of these procedures.

Two hundred and four patients clinically diagnosed for bacterial otitis media were recruited for the study. Ear swabs were taken aseptically on sterile swab stick and cultured on heated blood agar (chocolate), 5% blood agar and McConkey agar and incubated at 37oC for 18-24 hs. The clinical isolates comprise of Escherichia coli, Pseudomonas aeruginosa, Proteus spp, Staphylococcus spp. and Streptococcus spp. An in-vitro sensitivity testing on these five genera of bacteria against fourteen antimicrobial agents demonstrated a high multiple resistance to Ampicillin, Erytrhromycin, Cotrimoxazole, Chloramphenicol and Cefoxatime and a relatively lower resistance to Cluvulanate potentiated Amoxycillin, Gentamicin, Ceftriaxone, Ciprofloxacin and Ofloxacin. Result of this study demonstrated that the epidemiology of middle ear infection in the two study centres was not restricted to a particular sex or age group, although male children less than ten years are more often affected than older children. Restrictions in the use of antimicrobials as well as encouraging the use of appropriate vaccines are recommended for prevention/control of the infection.

Objective: To determine the frequency of Helicobacter Pylori seropositivity in patients with hepatic encephalopathy.
Study Design: Descriptive cross sectional study.
Place & Duration of the Study: This study was conducted at the Department of Medicine of Khyber Teaching Hospital Peshawar from February 2014 till September 2014.
Methodology: This study included 137 cirrhotic patients and data was collected on a structured questionnaire. An informed written consent was taken from patients or their attendants, who fulfilled the inclusion criteria. Both male and female Patients (age 15 and above) were assessed in the OPD and admitted to Medical Unit for work up. All patients were investigated for H. Pylori Serology by sending 5ml of venous blood to the same laboratory. Data was analyzed using SPSS version16. Results: The mean age of all the 137 patients was 41.36years ± 10.48SD. Out of total patients of 137, 75 (54.75%) were males and 62(45.55%) were females. H. pylori serology was positive in 94 (68.61%) of the patients while 43 (31.39%) had negative antibody results for H. pylori. West- Haven classification of the grades of Hepatic Encephalopathy showed that 25 (18.25%) patients had grade 1, 33 patients (24.09%) had grade 2, 40 patients (29.2%) had grade 3 and 39
participants (28.47%) were in grade 4 Encephalopathy respectively. Conclusion: Cirrhotic patients are more commonly infected with H. Pylori and the vast majority
of them (68.61%) have positive antibody against the causative pathogen.

Abstract:
Background: Acquired drug resistance has been reported in Pseudomonas spp by production of plasmid mediated AmpC-β-lactamase, Extended Spectrum-β-lactamase (ESBL) and
Metallo-β-lactamase (MBL) enzymes. Carbapenems, being the most potent and reserved drug for treating infections caused by multi-drug resistant bacteria especially Pseudomonas spp is under threat due to the emergence of MBL producing Pseudomonas. aeruginosa. Thus the study was undertaken to study Metallo- β-lactamase (MBL) production among isolates of P. aeruginosa to know their dissemination and thereby proper and judicious selection of antibiotics . Methods: 112 isolates of P. aeruginosa were obtained from various clinical
samples which were subjected to susceptibility testing to antipseudomonal drugs as per CLSI guidelines. Isolates resistant to imipenem were screened for MBL production by Imepenem-EDTA Double Disc Synergy Test (DDST) test. Result: Of the 112 isolates of P.aeruginosa, 22% strains were imipenem resistant and 16% strains were MBL producers. Conclusion: MBL mediated carbapenem resistance in P. aeruginosa is a cause for concern in the therapy of critically ill patients. Simple DDST can be done to help monitoring of these emerging resistant determinants.

Aims: It is currently unclear if the location of coronary artery disease affects decision making with regard to dual antiplatelet therapy (DAPT). We investigated if the presence of at least 30% luminal narrowing in the left main (LM) and/or proximal left anterior descending (pLAD) coronary arteries on angiography is an outcome modifier with respect to DAPT duration.

Methods and results: In the Prolonging Dual Antiplatelet Treatment After Grading Stent-Induced Intimal Hyperplasia (PRODIGY) study, 953 (54.3%) patients with and 801 (45.7%) without LM/pLAD lumen narrowing at the qualifying coronary intervention were randomised to six or 24 months of DAPT. Twenty-four month as compared to six-month DAPT reduced the occurrence of definite, probable or possible stent thrombosis by 50% in patients with (2.8% vs. 5.6%; HR 0.45, 95% CI: 0.23-0.89; p=0.02) but not in those without LM/pLAD lumen narrowing, with a highly significant interaction testing (PINT= 0.002). This result remained consistent irrespective of whether stenting was (PINT: 0.01) or was not (PINT: 0.02) performed in the LM/pLAD.

Conclusions: Left main and/or proximal LAD lumen narrowing may be a treatment modifier with respect to the duration of DAPT. Patients fulfilling these angiographic characteristics seem to benefit from a prolonged dual antiplatelet treatment

The people Tsachillas (designated by the Spanish as the “Colorados” because of the red hairstyle hair obtained with a preparation derived from the fruit of Achiote, Bixa orellana) arrived in Ecuador in an age indeterminate; Tsafiki language - used by Tsachillas, and whose name derives from “Tsa” that is “true” (but also “divine”) and “Fiki”, that is “language”, which could translate as “true language” or even “sacred language” - he belongs to the strain barbacoa; and we know that the first human settlements in Ecuador, whose trace was found near the extinct volcano Ilaló (20 km at southeast of Quito), date back to 10,500 B.C., supposedly originated from Asia and fron the islands of Pacific. So we have the probability that even Tsachillas, like other peoples of Latin America, came from the Asian continent. The first report of Tsachillas we have after the Spanish conquest, when, in a document of 1592, are cited the “Colorados of Angamarca”, near the Jesuits' settlement. The period before the Spanish colonization, the Tsachillas, we know virtually nothing.

El pueblo Tsachillas (designados por el español como los “Colorados”, por el peinado rojo del pelo, obtenido por una preparación derivada da el fruto del Achiote, Bixa orellana) llegaron al Ecuador en una época indeterminada; el idioma Tsafiki - utilizado por los Tsachillas, y cuya etimología deriva de “Tsa”, es decir “verdadero” (pero también “divino”), y “Fiki”, es decir “idioma”, que podría traducirse como “idioma verdadero” o, tambièn, “idioma sagrado” - pertenece a la cepa barbacoa; y sabemos que los primeros asentamientos humanos en el Ecuador, cuyos rastros fue encontrado cerca del volcán extinto Ilaló (20 km al sudeste de Quito), se remontan a 10.500 años antes de Cristo, supuestamente se llegaron da la Asia y da las islas de Pacífico. Así que tenemos la probabilidad que tambièn los Tsachillas, al igual que otros pueblos de América Latina, vino del continente asiático. La primera noticia sobre los Tsachillas se tiene después de la conquista española, cuando, en un documento del año 1592, donde se refirió sobre los “Colorados de Angamarca”, cerca del asentamiento jesuita. Del período antes de la colonización española, sobre los Tsachillas, no se sabe prácticamente nada.