Nanomedicine is a rapidly growing field in the area of diagnostics, imaging, and targeted therapeutic approaches for the basis of the pathophysiology of gastrointestinal diseases. Nanocarriers capable of delivering of anti-inflammatory drugs specifically to gastrointestinal tract affected region for a prolonged period of time reduces the side effects of encapsulated drugs. Therefore, the present book chapter provides in details on various gastric disorders and their pathophysiology on the recent development of nanomedicines for the detection and treatment of gastrointestinal diseases.
Paraovarian cysts are a rare entity, comprising 10–20% of all adnexal masses with very rare malignant potential (2–3%). These lesions are mostly seen in adults and very rarely present in pediatric age group (4%). These cysts mostly arise from mesothelium (68%), paramesonephric duct (30%) and very rare from mesonephric duct (2%). Mostly, these lesions remain asymptomatic until present with complications. Laparoscopy is the best diagnostic and therapeutic option to manage them, especially when these are small in size, difficult to differentiate from other pelvis lesions. Herein, we present a 9- year old girl presenting with acute abdomen owing to right paratubal cyst complicated by torsion and having paramesonephric duct remnant origin.
summary Autologous blood donation (ABD) has been widely recommended. Data from one of the oldest hospital‐based programmes in Canada describe both activities and drawbacks. Data were compared over the nearly two decades of activity that peaked in 1996. A 5‐year review of recent activity showed that of the 2410 patients referred for consideration, 1823 (75·64%) were accepted into the programme. Surgical services requested 5825 units of autologous blood. Of these, 3147 units were donated by 1536 patients, 803 units were transfused in the operating room and 558 units were given postoperatively. In total, only 1361 units (43·25%) were transfused. The mean age of the patients was 58 years (median 61 years and mode 69 years). The haemoglobin concentrations before donation were significantly higher, averaging 145·2 g L −1 before donation and 114·9 g L −1 immediately before surgery, whereas at the time of discharge, the haemoglobin concentration averaged 126·2 g L −1 ( P = 0·0001) in transfused patients. Data from this well‐established ABD programme indicate less than 50% overall utilization. The activity in the programme increased until 1996 following which it dropped progressively. The low haemoglobin concentration after surgery is of concern and should foster a transfusion algorithm for these patients.
A 58-year-old lady who had waxing and waning nonspecific symptoms including fatigue and unsteadiness for 15 months became acutely confused 12 h prior to presentation. Her travel history prior to presentation consisted of visits to Argentina, Chile and the Outer Hebrides. On admission to a district hospital she was pyrexial and unresponsive. CT was normal, she had a lymphocytic pleocytosis of 500, protein of 1 g, a low glucose ratio and type 2 oligoclonal bands, CSF cytology and HSV were negative. Baseline blood tests, tumour markers, autoimmune screening including paraneoplastic antibodies and voltage-gated potassium channel antibodies were also negative. Magnetic resonance imaging revealed multiple abnormal areas of high signal on T2 FLAIR sequencing within the cerebellum, temporal lobes, and periventricular areas. Western blotting of serum and CSF for Borrelia burgdoferi were both positive. She was treated with cefuroxime and acyclovir and within 24 h she was alert and responsive. She received 4 weeks of cefuroxime in total and made a good recovery. Lyme disease should be considered in patients with acute meningoencephalitis preceded by nonspecific waxing and waning symptoms even if a tick bite or erythema is not recalled.
Background: Cricket is considered 2nd most famous sports while the chances of injuries are very high. Proper warm-up, cool down exercises play important role in reduction of injuries and cricket injury prevention program may be effective in warm-up or cool-down phases of training. Objective: To compare the effects of injury prevention program on physical fitness among cricketers in warm-up and cool-down phases. Methods: A Randomized Clinical Trial (NCT04017715) was conducted at Rawalpindi cricket club. Subjects were recruited through purposive sampling. The inclusion criteria were athletes registered with Pakistan Cricket Board, age 16-30 years and attending minimum 3 sessions were week. The n=55 subjects were recruited and randomly divided into three groups by sealed and envelop method. Cricket Injury Prevention Program introduced in warm-up and cool-down phases in Group A (n=18) and B (n=20) respectively and group C (n=17) is considered as control group for 6 weeks. Assessment were taken through 100m sprint, Burpee test, Illinois Agility Run test, plank test and star excursion balance test at baseline and after 6 weeks of intervention. Data analysis was done through SPSS 25. Results: The mean age of the subjects was 19.31±2.79, mean Body Mass Index was 18.77±1.58. There is a significant difference among all groups in 100m sprint, T agility, plank test, 3 minutes burpee test and start excursion test (p value˂0.05).Conclusion: Cricket injury prevention program (CIPP) is effective in preventing injuries in cricketers in both warm up and cool down. Keywords: Athletics performance, Cricket sport, Cool-down exercises, Warm-up exercises.
Ingestion of two or more than two magnets is, almost never an innocent occurrence, because these are almost always associated with health morbidity, related to gastrointestinal tract complications. Children are more prone to this potentially life threatening hazard. Herein, we are presenting a unique case of three year old boy who ingested three magnetic beads one month back and presented with complaint of abdominal pain only with no other signs and symptoms. The magnetic objects were retrieved by laparoscopic assistance from gastro-colic ligament.
Background: Osteoarthritis (OA) is a common and disabling constant Musculoskeletal Disorder that causes significant weight on individual, Health Care Systems, and social economy. With the maturing of the populace and the commonness of undesirable way of life practices, the predominance and disease burden of OA are expanding day by day. Objective: To find the prevalence of knee osteoarthritis and quality of life among middle-aged adults. Methodology: A descriptive cross-sectional survey was conducted at the major hospitals and physical therapy clinical setups of Pakistan from April to July 2019 (4 months) after approval of IRB/ERC (SRMCH/MS/20/12/41) Suleman Roshan medical college hospital, Tando Adam. The total sample was n=300 selected using non-probability convenience sampling. The middle-aged adults (40-65 years) having moderate to severe knee pain, both male and female were included. According to the American college of rheumatology the criteria for assessing OA by using history, physical examination, and radiographic findings: pain in the knee and one of following over 50 years of age, less than 30minutes of morning stiffness crepitus on active motion and osteophytes and quality of life assessed according to WHOQOL-100 score. The results of the study are presented as frequency, percentages, and mean ±SD. The data were analysed through SPSS 21.Results: The mean age of the study participants (n=300) was a 48.96±6.804 year. The majority of the participants were female (n=208) and the remaining n=92 were male. The prevalence of OA in the middle aged adults (n=300) n=170 (56.7%). The significantly reduced QoL among patient having knee OA (37.19±23.22 ver 42.51±22.69, p<0.05) as compare to those having knee pain without Knee OA.Conclusion: The prevalence of knee pain in middle-aged adults is high and their quality of life is moderately affected. Key words: Knee, Middle-aged, Osteoarthritis, Prevalence, Quality of life.
Objective: The objective of the study are to audit our experience of the management of cases presenting with operative complications requiring acute re operation and to identify the factors resulting in the first operation failure requiring re-exploration. Study Design: A prospective observational/analytical study. Place and duration: Acute re-operative abdominal surgery during two years period 2002-2003 in surgical Unit 1 Allied hospital, Faisalabad. Patient and methods: All the cases which were re-explored after abdominal surgery admitted in surgical unit 1, Allied hospital, Faisalabad are included in the study. Results: The cases fall in three categories, trauma cases (29) 33.71%, non trauma emergency cases (32) 37.25 and elective surgery cases (25) 29.1%. The incidence of our own unit cases subjected to re-operation is 21.9% (24). The presenting pathologies after first operation are in 6 groups; Gastrointestinal fistulas (38 cases) 41.8%, bowel obstruction (7 cases) 8.15%, abdominal abscesses (12 cases) 13.9%, bleeding (18 cases) 20.9%, miscellaneous (biliary and G.U.) (8 cases) 9.35, abdominal wound dehiscence and evisceration (3 cases) 3.6%. Total of 136 complications are in 70 cases. Mortality of 7 cases (8.14) is shared by the semi-trained surgeons, Medical officer operators(6 cases) and the trainee surgeons(1 case).Incidence of mortality in elective surgery cases is 4% in trauma cases 10.34%,non trauma emergency cases 9.4%. Intensive resuscitation including nutritional support, team of senior consultants doing the re-operation, intraoperative and post operative monitoring are the hallmarks of the management. Conclusion: Training and retraining (continuous medical education) of surgeons and regionalization of trauma cases are recommended. The facilities for less invasive procedures blessed with low morbidity and very low mortality will shrink this list of re-operations.
Background: Low back pain among equestrian sports is because of the significant connection between thoracolumbar junction dysfunction (TLJD) and its commencement in equestrian sports; appearing as low back ache spreading out to the adjoining sites and structures. Objective: To determine the frequency of Thoracolumbar Junction Dysfunction (TLJD) among Equestrian Polo Athletes Methods: A descriptive cross-sectional study with a sample size of n=108 was conducted at different polo clubs of Lahore and Islamabad Pakistan for the duration of 6 months from July 2020 to December 2020. Participants were selected via non-probability convenient sampling technique. Male athletes between 18 to 50 years of age, non-competitive with mechanical low back pain were included in the study. Athletes who fulfill the inclusion criteria were assessed using Robert Maigne’s Gold standard examination protocol. SPSS version 21 was used for data entrance and Descriptive analysis was done to present the results of study. Results: The mean age of the subjects was 36.86±6.65 years, duration in sports was 13.58±4.81 in years and frequency of participation in sports was 3.648±0.75 days per week. Total n=108 athletes were examined for TLJD, 66.7% (n=72) were found to be positive with the thoracolumbar junction dysfunction. Conclusion: Thoracolumbar Junction Dysfunction among Equestrian Polo Athletes was an immensely prevailing condition Keywords: Athletes, athletic injuries, dysfunction, overuse injuries.
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