Live/Real time three-dimensional transthoracic echocardiographic assessment of aortopulmonary window

Aortopulmonary (AP) window is an extremely rare congenital anomaly involving a communication between the ascending aorta and pulmonary artery. Two-dimensional transthoracic echocardiography is traditionally used in the diagnosis but has limitations. We report the usefulness of three-dimensional transthoracic echocardiography in the assessment of AP window in two newborns studied by us.     

Sacral neuromodulation for the treatment of faecal incontinence in a patient with organophosphate poisoning

Faecal incontinence is a debilitating condition. Sacral neuromodulation may have a role in the treatment of faecal incontinence. We report a case of faecal incontinence secondary to chronic organophosphate poisoning, which was successfully treated with sacral neuromodulation. The patient’s faecal incontinence and quality of life improved significantly.     

Wound healing activity of root extracts of Berberis lyceum royle in rats

The wound healing activities of the aqueous and methanol extracts of the root of Berberis lyceum were assessed using incision, excision and dead wound space models of wound repair in rats. After application of both extracts it was observed that the area of epithelialization increased, followed by an increase in wound contraction, skin breaking strength, tissue granulation, dry weight and hydroxyproline content. Histopathological studies of the granulation tissue also indicated that there was an increase in collagen formation in those rats treated with the methanol extract, compared with the control group animals. The methanol extract was more effective than the aqueous extract, but both showed significant results compared with the control.     

Pulmonary complications associated with head and neck cancer surgery

Objective: To evaluate the frequency of short-term pulmonary complications in the patients undergoing various head and neck cancer surgeries in our setup and to assess possible risk factors responsible for these complications. Study Design: Quasi experimental study. Place and Duration of Study: Department of ENT, Head and Neck Surgery, Combined Military Hospital, Rawalpindi from July 2005 till August 2006. Patients and Methods: Seventy patients of age group 20 to 80 years, regardless of gender, treated surgically for head and neck cancers were enrolled. Main outcome measures included development of pulmonary complications following 15 days of oncological surgery. The complications studied were pneumothorax, bronchopneumonia, atelectasis, pulmonary embolism and cardiopulmonary arrest. Results: A total of 24.28% patients suffered from postoperative pulmonary complications; 17.14% developed bronchopneumonia, 5.71% pulmonary embolism, and 1.42% went into cardiopulmonary arrest, none developed pneumothorax or pulmonary atelectasis. A significant correlation of postoperative bronchopneumonia was seen with heavy smoking and assisted ventilation. Pulmonary embolism was associated with extended assisted ventilation and prolonged surgery. Cardiopulmonary arrest was associated with comorbidity and assisted ventilation after surgery. Conclusion: The frequency of bronchopneumonia supersedes all of the postoperative pulmonary complications in head and neck oncological surgery. Patients at risk of developing postoperative complications are heavy smokers, diabetics, those undergoing prolonged surgery, tracheostomy, and extended assisted ventilation.     

Role of inferior vena cava filter implantation in preventing pulmonary embolism

A retrospective review of all patients undergoing IVC filter implantation at Shifa International Hospital, Islamabad, from June 2004 to June 2006 was conducted to study the indications of inferior vena cava (IVC) filter use and impact on short-term morbidity/mortality. A total of 17 patients received IVC filters. Five patients were excluded due to data loss. One month clinical follow-up was available for 12 patients and 6 months follow-up was also available for 4 of 12 patients. The underlying disease was deep venous thrombosis (DVT) with pulmonary embolism (PE) in 6 (50%), DVT without PE in 4 (33.3%) and PE with negative duplex scan for DVT in 2 (16.6%) patients, respectively. Indications for IVC filter implantation were DVT and/or PE with contraindication to anticoagulation in 8 (66.7%) and DVT and/or PE with complications of anticoagulation in 4 (33.3%) patients. No procedure-related complications were noted in all 17 patients. Three patients (25%) died of non-PE related causes during the 1st month. There were no PE related mortalities at 6 months. This data set indicates that IVC filter implantation is a safe procedure with no short-term morbidity/mortality and potential long-term mortality benefit.     

Expression profiling of serum microRNA-101 in HBV-associated chronic hepatitis,liver cirrhosis,and hepatocellular carcinoma

MicroRNAs (miRNAs) represent a class of evolutionarily conserved, non-coding small RNAs (18–25 nt) that have emerged as master regulators of several biological processes. Recently, circulating miRNAs have also been reported to be promising biomarkers for various pathological conditions. In the present study, we report the comparative expression profiling of microRNA-101 (miR-101) in serum and tissue samples from chronic hepatitis B (CHB), HBV-associated liver cirrhosis (HBV-LC), and HBV-associated hepatocellular carcinoma (HBV-HCC) patients and healthy controls. The serum miR-101 levels were found to be significantly downregulated in the HBV-HCC patients compared with the HBV-LC patients (P < 0.001), CHB patients (P < 0.001) and healthy controls but were upregulated in the HBV-LC patients compared with the CHB patients (P < 0.001) and healthy controls (P < 0.001). Consistent with the serum data, the expression of miR-101 was also upregulated and downregulated in the HBV-LC and HBV-HCC tissue samples, respectively. A receiver operating characteristic (ROC) analysis of serum miR-101 yielded an area under the ROC curve (AUC) of 0.976 with 95.5% sensitivity and 90.2% specificity when differentiating between HBV-HCC and HBV-LC. Our results suggest that the serum miR-101 level can serve as a potential non-invasive biomarker to differentiate HBV-HCC from HBV-LC.