A Rare Case of Mullerian Agenesis (Mayer-Rokitansky-Kuster-Hauser Syndrome)

A 21 years old girl presented in Gyne OPD of Lady Aitchison Hospital Lahore with complaint of primary amenorrhea. There was no complaint of cyclical dysmenorrhea, urinary retention or feeling of abdomino pelvic mass. Her mother had menarche at 14 years of age. Her height was 5 feet and one inch. Her secondary sexual characteristics were of normal (female) and well developed, external genitalia were of female with rudimentary vagina.Ultrasound showed normal size ovaries and hypoplasticuterus and rudimentary vagina.Hormones (FSH, LH, Prolactin) were normal. HerKaryotype was 46XX.On the basis of these findings, diagnosis of Mullerianagenesis (Maye-Rokitansky-Kuster Hauser Syndrome) was made. Family was counselled about the case. They were informed the patient is unable to menstruate and reproduce. However, for sexual function, it is possible to create a new vagina bynon-surgical method using Hegar dilator or surgical by vaginoplasty.</jats:p

Frequency of retinal hemorrhage after thrombolysis with streptokinase in patients presenting with ST-elevation myocardial infarction: A single-center experience at a large tertiary care center in Lahore, Pakistan

Background: Thrombolytic therapy with streptokinase is the mainstay of pharmacological treatment in acute myocardial infarction in Pakistan. Retinal hemorrhage is a common complication of streptokinase-induced thrombolysis and is often overlooked which can lead to permanent vision loss. Therefore, this study was carried out to determine the frequency of retinal hemorrhage after thrombolysis with streptokinase in patients presenting with ST-elevation myocardial infarction (STEMI).&#x0D; Patients and methods: It was an observational, cross-sectional study conducted at the Emergency Department of Mayo Hospital Lahore from 11-08-2015 to 10-02-2016. The patients underwent injection of streptokinase (1.5 million U) intravenously over 60 min and intravenous heparin 5,000 U bolus followed by 1,000 U/hour. Then patients were followed up for 24 hours followed by the ophthalmoscopy to confirm the presence of retinal hemorrhage. The data were entered and analyzed using SPSS version 20.&#x0D; Results: A total of 130 patients were included in this study. The mean age of patients was 62±9.86 years. The male to female ratio was 1.6:1. The retinal hemorrhage was present in 17 (13.08%) patients. About 80 (61.5%) were diabetics and 96 (73.8%) were hypertensive. Stratified variables like age, gender, hypertension, and diabetes were not found associated with retinal hemorrhage (p-value ≥0.05).  &#x0D; Conclusion: Retinal hemorrhage was found in 13.08% after streptokinase injection in patients presenting with STEMI. Although the association was statistically insignificant but still the proportion of retinal hemorrhage was substantially high in these patients. This higher percentage demands vigilant monitoring with the drug for timely diagnosis of this ignored complication which latter can be proved hazardous to the vision.  </jats:p

Comparison of Mean Weight, Length and Head Circumference in Preterm Neonates with Zinc Supplement Group Versus without Zinc Supplement Group

Objective: To compare mean weight, length and head circumference in preterm neonates with zinc supplement group versus without zinc supplement group. Design of the Study: Randomized controlled trial Study Settings: The study was carried out in the Pediatric Department of Lahore General Hospital Lahore from February 2021 to July 2021. Material and Methods: There were two groups of babies: one that received Zinc supplementation and one that did not (not treated with Zinc supplements). An electronic weighing scale was used to measure weight prior to intervention. Mothers were given two bottles of supplement containing zinc when their newborns were 7 to 21 days old, before being discharged from the hospital, and encouraged to feed their babies orally at a dose of 2 mg/kg/day with other multivitamins for six weeks (study group). For the same period of time, the participants in the control group were advised to take only multivitamins. Additionally, anthropometric measurements such as weight, height, and head circumference were taken. Results of the Study: In our study, mean age was calculated as 33.74+1.36 weeks in study and 33.64+1.38 weeks in control group, 54.76%(n=23) in study and 59.52%(n=25) in control group were male while 45.24%(n=19) in study and 40.48%(n=17) in control group were females Conclusion: Preterm neonates supplemented with zinc were significantly better than those without zinc supplementation with regards to mean weight, length and head circumference Keywords: Preterm neonates, zinc supplementation, birthweight, body length, head circumference</jats:p

Characterization, development and evaluation of a cream by using terminalia chebula and cucumber sativus extracts

Background: Continual exposure to the sun's ultraviolet radiation damages skin. Freckles are little brown patches that develop on the skin after repeated sun exposure. Terminalia chebula and Cucumber Sativus extracts-infused water in oil (W/O) emulsion is created, that has anti-freckle and emollient effect. Methodology: Base with no extract and formulation containing three different extract concentrations 4% of Terminalia Chebula with 1% Cucumber Sativus, 5% T. Chebula with 2% C. Sativus and 6% of T. Chebula with 3% of C. Sativus are formulated and after 4 weeks of study and their stability parameters are evaluated at 8oC, 25oC, 40oC and 40oC + 75RH. Different parameters such as anti freckle effect, skin melanin, skin moisture content, sebum level and TEW loss level are investigated by applying these formulations on the volunteer’s cheeks for 4 weeks. Results: Skin melanin levels, sebum level, moisture level and TEW loss level of three formulations containing both plant extracts are significant statistically (p &lt; 0.05). Skin melanin level and TEW loss are decreased after application of cream. But skin moisture and sebum level are increased after application of formulation

Epidemiology of Dupuytren’s and Sociodemographic Factors Related to it Among Chronic Diabetic Patients

Background: Dupuytren’s disease(DD) is characterized by progressive idiopathic fibrosis of the hand palm and the formation of nodules &amp; contractures. Its prevalence ranges from 3 to 42% worldwide. Aim: To assess Dupuytren’s disease’s prevalence, severity and its association with different demographic factors. Study design: Analytical, Cross-sectional study done using Non-probability convenient sampling. Method: This study was conducted on 424 diabetic patients of age between 40 and 80. A questionnaire was used to assess different sociodemographic factors among them. Tubiana classification &amp; tabletop test was used to assess the severity of the disease. Chi-square test was applied to find out the p-value for the association between variables. Results: About 9% of total participants were affected by DD. Most of the affected people were in the nodular stage or stage 1.There was a significant relationship found between DD and different factors like age group (p=&lt;0.01),Family history of DD(p=&lt;0.01), and previous hand injury (p=&lt;0.01) Practical implication: This study provides us the baseline risk factors leading to the disease for better future interventions. Treatments gets easier when we reach the cause. Because nowadays the widely available treatment is surgical excision which is not a good option for everyone. Also there is a dearth of research on this emerging hand disability caused by diabetes that’s why this research is being conducted Conclusions: The results showed high prevalence of DD in diabetic patients with old age, positive family history of DD disease and previous hand injury. Therapeutic studies are required for the betterment of society and to prevent the disease from causing disability. Keywords: Contractures, Dupuytren’s disease, Dupuytren’s nodules, diabetes, personal factors, Family history.</jats:p

A Winning New Combination? Toward Clinical Application in Oncology

Immunotherapy has substantial attention in oncology due to the success of CTLA-4 and PD-1 inhibitors in the treatment of melanoma, lung cancer, head and neck cancer, renal cell carcinoma, and Hodgkin’s lymphoma. A deeper understanding of interaction of tumor with its environment and the immune system provides best guide for oncology research. Recent studies in oncology have explained how a tumor alters antigen presentation, avoids detection, and activation of the host immune system to live and develop. Understanding the connections between the tumor and the immune system has resulted in several innovative therapy options. The extensive field of gene therapy has provided a number of cutting-edge medicines that are expected to play an important role in lowering cancer-related mortality. This article explains the history, important breakthroughs, and future prospects for three separate gene therapy treatment modalities: immunotherapy, oncolytic virotherapy, and gene transfer. Immunotherapies have completely changed how cancer is treated, especially for individuals whose condition was previously thought to be incurable. Examples include ACT (adoptive cell therapy) and ICB (immune checkpoint blockade). This review article will discuss the relationship between the immune response to cancer and the mechanisms of immunotherapy resistance. It will cover combination drugs authorized by the US Food and Drug Administration and provide a thorough overview of how these drugs are doing clinically right now. Cytokines, vaccines, and other soluble immunoregulatory agents, innate immune modifiers, ACT, virotherapy, and other treatment modalities will all be covered in detail