Motor neuronopathy associated with Adenocarcinoma of Esophagus

Neurologic paraneoplastic syndromes (NPS) are remote neurologic effects, except metastasis, of systemic cancers. These are a rare group of disorders, commonly associated with small cell lung carcinoma (SCLC).1 Various NPS have been described, including motor neuronopathy. The motor neuronopathy has commonly been described with small cell carcinoma of lung, breast cancer and lymphoproliferative disorders.2,3 We report a case of motor neuronopathy in association with large cell adenocarcinoma of esophagus. To our knowledge this is the first reported case of motor neuronopathy associated with adenocarcinoma of the esophagus

Perspective and Prospects of Commencing New Education Policy (NEP) of Pakistan: A Review of Conference.

This article focuses on four important factors: Assessment, Curriculum and Text Books’ Policy, Teachers for quality education and Education and management, as formulated by Education and Literacy Department of Sindh Government. Open poll discussions and views given by educationists and experts were taken. All the views have been summarized for consideration by all concerned. Chief Minister Sindh, Arbab Ghulam Rahim, Javed Hussain, Education Minister, Hamida Khoro and Education Secretary to Government of Sindh, Ghulam Ali Pasha also shared their opinions on the new Education Policy and Government’s intention to ensure quality education in Sindh Province. The purpose of this article is to review and summarize the views presented in the Education Conference and reach fruitful conclusions. The implications are also made keeping in mind the targets of New Millennium Development Goals (NMDGs).Assessment, Curriculum and Text Book Policy, Education and Management, Literacy

An audit of the quality of care indicators for the management of diabetes in family practice clinics in Karachi, Pakistan

BACKGROUND: Management of diabetes is a painstaking and careful approach. This study was aimed to evaluate the quality of care for the management of diabetes provided by family practitioners to their patients having diabetes. This is a retrospective audit of medical records conducted in a tertiary care teaching hospital of private sector in Karachi for one month. METHODS: For this study, 150 medical records of patients with type 2 diabetes that visited family practice clinics for their diabetes care were examined. A total of 88 patient\u27s medical records were selected and analyzed who attended the studied clinics for at least one year and had minimum of four out-patient visits. Majority (68%) of the audited medical records were of females. RESULTS: Of the total medical records analyzed, only one-quarter of the cases qualified the criteria of \u27excellent\u27 or \u27good\u27 diabetes care. Monitoring of body weight of the patient was only one indicator which was according the recommendations in 100% case at every visit. The other nearest quality of care indicator documented was blood glucose advice at every visit in 79.5% (95% CI: 71.1-87.9) of cases. Physical activity advised/reinforced at every visit was least observed (27.3%; 95% CI: 18.0-36.6). In addition, blood sugar control was reported in less than a quarter (23.9%) with 95% CI of 15.0-32.8. CONCLUSION: This work has identified a big gap in the management of type 2 diabetes provided by family practitioners. In addition, majority of the patients found to have poor glycemic control. Interventions are suggested to improve the quality of diabetes care. More such audits and research are recommended at the larger scale

Family Types, Authority Structure and Women Workers in Sindh Labor Force: Problems and Prospects

The development of a society is virtually dependent upon the quality of human resources both male and female, the changing pattern of economic and social development of world societies irrespective of their level of development, necessitates and equal advancement of both the social segments. The numerical reality that women constitute about nearly half of the total population of Sindh ideally assigns to them equal participating role in the economic life of the province. However, like other developing countries, women’s role in Sindh as an active worker-producer of goods and services has not been duly recognized by this male dominated society. With the objective of ensuring increased participation of women, clear-cut guidelines about integrating women in the development process and defining their roles are still lacking in Sindh. The present study is a step in the direction of bridging the gap of information about female labor force participation of Sindh in different, activity rates, industry group, occupation group and employment status in 1981 and 1998 population census. The most important conclusion that emerges from this study is that though percentage of women labor force in different, activities, industry group, occupation group and employment status has mostly increased in 1998 as compared to 1981, but being nearly half of the population this increase is still very low.Family, Authority, Problems, Female, Labor Force, Sindh

Factor VII deficiency and pregnancy: a case report and review of literature

Factor VII deficiency is one of the \u27rare inherited disorders of coagulation.\u27 Few cases of Factor VII deficiency have been reported during pregnancy, a state which could potentially cause fatal haemorrhage. Here we report a case of a pregnant lady with a history of heavy menorrhagia and multiple first pregnancy failures. Delivery was carried out via Caesarean section due to non-reassuring foetal heart monitoring. Patient was treated with Fresh Frozen Plasma (FFPs) and Factor VII concentrates, however, the patient developed bleeding postoperatively. Literature indicates that whilst Factor VII levels rise during pregnancy in normal women, no increase is seen in homozygous cases, whereas there is a moderate rise in heterozygous individuals. History of heavy menorrhagia, multiple first pregnancy failures and a positive family history for bleeding disorders necessitate investigation and monitoring of Factor VII levels during pregnancy. Factor VII concentrates achieve adequate homeostasis in most cases. Recombinant Factor VIIa, however, is the treatment of choice and does not carry a risk of infection transmission or thrombus formation

Successful use of rituximab in Evans syndrome and refractory immune thrombocytopenic purpura

Immune cytopenias are mediated by auto-antibodies produced by B-lymphocytes. Conventional treatment of immune-mediated haematological disorders includes immunosuppression with steroids and other immune modulating therapies and in some refractory cases, splenectomy. Response rates to conventional and second-line agents are variable and a proportion of patients require lifelong immunosuppression to maintain the disease in remission. Rituximab, an anti- CD 20 monoclonal antibody has gained widespread acceptance in the management of B-cell malignancies. Additionally, it has been used to treat the disorders associated with autoantibody production. We report herein the successful use of Rituximab in the treatment of two patients with autoimmune cytopenias one had Evan\u27s syndrome and other had refractory immune thrombocytopenic purpura. Both of these patients are still in remission at 16 and 25 months following treatment

Silencing of MBD1 and MeCP2 in prostate-cancer-derived PC3 cells produces differential gene expression profiles and cellular phenotypes

Alterations in genomic CpG methylation patterns have been found to be associated with cell transformation and neoplasia. Although it is recognized that methylation of CpG residues negatively regulates gene expression, how the various MBPs (methyl-binding proteins) contribute to this process remains elusive. To determine whether the two well characterized proteins MeCP2 (methyl-CpG-binding protein 2) and MBD1 (methyl-CpG-binding domain 1) have distinct or redundant functions, we employed RNAi (RNA interference) to silence their expression in the prostate cancer-derived PC3cell line, and subsequently compared cell growth, invasion and migration properties of these cell lines in addition to their respective mRNA-expressionprofiles. Cells devoid of MeCP2 proliferated more poorly compared with MBD1-deficient cells and the parental PC3 cells. Enhanced apoptosis was observed in MeCP2-deficient cells, whereas apoptosis in parental and MBD1-deficient cells appeared to be equivalent. Boyden chamber invasion and wound-healing migration assays showed that MBD1-silenced cells were both more invasive and migratory compared with MeCP2-silenced cells. Finally, gene chip microarray analyses showed striking differences in the mRNA-expression profiles obtained from MeCP2- and MBD1-depleted cellsrelative to each other as well as when compared with control cells. The results of the present study suggest that MeCP2 and MBD1 silencing appear to affect cellular processes independently in vivo and that discrete sets of genes involved in cellular proliferation, apoptosis, invasion and migration are targeted by each protein

Consensus interferon plus ribavirin for Hepatitis C genotype 3 patients previously treated with pegylated interferon plus ribavirin

Background Not enough data are available about the effectiveness of consensus interferon (CIFN) among HCV genotype 3 patients who failed to respond to pegylated interferon and ribavirin. Objectives We aimed to assess the efficacy and safety of CIFN and ribavirin in non-responders and relapsers to pegylated interferon with ribavirin therapy. Patients and Methods This open-label investigator-initiated study included 44 patients who received CIFN 15 µg /day plus ribavirin 800-1200 mg daily. In patients with an early virological response (EVR), the dose of CIFN was reduced to 15 µg thrice a week for further 36 weeks. Patients with delayed virological response continued to receive daily CIFN plus ribavirin to complete 48 weeks. The patients were considered “non-responders” if there were less than 2 log reduction in HCV RNA at 12 weeks and detectable HCV RNA at 24 weeks. Results Twenty-four patients (55%) were non-responders and 20 patients were relapsers to the previous treatment with pegylated interferon plus ribavirin (mean age 43.6 ± 9.4 years, males 25 (57%)). Nine patients were clinically cirrhotic (Child A). End of treatment virological response was achieved in 19 (43.1%) patients and sustained virological response (SVR) occurred in 12 (27.3%). Out of these 12 patients, eight were non-responders and four were relapsers to the previous treatment. Advanced fibrosis or clinical cirrhosis was associated with low SVR. Adverse events were fever, myalgia, anorexia, depression, and weight loss. Two patients received granulocyte colony stimulating factor for transient neutropenia. Seven patients were given erythropoietin to improve hemoglobin, and six were treated for mild depression. Two patients developed portosystemic encephalopathy. Conclusions More than one-quarter of treatment-experienced patients with HCV genotype 3 achieved SVR after re-treatment with consensus interferon plus ribavirin

Proximate chemical composition of sea grapes Caulerpa racemosa (J. Agardh, 1873) collected from a sub-tropical coast

Background: Nutritional fact study has prime importance to make the species edible and commercially viable to the consumers. Proximate chemical composition and amino acid profile were investigated to understand the nutritional value and protein quality of an edible algae Caulerpa racemosa. Methods: Samples were collected randomly by hand from the intertidal zone of the sub-tropical coastal Island St. Martin’s Island from February 2013 to May 2014. Samples were preserved using standard methods for chemical analysis. Proximate composition was determined using standard methods, Kjeldahl method for protein, Soxhlet method for crude lipid, H2SO4 (0.3 N) and NaOH (0.5 N) for dietary fibre, muffle furnace method for moisture content, ion-exchange chromatography for amino acid and statistical package used for validating the data. Results: The result of the study reveals that C. racemosa contains higher amount of proteins (19.72±0.77%), crude lipid (7.65±1.19%) and fibre (11.51±1.32%) compared to other green and brown algae. The higher concentration of aspartic acid (12.7±0.2%) and glutamic acid (9.2±0.7%) were observed in C. racemosa, while histidine (2.6±0.7%), methionine (1.4±0.4%) and tyrosine (3.8±0.2%) were the limiting amino acids. Lysine (6.6±0.2%), leusine (6.9±0.6%), glycine (6.5±0.4%), arginine (6.4±0.3%), alanine (7.6±0.6%) and threonine (6.2±0.5%) were obtained at a higher percentage of total amino acids. Conclusion: This study suggests that C. racemosa could be potentially used as a nutritious and functional food item for human consumption. Further studies on this edible species should be focused on fatty acid composition, vitamins, non-starch polysaccharide constituents, trace elements and sensory perceptions in order to depict safer and versatile utilization