Pleural Fluid Alkaline Phosphate Levels to Differentiate between Tuberculosis and Malignant Pleural Effusion a Tertiary Care Experience

Introduction: Pleural effusion (PF) is a common clinical presentation in several diseases. Tuberculosis is one of the most frequent causes of exudative pleural effusions in immunocompetent patients. Tuberculosis is the leading cause of morbidity and mortality from an infectious disease in developing countries. Pakistan is ranked fifth in the world in terms of tuberculosis high-burden countries. Various pleural fluid parameters have been used to identify the cause of pleural effusion. It has been discovered that tuberculous pleural effusions had a greater alkaline phosphatase (ALP) concentration than transudative effusions. This study used pleural fluid alkaline phosphatase levels to distinguish between tuberculous pleural effusion and malignant pleural effusion because there is little information from tuberculosis-high burden nations like Pakistan. Study Design: A descriptive cross-sectional study conducted at the Jinnah Postgraduate Medical Center in Karachi between October 2016 and October 2017. Material and Methods: The study comprised all patients who were admitted to the department of chest medicine at Jinnah post graduate medical centre (JPMC) of either gender between the ages of 18 and 70 who had exudative lymphocytic pleural effusions lasting two weeks or more included in the study. Non probability consecutive sampling was used to collect data. Patients who have tonsillitis, pharyngitis, pneumonia, asthma, Chronic obstructive pulmonary disease (COPD), or a history of hemoptysis, Bleeding disorders like, platelet function disorder, thrombocytopenia, Liver cirrhosis and Pregnant women were excluded. Parents’ informed consent was obtained after being informed of the study’s protocol, hazards, and advantages. Each patient had their level of pleural fluid alkaline phosphate (PALP) assessed. In order to evaluate the patient’s pleural effusion, a pre-made questionnaire was used. All the collected data were entered into the SPSS 20. An independent sample t-test was used to recognize alkaline phosphate levels association with pleural fluid secondary to tuberculosis or malignancy. Results: In this Descriptive Cross-Sectional Study, the total of 156 patients with age Mean ± SD of was 41.96 ± 17.05 years. The majority of patients 110 (70.5%) were male and 46 (29.5%) were female. Advanced age was associated with raised pleural fluid alkaline phosphatase. The difference of pleural fluid alkaline phosphate level between tuberculous v/s malignant group was found to be (38.03 ± 45.97) v/s (82.77 ± 61.80) respectively with P-value (P = 0.0001). Conclusion: Malignant pleural effusions had elevated PALP when compared to tuberculous pleural effusions in exudative lymphocytic pleural effusions;better differences are seen in older ages and shorter disease durations.

Albendazole versus metronidazole treatment of adult giardiasis:An open randomized clinical study

To investigate the efficacy and tolerability of albendazoleand metranidazole treatment in giardiasis.

Vascular and Morphogenetic Abnormalities Associated with Exposure of Cigarette Smoke Condensate during Chicken and Murine Embryogenesis

Objective Embryonic movements （EM） and angiogenesis pathways are evolutionarily conserved mechanisms which are essential for proper embryonic development. Deviations in these processes by exposure to cigarette smoke condensate （CSC） may cause vascular and morphogenetic disorders. Methods Using chicken and mouse embryos, we have demonstrated the in vivo effects of CSC on EM, vascular development, and organogenesis. Results Examination of the CSC exposed chicken embryos revealed a significant reduction in EM, stunted growth, deviated pattern of blood vessels, hemorrhages, and localized necrosis. Likewise, mouse embryos that were exposed to CSC at E8.5 and E9.5 died between E11.5 and E12.5, respectively. These mouse embryos showed defects in morphogenesis and remodeling of the embryonic vasculature, while littermate controls showed normal development. Conclusion Cigarette smoking during pregnancy is fatal for growing embryos. CSC may induce the remodeling of embryonic vasculature, leading to various pathologies.

COMPARISON OF TOPICAL LA- TANOPROST 0.005 % AND BRIMONIDINE 0.2% EYE DROPS IN THE ADJUNCTIVE TREATMENT OF PATIENTS WITH OPEN ANGLE GLAUCOMA

Purpose: To compare intraocular pressure (IOP) lowering effect of topical latanoprost 0.005% once daily with brimonidine 0.2% twice daily in patients with open angle glaucoma receiving of dorzolamide plus timolol twice daily. Methods: Fifty one eyes of 43 patients with open angle glaucoma not adequately controlled on timolol maleate plus dorzolamide were randomly assigned

Accurate diagnosis is essential for amebiasis

Amebiasis is one of the three most common causes of death from parasitic disease, and Entamoeba histolytica is the most widely distributed parasites in the world. Particularly, Entamoeba histolytica infection in the developing countries is a significant health problem in amebiasis-endemic areas with a significant impact on infant mortality. In recent years a world wide

A discussion on cotton transformation during the last decade (2010–2021);an update on present trends and future prospects

The introduction of genetically modified(GM)cotton in 1996 in the US and its worldwide spread later rejuvenated cotton production in many parts of the world.The evolution is continued since then and currently,the 3rd and fourth generation of same GM cotton is grown in many parts of the world.The GM cotton introduced in 1996 was simple Bt cotton that expressed a single Cry1Ac gene,the later generation carried multiple Cry genes along with the genes controlling herbicide tolerance.Current day GM cotton does not only give stable resistance against lepidopteran insects but also facilitates the farmers to spray broad-spectrum herbicides without harming the crop.The evolution of GM cotton is continued both on the basic and applied side and interventions have been introduced during the last decade.Earlier the cotton transformation was limited to Cocker strains which are getting possible in many other varieties,too.It is successful with both gene gun,and Agrobacterium and inplanta transformation has made it a routine activity.Apart from overexpression studies for various purposes including biotic,abiotic,and quality traits,RNAi and genome editing are explored vigorously.Through this review,we have tried to explore and discuss various interventions for improving transformation protocols,the applications of cotton transformation,and future strategies being developed to get maximum benefits from this technology during the last decade.