Background: Congenital anomalies are a major cause of perinatal and neonatal deaths, both in low- and high-income countries. They are relatively common worldwide, affecting 3% to 5% of live births. Methods: A cross-sectional study was conducted from January 2014 to June 2014 at the Khyber teaching hospital in Peshawar. Specific patient information was obtained from patient records at the beginning of the study. Those individuals found to have at least one birth defect were approached and their attendants (mothers) were interviewed. Information regarding various risk factors was collected. Descriptive analyses were carried out. Results: Out of 1062 deliveries, 2.9% (31) of newborns had various congenital anomalies.b Hydrocephalus (22.6%), anencephaly (12.9%), and spina bifida (9.7%) were major anomalies. The maternal age ranged from 18 years to 46 years (mean: 30 ± 8). Most of the anomalies (35.5%) were present in the 26-30 years age group. Out of 31 babies, 6.4% had multiple anomalies. The preponderance of various congenital anomalies was seen in parity 1 (35.4%); parities 2 to 4 had lower incidences (35.4%). The consanguinity rate was 67.7%; only 32.3% of patients were using folic acid. History of passive smoking was positive in 16.1% of cases. Conclusion: Anencephaly and hydrocephalus were the most prominent anomaly detected; early prenatal diagnosis may be helpful in decreasing mortality by offering early termination. Low intake of folic acid and a high consanguinity rate were the most common associated risk factors for congenital anomalies. These risk factors may be reduced by creating awareness regarding the avoidance of consanguineous marriage and promoting the use of folic acid during pregnancy.

OBJECTIVES: The main objective of this study was to assess post thrombolytic resolution of ST-segment and its outcome in patients with acute myocardial infarction. METHODOLOGY: This Prospective Comparative Study was carried out at the Cardiology Unit of Ayub Teaching Hospital, Abbottabad. All patients irrespective of gender and age with ST-Segment elevation myocardial infarction (STEMI), having no immediate access to angioplasty and thrombolysed with streptokinase, were included in this study. ECG was taken at the beginning and 90 minutes after the administration of streptokinase. Based on ST-segment resolution on ECG taken at 90 minutes these patients were classified into group A and B. Group A included patients with ST-segment resolution while group B showed no resolution of ST-segment after streptokinase administration. These patients were followed during their hospital stay for complications such as arrhythmias, cardiogenic shock, acquired ventricular septal defects (VSD) aneurysm and death. RESULTS: Among 115 patients, 94 were male and 21 female. Group A included 102 (89%) patients and group B included 13 (11%). In group A, only 1 (0.98 %) patient developed complications and in group B, 13 patients (100%) developed complications. Arrhythmias were the most common complication among MI patients in group A while cardiogenic shock was the commonest complication in group B. CONCLUSION: ST-segment resolution is a practical and applicable indicator of successful thrombolysis and has a significant correlation with clinical outcome in acute myocardial patients after thrombolysis with streptokinase.

There was a significant improvement of results in cycle 2, where 60% of the patients with decompensated cirrhosis had the above-mentioned parameters documented in the discharge letters respectively.

albumin supplementation (figure 1). Hepatic expression of TLR4 and associated pathways: Cirrhotic NAR animals had greater hepatic TLR4 expression which was reduced by albumin administration. Hepatic TLR4 gene array confirmed the activation of TLR4 dependent pathways in the cirrhotic NAR animals, which was abrogated by albumin infusion. Conclusion NAR animals have significantly greater liver injury, increased sensitivity to LPS and mortality which is prevented by albumin administration. Our data show for the first time that the mechanism of the protective effect of albumin is consequent upon restoration of gut junctional proteins and reduction of hepatic TLR4 expression.