Objective:  To determine the factors that affects the decision making process of the spine surgery from a patient’s perspective. Material and Methods:  The study was carried on 264 patients admitted for spine surgery in the Department of Neurosurgery, Khyber Teaching Hospital, Peshawar, Pakistan. Data was collected from patients on questionnaire using a Likert scale. Reliability was ensured by Cronbach alpha. Results:  The results for regression analysis revealed that there is a significant negative relationship between previous experiences and decision for spine surgery in patients (β = -0.156, p = 0.001 < 0.05). There is a significant positive influence of emotional and social state (β = 0.193, p = 0.002), information & counselling (β = 0.097, p = 0.011), socioeconomic status (β = 0.131, p = 0.004), severity of disability (β = 0.602, p = 0.000), ineffective conservative treatment (β9 = 0.082, p = 0.013) and intensity of pain (β = 0.527, p = 0.000) on decision for spine surgery in patients. The independent variables, including physical health, gender role and age were found to have an insignificant effect on the decision for spine surgery (p > 0.05). Conclusion:  It is concluded that the factors affecting the decision of patients on spine surgery included previous experience, emotional & social state, information & counselling, socioeconomic status, severity of disability, ineffectiveness of previously taken conservative treatment and intensity of pain.

Background: The analgesic drugs are the main cause of gastric ulcer. The objective of this study was to determine the gastroprotective ability of flavonoid, 6-aminoflavone in a rat pyloric ligation model of aspirin associated gastro-ulcerogenesis. Methods: A laboratory based experimental study was conducted in the animal house and research laboratory at Khyber Medical College, Peshawar from July to November 2019. A total of 42 adult male Spargue-Dawely rats were divided into seven groups. Flavonoid, 6-aminoflavone was administered orally in doses of 10, 25 and 100 mg/kg with misoprostol, as standard at 50 µg/kg orally for 4 days. On the last day aspirin was given orally at 200 mg/kg and the pyloric ligation surgery was performed. After 4 hours all animals were killed by cervical dislocation. The gastric tissues were collected for histomorphological study. The obtained data were expressed as mean±SEM. Analysis was carried out by using ANOVA.  p value ˂0.05 was considered significant. Results: The animals treated with the different doses of 6-aminoflavone showed a marked protective effect in the histological observations. The 10 mg/kg dose had a mild protective effect as occasional ulcerative changes were observed. However, doses of 25 and 100 mg/kg significantly caused the reduction in the ulcer score. These effects produced were equipotent to the gastroprotective effectiveness inherent in the misoprostol. Conclusion: These findings conclude that 6-aminoflavone as like other flavonoids has a significant gastroprotective propensity with significant effect produced at doses of 25 and 100 mg/kg and can be used as a part of therapy management for the treatment of gastrointestinal disease particularly ulcerative condition.

Objectives: To confirm sonographic findings of fatty liver by histologic study of liver biopsies and to look for related histological changes associated with fatty liver.Material and method: It was case series study. The study was conducted in Gastroenterology unit of Hayatabad Medical Complex, Histology lab of Khyber Medical College Peshawar. The study period was five months. Ten cases labeled as fatty liver on Ultrasonography were designated for liver biopsy proceeded by microscopic study. The patients with advanced liver disease were excluded. Tissue slides were observed under light microscope. The morphometric measurements were carried out. Histological Scoring System for non-alcoholic fatty liver diseases was applied for histological staging and grading. Results: Microscopic examination showed that the mean value of size of hepatocytes and nuclei were significantly more than normal mean. 50% of total cases were with panacinar steatosis, zone 1 and zone 3 steatosis were noted in 20% and 30% of patients respectively. Ballooning was revealed in all the cases, while lobular inflammation was seen in 60% of patients. All of the cases depict various phases of fibrosis, but Cirrhosis could not be noticed in any of the specimen. 30% of the cases were recorded with definite non-alcoholic steatotic hepatitis (NASH), 50% were labelled as borderline NASH and 20% were as simple steatosis. Conclusions: All cases detected as simple fatty liver on ultrasonography are found with some degree of steatosis and steatohepatitis on histological examination. Morphometric study showed that steatotic process increases hepatocytes and nuclei size. Ballooning and lobar inflammation were the hallmark of NASH