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Background: Diabetes mellitus (DM) is well known for related micro and macrovascular complications. Uncontrolled hyperglycemia in diabetes mellitus leads to endothelial dysfunction, inflammation, microvascular impairment, myocardial dysfunction, and skeletal muscle changes which affect multiple organ systems. This study was designed to take an extensive view of cardiorespiratory dynamics in patients with type 2 DM. Methods: One hundred healthy controls (HC) and 100 DM patients were enrolled. We measured and compared the breathing patterns (spirometry), VO2 max levels (heart rate ratio method) and self-reported fitness level (international fitness scale) of individuals with and without diabetes. Data was analyzed in SPSS v.22 and GraphPad Prism v8.0. Results: We observed restrictive spirometry patterns (FVC <80%) in 22% of DM as compared to 2% in HC (p = 0.021). There was low mean VO2 max in DM as compared to HC(32.03 ± 5.36 vs 41.91 ± 7.98 ml/kg/min; p value <0.001). When evaluating physical fitness on self-reported IFiS scale, 90% of the HC report average, good, or very good fitness levels. In contrast, only 45% of the DM shared this pattern, with a 53% proportion perceiving their fitness as poor or very poor (p = <0.05). Restrictive respiratory pattern, low VO2 max and fitness level were significantly associated with HbA1c and long-standing DM. Conclusion: This study shows decreased pulmonary functions, decreased cardiorespiratory fitness (VO2 max) and IFiS scale variables in diabetic population as compared to healthy controls which are also associated with glycemic levels and long-standing DM. Screening for pulmonary functions can aid optimum management in this population. [ABSTRACT FROM AUTHOR]

The experiments were carried out to evaluate the comparative efficacy of different postemergence weedicides on weeds in wheat crop at Adaptive Research Farm Karor, Distt. Layyah and at farmer's field a.i. Chak No. 116/TDA, tehsil Karor, Distt. Layyah during Rabi crop season 2022-23 under irrigated conditions. The experiments were laid out in randomized complete block design (RBCD) with three replications. Four different herbicides were applied as post-emergence treatments viz. Buctril Super 60 % EC (Bromoxynil + MCPA) @ 1125 ml ha-1, Bromoxynil 40 % EC @1250 ml ha-1, Findus Extra 60 WG (Mesosulfuron-Methyl + Iodosulfuron-Methyl-Sodium) @ 240 g ha-1 and Clean wave (Imino Pyralid + Fluroxyber) @ 800 ml ha-1. An untreated control was also included in the trials. All herbicides decrease the weeds population over control up to nine days in both locations and maximum grain yield 4533.35 kg ha-1 and 4635.50 kg ha-1 were produced in Adaptive Research Farm Karor, and at farmer's field a.i. Chak No. 116/TDA, Tehsil Karor, Distt Layyah respectively, where Buctril Super 60 % EC (Bromoxynil + MCPA) @ 1125 ml ha-1 was applied. Therefore, it is recommended that Buctril Super 60 % EC (Bromoxynil + MCPA) may be applied @ 1125 ml ha-1 for offering the control of broad leaves weeds and increase grain yield of wheat. [ABSTRACT FROM AUTHOR]

Objective: To determine the postoperative outcomes of video-assisted thoracoscopic single port surgery (VATS) in the treatment of pleural empyema. Methods: This case series was conducted at Department of thoracic Surgery, Karachi. It was 16 months study from September 2020 to January 2022. Total 170 patients of both genders were included. Informed and written consent was taken from all included patients. Complete history and thorough clinical examination of patients were obtained. All operations were employing one lung ventilation, general anesthesia, and a double-lumen endotracheal tube. Each and every patient was followed up till 4 weeks to assess the postoperative outcomes. Data was compiled and analyzed using SPSS-21. Results: In this study mean age was 56.9±17.7 years. Out of 170 patients, 97 (57%) were male and 73 (43%) female. The postoperative outcomes of U-VATS in the treatment of pleural empyema were determined, mean operation time was 130.0±64.6minutes, mean pain score at first post-operative day was 2 ± 1.6, the mean duration of pain was 2.5±2.1 days, mean pain score after removal of chest tube was 0.33±0.9 and mean cosmetic score was 2.45±0.4. Postoperative paresthesia was observed in 9 (5.3%) cases, no wound infection was observed and satisfactory re-expansion of lung was noted in 154 (90.5%) cases. Conclusion: Even in stages 1 and 2 of the condition, pleural empyema can be effectively treated with U-VATS, and the procedure has relevant postoperative outcomes in terms of reduced discomfort, less complications, and aesthetic improvements. [ABSTRACT FROM AUTHOR]

The continuous development of crop cultivars with desired attributes is crucial due to the vulnerability of crop varieties to various biotic and abiotic stresses over time. This necessitates the replacement of existing varieties with genotypes that exhibit enhanced productivity potential and built-in tolerance against a range of stresses. This study highlights the development of a new desi chickpea cultivar "Thal-2020" using conventional plant breeding procedures. This variety expressed higher yield potential, bold seed size and resistance to various diseases. The breeding process commenced in 2006-07 by crossing two local genotypes, 97086 (female parent) and 950130 (male parent), to create genetic variability for bold seed size. Recombinants having higher yield along with bold grains were selected from the F2 population raised from the F1 seed. Subsequent single plant selections (SPS) were accomplished and further advancement from F3 to F5 generations were carried out through the plant pedigree selection method, mainly focusing on recombinants possessing high yield potential with bold grains. Uniform lines were selected from F6 generation and bulked. Ultimately, the promising and uniform line "TG1410" later on named "Thal-2020" was selected from F7 population during 2013-14. This selected line underwent rigorous evaluation for yield potential and disease resistance during the process of evolution. In various station, adaptation, and national yield trials, this cultivar consistently outperformed standard checks (Bittle-2016, Punjab-2008 and Bhakkar-2011) with higher yield. Notably, the candidate variety TG1410 expressed a potential yield of 4513 kg ha-1 in Provincial Yield Trial 2018-19 conducted at Gram Breeding Research Sub-Station, Kallur Kot (Bhakkar), Punjab, Pakistan. The salient features of "Thal-2020" include bold, brown-colored ram-headed grains, with 100-grains weight of 27-28g, semi-erect growth habit, medium canopy, higher yield potential and resistance to Ascochyta blight and Fusarium wilt diseases. This first report on the "Thal-2020" chickpea variety highlights its promising traits, including high yield potential, disease resistance, and adaptability to various conditions. "Thal-2020" offers future benefits such as enhanced productivity, reduced pesticide use, and improved economic returns for farmers. Its introduction is expected to significantly enhance the sustainability and profitability of chickpea cultivation. [ABSTRACT FROM AUTHOR]

Chickpea (Cicer arietinum L.) is the second largest pulse crop cultivated worldwide. Ascochyta blight caused by Ascochyta rabiei is the major constraints to chickpea production across the continent including Pakistan. The pathogen Ascochyta rabiei is highly variable. Chickpea cultivars contain limited resistance to pathogen due to their potential for sexual recombination. Investigations were conducted for the identification resistant sources against A.rabiei. Sixty-six chickpea accessions and one susceptible variety were tested against A. rabiei. However, four accessions TG-1427, Star Channa, PARB913/CH03 and PARB913/CH02 showed resistant reaction, eight accessions moderately resistant reaction, eleven accessions developed moderately susceptible reaction whereas twenty two accessions recorded susceptible reaction, moreover remaining twenty one accessions exhibited highly susceptible reaction with maximum ratings = 9. Ten fungicides were tested against A. rabiei at three concentrations (3g, 5g and 7g/liter of water) on the susceptible cultivars (AUG-424). Application of Pyraclostrobin and Azoxystrobin proved most effective and expressed minimum disease incidence 8.37 and 10.97% respectively on comparison to control 77.31%. Results of the present investigation will help the farming community and researchers for timely management of A. blight. Resistant accessions that were identified in this study will be useful for developing blight resistant cultivars. [ABSTRACT FROM AUTHOR]

Chickpea (Cicer arietinum L.) is a major food legume which ranks third in the world. Wilt and blight, two damaging diseases of chickpea, are prevalent in Pakistan, and this has resulted in a low output of the crop. Except for exploiting the host plant's resistance mechanism, the available control techniques are neither practicable nor cost-effective. To determine the sources of resistance in chickpea germplasm that is currently available.278chickpea genotypes (168 Desi and 110 Kabuli) originated from different springs were evaluated for disease resistance against Ascochyta rabiei in poly house and 102 different genotypes were screened for Fusarium oxysporum resistant sources in the sick field at Arid Zone Research Institute Bhakkar. Experiments were laid out following augmented design without replications during 2019-20 and highly susceptible check (AUG-424) was replicated as indicator for disease advent. The disease frequency was assessed twice at different growth stages and genotypes were categorized as per ICARDA rating scale (1-9). Ascochyta blight incidences revealed that39 lines displayed resistant (R) reaction and 12 had moderately resistant reaction (MR) in desi. However, 38 were found resistant and 26 genotypes were recorded as moderately resistant in kabuli chickpea, respectively. Similarly, 102 genotypes were sown in sick plot for screening against F. oxysporum, out of which only10 entries showed resistant and 21 moderately resistant reaction. The collected information was the most valuable to be used in breeding program for exploiting the genetic resistance and its direct use in severely blight and wilt hit areas may be preferred on the basis of resistance type. [ABSTRACT FROM AUTHOR]

Bhakkar-2011, a bold seeded, wilt resistant and high yielding variety of chickpea (Cicer arietinum L.), was developed from a cross between two genotypes (90243 x Paidar-91). The hybridization work was initiated at Arid Zone Research Institute, Bhakkar, Pakistan during the year 1995-96 using pedigree method of selection. The segregating population was evaluated for desirable traits and advanced to F6 generation. The pure line was selected from F6 generation during 2001-02. It was tested in various station yield trials from 2002-03 to 2006-07 before moving to adaptability trials. It was then evaluated simultaneously in coordinated uniform yield trials and national uniform yield trials during the years 2008-09 and 2009-10. The variety produced 5.34-39.4 percent more seed yield in different yield trials over respective checks with a yield potential of 4000 kg per hectare. Its plant habit is semi-erect with 60-65 cm plant height. It has narrow leaves. Number of primary branches varies from 2-4 whereas secondary branches range from 11-15 depending upon abiotic and biotic factors. It takes 90-95 days to 50 percent flowering after sowing while flowering duration is 60-65 days. Number of pods per plant varies from 90-96 with 2-3 seeds per pod while pod shattering is absent. Its seed is bold in size having higher 1000-seed weight (276 g). It performs better at seed rate of 75 kg per hectare with 15 cm plant spacing and 32-84-0 kg NPK per hectare. With resistance bold seededness, high yield potential and suitability for both irrigated and rainfed conditions are major attributes of new chickpea variety Bhakkar-2011. [ABSTRACT FROM AUTHOR]

A 16 year old female presented with complain of fever, shortness of breath and upper abdominal pain. Investigation and clinical examination suggestive of empyema thoracis. At thoracotomy Margagni's hernia was found. The purpose of this case report is to highlight the incidental diagnosis of Morgagni's hernia presenting as a thoracic mass in a patient with empyema thoracis. The rationale behind reporting this case is to create educational awareness regarding the rarity of this hernia and its associated presentation with empyema thoracis, both of which were managed surgically during a single procedure. [ABSTRACT FROM AUTHOR]

A study was conducted at Arid Zone Research Institute, Bhakkar, Pakistan during 2007-10 to observe the impact of canopy management on bio-economic efficiency of chickpea on sandy loam soil. Treatmetns comprising plant growth regulators i.e. Nephthalene Acetic Acid (NAA) was kept in main plots while four available moisture depletion levels (ASMDL 50, ASMDL 65, ASMDL 80 and ASMDL 95) were kept in sub-plots, using split plot arrangements. Naphthalene acetic acid (4.5% as sodium salt) was applied @ 600 ml per hectare at 90, 110, 130, 150 and 165 days after sowing. The results showed that NAA applied at flower blooming stage (90 days after sowing) significantly increased number of pods per plant, seeds per pod, 100-seed weight and seed yield by 12.50, 6.98, 9.59 and 13.98 percent, respectively compared with control (NAA0). Treatment combination NAA1 x ASMDL80 gave maximum pods per plant (70.68), 100-seed weight (30.15 g) and grain yield (3219.1 kg/ha). Water productivity ranged from 8.23 (ASDML50 x NAA0) to 18.18 kg per ha per min (NAA x ASSML95). Maximum dry matter accumulation was recorded at 150 DAS in case of both NAA levels. The application of 600 ml per hectare NAA at flower initiation and maintenance of irrigation at 80 percent ASMDL (total amount of water applied was 252 mm with irrigation depth of 126 mm each) proved best for higher chickpea seed yield with 4.28 BCR. [ABSTRACT FROM AUTHOR]

Dermatofibrosarcomaprotuberans is a rare, soft tissue tumour with high rate of recurrence. It is locally aggressive, with a low rate of metastasis. We describe the case of a 42 year old man who presented with a re-recurrent, large tumour situated on the anterior chest wall in the sternal region. We did a wide local excision and covered the resulting defect by using bilateral, pectoralis major myocutaneous flaps. Histopathology and immunohistochemical staining findings were consistent with the diagnosis of Dermatofibrosarcoma Protuberance. Post operatively the patient was treated with chemotherapy and radiotherapy.

A 20-year-old female presented with complaints of right-sided chest pain, cough, fever and shortness of breath for the preceding one-and-a-half year. Air entry was decreased over the middle and lower chest. Computed tomography scan of the chest revealed a cystic lesion with thick margins present in the right hemi-thorax. The cyst was excised by posterolateral thoracotomy. Histopathology revealed it to be mediastinal enteric cyst with intestinal and pancreatic tissue.

Objective: To determine the outcome of thymectomy in patients with myasthenia gravis and safety of median sternotomy approach., Methodology: An observational descriptive study was conducted in the department of thoracic surgery JPMC from February 2005 to January 2009. Twenty-two patients having persistent generalized or ocular myasthenia gravis referred to our department by neurologists and general physicians, partially or not responding to medical treatment with or without thymoma, were included in the study. Those who were not fit for anaesthesia were excluded. Preoperatively 2 to 3 sessions of plasmapheresis were done and each patient was given anti myasthenia gravis treatment. Clinical staging was done by Modified Osserman classification. Median sternotomy approach was used. Outcome was assessed on the basis of remission of disease in different Osserman groups. All patients were followed for a minimum of 6 months., Results: Out of 22 patients, 16 (72.7%) were females and 6 (27.2%) males. Mean age at presentation was 35.2 +/- 14.5 years. Mean duration of symptoms was 1.5 +/- 1.2 years. A total of 4 (18.1%) patients with myasthenia gravis had thymoma and histopathology of 18 (81.9%) patients showed thymic hyperplasia. Remission was seen in most grades of Osserman. The best response was seen in Grade I where all patients achieved remission. Most patients in Grade II A and II B were benefited. The only patient in Grade III had no improvement of symptoms. No patient in Grade IV underwent thymectomy. Overall 86.3% had a positive outcome on basis of remission and improvement., Conclusion: Thymectomy by median sternotomy is safe and effective with more favourable outcomes for patients of myasthenia gravis not responding to medical treatment.

Objective: To compare the clinical presentation and results of pulmonary resection in simple and complex aspergilloma of the lung., Study Design: Observational study., Place and Duration of Study: The Department of Thoracic Surgery, Jinnah Postgraduate Medical Centre, Karachi, from January 2003 to December 2008., Methodology: Fifty-one adult patients with unilateral aspergilloma lung were included in this study. Patients were divided into two groups: A (simple aspergilloma-SA, n=14) and B (complex aspergilloma-CA, n=37), based on the radiological and operative characteristics of the cavitatory lesion and the presence or absence of extensive adhesions with the chest wall. Suitability for resection was assessed with arterial gases, pulmonary function tests and echocardiogram. Results were compared using Fishers exact test., Results: Recurrent hemoptysis was the predominant symptom in both the groups. Exertional dyspnea (A=21.4%; B=56.8%; p=0.03), chest pain (A=21.4%; B=59.5%; p=0.027), cough (A=35.7%; B=70.3%; p < 0.05) and postoperative complications like residual pleural space A=14.2%; B=54%; p=0.013) and pleural collection (A=7.1%; B=37.8%; p=0.041) were predominant in group B. Lobectomy was the most common procedure performed in group B (A=28.6%; B=59.5%), while wedge excision was performed in the majority of patients in group A (A=42.9%; B=29.7%). Recurrence of aspergilloma was seen in 3 patients (8.1%) in group B only. Total number of early and late complications in SA and CA were 7, and 60, respectively. Early mortality was 8.1% and 0.0% in group B and group A, [corrected] respectively (p=0.552). The overall mortality was 5.4%., Conclusion: Symptoms were more frequently associated with CA as compared to SA. Surgery for CA was associated with low mortality but significant morbidity, whereas SA had low postoperative morbidity and no mortality.

Objective: To determine the frequency of survival in patients with thoracic trauma, undergoing Urgent Thoracotomy (UT)., Study Design: Quasi-experimental study., Place and Duration of Study: The study was carried out in the Department of Thoracic Surgery, JPMC, Karachi, from January 2005 to June 2007 (30 months)., Methodology: Fifty two patients, who presented with chest trauma and underwent UT within 48 hours of sustaining thoracic trauma, were included in the study. All patients were assessed by history, physical examination and relevant investigations., Results: A total of 475 patients with acute thoracic trauma needing admission during the study period presented to the Accidents and Emergency Department. Fifty-two (52/475; 10.9%) patients were indicated for UT. The most common indication for UT was massive hemothorax (43/52; 82.6%). The mean age of the patients was 34.36 +/- 11.02 years. There were 22 (42.2%) blunt injuries and 30 (57.8%) penetrating injuries. Road Traffic Accidents (RTA) were the most frequent cause of blunt chest injuries (15 patients; 75%), while firearm injury was the commonest (21 patients; 70%) cause of penetrating chest trauma. Post thoracotomy mortality was 13.3 % (4 out of 30) in patients with penetrating injuries and 18.2% (4 out of 22) in patients with blunt injuries (p < 0.01). Mortality of UT was 15.3 % with survival of 84.7%. Overall survival in 475 patients was 95.58%., Conclusion: Early recognition of treatable injuries and an aggressive approach in management with Urgent Thoracotomy can increase chances of survival of patients suffering from severe chest trauma.

A young man aged 22 years presented with shortness of breath, left sided chest pain, mild dry cough, peripheral cyanosis, fever and generalized weakness for three years. He was diagnosed as having a large infected cystic mediastinal mass with tricuspid regurgitation and severe pulmonary hypertension. On thoracotomy, one litre of pus was aspirated and tumour was excised and sent for histopathology. Biopsy report revealed benign cystic teratoma. This case is reported to highlight the management of a huge infected benign cystic teratoma which is rarely found.

Morgagni's hernia is an uncommon type of diaphragmatic hernia. These patients usually present in childhood but sometimes later in life. We report a case of 75 years old female who presented with epigastric discomfort and vomiting. She was diagnosed as a case of calculous cholecystitis and was treated with antibiotics but was not relieved. Further investigations revealed Morgagni's hernia. She was successfully managed by open surgical technique.