Intraventricular dyssynchrony among patients with left bundle branch block

Objective: To determine the frequency of intraventricular dyssynchrony among patients with left bundle branch block

Methods: The study was conducted at Hayatabad Medical Complex, Peshawar, from January, 2017 to July, 2017. All patients aged 18 years and above with Left Bundle Branch Block [LBBB] on ECG with or without heart failure were included in the study. Patients with valvular heart disease, predominant diastolic heart failure, acute coronary syndromes or coronary revascularization in last three months and atrial fibrillation were excluded. Tissue Doppler Imaging [TDI] parameters were measured from 2-D images in apical 4-chamber and 2chamber views. Consecutive non-probability sampling technique was used for sample collection

Results: Our study included 159 patients. Mean age was 52 years with SD +/- 2.74. Ninety-nine [62%] patients were male and 60 [38%] patients were female. One hundred and three [65%] patients had heart failure while 56 [35%] patients didn't have heart failure. More over in our study 124 [78%] patients had Intraventricular dyssynchrony while 35[22%] patients didn't have Intraventricular dyssynchrony

Conclusion: The incidence of Intraventricular dyssynchrony is high among patients with heart failure and left bundle branch block

Subclinical Hypothyroidism among local adult obese population

Objective: To determine the frequency of subclinical hypothyroidism in local adult obese population

Methods: The study was conducted at Hayatabad Medical Complex, Peshawar, from March, 2017 to August, 2017. All patients aged between 18 and 60 years with BMI of more than 29kg/m[2] were included in the study. Patients on lipid lowering drugs, with renal failure, hepatic failure and already diagnosed cases of thyroid dysfunction were excluded from the study. Thyroid functions were measured for all patients

Results: A total of 127 adults were included in the study in a consecutive manner. Mean age was 34.5 + 7.9 years of which 46.5% were male and 53.5% were female. Mean BMI was 32.05 +/- 2.06 kg/m[2]. The mean serum TSH was 3.13 +/- 1.10 mIU/L and mean serum thyroxine level was 1.08 +/- 0.25 ng/dl. Subclinical hypothyroidism was recorded in 15% of the study population

Conclusion: Subclinical hypothyroidism is highly prevalent in our population with BMI of more than 29kg/m[2]. Further studies are recommended on relationship between thyroid functions and BMI and its effect on cardiovascular functions

Antipyretic potential of herbal coded formulation [Pyrexol]

The antipyretic effect of the aqueous extract of herbal coded formulation containing equal amount of Salix alba, Emblica officinalis, Glycyrrhiza glabra, Adhatoda vasica, Viola odorata, Thea sinensis, Veleriana officinalis, Foeniculum vulgare, Sisymbrium irrio and Achillea millefolium was investigated using the yeast induced pyrexia model in rabbits. Paracetamol was used as a control group. Rectal temperatures of all rabbits were recorded immediately before the administration of the extract or paracetamol and again at 1 hour, after this, temperature was noted at 1 hrs interval for 5 hrs using digital thermometer. At 240 mg/kg dose the extract showed significant reduction in yeast-induced elevated temperature as compared with that of standard drug paracetamol [150 mg/kg]. It is concluded that herbal coded medicine at a dose of 240 mg/kg has marked antipyretic activity in animal models and this strongly supports the ethno pharmacological uses of medicinal plants of this formulation

Simple, rapid and highly sensitive HPLC method for measurement of Lamotrigine in human plasma and its clinical applications

Spikes in Lamotrigine concentrations levels and associated clinical toxicity may occur unpredictably. This study describes the development and validation of a simple, more rapid, highly sensitive and economical method for measuring Lamotrigine [LTG] concentration levels in human plasma using HPLC-UV and its clinical applications. Analyte from plasma was extracted with methanol [protein precipitation] and separated on the analytical column Diamonsil C[18] [150mmx4.6mm, 5 micro m] Waters-Milford, MA, United States. Mixture of 0.1% Trifluoroacetate and Methanol used as mobile phase in a 59:41 volume/volume mixture with an isocratic flow rate of 1.5 ml/min and wavelength was adjusted to 260nm. Standard curve of lamotrigine showed good linearity over the range of 1.0-50 micro g/mL [r[2]=0.9961] and LLOQ was 1.0 micro g/ml. The Specificity, Recovery, Accuracy, Stability, Robustness and RSDs for both intraday and interday precision were within acceptable limits. The highly sensitive HPLC assay for determination of LTG in human plasma was demonstrated, validated and applied in Therapeutic Drug Monitoring [TDM] of sixty seven epilepsy patients who were using LTG. The proposed method can be easily applied in routine Therapeutic monitoring of LTG, Besides TDM, stated method can be also very useful for Bioequivalence studies, Pharmacovigilance and Pharmacokinetics studies

Evaluation of medicinal value of Epimedium datum on the basis of pharmacologically active constituents, Icariin and Icariside-II

Epimedium L. is well known medicinal genus of Chinese pharmacopoeia. Various species are ethno-botanically used against diseases of eye and kidney, impotence, asthma, arthritis and hypertension; besides being used as analeptic, expectorant, antibacterial, hypoglycemic, vasodilator and refrigerant. Recent studies have attributed most of these medicinal properties to its flavonoid glycosides, especially Icariin which is the major pharmacologically active constituent. Icariin has been found to possess effective aphrodisiac, antioxidant, immunomodulatory, hepatoprotective, cardioprotective, vasodilatory, antidepressant and anti-osteoporosis activities. Icariside-II, another active constituent, has cytotoxic and cytostatic effects on 6 cancer cell-lines, and immunosuppressive effects on allograft rejection. In this present study, Epimedium elatum Morr. and Decne., the only species of this genus growing in Indian subcontinent, has been investigated for its medicinal value by determining the content of pharmacologically active constituents, Icariin and Icariside-II, by HPLC method. HPLC analysis of alcohol extract of its shade dried parts was performed with reverse phase C-18 column. The mobile phase for Icariin was acetonitrile-water in gradient mode; while for Icariside-II, it was methanol-water. The effluent was monitored at 270nm. The results have revealed an appreciable content of Icariin and Icariside-II in its aerial and underground parts; the content being higher in populations growing at higher altitudes. The substantial presence of pharmacologically active constituents, Icariin and Icariside-II, in this species of Epimedium, signifies its value as a medicinal plant

Autologous noncultured epidermal cell suspension in case of resistant segmental vitiligo: a preliminary study

To assess the repigmentation efficacy of noncultured epidermal cell suspension [NCECS] in case of resistant segmental vitiligo. Three patients having resistant segmental vitiligo were treated with noncultured epidermal cell suspension at the Department of Dermatology, STD and Leprosy, SMHS Hospital [associated teaching hospital of Govt. Medical College, Srinagar] and were followed up for six months. Two patients showed more than 70% response, one patient more than 50% response. The pattern of pigmentation was uniform and aesthetically acceptable. Autologous non cultured epidermal cell suspension is one of the best modalities as far as segmental vitiliginous patches resistant to other treatment modalities are concerned and is one of the novel techniques as far as its outcome is concerned in the form of uniform pigmentation

Frequency and management of raised intraocular pressure following intravitreal triamcinolone acetonide

To determine the frequency and management of intraocular pressure [IOP] elevation following intravitreal triamcinolone acetonide [IVTA]. Case series. Isra Postgraduate Institute of Ophthalmology/Al-Ibrahim Eye Hospital, Karachi, from May 2007 to May 2008. In this study, 198 eyes of 150 patients requiring IVTA injection, were included. Pre-injection assessment comprised of detailed history, general and ocular examination including anterior and posterior segment examination with IOP measurements with Goldmann tonometer. After informed consent, IVTA 4 mg/0.1 ml was injected through pars plana and IOP was measured at 1 week, 1 month, 3 months and 6 months and if raised, treated accordingly. Out of 150 patients, 82 were male [54.7%] and 68 were female [45.3%] [M: F = 1.2: 1]. Mean age was 50.61 +/- 10.59 years. Raised IOP value after IVTA, higher than 21 mmHg was observed at one week in 28 eyes [14.1%], at 1 month in 48 eyes [24.2%], at 3 months in 76 eyes [38.4%] and at 6 months in 25 eyes [12.6%]. Raised IOP was controlled by topical beta blockers alone or in combination with carbonic anhydrase inhibitors in 58 eyes [76.3%]. Elevation of IOP after IVTA injection occurred in 76 eyes [38.3%]. It may take an extended period of time to manifest raised IOP. In majority of the patients, raised IOP was managed with topical medications