Efficacy of cyclosporin: a in refractory rheumatoid arthritis

The aim of the study was to evaluate the efficacy of cyclosporin-A in patients of rheumatoid arthritis not responding to standard therapy early in the course of the disease. Design: A non-randomized controlled clinical trial. Place and Duration of Study: Outpatients Department of Abbasi Shaheed Hospital and Imam Clinic over a period of 18 months from March 1999 through September 2000. Materials and The study was carried out on 63 patients of both gender suffering with refractory rheumatoid arthritis for at least 3 months. Patients were divided into two groups A and B. Group-A was the experimental one, treated with cyclosporin-A in combination with methotrexate while Group-B was continued with methotrexate alone. Their pre and post assessments regarding recovery criteria and drug profile had been done in order to establish the efficacy of cyclosporin-A. The study showed a significant difference [p<.000 with a.05] after six months between treatment group and the controls, in the mean values of articular index [2.53 vs. 5.39], right grip [14.28 vs. 33.8 mmHg], left grip strengths [16.5 vs. 34.31 mmHg] and number of tender joints [26.9% vs. 38.6%]. Furthermore, a significant negative correlation between articular index at recruitment and visual analogue scale [VAS] of pain after 6 months of therapy was observed in experimental group. This study indicates that the combination of cyclosporin with methotrexate benefits rheumatoid arthritis patients refractory to methotrexate monotherapy. Cyclosporin was well tolerated by those having shorter duration of disease

Evaluation of academic performance by dental graduates of Karachi medical and dental college: In lieu of their selection criteria for professional education

Creditable selection of candidates in the professional colleges is of crucial importance in producing capable and talented doctors to deliver good service to the people. KMDC selects its candidates on the bases of an admission test conducted by Institute of Business Administration [I BA] with weightage given to Intermediate [HSC] and Matric [SSC]. Evidence shows that academic achievements of professional graduates can not be predicted on the basis of their preprofessional records hence it has been suggested that innovative methods should be evolved for selecting the most suitable professionals. Aims: The purpose of this study is to look at the ability of the pre-professional records and the admission test to predict the academic performance of dental graduates. Results of professional exams of first four dental batches [n=80] of Karachi Medical and Dental College were retrieved and their academic records in Higher secondary, Secondary school and IBA test were also taken. The descriptive statistics show that average score of first BDS batch for IBA is 59.0 while for batch 4th it is 71.04. Whereas the average professional marks of batch 1 is 356.9 to that of 346.81 of batch 4. There is negative correlation between IBA and final prof results with R=-.048 [P<.510], -.340 [P<.152],.163 [P<.079] and -.198 [P<.033] respectively for each batch. There is no significant difference in final professional marks between the four batches with F=1.991 [P<.193] for higher IBA scores. It was concluded that there is no significant positive correlation between IBA Test score and the final professional results in all four batches of dental graduates of Karachi Medical and Dental College. The IBA score was improved in the subsequent batches without influencing the professional scores

Response of mono- therapy with interferon in hepatitis C patients and its comparison with combination therapy in the non-responders

The study was conducted to observe the response of mono-therapy with Interferon g in Hepatitis C patients. A second objective was to determine the efficacy of the combination therapy with INF u and Ribavarin in the non-responders. Thirty patients having Hepatitis C [HCV] infection were included in the study during the year 1998 and 1999. All the patients were initially started on INF u alone for 24 weeks and then those who did not respond to this mono-therapy, were treated upon with combination therapy. Finally the two groups were analyzed to prove efficacy of the treatment modalities. After 24 weeks of mono-therapy with INF u, three out of 30 patients[10%] could be normalized biochemically while the rest 27 were shifted onto combination therapy with INF u and Ribovarin. Seventeen patients [56.7%] showed normal ALT after 24 weeks of combination therapy. Whereas 9 patients [30.33%] were identified as non-responders and placed on Induction therapy, out of which only 2 patients had sustained virological and biochemical response after 48 weeks of therapy. The combination of INF a and Ribovarin for hepatitis C shows a 5 times more sustained biological [SBR] and virological response [SVR] as compared to monotherapy. This combination should be further evaluated for patients in the developing countries where cost effectiveness is of dire importance

Bacteriological pattern in 50 cases of pyogenic meningitis at Abbasi Shaheed Hospital

Neisseria Meningitis and streptococcus pneumoni being the most common organisms in bacterial meningitis, penicillin resistance is emerging fast in them worldwide. As there are very few studies in this regard a study was done at Abbasi Shaheed Hospital to determine the comparative yield of causative organisms along with observing penicillin resistance in these organisms causing pyogenic meningitis. Materials And One hundred and twenty patients were enrolled out of which 50 were selected for this study. Among these 38 were males and 12 were females. Lumber puncture was done on all of them and C.S.F was sent for Gram staining and culture. Result: Neisseria meningitidis and Streptococcus Pneumoniae were responsible for 48% and 40% of cases respectively. Haemophilus influenzae showed a very low occurrence rate. of 8%. While 16.25% of isolated pneumococcus were resistant to penicillin. Majority of cases occurred in young adults and in winter season. Neisseria meningitidis and Streptococcus Pneumoniae are the most frequent causative organisms. The Penicillin resistance is significantly high [P<.000] among pneumococcal strains