Rheum spiciforme Royle—the medicinal herb with positive modulatory effect on controlled in vitro oxidative stress

Oxidative stress is the root cause of many diseases, affecting the humans by deranging the balance between the oxidants and antioxidants. Pathologies, such as Alzheimer’s, Parkinson’s, diabetes and cancer have been well associated with the production of free radicals during various metabolic processes. Many medicinal plants are used to treat such kind of diseases since ancient times. Here, we evaluated the medicinal herb Rheum spiciformis Royle (RS), used commonly in folklore to treat many aliments for its potential against oxidative stress. Five different extracts (aqueous, chloroform, ethyl acetate, methanol and PET ether) of RS were evaluated against oxidative stress generated in vitro. Phytochemical constituents were assessed followed by total phenolics, DPPH, reducing power, hydroxyl radical scavenging activity and in vitro calf thymus DNA damage. The highest phenolic content (TPC) of 1191.65 mg GAE/g was observed in RS-MeOH extract. DPPH radical scavenging activity was found to be highest in RS-MeOH (96.60%) with IC50 125.91 µg/mL. The reducing power of the extracts increased in a concentration dependent manner. Again superoxide radical scavenging activity of RS extracts with IC50 values 34.10 µg/mL (RS-MeOH) for methanol was highest. The H2O2 scavenging activity 84.76 µg/mL shown by RS-MeOH extract at 250 µg/mL of plant extracts was the maximum. RS-MeOH showed great effect to scavenge free radicals as such prevents Calf thymus DNA damage induced by Fenton reaction. These results clearly indicate that RS-MeOH and RS-EtA among the five extracts possesses the highest positive modulatory effect on free radical scavenging on wide variety of free radicals as such can be employed as potential antioxidant and anti-inflammatory agent against various oxidative stress related pathological conditions.

Detection of interleukins-6 and 8 in saliva as potential biomarkers of oral pre-malignant lesion and oral carcinoma: a breakthrough in salivary diagnostics in Pakistan

Oral cancer is at rise in our population due to increasing use of areca nut [Betel nut] with or without tobacco. It is the second frequent malignant tumour for both the gender in Pakistan. This non-interventional case control study was carried out with the aim to explore saliva as diagnostic medium for detecting interleukins [IL] 6 and 8 as biomarkers of pre-malignant lesions [PML] and oral carcinoma. Total 105 subjects were recruited and were divided into three groups "A", "B" and "C" each comprising of 35 subjects. Group "A" comprised of cases with strong clinical evidence of oral PML. Group "B" constitute clinical and histologically proven OSCC and group "C" include disease free subjects as controls. Saliva from all the recruited subjects was procured by drooling method and stored at-20[degree sign]C before further process. All the collected samples were centrifuged at 4500 rpm for 15 minutes at 4[degree sign]C. Supernatant fluid was used in ELISA for detection and quantification of IL-6 and IL-8. Data was analysed by using Chi-square test and multivariate analysis was done by non-parametric test. P-value of 0.05 was taken as standard reference. Significant co-relation was found for qualitative salivary detection of IL-6 and IL-8 among the groups [P<0.001 and <0.0001 respectively]. Regarding quantitative salivary concentration of leukotrienes, no significant co-relation was found in levels of IL-6 among the groups while there was significant association of IL-8 levels between the groups [P<0.0001].On post Hoc multiple comparison, significant co-relation was found among oral PML group and controls [P=0.001] and OSCC group and control [P=<0.0001]. In conclusion salivary detection of IL-6 and IL-8 could be used as probable biomarker for early detection of oral PML and OSCC in etiologically distinct population of Pakistan

Effect of smoking on C-reactive protein levels in chronic periodontitis

The objective of the study was to compare the effect of smoking on the level of C-reactive protein [CRP] in chronic periodontal disease. The response of periodontal treatment and its effect on the level of the CRP was also observed in both groups. Hundred patients with chronic periodontitis were taken. Smoking history of the patients was assessed and accordingly, they were categorized as: Group A [smokers] and Group B [non- smokers]. Periodontal evaluation was done on every patient and blood samples were collected for noting the levels of CRP. All patients were then given treatment of chronic periodontitis by mechanical removal of calculus as well as prescription of antimicrobials and mouth rinses. Periodontal evaluation and blood samples were repeated three months after the given treatment to check the change in CRP levels. At Baseline, CRP levels of smoker group was more than non- smoker group. Three months after the given periodontal treatment, the periodontal health was significantly improved. Mean CRP level in both smoker group and non- smoker group was significantly decreased. Chronic periodontitis has significant effect on CRP levels. Chronic periodontitis may add to the inflammatory burden of an individual and this can be reverted to some extent if appropriate treatment is given. This response will not be affected by adverse effects of smoking

Salivary detection of human Papilloma virus 16 and 18 in pre-malignant and malignant lesions of oral cavity: Is it feasible in Pakistani context of Socio-Cultural Taboos?

To evaluate salivary detection of HPV-16 and 18 would be feasible and informative biomarker for oral pre-malignant and malignant lesion in our population. This non-interventional, case control study was carried out at department of E.N.T, Head and Neck Surgery, Dow University of Health Sciences, Dow Medical College and Civil Hospital Karachi, Pakistan between July 2011 to December 2012. Total of 105 cases were recruited. These were divided in three groups 'A', 'B' and 'C having 35 subjects each. Group'A' constitutes patients having strong clinical evidence of oral pre-malignant lesions [PML]. Group 'B' includes historically proven oral squamous cell carcinoma [OSCC] and Group 'C' comprised disease free subjects as controls. After taking informed consent, relevant clinical history was recorded on institutional approved performa. Saliva from all subjects was procured by standard 'drooling method'. Samples were stored at +4°C and later transferred to Laboratory to store at-20°C before further process. Samples werKfcentrifuged at 4500 rpm for 15 minutes at 4°C. Cell pellets sediments were used for identification of HPV-16 and 18 by real-time PCR method. Data was entered and analysed using SPSS version 16. P-value of 0.05 was taken as standard. In group 'A', HPV-16 was detected in 3 [8.6%] cases while HPV-18 was not detected in any of the subject. In group 'B', HPV-16 was detected in 07 [20%] while HPV-18 was found in 06 [17.1%] cases. Mixed HPV-16 and HPV-18 were found in 02 [5.7%] cases. In group 'C, HPV-16 was detected in 03 [8.6%] while HPV-18 was not detected in any of the subjects. Significant relationship was observed between the groups for HPV-18 detection [P= 0.002] while for HPV-16, no significant association was found [P= 0.245]. HPV infection for the causation of oral cancer cannot be fully established possibly due to small sample size. More over differences in genetic makeup, environment, indulgence in peculiar risk factor habits, sexual practices and difficult evaluation of the acquisition of viral load due to socio-cultural and religious restrictions could be the reason

Influence of anthropometric measurements on abnormal gonadotropin secretion in women with polycystic ovary syndrome

To evaluate the influence of anthropometric measurements on abnormal gonadotropin secretion in patients with polycystic ovary syndrome [PCOS]. Cross-sectional study. The Institute of Basic Medical Sciences [IBMS], DUHS in collaboration with Gynae/infertility clinics of the Civil Hospital and Lady Dufferin Hospital, Karachi, from October 2010 to February 2011. One hundred and sixty three oligomenorrhic PCOS women of reproductive age [18 - 40 years] fulfilling the revised Rotterdam 2003 criteria were studied. The data recorded on a prescribed proforma included current age, age at menarche, menstrual irregularities, presence of hirsuitism, acne, infertility, familial nature, blood pressure, BMI and waisthip ratio. Blood samples for gonadotropin assay were taken randomly on day 6th to 30th of menstrual cycle, in a gel tube. Hormonal assay was performed using chemiluminescent immunoassay. Kruskul Wallis test was used to assess the influence of BMI levels on LH:FSH values. The mean weight was 66.14 +/- 11.02 kg and mean BMI was 27.03 +/- 4.42 kg/m2. There was no significant difference in mean LH/FSH ratio [p=.575] among BMI groups. However, there was a positive correlation between BMI and LH:FSH ratio [p=0.04, r=0.155]. There was high frequency of obesity [69%] in women with PCOS. Although no significant difference was found between mean LH:FSH ratio among different BMI groups levels but significant correlation between BMI levels and LH: FSH suggested that there was positive relation between BMI and LH: FSH

Impact of untreated high blood pressure on renal function tests at initial diagnosis of hypertension

Pakistani population is at higher risk of developing hypertensive complications at a younger age, resulting from undiagnosed and untreated hypertension [HTN]. High cost of medical care is a barrier to early detection and assessment of end organ damage as well as physicians are disinclined to adopt more aggressive therapeutic management to improve blood pressure control. A cross sectional study was planned to determine the effect of high blood pressure on renal function tests in a random population aged 25-50 year, at initial diagnosis of hypertension. The study was conducted on total 276 subjects; 201selected from five general practitioners clinics in Karachi and were classified into pre hypertensive, and hypertensive stages I and II on the basis of 7th JNC report. Two BP readings were taken half an hour apart. A blood sample was drawn for measurement of serum urea, creatinine and a dipstick test was done to check protein in urine. The results were compared with 75 control, normotensive subjects. The percentage, mean and Standard deviation were computed. ANOVA was performed to compare four study groups and LSD test was applied to compare pair-wise group. Pearson's correlation was applied to find out association of renal function with stages of hypertension. The mean urea and creatinine levels were on higher normal side in HTN stages-I and II [39.91 +/- 8.51 and 1.72 +/- 0.54 in stage-I and 44.51 +/- 9.93 and 1.91 +/- 0.88 in stage-II respectively]. The frequency of proteinuria was also more in these groups, indicating declining renal function in these patients as compared to control and prehypertension groups. Subjects diagnosed with stage I and II HTN showed evidence of subclinical renal damage, along with the presence of proteinuria at the time of diagnosis

Molecular diagnosis of oral pre-malignant lesions and oral squamous cell carcinoma in saliva-a breakthrough in Pakistan

To evaluate salivary detection of interleukin 6 and 8 and high risk HPV-16 and 18 are informative biomarkers of Oral Pre-malignant Lesion [PML] and Oral Squamous Cell Carcinoma [OSCC] in our population. July 2011 to December 2012. Total 105 cases were included. The subjects were divided in three groups 'A', 'B' and 'C' having 35 participants each. Group 'A' comprised of patients having strong clinical evidence of oral PML. Group 'B' constitutes histologically proven OSCC and Group 'C' includes disease free subjects as controls. Relevant clinical history was recorded after informed consent on institutional approved performa. Saliva was collected as per standard drooling method'. Samples were stored at +4oC and later transferred to Dow Diagnostic, Research and Reference Laboratory to store it at -20oC before further process. Samples were subjected to centrifugation at 4500 rpm for 15 minutes at 4oC. Supernatant fluid phase was used in ELISA for detection and quantification of IL6 and IL8. . Cell pellets were used for identification of high risk HPV-16 and 18 by real-time PCR. Data was entered and analyzed on SPSS version 16. P-value of 0.05 was taken as standard reference. In group 'A', IL6 was not detected in almost all the subjects except one case. IL8 was detected in 26/35 [74.3%] subjects and not detected in 09 [25.7%] cases. In group 'B', IL6 was detected in 13 [37.1%] cases and in 22 [62.9%] cases, it cannot be detected. IL8 was detected in 33 [94.3%] and it was not detected in 02 [5.7%] subjects. It is observed that IL8 is consistently found raised in group 'A' and 'B'. In group 'C', IL6 was not detected in any of the subject while IL8 was detected in 10[28.6%] cases. Significant association was found for qualitative salivary detection of IL6 and IL8 between the groups [P= < 0.0001 and < 0.0001 respectively]. Regarding quantitative salivary concentration of IL6 and IL8, no significant co-relation was found in salivary levels of IL6 between the groups while there was significant association of salivary IL8 levels between the groups [P= <0.0001]. On post Hoc multiple comparison, significant co-relation was found in IL8 levels between oral PML group and controls [P=0.001] and OSCC group and controls [P= <0.0001]. In group 'A', HPV-16 was detected in salivary samples of 3 [8.6%] cases while HPV-18 was not detected. In group 'B', HPV-16 was detected in the salivary samples of 07 [20%] cases while HPV-18 was detected in 06 [17.1%] cases. Mixed HPV-16 and HPV-18 were found in 02 [5.7%] cases. In group 'C', HPV-16 was detected in 03[8.6%] cases while HPV-18 was not detected in any of the subjects. Significant relationship was observed between the groups for salivary HPV-18 detection [P= 0.002] while for detection of HPV-16, no significant association was found [P= 0.245]. Salivary concentration of IL6 and IL8 in oral PML and oral cancer are useful biomarkers in our population. Detection of HPV infection for the causation of oral cancer cannot be fully established possibly due to small sample size. More over different genetic makeup, environmental and geographic differences, indulgence in peculiar risk factor habits and different sexual practices compared to west due to socio-cultural and religious restrictions could be the reason

relationship between sleep and cognitive functioning in adult people

The purpose of the current study is to find out if subjective sleep complaints will have less cognitive functioning in older people [50 years and above]. Sleep was assessed with the subscale Sleep Problems of the Symptoms Checklist-90 [Arrendell and Ettema 1986]. Cognitive performance was measured with the Mini Mental Status Examination [Folstein, et al 1975] which is used as a dependent variable. Subjective complaints would be negatively associated with cognitive performance, since in elder people biological sleep is likely to be related with cognitive changes. A group of 12 people were given the task of collecting data through purposeful sampling techniques. Sample size of 120 participants was assessed. Each member of the group collected data from 10 subjects. Pearson Correlation Moment was applied for data analysis. In older persons the coefficient of falling asleep difficulty was -0.05 [p=0.33] and for waking up too early the coefficient was -0.13 [p=0.012] while for restless sleep coefficient was calculated as -0.09 [p=0.094]. The assumption was verified that sleep problems negatively associated with cognitive functioning

Effect of exercise training program in post-CRET post-CABG patients with normal and subnormal ejection fraction [EF > 50% or < 50%] after coronary artery bypass grafting surgery

The aim of the present study is to compare the effect of exercise training program in post-Cardiac Rehabilitation Exercise Training [CRET], post-CABG patients with normal and subnormal ejection fraction [EF >50% or <50%] who have undergoing coronary artery bypass grafting [CABG] surgery. The study was conducted on 100 cardiac patients of both sexes [age: 57-65 years] who after CABG surgery, were referred to the department of Physiotherapy and Rehabilitation between 2008 and 2010 at Liaquat National Hospital and Medical College, Karachi. The patients undertook exercise training program [using treadmill, Recumbent Bike], keeping in view the Borg's scale of perceived exertion, for 6 weeks. Heart Rate [HR] and Blood Pressure [BP] were measured and compared in post CABG Patients with EF [>50% or <50%] at the start and end of the exercise training program. Statistical formulae were applied to analyze the improvement in cardiac functional indicators. Exercise significantly restores the values of HR and BP [systolic] in post CABGT Patients with EF [>50% or <50%] from the baseline to the last session of the training program. There appeared significant improvement in cardiac function four to six weeks of treadmill exercise training program. After CABG all patients showed similar improvement in cardiac function with exercise training program. The exercise training program is beneficial for improving exercise capacity linked with recovery cardiac function in Pakistani CABG patients

Prevalence of elevated luteinizing hormone [LH]/follicle stimulating hormone [FSH] ratio in polycystic ovary syndrome [PCOS] women among local population

To assess the frequency of elevated LH/FSH ratio>l in women with polycystic ovary syndrome among local population. Cross-sectional study. This cross sectional study was carried out at two tertiary care hospitals in Karachi during October 2010 to Feb 2011. A total of 163 PCOS women of reproductive age [18-40years] fulfilling revised Rotterdam 2003 criteria were studied. The data recorded on a prescribed proforma include current age, age at menarche, menstrual irregularities, presence of hirsuitism, acne, infertility, familial nature, blood pressure, BMI, waist to hip ratio. Blood sample for gonadotropin assay were taken in random state on specific dates of menstrual cycle [day 6[th] to day 30[th]] in gel tube. Hormonal assay were performed using chemiluminescent immunoassay. Mean age of presentation of PCOS subjects was 24.88 +/- 5.35 years. Menstrual irregularities [99%] were the commonest presentation followed by acne [88%], hirsuitism [71%] and infertility [62%]. A high frequency [>71%] of elevated LH/FSH >1 ratio was observed among local population. The present study concludes that elevated LH/FSH ratio>l is a characteristic finding of Pakistani population of PCOS [present in = 71% of patients] and with proper sampling dates can be used as diagnostic tool for establishing the diagnosis of PCOS

Perception and preferences of undergraduate medical students regarding the use of contemporary teaching aids at Dow International Medical College, Karachi

In this study, perception and preferences of the medical students' studying at Dow International Medical College have been described about the use of different teaching aids. Cross sectional survey was conducted on a stratified random sample of 200 undergraduate medical students during the month of October 2010 at Dow International Medical College, Karachi, Pakistan. 80% of the students responded to the questions asked. Over all 40% of the students chose powerpoint presentations as a reliable mode of teaching and favoured it as interesting and interactive teaching aid over problem based learning [28.8%], audio visual aid [18.6%] and white board [12%]. They believe that powerpoint provides a better learning experience as compared to other teaching tools. Projectors as a teaching tool was rejected by the students. This article serves as a source of valuable information for the faculty members. Students have chosen powerpoint presentations as the best teaching aid and have preferred the integration of different teaching tools for better understanding. Teachers will be able to use this information to develops better understanding about the subject matter among students by considering their learning style preferences. It will also facilitate them in developing interest and active participation of students in the classroom

Level of C-reactive protein in periodontal patients before and after treatment in a teaching hospital selected population

To determine the change in C-reactive protein [CRP] levels in subjects after treatment of chronic periodontitis. 100 patients, aged 30 to 50 years, having chronic periodontitis with a periodontal index [PI] of 6 and 8 were selected from low socioeconomic class. The patients completed a structured questionnaire that included data regarding oral and general health habits. They received treatment for chronic periodontitis and PI was reassessed after 3months.CRPlevelswere similarly measured at baseline and 3months after treatment. The mean PI of all subjects was 7.3 +/- 0.96 and 4.53 +/- 1.93 before and after treatment, respectively. Similarly, the mean CRP level [in mg/L] was 6.34 +/- 2.29 and 5.62 +/- 2.01 before and after treatment, respectively. CRP levels were higher in males as compared to females, at baseline than after treatment. However, both groups responded equally to treatment [P < 0.0005]. CRP levels were also higher in older age groups [> 40 years], both at baseline and after treatment. The CRP levels accompanied the severity of periodontal infection, and decreased significantly after improvement of periodontal health following the treatment

Diabetes mellitus type 2 as a major risk factor of developing Alzheimer-s disease in Pakistani population

Diabetes mellitus type-2 [DMT2] could increase the risk of Alzheimers disease [AD] specifically related dementia, through several biological pathways, but the relationship between DM and the development of AD remains uncertain. The aim of the present study was to explore the status of diabetes as one of the major risk factors of cognitive decline and dementia in AD and to compare the risk of developing AD among subjects with and without DM. The baseline examination was conducted from January 2008 to October 2010 on 611 subjects of both sexes who were above 50 years of age, to detect the prevalent cases of dementia. The Mini-Mental State Examination [MMSE] was done on all of these subjects. At each follow-up, random blood glucose levels were determined; all participants underwent a comprehensive clinical examination The study shows that risk of dementia increases with age, duration of diabetes and relevant conditions e.g. obesity. The risk of Dementia increases with duration of diabetes and the chi-square tests verify the claim. The calculated chi-square test statistics value was found to be 130.26 with degrees of freedom 9, corresponding p-value is [<0.005]. It was also found that obese diabetics had higher risk of developing AD, as well as those having borderline diabetes were also at the higher risk. The present study revealed that DMT2 is one of the major risk factors that would increase the risk of AD; but along with other factors like obesity, lifestyle and aging, it can lead to AD and related pathological conditions in individuals markedly characterized by dementia and cognitive decline

Prevalence of metabolic syndrome in patients with psoriasis.

Background: Psoriasis is a chronic inflammatory disease of the skin and is associated with an increased risk of cardiovascular atherosclerosis. Metabolic syndrome, a conglomerate of various clinical and biochemical parameters is a significant predictor of atherosclerotic disease and the associated risk for cardiovascular events in such patients. Aim: To investigate the prevalence of metabolic syndrome in patients with psoriasis. Methods: The study was a prospective, hospital based case-control study involving 150 adult patients with chronic plaque psoriasis and 150 healthy controls. Venous samples were taken at the enrolment visit after the subjects had fasted overnight (at least 8 h). Serum cholesterol and triglycerides were measured with enzymatic procedures. Plasma glucose was measured using a glucose oxidase method. Metabolic syndrome was diagnosed by the presence of three or more criteria of the National Cholesterol Education Programme's Adult Panel III (ATP III). Statistical analysis of the data was done using statistical processing software (SPSS-17) and epi-info software. Results: Metabolic syndrome was significantly more common in psoriatic patients than in controls 42(28%) vs 9(6%), odds ratio (OR) = 6.09, P<0.05. Psoriatic patients also had a significantly higher prevalence of hypertriglyceridaemia (73/150 among cases vs 24/150 among controls; P<0.05), arterial hypertension (74/150 among cases vs 24/150 among controls; P<0.05) and impaired fasting plasma glucose levels (27/150 among cases vs 04/150 among controls; P<0.05). Psoriatic patients with metabolic syndrome had mean disease duration of 13.67±11.87 years against 6.46±5.80 years in those without metabolic syndrome. Conclusion: There is a significantly higher prevalence of metabolic syndrome in psoriasis patients as compared to general population and so is the risk of having atherosclerotic adversity. While managing the psoriatic plaques of these patients, concerns should extend to the atherosclerotic plaques as well.

Awareness and practices regarding sexually transmitted infections among currently married males and females in a rural district of Sindh

To determine the levels of awareness and practices regarding sexually transmitted infections [STIs] in a Rural District of Sindh - Pakistan. It was a cross - sectional survey conducted in Taluka Khipro, District Sanghar-Sindh during June 2004 in fifteen villages. Data was collected through a structured questionnaire by trained local male and female workers who interviewed door to door. A total of 116 currently married males and females were interviewed. Majority of males 34[29%] were in 25-29 years age group, while among females 32 [28%] fell in 20-24 years age group. Majority of males i.e. 79 [68%] and females 108[93%] was not educated. Only 36[31%] males or females knew symptoms of STIs like vaginal discharge, discharge from urethra and back pain. Twenty-five [22%] males and 12[10%] females reported that "only wife can have sexual disease". Two [2%] females shared that both [male and female] can have Sexually Transmitted Infections [STIs], AIDS and Hepatitis C. Male respondents [72%] knew different symptoms of STIs. Majority of males [78%] and females [51%] were aware about Hepatitis B and C infections. Majority of respondents had never heard about AIDS. Only 4% males were of the view that it spreads by inappropriate sexual relation. Sixty married females [52%] had knowledge about any contraceptive method. No subject [male or female] reported having ever used any contraceptive method. This study depicts poor picture of a rural population in awareness and practices regarding STIs in particular and reproductive health in general in the target area. This was a limited study and to further explore reproductive health issues in rural areas, studies with larger sample size and stronger statistical evidence are required

Anthropometric and metabolic indicators in hypertensive patients

To determine the relationship between anthropometric variables with blood glucose and lipid concentrations in different stages of hypertension and evaluate the risk factors involved in progression of pre-hypertension stage in to clinical hypertension stage-1. Case-control study. National Institute of Cardiovascular Disease and General Practitioner's Clinics, Karachi, from 2005 to 2007. The study was conducted on 276 participants aged 25-65 years and classified into four categories of control, prehypertension [pre-HTN], hypertension [HTN] stage I and II, according to 7th JNC report. Anthropometric measurements and blood chemistry were obtained. The relationship between obesity indices [Body Mass Index [BMI], Waist Circumference [WC], Waist Hip Ratio [WHpR], Waist Height Ratio [WHtR], Basal Metabolic Rate [BMR] and Cardiovascular Disease [CVD] risk factors [blood pressure, serum lipids and glucose levels]] were investigated. The analysis of variance and test of Pearson's coefficient correlation were applied to assess relationship of all the variables. The mean WHR had significant correlation with both systolic and diastolic BP in all groups of HTN, as well as with blood glucose level in control and pre-HTN groups. BMI was positively correlated with cholesterol [r=0.29] and triglyceride [r=0.25] in HTN stage-1. Impaired and high blood glucose levels were found in pre-HTN group; all lipid parameters except triglycerides were higher in HTN stage I. WHR was positively and independently related to occurrence of arterial hypertension. Elevated levels of WHR, BMI, fasting blood glucose, total cholesterol and triglycerides were responsible for progression of pre-HTN stage in to HTN stage-1

Apoptosis in oral diagnostics: an overview

Apoptosis describes the molecular and morphological processes leading to controlled cellular self destruction. In recent years, it has been investigated for its biological significance in numerous physiological processes including embryogenesis, differentiation, proliferation /homeostasis and in the regulation of immune system. Its dysfunction and deregulation seems responsible for variety of pathological conditions e.g immune deficiency, autoimmune diseases, neuro-degenerative diseases and cancer. This communication updates molecular understanding of this natural phenomenon and its application in oral diagnostics. The present concept of signaling pathways for initiation of apoptotic characteristic changes is illustrated and the role of certain apoptotic genes identified so far is discussed. Abnormality of apoptosis and apoptotic regulatory genes during oral carcinogenesis. though conflictory, is presented. Further, clinical potential for monitoring reactions to chemo-radiotherapy is evaluated from human and animal studies and their usage as physiological markers for oral preneoplasia and squamous cell carcinoma is analyzed. On the basis of oral cytology the application of new physical and molecular methodological techniques is outlined e.g cytophotometry, DNA cytometry in relation to molecular studies and their diagnostic and prognostic implications. Understanding of molecular mechanisms provides development of newer therapeutic approaches in disease management and in future biomedical research. This overview updates molecular understanding of this natural phenomenon as its applications seem to have potential for managing common diseases in future

Changes in blood pressure, BMI and ECG patterns in women using low-dose contraceptives

To determine the cardiovascular risk factors in users of second generation contraceptives by recording changes in body mass index, blood pressure and electrocardiogram. Cross-sectional study. The National Institute of Fertility Research Centers at Jinnah Postgraduate Medical Center and PIB Maternity Home Karachi, from July 1997 to 1999. Sixty four women volunteered for this study [age range 20-35 years], belonging to low-income group with similar socio-cultural background. The Body Mass Index [BMI] was calculated by measuring height and weight of the subjects; systolic and diastolic blood pressure and ECG recording by standard method. The group means, standard deviations and coefficient correlation for interrelationship among variables in respective groups of subjects were calculated using relevant statistical method and software program. There was no significant difference between BMI of two types of contraceptive users as compared to non users; but BMI was significantly correlated with both systolic and diastolic blood pressures in injectable users as compared to controls. ECG alterations frequently observed in contraceptive users [40%] as compared to controls were normal findings. It was observed that women aged < 30 years and using contraceptives for more than three years had a tendency to gain weight and developed a mild increase in systolic and diastolic blood pressures

When is a bone scan study appropriate in asymptomatic men diagnosed with prostate cancer? / 亚洲男科学杂志(英文版)

<p><b>AIMS</b>To determine when a bone scan investigation is appropriate in asymptomatic men diagnosed with prostate cancer.</p><p><b>METHODS</b>Between November 2005 and July 2006, 317 men with prostate cancer underwent a bone scan study; 176 men fulfilled the inclusion criteria. Prostate-specific antigen (PSA) cut-offs as well as univariate and multivariate logistic regression analyses using digital rectal examination finding, biopsy Gleason scores and age were performed to determine when a bone scan study is likely to be of value.</p><p><b>RESULTS</b>Only 1/61 men (1.6%) with a serum PSA 20 ng/mL had a positive bone scan. However, 2/38 men (4.7%) with a serum PSA 20.1-40.0 ng/mL, 3/20 men (15%) with a serum PSA 40.1-60.0 ng/mL, 7/19 men (36.8%) with a serum PSA 60.1-100.0 ng/mL and 19/38 men (50%) with a serum PSA > 100.0 ng/mL had positive bone scans. Univariate and multivariate logistic regression analyses were uninformative in these groups.</p><p><b>CONCLUSION</b>Based on our findings, a bone scan is of limited value in asymptomatic prostate cancer patients presenting PSA =or< 20 ng/mL. Therefore, this investigation can be eliminated unless a curative treatment is contemplated. Furthermore, digital rectal examination finding, biopsy Gleason score and age are unhelpful in predicting those who might harbor bone metastasis.</p>