Mini titanium plates; hearkening the end of nonrigid cranial bone flap fixation

Background and Objective: Craniotomy bone flaps should be replaced for both cosmetic and protective purposes. Different methods are available commercially. The aim of this study was to assess outcome of bone flap fixation using mini titanium plates and screws

Methods: Between March 2011 and March 2014, 71 patients underwent cranial bone flap fixation with mini titanium plates and screws after craniotomy and excision of supratentorial lesions at Combined Military Hospital, Peshawar. There were 42 males and 30 females with a mean age of 40.07. All patients had supratentorial lesions. Intracranial lesion size ranged from 3 cm by 2 cm to 7 cm by 5 cm. The changes of local incision and general condition were observed

Results: Subcutaneous effusion occurred in two patients. One patient developed a mild postoperative wound infection. CT scan showed good repositioning of the flap and edge to edge apposition at two weeks after operation. All the patients were followed up for 12 months post operatively. Skull had good appearance without any discharge and, local deformity or effusion. Repeat CT/MRl showed no subsidence or displacement of cranial flap or artifacts

Conclusion: Mini titanium plate and screw fixation of cranial flaps is a simple, cost effective and safe option for repositioning and immediate stability as compared to traditional sutures

Intrathecal tramadol may cause respiratory depression

Opioids such as morphine and fentanyl have been used in neuraxial anesthesia to prolong the analgesic effects since long, but these have frequently been associated with few adverse effects e.g. nausea, vomiting, pruritus and rarely respiratory depression. Tramadol has also been used in epidural as well as spinal anesthesia, and respiratory depression has not been reported with its intrathecal use. We present a case in which 20 mg of intrathecal tramadol produced signs of opioid overdose including respiratory depression. The side effects were reversed with naloxone confirming our suspicion that these were caused by tramadol. We recommend adequate monitoring and vigilance for tramadol as is used for other intrathecal opioids

Impairment of liver synthetic function and the production of plasma proteins in primary breast cancer patients on doxorubicincyclophosphamide [AC] protocol

Doxorubicin and Cyclophosphamide [AC protocol] combination is usually considered as a first line therapy in newly diagnosed breast cancer patients. Thus, a retrospective observational study was conducted to monitor the effect of AC protocol on liver synthetic functions and production of plasma proteins in breast cancer patients, reporting to specialized cancer care hospital of Lahore, Pakistan. A total of 75 patients [n=75] on AC protocol with breast cancer were observed in this study. The patient data including age, gender, body surface area, dosage, disease status and laboratory biochemical values were recorded by reviewing historical treatment records. Pre-treatment values were taken as baseline values for albumin, globulin, blood urea nitrogen [BUN], albumin/globulin [A/G] ratio and total proteins. The baseline values were compared after each cycle of by applying ANOVA using statistical tool SPSS[Registered sign] version 21. The plasma levels of blood urea nitrogen [BUN], total protein and globulin dropped significantly [p<0.05] in patients of all age groups. However, the albumin levels were not significantly changed [p>0.05]. The A/G ratio level increased [p<0.05] as a result of reduction in globulin levels. Significant changes in plasma protein levels were observed in the elderly patients [50 to 65 years] than patients between 20 to 50 years of age. AC protocol impairs liver synthetic functions as observed by decreased blood urea nitrogen [BUN] and plasma protein levels

Investigation of in vivo antioxidant activity of Euphorbia helioscopia latex and leaves methanol extract: A target against oxidative stress induced toxicity

Objective: To evaluate in vivo antioxidant activity of latex and leaves methanol extract of Euphorbia helioscopia using mice as experimental animals. Methods: The plant was collected, identified, dried under shade, ground to fine powder and extraction was done. Latex was collected in dried bottles by cutting the stem. Oxidative stress was induced in mice with acute toxic dose of paracetamol administered intrperitoneally. Latex and leaves methanol extract (600 and 1 200 mg/kg) orally, once a day, were given to mice for two weeks. Then oxidative stress biomarkers were measured in tissue homogenates and serum. Results: Leaves methanol extract exhibited prominent in vivo antioxidant effect as compared to latex. Results showed significant rise in antioxidant enzymes (catalase, superoxide dismutase and glutathione) levels at 1 200 mg/kg dose of extract. Thus, extract helped to detoxify the free radicles by increasing antioxidant enzymes levels. Malondialdehyde value decreased significantly with extract (1 200 mg/kg) which was indicator of extract's power to inhibit the generation of free radicals. Extract (1 200 mg/kg) exhibited maximum cure against stress induced changes in liver, kidney, lipid profile parameters and complete blood count. Conclusions: Leaves methanol extract of Euphorbia helioscopia raised antioxidant enzymes levels in mice. It showed hepatorenal-curative effect, hypolipidemic effect and hemostasis potential. Thus, it can help the biological systems to fight against stress induced pathological conditions.

Investigation of in vivo antioxidant activity of Euphorbia helioscopia latex and leaves methanol extract: a target against oxidative stress induced toxicity

OBJECTIVE@#To evaluate in vivo antioxidant activity of latex and leaves methanol extract of Euphorbia helioscopia using mice as experimental animals.@*METHODS@#The plant was collected, identified, dried under shade, ground to fine powder and extraction was done. Latex was collected in dried bottles by cutting the stem. Oxidative stress was induced in mice with acute toxic dose of paracetamol administered intrperitoneally. Latex and leaves methanol extract (600 and 1 200 mg/kg) orally, once a day, were given to mice for two weeks. Then oxidative stress biomarkers were measured in tissue homogenates and serum.@*RESULTS@#Leaves methanol extract exhibited prominent in vivo antioxidant effect as compared to latex. Results showed significant rise in antioxidant enzymes (catalase, superoxide dismutase and glutathione) levels at 1 200 mg/kg dose of extract. Thus, extract helped to detoxify the free radicles by increasing antioxidant enzymes levels. Malondialdehyde value decreased significantly with extract (1 200 mg/kg) which was indicator of extract's power to inhibit the generation of free radicals. Extract (1 200 mg/kg) exhibited maximum cure against stress induced changes in liver, kidney, lipid profile parameters and complete blood count.@*CONCLUSIONS@#Leaves methanol extract of Euphorbia helioscopia raised antioxidant enzymes levels in mice. It showed hepatorenal-curative effect, hypolipidemic effect and hemostasis potential. Thus, it can help the biological systems to fight against stress induced pathological conditions.

Protective effect of crude Curcuma longa and its methanolic extract in alloxanized rabbits

Curcuma longa [C. longa] is commonly found in different areas of Pakistan. It has been locally utilized as a traditional medicine. The aim of this study was to evaluate the antidiabetic, hepatoprotective and total antioxidant effect of the crude drug and its methanolic extract in rabbits. Diabetes was induced with alloxan [180mg/kg]. Two major groups were designed, curative and protective groups. In curative group the crude drug and its methanolic extract was orally administered to the diabetic animals and acute study was performed. On the other hand in protective group the crude drug and its methanolic extract were administered for eight days prior to the diabetes induction. Results indicated that in Curative group the crude and methanolic extract of C. longa significantly improved the levels of serum glucose, serum transaminases and antioxidant activity [AOA]. In protective group, serum glucose, serum transaminases were not significantly increased by alloxan, in both crude as well as methanolic extract group. This study shows that C. longa acts as antidiabetic, hepatoprotective and antioxidant in diabetes especially type 1 diabetes.

Physicochemical and phytochemical analysis of Euphorbia helioscopia [L.]

The present study aimed to standardize the crude drug from "Euphorbia helioscopia" by doing qualitative and quantitative analysis of different pulverized plant parts and extracts. Physicochemical analysis [determination of moisture contents, total ash, water insoluble ash, sulphated ash, acid insoluble ash, and water and alcohol extractives] was done on powdered raw materials [stem and leaves]. The moisture contents and the ash value were found within the normal recommended range [moisture contents 6% and ash value 20%]. The value of water-soluble extracts was higher as compared to alcohol soluble extractives. Percentage yield was highest in methanol solvent. The phytochemical analysis i.e. total lipids, total proteins and carbohydrates of crude powder showed that lipids and proteins contents were high [2.4% and 0.91% respectively] in pulverized stem while carbohydrate contents were high [78.27%] in pulverized leaves. Qualitative analysis by FTIR fingerprints and UV-scanning showed that stem and leaves of the plant contained the same constituents because their spectra are super-imposable. Aqueous-, ethanol-, petroleum ether-, chloroform- and methanol extracts were used in the study. Quantitative analysis was done by calculating the primary and secondary metabolites [total proteins, total glycosaponins, total alkaloids, total flavonoids, and total polyphenolics] in all the extracts using suitable markers. Chloroform gave very less percentage yield and nil primary metabolites so it was eliminated from secondary metabolites estimation. The maximum value of total proteins, total glycosaponins, total alkaloids, total flavonoids and total polyphenolics were found in the leaves methanol [36.56%], stem methanol [34%], stem ethanol [41.84%], leaves methanol [108.96%], and leaves petroleum ether [7.22%] respectively. Different pharmacological activities of the plants are due to their flavonoid contents. It is concluded that methanol is the best solvent for extraction. Any arial part of the plant can be used in pharmacological evaluations prior to pre-clinical and clinical studies because leaves and stem had superimposable spectra in FTIR and UV-scanning.

Surgical management of peptic ulcer disease in proton pump inhibitor era

To evaluate the important risk factors involved in complications of peptic ulcer disease and the need, timing, extent and outcome of surgery with the evolution of proton pump inhibitors. Descriptive study. POF Hospital Wah Cantt, from December 2006 to December 2008. All the patients presenting with complications of peptic ulcer disease [perforation, bleeding duodenal ulcers and gastric outlet obstruction] were included in this study. A total of 46 patients were included in this study. Thirty five patients had peptic ulcer perforation, 8 patients presented with bleeding peptic ulcer that failed to respond to medical and endoscopic treatment and 3 patients presented with gastric outlet obstruction. Smoking was the most common risk factor followed by the use of non streroidal anti inflammatory [NSAID] drugs and steroids. Ramadan fasting was also a factor in patients with history of dyspepsia. Peptic ulcer perforation was more common in patients in second and third decade of life as compared to bleeding which was more prevalent in fourth decade. Modern medical and endoscopic therapy has caused a decline in complications of peptic ulcer disease but they are still prevalent in developing world. Smoking is one of the most common and important risk factors

Absorption and disposition kinetics of potential anticonvulsant 3-hydroxy-3 acetonyl oxindole in rabbits

Pharmacokinetic parameters describing the absorption, distribution and excretion of 3-hydroxy-3-acetonyloxin-dole were determined in rabbits, Oryctolagtts cuniculus. The drug was given in the dose of 100 mg/kg body weight intravenous and oral routes in two different groups of rabbits. Incomplete availability of the drug was observed weight by administered orally, which may be due to metabolism in the gut wall or in the liver. A higher value of total body clearance [CpT.B] in case of intravenous route was observed which is due to a higher rate of elimination [Beta]. volume of distribution [vd] was also found to be higher, which is due to the fact that absorption was maximum in case of the intravenous route. The investigation revealed that incomplete absorption through oral route or hepatic metabolism may be the ha factor for lowering the values of different pharntacokinetic parameters in case of the oral route