Study of Binary and Ternary Solid Dispersion of Spironolactone Prepared By Co-Precipitation Method for the Enhancement of Oral Bioavailability.

The study was designed to formulate novel spironolactone, a BCS class II drug loaded solid dispersion system (SDs) with improved dissolution rate. For this purpose binary and ternary solid dispersion were prepared by co-precipitation method using Poloxamer-407 only and mixture of poloxamer-407 with a second polymer such as HPMC 6cps, HPC, Kollicoat IR, Kollidon VA 64 respectively. To prepare binary SDs poloxamer 407 was used in three concentrations: 33%, 50% and 66.67% wt/wt of total SDs, whereas in case of ternary SDs, poloxamer 407 was used at 15%, 25% 35% wt/wt of the total SDs content and the concentration of the second polymer is maintained at fixed amount (1gm). In vitro dissolution study was carried out in a USP type II dissolution apparatus in 0.1 N hydrochloric acid solution for 1 hour. Release property of spironolactone from two different SDs was examined. Both the systems showed improved release profile compared with pure spironolactone powder. Enhanced release of spironolactone from the optimized SDs was characterized in light of cumulative percent release, % release after 5 min of dissolution and release rate of the drug from different SDs. When the amount of carriers increased with a decrease in drug content, the release of spironolactone was elevated. And it was found that almost two fold increase in the release of spironolactone while 66.67% poloxamer was used.

Evaluation of antidiabetic phytochemicals in Syzygium cumini (L.)Skeels (Family: Myrtaceae).

Traditionally the leaves of Syzygium cumini (Myrtaceae) are widely used for treating diabetes. The present study was carried out to identify the putative antidiabetic constituents from the S. cumini leaves. From the NMR data four different compounds, Lupeol, 12-oleanen-3-ol-3ß-acetate, Stigmasterol, ßsitosterol were identified from n-hexane fraction of plant extract. These compounds have potential antidiabetic activities which support the traditional use of the leaves as being remedy for treating diabetes.

Anthelmintic and diuretic activity of bark extracts of Sterculia villosa.

The study was evaluated for diuretic and anthelmintic activity of the ethanolic extract of the barks of Sterculia villosa Roxb, (Sterculiaceae). The diuretic assay was done on both healthy wistar rats and rabbits. The dose used for the diuretic assay was 100, 200 & 400mg/kg of the extract. Compared to the control and standard drug furosemide (20mg/kg), the result of diuretic study showed dose dependent activity of the extracts. The result also indicated higher excretion of Na+, K+ & Cl- in urine. Pheretima posthuma, adult earthworms were used for anthelmintic activity and the results of anthelmintic assessment at the dose of 50, 100 & 200mg/ml showed significant activity compared with control and standard drug albendazole (10mg/ml).

Proteomics in drug discovery.

Drug discovery is a lengthy and highly expensive process that uses a variety of tools from diverse fields. To facilitate the process, several biotechnologies, including genomics, proteomics, cellular and organismic methodologies have been developed. The present review aims to provide a basic understanding of proteomics research by discussing the methods used to study large numbers of proteins and by reviewing the application of proteomics methods to identify biomarkers, to identify drug target and to conduct drug’s mode of action and toxicology studies. It is expected that this will lead to important new insights into disease mechanisms and improved drug discovery strategies to produce novel therapeutics.

Radial artery approach for coronary intervention - early experience

To see the clinical outcome of patients undergoing Transradial Coronary Angioplasty with stable Angina. This was a single center observational study with prospective data collection of 338 patients who underwent transradial coronary angioplasty from September 2009 to August 2011, at Post Graduate Medical Institute, Lady Reading Hospital, Peshawar. Patients of both genders and all ages who had transradial coronary angioplasty for chronic stable angina were included in the study. Patients were clinically examined in out patients department on first month of hospital discharge and clinical outcome data was recorded. A total of 338 patients were included in the study. Male were 58.8% and 41.2% were female with mean age of 52 +/- 7years. All the patients had coronary intervention through right radial artery. Baseline characteristics of the patients were; 48.2% diabetic, 43.2% hypertensive, 30.5% smokers, dyslipidemia was 45.7% and mean values of serum creatinine and Hemoglobin were 1.1 +/- 0.3 and 11.5 +/- 1.5, respectively. The frequency of various complications were as follow; hematoma 1.3%, nausea and vomiting 2.2%, pain in hand 11.2%, readmission to hospital for chest pain 6.5%, need for revascularization 2.2%, hand ischemia 1.8%, minor bleeding 0.9%, no major bleeding and 1.9% mortality. The radial artery approach for coronary intervention is useful with low degree of access site vascular complications and an early mobilization

Efficacy and safety of percutaneous transvenous mitral commisurotomy [ptmc] performed through patent foramen ovale [pfo]

The aim of this study was to assess efficacy and safety of PTMC in patients with severe mitral stenosis [MS] perform through patent foramen ovale. All symptomatic patients with severe MS were included in the study from January 1998 to December 2010, at Cardiology department, Lady Reading Hospital, Peshawar. Transthoracic and trans-esophageal echocardiogram was performed to exclude left atrial appendage/left atrial clot and check the anatomy of interatrial septum. Severely calcified mitral valve and severe mitral regurgitation were excluded. Patent foramen ovale was crossed in majority of cases to reach left atrium. Stenosed mitral valve was dilated with Inoue balloon. Total number of patients was 1818. Females were 74% [p<0.05]. The mean age was 26.51 +/- 7.82 years and mean Body Mass Index [BMI] was 2 19.05 +/- 1.2kg/m[2]. The number of patients who had PTMC through PFO were 2 92.08%. Mean valve area was 0.9 +/- 0.19cm[2] on 2D Echocardiography, which 2 increased to 1.82 +/- 0.17cm[2] [p<0.05], mean mitral valve gradient decreased from 18 +/- 4.04mmHg to 7 +/- 0.25mmHg [p<0.005] and mean right ventricular systolic pressure decreased from 70 +/- 17.4mmHg to 48 +/- 13mmHg [32% drop] [p<0.05] at 24hours after PTMC. Mean time of crossing interatrial septum via PFO was 17 +/- 05minutes. Post PTMC severe MR in PFO group was 3.6% and 2.8% in inter atrial septum group [p=0.21]. Pericardial effusion was noted in 0.11% patients in PFO group and 0.27% in interatrial septum group [p>0.05]. Stroke was present in 1.5% patients. PTMC through patent foramen ovale [PFO] is a safe procedure, with few complications

Study of binary and ternary solid dispersion of ibuprofen for the enhancement of oral bioavailability.

To develop a novel ibuprofen loaded solid dispersion system (SDs) with enhanced dissolution rate, binary and ternary solid dispersion were prepared by co-precipitation method using poloxamer-407 only and mixture of poloxamer-407 with a second polymer such as HPMC 6cps, HPC, Kollicoat IR, Kollidon VA 64 respectively. In case of binary SDs, poloxamer 407 was used in three concentrations: 33%, 50% and 66.67% wt/wt of total SDs. In case of ternary SDs, poloxamer 407 was used at 15%, 25% 35% wt/wt of the total SDs content while maintaining the concentration of the second polymer at fixed amount (1gm). In vitro dissolution study was conducted in phosphate buffer of pH 6.8 for 1h. Release property of ibuprofen from two different SDs was investigated. And in case of both the systems, enhanced release property was found where the release was compared with pure ibuprofen powder. Enhanced release of ibuprofen from the optimized SDs was characterized in light of cumulative percent release, % release after 5 min of dissolution and release rate of the drug from different SDs. When the amount of carriers increased with a decrease in drug content, the release of ibuprofen was elevated. And it was found that almost two fold increase in the release of ibuprofen while 66.67% poloxamer was used.

Mitral regurgitation in patients with mitral valve prolapse

To determine the frequency, severity and gender distribution of mitral regurgitation [MR] in patients with mitral valve prolapse [MVP] and effect of severity of MR on the left heart chambers enlargement. Echocardiography reports of patients from June 2003 to July 2006 were retrospectively searched for presence of MVP from the computerized database of Cardiology department, Lady Reading Hospital Peshawar. Demographic details and findings of comprehensive echocardiographic examination, including M-mode echocardiography, 2-dimensional echocardiography, and conventional and color Doppler ultrasonography conducted by experienced echocardiographers were recorded. Out of 25,303 echocardiographic examinations performed in the period, 1073 [4.24%] patients had MVP with mean age of 26 + 14 years. Males were 585[54.52%] and females were 488[45.48%]. MR was found in 444/1073 [41.37%] patients of which 211 [47.53%] were males and 233 [52.47%] were females. Overall MVP was more common in males however MVP with MR was more common in females. In patients of MVP having MR, mild, moderate and severe MR was noted in 312[70.3%], 54 [12.2%] and 78 [17.5%] patients respectively. In patients with MVP having severe MR, the mean LV end diastolic diameter was 6.94+0.93 cm, mean LV end systolic diameter was 4.13+0.75 cm and mean left atrial diameter was 5.56+1.12 cm. With no significant changes in gender distribution of MVP, a high proportion of patients with MVP have associated MR. Severity of MR in patients with MVP had significant effect on enlargement of left heart chambers

Should we say good bye to exercise ECG testing?

This study was aimed to find out the accuracy of exercise test in patients with suspected coronary artery disease [CAD] presenting to Cardiology department, Lady Reading Hospital, Peshawar. In this retrospective study, records of all those patients with suspected CAD, who presented to Cardiology department, Lady Reading Hospital, Peshawar from July 2000 to July 2003, were analyzed. Only those patients who underwent both exercise tolerance test [ETT] and coronary angiography were included in the study. Exercise test was performed using standard Bruce protocol. Study population comprised of 664 patients, including 559 [84%] men and 105 [16%] women, with mean age of 50+9.7 [range 20-85] years. Coronary angiography showed 601/664 patients had stenosis of >70% in at least one coronary artery. Of these 601 patients 351[58.47%] had abnormal ETT, 105[17.47%] had negative ETT and 145[24.12%] had non-diagnostic ETT. After excluding the non-diagnostic results, the sensitivity was 76.97%. Among the 63/664 individuals with minimal or no coronary stenosis, 18[28.57%] had no ischemic ST changes during ETT, 21[33.33%] had positive ETT and 24[38.09%] had non-diagnostic ETT. Thus the specificity was 46.15%. Positive predictive value of ETT was 95% and negative predictive value was 15%. Overall accuracy of ETT was 55.50%. Exercise ECG testing has an important role in diagnosing suspected coronary artery disease. Patients with positive ETT should further be evaluated by coronary angiography. A negative ETT does not exclude CAD