Phytochemicals of Periploca aphylla Dcne. ameliorated streptozotocin-induced diabetes in rat

BACKGROUND@#Periploca aphylla is used by local population and indigenous medicine practitioners as stomachic, tonic, antitumor, antiulcer, and for treatment of inflammatory disorders. The aim of this study was to evaluate antidiabetic effect of the extract of P. aphylla and to investigate antioxidant and hypolipidemic activity in streptozotocin (STZ)-induced diabetic rats.@*METHODS@#The present research was conducted to evaluate the antihyperglycemic potential of methanol extract of P. aphylla (PAM) and subfractions n-hexane (PAH), chloroform (PAC), ethyl acetate (PAE), n-butanol (PAB), and aqueous (PAA) in glucose-overloaded hyperglycemic Sprague-Dawley rats. Based on the efficacy, PAB (200 mg/kg and 400 mg/kg) was tested for its antidiabetic activity in STZ-induced diabetic rats. Diabetes was induced via intraperitoneal injection of STZ (55 mg/kg) in rat. Blood glucose values were taken weekly. HPLC-DAD analysis of PAB was carried out for the presence of various polyphenols.@*RESULTS@#HPLC-DAD analysis of PAB recorded the presence of rutin, catechin, caffeic acid, and myricetin. Oral administration of PAB at doses of 200 and 400 mg/kg for 21 days significantly restored (P < 0.01) body weight (%) and relative liver and relative kidney weight of diabetic rats. Diabetic control rats showed significant elevation (P < 0.01) of AST, ALT, ALP, LDH, total cholesterol, triglycerides, LDL, creatinine, total bilirubin, and BUN while reduced (P < 0.01) level of glucose, total protein, albumin, insulin, and HDL in serum. Count of blood cells and hematological parameters were altered in diabetic rats. Further, glutathione peroxidase, catalase, superoxide dismutase, glutathione reductase, and total soluble protein concentration decreased while concentration of thiobarbituric acid reactive substances and percent DNA damages increased (P < 0.01) in liver and renal tissues of diabetic rats. Histopathological damage scores increased in liver and kidney tissues of diabetic rats. Intake of PAB (400 mg/kg) resulted in significant improvement (P < 0.01) of above parameters, and results were comparable to that of standard drug glibenclamide.@*CONCLUSION@#The result suggests the antihyperglycemic, antioxidant, and anti-inflammatory activities of PAB treatment in STZ-compelled diabetic rat. PAB might be used as new therapeutic agent in diabetic patients to manage diabetes and decrease the complications.

Pilea umbrosa ameliorate CCl induced hepatic injuries by regulating endoplasmic reticulum stress, pro-inflammatory and fibrosis genes in rat

BACKGROUND@#Pilea umbrosa (Urticaceae) is used by local communities (district Abbotabad) for liver disorders, as anticancer, in rheumatism and in skin disorders.@*METHODS@#Methanol extract of P. umbrosa (PUM) was investigated for the presence of polyphenolic constituents by HPLC-DAD analysis. PUM (150 mg/kg and 300 mg/kg) was administered on alternate days for eight weeks in rats exposed with carbon tetrachloride (CCl). Serum analysis was performed for liver function tests while in liver tissues level of antioxidant enzymes and biochemical markers were also studied. In addition, semi quantitative estimation of antioxidant genes, endoplasmic reticulum (ER) induced stress markers, pro-inflammatory cytokines and fibrosis related genes were carried out on liver tissues by RT-PCR analysis. Liver tissues were also studied for histopathological injuries.@*RESULTS@#Level of antioxidant enzymes such as catalase (CAT), superoxide dismutase (SOD), peroxidase (POD) and glutathione (GSH) decreased (p < 0.05) whereas level of thiobarbituric acid reactive substance (TBARS), HO and nitrite increased in liver tissues of CCl treated rat. Likewise increase in the level of serum markers; alanine transaminase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP) and total bilirubin was observed. Moreover, CCl caused many fold increase in expression of ER stress markers; glucose regulated protein (GRP-78), x-box binding protein1-total (XBP-1 t), x-box binding protein1-unspliced (XBP-1 u) and x-box binding protein1-spliced (XBP-1 s). The level of inflammatory mediators such as tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and monocyte chemoattractant protein-1 (MCP-1) was aggregated whereas suppressed the level of antioxidant enzymes; γ-glutamylcysteine ligase (GCLC), protein disulfide isomerase (PDI) and nuclear erythroid 2 p45-related factor 2 (Nrf-2). Additionally, level of fibrosis markers; transforming growth factor-β (TGF-β), Smad-3 and collagen type 1 (Col1-α) increased with CCl induced liver toxicity. Histopathological scrutiny depicted damaged liver cells, neutrophils infiltration and dilated sinusoids in CCl intoxicated rats. PUM was enriched with rutin, catechin, caffeic acid and apigenin as evidenced by HPLC analysis. Simultaneous administration of PUM and CCl in rats retrieved the normal expression of these markers and prevented hepatic injuries.@*CONCLUSION@#Collectively these results suggest that PUM constituted of strong antioxidant chemicals and could be a potential therapeutic agent for stress related liver disorders.

Potential of botanical driven essential oils against Haemonchus contortus in small ruminants / Potencial de aceites esenciales botánicos contra Haemonchus contortus en pequeños rumiantes

The livestock sector is continuously facing problems in controlling parasitic diseases especially Haemonchosis due to emergence of anthelminthic resistance and failure in vaccination control programmes. Therefore, to increase milk and meat production and emerging demand of meat free from drug residues development of new alternative approaches are appealing for prevention and control of Haemonchosis in small ruminants. Among alternatives, plants driven essentials oils have shown promising results in control of Haemonchus contortus infection at various concentrations by different assays including egg hatch assay, larval development assay, larval exsheathment assay and adult motility assay. Essential oils are complex mixtures of various impulsive or volatile compounds which have potential to control Haemonchosis. The current study reviews the therapeutic effects of essential oils of plants against Haemonchus contortus and to be used them against Haemonchus contortus for future perspectives.

El sector ganadero enfrenta continuamente problemas para controlar las enfermedades parasitarias, especialmente la hemoncosis, debido a la aparición de resistencia antihelmíntica y al fracaso en los programas de control de vacunación. Por lo tanto, para aumentar la producción de leche y carne, y la demanda emergente de carne libre de residuos de medicamentos, el desarrollo de nuevos enfoques alternativos es atractivo para la prevención y el control de la hemoncosis en pequeños rumiantes. Entre las alternativas, los aceites esenciales producidos por las plantas han mostrado resultados prometedores en el control de la infección por Haemonchus contortus a diversas concentraciones mediante diferentes ensayos, incluido el análisis de eclosión de huevos, el desarrollo de larvas, el análisis de vaciado de larvas y el ensayo de motilidad en adultos. Los aceites esenciales son mezclas complejas de varios compuestos impulsivos o volátiles que tienen potencial para controlar la hemonchosis. Este estudio revisa los efectos terapéuticos de los aceites esenciales de las plantas contra Haemonchus contortus y evalúa sus perspectivas futuras como agentes para combatir las enfermedades causadas por este parásito.

Neuroprotective potential of polydatin against motor abnormalities and dopaminergic neuronal loss in rotenone induced Parkinson model / Potencial neuroprotector de la polidatina contra las anomalías motoras y la pérdida neuronal dopaminérgica en un modelo de Parkinson inducido por la rotenona

Among the neurodegenerative disorders, Parkinson disease (PD) is ranked as second most common. The pathological hallmark is selective degeneration of the dopaminergic neurons in the nigro-striatal regions of brain with appearance of the Lewy bodies. Present study explores the neuro-protective potential of polydatin in terms of amelioration of degeneration of dopaminergic neurons in nigro-striatal regions of brain and distorted neuromotor behavior in the rotenone model of Parkinson's disease. Thirty-six male Sprague Dawley rats were divided into three groups. Group A (control), Group B (rotenone treated) and Group C (rotenone+polydatin treated). Rotenone was administrated intraperitoneally (i.p) at a dose of 3 mg/kg/body weight while polydatin was given i.p. at a dose of 50 mg/ kg/body weight for four weeks. Then, animals were sacrificed; substantia nigra (SN) & striatum isolated from brain and five micron thick sections were prepared. Cresyl violet (CV), H&E and Immuno-histochemical staining using anti-TH antibody was done. Motor behavior was assessed weekly throughout the experiment using five different methods. Rotenone treated parkinsonian animals showed deterioration of motor behavior, weight loss, loss of dopaminergic neurons and diminished immune-reactivity in the sections from the nigrostriatal regions of these animals Polydatin+rotenone treatment showed contradicting effects to parkinsonism, with amelioration in weight loss, neuro-motor behavior, dopaminergic loss and immune-reactivity against dopaminergic neurons. Present study revealed a neuro-protective potential of polydatin in animal model of PD by ameliorating the neuro-motor abnormalities and degeneration of dopaminergic neurons in nigrostriatal regions.

Entre los trastornos neurodegenerativos, la enfermedad de Parkinson (EP) se clasifica como la segunda más común. El sello patológico es la degeneración selectiva de las neuronas dopaminérgicas en las regiones nigro-estriatales del cerebro, con la aparición de los cuerpos de Lewy. El presente estudio explora el potencial de protección neuronal de la polidatina en términos de la mejora de la degeneración de las neuronas dopaminérgicas en las regiones nigro-estriatales del cerebro y el comportamiento neuromotor distorsionado en el modelo de rotenona de la enfermedad de Parkinson. Treinta y seis ratas macho Sprague Dawley se dividieron en tres grupos: Grupo A (control), Grupo B (tratado con rotenona) y Grupo C (tratamiento con rotenona + polidatina). La rotenona se administró por vía intraperitoneal (i.p.) a una dosis de 3 mg/kg/peso corporal, mientras que la polidatina se administró i.p. a una dosis de 50 mg/kg/ peso corporal durante cuatro semanas. Posteriormente, los animales fueron sacrificados. Se aislaron la substantia nigra (SN) y cuerpo estriado de los cerebros y se realizaron secciones de cinco micras de espesor. Se realizó una tinción de violeta de cresilo (CV), H&E y tinción inmunohistoquímica usando anticuerpo anti-TH. El comportamiento motriz se evaluó semanalmente durante todo el experimento utilizando cinco métodos diferentes. Los animales parkinsonianos tratados con rotenona mostraron deterioro del comportamiento motriz, pérdida de peso, pérdida de neuronas dopaminérgicas y disminución de la reactividad inmune en las secciones de las regiones nigroestriadas. El tratamiento con polidatina + rotenona mostró efectos contrarios al parkinsonismo, con mejoría en la pérdida de peso, en el comportamiento motor, en la pérdida dopaminérgica y en la reactividad inmune contra las neuronas dopaminérgicas. El presente estudio reveló un potencial de protección neuronal de la polidatina en el modelo animal de la EP al mejorar las anomalías neuro-motoras y la degeneración de las neuronas dopaminérgicas en las regiones nigroestriatales.

Outcomes of gastric pull-up reconstructive surgery following laryngopharyngoesophagectomy in hypopharyngeal and upper esophageal carcinomas

Objective: To determine the commonest stage of hypopharyngeal and upper esophageal carcinoma at presentation, common complications after surgery, perioperative mortality, and one-year survival rate after surgery. Study Design: A descriptive prospective study. Place and Duration of Study: Combined Military Hospitals, Rawalpindi, Lahore, and Malir, from Oct 2008 to Oct 2016

Material and Methods: Through consecutive sampling, 25 individuals were sampled after staging disease through TNM classifications provided by the 1983 American Joint Committee on Cancer Classification for hypopharyngeal cancers. Total laryngopharyngoesophagectomy and gastric pull-up reconstructive surgery was performed by two teams. The total operation time in hours and the approximate blood loss in ml during the procedure was documented. The patients were monitored post-operatively for pulmonary [respiratory failure requiring ventilatory support, atelectasis, pneumonia, pulmonary embolism, pleural effusion/hemothorax, etc.], cardiac [arrhythmias, myocardial infarction, and congestive cardiac failure], and surgical complications [wound infections, anastomotic leak, and fistula formation]. The patients were also followed-up for survival at 1[st], 6[th], and 12[th] month

Results: There were 18 males and 7 females [mean age: 53 +/- 14 years]. Majority presented with T4N2M0-stage disease. The operation lasted for a mean time of 7.7 +/- 1.3 hours [range: 6.3-11 hours] and a mean 1218 +/- 338 ml [range: 590-2020 ml] blood was lost during the operation. The patients remained in the hospital for a mean 26 +/- 16 days [range: 1-56 days]. The commonest complication following operation was pleural effusion/hemothorax present in 72% of the patients. The perioperative mortality was 12% and one-year survival rate was 36%

Conclusion: Majority of our sampled patients presented with T4N2M0-stage disease. The mean operation time in our sample was longer with an increased incidence of anastomotic leaks when compared to the international data. The other complications and perioperative mortality were comparatively similar while one-year survival rate was lower

Efficacy of benzoyl peroxide and clindamycin combination therapy with benzoyl peroxide alone in the treatment of acne vulgaris

Objective: to assess the efficacy of benzoyl peroxide and clindamycin combination therapy with benzoyl peroxide alone in the treatment of acne vulgaris

Methods: a clinical trial was carried out in the Department of Dermatology and Venereology, Bangabandhu Sheikh Mujib Medical University [BSMMU], Dhaka. The study duration was from July 2013 to December 2013. Total sixty patients of clinically diagnosed mild to moderate acne was enrolled and thirty of group A patients were treated by benzoyl peroxide alone and thirty of group B patients were treated by benzoyl peroxide and clindamycin combination therapy

Results: at baseline mean number of comedones in group A and group B was 12.77 +/- 4.01 and 11.80 +/- 3.93, respectively [p=0.350] and at final follow-up 4.17 +/- 4.02 and 3.47 +/- 4.00 [p>0.05]. At baseline mean number of papules in group A and group B was 17.30 +/- 10.29 and 18.57 +/- 13.88, respectively [p=0.690] and at final follow-up 7.63 +/- 8.08 and 7.73 +/- 9.98 [p>0.05]. At baseline mean number of pustules in group A and group B was 0.50 +/- 1.33 and 0.53 +/- 1.28, respectively [p=0.922] and at final follow-up 0.07 +/- 0.37 and 0.00 [p>0.05]. At baseline mean of total acne score was 30.57 +/- 13.62 and 30.90 +/- 17.17 in group A and B and at final follow-up it was 11.87 +/- 12.04 and 11.20 +/- 13.85, respectively in group A and B [p>0.05]. Percent reduction of acne severity from baseline to final follow-up was 69.20 +/- 23.41 in-group A and 74.77 +/- 23.30 in-group B [p=0.360]. At final follow-up 56.7% of group A and 63.3% of group B achieved excellent response and 13.3% of group A and 16.7% of group B achieved good response

Conclusion: it can be concluded that the drug, benzoyl peroxide when used individually, was found to be effective in the treatment of acne, but the combination of the two clindamycin and benzoyl peroxide was found to be superior in efficacy

Pistacia chinensis: Strong antioxidant and potent testicular toxicity amelioration agent

Objectives To evaluate in vitro and in vivo antioxidant potency of Pistacia chinensis (P. chinensis) bark and leaves extracts along with its protective role against CCl

Pistacia chinensis: Strong antioxidant and potent testicular toxicity amelioration agent

OBJECTIVES@#To evaluate in vitro and in vivo antioxidant potency of Pistacia chinensis (P. chinensis) bark and leaves extracts along with its protective role against CCl induced toxicity in testis of the rat.@*METHODS@#Various in vitro models such as DPPH, ABTS, hydrogen peroxide, superoxide, hydroxyl and nitric oxide scavenging activities, anti-lipid peroxidation activity, phospho-molybdenum activity, β carotene bleaching assay was used for analysis of antioxidant potential. Experimental groups for in vivo study were: Group Ⅰ (control) untreated, Group Ⅱ (Vehicle control), Group Ⅲ (1 mL/kg b.w 30% CCl), Group Ⅳ (1 mL/kg b.w CCl + Silymarin), Group Ⅴ (200 mg/kg b.w PCBE + CCl), Group Ⅵ (400 mg/kg b.w PCBE + CCl) and Group Ⅶ (400 mg/kg b.w PCBE alone).@*RESULTS@#In vitro antioxidant assays displayed significant results and the highest activity was not specified to a specific extract. However, ethyl acetate extract of bark (PCBE) showed highest results in most of the antioxidant assays i.e. beta-carotene bleaching, hydroxyl radical scavenging, ABTS, lipid peroxidation and superoxide radical scavenging activity. On this base, this fraction was selected for in vivo antioxidant experiment. Testis tissues were analyzed to observe the protective effects of PCBE on antioxidant enzymes; catalase, superoxide dismutase, peroxidase, glutathione-S-transferase, glutathione reductase, glutathione peroxidase and quinone reductase activities and glutathione (GSH) as well as nitrite content. Profile of plasma testosterone was also compared to various treatments. Observation suggests a protective role of P. chinensis against CCl induced toxicity.@*CONCLUSIONS@#It is concluded that some bioactive antioxidants of P. chinensis bark might be a good source to isolate the potent antioxidant components.

Prevention of CCl[4] induced hypogonadism with Raphanus sativus seeds in rat

Raphanus sativus seeds are used as condiment and to treat hypogonadism, various ailments of liver and kidneys. The aim of this study was to evaluate the potential protective effects of methanol extract of R. sativus seeds [RSME] against hypogonadism induced with carbon tetrachloride [CCl[4]] in Sprague-Dawley male rats. Thirty six rats were divided in to six groups with six animals in each. Animals of Group I were control and treated with saline, Group II, III and IV were given orally CCl[4] [1 ml/kg bw; 10% in corn oil]. Rats of Group III and IV were also simultaneously given RSME at 100 mg/kg bw and 200 mg/kg bw respectively. However, Group V and VI received RSME [100; 200 mg/kg bw, respectively] alone. All treatments were given at alternate days for 15 days. Treatment of CCl[4] to rats decreased [P < 0.001] the level of CAT, POD, SOD, GST, GSH-Px and GSR antioxidant enzymes in testes of rat. Concentration of lipid peroxides [TBARS] was increased [P < 0.001] whereas concentration of GSH was decreased [P < 0.001] in testes of CCl[4] treated animals. Concentration of testosterone, FSH and LH in serum was decreased [P < 0.001] while the level of estradiol and prolactin was increased [P < 0.001] in CCl[4] treated rats. Injuries in seminiferous tubules were determined in histopathology of testes. Administration of RSME, dose dependently, markedly ameliorated the oxidative stress of CCl[4] thereby restoring the level of antioxidant enzymes, lipid peroxides, reduced glutathione, male hormones and alterations in histopathology

Breast cancer: clinical and histopathological features at combined military hospital Rawalpindi

Objective: This study was aimed to evaluate the various clinical and histopathological features of carcinoma of breast in the surgical unit of Combined Military Hospital [CMH] Rawalpindi in an attempt to appraise about the pattern of disease in this setting

Study Design: Descriptive cross sectional study

Place and Duration of Study: The study was conducted from September 2013 to August 2015 in surgical unit of CMH, Rawalpindi, Pakistan

Material and Methods: A total of 446 female patients diagnosed with carcinoma breast in surgical unit CMH during 2 years were included in this study. Patient's age, clinical examination and histopathological findings were recorded

Results: Among the 446 female patients, 269 patients [60.3%] presented in an age group between 40-49 years making it the most common age group. About 393 patients [88.1%] had the tumor size more than 2 cm. The commonest quadrant involved was upper outer quadrant [n=236; 52.9%]. Axillary lymph nodes were positive in 76.0% [n=339] of patients. Most common type of carcinoma was invasive ductal carcinoma in 336 patients [75.3%]. The disease was left sided in 249 cases. The most common was stage III [n=200] and grade II [n=289] carcinoma

Conclusion: In our settings the breast cancer is affecting the middle age group more commonly with upper outer quadrant being the commonest site and invasive ductal carcinoma being the commonest variant. The majority of patients presented in the later stages of disease with a moderate grade, more common lymph node metastasis and a size larger than 2 cm

Lobectomy for congenital lobar emphysema, experience of two centers in Pakistan

Objective: To assess outcome of lobectomy in congenital lobar emphysema in pediatrics group of patients

Methods: This retrospective study was conducted in Department of Thoracic Surgery Nishtar Hospital Multan and Services Hospital Lahore from October 2003 to December 2015.All the patients of pediatric group who underwent lobectomy for congenital lobar emphysema were included in study. Demographic data, operative findings outcome of the procedure in terms of post operative complications and 30 days morbidity and mortality were recorded .All the patients presented with respiratory distress. Standard lobectomy was performed and bronchial stump was buttressed with surrounding lymph nodes, pericardial or pleural flap

Results: Of these 41 study cases, 30 [73.2%] were boys while 11 [26.8%] were girls and male to female ratio was 2.72: 1. Mean age of our study cases was 3.32 +/- 1.59 months [with age range; 15 days to 7 months]. Mean age of the boys was noted to be 3.38 +/- 1.52 months while that of girls was 3.18 +/- 1.84 months [p = 0.405]. Of these 41 study cases, left upper lobectomy was performed in 27 [65.9%] patients, right middle lobectomy in 11 [26.8%] patients, left lower lobectomy in 2 [4.9 %] patients and right upper lobectomy in 1 [2.4%] patients. Out of 41 patients 8 [19.5%] were preoperatively on ventilator. Out of 8 ventilated patients one had left sided chest intubation which was malpositioned and was in the lung parenchyma. Morbidity was superficial wound infection in 2 [4.9%] patients and post lobectomy empyema in 2 [4.9%] patients who required prolonged tube thoracostomy, antibiotics and chest physiotherapy. Mortality was recorded in 1 [2.4%] patient who was preoperatively on ventilator and had misplaced chest tube. That patient died on the 3rd post-operative day due to respiratory failure secondary tolung parenchymal injury

Conclusion: Our study results support surgical management of congenital lobar emphysema as Lobectomy was found to be safe, reliable and effective in these children presenting with respiratory distress due to lobar emphysema. There were no significant morbidities in these patients and clinical outcomes were satisfactory and surgical management is reported to be treatment of choice in pediatric patients with CLE

Laparoscopic cholecystectomy for empyema gall bladder

Objective: To describe the experience of treating empyema gall bladder with laparoscopic cholecystectomy. Study Design: Descriptive observational study

Place and Duration of Study: The study was carried out at Combined Military Hospital [CMH] Peshawar, from Feb 2012 till May 2014 for a period of twenty eight months

Material and Methods: Twenty eight patients were enrolled in the study who fulfilled the criteria for empyema and were willing for laparoscopic cholecystectomy, chances of conversion to open cholecystectomy and risk of complications involved. We defined the operative difficulty levels according to the intra-operative findings. Level 1-adherent ornentum, level 2-oedematous gall bladder wall, level 3-necrotic gall bladder wall, level 4-adherent gut and level 5 - adherent Hartmann's pouch and oedematous Calot's triangle having no defined planes. The results were noted in terms of time taken for the operation and complications of the operative procedure. Results: Twenty eight patients of empyema gall bladder underwent laparoscopic cholecystectomy. Mean age was 46.2 +/- 7.1 years. Average duration of symptoms was 4.1 +/-2.3 days. Two patients had level-I operative difficulty, 6 patients had level-II difficulty, 9 patients had level-3 difficulty, 2 patients had level-IV difficulty and 9 patients had level-V difficulty. In 21[75%] patients total cholecystectomy was performed, anterior partial cholecystectomy was done in 2 patients [7.1%] and 5 patients [17.9%] were converted to open cholecystectomy. One patient [3.5%] had Stresburgh Bismuth type D injury and was managed by open exploration and T-tube placement. No mortality was encountered in the study group

Conclusion: The technique of laparoscopic cholecystectomy can be used effectively for treating empyema gall bladder specifically in American Society of Anaesthesiologists [ASA] I and II patients. Further randomized controlled trials can elaborate its efficacy. This will not only prove to be cost effective but it will also add to the comfort of the patient

Comparative hypoglycemic activity of different fractions of Thymus serpyllum L. in alloxan induced diabetic rabbits

The aim of present study was to evaluate and compare the hypoglycemic activity of different solvents extracts of Thymus serpyllum in rabbits. Diabetes was induced with single intravenous injection of alloxan monohydrate [150mg/kg]. Glibenclamide and acarbose were used as standard drugs. The crude powder of Thymus serpyllum [500 mg/kg b.w] significantly reduced blood glucose level in both normal and diabetic rabbits. Various extracts of Thymus serpyllum were compared for their hypoglycemic activity in diabetic rabbits. Ether and aqueous extracts significantly reduced the blood glucose level with maximum effect [p<0.001] produced by aqueous extract, which was selected for further study. Aqueous extract significantly inhibited the rise in glucose level in oral glucose tolerance test. The extract showed synergistic effect with different doses of insulin; however serum insulin level of the diabetic rabbits was not significantly increased by the extract. HbA1c level was significantly [p<0.05] reduced whereas hemoglobin level was significantly increased in three months study. Phytochemical screening of the aqueous extract showed the presence of alkaloids, flavonoids, tannins, terpinoids, reducing sugar and cardiac glycosides. It is concluded that the aqueous extract might be used alone or in combination with insulin to manage diabetes and its associated complications

Frequency of hypomagnesemia in patients with uncontrolled type II diabetes mellitus

Objective: The objective of this study was to determine the frequency of Hypomagnesemia in patients with uncontrolled type II diabetes mellitus

Study Design: Cross-sectional study

Place and Duration of Study: Department of Medicine, PNS Shifa Naval Hospital Karachi, from Jul 2012 to Dec 2012 over a period of six months

Material and Methods: In this study, three hundred and twenty three patients of uncontrolled diabetes mellitus type-II on oral hypoglycemic agents for more than five years, presenting to medical OPD, were recruited. All patients fulfilled inclusion and exclusion criteria. Blood samples of all patients for serum HbA1c and serum magnesium levels were analyzed at the time of enrollment. Statistical analysis was done on SPSS 20

Results: Out of 323 patients, 243 [75.23%] were males and 80 [24.76%] were females with the age ranging from 40 - 65 years [mean age and SD 54.76 +/- 6.43]. Hypomagnesemia was found in 117 patients, without any significant difference in men and women [38.45% and 35.39% respectively]. The mean duration of diabetes was 12.5 years [ranging from 5 to 22 years]. By frequency test in SPSS-20, the highest frequency of hypomagnesemia [49.42%] is seen in [8.6-9.0] HbA1c group while lowest frequency hypomagnesemia [15.38%] is seen in [>10.0] HbA1c level group mean standard deviation and p-value calculated by Pearson correlation statistic in SPSS-20 for quantitative variables [HbA1c, Magnesium level]

Conclusion: Hypomagnesemia is frequent in poorly controlled type-II diabetes mellitus having increased level of HbA1c. So it may be prudent in clinical practice to periodically monitor plasma magnesium and HbA1c in type-II diabetes mellitus patients

Effects of Camellia sinensis L. [green tea] extract on the body and testicular weight changes in adult Wistar rats

This research was aimed to study the effects of oral administration of Camellia sinensis L. on the testicular and body weights of adult Wistar rats for short and long time periods. The adult Wistar rats were divided into 3 groups [A, B and C]. Every group had ten rats. Green tea extract 0.692% [w/v] was given to groups A and B on daily basis. The extracts were prepared fresh and given for a period of ten and thirty days, respectively, while distilled water was given to the group C rats only. The adult Wistar rats were sacrificed on eleventh and thirty-first day of experiment for the particular groups. The testes were dissected out cautiously, free from the supporter tissues and weighed to the adjacent 1 mg. There is no significant difference in the body weight in all 3 groups. Moreover, it was observed that Wistar rat's testicular weight was considerably increased in group B but no major changes were seen in group A. Our results indicated that green tea when given for short period of time may be effective to the testes but has no consequence on Wistar rat's body weight. However, it is indistinct if these alterations are reversible

Hemi-hamate arthroplasty for unstable dorsal proximal interphalangeal joint fracture dislocation of the fingers

To assess restoration of finger functions after hemi-hamate reconstruction. Experimental / Analytic study. This study was carried out at two different centres at Jinnah Hospital, Lahore and King Khalid Hospital, Najran KSA from between 2010 and 2013. We performed hemi-hamate autograft arthroplasty in 20 patients age 16-45 years. All were having comminuted metaphyseal fracture of volar surface of middle phalynx involving more than 50% [55%-90% average 70%] of articular surface with dorsally displaced unstable proximal interphalyngeal joint. Functional outcome was assessed by grip strength, proximal interphalyngeal joint, distal interphalyngeal joint range of motion and residual pain and patient's satisfaction. At the end of average 24.4 months follow-up mean active range of motion for proximal interphalyngeal joint was 62 °[40°- 90°], distal interphalyngeal joint was 54°[40°-65°] and flexion contracture was 150[00-35°]. Grip strength was achieved upto 95% [50%-95%] of opposite normal hand. Almost all patients were satisfied with functional outcome and appearance of the finger. We had not come across donor site morbidity, graft resorption, avascular necrosis, subluxation/dislocation, coronal/sagittal instability, infections except 4 patients, one scar tenderness, one ulnar digital nerve paresthesia and 2 with early osteoarthritic changes. Non-vascularized hemi-hamate autogarft is a good treatment option for comminuted proximal interphalyngeal fracture dislocation having more than 50% volar lip involvement, resulting in satisfactory functional outcome as compared to other surgical treatments. We recommend it in patients of active age group

Comparative study of olopatadine hydrochloride 0.1% and emedastine difumarate 0.05% comparing their clinical efficacy and adverse effects in allergic conjunctivitis

To assess the efficacy and adverse effects of 0.1% Olopatadine hydrochloride [OHC] and compare them to 0.05% Emedastine difumarate [ED] in the treatment of allergic conjunctivitis. Prospective and comparative study. The study was conducted at Islam Teaching Hospital, Islam Medical College, Sialkot from February 2013 to June 2014. 74 adult patients including 35 male patients aged 21- 47 years [Average 32.39] and 39 females aged 20 - 42 years [Average 31.8] some with a history of systemic allergic manifestation [e.g. asthma,dermatitis, or bronchitis] along with sign and symptoms of allergic conjunctivitis were enrolled in the study. At the time of induction, manifestations of allergic conjunctivitis [mucous discharge, itching, conjunctival congestion,chemosis, and watering] were present. Patients were allocate at random to either of the 2 groups, A and B. The patients in the Group A, [n = 36] received OHC and those in the Group B [n = 38] were treated with ED. The dose in Group A was one drop in both the eyes 12 hourly. Group B received one drop in both the eyes 6 hourly. The study was started on the first patient visit, when after the diagnosis; the drug was administered. Patients from both the groups were re-evaluated half an hour, forty eight hours, seven and fourteen days later. Efficacy and side effects in both the groups were assessed. The severity of signs and symptoms were assigned a score from 0 - 3. The results were analysed using independent sample T test. At the start of the study, cumulative score of the patient's sign and symptoms was calculated, with a mean value of 7.31 for group A and 7.38 for group B. There was no significant statistical disparity between the groups [p= 0.88]. The cumulative scores at the end of study on day fourteen were 0.72 for group A and 1.0 for group B. This was also statistically not significant [p = 0.15] but Olopatadine was noted to be more effective. The side effects of both the medicines were similarly assessed with cumulative scores calculated at each follow up. In group A, there were minimal side effects with mean cumulative score on the final visit was 0.25 in group A and0.54 in Group B, with statistically significant [p = 0.015] difference. Olopatadine was discovered to have better efficacy [not statistically significant] and less adverse effects [statistically significant] than Emedastine

Cardiotonic and vasoconstriction effects of aqueous methanolic extract of Paspalidium flavidum L.

The cardiovascular activity of aqueous methanolic extract of Paspalidium flavidum L. was evaluated on isolated rabbit heart and aorta. Heart rates, force of contraction and perfusion pressure were assessed in the presence of different concentrations of extract and adrenaline by using Langendorff's technique. Moreover, the vasoconstriction effects were studied in rabbit aorta using isolated organ bath. The results indicated that the extract [1ng-100[micro]g/ml] exhibited a significant increase in heart rate, contractility and perfusion pressure of isolated rabbit's heart; with a maximum effect at 1ng/ml, which was comparable to adrenaline [1[micro]g/ml]. Similarly, adrenaline at doses from 1-10[micro]g/ml produced a significant dose dependant increase in all the cardiac parameters. The cardiotonic effects of the extract were significantly blocked by propranolol [10[-5]M] while an increase in perfusion pressure was completely antagonized by verapamil [10[-6]M]. Activity of cardiac marker enzymes was also significantly raised in the perfusate of isolated heart pretreated with the extract. In rabbit aorta, the extract exhibited a dose dependent vasoconstriction effect however it did not increase the tone of aorta when pre-treated with verapamil [10[-6]M]. It is conceivable therefore; that the cardiotonic and vasoconstriction effects of the extract might be due to its agonistic actions on beta-receptors and Ca[+2] channels

Lithium induced histological alteration in testes of albino rats and theiramelioration with vitamin E

Objective: To evaluate the lithium induced histological alteration in testes of albino rats and their amelioration by Vitamin E

Study Design: Experimental study

Place and Duration of Study: This study was conducted at department of Anatomy, Baqai Medical University, Karachi from July 2010 to August 2010

Materials and Methods: The rats were assigned into three experimental groups [eight rats/group]: control group, lithium group and lithium plus vitamin E treated group. Lithium [50 mg/kg/day] and vitamin E [50mg/kg/day] were given intraperitoneally for 21 days. At the end of experiment, rats were sacrificed and testes removed and processed for routine H and E. Slides were studied for histological examination under light microscope

Results: Lithium treated rats showed decreased body and testicular weights, spermatogenic cells such as primary and secondary spermatocytes and spermatids were decreased, very little spermatozoa were seen in lumen of seminiferous tubules, significant increase in tubular count observed while tubular diameter, germinal epithelial thickness, number and size of nuclei of leydig cells were highly significantly reduced. In lithium plus vitamin E treated group, body and testicular weight, primary and secondary spermatocytes, spermatids were restored near to control. Tubular lumen also showed many spermatozoa. Tubular diameter, germinal epithelial thickness, numberand size of nuclei of leydig cells were also returned tocontrol

Conclusion: Our study conclude that lithium causes detrimental effect on testicular morphology through oxidative stress and vitamin E provided protection through its antioxidative property

Comparison of efficacy of carbon dioxide [CO[2]] laser with cutting diathermy in surgical excision of early carcinoma tongue

Objective: To compare the efficacy of carbon dioxide [CO[2]] laser with cutting diathermy as a cutting device in surgical excision of early carcinoma tongue

Study Design: Experimental study

Place and Duration of Study: Combined Military Hospital [CMH], Rawalpindi and CMH, Lahore, from July 2008 to July 2011

Methodology: Twenty two biopsy proven cases of T[1] and early T[2] squamous cell carcinoma of tongue were divided in two equal groups of 11 each labeled as A and B. Tumor was excised by CO[2] laser in group A while cutting diathermy was done in group B. For both groups tumor excision time, per-operative blood loss, postoperative oral swelling and pain was recorded. Excision time of tumor was assessed in minutes and amount of blood loss in milliliters till complete hemostasis after removal of primary tumor. Postoperatively patients were assessed on 12 hourly basis for 48 hours for pain. Pain was analyzed on visual analogue score 1 - 10. Oral swelling was assessed once after 24 hours and labeled as mild, moderate and severe. Independent sample t-test was applied for analysis of excision time, postoperative pain and per-operative blood loss for both groups. Postoperative swelling was analyzed using Fisher's exact test. P-value of < 0.05 was considered significant

Results: The mean age at diagnosis in group A was 49.36 +/- 5.27 years, while in group B patients had mean age of 50.73 +/- 8.13 years. In group A, 4/11 [36.3%] patients were having tumor stage T[1] while 7/11 [63.6%] had T[2] stage tumor. In group B, 5/11 [45.4%] were having T[1] and 6/11 [54.5%] were having stage T[2] tumor. Excision time was significantly shorter for group B [p=0.003], but group A had less postoperative pain [p=0.001], less per-operative blood loss [p=0.001] and less postoperative oral swelling [p=0.021]

Conclusion: Early carcinoma tongue is better removed by laser than electrocautery in terms of postoperative morbidity, per-operative blood loss, postoperative pain and oral swelling