Comparative hepatoprotective effect of Nigella sativa pre- and post-treatment to rabbits

Synthetic drugs are associated with adverse side-effects and rapid increase in resistance to most of them inspires to evaluate plants for their therapeutic values. We have been aimed to suggest the medicinal use of Nigella sativa seed aqueous extract to minimize the severity of liver damage via its antioxidant properties and its role in maintenance of cell ion-homeostasis. Annoyances in serum levels of some antioxidants and trace metals in human hepatitis C infected patients were compared with that from acetaminophen-induced hepatotoxic rabbits. Serum analysis of human patients and that of hepatotoxic rabbits have exhibited the same trend of incidence of liver marker enzymes, antioxidant levels, and trace metal concentrations, except for the serum levels of cobalt. Significance of pre-/ or posttreatment of Nigella sativa to acetaminophen induced-hepatotoxic rabbit has also evaluated. NS post-treatment to rabbits has been found effective in normalizing the levels [P<0.001] of serum liver markers; especially the ALP levels, and the antioxidants; with significant effect on the serum catalase levels. However, NS pre-treatment has shown its role [P<0.001] in maintaining the serum nickel and cobalt concentrations. Therefore, we suggest the use of Nigella sativa seeds as pre-/ or post-treatment therapy, and also as supplement to the normal medications of liver infection to normalize the status of cell antioxidants and trace metal concentrations

Development and in vitro characterization of niosomal formulations of immunosuppressant model drug

Among immunosuppressive agents cyclosporine A is drug of unique importance. This drug has a low therapeutic index, and it has many toxic effects. After oral administration its absolute bioavailability is variable due to poor absorption. Niosomes are new and versatile carriers to deliver drug. The bioavailability of immunosuppressant drug cyclosporine A can be increased by niosomal drug delivery system. So our basic theme was to prepare niosomes of immunosuppressant drug using cholesterol, span 60 and tween 60 etc. Niosomes were characterized for zeta potential, size, poly dispersivity index [PDI], entrapment efficiency and In vitro release profiles. Six niosomal formulations [F1-F6] were successfully developed using thin film hydration technique. Among various formulations F2 showed the highest entrapment efficiency 77.29 %. The DSC thermograms of physical mixtures and niosomal formulations indicated the presence of drug in crystalline form. In vitro drug release study demonstrated higher drug release values as compared to drug aqueous dispersion. Niosomal formulations were capable of releasing drug in sustained manner. The overall results demonstrated that developed niosomal carriers are competitive candidates for improving dissolution profile of cyclosporine A leading to increased bioavailability at the site of action

Early outcome of coronary artery bypass graft surgery in patients with significant Left Main Stem stenosis at a tertiary cardiac care center

Primary objective of this study was to evaluate the impact of significant left main stem [LMS] stenosis on the early outcome of coronary artery bypass graft [CABG] surgery. A Retrospective non-randomized analytical study was conducted in Cardiac surgery department, Chaudhary Pervaiz Elahi Institute of Cardiology [CPEIC] Multan, Pakistan. The data of patients who underwent isolated CABG at our institution from February 2008 to March 2014 were analyzed. Two thousand six hundred two [2602] patients of isolated CABG were divided into 2 groups according to the LMS disease. Group I [n=2088]: without significant LMS disease and Group II [n=514]: with LMS disease. Data was analyzed using SPSS V16. The groups were compared using Student's t-test for numeric variables. Chi-square test and Fishers Exact test were used for categorical variables. P-value ? 0.05 was considered as significant difference. Out of two thousand six hundred two, 2088 patients were in Non.LMS group [Control Group] and five hundred fourteen were in LMS Group [Study Group]. Patients with LMS disease were older. In both groups there was no statistically significant difference regarding gender distribution, risk factors of IHD, pre-operative renal function and preoperative CKMB levels. Significant number 50 [9.7%] of patients were unstable in LMS group and they needed urgent surgery [p-value <0.0001]. Need and duration for inotropic support and intra-aortic balloon counter-pulsation support were significantly high in LMS group [p-value <0.0001, 0.002, 0.003 respectively]. Similarly Mechanical ventilation time and hospital stay were higher in LMS group. Incidence of pulmonary complications and operative mortality were significantly higher in LMS group [p-value 0.005 and 0.001 respectively]. Mortality of CABG patients with significant left main coronary stenosis was 13 out of five hundred fourteen [2.5%] as compared to just 17 out of two thousand eighty eight [0.8%] in control group. This study showed that significant LMS disease is an independent risk factor for early cardiopulmonary morbidity and mortality after CABG surgery

Effect of skimmed milk on the absorption and metabolism of5-fluorouracil [5-fu] in animals

Several modalities of drug administration have been investigated to improve bioavailability and to reduce 5-FU related toxicity. The aim of present study was to evaluate the effect of skimmed milk on the absorption and metabolism of 5-FU in rabbits, mice and dogs. It was further aimed to determine its route related toxicity in rabbits. Plasma concentration of both 5-FU and its metabolite 5-Fluoro-2-deoxyuridine [5-Fdurd] was determined using HPLC. The absorption of 5-FU co-administered with skimmed milk was significantly higher as compared to its co-administration with water in rabbits and mice [p < 0.001], whereas no significant difference was observed in dogs. The plasma concentration of 5-Fdurd a major metabolite of 5-FU was significantly higher in water group when compared with skimmed milk group in rabbits and mice [p < 0.05], whereas no significant difference was observed in dogs. Route related toxicity was also determined in rabbits. Various hematological parameters were studied at 4[th] and 7[th] day after oral and intravenous administration of 5-FU. WBCs count was significantly decreased in intravenous group as compared to control and oral groups [p < 0.001]. It was concluded that co-administration of skimmed milk with 5-FU increases its absorption and reduces its metabolism. Skimmed milk also reduces 5-FU related toxicity in rabbits

Caudal analgesia in children; comparison between bupivacaine and bupivacaine plus tramadol

Caudal analgesia with bupivacaine is used commonly for pain relief in children and extradural administration of tramadol seems to be a safe method of analgesia. The aim of the study was to compare the analgesic efficacy of caudal bupivacaine and bupivacaine and tramadol mixture for postoperative analgesia and to observe for the side effects. Department of Anesthesia and Intensive Care Unit, Bahawal Victoria Hospital, Bahawalpur. 01-12-2010 to 30-11-2011. Eighty children, aged between 2 to 12 years of age undergoing infra umbilical surgeries were selected for this randomized, controlled trial. They were randomly divided into two groups A and B. Group A [n = 40] received 0.5 ml/kg of 0.25% bupivacaine and Group B [n = 40] received 0.5 ml/kg of 0.25% bupivacaine with 1 mg/kg of tramadol as a single shot caudal block. In the postoperative period, duration of analgesia, pain score, nausea, vomiting and side effects were noted and analyzed. Patients in both groups were comparable for age and weight. It was observed that the mean duration of analgesia in group A patients was 6.23+0.68 hours while in group B, it was 9.33+0.72 hours [p<0.05]. Nausea and vomiting was present in 20% [n=8] patients in group A, while in group B, 27.5% [n=11] had nausea and vomiting in the post operative period [p<0.05]. None of the patients in both the groups had complications like motor weakness, urinary retention in the postoperative period. The addition of tramadol to bupivacaine in the caudal analgesic technique provides longer analgesia and lesser need for rescue analgesia in the postoperative period compared to bupivacaine alone

Primary postpartum hemorrhage; efficacy of oral misoprostol in comparison to intravenous oxytocin

It is to compare efficacy of Oral Misoprostol with intravenous oxytocin in the management of primary post partum hemorrhage. Quasi experimental study. Obstetrics and Gynaecology Unit-I, Bahawal Victoria Hospital, Bahawalpur. From 1st December, 2006 to 1st December, 2007. The study was conducted on 90 patients who went into post partum hemorrhage during the study period. Cases were divided into two groups each having 45 patients fulfilling the inclusion criteria. Group 'A' had those who received oral misoprostol 600microg and group 'B' those who received 5 UNITS intravenous oxytocin. The variables analyzed were failure of drug, time taken to control bleeding and side effects of drugs. Students t-test was used for comparison between means and chi-square test for comparison between percentages. Significance was taken at P<0.05. It was noted that failure rate of oral misoprostol was 11.1% and that of oxytocin was 22.2%. Mean time taken to control bleeding by misoprostol was 16.6 minutes and 1.311 minutes by intravenous oxytocin. Side effects was observed in 35.5% cases of misoprostol group and 2.22% cases of oxytocin group. The time taken to control bleeding and side effect profile is more better in intravenous oxytocin as compared to oral misoprostol in the menagemnt of primary postpartum hemorrhage, but number of patients responded to oral misoprostol are more, so it can be used as in combination of oxytocin where oxytocin alone failed to work

Complications in cases of enteric perforation

Enteric perforation is a disastrous complication of untreated or poorly treated typhoid fever and unless treated by surgical method, it results in considerable morbidity and mortality. The purpose of this study to describe complications of ileostomy in patients of enteric perforation. The study was conducted was in surgical units B-V hospital, Bahawalpur from 1[st] July 2008 to 30[th] June 2009. This was a descriptive case series study. 100 patients of both genders suffering from typhoid fever with perforation who underwent ileostomy were included the study. All the data was collected on pre-designed proforma. Most of the patients were young with male to female ratio 1.6:1. Ileostomy was done in all the patients after cleaning the peritoneal cavity. Ileostomy was associated with diarrhea 20%, peristomal skin problems 22%. Other complications were bleeding in 3%,prolapsed in 5%, retraction in 4%, parastomal hernia in 5%, wound infection in 8%, intestinal obstruction in 5% patients, incisional hernia and psychological symptoms in 2% patients and stoma stenosis in one patient in our study. Two patients expired due the complication of ileostomy. Although ileostomy is not the most favored way of treatment of enteric perforation and it is associated with a number of complications and management problems, it is still a good option and life saving procedure in our setup where patients present very late with gross peritoneal contamination

Fabrication of potential macromolecular prodrugs of aspirin and diclofenac with dextran

Aspirin and diclofenac conjugates with dextran were synthesized as potential macromolecular prodrugs under homogeneous reaction conditions by using 4-methyl-benzenesulfonyl chloride as an acylating agent in the presence of triethylamine as a base. Highly pure conjugates with good yields were synthesized by this acylation method. All of the products were found soluble in aqueous medium as well as in dimethylsulfoxide and N, N-dimethylacetamide. The UV/Vis spectrophotometry has indicated the incorporation of drugs in conjugates and extent of substitution of drug onto dextran polymer. Covalent attachment of the drug onto the drug carrier polymer [dextran] was verified by [1]H NMR and Fourier transform infrared [FTIR] spectroscopic analysis. The prodrugs were analysed by powder X-ray diffraction [XRD] measurements. Phase changes were noticed by powder XRD for all macromolecular prodrugs indicating the change of state of matter towards more crystallinity. Therefore, fabricated macromolecular prodrugs are potential candidates to show better pharmacokinetic profile. All of the products were thoroughly characterized by using different spectroscopic techniques

Risk factors for primary postpartum hemorrhage

To describe the associated risk factor for primary Postpartum Hemorrhage [PPH] and its severity with increasing parity and duration of labour. It was a descriptive study. Place and duration of study: The Department of Obstetrics and Gynecology [Unit II] of Bahawal Victoria Hospital, Bahawalpur from January 2004 to December 2004. Patient and method: Fifty patients with primary postpartum hemorrhage were included in this study. Data was collected from the patients through a structured proforma. The variable studied were parity, duration of labour and risk factors for primary PPH. The results were statistically analyzed, chi-square test was applied to find out the significance of parity and duration of labour and their relationship with severity of PPH. Simple percentages were used to find associated risk factor for primary PPH. The frequency of primary PPH in primary para was 24% [12 patients] and in multi para was 76%[38 patients]. Severity of PPH increased with increasing parity [P<.05]. After merging the variable of parity severity of PPH increased in patients with prolonged labour in normally delivered patients [P<.05]. As for as risk factors are concerned 60% had uterine atony while 16% got cervical tear and the same number had retained placenta, 8% had preneal tear, Uterine inversion was seen in 6%, 4% presented with polyhydrominos, same with placenta previa type-1. 4% had vaginal laceration, 2% had DIC and 2% had abruptio placenta. The result of the study revealed a number of associated risk factors for primary PPH and proved the relationship of its severity with increasing parity and duration of labour. Duration of labour had a significant relationship with PPH even in Primipara