Role of prophylactic ondansetron for prevention of spinal anaesthesia induced hypotension in lower segment caesarean section

Objective: To determine the efficacy of prophylactic administration of intravenous Ondansetron for prevention of spinal anaesthesia induced hypotension in lower segment caesarean section

Study Design: Double blinded randomized controlled trial

Place and Duration of Study: It was conducted in Anesthesiology department, CMH Rawalakot; from 3 Mar to 4 Jun 2014

Material and Methods: One hundred patients were selected for this study, and randomly divided in two groups of 50 each, using random numbers table. Both groups were preloaded with Ringer's lactate at dose of 10ml/kg. Group A received 04 mg of IV ondansetron 5 min prior to spinal anaesthesia, whereas Group B received normal saline 05 minutes before administration of Spinal Anaesthesia

Results: Average age of Group A was 28.62 +/- 4.64 years, whereas that of Group B was 27.88 +/- 3.98 [p-value= 0.394]. Average weight of Group A was 70.30 +/- 6.25 kg, whereas that of Group B was 70.74 +/- 6.17 kg [p-value= 0.724]. Hypotension was noted in 21 patients in group A [42%], whereas it was observed in 34 Patients in Group B [68%] [p-value= 0.009]. Bradycardia was noted in 9 patients in Group A [18%] and 19 patients in Group B [p=0.026]

Conclusion: Intravenous administration of 04 mg of intravenous ondansetron, 05 minutes prior to subarachnoid block, is effective in decreasing frequency of hypotension

Frequency of proven risk factors for deep vein thrombosis in clinical patients: results of a study on patients being treated at a tertiary care hospital in Rawalpindi, Pakistan

To enlist the dominant risk factors predisposing patients to deep venous thrombosis. The prospective study was conducted in surgical and medical departments of Combined Military Hospital, Rawalpindi, and Fauji Foundation, Islamabad, from January 2012 to December 2013. Patients having deep venous thrombosis of lower extremities by duplex scan were enrolled. After taking their detailed personal and biochemical history, frequency of risk factors was noted and graded accordingly. Of the total 120 patients, 71[59%] were males. Overall, left leg was involved in 53[44%], right leg in 34[28%] and both legs in 33[28%]. Of the total, 68[57%] patients were >40 years of age. Immobility was the main cause of deep venous thrombosis in 18[15%], followed by surgical interventions in 10[8%]. Pregnancy and post-partum thrombosis was the major cause in 9[8%] women. Only 6[5%] patients had natural predisposition to deep venous thrombosis. Immobility was an independent and important risk factor for deep venous thrombosis. Thromboprophylaxis is not routinely provided in most health centres in Pakistan, exposing patients to the risk

Phytochemicals, in vitro antioxidant, total phenolic contents and phytotoxic activity of Cornus macrophylla Wall bark collected from the north-west of Pakistan

Plants are one of the precious creatures of Allah, producing a verity of useful bioactive compounds having definite pharmacological actions on human body. Keeping in view this idea, the methanolic extract from the bark of Cornus macrophylla was investigated for phytochemicals, antioxidant, total phenolic contents [TPC] and phytotoxic activities. Phytochemical analysis of Cornus macrophylla revealed the presence of tannins, anthraquinones, glycosides, reducing sugar, saponins and flavonoids. The percent free radicals scavenging potential of DPPH at 20, 40, 60, 80 and 100 micro g/ml was 72.69%, 73.32%, 73.51, 73.83% and 74.33% respectively and were compared to ascorbic acid [84.6%, 92.83%, 95.36%, 96.40% and 98.03%], gallic acid [85.49%, 92.47%, 95.14%, 98.22% and 98.03%] and quercetin [95.35%, 96.30%, 97.16%, 98.02% and 98.28%] as standards. The IC[50] value of Cornus macrophylla was 14.5/ micro g/ml. The TPC of the methanolic bark extract was 2.916 mg gallic acid equivalents/g of extract. The extract have shown excellent phytotoxic activity against the tested plant Lemna minor and inhibited the growth at 1000 micro g/ml. Our findings revealed that the crude methanolic extract of Cornus macrophylla is a potential source of natural antioxidants and herbicidal

Biological screening of selected flora of Pakistan

Methanolic extracts of different parts of five medicinal plants, Ferula assafoetidaL. resin, Grewia asiaticaL. leaves, Ipomoea hederaceaJacq. seeds, Lepidium sativumL. seeds and Terminalia chebulaRetz. fruits were tested in vitrofor their cytotoxic, phytotoxic, insecticidal, nematicidal and anthelmintic activities. Ipomoea hederaceashowed very significant phytotoxic and cytotoxic activity, with 100% inhibition of Lemna minorgrowth and 100% death of Artemia salinaat concentrations of 1000 and 100 µg mL-1. Grewia asiaticaexhibited very weak activities while Lepidium sativumand Ferula assafoetidashowed moderate to good potential in all three bioassays. The results suggest screening of Ipomoea hederaceaseeds further for isolation of bioactive compounds that may be responsible for its toxic potential.

Influence of gender, BMI, and ethnicity on serum ALT levels of healthy students of a medical school

Alanine Aminotransferase [ALT] is an enzyme found in Liver and indicates injury to Hepatocytes. It is influenced by various factors. The objectives of this study were to identify the correlates of ALT activity among healthy medical students of Army Medical College, National University of Sciences and Technology, aged 18-22 years. This was to establish the mean ALT levels of the students and compare them with those in various parts of the world and observe various correlations that exist and factors that may influence ALT levels. This population included 143 volunteer students [93 men and 50 women] selected on the basis of negative answers to a detailed medical questionnaire including past medical history, drug and alcohol consumption, on the absence of clinical signs of liver disease, on the negativity of serological testing for Hepatitis B and C virus. The mean ALT level of the entire population was 28.7 IU/L. A major sex-difference in ALT value was observed, the mean ALT value being higher in men than in women [32.1 +/- 21.7 vs. 22.6 +/- 9.7 IU/L, p<0.004]. According to WHO criteria for Asians, normal BMI was taken from 18.5-23.0 Kg/m[2]. There was a positive significant correlation between serum ALT level and BMI [p<0.002]. ALT level strongly correlates with body mass index and gender. There was no significant variation in ALT levels among Punjabis and Sindhis, Balochis, Pathans, and Kashmiris. We suggest the need of taking into account these parameters in a clinical interpretation of ALT level

Awareness of novel h1n1 pandemic influenza among non-medical personnel, medical students and medical professionals

To study the awareness of swine flu among general population, medical students and medical professionals Descriptive study. Place and Duration of Study: Study was carried out in the department of Pathology [Microbiology], Army Medical College, the Military Hospital [MH] and Combined Military Hospital, Rawalpindi, from 17th January 2010 to 24th January 2010. Materials and A total of 519 people were included in this study, 228 were medical students, 181 were doctors and 110 were non health care professionals. A questionnaire with closed questions regarding the awareness of the basics of swine flu was required to be filled by all participants. It was found that the general population was totally unaware to the extent that 1/3rd had never heard of this disease. The survey of medical students showed reasonable knowledge in the senior classes [80-85%] knew the main features of the disease], whereas the 2nd year students had the awareness around 40-45%. Among the medical professionals the knowledge was excellent in the seniors, whereas the trainees and house officers had suboptimal knowledge of swine flu. The result of this study show a significant gap between the seniors specialists and the juniors and this gap warrants immediate bridging. The general public also need to be informed by various means more comprehensively