Induction and Activities of Pyruvate Dehydrogenase and α-ketoglutarate Dehydrogenase in Type 2 Diabetic Patients and Therapy with Vitamin B1.

Aims/Introduction: Thiamine deficiency in diabetes mellitus may impair the function of thiamine pyrophosphate dependent enzymes pyruvate dehydrogenase (PDH) and α-ketoglutarate dehydrogenase complexes (α KGD) resulting in renal dysfunction. This study was designed to investigate the effect of high dose thiamine therapy on the expression and activities of PDH and α KGH in such patients. Materials and Methods: 125 patients with type 2 diabetes and microalbuminuria were assessed for enrollment in a randomized, double blind placebo controlled clinical trial for 5 months. 40 Patients fulfilling the requisite criteria were divided into two groups, one treated with 300mg/day thiamine and the other group was administered placebo. Fifty normal healthy controls were included in the study only for baseline estimation of the parameters. Results: The enrolled patients with type 2 diabetes showed decreased activities of mononuclear enzymes as compared to the healthy controls. Q-PCR study showed that the expression levels of the genes encoding PDE1β and α KGDE1k were significantly reduced in the patients with type 2 diabetes as compared to the healthy controls. Thiamine therapy resulted in significant increases in the expression of PDE1β and α KGDE1 genes, which persisted even 2 months after the washout. Thiamine therapy therefore resulted in significant increase in activities of these enzymes and incremental activity persisted into the washout period. Conclusion: These results indicate that the thiamine acts as an inducer in the expression of mononuclear PDH and α KGD thus enhancing their activities in the type 2 diabetes patients with incipient nephropathy. It was internationally registered with the South Asian Clinical Trials Registry based in India as CTRI/2008/091/000112 and with the World Health Organization’s (WHO) International clinical trials registry Platform search portal http://www.ctri.in/Clinicaltrials/ViewTrial.jsp?trialno=203

Crimean Congo hemorrhagic, lack basic epidemiologic information and risks to public health

We report a case of Crimean Congo haemorrhagic fever in a health care worker who presented with a history of fever and mild mucosal Bleeding. Although Crimean Congo hemorrhagic fever was first reported from Pakistan many decades ago, there is a lack of basic epidemiologic information in non-endemic areas such as Lahore. This often precludes the diagnosis, which may prove detrimental for both the patient and health care workers

Effects of George Ohsawaone [macrobiotic] on biochemical and haematological parameters other than prothrombin time and activated partial thromboplastin time in rabbits

Objective: To determine the effects of George Ohsawa One [GO1] on sodium, potassium, calcium, hemoglobin and platelet count in rabbits with and without anticoagulated blood

Study Design: Interventional study

Place and Duration of Study: This study was conducted at the Department of Pharmacology, FederalPost Graduate Medical Institute and National Health Research Complex, PMRC, Sheikh Zayed Hospital Complex, Lahore from January 2010 to August2011

Materials and Methods: Forty eight [n=48] male rabbits were included in the study. They were divided into two groups which were further divided into two subgroups each. About 700 grams of GO1 was used in the study

Results: The effect of GO1 on platelet count, hemoglobin, serum sodium, potassium and calcium were found to be insignificant

Conclusion: This work on the effect of GOI is first of its kind on biochemical and hematological parameters other than prothrombin time and activated partial thromboplastin time in rabbits measured quantitatively. Although theuse of herbal products may not be dangerous per se, further research work is required to explore the benefits of GO1 on biochemical and hematological parameters before it can safely be used in humans as an anti-hemorrhagic agent

Perception of leadership among health managers working in tertiary level hospitals

Rapid growth of medical knowledge has created major changes in technology which in turn has created greater demand of the client for better health services, and health sector is constantly under pressure of great internal and external demands. Quality of services, largely depend on to what extent managers are well versed with the concept of evidence based management, team and group approach in achieving organizational objectives. Making an effective health system, addressing the double burden of diseases coupled with resource crunch in developing countries is a big challenge for policy makers and health managers. Comprehensive concepts and application knowledge of leadership is very important for health managers in the present day in order to get best output that satisfies all the stake holders. Present anthropological study was done to assess the perception and knowledge of leadership among the health managers working in tertiary level hospitals. This qualitative study was conducted in two public sector tertiary level hospitals of Lahore chosen randomly out of a total of seven such hospitals in the same city. Convenient sampling technique was used. Observation and in- depth interviews were conducted for data collection. Open ended questionnaire on the lines of MLQ was used. One main domain of leadership was developed and categorisation of the themes was done in the two evolved categories of transformational and transactional leadership. In the domain of leadership 10 of the health managers showed positive themes for transactional leadership, 6 showed positive themes for transformational leadership, and still 1 health manager showed overall negative response for the concept of leadership; he was totally in favour of dictatorship. Health managers with degrees in management/administration had better concept about the key idea of leadership and its variables. Female health managers were more inclined towards transformational leadership behaviour.

Perception of intellectual stimulation, creativity and innovation among health managers working in tertiary level hospitals

Background: Management in health sector is becoming focus of attention world over being an important subject due to resource crunch particularly in developing countries. Beside sociodemographic factors, poor management in health sector is also an important factor responsible for poor health in developing countries. Moreover, there is gross lack of effective leadership in our national setup. It is necessary for health managers to be well versed with the knowledge about emerging theories, concepts and new philosophies of management/administration and leadership. This anthropological study was done to assess the perception and knowledge of Intellectual stimulation, creativity and innovation among the health managers working in the tertiary level hospitals of Lahore. Methods: This qualitative study was conducted in two public sector tertiary care hospitals of Lahore. Observation and in-depth interviews were conducted for data collection. Open ended questionnaire, developed on the lines of Multifactor Leadership Questionnaire was used. One main domain of Intellectual stimulation and its variables were developed and emergence of different themes was noted. Results: In the domain of Intellectual stimulation all the participants of the study showed positive themes for the variable of creativity. Seven of the health managers showed positive themes for the variable of innovation, where as three health managers showed negative responses. Conclusion: Health managers with management/administration qualification had better concept about the key ideas of Intellectual stimulation, creativity and innovation; as compared to those who were working at these managerial posts on the basis of their long term experience only. Female health managers were stronger in building their team members on a broader horizon as a wholesome personality and not just taking the daily routine work. Keywords: Intellectual stimulation, creativity, innovation, health managers

comparative study on resistance pattern of pathogenic staphylococcus aureus against imipenem, methicillin, and vancomycin

Objective: The objective of this study was to evaluate current susceptibility of pathogenic isolates of Staph. aureus against imipenem, methicillin and vancomycin

Methodology: Antibacterial activity was performed using disc diffusion technique

Results: The average zone values were compared by using ANOVA and result found to be significant with p-value <0.001. Highest zone values were found to be 31.36+/-5.14 for imipenem followed by methicillin 23.77 +/- 6.53. The lowest zone value were found to be for vancomycin i.e; 14.76 +/- 4.30. Imipenem was the found to be the most effective drug as 91.67% isolates were susceptible to imipenem. While high degree of resistance was observed among isolates against vancomycin [83.33%] and methicillin [70.83%]

Conclusion: Increase in resistance demands the development and rational use of new, safe and effective therapeutic agents

Alloxan induced diabetes in rabbits

Alloxan monohydrate is a common drug used for developing experimental diabetes in animals, as streptozotocin, though less toxic than alloxan is considerably costlier. This study aimed to provide an exact and detailed account of alloxan induced diabetes in rabbits as none was available in both local and international literature and in Pharmacology textbooks. This resulted in extremely high mortality in experimental animals i.e., rabbits, leading to inevitably wasted research time and effort for a researcher.Twenty-four healthy rabbits of a local strain weighing 1000 to 1800 g were obtained and kept at the animal house of the Department of Pharmacology Shaikh Zayed Hospital, Lahore. They were injected with varying doses of Alloxan monohydrate [from 75mg -1 l0mg]/ kg body weight in order to induce diabetes. The blood glucose RBS levels were estimated 8 days after injecting the alloxan and subsequently randomly at intervals of five to ten days till the rabbits became diabetic. These doses were found to lower the rabbit mortality by 25% as compared to [upto 75%] that was encountered with a single standardized dose of 160mg/kg body weight suggested by Akhtar et al. [1982] or 80mg/kg body weight [Puri and Prabhu 2002]. It was therefore concluded that our proposed regime may be beneficial for future researchers aiming to develop a similar animal model

Frequency of Hepatitis B, C and Human Immunodeficiency virus in blood donors at Shaikh Zayed Hospital, Lahore

To find out the frequency of hepatitis B, C and human immunodeficiency virus [HIV] in blood donors at Shaikh Zayed Hospital, Lahore. Design: This is a non-interventional study. Study Period: Period of this study is from 1-1-2005 to 30-6-2005. Study was conducted at the Blood Bank of Shaikh Zayed Hospital, Lahore. Subjects and Methods: In this study 18216 young healthy voluntary blood donors [age 16-50 years] comprising of 16611 males and 1605 females were included and tested for HBsAg, Anti-HCV and HIV by Accu check one step test [chromatographic immunoassay] in serum. Results: Frequency of hepatitis B, C and HIV infection was 3.36%, 4.16% and 0% respectively. We can get representative prevalence values of HBV, HCV and HIV infection in general population by collecting data from all blood transfusion centers of Pakistan. This is also helpful to create public awareness regarding hepatitis and HIV transmission through blood transfusion