Prevalence of non alcoholic fatty liver and non alcoholic steatohepatitis in Peshawar cantonment, Khyber Pakhtunkhwa, Pakistan

Non-alcoholic fatty liver disease prevalence has not been well established. The aims of this study was to define prospectively non-alcoholic steatohepatitis [NASH] and non-alcoholic fatty liver disease [NAFLD] prevalence in hospitalized and ambulatory patients 20-65 years old during June 2013 to June 2014 were selected from Combined Military Hospital Peshawar Cantonment area. A base line questionnaire and right upper quadrant ultrasound was completed by all patients. On identifications of fatty liver among the selected cases further lab test data and liver biopsy reports were obtained. Mean BMI of female was 29.9 + 5.65 while prevalence of hypertension and diabetes was 49.8% and 16.6% respectively. Among all patients 62% were Punjabies, 23% were Pathans while 12% were Sindhies. Overall NAFLD prevalence was 47% while NASH was confirmed in 20 patients [12.3% of total and 30%of ultrasound positive patients]. Pathans had the highest prevalence of NAFLD [58.5%] as compared to Punjabies [44.5%] and Sindhies [35.3%]. Pathans also had a higher prevalence of NASH compared with Punjabies [19.5% VS 10%: P= 0.03]. In general, NAFLD patients were more prevalent among male [59%], Diabetic [P<0.00005], hypertensive [P<0.00005] and older [P =0.005]. They consumed more fast food [P=.049] had a higher BMI [P<0.0005] and had little or no exercise as compared to their normal or non NAFLD counter parts [P=0.02]. NAFLD was found in 75% and NASH in 22.5% among the 26 diabetic patients. ALT, AST, BMI, insulin, quantitative insulin sensitivity checks index and cytokeratin - 18 correlated with NASH. It was concluded that NAFLD and NASH prevalence is higher than estimated previously, Pathans and Patients with diabetes are at high 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

Endovascular treatment of renal artery stenoses

To evaluate the procedure success and effect on hypertension after stenting of incidentally diagnosed atherosclerotic renal artery stenoses. An experimental study. A multicentric study was conducted at the Plastic Surgery and General Hospital, National Medical Center and Ziauddin University Hospital, Karachi, Pakistan from January 2009 to March 2013. Hypertension [systolic blood pressure > 160 and diastolic > 90 mmHg with two or more than two medications] with coronary artery disease were initially evaluated for coronary angiography, Renal artery angiography was also endovascular performed and stent was deployed for atherosclerotic renal artery stenosis when found. Blood pressure readings, reduction in need of antihypertensive medication and serum creatinine levels were taken as outcome measures. Patients having renal artery stenoses secondary to connective tissue disorders and fibromuscular dysplasia were excluded. There were 25 patients, 14 [56%] male and 11 [44%] female, with mean age of 49 +/- 6 years. Diabetes mellitus, dyslipidemia and smoking were seen in 11 [44%], 10 [40%] and 4 [16%] patients respectively. Renal insufficiency [serum creatinine > 1.5 mg/dl] was seen in one [04%] patient. Bilateral, and isolated right and left renal artery stenoses was seen in 5 [20%], 9 [36%] and 11[44%] patients respectively. Mean percentage of renal artery stenoses was 89%, ranged from 70% to 99% while ostial lesion was found in 20 [80%] patients. A significant decrease in systolic [168.20 +/- 9.987 vs. 140.60 +/- 5.649 mmHg, p < 0.001] and diastolic blood pressure [88.60 +/- 5.50 vs. 77.20 +/- 5.017 mmHg, p < 0.001] and reduction of medication [2.72 +/- 0.458 vs. 1.5 +/- 0.510, p < 0.01] were noted without a change in renal function [p= 0.061] after renal artery stenting. Endovascular stenting of renal artery stenoses in patients with poorly controlled hypertension is a safe and effective treatment

Larvicidal, insecticidal, brine shrimp cytotoxicity and anti-oxidant activities of Diospyros kaki [L.] reported from Pakistan

Diospyros kaki is cultivated in different agro-ecological zones of Pakistan, especially in Malakand division. The current study was designed to investigate the hide potential of the vulnerable species of the plant. Aqueous extracts of Diospyros kaki leaves were screened for larvicidal, insecticidal cytotoxic and antioxidant activities. The extract exhibited moderate to outstanding larvicidal activity [100 to 28%] at 100, 80, 70, 50, 40, 30, 20 and 10% concentrations respectively after 24 hours, showing 42% LCso. Permitrin displayed 100% lethality at 0.3%. The extract demonstrated outstanding cytotoxic action against brain shrimps nauplii [Artemia salina], showing 10 ppm LC[50] which is closed to the LC[5]o [9.8jtig/ml] of standard drug Etoposide. Similarly profound insecticidal potential [100%] was recorded after 15 min against Cimex lectularius. In DPPH scavenging activity the extract demonstrated moderate 30.22%, while Quercetin, Gallic acid and Acetic acid showed 98, 96 and 97% activity respectively at lOOppm. Thus on the basis of our finding it could be concluded that the decoction of the leaves of D. kaki is a good natural alternative for the control of insects and neoplasia

Comparative studies of binding potential of Prunus armeniaca and Prunus domestica gums in tablets formulations

The current study was undertaken to compare the binding potential of Prunus armeniaca L. and Prunus domestica L. gums in tablets' formulations. Tablet batches [F-1 to F-9] were prepared Diclofenac sodium as model drug using 5%, 7.5% and 10% of each Prunus armeniaca L., Prunus domestica L. gums as binder. PVP K30 was used as a st and ard binder. Magnesium stearate was used as lubricant. Flow properties of granules [like bulk density, tapped density, Carr's index, Hausner's ratio, angle of repose] as well as the physical parameters of compressed tablets including hardness, friability, thickness and disintegration time were determined. Flow parameters of granules of all the batches were found good. Physical parameters [drug content, weight variation, thickness, hardness, friability, disintegration time] of formulated tablets were found within limit when tested. The dissolution studies showed that tablets formulations containing each Prunus domestica showed better binding capacity compared to Prunus armeniaca gum. The binding potential increased as the concentration of gums increased. The FTIR spectroscopic investigation showed that the formulations containing plant gum are compatible with the drug and other excipients used.

Variation in admission rates of acute coronary syndrome patients in coronary care unit according to different seasons

Environmental stresses, especially extreme cold and hot weathers, have tendency to have more admissions for acute coronary syndromes. Due to scarcity of local data, we studied the variation in patient admission rates with acute coronary syndrome according to different seasons. Descriptive study. Coronary Care Unit, Civil Hospital and Pakistan Steel Hospital, Karachi, from January 2011 to December 2011. The study group comprised consecutive patients with acute coronary syndrome [unstable angina, Non STElevation Myocardial Infarction [NSTEMI], ST-Elevation Myocardial Infarction [STEMI] admitted to the coronary care unit. Patients with stable angina and valvular heart disease were excluded. Data was analyzed for admission according to different seasons, [winter, spring, summer and autumn]. The mean age of the 428 cases was 48.5 +/- 10.4 years [range 27 to 73 years]. Among the study group, 261 [61%] and 167 [39%] cases were male and female respectively. ST-elevation myocardial infarction, non ST-elevation myocardial infarction and unstable angina were present in 206 [48%], 128 [30%] and 94 [22%] respectively. Among the 428 patients, 184 [43%] cases had hypertension, 133 [31%] cases were smokers, 103 [24%] cases had dyslipidemia and diabetes mellitus and 08 [2%] cases had history of premature coronary artery disease. The number of patients admissions with acute coronary syndrome tended to change with sudden change in season. It increased in Winter 158 [36.9%] and Summer 130 [30.3%] in comparison to Spring 80 [18.69%] and Autumn 60 [14.02%] season. It was found variation in admission rates of acute coronary syndrome patients according to different seasons. The number of admissions not only increased in the cold season [winter] but also in hot season [summer] with sudden changes in temperature

Incidence of Pinhole Type Durotomy and Subsequent Cerebrospinal Fluid Leakage Following Simple Laminectomy

STUDY DESIGN: Cross sectional study. PURPOSE: The purpose of this study was to determine the incidence and the associated risk factors of pinhole type of durotomy and cerebrospinal fluid (CSF) leakage following a simple laminectomy for spinal stenosis. OVERVIEW OF LITERATURE: The incidence of spinal stenosis is expected to rise with increasing life expectancy. Moreover, lumbar spinal stenosis is the most common indication for spinal injury in the geriatric population. It is therefore important to identify and prevent the risks associated with laminectomy, the most widely used surgical procedure for spinal stenosis. The serious complication of incidental dural tear or durotomy and subsequent CSF leakage has not been studied in the region of Southeast Asia. METHODS: In this cross sectional study, we included 138 adult patients (age>18 years), who underwent a simple laminectomy for lumbar stenosis between 2011 and 2012. CSF leakage was the main outcome variable. Patients' wounds were examined for CSF leakage up to 1 week postoperatively. RESULTS: The incidence of pinhole type durotomy and subsequent CSF leakage in our region was 8.7%. Univariate analysis showed that hypertension, diabetes and smoking were significantly associated with durotomy and increased CSF leakage by 16.72, 44.25, and 33.71 times, respectively. Multivariate analysis showed that only smoking and diabetes significantly increased the chances of leakage. CONCLUSIONS: Glycemic control and cessation of smoking prior to a simple laminectomy procedure reduced the incidence of a dural tear. Larger clinical studies on this lethal complication are required.

Impact of statins on risk and survival of ovarian cancer / 부인종양

No abstract available.