Eczema; frequency of different types in a tertiary care hospital

Objectives: To determine the frequency of different types of eczema in patients presenting in a tertiary care hospital. Study Design: Cross sectional descriptive type of study. Setting: Hamdard University Hospital Karachi. Period: January 2013 till December 2013

Patients and Methods: All new cases of any type of eczema were registered by nonprobability convenient sampling. Total 192 patients of both genders and all ages were enrolled after taking informed consent. Diagnosis was made on detailed history and clinical examination by consultant dermatologist. All specific and relevant investigations were done according to requirement. Patients were divided in two groups, exogenous eczema and endogenous eczema, for convenience. Data was analyzed by the latest version of SPSS

Results: There were 192 patients, out of which 52.08% were males and 47.91% females. Out of the total presented patients 50% had endogenous eczema, 43.37% had exogenous eczema and 25.62% had unspecified eczema. In endogenous group 11.45% had hand dermatitis followed by seborrhoeic dermatitis, atopic dermatitis and asteatotic eczema in descending frequency of presentation. Pityriasis alba, discoid eczema and pompholyx were seen less frequent. In exogenous eczema allergic contact dermatitis was seen in 14.06% patients, while irritant contact dermatitis in 11.45% patients. Infective eczema and photo-allergic eczema were seen in small number of patients

Conclusion: It was found in this study that allergic contact dermatitis was most common type of eczema followed by other types. Whatever the type is, eczema can be treated, symptoms can be relieved and recurrences can be prevented by appropriate therapy. All types of eczema affect patient's quality of life adversely. However, they can be prevented by educating patients and their relatives to take adequate safety measures like using good quality emollients prophylactically

Antiurolithiatic plants: formulations used in different countries and cultures

About 12% of world population is affected by different forms of urolithiasis in which the recurrence rate in female is 47-60% and in male is 70-80%. According to WHO 75% people rely on traditional medicines for the prevention and cure of different ailments. Similarly, the majority of the world population use a number of plants to treat problems related to the urinary tract system in which urolithiasis is the major cause. The aim of the review is to collect the data of the plants used in different parts and cultures of the world against urolithiasis with their parts, mode of preparation, dosage and administration. A literature review was conducted for traditionally used antiurolithiatic plants. The articles mentioning plant, parts, mode of preparation, dose and route of administration were selected. This information was extracted to compose Mono and Poly herbal antiurolithiatic formulations used in Appalachia [region in Eastern United States], Canada, India, Iran, Israel, Italy, Jordan, Latin America, Pakistan, Turkey and Yemen. The review provides an important data about plants used as antiurolithiatic in different parts of the world. The information not only useful for common people, but also for the scientific community to carry out further phytochemical, pharmacological and toxicological studies for the discovery of new, effective and safer molecules against urolithiasis

Formulation design and evaluation of Cefuroxime axetil 125 mg immediate release tablets using different concentration of sodium lauryl sulphate as solubility enhancer

Cefuroxime axetil immediate release tablets were formulated by direct compression method with different percentages of sodium lauryl sulphate (SLS) such as 0.5, 1.0, 1.5 and also without SLS. Resulting batches of tablets were evaluated by both pharmacopeial and non-pharmacopeial methods to ascertain the physico-mechanical properties. Dissolution test were carried out in different medium like 0.07 M HCl, distilled water, 0.1M HCl of pH 1.2 and phosphate buffers at pH 4.5 and 6.8 to observe the drug release against the respective concentration of SLS used. Later, test formulations were compared by f1 (dissimilarity) and f2 (similarity) factors using a reference brand of cefuroxime axetil. Significant differences (p<0.05) in dissolution rate were recorded with the change in concentration of SLS in different media. Test formulation T3 containing 1% SLS was found to be best optimized formulation based on assay, disintegration, dissolution and similarity and dissimilarity factors.

Formularam-se comprimidos de liberação imediata à base de cefuroxima axetil, pelo método de compressão direta, com diferentes percentagens de lauril sulfato de sódio (LSS), tais como 0,5, 1,0, 1,5, e também sem SLS. Os lotes resultantes dos comprimidos foram avaliados por ambos os métodos da farmacopeia e não farmacopeicos para determinar as propriedades físico-mecânicas. O teste de dissolução foi realizado em meios diferentes, como HCl 0,07 M, água destilada, HCl 0,1 M com pH 1,2 e os tampões fosfato (pH 4,5 e 6,8) para observar a liberação do fármaco contra a correspondente concentração de LSS utilizado. Em seguida, as formulações de teste foram comparadas por fatores f1 (dissimilaridade) e f2 (similaridade), utilizando uma marca de referência de cefuroxima axetil. Diferenças significativas (p<0,05) na taxa de dissolução foram registradas com a mudança na concentração de LSS em diferentes meios de dissolução. A formulação T3 contendo LSS a 1% foi considerada a melhor formulação otimizada com base nos ensaios de desintegração, dissolução e fatores de semelhança e dissimilaridade.

Pattern of skin diseases in a tertiary care private hospital, Karachi

To determine the pattern of skin diseases in a tertiary care hospital in Karachi and to compare the results with local and international literature. The current study was carried out in the Dermatology Department, Hamdard University Hospital, Karachi from 1[st] September 2011 to 31[st] August 2012 over a period of 1 year. All the freshly registered patients presenting in the outpatient were enrolled irrespective of gender and age, after an informed consent. Clinical diagnosis was made on the basis of detailed history and clinical examination. Laboratory investigations were performed where required e.g. routine investigations and biochemical profile. Skin biopsy and histopathology were performed in doubtful cases. All the findings were recorded, compiled, tabulated and analyzed. 1733 patients comprising 936 [54%] females and 797 [46%] males were enrolled. There were 728 [42%] children and 1005 [58%] adults. Infections and infestations were the most common skin conditions constituting 37.4% of all the enrolled patients of which 399 [23%] were children and 250 [14.4%] adults. Eczema was next in frequency comprising 313 [18%] patients including 150 [8.6%] children and 163 [9.4%] adults. Acne was seen in 229 [13%] patients, urticaria in 97 [5.5%] while hair disorders were recorded in 66 [4%] patients. Papulosquamous disorders and pigmentary dermatoses were observed in less than 3% of the patients studied. Scabies presented with the highest frequency [18%] and among pyodermas [10%], furunculosis [4%] and impetigo 59 [3%], being the most frequent. Fungal infections [3%] had a frequency more then viral infections [2%]. Atopic dermatitis was the most frequently seen eczema [6%] followed by seborrhoeic dermatitis [5%] and contact dermatitis [4.5%]. The pattern of skin diseases is same in various cities of Pakistan with minor differences. Scabies and infections remain the most common diseases while eczema also constitutes an important group of dermatoses in our part of the world

Analgesic and anti-inflammatory activities of Piper nigrum L

Objective: To evaluate and compare the analgesic and anti-inflammatory activity of pure compound, piperine along with hexane and ethanol extracts of Piper nigrum L. fruit in mice and rats. Methods: The analgesic activity was determined by tail immersion method, analgesy-meter, hot plate and acetic acid induced writhing test. While the anti-inflammatory activity was evaluated by carrageenan-induced paw inflammation in rats. Results: Piperine at a dose of 5 mg/kg and ethanol extract at a dose of 15 mg/kg after 120 min and hexane extract at a dose of 10 mg/kg after 60 min exhibited significant (P<0.05) analgesic activity by tail immersion method, in comparison to ethanol extract at a dose of 10 mg/kg using analgesy-meter in rats. However, with hotplate method, piperine produced significant (P<0.05) analgesic activity at lower doses (5 and 10 mg/kg) after 120 min. A similar analgesic activity was noted with hexane extract at 15 mg/kg. However, in writhing test, ethanol extract significantly (P<0.05) stopped the number of writhes at a dose of 15 mg/kg, while piperine at a dose of 10 mg/kg completely terminated the writhes in mice. In the evaluation of anti-inflammatory effect using plethysmometer, piperine at doses of 10 and 15 mg/kg started producing anti-inflammatory effect after 30 min, which lasted till 60 min, whereas hexane and ethanol extracts also produced a similar activity at a slightly low dose (10 mg/kg) but lasted for 120 min. Conclusions: It is concluded from the present study that Piper nigrum L possesses potent analgesic and anti-inflammatory activities.

Analgesic and anti-inflammatory activities of Piper nigrum L

OBJECTIVE@#To evaluate and compare the analgesic and anti-inflammatory activity of pure compound, piperine along with hexane and ethanol extracts of Piper nigrum L. fruit in mice and rats.@*METHODS@#The analgesic activity was determined by tail immersion method, analgesy-meter, hot plate and acetic acid induced writhing test. While the anti-inflammatory activity was evaluated by carrageenan-induced paw inflammation in rats.@*RESULTS@#Piperine at a dose of 5 mg/kg and ethanol extract at a dose of 15 mg/kg after 120 min and hexane extract at a dose of 10 mg/kg after 60 min exhibited significant (P<0.05) analgesic activity by tail immersion method, in comparison to ethanol extract at a dose of 10 mg/kg using analgesy-meter in rats. However, with hotplate method, piperine produced significant (P<0.05) analgesic activity at lower doses (5 and 10 mg/kg) after 120 min. A similar analgesic activity was noted with hexane extract at 15 mg/kg. However, in writhing test, ethanol extract significantly (P<0.05) stopped the number of writhes at a dose of 15 mg/kg, while piperine at a dose of 10 mg/kg completely terminated the writhes in mice. In the evaluation of anti-inflammatory effect using plethysmometer, piperine at doses of 10 and 15 mg/kg started producing anti-inflammatory effect after 30 min, which lasted till 60 min, whereas hexane and ethanol extracts also produced a similar activity at a slightly low dose (10 mg/kg) but lasted for 120 min.@*CONCLUSIONS@#It is concluded from the present study that Piper nigrum L possesses potent analgesic and anti-inflammatory activities.

Formulation development and evaluation of diltiazem HCl sustained release matrix tablets using HPMC K4M and K100M

The aim of this study was to develop a sustained release hydrophilic matrix tablet of Diltiazem HCl and evaluates the effect of formulation variables [e.g. lubricant, binder, polymer content and viscosity grades of HPMC] on drug release. Twelve different formulations [F1-F12] were prepared by direct compression. The results of the physical parameters and assay were found to be within the acceptable range. Rate of drug release was found to be slow as the fraction of the polymer was increased from 20-50%. The drug release rate from tablets containing K4M was effectively controlled by increasing the talc concentration, whereas the burst effect was reduced by increasing binder content. The drug release was higher with K4M as compare to K100M. Model-dependent and independent methods were used for data analysis and the best results were observed for K4M in Higuchi [R[2]=0.9903-0.9962] and K100M in Baker and Lonsdale [R[2]=0.9779-0.9941]. The release mechanism of all formulations was non-Fickian. F7 [50% K4M, 2% talc, 10% Avicel PH101] and F11 [40% K100M] were very close to targeted release profile. F12 [50% K100M] exhibited highest degree of swelling and lowest erosion. The f[1] and f[2] test were performed taking F11 as a reference formulation

Evaluation of Centella asiatica for its neuropharmacology

To determine the effect of Centella Asiatica on Neuro pharmacological activities as memory, behavior [anxiety, depression]. Experimental Study. This study was conducted in the department of Pharmacology, Faculty of Pharmacy, University of Karachi, Karachi from 15[th] March 2011 to 30[th] April, 2011. Albino mice and albino rats were used. Animals were divided into control and treated groups [10 animals each]. Neuro pharmacological parameters were assessed using standard techniques as Stationary rod activity, Swimming induced depression [FST], Open field, Light and dark box test and water maze model. Control group was maintained on distilled water and treated group was fed with 8.3 mg/kg Centella asiatica for 10 days. Observations were taken on 1[st], 5[th] and 10[th] days. The results showed decline in the elapsed time taken by animal to reach the platform in Stationary rod and water maze model, significantly enhanced struggling time in FST, decreased number of peripheral square crosses but relatively increased central square crosses on 10[th] day in open field test and increased time spent in light box in Light and dark box mode. It can be concluded that Centella asiatica enhances memory and show antidepressant activity on acute administration while chronic use results in anxiolytic behavior

Enteric coating of ibuprofen tablets (200 mg) using an aqueous dispersion system / Revestimento entérico dos comprimidos de ibuprofeno (200 mg), utilizando um sistema de dispersão aquosa

Ibuprofen is a propionic acid derivative that belongs to the class NSAIDs. Major adverse reactions associated with Ibuprofen are related to GIT and include peptic and mucosal ulcers, dyspepsia, severe gastric pain and bleeding, that results in excessive treatment failure. The goal of this study was to develop enteric coated ibuprofen tablets in order to avoid gastric mucosal irritation, diffusion of drug across mucosal lining and to let active ingredient be absorbed easily in small intestine. The formulation was developed and manufactured through the direct compression process, the simplest, easiest and most economical method of manufacturing. Enteric coating was done using an Opadry white subcoating and an aqueous coating dispersion of Acryl-Eze. Enteric coated formulation was subjected to disintegration and dissolution tests by placing in 0.1 M hydrochloric acid for 2 h and then 1 h in phosphate buffer with a pH of 6.8. About 0.04 percent of drug was released in the acidic phase and 99.05 percent in the basic medium. These results reflect that ibuprofen can be successfully enteric coated in order to prevent its release in the stomach and facilitate rapid release of the drug in the duodenum, due to the presence of superdisintegrant. Formulating this enteric coated tablets could increase patient compliance by decreasing adverse drug reactions (ADR S) associated with Ibuprofen therapy.

Ibuprofeno é um derivado do ácido propiônico, que pertence à classe dos fármacos não-esteróides (AINES). As principais reações adversas associadas com o ibuprofeno se referem àquelas do trato gastrintestinal (TGI), como úlceras pépticas e da mucosa, dispepsia, dor gástrica grave e sangramento, que resultam em muitas falhas de tratamento. O objetivo do estudo foi desenvolver comprimidos revestidos de ibuprofeno que impeçam a irritação da mucosa gástrica, difusão do fármaco através da mucosa e permitam, facilmente, a absorção do princípio ativo do intestino delgado. A formulação foi desenvolvida e manufaturada por meio de processo de compressão direta, método mais simples e econômico de preparação. O revestimento entérico foi efetuado utilizando-se subrevestimento com Opadry branco e revestimento por dispersão aquosa de Acryl-Eze. A formulação de revestimento para liberação entérica foi submetida a testes de desintegração e de dissolução, em ácido clorídrico 0,1 M, por 2 h, e, então, a h, em tampão fosfato pH 6,8. Cerca de 0,04 por cento do fármaco foi liberado na fase ácida e 99,05 por cento, no meio básico. Estes resultados refletem o fato de que o ibuprofeno pode ser revestido com sucesso, a fim de impedir sua liberação no estômago e facilitar a rápida liberação do fármaco no duodeno, devido à presença de superdesintegrante. A formulação de tais comprimidos aumentaria a adesão do paciente pela diminuição das reações adversas (RAs), associadas à terapia com ibuprofeno.

Studies on the chemical composition of kohl stone by x-ray diffractometer

Use of Kohl [Surma] creates toxicity or protects eye, is one of the most controversial topic of modern medicines. However, modern researches show that kohl forms a thin film on the eye lens thus avoiding the direct contract of harmful UV radiation and glare of sun with lens. Black and shining particles of galena in kohl shield the eyes from glare and reflection of sun and thus protect them from harmful effect of UV radiation emerging from the sun. Based on these findings and other properties of kohl, it was decided to undertake this study to ascertain it's chemical composition and to correlate these properties scientifically. In the present study, kohl stone obtained from Madina [Saudi Arabia] was analyzed to ascertain it's chemical composition. The chemical analysis and X-ray diffractometer results obtained, showed that the main component of kohl stone is galena [PbS]

Herbal treatment for cardiovascular disease the evidence based therapy

More than 2000 plants have been listed in the Traditional [Herbal/Alternative] systems of medicine and some of these are providing comprehensive relief to the people suffering from cardio-vascular diseases, specially [hyperlipidemia] and [ischemic heart disease]. WHO reports indicate that around eighty percent of the global population still relies on botanical drugs and several herbal medicines have advanced to clinical use in modern times. Based on these findings, present review is written to identify the [Pharmacology and Cardio-vascular Application] of four commonly used plants in Pakistan. These include, Crataegus oxycantha, Inula racemosa, Terminalia arjuna and Commiphora mukul The selection of the plants in the present study is primarily based on their chemistry and pharmacological properties including toxicology reported in various research articles and reviews. Some very interesting findings have been observed and thus recorded and reported in this review

Bioactive alkaloids produced by fungi I. updates on alkaloids from the species of the genera boletus, fusarium and psilocybe

Fungi, in particular, are able in common with the higher plants and bacteria, to produce metabolites, including alkaloids. Alkaloids, along with other metabolites are the most important fungal metabolites from pharmaceutical and industrial point of view. Based on this observation, the authors of this review article have tried to provide an information on the alkaloids produced by the species of genera: Boletus, Fusarium and Psilocybef from 1981-2009. Thus the review would be helpful and provides valuable information for the researchers of the same field

Kohl [SURMA]: retrospect and prospect

Kohl, since antiquity has always been given a prime importance in ophthalmology for the protection and treatment of various eye ailments. However, for decades various conflicting reports in the literature have been published relating to Kohl application to eyes being responsible for causing higher blood lead concentration, which may cause lead poisoning. While at the same time, a number of research studies and reports have also been published negating any such links with increased blood lead level upon Kohl [surma] application. In view of the above mentioned facts, this review article is written with the objective to highlight various data from past and present research studies and reports about Kohl, so as to provide valuable information to both the users and the research workers about it-s scientific background and effects when applied into eyes. A large number of items and topics [such as Kohl, surma, eye cosmetic, traditional eye preparations, environmental lead pollution, galena, lead sulphide etc.] have been taken into consideration while compiling this review article. In conclusion, the authors of this review article feel that the relation between Kohl and toxicity or increased blood lead concentration upon it-s application to eyes as reported elsewhere is likely to be more of theoretical nature rather than a practical health hazard

Role of amantadine in treatment of chronic hepatitis C

Background: Interferon afla [IFN-alfa] is the only effective treatment for patients with Chronic hepatitis C. Forty percent of patients have an initial response to therapy. But most subsequently relapse. Amantadine, an antiviral agent, in addition ability, of preferably concentrating in liver, has shown a role in reducing hepatic inflammation and suppressing viral replication. The aim of this study was to assess the efficacy and safety Of amantadine for treatment of chronic infection with hepatitis C virus [HCV]. Design: Prospective study. Period: From January 2002 to Dec 2003, Setting: Allied Hospital, Faisalabad

Methods: Fifty patients either naive or interferon resistant, with age range of 18-65 years, were enrolled and treated with amantadine 100 mg orally twice daily for six month. Control groups included the same cohort followed of therapy for 12-18 month or during therapy with interferon. All patients were assessed for safety. Tolerance and efficacy at the end of every month during treatment was completed. Patients were followed up for an additional six month to assess durability of response. The primary end - point were loss of detectable HCV-RNA six month after cessation of therapy

Findings: Out of 50 patients treated for six months with amantadine compared to intervals without therapy or to interferon therapy, 17 [34%] had normal serum alanive aminotransferase [ALT] values and had cleared HCV RNA in serum by the end of treatment. The sustained virological response was found in 11 patients with an undetectable serum HCV RNA level six month after therapy Baseline low serum HCV RNA levels were associated with higher rates of Response. During the therapeutic trial, amantadine caused no potential treatment limiting side effects but had a good safety profile

Interpretation: Therapy with amantadine results in biochemical as well as virological response both in the naive and interferon resistant cases of chronic hepatitis C

Prevalence of retinopathy in hypertensive patients

Objective: The objectives of this study were to find out the prevalence of hypertensive retinopathy among hypertensive patients in this area of Pakistan and grading of hypertensive retinopathy at the time of examination according to the Keith-Wagener retinal changes classification for hypertension. Study Design: An observational study. Period: 5½ months Setting: Outdoor/emergency department as well as in medical unit - II of Allied Hospital, Faisalabad

Material and Methods: Three hundred consecutive patients with hypertension of either sex and between 20-85 years of age were examined. Opthalmoscopy was done after dilating the pupil with 1% Mydriacyl and retinopathy graded according to Keith-Wagener Classification

Results: Among these patients, 168 had the finding of hypertensive retinopathy, with overall prevalence of 56%. Out of these 168 patients, 70 had grade I, 75 had grade II, 18 had grade III and 05 had grade IV changes according to the Keith-Wagener Classification of hypertensive retinopathy. Among these 168 patients with hypertensive retinopathy, 64 were males and 104 were females, with overall prevalence in males 58.18% and in females 54.73%. It is found that prevalence of hypertensive retinopathy is maximum in patients with 50 years of age or above. The prevalence of hypertensive retinopathy increases with the duration of hypertension and is maximum in patients with duration of 10 years or more. Two hundred twenty five [225] patients were taking single drug and out of these 110 patients were found to have retinopathy with prevalence of 48.8%, 40 patients were taking combination therapy and out of these 34 patients were found to have retinopathy with prevalence of 86%. The remaining 35 hypertensive patients who had never taken medicine for their B.P control, out of these 35, 22 patients were found to have hypertensive retinopathy with prevalence of 62.8%

Conclusion: Prevalence of hypertensive retinopathy in our population is quite high, seen in both sexes and almost in all age groups. It increases with duration of the disease, higher in patient who are taking combination of drug as compared to those who were on single drug

Stroke in hypertensive patients; a scan based 100 case study

Objective: To compare the incidence of intracerebral haemorrhage and cerebral infarction in hypertensive patients in stroke. Design: Prospective study: Setting: Medical Unit II Allied Hospital Faisalabad. Period: From 1[st] Aug 2000 to 15[th] April 2001

Material and Method: 100 patients admitted to medical unit II, with a completed stroke along with hypertension. Stroke was suspected on clinical examination and for confirming the diagnosis, CT scan facilities were made available. Out of 100, 65 were males and 35 were females. 73 patients had infarctive stroke, 22 had a haemorrhagic stroke and 5 patients had subarachnoid hemorrhage

Results: Patients were divided into various sub groups according to age, sex, type of stroke and risk factors. The results were tabulated as per outcome on CT brain. 73 patients had infarctive stroke, 22 had a hemorrhagic stroke and 5 patients had SA hemorrhage

Conclusion: Hypertension is risk factor in stroke and should be properly controlled