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Hepatocellular carcinoma also known as hepatoma is considered as the most common type of primary liver malignancy and is the leading cause of death worldwide. The incidence and mortality is still on the rise despite the drastic progress in early screening tools and new advancements in diagnosis and treatment. For the patients presenting with advanced disease, Sorafenib is the only approved drug, however the treatment outcome of metastatic cancer is still unsatisfactory with median overall survival below 15 months. Over the past few years great progress has been achieved in anticancer therapy, but development of resistance and unavoidable side effects have weakened these attainments. Keeping in view this stern condition, a number of drugs with novel antitumor mechanisms are under investigations including antimicrobials which have been shown to possess anti-inflammatory, immunomodulatory and cytotoxic effects. In this regard, both conventional and novel antimicrobials are being studied to explore their anticancer potential along with underlying mechanisms which may render them as effective anticancer drugs in near future. Moreover, the new approach of drug repurposing is also being encouraged especially in cancers in order to reduce cost and limit adverse effects. The purpose of this review is to provide comprehensive landscape of current information on anti-tumor evidence in support of certain compounds with well-known antimicrobial activities, against HCC based on relevant literature search on different HCC cell lines.
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Aim:The aim of this study is to determine the prevalence of PCOS among different gynecological disorders at tertiary care hospital of Karachi and to assess the most frequent presenting complaint with associated complications among them. Study Design:Single-centered cross-sectional study.Place and Duration of Study:Gynecological clinic of Karachi at a Tertiary care Hospital during 3rd December 2018 to 29th March 2019.Methodology:Total 335 premenopausal women approached the clinic with different gynecological disorders during the period of four months and 305 patients agreed to participate. The patients were enrolled via convenient sampling technique. After taking the informed consent they were evaluated through clinical interviews, questionnaire, and anthropometric measurements. The diagnosis of PCOS was made by using Rotterdam criteria 2003. Menstrual irregularities were assessed via history. Clinical hyperandrogenism was evaluated by using modified Ferriman–Gallwey scale and Acne Global Grading System. Obesity was calculated through BMI. The Hamilton scale was used to appraise associated psychological disturbances.Results:PCOS was the most prevalent gynecological disorder (55.41%) among women of the premenopausal age. Overall, the most frequent presenting complaint was infertility but age related variations in symptoms showed that young adolescent and adulthood had more menstruation irregularities while, in late adolescent the chief complaint was infertility. Moreover, these patients were either overweight 32% or obese 46.2%. Other associated problems such as anxiety and migraine were more frequent in young adults and juveniles respectively.Conclusion:PCOS is the most common gynecological problemin our region. These women usually presents with altered complains that influence their physiological and psychological health which in turn effects the quality of life
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MicroRNAs [miRs] are non-coding ribonucleic acids consisting of about 18-22 nucleotide bases. Expression of several miRs can be altered in breast carcinomas in comparison to healthy breast tissue, or between various subtypes of breast cancer. These are regulated as either oncogene or tumor suppressors, this shows that their expression is misrepresented in cancers. Some miRs are specifically associated with breast cancer and are affected by cancer-restricted signaling pathways e.g. downstream of estrogen receptor-alpha or HER2/neu.Connection of multiple miRs with breast cancer, and the fact that most of these post transcript structures may transform complex functional networks of mRNAs, identify them as potential investigative, extrapolative and predictive tumor markers, as well as possible targets for treatment. Investigative tools that are currently available are RNA-based molecular techniques. An additional advantage related to miRs in oncology is that they are remarkably stable and are notably detectable in serum and plasma.Literature search was performed by using database of PubMed, the keywords used were microRNA [52 searches] AND breast cancer [169 searches]. PERN was used by database of Bahria University, this included literature and articles from international sources; 2 articles from Pakistan on this topic were consulted [one in international journal and one in a local journal]. Of these, 49 articles were shortlisted which discussed relation of microRNA genetic expression in breast cancer. These articles were consulted for this review
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Objective: To isolate, determine the frequency, and study the demographic trends of MBL positive Pseudomonas aeruginosa from imipenem resistant isolates collected from clinical samples in a tertiary care hospital of Pakistan. Methods: In this cross sectional study a total of 230 strains of Pseudomonas were isolated from various clinical specimens on the basis of culture and biochemical tests. Imipenem resistant isolates were selected by Kirby Bauer Diffusion technique, followed by screening for MBL production by Imipenem EDTA Combined Disk Test. Demographic details of each patient were recorded on a separate questionnaire. Chi-Square goodness-of-fit test was computed to review the isolation of MBL positive isolates [P-value = 0.05] in different specimen. Results: Out of 230 strains of P. aeruginosa 49.5% were imipenem resistant; MBL production was confirmed in 64.9% of the resistant isolates. Resistance to polymyxin B [12.5%] was notable. Majority of the MBL positive strains were isolated from patients aged between 20-39 years [45.9%] and the predominant source was pus [43.24%] which was found to be statistically significant [P-value=0.04]. Outpatient departments [24.3%] and burn unit [21.6%] were the major places for resistant isolates. Conclusion: MBL production is one of the major causes of IRPA. Increasing resistance to polymyxin B is grave. Due to acquisition of MBL strains MDR P. aeruginosa has become endemic in tertiary setups
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Our objective of the study was to determine the association between frequent use of Penicillins and Cephalosporins with developmental defects of enamel in pediatric age group. This is a cross sectional study, conducted at Ziauddin University. A total of 367 children, having the history of either Penicillin or Cephalosporin exposure were included. The parents of children were asked to complete a questionnaire related to disease and drug history. Dental examination was carried out to assess the hypomineralization in tooth enamel based on modified Developmental Defects of Enamel [DDE] index. Out of 367 children, 124 [34%] were males and females were 243[66%]. In the study group 22.6% [n= 83] of children were found to be hypomineralized. The maximum type of teeth defects were diffused opacities that was 12.0% [n=44]. The statistically significant association [p-value < 0.05] was found between frequency of antibiotic use and hypomineralization for most teeth. Children who were exposed to either Penicillins or Cephalosporin in early childhood showed significant [p-value < 0.002] hypomineralized enamel. This study concludes that frequent use of antibiotics such as penicillins and cephalosporins has positive association with enamel hypomineralization in developing tooth structure
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Background: Prescription writing is highly intricate. It is a reflection of the prescriber's knowledge of clinical pharmacology and well-defined judgment. Weak prescribing skills are mostly exhibited by junior doctors. Contributory factors include improper training, integrated system, and weak skills of the prescriber. Research provides substantial evidence that these flaws can be minimized through structured educational interventions
Objective: To evaluate medical and dental students on rational prescription writing, identification of elements and abbreviations of a prescription
Methods: A cross sectional study was performed on second year medical and dental students of Ziauddin University. In three 3 sessions, the students were taught rationale prescription writing, abbreviations, and elements used in prescription writing consecutively. The elements were based on doctor's and patient's information, followed by the drug component written explicitly. Each session was followed by exercises on case scenarios, to assess their comprehension of the topic. The p value < 0.05 was considered significant
Results: In the study 83% of the students completed components of rational prescription writing for a given case scenario, with 75% and 77% students identifying abbreviations and various elements in five tailor-made prescriptions respectively
Conclusion: Rational prescription writing is a curriculum-based inherent skill acquired by medical and dental students during their training. When rational prescription writing is taught together with elements of a prescription and abbreviations, it equips students with sound knowledge of clinical pharmacology and refines their judgment in formulating prescriptions
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To determine the effect of non-selective 5-HT2C antagonist mesulergine and 5-HT2C agonist mCPP [metachlorophenylpiperazine] on learning acquisition [LA], short-term memory [STM] and long-term memory [LTM]. Experimental study. Department of Biochemistry, University of Karachi, from December 2009 to June 2010. Twenty-four male albino Wistar rats were used in this study. The agonist and antagonist [mCPP and mesulergine] were injected intraperitoneally at a dose 3.0 mg/kg in volumes of 1 ml/kg. Control animals were injected with saline [1 ml/kg]. Animals were randomly divided into four groups [n=6]. 1st being control group, 2nd being mCPP injected group, 3rd being mesulergine injected group and 4th group being injected with both mesulergine and mCPP. Behavioural activities of rats were monitored after 30 minutes of injection. For assessment of memory functions, water maze apparatus was used. Administration of mCPP impaired STM, LTM and LA of rats. Mesulergine injected rats exhibited no alteration in memory functions. However, when it was injected with mCPP then there were no memory deficits induced by mCPP. Ability of 5-HT2C receptor antagonist mesulergine to block the memory impairment effect of mCPP indicated an important regulatory role of 5-HT2C receptors in cognitive processes
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To compare the effect of metformin with clomiphene citrate on ovulation and conception rate in patients with polycystic ovarian syndrome [PCOS] one hundred infertile patients due to PCOS were selected from the Gynecology Unit III of Dow University of Health Sciences. They were divided into 2 groups each with 50 patients. Group I received metformin 500 mg per orally thrice daily for 4 months while Group II received clomiphene citrate 50 mg per orally [which was increased to 100 mg according to response] per day for 5 days following spontaneous or medroxyprogesterone acetate induced withdrawal bleeding for 4 months. Serum progesterone level was estimated on day 0, then on day 21 and finally on day120. In both the groups significant increase was found in serum progesterone level from day 0 to day 120. In group I, serum progesterone increased from 1.7ng/ml at day-0 to 11.3ng/ml at day-120. In group II, it increased from1.5 ng/ml at day-0 to7.3 ng/ml at day-120. Out of 50 patients 40 [80%] patients showed evidence of ovulation in Group I and 13 [26%] patients showed evidence of ovulation in Group II with conception rate of 67% in Group I and 16% in Group II being confirmed by urine pregnancy test. In conclusion metformin has exerted highly significant effects on the ovulation and conception rate in comparison to clomiphene citrate in PCOS infertile patients
Subject(s)
Humans , Female , Metformin , Clomiphene , Ovulation , Ovulation Induction , FertilizationABSTRACT
The Purpose of this research study was to examine the lipid lowering activity of a traditionally used poly herbal product "Mufarreh Yaqooti Motadil [MUYM], in Egg yolk induced hyperlipidaemic rats. The product is being manufactured by Hamdard Laboratories [waqf] Pakistan for the last thirty years and has shown significant therapeutic effects. During our study the product was found to have protective effects against hyperlipidemia in Human dose. The activity was performed by the help of Biochemical Investigation, using Spectrophotometric method. The results were justified by the presence of scientific data during the retrospective literature search of the Product's Ingredients. A comparative study with the Allopathic Medicine used for Antihyperlipidemic activity was also performed. Significant effect of Herbal Drug on LDL and HDL and Triglyceride levels were observed which was statistically comparable with that of Atorvastatin
Subject(s)
Animals, Laboratory , Phytotherapy , Egg Yolk , Hypolipidemic Agents , Rats, Sprague-Dawley , Heptanoic Acids/pharmacology , Heptanoic Acids , Anticholesteremic AgentsABSTRACT
To compare the efficacy and safety of chlorpromazine with Verapamil in patients with Acute opioid Abstinence Syndrome. Single blind comparative clinical trial was conducted at Department of Pharmacology, BMSI, JPMC, Karachi, over the period of one year. Forty opiate-dependent subjects were chosen at random who were in search of opioid abstinence treatment. All patients were grouped into two groups, group-I received chlorpromazine 150 mg/day and group-II received Verapamil 120mg/day in divided doses. Every patient completed the management plan while admitted in the hospital for 10 days. The chlorpromazine showed decreased efficacy and safety, whereas verapamil showed clinically pertinent decline in the subjective symptoms of acute opioid abstinence syndrome. The study showed Verapamit is superior to chlorpromazine in the treatment of opioid abstinence syndrome indicated by better reduction of withdrawal symptom scores, excessive opioid urinary excretion and lees side effects. The superiority of verapamil over chlorpromazine in controlling opioid abstinence syndrome may indicate that calcium is involved in the initiation and development of opioid abstinence syndrome
Subject(s)
Humans , Male , Verapamil , Substance Withdrawal Syndrome/drug therapy , Analgesics, Opioid/adverse effects , Acute Disease , Single-Blind Method , Opioid-Related DisordersABSTRACT
To determine the status of haemoglobin levels in pregnant women who visited tertiary care hospitals of various cities in Pakistan for their antenatal care from January 1 to April 30, 2007. This was a descriptive cross-sectional multi-centre study This study was conducted at the Aga Khan University Hospital [AKUH], Karachi, Civil Hospital, Karachi [CHK] and Nawabshah Medical College Hospital [NMCH], Nawabshah. Copies of medicinal prescriptions given to pregnant patients attending the antenatal clinics were collected from January 1 to April 30, 2007. Reports or results of hemoglobin concentrations were also obtained from the patients. A total of 1709 pregnant women were recruited. Majority 1145[67%] were from the age group of 25 to 34 years and 1555[91%] had some degree of anemia. The number of women with moderate to severe anemia [hemoglobin levels < 8 or 8-9.9 gm/dl, respectively] was significantly higher in CHK and NMCH compared to AKUH [p < 0.001]. Whereas mild anemia [hemoglobin levels 10-10.9gm/dl] or normal hemoglobin levels was significantly higher at AKUH [p < 0.001]. Moderate anemia [hemoglobin levels of 8-9.9gm/dl] was statistically more frequent in second and third trimester, while mild anemia [hemoglobin levels of 10-10.9gm/dl] was more in first trimester of pregnancy. The distribution of severe anemia however; was not different is the three trimesters. About 90-92% subjects received iron/vitamin/mineral supplements irrespective of the hemoglobin status of the woman. Prevalence and severity of anemia in pregnant subjects attending the tertiary care hospitals of Pakistan is exceptionally high. Current findings highlight the anemia in pregnancy as a priority area of concern
Subject(s)
Humans , Female , Anemia/epidemiology , Pregnancy , Cross-Sectional Studies , Hospitals , Prevalence , Prenatal Care , Pregnancy Trimesters , IronABSTRACT
Based on World Health Organization statistics, the worldwide prevalence of diabetes is expected to increased from an estimated 155 million in the year 2000 to 300 million in 2025. Diabetic nephropathy is an important cause of morbidity and mortality and is now among the most common causes of end stage renal failure [ESRF] in the developed countries. Renin angiotensin system has been implicated in the pathophysiology of diabetic nephropathy and associated complications due to its specific effects on intra-glomerular blood flow, resistance and general effects. In this clinical trial we have used antitypertensive agent i.e., Losartan [AT-1 receptor blocker] and found it to be effective both in delaying the development of renal damage secondary to diabetes and avoidance of other major complications associated to diabetic nephropathy