Effect of paracetamol on pharmacokinetics of isoniazid in Teddy goats

In this study the effect of paracetamol on pharmacokinetics [PK] of isoniazid [INH] in Teddy goats was investigated. INH was administered as a single oral dose at 10 mg/kg body weight to every experimental goat. After a wash out period of 7 days, INH and paracetamol [at the rate of 15 mg/kg body weight] were given simultaneously through oral route for investigation of drug interactions. Both times, following drug administration, blood samples were collected at predetermined time intervals from the jugular vein of each animal and analyzed for INH by spectrophotometric analysis. PK parameters were calculated using two compartment open model. When used with paracetamol, the value of biological half life [t1/2beta] of INH was significantly decreased [p<0.05] from 2.391 +/- 0.216 to 2.17 +/- 3.46 hours. The value for apparent volume of distribution [Vd] was also significantly decreased [p<0.05] from 0.905 +/- 0.327 to 0.786 +/- 0.161 L/kg and total body clearance [CL] was increased insignificantly [p>0.05] from 3.59 +/- 2.03 to 4.04 +/- 2.61 mL/min/kg. Based on these results, it was concluded that dose of isoniazid should be increased when concomitantly used with paracetamol

Hypertensive encephalopathy: a rare presentation of Williams-Beuren syndrome

A male child of four years is reported with Williams-Beuren Syndrome [WBS]. It was not recognized initially when he presented with odd facies and developmental delay since early infancy. The diagnosis was established later when he developed hypertensive encephalopathy secondary to bilateral renal artery stenosis, a congenital anomaly that must be looked for in such patients. No echographic evidence of congenital heart disease was found. Blood pressure estimation on routine physical examination of every child is emphasized. The diagnosis is mainly clinical as the definitive chromosomal studies are presently not available in Pakistan

Pharmacokinetics and dosage regimen of ciprofloxacin following single intramuscular administration in Teddy goats

The objective of this study was to determine the pharmacokinetics and dosage regimen of ciprofloxacin in Teddy goats. Ciprofloxacin was administered intramuscularly at 5 mg/kg body weight in each of eight animals. Following drug administration, blood samples were collected at different time intervals and analyzed for ciprofloxacin using HPLC. Pharmacokinetic parameters were calculated using two compartment open model. Peak plasma concentration [C[max] of ciprofloxacin, 1.77 +/- 0.20 microg/ml was achieved at 0.90 +/- 0.04 hours [T[max]. Values for half-life of absorption [t [1/2] abs], distribution [t [1/2] alpha] and elimination [t [1/2] beta] were 0.52 +/- 0.04, 0.52 +/- 0.04 and 2.62 +/- 0.39 hours, respectively. The value for apparent volume of distribution [Vd] was 3.76 +/- 0.92 1/kg, area-under-the-curve [AUC] 5.89 +/- 0.91 microg.hr/ml and total body clearance [CL] was 1.09 +/- 0.11 1/hr/kg. Based on these results, it was concluded that calculated dose should be higher than the dose recommended by the manufacturer to treat susceptible bacteria in goats

Surgical management of otosclerosis- stepedectomy versus stapedotomy

To compare post operative morbidity after stapedotomy with stapedectomy. Quasi-experimental study. Place and Duration of Study: ENT Departments of CMH Rawalpindi and CMH Lahore from Jan 2006 to Jan 2009. Forty eight patients were included in this study and were divided into two groups; 14 patients underwent stapedectomy and 34 patients underwent stapedotomy. Severity and duration of vertigo and hospital stay with stapedotomy were less as compared to stapedectomy. Conclusions: These results demonstrated that postoperative morbidity with stapedotomy was less as compared to stapedectomy

Ultrasound scan; coupling gel as a potential source of infection

To assess the infective potential of ultrasound gel and probes when used in a routine manner on ambulatory patients with intact skin. At our institute, ultrasound probes are wiped with a non-sterile absorbent paper towel after each patient. The probes become dry and clean in social terms but we were unsure if they also became bacteriologically decontaminated after wiping clean. We also wished to ascertain the intrinsic infective potential of ultrasound gel. Bacteriological samples were taken from probe surface [after wiping it clean as per out protocol]; gel dispensing bottles; and the gel jars that contain the gel in bulk. A total of 61 samples were cultured, out of these 13 were jar samples that were acquired daily on 13 days, 10 from gel bottles and 38 from probe surface [27 before beginning ultrasound, 11 after ending the day's work]. Probe surface samples were collected on sterile cotton wipes dipped in sterile nutrient both; bottle and jar samples were collected by sterile nickel loops and cultured on commercially available nutrient ager. Colonies were counted at 24 and 48 hours. The results show bacterial contamination in all [10/10] gel bottle samples, 7% pre-scan probe surface wipes [2/27] and 27.3% [3/11] on post scan wipes. Gel Jar samples were sterile on the first 3 days and then progressively showed greater colony counts. This showed that the gel is initially sterile but is apparently contaminated from air and it serves as growth medium for bacteria. We conclude that the highest contamination is observed in gel bottle samples [100%]. The lowest contamination was observed from wipes probe sample. This was probably due to repeated cleaning of probes by the operators. Gel jar samples have the second highest contamination but the initial samples showed no growth. The ultrasound gels probably contain no or little antibacterial agent and the gel serves as a growth medium for bacteria

Evaluation of mastoid cavities after canal wall down mastoidectomy

To evaluate mastoid cavities after canal wall down procedures in terms of achieving a dry mastoid cavity, presence of residual or recurrent disease [Granulations and cholesteatoma]. Quasi-experimental study. The study was done in the ENT Department, CMH Rawalpindi Study was done in fourteen months from Nov 2006 to Jan 2008. Fifty patients undergoing canal wall down mastoidectomy were included. Their mastoid cavities were evaluated for persistence of discharge and recurrence of granulations and cholesteatoma after the surgery. After follow up period of 3 months, 8% patients had mild discharge, 12% had granulation and 2% patients had recurrence of cholesteatoma. Canal wall down mastoidectomies are very effective in controlling the recurrence of cholesteatoma, granulations formation and otorrhoea to a greater extent