Design and preparation of a new multi-targeted drug delivery system using multifunctional nanoparticles for co-delivery of siRNA and paclitaxel / 药物分析学报

Drug resistance is a great challenge in cancer therapy using chemotherapeutic agents.Administration of these drugs with siRNA is an efficacious strategy in this battle.Here,the present study tried to incor-porate siRNA and paclitaxel(PTX)simultaneously into a novel nanocarrier.The selectivity of carrier to target cancer tissues was optimized through conjugation of folic acid(FA)and glucose(Glu)onto its surface.The structure of nanocarrier was formed from ternary magnetic copolymers based on FeCo-polyethyleneimine(FeCo-PEI)nanoparticles and polylactic acid-polyethylene glycol(PLA-PEG)gene delivery system.Biocompatibility of FeCo-PEI-PLA-PEG-FA(NPsA),FeCo-PEI-PLA-PEG-Glu(NPsB)and FeCo-PEI-PLA-PEG-FA/Glu(NPsAB)nanoparticles and also influence of PTX-loaded nanoparticles on in vitro cytotoxicity were examined using MTT assay.Besides,siRNA-FAM internalization was investi-gated by fluorescence microscopy.The results showed the blank nanoparticles were significantly less cytotoxic at various concentrations.Meanwhile,siRNA-FAM/PTX encapsulated nanoparticles exhibited significant anticancer activity against MCF-7 and BT-474cell lines.NPsAB/siRNA/PTX nanoparticles showed greater effects on MCF-7 and BT-474 cells viability than NPsA/siRNA/PTX and NPsB/siRNA/PTX.Also,they induced significantly higher anticancer effects on cancer cells compared with NPsA/siRNA/PTX and NPsB/siRNA/PTX due to their multi-targeted properties using FA and Glu.We concluded that NPsAB nanoparticles have a great potential for co-delivery of both drugs and genes for use in gene therapy and chemotherapy.

Effect of caffeine on anti-clotting activity of warfarin in healthy male albino rabbits

Drug-drug interactions are most commonly occurring phenomenon in clinical practice. Many physicians are afraid of being involved in an allegation of malpractices due to the occurrence of any severe interaction. These interactions not only occur between drugs but also between any kind of food, tobacco smoke, caffeine and alcohol etc. Therefore, the present study was directed to inspect the effect of caffeine on the anticoagulation activity of warfarin in healthy adult male albino rabbits. Blank blood samples were collected from each rabbit. Rabbits were given warfarin [0.5mg kg-1] orally via stomach tube and blood samples were collected in PT/INR vials at various intervals. After a washout period of 14 days, warfarin was orally administrated at same dose rate along with caffeine [5 mg kg-1 every twelve hours for three days] and same sampling schedule was repeated. Prothrombin time [PT] and the international normalized ratio [INR] of blood samples were determined to estimate changes in the anticoagulation activity of warfarin after its concurrent administration with caffeine. The PT data revealed that Rmax and AUC increased significantly [P

Level of vitamin d in Orthopaedic Trauma among adult patients

Background: The evidence on level of vitamin D in trauma patients is scarce in the developing countries

Objective: To determine the levels of vitamin D in trauma patients above 18 years of age

Methodology: This was a cross sectional study conducted on patients admitted in the Orthopedic department of Sheikh Zayed Medical College /Hospital, Rahim Yar Khan, patients included in this study were 340. The duration of study was 21st July to 16th March 2016. Vitamin D level were measured by using vitamin D kits [Roche]. Patients less than 18 years were not included in the study. Data was analyzed by using SPSS version 16

Results: A total of 340 patients admitted in orthopedic department were included in this study. Overall 92.6% patients have deficient or insufficient level of vitamin D. Most of the patients [68.8%] were less than 45 years of age. Majority of the patients were male [71.8%]. Most of the patients [72.4%] were not smokers. Majority belonged to rural areas [56%], and have no history of steroid intake

Conclusion: This study confirmed that majority of the trauma patients were vitamin D deficient or insufficient. This highlights that trauma surgeons should consider vitamin D in the armamentarium of orthopaedic treatment

Outcome of wound coverage around ankle joint with sural artery flap

Background: Trauma is the most common cause of fractures and majority of these fractures involve the foot. So the early coverage is mandatory to prevent the complications, it is challenging to the orthopaedic, plastic and reconstructive surgeons. Sural artery reversible flap is one of the options

Objective: To determine the outcome of sural artery flap for wound coverage around ankle

Methodology: A total of 24 patients were included in this interventional study. All the patients having wound around the ankle due to any cause and of either sex presenting in emergency department of Sheikh Zayed Medical College/Hospital, Rahim Yar Khan from 1st June 2014 to 30th April 2016 were included in this study. Outcome was measured as "Good", "Fair" and "Poor". The data was entered and analyzed by using SPSS version 16

Results: In this study 24 patient were operated, 41.66% were children and 54% were male. In 50% heel region was involved and in 25% melleolar region and 12.5% dorsum of foot and in 12.5% above ankle joint. Outcome noted was "Good" 83.3% "Fair" 8.3% and "Poor" 8.3%

Conclusion: Sural artery flap for the coverage around ankle is simple, safe and can be performed by orthopedic surgeon at any center without the requirement of special instrumentation and special test, with good outcome

Efficacy of manual vacuum aspiration in first trimester miscarriages

Background: First trimester miscarriages are commonly encounted by gynecologists

Objective: To determine efficacy of manual vacuum aspiration in first trimester miscarriages

Methodology: This cross sectional study was carried out in Department of Obstetrics and Gynaecology, Lady Willingdon Hospital Lahore from 1 May to 30 October 2010. 150 patient were enrolled in study fulfilling inclusion criteria and manual vacuum aspiration [MVA] was performed under local anesthesia. Post evacuation ultrasonography was performed in all patients. The data was entered and analyzed by using SPSS version15

Results: Efficacy of MVA was 89.3% and 16% patients has incomplete uterine evacuation. No major complication was noted, except one patient out of 150, has moderate to severe bleeding and 6 has infection

Conclusion: MVA has high efficacy and is associated with less complications

Comparison of outcome of fractures of inferior pole of patella

Background: Fractures of patella are common and it constitutes about significant proportion of all skeletal injuries resulting from either direct or indirect trauma

Objective: To evaluate the outcome of inferior pole fractures of patella treated with tension band wiring and resection of avulsed fragment and re-attachment of ligament to patella

Methodology: This was an comparative study, carried out in Department of Orthopaedic surgery of Lahore General Hospital, Lahore from 16[th] June 2012 to 15[th] June 2014. A total of 20 patients were included in this study. These patients were randomly divided into two groups. In Group-A patients were treated with open reduction and internal fixation with tension band wire and in Group-B patients were treated by resection of the avulsed fragment and reattachment of the patellar ligament to the patella. Patients were followed up for surgical site infection and functional outcome at 1[st], 7[th], 15[th], day one month, three months and six months post operatively. Final outcome was assessed by using Bostman criteria. Data entry and analysis was done by using SPSS version 17

Results: Mean age of all 20 patients was 34.20 +/- 12.13 years. Although both treatment groups had statistically same rate of surgical site infection from 1[st] day till 15[th] day post operatively. From 1[st] month till 6[th] months follow up time period none of the patients had surgical site infection in both treatment groups. At 1[st] month and 6[th] month post operatively in Group-B outcome was statistically better as compared to Group-A patients. But at 2[nd] month outcome of patients was statistically same in both treatment groups

Conclusion: Resection of the avulsed fragment and reattachment of the patellar ligament to the patella had good outcome according to the Bostman criteria as compared to open reduction and internal fixation with tension band wire

Endodontic therapy of mandibular canines with two canals in a single root

Mandibular canines have less anatomical diversities than other teeth.Mandibular canine is generally asingle rooted tooth with one wide root canal.This case describes the root canal treatment of a mandibular canine with two completely separate root canals in a single root. Clinical and radiographic examination revealed a mandibular canine with carious lesion and pulp exposure, tender to percussion.The precise understanding of the dental endocanalicular system's anatomy is critical in the success of the root canal management

Caries experience and oral health status among disabled individuals of special school of gadap town karachi

Objective: To assess caries and oral health status of disabled individuals of special school in Gadap Town of Karachi, Pakistan

Materials and Methods: This descriptive cross sectional study was carried out in 94 participants. The study was conducted on special persons, aged between 4-33 years, who were examined for caries and oral health status and were then included in the study upon fulfilling the inclusion criteria. A self-structured questionnaire related to the DMFT and plaque index was developed and data of each disabled individual was collected by trained house officers. Data was analyzed using SPSS software 20 version

Results: In this study males were 72.6% and females were 26.3%.Study participants with mental retardation were 41.1%, being highest in frequency, followed by cerebral palsy 9.5%,autistic disorder 3.2% and Down`s syndrome 3.2% respectively. Study results clearly indicated that oral hygiene was inadequate in all conditions of special persons who were studied. The group with lack of motor skills did not have significantly better oral hygiene than the group who had good motor skills. Overall both groups had poor oral hygiene

Conclusion: Oral health status in disabled individuals is found to be poor.Adequate follow-up of daily oral hygiene, even in self-sufficient special persons is needed. There is a strong need for enhanced education on mechanical as well as chemical plaque control to the parents/ guardians/ care givers of the disabled individuals

Comparison of spinal anesthesia dosage based on height and weight versus height alone in patients undergoing elective cesarean section / 대한마취과학회지

BACKGROUND: Spinal anesthesia with bupivacaine, typically used for elective and emergency cesarean section, is associated with a significant incidence of hypotension resulting from sympathetic blockade. A variety of dosing regimens have been used to administer spinal anesthesia for cesarean section. The objective of this study was to compare the incidence of hypotension following two different fixed dosing regimens. METHODS: This was a randomized double-blind clinical trial with a two-sided design, 5% significance level and 80% power. After approval of the hospital ethics review committee, 60 patients were divided randomly into two groups. In one group, the local anesthetic dose was adjusted according to height and weight, and in the other, the dose was adjusted according to height only. RESULTS: Sixty women with a singleton pregnancy were included. Of the factors that could affect dose and blood pressure, including age, weight, height, and dose, only height differed between the groups. Mean heart rate was similar between the groups. Hypotension was significantly more frequent with dosage based on height alone than with two-factor dose calculation (56.7% vs. 26.7%; P = 0.018). CONCLUSIONS: Adjusting the dose of isobaric bupivacaine to a patient's height and weight provides adequate anesthesia for elective cesarean section and is associated with a decreased incidence and severity of maternal hypotension and less use of ephedrine.

Echocardiographic Evaluation of the Right Heart

The appropriate use of echocardiography may reduce the need for invasive diagnostic cardiac procedures. The right side of the heart has recently gained interest among cardiologists as it became clear that abnormalities of the right heart morphology and function are associated with increased morbidity and mortality. Echocardiography is easy to perform, relatively cheap, readily available and do not pose the risk of ionizing radiation. Conventional 2D and, more recently, 3D echocardiography provides pertinent anatomic and physiologic information about the right side of the heart. Because of the advantages and simplicity of echocardiography it continues to be an excellent tool for evaluating the structure and function of the right side of the heart. This review outlines the uses of echocardiography in evaluating the right heart structure and function.

Association between pulp exposure on clinical and radiographic examination in first permanent molars with class II carious lesions

This study was conducted to assess association between clinical and radiographic exposure of the pulp in class II carious lesion in first permanent molars. This observational study was carried out in the Operative Department of Bahria Dental College during the period of January -December 2014. Two hundred fifty eight patients with class II carious lesion were examined clinically and radio-graphically to confirm either pulp was involved or not by a single operator. Data were entered in SPSS [statistical packages of social science, version 17] for descriptive analysis and to check statistically significant relationship between clinical and radiographic pulp exposure. There were 154 males and 104 females. Frequency of left mandibular first molars was 52.7%, high among all molars. This study showed, out of 258 patients, 150 had exposed pulp on clinical examination and 108 were not having exposed pulp on clinical observation. Radiographic analysis of same teeth showed different result. Out of 258 patients, 216 had pulp exposure on radiograph and 42 teeth did not have pulp exposure. About pulp exposure, significant relationship was found between clinical and radiographic examination with p-value 0.000

Histopathological evaluation of gastro protective effect of Berberis vulgaris [Zereshk] seeds against aspirin induced ulcer in albino mice

The present study was carried out to investigate the antiulcer activity of Berberis vulgaris [Zereshk] seeds in albino mice. After acclimatization, animals were divided into six equal groups. Aspirin 150mg/kg was used to induce gastric ulcer in all groups except normal control. Omeprazole 20mg/kg was used as synthetic anti ulcer drug in study. Three dose levels of B. vulgaris seed powder 300mg/kg, 600mg/kg and 900 mg/kg were used respectively orally. Histopathological analysis was carried out to evaluate the gastroprotective activity of B. vulgaris seed powder. Results of the study showed that in case of aspirin treated mice gastric luminal mucosa villi were decreased in height or were absent. In the glandular region there was connective tissue proliferation and also infiltration of cells. Similar infiltration of cells was present on muscularis mucosa. In esophageal region tumor cells were present. However three dose levels of B. vulgaris significantly reduced thetissue proliferation, infiltration of cells and sloughing induced by aspirin. Highest dose of B. vulgaris [900mg/kg] showed similar results as synthetic antiulcer drug omeprazole

Knowledge, attitude and practice of hepatitis B among dental and medical students of private medical university, Karachi

The aim of this study was to evaluate the knowledge, attitude and behaviour of hepatitis B and infection control of dental and medical undergraduates of private medical university. Karachi. Pakistan. It was the cross sectional survey study. 227 clinical students were approached. A self-structured questionnaire related to KAP of HB was used and data collected through survey questionnaire from each individual. Response rate was 100%. Data were entered and analyzed using Stata software. There were 84 [37%] students from dental college and 143[63%] students from medical section. There were 92[41%] male and 125[59%] female students. The mean level of knowledge, attitude and practice of HB in medical and dental graduates was 58% and 65% respectively. The dental graduates had overall high KAP score than medical undergraduates and the results were statistically significant. Description of the frequency of knowledge, attitude and practice of hepatitis B and infection control has revealed that dental students follow preventive guidelines of transmission during treatment procedure and were more cautious during practice than medical students

Wound healing potential of Althaea ofifcinalis lfower mucilage in rabbit full thickness wounds

Objective:To evaluate and practically demonstrate the influence of Althaea ofifcinalis flower mucilage as a plant known in Iran’s and other Middle Eastern countries’ traditional medicine for its wound healing properties. Methods:Animals were divided into 6 groups of 5 cases including a non-treated group as the negative control group receiving no treatment, a group treated with eucerin as the positive control group, a phenytoin 1%group as a standard group treated topically with phenytoin 1%hand-made ointment, and treatment groups treated with hand-made Althaea ofifcinalis flower mucilage (AFM) ointment in a eucerin base with different concentrations (5%, 10%, 15%). Results:Among the treatment groups, the AFM 15%ointment showed the best result. Wound healing duration was reduced by the surface application of these groups. Wound closure was completed on Days 14 and 15 in the AFM 15% ointment and phenytoin 1% groups, respectively. No significant difference was observed in healing period between these groups. Conclusions:In conclusion, AFM 15%ointment was found to reduce wound healing time without any significant difference with the phenytoin 1% ointment. The authors suggest increased AFM effectiveness in when combined with phenytoin or other effectual plants.

Outcome of surgical treatment of de-quervains disease

Background: De Quervains disease causes significant pain among patients

Objective: The purpose of this study was to evaluate the outcome of surgical treatment of de-Quervains disease

Material and Method: This cross-sectional study was conducted in Sheikh Zayed Medical College/Hospital Rahim Yar Khan from 1[st] January, 2009 to 31[st] December 2011. Patients with de Quervains disease who did not respond to conservative treatment with analgesics, splintage and local steroid injections for four to six months, were operated under local anesthesia. The tendons of abductor pollicis longus and extensor pollicis brevis were released in separate compartments. Patients were followed for a minimum of 4 months to assess the outcome of procedure. The data was analyzed by using SPSS version 15

Results: A total of 20 patients were included in study.Female to male ratio was 8:1. All females were house wives, exposed to manual work, four of them had rheumatoid arthritis. The age range was 35-50 years with mean age of 39 years. Results of surgical treatment were excellent with 94% patients being completely relieved of symptoms

Conclusion: Surgical release of first dorsal compartment [abductor pollicis longus and extensor pollicis brevis] of wrist has excellent results in patients with resistant De-Quervains disease

Emergency dilatation and curettage in a patient with bombay blood group

Bombay blood group is a rare autosomal recessive phenotype within the ABO blood group. It represents genetically suppressed A, B and H genes. When considering such patients for transfusion, only blood of identical Bombay type can be safely transfused. We are reporting a patient having Bombay phenotypic blood, underwent emergency dilatation and curettage with active per vaginal bleeding due to retained products of placenta. There are numerous anaesthetic considerations, including emergency surgery with hemodynamic instability due to ongoing blood loss, dilutional coagulopathy as well as presence of Bombay phenotype that severely limit the possibility of red blood cell transfusion. Only four donors were registered with the blood bank of the institution and none was traceable. It becomes a real challenge for the anesthesiologist to manage such type of patients without having units of red packed cell which management is described hereby

Depth of the cavity and its relationship with the post-operative sensitivity in class I posterior resin composite restorations on molars

This study was conducted to assess the post-operative sensitivity in different depths of Class I cavities in molars restored with posterior composite resin. It was an Experimental study and was conduct-ed in Fatima Jinnah Dental Hospital, Karachi from May 2010 to October 2010. One hundred and thirty one patients had Class I cavities [depth of cavities between 3-4mm] were selected after clinical and radiographic examination. After rubber dam isolation, Class 1 cavity prepared on molars teeth. Incremental technique was used to restore cavity with posterior composite resin. After finishing the filling, patient was recalled at day 7 to assess post-operative sensitivity with cold and hot stimuli. Data were collected using data collection proforma, were computerized and analyzed by using SPSS [Statistical Package of Social Sciences] version 17. One hundred thirty one patients, 61 male and 70 female formed the study group. The mean age was 29.6 [ +/- 9.004] years. The mean score of post-operative sensitivity was 1.05 for cold [ +/- 0.226] and 1.04 [ +/- 0.192] for hot. The chi-Square test revealed significant results with p- value < 0.000 for cold and < 0.009 for hot, when both stimuli were analyzed with different cavities depths. Deeper cavities in Class I composite resin restorations showed more post-restoration sensitivity as compared to cavities with lesser depth in dentine

Occlusal reduction reduces postoperative pain after endodontic instrumentation

Pain management after root canal treatment is a very important issue in clinical practice. The purpose of this study was to evaluate the effect of occlusal reduction on postoperative pain in teeth with irreversible pulpitis and tenderness to percussion. This was a prospective, randomized study conducted in Operative Department of dental section of Bahria Dental College and Hospital from June 2013 to May 2014. One hundred and ten posterior teeth with no or mild preoperative pain, sensitive to percussion requiring endodontic treatment were included in this study. After administration of local anesthesia, the root canals were instrumented, and an intracanal calcium hydroxide dressing was placed. The patients were randomly divided into 2 groups of 55 each. In 1 group the occlusal surface was reduced [OR group], whereas in the other group the occlusal surface was not modified [no occlusal reduction, NOR group]. The patients were recalled after 24 hour, 2nd day and 3rd day to record their postoperative pain on the visual analogue scale. Data was analyzed by using Chi-square test. There was no significant difference in postoperative pain between the 2 groups [P > .05] after root canal preparation and calcium hydroxide dressing. Occlusal surface reduction did not provide any further reduction in postoperative pain for teeth with irreversible pulpitis and mild tenderness to percussion compared with no occlusal reduction

α:Non-α and Gγ:Aγ globin chain ratios in thalassemia intermedia patients treated with hydroxyurea

Objectives: To elucidate the possible ways by which hydroxyurea molecules affect globin chain (αor β-like) synthesis.Methods:5 and 26 years were treated for five months with 15 mg/(kg·day) of hydroxyurea. Hemoglobins electrophoresis and globin chain electrophoresis was performed on each sample at different time points before and during the treatment. A total of 23 thalassemia intermedia patients (13 male and 10 female) aged between Results: Fetal hemoglobin increased significantly in most patients and average episodes of transfusion decreased. Both Gγ and Aγ-globin chains increased significantly andα-globin:Nonα-globin chain as well as Gγ-globin:Aγ globin chains ratios decreased. Conclusions: Improvement in α:non-α ratio and consequent decrease of free α-globin chain might be the cause of beneficial effects of hydroxyurea therapy. Two patients who felt better didn’t show significant increase in their fetal hemoglobin level, and this is in contradiction with the hypothesis claiming that the HbF level increase is the cause of such therapeutic effect. In spite of the unclear mechanism of action of this drug, hydroxyurea therapy had noticeable impacts on thalassemia intermedia and also sickle cell disease and even patients suffering from thalassemia major.