Evaluation of prevalence of different types of cancer and its chemotherapy in various ethnic groups of Pakistan: A retrospective study

The objective of the study was to evaluate different types of cancer and its chemotherapy in various ethnic groups of Pakistan. Ethnic groups includes, Pukhtoons, Punjabis, Sindhis, Muhajirs, Siraikis, Memoons, Hazaras, Hindkos, Baltis, Gilgitis, Kashmiris, and Afghanis. The data was collected from well reputed hospitals located in the different provinces of Pakistan. The collected data was taken from 15 hospitals where around 8500 patients visited during 2010 to 2017. From the visited patients, 8356 were analyzed for their ethnicity, age and sex while, 144 patients (male 77 and female 67) were excluded from analysis due to incomplete information or loss of follow-up. Among 8356 patients, 3762 were male (45%) whereas, 4594 were female (55%). The chemotherapy was carried out as per National Comprehensive Cancer Network guidelines (NCCN- guidelines). The most common five prevalent cancer among these ethnic groups were Head and Neck, Blood, Respiratory, Genito-urinary and Breast cancer. The most common cancer in female was breast cancer while, head and neck cancer was more prevalent in male. It can be concluded that the prevalence of cancer in Pakistan is very alarming, which may be due to lack of awareness, illiteracy, lack of national cancer control programs, and economics issues.

Transhumanism: the epitome of doom and gloom

Ever since the idea of [Transhumanism] came into being, it has divided our society into two opposing factions i.e. the bioconservatives and transhumanists. The transhumanist movement is based on the idea that enhancements should be made in humans through technology while bioconservatives oppose this idea. Transhumanism is already feared to be world's most dangerous idea by bioconservatives such as Francis Fukuyama, as it is not justified or proven yet that transhumanism is safe for our future. The notion is believed to be not only de-humanising but also poses many threats to the rest of humanity. As explicitly suggested by bioconservatives human enhancing technologies are more of a bane than a boon. Furthermore, many of the transhumanist technologies have many demerits to them. Bioconservatives believe that the technological enhancements will lead to obscenity and be a blemish on the human race. It is highly possible that humans will suffer from autocracy by the hands of the posthumans, since the posthuman age will certainly give rise to several moral dilemmas, such as racism, which will plague the human world. There are four fundamental aspects of transhumanism; nanotechnology, biotechnology, information technology [IT] and cognitive sciences, which come with many promising advantages, but can also turn our future into a dystopia. Even with constant opposition from the bioconservatives, the dark scenarios related with the ascend of the transhuman era are inevitable and the amalgamation of machines with man is equivalent to forfeiting true humanity

Comparative bioavailability and pharmacokinetic study of Cefadroxil capsules in male healthy volunteers of Pakistan

The current study was aimed to judge bioequivalence between two formulations of cefadroxil capsules as guided by FDA guidelines. Another objective was to conduct pharmacokinetic evaluation in Pakistani population. A single-dose, randomized, cross-over pharmacokinetic study was conducted during the month of May'2013 to August'2013. Washout period was one week. Fourteen healthy male adult volunteers were enrolled in the study, however twelve completed the study. Cefadroxil plasma concentration was analyzed by using validated HPLC method. Protein precipitation was achieved by the addition of 6% tri chloro acetic acid in 1:1 ratio and detection was done at 260 nm. Retention time was 7.792 min and correlation coefficient [R[2]] was 0.9953 showing linearity of the method. Blood sampling was carried out at different time intervals after administration of either test [TEST 500 mg] or reference [REF[registered] 500mg] formulation. Pharmacokinetic parameters [AUC[0-infinity], AUC[0-t], C[max], T[max], t[1/2] and k[el]] were calculated using Kinetica[register] PK/PD software. The geometric mean ratios and 90% confidence interval [CI] of these pharmacokinetic parameters for cefadroxil [test and reference] formulations were 0.986 [90.83-106.98%] for AUC[1-t]; 0.967 [89.13-104.92%] for AUC[0-infinity] and 0.999 [91.06-109.69%] for C[max]. The differences between T[max] of both formulations were not found to be statistically significant [p-value was more than 0.05]. The 90% CI of the test/reference AUC and C[max] ratio of cefadroxil were within the FDA recommended range for bioequivalence. Maximum plasma concentration C[max] was 12.5 micro g/ml for test and 12.47 micro g/ml for reference formulations. Average time to reach C[max] for test and reference formulation was 1.54 and 1.5 hrs. The two formulations of cefadroxil studied during the above study were verified bioequivalent. Maximum plasma concentration of cefadroxil was lower than those mentioned in some previous studies, while T[max] and half-life were near to values reported in literature

Determination of cefadroxil in tablet/capsule formulations by a validated reverse phase high performance liquid chromatographic method

An innovative, selective and rapid reversed phase High Performance Liquid Chromatographic [RP-HPLC] method for the analysis of cefadroxil in bulk material and oral solid dosage forms has been developed and validated. The Chromatographic system consisted of Sil-20A auto sampler, LC-20A pump and SPD-20A Uv/visible detector. The separation was achieved by C[18] column at ambient temperature with a mobile phase consisting of methanol: Phosphate buffer [10: 90] at a flow rate of 1.5 ml/min. The method is reproducible, repeatable [%RSD for intra-day and inter-day ranged between 1.75-5.33% and 0.58-2.69%] and linear [R[2]=0.9935]. The LOD and LOq of the method were 0.5 and 1.0 microg/ml, respectively. The present RP-HPLC method was found to be sensitive, accurate, precise, rapid and cost effective that can be efficiently used in QC/QA laboratories for routine analysis of the raw materials as well as oral dosage formulations of cefadroxil

Staphylococcal resistance against five groups of life saving antibiotics in the year 2003-2005

In the year 2003 to 2005 a prospective study was conducted to find out the predominance of Staphylococcus [Staphylococcus aureus] resistance pattern in opposition to five life saving antibiotics as these are the sole agents to treat critically ill patients in hospitals. During the period of two years almost 2500 samples of bacterial culture were taken from different pathological laboratories and hospitals in Karachi. Among these 1500 were Gram positive cocci and 1000 samples were identified as Staphylococcus aureus. Life saving antibiotics were taken from five different groups and by mean of disk diffusion technique antibiogram of Staphylococcus aureus against these antibiotic were determined. During the course of study imipenem showed 11%, amikacin exhibited 58%, cefipime showed 31%, vancomycin and piperacillin/tazobactam displayed 24% resistance against Staphylococcus aureus. Imipenem was found to be most effective against Staphylococcus aureus.Resistance to other antibiotics developed quickly in Staphylococcus aureus collected from clinical areas where these antimicrobial agents are extensively used

Efficacy of newly formulated ointment containing 20% active antimicrobial honey in treatment of burn wound infections

Honey has been familiar to possess antimicrobial potential to clear infection against burn wound infecting bacteria since ancient times. The objective of the study was to evaluate the efficacy of the newly formulated honey ointment during the treatment of burn wound infections. The Experimental [Non comparative] study was conducted at outpatient department of Dermatology, Fauji Foundation Hospital, Rawalpindi from November 2009 to October 2010. The antimicrobial activity of different Pakistani floral sources [Acacia nilotica species indica, Zizyphus, Helianthus annuus and Carissa opaca] honey samples were investigated by disc diffusion method against freshly isolated burn wounds infecting bacteria. Ointment containing 20% active antimicrobial honey was formulated as a sovereign remedy. A total number of twenty patients with second degree of burn wounds on different parts of the body were studied. A thin layer of honey ointment on gauze was applied to the wounds two to three times a day up to the complete healing. During microbiological study, Pakistani honey samples were discovered to exhibit a very promising antimicrobial activity against all the wound infecting microorganisms tested. Clinical trials demonstrated that the topical application of honey ointment have significant control of infections arising form pathogenic bacteria and up to 100% healing results were observed in all burn wound cases within mean healing time for the duration of 8.15 [3-18] days time period. Newly formulated ointment containing 20% active antimicrobial honey is more effective and low-cost alternative preparation for the treatment of burn wound infections

Validation and application of RP-HPLC method for the quantification of metoclopramide hydrochloride in oral formulations prepared for IVIVC studies

The objective of this study is to develop sensitive and cost effective reverse phase high performance liquid chromatographic method for the estimation of Metoclopramide Hydrochloride in oral solid dosage formulations. A reverse chromatographic method was used with the mobile phase of Acetonitrile, 20 m M Potassium dihydrogen phosphate buffer solution [pH 3 adjusted with orthophosphoric acid] in the ratio of 40:60. The column used was Waters C18 3.9×300 mm microBondapak [RP]. The flow rate of the mobile phase was 2 ml/minute. The detector was set at the wavelength of 275 nm. This method showed good sensitivity. The linearity was also found to be excellent [gamma[2]=0.997] in the range of 5-75 microg/ml. No interfering peaks were observed at the retention time of Metoclopramide Hydrochloride when both placebo and blank samples were injected [Retention time =1.93 min]. The parameters such as specificity, linearity, range, accuracy, precision, system suitability, solution stability, detection and quantification limits were evaluated to validate this method. This method can effectively be used for quantitative analysis of Metoclopramide Hydrochloride tablet formulations because of its specificity, accuracy and convenience of use

Human Pappilomavirus [HPV] induced cancers and prevention by immunization

Incidences of different types of cancer are increasing in Pakistan, among which cancer of Cervix and Respiratory pappilomatosis are of great concern because of their association with human Pappilomavirus [HPV]. Cervical cancers typically distress women of middle age or older; however it may affect women in any age after the puberty. Two serotypes of HPV [16 and 18] accounts 70% of cervical cancer cases, while HPV [6 and 11] are considered low-risk viruses associated with genital warts [Condyloma acuminata] and Respiratory pappilomatosis in both gender. Generally, there is transient role of HPV in human body and are removed by immune system in or around 1 year. Data from different Pakistani hospitals provides sound evidence for increasing trends of cervical cancer, which is, being developing country imperative for us. As the cost of cancer management is increasing day by day with poor survival rate and its burden is borne by patient, their family or society in-large, so if screening or prevention is possible then there would be need to identify target population for screening and vaccination. By quality adjusted life year [QALY] measurement, the data from different sources indicates that adolescent age is the appropriate target population and is cost effective for vaccination. Two vaccines manufactured by recombinant DNA technology are licensed in some parts of the world for prevention of HPV related cancers, however both have certain advantage over another, as one of the vaccines contains viral like proteins of two HPV serotypes 16 and 18 and provide additional cross protection against HPV type 13 and 45 with 100% seroprotection, while the other vaccine, being quadrivalent offers protection against four serotypes 6, 11, 16 and 18. Both vaccines tolerability and safety profiles are similar and acceptable, however bivalent vaccine appears to provide long-lasting immunity by the development of memory B-cells hypothetically due to difference of adsorbing agent used by manufacturer, on the other hand, quadrivalent vaccine offers protection against cervical cancer but also offers additional protection against Condyloma acuminata and respiratory Pappilomatosis. As these vaccines are new in the market and initial trials indicate availability of antibodies for up to around 5 years i.e. why it is controversial at the moment that whether booster dose is recommended or not, however it is assumed that, there is no harm to have booster dose at 5[th] year of vaccination

Studies on antibacterial activity of some traditional medicinal plants used in folk medicine

Ethanolic extracts of eight medicinal plants commonly used in folk medicine were tested for their antibacterial activity against four Gram positive strains [Bacillus subtilis, Staphylococcus aureus, Staphylococcus epidermidis and, Streptococcus pneumoniae] and six Gram negative strains [Escherichia coli, Proteus vulgaris, Proteus mirabilis. Salmonella typhi para A, Salmonella typhi para B and Shigella dysenteriae] that were obtained from different pathological laboratories located in Karachi, Pakistan. Disc diffusion method was used to analyze antibacterial activity. Out of eight, five medicinal plants showed antibacterial activity against two or more than two microbial species. The most effective antimicrobial plant found to be Punica granatum followed by Curcuma zedoaria Rosc, Grewia asiatica L and Carissa carandas L, Curcuma caesia Roxb respectively. From these results, it is evident that medicinal plants could be used as a potential source of new antibacterial agents

In vitro evaluation of antimicrobial activity of calcium hydroxide with oily vehicles in dental treatment

The purpose of this study was to assess the in vitro antimicrobial activity of calcium hydroxide with oily vehicles against aerobes and facultative anaerobic microorganisms commonly isolated from infected root canals. Experimental Study. This study was conducted in the Department of pharmacology, University of Karachi from April 2009 to March 2011. The microbial strains were evaluated against calcium hydroxide pastes prepared with calcium hydroxide powder mixed with oily vehicles. Antimicrobial activity of the vehicles was also evaluated. For such purpose agar diffusion and broth dilution method were used. The results showed that calcium hydroxide mixed with oily vehicles was inhibitory against all the microbial strain tested. Calcium hydroxide pastes eliminated the Enterococcus faecalis [the most resistant organism in infected root canals] as well as other microorganisms effectively and the oily vehicles have also inherent antibacterial properties. We concluded from our study that although calcium hydroxide when mixed with oily vehicles can eliminate the endodontic bacteria but such oily vehicles may be irritant to the periapical tissue. Therefore further studies should be done on their role as an intracanal medicine in different combinations with calcium hydroxide

Comparison of in vitro antibacterial activity of levofloxacin and ciprofloxacin

Levofloxacin and ciprofloxacin are widely used antibiotics that belong to the class of fluoroquinolones. The in vitro antibacterial activity of these two antimicrobials were evaluated and compared in the present study by Disk Diffusion [Kirby-Bauer] method against 52 clinical isolates of Staphylococcus aureus [n = 36] and Klebsiella pneumoniae [n = 16]. These clinical isolates were obtained from different pathological laboratories and medical centers of Karachi. Among clinical isolates of Staphylococcus aureus the average zone of inhibition for levofloxacin was 16.7 mm while for ciprofloxacin the zone of inhibition was 21 mm. For the clinical isolates of Klebseilla pneumoniae the average zone of inhibition of levofloxacin was 16.5 mm while for ciprofloxacin was 16.9 mm. Comparison of susceptibility results indicated that both fluoroquinolones have excellent in vitro antibacterial activity but comparatively ciprofloxacin showed broader spectrum of activity against most of the tested clinical isolates

Anti-inflammatory and analgesic activities of ethanolic extract of sphaeranthusindicus linn

The aim of the present study was to evaluate the intensity of the anti-inflammatory and analgesic activities of Sphaeranthus indicus on albino mice and rat of either sex. The flowers of S. indicus are an important herb used in folk eastern medicines. In this study, the ethanolic extract of S. indicus in doses of 300 and 500 mg/kg was used. Anti-inflammatory activity was evaluated by measuring the mean decrease in hind paw volume after the sub planter injection of carrageenan. The analgesic activity was tested against acetic acid induced writhing response using albino rats. Result of the study shows that at the end of one hour the inhibition of paw edema was 42.66 and 50.5% respectively and the percentage of protection from writhing was 62.79 and 68.21 respectively. S. indicus possesses several important pharmaceutical and pharmacological properties. The current study describes that flower of S. indicus has significant anti-inflammatory and analgesic properties. Conclusion of the study is that this herbal medicine can be used as an alternative therapy for the treatment of minor to moderate types of inflammation and as a painkiller

evaluation of the resistance pattern of different clinical isolates of bacteria against cephradine and cefotaxime

During the present study an effort has been made to determine the sensitivity of clinical isolates to complish this task, ninety clinical isolates of Escherichia coli [n-41], Klebsialla spp. [n-12], Proteus spp [n-6], Pseudomonas aeruginosa [n-11], and Staphylococcus aureus [n-20] were collected from different pathological laboratories and medical center in Karachi. An in vitro study of these clinical isolates were carried out by ICLS reference Disk diffusion [Kirby-Bauer] method, using Cephradine and Cefotaxime. An attempt has been made to measured the Zone if inhibition produced by Cephradine and Cefotaxime against these clinical isolates. Results indicated that both Cephradine and Cefotaxime has excellent in-vitro antibacterial activity, but Cefotaxime had relatively broad spectrum of activity against most of clinical isolates tested its mean that Cefotaxime is more effective against Gram-positive and Gram-negative bacteria. On the basis of present study it can be evaluated that Cephradine and Cefotaxime were two very good antibacterial agent in the field of antimicrobial Chemotherapy but different clinical isolates had started to develop resistance to these antibiotics, which is shocking for prescriber because these two cephalosporins are massively prescribe for most of infections in our country

Comparison of in vitro antibacterial activity of levofloxacin and gatifloxacin

Clinical isolates including Staphylococcus. aureus, Escherichia coli, Klebsiella pneumonia, Pseudomonas. aeruginosa and Salmonella. typhi were obtained from different pathological laboratories and medical center were included in the study. Comparison of in vitro antibacterial activity of levofloxacin and gatifloxacin was carried out by ICLS reference Disk diffusion [Kirby-Bauer] method. An attempt has been made to measure the zone of inhibition produced by Levofloxacin and gatifloxacin against these clinical isolates. Comparison of susceptibility results indicated that both Levofloxacin and Gatifloxacin has excellent in vitro antibacterial activity but gatifloxacin had relatively broad spectrum of activity against most of clinical isolates tested its mean that Gatifloxacin is more effective than Levofloxacin. On the basis of present study it can be evaluated that levofloxacin and gatifloxacin were two very good antibacterial agent in the field of antimicrobial chemotherapy but different clinical isolates had started to develop resistance to those antibiotics, w/c is alarming because if organism started to develop resistance to these antibiotics than we will be left with no other choice of antibiotics

Development of new ophthalmic suspension prednisolone acetate 1%

Formulation of a new Prednisolone acetate [1%] ophthalmic suspension to obtain a better contactibility of the drug at the site of action. The formulation was evaluated and optimized based on physiological, physicochemical and pharmaceutical parameters and prepared aseptically, keeping particle size between 1-3 micro m, while viscosity enhancer, preservative, chelating agent were used to increase the transient residence time, antimicrobial preservation respectively. Isotonicity of the formulation was maintained. Buffering agents used were having buffering capacity NMT 0.05%. pH adjusted at which Prednisolone acetate was stable. The finished product subjected to stress conditions to check the physical stability of the formulation. The formulation was packed in LDPE plastic vials, and subjected to accelerated stability studies at 40°C and the kinetic and predictive method was employed for the determination of degradation rate constant and shelf life. The results showed that the development of a new ophthalmic formulation having significantly better contact time by the selection and optimization of viscosity [HPMC] that obtained [21 cps] with better stability studies. The results concluded that prednisolone acetate 1.0 per cent ophthalmic suspension is more effective than prednisolone phosphate 1.0 per cent ophthalmic solution in suppressing corneal inflammation

Development and validation of a HPLC method for determination of pefloxacin in tablet and human plasma

Developing and validating a simple, efficient, reproducible and economic reversed phase high performance liquid chromatographic [RP-HPLC] method for the quantitative determination of pefloxacin in bulk material, tablets and in human plasma. A shim-pack CLC-ODS column and a mobile phase constituting acetonitrile: 0.025 M phosphoric acid solution [13:87 v/v, pH 2.9 adjusted with KOH] was used. The flow rate was 1 ml/min and the analyses performed using ultraviolet [UV] detector at a wavelength of 275 nm using acetaminophen as an internal standard. The developed method showed good resolution between pefloxacin and acetaminophen. It was selective to pefloxacin and able to resolve the drug peak from internal standard and from formulation excipients. The percentage of coefficient variation [CV] of the retention times and peak areas of pefloxacin from the six consecutive injections were 0.566% and 0.989%, respectively. The results showed that the peak area responses are linear within the concentration range of 0.125 mg/ml-12 mg/ml [R2=0.9987]. The limits of detection [LOD] and limits of quantitation [LOQ] for pefloxacin were 0.03125 mg/ml and 0.125 mg/ml. The intra-day and inter-day variation, RSD were 0.376-0.9056 and 0.739-0.853 respectively; also, inter-day variation with relative standard deviation [RSD] were 0.1465-0.821 in plasma. The accuracy results of 70%, 100%, and 130% drugs were 100.72%, 100.34%, and 100.09%, respectively. The method is linear, quantitative, reproducible and could be used as a more convenient, efficient and economical method for the trace analysis of drug in biological fluids, in raw material and tablets

Antibacterial activity of 1-methyl-7-methoxy-B-carboline and its phenacyl and coumarine analogues

Antibacterial activity of 1-methyl-7-methoxy-pound]-carboline [harmaline] and its phenacyl and coumarine analogues 1-[3-nitro-phenyl]-[2-[7-Methoxy-1-methyl-1,3,4,9-tetrahydro-pound]-carbolin-2-yl]-ethanone[II], 1-[3,4-Dihydroxy-phe-nyl]-2-[7-methoxy-1-methyl-1,3,4,9-tetrahydro-pound]-carbolin-2-yl]-ethanone[III] 7-[methoxy-pound]-carboline],15-24, de-hydro[19,20-dimethoxy]coumarine [IV], 7-[methoxy-pound]-carboline]15-24,dehydro[20-methoxy]coumarine [V] were studied by disc diffusion method. All compounds were tested against three Gram positive and four Gram-negative bacteria. Parent compound showed good activity. All compounds revealed better results against Gram positive as compared to Gram-negative bacteria. 1-[3,4-dihydroxy-phenyl]-2-[7-methoxy-1-methyl-1,3,4,9-tetrahydro-pound]-carbolin-2-yl]-ethanone [III] was found most potent compound showing broad spectrum activity when compared with all synthesized analogues. Coumarine analogues showed more or less same activity indicating that number and position of methoxy groups are not important regarding antimicrobial activity

Post surgical wound infections: a study on threats of emerging resistance

300 bacterial isolates associated with post surgical wound infections were tested in vitro for their sensitivity/resistance pattern against 20 antibacterial agents. The study indicated that the bacteria in which clinically significant resistance has now become a potential problem include Pseudomonas aeruginosa, Staphylococcus aureus, Escherichia coli, Proteus. Klebsiella, Staphylococcus epidermidis, Enterobacter and Citrobacter species. Among the tested drugs the percent resistance rate observed were tobramycin [9.75%], amikacin [10.03%], enoxacin [20.53%], ofloxacin [25.93%], ciprofloxacin [26.27%], gentamicin [29.03%], ceftrioxone [36%], aztreonam [41.07%], cefaclor [44.07%]. The conclusion from the study can be drawn that tobramycin and amikacin [aminoglycosides] and enoxacin, ciprofloxacin and ofloxacin [Fluoroquinolones] are very effective agents for treating post surgical wound infections. However resistance to these agents is rapidly increasing