Phytochemical standardization of Vasicine in cough syrup by high performance liquid chromatography-densitometry

The highly oriented modern detection techniques provide a precise and definite tool for investigation in natural medicines. Current study directed the standardization of eminent biomarker Vasicine in a natural cough syrup. A highly accurate and precise method of High-performance thin layer chromatography [HPTLC] has been developed to certify the quantity of vasicine inside the syrup. Ethyl acetate, chloroform, ethanol and ammonia [6:3:1: 1 v/v] were mobile phase for the study. The TLC plate silica gel G60F254 was used with CAMAG Scanner III and CAMAG Linomate 5. The detected Rf value was 0.51 in both sample and reference standard at 254 nm. International conference of Harmonization [ICH] guidelines were followed for the validation of the developed method. Linearity was achieved in the range of 200microg to 1600microg with co-efficient correlation r2=0.9995. Accuracy was found in between 98.9 to 101.4% however precision was good at both inter and intra-day. As per the standardization of ICH, the developed method was found to be reproducible and showed sharp similar peak with high resolution

Diagnostic accuracy of sonoelastography in the non-invasive diagnosis of malignant breast cancer compared to histopathology as a gold standard

Objective: To observe the diagnostic accuracy of elastography in detecting malignant breast lesion taking strain ratio of 4.8 and histopathology as gold standard

Study Design: Descriptive cross-sectional study

Place and Duration of Study: Department of Diagnostic Radiology, from March to September 2015

Methodology: A total of 137 patients aged 20 to 60 years with clinically palpable breast lump of any size for at least one month duration were included in this study. Patients with purely cystic lesions and those on chemotherapy or hormonal therapy were excluded. Each patient was subjected to sonoelastography followed by ultrasound guided trucut biopsy. The strain ratio cut off value of 4.8 was used to differentiate benign from malignant lesion. Consultant histopathologist's report upon the biopsy specimens was obtained. Results of sonoelastography were compared with histopathology reports

Results: Mean age was 38.20 +/- 10.63 years. The size of the lesion ranged from 2.0 to 6.0 cm, a mean = 3.97 +/- 1.26 cm. The duration since the lump was noticed ranged from 12 weeks [3 months] to 20 weeks [5 months] with a mean of 15.09 +/- 2.56 weeks. Forty-one [29.9%] lesions were labelled malignant on sonoelastography while the actual number of malignant lesions was 35 [25.5%] on histopathology. When the results of sonoelastography were cross-tabulated with histopathology results, the number of TP [true positive], FN [false negative], FP [false positive] and TN [True negative] were 31, 4, 10 and 92 cases, respectively. It yielded 88.57% sensitivity, 90.20% specificity, 75.61% positive predictive value, 95.83% negative predictive value, 89.78% accuracy for sonoelastography in the diagnosis of malignant breast lesion taking histopathology as gold standard with an observed prevalence of malignant breast mass to be 25.55%

Conclusion: Using a strain ratio of 4.8, sonoelastography was found to be 88.57% sensitive, 90.20% specific, and 89.78% accurate in the diagnosis of malignant breast masses

interquartile relationship between polyherbal extract based lozenges linkus a phase four comparative randomised control trial

The aim of the study is to determine the efficacy of polyherbal linkus with the other pharmaceutical marketed syrup having Acefyllin Piperazine, Diphenhydramine group and Aminophylline Diphenhydramine group on the basis of interquartile ranges on children. It was open label multi centric randomize control trial. The study was conducted on different private schools of East and West Malir, Karachi Pakistan with the special approval from the school's honors. Informed consent and assents were taking before the enrollment of the study subjects. The study enrolled participants were 147 who evaluate on cough. Participants were divided into 3 interventional group according to the treatment regimen. One group of participant received Linkus Syrup however the 2[nd] group received Acefyllin Piperazine and 3[rd] group received Aminophylline Diphenhydramine group. The frequency of the cough on linkus syrup was considered to be achieved on the basis of interquartile relationship and impact has been observed on child and parent sleep and found significant [p <0.01].Poly herbal Linkus Syrup has the significant impact on cough frequency and associated problem on children and parent's sleep with minimum side effects [p<0.01] however the pharmacological treatments are considered to be more unwanted effects on human subjects

Efficacy and safety of Linkus, Aminophylline diphenhydramine and acefyllin piperazine for the treatment of cough in children

To evaluate the safety and efficacy of Linkus, Aminophylline with Diphenhydramine group and Acefyllin Piperazine with Diphenhydramine cough syrup on children having cough and sleep difficulty associated with cough. To determine the effects of Linkus polyherbal syrup [group A] and compared with other parallel allopathic groups [Group B and C] for cough on children and associated sleep quality and improvement. 360 children having cough inducted in 3 different groups randomly selected. Three parallel groups were the part of the study. The first study group was the herbal syrup Linkus, second group of children were taking a syrup of multinational pharmaceutical industry having Aminophylline plus Diphenhydramine however the third group received another famous brand having Acefyllin Piperazine with Diphenhydramine. Informed assent and informed consent have taken from the study subjects and their parents. Subjects with acute cough were included in the study however the subjects with chronic cough considered to be excluded. Every group of individual in the study was informed about the investigational drugs provided. Ethnic groups, frequency of cough and diseases illness [<0.05] were determine on every group on the investigational syrup. Cough impact on child and its sleep of three different syrups [every group] were assessed on dayl and day 14[p<0.001] via a likert scale. For the evaluation of pain assessment Wong baker face scale were used and level of significance in each group [p<0.001]. Significant results were observed in the Linkus Group as compared to the other parallel groups including Aminophylline plus Diphenhydramine and Acefyllin Piperazine with Diphenhydramine on day 14 [p<0.001]. Side effects on group B and group C [Aminophylline with Diphenhydramine and Acefyllin Piperazine with Diphenhydramine] were almost similar in number however Linkus syrup has minimum side effects on study duration. Polyherbal syrup Linkus shows better results in treatment of cough including side effects as compare to the other parallel groups B and C [Aminophylline with Diphenhydramine and Acefyllin Piperazine with Diphenhydramine]. For nocturnal sleep Linkus providing better results in cough and associated problems. Pain were significantly reduce on day 14 with the herbal Linkus syrup group A [<0.001]. Group B and C found less effective with more side effects as compared to Linkus syrup. Poly herbal Linkus syrup could substantially improve the clinical effect and relieves coughs and benefit lung functions and better sleep facilitation

Reasons for conversion of laparoscopic cholecystectomy to conventional cholecystectomy, in a tertiary care hospital

Objective: To determine and assess the common causes of conversion of laparoscopic cholecystectomy to conventional cholecystectomy

Methods: A cross sectional hospital based study was conducted in Surgical Unit-III, Abbasi Shaheed Hospital and Karachi Medical and Dental College. Overall 197 patients were selected through consecutive non probability sampling. Patients included were those with symptomatic cholelithiasis including acute cholecystitis, chronic cholecystitis and asymptomatic gall stones in which ultrasound abdomen demonstrated cholelithiasis with normal common bile duct. Written consent was taken from each admitted patients and assessed clinically androutine investigations [CBC, ESR, RBS, Urea, Creatinine, Liver Function test, Hepatitis Profile, X-ray chest, ECG and ultrasonography of abdomen] were done. Laparoscopic cholecystectomy was done under general anesthesia

Results: Laparoscopic cholecystectomy was successful in 188 patients [95.43%] while in 9 patients [4.59%] laparoscopic cholecystectomy was converted to open cholecystectomy

Conversion was because of haemorrhage in one patient [0.51%], Common bile duct injury inone patient [0.51%], non-visualization of gall bladder in one patient [0.51%], shortage of time for laparoscopic cholectectomy in two patients [.02%], cholecystoduodenalfistula in two patients [1.02%] while two patients [1.02%] were converted to open procedure due to carcinoma gall bladder

Conclusion: The conversion rate was five percent from laparoscopic cholecystectomy to open cholecystectomy hence laparoscopic cholecystectomy is a safe procedure

The knowledge of common reasons of conversion in our tertiary hospital will help to overcome these factors in future, which benefit in reducing cost and improve patients wellbeing

Optic nerve sheath diameter on sonography in idiopathic intracranial hypertension versus normal

Objective: To compare the mean optic nerve sheath diameter [ONSD] in patients with idiopathic intracranial hypertension [IIH] versus normal healthy individuals using B-scan ultrasonography as diagnostic tool

Study Design: Cross-sectional analytical study

Place and Duration of Study: Armed Forces Institute of Radiology and Imaging, Rawalpindi, Pakistan, from June to December 2015

Methodology: Participants aged 30 - 50 years were divided into two groups. Group A [GP] comprised of patients who were diagnosed cases of idiopathic intracranial hypertension while normal healthy adults who volunteered to participate in the study were included in Group B [GC]. Ocular B mode ultrasound scan was performed on all the participants and each eye was considered separately. The optic nerve head was visualized as a linear hypoechoic structure, and ONSD was measured 3 mm behind the retina. A total of three readings were taken by the same radiologist and the average of three was recorded. Mean values of both groups were compared by t-test with significance at p < 0.05

Results: Fifty-two eyes of 26 patients [26 eyes in each group] were included in the study. Twenty-four out of 26 in Group A [GP] and 23 out of 26 in Group B [GC] were females. Mean age of the patients was 33.92 +/-4.89 years in group A [GP] while it was 34.69 +/-4.79 years in group B [GC]. Mean ONSD was 6.61 +/-0.39 mm in group A [GP] and 4.33 +/-0.38 mm in group B[GC] which was significantly different [p < 0.001]

Conclusion: Ultrasound can provide a reliable, non-invasive tool to measure optic nerve sheath diameter in monitoring the patients with benign intracranial hypertension [BIH]

Traditional remedy of morus nigra L. herb formulated into lozenges to enhance the localized effect

Allopathic system of medication is the most popular and preferable approach of the treatment in the current scenarios, but in spite of the wide use of allopathic medicine, the trend of use of herbal medicines are also valuable contributor with the current medicinal therapies in the health care professions. In this connection, an eastern use of Morus nigra L. fruit was formulated into solid dosage from named as Lozenges. The lozenges consisted of Morus nigra L. aqueous extract, which dissolves in the mouth providing localized effect against sore throat and cough. A full-scale batch of lozenges trial was manufactured to ensure uniform process and analytical parameters. The un-packed lozenges were evaluated for qualitative specifications like, average weight which was about 2.250-2.750 [2.5 g +/- 10%] and uniformity of weight was 18/20-NMT +/- 10% 2/20. The results were found within the official limits. The appearance of the lozenges was checked organoleptically while dimensions were evaluated using calibrated vernier caliper. Packed and finished lozenges dosage form were evaluated for microbiological test like, aerobic bacteria, fungi, P.aeruginosa, E. coli, Staphylococcus aureus, Salmonella and other enteric bacteria. Thin Layer Chromatography [TLC] confirmed the presence of flavonoids as anthocyanins at 254 nm. The quantity of flavonoids as anthocyanin [cyaniding-3-glucoside] was determined as not less than [NLT] 0.80 mg/Loz. Caffeic acid was also estimated quantitatively using High Performance Thin Layer Chromatography [HPTLC] and was found NLT 0.002 mg/loz

effect of Unani antiacne formulation [Zimade Muhasa] on acne vulgaris: a singleblind, randomized, controlled clinical trial

To evaluate clinically the efficacy of Zimade Muhasa, a Unani anti acne formulation, for Busoore labaniya [Acne vulgaris] against 5% benzoyl peroxide. The randomized, single-blind, standard controlled trial of 6 weeks evaluated the efficacy and tolerability of Unani topical antiacne formulation against standard control i.e. 5% benzoyl peroxide in 48 patients of either sex on the basis of Global Evaluation of Acne Scale [GEA Scale] along with arbitrary scale for assessment of effect over postinflammatory hyperpigmentation, scarring and fairness. In addition quality of life was assessed according to Cardiff Acne Disability Index [CADI] questionnaire. The alterations in improvement and possible complications were regularly assessed. After 6 weeks of treatment, compared with baseline both the treatment preparations decreased the acne lesions [P<0.001]. Further, the test formulation improved postinflammatory hyperpigmentation [P<0.001], scarring [P=0.025] and complexion [P0.001]. There was significant [P<0.001] improvement in the quality of life in treatment groups at the end of study. The test formulation was well-tolerated and equivalent to 5% benzoyl peroxide in alleviating acne lesions. Test formulation was also more effectual concerning the effects over sears, post inflammatory hyperpigmentation and fairness. This formulation can be used safely to treat active acne as well as in patients with post acne scarring. The clinical relevance may be clarified by longer duration treatment

historical panorama of acne vulgaris

Although acne is described in very ancient writings dating back to Ebers papyrus, its clear description is found after Fuchs coined the term 'Acne vulgaris' and Erasmus Wilson separated it from acne rosacea. The early treatment of acne was based upon the witchcraft. Later new therapies evolved with the discoveries in the field of anatomy, physiology and biochemistry. The following review focuses on the historical overview of acne vulgaris, highlighting persons and discoveries in medieval and modern period.

Cardiovascular drug interaction; evaluation in poly prescription in the city of Karachi, Pakistan

Cardiovascular drug interaction is the alarming and becoming leading cause of death in the society of Karachi Pakistan where the prevalence rate of CVS diseases in urban areas is very high. The aim was to evaluate the cardiovascular interactions in poly prescription in the city of Karachi, Pakistan. The methodology adopted forthis study is cross sectional study. In which verbally and signed informed consent prepare which help to limitize the biasness. In this study the determination of the percentage of interactions is about 30%.The gender which is most susceptible for interaction is females. The Significance or consequences of interaction would measured by minor, moderate and major level. In our study minor is about 28, moderate is about"! 9 while Major is about 9.The most untoward effects which was seen was bradycardia and the class of drug which lead for interaction is Beat and ACE blockers in the prescribing practice and some severe interaction lead to life threatening. The main result which is concluding forthis study is the huge number of interaction which is found in the prescription creates life threatening circumstances. With the proper consultation and time we can minimize the interaction as well as the health scenario can be improved and the quality of life can be improved