Cardiotonic and vasoconstriction effects of aqueous methanolic extract of Paspalidium flavidum L.

The cardiovascular activity of aqueous methanolic extract of Paspalidium flavidum L. was evaluated on isolated rabbit heart and aorta. Heart rates, force of contraction and perfusion pressure were assessed in the presence of different concentrations of extract and adrenaline by using Langendorff's technique. Moreover, the vasoconstriction effects were studied in rabbit aorta using isolated organ bath. The results indicated that the extract [1ng-100[micro]g/ml] exhibited a significant increase in heart rate, contractility and perfusion pressure of isolated rabbit's heart; with a maximum effect at 1ng/ml, which was comparable to adrenaline [1[micro]g/ml]. Similarly, adrenaline at doses from 1-10[micro]g/ml produced a significant dose dependant increase in all the cardiac parameters. The cardiotonic effects of the extract were significantly blocked by propranolol [10[-5]M] while an increase in perfusion pressure was completely antagonized by verapamil [10[-6]M]. Activity of cardiac marker enzymes was also significantly raised in the perfusate of isolated heart pretreated with the extract. In rabbit aorta, the extract exhibited a dose dependent vasoconstriction effect however it did not increase the tone of aorta when pre-treated with verapamil [10[-6]M]. It is conceivable therefore; that the cardiotonic and vasoconstriction effects of the extract might be due to its agonistic actions on beta-receptors and Ca[+2] channels

Validity of pleural fluid protein in differentiating tuberculouse from malignant pleural effusion

Validity of pleural fluid protein in differentiating tuberculouse from malignant pleural effusion keeping histopathology as gold standard. Cross sectional study. This study was conducted in the Pulmonology department post graduate medical institute, Lady Reading Hospital Peshawar, Khyber Pakhtunkhwa [KPK] Pakistan from March 2009 to March 2010. One hundred and seventy nine patients having clinical suspicion of pulmonary tuberculouse and malignancy and fulfilling the inclusion criteria were subjected to Abrams needle biopsy, plural tissue was examined by histopathology. Biopsy in order to know the significant difference of pleural fluid protein level between tuberculous and malignant pleural effusion, histopathology finding and protein concentration were determined their frequency and percentage. Among total number of 179 patients one hundred and fourteen [63.69%] were male and sixty five [36.32%] were female. The age limit from 15-80 years, the result shows that 60.9% were tuberculous and 39.9% were malignant pleuraleffusion, among these malignant 20 [11.2%] showed primary and 50 [27.9%] secondary malignancy. Tuberculous PE was more common in younger age group while malignant PE in older age group, 32 number of patients falling in category A, 59 in category B, and 88 in category C.A protein level in belonging to category C, there was statistically significant difference between tuberculous and malignant PE, tuberculous PE have high concentration of protein than malignant PE, The category [A] have malignant PE. Plural fluid total protein level determination and differentiating is a valuable tool in reaching to the diagnosis of suspectedtuberculouse from malignant pleural effusion provided it is used in addition to the adequate clinical scenario

Antioxidant level in normal and dialyzed patients using frap method

To examine the serum antioxidant levels like vit-C, vit-E and glutathione in patients with renal diseases who were subjected to dialysis and to evaluate the antioxidant by FRAP method. To find out the involvement of free radicals in pathogenesis of renal disease. Fifty patients with high levels of creatinine and urea level were included in the study of dialysis. A difference of antioxidant level of vit-C, vit-E and glutathione was observed. The study therefore suggests the importance of assessing these marker oxidative stress antioxidant capacities in renal disease during dialysis

Grover's disease: a case report

Grover's disease, a non-immune acantholytic dermatosis affects mostly adult males over 50 years of age. We present this case as it has not been reported in Pakistani medical literature before and the disease started under 50 years of age in a male patient

Overlapping syndromes: keratosis follicularis spinulosa decalvans with overlapping features of ichthyosis follicularis with alopecia and photophobia

We report a case of a 20-year-old male who presented in our dermatology clinic with congenital alopecia totalis, ectropion, bilateral cataract, follicular prominence, plantar keratoderma, ichthyosis on legs, cheilitis, xerosis and photophobia. He had overlapping features of both keratosis follicularis spinulosa decalvans and ichthyosis follicularis with alopecia and photophobia. Or was it a different entity altogether?

Meckle's diverticulum in patients with acute abdomen

Meckle's diverticulum is not a very common cause of acute abdomen, yet occasionally it manifests itself as a life threatening condition. We carried out this study to observe the varied clinical manifestations of Meckle's diverticulum in patients with acute abdomen. This study was conducted in Agency Headquarter Hospital Wana and data collected from various surgical clinics. It was a prospective study conducted during four years form 2000-2003. All patients underwent laparotomy for signs and symptoms of acute abdomen. A total of 900 cases were studied. Of these [18 patients] 2% were found to have Meckle's diverticulum. Nine hundred patients of acute abdomen were studied. All were operated and the diagnosis confirmed by histopathologic examination. Eighteen patients [2%] were having Meckle's diverticulum. Six patients [37.5%] were symptomatic. Twelve patients [62.5%] were having Meckle's diverticulum with no signs of pathology. Of the symptomatic 6 patients, 2 patients [39%] presented with intestinal obstruction. Haemorrhage, perforation, diverticulitis, and Meckle's diverticulum having ectopic mucosa were presented each in one patient [15%]. Meckle's Diverticulum is a rare cause of acute abdomen. It presents with obstruction in the pediatric age group and with perforation, heamorrahage and ectopic mucosa in adults. The symptoms caused by Meckle's diverticulum are mainly due to bands or ectopic mucosa. Diverticulum found in patients less than 30 years age should be resected and in older patients resection is indicated if ectopic gastric tissue is suspected. Diverticular bands can simply be cut in these patients

Pattern of medical disorders in adults in district Lakki Marwat, Pakistan

The objective of this study was to determine the pattern of various diseases /problems with which the patients present to a medical specialist in District Lakki Marwat. A total of 862 patients ranging in age between 15 and above from various parts of district Lakki Marwat, presenting to a weekly based clinic were studied from March, 2006 to June 2006. A printed proforma containing details of history, findings of clinical examination and reports of investigations was filled for each patient. After completion of the study period proformas were grouped in a systematic way and were studied to achieve the objective. Overall females dominated the picture. The highest number of patients fell in the group of cardiovascular diseases with a total of 222 [25.75%] patients followed by disorders of gastrointestinal system in 146 [16.93%] patients. Respiratory problems were observed in 126 [14.61%] patients. Sixty patients [6.96%] presented with Rheumatological problems, 40 [4.64%] with problems related to CNS, 34 [3.94%] with endocrine diseases, 16 [1.85%] with Uro-genital disorders, 12 [1.39%] with infectious disorders and 4 [0.46%] with metabolic problems. A group named miscellaneous comprised of 144 [16.74%] patients who had nonspecific symptoms like headache, giddiness, body-aches and weakness with no positive findings on clinical examination. Fifty eight patients [6.72%] had both diabetes mellitus and hypertension. The number of female patients presenting to physician are more than the male patients in District Lakki Marwat. Hypertension is the commonest disorder and majority is unaware of their high blood pressure

Darier's disease with comedons

Darier's disease is an uncommon genodermatosis which is difficult to recognize and usually refractory to treatment. We present a variant of Darier's disease with comedons showing histological features of Darier's disease

Comparative lipid profile studies in cardiac and diabetic conditions

Lipid profile in cardiac patients [myocardial infarction, angina pectoris, coronary heart disease, ischaemic heart disease], diabetic patients and normal humans was investigated. Total serum cholesterol, high density lipoprotein cholesterol [HDL-C], low density lipoprotein cholesterol [LDL-C], triglycerides, blood glucose, calcium, potassium and sodium were determined, employing established methods and procedures. Higher level of total cholesterol, LDL-C and triglyceride were found in both cardiac and diabetic patients, however, cardiac patients had much lower level of HDL-C as compared to normal humans. Age wise comparison revealed that level of total cholesterol; triglyceride and LDL-C were elevating while the level of HDL-C were decreasing with the age in cardiac and diabetic patients. Sex wise comparison showed that females had higher HDL-C level than males and therefore had fewer incidences of heart diseases. The level of Ca++, K+ and Na+ were similar in all age groups and sexes. No significant elevation in the level of these electrolytes was discovered

clinical experience with patients of syphilis

Twenty five consecutive cases of Syphilis presenting to the dermatology department of Pakistan Institute of Medical Sciences, Islamabad, were reviewed regarding the clinical pattern of presentation, laboratory findings and their response to treatment. Other associated sexually transmitted diseases were also looked for and HIV status was also determined. Most of the patients responded well to penicillin and those not responding were adequately treated with erythromycin. Patients' age ranged from 10 to 70 years; most of the patients were clustered between 20 to 40 years. There were 22 males and 3 female patients. Following clinical signs were seen in the patients: Body Rash with particular involvement of the face, palms, soles and genitalia, oral and other mucous membrane lesions, hair loss, lymphadenopathy and condylomata lata

Colonoscopic polypectomy in children

Juvenile polyps are common in children and present with bleeding per rectum. The aim of present study was to evaluate the role of endoscopic polypectomy by snare and diathermy technique on outdoor basis. Design: A prospective study. Place and Duration of Study: Postgraduate Medical Institute, Lady Reading Hospital / Hayatabad Medical Complex from 1992 to 1999. Subjects and Children presenting with fresh bleeding per rectum with normal stool were included in this study. They underwent colonoscopy on outdoor basis after 72 hours preparation. Polypectomies were performed by polypectomy snare on coagulation mode with a voltage of 2.5 MV. The maximum number of children were between 9-15 years with a male dominance. Polyp size ranged from 1-4 cm. All polyps were recovered successfully and most of them were hamartomatous lesions [85.50%]. No major complications were seen. Colonoscopic polypectomy is effective and safe in children and can be done on outpatient basis

Esophageal stricture dilatation with bougienage without fluoroscopy

Endoscopic dilatation is considered as the best treatment for most cases of benign esophageal stricture. In most centres it is performed under fluoroscopy specially those done with bougienage. We report our past experience of 75 patients treated by dilatation without the aid of fluoroscopy and comparison of its efficacy among patients with strictures from different causes. Design: A descriptive study describing findings on oesophascopy for patients coming with dysphagia. Place and Duration of Study: The study was carried out at the Department of Gastroenterology, PGMI, Peshawar from 1994 to 1999. Subjects and We performed dilatation in 75 patients [50 male, 25 female] with pathologies ranging from reflux stricture, malignant stricture, corrosive stricture and achalasia respectively. Treatment was considered adequate if the esophageal lumen could be dilated upto the 58 Fr. Etiology of esophageal stricture found was reflux stricture [40], malignant stricture [18], achalasia [8], systemic sclerosis [04], corrosive stricture [04] and dysphagia with no intrinsic pathology [01]. Complications like massive bleed, rupture and perforations were not recorded. Endoscopic dilatation without the aid of fluoroscopy was safe and effective in relieving dysphagia caused by different pathologies although repeated sessions were necessary because of stricture recurrence. Our follow-up during the period of eight years showed that all the subjects, except those with malignant stricture, were symptom-free and doing well

Efficacy of low-dose intravenous octreotide for 24 hours in acute variceal bleed

To compare low-dose octreotide with endoscopic sclerotherapy for acute variceal bleeding. Design: A clinical trial. Place and Duration of Study: From 1995 to 2000 at PGMI, Peshawar. Subjects and Out of a total of 113 patients, 63 were allocated to low-dose octreotide [group-I] and 50 to sclerotherapy [group-II] on simple randomization method. Octreotide was given in a dose of 25 mg/hour for 24 hours followed by 50 mg subcutaneously [s/c] every 8 hours for 48 hours. Injection sclerotherapy was done by Olympus GIF 2 T 20 using absolute alcohol as sclerosing agent. Overall control of bleeding and mortality was comparable in both groups over 24 hours trial period irrespective of child grading. No rebleed occurred among the patients of either group in first 24 hours. However, a statistically significant difference p < 0.05 between the two groups regarding the occurrence of rebleeding in 48 hours was observed. Low-dose intravenous [i/v] octreotide is as effective as injection sclerotherapy in control of acute variceal bleeding and prevention of rebleed. However, subcutaneous octreotide was not found to be as effective as sclerotherapy regarding prevention of early rebleed