Sedative and antinociceptive activities of two new sesquiterpenes isolated from Ricinus communis / 中国天然药物

Two new sesquiterpenes, trivially named ricinusoids A (1) and ricinusoids B (2), were isolated from ethyl acetate fraction of Ricinus communis. The structures of new compounds were elucidated by detailed spectroscopic techniques, including 1D- and 2D-NMR, UV, IR spectroscopy, and mass spectrometry. The compounds (1-2) were also assessed for in-vivo sedative and analgesic like effects in open field and acetic acid induced writhing tests respectively at 5, 10, and 20 mg·kg i.p. Pretreatment of both test compounds caused significant (P ≤ 0.05) reduction in locomotive activity like sedative agents and abdominal constrictions like analgesics. Both compounds (1-2) possessed marked sedative and antinociceptive effects in animal models.

Sedative and antinociceptive activities of two new sesquiterpenes isolated from Ricinus communis / 中国天然药物

Two new sesquiterpenes, trivially named ricinusoids A (1) and ricinusoids B (2), were isolated from ethyl acetate fraction of Ricinus communis. The structures of new compounds were elucidated by detailed spectroscopic techniques, including 1D- and 2D-NMR, UV, IR spectroscopy, and mass spectrometry. The compounds (1-2) were also assessed for in-vivo sedative and analgesic like effects in open field and acetic acid induced writhing tests respectively at 5, 10, and 20 mg·kg i.p. Pretreatment of both test compounds caused significant (P ≤ 0.05) reduction in locomotive activity like sedative agents and abdominal constrictions like analgesics. Both compounds (1-2) possessed marked sedative and antinociceptive effects in animal models.

Body mass index in medical students and its association with gender and academic year

Background: Students are generally prone to weight related problems due to sedentary lifestyle and disordered eating habits. The objective of current study was to evaluate the body mass index among MBBS and Physiotherapy students of Peshawar and to see its association with gender and academic year

Methods: This was a cross-sectional study conducted among MBBS and Physiotherapy students in Peshawar, from Sep 2016 to Sep 2017. A self-administered questionnaire was distributed among 250 students of different institutes, 213 filled questionnaires were returned. Body mass index [BMI] was used to classify underweight, overweight, and obesity grade I and grade II. Data was analyzed using SPSS-20

Results: Mean age of participants was 21.77+/-1.45. Females were 137 [64.3%] while males were 76 [35.7%]. Unmarried participants were 192 [90.1%], while 21[9.9%] were married. Mean height, weight and BMI of the participants were 1.654 meter, 61.1 Kg, and 22.8 respectively. One hundred and thirty [61.0%] were MBBS, and 83 [39.0%] were Physiotherapy students. Out of 213 respondents, 109 [51.2%] had normal BMI, 21[9.9%] were underweight, 41 [19.2%] were overweight, 31 [14.6%] were grade I obese and 11 [5.2%] were grade II obese. Majority of 1[st] year [68.0%] and 4[th] year [72.7%] students had normal BMI. BMI was not associated with gender or academic year [p>0.05]. Mean BMI in MBBS students was higher than the physiotherapy students [23.3 vs 22.1 Kg/M[2], p=0.03]

Conclusion: The prevalence of obesity appears higher in our students

Efficacy and toxicity of concurrent chemoradiation in inoperable oral carcinoma in pakistani population

Objective: To evaluate the efficacy of concurrent Chemoradiation in patients with locally advanced inoperable squamous cell carcinoma of oral cavity in terms of local control and toxicity

Study Design: Case series

Place and Duration of Study: Institute of Nuclear Medicine and Oncology [INMOL], Lahore, from January 2008 to December 2013

Methodology: Sixty-nine patients with locally advanced inoperable oral cavity cancer, registered in INMOL hospital from January 2008 to December 2013 who fulfilled a pre-defined eligibility criteria, were enrolled in the study

Concurrent Chemoradiation protocol consisted of conventional fractionation delivering 70 Gy with weekly Cisplatin [50 mg/m[2]] during the course of radiation

Tumor response was calculated by RECIST criteria version 1.1 along with the median overall survival and disease-free survival. Acute treatment related toxicities were graded as [G]

Results: Thirty-six [52.17%] patients showed complete response; while 19 [27.54%], 8 [11.59%] and 6 [8.7%] were observed with partial response, stable and progressive disease, respectively. Treatment response was significant [p<0.001] in terms of responders vs. nonresponders to treatment. Median overall survival was 18.00 months; whereas, median disease-free survival remained 14.00 months. Main toxicities included mucositis [G3 and G4, 71%], xerostomia [G2 and G3, 82.5%], vomiting [G3 and G4, 51%], myelosuppression [G3 and G4, 26.2%], dermatitis [G3 and G4, 49.2%], and fatigue [G3 and G4, 57.9%]

Conclusion: Platinum based CCRT remained effective for inoperable oral cancer patients

Growth pattern in children with systemic lupus erythematosus

Objectives: Children with childhood-onset systemic lupus erythematosus [cSLE] enter adulthood with considerable morbidity. Of the recognized morbidities, growth failure is unique to cSLE. The aim of this study was to evaluate the growth pattern in children with cSLE longitudinally and identify possible risk factors

Methods: Serial anthropometric measurements of cSLE patients were obtained over two years and expressed as z-scores. Parental heights were obtained to calculate target height. Parent-adjusted height z-score was calculated as the difference between height z-score and target height. Growth failure was defined as parent-adjusted height z-score < -1.50. Risk factors that might have contributed to growth failure were evaluated including the presence of growth failure at baseline, disease activity, disease duration, and cumulative steroid doses

Results: Twenty-five patients were included in the study. Growth failure was observed in eight patients with an overall incidence of 32.0% [95% confidence interval [CI]: 14-50%]

When comparing the cohort with and without growth failure, the factors that determined growth failure was the pre-existence of growth failure at the time of diagnosis [z-score < -1.95 vs. 0.35; p < 0.001]; higher cumulative steroid dose [15.8 vs. 9.1 g //p - 0.061]; and tendency for longer disease duration [5.4 vs. 3.7 years;/? = 0.240]. However, the severity of disease activity at the time of diagnosis was not a significant contributing factor [12 vs. 14; p = 0.529]

Conclusions: Children with cSLE are at risk of having a negative effect on height including patients with pre-existing growth failure, high cumulative steroid dose, and longer disease duration. However, longitudinal prospective studies are needed to examine damage over time to improve health-related quality of life

Screening outcomes of household contacts of multidrug-resistant tuberculosis patients in Peshawar, Pakistan

OBJECTIVE@#To assess the profile of TB/multidrug-resistant TB (MDR-TB) among household contacts of MDR-TB patients.@*METHODS@#Close contacts of MDR-TB patients were traced in the cross-sectional study. Different clinical, radiological and bacteriological were performed to rule out the evidence of TB/MDR-TB.@*RESULTS@#Between January 2012 and December 2012, a total of 200 index MDR-TB patients were initiated on MDR-TB treatment, out of which home visit and contacts screening were conducted for 154 index cases. Of 610 contacts who could be studied, 41 (17.4%) were diagnosed with MDR-TB and 10 (4.2%) had TB. The most common symptoms observed were cough, chest pain and fever.@*CONCLUSIONS@#The high incidence of MDR-TB among close contacts emphasize the need for effective contact screening programme of index MDR-TB cases in order to cut the chain of transmission of this disease.

Screening outcomes of household contacts of multidrug-resistant tuberculosis patients in Peshawar, Pakistan

Objective To assess the profile of TB/multidrug-resistant TB (MDR-TB) among household contacts of MDR-TB patients. Methods Close contacts of MDR-TB patients were traced in the cross-sectional study. Different clinical, radiological and bacteriological were performed to rule out the evidence of TB/MDR-TB. Results Between January 2012 and December 2012, a total of 200 index MDR-TB patients were initiated on MDR-TB treatment, out of which home visit and contacts screening were conducted for 154 index cases. Of 610 contacts who could be studied, 41 (17.4%) were diagnosed with MDR-TB and 10 (4.2%) had TB. The most common symptoms observed were cough, chest pain and fever. Conclusions The high incidence of MDR-TB among close contacts emphasize the need for effective contact screening programme of index MDR-TB cases in order to cut the chain of transmission of this disease.

Development and bioevaluation of [99m] Tc[CO][3]-labeled [1-azido-1- deoxy-beta -D-glucopyranoside] complex as a potential tumor-seeking agent

The 1,2,3-triazole-containing [1-azido-1-deoxy-beta -D-glucopyranoside] complex was synthesized using click chemistry approach and evaluated its potential as a tumor-seeking agent. In the present study, [99m] Tc-tricarbonyl labeled [1-azido-1-deoxy-beta -D-glucopyranoside] radiotracer [[99m] Tc[CO][3]-BM], [where BM stands for biomolecule, e.g., [1- azido-1-deoxy-beta -D- glucopyranoside]] was synthesized via click chemistry approach and then labeled with technetium- 99m through isolink kit. Radio labeled drug was tested for radiochemical purity and in vitro stability by chromatographic techniques. Normal distribution and tumoral uptake were studied in Swiss Webster mice. Radiochemical purity results show 97.9 +/- 1.5% labeling and its in vitro stability were studied at room temperature up to 5h. The radio labeled drug exhibited 73.6 +/- 1.1% binding with blood proteins. Normal distribution of drug shows prominent uptake in brain while in case of tumor-bearing mice, the uptake was maximum in tumor tissue and negligible amount was shown in brain. The biodistribution was further compared with 2-fluoro-2-deoxy glucose [[18]F-FDG], which was used as a positive control. The data indicate that [99m] Tc-tricarbonyl labeled [1-azido-1-deoxy-beta -D- glucopyranoside] radiotracer might be a feasible candidate with reasonable potential for tumor diagnosis

[Echocardiographic evidence of early diastolic dysfunction in Asymptomatic children with Osteogenesis Imperfecta]

Objectives: Structural and functional cardiovascular abnormalities have been reported in adults with osteogenesis imperfecta [OI]; however, there is a lack of paediatric literature on this topic. This study aimed to investigate cardiovascular abnormalities in children with OI in comparison to a control group

Methods: This case-control study was conducted at the Sultan Qaboos University Hospital in Muscat, Oman, between May 2013 and August 2014. Data from eight patients with OI and 24 healthy controls were compared using conventional and tissue Doppler echocardiography [TDE]

Results: The OI group had significantly lower peak early mitral valve flow velocity [P = 0.027], peak a-wave reversal in the pulmonary vein [P = 0.030] and peak early diastolic velocity of the mitral valve and upper septum [P = 0.001 each]. The peak late diastolic velocities of the mitral valve [P = 0.002] and the upper septum [P = 0.037] were significantly higher in the OI group; however, the peak early/late diastolic velocity ratios of the mitral valve [P = 0.002] and upper septum [P = 0.001] were significantly lower. Left ventricular dimensions and aortic and pulmonary artery diameters were larger in the OI group when indexed for body surface area. Both groups had normal systolic cardiac function

Conclusion: Children with OI had normal systolic cardiac function. However, changes in myocardial tissue Doppler velocities were suggestive of early diastolic cardiac dysfunction. They also had increased left ventricular dimensions and greater vessel diameters. These findings indicate the need for early and detailed structural and functional echocardiographic assessment and follow-up of young patients with OI

Switching to multiple daily insulin injections in children and adolescents with type 1 diabetes: revisiting benefits from Oman

Optimal glycemic control is an important goal in the management of type 1 diabetes mellitus [T1DM]. Although the use of multiple daily injections [MDI] is a common regimen worldwide, its use is not yet universal in many countries. Our aim was to evaluate the effects of switching from a twice daily [BID] to a MDI insulin regimen in children and adolescents with T1DM in order to revisit its benefits in the Omani population. We conducted a retrospective cohort study of children and adolescents with T1DM at Sultan Qaboos University Hospital, Muscat, Oman, between January 2007 and June 2013. Patients using the BID regimen for more than six months who were then switched to MDI were included in the analysis. We compared glycated hemoglobin levels [HbA[1C]] before and after the regimen change. Fifty-three children were eligible for the study. Ten patients were excluded for various reasons. The remaining 43 patients were 58% male and 42% female, with a mean age of 9.4 +/- 3.7 years. There was significant decrease in the overall mean HbA[1C] level from baseline [10.0] compared to three months after switching to MDI [9.5]; p=0.023. Nevertheless, the improvement was not significant in the subsequent follow-up visits at six and nine months. The reduction in HbA1c values was observed mainly in children five to 11 years. Switching from a BID to MDI insulin regimen has favorable effects on the overall control of T1DM in children and adolescents, as assessed by HbA1c levels. In addition, this regimen has been proved to be safe and well tolerated by patients

Microbial spoilage, instability risk of antacid suspension in the presence of commonly used preservative system

Manifestation of microbial spoilage of any product by bacteria and to assess the effectiveness of the antimicrobial preservatives [parabens] used for the prevention and stability purpose. The aim of the present work is to study the effectiveness of preservatives used in the antacid suspensions and to analyze the effect of microbial growth on the quality of respective antacid suspensions. Samples of various antacid suspensions were randomly collected from local market and Government hospital pharmacies. Three different antacid formulations were prepared in the laboratory. All the formulations were preliminarily evaluated on the basis of organoleptic characteristics, pH, viscosity and assay. Efficacy of the preservative system in suspension formulation was determined by inoculating the samples in its final container, with specific strains of bacteria i.e. Escherichia coli ATCC 8739, Pseudomonas aeruginosa ATCC 9027 and Staphylococcus aureus ATCC 6538, taking samples from the inoculated preparation at specified intervals of time i.e. 0 time, 07 days, 14 days and 28 days, growing it on nutrient agar medium and colony forming units [CPUs] were scored by plate count. At the same time the samples were also subjected to qualitative and quantitative testing. The decrease in CPU and alteration in assay, pH and viscosity was observed in all the formulations except formulation M2 and F3 that showed stability throughout the study period

Nasolabial flap: a workhorse for the reconstruction of nasal ala after tumor resection

To share our experience of the superiorly based nasolabial flap in the reconstruction of nasal ala. This experimental study was conducted at the Plastic Surgery and Burn Unit, Khyber Teaching Hospital, Peshawar from June 2011 to December 2013. A total of 56 patients underwent reconstruction of nasal ala after excision of malignant skin tumors. Superiorly based nasolabial flap was performed in all the patients who underwent tumor excision and required reconstruction of nasal ala. The flap was designed immediately lateral to the nasolabial fold. The flap then dissected, elevated and set into the defect. Out of 56 patients, 39 were males and 17 were female. Forty nine patients had basal carcinoma and 7 patients had squamous cell carcinoma. In all patients the flaps survived completely. Complications observed were scar hypertrophy in 3 patients, bulkier ala in two patients and partial dehiscence in 2 patients. In our experience nasolabial flap is a very reliable flap for the alar defects after tumor resection. Besides providing a good colour match, the flap is easy to dissect and inset

Demographic and clinical characteristics of type 1 diabetes mellitus in Omani children - single center experience

To describe the demographic characteristics and clinical presentation of Omani children with type 1 diabetes mellitus at Sultan Qaboos University Hospital, Muscat, Oman. A retrospective analysis of all children with type 1 diabetes mellitus attending the Pediatric Endocrine Unit at Sultan Qaboos University Hospital, Oman from June 2006 to May 2013. One hundred and forty-four patients were included in the study. The mean +/- SD of age at diagnosis was 6.7 +/- 3.7 years. The median duration of symptoms was 10 days [IQR; 5-14]. The most commonly reported presenting symptoms were polyuria [94%], polydipsia [82%], and weight loss [59%]. Diabetic ketoacidosis at initial presentation was diagnosed in 31% of the patients. Different insulin regimens were prescribed: multiple daily injections in 109 [76%] patients, twice daily insulin regimen in 23 [16%] patients, and insulin pump therapy in 12 [8%] patients. Family history of type 1 diabetes mellitus was present in 31 [22%] patients. There were no significant differences in presenting complaints [polyuria, p=0.182; polydipsia, p=0.848], duration of symptoms [p=0.331], reported weight loss [p=0.753], or diabetic ketoacidosis at presentation [p=0.608] between patients with and without family history of type 1 diabetes mellitus. Polyuria, polydipsia and weight loss are the most common presenting symptoms. Family history of type 1 diabetes mellitus is highly prevalent among the studied patients. Diabetic ketoacidosis was found to be less common in Oman compared to other diabetes centers in the Middle East.

Outcome of open transcortical approach in the management of intraventricular lesions

To evaluate the outcome of management of intraventricular lesions operated by an open transcortical [nonendoscopic] approach. Case series. Department of Neurosurgery, Dow University of Health Sciences and Civil Hospital, Karachi, from January 2009 to December 2011, with six months follow-up. All cases with lesions in the lateral ventricle and anterior third ventricle operated by open transcortical approach, were included after informed consent. Total excision of the lesion was attempted in all cases. Patients were analyzed for outcome in terms of establishment of diagnosis, completeness of resection, morbidity and mortality. A total of 33 patients were operated. Twenty three were males and 10 were females. Colloid cyst was diagnosed in 14 patients [42%], giant cell astrocytoma and choroid plexus papilloma in 4 cases each and subependymoma and central neurocytoma in 2 cases each, epidermoid, choroid plexus carcinoma, oligodendroglioma, metastasis, meningioma, ependymoma and cavernous hemangioma in one patient each. The overall outcome could be labeled as good in 24 out of 33 cases [73%] and in 8 cases [24%] it was fair. One patient died due to ventriculitis and was categorized as poor outcome [3%]. Postoperative complications included meningitis, seizures, intraventicular haemorrhage, subdural collection and transient hemiparesis. Nine patients had persistent hydrocephalus requiring ventriculoperitoneal shunt. Conventional open transcortical approach is still effective in getting conclusive biopsy or near total excision of the lesion with minimum morbidity.

Development of [99m]Tc-5-fluorouracil as a potential tumor diagnostic agent

5-Fluorouracil is a well know drug for chemotherapy of various types of cancer. In the present study, we radiolabeled 5-fluorouracil with 99mTc for a diagnostic study of cancer. After successful labeling of the drug we performed an animal study to evaluate the potential of this radiopharmaceutical as a tumor diagnostic agent. The results showed 98.1 +/- 1.2 % labeling efficacy of 5-fluorouracil with [99m]Tc. The in vitro stability of the radiolabeled drug at room temperature at 4 hr of post-labeling was >96.5 +/- 0.4 %. The binding of the radiolabeled drug with plasma proteins was 66.6 +/- 3%. Partition coefficient results showed that this drug is hydrophilic in nature. Biodistribution study in rabbit models displayed faint uptake in liver. Both kidney and bladder were prominent as excretory route of the labeled drug. Bioevaluation was performed in Swiss Webster mice having naturally developed tumor. Mice were dissected, uptake of drug in various organs was studied and results showed prominent uptake in liver and tumor. Tumor was further investigated by histopathological study

Synthesis, characterization and bioevaluation of technetium-99m labeled N-[2-Hydroxybenzyl]-2-amino-2-deoxy-D-glucose as a tumor imaging agent

N-[2-Hydroxybenzyl]-2-amino-2-deoxy-D-glucose [NHADG] was synthesized by conjugation of salicylaldehyde to glucosamine. The obtained compound was well characterized via different analytical techniques. Labeling of the synthesized compound with technetium-99m [[99m]Tc] in pertechnetate form [[99m]TcO4[-]] was carried out via chelation reaction in the presence of stannous chloride dihydrate. Maximum radiochemical yield of [99m]Tc-NHADG complex [99%] was obtained by using 1 mg NHADG, 200 micro g SnCl[2].2H[2]O, at pH 9.5 and reaction time of 15 min. The radiochemical purity of the [99m]Tc-NHADG complex was measured by Instant Thin Layer Chromatography [ITLC] and Paper Chromatography [PC], without any notable decomposition at room temperature over a period of 4h. The biological evaluation results show that the [99m]Tc labeled NHADG conjugate is able to specifically target mammary carcinoma in mice models, thus highlighting its potential as an effective [99m]Tc labeled glucose-derived agent for tumor imaging

In house development of [99m]Tc-Rhenium sulfide colloidal nanoparticles for sentinel lymph node detection

In this study, rhenium sulfide colloidal nanoparticles were developed as radiopharmaceutical for sentinel lymph node detection. We directly used rhenium sulfide as a starting material for the preparation of colloidal nanoparticles. UV-visible spectrophotometry was used for characterization of in house developed colloidal particles. The size distribution of radioactive particles was studied by using membrane filtration method. The percentage of radiolabeled colloidal nanoparticles was determined by paper chromatography [PC]. The study also includes in vitro stability, protein binding in human blood and bioevaluation in a rabbit model. The results indicate that 77.27 +/- 3.26 % particles of size less than 20nm [suitable for lymphoscintigraphy] were radiolabeled. [99m]Tc labeled rhenium sulfide labeling efficacy with the radiometal is 98.5 +/- 0.5%, which remains considerably stable beyond 5h at room temperature. Furthermore, it was observed that 70.2 +/- 1.3 % radiolabeled colloid complex showed binding with the blood protein. Bioevaluation results show the remarkable achievement of our radiopharmaceutical. The in house prepared [99m]Tc labeled rhenium sulfide colloidal nanoparticles reached the sentinel node within 15 min of post injection. These results indicate that [99m]Tc labeled rhenium sulfide colloid nanoparticles kit produced by a novel procedure seems of significant potential as a feasible candidate for further development to be used in clinical practice

Synthesis, characterization and biodistribution of novel amine thiophene [99m]Tc labeled complex

[99m]Tc-labeled amine thiophene ligand might be a potential candidate for brain imaging. The purpose was to investigate the uptake of a radiolabeled drug in the brain. In this study, a tetradentate amine-thiophene-dione ligand was synthesized by the reaction of thiophene-2-carboxaldehyde with ethane-1,2-diamine and reducing with NaBH4. The ligand system was characterized by elemental analysis, FTIR and [1]H NMR. Radiolabeling of the complex with [99m]Tc was performed by reducing with stannous ions. The radiochemical purity of the radiolabeled drug was determined by paper chromatography [PC] and instant thin layer chromatography [ITLC]. Bioevaluation of the [99m]Tc complex was studied in rabbits. The yield of the final product was 4.42 g [60%] and the characterization data confirmed the synthesis of the final product. The efficacy of radiolabeling was >98%. A significant uptake was observed in the brain which retained significantly up to 4h. The data indicate that the proposed system may be suitable for brain imaging in future clinical applications

Intramedullary spinal tuberculoma

Spinal intradural intramedullary tuberculoma is extremely rare entity of tuberculosis involving the nervous system. Because of its atypical symptomatology, it must be considered in differential diagnosis of spinal cord lesions, especially where prevalence of tuberculosis is high. In this case report this atypical disease is described where good outcome was achieved by surgical excision of the intramedullary lesion followed by antituberculous therapy

Shear bond strength of conventional glass ionomer cement to mechanically treated versus chemo-mechanically treated dentin

To determine the effect of a chemo mechanical caries removal [CMCR] gel Carisolv[TM] on shear bond strength [SBS] of conventional glass ionomer cement bonded to human permanent dentin. One conventional glass ionomer cement [Fuji IX, GC Co, Tokyo Japan] was used. Sixty four teeth were sectioned occlusally; exposed coronal dentin was polished with silicon papers. Teeth in the control groups [C] were directly bonded to respective glass ionomer cements [GIC]. For test groups [T] the polished dentin surface was pre-treated with Carisolv [TM] [Singlemix Uncoloured Gel, Medi Team, Sweden] prior to bonding. Bonded specimens were stored for 24 hours and stressed to failure in the shear mode. SBS of Fuji IX, test group [4.97 +/- 0.82 MPa] was significantly higher [P = .001] than its control group [3.98 +/- 0.67MPa]. Carisolv[TM] pre-treatment significantly increased the shear bond strength of conventional glass ionomer cement to dentin