Estimation of simvastatin and cetirizine by RP-LC method: application to freeze and thaw [FT] stability studies

Sensitive, simple, reliable and rapid HPLC technique for the estimation of simvastatin [SMV] and cetirizine has been designed in this study. The chromatographic conditions were set using Shimadzu LC-10 AT VP pump, with UV detector [SPD-10 AV-VP]. System integration was performed with CBM-102 [Bus Module]. Partitioning of components was attained with pre-packed C-18 column of Purospher Star [5 microm, 250 x 4.6 mm] at ambient conditions. Injected volume of sample was 10 microl. Mobile phase was composed of 50:50 v/v ratio of Acetonitrile/water [pH 3.0 adjusted with ortho-phosphoric acid] having 2 ml/minutes rate of flow. Compounds were detected in UV region at 225 nm. Percent Recovery of simvastatin was observed in the range of 98-102%. All results were found in accept table range of specification. The projected method is consistent, specific, precise, and rapid, that can be employed to quantitate the SMV along with cetirizine HCl. It was estimated by 3 successive cycles of freeze and thaw stability. Results of FT samples were found within accept table limits the method was developed and validated in raw materials, bulk formulations and final drug products

Intermediate release formulations of diclofenac potassium tablets for IVIVC

In recent days response surface methodology [RSM] has widely been applied for development and optimization of cost effective formulations with required quality. Study comprised of three steps including micromeritic comparison of different powder blends of placebo and diclofenac potassium [DP], formulation designing with CCRD [Design Expert, version 7.0.0], and stability testing of selected formulations by using R Gui. Ten formulations [F11-F20] were developed using microcrystalline cellulose [Avicel PH-102] [X1] [13-72%], methocel K15M [X2] [6.59-23.4%] and magnesium stearate [X3] [1.32-4.68%], while responses were % friability and % drug release. Blending rate constant was determined at 3, 6, 9 and 12 minutes. The results of physicochemical parameters were found within acceptable limits. After in vitro testing at pH 1.2, pH 4.5 and pH 6.8, mechanism of drug release, kinetic analysis and statistical evaluation were carried out by model - independent, model-dependent and one-way ANOVA methods. Most formulations followed zero order kinetics at higher pH. Fickian release [0.326

Synthesis and anticonvulsant activity of some newer dihydro-pyrimidine-5-carbonitrile derivatives: part II

Objectives: To synthesize dihydro-pyrimidine-5-carbonitrile derivatives [5-23], as an extension of the previous series, and to evaluate their anticonvulsant potential

Methods: The designed compounds were synthesized and characterized using infrared [IR], nuclear magnetic resonance [NMR] and mass spectroscopy and were evaluated for anticonvulsant activity using the maximal electroshock seizure [MES] and subcutaneous pentylenetetrazole [scPTZ] methods. Compounds with appreciable activity were investigated for their neurotoxicity using the rotarod test

Results: Compounds 17 and 23 were found to be most active at a dose of 30 mg kg[-1] at 0.5 h and 4 h in both models and did not exhibit motor impairment activity, even at higher doses

Conclusion: The newer designed compounds were found to be better than previously reported compounds. This study also shows that increased lipophilicity is directly related to the anticonvulsant activity

Lumbar Morphometry: A Study of Lumbar Vertebrae from a Pakistani Population Using Computed Tomography Scans

STUDY DESIGN: A cross-sectional study. PURPOSE: To describe the characteristics of lumbar vertebrae of Pakistani patients reporting at a tertiary care hospital and compare with studies from other populations. OVERVIEW OF LITERATURE: Several studies have been conducted to determine morphometry of lumbar vertebrae. Most of the studies involve Caucasian populations, still data on other populations still sparse. This is the first study describing lumbar morphometry of a Pakistani population. METHODS: An observational study was conducted based on a review of thin-cut (3 mm) computed topographic images of lumbar vertebrae. Two-hundred and twenty vertebrae from forty-nine patients were studied, and various dimensions were analyzed. RESULTS: Generally, the size of the vertebrae, vertebral canals and recesses were found to be greater in male patients. The difference was statistically significant for transverse and anteroposterior diameters of the vertebral bodies and sagittal diameter of pedicles on the left side (p<0.05). Comparison of populations revealed statistically significant differences in pedicle dimensions between Pakistani population and others. CONCLUSIONS: This study provides anatomical knowledge of the lumbar region in a sample population of Pakistan. There were significant differences in various dimensions of lumbar vertebrae between female and male patients. This would prove to be critical for performing a safe operation.

Al-Arkan theory of origin and continuation of life: misunderstood and ignored

To explain the origin and continuation of life, Scholars of Unani [Greco-Arab] System of Medicine proposed the theory of Al-Arkan/Arkan or Anasir [element] [wrongly interpreted and correlated with modern Elemental theory]. This theory was being criticized mostly for its contents in present scenario. But critics hardly think of the spirit of theory. They simply criticized its wording without context and relation in which it was proposed. The very first word which drawn maximum attention was "simplest" in this theory and we always put it for matter while it is for status. This word was supplied for elementary participation of the Arkan in origin and continuation of life.

Frequency of chemotherapy induced neutropenia in patients of non hodgkin's lymphoma

The aim of the study is to see the frequency and severity of neutropenia after first or subsequent cycles of chemotherapy in patients of Non Hodgkin's lymphoma [NHL]. Descriptive cross sectional study. This study was carried in the Radiotherpay and Oncology Department, Bolan Medical Complex Hospital, Quetta, from March 2010 to February 2012, Forty two patients of different types of NHL diagnosed on lymph node biopsy presenting for the first time at Radiotherapy and Oncology Department in collaboration with Haematology Section [Pathology Deptt:], Bolan Medical Complex Hospital. Quetta, were included. They were admitted in the ward and evaluated with history, physical examination and for staging investigations. Patients were then planned for chemotherapy comprising cyclophosphamide, doxorubicin, and vincristine with prednisolon [CHOP] and with rituximab [R CHOP]. After the first cycle of chemotherapy they were monitored for expected neutropenia in the ward. The neutrophil counts were repeated on days 7 and 10 following chemotherapy. Neutropenia was graded as defined in the operational definition and all the data were entered on a designed data sheet. Forty two patients of NHL were included in this study, of which 34 patients received CHOP, and 08 patients R-CHOP, from March, 2010 to February, 2012. According to WHO classification, 24[57.1%] patients were of Diffuse large B-cell lymphoma [DLBCL], 08[19.0%] were follicular lymphoma [FL] and 04[9.5%] patients were Mantle cell lymphoma [MCL] and remaining 06[1430] are other types of NHL's. 2[4.7%] of patients suffered from grage IV neutropenia [absolute neutrophil count of <0.5 x 10[9]7L], 3[7.1%] had grade III Neutropenia [absolute: Neutrophil count of 0.5 x 10[9]L-0.9 x 10[9]/L], 3[71%] had Grade II neutropenia [absolute netrophil count 1.5 x 10[9] /L-1.4 x 10[9]/L] and 5[11.9%] had Grad I neutropenia [absolute netrophil count 1.5 x 10[9]/L-1.900/L]. Other risk factors noted, i.e., cardiac, Liver and Renal comorbidities in 3[7.1%], 5[11.9%] and 4[9.5%] of patients respectively. Overall 30.8% of patients of NHL's suffered from neutropenia of all grades post first cycle of chemotherapy comprising CHOP and R-CHOP

Surgical anatomy of the hepatic arteries: a prelude to living donor liver transplantation

In the setting of Liver Transplantation as a new and emerging specialty in Pakistan the need has arisen for exact descriptions of the hepatic vascularization to avoid iatrogenic vascular damage. Exact knowledge of the arterial anatomy is required to plan the best resection as well as to minimize the risks of donor morbidity. We studied variations of extrahepatic arterial anatomy in forty six patients who underwent major hepatobiliary or pancreatic resections with complete exposure and/or skeletonization of the extrahepatic arterial anatomy. The extrahepatic arterial anatomy in twelve cadaveric dissections was also studied. The commonest arterial variant seen in our series was Type 1 i.e. 91.37% . The prevalence of anatomical variants was 8.63% . Knowledge of the variation in the hepatic arterial anatomy will help us in planning and performing the safe procurement of grafts from living donors with less risk of serious ischemic complications

Management of dental waste in a dental hospital of lahore

It is a descriptive study based on personal observations at Punjab Dental Hospital, Lahore carried out over a period of two weeks. A structured checklist was made to collect the data regarding the management of Dental hospital waste and filled in by observation. Final analysis was made with the help of Epi info 2002 statistical package. There was no categorization and segregation of infectious waste at the point of origin. Bags and containers for infectious waste were not marked with Biohazard symbol. White bags were not available for the general waste. There is no incinerator, storage site and landfill sights in the dental hospital. Transportation of waste within the hospital is through open baskets. Dental Hospital sends its infectious waste to the Children Hospital Lahore for incineration twice a week. Amalgam/mercury, X-ray developer and fixer waste were drained through main sewage system. Sanitary workers are not provided with the protective clothing, gloves, masks and shoes. Waste management at Punjab Dental Hospital is not satisfactory. Interest and motivation in hospital waste management is lacking. The administration is required to play its role

Effective factors on survival time of the leukemic patients and estimating the mean of survival time by expectation and maximization algorithm and Monte Carlo Markov chains simulation method

Leukemia is a kind of malignancy blood system which leads to death of human beings in a very short period of time. In this paper, the effective factors on survival time of the acute lymphoblastic leukemia [ALL] patients have been considered to achieve a linear regression model show the relation between the life-time after diagnosis and some explanatory factors. In this study, the data of 52 patients died from ALL was used. The designed model contained three variables, hemoglobin, large undifferentiated cell [LUC] and age. According to the data suggesting, a kind of mixture distribution, we considered a mixture model for survival time. Applying the EM-algorithm, we have found the maximum likelihood estimate of mean survival time and the Bayesian estimate of the mean survival time by Monte Carlo Markov Chain method. Based on the obtained estimating survival function, we can predict the survival time of the patients and decide about their treatment protocol. It is suggested that by conducting larger studies and statistical analysis used in this paper, a correlative can be found between clinical and paraclinical findings and the survival time. This model can be used in often kinds of diseases for determining the prognosis

[Alterations in urinary sodium and blood pressure after permanent pacemaker implantation]

Permanent pacemakers are applied to treat some 2[nd] and 3[nd] degree AV blocks. Previous studies have shown the hemodynamic changes that may occur after pacemaker implantation. In this study, we have evaluated these hemodynamic changes from a different view point, with measurement of urinary sodium and blood pressure. This is a before and after clinical trial study in which 30 patients, who were hositalized for permanent pacemaker implantation for the first time in Tehran heart center during 3 years, including 12 women [mean age 62.92 years] and 18 men [mean age 60.07 years], were tested for urinary specific gravity and sodium, blood pressure, blood sodium and potassium, before and after pacemaker implantation. Paired sample T test and Chi Square test were used for statistical analysis. Systolic blood pressure was 136.5 mmHg and 120.6 mmHg before and after pacemaker implantation, [P< 0.001]. Also, after pacemaker implantation, urinary sodium rose from 83.45 meq/L to 106.61 meq/L [p=0.018]. This study is consistent with previous studies, which showed hemodynamic changes after permanent pacemaker implantation including decrease in blood pressure and elevation of serum neuropeptides

Seroprevalence of herpes simplex virus types 1 and 2, Epstein-Barr virus, and cytomegalovirus in children with acute lymphoblastic leukemia in Egypt

Viral infection, especially caused by herpes viruses, is now recognized as an important cause of morbidity and mortality in immunocompromised cancer patients. This study aimed at studying seroprevalence of 3 herpes viruses Herpes simplex virus types 1 and 2 [HSV 1 and 2], Epstein-Barr virus [EBV], and cytomegalovirus [CMV] in children with acute lymphoblastic leukemia [ALL]. We conducted this study on 68 newly diagnosed pediatric patients with ALL presented to the Pediatric Oncology Service of National Cancer Institute, Cairo University, Egypt from November 2001 to June 2003. We used enzyme-linked immunosorbent assay in detecting HSV 1 and 2, CMV, EBV antibodies of both types immunoglobulin [Ig] M and IgG detection of DNA for both CMV and EBV by polymerase chain reaction was carried out. High seroprevalence of HSV-1 and 2, CMV and EBV IgG antibodies in both leukemic children and their control was observed [69%, 100%, 83%] and [80%, 100%, 95%]. Significantly higher percentage of HSV-1 and 2 IgM or reactivated infection was found among leukemic children 17/68 [25%] compared with normal control 0%. Analysis showed that prevalence of HSV 1 and 2 IgG increased from 18/33 [54%] in children <5 years to 11/13 [77%] in children >10 years, and reactivation of HSV-1 and 2 increased with increasing age from 1/33 [3%] in children <5 years to 4/13 [30%] in children >10 year. This was in contrast to seroprevalence of CMV and EBV IgG which were 100% and 83% in children <5 years. No difference in seroprevalence was found among both gender, and no difference was found in leukemic patients with granulocytopenia. The data show a higher exposure to HSV-1 and 2 both primary infections and reactivation among ALL children. Therefore, acyclovir prophylaxis could be highly effective for seropositive leukemic patients who are undergoing induction chemotherapy

p53 Mutation in HCV-genotype-4 associated hepatocellular carcinoma in Egyptian patients

HCV-associated hepatocellular carcinoma [HCC] is a common neoplasm in Egypt where genotype-4 is prevalent. In the present study the incidence and pattern of p53 mutations was assessed in relation to HCV-genotype-4 in Egyptian HCC patients. We investigated 25 HCV positive HCCs for p53 mutations over expression in relation to HCV-N53 by immunohistochemistry, SSCP and sequencing. Genotyping was done using LiPA-Il and TRUGENE 5 NC sequencing kit. Results were correlated to standard clinicopathologic prognostic factors for HCC. Thirteen cases showed p53 overexpression, and 10 showed p53 mutation [13 mutations] by sequencing [72% concordance]. The highest mutation rate was in exons 6 and 7 [30%] followed by exons 5 and 8 [20%]. Mutations included 3 transitions, 5 transversions, 3 deletions, and 2 insertions. All exon 7 mutations were at codon 249 specific for AFB1 [AGG-AGT, Arg-Ser] and codon 248 specific for vinyl chloride contamination [CGG-TGG, Arg-Trp]. Other mutations reported are novel. Immunostaining for HCV N53 was detected in 19 cases independent of p53 mutation. p53 aberrations were significantly associated with poor prognostic factors for HCC. However, no specific pattern for p53 mutations was observed in HCV genotype 4-associated HCC and no significant relation between p53 mutations, HCV-N53 expressions or any HCV sub-genotype-4 sequence

Hepatitis Cvirus infection in non hodgkin's lymphoma patients: virological evaluation

Viral hepatitis is a common and important problem in immunocompromised cancer patients. The present study was conducted to investigate changes in some virological parameters as a consequence of Hepatitis C Virus [HCV] infection in non Hodgkin's lymphoma patients [NHL]. The Pediatric Service of the National Cancer Institute, Cairo University, Egypt. The study included 40 NHL patients: 20 anti-HCV antibody positive [Gr. I] and 20 anti-HCV antibody negative [Gr. II]. In addition, forty non-cancer controls [NCCs] were included: 20 of them were anti-HCV antibody positive [Gr. Ill] and 20 anti-HCV antibody negative [Gr. IV]. Virological studies included detection of HCV antibody [Ab] of both types [IgG and IgM] by ELISA. In addition. Line Immunoassay for HCV by LIA test as well as RT-PCR to detect HCV viremia were done. Eleven out of the twenty [55%] NHL patients from Gr. I had HCV antibody index value of > 6 in comparison to 8/20 [40%] only in their non-cancer controls. No difference was observed between the positivity of anti-HCV IgM Ab in NHL patients from Gr. I and their non-cancer controls in Gr. Ill; eleven out of 20 [55%] were positive for anti-HCV IgM Ab in both Gr. I and Gr. III. As regards confirmatory HCV-Ab patterns [LIA], nineteen out of 20 [95%] NHL patients of Gr I were LIA positive in comparison to 18 out of 20 [90%] NCCs of Gr. III. Further analysis showed that reactivity to both core and nonstructural regions combined was more frequent in NHL patients [18/19, 95%] than in their non-cancer controls [12/18, 67%]. HCV viremia was displayed by RT-PCR in 18 out of 20 [90%] NHL patients of Gr. I in comparison to 12 out of the 20 [60%] NCCs of Gr. III. From all the above virological findings two main inferences could be drawn: [1] HCV leads a mild course of infection in NCCs as evidenced by normal ALT level in all but 20% [4/20] of subjects, and hence a mild hepatocellular injury, and [2] In the immunocompromised NHL patients the virus leads a potentially more aggressive course as evidenced by higher percentage of positive HCV RNA in blood, higher .HCV-Ab titer and higher incidence of reactivity to both core and NS regions[s]

Genetic distance and heterogenecity between quasispecies is a critical predictor to IFN response in Egyptian patients with HCV genotype-4

HCV is one of the major health problem in Egypt, where it is highly prevalent. Genotype 4 is the most common genotype of HCV and its response to treatment is still a controversy. HCV genotype 4 quasispecies diversity within the 5' untranslated region [5'UTR] was studied in a series of 22 native Egyptian patients with chronic hepatitis C virus with no previous treatment who satisfied all NIH criteria for combined treatment of pegylated IFN and ribavirine and was correlated with the outcome of treatment. The study also included 7 control patients with no antiviral treatment. HCV sequencing was done using the TRUGENE HCV 5-NC genotyping kit. At the 48[th] week of treatment, 15 patients [68%] showed virological response. Whereas HCV-RNA was still detected in 7 patients [32%] in this period; of those, 6 experienced a partial virological response followed by viral breakthrough during treatment. Only one patient did not show any virological or chemical response. The four females included in this study were all responders. There was a significant correlation between the response rate and lower fibrosis [p=0.026] as well as the total number of mutation spots [including all the insertions, deletions, transitions and transversions] [p=0.007, p= 0.035]. Patients who responded to interferon treatment had statistically significant less number in both transitions [p=0.007] and the genetic distances between the quasispecies [p= 0.035]. So, viral genetic complexity and variability may play a role in the response to IFN treatment. The consensus alignment of all three groups revealed no characteristic pattern among the three groups. However, the G to A transitions at 160 was observed among non responders who need further study to confirm this observation

Intracerebral hemorrhage: presentation, early morbidity and mortality

To study the mode of presentation, risk factors, early morbidity and mortality of patients presenting with intracerebral hemorrhage [ICH] to a General Neurology Unit This study was conducted at Lady Reading Hospital from January 2001 up to December 2001 on patients with confirmed ICH. Traumatic bleed was excluded from the study. After initial clinical assessment Glasgow coma scouring was done in all patients and the morbidity was assessed by modified ranking scale [MRS]. Patient's MRS was recorded at the time of discharge and at one month follows up. Out 74 patients [46 male and 25 female] 33 patients presented with headache and 30 patients had vomiting. Twenty patients had GCS /= 10. Five patient developed obstructive hydrocephalus which needed surgical intervention. Thirty nine patients had severe disability at the time of discharge. After a follow up of one month, 32 patients had improved, 17 patients were in status queue while two patients had deteriorated. Six patients died in the hospital and 04 patients died at home while 13 patients were lost to follow-up. High mortality was seen in patients with GCS

Seasonal variation in bacterial pathogens isolated from stool samples in Karachi, Pakistan

To determine the seasonal variation of the commonly isolated bacterial pathogens in stool samples. A retrospective descriptive study was undertaken of all the stool samples submitted from within Karachi to the Aga Khan University Hospital Laboratory over a period of five years [January 1997- December 2001] in order to determine the commonly isolated bacterial pathogens and to predict their seasonal variation. A total of 16379 stool samples were included in this review. Bacterial isolates were found in 6670 stool samples [culture detection rate=40.7%]. The mean age at the time of culture of each sub-group was <1 year group [6.58 +/- 3.1 months], 1-5 years [2.13 +/- 0.94 years], 5-14 years [8.3 +/- 2.6 yrs] and adults [43.2 +/- 18.5 years]. Male: Female ratio was 1.2:1. Vibrio cholera 01 Ogawa [32.8%], Campylobacter jejuni [17.3%], Enteropathogenic Escherichia coli [9.9%], Salmonella paratyphi b [6.6%] and Shigella flexneri [6.2%] were the most common organisms isolated. These organisms show a distinct seasonal variation with summer predilection. In contrast to the previous studies from South Asia, which have identified E. coli, followed by Vibrio cholerae as the most common enteric isolates, we found Vibrio cholera 01 Ogawa followed by Campylobacter jejuni as the most common enteric pathogens isolated in an urban setting. It is important to consider seasonal variation when empirically treating diarrheal diseases in our region

Serum inhibin as predictor marker of pre echampsia

This work was done on 150 pregnant women. Serum inhibin was measured to assess the use of inhibin level as a sensitive predictor of preeclampsia and its relation to the clinical presentation. Inhibin level was significantly higher among mild preeclampsia group than severe preeclampsia and the control groups. However, its level among severe preeclampsia group was significantly higher than the control group. So, it can be used as a sensitive predictor for preeclampsia

Structure, composition and above ground standing phytomass of some grass dominated communities of Karachi: summer aspect

Some 120 species [83 dicotyledons and 37 monocotyledons] were seen growing naturally to make summer aspect of 22 grass dominated sites of Karachi, Pakistan. They have high percentage of therophytes [43.3%] followed by chamaephytes [30%]. Legumes were present invariably in all sites except that of Urochondra setulosa. The number of species in a site varied with the nature of site and its salinity status. The above ground standing biomass [AGSP] varied with species dominating the site [49.6 to 908 g/m[2]]. On phytomassbased quantitative spectrum, hemi-cryptophytes and sometimes geophytes [protected forms] were the dominant. The number of legume species varied as a function of number of grasses in a site. The litter component related positively with AGSP [r = 0.7175] and the percent proportion of legume biomass [PPLB] associated inversely with percent proportion of grass biomass [PPGB] [r = -0.6566] The more diverse communities of non-saline habitats appeared to be approaching to log-Normal distribution of biomass among the species whereas the distribution of biomass in less diverse communities of saline habitats was distinctly geometric. Twelve community types, recognized on the basis of 40% biomass-based compositional similarity, in accordance with the decreasing AGSP magnitude may be arranged as follows: Cenchrus setigerus > Desmostachya bipinnata=Urochondra setulosa > Lasiurus scindicus > Dichanthium annulaturn = Sporobolus arabicus > Aeluropus lagopoides > Sporobolus halvolus > Chrysopogon aucherii > Dactyloctenium scindicum > Aristida mutabilis > Sporobolus coromendelianus. Edapho-topographic relations of these communities are described. When stability was evaluated through life-span consideration of species, diversity-stability relations appeared to be negative. Salt marsh communities were more stable than those of the salt free habitats. The results are discussed in ecological context