Effect of eradication of helicobacter pylori infection on the platelet counts in patients presenting with idiopathic thrombocytopenic purpura

Background: Idiopathic thrombocytopenic purpura [ITP] is a rare autoimmune disease characterized by the platelet destruction that is autoantibody mediated, and there is suboptimal platelet production in the absence of a known cause, this leads to decreased peripheral blood platelet counts or thrombocytopenia and Helicobacter pylori has direct association with ITP. The aim of this study was to see the platelet recovery in patients of ITP after the H. pylori infection eradication

Methods: This was a case control study and 120 ITP patients who tested positive for H. pylori [divided into age and sex matched treatment and the control groups] were enrolled from the outdoor patients [OPD] of Sheikh Zayed Medical Complex. Stool antigen [HpSA] enzyme immunoassay method [EIA] method was used for H. pylori detection

Results: The response of the platelet count in the treatment group was a 'complete response' in 35 [60.3%] patients, a partial response in 16 [27.6%] patients and no response was found in 7 [12.1%] cases. However, no remarkable change was seen in the platelet counts of the patients in the control group

Conclusion: Complete eradication of H. pylori helps in the recovery of H. pylori induced platelet reduction and detection and eradication of H. pylori infection should be considered in the work-up of patients with ITP

Left atrium volume as a surrogate marker of left ventricular diastolic dysfunction

Objective: To determine correlation between left atrial volume and left ventricular diastolic dysfunction

Methodology: This was a single center observational study conducted at Lady Reading Hospital, Peshawar. Patients above 18 years of both genders, who were in sinus rhythm and having no significant systolic dysfunction or significant mitral insufficiency on echocardiography, were included in the study, using purposive non-probability sampling technique. A total 339 patients underwent transthoracic echocardiography from July 2013 to June 2014. Detailed cardiac echocardiography was performed to determine left atrial volume, ejection fraction, E and A velocities, deceleration time and e've-locity, E/e

Results: A total of 339 patients were studied. Male were 61.9%. Mean age of study population was 58.42 +/- 10.48 years. Baseline characteristics of patients having some degree of diastolic dysfunction were; mean age 65.5 +/- 12.3, mean body mass index 25.2 +/- 2.5 kg/m2, mean ejection fraction 55.1 +/- 7.5%, hypertension 48.6%, diabetes mellitus 10.1% and left ventricular hypertrophy 38.6%. Echocardiographic findings in diastolic dysfunction patients were as follow: mean left atrial volume was 65.3 +/-10.1 ml, E/A 1.4 +/- 0.6, TDI e' was 6.7 +/-1.3 m/sec and TDI E/e' was 12.7 +/- 2.1. Increasing left atrial volume was well correlated with increasing severity of left ventricular diastolic dysfunction [y = +0.8, Spearman rank correlation]

Conclusion: Increase in left atrial volume is directly correlated with severity of diastolic dysfunction. Severity of diastolic dysfunction increases with increased left atrial volume

Comparative efficacy of prolene and prolene-vicryl composite mesh for experimental ventral hernia repair in dogs

In this study, efficacy of two hernia mesh implants viz. conventional Prolene and a novel Prolene-Vicryl composite mesh was assessed for experimental ventral hernia repair in dogs. Twelve healthy mongrel dogs were selected and randomly divided into three groups, A, Band C [n=4]. In all groups, an experimental laparotomy was performed; thereafter, the posterior rectus sheath and peritoneum were sutured together, while, a 5 × 5 cm defect was created in the rectus muscle belly and anterior rectus sheath. For sublay hernioplasty, the hernia mesh [Prolene: group A; Prolene-Vicryl composite mesh: group B], was implanted over the posterior rectus sheath. In group C [control], mesh was not implanted; instead the laparotomy incision was closed after a herniorrhaphy. Postoperative pain, mesh shrinkage and adhesion formation were assessed as short term complications. Post-operatively, pain at surgical site was significantly less [P<0.001] in group B [composite mesh]; mesh shrinkage was also significantly less in group B [21.42%, P<0.05] than in group A [Prolene mesh shrinkage: 58.18%]. Group B [composite mesh] also depicted less than 25% adhesions [Mean +/- SE: 0.75 +/- 0.50 scores, P

Clinical Presentation of Left Atrial Myxoma in Relation to Anatomic and Pathologic Type.

Background: Atrial myxoma is the most common benign cardiac neoplasm. Most of the case series have focused on the variable clinical presentation of myxoma rather than its gross and microscopic features. The objective of our study was to evaluate prevalence of different morphologic types of myxoma and to correlate with their clinical presentations. Methods: 68 patients were included in the study. The study population was divided into two groups- Group-A (n-18) patients having soft (papillary) tumor in the left atrium, Group B (n=50) patients having solid tumor in the left atrium. Results: 88.3% patients suffered illness more than 12 months. 92% of the solid myxomas were located in the septal wall compared to 55.6% of the papillary myxomas (p = 0.031), while one-third (33.3%) the papillary tumors were found in the left atrial free wall compared to only 4% of the solid myxomas (p = 0.048). Fever, congestive heart failure and dyspnoea were significantly predominant in patients with solid myxomas (72% vs. 44.4%, p = 0.036; 92% vs. 22.2%, p < 0.001 and 88% vs. 55.6%, p = 0.010 respectively). Atrial fibrillation and neurologic manifestations were more frequently encountered in the papillary myxoma group. No statistically significant difference was found between the groups (p>0.05) by postoperative complication during in hospital follow up but one mortality in each group. Conclusion: Our findings lend support to the view that different gross left atrial Myxoma tumor types and tumor location predict presentation.

Chemical characterization of Siloraneby Ftir and Raman spectroscopy

Background: Silorane, introduced to the dentistry recently. It is named after the functional groups present in the material i.e. Siloxane and Oxirane. It is introduced in the market to overcome the main problems of composite resins i.e. Polymerization shrinkage. Claims are being made that the polymerization shrinkage have been overcome in the material and the material results in less than 1% polymerization shrinkage. The material claims to have properties which may fulfil the criteria of being the ideal restorative materials of all times

Objective: To confirm the presence of Siloxane and Oxirane in the chemical structure of the Silorane by Fourier Transform Infra-red [FTIR] and Raman Spectroscopy

Methods: Solvation of Silorane was done in Tetrahydrofuran [THF] using the magnetic stirrer. After the evaporation of THF, the resultant powder was then evaluated under the FTIR and Raman Spectroscopy

Results: The FTIR spectrum of Silorane shows some primary reference bands in the spectrum of Silorane and shows the absorption of primary oxirane bands. The peaks indicated the presence of Siloxane bands and CH groups. Raman spectrum of Silorane confirming the presence of _ phase of Siloxane. The peaks show the presence of O-Si-O and C = C group

Conclusion: The FTIR and Raman spectrums confirms the presence of Siloxane and Oxirane bands which results in low polymerisation shrinkage due to the cationic ring opening mechanism when compared with methacrylates which polymerises via a free radical mechanism

Spectrum of diseases in acute intestinal obstruction

To determine the etiological spectrum of acute intestinal obstruction in our clinical setup Military Hospital Rawalpindi. Descriptive study. Surgical department of Military Hospital, Rawalpindi from Jul 2012 to Jul 2013, over a period of about 1 year. A total of 120 patients with acute mechanical intestinal obstruction who underwent laparotomy were included in our study while those with non-mechanical intestinal obstruction like history of trauma and paralytic ileus were excluded from the study. All the patients were selected by non-probability purposive sampling technique. Emergency laparotomy was done and operative findings were recorded. A total of 120 patients with mechanical intestinal obstruction were included in this study out of which 93 [69.17%] were female and remaining 27 [30.83%] were males. Male to female ratio was 1:2.24. Age range of patients was 22-85 years. Out of 120 patients operated for acute intestinal obstruction post-op adhesions were found in 37 [30.83%] patients followed by intestinal tuberculosis in 23 [19.17%] patients, obstructed inguinal hernias in 13 [10.83%], gut malignancies in 15 [12.5%], Meckel's diverticulum with bands in 7 [5.83%], volvulus in 7 [5.83%], perforated appendix in 6 [5%], intussusception in 2 [1.7%], inflammatory bands in 5 [4.17%], trichobezoar and faecal impaction in 2 [1.7%] while in 3 [2.5%] patients no definite cause was found. Post-op adhesions are the commonest cause of mechanical intestinal obstruction in our setup followed by intestinal tuberculosis as second most common clinical pattern of presentation

Outcome of Early Surgical Intervention in Acute Lower Limb Ischemia due to Thromboembolism.

Background: Acute lower extremity ischemia is a common vascular disease and considered limb- and life- threatening. The present study evaluated and compared the outcome of early and late surgical intervention in acute lower limb ischemia due to thromboembolism. Methodology: This non randomized comparative parallel study was conducted at the Department of Cardiovascular Surgery, NICVD, Dhaka, Bangladesh from January 2007 to December 2008 for duration of two year. Total 80 patients were enrolled in this study. The patients were divided into equal two groups, Group A, for early surgical intervention (with in 24 hours) and Group B, late surgical intervention (more than 24 hours). Results: Mean (±SD) age of both Group A and Group B was 51.93 (±11.73) and 47.00 (± 11.01) years. Male and female ratio of the total study population was 1.76:1 Pain and absence of pulse distal to occlusion was common for all. Cold extremity, sensory deficit, motor deficit, diminish vascular flow was the commonest findings of both group. In Group A, 57.5% had superficial femoral artery occlusion, 22.5% had iliac artery and 20.0% popliteal artery occlusion. In Group B, 42.5% had superficial femoral artery occlusion, 32.5% had popliteal artery occlusion and 25.0% had iliac artery occlusion. Fasciotomy was performed in 15.0% patients of Group A and in 22.0% patients of Group B. After Fogarty embolectomy in group A and group B had warm extremity (80.0% vs. 65.0%), pulsation distal to occlusion (90.0% vs. 75.0%), intact sensory function (82.5% vs. 67.5%), intact motor function (80.0% vs. 65.0%), and normal vascular flow by Doppler US (80.0% vs. 65.0%). During postoperative period history of bleeding, infection, reperfusion injury, muscle necrosis and limb amputation were 12.5% vs. 10.0%, 5.0% and 7.5%, 17.5% vs. 35.0%, 15.0% vs. 12.5% and 37.5% vs. 32.5% respectively. Conclusion: Duration of embolism may be the significant factor determining the outcomes of the management of acute arterial embolism in the lower extremities. The 24- hour duration of arterial embolism is a crucial factor influencing the surgical the management and early diagnosis and shifting of patients to specified centre as early as possible to save limb as well as life.

Effect of hypothyroidism on lipid profile in asymptomatic newly diagnosed patients

Hypothyroidism is a very common endocrine problem. It can be either overt or subclinical. Subclinical hypothyroidism predisposes to overt hypothyroidism. Hypothyroidism leads to hypercholesterolaemia because of reduced activity of lipoprotein lipase and thus increases the cardiovascular risk. The objective of this study was carried out to find the lipid profile in hypothyroid patients in asymptomatic previously undiagnosed cases and to correlate different components of lipid profile with TSH and ft[4]. This is a case control study consisting of 82 hypothyroid patients with age and gender matched controls selected through convenient sampling from Chemical Pathology Department, Army Medical College, Rawalpindi and National University of Sciences and Technology [NUST], Islamabad between May and October 2012. Data were recorded using specially designed pro forma and analysis was carried out on SPSS 17. Among the 82 hypothyroid patients, 62 were females while 20 were males. Mean age of patients was 40.6 +/- 11.7 years. Hypothyroid patients showed a dyslipidaemic picture and all the components namely total cholesterol, triglycerides, low density lipoprotein and high density lipoprotein were significantly raised when compared with the controls. TSH showed significant positive correlation [p value] with total cholesterol, low density lipoprotein and high density lipoprotein. Hypothyroid patients show a dyslipidaemic picture, thus increasing the risk for cardiovascular complications. A hypothyroid patient must be screened for lipid abnormalities, while in case of unexplained hyperlipidemia, thyroid screening must be performed

Estimation of phytochemicals and antimicrobial activities of mentha spicata from southern districts of KPK.

The medicinal value of the plant is due to the phytochemical constituents they produce, which exhibit certain physiological actions on human body. Phytochemicals are plant derived chemical compoundS, which are non-essential nutrients, some of which show potential health promoting properties. The phytochemical constituents were determined by using known literature method while the antimicrobial activity was analyzed by classical literature methods. In case of phytochemicals, Tannin, Alkaloids, Glycosides, Flavonoids, Steroids, Coumarines, Sterols and Terpenes were found while saponins and anthraquinones were not determined in all the samples. Antibacterial activity was noted high in all the samples of crude extract followed by ethyl acetate and lowest activity was found was found in aqueous extract of Mentha spicata. The Same results were analyzed for antifungal activity.

Comparison of Phytochemical constituents and antimicrobial activities of Mentha spicata from four northern districts of Khyber pakhtunkhwa.

The medicinal value of plants lies in bioactive phytochemical constituents that produce definite physiological actions on the human body. Some of the most important bioactive phytochemical constituents are Tannin, Alkaloids, Saponins, Flavonoids, Steroids, Anthraquinones, Coumarins and Sterols and Terpenes. Infectious diseases are the leading cause of death worldwide, accounting for nearly one half of all deaths in tropical countries which are also becoming a significant problem in developed countries. Therefore the present study was aimed to analyzed the phytochemicals and antimicrobial activities of Mentha spicata. The phytochemical constituents were determined by using known literature method while the antimicrobial activity was analyzed by classical literature methods. In case of phytochemicals, Tannin, Alkaloids, Glycosides, Flavonoids, Steroids, Coumarines, Sterols and Terpenes were found while saponins and anthraquinones were not determined in all the samples. Antibacterial activity was noted high in all the samples of crude extract followed by ethyl acetate and lowest activity was found was found in aqueous extract of Mentha spicata. The Same results were analyzed for antifungal activity.

Hepatoprotective and therapeutic effect of Muravvaq of Mako on rifampicin-induced hepatotoxicity in rats just after rainy season [August-September]

The efficacy of Muravvaq of Mako [Frothless juice of Aolanum nigrum leaves] to control hepatic damage induces by Rifampicin was studied in Wistar albino rats. Rifampicin was administered orally as suspension to rats with a daily dose of 50 mg/kg body weight till 30 days with Muravvaq of Mako in concurrent group. In the second phase of study the effect of Muravvaq on established hepatotoxicity was studied by giving it for 20 days after withdrawal of Rifampicin. Hepatic dysfunction was assessed by biochemical and histological parameters. A significant increase observed in serum bilirubin, SGOT, SGPT and Alkaline phosphatase levels in negative control groups. However, there was a significant reduction in increased enzymatic levels in concurrent and treated group of rats, which received Muravvaq alongwith Rifampicin for 30 and 50 days, respectively. Histopathological analysis of liver samples also confirmed the hepatoprotective effect of Muravvaq. These results suggest that Muravvaq of Mako shows hepatoprotective effect against Rifampicin-induced hepatic damage in rats. The study was done in two different seasons, just after rainy [August-September] and in autumn season, to assess the efficacy of seasonal variation

Renoprotective effects of combining ACE inhibitors and statins in experimental diabetic rats

The combination of angiotensin II receptor antagonists and HMG CoA reductase inhibitors have shown to confer renoprotection.The purpose of this study was to find out the renoprotective effects of telmisartan and atorvastatin in combination and in monotherapy of Streptozotocin [STZ] induced diabetic nephropathy in rats. Diabetes was induced by i.p injection of STZ to rats, after 18 hrs of fasting. Diabetic rats were randomly grouped and treated with telmisartan and atorvastatin in combination as well as monotherapy for 30 days. The serum and urine glucose, creatinine and serum triglyceride, cholesterol, albumin and micro-albumin and blood urea nitrogen, total protein and histological analyses of the left kidney were performed at the end of the study. By the end of the study, the combination showed significant [P < 0.05] improvement in urine glucose, serum cholesterol, serum and urine creatinine, blood urea nitrogen, total protein, serum albumin, micro-albuminuria levels in comparison to monotherapy. However, this combination didn't show significant changes on serum glucose and triglyceride levels. Kidney pathological injury was attenuated by the combination as compared to the diabetic group. The present study document that, telmisartan and atorvastatin combination have better renoprotective effects but not with individual drug when compared to the diabetic group. The combination also attenuated the progression of diabetic nephropathy by slowing the proteinuria and microalbuminuria and these effects were confirmed by histopathological analysis

Homology modeling and active site analysis of leptin receptor of homo sapiens involved in obesity.

The discovery of leptin has initiated a flurry of research into the molecular basis of weight control. In obese people levels of leptin found in the blood are normally very high and more than sufficient to suppress the appetite and increase the metabolism. This however does not happen and it is believed that obesity may be the result of a resistance to leptin. This suggests that the problem in these individuals may be related to a lack of binding of the leptin protein to its receptor. No known structure of leptin receptor is known. Therefore in present the present study we model the 3D structure of leptin receptor using MODELLER. This was done using the template GP130 of H. sapiens (PDB code: 1BQU). On the basic of results MODEL 6 was selected as the best model. The observed G-factors for the present model were -0.22 for dihedrals, -0.32 for covalent and overall -0.25. The MODEL 6 contains 88.7% of the residues in the most favored region, 11.3 % in the additional allowed and no single residue in generously allowed regions and disallowed region. The predicted model was further analyzed to locate the residues in the active sites those provide interactions with the ligand.

Effect of prostaglandin F[2] alpha and indomethacin on the rabbit ileum; invitro study

The smooth muscle of gastrointestinal tract undergoes almost continuous but slow electrical activity. This activity tends to have two basic types of electrical waves. Slow electrical waves are generated in the longitudinal muscle layer of small intestine and are not found in the circular muscle in the absence of longitudinal muscle. The other waves are peristaltic waves which are a reflex response. The purpose of the study was to deal with the mechanism of action involved in determining the therapeutic potential ofPGF2a and its antagonist in gastrointestinal motility. Rabbits of equal weights were brought from the animal house of BMSI and sacrificed in the Pharmacology Research laboratory. Ileum strips were isolated and with a special recommended methodology, longitudinal and circular muscles were separated. Individual muscle strips were then exposed separately to the desired drugs in the organ bath and readings were recorded on the polygraph machine. The study was performed at Basic Medical Sciences Institute, Jinnah Postgraduate Medical Center, Karachi from 1996 to 1998. PGF[2]alpha decreases the contractile effects of longitudinal muscles whether applied before or after the antagonist whereas in circular muscle it increases the amplitude of contraction. Indome-thacin antagonizes the effects of PGF[2]alpha in both longitudinal and circular muscle. Secondly when indomethacin applied directly it causes reduction in the amplitude of contraction in longitudinal muscle and increase in the force of contraction in circular muscle. Prostaglandin has a definite role on the smooth muscle ofileum; hence can be used in the regulation of intestinal motility. New drugs as an analogue or as an antagonist can be developed on the basis of these results

Physico-chemical standardisation of market sample of zufa khushk [agastache urticifolia]

In Unani system of medicine Zufa Khushk is in medicinal use since ancient times. There is controversy in botanical identity in between the two plants of same family [Labiatae]. Commonly available Zufa Khushk in north Indian market is botanically identified as Agastache urticifolia [Benth] Kuntze [Giant Hyssopus] but it has been described by some latest authors of Unani literature as Hyssopus officinalis [Common Hyssopus] and standardization of its flower has also been carried out by them. Keeping in view the necessity to provide pure and genuine drug to the patients for better efficiency of the prescribed drug, standardization of the sample drug has been carried out and revealed that actual botanical source of Zufa Khushk is Agastache urticifolia of Labiatae. It has also been studied that in spite of its aromatic nature, the market sample of Zufa Khushk was free from volatile oil

review of medicinal plants exhibiting potential anti-ulcer activity

Plants have been used for medicinal purposes from the time immemorial. Medicinal plants are an indispensable source of new chemical substances with potential therapeutic effects. Their chemical compounds may serve as lead for the development of new drugs. In the present communication a review of the plants exhibiting antiulcer activity is presented

Effect of Muravvaq of Mako, Muravvaq of Kasni and Muravvaqain on hepatotoxicity induced by rifampicin in rats just after rainy season [August-September]

To assess the hepatoprotective activity of Muravvaq of Mako, Muravvaq of Kasni and Muravvaqain frothless juice of Mako [Solanum nigrum] leaves, and Kasni [Cichorium intybus] leaves and collectively leaves of both plants on Rifampicin-induced hepatotoxicity in Wistar albino rats. Hepatotoxicity was induced in rats by Rifampicin given orally as suspension for 30 days. Concurrent group received Muravvaq of Mako, Muravvaq of Kasni and Muravvaqain alongwith Rifampicin. In the second phase of study the effect of Muravvaq of Mako, Muravvaq of Kasni and Muravvaqain on established hepatotoxicity was studied by giving the Muravvaq of Mako, Muravvaq of Kasni and Muravvaqain for 20 days after withdrawal of Rifampicin. Hepatic dysfunction was assessed by biochemical and histological parameters. Muravvaq of Mako, Muravvaq of Kasni and Muravvaqain significantly [p<0.05] prevented changes in the serum levels of bilirubin, SGOT, SGPT and SALP. Similarly it significantly prevented the histological changes as compared to the group receiving Rifampicin. It also significantly reversed the biochemical and histological changes

prevalence of tobacco consumption in youth of Karachi, Pakistan - a pilot study

The aim of this study is to explore the prevalence of tobacco consumption in young people and observe its association with second hand smoking. It is a pilot study conducted in Karachi, Pakistan. Following are the objectives of this study: This pilot study will help to proceed with conducting validated Global Youth Tobacco Survey [GYTS] in Karachi using standard methodology in future. It will also establish current and life time prevalence of smoking in young people of Karachi, Pakistan. To study correlation between young people consuming tobacco and the effect of environmental tobacco smoke [second hand smoking]. A cross sectional study was conducted in a private school in Karachi. School was selected through convenience sampling. The sample consisted of 76 students both boys and girls had equal opportunity to participate in the survey. A Validated GYTS questionnaire was used. The current prevalence of smoking is 16% while the students who ever smoked is 41% which is comparatively high to other Global Youth Tobacco Survey [GYTS] conducted in other cities in Pakistan, The results matched with GYTS Eastern Mediterranean Regions which reports 15.3% as current smokers. Environmental tobacco smoke or second hand smoking reported was statistically significant. In this study environmental tobacco smoke [ETS] second hand smoking has been considered as an associated factor and has correlation with tobacco consumption in young people in Karachi. Further research is needed by conducting GYTS using the standard methodology and tobacco awareness programmes need to be integrated in health promoting schools to reduce the ETS

Medicinal plants as potential sources of drugs for cardiovascular diseases traditional and mineral approaches

Nature has provided man with herbal medicine suiting different conditions and climate. These herbs or medicinal plants have been used in traditional system - or folklore system of medicine for centuries. Traditional system of medicine have provided lead over many of the important drugs used in the modern medicine. Perhaps all basic principles pertaining to human therapy have been derived from plants. Phyto-chemical investigations of these medicinal plants show the presence of flavonoids, glycosides, essential oils, bioactive terpenoids and minerals. For the last few decades great deal of work has been done on pharmacological activity of the organic constituents of these plants but role of minerals in health and disease has attracted attention only recently. Scientific research has established the fact that the relative concentration of several trace elements in the body are altered in all diseases. Possible role of few trace elements are discussed in Table 1. In the present work, three medicinal plants used in cardiovascular diseases in the Unani system of medicine were analyzed for their elemental composition and effectiveness of these drugs have been discussed from traditional, phytochemical and elementological point of view

Trace elements in the fruit of ficus carica L. and their nutritional importance

Fruit pulp of Ficus carica was analyzed for the presence of inorganic trace elements with the help of Atomic Absorption Spectrophotometer. Sixteen elements such as P, Ca, Mg, K, Na, Fe, Cu, Ni, Co, Ba, Zn, Cr, Mn, Sr, Cd and Al were detected in the water extract of fruit pulp of F. carica by this method. Phosphorus, calcium, magnesium, potassium, sodium and iron were found to be in larger quantities than other ten trace elements. The amount of the trace elements obtained were also compared with the recommended daily requirements for human beings. The amounts of these elements obtained from the fruit pulp of Ficus carica were found to be closely correlated with the recommended daily requirements for human beings