Clinical and echocardiographic features of children with rheumatic carditis: correlation with high sensitivity C-reactive protein

Rheumatic fever [RF] and rheumatic heart disease [RHD] are leading causes of cardiovascular mortality and morbidity in developing countries. To describe the clinical and echocardiographic features of children with RF and RHD and compare these features with their serum C-reactive protein in 2 pediatric cardiology centers in Khartoum. It was a prospective cross sectional study. Patients were examined clinically and by echocardiography. Serum high sensitivity C-reactive protein [hsCRP] was measured from children with Acute RF as well as from healthy age and sex matched controls selected from children attending the clinics. Statistical Analysis Used: Mean and standard deviation, P value using Fisher's exact test. Sixty six patients [45% males] were enrolled. Mitral regurgitation [MR] was found in 65 patients [98%], it was severe in 42 patients [64%], combined with aortic regurgitation [AR] in 27 patients [41%] and with Mitral stenosis [MS] in 3 patients [4.5%]. For patients with carditis, hsCRP ranged between 1.10 and 15 mg/1 [mean 8.0817, SD 4.47]. In the control group it was 0.6-1.3 mg/1 [mean 0.93 SD 0.23] P<0.0001.Patients with Acute RF had hsCRP mean of 12.35 mg/1 [SD 2.11] while those with chronic RHD had hsCRP mean of 7.34 mg/1 [SD 4.16], P<0.0001. RHD is manifested in our patients with severe valve damage dominated by MR and there is evidence of an ongoing inflammation during the chronic phase. RHD is manifested in a severe form in Sudan. High sensitivity CRP is elevated in acute phase as well as in the chronic phase

Spectrophotometric and spectrofluorimetric determination of 1,4-dihydropyridine drugs using potassium permanganate and cerium [IV] ammonium sulphate

Simple and sensitive spectrophotometric and spectrofluorimetric methods have been developed for determination of 1, 4-dihydropyridine [1, 4-DHP] drugs based on the oxidation of the investigated 1, 4-DHP drugs with acidic KMnO4 [method I] or Ce [IV] [method II]. The first method is based on the decrease in the colour of the permanganate solution due to the presence of the studied drug was measured at 525 nm. And the second method is based on monitoring the fluorescence of the produced cerium [III] at emission 355 nm [excitation at 255 nm]. All variables that affect the performance of the proposed methods were carefully studied and optimized. The analytical performance of the methods was validated according to International Conference of Harmonization guidelines. The proposed methods were applied successfully to the determination of the drugs in commercial tablets and capsules. The results of the proposed procedures were statistically and compared with those obtained by the reference methods

Effect of cardiopulmonary bypass on the pharmacokinetics of intravenous paracetamol

Recently, intravenous paracetamol [propacetamol] is commonly in use as analgesic and antipyretic after surgery. The pharmacokinetics of intravenous paracetamol in patients undergoing cardiac surgery with cardiopulmonary bypass [CPB] were not previously described. This study was designed to investigate the effect of CPB on the pharmacokinetics of single intravenous dose of paracetamol in adult patients. Experimentally, nine patients undergoing coronary artery bypass graft surgery with cardiopulmonary bypass using mild hypothermia were selected. Intravenous propacetamol [2 g] was infused over 10 min and arterial samples were taken starting from 20 min after infusion and afterwards over 8 hours from infusion. Plasma paracetamol concentrations were measured by high-pressure liquid chromatography. ANOVA was used to compare between the pharmacokinetic parameters before and after CPB. The results revealed a C of 10.19 +/- 0.9545 mg. litre[-1] which was appeared after 20 min of infusion [experimentally]. Mean clearance [CL] was significantly reduced by about 40% in post CPB [prebypass 0.589 +/- 0.1069 L.h[-1]. Kg[-1] vs. 0.357 +/- 0.0394 L.h[-1]. Kg[-1] after CPB, P < 0.05]. The elimination rate constant [Ke] was significantly reduced by about 55% after CPB compared to prebypass values. However, the elimination half-life [t1/2] was significantly increased from 1.380 h before bypass to 2.431 h in post bypass period. It appears from this study that hypothermic cardiopulmonary bypass can affect the kinetic profile of IV paracetamol in patients undergoing coronary artery bypass graft surgery by altering its elimination. However, the change in the pharmacokinetic parameters and blood level of paracetamol is not serious and its use in such situations as analgesic and antipyretic is safe

Digital arterial injury leading to gangrene of the thumb

An unusual case of a blunt and penetrating injury to the thumb is described. A laterally displaced epiphyses of the first metacarpal divided the digital artery and a penetrating injury in the first web space inflicted on the medial digital artery resulting in a total vascular interruption leading to gangrene and ultimate amputation. Such injuries are rare in children but proper assessment and examination could have prevented the end result

Comparison of gender performance on an intelligence test among medical students

Since the Government of Pakistan abolished the gender based system of admission to medical colleges, all colleges have seen a huge influx of female medical students, reaching up to 70-80% of all students in some colleges. This trend is still persisting about 15 years after the decision. The objectives of the current study were to assess if there is any significant difference between male and female medical students in scores on a structured, standard, robust test of intellectual ability. Exact venue of the research is withheld for confidentiality. The study was carried out in 2003-2005. A cross-sectional, comparative study with sample size of 150 students, 75 male and 75 female students. Participants signed a consent form, were assessed on Raven's Standard Progressive Matrices [SPM], and data was analysed using SPSS-12. On the SPM test, the male students as a group, scored higher than the female students as a group, the difference was small but statistically significant [p=0.015]. Performance on the SPM inclines in favour of the male gender group. More research needs to be carried out into the other possible factors that could explain the gender disparity in medical colleges in Pakistan

Some biological evaluations on samanea saman

Samanea saman [Jacq.] Merr. Was subjected to bioactivity analysis. The records of these investigations are described in this communication. A battery of assays was performed on hexane and methanol extracts of Samanea saman leaves, which include antibacterial activity, antifungal activity, brine shrimp bioassay, Lemna bioassay and insecticidal activity. Both the extracts showed moderate antibacterial activity against Pseudomonas aeruginosa where as moderate antifungal activity of hexane extract against Fusarium solani and of methanol extract against Trichophyton longifusus was observed. In brine shrimp bioassay the methanol extract exhibited cytotoxicity with LD[50] value of 757.3672 micro g/ml. In Lemna bioassay the methanol extract in concentration of 1000 micro g/ml significantly inhibited the growth of Lemna. The results of insecticidal activity showed that the hexane extract of Samanea saman exhibited 505 mortality against Rhyzopertha dominica and Tribolium granarium where as methanol extract remained inactive against all the tested insects

Two triterpenes lupanone and lupeol isolated and identified from tamarindus indica linn

Tamarindus indica, a useful medicinal plant was subjected to phytochemical investigation. Two triterpenes [lupanone and lupeol] have been isolated from the leaves of this plant. Their structures were elucidated with the help of physico-chemical methods and spectroscopic techniques. The lupanone and lupeol from this plant are being reported for the first time

Biological activity and phytochernistry of Phoenix Species

Phoenix species are considered as important plants in traditional system of medicine and are used extensively as remedy for various ailments. Exploitation of Phoenix species by the researchers, focused the scientific facts behind their usage in traditional system of medicine. The authors present a comprehensive review of their utility in the light of contemporary research

Familial Dream's disease[Adiposis dolorosa]

Dercum's disease consists of multiple, painful lipomata seen mostly in postmenopausal, obese women. Its exact aetiology is not known. A family with six members in two generations affected with Dercum's disease is presented supporting the hereditary aetiology of this condition