Isolation of flavonoides from Artemisia macrocephala anticholinesterase activity: isolation, characterization and its in vitro anticholinesterse activity supported by molecular docking

In this study the flavonoids isolated from Artemisia macrocephala were screened out for anticholinesterase activity. The isolated flvanoids were characterized by HNMR, NOESY, COSY, HMBC, HSQC and mass spectroscopy. The compounds [1-4] in appropriate quantities were isolated from chloroform fraction using gravity column chromatography by eluting ethyl acetate/n-hexane solvent system. The flavonoids were characterized and resulted in the form of mono substituted methoxy flavones to tri substituted flavones. Ellman's assay techniques were used to find out enzyme inhibition. Operating environment [MOE] software was used for molecular docking studies. Compounds [1], [2] and [3] showed 88.42+/-2.76, 84.50+/-1.60 and 90.16+/-2.98 percent inhibition of the acetyl cholinesterase [AChE] respectively at 1000µg/mL concentrations with IC50 value 165, 60, 65µg/mL respectively which were comparable to that of standard galanthamine. While for butyryl cholinesterase [BChE], [1], [2] and [3] showed 91.63+/-4.32, 81.03+/-3.53 and 87.69+/-2.84 percent inhibitions respectively at 1mg/mL as compared to the standard galanthamine which caused 96.50+/-2.41 percent inhibition at the same concentration. Whereas, compound [4] exhibited moderate activity for both the enzymes. Molecular docking studies confirmed the experimental AChE and BChE inhibitory activities of the test samples by their virtue of multiple interactions with target enzymes. The results confirm that the specie has biologically active constituents that are more useful for the management of several neurodegenerative ailments like ataxia, Parkinson's disease, Alzeimer's disease and some other types of dementia

Synthesis, characterization, antioxidant and brine shrimp cytotoxic activity of novel 3-benzothioyl-l-[3-hydroxy-3-phenyl -3-propyl]-l-methylthiourea

In the present research work novel ephedrine based thiourea derivative, 3-benzothioyl-l-[3-hydroxy-3-phenyl -3-propyl]-l-methylthiourea 4is synthesized and then characterized elemental analyzed via various techniques i.e., Proton NMR, carbon13 NMR and fatherly confirmed via X-ray crystallography. Compound 4 was then screened for their possible antioxidant and cytotoxic potentials. Benzoyl chloride was treated with an equimolar potassium thiocyanate in acetone to achieve benzoyl isothiocyantes. It was then treated with an equimolar [1R, 2*S]-[-]-Ephedrine to obtain the 3-benzothioyl-l-[3-hydroxy-3-phenyl-3-propyl]-l-methyl thiourea4. It was then screened for antioxidant and cytotoxic potentials. The compound 4 showed excellent antioxidant activity almost comparable to ascorbic acid [standard] and have significant cytotoxic activity with LC[50] value 05+/-0.58 ppm

Synthesis, acute toxicity, analgesic activity and cytotoxicity of Some bisthiourea derivatives

Bisthiourea derivatives were synthesized by the reaction of benzoylisothiocyanate and diamines to give 1,2-Bis [N'-benzoylthioureidobenzene [1], l,3-di[benzoylthioureido] benzene [2] and l,4-di [benzoylthioureido] benzene [3] in acetone. Acute toxicity study revealed that LD[50] of compound [1] and [3] is 120 mg/kg body weight. Visceral pain induced by injecting i.p acetic acid in mice were strongly inhibited by all the compounds. 94.65, 95.25 and 85.54% analgesic activity were observed in compounds [1], [2] and [3] at 15 mg/kg and [2] and [3] shows 97.63 and 96.42% at 30 mg/kg body weight respectively while [1] gives 100% analgesic activity. 100% cytotoxicity was observed in compounds [2] and [3] and 96% in compound [1] at 750 ppm. The results suggest that these compounds may have potential values for treatment of cancer and painful disorders

Synthesis, characterization and antinociceptive activities of Novel 2-[2,4-dichlorophenyl]-4H-chromen-4-one

A novel flavone derivative has been synthesized in good yield from ketone and aldehyde. The structure has been established by different spectroscopic techniques like H NMR, C NMR, IR and elemental analysis. The compound was then screened for its acute toxicity and antinociceptive activity studies on animal model. The novel compound was safe upto a maximum dose of 500mg/kg body weight oral dose in mice and showed 65.92 and 82.18% pheriperal analgesic activity at 15 and 30mg/kg body weight doses. Central antinociceptive activity of the compound was 53.13 and 64.44% at 15 and 30mg/kg body weight respectively

Histological effect of methotrexate and folinic acid on oral epithelium of albino rats

Objective: To determine the extent of damage to oral epithelium caused by high dose methotrexate [HDMTX] and the ameliorating role of folinic acid [FA] on damaging effect of methotrexate

Study Design: Experimental study

Place and Duration of Study: Anatomy Department of Post Graduate Medical Institute [PGMI], Lahore, from March to September 2013

Methodology: Forty-two albino rats were randomly allocated to 3 groups: Exp group-l was given HDMTX intramuscularly [I/M] on alternate days, Exp group-ll was given both MTX and FA [I/M] on alternate days, and the control group received no intervention. After 16 days, buccal mucosa was excised for histological analysis under light microscope using H and E stains to see the effect of intervention

Results: Exp group-l showed marked reduction in epithelial thickness compared to Exp group-ll, and the control [F = 46.44, p < 0.001] had significantly depleted basal layer [F = 6.32, p < 0.004], as well as inflammatory infiltrate with evidence of erosion and ulceration. Exp group-ll showed less atrophic changes, a few inflammatory cells, no erosion and ulceration compared to the Exp group-l. Assuming epithelial thickness of control group 100% intact, the Exp group-ll was found to have 78% intact and Exp group-l had only 38% thickness intact. Thus FA rescued epithelial thickness by 40%

Conclusion: Folinic acid considerably saved oral mucosa from the damaging effect of HDMTX, improving quality of life of patients

Ascitic fluid culture in cirrhotic patients with spontaneous bacterial peritonitis

Objective: to determine the frequency and compare the culture yield of bacterial isolation by conventional and blood culture BACTEC bottle techniques in cirrhotic patients with spontaneous bacterial peritonitis [SBP]

Study Design: cross-sectional comparative study

Place and Duration of Study: pathology Department, Bannu Medical College, Bannu, KPK, from January 2012 to December 2013

Methodology: paracentesis of 20 ml of ascitic fluid tapped from cirrhotic patients with SBP was carried out by a single technologist. The analysis included differential leukocyte count [DLC], while 5 ml each of the fluid was inoculated into conventional culture media and BACTEC blood culture bottle. All the data were analysed on [SPSS] version 16 to determine frequencies with percentages and mean values with standard deviation. Chi-square test was used for comparing the yield of conventional and blood culture bottle methods. P-value was considered significant if < 0.05

Results: in 105 cases of ascitic fluid analyses, 27 [25.72%] had positive ascitic fluid culture whereas 78 [74.28%] had negative ascitic fluid culture. Ascitic fluid culture was positive in 6 cases by conventional culture media and in 27 cases by BACTEC culture bottle media [p < 0.001]. Bacterial isolation was obtained by both culture methods in 6 cases [p < 0.001]

Conclusion: direct bedside inoculation of ascitic fluid by BACTEC culture bottle method has better yield as compared to conventional culture method

Acute toxicity and antispasmodic activities of achillea wilhelmsii C. Koch

Since Achillea wilhelmsii is used as antispasmodic in traditional medicine, we conducted our current work to investigate its rationale on scientific grounds. Acute toxicity studies of crude methanol extract of Achillea wilhelmsii [Aw. CMeOH] is also performed. Effect of Aw. CMeOH and its fractions were tested on isolated sections of rabbits' jejunum at test concentrations 0.01, 0.03, 1.0, 3.0, 5.0 and 10mg/ml. The test extracts, in similar concentrations, were also tested on KCl-induced contractions. Calcium chloride curves were constructed for those fractions which relaxed KCl induced contractions in the absence and presence of the test samples to investigate its possible mode of action through calcium channels. Aw. CMeOH tested positive for flavonoids, saponins, tannins, glycosides, terpenoids, sterols, phenols, carbohydrates and proteins. LD[50] for acute toxicity studies is 2707 +/- 12.6 mg/kg. Mean EC[50] values for Aw. CMeOH on spontaneous and KCl-induced contractions are 3.41 +/- 0.18 [2.56-3.8, n=6] and 0.68 +/- 0.05 [0.6-0.85, n=6] mg/ml, respectively. Respective EC[50] values for n-hexane fraction on spontaneous and KCl-induced contractions are 3.06 +/- 0.08 [2.8-3.3, n=6] and 1.68 +/- 0.8 [1.4-1.9, n=6] mg/ml, respectively. Corresponding EC[50] [mg/ml] values for chloroformic, ethylacetate and aqueous fractions of Achillea wilhelmsii on spontaneous rabbits' jejunum preparations are 4.8 +/- 0.2 [4.41-5.63, n=6], 5.07 +/- 0.15 [4.7-5.58, n=6] and 5.2 +/- 0.13 [4.91-5.64, n=4], respectively. Constructing calcium chloride curves, in the presence of 0.1 mg/ml of Aw. CMeOH, mean EC[50] value [log molar [Ca[++]]] is-1.98 +/- 0.03 [-1.89-2.05, n=6] vs. control EC50 [log molar [Ca[++]]]-2.41 +/- 0.02 [-2.32-2.44, n=6]. Mean EC50 value [log molar [Ca[++]]] for 0.3 mg/ml n-hexane fraction is-1.76 +/- 0.05 [-1.70 -1.93, n=6] vs. control EC50 [log molar [Ca[++]]] value-2.18 +/- 0.07 [-2.0-2.46, n=6]. While in the presence of chloroformic fraction [3 mg/ml], mean EC50 [log molar [Ca[++]]] value is -2.4 +/- 0.1 [-2.78 - 2.9, n=6] vs. control EC50 [log molar [Ca[++]]] value-2.70 +/- 0.05 [-2.5-2.8, n=6]. Mean EC50 value [log molar [Ca[++]]] for ethyl acetate fraction [1 mg/ml] is-1.94 +/- 0.07 [-1.75-2.05, n=6] vs. control EC50 [log molar [Ca[++]]] value-2.69 +/- 0.04 [-2.57-2.79, n=6]. Mean EC50 [log molar [Ca[++]]] value for residual aqueous fraction [3 mg/ml] is-1.8 +/- 0.3 [-1.71-1.84, n=6] vs. control EC50 [log molar [Ca++]] -2.6 +/- 0.04 [-2.59-2.76, n=6]. Whereas, the verapamil [0.1 micro M] EC[50] value [log molar [Ca[++]]] is-1.7 +/- 0.1 [-1.6-1.8, n=6] vs. control EC50 value [log molar [Ca[++]]]- 2.4 +/- 0.09 [-2.3-2.47, n=6]. The present research work confirms that the intestinal relaxation effect of Achillea wilhelmsii is supporting its traditional use as antispasmodic. The plant species can be a source for calcium antagonist[s], which can preferably be isolated from n-hexane fraction

Serum zinc and neutrophil function in lower, middle and upper socioeconomic groups

To assess the serum zinc and neutrophil function levels in different socioeconomic groups. A total of 100 healthy subjects of 10-30 years of age, both male and female were investigated. Out of these, 50 [25 males and 25 females] belonged to the lower socioeconomic [LSEC] group and 50 [25 males and 25 females] belonged to the upper / upper middle socioeconomic [USEC] group. Serum zinc was determined by colorimetric method and neutrophil function was estimated by the Nitroblue Tetrazolium reduction test [NBT]. Both the parameters were compared in the two socioeconomic [SEC] groups. It was found that serum zinc was significantly lower in the LSEC group. Similarly NBT percentage phagocytosis was also significantly lower in the LSEC group as compared to the USEC group. NBT percentage phagocytosis did not show significant gender difference in the LSEC group, however it was significantly higher in females than in males in the USEC group. Generally a significant positive correlation was found between serum zinc and neutrophil phagocytic function. The LSEC class has low serum zinc levels and low NBT percentage phagocytosis and hence is at greater risk of developing infections.

Child Labour in Pakistan - A tip of an iceberg

To study the basic demographic characteristics of child laborers and to ascertain their working conditions. This cross sectional study was conducted in district Rawalpindi from January to September 2008 and 700 children between 4 - 18 years were enrolled after taking informed consent from both children and their masters. Information on demography and work details was recorded on a structured performa. Total 700 children 4-18 years old with mean age of 13.5 years were enrolled. Male: Female ratio was 5.4:1. Most of the children [401] had a family size of 5-8 members. In 634 cases, 1-4 family members were earning while 05 had 10-12 earning members. Only 479 [68%] children ever attended school, mostly [291, 42%] till primary level. 258 children's families had monthly income of more than PKR 8000, 210PKR 6000-8000, 167 PKR 4000-5000 and 63 families were earning less than PKR 3000/ month. Mostly [270] worked in shops. Reason of work was low family income in 222 and poverty in 207 children. 283 children worked for 7-10 hours per day, 216 for 07 days, 115 for 4-6 hours, 45 for more than 12 hours and 39 for 1-3 hours. Maximum monthly pay was 1000- 2000 rupees in 187 and minimum 500 rupees per month in 106 children. 284 cases sustained injury while at work. Most child labourers are male with a family size of 5-8 members, never attended any school and living in a family whose monthly income is less than 8000 Pakistani Ruppee. The major reason of work was low family income and poverty

Seminal volume in the investigation of male infertility

To determine the seminal volume among infertile males and the frequency distribution of hypospermic and hyperspermic patients in infertile males. Cross-sectional observational study. Department of Reproductive Physiology/Health, Public Health Laboratories Division, National Institute of Health, Islamabad, from 2002 to 2009. Semen examinations of infertile male were carried out according to the standardized method of the World Health Organization. Seminal volume of 2-6 ml were considered normal, while volumes less than 2 ml and higher than 6 ml were considered hypospermic and hyperspermic respectively. Out of 1521 patients, 355 were hypospermic [23.34%], 1046 were normospermic [68.78%] while 120 were hyperspermic [7.88%]. In the hypospermic cases, 57 out of 355 [16.05%] had a volume of less than 1 ml. Of those 57 patients, 34 were found to be azoospermic, 12 were asthenozoospermic, one each were terato and polyzoospermic, while 6 had normal counts. Among the hyperspermic patients [n=120], 3 were azoospermic, 24 were oligozoospermic and 19 cases [15.84%] had count within the normal range, while 1 patient was polyzoospermic. Significant differences [p < 0.05] were observed among azoospermic, oligoasthenozoospermic and teratozoospermic groups when comparing hypo and hyperspermic patients. Seminal volume is an important parameter for assessment of infertility investigation and its abnormalities constitute a valuable index of problems with the male partner, even if the count and motility are well within the acceptable limits

History of ophthalmic surgery and contributions of Unani scholars

Ophthalmological diseases mainly cataract has its own history from the treatment point of view. Hippocrates the Father of Medicine himself treated cataract by depressed or couched method, since in his time the same methodology was adopted by other Greek scholars. When Tib reached into the land of Arabia the system derived other techniques and instruments for the management of cataract. Surgeons of the Arab land and renowned Unani scholars such as Galen, Albucasis [Zahravi], Isa bin Kahhal, Ibn Al-Haitham and Avenzoar [Ibn Zohr]. They operated and managed the cataract cases and were known as renowned Ophthalmologists of their times. Later on these pioneer works were transmitted as well as translated by French scholars and other Europeans. They modernized such works and finally transmitted through their hands. Despite having rich literature rendered by Unani scholars and works done by Unani and Arab scholars, the knowledge has been transferred and unfortunately we are the follower in todays scenario

Trend of fertility potentials with increasing age in Pakistani males

The objective being to examine the magnitude and the shape of the relationships between age and semen volume, sperm concentration and sperm motility by keeping the other factors affecting fertility directly constant among patients undergoing infertility evaluation at National Institute of Health, Islamabad, Pakistan. This experimental study with non-probability sampling was conducted in Reproductive Physiology/Health, Public Health Laboratories Division, National Institute of Health, Islamabad during 2006-2009. A total 350 patients [21-50 years] were divided age wise into three groups [21-30, 31-40 and 41-50 years] to compare alteration in sperm count and motility. Semen profile was evaluated according to WHO reference value for normal semen characteristics. The result of Sperm concentration showed a non significant [p>0.05] decreasing trend with increasing age that was 0.047million/ml for every year where as sperm motility declined significantly with increasing age at p>0.05. Age-related decreases in semen qualities particularly decline in sperm motility revealed that men may become progressively less fertile as they age. However, unlike women, there appears to be no evidence of an age threshold for men

Effects of cowdung and poultry manure on growth performance of Indian major carps [Catla catla, Labeo rohita] and exotic carp [Cyprinus carpio] in Thatta district [Sindh], Pakistan

In the manuring trials conducted in earthen ponds of 120 m[2] for one year, the juveniles of Indian major carps [Catla catla and Labeo rohita] and exotic carp [Cyprinus carpio] responded positively during warmer months i.e. March to August. The mean weight increase and mean specific growth rate [SGR] were better in the ponds fertilized with cowdung. Total growth rate per day calculated for Catla catla was 32.96 g, for Labeo rohita 95.02 g and for Cyprinus carpio 14.37 g under the influence of cowdung. Moreover individual growth rates/day were also high i.e. 2.06, 2.50 and 1.43 g, respectively. Percent contribution in fish production was 21.15%, 66.74% and 10.09%, respectively. Total growth rate of the three was significantly higher in cowdung [142.36 g] as compared to that in poultry manure i.e. 106.64 g. Both the fertilizers significantly differed in terms of monthly and treatment variations [P<0.05] except for treatment variation for Cyprinus carpio. Water treatment, light penetration, electrical conductivity, total dissolved solids, total suspended solids and nitrates were highly significant [P<0.05] both for treatment and monthly variation except pH and dissolved oxygen

End treatment response with pegylated interferon among chronic Hepatitis C non-responders

To determine the frequency of end treatment virologic response [ETR] with pegylated interferon alpha and ribavirin in treatment of chronic hepatitis C patients who failed to respond to interferon plus ribavirin therapy given for at least 24 weeks. Descriptive study. Medical Unit-II, Benazir Bhutto Hospital, Shafi clinic Rawalpindi and PAEC Hospital Islamabad, Pakistan, from July 2208 to June 2009. Patients with hepatitis C who were non-responders to previous treatment with standard interferon and ribavirin, were given Pegylated Interferon alpha plus ribavirin. Total duration of treatment was 24 weeks for genotypes 2 and 3 and 48 weeks for genotypes 1 and 4. The primary end point was undetectable HCV RNA by polymerase chain reaction assay at the completion of therapy. Out of the 44 enrolled patients, 24 [54.5%] were males and 20 [45.5%] were females. Mean age of patients was 45.25 +/- 7.14 years. HCV genotypes were 3 in 64%, 2 in 30% and 7% each had genotypes 1 and 4. Both the early virological response and end of treatment response was seen in 75% patients. There was a high ETR rate of 75 in previous non-responders to conventional combination therapy. This high ETR as compared to international data is because of existence of favourable genotypes in our country which is encouraging in the treatment of non-responders

Assessment of male reproductive health by conventional method of semen analysis

Data available over the past twenty years reveal that in approximately 30% of cases of infertility, pathology is found in man alone, and in another 20% both man and woman are abnormal. Therefore, the male factor is at least partly responsible in about 50% of infertile couples. The longer a couple remains sub fertile, the worse is their chance for an effective cure. This study was planned to analyse the complete semen picture of infertile men for assigning the specific cause to male infertility related to concentration, motility and morphology and to know the distribution and pattern of male infertility in the various subclasses in Pakistani population. It was a prospective descriptive analytical study conducted at Department of Reproductive Physiology/ Health, Public Health Divisions, National Institute of Health [NIH], Islamabad. One thousand five hundred twenty-one [1,521] infertile male patients, and 97 proven fathers, taken as a control. Conventional semen analysis was performed on all samples. Out of 1,521 infertile men, 13.3% were azoospermic, 23.2% oligozoospermic, 0.9% polyzoospermic, 14.5% normozoospermic, 35.2% asthenozoospermic 10.5% oligoasthenozoospermic and 2.4% teratozoospermic. Sperm concentration and active motility of proven fathers, was significantly higher [p<0.05] than the normal concentration group. Least liquefaction time was recorded in case of polyzoospermic subjects, and highest for azoospermic cases. Although, the liquefaction time of azoospermic and oligozoospermic subjects varied non-significantly [p>0.05] with the proven fathers. Normal forms were significantly higher [p<0.05] among the proven fathers and polyzoospermic cases, in comparison with the other groups. Head defects were more in teratozoospermic group, followed by oligoasthenozoospermic and oligozoospermic patients. Neck defects were more profound in oligoasthenozoospermic and oligozoospermic patients, while, tail defect showed significant increase in teratozoospermic and asthenozoospermic cases only. Head and neck defect varied significantly [p<0.05] with proven fathers in all groups, while tail defect varied significantly [p<0.05] in oligozoospermic, asthenozoospermic and teratozoospermic groups only when compared with proven fathers. Complete semen analysis which provides important information about the quality and quantity of the sperm, should be performed before reaching a final conclusion

Common trend of antibiotics usage in a tertiary care hospital of Peshawar, Pakistan

Antibiotics are used to eradicate the pre- and postoperative infections in surgical procedures and in all others medical cases. However, inappropriate and indiscriminate use of antimicrobial agents can potentially have a number of problems. The emergence of antimicrobial resistant bacteria, an increased number of patients experiencing adverse drug events, and increased drug-related cost have been documented. The objective of the study was to determine the trend of use of antibiotics and hospitalisation of patients in various units of a tertiary care hospital, to investigate practice variation of antimicrobial agents within the hospital, and to identify and document any opportunity for its improvement. A questionnaire containing relevant information about the study was prepared. Patients' age, sex, diagnosis, duration of hospital stay and type of antibiotic used were recorded and analysed, with particular reference to antibiotic group and disease pattern, in 3 different treatment areas of Hayatabad Medical Complex [HMC], Peshawar, Pakistan, from July 2006 to June 2007. During the period under report, a total of 519 patients were studied for their disease and the type of antibiotics used. The leading type of antibiotics reported were 3rd generation antibiotic used on 147 [28.33%] patients in the 3 units collectively, 1[st] generation 127 [24.47%], and penicillin 99 [19.08%], while macrolides were the least used. The available resources are needed to be effectively utilised, to minimise the hospital stay due to rational use of antibiotics, and to minimise burden of antibiotics on poor patients

Relationship between blood groups and male infertility

Blood is man's complete and unchangeable identity. The ABO and Rh groups are recognised as major and clinically significant blood groups. Blood group antigens are not only important in relation to blood transfusion and organ transplantation, but also have been utilised in genetic research, anthropology and tracing ancestral relation of humans. The objective the present study is to examine the blood group antigens in infertile men for assessing the relationship to male infertility and to know the frequency of various blood groups among infertile males in our population. A total of 1,521 patients along with 460 proven fathers as controls were recruited for the present study from both rural and urban areas of Pakistan and referred to Department of Reproductive Physiology/Health, Public Health Divisions, NIH, Islamabad, during 2002 to 2006. Blood grouping [ABO] and Rhesus factors [Rh] was done by the antigen antibody agglutination test. Overall distribution of blood groups in the studied population of 1,521 subjects was 35.50%, 28.27%, 26.89% and 9.34% for blood groups O, B, A and AB respectively. The ratio of control to patient was 1:3.3. The present preliminary study revealed that in our population the prevalence of male infertility in blood group O is invariably higher than in all other ABO blood groups, showing a strong relationship between blood group O and male infertility

Cerebral blood flow patterns using single photon emission computed tomography in patients with dissociative disorders and healthy controls

To compare the cerebral blood flow [CBF] changes in patients diagnosed to have Dissociative Disorder with healthy controls. Cross Sectional Comparative study. The study was done in the Department of Psychiatry Military Hospital Rawalpindi in collaboration with Nuclear Medical Centre [NMC] Armed Forces Institute of Pathology [AFIP], a tertiary care centre of Pakistan Armed Forces from Dec 2004 to May 2005. This cross sectional comparative study was done at Dept of Psychiatry Military Hospital Rawalpindi in collaboration with nuclear Medical Centre [NMC], at Armed Forces Institute of Pathology [AFIP] which is a tertiary referral center. A sample of 30 patients diagnosed as having Dissociative Disorder was compared with 10 controls for brain perfusion changes using TC-99m HMPAO [Hexamethyl-propylene-amine-oxime] Tc-99m. In group 1 perfusion changes were observed in 27 [90%] cases whereas unremarkable and insignificant changes were noted in 3 [10%] cases but no perfusion were noted in controls [P< 0.001] In patients who were suffering from different types of dissociative disorder marked cerebral hypoperfusion was observed in frontal, frontomotor, orbitofrontal and temporal regions whereas hyperperfusion was noted in frontal and orbitofrontal areas in few cases. Cerebral blood flow changes in the fronto parietal brain are associated with symptomotology in dissociative disorders

Rising prevalence of hepatitis B and C and risk factors at district headquarter teaching hospital Bannu, Khyber-Pakhtunkhwa

HBV and HCV are common health problems in developing countries like Pakistan, sharing the same mode of transmission. The purpose is to determine the prevalence of HBV and HCV, and its risk factors in Bannu. A cross sectional descriptive study was conducted in medical units of DHQTH, Bannu, from January, 2004 till December, 2008. A total of 25944 patients comprising 13953 males [53.7%] and 11991 females [46.3%] all above the age of 15 years, were screened for HBV and HCV by rapid method and confirmed by ELISA technique. Out of those, 1352 [5.2%] patients were found positive either for HBV or HCV, 502 [1.93%] patients for HBV, whereas 850 [3.27%] patients for HCV. Non of the patients were found positive for both HBV and HCV. Nine hundred and five [67.0%] were males and 447, [33.0%] were females. Average age was 35-55 years. Keeping in mind the above mentioned results, the most important goal to be achieved is to increase the literacy rate and awareness among people about HBV and HCV so that it endeminity could be controlled

Treatment induced leucopenia in hepatitis C and role of G-CSF in its management

To determine the frequency and severity of leucopenia during antiviral treatment in patients with hepatitis C and the effectiveness of G-CSF [Granulocyte-Colony Stimulating Factor] in its management. An observational study. Shafi Clinic, Rawalpindi, from July 2005 to July 2007. Patients with Polymerase Chain Reaction [PCR] positive for Hepatitis C Virus-Ribonucleic Acid [HCV-RNA] by Enzyme Linked Immunosorbent Assay [ELISA] method were included in the study. Standard combination therapy was given to all i.e. interferon and ribavirin. Those with total leukocyte count [TLC] <4000/cmm were given injection Granulocyte-Colony Stimulating Factor [G-CSF] according to severity of leucopenia. Response to therapy was noted and dose titration was done accordingly. A total of 208 patients were enrolled in the study with 99 [48%] males and 109 [52%] females. Total leukocyte count [TLC] < 4000/cmm was observed in 78 [37.5%] cases. Conventional interferon induced leucopenia was seen in 60 out of 172 [35%] cases. Pegylated interferon induced leucopenia was seen in 18 out of 36 [50%] cases. Patients on Pegylated interferon had more severe leucopenia as compared to those on conventional interferon. Granulocyte-Colony Stimulating Factor [G-CSF] administration resulted in an increase in mean total leukocyte count from 2300 to 5200/cmm. No patient required antiviral dose reduction or discontinuation. Recombinant Granulocyte-Colony Stimulating Factor [G-CSF] administration tends to manage leucopenia, which is a common adverse effect of antiviral treatment for hepatitis C