Efficacy of Azadirachta indica organic extracts against clinical methicillin resistant Staphylococcus aureus isolates

In current study we investigated the efficacy of organic extracts of Azadirachta indica leaves against Methicillin Resistant Staphylococcus aureus [MRSA] clinical isolates. For this purpose fresh leaves were used to prepare ethanol, methanol and chloroform extract. Secondly, a cross sectional study was conducted to isolate MRSA in clinical samples from patients having surgical/ non-surgical wounds from Allied Hospital and District Head Quarter Hospital, Faisalabad. The S. aureus isolates were initially identified by biochemical characterization, followed by identification of MRSA using cefoxitin disc diffusion test that was finally confirmed by genomic amplification of mecA gene, responsible for resistance. All MRSA isolates were tested to find vancomycin resistant S. aureus [VRSA] using E-strips [M.I.C. EvaluatorTM, Oxide, UK]. The data showed an overall 37% prevalence of S. aureus including 56.75% clinical MRSA isolates while none of the isolated S. aureus showed resistance to vancomycin. The antimicrobial activity was measured as mean zone of inhibition for each extract against all MRSA isolates and it was found as 15.38+/-2.26, 16.09+/-3.09 and 17.42+/-2.48 for methanol, ethanol and chloroform extracts respectively. Chloroform extract showed significantly high antimicrobial activity against MRSA isolates. Altogether, the current study exposed the high prevalence of MRSA isolates from tertiary care hospitals. However, all MRSA isolates were found susceptible to organic extracts of A. indica leaves

Effect of daily versus monthly mega dose of vitamin D supplementation to improve vitamin D level in long bone fractures

Objective: To compare the mean increase in vitamin D level after treatment with daily versus monthly mega dose for long bone fracture

Methods: This study was simple randomized control trial done in Department of Orthopedic Surgery and Traumatology, Mayo Hospital, Lahore. Sample of 200 cases was collected with non-probability purposive sampling. Patients were randomized in two equal groups through lottery method. In group A, daily dose of vitamin D with Calcium and in group B; injectable monthly mega dose of 200000 IU of vitamin D with calcium were given. Patients were followed up on lst, 4th, 6th and 8th week post-operative period. Laboratory reports were assessed to measure the increase in vitamin D level in serum

Results: The mean age of patients was 27.42 +/- 10.48 years. There were 31.5% males and 68.5% females. The mean vitamin D level at baseline was 16.53 +/- 3.60mg/dl which was increased to 32.73 +/- 4.57ng/dl after 4 weeks. The mean increase in vitamin D level in daily dose groups was noted as 14.31 +/- 2.22ng/dl whereas the mean value in Monthly dose group was noted as 18.17 +/- 2.27ng/dl, 9p-value=0.000]

Conclusions: The study results showed that monthly mega dose of vitamin D is more effective and beneficial as compared to daily slow dose

In-silico identification and evaluation of plant flavonoids as dengue NS2B/NS3 protease inhibitors using molecular docking and simulation approach

Dengue infection is prevailing among the people not only from the developing countries but also from the developed countries due to its high morbidity rate around the globe. Hence, due to the unavailability of any suitable vaccine for rigorous dengue virus [DENY], the only mode of its treatment is prevention. The circumstances require an urgent development of efficient and practical treatment to deal with these serotypes. The severe effects and cost of synthetic vaccines simulated researchers to find anti-viral agents from medicinal plants. Flavonoids present in medicinal plants, holds anti-viral activity and can be used as vaccine against viruses. Therefore, present study was planned to find anti-viral potential of 2500 flavonoids inhibitors against the DENVNS2B/NS3 protease through computational screening which can hinder the viral replication within the host cell. By using molecular docking, it was revealed that flavonoids showed strong and stable bonding in the binding pocket of DENY NS2B/NS3 protease and had strong interactions with catalytic triad. Drug capability and anti-dengue potential of the flavonoids was also evaluated by using different bioinformatics tools. Some flavonoids effectively blocked the catalytic triad of DENY NS2B/NS3 protease and also passed through drug ability evaluation. It can be concluded from this study that these flavonoids could act as potential inhibitors to stop the replication of DENY and there is a need to study the action of these molecules in-vitro to confirm their action and other properties

Tumour induced osteomalacia

Tumour-induced osteomalacia [TIO] is a rare paraneoplastic syndrome usually presenting with bone pain, fracture of bones and muscle weakness. It is caused by high serum levels of fibroblast growth factor 23 [FGF-23], which is a hormone-regulating phosphate, and vitamin D. FGF-23 is secreted by several tumours, especially benign mesenchymal tumours which are very small and difficult to locate. There is a significant delay from onset of symptoms to the diagnosis of this entity due to occult nature of this disease. We present a case of young male who presented with long history of progressively worsening muscular pain and weakness, rendering the patient confined to bed. Our aim of presenting this patient as a case report is to make physicians realise that any patient with unexplained muscular weakness and pain must undergo workup for TIO, including serum phosphate measurement, as this is a rare but potentially curable disease

Evaluation and comparison of different brands of domperidone tablets available in Karachi, Pakistan

Domperidone is an anti-dopaminergic drug used for the treatment of nausea, vomiting and dyspepsia. It has also been used in Parkinson's disease. In this study, five different brands of Domeperidone tablets were selected from the local market for evaluation of their quality as the local market is occupied of many competitors for a single generic. The evaluation of Domperidone tablets was done using various pharmacopoeial and non-pharmacopoeial tests. All the test results fell within BP specified limits for all the selected brands i.e. the results for Brands A to E for weight variation, thickness and diameter were satisfactory and within limits. For Brands A to E, the results for hardness and friability were also satisfactory i.e. 4-10kg/cm2and 0.1-0.6% respectively. The results for Brands A to E for disintegration were 2-6 minutes; for dissolution and assay, the results were 89-92% and 95-99% respectively. The results of similarity factor [f[2]]also showed that all brands of Domperidone have comparative dissolution profiles

Risk factors of retinopathy in type 2 diabetes mellitus at a tertiary care hospital, Bahawalpur Pakistan

Objectives: To find out the risk factors of diabetic retinopathy in type 2 diabetes mellitus

Methodology: It was a cross-sectional study involving 300 patients of type 2 diabetes. Clinical history, relevant examination including fundoscopy and lab investigations were done. Data was analysed with SPSS 17.0. T-test and chi square/Fischer exact were applied to determine significance

Results: Mean age of the patients was 49.04 +/- 0.69 years with slight female predominance with male to female ratio of 3:4. Average duration of disease was 7.17 +/- 0.38 years. Diabetic retinopathy was diagnosed in [74, 23.9%]. Mean HbA1c was 8.15% in patients with retinopathy and 8.884% in those who had no retinopathy [p=0.08]. However, duration of DM, age of patients, male gender, high total cholesterol, high LDL and microalbuminuria were significantly associated with the development of retinopathy

Conclusions: Diabetic retinopathy was found in 23.9% of type 2 diabetics. It was associated with duration of disease, age at presentation, male gender, high total cholesterol, high LDL and microalbuminuria. A single high level of HbA1c was not associated with retinopathy