Comparative histological analysis of cerebellum of representative species of elasmobranchii

SUMMARY: In elasmobranch fishes, variations in gross structural organization of cerebellum has been extensively explored. The basic histological features of cerebellum although conserved in the group but the comparative account on subtle cellular variations is largely underestimated. The present study aims to explore the histological and cellular variations in different layers of cerebellar cortex of the representative elasmobranchs' species belonging to different habitat. Our findings showed that the histological architecture of cerebellar granular layer between the examined species varies noticeably. By and large increase cellular density were observed in all the layers of cerebellum in the representative species of shark compared to ray. The findings were then compared and discussed with reference to their habitat and behavior.

En los peces elasmobranquios, las variaciones en la organización estructural general del cerebelo se han explorado ampliamente. Las características histológicas básicas del cerebelo, aunque se conservan en el grupo, pero la descripción comparativa de las variaciones celulares sutiles es limitada. El presente estudio tiene como objetivo explorar las variaciones histológicas y celulares en diferentes capas de la corteza cerebelosa de las especies representativas de elasmobranquios pertenecientes a diferentes hábitats. Nuestros hallazgos mostraron que la arquitectura histológica de la capa granular del cerebelo entre las especies examinadas varía notablemente. Se observó un gran aumento de la densidad celular en todas las capas del cerebelo en las especies representativas de tiburón en comparación con la raya. Luego, los hallazgos se compararon y discutieron con referencia a su hábitat y comportamiento.

Half Minimally Invasive Strabismus Surgery (MISS): A single para-muscular approach to horizontal muscle strabismus surgery

Purpose: Minimally invasive surgeries are gaining popularity. We compared two different approaches to rectus muscles: namely the standard para limbal (SPL) and the single para?muscular (SPM). Methods: Thirty?six patients planned for monocular horizontal strabismus surgery were block randomized to SPL and SPM approach. SPM approach involved a single para?muscular 10?mm conjunctival incision levelled at the inferior border of rectus muscle. We compared the post?operative grades of redness, congestion, chemosis, foreign body sensation, and drop intolerance at day 1, 2 weeks, and 6–8 weeks; scar visibility and success rates at 6–8 weeks and operation duration in minutes. We compared the results using Mann–Whitney U?test for inflammatory grades, Fisher’s exact test for proportions, and t?test for parametric measures. Significance was set at P < 0.05. Results: On postoperative follow-up at any time point, no significant difference was found on comparing inflammatory grades, scar visibility, and success rates. In terms of duration, SPL approach was on an average 21.5 minutes quicker than SPM (P = <0.001). Conclusion: The SPM is comparable to the SPL approach in terms of postoperative comfort and appearance, but takes significantly longer to accomplish.

Synergy in penicillin, cephalosporin, amphenicols, and aminoglycoside against MDR S. aureus isolated from Camel milk

Abstract This study investigated the synergy testing of penicillin, cephalosporin, amphenicols, and aminoglycoside in the camel milk (n=768 samples), subsequently used for isolation of MDR S. aureus targeting mecA gene. Antibiotic susceptibility of S. aureus showed >90% isolates were sensitive to ciprofloxacin and trimethoprim and resistant against oxacillin, ampicillin, and cefoxitin. Further, 50-85% of the S. aureus were sensitive to gentamicin, oxytetracycline, and chloramphenicol and resistant against cefotaxime, vancomycin, and cefixime. Minimum inhibitory concentration (MIC) of cefotaxime, (C) and ampicillin (A) in combination with gentamicin (G) was reduced by 99.34% and 70.46%, respectively, while with chloramphenicol (Ch), reduction was 57.49% and 60%, respectively. In addition, the Fractional Inhibitory Concentration Index (FICI) of G+A, Ch+C and Ch+G combinations showed synergy against 80%, 60%, and 30% of MDR S. aureus, respectively. Similarly, C+A and Ch+G displayed indifferent interaction against 70 % and 30% of isolates, respectively, while the later showed additive interaction against 10% of MDR S. aureus. Altogether, our results described effective combination of gentamicin and chloramphenicol with ampicillin and cefotaxime to combat MDR S. aureus

Selective Cytotoxic effect of Probiotic, Paraprobiotic and Postbiotics of L. casei strains against Colorectal Cancer Cells: Invitro studies

Abstract This study highlights the cytotoxic effect of three L. casei strains on colorectal cell lines in invitro conditions. Different concentrations of live, heat killed (HK) and cell free supernatant (CFS) of three L.casei strains were subjected to CaCo2 and MRC5 cell lines. The viability of the treated and untreated cells was determined after 72 hrs by MTT assay, and IC50 estimated. Apoptosis was evaluated by Annexin V-propidium iodide method using flow cytometry. The live, HK and CFS of the L. casei strains showed cytotoxic effects on colorectal cell lines with significant differences. The cytotoxicity effects of live cells on CaCo2 cells were significantly higher (p˂0.01) than the HK cells. A dose dependent response was observed, as higher concentrations resulted in enhanced cytotoxicity effects. Live L.casei 1296-2cells inhibited 91% of CaCo2 cell growth, with IC50 of less than 108 cfu/ml. MRS medium and concentrations of CFS at above 20% v/v, were cytotoxic to the normal cell lines. Flow cytometry analyses of L. casei 1296-2 indicated that cytotoxicity effects on CaCo2 cells is related to apoptotic induction. Invitro studies indicate that Live and CFS of L. casei 1296-2 might be promising candidate for the control of colorectal cancers

Ameliorating effect of Malva Neglecta on hyperglycemia and hyperlipidemia in diabetic rats

The plant, Malva neglecta wallr., is widely consumed for medicinal and nutritional purposes. The current study was carried out to assess the hypoglycemic and antihyperlipidemic potential of aqueous methanolic extract of M. neglecta. Chemical evaluation of the extract was performed by high pressure liquid chromatography. Oral glucose tolerance test (OGTT) was done in diabetic rats pre-exposed to 250, 500 and 750 mg/kg plant extract via the oral route. For hypoglycemic and biochemical study, the same therapy was administered to alloxan induced diabetic rats for 14 days. The standard control group received Glibenclamide (5 mg/kg). Ferulic acid, p-coumaric acid and other phenolic acids were detected and estimated in the extract. Administration of the plant extract significantly reduced blood glucose level in diabetic rats subjected to OGTT. The plant extract lowered the fasting blood glucose and alpha amylase, and prevented the damage to pancreas. It also corrected dyslipidemia in diabetic animals following 14 days therapy. Hence, this experimental study establishes the fact that M. neglecta exhibited significant antidiabetic and antihyperlipidemic activities in alloxan induced diabetic rats.

Comparison of outcome in medical versus expectant management in unruptured tubal pregnancy with β-hCG 1000-3000 IU/L

Background: Ectopic pregnancy (EP) is an important cause of maternal morbidity as well as mortality in the 1st trimester. This study was done to compare outcome in medical versus expectant management in patients with unruptured tubal pregnancy having β-hCG 1000-3000 IU/L.Methods: In this randomized controlled trial, 82 (41 in each group) women with tubal ectopic pregnancy (TEP) having β-hCG levels between 1000-3000 IU/L and 18 to 40 years of age were enrolled. Women having non-tubal pregnancy, ruptured ectopic pregnancy, heterotopic pregnancy, hypersensitivity to methotrexate were excluded. Included women were randomly assigned to either Group-A (expectant management) or Group-B (medical management). Outcome was measured after one week and considered successful if patient had β-hCG levels negligible i.e. <10 IU/L and complete resolution on ultrasonography (absence of adnexal mass, pelvic free fluid, gestational sac).Results: Overall mean age was 30.65±6.37 years. The mean gestational age in Group-A was 7.12±2.12 weeks and 7.63±2.41 weeks in Group-B. The mean β-hCG levels in Group-A was 1984.63±515.81 IU/L and 1937.33±519.68 IU/L in Group-B. Outcome was successful in 90.24% in Group-A and 63.41% in Group-B (p-value=0.004).Conclusions: Expectant management is associated with better outcome as compared to medical management in tubal ectopic pregnancy having β-hCG between 1000-3000 IU/L.

Analysis of frequency of congenital fetal anomalies diagnosed on antenatal ultrasound in a tertiary care hospital of Balochistan

Background: The objective of our study is to check the incidence of various congenital fetal anomalies in antenatal period by ultrasonography in a subset of population.Methods: This cross sectional study was conducted in the department of Radiology, Bolan Medical Complex Hospital Quetta from November 2017 to October 2018. Total of 1323 second and third trimester pregnancies were analyzed for a period of one year. 34 fetal anomalies were detected making the prevalence of 2.5%. Information obtained from history, clinical examination and Ultrasound examination were recorded. The data was analyzed in SPSS 20.These patients were also interviewed for folic acid supplementation and consanguineous marriage.Results: 1323 patients were examined with congenital abnormalities detected in 34 fetuses. Among 34 fetuses, 20 were male and 14 were female fetuses. Out of 34, mother of 24 fetuses verified that they did not take folic acid supplementation. Consanguineous marriage recognized as the important risk factor as found in 22 congenital abnormal fetus.  CNS anomalies were the most commonly occurring anomalies with prevalence of (0.9%) followed by gastrointestinal tract anomalies (0.3%) and Urinary tract anomalies (0.3%).Conclusions: The fetus prognosis largely depends on early detection of its any congenital anomaly on antenatal ultrasound as they can result in abortions, still births and other fetal defects. So antenatal ultrasound is very important and safe method for early detection and management of fetal anomalies.

Effect of Apple Cider Vinegar in Type 2 Diabetic Patients with Poor Glycemic Control: A Randomized Placebo Controlled Design

Aim: The aim of the trial was to measure the effect of apple cider vinegar on glycemic control and biochemical parameters in type 2 diabetes mellitus (DM) patients with poor glycemic control. Methods: A single-blind, randomized, placebo-controlled trial was conducted on 110 eligible types 2 DM patients who were selected and allocated into 2 groups. The interventional group was given 15 ml apple cider vinegar in 200 ml water during dinner for 3 months while the other group was placebo. Before and after HbA1C (glycosylated hemoglobin), fasting lipid profile, fasting blood sugar, anthropometrics, and dietary changes were assessed and analyzed using IBM SPSS version 20, through statistical tests. Formal ethical approval was obtained from the local institutional review board. Results: Significant mean change was found in interventional group in HbA1c (p<0.001), blood sugar fasting (p<0.001), total cholesterol (p=0.002), triglyceride (p=0.002) and hip-waist ratio (p=0.002). No significant change was observed in the mean of these statistics in the placebo group. No significant change was observed in height, weight, mid-upper arm ratio, and low density lipoprotein, high density lipoprotein and food frequency in intervention and placebo groups before and after. Conclusion: Apple cider vinegar if used regularly is effective in controlling diabetes, lowering hypercholesterolemia and hypertriglyceridemia in DM type 2 patients.

Observational study to assess the effectiveness of post-operative pain management of patients undergoing major abdominal surgeries in a tertiary care hospital

Background: Patients undergoing major surgical operations continue to experience pain with an overall reported incidence of 29.7% for moderate-to-severe pain and 10.9% for severe pain. Even in developed countries, 86% of patients experience postsurgical pain and 75% of those who reported pain described its severity as moderate-to-severe during the immediate postoperative period Major abdominal surgical operations ideally require the Acute Pain Management Service (APMS) for regular pain assessment and timely management of breakthrough pains and complications in the postoperative period. Aim of the study: To determine the effectiveness of Postoperative Analgesia used for Major Abdominal surgery and its efficacy and safety. Materials and methods: 38 Patients under General Anesthesia and 13 Patients under Regional + General Anesthesia who underwent major Laparotomy procedures were included in the study. Data regarding the type of postoperative Analgesia, Co–Analgesic used (NSAIDS, Paracetamol in oral/suppository form) during both intra and postoperative period were noted. All patients were followed on the first and second postoperative day at 4 PM. Pain severity with VAS score, side effects of Analgesia and Patient satisfaction with Pain management were recorded. Sindhu, Naheed Azhar, Nalini. Observational study to assess the effectiveness of post-operative pain management of patients undergoing major abdominal surgeries in a tertiary care hospital. IAIM, 2019; 6(5): 98-103. Page 99 Results: Use of Epidural Analgesia and Multimodal approach for Postoperative Pain relief greatly improves the patient satisfaction and early recovery of patients undergoing Major Abdominal surgeries. Conclusions: Although there is limited drug availability, regular assessments and appropriate dose adjustments and Use of Epidural and multimodal analgesic practice led to a high level of patient satisfaction

Anesthetic management of Pediatric cochlear implantation in a tertiary care centre

Background: Cochlear implantation has been evolved as the management of choice in patients with bilateral severe to profound sensorineural hearing loss in both children and the elderly population. Children who undergo cochlear implantation early in life, followed by appropriate rehabilitation have improved communication and learning skills. Aim of the study: In this study, we review the anesthetic management of seven cases of pediatric cochlear implantation done in our institution in the last one year. Materials and methods: Randomized control study was done at Government Stanley Medical College Hospital, Chennai, Tamil Nadu (January 2018). Intraoperative facial nerve integrity testing was not done for any of our cases. The nasopharyngeal temperature was monitored. To prevent hypothermia, forced air warmer was used. In our institution, stimulation techniques to identify facial nerve were not used for any of the cases. The intraoperative period was uneventful in all cases. Hemodynamics was maintained in all the cases in order to provide a bloodless surgical field. Results: No patients had emergence agitation. Post-operative analgesia was achieved with paracetamol rectal suppositories. No children had postoperative shivering. All children were followed up after discharge for stimulation of electrodes and speech therapy. Presence of mental retardation should be assessed as it may be associated with a retrocochlear hearing loss. Counseling was an important part of the pre-operative period to improve the outcome. Conclusion: Cochlear implantation is a specialized surgery and anesthesiologist’s awareness of the pitfalls and resourcefulness in dealing with communication impaired, pediatric age group makes the task challenging. The procedure itself has no significant anesthetic complications provided a thorough preoperative evaluation and good conduct of anesthesia is done.

To study the effect of using ringer’s lactate with or without addition of dextrose on intra-operative blood sugar levels in Pediatric age group undergoing surgeries

Background: General anesthesia without supplemental regional anesthesia might result in elevated blood sugar levels secondary to the stress response of anesthesia and surgery. Increased levels of cortisol and catecholamines augment glucose production because of increased hepatic glycogenolysis and gluconeogenesis along with reduced peripheral utilization of glucose. Hence, there exists a high possibility that supplementing dextrose intraoperatively without regular blood sugar estimation might result in hyperglycemic episodes which can lead to osmotic diuresis, impairment of neurological outcome, and risk of hypoxic episodes under anesthesia. Aim: To compare the effect of using Ringer's lactate with or without the addition of 1% dextrose on intra-operative blood sugar levels in the pediatric age group undergoing surgeries. Methods and methods: 44 pediatric age group patients, male patients undergoing circumcision for phimosis under I.V sedation with caudal block were chosen and divided into two groups randomly into Group A and Group B. Group A received 1% dextrose RL and Group B received RL without the addition of dextrose as intra-operative maintenance fluid. Along with basic parameters like heart rate and oxygen saturation, capillary blood glucose was also measured preoperatively just before induction and after the end of procedure postoperatively. Results: Preoperative and post-operative blood sugar values were compared. No significant hypoglycemia was developed in patients who had received only RL. And patients who received 1% Dextrose RL as intra-operative fluid had not developed significant hyperglycemia. Arivuselvan K, Nalani, Naheed Azhar. To study the effect of using ringer’s lactate with or without addition of dextrose on intra-operative blood sugar levels in Pediatric age group undergoing surgeries. IAIM, 2019; 6(5): 87-91. Page 88 Conclusion: Even with patients received only RL without dextrose as intraoperative fluid there is no significant hypoglycemia. So, the addition of dextrose is not mandatory in patients undergoing short surgeries provided their preoperative sugar level is not less than 80 mg/dl.

A comparative study between the efficacy of fentanyl with bupivacaine 05% and buprenorphine with bupivacaine 05% for lower abdominal and lower limb surgeries in a Government Tertiary Care Teaching Hospital

Background: Pain is one of the most common and uncomfortable consequences of surgery, feared by all. Effective and rapid relief from pain is always a challenge but is necessary for alleviating nocioception – induced responses like endocrine-metabolic responses to surgery, autonomic reflexes with adverse effects on organ function, reflexes leading to muscle spasm, and other undesirable results. Aim of the study: This study was done to compare the efficacy of intrathecal fentanyl with bupivacaine and buprenorphine with bupivacaine for all lower abdominal and lower limb surgeries. Materials and methods: Totally 60 ASA I and II patients of both sexes for different lower abdominal and lower limb surgeries were chosen for the study and the patients were divided into two groups of 30 patients in each group. Group F received 3 ml of 0.5% hyperbaric bupivacaine with 25 mcg fentanyl and group B received 3 ml of 0.5% hyperbaric bupivacaine with 75 mcg of buprenorphine. In our study, the time taken to achieve T10 level of the sensory blockade was considered as the time of V. Muruganantham, Nalini, Naheed Azar. A comparative study between the efficacy of fentanyl with bupivacaine 0.5% and buprenorphine with bupivacaine 0.5% for lower abdominal and lower limb surgeries in a Government Tertiary Care Teaching Hospital. IAIM, 2019; 6(5): 80-86. Page 81 onset of sensory block tested with pinprick method, motor block assessed by the onset of Bromage scale 3 and it was found that onset of the sensory block with bupivacaine + Fentanyl was earlier than compared with bupivacaine + Buprenorphine. Results: In the postoperative period VAS scores were significantly low for the buprenorphine group (Group B) when compared with fentanyl group (Group F). Conclusion: To summarize buprenorphine has higher efficacy with intrathecal bupivacaine, prolonged duration of postoperative analgesia and also analgesic-sparing effect in the post-operative period when compared to fentanyl.

Spectrum of gynecological malignancies at Jamshoro

Objective: To describe the frequency and spectrum of different types of gynecological malignancies. Study Design: An observational study. Place and Duration of Study: Department of Obstetrics and Gynaecology, Liaquat University of Medical and Health Sciences, Jamshoro, from January 2014 to December 2015

Methodology: All patients with gynecological malignancies, admitted at the study place, whether previously diagnosed or need to establish the diagnosis on the basis of EUA, biopsy, staging and for surgery during the study period were included. All patients with benign gynecologic masses were excluded. Studied variables were age, marital status, parity, education, socioeconomic status, clinical presentation, clinical diagnosis, tumor site and surgical procedure. The diagnosis and type of malignancy was confirmed on the histopathology report of the specimen taken

Results: There were a total of 65 patients [6.39%] with gynaecological malignancies. The median age was 15 years [46.26%]. Ninety-four percent were married. Seventy-one percent had a poor socioeconomic status. Cervical cancer was most common as seen in 27 [41.5%] followed by ovarian malignancy in 21 [32.3%] of cases, uterine caners in nine [13.8%], vaginal cancer in six [9.2%], and vulval cancer in three [4.6%] of cases. The common histopathological type of cervical cancer was moderately differentiated squamous cell carcinoma [n=19, 29.2%], papillary serous cyst adenocarcinoma in ovarian [n=13, 20.0%], and squamous cell carcinoma in vagina and vulva. There was no case of primary fallopian tube malignancy

Conclusion: Gynecological malignancies are common in younger age group. The need is to strengthen screening practices, making it easy and cost-effective for all the general and at risk population, so that early detection and treatment can be possible to control the female genital tract cancers

Association of impaired fasting glucose with hypertension

Objective: To evaluate the association of impaired fasting glucose [IFG] with hypertension in Pakistani population. Study Design: A cross-sectional, analytical study. Place and Duration of Study: Shifa Community Health Centre, Islamabad from December 2016 to July 2017

Methodology: One hundred and eighty-seven hypertensive patients were included in the study, using consecutive sampling technique. Demographic, anthropometric, and laboratory data of the patients were recorded. Continuous variables were expressed as mean + SD and categorical variables as numbers and percentages. Differences among males/females and between hypertensive patients with normal, impaired fasting glucose and diabetes for risk factors were analysed, using independent sample t-test, ANOVA and chi-square test using SPSS version 24

Results: The mean age of patients was 52.98 +11.22 years. Females were 69.9% and males 30.1%. The total frequency of IFG in patients with hypertension was 42.6% and new onset diabetes 12.5% showing its close association with hypertension. There was no significant difference between males and females for risk factors [age, BMI, blood pressure, total cholesterol, LDL-cholesterol, and HDL-cholesterol] except for more education, smoking, and high triglyceride in males. There was no significant difference among hypertensive patients with normal, impaired fasting glucose and diabetes for risk factors [gender, BMI, blood pressure, total cholesterol, LDL-cholesterol, triglycerides, HDL-cholesterol and family history] except for smoking

Conclusion: The significant association of impaired fasting glucose with hypertension necessitates early screening for impaired fasting glucose

Anti-diabetic activity of aqueous extract of Ipomoea batatas L. in alloxan induced diabetic Wistar rats and its effects on biochemical parameters in diabetic rats

Diabetes is a condition where the fasting blood glucose level elevated above the normal range [80-120mg/dL]. This increase in blood glucose level may be due to the insulin deficiency i.e. insulin dependent diabetes mellitus [IDDM or type I] or due to insulin resistance i.e. non-insulin dependent diabetes mellitus [NIDDM or type II]. Diabetes leads to severe complications in the body even life treating complications e.g. nephropathy, retinopathy, neuropathy increased vascular permeability and delayed wound healing if left untreated. Different drugs are used for the treatment of diabetes mellitus, but synthetic drugs are costly and possess severe side effects. So, more emphasis is being placed on the use of traditional medicines because these sources have fewer side effects than the synthetics drugs and are economical. So the white skinned sweet potato [Ipomoea batatas L.] peel-off was selected for its anti-diabetic effect as well as to see its effects on biochemical parameters. Both young [3-4 months] and old [up to 1 year] Wistar rats were selected for current study. It was found that the aqueous extract of WSSP peel-off had shown beneficial effects. In addition to the decrease in blood glucose level it also decreased protein glycation level total cholesterol, triglycerides, and LDL-cholesterol. Increase in HDL-cholesterol was also observed after treating the rats with aqueous extract of Ipomoea batatas. Additionally, WSSP peel-off had also shown positive results on total protein concentration, albumin, globulin, and plasma enzymes [SGOT and SGPT]. Further research would be needed in order to purify the anti-diabetic components and it should be available in compact dose form for all diabetic patients

Synthesis, characterization and evaluation of antibacterial activity of copper oxide nanoparticles against clinical strains of Staphylococcus aureus

Bacterial resistance is spreading globally due to excessive use of antibiotics, making it one of our times biggest challenges. To address this issue present study was conducted to evaluate the antibacterial activity of copper oxide nanoparticles against methicillin-resistant S. aureus [MRSA]. Copper oxide nanoparticles were synthesized by chemical precipitation method and were characterized by UV-Visible, FT-IR spectroscopy, X-ray diffraction [XRD] and Scanning Electron Microscopy. These nanoparticles of 27nm were assessed for antibacterial activity using disc diffusion method. Our results showed superb inhibitory effects of CuO nanoparticles with increase in concentration and complete inhibition was recorded against tested strains of S. aureus at 100Mul/ml and 125Mul/ml concentration. The study concludes that the drugs which do not show any inhibitory effects against resistant bugs could be augmented with CuO nanoparticles to achieve the treatment goal

Enhanced production of Lovastatin by filamentous fungi through solid state fermentation

Lovastatin is a natural competitive inhibitor of 3-hydroxy-3-methyl glutaryl coenzyme-A [HMG-CoA] reductase and inhibits specifically rate limiting step in cholesterol biosynthesis. Further, lovastatin in comparison with synthetic drugs has no well-reported side effects. Four pure isolated filamentous fungal strains including Aspergillus niger IBL, Aspergillus terreus FFCBP-1053, Aspergillus flavus PML and Aspergillus nidulans FFCBP-014 have been cultured by solid state fermentation [SSF] using rice straw as substrate for the synthesis of lovastatin. After selecting Aspergillus terreus FFCBP-1053 as the best producer of lovastatin, various selected physical parameters including pH, temperature, inoculums size and moisture content were optimized through response surface methodology [RSM] under center composite design [CCD] for lovastatin hyper production. Maximum lovastatin production of 2070+/-91.5 was predicted by the quadratic model in the medium having moisture content 70% and pH 4.5 at 35 degree C which was verified experimentally to be 2140+/-93.25Mug/g DW of FM [microgram/gram dry weight of fermentation medium], significantly [P<0.05] high as compared to un-optimized conditions while it was noted that lovastatin production is independent on inoculum size [P>0.05] measured by spectrophotometer at 245 nm against standard. It was determined that optimized conditions for the hyper-production of lovastatin from fungal sources have a significant effect

Effects of methanolic and aqueous extracts of Ipomoea batatas L on mineral contents level [calcium and magnesium] in alloxan-induced diabetic rats

In diabetic patients, electrolyte disorders frequently occur with the characteristic changes in minerals like calcium and magnesium etc. Several medicines are used to manage diabetes mellitus but they exert adverse effects. Plants are a valuable alternative to synthetic medicines because they are easily available, economical and have fewer side effects. Ipomoea batatas L is a well-known antidiabetic plant [sweet potato] but its effects on calcium and magnesium concentration have not studied. The prime focus of this study is to estimate the potential of Ipomoea batatas L peel-off on magnesium and calcium level in Alloxan-induced diabetic rats. Alloxan monohydrate was mixed in 0.9% NaCl solution and administrated [150 mg/kg [S/C]] to male Wistar rats to induce diabetes. After three days blood samples were collected and blood glucose level was recorded. Wistar rats having a blood glucose level of 200 mg/dl and above were selected for the study. Methanol and water extract of Ipomoea batatas L peel–off was given orally with a dose rate of 4g/day. Calcium and magnesium estimation was done using an atomic absorption spectrophotometer. Our results revealed an increase in both the calcium and magnesium level in heart, brain, liver, hind limb, and forelimb after Ipomoea batatas extract treatment. In kidneys decreased calcium level was noted as they excrete calcium. Mineral [Calcium, magnesium] level was increased in all organs except kidney after both extracts treatment. Ipomoea batatas being anti-diabetic in nature also maintain the homeostasis of calcium and magnesium in diabetes. Therefore, we propose the long-term use of such agents might help in the prevention of diabetes-associated complications. However, the validation of these results to human population needs further extensive study

Association of impaired fasting glucose with hypertension

Objective: To evaluate the association of impaired fasting glucose [IFG] with hypertension in Pakistani population

Study Design: A cross-sectional, analytical study

Place and Duration of Study: Shifa Community Health Centre, Islamabad from December 2016 to July 2017

Methodology: One hundred and eighty-seven hypertensive patients were included in the study, using consecutive sampling technique. Demographic, anthropometric, and laboratory data of the patients were recorded. Continuous variables were expressed as mean + SD and categorical variables as numbers and percentages. Differences among males/females and between hypertensive patients with normal, impaired fasting glucose and diabetes for risk factors were analysed, using independent sample t-test, ANOVA and chi-square test using SPSS version 24

Results: The mean age of patients was 52.98 +/-11.22 years. Females were 69.9% and males 30.1%. The total frequency of IFG in patients with hypertension was 42.6% and new onset diabetes 12.5% showing its close association with hypertension. There was no significant difference between males and females for risk factors [age, BMI, blood pressure, total cholesterol, LDL-cholesterol, and HDL-cholesterol] except for more education, smoking, and high triglyceride in males. There was no significant difference among hypertensive patients with normal, impaired fasting glucose and diabetes for risk factors [gender, BMI, blood pressure, total cholesterol, LDL-cholesterol, triglycerides, HDL-cholesterol and family history] except for smoking

Conclusion: The significant association of impaired fasting glucose with hypertension necessitates early screening for impaired fasting glucose

relationship of dyspnea and disease severity with anthropometric indicators of malnutrition among patients with chronic obstructive pulmonary disease

Objective: To find the association of dyspnea and disease severity with anthropometric indicators of malnutrition among chronic obstructive pulmonary disease patients

Methods: The cross-sectional analytical study was carried out at Sir Ganga Ram Hospital, Lahore during October 2013 to December 2014. Total 138 adult patients with severe COPD were enrolled. The severity of disease was measured by global initiative for chronic obstructive lung disease criteria; and dyspnea was assessed by modified medical research council dyspnea scale. Anthropometric indicators of malnutrition such as body mass index [BMI] and mid upper arm circumference [MUAC] were measured to evaluate the nutritional status of COPD patients. Data was analyzed by using Statistical Package for Social Sciences version 20

Results: The mean age of 138 patients was 55±3 years. The frequency of male patients [76.8%] was threetimes higher than female patients [23.2%]. The overall frequency of underweight patients measured by BMI was 44%, which was increased to 92% undernourished patients by using MUAC. When compared with female patients, the male patients showed lower means of BMI, MUAC, FEV1% and FEV1/FVC ratio. The significant relationship of high grade dyspnea with BMI [p=0.001], and MUAC [p=<0.001] revealed that malnourished COPD patients had more shortness of breathing as compared to normal-weight patients. Similarly, the association of FEV1% with BMI [p=0.001], and MUAC [p=<0.001] showed that malnourished patients had very severe type of COPD than normal-weight patients

Conclusion: Dyspnea and severity of disease had significant association with BMI and MUAC among COPD patients. Thus, assessment of nutritional status by measuring BMI and MUAC should be considered to predict the severity of disease among adult COPD patients