Vertebral Endplate Changes Correlate with Presence of Cartilaginous Endplate in the Herniated Disc Tissue: Factor Predicting Failure of Conservative Treatment

Methods@#Fifty-one discs were obtained from patients undergoing surgery for herniated disc. Their ages ranged from 19-65 years, and 31/51 were male. Pre-surgical T1 and T2 weighted lumbar-spine MRIs were analyzed to observe Pfirrmann grade, VEP defects, herniation type, Modic changes, and high-intensity zones (HIZ) at the affected level. Five-micron thick sections were stained with hematoxylin and eosin, Alcian blue periodic acid–Schiff stain; examined for histological degeneration scores (HDS; 0–15), inflammation (0 [absence]–3 [severe]), and presence of cartilaginous endplate (CEP). Three-micron thick sections were stained with protein-gene-product 9.5 and expression was counted/mm2. Data was analyzed, and p<0.05 was considered to indicate statistical significance. @*Results@#VEP defects, Modic changes, and HIZ were respectively observed in 30/51, 16/51, and 6/51 of the samples. CEP was observed in 26/51 samples and in 23/51 with endplate defects. Discs with adjacent VEP defects showed increased HDS (p<0.001) and inflammation (p<0.001). Discs with adjacent Modic changes also revealed increased HDS (p=0.01). Histological sections with CEP showed increased HDS (p<0.001) and inflammation (p<0.001), and nerve density was significantly positively correlated with HDS (r=0.27, p=0.02). @*Conclusions@#VEP changes can modulate degeneration and inflammation of herniated discs. Presence of these changes is highly predictive of the occurrence of CEP in herniated discs, which leads to slow resorption and persistent clinical symptoms.

Medical and biomedical research productivity from the Kingdom of Saudi Arabia [2008-2012]

Biomedical publications from a country mirror the standard of Medical Education and practice in that country. It is important that the performance of the health profession is occasionally documented. This study aimed to analyze the quantity and quality of biomedical publications from the Kingdom of Saudi Arabia [KSA] in international journals indexed in PubMed between 2008 and 2012.PubMed was searched for publications associated with KSA from 2008 to 2012. The search was limited to medical and biomedical subjects. Results were saved in a text file and later checked carefully to exclude false positive errors. The quality of the publication was assessed using Journal Citation Report 2012. Biomedical research production in KSA in those 5 years showed a clear linear progression. Riyadh was the main hub of medical and biomedical research activity. Most of the publications [40.9%] originated from King Saud University [KSU]. About half of the articles were published in journals with an Impact Factor [IF] of < 1, one-fourth in journals with no IF, and the remaining one-fourth in journals with a high IF [>/= 1]. This study revealed that research activity in KSA is increasing. However, there is an increasing trend of publishing in local journals with a low IF. More effort is required to promote medical research in Saudi Arabia

Knowledge and attitude of Saudi female students towards breast cancer: a cross-sectional study

In Saudi Arabia, females suffering from breast cancer often present late when their cancer has progressed to advanced stages. Hence the overall survival rate is low. Medical help-seeking behavior of females may be influenced by their awareness about breast cancer. Therefore, a cross-sectional study was designed to assess the knowledge, attitude and practices of university students towards breast cancer. One hundred and fifty females from a university in Saudi Arabia completed a questionnaire intended to provoke their sociodemographic information and knowledge, attitude and practices towards breast cancer. Data analysis was carried out using Statistical Package for the Social Sciences [SPSS] Version 19. Mean knowledge score was 16.6 out of 29. One hundred and six participants [70.7%] scored 50.0% and more. On the other hand, number of participants whose scores were below 50% was rather less [44; 29.3%]. Variables like single, knowing of a friend/family member suffering from breast cancer or practice of breast self-examination were significantly related to participants' knowledge scores. 50.7% participants admitted to carry out the breast self-examination procedure. Only 13 study participants [8.7%] had clinical breast examination. None of the participants had undergone mammography. Female university students have mild knowledge of breast cancer symptoms and management. They are also not clear about etiology and risk factors associated with breast cancer. Practice of clinical breast examination and mammography was rare in the participants. There is a need to enhance their knowledge regarding breast cancer and emphasize the need of breast cancer screening programs

Effects of ascorbic acid and alpha tocopherol supplementation on basal testosterone cortisol ratio in male sprague dawley rats

Basal testosterone cortisol ratio is considered very important to maintain homeostasis. Increase in this ratio has various beneficial effects on body. In this study we determined the effects of ascorbic acid and alpha tocopherol supplementation on basal testosterone cortisol ratio in male Sprague Dawley rats. It was quasi experimental study carried out in department of Physiology, Army Medical College Rawalpindi in collaboration with National Institute of Health, Islamabad during October 2006 to September 2007. Forty male Sprague Dawley rats were divided into four groups with ten rats in each group and above mentioned antioxidants supplementation were given along with standard diet for one month. After this, blood samples were taken and analyzed for serum testosterone and cortisol by ELISA and malondialdehyde levels colorimetrically. Data were analysed on SPSS version 13 and p<0.05 was considered significant. There was no significant rise in testosterone cortisol ratio in rats supplemented with single antioxidant; however rats supplemented with combination of ascorbic acid and alpha tocopherol revealed significant rise in testosterone cortisol ratio with a fall in malondialdehyde levels. Synergistic effects of ascorbic acid and alpha tocopherol resulted in a decline in reactive oxygen species induced lipid peroxidation and rise of testosterone cortisol ratio

Attitude of Pakistani doctors towards euthanasia and assisted suicide

To determine the attitude of junior and senior Pakistani physicians towards euthanasia and assisted suicide. A descriptive study. The study was carried out at Shifa International Hospital Islamabad in 2006 [January to November]. Shifa International Hospital Islamabad is a 500 bed tertiary care hospital with 400 resident staff and 140 specialists. An anonymous enclosed questionnaire on the respondent's opinion of euthanasia / assisted suicide was distributed to the doctors who were requested to rate according to degree of agreement, willingness to participate in these practices, and safeguard or restrictions needed if the practices were legalized. The total response rate was 66% and male to female ratio was 7:1. Most of the respondents were Muslims and had familiarity with the subject. Seventy seven percent believe that the practice of euthanasia and assisted suicide was not ethically justified, while 9% were in its favor. Pakistani doctors oppose euthanasia and assisted suicide

Effects of amlodipine besylate on spermatogenesis in sprague dawley rats

To determine the effects of chronic treatment with amlodipine besylate on spermatogenesis in Sprague Dawley rats. Quasi experimental study. The study carried out in the department of Physiology, Army Medical College Rawalpindi in collaboration with the department of Pathology, Army Medical College and National Institute of Health, Islamabad during April 2007 and March 2008. Thirty male Sprague Dawley rats were divided into two groups; each comprising of 15 rats. Group A was given vehicle whereas group B was given amlodipine besylate [norvasc] by oral and gavage for 50 days along with standard rat diet. Testes were removed 24 h after the last experimental day and sectioned. The sections were stained by hematoxylin and eosin and examined microscopically. Results were analyzed on SPSS version 13. There were significant differences in mean tubular diameter and height of germinal epithelium of testes between amlodipine and vehicle treated rats. Long term treatment with amlodipine besylate [norvasc] results in suppression of spermatogenesis in male rats

Effects of amlodipine on serum testosterone, testicular weight and gonado-somatic index in adult rats

Calcium ions are vital in many biological processes including hormonal secretion, mitosis, reproduction, fertility and regulation of gene expression. Thus, calcium antagonists who are frequently prescribed for the cure of cardiovascular diseases may affect any of these physiological processes. This quasi experimental study was done at Army Medical College, Rawalpindi from October 2007 to March 2008. Thirty male Sprague Dawley rats, purchased from National Institute of Health, Islamabad were divided into group A [vehicle treated controls] and group B [amlodipine treated]. After receiving drug treatment for 50 days, all the rats were sacrificed. Serum was stored to measure testosterone by enzyme immunoassay technique. The testes were removed for measuring absolute testicular weight and gonado-somatic index. Serum testosterone, absolute testicular weight and gonado-somatic index were found to be significantly reduced in amlodipine treated rats. These results suggest that long term treatment with amlodipine might be associated with significant testicular regression and reduction in serum testosterone. Furthermore, since dihydopyridine antagonists are widely used in hypertension, our data may have some clinical implication in the management of infertility associated with hypertension