The first use of combination of Intrapleural Fibrinolytics (Alteplase & DNAse) for pleural infection in Malaysia

@#The use of a combination of intrapleural fibrinolytics or tissue plasminogen activator(tPA) Alteplase and deoxyribonuclease (Dnase) has been increasing for cases of complicated pleural infection/parapneumonic effusion worldwide. Its efficacy and success rate in selected cases of complicated parapneumonic effusion unresponsive to antibiotics and chest drainage are well documented. This case report demonstrates the first use of combination intrapleural fibrinolytic (Alteplase) and DNAse (Pulmozyme) in Malaysia for a case of pleural infection/parapneumonic effusion.

Evaluation of in vitro urease and lipoxygenase inhibition activity of weight reducing tablets

Enzyme inhibition is a significant part of research in pharmaceutical field in view of the fact that these studies have directed to the innovations of drugs having remarkable performance in diverse physiological conditions. The present study was aimed to assess urease and lipoxygenase inhibitory activity of weight reducing tablets. For evaluating the urease activity indophenol method was employed using Thiourea as the model urease inhibitor. The lipoxygenase inhibition was evaluated by measuring the hydroperoxides produced in lipoxygenation reaction using a purified lipoxygenase with lionoleic acid as substrate. When formulation of the weight reducing tablets was compared at various concentrations [50, 100 and 500microg/ml]. The antiurease activity and lipoxygenase inhibition activity increased in a dose dependent manner. The formulations under test have an excellent antiurease and lipoxygenase inhibition potential and prospective to be used in the cure of a variety of complications associated with the production of urease and lipoxygenase enzymes

In vitro antioxidant and reducing capability of weight loss tablet formulation

Antioxidants are used as an influential counteractive measure in opposing the generation of reactive oxygen species. The current study was carried out to investigate antioxidant potential and reducing capability of developed weight reducing tablet formulation. When tablets were evaluated at concentrations of 50, 100 and 500 micro g/ml, antioxidant activity improved in a dose depending way just similar to standard Butylated hydroxyl anisol [BHA]. For evaluation of reducing ability the formulation under test evaluated at concentrations of 50, 100 and 500micro g/ml and it was observed that formulation contain good reducing capability and possess considerable activity to scavenge super oxide radicals. In-vitro analysis of weight reducing tablets formulation showed considerable antioxidant and reducing capacity that will be supportive in averting the development of a variety of oxidative stress-related diseases

Individualised second line anti-tuberculous therapy for anextensively resistant pulmonary tuberculosis (XDR PTB) in East Malaysia

Clinical experience with extensively Drug Resistant tuberculosis (XDR-TB) has not been reported in Malaysia before. We describe the clinical characteristics, risk factors, progress and therapeutic regimen for a healthcare worker with XDR-TB, who had failed therapy for multidrug resistant TB (MDR TB) in our institution. This case illustrates the risk of TB among healthcare workers in high TB-burden settings, the importance of obtaining upfront culture and susceptibility results in all new TB cases, the problem of acquired drug resistance developing during MDR-TB treatment, the challenges associated with XDR-TB treatment regimens, the value of surgical resection in refractory cases, and the major quality of life impact this disease can have on young, economically productive individuals.

A Rare Double Pathology- Coexistent Large Cell Neuroendocrine Cell Carcinoma of the Lung with Basal Cell Carcinoma of the Skin

No abstract available.

Pattern of stroke in diabetics and non-diabetics

Diabetes mellitus has been established as a risk factor for stroke. Diabetes increases the risk of stroke in younger patients and diabetics are more likely to have an ischemic stroke. There are numerous studies on microvascular complications but there are only a few studies on strokes in diabetics. Therefore, this study was conducted to assess the impact of diabetes on the pattern of stroke in our population. This descriptive study was carried out in Department of Medicine, Ayub Teaching Hospital, Abbottabad from September 2011 to February 2012. Forty diabetics and 40 nondiabetics stroke patients were included in the study. Risk factors were noted and their distribution in both groups was analysed. The difference in age and gender distribution in both groups was not significant. Thirty-four [85%] of diabetics, and 25 [62.5%] non-diabetics suffered from ischemic stroke. Six [15%] of diabetics and 15 [37.5%] of non-diabetics suffered from haemorrhagic stroke. The differences between the distribution of ischemic stroke were significant [p<0.02]. In the diabetic group 32.5% of the individuals suffered from lacunar infarcts and in the non-diabetic group 10% suffered from lacunar infarctions [p<0.02]. There was no significant difference in distribution of risk factors. Diabetics are more likely to have an ischemic stroke and lacunar infarctions

Diabetes Mellitus; frequency among general population of Rahim Yar Khan

To determine the frequency of diabetes mellitus and to assess the level of awareness about diabetes amongst persons attending a free health camp in cultural festival of Rahim Yar Khan. Cross sectional observational study. Three days free health camp arranged in a cultural festival in Rahim Yar Khan. Over all frequency of type II diabetes was 19.38% and the frequency of diabetes increased both in men and women with increasing age [p<0.001]. Newly diagnosed subjects were 6.77% and these do not know that they were suffering from diabetes. 18.92% subjects were having glucose intolerance and 61.70% subjects were having random blood glucose level within normal limits. Diabetes was correctly defined by 57% subjects and this was significantly associated with educational level, suffering from the disease and presence of disease amongst family members. 14.62% gave history of presence of disease in their families. As compared to females, males were more suffering from disease and these were consuming more foods and snacks than females [p<.0.01]. High frequency of diabetes mellitus was observed amongst the study population. This may be due to health consciousness and higher level of educational status in the subjects who participated. Emphasis on health education and preventive strategies are needed to increase public awareness and early detection of high risk groups and risk factors of this common disease in our country. The lifestyle behaviors and environmental factors are strong modifiers of diabetes The life style changes and interventions in early age may prove to be more effective than interventions done at a later stage

Prophylactic antibiotic in cardiac surgery - does duration of prophylaxis effect the outcome?

To evaluate that duration of prophylactic antibiotics in patients undergoing open-heart surgery have an impact on deep sternal infection. [Mediastinitis]. Cross sectional comparative study on patient undergoing open-heart surgery. This study was conducted at cardiac surgery department, Mayo Hospital Lahore. It included patients operated from May 2005 to July 2006. Duration of study was 14 months. Total of 200 patients undergoing open-heart surgery were included in the study. We compared 100 patients, receiving less than 48 hours of prophylactic antibiotics [Group A] with another 100 patients, receiving more than 48 hours of prophylactic antibiotics [Group B]. The endpoint of study was development of mediastinitis requiring sternal rewiring. Ten patients were rewired for sternal dehiscence [5%]. Test of proportion was applied and it was concluded that there is no difference in proportion of infection in the two groups. [p value of 0.05]. Conclusions: The results provide evidence that there is no need to continue antibiotic prophylaxis for more than 48 hours in patients undergoing open-heart surgery

Cauterization in unani system of medicine a review

In Unani system of medicine, treatment of a patient is performed by administering medicines [Ilaj bil-Dawa], by adopting suitable technique of interference in six-essentials of life [Regimental therapy] and by using manual art and surgical instruments [Ilaj bil-Yad/Ilaj bil-Hadid]. Since ancient time Ilaj bil-Yad consists of treatment of fractured bones, reduction of dislocated bones, incision of body tissues, amputation and excision of diseased body parts, cauterization of diseased body parts and stitching of incised and damaged tissues. In Arabic literature, Ilaj bil-Yad is also termed as Ilaj bil-Hadid [treatment by surgical instrument] or Sana'at ul-Yad [Manual Art or Operative Procedure]. Cauterization is reckoned in the category of manual treatment and it is performed either by fire [Hot metal] or by strong corrosive medicine. Now it is being realized that if cauterization is performed/applied as a common surgical procedure in the contemporary medical practise, it may provide successful treatment for a large number of diseases