Efficacy of platelet rich plasma versus steroid injection in planter fasciitis

Background: Plantar fasciitis is local inflammation and fibrosis of the plantar aponeuroses reducing the quality of life and productivity of affected individuals. Pain in the heel and bottom of the foot is the ultimate outcome

Objectives: To compare the effect of platelet rich plasma and steroid injections among patients having planter fasciitis

Methodology: This Qusai experimental study was conducted at the Department of Orthopedic Surgery at Allied and DHQ Hospital, Faisalabad from 1[st] July 2015 to 30[th] June 2017. Total of 28 patients with age range of 25 -60 years were included in the study. 14 patients received platelet rich pleasure [PRP] injection [GROUP A] and 14 were treated with a steroid injection [GROUP B] and were followed for the outcome at 0, 6 and 24 weeks to assess mean American Foot and Ankle score and Visual Analogue score. The data was entered in and analyzed by using SPSS version 20

Results: Our study showed that mean AFAS was 80. +/- 4. at 6 weeks and 91. +/- 1.6 at 24 weeks in the group A and 71.4 +/- 3.7 and 80 +/- 3.2, respectively, in the group B. [p<0.001] The mean VAS 14 the group A was [2.7 +/- 0.6 and 1 +/- 0.3] and the group B [3 +/- 1.1 and 2.1 +/- 0.9] at the 6th week and 24 weeks was statistically significant.[p<0.001]

Conclusion: Plasma Rich Protein appears to be better as compared to steroid injection in terms of pain relief in the treatment of plantar fasciitis

Anti-infective, cytotoxic and antioxidant activity of Ziziphus oxyphylla and Cedrela serrata

Objective To search for the most active antimicrobial and antioxidant sub-fractions related to traditional use of Ziziphus oxyphylla (Z. oxyphylla) and Cedrela serrata (C. serrata) in Pakistan against infectious and liver diseases. Methods Factions of different polarity were tested in vitro for their antiprotozoal, antimalarial, antibacterial and antifungal activity against different pathogens. Cytotoxicity on MRC-5 cell lines (human lung fibroblasts) as well as, in vitro radical scavenging activity was evaluated using the 1, 1-diphenyl-2-picrylhydrazyl radical assay. Results The highest antiprotozoal activity was observed for the CHCl

Assessment of antinociceptive, antipyretic and antimicrobial activity of Piper cubeba L. essential oil in animal models

This study was designed to investigate the possible antiniciceptive, antipyretic and antimicrobial activities of the essential oil obtained from the fruits of Piper Cubeba [L.]. To assess the antinociceptive and antipyretic activities, three doses [150, 300 and 600 mg/kg, i.p.] were tested in acetic acid-induced abdominal writhing, tail flick reaction and hot-plate and Brewer's yeast-induced hyperpyrexia test models in animals. Moreover, the antimicrobial activity was examined using agar diffusion method and broth micro-dilution assay for minimum inhibitory concentrations [MIC]. The Piper Cubeba essential oil [PCEO] showed a marked antinociception [17, 30 and 54%] and an increase in reaction time in mice in the flick tailed and hot-plate tests. The brewer's yeast induced hyperpyrexia was decreased in a dose dependent manner. PCEO also exhibited a strong antimicrobial potential. These findings confirm the traditional analgesic indications of P. cubeba oil and provide persuasive evidence and support its use in Arab traditional medicine

Ciprofloxacin; the frequent use in poultry and its consequences on human health

Fluoroquinolones are bactericidal agents that exhibit AUC/MIC dependent killing. In general, they are effective against Gram-negative organisms and some mycobacteria. Ciprofloxacin is the members of this group and its bactericidal action involves the impeding of enzyme topoisomerase II and IV. In human beings, this drug is recommended for a variety of infections including typhoid fever, chronic bacterial prostatitis, lower respiratory tract infections, skin infections, urinary tract infections, acute exacerbations of chronic bronchitis, complicated intra-abdominal infections, infectious diarrhea, and uncomplicated cervical as well as urethral gonorrhea. The drug is as effective in animals as in humans, and is therefore used in animals as well. According to European health law and National Office of Animal Health [NOAH], UK, the statutory withdrawal period for veterinary medicinal products must not be less than 28 days for meat from poultry. The chicken used for meat purpose usually is of the age between 6 to 8 weeks, therefore the use of the drug must be discontinued by the age of 2 weeks. Whereas the age of chick at which it usually develops indicated diseases, is 3 weeks. In this situation, it is not possible to attain a withdrawal period of 28 days. Based on these observations, ciprofloxacin use may not be recommended in poultry for treatment of diseases as it may cause unnecessary exposure to humans while utilizing poultry meat and may lead to the development of drug resistance

Review of dental operative procedures and the causes of tooth extraction at the railway general hospital rawalpindi

To study the frequency of various dental procedures and the causes of dental extractions at Railway General Hospital Rawalpindi and to suggest measures to improve the existing scenario. A descriptive cross-sectional study The study was conducted at IIMCT, Railway General Hospital from June 2014 to May 2015. All consecutive patients undergoing dental operative procedures at IIMCT Railway General Hospital were studied. The patients were examined clinically and by dental X-Ray when required. The extent of caries was ascertained and Miller's Mobility Index was used to grade the extent of Periodontitis. Tooth extraction was done in patients having broken down roots, gross caries, tooth mobility grade >2 and those with impaction, trauma, cysts etc. A total of 3116 dental procedures were done that included 1902 [61.0%]tooth extractions, 930 [29.8%] fillings, 166 [5.3%] scalings and 118 [3.8%] root canal treatments. The number of scalings and root canal treatments significantly, increased with addition of an extra dental surgeon [p<0.001]. A total of 1902 teeth were extracted from 1560 patients. Caries was the leading cause of tooth extraction [60%]. Most of the patients with advanced caries presented with broken down root [763/1902,40%]. Gross caries was the reason for extraction in 380/1902 [20%], periodontitis with mobile teeth [grade >2] in 569/1902 [30%] and other reasons like cysts, impaction and trauma etc. in 190/1902 [10%] of patients. Conclusion: Caries and periodontal infections are the commonest dental problems and the reason for tooth extraction at the Railway General Hospital Rawalpindi where people mostly come from the lower socio-economic status. The quality of work in a public sector dental setting like Railway General Hospital can be improved by providing adequate number of dentists and other resources

Alcoholic liver disease [ALD]; implication of oxidative stress and extrapolative factors in patients suffering, update from local population of punjab-Pakistan

The aim of the present study was to investigate the changes in biochemical parameters including lipid profile, liver and kidney profile as well as oxidative stress profile, particularly in patients suffering from alcoholic liver disease [ALD]. Fifty chronic alcoholics admitted for treatment to the in-patient wards at Jinnah Hospital, Lahore-Pakistan. Chronic alcoholics with alcohol abuse for more than four to five years, and with or without clinical complications, were included. Apparently twenty healthy individuals served as control. 2012-2013. Various circulating biochemical biomarkers including renal profile, hepatic and lipid profile were evaluated. Moreover, stress markers [MDA. SOD, GSH and catalase] were also investigated. A very strong direct and indirect correlation of ALP was found with TB, MDA and GSH [r=.950**, r=.929** and r=-.967** respectively, P<0.01]. MDA was observed having very strong indirect correlation with GSH and catalase [r=-.909** and r-.777** respectively, P<0.01]. All parameters in combinations may be useful indicator or may be good and reliable biochemical markers for identification and determination of severity of alcoholic liver diseases [ALD]. The damaging of hepatocytes due to the consumption of alcohol disturbs almost all types of biochemical coordination in the biological system

Alternative medicine; the tendency of using complimentary alternative medicine in patients of different hospitals of Lahore, Pakistan

From ancient times, humankind has used self-created traditional methods for handling the illnesses and continues to use them along with modern medicine. Even today, more than 70% of the world's population still depends on the complementary and alternative systems of medicine [CAM]. The objective of this study is to create awareness of health hazards with the use of CAM therapies and to find out its utility among Pakistani population. Comprehensive questionnaire was developed for the study on the use of CAM and was distributed to 470 patients/attendants in different hospitals of Lahore as well as major hospitals and clinical setups in the peripheral regions of Lahore, Pakistan. Over all, the response rate of the study was 81.7% while 78.1 % population found as CAM user. The most common type of alternative medicine used by patients is from Hakeem [Natural Therapist] which is about 17% and the most frequent disease for which patients often go for CAM therapy is liver diseases [19%]. Respondents found inclined towards CAM only due to its marketed false benefits and not because of their dissatisfaction with conventional therapy. A noteworthy population of Pakistan is using CAM therapies from different practitioners, irrespective of any education and awareness about their disease and long-term drawbacks because of improper treatment of the disease. Though adverse events due to the use of CAM therapy are not unusual still a delay in the proper treatment usually ends up in serious consequences and even loss of lives

Phytochemical screening and Anti-oxidant activity of the two plants Ziziphus oxyphylla Edgew and Cedrela serrata Royle

Phytochemical studies of medicinal plants are a basic and helping tool for the isolation of active secondary metabolites

The isolation of active compounds is made easy by the help of preliminary phytochemical studies, which the presence of a specific class or group of compounds present in these medicinal plants. Ziziphus oxyphylla and drela serrata are medicinal plants with valuable local uses

The present study is for the first Phytochemical investigation of these two medicinal plants which consists of, Quantitative tests showing very good results except Ztiphus oxyphylla plants which does not showed the results for Ester value and Peroxide value

Color reactions are studied for all the crude extracts showing the presence of a number of chemical groups belonging to the class of Alkaloids, Phenol compounds, Phenothiazines, Aromatic compounds, Amino acids, Sulfur compounds etc. Brine shrimp activity was performed which showed a LD[50] value of 45.74 and 53.36 in the case of Ziziphus oxyphylla roots and Cedrela serrata bark respectively, which is comparable to the standard drug Cyclophosphamide results of 16.09

Insecticidal activity did not show any promising result indicating the absence of any insect killing potency

Antioxidant activity was very positive for all the extract particularly, the Ziziphus oxyphylla roots, which showed even better results than the standard drug Ascorbic acid used in various dilutions

E-cadherin expression, a valuable predictor of invasiveness in histological grades of oral squamous cell carcinoma

The aim of this study was to evaluate E-Cadherin expression in oral squamous cell carcinoma [OSCC] with its relation to histological grades. It was a quasi experimental study in which sixty diagnosed cases of oral squamous cell carcinoma were selected by purposive sampling technique. Fresh sections were prepared and re-diagnosed for relative histological grades by H and E staining, regardless of their previous diagnosis. E-Cadherin expression was assessed in terms of Intensity and Site of staining and its expression was recorded. The collected data were analyzed by SPSS version 17. The differential grades observed in 60 cases both with H and E and E-Cadherin staining methods were compared which showed a highly significant association, P-value < 0.001. A strong membranous E-Cadherin expression was observed in cells of well differentiated squamous cell carcinoma, which changed to heterogeneous [both membranous as well as cytoplasmic expression] in moderately differentiated SCC and became weak cytoplasmic to absolute negative in poorly differentiated OSCC. Intensity of E-Cadherin expression was also observed to be reduced, P-value < 0.001, with the advancing histological grades of oral squamous cell carcinoma. It was concluded that E-Cadherin expression provides accurate details of tumour behaviour at all levels in a given section which can be used to predict the prognosis of the disease more accurately

Phytochemical, antimicrobial, insecticidal and brine shrimp lethality bioassay of the crude methanolic extract of ajuga parviflora benth

Methanolic extract of medicinal herb Ajuga parviflora Benth. was evaluated for phytochemical screening [the plant extract showed the presence of aromatic compounds, carbohydrates, glycosides, tannins, alkaloids, polyphenols, quinines and dions, aminophenols, steroids/sterols, flavonoids and terpenoids], antimicrobial activities against various strains of bacteria and fungi by using disc diffusion method and insecticidal activities against red flour beetle [Tribolium castaneum], wheat weevil [Sitophilis granaries] and their larvae. The crude extract showed anti-bacterial activity against all strains with a maximum zone of inhibition of 12mm diameter against Citrobacter and Pseudomonas aurogenosa. Standard drugs Ampicillin, Gentamicin and Amoxicillin were used in parallel. The crude extract did not show antifungal activity against the tested strains of fungi even at high doses. The crude methanolic extract was also used for insecticidal activity against the two types of insects and their larva. The extract showed no significant mortality in the tested strains. For brine shrimp lethality bioassay different concentrations 10, 100 and 1000ug/ml of the medicinal herb A. parviflora methanolic extract were used. After 24 hrs the percent mortality and LD[50] value was calculated through probit analysis. The LD[50] value of extract was 321.42microg/ml while that of standard drug cyclophosphamide was 16.09ug/ml

Neonatal Intracranial Ischemia and Hemorrhage : Role of Cranial Sonography and CT Scanning

OBJECTIVE: To evaluate the role of cranial sonography and computed tomography in the diagnosis of neonatal intracranial hemorrhage and hypoxic-ischemic injury in an Indian set-up. METHODS: The study included 100 neonates who underwent cranial sonography and computed tomography (CT) in the first month of life for suspected intracranial ischemia and hemorrhage. Two observers rated the images for possible intracranial lesions and a kappa statistic for interobserver agreement was calculated. RESULTS: There was no significant difference in the kappa values of CT and ultrasonography (USG) for the diagnosis of germinal matrix hemorrhage/intraventricular hemorrhage (GMH/IVH) and periventricular leucomalacia (PVL) and both showed good interobserver agreement. USG, however detected more cases of GMH/IVH (24 cases) and PVL (19) cases than CT (22 cases and 16 cases of IVH and PVL, respectively). CT had significantly better interobserver agreement for the diagnosis of hypoxic ischemic injury (HII) in term infants and also detected more cases (33) as compared to USG (18). CT also detected 6 cases of extraaxial hemorrhages as compared to 1 detected by USG. CONCLUSION: USG is better modality for imaging preterm neonates with suspected IVH or PVL. However, USG is unreliable in the imaging of term newborns with suspected HII where CT or magnetic resonance image scan is a better modality.

Studies on biomarkers for oxidative stress in patients with chronic myeloid leukemia

Chronic myeloid leukemia [CML] is a myeloproliferative disorder with a unique genetic rearrrangement, the Philadelphia chromosome. High reactive oxygen species [ROS] levels favor oxidative stress, which could play a vital role in normal processes and various pathophysiologies including neoplasm. Biomarkers of oxidative stress are measured as products of oxidized proteins and lipids. Plasma levels of protein carbonyl [PC], thiobarbituric acid reactive substances [TBARS] and total lipid hydroperoxide [LOOH] were used as biommarkers of oxidative stress in the past. The aim of this study was to evaluate the products of protein oxidation and lipid peroxidation in plasma as biomarkers of oxidative stress in CML patients. The study included 40 CML patients and 20 age- and sex-matched healthy voluntteers. Of 40 CML patients, 28 were in chronic phase [CML-CP] and 12 in accelerated phase [CML-AP]. Plasma levels of PC, TBARS and LOOH as biomarkers of oxidative stress were evaluated by spectrophotometric methods. There were significant differences [P<.05] in plasma levels of PC, TBARS and LOOH in CML, CML-CP and CML-AP patients as compared to controls. PC, TBARS and LOOH might reflect oxidative stress in CML patients and might be used as biomarkers in such patients

Giant angiomyolipoma associated with a dilated vessel prone to hemorrhage

Angiomyolipomas are benign neoplasms of the kidney which can clinically mimic renal malignancy. The imaging features are quite characteristic, and diagnosis can be clinched solely based on radiological investigations. Although mostly asymptomatic, they can be a cause of significant morbidity due to size and hemorrhage. We report a case of giant angiomyolipoma with a dilated vessel susceptible to hemorrhage

S-phase fraction as a useful marker for prognosis and therapeutic response in patients with aplastic anemia

The functional definition of aplastic anemia [AA] is the failure of hematopoietic stem cells to proliferate. The aim of the present study was to analyze the S-phase fraction [SPF] [proliferative activity] in patients with AA at diagnosis to explore its relationship with disease characteristics and its value in discriminating among patients with different prognoses. We also investigated whether the SPF value influenced the response to immunosuppressive therapy in AA patients. The analysis of SPF at the time of diagnosis was carried out by flow cytometry on peripheral blood samples from 53 consecutive patients with AA and 30 age- and sex-matched controls. All patients were given cyclosporine and followed up periodically to determine response to therapy. Based on the median SPF, AA patients were divided into two groups: patients with SPF <0.59% [n=27] and patients with SPF >0.59% [n=26]. An SPF >0.59% was associated with advanced age [P=.02] and elevated serum LDH level [P=.01]. Patients with an SPF >0.59% also had a higher incidence of paroxysmal nocturnal hemoglobinuria and cytogenetic abnormalities. During a median follow-up of 18 months, 3.7% of patients with SPF <0.59 and 11.5% of patients with SPF >0.59% developed dysplasia and one patient with SPF >0.59% converted into AMI. A significantly higher [P=.018] overall response rate of 53.9% was found in patients with SPF >0.59% versus 22.2% of patients with SPF <0.59% at 6 months. Independently of the peripheral blood count, the SPF at diagnosis may provide information on the expected response to immunosuppressive therapy and the propensity for disease to evolve into MDS/AML. Hence, SPF may serve as an early indicator for the evolution of MDS/AML in patients with AA and thus contribute to therapeutic decisions

Hydrometrocolpos due to persistent urogenital sinus mimicking neonatal ascites

A urogenital sinus is a common channel into which both the urethra and genital tracts open. Occasionally there might be transverse obstructing membrane leading to hydrometrocolpos from either uterine secretions or urine. Although the presentation is varied, a neonatal presentation of a large hydrometrocolpos mimicking gross ascites is rare. A 3-day-old female infant was referred to us from periphery as a case of gross ascites of unknown cause. Patient was having rapid and shallow breathing and had gross ascites. The patient was evaluated and was diagnosed to have large hydrometrocolpos. To avoid unnecessary delay in diagnosis and proper treatment the possibility of hydrometrocolpos secondary to urogenital sinus presenting as generalized abdominal distension should be kept in mind. A focused genital examination can help achieve the diagnosis