Role of pitavastatin in prevention of osteopenic changes in ovariectomized rats

Objective: To determine the effect of pitavastatin, a third generation statin, on development of osteopenia in ovariectomized rats

Study Design: Experimental study

Place and Duration of Study: Department of Pharmacology, Basic Medical Sciences Institute, Jinnah Postgraduate Medical Center, Karachi, from January to July 2013

Methodology: Forty female Sprague Dawley rats were divided into ovariectomized [OVX], Sham OVX and OVX given pitavastatin 0.4 mg/kg/day, 0.8 mg/kg/day, for 8 weeks. Bone density measurements using CT scan and Archimedes' principle were made on femora and tibiae. Blood samples were analyzed for acid phosphatase [ACP] and alkaline phosphatase [ALP] levels

Results: Ovariectomy-induced osteopenic changes were indicated by significant decrease in bone densities and Hounsfield [HU] index of distal femoral and proximal tibial metaphyses and elevation of ACP and ALP levels. 0.4 mg/kg pitavastatin did not significantly alter the evaluated parameters. 0.8 mg/kg produced a restoration of HU of lower femur and femoral density comparable to Sham. HU of upper tibia and tibial density following 0.8 mg/kg was significantly higher than OVX but was not approximate to Sham. ALP and ACP with 0.8 mg/kg were comparable to Sham

Conclusion: Supra-therapeutic dose of pitavastatin was effective in preventing estrogen deficiency-induced decrease in bone density of ovariectomized rates, over an 8-week period

Balanced diet; balanced life

Objective: Non-pharmacological intervention to manage the health by healthy balanced diet and life style modifications

Study Design: Randomized Cross sectional Study

Place and Duration: Pakistan Council of Scientific and Industrial Research [PCSIR] laboratory Karachi from March 2012 to June 2013

Material and Methods: In this study, 210 volunteers were included [137 male and 73 female] aged between 25-60 years. The study was conducted with the questionnaire being filled at PCSIR labs, Karachi. The study period included from March to May 2012. One year later the same group of volunteers were re-examined from March to June 2013, who managed to alter the diet and life style for one year. The questionnaire was filled by an expert well versed in collecting the data from the patients who attended the OPD at PCSIR labs

Results: The results indicate that a lot of people in our population lead a sedentary life style and do not take part in physical activity which leads to health problems due to comparatively less energy / calories expenditure

Conclusion: Efforts should be made globally to create a public awareness and provide healthy environment to the people about pursuing healthy lifestyles. Several life style behaviors may influence to maintain energy balance over long term. The primary approach for achieving weight loss is lifestyle changes which includes reduced intake of calories and increase in physical activity. Regular, moderate intensity physical activity enhances long term weight maintenance and balance between energy input and output

ringing bells: perspective of Karachiites regarding noise pollution

To identify the awareness regarding noise pollution and its adverse effects on human health in the people of urban areas of Karachi. Cross-sectional survey. Urban areas of Karachi, from September to October 2012. A survey was conducted with 50 selected subjects of urban areas of Karachi with their informed consent. The questionnaire covered aspects of noise pollution. Descriptive analysis was done with percent responses. All [100%, n=50] subjects admitted to be suffering from noise pollution. The source of noise pollution was vehicles in 64% [n=32]. There was 90% [n=45] agreement for laws and regulations regarding noise pollution to be in place. Awareness sessions need to be conducted for the public regarding the effects of noise pollution on health with formulation of laws and regulations

Lessons learnt: pilot of mid rotation feedback

The Aga Khan University went through an external review of its undergraduate medical education in December 2006 based on the accreditation guidelines by the Liaison Committee for Medical Education [LCME]. The external review panel comprised of international and local experts which developed a comprehensive report on its findings with regards to LCME standards of accreditation. In the final report of the external review one of the areas highlighted as not meeting the standards of LCME was documentation of formal mid-rotation feedback of the students by the faculty in AKU clerkships through years 3 to 5. A four hour faculty development workshop was organized by the Department of Medicine in collaboration with the Department for Educational Development to emphasize the role of feedback in improving student's performance, improve faculty's skill in giving effective feedback, and to come up with recommendations for documenting the formative feedback process. A mid-rotation feedback form was designed to facilitate the documentation process. Faculty members who participated in the workshop took a lead in piloting this form and reported the areas that could be further improved upon to facilitate the process of timely and effective feedback

Efficacy and safety of metformin in over weight and obese patients with polycystic ovary syndrome

To evaluate the efficacy and safety of metformin in overweight and obese women with polycystic ovary syndrome. Forty-four overweight and obese female patients with diagnosed polycystic ovary syndrome were evaluated in an open label study. Patients were assigned metformin SOOmg thrice daily for six months. The primary outcomes were to assess change in the fasting serum insulin level, fasting plasma glucose, insulin sensitivity, weight, BMI, Waist to hip ratio and ultrasonographic features of overweight and obese women. The secondary outcomes were systolic and diastolic blood pressure, menstrual cyclicity and hirsutism. The safety of intervention was assessed by recording the self-reported adverse effects and performing renal and hepatic profiles. The patients were evaluated at monthly intervals. Forty subjects [90.9%] completed the study. At the end of six months, there was a significant effect of the drug on all the clinical parameters. Weight decreased from 85.71 +/- 1.04 to 84.38 +/- 1.02, BMI from 33.2 +/- 0.32 to 32.8 +/- 0.33[p <0.05] and Waist to hip ratio from 0.85 +/- 0.003 to 0.83 +/- 0.002.Ultrasonographic features, systolic and diastolic blood pressure also showed statistically significant improvement. Menstrual cyclicity, hirsutism, and metabolic parameters [serum fasting insulin level, fasting plasma glucose, HOMA index] also showed statistically significant improvement. The drug was well tolerated by the patients. No change was observed in blood urea, ALT and serum creatinine levels. Metformin is a safe and effective drug for the treatment of obese and over weight, women with PCOS

Use of concept mapping as a facilitative tool to promote learning in pharmacology

To assess whether students find concept mapping a useful learning methodology to conceptualize and organize topics studied in CNS module of Pharmacology; and to evaluate whether addition of concept mapping assignment could help to improve examination scores. An analytical study. College of Dentistry, Jinnah Medical and Dental College, Karachi, Pakistan, from March to May 2009. A class of 50 BDS students was recruited for the study. Two randomly selected groups of 12 students each, prepared concept maps in topics from CNS pharmacology which were displayed and discussed during tutorial sessions. The other two groups [n=25] following the traditional teaching methodology, served as controls. Scores from best choice questions and short essay questions were compared between the investigational and control groups using the student's t-test with significance at p < 0.05. Feedback obtained after completion of the study was evaluated as percent response. One-best-choice test of the control group showed a mean grade of 57.1 + 16.7 vs. test group mean of 58.8 + 13. For the short essay questions, control group obtained a mean of 52.3 + 18.8 vs. test group mean grade of 53.8 + 22.5. Both results were not significantly different [p > 0.05]. However, feedback about concept mapping showed that the technique helped the students to conceptualize difficult topics in CNS pharmacology [86.36%]. Concept mapping was particularly beneficial in preparing for exams as it provided a quick overview of the entire subject [68.68%]. Students found concept mapping as a useful pedagogical tool which could potentially be used to acquire meaningful learning in Pharmacology as a supplement to traditional teaching techniques. It was not found beneficial in improving examination grades probably because standard examinations and concept mapping measure different cognitive domains

Effect of montelukast on patients with mild persistant asthma

To determine the clinical effects of oral montelukast sodium [a leukotriene receptor antagonists] in asthmatic patients aged 15 years and above. This was a 2 month [60 days] study carried out in the Department of Pharmacology and therapeutics, Basic Medical Sciences Institute with collaboration of Chest Medicine, JPMc, Karachi. Patients> 15 years and above suffering from persistant asthma [prebronchodilator FEVI = 60% of the predicted value] and insufficiently controlled on inhaled corticosteroids were included in the study. Total of 100 patients completed the study. The study comprised of two arms of 50 patients each. Group A was the control group on the placebo group receiving inhaled corticosteroids and a placebo drug. Group B was the active group or the drug group receiving inhaled steroids as well as 10 mg montelukast at bed time. Asthma control was assessed by spirometery [name model No.] at the onset i.e. start of the study and then after 60 days i.e. end of the study as per the specifications and guide lines laid down by the global initiative for asthma. Along with this the patients were evaluated weekly in which PEER was measured using a peak expiratorv flow meter. Similarly the ptient was asked to maintain a daily diary in which day time asthma symptoms were recorded along with nocturnal awakenings. use of beta2 agonists use, asthma exacerbations and asthma free days and use of health related resources for worsening asthma symptoms. Montelukast improved airway obstruction FEVJ-PEFR and patients reported end points i.e. day time asthma symptoms, nocturnal awakenings [P<0.001 compared with placebo]. The comparison of difference in mean value of PEFR, FEVI and nocturnal awakenings among two groups from baseline to 811 week was compared by students t-test [test for two independent groups for mean]. 95% confidence interval of the difference of mean was also calculated. Montelukast, compared with placebo significantly improved asthma control during a 8 week treatment period