Study of erythrocytes as a novel drug carrier for the delivery of artemether

Resealed erythrocytes have been explored in various dimensions of drug delivery, owing to their high biocompatibility and inability to initiate immune response. The present research was designed to evaluate the drug delivery potential of erythrocytes by loading a hydrophobic anti-malarial drug, Artemether. Three different loading techniques were applied to achieve maximum optimized drug loading. A HPLC method was validated for drug quantification in erythrocytes. The relatively high loading was achieved using hypotonic treatment was 31.39% as compared to other two methods. These, drug loaded erythrocytes were characterized for membrane integrity via ESR showing higher ESR values for drug loaded cells as compared to normal cells. Moreover, microscopic evaluation was done to observe morphological changes in erythrocytes after successful loading which showed swollen cells with slight rough surface as compared to smooth surface of normal cells. Drug release was studied for 8 h which showed more than 80% release within 3-7 h from erythrocytes treated with different hypotonic methods. Overall, the study revealed a potential application of erythrocytes in delivery of hydrophobic drugs using hypotonic treatment as compared to other methods.

Sedative and antinociceptive activities of two new sesquiterpenes isolated from Ricinus communis / 中国天然药物

Two new sesquiterpenes, trivially named ricinusoids A (1) and ricinusoids B (2), were isolated from ethyl acetate fraction of Ricinus communis. The structures of new compounds were elucidated by detailed spectroscopic techniques, including 1D- and 2D-NMR, UV, IR spectroscopy, and mass spectrometry. The compounds (1-2) were also assessed for in-vivo sedative and analgesic like effects in open field and acetic acid induced writhing tests respectively at 5, 10, and 20 mg·kg i.p. Pretreatment of both test compounds caused significant (P ≤ 0.05) reduction in locomotive activity like sedative agents and abdominal constrictions like analgesics. Both compounds (1-2) possessed marked sedative and antinociceptive effects in animal models.

Sedative and antinociceptive activities of two new sesquiterpenes isolated from Ricinus communis / 中国天然药物

Two new sesquiterpenes, trivially named ricinusoids A (1) and ricinusoids B (2), were isolated from ethyl acetate fraction of Ricinus communis. The structures of new compounds were elucidated by detailed spectroscopic techniques, including 1D- and 2D-NMR, UV, IR spectroscopy, and mass spectrometry. The compounds (1-2) were also assessed for in-vivo sedative and analgesic like effects in open field and acetic acid induced writhing tests respectively at 5, 10, and 20 mg·kg i.p. Pretreatment of both test compounds caused significant (P ≤ 0.05) reduction in locomotive activity like sedative agents and abdominal constrictions like analgesics. Both compounds (1-2) possessed marked sedative and antinociceptive effects in animal models.

Squamous cell carcinoma of the breast

Objective: To analyse the epidemiological characteristics, clinical presentations, and histopathological as well as immunological characteristics of squamous cell carcinoma [SCC] of breast

Study Design: A descriptive study

Place and Duration of Study: Combined Military Hospital, Rawalpindi, from January 1997 to January 2017

Methodology: Data of all patients, diagnosed as squamous cell carcinoma of breast over defined period of time, were collected and analysed with respect to their clinical presentation, histopathology and receptor status. Year-wise cases of SCC of breast were separated

Results: Thirty patients, diagnosed as squamous cell carcinoma of breast, were identified over a period of 20 years. There was an increase in number of cases diagnosed after 2007 as compared to before 2007. Moreover, 12 [40%] cases were hormone receptor positive while 18 [60%] were of unknown status. Out of the total, 10 [33%] cases were well differentiated, 17 [57%] were moderately differentiated, while 3 [10%] were poorly differentiated. Seventeen [57%] cases presented as breast masses, 10 [33%] had skin ulceration in addition to breast mass, while 3 [10%] cases presented as fungating masses along with chest wall involvement

Conclusion: There is an increased incidence of SCC of breast which can be due to better diagnostic facilities and more awareness amongst doctors about different varieties of breast cancers and their impact on the prognosis of disease

Squamous cell carcinoma of the breast

Objective: To analyse the epidemiological characteristics, clinical presentations, and histopathological as well as immunological characteristics of squamous cell carcinoma [SCC] of breast. Study Design: A descriptive study. Place and Duration of Study: Combined Military Hospital, Rawalpindi, from January 1997 to January 2017

Methodology: Data of all patients, diagnosed as squamous cell carcinoma of breast over defined period of time, were collected and analysed with respect to their clinical presentation, histopathology and receptor status. Year-wise cases of SCC of breast were separated

Results: Thirty patients, diagnosed as squamous cell carcinoma of breast, were identified over a period of 20 years. There was an increase in number of cases diagnosed after 2007 as compared to before 2007. Moreover, 12 [40%] cases were hormone receptor positive while 18 [60%] were of unknown status. Out of the total, 10 [33%] cases were well differentiated, 17 [57%] were moderately differentiated, while 3 [10%] were poorly differentiated. Seventeen [57%] cases presented as breast masses, 10 [33%] had skin ulceration in addition to breast mass, while 3 [10%] cases presented as fungating masses along with chest wall involvement

Conclusion: There is an increased incidence of SCC of breast which can be due to better diagnostic facilities and more awareness amongst doctors about different varieties of breast cancers and their impact on the prognosis of disease

Detection of interleukins-6 and 8 in saliva as potential biomarkers of oral pre-malignant lesion and oral carcinoma: a breakthrough in salivary diagnostics in Pakistan

Oral cancer is at rise in our population due to increasing use of areca nut [Betel nut] with or without tobacco. It is the second frequent malignant tumour for both the gender in Pakistan. This non-interventional case control study was carried out with the aim to explore saliva as diagnostic medium for detecting interleukins [IL] 6 and 8 as biomarkers of pre-malignant lesions [PML] and oral carcinoma. Total 105 subjects were recruited and were divided into three groups "A", "B" and "C" each comprising of 35 subjects. Group "A" comprised of cases with strong clinical evidence of oral PML. Group "B" constitute clinical and histologically proven OSCC and group "C" include disease free subjects as controls. Saliva from all the recruited subjects was procured by drooling method and stored at-20[degree sign]C before further process. All the collected samples were centrifuged at 4500 rpm for 15 minutes at 4[degree sign]C. Supernatant fluid was used in ELISA for detection and quantification of IL-6 and IL-8. Data was analysed by using Chi-square test and multivariate analysis was done by non-parametric test. P-value of 0.05 was taken as standard reference. Significant co-relation was found for qualitative salivary detection of IL-6 and IL-8 among the groups [P<0.001 and <0.0001 respectively]. Regarding quantitative salivary concentration of leukotrienes, no significant co-relation was found in levels of IL-6 among the groups while there was significant association of IL-8 levels between the groups [P<0.0001].On post Hoc multiple comparison, significant co-relation was found among oral PML group and controls [P=0.001] and OSCC group and control [P=<0.0001]. In conclusion salivary detection of IL-6 and IL-8 could be used as probable biomarker for early detection of oral PML and OSCC in etiologically distinct population of Pakistan

Pharmacognostic and phytochemical studies of Zanthoxylum armatum DC

The pharmacognostic and phytochemical investigations on the leaf, stem bark, and fruit of Zanthoxylum armatum were carried out. Macroscopic study of leaf, stem bark, and fruit of Z. armatum revealed some of the characteristic features like size, shape, color, odor and taste of the crude drug. Distinguishing fragments were identified from the powder drug. Leaf, bark, and fruit powder of this plant have higher values of total, acid insoluble, and water soluble ash as compared to the powder of this plant exhausted with ethanol and n- hexane. Extraction values in methanol were highest for leaves [20.10%] and fruit [11%], while bark showed highest value in chloroform [8.5%]. The extractive values varied among other parts with different solvents. Fluorescence analysis of the Z. Armatum leaf, stem bark, and fruit powder with various reagents showed characteristic coloration at day and under UV light. Quantitative phytochemical screening revealed the presence of many bioactive constituents in leaves, such as alkaloids [15.60+/-0.10 mg/g], sterols [71.60+/-0.10mg/g], saponins [21.57+/-0.12mg/g], tannins [34.43+/-0.21mg/g], phenols [11.66+/-0.33mg/g] and flavonoids [13.68+/-0.66mg/g]. Alkaloids [19.60+/-0.10mg/g], sterols [33.83+/-0.29mg/g], saponins [14.78+/-0.10mg/g], tannins [28.62+/-0.13mg/g], phenols [16.48+/-1.33mg/g] and flavonoids [18.33+/-1.22mg/g] were reported form the bark, while fruits were reported to have alkaloids [25.07+/-0.21mg/g], sterols [164.92+/-0.14mg/g], saponins [28.60+/-0.10mg/g], tannins [35.5+/-0.5mg/g], phenols [21.68+/-0.44mg/g] and flavonoids [22.8+/-1.33mg/g]. Z. armatum is an important medicinal plant, traditionally used for various ailments. This study will be helpful in the future pharmacognostic standardization of this important plant

Bioassay-guided isolation of novel and selective urease inhibitors from Diospyros lotus / 中国天然药物

Two new dimeric naphthoquinones, 5',8'-dihydroxy-6,6'-dimethyl-7,3'-binaphthyl-1,4,1',4'-tetraone (1; Di-naphthodiospyrol D) and 5',8'-dihydroxy-5,8-dimethoxy-6,6'-dimethyl-7,3'-binaphthyl-1,4,1',4'-tetraone (2; Di-naphthodiospyrol E), along with known naphthoquinones diospyrin (3) and 8-hydroxy diospyrin (4) were isolated from the chloroform fraction of extract of Diospyros lotus roots. Their structures were elucidated by advanced spectroscopic analyses, including HSQC, HMBC, NOESY, and J-resolved NMR experiments. The fractions and compounds 1-4 were evaluated for urease activity and phosphodiesterase-I, carbonic anhydrase-II and α-chymotrypsin enzyme inhibitory activities. Compounds 1 and 2 and their corresponding fractions showed significant and selective inhibitory effects on urease activities. The IC values of 1 and 2 were 260.4 ± 6.37 and 381.4 ± 4.80 µmol·L, respectively, using thiourea (IC = 21 ± 0.11 µmol·L) as the standard inhibitor. This was the first report demonstrating that the naphthoquinones class showed urease inhibition.

Three new anthraquinone derivatives isolated from Symplocos racemosa and their antibiofilm activity / 中国天然药物

Three new alkyl substituted anthraquinone derivatives, trivially named as symploquinones A-C (Compounds 1-3) were isolated from Symplocos racemosa. The structures of these compounds were determined on the basis of extensive spectroscopic analyses (UV, IR, Mass, H- and C-NMR, and two-dimensional (2D) NMR techniques). The resulting data were also compared with the reported literature. These compounds were then subjected to antibacterial or antibiofilm testing. Compounds 1 and 3 exhibited good antibacterial activity in the concentration range of 160-83 μg·mL against Streptococcus mutans, methicillin resistant Staphylococcus aureus and Proteus mirabilis. Both compounds were further screened for anti-biofilm activity, which revealed promising activities at sub-MIC concentrations. None of the compounds were found to be active against Klebsiella pneumoniae.

Hepatitis B and C; prevalence in south Punjab population

Background: Pakistan is a developing country of 180 million people with low health and educational standards. According to the Human Development Index of the United Nations, it is ranked 146[th] out of 187 countries

Objective: To know the actual disease burden of Chronic Hepatitis Viruses B and C in Southern Punjab. Study Design: Cross-sectional, Observational study. Setting: Ibn-e-Sina Hospital and Research Centre. Period: March 2010 to February 2014

Methodology: A total of 26800 people from general population were included in the present study. Free vaccination camps were established in rural and urban union councils with the help of local politicians, in Schools, Madrassahs and Industrial units and a permanent camp was established in Ibn-e-Sina Hospital. People of all age groups and either sex were vaccinated

Results: A total of 26800 individuals were screened, [mean: 36.47 +/- 13.81]. 2090 [7.8%] tested positive for Anti-HCV. Among these 68.6% [n=1433] were males while 31.4% [n=657] were females. 616 [2.3%] tested positive for HBsAg of which 401 [65.2%] were male and 215 [34.8%] were female. 75 subjects [0.28%] were positive for both HBsAg and Anti-HCV

Conclusion:- We as a community need to be more vigilant as the disease burden of HBsAg is not decreasing in the general population and the Burden of Anti-HCV is one of the highest in the world

Non-Alcoholic Fatty Liver Disease in Type 2 Diabetes: Effect on Diabetic Control and Lipid Profile

Objective: To determine the frequency of non-alcoholic fatty liver disease in patients with type 2 diabetes and to compare the diabetic control and dyslipidemia in diabetic patients with and without non-alcoholic fatty liver disease

Study Design: Cross sectional study

Place and Duration of Study: This study was conducted in Outpatient Department of Medicine, Jinnah Hospital, Lahore from 31[st] August 2013 to 28[th] February 2014

Materials and Methods: Both male and female with age ranging from 30-60 years having type 2 diabetes for more than 5 years duration were included. Two hundred and sixty diagnosed diabetes patients presenting to outpatient department were enrolled. Screening was done for NAFLD on the basis of ultrasonography. Sampling for HbAlC and lipid profile was done. Data was analyzed using SPSS 17

Results: Proportion of NAFLD was quite high i.e. 70%. Seventy five patients [28.8%] had abnormal triglyceride level and 72 patients [27.7%] had raised serum cholesterol. Low density lipoprotein was abnormally high in all individuals and high density lipoprotein was low in all individuals. One hundred and six [40.8%] diabetics patients had good control while rest has poor control and 135 patients [51.1%] were obese

Conclusion: Proportion of NAFLD was quite high in diabetic patients. We should screen every patient for NAFLD as it may reduce the co morbidity

Frequency of prediabetes and its association with lipid profile in patients with non- alcoholic fatty liver disease

Objective: To determine the frequency of prediabetes in patients with non-alcoholic fatty liver disease and to compare the mean values of cholesterol, triglycerides, low density lipoproteins and high density lipoproteins in patients of non-alcoholic fatty liver disease with and without prediabetes

Study Design: Cross sectional study

Place and Duration of Study: This study was conducted at Medical Outpatient Department, Sharif Medical City Hospital, Lahore from 30[th] December 20 1 3 to 29[th] June 20 14

Materials and Methods: Three hundred twenty five patients with ultrasonic diagnosis of NAFLD were included

All the patients with other causes like alcohol, viral hepatitis, toxins and drugs were excluded. All patients were screened by Glucose tolerance test [GTT] and if post GTT, blood sugar level came out greater than mg/dl, it was labeled prediabetes. Lipid profile was compared in both groups

Results: Frequency of the pre-Diabetes is quite high in our population with nonalcoholic fatty liver disease i.e.82.2% and means values of cholesterol, triglyceride low density of lipoprotein and high density lipoprotein in patients of non-alcoholic fatty liver disease are equally distributed patients with and without pre-diabetes

These mean values are, mean value of cholesterols patients with pre-diabetes was 1.86.8 +/- 2.3 mg/dl while without pre- diabetes it was 193.4 +/- 40.8 mg/dl while mean triglyceride level in patients with pre-diabetes was 180.5 +/- 37.2 mg/dl while without pre-diabetes patients it was with 180.7 +/- 40.4 mg/dl. Similarly the mean LDL level was 157.8 +/- 19.4 mg/dl and with pre-diabetes and 156.8 +/- 19.8 mg/dl in patients of NAFLD without pre-diabetes

Conclusion: It is concluded that frequency of prediabetes and dyslipidemia is quite high so we should screen all patients of NAFLD for glucose intolerance

In vitro antimalarial and xanthine oxidase inhibition of 2-Aminoanthraquinone

In the present research study 2-Aminoanthraquinone were scrutinized for their antimalarial and Xanthine oxidase inhibitor potential. It demonstrated marked concentration dependent antimalarial activity with maximum effect of 89.06% and with IC[50] of 34.17 micro M. Regarding Xanthine oxidase inhibitor activity, it evoked significant effect with 57.45% activity with IC[50] value of 81.57.19 micro M. In conclusion, 2-Aminoanthraquinone showed potent antimalarial and xanthine oxidase inhibitory activity

Gamma radiation induced changes in primary oocyte and zona pellucida

Objective: this study was performed to analyze the morphological changes in primary oocyte and zona pellucida of primary follicle in prepubertal albino rats of three weeks ago after exposure to gamma radiation

Material and Methods: 72 female albino rats of age of three weeks were used. Out of these 24, received 4.5 Gray, another 24 received 8.3 Gray of Gamma radiation, and the rest of them received sham radiation. Ovaries of rats were dissected after one day, 7 days and 14 days after irradiation. Five random histological sections of each ovary were examined

Results: intense necrosis was evident in oocyte and granulosa cells of primary follicles after one day- post radiation. The zona pellucid a remained in contact with the oocyte and granulosa cells in initial phase of atresia. With progressing atresia, zona pellucida lost its contact with the oocytes and granulosa cells. Disintegration of zona pellucida started after development of apoptotic bodies in primary follicles. Disintegrated zona pellucida disappeared rapidly in experimental groups, particularly in high dose group. The basement membrane was irregular and disrupted in atretic follicles

Conclusion: therefore, we can conclude that gamma radiation induces rapid necrosis and cyst formation in primary oocyte. Disintegration of zona pellucida with progression of atresia in ovarian follicle was evident. Gamma radiation also produces irregular, disrupted and thinner basement membrane

Fall-related injuries in a low-income setting: results from a pilot injury surveillance system in Rawalpindi, Pakistan

This study assessed the characteristics and emergency care outcomes of fall-related injuries in Pakistan. This study included all fall-related injury cases presenting to emergency departments [EDs] of the three teaching hospitals in Rawalpindi city from July 2007 to June 2008. Out of 62,530 injury cases, 43.4% [N = 27,109] were due to falls. Children [0-15 years] accounted for about two out of five of all fall-related injuries. Compared with women aged 16-45 years, more men of the same age group presented with fall-related injuries [50% vs. 42%]; however, compared with men aged 45 years or more, about twice as many women of the same age group presented with fall-related injuries [16% vs. 9%, P < 0.001]. For each reported death due to falls [n = 57], 43 more were admitted [n = 2443, 9%], and another 423 were discharged from the EDs [n = 24,142, 91%]. Factors associated with death or inpatient admission were: aged 0-15 years [adjusted odds ratio [aOR] = 1.35], aged 45 years or more [aOR = 1.94], male gender [aOR = 1.15], falls occurring at home [aOR = 3.38], in markets [aOR = 1.43], on work sites [aOR = 4.80], and during playing activities [aOR = 1.68]. This ED-based surveillance study indicated that fall prevention interventions in Pakistan should target children, older adult women, homes, and work sites

Salivary detection of human Papilloma virus 16 and 18 in pre-malignant and malignant lesions of oral cavity: Is it feasible in Pakistani context of Socio-Cultural Taboos?

To evaluate salivary detection of HPV-16 and 18 would be feasible and informative biomarker for oral pre-malignant and malignant lesion in our population. This non-interventional, case control study was carried out at department of E.N.T, Head and Neck Surgery, Dow University of Health Sciences, Dow Medical College and Civil Hospital Karachi, Pakistan between July 2011 to December 2012. Total of 105 cases were recruited. These were divided in three groups 'A', 'B' and 'C having 35 subjects each. Group'A' constitutes patients having strong clinical evidence of oral pre-malignant lesions [PML]. Group 'B' includes historically proven oral squamous cell carcinoma [OSCC] and Group 'C' comprised disease free subjects as controls. After taking informed consent, relevant clinical history was recorded on institutional approved performa. Saliva from all subjects was procured by standard 'drooling method'. Samples were stored at +4°C and later transferred to Laboratory to store at-20°C before further process. Samples werKfcentrifuged at 4500 rpm for 15 minutes at 4°C. Cell pellets sediments were used for identification of HPV-16 and 18 by real-time PCR method. Data was entered and analysed using SPSS version 16. P-value of 0.05 was taken as standard. In group 'A', HPV-16 was detected in 3 [8.6%] cases while HPV-18 was not detected in any of the subject. In group 'B', HPV-16 was detected in 07 [20%] while HPV-18 was found in 06 [17.1%] cases. Mixed HPV-16 and HPV-18 were found in 02 [5.7%] cases. In group 'C, HPV-16 was detected in 03 [8.6%] while HPV-18 was not detected in any of the subjects. Significant relationship was observed between the groups for HPV-18 detection [P= 0.002] while for HPV-16, no significant association was found [P= 0.245]. HPV infection for the causation of oral cancer cannot be fully established possibly due to small sample size. More over differences in genetic makeup, environment, indulgence in peculiar risk factor habits, sexual practices and difficult evaluation of the acquisition of viral load due to socio-cultural and religious restrictions could be the reason

Prevalence and risk factors of premenstrual syndrome among female population of Rahim Yar Khan

Background: Premenstrual syndrome [PMS] is one of the disorders associated with onset of menstruation causing physical, psychological and behavioral symptoms

Objective: To determine the prevalence and risk factors of premenstrual syndrome among female population of Rahim Yar Khan

Methodology: Study Design: Cross sectional study. Study subjects: Females of reproductive age from 16 to 40 years. Place and duration of study: Research was conducted from 16[th] to 29[th] March 2015 that was carried out in OPD and Gynecology ward of Sheikh Zayed Medical College/Hospital, Rahim Yar Khan. Performa was designed and pretested. Before commencing with the data collection, informed verbal consent was taken from all the 300 study subjects. The performa contained information on age, marital status, occupation, educational level of subjects and signs/symptoms of premenstrual syndrome among females. The data was entered on SPSS version 16 and results of various variables were presented as percentage and mean +/- standard deviation

Results: Study subjects has mean age of 22 +/- 4.9 years. Age distribution of subjects was 16-20 years [47%], 21-25 years [38.3%], 26-30 years [7%], 31-35 years [4.3%] and 36-40 years [4.3%]. In this study, 5.7% were illiterate, 3% primary, 3% middle, 7% secondary and 81% were highly educated. In this study, 74% were students, 14% housewives, 10% has government job and 2.3% has private job. In this study, 74.7% were unmarried. Out of 300 females 251 [83.7%] were found to have PMS. Frequency of PMS symptoms in study subjects were anxiety [57.7%], depression [57.7%], mood swing [71.7%], irritability [73.3%], pain [86.7%], fatigue [79.7%], discomfort [83.7%], abdominal cramps [47.7%], breast tenderness [25%], bloating [27.7%] and acne [32.3%]. The frequency of most common risk factor was low cheese/butter intake [87.7%], high tea/coffee intake [74.7%], high salty / junk food intake [66.3%], Low yogurt intake [61%], daily exercise [48%], low milk intake [39%], low egg intake [35.5%], low vegetable intake [13.7%], sedentary life style [33.3%], stressed state [30.3%], and eating spicy/cold food [7.3%]

Conclusion: Premenstrual syndrome was high in study subjects and high in young females. Majority of the women having PMS were unmarried, students and education level above bachelors and has low cheese/ butter intake, high tea/coffee and junk food intake

Evaluation of outcome of totally extra peritoneal laparoscopic inguinal hernia repair with Lichtenstein open repair

The objective of this study was to evaluate outcome of total extraperitoneal laparoscopic inguinal hernia repair with Lichtenstein open repair in terms of postoperative pain. Quasi experimental study. Surgical unit 1 Rawalpindi and Allied hospitals from January to June 2012. Sixty patients, with unilateral, primary, inguinal hernia were alternately allocated to undergo either total extraperitoneal [TEP] laparoscopic repair of inguinal hernia or Lichtenstein tension free, mesh repair of inguinal hernia. Pain scores at 12, 24, and 48 hours and at 7 days of follow up were noted using a visual analogue scale. Total number of intravenous injections of Diclofenac Sodium requested by the patient for pain relief was also noted. At 12 hours after surgery, the mean pain scores in the TEP group were 3.1 +/- 1.8 and in the Lichtenstein group they were 4.2 +/- 2.1 [p 0.031]. At 24 hours after surgery, the scores were 2.3 +/- 1.5 and 3.1 +/- 1.9 for the TEP and Lichtenstein groups, respectively [p = 0.026]. At 48 hours after surgery, the mean pain scores in the TEP group were 1.5 +/- 1.1 while in the Lichtenstein group they were 2.0 +/- 1.6 [p = 0.041]. At 7 days after surgery, the scores were 0.3 +/- 0.5 in the TEP group and 0.4 +/- 0.8 in the Lichtenstein group [0.137]. The mean number of injection of Diclofenac Sodium required by the TEP and Lichtenstein groups was 3.1 +/- 1.6 and 5.8 +/- 2.2, respectively [p = 0.011]. Less postoperative pain and requirement for analgesics were reported by patients who underwent total extraperitoneal laparoscopic repair of inguinal hernia as compared to those who underwent inguinal hernia repair by Lichtenstein tension free mesh hernioplasty

Molecular diagnosis of oral pre-malignant lesions and oral squamous cell carcinoma in saliva-a breakthrough in Pakistan

To evaluate salivary detection of interleukin 6 and 8 and high risk HPV-16 and 18 are informative biomarkers of Oral Pre-malignant Lesion [PML] and Oral Squamous Cell Carcinoma [OSCC] in our population. July 2011 to December 2012. Total 105 cases were included. The subjects were divided in three groups 'A', 'B' and 'C' having 35 participants each. Group 'A' comprised of patients having strong clinical evidence of oral PML. Group 'B' constitutes histologically proven OSCC and Group 'C' includes disease free subjects as controls. Relevant clinical history was recorded after informed consent on institutional approved performa. Saliva was collected as per standard drooling method'. Samples were stored at +4oC and later transferred to Dow Diagnostic, Research and Reference Laboratory to store it at -20oC before further process. Samples were subjected to centrifugation at 4500 rpm for 15 minutes at 4oC. Supernatant fluid phase was used in ELISA for detection and quantification of IL6 and IL8. . Cell pellets were used for identification of high risk HPV-16 and 18 by real-time PCR. Data was entered and analyzed on SPSS version 16. P-value of 0.05 was taken as standard reference. In group 'A', IL6 was not detected in almost all the subjects except one case. IL8 was detected in 26/35 [74.3%] subjects and not detected in 09 [25.7%] cases. In group 'B', IL6 was detected in 13 [37.1%] cases and in 22 [62.9%] cases, it cannot be detected. IL8 was detected in 33 [94.3%] and it was not detected in 02 [5.7%] subjects. It is observed that IL8 is consistently found raised in group 'A' and 'B'. In group 'C', IL6 was not detected in any of the subject while IL8 was detected in 10[28.6%] cases. Significant association was found for qualitative salivary detection of IL6 and IL8 between the groups [P= < 0.0001 and < 0.0001 respectively]. Regarding quantitative salivary concentration of IL6 and IL8, no significant co-relation was found in salivary levels of IL6 between the groups while there was significant association of salivary IL8 levels between the groups [P= <0.0001]. On post Hoc multiple comparison, significant co-relation was found in IL8 levels between oral PML group and controls [P=0.001] and OSCC group and controls [P= <0.0001]. In group 'A', HPV-16 was detected in salivary samples of 3 [8.6%] cases while HPV-18 was not detected. In group 'B', HPV-16 was detected in the salivary samples of 07 [20%] cases while HPV-18 was detected in 06 [17.1%] cases. Mixed HPV-16 and HPV-18 were found in 02 [5.7%] cases. In group 'C', HPV-16 was detected in 03[8.6%] cases while HPV-18 was not detected in any of the subjects. Significant relationship was observed between the groups for salivary HPV-18 detection [P= 0.002] while for detection of HPV-16, no significant association was found [P= 0.245]. Salivary concentration of IL6 and IL8 in oral PML and oral cancer are useful biomarkers in our population. Detection of HPV infection for the causation of oral cancer cannot be fully established possibly due to small sample size. More over different genetic makeup, environmental and geographic differences, indulgence in peculiar risk factor habits and different sexual practices compared to west due to socio-cultural and religious restrictions could be the reason

Pattern and mortality of burns injuries in children

To see the type of burns, pattern of burn injuries, burning agent, place of injury and total body surface area involved in children. Descriptive study. This study was carried out at Burn Unit, Social Security Hospital, Islamabad from. January 2006 to March 2014. Children below 16 years of age reporting to causality department with burns were included in the study. Among 112 patients, 17.85% and 16.96% were from 5 - 6 and 3 - 4 year of age respectively. Flame injuries were commonest [41.07%], followed by hot liquids [31.25%] and electric burns [16.07%]. Majority [74.11%] of burn injuries sustained at home. 39.28% and 20.54% sustained less then 10% and 11-20% of burns respectively. Only 8.04% and 5.36% sustained burns between 21-30% and 31-40% respectively. No mortality was observed in patients having less than 40% of burns and 100% mortality among patients having more than 80% burns. Burn injuries from hot liquid are common in less than 6 years of age and flame burns above 10 years of age while playing with burning shopping bags and working in kitchen. As most of these injuries are avoidable, intensive educational programmes are needed to increase public awareness regarding burn dangers and to teach them how to take proper preventive and safety measures at home