In vitro antioxidant, hepatoprotective potential and chemical profiling of Syzygium aromaticum using HPLC and GC?MS

The objective of the present study was to evaluate the in vitro antioxidant and hepatoprotective potential of Syzygium aromaticum [clove] against CCl[4]-induced hepatotoxicity using rat liver slice culture [LSC] model. Antioxidant activity in terms of DPPH radical scavenging activity and ferric reducing antioxidant power [FRAP] of different concentrations of S. aromaticum was in the range of 41.01-90.33% and 138.15-595.63 Fe [II] mg/mL, respectively. Plasmid pBR322 DNA protection activity was observed with all three concentrations of S. aromaticum against H2O2 induced oxidative damage, as no strand breaks were observed. Chemical profiling through HPLC confirmed the presence of six major phenolic acids and 13 volatile bioactive compounds were identified though GC-MS. Significant hepatoprotection [p<0.05] was observed in liver slice culture [LSC] as liver slices treated with various concentrations of S. aromaticum extract presented very low percentage cytotoxicity [7.35-16.16%] as compared to the CCl4 treated liver slices [75.58 %]. The hepatoprotective potential of S. aromaticum may be due to the presence of bioactive components as confirmed by HPLC and GC-MS. The results of present study support the use of S. aromaticum in the formation of potential hepatoprotective drugs against various liver diseases

Congenital Hypothyroidism in Neonates of a Tertiary Care Hospital

Objective: To determine neonatal congenital hypothyroidism among neonates born in a tertiary care hospital of Lahore Pakistan

Methods: This cross-sectional study was carried out at Pathology Department of Allama Iqbal Medical College, Lahore in collaboration with Pediatrics and Gynecology and Obstetrics Department, Jinnah Hospital, Lahore Pakistan. A total of 770 babies were included in this study, both male and female. About 2 ml venous blood samples were collected aseptically from the neonates in sterile clotted tube. Serum was separated and serum TSH was determined by ELISA method

Results: Out of total 770 neonates, 48.9% were female and 51.0% were males with the ratio of 1:1.04. Neonatal congenital hypothyroidisim [TSH, >30 mlU/L], was observed in 0.4% [Frequency, 1:257] nenates, with the incidence rate of 1:257. Female to male ratio of hypothyroid neonates was 2:1. The mode of delivery vise distribution showed, among n=251 neonates born by normal delivery, only a single case of hypothyroidism was detected, and among n=519 neonates delivered by cesarean section, only two neonates were belong to hypothyroidism

Conclusion: The frequency of Congenital Hypothyroidism is notably higher in pediatric community than reported in most other countries. This result emphasizes the necessity of a nationwide screening program

Development of systemic lupus erythematosus following interferon-alpha therapy for hepatitis C infection

Interferon-alpha [IFN-alpha] therapy has been associated with de novo development of systemic lupus erythematosus [SLE]. We report a 48-year woman with chronic hepatitis C, who developed low grade fever, joint aches and pains, painful mouth ulcers, shortness of breath, dry cough and pleuritic chest pain after 2 months of completion of treatment with pegylated interferon-alpha. These clinical manifestations and the relevant immunologic investigations were in favour of SLE. She responded well to corticosteroids and hydroxychloroquine treatment

Quality of colonoscopy and spectrum of lower gastrointestinal disease as determined by colonoscopy

To document the quality of colonoscopy practice and the pattern of colonic disease including polyp detection rate at Shifa International Hospital, Islamabad, Pakistan. An observational study. Shifa International Hospital, Islamabad, Pakistan, from May 2013 to June 2014. This retrospective study recorded demographics of patients, indications and quality indices of 505 colonoscopies performed during the study period. Preparation was done with low residue diet and polyethylene glycol. Conscious sedation was generally used. Quality indices studied were compared with guideline standard. Out of 505 colonoscopy patients, 305 were males and 200 were females. The indications for colonoscopic examination were lower gastrointestinal bleeding [26.5%, n=134], screening for colorectal cancer [14.1%, n=71], chronic diarrhea [12.9%, n=65], abdominal pain [10.9%, n=55], anemia [9.1%, n=46], constipation [7.3%, n=37], hematochezia and diarrhea [6.3%, n=32], altered bowel habits [5.1%, n=26], weight loss [3.6%, n=18], colonic thickening on CT scan [3.0%, n=15] and others [1.2%, n=6]. Bowel preparation was adequate [in 92%, n=465] cases. Cecal intubation rate was 88.71% [n=448]. Endoscopic diagnoses were hemorrhoids [36.2%, n=183], normal [22%, n=111], polyps [11.3%, n=57], ulcerative colitis [8.7%, n=44], cancer [4%, n=20], diverticulosis [3.4%, n=17], infective colitis [2.6%, n=13], intestinal TB [2.6%, n=13], non-specific colitis [2.2%, n=11], proctitis [1.8%, n=9] and others [5.3%, n=27]. There is room for improvement in quality of colonoscopy, cecal intubation rate is slightly below the recommended standard and polyp detection rate is quite low however, it is not clear if the low rate of polyp detection is due to missed lesions or low population incidence. Time to reach caecum and withdrawal time should clearly be documented in the notes which can help to evaluate quality of the procedure in a better way

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

Supracondylar humeral fracture in children: management by percutaneous lateral-entry pin fixation

This case series was conducted at the Department of Orthopaedics and Traumatology, Lady Reading Hospital Peshawar, from January 2007 to June 2008 to assess the outcome of two percutaneous lateral-entry pins in the operative management of supracondylar humeral fractures. The study included management of Type II and III displaced supracondylar humeral fractures according to Wilkins's modification of Gartland's classification system in 193 patients. The fractures were fixed with two percutaneous lateral-entry pins. Seventy-two children had Type II fracture and One Hundred and Sixty-five children presented with Type III fracture according to Wilkins's modification of Gartland's classification system. A comparison of perioperative and final radiographs showed no loss of reduction of any fracture. There was no hyperextension, loss of motion, cubitus varus, iatrogenic nerve palsies and no patient required additional surgery. Six patients had pin tract infection. Follow up rate was 81.5% Results were evaluated by Flynn's Criteria, 93.3% Excellent/good results were obtained. In this case-series, the use of lateral-entry pins was found to give excellent/very good results. It is an effective treatment option for unstable supracondylar fractures of humerus in children. This method provides the greatest skeletal stability and prevents neurovascular complications in children, as in other techniques, hence giving excellent results

Cardioprotective and Antilipidemic Effect of Gemmotherapeutically Treated Glycyrrhiza glabra against Isoproterenol Induced Myocardial Injury.

Aims: To evaluate preventive (pre- treated) and curative (post treated) potential of gemmomodified and native extract of Glycyrrhiza glabra for alleviating harmful changes in lipid profile (HDL, LDL, TG, TC) and cardiac enzymes (CK-MB, LDH, SGOT, SGPT) against isoproterenol (ISO) induced myocardial injury in rabbits. Study Design: In vivo study. Place and Duration of Study: Department of Chemistry and Biochemistry, University of Agriculture, Faisalabad, Pakistan, between February 2011 and April 2011. Methodology: Thirty six rabbits weighing 1.25 ± 0.2 Kg were allocated into six groups (Control, Ischemia, Gemmo curative, Native curative, Gemmo preventive and Native preventive) having six animals each. Rabbits were fed normal diet for 20 days. Gemmo preventive and Native preventive groups were also given gemmo modified and native extract (100 mg kg-1). On 20th day and 21st day rabbits were given ISO (50 mg kg-1). Five days after the ischemia the Gemmo curative and Native curative groups were given gemmo and native extracts (100 mg kg-1). Serum activities of lipid profile and cardiac enzymes were determined. Results: ISO administration significantly lowered (P=.05) HDL level and increased (P=.05) LDL, TG and TC as compared with control rabbits. ISO injury significantly increased (P=.05) the levels of cardiac enzymes CK-MB. LDH, SGOT and SGPT as compared with control rabbits. Curative treatment with gemmo and native extracts of Glycyrrhiza glabra significantly increased (P=.05) level of HDL and lowered (P=.05) the level of LDL, TG, TC and cardiac enzymes as compared with ischemic rabbits. Pre treatment with gemmo and native extracts prevented the reduction (P=.05) in HDL level and resisted the rise (P=.05) in other lipid parameters and cardiac enzymes as after ISO induced myocardial injury. Pretreatment with extracts was significantly better (P=.05) than curative treatment. Gemmo extract was significantly better (P=.05) than native extract in preventive and curative treatment in normalizing serum levels of lipid parameters and cardiac enzymes in ISO injured rabbits. Conclusion: The results provide evidence for the first time that gemmo extract of Glycyrrhiza glabra prevents myocardial injury induced by ISO in rabbits.

Isolation and characterization of irritant components of Euphorbia pilulifera L.

Euphorbia pilulifera is commonly found weed along road sides and loamy soils. This weed is commonly used as treatment of female disorders and respiratory problems. The latex of this weed causes irritation on hand on contact. To evaluate its irritant potentials, the dermatological investigation of irritant principles from locally occurring Euphorbia pilulifera was carried out. For this purpose, after collection and drying, a series of solvents with increasing polarity were used for the successive extraction of non-polar compounds [petroleum ether extract], constituents of intermediate polarities [chloroform extract] and polar constituents [methanol extract] from the whole herb of Euphorbia pilulifera. The chloroform extract of this weed was found most irritant to rabbit's skin. Chloroform extract was further subjected to column chromatography; four fractions Ep 1 to Ep 4 were isolated from active chloroform extract by column and thin layer chromatography. The irritant potentials of these isolated fractions were evaluated on rabbit's skin. Two fractions out of the four, Ep 1 and Ep 3 appeared to be the most irritant than others. A possible structure activity relationship of these active compounds was discussed in order to establish their activity

Counter irritant activity of carthamus oxycantha

Many locally occurring species of Asteraceae are used as medicinal plants by various tribal and ethnic communities in Pakistan. Carthamus oxycantha is often occurs as weed in cultivated fields. Folk medicines indicated its use as an anti inflammatory and wound healing plant. It is used for wound healing by the local population in the form of powder paste. No scientific report, about the behavior of this plant has so far been published. The counter irritant studies of locally occurring Carthamus oxycantha was carried out. The main objectives of the project were to evaluate its wound healing effects on animal skin and the identity and characterization of chromatographically isolated fractions. For this purpose, different solvents with a broad range of polarity were successively used to extract non-polar compounds [petroleum ether extract], constituents intermediate polarities [chloroform extract] and polar constituents [methanol extract] from the whole herb of Carthamus oxycantha. The counter irritant activity of the crude extracts and isolated fractions was evaluated on rabbit's skin. Five fractions Co-1 to Co-5 were isolated from the active chloroform extract by column and thin layer chromatography. Co-1, Co-3 and Co-5 appeared to be the most potent counter irritant than others. A possible structure-activity relationship of these active compounds was investigated by using spectroscopy [UV and FTIR analysis]

comparison between open and closed hemorrhoidectomy

Haemorrhoidectomy is associated with complications including pain, bleeding and wound infection which can result prolonged hospital stay. Haemorrhoidectomy is considered to provide a better outcome in terms of postoperative pain and wound healing. Aims were to compare postoperative pain, bleeding, operating time and wound healing in patients undergoing open and closed haemorrhoidectomy. This comparative study was conducted in the surgical department at Fauji Foundation Hospital, Rawalpindi from December 13, 2006 to December 31, 2011. Consecutive patients, both male and female, presenting with 3[rd] and 4[th] degree haemorrhoids in the surgical Outpatient Department were included in this study. Half of the patients were assigned to the open haemorrhoidectomy group while the other half was put in the closed haemorrhoidectomy group. Each patient was evaluated by detailed history and examination. Both digital rectal examination [DRE] and proctoscopy were done to confirm the diagnosis. A total of 260 patients were assessed, 130 in each group. In the open group, 52 patients experienced mild pain and 78 moderate while in the closed group, 30 patients experienced mild pain, 87 moderate and 13 patients severe pain. All 130 patients in the closed group showed complete wound healing after 2 weeks as compared to only 66 patients in the open group with a p<0.001. Early and late postoperative bleeding was similar in both groups. The closed technique provides a better outcome in terms of less postoperative bleeding and complete wound healing, but it is associated with more pain