role of allopurinol and angiotensin receptor blockers in serum uric acid reduction in gouty and hypertensive patients

To evaluate the effect of Allopurinol in combination with angiotensin receptor blockers on hyperuricemia in gouty and hypertensive patients. Randomized, open label, prospective, comparative trial. This study was conducted in the Department of Pharmacology and Therapeutics; BMSI/JPMC, Karachi from April 2010 to November 2010. 80 hypertensive and hyperuricemic patients were enrolled from OPD and medical wards and were divided into two groups. Group DR-1[40 Patients] were given allopurinol 300mg plus candisartan 8mg daily and group DR-2 [40 patients] were given allopurinol 200mg Plus Losartan 50mg, daily four 4 months. 6 patients were unable to continue the follow-up 3 patients in each group. DR-1 combination therapy decreased serum uric acid level from 8.92 +/- 0.19mg/dl at day 0 to 5.33 +/- 0.11 mg/dl at day120. DR-2 group also showed a significant reduction in serum uric acid level from 9.14 +/- 0.19mg/dl at day 0 to 4.74 +/- 0.09mg/dl at day 120 [p<0.001]. When effects were compared in both treatment groups, the effect of group 2 regimens on serum uric acid level was more marked due to Losartan combination which also have uricosuric effects than in group 1 regimen, with average percentage decrease in serum uric acid - 40.35% in group DR-1 and -48.24% in group DR-2. The allopurinol 200mg and Losartan 50mg is more effective than allopurinol 300mg+ candesartan 8mg, to decrease serum uric acid level and group DR-2 drugs combination useful in those hyperuricemic patients who cannot tolerate high doses of uric acid lowering drugschromatogram obtained indicated the quantity of pesticide residues. Milk samples and serum samples were analyzed using HPLC technique. Pesticides such as malathion, permethrin, deltamethrin and Polytrin-C were detected in different concentrations. The levels were significantly higher than the maximum residual limit. It is concluded that the presence of pesticides in the human body is a major concern in the development of various ailments because of possible immunotoxic, mutagenic and carcinogenic potential of pesticides

Effect of psyllium hydrophilic mucilloid [husk] on primary hyperlipidemic patients

Background: Psyllium husk has been used for treating gastrointestinal upsets like diarrhea, constipation and irritable bowel disease in the past. Recent medical researches have shown remarkable effects of psyllium husk on all parameters of lipid profile, except triglycerides and very low density lipoproteins

Objective: This study was conducted to determine the effects of psyllium husk on lipid profile of primary hyperlipidemic patients

Patients and Methods: It was a single blind placebo controlled experimental study,conducted in Jinnah Hospital Karachi, from January 2009 to June 2009. Forty hyperlipidemic patients were included in this study. Twenty patients were on placebo as control group, and twenty were on psyllium husk, ten grams daily in three divided doses, for three months. Patients with hypothyroidism, alcoholism, renal and hepatic disease were excluded from the study. Serum total cholesterol and triglycerides were estimated by the enzymatic calorimetric method. Serum High Density Lipoprotein [HDL] was determined by direct method, at day one and on last day of the treatment. Low Density Lipoprotein, [LDL] was calculated by Friedwald formula [LDL-C= TC- [TG/5 + HDL-C]. Data was analyzed as the mean +/- standard deviation. To determine statistical significance of results, paired t-test was applied and p < 0.05 was taken as significant

Results: Two patients withdrew from the study due to personal reasons. Psyllium decreased serum total cholesterol from 228.27+/-4.89 mg/dl to 199.22 +/- 2.30 mg/dl, triglycerides from 169.27+/- 9.92 mg/dl to 164.5+/-8.56 mg/dl, LDL from 159.72 +/- 5.70 to 129.55+/- 2.81 mg/dl and increased serum HDL from 34.61+/-1.85 to 36.77+/-1.96 mg/dl in three months of treatment. Results of all parameters were significant, except triglycerides, when paired 't' test was applied for significance

Conclusion: From this experimental study, it was concluded that psyllium husk fibers are effective in maintaining lipid profile at normal limits in hyperlipidemic patients

Effects of vitamin B-3 on selected coronary heart disease risk factors; a placebo controlled experimental study

Background: well recognized and explained risks factors for development of atherosclerosis include hypertension, old age, sedentary life style, smoking and high serum lipid levels

Objective: to determine the effects of niacin on blood pressure, body weight, low density lipoprotein [LDL] and high density lipoprotein [HDL]

Patients and Methods: this single blind placebo controlled experimental study was conducted at Jinnah Hospital, Karachi, from June 2009 to December 2009. Forty hyperlipidemic patients of both sexes were included in the research study, among which 20 patients were on placebo as control group, and 20 were on tablet niacin, 2.25 grams daily, in divided doses for the period of three months. Patients with diabetes mellitus, peptic ulcer, renal disease, hepatic disease, hypothyroidism and alcoholism were excluded from the study. Body weight and blood pressure of patients were recorded at fortnightly visit. LDL was calculated by Friedwald formula [LDL= TC- [TG/5 + HDL-C]. Serum HDL was determined by direct method. Serum cholesterol and triglycerides were estimated by the enzymatic calorimetric method. Data regarding results were expressed as the mean +/- SD and "t" test was applied to determine statistical significance of results. A probability value of <0.05 was taken as significant. Three patients were dropped from the study due to side effects of niacin

Results: in three months of treatment with 2.25 grams of niacin, HDL increased from 36.41+/-1.96 to 43.70+/-1.81 mg/dl, which was highly significant change when analyzed statistically. Niacin decreased LDL from 182.58+/-8.74 mg/dl to 119.29+/-4.08 mg/dl, which was highly significant [p<0.00] statistically. Overall, percentage change from day-0 to day-90 was 34.66. Triglycerides reduced from 169.64+/-7.60 to 137.35+/-6.31 mg/dl, which was highly significant [p<0.001] reduction in three months. Niacin has also reduced blood pressure, the difference between mean values of systolic and diastolic blood pressure at day-0 and day-90 were found highly significant [p<0.001]. Body weight was reduced from 66.29+/-1.94 kg to 64.79+/-1.82 kg in three months. This change was significant [p<0.01]

Conclusion: we concluded from the research study that niacin decreases blood pressure, body weight and LDL-Cholesterol and increases HDL-cholesterol in primary hyperlipidemic patients

Psyllium husk to increase HDL- Cholesterol; placebo controlled study

To examine the effects of Psyllium husk on HDL-Cholesterol. Single blind placebo controlled study. Study was conducted at department of pharmacology and therapeutics at Basic Medical Sciences Institute [BMSI], Jinnah Postgraduate Medical Centre [JPMC], Karachi, from January 2006 to July 2006. Forty hyperlipidemic patients were included, among which 20 patients were on placebo as control group, and 20 were on Psyllium husk, 3 gram daily, in divided doses for the period of three months. Patients with peptic ulcer, renal disease, hepatic disease, hypothyroidism, diabetes mellitus, and alcoholism were excluded from the study. HDL- Cholesterol was determined by using kit Cat. #303210040 by Eli Tech Diagnostic, France. Data were expressed as the mean +/- SD and [t] test was applied to determine statistical significance as the difference. A probability value of <0.05 was the limit of significance. Two patients were dropped from the study due to low compliance of metallic taste of psyllium husk. Psyllium husk has increased HDL-Cholesterol, in 90 days of treatment, from 34.61 +/- 1.85 to 36.77 +/- 1.96 [mg/dl], which was highly significant statistically when paired [t] test was applied for results. Percentage change was +6.24. It is concluded from this study that Psyllium husk decreases the risk of CHD by increasing HDL-Cholesterol

Relationship of brain natriuretic peptide with serum lipids and body mass index in healthy adult males

Prevalence of morbid obesity has increased dramatically world wide during past three decades. BMP a cardiac lipolytic hormone is found to be decreased in obese hypertensive and heart failure patients. Increasing values of BMI are associated with dyslipidemia. To find out the relationship of BMP with increasing values of BMI and individual serum lipid fractions in apparently healthy adult males. Study Observational, cross-sectional Department of Physiology at Basic Medical Sciences Institute, Jinnah Post Graduate Medical Center, Karachi. Study included 85 adult males, aged between 20-60 years. All were non-smokers, non- diabetic, having no other chronic illness and not taking any lipid lowering therapy. Study participants were evaluated for lipid profile and divided into three groups for the calculated BMI values according to WHO and International Obesity Task Force. Brain Natriuretic Peptide was assayed by AxSym technology. Brain Natriuretic Peptide developed a negative correlation with BMI, total and LDL-cholesterol and a positive relation with HDL-cholesterol and triglycerides. This study concluded that Brain Natriuretic Peptide is negatively related with increasing values of BMI and degree of dyslipidemia in apparently healthy adult males

Single blind placebo controlled study of psyllium fibres to reduce risk of myocardial infarction

Recent research studies claim that myocardial infarction as a major cause of morbidity and mortality throughout the world. Among other risk and predisposing factors atherosclerosis is one of the major risk for myocardial infarction. Each 1% increase in the serum cholesterol concentration results in 2 to 3% increase in coronary heart disease risk. By lowering serum 'bad' li-pids, and increasing good lipid, i.e.; HDL - cholesterol, atherosclerosis may be prevented and so the prevention of myocardial infarction ensues. Research study was conducted to examine the effects of Psy Ilium fibres to decrease 'bad'cholesterol [LDL - C, Triglycerides, and Serum Total Cholesterol] and increase good cholesterol [HDL - C] which prevent the risk of myocardial infarction [MI]. It was single blind placebo controlled research study. Forty already diagnosed primary hyperlipidaemic patients were selected from Cardiology OPD ofJinnah Hospital, Karachi, Pakistan. Exclusion criteria were patients suffering from hypothyroidism, renal dysfunction, any hepatic disease. Consent Proforma was designed and got the approval from [Research Ethical Committee of Jinnah Postgraduate Medical Centre, Karachi]. After explaining the limitations, consent was obtained from all study participants before they were recruited to the study. They were divided in two groups, 20 patients were on Psy-llium husk fibres, 10 gram daily in divided doses. And 20 patients were kept on placebo as control group. Lipid profile of all participants was estimated at day - o and at day - 90. All other vital functions of patients were also estimated and kept on record. They were advised to visit clinic fortnightly. When results were compiled at the end of this study, it was observed that two patients discontinued taking the drug, due to metallic taste of psyllium fibres. Psyllium decreased serum total cholesterol from 228.27 +/- 4.89 mg/dl to 119.22 +/- 2.30 mg/dl, 159.72 +/- 5.70 to 129.55 +/- 2.81 mg/dl, and increased serum HDL - Cholesterol from 34.61 +/- 1.85 to 36.77 +/- 1.96 mg/dl in three months of treatment. Data were expressed as the mean +/- SD and [t] test was applied to determine statistical significance of results. P - value lesser than 0.05 was the limit of significance. Results of all parameters of lipid profile were significant when paired [t] test was applied for statistical analysis. We concluded from this study that psyllium is an effective agent to maintain lipid profile parameters at normal limits in hyperlipidaemic patients, and normal limits of all lipid parameters play major role in prevention of atherosclerosis and MI

new and novel treatment of opioid dependence: nigella sativa 500 mg

Opioid dependence is one of the major social and psychiatric problem of society. Unfortunately there is no non opiate treatment available. For centuries man has used plants for their healing proprieties. These plants play a fundamental part in all treatment modalities, both ancient and modern. This study was conducted to find non opiate treatment for opiate withdrawal. Total 35 known addicts of opiates were included in the study. This study was based on DSM IV criteria for opioid dependence. This study demonstrates that non opioid treatment for opioid addiction decreases the withdrawal effects significantly. It further demonstrates that there are no changes in physiological parameters of subjects during treatment [BP, Pulse rate etc.]. There is increased appetite but no significant weight gain in the subjects. Non opioid drug Nigella sativa is effective in long term treatment of opioid dependence. It not merely cures the opioid dependence but also cures the infections and weakness from which majority of addicts suffer

Niacin is a major drug for lowering LDL-Cholesterol

Objective: Study was planned to examine the effects of Niacin [Vitamin B-3] on serum LDL Cholesterol levels

Patients and Methods: Study was conducted at department of Pharmacology, Basic Medical Sciences Institute [BMSI], Jinnah Postgraduate Medical Centre [JPMC], Karachi, from January 2002 to July 2002. Forty hyperlipidemic patients were included, among which 20 patients were on placebo as control group and 20 were on tablet Niacin, 2 gram daily, in divided doses for a period of three months. Patients with diabetes mellitus, peptic ulcer, renal disease, hepatic disease, hypothyroidism and alcoholism were excluded from the study. Serum LDL-cholesterol was calculated by Friedwald formula [LDL-Cholesterol Total Cholesterol-[Triglycerides/5 +HDL-Cholesterol] described by Delong et al [1986] and Beamount et al [1970]. Data were expressed as the mean +/- SD and "t" test was applied to determine statistical significance of the difference. A probability value of <0.05 was the limit of significance

Results: Three patients were dropped from the study due to side effects of Niacin. Niacin decreased the levels of LDL-Cholesterol froml82.58+/-8.74 mg/dl to 119.29+/-4.08 mg/dl, which was highly significant [p<0.001], when compared statistically by paired "t" test. Overall percentage [%] changes from day-0 to day-90 were -34.66

Conclusion: Niacin decreases the risk of CHD by decreasing LDL-Cholesterol

Effect of Ciprofloxacin on growing cartilage in albino Rat pups

Administration of quinolone therapy is controversial during growing age as stated by earlier worker. The flroquinolones are currently not indicated for young children, because of arthropathy and adverse effect on growing cartilage shown by studies. However the effects of ciprofloxacin on epiphyseal growth plate has remained undocumented. This study is therefore, undertaken to determine the risk of ciprofloxacin administration an growing cartilage by prospective experimental animal study model using Wistar albino rat pups. Ciprofloxacin was administered to newly born Wistar albino rat pups with a doze of 20mg/kg body weight intraperitonealy twice a day from day-1 to day-14 after birth. The animals were sacrificed by deep ether anesthesia. The limbs were disarticulated from axial skeleton, soft tissue was removed. The intact bone mean length in millimeter of right and left humerus and femur was measured with the help of electronic vernier caliper and bones were fixed in 10% buffered farmalin. Decalcification was done in 10% nitric acid and 10% formic acid changes. After paraplast embeding, 4 mm thick longitudinal sections of the proximal long bones were cut by a rotary microtome. Routine staining with haemotoxylin and eosin was performed. Histomorphometry was done measuring the thickness of epiphyseal cartilage and was compared with similar value of control animals. The results were statistically analysed to find out the significance. The ciprofloxacin induces a mordanting effect as abviated by increased basophilia. Our study reveales that cirprofloxacin administration in the newly born pups decreased the width of epiphyseal growth plate cartilage by 10.43% in humerus and 4.72% in femur as compared to the growth of control cartilage. The decrease in the width was brought about mainly by the reduced count of the proliferative cells in the proliferative zone and the diminuation in the average size of the hypertrophic condryocytes in the hypertrophic zone. The reserve zone has become markedly reduced in thickness. The ciprofloxacin post-natal administration effected growth plate retardation by inhibiting the mitosis in the proliferative zone and also effected the mean length of humora and femora leading to reduction in limb length of rat pups

Role of Nigella Sativa in opioid dependence treatment

Opioid dependence is one of the major social and psychiatric problem of society. Unfortunately there is no non-opiate treatment available. This study was conducted to find out the role of Nigella Sativa as a potential non-opiate treatment for opiate withdrawal. The study was conducted at the Department of Pharmacology, University of Karachi and Drug Rehabilitation Centre, R.H.C., Murad Memon Goth, Karachi. The study was based on DSM IV criteria for opioid dependence. Nigella Sativa 250 mg is found effective in long-term management of opioid dependence