An Observational Study on Cutaneous Appendageal Tumours with Pilar Differentiation

Background: Cutaneous appendageal tumours belong to a diverse group of tumours with specific histo pathology.The aim of this study is to determine the pattern, age,gender and site distribution of Pilar differentiation tumours. Material & Methods: The study was conducted in the department of Pathology,Government Medical College Srinagar for a period of 18 months. It was an observational cross sectional study.Formalin fixed,paraffin embedded tissue sections were stained with hematoxylin and eosin stain for histopathological analysis. Results: A total of 112 cases of Pilar tumours were studied.108 were benign and 4 were malignant with male to female ratio of 1.07:1. The maximum number of benign cases were observed in 11 -20 years of age group and the malignant tumours age ranges from 35-45 years and the tumour usually presented in the eighth decade.Head and Neck was the most common site. Conclusion: Histopathological examination of Pilar Tumours is the gold standard to differentiate between benign and malignant tumours. It is also useful for exact categorization of cutaneous appendageal tumours.

Medical thoracoscopy in evaluation of undiagnosed pleural effusion

Background: Medical thoracoscopy or pleuroscopy, in recent past has received lot of interest for diagnostic as well as therapeutic purposes. In the evaluation of undiagnosed pleural effusion, it has become a key diagnostic modality as it is a cost effective and safe procedure. The aim of present study was to assess the diagnostic yield of medical thoracoscopy in patients with undiagnosed exudative pleural effusion.Methods: This prospective study was conducted at government chest diseases hospital Srinagar between December 2016 to June 2018. One hundred and twenty-five (125) patients who fulfilled inclusion criteria were included in this study. Thoracoscopy was done using rigid thoracoscope under local anesthesia.  Thoracoscopic and histopathological data of enrolled patients was collected prospectively and analysed.Results: Patients enrolled in the study were in the age range of 17 to 82 years and consisted of 80 males and 45 females. Most common thoracoscopic finding was multiple variable sized nodules (53.6%) followed by sago grain infiltration (15.2%). Malignancy was the most common histopathological diagnosis (60.8%) with metastatic adenocarcinoma being the most common histopathological diagnosis (50%). The overall diagnostic yield of thoracoscopy was 90.4%.Conclusions: Medical thoracoscopy is a safe procedure with excellent diagnostic yield for evaluation of undiagnosed pleural effusion with minimal complication rates.

Comparative pharmacokinetics of omeprazole and its metabolites in poor and extensive metabolizer Pakistani healthy volunteers and a review of different studies

This study was designed to evaluate a comparative single dose [40mg] pharmacokinetics [PK] of Omeprazole [OMP] and its two metabolites, 5-hydroxy Omeprazole [5-OH-OMP] and Omeprazole sulphone [OMP-S] in poor [PM] and extensive [EM] metabolizer Pakistani healthy adult volunteers. The frequency of CYP2C19 and CYP3A4 varies widely in different populations. The present study was conducted to evaluate the PK of OMP and its two metabolites in Pakistani population and to review different studies conducted after administration of single dose of OMP. Twenty two subjects were enrolled in this study and divided into two groups. The CYP2C19 phenotyping was evaluated by the metabolic ratio of OMP to 5-OH-OMP. It was a single dose, open label study and the blood samples from subjects were collected at different time intervals until 24 hours. The PK parameters were calculated using the PK-summit software. The metabolic ratio of area under the plasma concentration-time curve AUCOMP/5-OH-OMP was 1.86 +/- 0.572 and13.84 +/- 2.504 for EM and PM, respectively; maximum plasma concentration [Cmax] of OMP was increased by two folds for PM while the AUC? was increased by 3 folds; the Cmax and AUC? of 5-OH-OMP decreased for PM by 2 folds while there was 3 fold increase observed in the Cmax and AUC? of OMP-S. The PK of OMP and its metabolites in different populations were also discussed, and issues regarding CYP2C19 and CYP3A4 genotyping were also extensively reviewed. In EM of CYP2C19 the concentration of 5-OH-OMP is higher while that of OMP-S is lower. This study as well as reported studies reveals that in PM of CYP2C19 more drugs are available for CYP3A4 to be metabolized. A correlation between CYP2C19 EM and PM activity with CYP3A4 needs to be established

Variation in pharmacokinetics of omeprazole and its metabolites by gender and CYP2C19 genotype in Pakistani male and female subjects

Pharmacokinetics [PK] variation of drugs in males and females may affect therapeutic effectiveness and safety. In current study the PK differences for omeprazole and its metabolites5-hydroxy-omeprazole and omeprazole-sulphone were evaluated in males and females. The current study also considered PK comparison of Pakistani subjects using the CYP2C19 genotype as variable. A single oral dose [40mg omeprazole], open-labeland, non-controlled clinical trial was arranged. Samples were quantified using reversed phase HPLC-UV method. CYP2C19 genotype of subjects was determined by tetra primer polymerization chain reaction [PCR] assay. There was a significant increase in Cmax [from 2 to 2.9microg/ml, p=0.004], [from 6.67 to 8.74microg-hr/ml, p=0.05] and elimination half-life [from 1.05 to 2.1 hr, p=0.0001] of omeprazole in females compared with males. Cmax and of 5-hydroxy-omeprazole [0.0248 and 0.0001, respectively] and omeprazole-sulphone [0.0001 and 0.001, respectively] was significantly higher in females than males when compared at 95 onfidence interval. The Cmax and AUC of omeprazole showed a significant raise [p=0.01 and 0.04, respectively] in Homz PMs [Homozygous Poor Metabolizers] compared with Homz EMs [Homozygous Extensive Metabolizers] and Htrz PMs [Heterozygous Poor Metabolizers] while Cmax and AUC of 5-hydroxy-omeprazolewas significantly higher [p=0.01 and 0.04, respectively] in Homz EMs compared with Homz PMs and HtrzPMs. AUC of omeprazole was significantly higher in females while its elimination also took longer compared with males. AUC of omeprazole was significantly higher in Homz PMs indicating that CYP2C19 displayed genetically deficient metabolism in its homozygous state

Antibacterial and antifungal activities of leaf extract of Achyranthes aspera [Amaranthaceae] from Pakistan

Alcoholic extract and various fractions of Achyranthes aspera leaves, traditionally used in Pakistan for treatment of infectious diseases was screened for in vitro antibacterial and antifungal activity. The chloroform and butanol fractions were found to be the most active among the fractions, showing considerable antibacterial activity against Shigella flexneri and Escherichia coli. The highest activity was found in the ethylacetate fraction [17 mm zone of inhibition] against gram-negative [Salmonella typhi] bacteria, with MIC value as 0.29 mg/mL. In antifungal screening, moderate activity was shown by the chloroform fraction [50 % inhibition] against Microsporum cams, with MIC value as 0.25mg/mL. Considerable level of antifungal activity was depicted by crude extract, hexane and butanol fractions against Aspergillus flavus and Microsporum canis. The ability of various extracts of Achyranthes aspera to inhibit different strains of fungi and bacteria indicates its potential use for the treatment of microbial infections

Evaluation of anti-inflammatory activity of selected medicinal plants of Khyber Pakhtunkhwa, Pakistan

In present study, the anti-inflammatory potential of three medicinal plants, Xanthium strumarium, Achyranthes aspera and Duchesnea indica were evaluated, using both in vitro and in vivo assays. Carrageenan induced hind paw edema model was used to carry out the in vivo anti-inflammatory activity, while for in vitro screening lipoxygenase inhibition assay was used. Crude extract of all the selected plants depicted significant [p