Association of the use of bacterial cell wall synthesis Inhibitor drugsin early childhood with the Developmental Defects of Enamel

Our objective of the study was to determine the association between frequent use of Penicillins and Cephalosporins with developmental defects of enamel in pediatric age group. This is a cross sectional study, conducted at Ziauddin University. A total of 367 children, having the history of either Penicillin or Cephalosporin exposure were included. The parents of children were asked to complete a questionnaire related to disease and drug history. Dental examination was carried out to assess the hypomineralization in tooth enamel based on modified Developmental Defects of Enamel [DDE] index. Out of 367 children, 124 [34%] were males and females were 243[66%]. In the study group 22.6% [n= 83] of children were found to be hypomineralized. The maximum type of teeth defects were diffused opacities that was 12.0% [n=44]. The statistically significant association [p-value < 0.05] was found between frequency of antibiotic use and hypomineralization for most teeth. Children who were exposed to either Penicillins or Cephalosporin in early childhood showed significant [p-value < 0.002] hypomineralized enamel. This study concludes that frequent use of antibiotics such as penicillins and cephalosporins has positive association with enamel hypomineralization in developing tooth structure

Comparison of efficacy of thioridazine with clonidine acting through different mechanisms in acute opioid abstinence syndrome

To compare the efficacy, safety and tolerability of thioridazine with clonidine in patients with Acute opioid Abstinence Syndrome. This single blind comparative clinical trial was carried out at Department of Pharmacology, Basic Medical Sciences Institute [BMSI], Jinnah Postgraduate Medical Center [JPMC], Karachi. Fifty two addicts were selected randomly and were grouped into, group-A to received thioridazine 100 mg/day and group -B to received clonidine 150mcg/day. All participants completed the treatment program and stayed in hospital for ten days. The efficacy safety and tolerability of thioridazine was scant, while clonidine showed statistically significant turn down in the objective signs of acute opioid abstinence syndrome. Clonidine had more powerful effects than thioridazine. While treating the withdrawal signs of opioid abstinence syndrome may possibly pointed out that over activation of norepinephrine is a major factor contributes to the commencement of opioid abstinence syndrome

Montelukast versus nigella sativa for management of seasonal allergic rhinitis: a single blind comparative clinical trial

To compare the therapeutic role of leukotriene receptor blocker Montelukast with N. Sativa seeds in seasonal allergic rhinitis patients. Comparative uncontrolled single blind clinical assessment was carried out over forty seven untreated adult patients torment from seasonal allergic rhinitis and staring for outpatient management. All patients were chosen from different primary care health centers, registered and were divided in a single-blind approach to obtain Montelukast, 10 mg/day, group I [n=24] and 250 mg/day of N. Sativa, group II [n=23] orally for two weeks. Patients joined-up the study has completed the therapeutic plan. Montelukast and N. Sativa both demonstrated a significant and early decrease in daytime as well as ophthalmic symptoms, while montelukast showed diminished and late effects on nighttime symptoms when compared with N. Sativa. In addition montelukast has also been showing to cause drug allied side effects like headache, dizziness and heart burn. It would come into view that N. Sativa is safe and thoroughly free from threat of adverse effects. So it is a liable management alternative for seasonal allergic rhinitis patients

Imipramine induced ECG changes in rabbits

An uncontrolled In-vivo study was conducted to assess alterations in heart rate, QT interval and QRS complex duration in male chinchilla rabbits. Animals [n=10] were treated with 25mg/5ml/day imipramine, through oral route of administration for five days. The electrocardiographic tracings were recorded by needle electrodes in all conscious animals first before and then after drug administration, following every day up to five days. It showed cardiotoxic effects like QT interval prolongation in addition to significant widening of QRS complex, along with decrease in heart rate. Because of these cardiotoxic effects prescribing imipramine to patients with prominent cardiovascular risk factors desires added attentiveness

Surgical outcome of 7-millimeter bilateral medial rectus recession in large angle child esotropia

To evaluate the surgical success in the patients undergoing bilateral 7 mm medial rectus recession for large angle esodeviation. The subjects less than 15 years of age presenting with concomitant esotropia with deviations of 60 prism diopter [PD] and more were registered for bilateral medial rectus recession surgery. Anterior segment slit lamp examination and posterior segment examination was performed with 90 D and 78D fundoscopes in selected cases. Angle of deviation was measured. All necessary investigations were completed. Surgical procedures were performed under general anesthesia. Postoperative follow-up was done. Almost 71% children underwent successful surgery with residual deviation of less than 15 PD, while 29.0% subjects developed residual strabismus. Four patients presented with foreign body granuloma. Two children developed limitation in adduction. The preoperative deviations of 60 PD showed good results with residual deviation of fewer than 15 PD. There is a need for guarded muscle correction during bilateral medial rectus recession for improvement in visual alignment and binocular function

Comparison of the efficacy and safety of chlorpromazine with verapamil for the treatment of acute opioid abstinence syndrome

To compare the efficacy and safety of chlorpromazine with Verapamil in patients with Acute opioid Abstinence Syndrome. Single blind comparative clinical trial was conducted at Department of Pharmacology, BMSI, JPMC, Karachi, over the period of one year. Forty opiate-dependent subjects were chosen at random who were in search of opioid abstinence treatment. All patients were grouped into two groups, group-I received chlorpromazine 150 mg/day and group-II received Verapamil 120mg/day in divided doses. Every patient completed the management plan while admitted in the hospital for 10 days. The chlorpromazine showed decreased efficacy and safety, whereas verapamil showed clinically pertinent decline in the subjective symptoms of acute opioid abstinence syndrome. The study showed Verapamit is superior to chlorpromazine in the treatment of opioid abstinence syndrome indicated by better reduction of withdrawal symptom scores, excessive opioid urinary excretion and lees side effects. The superiority of verapamil over chlorpromazine in controlling opioid abstinence syndrome may indicate that calcium is involved in the initiation and development of opioid abstinence syndrome

Role of D-2 receptor antagonist chlorpromazine in observer rated signs of acute opioid abstinence syndrome

Chlorpromazine is very common non-opioid treatment option for acute opioid abstinence syndrome at different hospitals and detoxification centers at Karachi. Hence the study was conducted to investigate the efficacy of chlorpromazine compared with placebo in acute opioid abstinence syndrome. Forty healthy opiate-dependent patients seeking inpatient treatment were selected randomly. Of the 40 study patients, 20 were given placebo and 20 were given chlorpromazine 150 mg/day in divided doses under single blind protocol. All patients completed the treatment program and stayed in the hospital for 10 days. Chlorpromazine is ineffective treatment to control the signs of acute opioid abstinence syndrome. There were non- significant differences in the cumulative scores of signs of acute opioid abstinence syndrome between the two groups. The investigators found no benefit of chlorpromazine over placebo in treating acute opioid abstinence syndrome

Cetirizine and nigella sativa: comparison of conventional and herbal option for treatment of seasonal allergic rhinitis

To compare the efficacy of the second-generation antihistamine cetirizine with Nigella sativa [N. sativa] seeds in management of seasonal allergic rhinitis [SAR]. Comparative uncontrolled clinical trial. Forty untreated adult patients, suffering from seasonal allergic rhinitis, seeking outpatient treatment were selected from different primary care clinics. They were enrolled and randomized in a single-blind manner to receive Cetirizine, 10 mg/day, group I [n=20] and 250 mg/day of N.sativa, group II [n=20] orally for 14 days. Response to treatment was evaluated at the end of the study. All patients completed the treatment. Both study drugs i.e cetirizine and N.sativa were equally effective at relieving the symptoms of seasonal allergic rhinitis; however, the group using cetirizine had more sedation and other adverse effects. It appears that N.sativa is has minimal adverse effects and is therefore a safe treatment option for the patients of seasonal allergic rhinitis

Calcium channel blocker verapamil: a nonhormonal option for hot flashes management in patients with acute Opioid Abstinence Syndrome

Given the problems associated with hormonal therapy, and the prominent problem of hot flashes, there is a need for nonhormonal agents to alleviate hot flashes. Calcium ions play an important role in brain synaptosomes. This study was conducted to investigate the efficacy of calcium channel blocker verapamil in hot flashes, the most frequently reported subjective symptom of acute opioid abstinence syndrome. The study was a 10 days single blind, random-assignment, inpatient trial for the patients of opioid abstinence syndrome with a very common symptom, the hot flashes. Twenty patients were given Verapamil, 120mg/day in divided doses. All patients, who have completed the treatment program, stayed in the hospital for 10 days. Mean absolute change scores of number of hot flashes per day at endpoint, with baseline scores, showed a highly significant decline with verapamil treatment program. The investigators found a benefit of verapamil in hot flashes

Nagilla sativa: a non-conventional herbal option for the management of seasonal allergic rhinitis

Seasonal allergic rhinitis [SAR] is one of the top reasons for patient visits to primary care physicians because of its bothersome symptoms. This highly prevalent disease also impairs quality of life, sleep, and work. Oral antihistamines are one of the most frequently prescribed medications for the management of SAR but they have their own side effects. Hence the effects of traditional Nigella sativa seeds, on seasonal allergic rhinitis were studied in 20 patients. Daily dosages of 250 mg of seeds for a 15 days period significantly reduced the symptom severity scores of allergic rhinitis in patients. It was concluded that Nigella sativa seeds could be successfully used for seasonal allergic rhinitis

Gingival hyperplasia; during verapamil therapy in hypertensive patients

Calcium ion plays an important role in gingival hyperplasia due to its effects on hemostatic balance of epithelial differentiation and apoptosis. It is hypothesized that non inflamed gingival fibroblasts are less active and do not respond to circulating drugs. While the fibroblasts within inflamed tissue are in an active state. Hence a study was conducted to investigate and assess the relationship between oral hygiene and severity of gingival hyperplasia in hypertensive patients receiving verapamil. In the present comparative investigation, clinical periodontal parameters were determined. Thirty hypertensive patients who were taking verapamil 240 mg/day in divided doses selected randomly. Subjects were divided in to HEL groups. A gingival enlargement score was assessed for each patient by using hyper plastic index, while using plaque index assessed the oral hygiene status. There were highly significant differences between test groups E and L, when they were compared with group H [Healthy group]. Mean plaque index and hyper plastic index varied between test groups H, E and L. The differences showed statistical high significance. Oral hygiene plays a decisive role in the development of gingival hyperplasia and the incidence can be controlled successfully by meticulous professional and individual oral hygiene

Effects of Azelastine and Sodium cromoglycate in the inhibition of Broncho - Constriction of ovalbumin sensitized Lung Parenchymal Tissues of Guinea Pigs in Vitro

To see the ability of Azelastine and Sodium cromoglycate in influencing antigen induced contractile responses in isolated parenchymal tissues of Guinea pig in vitro. An experimental study. Department of Pharmacology and Therapeutics of Basic Medical Sciences Institute, Jinnah Postgraduate Medical Center [JPMC], Karachi during 1998. The Guinea pigs [n=10] were sensitized with ovalbumin and their parenchymal strips were exposed to different concentrations of ovalbumin to observe the EC50. Each sensitized parenchymal strip was treated with either Azelastine or Sodium cromoglycte in an organ bath for 10 minutes and treated with EC50 ovalbumin and contraction was recorded by Grass Polygraph model 7B. EC50 [n=6] of parenchymal strips [0.3x10-6 + 0.16x10-6g/ml] produced a mean response of contraction 9+0.44mm. Azelastine in concentration of 10-9 g/ml did not show any inhibitory effect but as the concentration increased to 10-8 g/ml, marked inhibition was recorded and with further increase in concentration by 10-7 g/ml, it completely antagonized the EC50 induced contraction. Sodium cromoglycate did not show any inhibition at concentration 10-8 g/ml while at higher concentration of 10-6 g/ml, it showed complete antagonism. Ovalbumin induced contraction of sensitized lung parenchymal tissues of Guinea pig in vitro is dose dependent and controlled better with Azelastine than Sodium cromoglycate

Role of alpha-2 agonist clonidine in attenuation of hot flashes in patients with acute opioid abstinence syndrome

The demand for nonhormonal interventions for hot flashes is increasing because of the number of patients diagnosed with hormone-sensitive cancers and the hormone replacement therapy is not as beneficial as originally believed. So this study was conducted to investigate the efficacy of Clonidine in hot flashes, the most frequently reported subjective symptom of acute opioid abstinence syndrome. The study was a 10 days single-blind, random-assignment, inpatient trial of Clonidine for patients of opioid abstinence syndrome with a very common symptom the hot flashes. 20 patients were given Clonidine 300 meg/ day in divided doses. All patients, who have completed the treatment program, stayed in the hospital for 10 days. Mean absolute change scores of number of hot flashes per day at endpoint, with baseline scores, showed a very rapid and highly significant decline with Clonidine treatment program. The investigators found a benefit of Clonidine in hot flashes

Calcium channel blocker verapamil. A non opioid treatment for acute opioid abstinence syndrome

Calcium ion plays an important role in acute opioid abstinence syndrome due to its effects on brain synaptosomes. Hence this study was conducted to observe the effects of calcium channel blocker Verapamil as a non-opioid treatment of acute opioid abstinence syndrome. Setting: Twenty healthy opiate-dependent patients seeking inpatient treatment were selected randomly. Verapamil 120mg/day was given in divided doses under single blind protocol. All patients completed the treatment program and stayed in the hospital for 10 days. Verapamil showed a gradual but highly significant improvement in signs and symptoms of acute opioid abstinence syndrome. Verapamil was observed to be highly effective non-opioid treatment of acute opioid abstinence syndrome. Hence verapamil may be given extended clinical trial, because it did not show any adverse effect

Role of clonidine in acute opioid abstinence syndrome

Recently clonidine has been used in opioid abstinence syndrome. It is proposed that, norepinephrine is involved in the expression of abstinence syndrome, and it depends upon the cerebral stores of these catecholamines. The effects of activation of locus coeruleus was demonstrated to produce changes that resembled those seen in opiate withdrawal. Hence this study was conducted to observe the effects of clonidine on acute opioid abstinence syndrome. Setting: Twenty healthy, opiate-dependent patients were selected randomly, who were seeking inpatient opioid abstinence treatment. This study was conducted in single blind protocol. Clonidine 300mcg/day was given. All patients completed the treatment program and stayed in the hospital for 10 days. Clonidine showed a very rapid and highly significant decline in the objective signs and subjective symptoms of opiate withdrawal syndrome. Clonidine proved to be highly effective non-opioid treatment of acute opioid withdrawal syndrome. This observation indicates that opioid withdrawal syndrome may be due to increased neural activity in locus coeruleus, which is regulated by both alpha-2 adrenergic and opiate receptors