Enhanced leucopoiesis in Ghrelin treated myelosuppressed rats

Objective: To determine the role of ghrelin in stimulating leukopoiesis of myelosuppressed rats by stimulating growth hormone release

Study Design: Randomized controlled trial

Place and Duration of Study: It was conducted at Department of Physiology, Foundation University Medical College, in collaboration with National Institute of Health, Islamabad, from February 2013 to June 2014

Material and Methods: Out of 130 Sprague-Dawley rats, 10 were used for baseline sampling and rest was randomly divided into four groups. Group I received ghrelin only while group II and III were administered intraperitoneally with both carboplatin and 5-flurouracil with and without rat ghrelin. Group IV in addition to chemotherapy and ghrelin received growth hormone releasing hormone antagonist [GHRH antagonist]. Total leukocyte count, differential leukocyte count and growth hormone levels were measured on day 7 and 14

Results: The fall in leukocyte count of chemotherapy and ghrelin group on day 7 was less as compared to the chemotherapy-only treated group and chemotherapy, ghrelin and growth hormone releasing hormone antagonist treated group [p<0.05]. Further decreases were also prevented in the chemotherapy and ghrelin group. The serum growth hormone levels in chemotherapy and ghrelin treated group were higher as compared to the chemotherapy and chemotherapy, ghrel in, GHRH antagonist treated group [p< 0.05]

Conclusion: Enhanced leukopoiesis in ghrelin treated myelosuppressed rats as compared to the chemotherapy group [p<0.05] suggest role of ghrelin in enhancing leukopoiesis. While the failure of enhanced leukopoiesis and growth hormone level to rise in chemotherapy, ghrelin and GHRH antagonist treated group suggested the possibility of growth hormone as possible mediator of ghrelin in leucopoiesis

Surgical correction of grade III hypertelorism

Orbital hypertelorism is an increased distance between the bony orbits and can be caused by frontonasal malformations, craniofacial clefts, frontoethmoidal encephaloceles, glial tumors or dermoid cysts of the root of the nose, and various syndromic or chromosomal disorders. We report a series of 7 cases of hypertelorism that were treated in our hospital. The underlying causes in our series were craniofacial clefts 0 to 14 (4 cases), craniofacial clefts 1 to 12 (1 case), and frontonasal encephalocele (2 cases), all congenital. Surgical techniques used to correct the deformity were box osteotomy and medial wall osteotomy with or without calvarial and rib grafts. A few of our cases were reoperations with specific challenges.

Frequency of nonalcoholic fatty liver disease and non-alcoholic steatohepatitis in patients with metabolic syndrome

Obesity and metabolic syndrome is an epidemic seen in the developed, as well as developing countries. Early recognition of this disorder may prevent major non-communicable diseases such as type 2 diabetes mellitus, hypertension and dyslipidemia. Non-alcoholic fatty liver disease and non-alcoholic steatohepatitis are the hepatic manifestations of metabolic syndrome. Prospective, observational, cross-sectional study was conducted in Endocrine Clinic of Jinnah Postgraduate Medical Centre, Karachi from June 2008 to September 2010. This study was conducted in patients suspected to have metabolic syndrome, as defined by International Diabetes Federation. Patients fitting the clinical consensus definition, having either palpable liver or ultrasound evidence of fatty infiltration were enrolled. Detailed history, physical examination, anthropometrics and biochemical measurements were recorded. Liver biopsies were performed where possible and were assessed according to Brunt et al's classification. A total of 101 patients who met the inclusion criteria were enrolled in the study. Liver biopsy was done in 31 patients. On biopsy, non-alcoholic fatty liver disease was confirmed in 28 [90%], non-alcoholic steatohepatitis in 18 [58%] and fibrosis in 8 [25%] patients. Of the biopsied cases, fatty infiltration on ultrasound was seen in 14 [87.5%] cases. Alanine aminotransferase was higher in patients having fibrosis. There was a direct correlation of histopathological changes with rising waist circumference, total cholesterol, triglyceride, low density lipoprotein and alanine aminotransferase. There was high prevalence of non-alcoholic fatty liver disease / non-alcoholic steatohepatitis in patients with metabolic syndrome and liver biopsy confirmed this in 90.3% patients who consented to this procedure

Efficacy of newly formulated ointment containing 20% active antimicrobial honey in treatment of burn wound infections

Honey has been familiar to possess antimicrobial potential to clear infection against burn wound infecting bacteria since ancient times. The objective of the study was to evaluate the efficacy of the newly formulated honey ointment during the treatment of burn wound infections. The Experimental [Non comparative] study was conducted at outpatient department of Dermatology, Fauji Foundation Hospital, Rawalpindi from November 2009 to October 2010. The antimicrobial activity of different Pakistani floral sources [Acacia nilotica species indica, Zizyphus, Helianthus annuus and Carissa opaca] honey samples were investigated by disc diffusion method against freshly isolated burn wounds infecting bacteria. Ointment containing 20% active antimicrobial honey was formulated as a sovereign remedy. A total number of twenty patients with second degree of burn wounds on different parts of the body were studied. A thin layer of honey ointment on gauze was applied to the wounds two to three times a day up to the complete healing. During microbiological study, Pakistani honey samples were discovered to exhibit a very promising antimicrobial activity against all the wound infecting microorganisms tested. Clinical trials demonstrated that the topical application of honey ointment have significant control of infections arising form pathogenic bacteria and up to 100% healing results were observed in all burn wound cases within mean healing time for the duration of 8.15 [3-18] days time period. Newly formulated ointment containing 20% active antimicrobial honey is more effective and low-cost alternative preparation for the treatment of burn wound infections

Effects of combined interferon alpha and ribavirin therapy on thyroid functions in patients with chronic hepatitis C

To determine the frequency of thyroid dysfunction in patients of chronic hepatitis C during treatment with interferon alpha-2b and ribavirin therapy. A cohort study. Army Medical College and Military Hospital, Rawalpindi, from February 2006 to January 2007. One hundred and sixty seven non-cirrhotic chronic hepatitis C patients were grouped into treatment group [n=107] and control group [n=60] awaiting treatment. Baseline serum[s.] Alanine Transferase [ALT] and S. Aspartate Transferase [AST] were measured by IFCC method. Serum Thyroid Stimulating Hormone [S. TSH], serum free thyroxine [S. Free T4] and serum total triiodothyronine [S.T3] level were determined by chemiluminescence. Study group patients underwent 24 weeks IFN and ribavirin therapy and were followed-up for thyroid dysfunction at weeks 0, 12 and 24. Control group patients underwent the same tests at weeks 0, 12 and 24. Statistical analysis was done on SPSS 15. Out of 107 patients of treatment group, 20 patients [18.69%] developed thyroid dysfunction. Females were at higher risk with Relative Risk [RR] of 11.25 and Attributable Risk [AR] of 91%. Hypothyroidism was more common than hyperthyroidism. Interferon-alpha and ribavirin therapy induces thyroid dysfunction in chronic hepatitis C patients. Hypothyroidism was more common. Females are at a higher risk of developing thyroid dysfunction

study of sperm morphology in a Pakistani population

The aim of this study was to determine the sperm morphology of proven fertile males and to compare the same with that of infertile males. This study was carried out at International Medical College Rawalpindi and its attached Railway hospital and Islamabad Clinic Serving Infertile Couples Islamabad, from June 2005 to July 2006. 50 healthy fertile males were selected and their semen morphology was determined according to Tygerberg's strict criteria, while another 50 infertile males were recruited as controls Proven fertile group showed significantly higher morphologically normal forms of sperms [3.04 +/- 1.63] than the infertile group. Sperm morphology assessed by strict criteria is of value in the in-vivo situation to identify a group with greater chance of having an infertility problem and strict criteria sperm morphology analysis should be used to minimize variations in intra and inter-individual and inter-laboratory sperm morphology assessment

Efficacy of combined interferon alpha and ribavirin therapy in patients of chronic hepatitis C

This study was carried out to determine the efficacy of combined interferon alpha and ribavirin therapy in patients of chronic hepatitis C. This study was conducted at Military Hospital Rawalpindi and Army Medical College, Rawalpindi from January 2006 to Feb 2007. One hundred and sixty seven non cirrhotic chronic hepatitis C patients were studied. The patients were grouped into study group [n=107] and control group [n=60]. The patients had persistently raised serum aminotransferase [ALT], positive HCV antibodies by 3[rd] generation ELISA, positive HCV RNA by polymerase chain reaction. Study group patients had positive histopathological findings on liver biopsy on basis of Knodell histopathological index [HPI]. At weeks 0, 12 and 24, blood samples were taken for the assay of serum alanine transferase [ALT] and serum, aspartate transferase [AST] levels in both the groups. Study group patients underwent 24 weeks Interferon and Ribavirin combination therapy and subsequently followed up for the response to treatment by the assay of HCV RNA by polymerase chain reaction at weeks 24. Control group included the patients without treatment plan but they also underwent screening for the same liver function tests. Patients of chronic hepatitis C [80 males and 27 females] had age range 18-48 years. After 24 weeks of INF and ribavirin therapy, 86% patients showed favourable response to treatment manifested by negative HCV RNA polymerase chain reaction. Treatment with Interferon and ribavirin combination therapy for 24 weeks produces significant virological response in patients of chronic hepatitis C at the end of treatment

Pulmonary function studies in Pakistani cotton ginners

The present study explored the relationship between the pulmonary functions and exposure to cotton dust. Pulmonary function tests i.e. forced vital capacity [FVC], forced expiratory volume in first second [FEV1], and peak expiratory flow rate [PEFR] were recorded in 64 non smoker cotton ginners. The data on pulmonary function test for healthy Pakistani population from previous studies was used as control. The follow-up study for lung function testing on the same cotton ginners was conducted from 1999 and repeated yearly up to 2005. Because of cotton dust exposure, cotton ginners showed a significant decline in their pulmonary function [P<0.05] .We concluded that the continuous exposure to cotton dust in ginners is associated with an increased progressive impairment of pulmonary functions

Sleep and wakefulness during holy month of Ramadan

The aim of this study was to explore sleep changes during the month of Ramadan and to compare the sleep pattern during the fasting and non fasting period in normal healthy individuals. This study was carried out at the department of Physiology FUMC Rawalpindi. Pakistan from 1[st] September 2006 to 31[st] October 2006 during which occurred the holy month of Ramadan from 25[th] September 2006 to 24[th] October 2006. A total of 435 subjects [172 women and 263 men] were provided the sleep cards to record their sleep hours. During Ramadan the total sleep time [TST] for the same individuals showed a significant difference [P<0.05] i.e. during fasting period as compared to non fasting period. During fasting period individuals slept 46 minutes per day more than during none fasting period. Sleep behavior changes during Ramadan in fasting individuals indicate that the life style changes during Ramadan having a significant effect on sleep behavior. Factors other than fasting may play an important role in modifying an individual's behavior during Ramadan. Further studies are needed to confirm these factors and sleep pattern during month of Ramadan

Level of nitrate and nitrite contents in drinking water of selected samples received at AFPGMI, Rawalpindi

Contamination of drinking water by nitrates is an evolving public health concern since nitrate can undergo endogenous reduction to nitrite and nitrosation of nitrites can form N-nitroso compounds, which are potent carcinogens. The carcinogenic feature of N-nitroso compounds has been well established. Nitrites can lead among infants to the disease called methemoglobinemia [blue baby syndrome]. There is a strong relationship between nitrate concentration and recurrent diarrhoea and also other illnesses. The aim of this study was to evaluate the level of nitrate and nitrite contents in some drinking water samples. In this study we analysed 162 water samples received at Water Quality Control Laboratory, AFPGMI, Rawalpindi for their nitrate and nitrite contents. Out of these 162 water samples, 153 [94%] and 133 [82%] samples had nitrate and nitrite contents in varying concentrations, while 64 [40%] and 22 [14%] had nitrate and nitrite concentrations more than Pakistani standards. Given the potential health risk associated with the presence of toxicants like nitrates and nitrites in water sources used for drinking yet the scarcity of available data, there is a need to evaluate these waters and develop strategies to reduce and prevent their contamination

Pedicled gastrocnemius muscle flap in the management of complex wound around the knee joint

To highlight the outcome of gastrocnemius muscle flap usage as a management of the complex wounds around the knee joint. Design: It was a retrospective study. Place and Duration: The study was conducted in Combined Military Hospital, Kharian, between January 1, 1998 and June 30, 2000. A total of 18 patients with complex injuries around the knee joint were included in the study. In all the patients, superiorly based pedicled gastrocnemius muscle flap, with skin grafting, was used. The medial head in 15 patients, lateral head in 2 patients and both in 1 patient were used in accordance with the dimensions of the defects. Flap survival was 100%. All the limbs were successfully salvaged. Donor site morbidity and complications resulting from the procedure were limited and manageable. It is a simple, quick and reliable procedure that can be done under any circumstances with very good results