Analysis of changes in intraocular pressure with changes in body position

To find out the patterns of changes in Intraocular Pressure [IOP] with changes in body position, both in the sitting and lying position. This descriptive study was conducted at Hayatabad Medical Complex, Peshawar from October 2010 to March 2011. All the individuals who voluntarily consented were included in the study. These include individuals without any eye pathologies, glaucomatous eyes, eyes with cataract and both hospitalized and non-hospitalized individuals. While all the individuals who have any corneal pathologies, uveitis, detachment, post operative and post lasered eye were excluded from the study. All the patients were examined with slit lamp. Then Per kins' hand-held applanation tonometer was used to measure the IOP both in the sitting and lying position. The proforma was then filled and data was analyzed by using SPSS v.17. A total of 100 volunteers were included in our study while total number of eyes were two hundred. The mean age of the sample was 49 +/- 15.4 years. There were 110[55%] males and 90[45%] females. Hypertension was present in 50[25%] patients and all of them were taking ant ihyper tensive medications. Thirty five [17.5%] were diabetic and were also on medications. The mean IOP in the sitting position was 13.28 +/- 3.6 mmHg and in lying position it was 16.4 +/- 3.9 mmHg. The difference between lying and sitting position was 3.12 +/- 0.3 mmHg [p<0.001]. A postural IOP change can occur when an individual changes its position from sitting to supine position. Intraocular pressure increases in the lying position as compared to the sitting position

Lithium toxicity

Background: Lithium is used for acute mania or prevention of the recurrences of bipolar manic-depressive illness in adults. There is a close relationship between toxicity and blood levels of sodium and potassium

Material and Methods: This study was carried out on 30 rabbits of mixed breed weighing 1 -2 kg. A lithium dose of 5mg/kg body weight/ day was given to rabbits for 22 days. Three blood samples were collected on 8th, 16th and 22nd days. Serum was separated and analyzed with flame photometer for lithium, sodium and potassium levels

Results: The level of serum lithium, sodium and potassium was significantly increased at 15th and 22nd day of administration of lithium carbonate

Conclusion: It is therefore concluded that concentration of lithium, sodium and potassium in serum must be determined. It is most important for family physicians who regularly treat patients receiving lithium as to how to monitor the safe use of drug

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

Anti vascular endothelial growth factor [bevacizumab] in central retinal vein occlusion: an interventional case series

Vascular endothelial growth factor plays major role in ocular angiogenesis and retinal edema production and is a step forward in the management of ocular neovascularization and retinal edematous pathologies. To determine the efficacy and safety of intra-vitreal Avastin [Bevacizumab] in cases having central retinal vein occlusion. A prospective interventional study. This study was done at Said Anwar Medical Centre, Dabgari Gardens, Peshawar from June, 2007 to September, 2009. All patients with central retinal occlusion occurring in the past 3 months and seen between the study period were included in the study. Diagnosis of central retinal vein occlusion was made clinically by slit lamp biomicroscopy with 78D examination Patients who had received any treatment for and eyes which already had developed Anterior Segment Neovascularization, Neovascularization elsewhere or Neovascularization on disc at presentation were excluded. Dose of 0.05 ml [1.25mg] of Avastin [Bevacizumab] was used as intra vitreal injection every month for 3 months in cases that presented within a month of occlusion and less injections were given in dose presenting later. Follow-up was done at 30th, 60[th], 90[th] and 120[th] day after the onset of disease. Visual outcome was defined as Snellen's or LogMar Best Corrected Visual Acuity at final follow up, of 120[th] day, compared to the visual acuity at presentation. Data were analyzed by SPSS version 17. Total of 17 eyes of 17 patients were included in this study. Eleven [64.7%] patients were males while 6 [35.3%] were females. Total of 40 intra-vitreal injections of Avastin were given to patients with a mean of 2.35 injections per eye. Good visual outcome was achieved in 10 [58.8%]] eyes, while 7[41.2%] had stable visual outcome. Mean initial Best Corrected Visual Acuity [LogMar] in all 17 eyes was 1.79 [SD +/- 0.87] which significantly improved to a mean of 1.18 [SD+0.77] at final follow up. Mean improvement in Best Corrected Visual Acuity [LogMar] after paired sample test in all patients at final follow up on day 120 was 0.61[SD+0.84]. Retinal hemorrhages and macular edema decreased clinically on examination on consecutive follow up visits. No eye developed neovascularization elsewhere, neovascularization on the disc, neovascularization, retinal tears, retinal.detachment, lens trauma, endophthalmitis or anterior chamber activity. Bevacizumab [Avastin] is an effective and safe treatment option for central retinal vein occlusion affected eyes and resulted in improvement in visual acuity. It reduced macular edema and prevented ocular neovascularization at least for short term

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

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

Prokinetic effect of clarithromycin and azithromycin in vitro study on rabbit duodenum

There is a continuous search for new prokinetic agents for use in gastro intestinal hypomotility. Erythromycin, a macrolide, is one of them. In this study we observed effect of other macrolides, i.e. clarithromycin and azithromycin on rabbit duodenum and compared with that of neostigmine. Both these drugs produced significant prokinetic effect with EC[50] 0.4 micro g/ml and 0.29 micro g/ml respectively. Effect of clarithromycin was well sustained as compared to that of azithromycin, so it seemed to be a better prokinetic agent

Role of ions, lipids, serum and urinary protein profile in developing hypertension

Study was conducted to observe the relationship of ions with lipid profile and protein content of hypertensive patients. Lipid profile, ions and serum and urinary proteins were studied in patients with hypertension and compared with normal subjects. Serum cholesterol, triglyceride and LDL-chol were significantly increased, whereas the level of HDL-cholesterol was significantly decreased in patients as compared to their controls. Serum calcium was increased, whereas the level of serum magnesium was decreased as compared to control subjects. Serum protein level is non significantly decreased whereas serum albumin and urinary protein decreased significantly. Beside lipid profile, there may be a role of ions like calcium and magnesium as will as of protein in hypertension

Prokinetic effect of erythromycin on contractility of an isolated strip of rabbit's intestine compared with neostigmine and metoclopramide

Intestinal hypomotility is a major problem after surgery on gastrointestinal tract and in certain conditions. Prokinetic effect of erythromycin on ILEAL contractility on an isolated strip of rabbit's intestine was compared with that of neostigmine and metoclopramide. Effect of neostigmine is highly significant [P > 0.001] in increasing contractility in intestinal muscle strips Metoclopramide effectively increased contractility [P > 0.1] and erythromycin also significantly [P > 0.05] improved contractility. This study proved that erythromycin is a potent Prokinetic agent, which can be useful in conditions associated with gastrointestinal hypomotility