Role of alpha tocopherol as an adjuvant therapy in pregnancy induced hypertension

Hypertension in the most common medical problem encountered in pregnancy and remains an important cause of maternal and fetal morbidity and mortality. To conduct a clinical study to evaluate the adjuvant effect of alpha-tocopherol along with routine hypertensive measures in patients with pregnancy induced hypertension. A total of 25 pregnancy induced hypertensive patients with single fetus were prospectively followed up from 24 to 28 weeks of pregnancy till the end of pregnancy. The patients were given capsule alpha-tocopherol 400 mg/day as adjuvant therapy. The base line readings and then at 4 weekly intervals of maternal blood pressure and platelets count and evaluated statistically till the end of pregnancy. The mean systolic blood pressure and diastolic blood pressure decreased by 3.5% and 4.36% respectively with significant p value <0.01. The platelet count increased by 5.98% though statistically non significant. Maternal blood pressure decreased and platelet count increased by oral supplementation of alpha tocopherol. Therefore the effect of alpha-tocopherol on these parameters should be considered in future for longer duration and larger scale studies

Streptokinase study on ST segment resolution in patients age less than 40 years with myocardial infarction

Thrombolytic therapy for Acute Myocardial Infarction has been one of the most potent treatment ever developed for condition that kill more patients worldwide than any other. To evaluate the benefit and efficacy or observational studies of streptokinase therapy on ST-segment elevation resolution in different types of myocardial infarction that focus especially on the younger age group less than forty years. To observe the streptokinase therapy, in ST-segment elevation resolution, in age less than 40 years and in different types of myocardial infarction. The study was conducted at national institute of cardiovascular diseases [NICVD] of Pakistan, Karachi. All patients fulfilling the inclusion criteria for thrombolytic therapy were included. Baseline ECO recorded before streptokinase infusion and repeated at completion of infusion i.e. 90 minutes, day 1 and day 2. Streptokiriase therapy on blood pressure, CKMB, and ST-segment resolution at 90 minutes, day 1, and Day2 in less than 40-year of age patient. The mean systolic blood pressure was 124 +/- 3.32 and 112 +/- 3.00 pre and post SK therapy reflecting a percentage decrease of 6.67 and highly significant [P<0.001]. The Diastolic blood pressure was decrease to 6.25% with a mean value of 76.80 +/- 2.70 and 72 +/- 1.91 before and after the Streptokinase therapy's, segment resolution at 90 minutes was decreased to 52.01 percent from the baseline and continued to decrease at Day-1 and Day-2 with a percentage reduction of 70.65 and 83.69% respectively. The P values were highly significant [P<0.001]. Thrombolysis improves survival when given within 12 hours of the onset of symptoms. The magnitude of benefit is greatest when reperfusion is established early. Age itself should not be considered a contraindication for fibronolysis

Myocardial infarction; streptokinase study on ST-segment resolution in patients age less than 40 years

Thrombolytic therapy for Acute Myocardial Infarction has been one of the most potent treatment ever developed for condition that kill more patients worldwide than any other. To evaluate the benefit and efficacy or observational studies of streptokinase therapy on ST-segment elevation resolution in different types of myocardial infarction that focus especially on the younger age group less than forty years. To observe the streptokinase therapy, in ST-segment elevation resolution, in age less than 40 years and in different types of myocardial infarction. The study was conducted at national institute of cardiovascular diseases [NICVD] of Pakistan, Karachi. Subject and All patients fulfilling the inclusion criteria for thrombolytic therapy were included. Baseline ECG recorded before streptokinase infusion and repeated at completion of infusion i.e. 90 minutes, day 1 and day 2. Streptokinase therapy on blood pressure, CKMB, and ST-segment resolution at 90 minutes, day 1, and Day2 in less than 40-year of age patient. The mean systolic blood pressure was 124+3.32 and 112+3.00 pre and post SK therapy reflecting a percentage decrease of 6.67 and highly significant [P<0.001]. The Diastolic blood pressure was decrease to 6.25% with a mean value of 76.80+2.70 and 72+1.91 before and after the Streptokinase therapy's, segment resolution at 90 minutes was decreased to 52.01 percent from the baseline and continued to decrease at Day-1 and Day-2 with a percentage reduction of 70.65 and 83.69% respectively. The P values were highly significant [P<0.001]. Thrombolysis improves survival when given within 12 hours of the onset of symptoms. The magnitude of benefit is greatest when reperfusion is established early. Age itself should not be considered a contraindication for fibronolysis

Comparative study of verapamil and thioridazine in acute opioid abstinence syndrome

To determine the effectiveness of verapamil and thioridazine in the treatment of acute opioid withdrawal syndrome in patients with chronic dependence on opioids. The study was conducted at Psychological Medicine Ward, Civil Hospital Karachi and Arshi Hospital, Naseerabad, F.B. area Karachi. A total of forty [40] patients were admitted for ten [10] days in hospital. No treatment was given during the first two days of admission after abrupt termination of opioid to observe the acute opioid withdrawal signs and symptoms. Patients were divided into 2 groups. Each group comprising of 20 opiate addicts. One group was given verapamil orally in a 40mg dose thrice daily and the other group was given thioridazine orally in a 10mg dose thrice daily from day 3 to day 9 of admission. The intensity of sign and symptoms were recorded by using subjective and objective opiate withdrawal questionnaire. Urine analysis for opioids was done on day 1, 5 and 10 of admission. Verapamil in comparison to thioridazine significantly decreased admission. Urine analyses for opioids were positive on day 01 while zero on day 10. Verapamil in comparison to Thioridazine was found to be safe and effective for the treatment of signs and symptoms of acute opioid withdrawal in in-door patients without any significant side effect

Histamine receptors; responses and modulations towards agonist and antagonist on the rabbit ileum, in vitro study

This research work deals with the mechanism of action involved in determining the therapeutic potential of histamine and its blockers in gastrointestinal motility. Rabbits of equal weights were used in this study. They were brought from the animal house of BMSI, sacrificed in the Pharmacology Research laboratory. lleum strip were isolated and with special recommended methodology, longitudinal and circular muscles were separated. Individual muscle strip were then exposed separately to the desired drugs in the organ bath and reading were recorded on the polygraph machine. Basic Medical Sciences Institute, Jinnah Postgraduate Medical Centre, Karachi. 1996 to 1998. Histamine increases the contractile effects of longitudinal and circular muscle. H[1] and H[2] blockers potentiate its effects on longitudinal muscle while in circular muscle no change was observed with H[1] blocker whereas H[2] blocker antagonized the histaminic effects. However when H[1] blocker applied directly it increases the amplitude of contraction in longitudinal and circular muscle whereas H[2] blocker decreases the height of contractions. Histamine in the presence of H[1] and H[2] blocker augmented their effects in longitudinal muscle and antagonizes in circular layer. Gastrointestinal motility can be controlled through histamine and its antagonist. New drugs can be formulated on the basis of this study for the regulation of intestinal motility

Organophosphate poisoning in the urban population; study conducted at National Poison Control Center, Karachi

The present study was performed to evaluate the patients suffered from pesticide poisoning during four years [1999-2002]. The study conducted at National Poison Control Center, Karachi. The patients were categorized according to the severity of poisoning ranges from mild, moderate to severe and designated as A, B and C. Laboratory tests included blood complete picture, serum urea, creatinine, electrolyte and serum cholinesterase. S. Cholinesterase was checked on zero day of admission, repeated after 24 hrs., 3rd day, 5th day and 7th day. The results revealed that 44.97% had S. Cholinesterase level below the normal value, 33.21% landed within threshold range while 13.10% had their value above 10000 IU/ml. Other parameters showed altered haemoglobin, WBC count and S. Electrolytes. We suggest that the need of the day in developing countries is to educate the people, launch programs to change their attitude, train them regarding the safety profiles of pesticide use and implementation of law in true sense

Role of verapamil in acute opioid abstinence syndrome

To determine the effectiveness of calcium channel blocker, verapamil in the treatment of acute opioid withdrawal syndrome in patients with chronic dependence on opioid. A clinical study. The study was conducted at Psychological Medicine ward, Civil Hospital Karachi from January 1998 to April 1998. A total of twenty [20] patients were admitted for ten [10] days in hospital. No treatment was given during the first two days of admission after abrupt termination of opioid to observe the acute opioid withdrawal signs and symptoms. Then the verapamil was given orally to each patient in a 40mg dose thrice daily from day 3 to day 10 of admission. The intensity of signs and symptoms was recorded by using subjective and objective opiate withdrawal questionnaire. Urine analysis for opioids was done on day 1, 5 and 10 of admission. Verapamil significantly decreased the intensity of signs and symptoms of acute opioid withdrawal from day 4 to day 10 of admission. Urine analyses for opioids were positive on day 1 while zero on day 10. Verapamil was found to be safe and effective for the treatment of signs and symptoms of acute opioid withdrawal in in-door patients without any significant side effect

Snakebite: identification, prevalence and management

Bites from venomous and non-venomous snakes occur throughout the world, but are particularly important in tropical and subtropical regions, where the large number of snake species and the rural lifestyle of the population can lead to significant morbidity and mortality. To determining the goals for reducing the morbidity and mortality as we have tried to explore the every aspect of the incidence. Jinnah Postgraduate Medical Center, Karachi. Clinical confirmation of snakebite with envenoming was by identification of the dead snake brought by victims and by clinical signs and symptoms such as paralysis [krait and cobra] and rapid progressive local edema with active bleeding [viper]. Whole blood clotting test is a simple, rapid and reliable test of coagulopathy. It is also of use in assessing the effectiveness of ASV and is of crucial importance for controlling administration of expensive ASV in relation to restoration of blood coagulability. 130 [57.27%] patients were bitten from cobra and krait whereas 63 [27.76%] individuals were suffered from viper bites. 6 [2.64%] cases were victimized by sea snakes while 28 cases were bitten by some other species labeled as non venomous variety [Graph II]. These 28 cases did not have any signs of systemic envenoming. Among all snakebite victims 33[14.54%] developed complications like severe bleeding, jaundice, acute renal failure, intracranial bleed and respiratory failure. 25 [11.01%] deaths were ensue while remaining 202 were completely recovered. It was observed that Cobra, Krait, Russell's viper commonly called Dabois whereas saw scaled viper locally called as Lundi or Jalebi are responsible for practically all the snakes bite cases. As venom secretion is greater in the months of May to September the incidences of snakebite cases are higher in these months

Drug overdose; study conducted at national poison control center

A prospective study of 588 cases of drug overdose was carried out in National Poison Control Centre [NPCC], Jinnah Postgraduate Medical Centre Karachi [JPMC] from 1999-2002. It was done to determine the incidence of renal, hepatic, respiratory, neural and cardiac injuries or toxicity. In this study all age groups were included above 8 years. various investigations were carried out that include blood CP, sugar, electrolytes, urea, creatinine, blood gases, electrocardiogram, ultrasound and Urine examination. The drug Overdose cases admitted from 1999-2002 were exposed to various drugs, such as benzodiazepines, barbiturates, non-steroidal anti-inflammatory drugs [NSAID], beta-blockers, carbamezapine, and Vitamin-A. The mortality rate was 2.89% with a male/ female ratio of 76.47%: 23.53%. However the recovery was 94.22%. These drug overdose cases were found to be the consequences of suicidal, accidental or homicidal attempts. This study may help in determining the goals for reducing the morbidity and mortality of drug over dose as it shows the rate of incidence, gender ratio, clinical presentations, diagnostic evaluations, complications, management, outcome and medicolegal aspects

Role of 5HT in the modification of intestinal motility, in vitro study

To determine with the mechanism of action involved in the therapeutic potential of serotonin and its blocker on gastrointestinal motility. The standard method was used for obtaining the longitudinal and circular muscles strip of rabbit ileum for in vitro studies. Each muscle strip was exposed to serotonin and its blocker and the result obtained was recorded on polygraph apparatus. The effects were recorded in vice versa fashion i.e. agonist v/s antagonist and antagonist v/s agonist on longitudinal and circular muscle strip separately. Serotonin had depressant effect on the force of contraction. On addition of antagonist in the presence of agonist, the effects were increased. Longitudinal muscle showed more pronounced effect i.e. 52.7% with methysergide in comparison to circular muscle, which was 15.6%. Circular muscle showed reduction in the force of contraction with serotonin, which was increased on addition of antagonist, but still below the level of base line contraction. Serotonin when given from external source in vitro, decreased the force, however, there was minimal increase in the rate of contraction. Hence, serotonin decreases the intestinal motility giving an impression of having antispasmodic effect. The results of this study can be utilized in the development of new drug related to G.I. motility mediated through 5HT receptors

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

Effects of verapamil on ovalbumin induced contraction of sensitized guinea pigs lung parenchymal tissues, in vitro

Calcium ions play an important patho-physiological role in allergic reactions. The release of mediators from mast cells, synthesis of some newly formed chemical mediators; airway smooth muscle contraction and nerve impulse conduction are all dependent on the availability and influx of Ca++ ions. It is therefore likely, that Ca++ antagonist, verapamil may modify the allergic broncho-pulmunary responses. Investigate the effects of verapamil on ovalbumin induced contractile responses on lung parenchymal tissue strip in vitro. Guinea pigs treated with two high doses of ovalbumin i.e. 5 mg on day 0 and 10mg on day 2, intra-peritoneal. Twenty-one days after sensitization the effect of verapamil on guinea pigs, parenchymal tissue was evaluated by incubation of strip with verapamil for 10 minutes and treated with EC50 ovalbumin. Verapamil exhibits dose dependent inhibition of ovalbumin-induced contraction with significant effect at concentration 10-9 g/ml. On the basis of these observations two possible mechanisms for this protective effects were suggested, firstly verapamil may have suppressed mediator release and second verapamil may have inhibited the contractile effect of mediators on parenchymal smooth muscle. It is therefore suggested that verapamil may prove useful in the management of airway hyper-reactivity

Volume of distribution and plasma concentration of alprazolam in hepatic insufficient patients

The volume of distribution and plasma concentration of alprazolam were assessed in fifteen hepatic insufficient patients. For this purpose, tab. Alprazolam 0.25 mg, orally was given twice a day, to five healthy, normal [control] subjects and fifteen hepatic insufficient patient. Drug was given for a period of twenty one days. Plasma concentration and Vd of alprazolam were evaluated on day seven and twenty one. Control group showed no change in plasma concentration and Vd on day 7 and 21. In hepatic group, there was a remarkable difference in plasma concentration on day 7 and 21, when compared with controls. In contrast, there was slight reduction in Vd in control vs hepatic group on day 21. So the study revealed that prolonged alprazolam treatment have less effect on Vd as compared to plasma concentration which was raised during long term therapy. Therefore, it is suggested that, the dose of alprazolm should be reduced in hepatic insufficient patients