comparative clinical study of unani formulation [maghz tukhm-e-jamun wa tukhm-e-hayat] and metformin in the management of ziabetus shakari [type 2 diabetes mellitus]

Type 2 diabetes mellitus is a major health concern in the 21st century, which is largely preventable but remains responsible for millions of deaths annually and many life-threatening complications. The present study was conducted to evaluate and compare the efficacy of Withania coagulans Dunal and Eugenia jambolana Lam with that of standard control metformin in managing type 2 diabetes mellitus. This was a randomized open study with standard control. A total of 60 diagnosed cases of type 2 diabetes mellitus were randomly allocated in the test [n = 30] and control groups [n = 30]. Test drug, a combination of E. jambolana [6 g in powder form] and oral infusion of W. coagulans [10 pieces], and control drug metformin [500 mg] were administered to the participants twice daily for 90 days. The subjective parameters were assessed at every follow-up, blood sugar was recorded at a monthly interval, while hemoglobin A1c, RFT, and lipid profile were recorded at baseline and at the termination of the trial. The study outcome was analyzed using appropriate statistical tests. The test drug showed significant improvement at par to the control drug in subjective [polydipsia, polyphagia, fatigue, and weight loss] and objective [blood sugar, glycated hemoglobin, RFT, serum cholesterol, and serum triglyceride] parameters without any side effects or toxicity. The study inferred that the drug was safe and effective in managing type 2 diabetes mellitus

Comparative bioavailability and pharmacokinetic study of Cefadroxil capsules in male healthy volunteers of Pakistan

The current study was aimed to judge bioequivalence between two formulations of cefadroxil capsules as guided by FDA guidelines. Another objective was to conduct pharmacokinetic evaluation in Pakistani population. A single-dose, randomized, cross-over pharmacokinetic study was conducted during the month of May'2013 to August'2013. Washout period was one week. Fourteen healthy male adult volunteers were enrolled in the study, however twelve completed the study. Cefadroxil plasma concentration was analyzed by using validated HPLC method. Protein precipitation was achieved by the addition of 6% tri chloro acetic acid in 1:1 ratio and detection was done at 260 nm. Retention time was 7.792 min and correlation coefficient [R[2]] was 0.9953 showing linearity of the method. Blood sampling was carried out at different time intervals after administration of either test [TEST 500 mg] or reference [REF[registered] 500mg] formulation. Pharmacokinetic parameters [AUC[0-infinity], AUC[0-t], C[max], T[max], t[1/2] and k[el]] were calculated using Kinetica[register] PK/PD software. The geometric mean ratios and 90% confidence interval [CI] of these pharmacokinetic parameters for cefadroxil [test and reference] formulations were 0.986 [90.83-106.98%] for AUC[1-t]; 0.967 [89.13-104.92%] for AUC[0-infinity] and 0.999 [91.06-109.69%] for C[max]. The differences between T[max] of both formulations were not found to be statistically significant [p-value was more than 0.05]. The 90% CI of the test/reference AUC and C[max] ratio of cefadroxil were within the FDA recommended range for bioequivalence. Maximum plasma concentration C[max] was 12.5 micro g/ml for test and 12.47 micro g/ml for reference formulations. Average time to reach C[max] for test and reference formulation was 1.54 and 1.5 hrs. The two formulations of cefadroxil studied during the above study were verified bioequivalent. Maximum plasma concentration of cefadroxil was lower than those mentioned in some previous studies, while T[max] and half-life were near to values reported in literature

Operations; cancellation on the intended day of surgery

To find out reasons for cancellation of operation on the day of surgery in the Surgical Department of Civil Hospital Karachi. Observational study. All operation theatre bookings of the Civil Hospital Surgical Department from July 2010 to October 2010 have been studied by using the 'daily operating theatre lists'. Frequency of cancellation, type of surgeries cancelled and their reasons studied. Out of total 455 cases, 97 [21%] surgical operations were cancelled on the day of surgery, highlighting patients' non-compliance as a major contributing reason, followed by the lack of operating room time and other causes. Among the less contributing factors were patient expiry on table, failure to administer anesthesia and delay in operation due to exams [engagement of patients in undergraduate exam in the college]. Patients non-compliance is a major challenging factor that causes a large number of cancellations of operations in the Civil Hospital Karachi

Utilization of operation theatre; a newly developed tertiary care teaching hospital

To find out the number and variety of different surgeries performed at the operation theatre of the Dow University Hospital. From January 2011 to December 2011, hospital operation theatre record was reviewed. Main outcome measures were age, gender, medical record [MR] number, name of operations with their indications, specialty and type of anesthesia used during the procedure, type of surgery. Monthly trend of surgeries were also evaluated. The total numbers of operations performed during first year of operation theatre working were 539 cases. Number of emergency surgeries done was 42 [7.79%] and elective were 497 [92.2%].Surgeries performed by General Surgery, Gynecology and Plastic surgery department were 319 [59.18%], 61 [11.3%], 54 [10.0%]. MR Number was not present in record register in 306 [56.7%] cases, indication for surgery was not written in 274 [50.8%] cases and name of surgery was missing in 18 [3.3%] cases. The most common case performed were different types of biopsies while other common cases performed in the year 2011 were incision and drainage, cholecystectomies and hernia repair. The record maintained was overall satisfactory however needs further improvement. Computerization of records with training of staff about its proper maintenance can improve its quality with international standards

Altered lipid profile in patients with gallstones admitted for cholecystectomy

The cholesterol content is important in classifying gallstones as either cholesterol or pigment stones. Most of the gallstones are cholesterol stones. There is a multifactorial and complex relationship between blood cholesterol, Low Density Lipoprotein, and High Density Lipoprotein levels and cholesterol gallstone formation. Evidence showed that more than half of patients with gallstones have altered serum lipids which are a risk factor for ischemic heart diseases. This study was done to find out frequency of altered lipid profile in patients with gallstones admitted for cholecystectomy at Dow University Hospital Karachi Pakistan. case series study. This study was conducted at the Surgical Unit-2, Dow University Hospital, OJHA Campus, Karachi for a period of 14 months from January 2012 to March 2013. All diagnosed patients of cholelithiasis were included in this case series study. Lipid profile was performed for all patients before performing cholecystectomy. Post operatively gallbladder specimens were sent for histopathology and stones for chemical analysis. A total number of 45 patients were included in this study, out of which 40 were female. The mean age of patients was 47.7 +/- 13.3 years. On chemical analysis, Cholesterol was found in all of the stones. The histopathology of all patients showed chronic cholecystitis. The total mean serum cholesterol level was 199.3 +/- 36.8 , HDL cholesterol was 43.5 +/- 7.7, LDL +/- 23.9 cholesterol was 127.2 +/- 23.9, and triglycerides were 139.1 +/- 37.5. Serum total cholesterol was elevated in 28/45 patients [62.2%], LDL cholesterol was elevated in 26/45 [57.7%], triglycerides elevated in 18/45[40.0 %,] whereas HDL cholesterol was below normal in 16/45 [35.5%] of patients. Most of the patients operated for Lap Cholecystectomy had altered lipid profile. Patients presenting with Cholelithiasis should be investigated for altered lipid profile, which is a major risk factor for developing cardiovascular disease if left untreated

Quality of surgical case notes at Dow university hospital according to modified ANKLe score

To find out quality of surgical case notes according to modified Adjusted Note keeping and Legibility [ANKLe] score in Dow University Hospital. For this audit, medical records of all the patients admitted in Dow University Hospital surgery department were reviewed from February 2012 to April 2012. The modified ANKLe score [total 24] is formed by the combination of, the content [out of 20] and legibility [out of 4] to give an overall score out of 24. A score of at least 20 [content score 17/20; legibility score 3/4] is considered as acceptable. It means that a surgical record is legible and the majority of the essential content is recorded. A total of 236 records were evaluated. Overall mean +/- standard deviation [SD] of ANKLe score was 18.4 +/- 2.1 out of maximum score of 24. Content and legibility has overall mean scores of 14.4 out of 20 and 3.9 out of 4 respectively. Only two variables, patient's name and consultant on call were documented in 100% of records while the least documented variable were social history 2 [0.2%]. Legibility scoring system provides that 218 notes out of total set of 236 notes [that is 92.4% of overall notes] have achieved a score of 4. The benchmark of 80% was achieved in 26.1% for total ANKLe score, 6.8% for contents and 99.1% for legibility. Overall, quality of records is not good but legibility part scores exceptionally high

Transfusion transmitted infections [TTIS] among blood donors of Sukkur

To estimate an approximate disease burden of HIV, HBV, HCV, and Syphilis in healthy blood donors. Blood transfusion department not only screen transmitted infections but also give clue about the prevalence of these infections in healthy population. The objective of this study was to estimate an approximate disease burden of HIV, HBV, HCV, and Syphilis in healthy blood donors, so as to determine how well we are doing in fight against these killers. As most of these healthy blood donors are first time donors aged 18-60 years, the results can also be utilized to estimate the prevalence in healthy population of this age group. Retrospective Study. This study was conducted in blood Bank of Ghulam Muhammad Mahar Medical College Hospital Sukkur from January 2008 to December 2010. All healthy blood donors reporting to the blood bank in the specified study period were screened for HIV, Hepatitis B, C and Syphilis. A total of 7085 were screened, out of these 364 donors [5.14%] were seropositive for hepatitis C, 268 [3.78%] were seropositive for hepatitis B, 36 [0.5%] were seropositive for Syphilis and only 4 [0.05%] had shown seropositivity for HIV. Transfusion transmitted infections are a major threat associated with unscreened blood donations. In Pakistan the prevalence of hepatitis B and C is very high in occult form. Selection of healthy blood donors and public awareness programs targeting local community will be an important measure to stop its transmission through blood transfusion

quality of surgical case notes using crabel score at Dow university hospital

To find out the quality of medical records in the department of surgery at Dow University Hospital, a tertiary care teaching hospital. Medical records of all patients admitted in surgery department of surgery at Dow University Hospital from February 2012 to April 2012 were reviewed. By analyzing two sets of medical notes, a numerical score out of total 100 was calculated which is used as a representative value of quality; 100 being most accurate. For each omission of any of the criteria of CRABEL score, one point was deducted and the total scores was presented as percentage. The overall CRABEL score was 72.1 in all surgical case notes. Most frequents points were deducted in subsequent entry section with total deduction of 30.3% while least deduction was seen in discharge section with total deduction of 4.4%. Quality of Record keeping in surgical department of surgery is 71% in relation to CRABEL score. Subsequent entry section is the major factor in decrease in the quality of notes

Weeds of bitter gourd [Momordica charantia-Linn.] crop in district Sukkur, Sindh, Pakistan

Survey of weeds of bitter gourd Momordica charantia Linn.] crop was carried out during 2000-2001 with the view to check their competition with vegetable crop of bitter gourd from District Sukkur. Five different growing localities viz. Abad, Bagarji, Kando Wahan, Salehpat and Rohri were selected for this study. Twenty six weed species belonging to 15 angiospermic families have been recorded from the study areas. The most dominant species recorded from all selected sites was Convolvulus arvensis with a density% of 33.02. It was followed by Cyperus rotundus, Trianthema portulacastrum, Amaranthus viridis, Corchorus aestuans and Echinochloa crus-galli with density of 3.23-16.18%. Whereas the most frequent species was Cyperus rotundus with frequency% of 96, followed by Cynodon dactylon, Amaranthus viridis, Euphorbia hirta, Echinochloa colona, Portulaca oleracea and Trianthema portulacastrum with a frequency% ranging from 64-72

Medicinal uses of bitter gourd [Momordica charantia Linn.] in District Sukkur, Sindh, Pakistan

Bitter gourd [Mornordica charantia Linn.] is widely used for various diseases, with different formulations such as leaf powder, paste, decoction, infusion and pills etc. have been recommended in various medicinal treatises for different ailments. This plant plays a vital role of insulin. In local area of Sukkur Hakeems/herbalists make powder and tablets from green small immature fruit of Bitter gourd for hypoglycemic activity