Acute lower respiratory tract infection; therapeutic role of zinc in patients

ABSTRACT: Zinc is an essential rnicronutrient with catalytic role in over a hundred specific metabolic enzymes in human metabolism regulates the expression of the metallothionein gene, apoptosis and synaptic signaling and needed for many aspects of immune system. Thus the zinc 'supplementation in patients with acute lower respiratory tract infections might have potential benefits

Objectives: To evaluate the efficacy of zinc supplementation in patients with acute lower respiratory tract infections. Study design: Quasi experimental study. Setting: Study was conducted in the pediatrics department Independent hospital Faisalabad; the indoor patients meeting the inclusion criteria from 26[th] January to 25[th] July 2013 were included in study

Material and methods: 100 children meeting the inclusion criteria were included in the study which were divided into two groups with random allocation i.e. Group A [Odd number] and Group B [Even number]. Group A was given zinc supplementation 20mg of elemental zinc for 14 days. Along with antimicrobials, oxygen and antipyretics for fever while 50 children in Group B were given with antimicrobials. Oxygen and antipyretics for fever without zinc

Results: Baseline clinical parameters were comparable in both groups at admission. Outcome measures considered were duration of fever, tachypneoa, chest indrawings and total duration of hospital admission. Effect of zinc supplementation is significant with p-value of less than 0.05 for duration of tachypnoea and chest indrawings and total duration of hospital admission while result showed p-value equal to 0.05 that is just significant for duration of fever

Frequency of early seizures in patients of acute ischemic stroke

Introduction: Stroke is the most common neurological disorder and leading cause of death and disability worldwide .Post stroke seizures are not uncommon complication of stroke, if remain untreated it may increase the rate of mortality in stroke patients

Objective: Aim of this study is to determine the frequency of early seizures [ES] among patients presenting with acute ischemic stroke at a tertiary care hospital

Materials and methods: Descriptive case series study, conducted at Department of neurology [SMBBMU] Shaheed Mohtarma Benazir Bhutto Medical University Hospital, Larkana for a Period of six months. A total number of 155 patients were enrolled according to inclusion and criteria

Results: Among 155 patients 103 patients [66.45%] were in 6th decade of life. Male patients were higher in frequency 89[57.42%] than female 66 [42.58%] patients. The mean age [+/-SD] of patients was 55.38 [+/-5.66] years with range of 39-65 years. At presentation, the mean duration [+/-SD] of stroke was 3.59 [+/-1.94 ] days. Mean time [+/-SD] lapsed between stroke and occurring of seizure was 3.09 [+/-2.98] days with range of 0-9 days. Mean duration [+/-SD] of seizures was 3.27 [+/-1.95] minutes. In this study 11[7.1%] patients of ischemic stroke have early seizures occurrence and frequency of male 9[10.1%] patients is higher as compared to female patients 2 [3%] Patients with male gender, elder age, longer stroke to fit duration and rural living patients were more prone to this complication of acute ischemic stroke

Conclusion: The early onset seizures in ischemic stroke patients is not common, however when occurs increases morbidity

Phototherapy; frequency of hypocalcemia in neonates undergoing in Tertiary Care Hospital in Faisalabad

Hyperbilirubinemia is the most common abnormal physical finding in first few weeks of lif and its most common management is phototherapy. Amongst other common complications a less known complication of phototherapy is hypocalcemia

Objectives: to study the incidence of phototherapy induced hypocalcemia in neonates and to have a comparison between preterm and term neonates

Study design: descriptive cross-sectional study

Setting: paediatric Unit II DHQ Hospital Faisalabad, which is a tertiary care centre for all kind of patients

Duration of study with dates: six months from 1-11-2012 to 30-04-2013

Methods: 196 neonates with hyperbilirubinemia full term / preterm neonates admitted in pediatric DHQ hospital faislabad were selected. Inclusion criteria. 1] Hyperbilirubinemia. 2] No hypocalcemia on admission. 3] Received phototherapy for hyperbilirubinemia. Serum Calcium levels were measured in all neonates before and 48 hours after receiving phototherapy. Incidence of hypocalcemia among all neonates was calculated as an absolute percentage and the sample population was also divided into preterm / full term neonates to evaluate the incidence of hypocalcemia in these two groups individually

RESULTS: mean serum calcium in neonates was 7.5+- 1.5 mg / dl .16.84% of neonates were found to have calcium level below the cut off value. 33 out of 196 developed hypocalcemia after phototherapy and out of these 54% were preterm and 45% were term neonates < P-value [0.01]>

Conclusion: phototherapy induces hypocalcemia in neonates more so in preterm neonates

Impact: consideration for additional calcium supplementation should be undertaken in all neonates undergoing phototherapy and further randomized trials need to be done with these concerns

Effect of chronic noise stress on mantle zone of lymphoid follicle of splenic tissue in albino rats

Noise is an ever growing problem in modern society. Apart from its effect on hearing, behavior, and mood it also has a potent effect on immune system. Therefore the present study was designed to asses effect of chronic noise stress on mantle zone [MnZ] of lymphoid follicle [LF] of spleen in albino rats. Two groups of twenty rats, each group labeled A and B were used; serving as control [no noise] and noise stress [30 days] respectively. Group B was exposed to noise stress of 100 dB for 30 day [3-4hrs/day]. Animals were sacrificed at the end of study, spleen was removed prepared, sectioned and stained with CD79a. A highly significant decrease in mean no of cell in MnZ of LF was observed [15747 +/- 87.82/mm[2]] in noise stressed group when compared with MnZ of control animals [16567 +/- 106/mm[2]]. There was also a highly significant increase in mean perimeter of nuclei observed in MnZ of stressed group [2.74 +/- 0.009microm] when compared with rats of control group [2.68 +/- 0.01microm]. Our study concludes that noise stress induced release of glucocorticoid can significantly decrease number of B lymphocytes in MnZ of LF of spleen in albino rats

Role of leukotriene receptor antagonist in acute severe attack of bronchial asthma in comparison with conventional therapy

This study was designed to determine the role of leukotriene receptor antagonist in acute severe attack of bronchial asthma in comparison with conventional therapy. Asthma is a chronic inflammatory lung disease in both the developed and developing countries. Asthmatic patients are at risk of worsening of disease characterized by an increased breathlessness, cough, chest discomfort and wheezing and decreased in expiratory airflow rate. Leukotrienes are lipid mediators synthesized from arachidonic acid, and element of which are potent chemo attractants. These chemical mediators are involved in the pathogenesis of asthma. Study results reveled the effectiveness of leukotriene receptor antagonist in preventing many types of aggravated asthmatic responses. Oral administration of leukotriene receptor antagonist in acute asthmatic patients improves airway function. Once-daily treatment with 10 mg of montelukast, as compared with conventional therapy, provided significant protection against severe broncho-constriction. Study also shows that there was no worsening of the disease. Parameters strongly confirmed the role of leukotriene receptor antagonist when in addition added with steroid therapy in the treatment of acute asthma, there were a smooth improvement was noticed

Effects of alpha-tocopherol on lipid profile in primary hyperlipidemia

To determine the antihyperlipidemic effects of alpha-tocopherol in primary hyperlipidemia. An analytical cohort study. This study was conducted in the Department of Pharmacology and Therapeutics, Basic Medical Sciences Institute of Jinnah Postgraduate Medical Center, Karachi, from February to April 2001. Newly diagnosed and un-treated primary hyperlipidemic persons of either gender between the ages 17 to 70 years were initially enrolled in the study for a 12 weeks [90 day] trial with fortnightly follow up visits. The selected patients were divided into 2 groups. The first group [Group-I] was treated with diet restriction and exercise only. The second group [Group-II] was treated with diet restriction, exercise and alpha -tocopherol. Results were compared using paired t-test. There were 35 patients in all. After treatment with alpha-tocopherol, cholesterol reduction was highly significant [p<0.01]. Triglyceride reduction was significant [p<0.05]. Increase in HDL-c level was highly significant [p<0.001]. The LDL-c reduction was statistically highly significant [p<0.001]. VLDL reduction was also significant [p<0.01]. When compared between the Groups I and II, the reduction in cholesterol was moderately significant [p<0.01], LDL-c reduction was found to be markedly significant [p<0.01]. HDL and VLDL reduction was also found to be significant [p<0.05]. In comparison there was no significant change in triglyceride level. Diet restriction and exercise had significant beneficial effects on lipid profile. When supplemented with alpha -tocopherol, there was a highly significant beneficial effect on lipid profile