Evaluation of nephroprotective activity of Musa paradisiaca L. in gentamicin-induced nephrotoxicity

The objective of the study was to investigate the nephroprotective activity of methanolic extract of different morphological parts [bract, flower, trachea and tracheal fluid] of Musa paradisiaca L. [Family: Musaceae] against gentamicin-induced nephrotoxicity in mice. Gentamicin produced significant changes in biochemical [increased levels of blood urea nitrogen level, blood urea, and serum creatinine], and histological parameters in mice. Treatment with methanolic extract of bract [100 and 250mg/kg, b.w] and flowering stalk [trachea] [250 and 500mg/kg, b.w] significantly prevented biochemical and histological changes produced by gentamicin toxicity. The extracts of M. paradisiaca[bract and flowering stalk] could contribute a lead to discovery of a new drug for the treatment of drug-induced nephrotoxicity

Phytochemical and dermatological investigations of tribulus terrestris l.

Tribulus terrestris extracts were prepared using solvents of different polarities and their irritant inducing effects were assessed in vivo on rabbit's ears

The result indicates that the polar components were in higher yield than the others and amounts of the extracted material were directly proportional to the polarities of solvents. Preliminary phytochemical screening shows diversity of compounds and comparative TLC analytical behaviour further indicated the resolution of mostly five compounds from the non-polar, intermediate polar and highly polar materials by different solvent systems. Irritant potency of water extract was assessed on rabbit's ears using a known method that was proved to be the most potent irritant [with +++ response, propagated in an area of 2.70 cm[2] diameter]

[Effects of dietary supplementation of mannan-oligosaccharide on virus shedding in avian influenza [H[9]N[2]] challenged broilers]

Avian influenza [AI] is a highly contagious disease causing significant economic losses worldwide. The aim of this study is to evaluate the effect of mannan-oligosaccharide [MOS] on tracheal and cloacal virus shedding in AI challenged broilers and contamination of environment with H[9]N[2]. A total of 300 1-day-old-broiler chicks were randomly divided into 3 groups [A, B and C] and supplemented 0.2, 0.5 and 0.0% MOS, respectively in NRC recommended diet for 36 days. On day 21 the groups were further split into two sub groups A+ve, A-ve, B+ve, B-ve, C+ve and C-ve with 5 replicates each. The positive groups were shifted to remote sheds and were challenged intranasally with 0.1 ml of reference virus [AIV; Pk-UDL/01/08 H[9]N[2]] with EID[50] = 10[-6.66]. Treatment reduces [P<0.05] cloacal virus shedding from day 24 to 26 and 28 to 32. Tracheal virus shedding was lower [P<0.05] on days 25-26 and 28-30 in treatment groups. Day 27 showed highest [P>0.05] virus shedding in all groups. However the reduction of viral shedding is faster in treatment groups and showed no virus shedding on day 32. Maternal antibody titer against AI showed a declining pattern but MOS influenced [P<0.05] the titer in treated groups. Hence the use of MOS may constitute a novel and effective plausible alternative that reduces the spread of disease by decreasing virus shedding and contamination of environment from AIV [H[9]N[2]] infection in poultry

Serum homocysteine level in vegetariansin district Tharparker, Sindh

The aim of present study was to investigate serum homocysteine levels in apparently healthy vegetarians and ominvores in Mithi, district Tharparker, Sindh, Pakistan. This study was conducted in the Department of Biochemistry, Basic Medical Sciences Institute [BMSI], Jinnah Postgraduate Medical Center [JPMC], Karachi and blood samples were collected from Mithi, district Tharparker, Sindh, Pakistan, in 2012. One hundred vegetarian and one hundred omnivores [age ranging from 20-40 years] were enrolled for this study. Serum homocysteine levels were measured by the chemiluminescence enzyme immunoassay method. Serum homocysteine [Hcy] level was considerably higher [p<0.001] in vegetarian group compared to omnivores. We further grouped and analyzed our study subjects according to their gender and according to Hcy level [greater than or lower than 15micromol/L]. A considerable number of vegetarian subjects 30% were having Hcy >15micromol/L compared to omnivores 6%, [p<0.001]. Gender-wise comparison showed that 27.02% male and 38.46% females had >15micromol/L serum Hcy level in vegetarian group and 6.9% male and 3.5% females had >15micromol/L serum Hcy level in omnivores group, but the difference was not significant in any group. Vegetarians are more prone to develop hyperhomocysteinemia, so they are at high risk to develop cardiovascular disease

Frequency and antimicrobial susceptibility of gram negative rods in high vaginal swabs

Background: The normal vaginal flora contains a variety of microorganisms. Vaginal discharge is a common gynaecologic problem especially among sexually active females. Pathological vaginal discharges are usually due to infection or inflammation of vagina and/or cervix

Objective: To find out the frequency of aerobic gram negative rods in high vaginal swabs and to determine their antimicrobial susceptibility profile

Materials and Methods: This study was conducted in Microbiology laboratory, Pathology Department, SZMC/H, Rahim Yar Khan from 1[st] January, 2012 to 30[th] June, 2012. High vaginal swabs were collected from 100 females visiting antenatal clinics and gynae OPD of Sheikh Zayed Medical College/Hospital, Rahim Yar Khan. Samples were cultured on blood and Mac Conkey agar plates. Plates were incubated aerobically at 35-37°C. All positive cultures were identified by gram staining, cultural characteristics and biochemical reactions. The antimicrobial susceptibility testing of all isolates was done by standard disc diffusion method

Results: Majority of culture positive females were between 25 to 30 years of age. Escherichia coli [72%] was the predominant organism, followed by Klebsiella spp [16%], Enterobacter [6%], Proteus spp [2%], Morganella [2%], Pseudomonas spp [2%]. All these isolates showed good sensitivity towards imepenem and cefoperazone-Sulbactam

Conclusion: In this study, E.coli were the predominant organism, followed by Klebsiella spp. Imepenem and cefoperazone-sulbactam were the most effective antimicrobials against all isolates

Serum magnesium levels in type 2 diabetic patients presenting with acute coronary syndrome and prevalence of cardiac arrhythmias in these patients

Hypomagnesaemia have been reported to occur with an increased frequency in type 2 diabetics compared with their counterparts without diabetes. Abnormalities of magnesium levels, such as hypomagnesaemia, can result in disturbances in nearly every organ system and can cause potentially fatal complications [e.g., ventricular arrhythmia, coronary artery vasospasm, sudden death]. Premature ventricular complexes [PVC] predict cardiovascular mortality among several adult populations. This study was done to find correlation between serum magnesium levels of diabetics and incidence of arrhythmias. We analyzed the serum magnesium levels in fifty consecutive patients with type 2 diabetes presenting with acute coronary syndrome in CCU of Services Hospital, Lahore and prevalence of cardiac arrhythmias in these patients. Serum magnesium levels were measured at presentation and twenty four hour Holter monitoring was done for the detection of arrhythmias. There were 33 male [66%]; 17 female [34%] patients and mean age of presentation was 60 years [ +/- 20 years]. 7 [14%] out of 50 patients had hypomagnesaemia [<1.7mg/dl], 2 females and 5 males. 'Ventricular premature contractions' in hypomagnesemic patients were 1.5 times the patients with normal magnesium level. There was no definite relationship observed between serum magnesium level and 'supraventricular premature contractions'. Although ventricular premature contractions are more common in patients with hypomagnesaemia and may result into life threatening arrhythmias but no life threatening arrhythmias [e.g., ventricular tachycardia and torsade de pointes] were seen in our study population with hypomagnesemia

Intramedullary spinal tuberculoma

Spinal intradural intramedullary tuberculoma is extremely rare entity of tuberculosis involving the nervous system. Because of its atypical symptomatology, it must be considered in differential diagnosis of spinal cord lesions, especially where prevalence of tuberculosis is high. In this case report this atypical disease is described where good outcome was achieved by surgical excision of the intramedullary lesion followed by antituberculous therapy

Using surveillance data for action: lessons learnt from the second generation HIV/AIDS surveillance project in Pakistan

Although many countries are now collecting useful, high-quality HIV surveillance data, more efforts are put into the collection of data than into ensuring it is deployed effectively. The Canada-Pakistan HIV/ AIDS surveillance project has strengthened and expanded the existing national AIDS control programme surveillance system in Pakistan through a comprehensive estimate of the size and location of some of the most at-risk populations [sex workers and injection drug users] and annual assessments of their sociodemographic characteristics, behaviours and HIV prevalence. The country now uses second generation surveillance data at a broad level to lobby for policy change, mobilize resources, improve programming and measure the success of prevention through an integrated national effort. This article aims to share the experiences and lessons learnt in the development of a second generation surveillance system for HIV/AIDS in Pakistan

Acute abdomen cases presenting at Fauji Foundation Hospital, Rawalpindi

To study the common causes of acute abdomen at Fauji Foundation Hospital, Rawalpindi, Study Design: Descriptive study. This Study was conducted at the Department of Surgery, Fauji Foundation Hospital, Rawalpindi from December 13, 2009 to February 22, 2011. A total of 840 patients who presented with acute abdominal pain and were admitted from the emergency department of Fauji Foundation Hospital, Rawalpindi from December, 2009 to February, 2011 were included in the study. The data of the 840 male and female patients was collected on the Patient Performa and then transferred to the data sheet IV of SPSS 10. The results were analyzed by calculating the frequencies of acute abdomen causes. The most frequent cause was non specific abdominal pain [38.7%] followed by acute cholecystitis [7.7%] and acute appendicitis [6.8%]. Total exploratory laparotomies done were 204 [24.3%] while 498 [59.3%] patients were managed conservatively with ultrasound abdomen and pain medication. Non specific pain was found to be the most common cause of acute abdomen followed by acute cholecystitis and acute appendicitis. The diagnostic accuracy can be enhanced especially in females of child bearing age by the use of ultrasonography and selective diagnostic laparoscopy

Control of cystic artery in laparoscopic cholecystectomy: to clip or to use monopolar electrocautery

The purpose of this study was to compare monopolar electrocautery with clip application for securing hemostasis of cystic artery in patients undergoing laparoscopic cholecystectomy. A comparative study was performed on data collected during a 6-years period [2005-2011] from 600 patients who underwent laparoscopic cholecystectomy. In 306 cases assigned to group 1, the cystic artery was clipped while in 294 cases assigned to group 2, the cystic artery was coagulated with monopolar electrocautery. In group 1, the cystic artery was single in 91%, branched in 6% and absent in 3% cases while in group 2, the cystic artery was single in all cases. The cystic artery was of normal size in 82%, short in 7%, long in 8% and absent in 3% cases in group 1 while in group 2, it was normal in size in 88%, short in 3% and long in 9% cases. The cystic artery was originating from the right hepatic artery in 97% cases and from the superior mesenteric artery in 3% cases in group 1. In group 2, the cystic artery was originating from the right hepatic artery in 97% cases and not visualized in 3% cases. In group 1, only 3 patients had an intra-operative hemorrhage while in group 2, 3 of the patients had bleeding. The post operative recovery was also similar in both groups with 83% and 81% patients going home on the next day. There was no difference in the outcome of patients whether clips or monopolar electrocautery was used for hemostasis of cystic artery in laparoscopic cholecystectomy

Ductal variations in the Calot's triangle seen on laparoscopic cholecystectomy

To describe the frequency and pattern of ductal variations seen in the Calot's triangle on laparoscopic cholecystectomy. Descriptive study. This study was conducted in the Surgical Unit 1, Fauji Foundation Hospital, Rawalpindi from December 13, 20008 to February 22, 2011. 200 patients with a diagnosis of biliary colic, cholelithiasis, acute cholecystitis, empyema gall bladder and mucocele gall bladder were included in this study. Patients with age less than 15 years were excluded. Careful dissection of the Calot's triangle was carried out. The anatomical variations of the cystic duct and other anomalous variations in the region were noted and data analyzed on SPSS 10. The age range was 19 to 88 years with a mean of 48 years. The majority [88%] of the patients presented with a clinical diagnosis of biliary colic. The cystic duct was of normal size in 88%, short in 7%, and long in 5% of the cases. The cystic duct terminated laterally into the common hepatic duct in 94% of the cases, anteriorly into the common hepatic duct in 5% and posteriorly into the common hepatic duct in 1% of the cases. Each Calot's triangle differs from the other. Ductal variations are the hallmark of this region and their knowledge is mandatory for a safe laparoscopic cholecystectomy

Vascular variations in the calot's traingle seen on laparoscopic cholecystectomy

To describe the frequency and pattern of vascular variations seen in the Calot's triangle on laparoscopic cholecystectomy. Descriptive study. From December, 2008 to February, 2011. Surgical Unit 1, Fauji Foundation Hospital, Rawalpindi. Two hundred patients with a diagnosis of biliary colic, cholelithiasis, acute cholecystitis, empyema gall bladder and mucocele gall bladder were included. Patients with age less than 15 years were excluded. Careful dissection of the Calot's triangle was carried out. The anatomical variations of the cystic artery and other anomalous variations in the region were noted and data analyzed on SPSS 10. The age range was 19 to 88 years with a mean of 48 years. The majority [88%] of the patients presented with a clinical diagnosis of biliary colic. The cystic artery was single in 91%, branched in 6% and absent in 3% cases. The cystic artery was supero-medial to the cystic duct in 88%, anterior in 6%, and posterior in 3% of the cases. Other arterial variations included Calot's arteries [2%], Moynihan's Hump [3%] and gall bladder arterial supply from liver bed [3%]. Each Calot's triangle differs from the other. Vascular variations are the hallmark of this region and their knowledge is mandatory for a safe laparoscopic cholecystectomy

Severity and risk factors of depression in Alzheimer's disease

To determine the frequency, severity and risk factors of depression in Alzheimer's disease. Descriptive study. The Department of Psychiatry, Sir Ganga Ram Hospital, Lahore, from August 2007 to December 2008. Consecutive patients of Alzheimer's disease reporting to the department during the study period were included and those with extreme cognitive impairment were excluded. The cognitive status was judged by using the Mini-Mental State Examination [MMSE]. The Hamilton rating scale for depression [Ham-D] was used as a symptom checklist to diagnose major depression according to the DSM-IV criteria. Chi-square test was used to check the significance of association. There were 73 patients comprising of 34 males and 42 females. The mean age was 67.74 +/- 6.71 years; 66% were married, 14% were single and 20% were widowed; 47% had family history of depression and medical co-morbidity was observed in 48%. Based on MMSE, 31.5% had mild Alzheimer, 55.3% had moderate and 13.1% had severe Alzheimer. Judging from Hamilton rating scale, 25% patients were free from depression, 19.7% had mild depression, 27.6% had moderate depression and 27.6% were suffering from severe depression. The frequency of depression was significantly higher [p= 0.0013] among females [90%] as compared to males [55.9%]. There is a high frequency of depression among patients of Alzheimer's disease particularly among female patients. This finding is consistent with the reports from other countries

Frequency of cardiac defects among children at echocardiography centre in a teaching hospital

To assess frequency of cardiac defects among children from birth to 12 years of age on echocardiography basis. A cross sectional study was conducted at echocardiography centre in coronary care unit at Bahawal Victoria Hospital Bahawalpur for fifteen months from April 2007 to July 2008. A sample of 150 patients [<12 years age] were selected by non-probability convenience sampling technique. The cardiologists performed echocardiography by Paediatric Transthoracic echo probe; 2-D colour Doppler, Acuson CV-70 and Niemo-30 echocardiography machines. Mothers of children with cardiac defects were interviewed at the echocardiography centre. Variables included were A- Muscular plus Vascular defects; B- Valvular defects; C-Pericardial effusion; D- Dextrocardia and E- Congestive cardiac failure. History of children for sore throat followed by joint pains; history of mothers for drug intake [antihypertensive, antipyretic, anti-emetic, hypoglycaemic] as well as chronic diseases [diabetes mellitus, hypertension, anaemia] during pregnancy were surveyed. Parity of mothers, their cousin marriages, and family socio-economic status was also inquired. The results were tabulated, analyzed and finally subjected to suitable test of significant [SR of proportion] to find out statistical significant if any. It was found that out of 150 patients, 76 [50.66%] were suffering from Cardiac muscular and Vascular defects, 61 [40.66%] Valvular defects, 7 [4.66%] Pericardial effusion, 2 [1.33%] Dextrocardia and 4 [2.66%] from Congestive Cardiac Failure. According to age, 54 [36%] were from birth to 3 years of age and 51 [34%] from 10 to 12 years. There was history of Rheumatic fever among 45 [30%] children. There were 106 [70.6%] children from lower socio-economic class and 79 [52.6%] parents had history of cousin marriages. Frequency of cardiac defects was more in children of male sex, lower socio-economic group, from birth to three years age and children from primipara mothers in our specified locality. Rheumatic fever, cousin's marriage, and prescribed drugs intake during pregnancy [for metabolic and hormonal disorders] were other contributors to cardiac defects

Fogarty balloon catheter ablation of posterior urethral valves in neonates

Neonates with posterior urethral valves in developing countries, where costly endoscopic instruments are usually not available, are a special problem. The objective of this study was to evaluate the efficacy of fogarty balloon catheter ablation of posterior urethral valves as an alternative to endoscopic valve fulgaration. From January 2006 to December 2006, we received 07 neonates with Posterior Urethral Valves which were subjected to this technique. Their age range was between 5-26 days, while the weight range varied between 2.5 Kg to 3.5 Kg. Valves were ablated by using size 6F Fogarty catheter in the main operation theater under general anesthesia. Technique was successful in all the 7 neonates which was evident by a good stream of urine. Two patients had Grade III, while two patients had Grade IV vesicoureterric reflux before ablation. In patients with Grade IV reflux, reflux downgraded to Grade III on MCUG done 3 months after ablation. Patients with Grade III reflux were lost to follow up. Ablation of posterior urethral valves with Fogarty balloon catheter in neonates is simple, economical and effective way to treat these patients. Endoscopic valve fulgaration in neonates is hazardous and this technique is a good alternative, especially in developing countries

Prevalence of functional GI disorder in the adult population of Arafat town, Karachi

To find out the prevalence of functional gastrointestinal disorders in the adult population of a low socioeconomic community in Pakistani population. A sample of 500 adult individuals was selected through a simple random sampling technique using simple random table. The Study conducted in 2004 based on a questionnaire comprising of 38 close ended questions as per ROME II criteria. The diagnosis established through the same criterion after analyzing the data on SPSS 10.0. The Study on 500 individuals revealed that a major proportion of the studied population 80.2% [401/500] were having one or more than one functional gastrointestinal disorders ranging from mild to server conditions, while only 19.8% [99/500] of them were free from any disorder. Out of these diseased individuals, the majority 77.8% [312/401] suffering from Multiple Gastrointestinal Symptoms, while 22.2% [89/401] were with that of Single Gastrointestinal Symptoms. Functional gastrointestinal disorders are prevalent in our community. These disorders found in individuals are of both Single and Multiple in nature. Although these are not fatal but may cause discomfort ranging from inconvenience to deep personal distress which may lead to great decline in their quality of life

Malnutrition; determinants in children between six months to five years of age in Bahawalpur

To find-out the determinants of malnutrition in children between six months to five years age in Bahawalpur. This was an observational descriptive cross - sectional study. At Paediatric Medicine out - patient department in Bahawal Victoria Hospital, Bahawalpur. From Feb. 2005 to March 2007. Eleven hundred children with malnutrition having ages six months to five years. Main outcome measures. Determinants of malnutrition in children under - 5 in Bahawalpur. This study consists of 1100 sick children between the ages six months to five years brought by their parents [mother] to the Pediatric Medicine out-patient department in Bahawal Victoria Hospital, Bahawalpur. Only the children with malnutrition [undernutrition] were included in the study population. Mothers of these children were interviewed and clinical examination of each child was carried-out to find-out the causes of malnutrition in them. According to Gome's classification, 39.45% of them had first degree malnutrition, 37.10%, second degree and 23.45%, third degree malnutrition. The major causes of malnutrition found in our study population included: Illiteracy; food-fads; poverty; lack of breast-feeding; improper weaning; diarrhea and respiratory diseases. All these factors were statistically significant

Carcinoma breast, late presentation: a big concern

To study the different presentation patterns and their treatment options in advanced carcinoma breast. A retrospective observational study North Surgical Ward, Mayo Hospital, Lahore, from November 2004 to April 2006. In total, 156 patients with carcinoma breast, confirmed histopathologically by biopsy and /or FNAC, were included in this study. Information was gathered from them using a structured questionnaire. The peak incidence of carcinoma breast was found to be between 31- 45 years of age. Majority of these patients presented in stage II [22%]. Maximum number of patients presented in stage III [56%]. However stage IV disease was also found in 12% of patients population. But stage I disease was least commonly presented disease [10%]. And infiltrative ductal carcinoma was the most prevalent [94%] histologic type. Modified radical mastectomy was the surgical treatment adopted in about 72% of cases with adjuvant or neoadjuvant chemotherapy. Advance stage breast lump with local or locoregional spread remained the commonest mode of presentation of carcinoma breast. And infiltrative ductal carcinoma is the commonest histologic variant. Majority of the of patients with carcinoma breast in Pakistan still present in advanced stages where almost no cosmetically more acceptable surgical procedure can be carried out

Safety and efficay of repaglinide compared with glibenclamide in the management of type 2 diabetic Pakistani patients

To evaluate the safety and efficacy [glycemic control] provided by repaglinide compared with glibenclamide in newly diagnosed type 2 [non-insulin dependant] diabetic patients. Diabetic clinic in medical outdoor of Mayo Hospital, Lahore. Randomized prospective study. This single center study of one year duration was carried out in 100 patients between 30-70 years, all diagnosed to have type 2 diabetes mellitus recently and were not on any treatment. They were randomly categorized into two groups, repaglinide [test] and glibenclamide [control] groups. The study consisted of an initial induction day followed by follow-up visits after every fortnight. Repaglinide was given pre-prandial up to three times a day and glibenclamide was administered once or twice daily. Dosage was adjusted after every visit according to blood glucose level. Fasting blood glucose level, two hours postprandial blood glucose, weight and blood pressure were recorded on every visit, while glycosylated hemoglobin [HbA1c] was estimated thrice during the study [at the beginning, at six months and at the end of one year]. Of the hundred randomized patients [50 in each groups], all showed a decrease in fasting blood glucose level, two hours postprandial blood glucose and HbA1c. Mean reduction in fasting blood glucose in repaglinide group was 64+53 mg/dl and those by glibenclamide group was 34.7+53 [P=0.007]. The mean reduction in two hours postprandial blood glucose was 119+66 in repaglinide group, while 87.6+74 was observed in glibenclamide group [P=0.02].HbA1c mean reduction in both repaglinide and glibenclamide groups was 1.1+0.3 and 0.7+0.5 respectively [P=0.00]. No statistically significant weight change was observed and no hypoglycemic events were recorded in both the groups. The results suggest that repaglinide and glibenclamide both were effective in lowering fasting glucose level, two hours postparandial blood glucose level and HbA1c if used regularly for one year. The effect of repaglinide in lowering HbA1c was impressive as compared to glibenclamide. Both the drugs were well tolerated and weight change was minimal in both the groups

Plasma lipid profile in sarcoma patients

Objective of the present study was to observe plasma lipid profile [triglycerides, cholesterol, LDL-cholesterol and HDL-cholesterol] in sarcoma patients. 120 subjects were included in the project. The subjects comprised of two groups; first as Controls [60 in number] and the second as Patients of Sarcoma [also 60 in number]. Fasting blood samples were collected for estimation. Sarcoma patients showed highly significant [P<0.01] decrease, when compared with the normal control subjects