Seasonality and trend analysis of tuberculosis in Lahore, Pakistan from 2006 to 2013

Tuberculosis [TB] is a respiratory infectious disease which shows seasonality. Seasonal variation in TB notifications has been reported in different regions, suggesting that various geographic and demographic factors are involved in seasonality. The study was designed to find out the temporal and seasonal pattern of TB incidence in Lahore, Pakistan from 2006 to 2013 in newly diagnosed pulmonary TB cases. SPSS version 21 software was used for correlation to determine the temporal relationship and time series analysis for seasonal variation. Temperature was found to be significantly associated with TB incidence at the 0.01 level with p = 0.006 and r = 0.477. Autocorrelation function and partial autocorrelation function showed a significant peak at lag 4 suggesting a seasonal component of the TB series. Seasonal adjusted factor showed peak seasonal variation in the second quarter [April-June]. The expert modeler predicted the Holt-Winter's additive model as the best fit model for the time series, which exhibits a linear trend with constant [additive] seasonal variations, and the stationary R[2] value was found to be 0.693. The forecast shows a declining trend with seasonality. A significant temporal relation with a seasonal pattern and declining trend with variable amplitudes of fluctuation was observed in the incidence of TB

Pattern of genitourinary tuberculosis in patients with pulmonary tuberculosis

Tuberculosis is an ancient disease. It is responsible for causing a major health problem in developing countries. Genitourinary tuberculosis is the second most common form of extra pulmonary tuberculosis after lymph node involvement. This study was carried out to determine the pattern of genitourinary tuberculosis in patients with active pulmonary tuberculosis. It is a cross sectional descriptive study. Carried out in the Urology Department of Jinnah Hospital and T.B outdoor of Gulab Devi Hospital, Lahore during the period Oct, 2002 to Oct, 2004. Two hundred patients with pulmonary tuberculosis, 117 males and 83 females, ranging from 17 to 80 years of age [mean 37.9 years] were included in the study. Hundred patients were freshly diagnosed cases [group-1] and the remaining hundred patients were already diagnosed cases of pulmonary tuberculosis and had received antituberculous treatment [ATT] for at least three months [group-2]. Diagnosis of pulmonary tuberculosis was based on positive sputum smear for acid fast bacilli [AFB] by Ziehl Neelsen [ZN] staining technique. Twenty four hours urine was collected from each patient. Each specimen was examined for the presence of mycobacterium tuberculosis by ZN staining and culture on Lowenstein Jensen [LJ] medium. Positive for one or both of these procedures was taken as positive for genitourinary tuberculosis. Biopsy of urogenital tract was carried out and histopathological examination was done in patients with positive bacilluria and having urinary symptoms. Genitourinary organs of 9 patients in group-1 and 18 patients in group-2 were found involved for genitourinary tuberculosis. Among 9 patients in group-1, the urinary bladder and kidney involvement were highest 3 [33.3%] followed by epididymis 2 [22.2%] and Ureter 1 [11.1%]. Among the 18 patients in group-2, urinary bladder involvement was highest 9 [50%] followed by kidney 5 [27.8%], epididymis 3 [16.7%] and testis 1 [5.5%], Genitourinary organ involvement in patients already on antituberculous treatment is more common as compared to freshly diagnosed cases. Urinary bladder involvement is highest in both groups

PR-HPLC method for the assay of cefpirome and its application in drug-metal interaction studies

An accurate, sensitive and least time consuming RP-HPLC method for the estimation of cefpirome in the presence of essential and trace metal has been developed and validated. Cefpirome was eluted from a B144A, OD-5-100, C18 [150 x 4.6 mm] column at room temperature with a mobile phase consisting of MeOH:H2O [15:85,% v/v] at a flow rate of 1 ml/minute, while UV detection was performed at 265 nm. The detection limit of cefpirome was 10 ng. Drug metal interaction studies were carried out at 37 oC to monitor the complexation of drug with metal ions. These studies were beneficial to determine the drug in therapeutic concentrations inside human body as well as its complexation with metal cations. The metals essential to human body like Mg[II], Ca[II], Cr[II], Mn[II], Fe [III], Co[II], Ni[II], Cu[II], Zn[II] and Cd[II] were in the form of chlorides. The carboxylic group of the dehydrothiazine ring has more binding capacity relative to other group that augments the drug complexes with essential and trace elements. The established HPLC method is rapid, accurate, and selective, because of its sensitivity and reproducibility. The order of complexation was ferric > chromium > copper > nickel > cadmium > zinc > magnesium > manganese > calcium > cobalt

Management of the lower urinary tract symptoms [LUTS] due to benign prostatic hyperplasia [BPH], with terazosin

This study was designed to assess the efficacy, safety and compliance of terazosin in the management of lower urinary tract symptoms due to benign prostatic hyperplasia. Study was conducted in the department of urology, DHQ Hospital Vehari, in about 1-year i-e from July 2004 to June 2005. Sixty patients with an age range of 45-85 years were included in the study. Data was collected prospectively. Patients were assessed according to the international prostate symptom score [I-PSS] at the start of study, during follow up and at the end of study. Out of sixty patients, fifty-two were able to complete the study. It was observed that most of the patients obtained a significant decrease in the prostate symptoms score and improvement in QoL score, with only a few side effects. Terazosin is a safe and effective treatment for BPH with good compliance

Prevalence of different types of glaucoma in a tertiary eye care hospital

Purpose of Study: To find out the prevalence of different types of glaucoma

Study Design: Retrospective analysis of glaucoma clinic record

Methodology: Retrospective analysis of glaucoma patients examined in glaucoma clinic at Al-Shifa Trust Eye Hospital during a period of three years from January 1992 to December 1994. The study included patients of all ages and both sexes. Diagnosis of different types of glaucoma was based on history and clinical examination which included slit-lamp examination, optic disc examination, applanation tonometry, gonioscopy and automated perimetry by Humphery visual field analyzer

Results: 5,906 patients were examined. Primary Open Angle Glaucoma [POAG] was diagnosed in 2,482 [42%] patients. Primary Angle Closure Glaucoma [PACG] was the second most common type, found in 1,005 [17%] patients. Aphakic Glaucoma affected 767 [13%] patients. Secondary glaucomas were diagnosed in 266 [4.5%] patients. Pseudoexfoliation Syndrome was the cause of glaucoma in 342 [5.8%] patients.177 [3%] patients were cases of Normotensive Glaucoma [NTG] while Congenital Glaucoma [Buphthalmos] was found in 171[2.9%] patients. In 696 [11.8%] patients definite diagnosis of glaucoma was not possible initially and these were labeled as glaucoma suspects

Conclusion: Primary Open angle glaucoma is the commonest type of glaucoma prevalent in this population

Measurement of optical parameters: absorption scattering and Auto-florescence of skin in vitro

To measure various optical parameters in skin sample of chicken. We illuminated the chicken breast skin tissues with collimated radiation of 400-700 nm Nd-YAG pumped dye laser, and measured skin optical properties for dry and hydrated sample in vitro. Total reflectance and transmitted intensities were recorded by which scattering, absorption and anisotropic factors of the sample obtained using double integrating sphere setup. The in vitro optical parameters are higher then in vivo measurements. Hydration of skin is found to influence its scattering properties. Dry sample scatter less then hydrated sample. Our in vitro results are in agreements with other data available in literature

Study of efficacy of enalapril in the treatment of Pakistani patients with heart failure

A randomized, prospective, open-ended study of 20 Pakistani patients with moderate-to-severe heart failure [NYHA class II and III] was carried out. Patients had to have global left ventricular [LV] dysfunction with ejection fraction [LVEF] <35%. The patients were randomized into two groups, C and E. Group C patients [N=9] were optimized on conventional therapy i.e. diuretic, digoxin and nitrates whereas group E patients [N=11] had enalapril added to this therapy and increased gradually. The subjects were followed for a period of 12 to 120 weeks with a mean of 58 weeks. Serial tests were done at 12 weekly intervals. These included echocardiography, exercise stress test, urea, creatinine, sodium and potassium. Showed a significant improvement in NYHA class in group E. 10 of the 11 patients in this group improved by one class while only 1 out of 9 patients improved by one class in group C. There was a highly significant [p< 0.001] increase in exercise time in group e from 417 sacs to 730 while there was an insignificant increase in group C. Hemodynamic measurements showed a significant fall in heart rate in group E from 90 bpm to 83 bpm [p=0.01] but an insignificant fall in group C from 94 bpm to 86 bpm. Systolic and diastolc blood pressure [BP] fell in both groups [121/81 vs 108/74 in group C and 117/77 vs 110/72 in group E] but only the fall in systolic BP in group E was significant [p=0.05]. Echocardiography showed significant improvement in left ventricular systolic [p=0.001] and diastolic [p< 0.05] dimensions and LVEF [p< 0.001] in group E while there was no significant change in group C. In addition, digoxin usage fell significantly in group C. Cough was more prevalent in group E, this did not reach significance levels. Other side effects were not significantly different between the two groups serial blood tests also did not show any significant difference. In conclusion, the addition of enalapril to conventional therapy in Pakistani patients of moderate-to-severe heart failure significantly improved NYHA class, exercise capacity, LV dimensions and LVEF. In addition, it also reduced the need for other anti-heart failure medications and was generally well tolerated

Bioavailability and disposition kinetics of erythromycin following oral administration in normal and febrile rabbits

Biovailability and disposition kinetics of erythromycin were determined in normal and febrile rabbits following oral [suspension] administration of 10mg/kg dose. The drug concentration, bioavailability and disposition kinetics of orally given erthromycin were not changed by endotoxin induced fever. The route of the drug administration is an important consideration while instituting therapy in the febrile patients

Pharmacokinetics and dosage of oxytetracycline PVP in dogs

Pharmacokinetic parameters which describe distribution and elimination of oxytetracycline were determined in 8 dogs. Following intravenous administration of a single dose [7.5 mg/kg], the disposition of the drug was described in terms of biexponential expression: Cp = Ae-alpha t + Be-beta t. The pseudo-distribution equilibrium was rapidly attained and the half-life for elimination was 17.3 +/- 4.2 h [average +/- SD]. Body clearance which is sum of all clearance processes, was 126.5 +/- 28 ml/kg/h. Based on these findings, intravenous dosage regimen at different time intervals was calculated. The influence of disease conditions on the predicted plasma levels remains to be verified