Synergistic potential of Zingiber officinale and Curcuma longa to ameliorate diabetic-dyslipidemia

To find the cure of world's one of the leading morbid and mortal disorders; diabetes mellitus and its most prevalent complication, 'diabetic-dyslipidemia', is one of the leading health challenges of 21st century. The use of phytomedicine is a glimmer of hope in this scenario. Studies of current decade have shown that methanolic extracts of Zingiber officinale and Curcuma longa have highly effective therapeutic potentials against the aforesaid disorders, however, which of the extracts has more potential is still unclear. Furthermore, synergistic effect of the extracts has never been studied. Forty-eight Albino adult rats of either sex were randomly divided into eight groups. A-D groups were containing healthy rats while E-H groups were of induced diabetic-dyslipidemic rats. For forty-two days, rats of each group were given either distilled water or Zingiber officinale methanolic extract [ZOME] or Curcuma longa methanolic extract [CLME] or ZOME+CLME therapies at dose rate of 300mg/100 mL dist. H2O/kg body wt/day. FPG and lipid profiles were estimated before and after the trial, and were statistically analyzed by one-way ANOVA along with Posthoc Tukey's multiple comparison tests. Although, ZOME and CLME significantly [P<0.05] lowered fasting plasma glucose [FPG] levels and controlled lipid profiles in diabetic-dyslipidemic rats; yet, synergistic therapy of both extracts [ZOME+CLME] most significantly [P<0.05] controlled all parameters of diabetic-dyslipidemia [78.00 +/- 1.06mg/dL FPG, 62.00 +/- 0.58mg/dL TG, 66.50 +/- 0.76mg/dL cholesterol, 32.00 +/- 0.36mg/dL HDL, 22.43 +/- 0.64 mg/dL LDL, and 12.40 +/- 0.12mg/dL VLDL]. Our findings may be useful to formulate new medicines having multiple potentials to control diabetes mellitus, dyslipidemia, and diabetic-dyslipidemia

Anticipated difficult airway management in a resource-constrained environment: Two case reports

In these reports we describe two cases of anticipated difficult airway. First one was secondary to a large thyroid gland in a resource-constrained environment without much-needed advance airway management equipment In an improvised three-step approach to establish a definitive airway coupled with thyroidectomy, significant improvement in general outlook of the patient was observed. Second case was that of a large fungating squamous cell carcinomatous mass involving nasal and maxillary regions. Apart from clinical consequences, these cases provides an impetus to develop difficult airway algorithms for local populace and brings to fore one of myriads of difficult situations encountered in secondary and tertiary care hospitals of Pakistan

Pattern and presentation of odontogenic jaw cysts: a clinical experience

Objective: To determine the pattern and presentations of odontogenic jaw cysts in patients reporting at the Armed Forces Institute of Dentistry

Study Design: Descriptive study

Place and Duration of Study: Armed Forces Institute of Dentistry, from Jan to Dec 2007

Material and Methods: Hundred patients including 70 males and 30 females with the age range 5-65 years were included in the study. History, clinical examination, radiographic examination and histopathologic examination of lesion were carried out for each patient. A proforma was filled for each patient for all relevant information, presentation and pattern. Diagnosis was confirmed by histopathology. Data were analyzed using SPSS version 10

Results: Out of total 100 patients, 58% were diagnosed with radicular cysts, 25% with dentigerous cysts, 15% with odontogenic keratocyst, 1% patient with calcifying epithelial odontogenic cyst and 1% patient was diagnosed with eruption cyst

Conclusion: The study demonstrates that radicular cyst was the most common odontogenic cysts followed by dentigerous and odontogenic keratocysts respectively in our study sample

role of Glutathione, Cysteine and D-Penicillamine in exchanging Palladium and Vanadium metals from albumin metal complex

Thiol groups are extensively present across biological systems being found in range of small molecules [e.g. Glutathione, Homo-cysteine] and proteins [e.g. albumin, haemo-globin]. Albumin is considered to be a major thiol containing protein present in circulating Plasma. Albumin contains a single thiolate group located at cysteine-34[cys-34] at its active site. Albumin also binds a wide variety of metals and metals complexes at various sites around the protein. Usually heavy metals are preferentially attached with the thiol group of albumin. The binding of heavy metals at cys-34 provides a mechanism by which the residence time of potentially toxic species in the body can be increased. In this research we have assessed the oxidative modification of and metal binding capacity of cys-34 with heavy metals Palladium and Vanadium to investigate the ease with which it is possible to effect disulfide-thiol exchange at this sites/or remove a metal bound at this position. Both the metals were treated with albumin and then the albumin metals [Pd and V] complexes were treated with small thoil molecules like Glutathione, Cysteine and D-Penicillamine. Our finding showed that the albumin thiol group retained the metals with itself by forming some strong bonding with the Thiols group, it is concluded from this finding that if by chance both the metals enter the living system; strongly disturb the chemistry and physiological function of this bio-molecule

Hspb1 and Tp53 mutation and expression analysis in cat mammary tumors

Background: Molecular marker based cancer diagnosis gaining more attention in the current genomics era. So, Hspb1 and Tp53 gene characterization and their mRNA expression might be helpful in diagnosis and prognosis of cat mammary adenocarcinoma. It will also add information in comparative cancer genetics and genomics

Objectives: Eight tumors of Siamese cats were analyzed to ascertain germ-line and tissue-specific somatic DNA variations of Hspb1 and Tp53 genes along with the ectopic differential expression in tumorous and normal tissues were also analyzed

Materials and Methods: Tumorous tissues and peripheral blood from mammary adenocarcinoma affected Siamese cats were collected from the Pet center-UVAS. DNA and RNA were extracted from these tissues to analyze the Hspb1 and Tp53 DNA variants and ectopic expression of their mRNA within cancerous and normal tissues

Results: Exon 1 and 3 revealed as hotspots in Hspb1 gene. The 5'UTR region of the exon1 bearsix mutation including 3 transitions, 2 transversion and one heterozygous synonymous transversion in two samples at locus c.34C>C/A. Exon 3 has 1 transversion at c.773A>A/T, 3'UTR of this exon harbor two point mutations at 1868A>T and 2193C>T loci. Intron 2 has two alterations at 1490C>C/T and GTCT4del at 1514. Overall up-regulation of Hspb1 gene was observed. While exons 3, 4 and 7 of Tp53 harbor a single variationat c.105A>A/G, c.465T>T/C and c.859G>T respectively. The locus c.1050G>G/A in exon 9 is a heterozygous [G/A] in 3 samples and homozygous [G] in 2 other tumours. Introns 3, 5, 7 and 9 harbor 3, 4, 2 and 7 altered loci respectively. Sixty percent of cancers showed up-regulated trend of Tp53 gene

Conclusions: Tumor specific mutations and ectopic expression of Hspb1 and Tp53 genes might be helpful in the diagnosis of the mammary lesions and endorse their involvement in cat mammary neoplasm

Efficacy of peripheral streptomycin injection in the treatment of idiopathic trigeminal neuralgia

To evaluate the efficacy of peripheral streptomycin injection in relieving the pain of idiopathic trigerninal neuralgia. Quasi experimental study. Oral and Maxillofacial Surgery Department, Armed Forces Institute of Dentistry Rawalpindi, from 1[st] June 2006 to 31[st] December 2007. Thirty patients of idiopathic trigerninal neuralgia were selected. They received five consecutive injections of streptomycin Ig in 3 ml of 2% Lignocaine [Septodont] with 1: 100,000 adrenaline at one week interval. Follow up was carried out at one, two and six months after the last injection. Age ranged from 15-78 years [mean 44.67]. Male to female ratio was 1:1.14. Right side of the face was involved in 70% and left side in 30% cases. Mandibular division of trigeminal nerve was involved in 43.3% and maxillary division in 40% of the cases. In the rest both maxillary and mandibular divisions were involved. Pain was significantly decreased from baseline to 1 month [p < 0.001]. The level of pain was increased a bit but the increase was significant at two months [p = 0.006] and at 6 months [p = 0.020]. Best treatment modality for this devastating disease is yet to evolve. Within the confines of the study it can be stated that efficacy combined with low post treatment morbidity makes streptomycin a useful treatment option

Esthetics, functional, and psychosocial satisfaction after orthognathic surgery in patients having dentofacial skeletal deformities

In this study, which was conducted at Armed Forces Institute of Dentistry Rawalpindi, the rate of satisfaction among patients who had dentofacial skeletal discrepancy and under gone orthognathic surgery along with orthodontic treatment from January 2010 till June 2015 was investigated. This retrospective study was conducted among fifty three patients who underwent Orthognathic surgery treatment from oral maxillofacial surgery department formed the study group. Patients were recalled for follow-up for their evaluation and to fill the questionnaire and those patients, who could not come for follow up were called on their personal phone numbers. Forty patients responded to fill the questionnaire. The questionnaire consisted of 19 questions. The survey response rate was 75.4%. Thirty five [87.5%] patients were satisfied with their final facial profile, and 37 [92.5%] were with their final esthetic profile. Related to the function 30 [75%] patients showed improvement in chewing ability, while 35 [87.5%] had no temporomandibular joint problem I pain post-operatively. The perception of patients for psychosocial benefits of treatment was positive, 27 [67.5%] patients stated that their social communication and 30 [75%] patient's self-confidence had improved a lot after treatment. It is concluded that orthognathic surgery was satisfactory and accepted treatment for dento-facial deformity, for improvement of appearance of individuals. On the other hand, any dissatisfaction that occurred in few individuals it was due to unrealistic expectations of the patients and expertise of surgeon and I or orthodontist

Role of radiology in the diagnosis and management of obstetrical emergencies

Obstetrical emergencies are important concerns and need immediate diagnosis and intervention to save the life of mother and fetus. These include obstetrical hemorrhage both ante partum and postpartum, ectopic pregnancy, preeclampsia and other conditions where radiologist, obstetricians, anesthesiologist and ICU team have important role to play. Radiologist play key role in diagnosing emergencies with the use of imaging modalities, though bed side ultrasonography has now become valuable tool in the hands of anesthesiologists as well, in diagnosing various emergencies. The role of interventional radiologist in cases of obstetric hemorrhage is worthwhile especially in postpartum hemorrhage where embolization can be minimally invasive lifesaving procedure.The aim of this article is to discuss the valuable role that the radiologists play with obstetricians and anesthesiologists in the management of these obstetric and emergencies

Comparison between signs and symptoms of medulloblastomas and desmoblastic medulloblastomas

To compare the signs and symptoms of Medulloblastomas and Desmoblastic Medulloblastomas. Retrospective study. This study was conducted at King Khalid University Hospital, Rayadh, Saudi Arabia from 1[st] January 2001 till 31[st] December 2010. Total of 37 patients were included in the study. After taking written consent from all the patients or their relatives, this study was conducted. Permission was also taken from the ethical committee of the hospital. 37 patients were included in the study. Percentage of important symptoms of intracranial tumors like headache, reduced vision and hydrocephalus was comparatively higher in medulloblastomas as compare to desmoblastic medulloblastomas. None of the desmoblastic variety had metastasis on presentation, hence all of them completely excised. Unfortunately, we were able to excise only 82.14% of medulloblastomes. 14.28% were partially excised while in 3.57% of cases, surgeon was only able to take biopsy. Desmoblastic variety of medulloblastoma had better prognosis as compare to Classical Medullblastoma

Prevalence of radiographic classification of impacted mandibular third molars - an overview

The purpose of this study was to evaluate radiographically the position of mandibular third molars. It is a descriptive study carried out at 1 Military dental Centre, Sialkot Cantt from August to March 2011. The patients who came with the complaints of pain or swelling in the lower third molar area were clinically assessed and advised radiograph [peri apical view or orthopantomograph] for their lower third molar. These radiographs were assessed according to the Winter's classification for angulation and Pell and Gregory classification was used to access the space and depth of impaction. A total of 415 patients were examined. 73.7% patients [n=306] were males and 26.3% [n=109] females. Most of the patients were between 20-29 years of age [n=244]. Mesioangular impaction was the most common found in 38.5% [n=160] patients. Position A 66% [n=274] and class II 55% [n=229] were found to be the most common

Efficacy of intra-alveolar chlorhexidine gel in reducing frequency of alveolar osteitis in mandibular third molar surgery

To determine the efficacy of intra-alveolar administration of chlorhexidine [CHX] gel in reducing the frequency of alveolar osteitis [AO] after impacted mandibular third molar surgery. A randomized control trial study. Department of Oral and Maxillofacial Surgery, Armed Forces Institute of Dentistry, Rawalpindi, Pakistan, from January to December 2007. One hundred patients including 65 males and 35 females with the age range 18-40 years were divided in two equal groups [50 each in the CHX and the control groups]. Surgical removal of impacted mandibular third molar was carried out and after surgery CHX gel was placed into the alveolus of CHX group. Patients were followed at the first, second and third postoperative days. A proforma indicating presence or absence of pain, blood clot disintegration, halitosis and AO was filled for each patient. Frequencies and percentages were calculated for qualitative data. Chi-square test was applied to compare both subgroups. Eighteen patients [18%] were diagnosed with AO [11 males and 7 females]. Out of these 18 cases, 14 [28%] were found in control group [9 males and 5 females], while 4 cases [8%] in the CHX group [2 males and 2 females]. This was statistically significant p=0.017. Single application of CHX gel was effective in reducing frequency of AO following mandibular third molar surgery

Pattern and presentation of oral white lesions

Oral white lesions are not uncommon and a significant number of patients are asymptomatic. The purpose of this study was to determine the pattern and presentation of oral white lesions in patients reporting at oral and maxillofacial surgery department of AFID. World Health Organization [WHO] guidelines for oral mucosal examination were used to record data of 100 patients who presented with oral white lesions. Biopsies were performed in lesions whose definitive diagnosis was deemed difficult purely on the basis of history and clinical examination. The mean age was 38 +/- 13years with 57[57%] males. Forty two [42%] patients were asymptomatic. The most frequent site was buccal mucosa [64%] and more than half of these lesions appeared white [57%] while others were yellowish white [18%], grey white [15%] and with areas of redness within the lesion [10%]. Among habits, smoking was most common. The most common lesion was lichen planus [28%] followed by frictional keratosis [15%] and oral submucous fibrosis [13%]. Other rare lesions were geographic tongue, mucosal burns, candidiasis. As some of these lesions are premalignant, it is imperative for the dental and medical professionals to familiarize with their pattern and presentation to effect early diagnosis and management

Chronic subdural haematoma: clinical presentation and surgical outcome

Chronic subdural hematoma having diversity of clinical features, poor index of suspicion and non availability of CT scan is still diagnosed very late in AJK. The objective of study was to find out the clinical status at the time of admission and outcome of surgery in these patients managed in our hospital. Descriptive study. This study was conducted at the DHQ Hospital Mirpur AJK from March 2006 to April 2010. A total number of 47 patients with chronic subdural hematoma of all age groups were operated at DHQ hospital Mirpur in this period. Clinical presentation of the patients at the time of admission was recorded. Patients were followed for a period of 2-3 months after surgery. Forty seven patients were studied. Among them 40[85%] were male and 7[15%] were female. The age range was 2 months to 100 years with average age 52.5 years. Thirty one [66%] had positive history of head trauma whereas 16 patients [34%] did not remember any injury. Thirty one [66%] had headache, 35[74.5%] had hemiparesis, 19[40.4%] had behavioral changes and urinary incontinence. Six patients [12.8%] were having GCS 3 with reactive pupils. One [2.1%] patient came with decreased vision. CT scan showed unilateral hematoma in 37 [78.7%] and bilateral in 10 [21.3%] patients. Twenty five [53%] patients had hematoma on left side, 12[25.5%] had hematoma on right side and 10[21.3%] had bilateral hematoma. Thirty four [72.3%] had good recovery. Four [8.5%] could not survive. Chronic subdural hematoma due to diversity of symptoms, poor index of suspicion, and non availability of CT scan is still diagnosed very late in AJK. Elderly patients with diversity of confusing neurological symptoms need to be kept under high index of suspicion for diagnosis of chronic subdural hematoma. Drainage of Chronic hematoma with two burr holes and placements of subdural drain offered excellent

prospective randomized trial comparing the spinal and general anesthesia in lumbar disc surgery: a study of 44 cases

General anesthesia is most frequently used for lumbar disc surgery despite the evidence that spinal anesthesia is as safe and may offer some additional advantages. The purpose of this study was to compare the intraoperative parameters and postoperative outcome after spinal and general anesthesia in demographically well matched patients undergoing elective lumbar Decompressive surgery. Prospective randomized controlled study. This study was carried out DHQ Hospital Mirpur AJK from January 2007 and May 2010. In this randomized controlled study we analyzed the outcome obtained in 44 patients in whom either spinal or general anesthesia was induced for lumber disc surgery. The variables recorded were anesthesia related class, surgical diagnosis, disc levels operated and pre, peri and postoperative measurements of variables like BP, and heart rate. All aspects of surgery, recovery, post anesthesia care and pain management were same irrespective of anesthetic type The narcotic and antiemetic requirement and length of stay in the hospital and incidence of urinary retention were also recorded in the post operative course. Demographically both groups were well matched. Anesthesia time was longer in patients receiving GA with increased heart rate and MABP perioperatively. There was more nausea and greater requirements for antiemetic and analgesics in patients receiving. GA [p value<0.05]. Perioperative heart rate and MABP was on normal side and there was no urinary retention in patients who received spinal anesthesia. Spinal anesthesia was a safe and effective as GA for patients undergoing lumbar Decompressive surgery. Spinal anesthesia had added advantages of short anesthesia duration, decreased antiemetic and analgesic requirements. GA general anesthesia, HR heart rate, I/V intravenous, MAP mean arterial pressure, PACU post anesthesia care unit, RCT randomized controlled trial, SA spinal anesthesia

Transpapillary versus palatal injection technique for maxillary tooth extractions

To compare the pain during injection administration and efficacy of transpapillary injection with palatal injection for simple maxillary tooth extractions. Randomized control trial. The oral and maxillofacial surgery department of Armed Forces Institute of Dentistry, Rawalpindi, Pakistan, from July to December 2009. Patients requiring simple extraction in maxilla were randomly divided into two groups each consisting of 100 patients. Group 1 was given conventional palatal injection and served as a control, whereas Group 2 received the transpapillary injection. Two percent Lignocaine with Adrenaline [1:100,000] was used for both groups. Pain during injection and then during the extraction were recorded for both groups using the Visual Analogue Scale and Faces Pain Score Scales on specially designed proformas. The data was analyzed using SPSS version 17.0 and independent t-test was applied to compare pain between both groups. P-value of less than 0.05 was considered to be statistically significant. Group 1 consisted of 61 males and 39 females with an age ranging from 11-73 years [mean= 39.92 + 14.85 years] while Group 2 consisted of 59 males and 41 females with an age ranging from 10-70 years [mean= 39.31 + 18.53 years]. Results of FPS and VAS scores for injection and procedure were analyzed using independent t-test. Difference of scores for pain during injection were found to be significant [p < 0.05] while the scores for the procedure were seen to be statistically insignificant [p > 0.05] showing that transpapillary injection is equally effective for maxillary extractions as palatal injection but with significantly decreased pain during injection. Transpapillary injection is an easy and effective way of eliminating the pain of palatal injection for maxillary extractions

Reasons and pattern of first molar extraction - a study

The aim of this cross sectional prospective study was to determine reasons and patterns of permanent 1[st] molar extraction in patients reporting to oral and maxillofacial surgery department at Armed Forces Institute of Dentistry, Rawalpindi. All patients referred to oral and maxillofacial surgery department for extraction of permanent first molar teeth from 1st of January 2009 till 31[st] of December 2009 were included in the study irrespective of their age and gender. The primary reason of extraction was recorded along with other relevant information. The pattern of extractions of the permanent first molars was also noted. A total of 470 patients were included in the study. Out of these 291 [61.9%] were males [M: F 1.6:1]. Caries was the most common cause with 281 extractions [59.8%] in all age groups in both genders followed by periodontitis, which was responsible for 109 [23.2%] of permanent first molar extractions. Mandibular molars were more frequently extracted [62.7%] as compared to the maxillary molars [37.3%], with the mandibular left molar being the most frequently extracted tooth in the sample population

Inadequacies in history taking and clinical examination by the dentists

History taking and clinical examination are the most important steps in the diagnosis and hence overall patient management in medicine, surgery and dentistry. The purpose of this study was to determine the history taking and clinical examination practices of dentists. Self-administered questionnaires were distributed among two hundred randomly selected dentists of Rawalpindi and Islamabad. The questionnaire assessed how often these dentists recorded all the steps of history and how often they examined their patients thoroughly. While the vast majority of dentists asked most of their patient's demographics, chief complaint and the history of their chief complaint and examined all teeth of their patients, a considerable number of them missed the medical, family and socioeconomic history, did not record vital signs, and did not examine the entire head and neck and oral mucosa of all their patients. This study emphasizes deficiencies and inadequacies in the history taking and clinical examination practices of dentists in the studied sample

Pattern of maxillofacial injuries in the earthquake victims

To observe the pattern of Maxillofacial injuries in Earthquake victims and to discuss their management. Descriptive Study. This study was conducted at the Maxillofacial Surgery Department, Armed Forces Institute of Dentistry [AFID], Rawalpindi over a period of six months following the 8[th] October, 2005 Earthquake. 176 patients who sustained maxillofacial injuries during the earthquake were included in this study. The pattern of maxillofacial injuries and their management was documented. Out of the 176 patients, 141 [80.11%] had fractures of the maxillofacial bones. The remaining 35 [19.89%] patients sustained minor maxillofacial injuries e.g. soft tissue injuries, dentoalveolar fractures and temporomandibular joint arthritis / dislocation. Isolated mandibular fractures were seen in 64 [36.4%] patients. Fifty-seven [32.4%] patients had multiple fractures of the facial bones. Zygomatic bone was fractured in 18 [10.2%] patients whereas 02 [1.1%] patients had isolated fracture of the maxilla. Fifty-nine [41.8%] patients were treated by closed reduction and IMF, 55 [39%] patients by open reduction and transosseous wire fixation in addition to IMF and 27 [19.1%] cases by open reduction and miniplate osteosynthesis. Postoperative complications were noticed in 18 [10.2%] of the patients. Multiple fractures of the facial bones were far more common than the routine trauma cases. The magnitude of the disaster dictated simple and timesaving conventional methods of management in majority of the cases

Functional rehabilitation by gap arthroplasty in temporomandibular joint ankylosis

A study was carried out from Jan 1999 till Dec 2001 at oral and maxillofacial department, AFID, Rawalpindi. The purpose of the study was twofold i.e.; retrospective to determine the cause of temporomandibular joint ankylosis and prospective to see the results of functional rehabilitation by gap arthroplasty with coronoidectomy followed by immediate postoperative mouth opening exercises with Monoblock by Reichenbach. Fifty [50] patients [63 joints] were treated and are regularly followed up. Study showed that major cause of temporomandibular joint ankylosis was trauma [88%] and the mean postoperative IED obtained through operative procedure and postoperative rehabilitation was 30.89 mm