Serum alkaline phosphatase screening for vitamin D deficiency states

To determine whether serum vitamin D levels are correlated with serum levels of alkaline phosphatase or not. Cross-sectional, observational study. Multi-centre study, conducted at Liaquat National Hospital and Medical College, National Medical Centre and Medicare Hospital, Karachi, from January to October 2009. Patients attending the Orthopaedic OPDs with complaints of pain in different body regions and serum vitamin D[3] levels of

Pharmacogenomic related toxicity of 6-mercaptopurine in childhood acute lymphoblastic leukemia

Polymorphisms in drug metabolizing enzymes, transporters and/or pharmacological targets of drugs may profoundly influence the dose-response relationship between individuals sometimes exacerbating the drug toxicity. Mercaptopurine [6-MP] is a pro drug that has been used for past 35 to 40 years in the treatment of various types of cancers especially acute lymphoblastic leukemia [ALL] of childhood. Thiopurine S-methyltransferase [TPMT] is a cytosolic enzyme that catalyzes it inactivation through methylation. It has been found that the activity of TPMT possesses genetic polymorphism, as an autosomal recessive trait. Continuous efforts of researchers and scientists to find out the molecular basis for altered activity of this enzyme now has been defined with various rapid and inexpensive assays especially allele specific polymerase chain reaction [AS-PCR] and restriction fragment length polymorphism [RFLP]. These assays are now internationally available for the four commonest signature TPMT variant alleles 2[*], 3A[*], 3B[*] and 3C[*]. Various studies on TPMT genotyping and phenotyping in patients using 6 MP demonstrated its close association with the risk of myelotoxicity. Alarmingly altered TPMT genotype may influence the risk of secondary malignancies also, including brain tumors and acute myelogenous leukemia. This review highlights the current approaches to improve the clinical impact of 6-MP in childhood ALL in context with polymorphic TPMT gene. Some of these investigations are entering routine clinical practice internationally but a lot of work is required in determining their optimal use in patients with ALL at our part of the world

Phytotherapy and its role in the treatment of depression

For centuries, man has used traditional remedies for the treatment of various ailments. Despite all the marvelous advancements in the field of medical science, traditional medicine has always been in practice. More than 50% of the developing world's population still depends on complementary and alternative systems of medicine [CAM], not only due to their efficacy but also because many of the modem drugs are beyond the financial reach of general population. Evidence-based CAM therapies have shown remarkable success in healing acute as well as chronic diseases. These therapies are first choice for problems such as infertility, epilepsy, psychosomatic disorders, depression and many other ailments. Phytotherapy is one of the therapeutic modalities in CAM that is gradually becoming very popular. Herbal remedies and extracts are traditionally being used and available worldwide for the treatment of many diseases including depression. Many of these plants have been scientifically validated by experiments that justify their traditional use. The standardized extract of Hypericum perforatum [St. John's wort] is the most promising herbal remedy, used as a therapeutic agent for depression in many countries and it seems to offer significant advantages over conventional antidepressants. Herbal practitioners have claimed for centuries that extracts from plants are effectively used for the alleviation of different types of diseases. Here we have reviewed the scientific status of some popular herbs that are being used in different parts of the world for the treatment of depression

In vitro synergy of fusidic acid and amikacin against methicillin resistant staphlococcus aureus

To test in vitro combination of fusidic acid and amikacin against infections caused by methicillin resistant Staphlococus aureus [MRSA]. In vitro study conducted in Department of Pharmacology and Microbiology, Dr. Ziauddin Medical University. The duration of study was March 2004- February 2005. Antibiotic susceptibility testing was done by Kirby Bauer"s disc diffusion method and by minimum inhibitory concentration [MIC] by broth macrodilution and checkerboard technique for synergy. FIC [fractional inhibitory concentrations] were calculated. MIC of fusidic acid was 0.03-1micro g/ml and amikacin 0.5-16 micro g/ml respectively. The combination of these demonstrated synergy. Evidence of synergy correlated directly with the MICs of fusidic acid and amikacin. Combination therapy with fusidic acid and amikacin may be a reasonable alternative in the treatment of infections caused by MRSA isolates and encourages clinical evaluation

Use of norethisterone oenanthate and predisposition to thrombosis

To observe the effects of progestin-only hormonal contraceptives in our population. Design: Cohort study. Place and Duration of Study: Department of Pharmacology, Ziauddin Medical University, Karachi and Department of Pathology, Faculty of Health Sciences, The Aga Khan University, Karachi from October 2002 to September 2003. Patients and The study comprised of 50 women of reproductive age group, divided into two equal and matched groups of 25 each, namely, a group of users of progestin-only injectable hormonal contraceptive Norethisterone oenanthate [NET EN] 200 mg used as a 2-monthly injection and a control group not using any hormonal contraception. Complete blood counts, prothrombin time [PT] and international normalized ratio [INR] as well as activated partial thromboplastin time [APTT] were monitored. APTT and prothrombin time were not significantly different in both the groups. Menstrual irregularities were found out by more frequent in users of injectable hormonal contraceptives than in non-users [p= 0.001]. Hemoglobin [p= 0.029] and hematocrit were slightly better preserved in the same group. Use of Norethisterone oenanthate does not predispose to thrombogenesis in current dose for contraception