Phytochemical and biological assessments on Lipidium meyenii [maca] and Epimidium sagittatum [horny goat weed]

The effects of Lipidium meyenii [maca, LM] and Epimidium sagittatum [horny goat weed, ES] have been investigated due to their involvement in fertilization. Both of the drugs showed good results before, during and after fertilization in male and female mice. The results revealed that the crude extract of Lipidium meyenii caused a significant decrease in the no. of writhes at 300 and 500mg/kg [p<0.05] as compare to control, Epimidium sagittatum and standard drug. The gross behavioral, open field, exploratory behaviour, forced swimming test for stress, diuretic activity, chronic toxicity with the effect on reproduction of both male and female and change in body weight were also studied. The phytochemical study showed the presence of tannin, alkaloid, carbohydrate, rich protein and absence of sterol in LM, whereas ES shows presence of sterol and less protein. LS improve in muscle activity and exploratory behaviours without any toxic effects on mice and their pups. It does not have diuretic effect for first two hour but act normally after initial phase of drug therapy. Epimidium sagittatum has dual action that is at low dose it has slight stimulation action and at high dose little depressive effect. ES also has some diuretic effect. Overall these results suggest that LM is highly effective remedy for treatment of impotency and reduces stress and depression, because of dual effect ES not only suggested as an anxiolytic medicine but also effective in female hormonal disorder

Evaluation of acute toxicity, sedative and analgesic effects of Taverniera glabra methanolic extract on mice

Present study was conducted on crude methanolic extract of stem and root of Taverniera glabra. In Pakistan T. glabra is found in the region of Balochistan only. T. glabra has numerous therapeutic uses in traditional medicine and it is also used for the pain relief. Current study was carried out to evaluate acute toxicity, analgesic and CNS depressant activity of the plant. Acute toxicity was carried out by oral administration of the T. glabra extract from 250 to 2000mg/kg oral dose. Analgesic activity was carried out by acetic acid induced writhing test and formalin test. Central Nervous System [CNS] depressant activity was carried out by exploratory activities [open field activity, cage crossing activity, rearing test] and forced swimming test. Oral administration of the methanolic extract of T. glabra was nontoxic at the dose of 1500mg/kg in the acute toxicity test. Exploratory behavior of mice treated with the methanolic extract of T. glabra showed sedative effects [P<0.05] in open field, cage crossing, traction and rearing test, particularly at the dose of 500mg as compared with standard drug Diazepam. In forced swimming test, mobility time was significantly [P<0.05] increased at 500mg/kg oral dose, and results were significant as compared with control. Methanolic extract of T. glabra produced significant [P<0.05] analgesic effects at the dose of 500mg/kg in the acetic acid induced writhing test and the formalin test. In conclusion, results show that the crude methanolic extract of T. glabra possess sedative as well as potent analgesic effects. Present pharmacological studies are the first ever studies conducted on the methanolic extract of T. glabra

Malabsorption of iron as a cause of iron deficiency anemia in postmenopausal women

Malabsorption is one of the causes of iron deficiency anemia in postmenopausal women. The main objective of this study was to access the frequency of malabsorption in iron deficient anemic postmenopausal women. A total of 123 postmenopausal women were enrolled in the study. Of these 123 women, 50 were included as [control group] and 73 patients with comparable severity of anemia were the [patient group]. Two tablets of ferrous sulfate [200 mg/ tablet] along with one tablet of vitamin C [500 mg] were given to all participants. Serum iron levels were determined on samples collected from all participants before and after the administration of ferrous sulfate. Difference between before and after serum iron levels of normal and patients were compared. No change in serum iron between sample one and sample two represented malabsorption. Out of 73, 5 postmenopausal anemic patients showed no change in their serum iron level after the administration of ferrous sulfate. This study shows that frequency of malabsorption of iron in postmenopausal women is 6.8%. Malabsorption should be considered as a prevalent cause of iron deficiency anemia in postmenopausal women. It should be properly diagnosed and iron response should be monitored properly in postmenopausal women with IDA after oral iron therapy. If a postmenopausal woman does not show any response to oral iron therapy, she should be evaluated for iron loss [blood loss and/or malabsorption]. Intravenous route should be used for the administration of iron in these patients

Comparative analysis of serum iron, serum ferritin and red cell folate levels among breast fed, fortified milk and cow’s milk fed infants

Objective: Iron and folic acid are essential nutrients needed for hematopoiesis. Infants' diet is commonly deficient in these micronutrients that lead to nutritional anemia. Aim of this study was to determine serum iron, serum ferritin and red cell folate levels among healthy breast fed, fortified milk and cow's milk fed infants. Methods: A total of 120 infants of 4-9 months of age were enrolled in this study. It included 40 normal breast fed controls, 40 fortified milk fed [FM] and 40 cow's milk fed [CM] infants. Serum iron, serum ferritin and red cell folate concentrations were determined using colorimetric and enzyme immunoassay techniques. Results: Mean serum iron, serum ferritin and red cell folate concentrations of breast fed control group were 120.9+/-68.4µg/dl, 109+/-71.7ng/ml and 1044.1+/-409.2ng/ml respectively. Fortified milk [FM] group showed significantly decreased serum iron [p<0.003] as compared with controls whereas serum ferritin and red cell folate values showed insignificant change [p=0.25 and p=0.85 respectively]. However serum iron, serum ferritin and red cell folate were significantly decreased in cow's milk fed [CM] group as compared with control subjects [p<0.04, p<0.006, p<0.02 respectively]. Comparison of these biochemical parameters between FM and CM groups showed statistically significant difference of serum ferritin and red cell folate among cow's milk group [p<0.0001 and p<0.02] whereas serum iron level showed no significant difference, a p-value being 0.38. Conclusion: Healthy breast fed infants do not need any supplementation and fortification of iron and folic acid. Fortified milk appears to be an acceptable alternative in the absence of breast milk whereas cow's milk is a poor source of iron and folic acid in infants

Anti-nociceptive activity of seed extract of Vernonia anthelmintica willd

Vernonia anthelmintica is commonly known as kali ziri. Its seeds are used for several therapeutical purposes. Its seeds contain many constituents of medicinal importance as vernodlin, vernodalol, and vernolic acid. It is commonly used psoriasis and leucoderma or white leprosy. It is potent wormicidal agent. The present study was conducted on seed's extract of V. anthelmintica to determine its analgesic potency. The activity was conducted on mice by using acetic acid induced writhes,hot plate method and by tail flick method using water bath. The results of the writhing test were highly significant and comparable with Aspirin, which produced 26 and 20 writhes. The percentage of inhibition of writhes with the two doses of crude extract was 65.45% and 64.28% at 300mg/kg, while 83.63% and 71.42% at 500mg/kg, where as with Aspirin it was 52.72% and 28.57% in first and second phase respectively. Hot plate and tail flick method also indicated that vernonia has potent analgesic activity. The drug can be utilized as anti-nociceptive agent

Analgesic, Anti-inflammatory and neuropharmacological effects of Atropa belladonna

The present study was carried out to investigate, in vivo, analgesic, anti-inflammatory and neuropharmacological activities of the methanolic extract of Atropa belladonna. The analgesic activity was measured by acetic acid induced writhing inhibition test. The neuro-pharmacological activities were evaluated by open field, rearing test, cage cross, swim test, head dip and traction tests. The anti-inflammatory activity was assessed by formalin induce inflammation on hind paw. The extract showed highly significant [p<0.001] analgesic activity with % inhibitions of writhing response at doses 100 and 300mg/kg body weight were 28.5% and 57.1%, respectively. The extract at both doses showed significant [p<0.05] sedative effect in-cage cross test and highly significance value [p<0.001] in high dose. In-open field test, the extract showed significant [P<0.05] anxiolytic activity at higher dose whereas in rearing test activity shows significant p-value at both doses. The extract also showed significant value for anti-inflammatory activity. The findings of the study clearly indicated the presence of significant analgesic, neuro-pharmacological and anti-inflammatory properties of the plant, which demands further investigation including, compounds isolation

Antidiarrhoeal, anti-inflammatory and analgesic activities of Symplocos racemesa roxb. Bark

The antidiarrheal activity of the drug Symplocos racemosa was performed in-vivo on isolated rabbit intestine. The effects of crude extract and fractions were observed at different doses. The overall response of the crude extract on isolated tissue of rabbit intestine was decreased in the tone of smooth muscle. Further studies were carried out on different fractions [ethylacetate, chloroform, n-butanol and aqueous] of crude extract of S. racemosa. The standard drugs were also used for further screening of the fractions of S. racemosa. Hot plate, writhing test, formalin test and carrageenan-induced paw edema in mice and rats were performed for determination of analgesic and anti-inflammatory activities respectively on S. racemosa bark extract. The results exhibited significant anti-inflammatory and analgesic effect at 300 and 500mg/kg doses

Etiological diagnosis of microbial keratitis

To identify the different microbial pathogens in infective corneal ulcers. Observational study. Department of Ophthalmology Unit I, Eye Hospital, Liaquat University of Medical and Health Sciences, Hyderabad, Sindh, from April 2006 to September 2008. Patients above 15 years of age with suspected infective corneal ulcers were studied. After detailed history every patient underwent a comprehensive ophthalmic slit lamp bio-microscopical examination, for characteristics of the ulcer to locate the site, size, depth of ulcer and anterior chamber inflammation. After a detailed ocular examination corneal scrapings were collected under aseptic conditions under magnification of slit lamp or operating microscope. The scraping material obtained from leading edge and base of each ulcer was spread onto labeled slides for staining. Another portion was inoculated on to the surface of solid and the liquid culture medias. The inoculated medias were incubated at appropriate temperature for appropriate time. Of the 328 patients; 192 [64.99%] were male with age ranging from 15 to 80 years, and majority from rural population [64.99%]. Majority i.e. 201 [61.28%] were previously treated. Out of 328 patients, 161 cultured [49.10%] for bacteria, 87 [26.52%] for fungi, and 12 were found positive culture for both bacteria and fungi. The rest of 68 [20.73%] were culture-negative corneal ulcers. Of the 173 bacterial isolates, 119 [68.79%] had Gram positive cocci, most common isolated being Staphylococcus aureus in 82 [47.40%]; fungal pathogens were isolated from 99 corneal ulcers. The commonest organism isolated was Candida albicans in 75.76%, followed by Aspergillus flavus in 11.11% of the total fungal isolates. Staphylococcus aureus, Candida albicans and Aspergillus flavus were common causes of microbial infective keratitis in this series

Hospital-base epidemiology,risk factors and microbiological diagnosis of bacterial corneal ulcer / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To determine the predisposing factors, clinical and microbial characteristics of bacterial corneal ulcer.METHODS: Three hundred patients (300 eyes) of clinically suspected microbial corneal ulcer were included in the study. Data was collected through history and slit lamp examination. Using standard techniques, corneal scraping was performed. A portion of each scraping was examined by direct microscopy for the presence of bacteria, fungi and acanthamoeba by using 100g/L potassium hydroxideand also by Gramand staining. Another portion was inoculated directly on the surface of solid media such as blood agar, Mac-Conkey agar, chocolate agar and Sabouraud's agar. A bacterial corneal ulcer was defined as a suppurative corneal infiltrate and overlying epithelial defect associated with presence of bacteria on corneal scraping examination and cured with antibacterial therapy. RESULTS: Of the 300 patients, sixty were lost in follow up, they were excluded from study. Of the remaining 240, bacterial corneal ulcer was identified in 156 (65.0%) patients. The age of patients ranged from 14 to 74 (mean age of 48) years. Majority of them were male (102). Corneal localization of the ulcers was distributed as central in 96 (61.5%) patients and peripheral in 60 (38.5%) patients. Ulcer depth in 82 (52.6%) patients was less than 1/3 of corneal thickness. In 64 (41.0%) patients, anterior chamber inflammation was 1+ to 2+ Tyndall effect with 1+ to 2+ cells present. Bacteria were isolated in 125 (80.0%) patients from the corneal smears. Sixty-nine percent of isolated bacteria were Grams' positive, and 39% were Grams' negative. Gram negative bacteria were associated with severe anterior chamber inflammation (P=0.003) and depth more than 2/3 of cornea (P=0.001). The most frequent organism isolated was Staphylococcus aureus. Forty percent of patients had good visual outcome with visual acuity same or better than the level at admission. Among the others 60% patients, final outcome was poor.CONCLUSION: Bacterial corneal ulcer is aserious ocular infectious disease that remains a therapeutic challenge and vision threatening ocular condition. Rapid isolation of bacteria and treatment with intensive ocular antibiotics represent decisive steps in the management of such pathologies.

Incidence of refractive error among adult population: a Hospital base study / 国际眼科杂志(Guoji Yanke Zazhi)

·AIM: To assess the incidence of refractive error among adult population: a Hospital base study.·METHODS: This Hospital based study was conducted between June 2008 to November 2008 at tertiary referral center, Liaquat University Eye Hospital, Hyderabad. All subjects underwent a complete ophthalmic examination. The best corrected visual acuity(BCVA) was ecorded. Refraction data are based on subjective refraction. Only the right eye of each subject was considered. Hypermetropia was defined as a spherical equivalent greater than +0.5 diopter sphere (DS). Emmetropia was defined as a spherical equivalent between -0.50 and +0.50DS, myopia was defined as a spherical equivalent worse than -0.50DS and a spherical equivalent or worse than -5.00 DS was classified as a high myopia. Astigmatism correction was prescribed in minus cylinder format, and astigmatism was defined as cylinder error worse than -0.50 diopter cylinder (DC) in any axis. ·RESULTS: Eight thousand and four hundred patients were attended the out patients department with age range of 20-60 years. The proportion of men and women was 61∶ 39. Both the rural and urban population were treated. Sixty seven percents of patients has completed their higher secondary education.Of the total 8 400 patients 2 719(32 37%) had BCVA 20/40 or better and remaining 5 681(67.63%) had BCVA poor than 20/40 due to different anterior and posterior segment eye pathologies, and were excluded from study. Of the 2 719 patients 1 065(39.17%) were phakic in right eye and making the 12.68% of total (8 400) examined patients, and remaining 1 654(60.83%) were pseudophakic. The result were analyzed for only 12 68(1 065 phakic ametropic patients) percent of total treated patients in last 6 months. There were 590(55.40% of phakic patients) men and 475(44. 60%) women.Hypermetropia was found in 300 patients (28.20% of phakic ametropic). Six hundred and ninety (64.80% of phakic ametropic) patients had myopia. The incidence of myopia increased significantly with age. High myopes constituted 7%(75) of the study population. Four hundred and five (38.03% of phakic) patients had astigmatism worse than 0.5D cylinder. There were 195(48.15%) men and 210(51.85%) women. ·CONCLUSION: Refractive error is a significant public health problem in our population that may be impact on visual function and activities of daily life. Optimal visual function may be compromised with uncorrected or under-corrected refractive errors.

Efficacy of probing in the treatment of congenital nasolacrimal duct obstruction in three age groups / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To compare the success rates of probing for the treatment of congenital nasolacrimal duct obstruction in children divided into three age groups.METHODS: One hundred and eighty children with uncomplicated congenital nasolacrimal duct obstruction underwent probing in Eye Hospital of Liaquat University of Medical and Health Sciences Hyderabad, Sindh, Pakistan from March 2005 to January 2008. The children were divided into three groups: Group Ⅰ (aged 4-6 months), Group Ⅱ (aged 7-12 months) and Group Ⅲ (aged 13-24 months). Success was defined as complete resolution of signs and symptoms. The chi-square test was used to analyze the results.RESULTS: The success rate was 100.0% in Group Ⅰ, 88.5% in Group Ⅱ and 82.3% in Group Ⅲ. The overall cure rate for the entire study was 90.7%.CONCLUSION: The efficacy of probing decreases with the increasing age. However, when probing is done within six months of age, it is highly effective and results in complete resolution of symptoms.

Fungal keratitis:84 cases report in Southern Pakistan / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To identify the predisposing factors,causative fungi and to improve the facilities for the laboratory diagnosis of fungal keratitis.METHODS:Two hundred and forty eyes of 240 patients of clinically suspected microbial corneal ulcer were included in the study.Data was collected through history and slit lamp examination.Using standard techniques,corneal scraping was performed.A portion of each scraping was examined by direct microscopy for the presence of fungi,bacteria and acanthamoeba by using 10% potassium hydroxide and also by Gram and Giemsa stainings.Another portion was inoculated directly on the surface of solid media such as Blood agar,Mac-Conkey agar,chocolate agar and Sabouraud agar in C-shaped streaks for culture.RESULTS:A total of 240 patients with suppurative corneaI ulcer were enrolled in the study,out of which fungi were identified in 84(35%)patients.Of these,48(57.1%)were males and 36(42.9%)females.The age ranged between 22-80 years.Sixty patients(71.4%)belonged to rural population and twenty four(28.6%)to urban population.Trauma with vegetative material was the most frequent cause noted in eighteen(21.4%)patients.Peak incidence was in the months of October-Nevember.Out of 84 eyes with fungal keratitis,fungi alone were the etiologic agents in 74(80.10%)cases and bacteria with fungi were identified in 10(11.90%).The most frequently isolated organism was Candida albicans which was found in 66(78.6%)patients.CONCLUSION:Fungal keratitis is the leading cause of infective corneal ulcer and Candida albicans being the most commonly isolated pathogen in the patients belonging to Southern Pakistan.The direct microscopic examination with potassium hydroxide 100mL/L method is a simple,rapid,inexpensive and reliable method in the diagnosis of this infection.

Clinical analysis of 124 patients with penetrating ocular injuries in Hyderabad Pakistan / 国际眼科杂志(Guoji Yanke Zazhi)

·AIM:To assess the common causes of penetrating ocular injuries and to determine the visual outcome of these cases.·METHODS:A total of one hundred and twenty four eyes of 124 patients suffering from penetrating ocular injury between the ages 6-60 years, presenting to the Department of Ophthalmology,Liaquat University of Medical and Health Sciences were assessed clinically to determine the common causes of the penetrating intraocular injury and the final visual outcome.·RESULTS:One hundred and twenty four eyes with penetrating ocular injuries were enrolled in the study.The mean age was 35 years,(range 6 to 60 years).Males were predominant 86.3% with most of the patients less than 20 years of age (71%).Occupational class was mostly affected by the intraocular injuries accounting to 76%.51% patients had best corrected final visual acuity between perception of light to 6/60.Among the 124 patients in whom both initial and final visual acuities were reliably recorded,there was a correlation between poor initial visual acuity and poor final visual acuity.·CONCLUSION:Penetrating eye injury is a common incident, predominantly in young males and often resulting in poor visual outcome in the injured eye.Labour work without protective measures and children playing with hazardous objects are associated with more frequent and severe ocular injuries.

To determine prevalence of pseudo exfoliation at a tertiary eye care centre: a hospital based study

To report the prevalence of pseudo exfoliation in association with Cataract and other ocular diseases at a tertiary eye care centre in Sindh, Pakistan. This was a hospital based study at Liaquat University Eye hospital, Hyderabad Sindh, Pakistan conducted from July, 2005 to November, 2006. A total of 1450 subjects of more than fifty years with senile cataract were registered who underwent a comprehensive ophthalmic evaluation. Visual acuity, refraction, Goldmann applanation tonometry, gonioscopy, slit lamp examination, and dilated pupil fundus examinations were performed. Pseudo exfoliation was diagnosed on slit lamp biomicroscopy by the presence of white dandruff-like material at papillary margin, on the anterior lens capsule, and trabecular meshwork, in one or both eyes. Out of 1450 patients, sixty five [4.48%] subjects was diagnosed having senile cataract with pseudo exfoliation. There was a significant increase in prevalence with age. Out of 65 cases, 15 cases [23.0%] were unilateral and 50 cases [76.9%] bilateral. Forty one eyes [63.0%] had raised intraocular pressure, in which four eyes [9.7%] had angle closure glaucoma, and 37 eyes [90.2%] had pseudo exfoliation [open angle] glaucoma. The prevalence of nuclear cataract was significantly higher [66.1%] in patients with pseudo exfoliation. It appears to be a common disorder in older individuals in the notified area. The association of pseudo exfoliation [PXF] with aging and cataract has public health implications

Efficacy of intravitreal ceftazidime in acute postoperative endophthalmitis

To assess the efficacy of intravitreal ceftazidime in acute postoperative endophthalmitis. Quasi experimental study Department of Ophthalmology Unit I, Eye Hospital, Liaquat University of Medical and Health Sciences, Hyderabad, from November 2004 to November 2006. Twenty-one eyes of 21 patients of acute postoperative endophthalmitis were treated with intravitreal antibiotic ceftazidime. The inclusion criteria of the patients was the clinical diagnosis of acute postoperative endophthalmitis within 15 days of postoperative period with visual acuity better than or equal to hand movement close to face. After enrollment, vitreous tap was carried out in all cases followed by intravitreal ceftazidime injection. The outcome was measured in terms of clinical resolution of endophthalmitis and postresolution best corrected visual acuity. Mean of difference was tested by paired t-test. Nineteen eyes [90.5%] responded to intravitreal ceftazidime therapy alone, while an additional pars plana vitrectomy was required in one eye. Sixteen eyes [84%] retained a visual acuity of 6/60 or better at 3 months after the initiation of the therapy [p<0.001]. Retinal detachment developed in one eye receiving intravitreal therapy. Ceftazidime was effective as intravitreal therapy for the management of acute postoperative endophthalmitis

Isolated eyelid tuberculosis

We report a case of a seventy years old lady of poor socioeconomic background who presented with painless swelling of the right upper lid since one year. No other local or systemic features were associated. An incisional biopsy was performed under local anaesthesia. Histopathological examination revealed epitheloid granuloma with Langerhan's giant cells suggestive of tuberculosis of lid skin. The clinical events and pathological findings were suggestive of Mycobacterium tuberculosis as the cause of infection. After diagnosis, the patient was referred to physician for anti-tuberculosis therapy. The eyelid swelling resolved gradually and was completely normal after 9 months of chemotherapy

Metallic intraocular foreign body removal by magnet V/A trans scleral pars plana approach

A young man working in a workshop sustained penetrating injury to his left eye and reported within 12 hours to Eye Hospital. Plain X-ray orbit confirmed the presence of intraocular foreign body near pars plana. Corneal wound of entry was repaired with 10/0 suture. The intraocular foreign body was removed by magnet through trans scleral magnet via pars plana approach without 3 port vitrectomy procedure. Mild traumatic endophthalmitis was controlled by intravitreal injection of Vancomycin 1mg/0.1ml, along with topical antibiotic and steroid therapy. After 6 weeks, extraction of soft traumatic cataract and posterior chamber lens implantation was done. Best-corrected vision of 6/12 was achieved

Proportion of gastroesophageal reflux symptoms in patients with chronic obstructive pulmonary disease

To determine the proportion of gastroesophageal reflux symptoms in patients with chronic obstructive pulmonary disease and its association with the severity and worsening of the symptoms of chronic obstructive pulmonary disease [COPD]. A prospective, questionnaire based, case control, analytical study was conducted in the Department of Pulmonology, Jinnah Postgraduate Medical Centre, Karachi during June 2002 to January 2005. Gastroesophageal reflux symptoms were compared between 100 chronic obstructive pulmonary disease patients who fulfilled the inclusion criteria and 150 control subjects. Both groups were interviewed according to modified version of Mayo clinic GER questionnaire. Chronic obstructive pulmonary disease patients were divided into two groups according to pulmonary function tests [PFTs] results into FEV1 <50% and FEV1 >50%. Chronic obstructive pulmonary disease patients had more frequent gastroesophageal symptoms than controls [25% vs. 9.33% respectively; p=0.001], heartburn/acid regurgitation [70% vs. 43.33% and 56% vs. 30.66% respectively; p-value=0.001], dysphagia [15% vs. 4%; p-value=0.002] and chronic cough [89% vs. 29.33%; p-value=0.001]. Twenty six COPD patients reported respiratory symptoms associated with reflux, whereas control subjects denied such association. Of the 11 patients with frequent gastroesophageal symptoms, 10 patients increased their inhaler use [p=0.001]. Frequent gastroesophageal symptoms had shown a significant association with decreased FEV1 [25% vs. 0% p-value 0.001]. In contrast Pulmonary function test results were similar among chronic obstructive pulmonary disease patients with and without gastroesophageal symptoms [48.13+20.81 vs. 50.94+23.33]. Anti-reflux medication proton pump inhibitor and H2-blockers were utilized more by COPD patients as compared to control subjects. A higher proportion of frequent gastroesophageal symptoms were noted by COPD patients than control subjects and higher proportion of gastroesophageal symptoms was present in severe COPD patients