Evaluation of hepatotoxic and nephrotoxic effects of piroxicam sulfonated derivatives

Background: Pain management requires new pharmacotherapy with good efficacy and less side effects. Piroxicam is used routinely in clinical practice but it is associated with side effects. To minimize the chances of adverse effects, sulfonated piroxicam derivatives [SPD] have been introduced. We sought to find hepatotoxic and nephrotoxic effects of SPD in Albino rats

Methods: An experimental study on SPD was carried out at the Institute of Basic Medical Sciences, Khyber Medical University, Peshawar. Healthy 24 albino rats were divided into 5 groups. One control group and four experimental groups [compound I and II, each with a dose of 10mg/kg and 20mg/kg] received treatment for 7 days. Liver function tests [LFTs], renal function tests [RFTs] and histology of liver and kidney specimens was performed after culling rats. The difference between median values of samples was assessed using Kruskal-Wallis test with post-hoc [for LFTs and RFTs]. SPSS-21 was used for all statistical analysis and p?0.05 was considered statistically significant

Results: The alanine aminotransferase [ALT] values were significantly high in the 20 mg/Kg group than control for both compounds [p=0.03, p=0.001 respectively]. The aspartate aminotransferase [AST] values were significantly high in the 10 mg/Kg and 20 mg/Kg group than control for compounds II [p=0.01, p=0.0001 respectively]. The alkaline phosphatase [ALP] values were significantly high in the 20 mg/Kg group than control for compounds II [p=0.002]. The blood urea values were significantly high in the 20 mg/Kg group than control for compounds II [p=0.008]. The mean final score of liver injury in all experimental groups [mean range 5-7] was less suggesting that the damage in liver was less pronounced. Renal injury was more pronounced in the 20 mg/Kg dose for both compound I and compound II [mean score 7] compared to 10 mg/Kg dose [mean score 4]

Conclusion: Piroxicam sulfonated derivatives can cause focal changes in liver and kidney which might be reversible. The changes are less pronounced for compound I with a low dose

Attributes of a good medical school: faculty perspective in local context

Background: Medical schools and institutions are required to meet the standards of national and international accreditation bodies. These standards guide the attributes of a good medical school. The current study was designed to identify the attributes of a good medical school from a local perspective

Methods: For this qualitative study based upon grounded theory, 25 participants were recruited through purposive sampling who underwent a workshop to get an insight about the attributes of a good medical school. They were asked to provide the faculty perspectives of a good medical school. The participant responses were put in online software 'Worditout' to look for the repetitions of words, followed by open coding technique. Initial coding was followed by a second phase of axial coding of the data in order to identify themes and thematic analyses of all the data were performed

Results: The teaching experience of the participants in medical schools varied from 2 to 20 years. In total, 198 responses/comments from all the participants were recorded. After doing the open and axial coding all the responses were summarized into four themes. The themes highlighted in order of the response frequency were: 1] improved learning strategies and opportunities; 2] modification and improvements in teaching methodologies; 3] standardised and programmatic assessment methods and 4] parameters of quality assurance and management

Conclusion: The attributes of a good medical school are guided by the national and international standards. However, some of the standards are contextual and our study showed these standards as attributes of a good medical school. It includes provision of better learning opportunities, teaching methodologies, standardised assessment and quality assurance

Results of comparative study of fractures fixed with DCP and nailing

The treatment methods of the fractures of humerus are treated in many ways. Interlocking nails and plates have both stood the test of time but the present study looks at both methods scientifically. Prospective, comparative study. This study was carried out at Ghazi Medical College, D.G.Khan from 07.01.2013 to25.02.2015. A total of 40 patients were included in the study. It was a, study of two groups of patients of fractures of humerus treated with dynamic compression plate versus with interlocking nails. Fractures in both groups healed uneventfully without significant complications. Both modes of treatment can be recommended for the treatment of fractures of the shaft of Humerus with minimal chances of complications

Relationship and Inter Observer Agreement of Tooth and Face Forms in a Saudi Subpopulation

Objective: To determine the relationship of tooth form with the face form by different observers and further investigate the inter observer agreement on tooth forms, face forms, their relationship among male Saudis. Study Design: A comparative cross-sectional study. Place and Duration of Study: Department of Prosthodontics, College of Dentistry, King Saud University, Riyadh, KSA, from February till August 2013. Methodology: Ninety four male participants aged 18 - 35 years were r and omly recruited for the study. Full-face and anterior teeth [intraoral] digital photographs in the frontal plane were recorded. The outline tracings of the face and the tooth were obtained using Autocad [version 2010] software. The outline of the tooth was enlarged proportionately, without altering the length to width ratio to fit the face outline. The outlines were then evaluated visually by 6 prosthodontists and results were tabulated. Results: The most common type of face form [49.65%] and tooth form [56.38%] was square tapering. Using the visual method, a good relationship [31.41%], moderate relationship [35.31%], weak relationship [19.68%] and no relationship [13.65%] between the tooth form and face form was found by the observers. Overall kappa for inter observer agreement on face form, tooth form and their relationship was 0.24, 0.17 and 0.26 respectively. The kappa values showed a fair agreement between the observers. Conclusion: The study results indicated that there was no highly defined relationship between the tooth form and face form in the studied Saudi subpopulation. A fair agreement was found between the observers for classifying the tooth forms, face froms and their relationship. Key Words: Face form. Tooth form. Tooth-face relationship. Inter observer agreement

Relationship of high sensitivity C-reactive protein with cardiac biomarkers in patients presenting with acute coronary syndrome

Objective: To determine high sensitivity C-reactive protein [hsCRP] levels in patients with acute myocardial infarction [AMI] and its correlation with classical enzyme markers of myocardial damage. Study Design: Observational study. Place and Duration of Study: Department of Emergency Medicine at King Khalid University Hospital, King Saud University, Riyadh and Department of Physiology, from August 2010 to December 2011

Methodology: Consecutive eligible patients with either ST elevation myocardial infarction [STEMI] or non-ST elevation myocardial infarction [NSTEMI] who were admitted to the Emergency Department of King Khalid University Hospital were recruited. A total of 71 subjects were finally selected for the study. The hsCRP, Troponin I [Trop I], creatine kinase myocardial bound [CK-MB], aspartate aminotransferase [AST] and lactate dehydrogenase [LDH] concentrations of all patients with an acute myocardial infarction [AMI] were measured

Results: Among all patients 34 [47.9%] patients had diabetes mellitus, 21 [29.6%] were hypertensive, and 16 [22.5%] had no associated illness. Patients with STEMI had significantly higher levels of CKMB [p=0.0348], LDH [p=0.0471] and hsCRP [p=0.0231] compared to NSTEMI patients. While the differences were non-significant for Trop I [p=0.7022], AST [p=0.9729] and Lp[a] [p=0.5985]. Spearman's correlations revealed that CRP correlated significantly with Trop I, CK-MB and LDH. There was a significant predictive relationship of hsCRP with Trop I, LDH and CK-MB while with AST it was nonsignificant

Conclusion: High sensitivity CRP levels is a significant predictor of standard markers for myocardial damage and it may be a useful prognostic marker in acute coronary syndromes

Early spica cast in children femoral shaft fractures

To find out the advantages of early spica cast as a treatment for isolated, uncomplicated femoral shaft fracture in children. Descriptive Study. This study was carried out in the Department of Orthopaedics, DHQ Hospital, Dera Ghazi Khan ospital DeraGhazi Khan from April 2009 to December 2010. A total of 30 patients were included in the study. All patients under the age of 12 years, who presented during the study period with femoral shaft fracture were included in the study. A total of 30 children with femoral fractures were treated with early spica cast. Age ranged from 2 year to 11 years. Male to female ratio was 2.75:1. Majority of children were under 5 years. In most of the children spica cast was applied on the day of presentation within few hours and were sent home on the same day. Twenty one children were followed till removal of spica cast. Period of immobilization in spica cast ranged from 4 weeks to 7 weeks with average of 5.73 weeks. Common problems related to spica cast were soakage and breakage of spica which occurred in 9[42.85%] children. At the time of cast removal shortening ranged from 0.5cm to 2.5 cm in 15 out of 21 [71.42%] children: Early spica cast is simple, effective and definite method of treatment with minmal complications and acceptable results in paediatric age group. It allows rapid return of child to family environment, thus avoiding prolonged separation from parents