Quality of life at six months after primary percutaneous coronary intervention performed at a predominantly rural population

Background: HRQL is important in improving the quality of patient care. However, there is a paucity of data from low-income and middle-income countries (LMIC). Differences in socio-demographics and socio-cultural contexts may influence HRQOL. Therefore, this research was designed with the aim to explore the HRQOL in patients after Percutaneous Coronary Intervention (PCI).Objective: The goal of the study was to evaluate the quality of life after six months of Percutaneous Coronary Intervention using HeartQol questionnaire at a tertiary care hospital in Pakistan.Method: This was a Cross-sectional, descriptive study. Patients between the ages of 20-60 years who underwent primary Percutaneous Coronary Intervention at least 6 months ago were inducted in the study. Coronary angiography was performed mostly through radial as preferred route. Data was collected using a structured questionnaire covering demographic characteristics, predisposing risk factors, procedural details, and quality of life. Heart related Quality of life was assessed using HeartQol questionnaire. Collected data was analyzed using SPSS v.21.Results: A total of 241 patients participated in the study. Mean age of the patients was 53.37±11.07 years. On analysis of quality of life at six months, the median (IQR) HeartQol score was 31 (37-23) with majority of the patients, 84.22% (203) fall under the excellent score (>20).Conclusion: It is of enormous prognostic importance that the quality of life of patient is assessed on a regular basis after PCI. Our study shows that the majority of patients had improved quality of life at six months of PCI. Majority of patients were not bothered by mild symptoms. Further investigation needs to be done to validate these results.

Spectrophotometric investigation of Glutathione modulation by Thallium chloride in aqueous medium

Thallium has been shown to significantly influence various tissues of living organisms; Exposure to Thallium can disturb mitochondrial function, degenerate neurons, and interfere with the function of critical metabolic enzymes and co-enzymes. Glutathione [GSH] an essential biomarker is considered a key factor in harnessing the thallium toxicity. In the present study the interaction of Thallium [Thallium Chloride] and glutathione was investigated spectro- photometrically in aqueous media. The renowned Elman's experimental protocol was followed at a wavelength of 412nm for Glutathione quantification in each sample. The pH of each sample was maintained at 7.6 using Phosphate buffer during the entire course of the experiment. A concentration as well as time dependent depletion of glutathione after exposure to various concentration of Thallium metal was observed, revealing chemical interaction between the metal and glutathione. The exact mechanism of interaction of Thallium and glutathione is still to be investigated. However, this piece of research suggests that a decrease in the concentration of Glutathione may be due to Thallium-GSH abduct or oxidize glutathione [GSSG] formation. This study was performed in-vitro as a model of in vivo

Palladium glutathione, N-acetylcysteine, D-penicillamine conjugation chemistry

The metalloelement Palladium has a number of potential Pharmaco-clinical advantages. Palladium compounds have antiviral, antibacterial, neuroprotective and antitumor properties. However studies have also indicated some mild to serious toxic effects of Palladium metalloelements. Biothiols are important antioxidants that provide protection against metals toxicity. The interaction of metalloelements with biothiols can provide valuable information about the level of toxicity of the metalloelements and about the protective role of biothiols thereof. In this piece of work the effect of salt and complexes of Palladium on the status of different thiols [GSH, NAC, and D-Pen] in aqueous medium, were examined, The thiol quantification was carried out using Elman's method through UV-visible spectrophotometry and 1 HNMR. Results of the study performed in aqueous medium showed that level of different thiols depleted after the addition of the inorganic salts and organic complexes of Palladium. The mechanism of interaction of Palladium with thiols was examined using H-NMR. The results indicate that the depletion in the level of thiols may be due to 1:1 or 1:2 conjugation of Palladium with thiols. These conjugation reactions further suggest that the Palladium have xenobiotic nature causing oxidative stress and thiols play their role in detoxification and biotransformation of these metalloelements

Interaction of palladium inorganic salt and organic complex with glutathione content of liver homogenate

Glutathione is an essential antioxidant of living organism that provides a primary protection against metals toxicity. A significant amount of glutathione is present in blood erythrocytes, plasma and liver hepatocytes to protect them from oxidative damage from both external and internal oxidants. Metalo-element palladium has numerous pharmacological, clinical and toxicological compensations, like palladium is used as anti-viral, anti-bacterial, neuroprotective and anti-tumor agent. However studies have also indicated some mild to serious toxic effects of palladium metallo-elements. In the presence study the interaction of palladium inorganic salt and organic complex with glutathione [GSH] content of liver homogenate was examined spectro-photometrically. 20% [w/v] liver homogenate was prepared of the collected liver of rabbit in 5% TCA [tri-chloro-acetic acid] solution and 1mm EDTA, using a potter-eveljhem homogenizer with motor driven Teflon pestle. The GSH content quantification was carried out by Elman's method. Our finding showed that there was a depletion of GSH content by both palladium inorganic salts and organic complexes, concentrations wise as well as with time elapse as level of GSH content decrease from [43.6% to 72.62%] with Palladium Nitrate and from [24.09 to 59.5%] with Bis-benzonitrile Palladium II Chloride as compared to control, and further dropped with time incubation from 0-90 minutes from [49.7 to 87.1%], with Palladium Nitrate and from [29.3% to 67.6%] respectively. The result showed that the effect of both inorganic salt of palladium was more enhanced as compare to its organic complex. It was suggested from our finding that the depletion in the glutathione content of liver homogenate may be due to oxidation of glutathione or due to glutathione metal abduct formation by both inorganic salt and organic complex of palladium. This study in situ is a model of in vivo

Frequency of acute kidney injury in tetanus patients of paediatric intensive care unit: a public hospital experience

Background and Objective: Tetanus is a potentially fatal but preventable disease. Mortality is related to severity of the disease, cardiovascular, pulmonary and renal complications. Acute kidney injury [AKI] is a frequent and lethal complication of tetanus. The objective was to determine the frequency of AKI in tetanus patients managed in a public hospital

Methods: Children aged 1-12 years admitted in Paediatric Intensive Care Unit [PICU] with the clinical diagnosis of tetanus over three and half years were recruited for the retrospective study. pRIFLE [Pediatric Risk, Injury, Failure, Loss, End] criteria was applied to all cases of tetanus to categorize them as having AKI or not, on the basis of estimated creatinine clearance [ECCL]. Comparison was done between AKI and non-AKI cases, as well as between AKI survivors and AKI non-survivors. The study was conducted at PICU of Dr. Ruth K.M. PFau Civil Hospital Karachi for tetanus cases admitted during July 2013 to December 2016

Results: During the study period, 44 patients of tetanus were enrolled. Nearly 32 % of tetanus patients developed acute renal dysfunction according to PRIFLE criteria. There were overall 15 [34.09%] expiries among tetanus patients among which nine [60%] had AKI. Oliguria was observed in five [35.71%] cases. All the AKI non-survivors had ECCL below 50% and all had autonomic instability. AKI developed towards the end of first week in three cases, mid of second week in four cases and third week in seven cases. Renal replacement therapy [RRT] i.e. peritoneal dialysis [PD] was done in four AKI cases but it did not improve the outcome. CRP was more than 50 in 24 [54.54%] cases. Ventilatory support was given to 85.71 % with AKI as compared to 66.66 % of non AKI patients

Conclusion: Development of AKI in tetanus is multifactorial. Major contributors are severity of the tetanus itself, presence of autonomic instability, ventilator dependency, and sepsis. Presence of AKI worsens the outcome of tetanus in terms of survival, length of stay, hospital cost and ventilator days

Synthesis, characterization and antihypertensive activity of 2-phenyl substituted benzimidazoles

Hypertension is one of cardiovascular disease that is not sufficiently prevented and controlled at both hospital and community levels. Hypertension resulted in significant morbidity and mortality. The benz-imidazole ring is very important pharmacophore in modern drug discovery. The substituted benzimidazoles are the important for medicinal research. Researchers have reported that substituted Benzimidazoles are the structural isosteres of nucleotides, and easily allow them to interact with the different biopolymers, possess pharmacological activity especially antihypertensive activity. Angiotensin II Receptor Antagonists/Blockers [ARBs] compete with angiotensin II at the receptor site and block the contractile effect of angiotensin II in all vascular smooth muscles. Among all Angiotensin II Receptor Antagonists/Blockers [ARBs], Telmisartan, Milfasartan and many others have benzimidazole ring in their structure. In this study Angiotensin II Receptor Antagonists/Blockers [ARBs] have been prepared. Synthesized compounds were characterized by physical data and FTIR spectroscopic technique. Synthesized compounds studied were finally screened for their antihypertensive activity by tail cuff method of measurement of blood pressure by NIBP apparatus [None Invasive Blood Pressure] using Chart 5.0 software. The compounds synthesized were 2-[3-nitrophenyl]-1Hbenzimidazole [1a], 3-[1H benzimidazol-2-yl]aniline [1b] and 5-[1H-benzimidazol-2-yl]-2-methoxyphenol [1c]. The synthesized compounds have shown antihypertensive activity by taking Losartan as lead compound

Gender based outcome of acute cholecystitis

Objective: To find out whether or not male gender is associated with more severe gallbladder inflammation

Study design Retrospective review of records

Place and Duration of study: Sheikh Khalifa Bin Zayed Al Nahyan [SKBZ] Hospital / CMH Muzaffarabad, from January 2012 to June 2015

Methodology: A retrospective data analysis of patients who underwent laparoscopic cholecystectomy for acute cholecystitis was done. Data for 740 patients with cholecystitis was retrieved. Out of these 220 patients who had laparoscopic cholecystectomy within 72 hours of admission, were included in the study. Gallbladder inflammation was confirmed on histopathology report

Results: There were 110 male and 110 female patients in this series. There was a significant number of male patients who had severe gallbladder inflammation in comparison with female patients [p=0.002]. The male gender was confirmed in a multivariate analysis as an independent risk factor for severe cholecystits [p=0.018]

Conclusions: Male gender is a risk for severe gall bladder inflammation. Early surgical intervention is therefore warranted to prevent complications

Factors associated with low birthweight in term pregnancies: a matched case–control study from rural Pakistan

Low birthweight [LBW] remains a significant public health problem in Pakistan and further understanding of factors associated with LBW is required. We conducted a hospital-based matched case control study to identify risk factors associated with LBW in a rural district of Pakistan. We found that illiteracy [AOR: 2.68; 95% CI: 1.59 - 4.38], nulliparity [AOR: 1.82; 95% CI: 1.26-2.44], having a previous miscarriage/abortion [AOR: 1.22; 95% CI: 1.06-2.35], having < 2 antenatal care [ANC] visits during last pregnancy [AOR: 2.43; 95% CI: 1.34-2.88], seeking ANC in third trimester [AOR: 3.62; 95% CI: 2.14-5.03], non-use of iron folic acid during last pregnancy [AOR: 2.72; 95% CI: 1.75-3.17], having hypertension during last pregnancy [AOR: 1.42; 95% CI: 1.13-2.20], being anemic [AOR: 2.67; 95% CI: 1.65-5.24] and having postpartum weight of <45 kg [AOR: 3.30; 95% CI: 1.97-4.52] were significantly associated with an increased odds of having a LBW baby. Our study identifies modifiable risk factors requiring immediate commitment from the health authorities

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

Controlled release matrix tablets of glipizide: influence of different grades of ethocel and Co-excipient on drug release

The aim of the current study was to formulate and evaluate glipizide controlled release matrix tablets by means of different grades of polymer Ethoceland different co-excipients in order to evaluate their effect on drug release profiles during in vitro dissolution studies. Type II diabetes mellitus is usually treated with Glipizide. Glipizide belongs to sulfonylurea group. Gastric disturbance and severe hypoglycemia has been observed after taking glipizide orally. To overcome these problems, controlled release matrices were developed using different grades of ethyl cellulose polymer with a drug-polymer ratio of 1: 3by the direct compression method. The effect on drug release of partial replacement of lactose by different co-excipients, HPMC K100M, starch and CMC, were also studied. Diameter, thickness, hardness, friability, weight variations, drug contents of formulations were tested, these properties were within prescribed limits. Co-excipients and polymer containing formulations were compared to the without co-excipients and polymer containing formulations with respect to their release profile. After a 24-hour release study, ethyl cellulose polymer containing formulation exhibited prolonged release for 5-16 hours; however the polymer Ethocel standard FP 7 Premium without co-excipient containing formulation exhibited controlled release for 24 hours. Incompatibility was investigated between drugs, co-excipient DSC and polymer study was performed and any type of interaction was not found. Different kinetic models were used to study the release mechanism. An enhanced release rate was observed in case of excipients containing formulations

Hypoglycemic and hypolipidemic effects of Lactobacillus fermentum, fruit extracts of Syzygium cumini and Momordica charantia on diabetes induced mice

A lot of treatment strategies available for diabetes but its complications are still a medical problem around the globe. It demands to find out some alternative therapeutic measures. In order to investigate the anti-diabetic potential of probiotics and natural extracts, this study was designed. Accordingly, a local source of yogurt probiotic strain Lactobacillus fermentum was isolated and characterized that showed its probiotic properties. Besides this, natural extracts of plants fruits like java plum [Syzygium cumini] and bitter gourd [M. charantia] were made. Lactobacillus fermentum and the extracts were administered individually as well as in combination to diabetes induced mice. Different parameters like body weight, blood glucose level and lipid profile including total cholesterol, HDL and LDL were analyzed before and after treatment. The results showed that Lactobacillus fermentum and natural extracts have hypoglycemic as well hypolipidemic activity against diabetic mice. This study can further investigated to screen potential compounds from these extracts to control the glucose and the lipid levels in diabetic patients

Severe Coronary Artery Ectasia with ST Elevation MI: A Challenging Situation.

Aim: To report a case of huge coronary artery ectasia presenting with acute myocardial infarction; a relatively rare finding encountered during coronary angiography. Presentation of Case: A young male presented with chest pain and profuse sweating at a local hospital. Electrocardiogram showed Infero-posterior STEMI. Patient received streptokinase. His symptoms settled however the electrocardiogram changes did not resolve. He presented at our hospital after 24 hours with chest discomfort. He was vitally stable and a murmur of MR was audible. His Troponin-I was raised and electrocardiogram showed ST elevations with Q waves. Coronary angiogram showed giant ectasia and occluded right coronary artery (RCA). Percutaneous coronary intervention of RCA was done; with TIMI II flow but still had some residual thrombus. The patient was kept on Tirofiban infusion. His CRP and homocysteine levels were raised. Dual antiplatelet, statin, ACE Inhibitor, beta blocker with vitamin B12 and folic acid supplement were continued. Discussion: Coronary artery ectasia is a form of atherosclerosis seen in 0.3–4.9% of coronary angiography procedures. It is described as dilation of the coronary arteries >1.5 times compared to adjacent normal vessel. An excessive expansive remodeling with enzymatic degradation of the extracellular matrix is considered to be the major pathophysiologic process. Clinical importance inclines on its association with acute coronary syndrome. Conclusion: A case of huge coronary artery ectasia presenting with acute myocardial infarction and successfully treated with PCI.

Medically unexplained symptoms and emotional disorders among school children

Objective: To determine the frequency of unexplained physical symptoms in 5-15 years old children and its association with emotional disorder in psychiatric clinic of a public sector hospital

Study Design: Cross-sectional descriptive study

Place and Duration of Study: This study was conducted in the Department of Paediatric OPD, DIMC, DUHS, Karachi from January 2015 to June 2015

Materials and Methods: 144 samples of 5-15 years old children of both genders with somatic /physical symptoms fulfilling the inclusion criteria which were referred to the Psychiatry clinic. Semi structured questionnaire based on Urdu version of SDQ parent version were filled by the parents to assess the emotional problems in these children

Results: Analyses were completed for sample of 135 patients. 9 were excluded due to incomplete questionnaire. The mean age of children was 10.95 years. Pain predominated as physical symptoms in 5-10 years age group was pain, it included abdominal pain, headaches, limb pain, backache, chest pain. Fatigue, difficulty in breathing tremors, jerky movement and nausea and vomiting were more common in females. Anxiety disorder n=51 [50%], depression n=28 [28%], and somatoform disorder n=22 [22%] were the psychiatric comorbidities observed in these children

Conclusion: Children presenting with unexplained medical symptoms are often not managed appropriately by the Pediatricians due to lack of awareness. Majority of children presenting with MUS suffer from emotional disorders

Evaluation of medicinal value of Epimedium datum on the basis of pharmacologically active constituents, Icariin and Icariside-II

Epimedium L. is well known medicinal genus of Chinese pharmacopoeia. Various species are ethno-botanically used against diseases of eye and kidney, impotence, asthma, arthritis and hypertension; besides being used as analeptic, expectorant, antibacterial, hypoglycemic, vasodilator and refrigerant. Recent studies have attributed most of these medicinal properties to its flavonoid glycosides, especially Icariin which is the major pharmacologically active constituent. Icariin has been found to possess effective aphrodisiac, antioxidant, immunomodulatory, hepatoprotective, cardioprotective, vasodilatory, antidepressant and anti-osteoporosis activities. Icariside-II, another active constituent, has cytotoxic and cytostatic effects on 6 cancer cell-lines, and immunosuppressive effects on allograft rejection. In this present study, Epimedium elatum Morr. and Decne., the only species of this genus growing in Indian subcontinent, has been investigated for its medicinal value by determining the content of pharmacologically active constituents, Icariin and Icariside-II, by HPLC method. HPLC analysis of alcohol extract of its shade dried parts was performed with reverse phase C-18 column. The mobile phase for Icariin was acetonitrile-water in gradient mode; while for Icariside-II, it was methanol-water. The effluent was monitored at 270nm. The results have revealed an appreciable content of Icariin and Icariside-II in its aerial and underground parts; the content being higher in populations growing at higher altitudes. The substantial presence of pharmacologically active constituents, Icariin and Icariside-II, in this species of Epimedium, signifies its value as a medicinal plant

simple and rapid approach to evaluate the in vitro in vivo role of release controlling agent ethyl cellulose ether derivative polymer

Diclofenac sodium [DCL-Na] conventional oral tablets exhibit serious side effects when given for a longer period leading to noncompliance. Controlled release matrix tablets of diclofenac sodium were formulated using simple blending [F-1], solvent evaporation [F-2] and co-precipitation techniques [F-3]. Ethocel[R] Standard 7 FP Premium Polymer [15%] was used as a release controlling agent. Drug release study was conducted in 7.4 pH phosphate buffer solutions as dissolution medium in vitro. Pharmacokinetic parameters were evaluated using albino rabbits. Solvent evaporation technique was found to be the best release controlling technique thereby prolonging the release rate up to 24 hours. Accelerated stability studies of the optimized test formulation [F-2] did not show any significant change [p<0.05] in the physicochemical characteristics and release rate when stored for six months. A simple and rapid method was developed for DCL-Na active moiety using HPLC-UV at 276nm. The optimized test tablets [F-2] significantly [p<0.05] exhibited peaks plasma concentration [C[max]=237.66 +/- 1.98] and extended the peak time [t[max]=4.63 +/- 0.24]. Good in-vitro in vivo correlation was found [R[2] =0.9883] against drug absorption and drug release. The study showed that once-daily controlled release matrix tablets of DCL-Na were successfully developed using Ethocel[R] Standard 7 FP Premium

Comparison of mean platelet volume in patients with psoriasis and healthy individuals

To compare mean platelet volume in patients with psoriasis and healthy individuals. This case control study was conducted in outpatients department and indoor of department of Dermatology, DHQ Hospital, Faisalabad. The duration of study was six months. Thirty consecutive patients of psoriais, 20 to 60 years of age and thirty age and gender matched healthy individuals were selected. 2cc venous blood sample from each subject was sent to the pathology laboratory of DHQ Hospital. Mean platelet volume [MPV] was measured as a part of blood complete analysis in Medonic M series Haematology analser. MPV was found higher in the patients of psoriasis as compared to the healthy individuals. The mean value of MPV in the case group was 8.24 +/- 1.22 fl, whereas in the control group, it was 7.29 +/- 0.77 fl [p<0.05]. The study demonstrated that mean platelet volume is increased in patients with psoriasis as compared to healthy individuals. Such patients are at an increased risk of cardiovascular complications

Effect of increasing dialysate flow rate on achieved kt/v in patients on maintenance hemodialysis

Background: In patients suffering from End Stage Renal Disease [ESRD] life can only be sustained by renal replacement therapy, including renal transplant or dialysis, which can be peritoneal dialysis or hemodialysis. Adequate dose of hemodialysis must be offered to patients for better quality of life. Hemodialysis adequacy, Kt/V, is one of the most important issues influencing the survival of patients on maintenance hemodialysis. Some patients do not achieve target Kt/V even with extended treatment time or by increasing blood flow rates. These patients have poor quality of life because of toxic effects of uremia, decreased appetite, metabolic complications of renal failure. These selected patients can be offered adequate dialysis by increasing dialysate flow rate, hence achieving adequate Kt/V, so quality of life can be improved

Objective: This study was conducted to determine the effect of increasing dialysate flow rate from 500 ml/min to 800 ml/min on achieved Kt/V, in under dialyzed patients who were on thrice weekly regular hemodialysis and were not achieving required Kt/V

Patients and Methods: This cross sectional study was conducted in hemodialysis unit, Sheikh Zayed Hospital, Rahim Yar Khan from 1 st November 2011 to 3 Oth April 2012. We included 100 regular under dialyzed patients using Fresenius 4008S dialysis machines, equipped with online clearance modules [OCM] to measure Kt/V. The patients were dialyzed for 4 hours, at dialysate flow rates 500ml/min and then 800ml/min each session. OCM-based single pool Kt/V was noted at the end of each dialysis session. The difference between two Kt/V was noted

Results: When 100 underdialyzed patients who were previously dialyzed at Qd 500ml/min, were offered 4 hour dialysis with Qd of 800ml/min, 87% patients achieved target Kt/V of > 1.2. While 13% still did not achieved target Kt/V. So a significant number of patients were able to have adequate dialysis

Conclusion: Some patients did not achieved required target Kt/V>1.2 on conventional dialysate flow rate of 500ml/min despite of extended treatment time and optimized blood flow rates and hence were underdialyzed. But they achieved Kt/V > 1.2 when dialyzed for 4 hours at Qd 800ml/min. So it is concluded that better dialysis can be offered to these selected patients by increasing dialysate flow rate from 500ml/min to 800ml/mm, achieving better Kt/V and thus quality of life can be improved

Histochemical and serological parameters of hepatic lithium toxicity ameliorated by L-arginine supplementation

The purpose of this study was to judge the ability of L-arginine to restore the carbohydrate, protein and fat metabolism particularly in the liver against lithium carbonate induced hepatotoxicity. This study is randomized, interventional, prospective, morphometric and histochemical study. This study was conducted in the department of anatomy, BMSI, JPMC, Karachi. Animals were obtained from the animal house of BMSI, JPMC, Karachi. The duration of this study comprises of two, six and twelve weeks. Sixty albino adult rats 90 - 120 days of age weighing about 200 - 300 grams were used for this study. Animals were divided into four different groups each comprising 15 rats. Each major group was subdivided into three sub-groups 1, 2 and 3 on the basis of 02 weeks, 6 weeks and 12 weeks duration of treatment respectively. 4 um thick sections of rat liver were stained with PAS haematoxylin, Gomori's calcium phosphate and oil red O. Serum analysis of ALT and ALP was done. Lithium treated group on PAS staining displayed depletion of glycogen content of hepatocytes. Gomori's calcium phosphate staining revealed diminution of the intracellular enzyme contents of hepatocytes especially alkaline phosphatase [ALP] and concomitant rise in serum hepatic enzymes like Alanine aminotransferase [ALT] and ALP. Oil red O stained sections of the liver depicted microvesicular fatty infiltration in liver cells in lithium treated group B animals. This study revealed that the toxicity of lithium is manifested histochemically by disturbances of in the glycogen, lipid and enzyme metabolism in the liver simultaneously exhibiting the restoration of the same metabolism by L-arginine as a best adjuvant in the treatment of bipolar disorder with lithium carbonate

L-arginine as a protective adjuvant in the treatment of bipolar disorders with hepatotoxic agent lithium

The purpose of this randomized experimental study was to explore the beneficial effects of L-arginine on lithium carbonate induced liver toxicity. This study is randomized, interventional, prospective and experimental in nature. This study was conducted in the department of anatomy, Basic medical sciences institute, Jinnah post graduate medical centre, Karachi. Animals were obtained from the animal house of BMSI, JPMC, Karachi. The duration of this study comprises of two to twelve weeks. Sixty albino adult rats of 90 - 120 days of age weighing about 200 - 300 grams were used for this study. These were divided into four major groups A,B, C and D each comprising 15 rats. Each major group was sub-divided into three sub-groups 1, 2 and 3 on the basis of 02 weeks, 6 weeks and 12 weeks duration of treatment respectively. 4 um thick sections of rat liver were cut using rotary microtome for H and E. The statistical significance of the differences of various quantitative changes between lithium carbonate and lithium carbonate + L-arginine treated rats from the control rats were evaluated by the student T-test. Lithium treated group exhibited significant augmentation in absolute and relative liver weight. Histopathological findings of liver revealed dilatation of central and portal veins, congestion of sinusoids, increment in mononuclear cell infiltration, microvesicular fatty change, swelling and hydropic degeneration of hepatocytes leading to pyknosis of nuclei, disintegration of organelles consequently leading to cell apoptosis and necrosis. Rats fed on co-administration of lithium plus L-arginine displayed significant improvement in the altered histology of liver lobules. This study revealed that concomitant administration of L-arginine with lithium considerably reduces lithium's adverse effects

Formulation and in vitro evaluation of clotrimazole gel containing almond oil and tween 80 as penetration enhancer for topical application

Achieving a desirable percutaneous absorption of drug molecule is a major concern in formulating dermal and transdermal products. The use of penetration enhancers could provide a successful mean for this purpose. The aim of this study was to develop Clotrimazole gel and to evaluate the effect of almond oil and tween 80 [in different concentrations], on the permeation of drug through rabbit skin in vitro. In order to investigate the effect of penetration enhancers used in this study on the permeation of Clotrimazole through sections of excised rabbit skin, Franz diffusion cell was employed. Sample solution was withdrawn at specific time interval up to 24 h. Significant difference in permeation among the eight formulations was seen in the study. The permeation profile of various formulations also showed that the added enhancers in individual batches affected the permeation of the drug. Drug permeation increased with increased concentration of Tween 80 and decreased concentration of almond oil. Furthermore, almond oil combined with tween 80 showed synergistic effect. The clotrimazole gels were successfully formulated and could be beneficial for topical use