Enhanced production of Lovastatin by filamentous fungi through solid state fermentation

Lovastatin is a natural competitive inhibitor of 3-hydroxy-3-methyl glutaryl coenzyme-A [HMG-CoA] reductase and inhibits specifically rate limiting step in cholesterol biosynthesis. Further, lovastatin in comparison with synthetic drugs has no well-reported side effects. Four pure isolated filamentous fungal strains including Aspergillus niger IBL, Aspergillus terreus FFCBP-1053, Aspergillus flavus PML and Aspergillus nidulans FFCBP-014 have been cultured by solid state fermentation [SSF] using rice straw as substrate for the synthesis of lovastatin. After selecting Aspergillus terreus FFCBP-1053 as the best producer of lovastatin, various selected physical parameters including pH, temperature, inoculums size and moisture content were optimized through response surface methodology [RSM] under center composite design [CCD] for lovastatin hyper production. Maximum lovastatin production of 2070+/-91.5 was predicted by the quadratic model in the medium having moisture content 70% and pH 4.5 at 35 degree C which was verified experimentally to be 2140+/-93.25Mug/g DW of FM [microgram/gram dry weight of fermentation medium], significantly [P<0.05] high as compared to un-optimized conditions while it was noted that lovastatin production is independent on inoculum size [P>0.05] measured by spectrophotometer at 245 nm against standard. It was determined that optimized conditions for the hyper-production of lovastatin from fungal sources have a significant effect

Effects of methanolic and aqueous extracts of Ipomoea batatas L on mineral contents level [calcium and magnesium] in alloxan-induced diabetic rats

In diabetic patients, electrolyte disorders frequently occur with the characteristic changes in minerals like calcium and magnesium etc. Several medicines are used to manage diabetes mellitus but they exert adverse effects. Plants are a valuable alternative to synthetic medicines because they are easily available, economical and have fewer side effects. Ipomoea batatas L is a well-known antidiabetic plant [sweet potato] but its effects on calcium and magnesium concentration have not studied. The prime focus of this study is to estimate the potential of Ipomoea batatas L peel-off on magnesium and calcium level in Alloxan-induced diabetic rats. Alloxan monohydrate was mixed in 0.9% NaCl solution and administrated [150 mg/kg [S/C]] to male Wistar rats to induce diabetes. After three days blood samples were collected and blood glucose level was recorded. Wistar rats having a blood glucose level of 200 mg/dl and above were selected for the study. Methanol and water extract of Ipomoea batatas L peel–off was given orally with a dose rate of 4g/day. Calcium and magnesium estimation was done using an atomic absorption spectrophotometer. Our results revealed an increase in both the calcium and magnesium level in heart, brain, liver, hind limb, and forelimb after Ipomoea batatas extract treatment. In kidneys decreased calcium level was noted as they excrete calcium. Mineral [Calcium, magnesium] level was increased in all organs except kidney after both extracts treatment. Ipomoea batatas being anti-diabetic in nature also maintain the homeostasis of calcium and magnesium in diabetes. Therefore, we propose the long-term use of such agents might help in the prevention of diabetes-associated complications. However, the validation of these results to human population needs further extensive study

evaluation of efficacy and safety of Cough [EMA] granules used for upper respiratory disorders

Ivy leaf is used for the treatment of respiratory diseases with the intensive mucus formation, respiratory infections, and irritating cough coming from the common cold. Conferring to clinical trials, the efficacy, and tolerability of ivy leaf is good. The main compounds accountable for biological activity are triterpene and saponins. Ivy leaves show convulsive/antispasmodic, anti-inflammatory, antimicrobial, analgesic, anthelmintic and anti-thrombin activity. Not only ivy but also marshmallow and mustard seeds are used for these indications. This study was conducted to evaluate the efficacy and safety of Cough [EMA; European Medicines Agency] granules used for upper respiratory disorders. This clinical trial was conducted on 150 patients, out of which 75 received the Cough [EMA] granules and 75 received the placebo. The age range of patients was 3 years to above 15 years. The sample paired t-test was applied to evaluate the significant level. Cough [EMA] granules were found effective in the treatment of cough, cold, and flu symptoms. The new treatment Cough [EMA] granules were safe and well tolerated in patient at given specific age group. The study recommends that Cough [EMA] granules can be used effectively in the treatment of upper respiratory tract infection

Phytochemical analysis and hepatoprotective effect of polyherbal formulation on CCl4 induced hepatotoxicity in mice

The potent phytotherapeutic modalities against the hepatotoxicity have motivated us to explore numerous plants and polyherbal preparations because conventional drug discovery is more expensive and tedious. So, this study was conducted to evaluate the hepatoprotective potential of a polyherbal formulation [PHF], comprising of Solanum nigrum, Silybum marianum, Atrmesia absinthium, Achillea millifolium and Cichorium intybus against carbon tetrachloride [CCl4] induced hepatotoxicity in experimental rats. CCl4 intoxication induced vacuole formation and fast degeneration so selective liver enzymes including alanine aminotransferase [ALT] and aspartate aminotransferase [AST], alkaline phosphatase [ALP] and total bilirubin in rat's plasma, as well as liver histological architecture, were used to evaluate the effect of herbal treatments with different doses [ranging 100-500 mg/kg] for two weeks. Statistical analysis showed that PHF significantly [P<0.05] improved the level of liver enzymes as well as improved the liver architecture comparative to control groups. It could be concluded from current findings that PHF prepared from Solanum nigrum, Silybum marianum, Atrmesia absinthium, Achillea millifiloium and Cichorium intybus have some hepatoprotective activities

Labour induction with gestational hypertension: a great obstetric challenge

Objective: To observe the fetomaternal morbidity and mortality with induction of labour in pregnant women with gestational hypertension

Methods: The subjected study population included was 138 pregnant women with gestational hypertension. These pregnant women were between 34-40 weeks of gestational period in whom labour was induced, while the pregnant women who had labour induction for other reasons were excluded. These women were registered on the predesigned proforma. The data was collected and analyzed on SPSS version 21

Result: Out of the 138 cases, mean age of the women was 25.93 +/- 5.037, prim gravid women were 78[56.5%], gestational period in majority of these women 71[51.4%] varied between 35-38 weeks. The common presenting symptoms were oedema 119[86.23%], headache 90[65.21%]. Labour induction in majority of the cases 81[58.7%] was carried with prosten pessary. The Caesarean section was needed in 39[28.3%] women in emergency due to maternal and fetal reasons or due to failed induction. Maternal complications were uncontrolled hypertension 23[16.7%], intensive care unit admission 21[15.2%], fits 15[10.9%], post partum haemorrhage 13[9.4%]. Fetal complications were birth asphyxia 49[35.5%], neonatal intensive care unit admission 17[12.3%], neonatal death 14[10.1%]

Conclusion: The emergency Caesarean section rate was quite high with induction of labour in pregnant women with gestational diabetes. The maternal morbidity as well as fetal morbidity and mortality rate was also high

Acute renal morbidities with obstetrical emergencies: an important women health issue

Objective: To observe the impact of acute renal morbidities with obstetrical emergencies on maternal health

Methods: In this study pregnant women between 28-40 weeks gestational period and delivered women in their puerperal period up to 42 days after delivery having acute renal problems associated with obstetrical emergencies were included. Pregnant and delivered women with obstetrical emergencies and associated other morbidities were excluded. These women were registered on the predesigned proforma after taking written informed consent and taking approval from institutional ethic research committee. The data was collected and analyzed on SPSS version 21

Result: Out of these 196 total registered women, majority of these women 81[41.32%] were between 21-30 years of age and multiparous women with parity four and above were 83[42.34%]. Commonest presenting symptoms were generalized oedema 123[62.75%] and oligouria 92[46.93%]. Frequent obstetrical emergencies observed were pre-eclampsia 53[27.04%], post partum haemorrhage 48[24.48%] and ante partum haemorrhage 36[18.36%] women. The complete recovery was observed in 86[43.87%] women, while mortality was seen in 56[28.57%] women

Conclusion: Renal morbidities were more frequently observed in obstetrical emergencies leading to high morbidity and mortality rate

systematic review of the safety of nipple sparing mastectomy

Background: Breast cancer is a complex disease, and local recurrence and cancer-related death is likely multifactorial. Over the past three decades there has been a move towards breast conservation and a focus on aesthetic outcomes while maintaining oncological safety. For some patients, mastectomy is the preferred option. There is growing interest in the potential use of nipple sparing mastectomy [NSM]. However, oncological safety remains unproven, and the benefits and indications have not been clearly identified

Methods: A Systematic search in the scientific database [Medline, EMBASE, Google Scholer and Ovid] from 1980 to 2016 was conducted for all relevant retrospective studies including; randomized controlled trials, cohort studies and case-studies involving women undergoing either NSM were analyzed and included based on the preset inclusion criteria

Results: The search yielded 1193 articles, of which 55 studies with 9053 patients met our selection criteria. After a mean follow up of 41 months [range, 7.1-78 months], the overall pooled locoregional recurrence rate [LRR] was 3.25%, the overall complication rate was 21.8% [1309 of 6003], and the overall incidence of nipple necrosis, either partial or total, was 6.6 % [561 of 8438]. Significant heterogeneity was found among the published studies and patient selection was affected by tumor characteristics

Conclusion: There is growing evidence that NSM has been marked as oncologically safe in women with small, peripherally located tumors, without multicentricity, or when performed as a prophylactic mastectomy. Hence, NSM has been recommended only if carefully selected for a particular group of patients

Preventing and reversing pakistan's medical brain drain through diaspora option and diaspora network

Brain drain is the flow of skilled and qualified man power from a home country to host country leaving the former, socio-economically underdeveloped. The role of Pakistani medical diaspora in improving the health care system and socio-economic development of the country through brain circulation is discussed in this paper. Different secondary sources such as published research studies, government reports, newspapers and published interviews were consulted to gather information. The data collected was analyzed by using documentary and content analysis. Diaspora option can be used as a strategy to reverse and prevent the harmful effects of medical brain drain through brain gain and brain circulation. The government can play its vital role to facilitate the diaspora network between home and host countries. Diaspora networks should be mobilized to transfer knowledge, skills and ideas to their home country. However, diaspora networks are successful when home country is equipped with infrastructure, and with economic and political stability and strategic policies

Iron deficiency anaemia is still a major killer of pregnant women

Objective: To observe the effects of iron deficiency anaemia on the health and life of pregnant women

Methods: This cross sectional study was conducted at the Department of Obstetrics and Gynaecology Unit IV, Liaquat University of Medical and Health Sciences Jamshoro from 1st June 2015 to 30th November 2015, for the period of 6 months. During this study period all the pregnant women from 13-40 weeks of pregnancy with iron deficiency anaemia having haemoglobin level less than 9 gram% were included, while the pregnant women with other medical disorders were excluded from the study. The data was collected and analyzed on SPSS version 21

Result: Out of the 305 pregnant registered women with iron deficiency anaemia most women were young 170[55.73%] between 20-30 years, belonged to low socioeconomic group 254[83.27%], they were multiparous 104[34.09%], having very low haemoglobin level between 1-3 gram % in 54[17.70%] women and between 4-6gram% in162 [53.11%] women. These women were prone to high complications such as ante partum haemorrhage 49[16.06%], renal failure 48[15.73%], disseminated intravascular coagulation 54[17.70%] and 16[5.24%] women died

Conclusion: Iron deficiency anaemia is common in pregnant women with higher rates of complications

Research productivity; evaluation among faculty members at dow university of health sciences karachi

Research training at higher education level for clinical and teaching staff is important and there are methods to introduce research culture in employees at clinical and teaching departmental level. Objectives: To recognize and quantify the research productivity status of teaching and clinical faculty of [DUHS] Dow University of Health Sciences Karachi before and after its establishment in 2003. Design: Non experimental cross sectional study. Period: 1st October 2012 to 1st February 2013.. Setting: Medical college Karachi. Subjects and method: Students of third semester were applied to sort out the ten years record from 1998 to 2008 of all researches conducted by faculty of Dow University of Health Sciences, published in international and national journals by using different online search engines. Research Output was measured in terms of the increase in the number of publications and quality of publications before and after the launch of Dow University. Data was entered in Microsoft office excel version 2007 and analyzed it in statistical package for social sciences [SPSS] version 17; person chi-square was applied to test the statistical significance at 95% confidence interval. Results: Data of total 594 researches was found out between the years1998 to 2008, 175[29.5%] researches were published before the foundation of Dow university of Health sciences Karachi [2003] while 419[70.5] researches were produced after 173[45.6%] research papers were published in indexed journals before, "whereas" 206[54.4%] were published in indexed journal after 2003. Original research articles were 152 [31%] before 2003, which rose to 339 [69%]. Publications of article types such as case reports, case series, and short communication, editorials and review articles also increased to 80 from 23 after establishment of Dow University. Conclusions: From a total of 594 faculty researches o published in indexed and non indexed journals between the years 1998 and 2008; there was a significant increase in production after establishment of Dow university of Health Sciences Hence it is confidently reported that due to establishment of research committees after the founding, there is a promotion and facilitation of research activities among faculty members.

Defensive medicine; to determine the prevalence of defensive medicine among doctors of civil hospital and Jinnah hospital Karachi and to introduce it towards the community of doctors

To determine the prevalence of defensive medicine among doctors of Civil Hospital and Jinnah Hospital Karachi and to introduce it towards the community of doctors. 200 doctors from different wards of Civil Hospital Karachi and Jinnah Hospital Karachi played crucial role in filling of Performa which was especially designed for this research. Cross sectional study. Civil and Jinnah Hospital Karachi. January 01, 2013 to December 31, 2013. 47.9% doctors already knew about defensive medicine while 52.1% didn't. 40.7% doctors avoid invasive procedures while 50.3% don't. 92.4% of doctors care for high risk patients while 7.6% avoid caring for them. 109 out of 190 doctors agree and 30 doctors strongly agree about the practice of defensive medicine, 34 doctors are neutral and the rest of them disagree with its practice. Mostly ordered tests are CBC 78.9%, urine D/R 3.2%, 1.1% stool D/R, 1.6% MRI, 2.2% CT scan, 1.1% UCE, 2.7% blood cultures, 0.5% LFTs 9.1% other tests and the doctors with experience of 10 or 15 years are found ordering only CBC mostly. The conclusion obtained from the results shows that most of the participants were experienced doctors but many of them were unaware of the defensive medicine and in spite of that too great number of doctors strongly believe in its practice. Majority of the doctors were found caring for high risk patients. However the prevalence and practice of defensive medicine reduced among doctors having experience of more than 5 years