Liraglutide in diabetes mellitus: more facts and findings

Liraglutide exert favorable effects on most of the diabetes associated cardiovascular [CV] risk factors and this study was designed to further explore the benefits of liraglutide by observing its effect on plasma sialic acid [PSA] in diabetic rats. A total of 30 streptozotocin induced [50mg/Kg; i. p] diabetic rats were randomized into vehicle treated [1 ml/Kg s.c, twice daily] group I, liraglutide treated groups II and III [30 micro g/Kg and 150 micro g/Kg, twice daily respectively] and studied for 6 weeks. Liraglutide treated groups showed significant reductions in fructosamine levels [p

Frequency of peptic ulcer perforation during fasting and without fasting

Objective: To find out the frequency of peptic ulcer perforation during fasting in the month of Ramadan with non-fasting during other months

Study design: Descriptive case series

Place and duration of study: Department of Surgery Ward-3 Jinnah Postgraduate Medical Center Karachi, from January 2005 to November 2014

Methodology: The data of 220 patients who were operated due to peptic ulcer perforation, was analylsed. Patients were divided into 2 groups. Group I [n= 139] included patients who were operated in the months other than Ramadan, while group II [n= 81] included patients who were operated during the month of Ramadan. The patients of peptic ulcer due to malignancy were excluded

Results: Of the total there were 209 male and 11 female patients. Age range was 12 year to 65 year. Most of the patients [n=178 - 85%] were between 20 year to 50 year of age. Frequency of perforation was highest in Ramadan then in Shawal month and was less in other months of the year. On average patients with peptic ulcer in Ramadan were 8.1 and in non-fasting months 1.2

Conclusion: The frequency of perforation in peptic ulcer disease was higher in Ramadan month during fasting state as compared to other months of the year

In vitro biological activity of decoction of Joshanda

Joshanda is a polyherbal product, commonly practicing in inflammation of upper respiratory tract as tea. The present study was conducted to find out its antimicrobial, phytotoxic, leishmanicidal and cytotoxic activities. The decoction of the product showed profound activity against Gram positive tested pathogens especially S. aureus 36.5 mm zone of inhibition at 8.0 micro g/ml. However, it was inactive against C. albicans. Closed correlation was observed between two methods in terms of results. It had potent phytotoxic activity [75%]. However, it was devoid of any activity leishmanicidal and cytotoxic activity. Phytochemical studies of Joshanda showed the presence of various pharmacologically active groups

Cellular and genomic toxicity produced by UV light in Chinese hamster ovary cells

UVB and UVC toxicity was detected in Chinese Hamster Ovary [CHO] cell lines AA8, UV5 and XEM2 [a V79-derived cell line expressing rat P 450 1A1]. Unlike FICZ-HPLC assay that showed induction of CYP1A1 enzyme activity after 20 minutes and 2 hour UVC exposure, the EROD assay showed no difference in cytochrome P450 1A1 [CYP1A1] activity after exposure to different doses of UVB and UVC light. Different cytotoxic and mutagenic effect of photo lesions induced by UVC and UVB light was investigated with the DRAG and HPRT assays, comparing the wild type cell line AA8 and the Nucleotide Excision Repair [NER] deficient cell line UV5. DRAG assay showed a significant difference in UV induced cytotoxicity between UVC and UVB reflecting the larger energy and toxic effect of UVC along with significant difference in UV induced toxicity between AA8 and UV5 cell lines. This was further validated through the HPRT assay, which also showed a significant difference in UVC [5 J/m[2]] induced mutagenic effect between these cell lines. In addition, HPRT assay showed the mutagenic effect of photosensitizer, acetophenone. These results show that UVB and UVC generate serious damage through photo products on DNA, and might induce the metabolic activity of CYP1A1

Efficacy of cervicothoracic sympathectomy versus conservative management in patients suffering from incapacitating Raynaud's syndrome after frost bite

Raynaud's syndrome is a known complication of cold injuries. Stress, smoking and metabolic diseases may further aggravate the disease course. The purpose of this study was to determine the efficacy of Cervico-thoracic sympathectomy as compared to conservative management in severe Raynaud's syndrome after frostbite. This non-randomized controlled trial was conducted at Railway Hospital, Rawalpindi and Islamic International Medical Complex, Islamabad between January 1999 and June 2006. All patients sustained severe cold trauma in the mountain ridges of Himalayas in Kashmir. In all cases, an informed consent was obtained from patients and families. All operations performed were free of charges. Out of the total 48 patients who developed incapacitating Raynaud's syndrome of the upper limbs after frost bite, 17 patients underwent thoracic sympathectomy through anterior supraclavicular route. Remaining 31 patients were treated conservatively and were placed in the control group. Data was collected on pre-designed proforma and assessed using SPSS [version 11]. Chi-square test was applied to assess the effectiveness of the two treatment modalities. All operated cases initially showed improvement in symptoms and incapacitation. Among sympathectomised patients, 11 patients became symptom free and 3 patients showed mild but improved symptoms. Two patients after initial transient improvement developed incapacitating symptoms requiring further treatment, one patient developed gangrene of distal phalanx nine month after sympathectomy requiring amputation of the finger. Frequency of attacks and duration between the attacks reduced in all operated patients of cervical sympathectomy [p<0.05] as compared to conservative management. Cervical sympathectomy is a very effective modality of treatment in patients having severe Raynaud's disease of upper limbs secondary to frost bite

Transient ischaemic attacks due to a pulsating mass in the neck produced after incision and drainage of parapharyngal abscess

Carotid endarterectomy is the most commonly performed vascular surgical procedure. One of the complications of carotid endarterectomy is Pseudoaneurysm of the carotid artery frequently managed by endo-vascular technique. Pseudoaneurysm caused by other aetiological factors is rare entity. Penetrating trauma and neck surgery are known but very rare causes of pseudo aneurysm of the carotid artery. We have successfully managed a case of carotid artery pseudoaneurysm caused by incision and drainage of parapharyngeal abscess. This surgery also leads to the palsy of right vagus nerve causing complete hoarseness of voice. The patient presented with Transit Ischaemic Attacks [TIA] and amurosis fugos. Resection of aneurysm and reconstruction of right carotid artery lead to complete recovery. Vocal cord palsy was managed by Vox implant injection leading to full recovery