Comparison of efficacy and tolerability between sertraline and fluoxetine in patients with major depression

Aim of this study was to compare the efficacy and tolerability between Sertraline and Fluoxetine to determine suitable treatment of major depression in Pakistani population. This study was conducted in the outpatients department of psychiatry, Jinnah Postgraduate depressive disorder were selected. Two groups A1 and A2 were made of 50 patients each. Group A1 received Tab Sertraline while Group A2 received Cap Fluoxetine daily for 24 weeks after going through screening tests and diagnostic evaluation. Efficacy was evaluated by using 21 item Hamilton Depression Rating Scale [HDRS] and 20 item Self Reporting Questionnaire [SRQ]. The patients were asked to attend the OPD every 15 days. Side effects and compliance of the patients was noted at each visit. The results showed that both groups showed significant improvement in depression from week 0 to week 24 with minimal adverse effects. Compliance of the patients in both groups was good. Although HDRS and SRQ scores were significantly reduced in both groups, it was noted that Tab Sertraline improved the symptoms earlier than Cap Fluoxetine. It can be concluded that both sertraline and fluoxetine are efficacious in major depression causing few adverse effects but because sertraline improves symptoms earlier and it is cost effective it may be preferred to fluoxetine

Age and gender related frequency of cancer in chronic cholelithiasis

To find out age and gender related frequency of cancer of the gall bladder in patients with chronic cholelithiasis. Descriptive case series. PNS Shifa Hospital Karachi for a period of 12 months. A total of 153 patients were inducted in the study who were suffering from chronic cholelithiasis and carcinoma [Ca] gall bladder. The diagnosis was confirmed by various laboratory and radiological methods. After surgical intervention the positive cases were referred to the oncologist who monitored and assessed them accordingly. Twenty-four patients had Ca Gall bladder. The youngest patient was 40 years of age and oldest of 70 years with an average of 54.8 years. The male to female ratio was 1:2. Preoperative diagnosis was made only in 4 patients. Frequency of carcinoma gall bladder peaked after 60 years in males while in females it peaked after 40 years. Although chronic cholelithiasis is predominantly a female disease but if present in males then chances of cancer is higher especially after the age of 60 years

Incidence of colorectal carcinoma: is there a "shift to the right"?

This study was carried out in Department of Pathology, Basic Medical Sciences Institute, Jinnah postgraduate Medical Center, Karachi over a period of five years. 124 cases of colorectal adenocarcinoma were studied with respect to age, gender and location. Relationship of these variables to each other was also analyzed. Patients with an age range of 10 - 80 years were divided into different age groups. Most of the patients were in 41 - 60 years age group [55; 44.5%]. Gender distribution revealed male predominance with a male to female ratio of 2.54:1. Incidence of colorectal cancer in both the male and female patients is more in 41 - 60 years age group. Relationship of location of tumor to age and gender reveal a male predominance in all the locations with highest number of both male and female patients, [59; 47.6%] seen the in rectum in 21 - 40 years age group [44; 40.7%]. Tumors in distal locations are much more common in this study than tumors in proximal subsites indicating that no 'shift to the right' is seen. In conclusion, incidence of colorectal carcinoma is more in young patients less than 60 years of age with a male predominance and a distal location specifically the rectum

Niacin is a major drug for lowering LDL-Cholesterol

Objective: Study was planned to examine the effects of Niacin [Vitamin B-3] on serum LDL Cholesterol levels

Patients and Methods: Study was conducted at department of Pharmacology, Basic Medical Sciences Institute [BMSI], Jinnah Postgraduate Medical Centre [JPMC], Karachi, from January 2002 to July 2002. Forty hyperlipidemic patients were included, among which 20 patients were on placebo as control group and 20 were on tablet Niacin, 2 gram daily, in divided doses for a period of three months. Patients with diabetes mellitus, peptic ulcer, renal disease, hepatic disease, hypothyroidism and alcoholism were excluded from the study. Serum LDL-cholesterol was calculated by Friedwald formula [LDL-Cholesterol Total Cholesterol-[Triglycerides/5 +HDL-Cholesterol] described by Delong et al [1986] and Beamount et al [1970]. Data were expressed as the mean +/- SD and "t" test was applied to determine statistical significance of the difference. A probability value of <0.05 was the limit of significance

Results: Three patients were dropped from the study due to side effects of Niacin. Niacin decreased the levels of LDL-Cholesterol froml82.58+/-8.74 mg/dl to 119.29+/-4.08 mg/dl, which was highly significant [p<0.001], when compared statistically by paired "t" test. Overall percentage [%] changes from day-0 to day-90 were -34.66

Conclusion: Niacin decreases the risk of CHD by decreasing LDL-Cholesterol