Effect of diabetes on neurological adverse effects and chemotherapy induced peripheral neuropathy in advanced colorectal cancer patients treated with different FOLFOX regimens

This retrospective study reports impact of diabetes on incidence rate of dose limiting symptoms of neurological toxicity and chemotherapy induced peripheral neuropathy [CIPN]. Post-surgical colorectal cancer [CRC] patients with metastatic disease, treated with four different schedules of FOLFOX were included in this study. Neurological adverse effects were assessed by CTC v2.0. The incidence rate of adverse neurological symptoms in CRC patients, clinically diagnosed with diabetes [n=6] were compared with non-diabetic CRC patients [n=32]. The results show that the difference in the incidence rate of paresthesia is significant [p=0.043] between diabetic and non-diabetic patients. The difference in the incidence rates of hypoesthesia [p=0.445], peripheral neuropathy [p=0.889], dizziness [p=0.445], insomnia [p=0.690], taste disturbances [p=0.258], and headache [p=0.498] in diabetic and non-diabetic CRC patients was not significant. The findings indicate that risk of frequent, distal and transient paresthesia within the first few minutes of Oxaliplatin infusion is higher in diabetic CRC patients

Sensitivity pattern of ceftriaxone against different clinical isolates

Emerging resistance against broad-spectrum antibiotics for standard empiric therapy is a global concern. Ceftriaxone [broad spectrum, third generation cephalosporin] is widely used in tertiary care settings to treat severe bacterial infections usually non-responsive to other antibiotics. The aim of the study is to evaluate the current sensitivity pattern of ceftriaxone [30micro g/disk] among different clinical isolates. For this purpose, three hundred clinical isolates including Escherichia coli [25%], Staphylococcus aureus [30%], Salmonella typhi [17%] and Klebsiella pneumoniae [20%] were collected from different pathological laboratories of Karachi, Pakistan. The in-vitro sensitivity of different Gram positive and Gram-negative bacteria was determined by disk-diffusion technique using 0.5 McFarland standard. Results showed that ceftriaxone was highly sensitive against Escherichia coli [90%] and least sensitive against Klebsiella pneumoniae [65%]. It is concluded that the sensitivity of ceftriaxone is progressively decreasing in comparison with past studies creating an alarming situation. Therefore, continuous surveillance is required to determine the current resistance status of clinical pathogens and for effective anti-microbial therapy

Adverse effects on cardiovascular status and lipid levels of albino Wistar rats treated with cisplatin and oxaliplatin in combination with 5 Fluorouracil

The study was designed to comparatively assess direct damages on cardiac tissues and aorta associated with abnormalities in lipid profile and cardiac biomarkers induced by two platinum cytotoxic compounds with and without 5FU [5Fluorouracil] in rats

Albino Wistar rats were treated with 5FU [15mg/kg], cisplatin [0.8mg/kg] and oxaliplatin [0.8mg/kg] in different dosing schedules. The changes in the lipid levels, CPK and Tropinin I levels, following treatment with single and combination schedules of CDDP, 5FU and Oxaliplatin were compared with the control group maintained on normal saline. Changes in LDL and cholesterol levels were highly significant in cisplatin and oxaliplatin treated rats. Myofibrillar loss and vascular wall thickening was seen in cisplatin treatment groups in the acute model of toxicity

The damages were mild but progressive. Tropinin I levels were raised well above diagnostic risk levels in the delayed model of toxicity in the rats treated with oxaliplatin in combination of 5FU, indicative of definite cardiotoxic potential of oxaliplatin in combination of 5FU mimicking the FOLFOX regimen

In-vitro susceptibility of levofloxacin against different clinical isolates

Background: Levofloxacin is a broad spectrum quinolone, widely used to treat infections caused by gram negative and gram positive bacteria. Development of resistance by pathogens against different broad spectrum antibiotics is increasing and now becoming a global issue

Objectives: The aim of the study is to evaluate the current sensitivity pattern of levofloxacin against various common clinical isolates like Escherichia coli, Staphylococcus aureus. Pseudomonas aeruginosa and Klebsiellapneumoniae

Methods: A total of one hundred and ten samples were collected from different pathological laboratories of Karachi, Pakistan. The above mentioned pathogens were isolated from blood, stool/urine, sputum, skin samples

Results: Results show least resistance of levofloxacin against Ecoli [27.5%], and P.aeruginosa [27%], while S.aureus possessed highest resistance [45%]

Conclusion: Study concluded levofloxacin still possesses excellent anti-microbial activity against common pathogens. Routine monitoring and surveillance is further required to ensure effective treatment regimens to community

Comparative cardiac toxicity in two treatment schedules of 5-FU/LV for colorectal carcinoma

The purpose of the study is evaluation and assessment of parameters of cardiac toxicity in patients subjected to 5-FU based chemotherapy. Cardiac morbidity is a reported outcome in different 5FU/LV regimens; however none of them are definite or proximate. The bimonthly regimen of high dose leucovorin is reported to be less toxic and more effective as compared to the monthly regimen of low dose leucovorin. We report the detailed assessment of few cardiac parameter of toxicity in patients of advanced colorectal carcinoma subjected to two Schedules of high and low dose Folinic Acid, 5-Fluorouracil, bolus and continuous infusion. The correlation of elevated cardiac biomarkers, angina and hypertension is comparatively assessed in patients with normal general status, hyperglycemia and known cardiac disorders subjected to two different 5FU based chemotherapeutic regimen

Irrational drug use based on self medication for some common clinical conditions in an educated population of Karachi

To assess the irrational treatment approach for some common clinical conditions by females in higher educational institutes of Karachi, Pakistan. The study was conducted in two private sector institutes for higher education in Karachi from Jan 2011-June 2011. A pretested questionnaire containing open-ended and closeended items was administered to female students and teachers. The tendency to self diagnose and self medicate [63.78%] is more than seeking appropriate medical treatment [36.21%]. The most common condition treated by self medication is Headache [96.52%] and the most common condition in which appropriate medical treatment sought, is Respiratory infection[58.70%].Self medication is also reported in fever [80%], GI infections [61.30%], menstrual pain [73.91%], allergies [72.61%], cough [71.30%], minor cuts/wounds [85%] and [54.57%] in anemia/fatigue and general weakness. Irrational drug use of OTC medicines and antibiotics commonly prevail in the educated population instigating the abuse potential and relative hazard. Effective regulation, control and pharmacovigilance in line with core intervention policies of WHO is required

Assessment of self medication in female university students of pharmacy and medicine- a prevalence study

To evaluate the tendency, incidence, relevant awareness, attitude and practice of self-medication in female students of pharmacy and medicine. Self medication is a common trait in those students who are studying medicine, pharmacy or other health sciences. Socio economic features, lifestyle status and awareness about the indications of the medicine are direct factors that affect the practice of self medication. Observational Comparative Study. The study was conducted in three universities of Karachi, two institutes of pharmacy education and one institute of medical sciences from January 2011 to September 2011. A self-developed, pre-validated questionnaire containing open-ended and close-ended items was used for data collection. 460 female students [age 20-25] enrolled for study after informed consent and knowledge of the study purpose, filled in the questionnaire anonymously. The study based on 460 student shows that self-medication prevails for the OTC medicines [76.27%] and Prescription Only medicines [51.30%]. The use of minerals and vitamins by self medication is 54.5%. The most common reason for self medication shown in 306 count is "previous knowledge of drug use". The students of medical and pharmacy practice self medication to varying degree for both the OTC and Prescription Only medications. The easy access to medications promotes such practice, where as large expense of proper health care plays a pivotal role. This tendency with peril signifies the role of an effective and well regulated pharmaceutical care system with its essential components

Correlation of BMI with age and blood pressure in medical and pharmacy female students of Karachi, Pakistan

The study is designed to assess the prevalence of abnormalities in weight and blood pressure in educated females enrolled in professional degree programs of Pharm. D and M.B.B.S. BMI score less than 18.5[underweight] is more frequently reported in students of age 20 [9.8%] and 21 [10.9%] years. Obesity is also reported more frequently in students of age 20 [0. 70%] as compared to other age group. BMI score less than 18.5 [underweight] is seen in 39.8% female students within age group [16-32], whereas 3.90% students are overweight with a BMI score of 25-29.9. Obesity is reported in 2% students. There is no significant correlation between BMI and age within the age bracket 16-32 [p = 0.168]. Although most of the students were normotensive, low systolic B.P was reported in 31.73% and low diastolic B.P was noted in 26.73 students. Prehypertension was assessed in few students [systolic 19.3% / diastolic 10.8%]. Low blood pressure associated with BMI abnormalities are predisposing risk factors assessed in female students of child bearing age

Prevalence of depression in medical and pharmacy students in two private sector universities of Karachi, Pakistan

Depression is a debilitating psychological condition in young people which can affect their growth, health and performance laying profound effects on their quality of life. The objective of the study is to assess the degree of depression with feature specifications and diurnal variations in medical and Pharm. D students in two private sector universities of Karachi, Pakistan. Severity of symptoms was more frequently assessed as psychological anxiety [9.3%] than somatic anxiety [1.3%]. General feeling of wellbeing was distorted in 57.2% students with varying degrees of severity. The psychogenic condition implicated the quality of sleep [19.6%] and latency of sleep [34.3%]. Appetite was affected adversely in 23.3% students with mild symptoms, whereas 5% reported severity of symptoms. Severity of symptoms was majorly assessed in late insomnia. We concluded that the symptoms of depression in young individuals were fairly common with both psychogenic and somatic feature specifications

therapeutic role of magnesium in different depressive syndromes of female patients

Numerous studies have proven that low levels of B vitamins, vitamins C and magnesium have been associated with depression. These all help in the brain's production of neurotransmitters and may enhance the effectiveness of antidepressant medications. Calcium and magnesium have a soothing effect on the nerves and can be particularly helpful when depression interferes with sleep. Previous studies have shown that there are depleted magnesium levels in the depressed patients. The present study is based on the finding that magnesium supplements can reduce the signs and symptoms of depression. In this experiment behavioral and somatic features were evaluated such as agitation, guilt feeling, psychomotor retardation, insomnia, anxiety, weight loss, hypochondria which are the hall marks of clinical depression. The female subjects who were diagnosed with clinical depression and premenstrual dysphoric disorder were treated with daily dose of 360 mg. of magnesium. Depression was evaluated for three months. Nearly all the female patients responded positively to the magnesium therapy with elevation of mood, relaxation and sleep duration

Comparison of potential renal solute load [PRSL] in healthy breastfed and non breastfed infants

Background: In our society due to some social and cultural beliefs many mothers deprive their infants from the benefits of breast feeding. The infants are fed cow milk/buffalo milk purchased from the market. The infant formula milk is very costly and it is not possible for an average family to afford formula milk for an infant. The milk of cows and buffalos is having three times more proteins and 3-4 times more minerals as compared to the human milk. By feeding the milk of cow or buffalo/infant formula, the infant is being loaded with more proteins and minerals, which can lead to high PRSL and high concentration of serum minerals

Study Design: This is a descriptive and cross-sectional study which has been conducted on infants up to the age of6 months being fed either mothers' milk, infant formula or cow/buffalo milk. Sample Size: A total sample of one hundred and fifty infants up to the age of 6 months was selected. The sample was divided into three groups of fifty infants in each group. Group-I: Infants on Formula Milk. Group II: Infants on Mother Milk. Group III: Infants on Cow/Buffalo Milk

Place of Study: The study was conducted in outpatient department of the Children's Hospital and the Institute of Child Health, Lahore after due permission from concerned authorities

Results: The serum levels of BUN, urea, sodium, potassium, phosphorus, chloride and PRSL were all significantly low in breast-fed infants as compared to the infants on bottle feeding taking infant formula or cow/buffalo milk

Conclusion: The present study has clearly highlighted that "Mother's Milk is the best milk". By feeding the milk of cow or buffalo/infant formula, the infant is loaded with more proteins and minerals, which can lead to high PRSL and high concentration of serum minerals. The effects of these components may not be visible immediately but may have consequences in later life