Anti-Alzheimer and Antioxidant Effects of Nelumbo nucifera L. Alkaloids, Nuciferine and Norcoclaurine in Alloxan-Induced Diabetic Albino Rats.

The present study is aimed to determine the efficacy and dose response of the nuciferine (1), norcoclaurine (2) and crude extract of Nelumbo nucifera in managements of diabetes, Alzheimer disease and related allergies. Experimentally, alloxan (100 mg/kg body weight (b.w.))-induced diabetic rats (200−250 g) were divided into seven groups (n = 6). Group I: normal control, Group II: diabetic control, Group III: standard treated with glibenclamide and Group lV-VII: treated with methanolic crude extracts (100, 200 mg/kg), nuciferine and norcoclaurine (10 mg/kg b.w.) for 15 days. Different tests were performed, including blood glucose, body weights and antioxidant enzyme assays, i.e., superoxide dismutase (SOD), catalase test (CAT), lipid peroxidation assay (TBARS), glutathione assay (GSH) and acetylcholinesterase (AChE) assay. Nuciferine and norcoclaurine significantly reduced blood glucose (p < 0.05) and restored body weight in diabetic rats. Moreover, nuciferine and norcoclaurine (10 mg/kg) significantly recovered the antioxidant enzymes (SOD, CAT, GPx and GSH) which decreased during induced diabetes. Significant increase in TBARS was also observed in the diabetic group and nuciferine as well as norcoclaurine (10 mg/kg) inhibited the increase in TBARS in diabetic animals (p < 0.05), as compared to glibenclamide. AChE activity was significantly recovered by nuciferine and norcoclaurine (10 mg/kg) both in the blood and brain of the diabetic group (p < 0.05). Nuciferine and norcoclaurine showed potent inhibitory effects against α-glucosidase and α-amylase with IC50, 19.06 ± 0.03, 15.03 ± 0.09 µM and 24.07 ± 0.05, 18.04 ± 0.021 µM, as confirmed by molecular docking studies. This study concludes that nuciferine and norcoclaurine significantly improve memory and could be considered as an effective phytomedicine for diabetes, Alzheimer's disease (AD) and oxidative stress.

Common trend of antibiotics usage in a tertiary care hospital of Peshawar, Pakistan.

BACKGROUND: Antibiotics are used to eradicate the pre- and postoperative infections in surgical procedures and in all others medical cases. However, inappropriate and indiscriminate use of antimicrobial agents can potentially have a number of problems. The emergence of antimicrobial resistant bacteria, an increased number of patients experiencing adverse drug events, and increased drug-related cost have been documented. The objective of the study was to determine the trend of use of antibiotics and hospitalisation of patients in various units of a tertiary care hospital, to investigate practice variation of antimicrobial agents within the hospital, and to identify and document any opportunity for its improvement. METHODS: A questionnaire containing relevant information about the study was prepared. Patients' age, sex, diagnosis, duration of hospital stay and type of antibiotic used were recorded and analysed, with particular reference to antibiotic group and disease pattern, in 3 different treatment areas of Hayatabad Medical Complex (HMC), Peshawar, Pakistan, from July 2006 to June 2007. RESULTS: During the period under report, a total of 519 patients were studied for their disease and the type of antibiotics used. The leading type of antibiotics reported were 3rd generation antibiotic used on 147 (28.33%) patients in the 3 units collectively, 1st generation 127 (24.47%), and penicillin 99 (19.08%), while macrolides were the least used. CONCLUSION: The available resources are needed to be effectively utilised, to minimise the hospital stay due to rational use of antibiotics, and to minimise burden of antibiotics on poor patients.

Validaty of Siriraj Stroke Scoring.

OBJECTIVE: To study the sensitivity and specificity of Siriraj Stroke Scoring (SSS) and to validate the accuracy of SSS in acute supratentorial stroke syndromes. DESIGN: Noninterventional descriptive study. PLACE AND DURATION OF STUDY: Department of Neurology, Pakistan Institute Of Medical Sciences, Islamabad, and Department of Medicine, Federal Government Services Hospital, Islamabad, from July to December 2000 and February to July 2002, respectively. SUBJECTS AND METHODS: One hundred (100) consecutive cases of acute supratentorial strokes were studied in accordance with SSS and sensitivity and specificity of SSS for supratentorial infarction and haemorrhage was tested against the computerised brain scanning (CT) as a gold standard. Siriraj Stroke Scoring was applied. Patients with subarachnoid haemorrhage and transient ischemic attacks were excluded from the study. The findings were recorded, compared and statistically analyzed. RESULTS: Out of 100 patients 45 were male and 55 female with mean age of 59 years. Sixty-two patients had hypertension, 36 patients had one or more atheroma markers (diabetes, coronary artery disease and claudication). Mean diastolic blood pressure was 98 mmHg with range of 60-140 mmHg and mean systolic blood pressure of 163 mmHg with the range of 90-240 mmHg. Forty-eight patients had cerebral infarction, 36 had cerebral hemorrhage while 16 were borderline cases on the basis of Siriraj stroke scoring. CT brain showed 56 and 39 patients had cerebral infarction and haemorrhage respectively while 5 of CT scans were normal. The sensitivity and specificity of SSS for cerebral infarction was 71 and 85 respectively and for intracerebral haemorrhage, it was 73 and 90 respectively. The positive predictive values of SSS for cerebral infarction and haemorrhage were 87% and 83 respectively. CONCLUSION: The siriraj stroke scoring system is a valid and specific scoring system for the diagnosis of acute supratentorial stroke and intracerebral haemorrhage.