Illicium verum anticancer activity against MDA-MB-231 cell line.

Objective: To evaluate the anticancer activity of methanolic extract of Illicium verum against triple-negative breast cancer MDA-MB-231 cell line. Methods: A cell culture experimental study was carried out at Pharmacology department of Bahria University Medical and Dental College (January to June 2021) in collaboration with Aga Khan University, Karachi, Pakistan. Cell viability and proliferation assays were used to quantify dead and alive cells by utilizing a tetrazolium assay and an enzyme immunosorbent plate reader was used to calculate their absorbance. For the apoptosis initiation assay, these cells were dyed with a fluorescent stain and observed for fluorescence and apoptosis. During cell viability testing, various I. verum methanolic extract doses (0.125, 0.25, 0.5, 1, 3, 6, 12, and 25µg/ml) were employed to treat MDA-MB-231 cells, while the IC50 dose of 2.8µg/ml was used for both the cell proliferation and apoptosis initiation assays. Results: In the cell viability assay, all I. verum methanolic extract doses exhibited a substantial decrease in the viability of MDA-MB-231 cells (less than 0.01 p-value). In cell proliferation assay and apoptosis initiation, the IC50 dose of 2.8µg/ml of I. verum methanolic extract also exhibited a substantial decrease in cell division (less than 0.01 p-value) and the initiation of apoptosis in MDA-MB-231 cells. Conclusion: Illicium verum methanolic extract have strong anticancer activity against triple-negative breast cancer MDA-MB-231 cell line through cytotoxicity, proliferation reduction, and apoptosis initiation mechanisms.

Anticancer effect of Illicium verum (star anise fruit) against human breast cancer MCF-7 cell line.

Objective: To investigate the anticancer effect of Illicium verum against human breast cancer MCF-7 cell line. Methods: An experimental study was conducted in Multidisciplinary and Tissue Culture Laboratory, Aga Khan University in collaboration with Pharmacology Department of Bahria University Medical and Dental College, Karachi, Pakistan from January 2021 to June 2021. MCF-7 cells of Luminal-A breast cancer were seeded in 96-well plate and treated with I.verum methanol extract. After incubation, MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) dye was used for cell viability and cell proliferation assays to determine the number of dead and viable cells, and the absorbance was measured using an enzyme-linked immunosorbent assay (ELISA) plate reader. In cell viability assay, different doses of I. verum methanol extract were used to treat the MCF-7 (0.25, 0.5, 1, 3, 6, 12, 25, and 50µg/ml) cells. For apoptosis analysis, the cells were processed with 4´, 6-diamidino-2-phenylindole fluorescent nuclear dye (DAPI) and were examined for fluorescence intensity and apoptotic cells. For cell proliferation assay and apoptosis the IC50 dose of 5.5µg/ml I. verum methanol extract was used. Results: The MCF-7 cells showed a significant reduction (p-value <0.01) in cell viability in the presence of all tested doses of I. verum methanol extract, except for the dose of 0.25µg/ml. The IC50 dose 5.5µg/ml of same extract also showed a significant reduction (p-value <0.01) in cell proliferation and apoptosis induction in MCF-7 cells. Conclusions: Illicium verum methanol extract possesses very potent anticancer action against MCF-7 cells through cytotoxicity, reduction, and inhibition of cancer cells and by inducing apoptosis.

Sound: Production, perception, hearing loss and treatment options.

Sound is an important communication tool for humans that contain information about the surrounding environment. It may signify a danger or a reward for an organism. In humans, the mechanism of sound production and perception is complex and sophisticated. Sound is produced by vibrating body in a medium that contains molecules in the surrounding space. The sound perception starts in the human foetus at around the third trimester where it plays a vital role in organising the foetal brain. This process continues after birth and can be exploited by various endogenous and exogenous factors. Many mechanisms that can modulate hearing process at different levels lead to subclinical or clinical presentation of hearing-related problems. It is important to contemplate the mechanisms underlying sound production, perception and pathogenesis of hearing loss. This will facilitate prescribing a relevant treatment option according to the cause and its underlying mechanism. The current narrative review was planned to focus on sound production, its perception, types of hearing loss and available treatment options vited in relevant literature searched by using Google Scholar and PubMed.

Polycystic Ovarian Syndrome: Correlation between clinical hyperandrogenism, anthropometric, metabolic and endocrine parameters.

OBJECTIVE: To evaluate the correlation between clinical hyperandrogenism-hirsutism assessed by modified Ferriman-Gallwey (F-G) score, anthropometric, metabolic and endocrine parameters among PCOS infertile women. METHODS: This observational study after approval of FRC & ERC of BUMDC was conducted from September 2018-March 2019. It included seventy women aged 20-40 years who presented in infertility clinic of a local Hospital in Karachi. After written informed consent participants were enrolled as per the inclusion criteria of the study and evaluated for cyclical pattern (oligomenorrhoea, amenorrhoea, polymenorrhea), physical (weight, height, BMI), anthropometric, (waist circumference, hip circumference, waist to hip ratio, hirsutism), metabolic (carbohydrate, lipid & protein) and endocrine parameters (serum FSH, LH, LH/FSH ratio, serum testosterone, prolactin and progesterone level). Hirsutism was assessed by visual method through modified F-G score and Pearson correlation was determined between hirsutism and other study parameters. RESULTS: A positive Pearson correlation is found between hirsutism and body weight, BMI, waist and hip circumference, waist to hip ratio (WHR), very low density lipoprotein, cholesterol, triglycerides and testosterone levels. CONCLUSION: Hirsutism has correlation with anthropometric, metabolic and hyperandrgenic disorders in PCOS infertile women as assessed by modified F-G score.

Potential Drug-Drug Interactions among Patients prescriptions collected from Medicine Out-patient Setting.

OBJECTIVE: To identify and evaluate the frequency, severity, mechanism and common pairs of drug-drug interactions (DDIs) in prescriptions by consultants in medicine outpatient department. METHODS: This cross sectional descriptive study was done by Pharmacology department of Bahria University Medical & Dental College (BUMDC) in medicine outpatient department (OPD) of a private hospital in Karachi from December 2015 to January 2016. A total of 220 prescriptions written by consultants were collected. Medications given with patient's diagnosis were recorded. Drugs were analyzed for interactions by utilizing Medscape drug interaction checker, drugs.com checker and stockley`s drug interactions index. Two hundred eleven prescriptions were selected while remaining were excluded from the study because of unavailability of the prescribed drugs in the drug interaction checkers. RESULTS: In 211 prescriptions, two common diagnoses were diabetes mellitus (28.43%) and hypertension (27.96%). A total of 978 medications were given. Mean number of medications per prescription was 4.6. A total of 369 drug-drug interactions were identified in 211 prescriptions (175%). They were serious 4.33%, significant 66.12% and minor 29.53%. Pharmacokinetic and pharmacodynamic interactions were 37.94% and 51.21% respectively while 10.84% had unknown mechanism. Number wise common pairs of DDIs were Omeprazole-Losartan (S), Gabapentine- Acetaminophen (M), Losartan-Diclofenac (S). CONCLUSION: The frequency of DDIs is found to be too high in prescriptions of consultants from medicine OPD of a private hospital in Karachi. Significant drug-drug interactions were more and mostly caused by Pharmacodynamic mechanism. Number wise evaluation showed three common pairs of drugs involved in interactions.

Feto-maternal outcomes and Glycemic control in Metformin versus insulin treated Gestational Diabetics.

OBJECTIVE: To evaluate and compare feto-maternal outcomes and glycemic control in metformin versus insulin treated gestational diabetics. METHODS: The study was conducted in 2010- 2012 as a part of M. Phil at Civil hospital, Lyari General Hospital and Mamji Hospital in Karachi. After written informed consent, 71 GDM diagnosed females with WHO criteria were enrolled. They were divided into two groups. Group-A, 32 females were given oral metformin 500 mg TDS while Group-B, 39 females were given insulin 0.8-0.9 mg/kg/day in two divided doses subcutaneously. Patients were followed till term. Feto-maternal outcomes were evaluated in 25 patients in each group who completed the study. RESULTS: When groups were compared, newborns in Group-B were significantly more in weight (p=0.01). Significant numbers of babies were delivered after 38 weeks of pregnancy in Group-B (P=0.021). There were two intrauterine deaths and significantly higher HbA1C at term in Group-B. (P=0.03). FBS at term was non-significant (p=0.079) and there was more number of cesarean sections due to feto-maternal disproportion in Group-B (28% vs.2%). Results analyzed for glycemic control before and after the treatment revealed that FBS was statistically less in Group-A (p=0.00) whereas for Group-B the value of FBS and HbA1C was statistically high. (p=0.002 & 0.04 respectively). CONCLUSION: Metformin has produced better effects on feto-maternal outcomes and glycemic control in comparison to Insulin in GDM.

Effects of Diet and Metformin on placental morphology in Gestational Diabetes Mellitus.

OBJECTIVE: To evaluate the effects of diet control and Metformin on placental morphology in gestational diabetes mellitus (GDM). METHODS: After written informed consent 62 GDMs were enrolled. According to WHO criteria, 30 cases of GDMs with blood sugar level <130 mg/dl, were assigned Group B (2000-2500Kcal/day and 30 minute walk thrice weekly were kept on diet control and 32 cases of GDM with blood sugar level >130 mg/dl, assigned Group C were kept on diet with tablet Metformin,(500mg TDS) Finally 25 normal pregnant females were kept in Group A as control. After delivery placentae were preserved and evaluated for morphology. RESULTS: Heavy placentae with abundant villous immaturity, chorangiosis and syncytial knots in group B and fibrinoid necrosis and calcification in group C were seen. In group B versus A placental and cord width while in Group C versus A only cord width in gross morphology showed significant results. In group B versus A villous immaturity, chorangiosis, infarction and syncytial knots in light microscopy were present; similarly in B versus C placental width, chorangiosis and syncytial knots showed significant results, while in C versus A results were non-significant. CONCLUSION: Metformin produced beneficial effects on placental morphology being comparable to normal control in contrast to diet group.

Occupational lead toxicity in battery workers.

OBJECTIVE: To estimate blood lead level (BLL) and to assess the features of lead toxicity among lead acid battery (LAB) industrial workers. METHODS: This prospective study was carried out in the medical centre of PCSIR Laboratories, Karachi from March 2012 - March 2013. Fifty LAB industry workers, males and females between 17-65 years were included in the study. They were divided into group 1 with 40 workers- directly related and group 2 with 10 workers -indirectly related, (administration staff members) to LAB manufacture. Detailed history, complete physical examination and BLL estimation by flameless atomic absorption spectrophotometer was done. RESULTS: Total 34 patients in group 1 and 3 patients in group 2 had elevated BLL. Comparison of group 1 and 2 revealed anemia (40v/s4), bone pain (38v/s7), abdominal pain (38 v/s 2), nausea (32v/s6), head ache & irritability (24v/s6), weakness & lethargy (21v/s6), tremors (13v/s0) insomnia (5v/s4), lead line (4v/s 0) and blood pressure above 140/90 mm of Hg (12v/s0) respectively. CONCLUSION: High blood lead level and features attributable to lead toxicity were prevalent among LAB industry workers of Karachi.

Metformin treatment in type 2 diabetes in pregnancy: an active controlled, parallel-group, randomized, open label study in patients with type 2 diabetes in pregnancy.

AIMS: To assess the effect of metformin and to compare it with insulin treatment in patients with type 2 diabetes in pregnancy in terms of perinatal outcome, maternal complications, additional insulin requirement, and treatment acceptability. METHODS: In this randomized, open label study, 206 patients with type 2 diabetes in pregnancy who met the eligibility criteria were selected from the antenatal clinics. Insulin was added to metformin treatment when required, to maintain the target glycemic control. The patients were followed up till delivery. Maternal, and perinatal outcomes and pharmacotherapeutic characteristics were recorded on a proforma. RESULTS: Maternal characteristics were comparable in metformin and insulin treated group. 84.9% patients in metformin group required add-on insulin therapy at mean gestational age of 26.58 ± 3.85 weeks. Less maternal weight gain (P < 0.001) and pregnancy induced hypertension (P = 0.029) were observed in metformin treated group. Small for date babies were more in metformin group (P < 0.01). Neonatal hypoglycemia was significantly less and so was NICU stay of >24 hours in metformin group (P < 0.01). Significant reduction in cost of treatment was found in metformin group. CONCLUSION: Metformin alone or with add-on insulin is an effective and cheap treatment option for patients with type 2 diabetes in pregnancy. This trial is registered with clinical trial registration number: Clinical trials.gov NCT01855763.

Metformin versus insulin treatment in gestational diabetes in pregnancy in a developing country: a randomized control trial.

AIM: To compare treatment with metformin alone, metformin plus insulin and insulin alone in women with gestational diabetes (GDM). METHOD: A total of 150 gestational diabetic patients who fulfilled the eligibility criteria were included in this prospective randomized control open labeled study. A risk factor based screening was done followed by a GCT and then local GTT criteria from antenatal clinics. They were initially divided into two groups with odd numbers assigned to metformin treatment and even numbers to insulin treatment. Metformin and/or insulin treatment was given and target blood sugar levels aimed at FBS ≤ 100 mg/dl and postprandial levels ≤ 126 mg/dl. Supplemental insulin was added to metformin treatment group to maintain the glycemic targets if required. Patients were followed until delivery and maternal fetal outcomes and pharmacotherapeutic characteristics were recorded on a performa. RESULTS: Less maternal weight gain was found in the metformin treated groups (9.8 ± 1.5 kg [metformin alone] vs. 9.8 ± 1.4 kg [metformin plus insulin] vs. 12.5 ± 1.1 kg [insulin alone] P < 0.000). Preeclampsia was significantly less in metformin treated groups. There were no perinatal deaths in the study. Mean birth weight was significantly less in metformin treated groups (3.4 ± 0.4 kg vs. 3.3 ± 0.5 kg vs. 3.7 ± 0.5 kg P < 0.01). Less neonatal morbidity was observed in metformin groups. 42.7% of patients required supplemental insulin (mean dose of 13.6 ± 2 units) in the metformin group. Mean gestational age at which insulin was added was 31.8 ± 5.9 weeks. CONCLUSION: Metformin is an effective and cheap treatment option for women with gestational diabetes with or without supplemental insulin.

Effects of insulin on placental, fetal and maternal outcomes in gestational diabetes mellitus.

OBJECTIVE: To observe the effects of exogenous insulin on placental, fetal and maternal outcomes in Gestational Diabetes Mellitus (GDM). METHODS: After screening and diagnoses(WHO criteria) 30 GDM patients(Group A) were kept on diet control and 39 GDM (Group B) who did not achieve glycemic targets were added subcutaneous insulin. Term placental weight, size, shape, consistency, fibrinoid necrosis, hemorrhages, cord color, length of the cord, completeness of membranes, weight and condition of baby and mode of delivery were assessed in 25 patients in each group. RESULT: Placental weight, cord width and baby weight were found to be more in Group B, than Group A and were statistically significant with p value 0.005, 0.02 and 0.003 respectively. Ten patients in group A and 17 patients in group B had cesarean deliveries. CONCLUSION: Exogenous insulin produces significant effects on the placental, fetal and maternal outcomes in patients with GDM.

Association of literacy of mothers with malnutrition among children under three years of age in rural area of district Malir, Karachi.

OBJECTIVE: To determine the association of literacy of mothers with malnutrition among children under three years of age in rural area of district Malir, Karachi. METHODS: A cross-sectional study was conducted on four hundred children under three years of age, residing in the rural area of district Malir, Karachi. The selection of the children was irrespective of gender, ethnicity and religion. RESULTS: Three hundred nineteen mothers (79.75%) were illiterate and 81 (20.25%) were literate. In the latter group, three mothers could read or write only, 38 had primary, 10 middle, 15 matric, 12 intermediate and 3 mothers had education up to graduate level. Maximum malnutrition regarding stunting (40.75%) was seen in children who's mothers were illiterate and maximum underweight (57.89%) was seen in children who's mothers had education up to primary level and maximum wasting (33.33%) was seen in children who's mothers (only 3 mothers out of 400) were graduates. There was a significant difference regarding underweight between the children who's mothers were illiterate or had education up to primary level in comparison to the children who's mothers had education to more than primary level (P<0.016), but in significant difference regarding stunting and wasting was found. Overall a total of 217 (54.25%) children were underweight, 156 (39%) were stunted and 86 (21.5%), had wasting. CONCLUSION: Mother's literacy status has a definite association with the malnutrition of the children <3 years of age regarding underweight. In order to combat this an uplift of mother's literacy status is badly needed especially in the rural areas.