Promising role of Metformin in reducing the viability of breast cancerous cells.

To evaluate the anticancerous effects of different dilutions of metformin were evaluated for in vitro anti-cancerous effects, primarily breast cancer cells (MCF-7, MDA-MB-231). This prospective experimental study was conducted in Department of Pharmacology & Therapeutics BMSI in alliance with PCMD. The duration of study was from March 2016 to February 2017. For evaluating the anticancerous effects of different dilutions of Metformin (0.5µM -100µM) we used 4 different cancerous cells lines; MCF-7, HT-29, MDA-MB-231 and Hela. For assessment of anticancerous effects we used MTT assay by which assessed IC50, SI, % viability of all cells and Trypan blue exclusion assay for only MCF-7 cell line. The % viability of MCF-7 was significantly decreases (χ2 (2) = 26.48, p=<0.001) in dose dependent manner from 99.8±0.2 to 39.71±1.3. For MDA-MB-231% viability significantly reduced (χ2 (2) =26.48, p=<0.001) from 99.474± 0.298 to 51.55±4. However Metformin had statistically no significant dose dependent effects on % viability of MCF-10 (χ2 (2) = 11.709, p=0.069). Metformin significantly exhibited the anticancerous effects on breast cancerous cells by selectively target the cancerous cells without any effects on normal epithelial cells of breast.

Atorvastatin as an adjuvant with betamethasone valerate reduces disease severity and cardiovascular risks in Psoriasis.

OBJECTIVES: To evaluate the effect of Atorvastatin as an adjuvant with betamethasone valerate on disease severity and cardiovascular risks in chronic plaque type psoriatic patients. METHODS: It is an interventional study conducted in Pharmacology Department of BMSI, JPMC with the collaboration of Dermatology Department of JPMC, Karachi. The duration of study was from June 2013 to June 2016. Seventy five psoriatic patients were prescribed Tablet Atorvastatin 40-20 mg/day (40mg for first three months twice daily followed by 20mg once daily for the next three month) plus topical Betamethasone Valerate 0.1% once daily for 6 months (three week apply than one week interval). The efficacy and safety profile of drugs was measured by PASI, DLQI, hsCRP, LFTS and Lipid profile. RESULTS: The percentage change of PASI is 86.749±0.547, DLQI is 82.697±.2.61 and hsCRP is 40.371±8.505, which showed highly significant improvement in patient at the end of last follow up. LFTs and CPK for safety profile of therapy showed non-significant results. CONCLUSION: Atorvastatin used as an adjuvant therapy with currently existing standard therapy (topical betamethasone) in patients having mild to moderate plaque type psoriasis reduces disease severity and cardiovascular risks.

Successful Management of a Large Orbital Hemangioma in an Infant: A Case Report.

Orbital hemangiomas are benign vascular tumors commonly affecting infants and young children, often manifesting with proptosis, eyelid swelling, or discoloration. Propranolol has emerged as the primary therapy due to its efficacy in promoting regression and minimizing complications. Here, we present a case of a previously healthy six-month-old male infant with progressive right eyelid swelling and discoloration. Magnetic resonance imaging confirmed a large orbital hemangioma. The patient was referred to an ophthalmology center where treatment with propranolol resulted in substantial improvement. Early recognition and initiation of propranolol therapy are crucial in managing orbital hemangiomas in pediatric patients. This case underscores the successful outcome achievable with pharmacologic intervention and emphasizes the importance of long-term follow-up for monitoring and optimizing patient outcomes.

A Case Report of Hemorrhagic Cavernoma Masquerading as a Thrombosed Aneurysm.

Cavernous malformations are vascular lesions characterized by dilated blood vessels with minimal intervening brain parenchyma. Although often asymptomatic, they can present with seizures, headaches, or neurological deficits. Accurate diagnosis relies on magnetic resonance imaging, with characteristic features such as a "popcorn" appearance. We present a case of a 45-year-old male with chronic headaches and seizures who underwent an extensive work-up. Initial magnetic resonance imaging suggested a thrombosed aneurysm, with subsequent cerebral angiography being unremarkable, supporting the final diagnosis of a cavernous malformation. Conservative management, initiated for asymptomatic lesions, led to effective seizure control and improved quality of life. This case underscores diagnostic complexities in neuroradiology, emphasizing the need for careful consideration of differentials when faced with unexpected imaging results. Clinicians must remain vigilant for alternative explanations, recognizing the dynamic nature of optimal strategies in neurovascular medicine.

Assessment of Knowledge and Attitudes Toward Palliative Care and End-of-Life Decision-Making in Saudi Arabia: A Cross-Sectional Study.

BACKGROUND: Palliative care in Saudi Arabia has witnessed significant recent progress through the establishment of the Saudi Society for Palliative Care and the National Palliative Care Program. The objective of this study was to assess knowledge and attitudes regarding palliative care and end-of-life decision-making in Saudi Arabia's Eastern and Central provinces among individuals residing in these regions. METHODS: Utilizing a cross-sectional survey-based research design, we assessed knowledge and attitudes regarding palliative care and end-of-life decision-making in Saudi Arabia's Eastern and Central provinces. Participants were recruited through purposive sampling via social media. Data collection included demographic information, palliative care knowledge, attitudes toward palliative care, and cultural influences on end-of-life decisions. RESULTS: A total of 710 participants completed the survey, resulting in a response rate of 85%, with a balanced gender distribution, predominantly aged 25-54. Over half were healthcare providers, many possessing more than 15 years of healthcare experience. A substantial proportion had received formal palliative care training and had personal involvement in end-of-life decisions. While most participants demonstrated a good understanding of palliative care, knowledge gaps, especially regarding its timing, persisted. Generally, participants felt at ease discussing end-of-life care and believed in palliative care's effectiveness. Cultural influences on end-of-life decisions were perceived both positively and negatively, with some facing cultural challenges in palliative care. CONCLUSIONS: This study underscores a promising understanding of palliative care in Saudi Arabia alongside persistent misconceptions. It highlights the necessity for targeted education to rectify misperceptions, particularly concerning the initiation timing of palliative care. Cultural factors strongly impact end-of-life decisions, emphasizing the need for culturally sensitive healthcare discussions and provider training.

Augmentation of anti-platelet effects of aspirin.

OBJECTIVE: To establish the anti-platelet or aspirin like effects of flavonoid rich food (chocolate). METHODS: This was a non-randomized quasi experimental study in which, 65 healthy adult volunteers, 27 males and 38 females, participated. The subjects included were healthy, non-smoking adults. Health of subjects was evaluated by a questionnaire for which a written informed consent was taken prior to admission in the study. Research protocol was approved by the college's, "Research and Ethical committee". Division of subjects into two groups, a control group which consumed 100 mgs of oral aspirin and an interventional group consuming 100 mgs oral aspirin and 18.75 gms of dark chocolate (flavonoid rich), was carried out. The Bleeding time estimation for both the groups was done by "Duke Method" of bleeding time estimation. RESULTS: Data was analyzed by SPSS 15.0. First, a bivariate analysis was done by comparing both the pre-test groups i.e. before consumption of aspirin and also before consumption of chocolate and aspirin together through independent t-test Later, regression analysis was also done. Bivariate analysis compared both the control and interventional groups. After comparing pre-test groups a p-value of 0.798 was obtained and after comparing post test groups a p-value of 0.006 was determined. Regression analysis yeilded an R-square of 0.25. CONCLUSION: Chocolate has a significant role in augmenting the anti-platelet effects of aspirin.

Effect of Addition of Incipient Carious Lesions in Caries Diagnostic Criteria on Prevalence of Caries in North Indian Preschool Children of East Lucknow Region.

AIM AND OBJECTIVE: To investigate the effect of the addition of incipient carious lesions into the WHO caries index on the prevalence of caries in preschoolers of East Lucknow city. STUDY DESIGN: A cross-sectional observational study was conducted on 530 participants in the age-group of 3-6 years. MATERIALS AND METHODS: The participants were randomly selected from nursery schools of the East Lucknow region. The dental caries status was assessed according to WHO and Ekstrand's criteria. In addition, the prevalence of cavitated and incipient carious lesions was also evaluated. The data were then subjected to statistical analysis. STATISTICS: Chi-square test and Wilcoxon signed-rank test were performed to carry out statistical analysis. p value < 0.005 was taken as statistically significant. RESULTS: Out of 530 participants examined, caries prevalence by WHO and Ekstrand's criteria was (36.8%) and (57.4%), respectively. The mean dmft values according to WHO criteria and Ekstrand's criteria were 1.16 and 1.60, respectively. The prevalence of cavitated carious lesions was higher (66.27%) when compared with that of incipient carious lesions (33.73%). CONCLUSION: A significant number of incipient carious lesions observed in the present study is an indication to include these lesions in caries diagnostic criteria. This would help in determining the exact prevalence of caries and aid in implementing proper preventive protocols for remineralization of incipient carious lesions. HOW TO CITE THIS ARTICLE: Asad F, Singh N, Rathore M, et al. Effect of Addition of Incipient Carious Lesions in Caries Diagnostic Criteria on Prevalence of Caries in North Indian Preschool Children of East Lucknow Region. Int J Clin Pediatr Dent 2021;14(5):644-647.

Introducing problem-based learning in a medical school with traditional/conventional curriculum.

BACKGROUND: Globally, over the last two decades, medical education and its learning strategies are being made more prone to problem-solving in order to produce better clinicians. The medical curriculum has not changed in Pakistan since its inception and that is reflected in the form of inadequacies in health delivery system. There is a dire need of creating relevance between medical education/training and medical practice in order to introduce an effective health care system. OBJECTIVE: This study is particularly aimed at evaluating the effect of problem-based learning (PBL) in a group of students accustomed to conventional teaching and to assess any change in students attitudes/learning abilities after repeated PBL interventions. DESIGN: An interventional study. SUBJECTS AND METHODS: Response of 32 students of fourth year MBBS of Karachi Medical and Dental College was recorded against two PBL exercises in September 2002. RESULTS: A significant change in the study trend and analytical ability (p < 003) was shown in the two PBL sessions. The students who liked PBL were 33% more prone to practice group-study (OR = 1.33 and 95% CI=1.28, 1.39) than those who preferred other modalities of teaching. The final professional grades of these students were significantly higher than those in the previous years (p < 0.000). CONCLUSION: A strong association between liking for PBL and group study was found and the analytical performance and thought process of students were significantly improved after the second PBL session.