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Introduction: Pyogenic granulomas are benign vascular lesions of the skin and mucosa which are often a source of concern because of their recurrent bleeding even with minimal trauma. Current treatment for pyogenic granuloma is ablative; no medical therapy is standardized to date. Timolol, due to its vasoconstrictive effect, vascular growth factor inhibition and apoptosis promotion properties, is a potential therapeutic option. Objectives: To assess the effectiveness and safety of topical timolol in the treatment of pyogenic granulomas. Methods: A two-centre, double-blind and placebo-controlled trial (Registration CTRI/2019/04/018581) was conducted. Patients of either sex were recruited with pyogenic granuloma lesions of less than eight weeks duration. Topical treatment with 0.5% timolol or matching glycerin placebo was continued for six weeks. Changes in color, size, bleeding tendency, physicians’ and patients’ global assessments and adverse events were assessed. Results: Forty subjects were randomized between the two groups which were comparable in age, sex, duration of illness and baseline lesion size.Significant improvement was noted with timolol, with color change from first follow-up onwards and lesion size reduction from second follow-up onward. Patients’ assessment of bleeding tendency also showed imrovement from the second visit onward. Between-group comparison showed significant difference with respect to percentage reduction in size (timolol 40.9%, placebo 3.4%; P = 0.002). Rescue treatment (electrosurgery) was required in five patients on placebo and in one in the timolol group (P = 0.182). Complete resolution occurred in 2 (10%) patients with timolol and in no patients on placebo (P = 0.231). Limitations: We observed effects of treatment for only six weeks. Conclusion: Topical timolol may be a treatment option for early pyogenic granulomas but complete resolution is unlikely in six weeks. Studies of longer duration are required to assess resolution and recurrence rates
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Objective:To evaluate the role of Nigella sativa in renoprotectionMaterial and Methods:This prospective, comparative study was completed in a tertiary care centre of north India in patients of Chronic Kidney Disease (CKD). Group I (Control) received conservative management of CKD and while Group II (Test) received conservative management along with Nigella sativa oil (2.5 mL, orally, once daily) for 12 weeks. Renal function tests were done at 0, 6 and 12 weeks of treatment.Results:There was more progressive improvement in biochemical values and clinical signs and symptoms in test group. There was decrement in blood urea, serum creatinine and 24-hour total urine protein (TUP). There was rise in glomerular filtration rate (GFR) and 24-hour total urine volume (TUV). Conclusion:Nigella sativa oil supplementation is effective and safe in prevention of progression of nephropathy.
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ABSTRACTBackground: Nigella sativa, a widely used medicinal plant throughout the world belongs to family ranunculaceae. Its Seeds and oil have a long history of folklore usage in various traditional systems of medicines and food. This study was performed to evaluate the protective effect of Nigella sativa oil (NSO) on kidney when simultaneously given with colistin sulfate (CS) which induces tubular damage in rats.Methods: Animals were treated for 7 days: Group I (n=6) with normal saline and CMC, Group II, III and IV with 300.000IU/kg/day of CS (n=6). Group III and Group IV with NSO at the dose of 1 and 2ml/kg per orum prior to CS administration. All the animals were sacrificed on 8th day. Afterwards, the plasma creatinine (pCr), blood urea, renal tissue level of malondialdehyde (MDA), reduced glutathione (GSH) and renal histology were performed.Results: Colistin sulfate induced tubular damage, increased the plasma creatinine (pCr), blood urea and MDA levels and decreased the reduced glutathione (GSH). However, simultaneous treatment with Nigella sativa oil at the dose of 1ml/kg and 2ml/kg for one week produced dose dependant improvement in tubular damage and reduced the biochemical alteration.Conclusions: It could be concluded that, Colistin sulfate induced nephrotoxicity is ameliorated by NS oil especially in higher dose of (2ml/kg). This nephroprotective effect is ascribed to free radical scavenging and potent antioxidant activity in Nigella sativa.
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Objective: to evaluate the correlation between Doppler echocardiography [DE] and right heart catheterization [RHC] derived pulmonary artery pressures and to assess the impact of right atrial [RA] pressures on this correlation
Study Design: cross-sectional analytical study
Place and Duration of Study: cardiology Department, Tahir Heart Institute, Chenab Nagar, from June 2013 to December 2014
Methodology: all patients undergoing RHC were included. Relevant data were collected from hospital database. Continuous variables were expressed as the mean and SD or as the median and interquartile range where the distributions were skewed. Pearson correlation coefficient and Bland-Altman method were used to correlate DE derived right ventricular systolic pressure [RVSP] and RHC derived systolic pulmonary artery pressures [sPAP]. Adjusted RVSP was calculated by replacing default value of RA pressure [10 mmHg] with RHC derived mean RA pressure. Receiver operating characteristic curve [ROC] was used to identify the best cut-off value of RVSP in predicting pulmonary hypertension
Results: fifty-one patients completed the study protocol. Mean age of study population was 45.22 +/- 15.25 years with male to female ratio of 1.47:1. Median error was 13 mmHg [7 to 20]. Pearson correlation coefficient [r] between RVSP and sPAP was 0.72. Bland-Altman method of correlation showed bias of +4.43 mmHg with 95% limits of agreement ranging from -34.61 to +43.47. Using ROC curve, the best cut-off value of RVSP was greater than 52 mmHg with accuracy of 75% [sensitivity: 81%, specificity: 69%] in predicting pulmonary hypertension. Adjusted RVSP showed only little improvement in correlation [r = 0.75], adjusted error [13.65 +/- 13.05] and diagnostic accuracy [79%]
Conclusion: doppler echocardiography can frequently overestimate pulmonary artery pressures. Though correctly estimated RA pressure may improve this correlation, yet its contribution is only minimal
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Background: Non-steroidal anti-inflammatory drugs are very commonly used as an analgesic, antipyretic, anti-inflammatory, and antiplatelet agent. They have significant adverse effect on liver and kidney besides damaging stomach. Their effect on liver and kidney are of serious concern. Hence, we have decided to study the preventive effect of Nigella sativa against paracetamol induced hepatic and renal damages. Methods: Ethanolic and aqueous extracts of N. sativa were prepared with the help of Soxhlet’s apparatus. Totally, 36 wistar albino rats (150-200 g) of either sex were divided into six groups of six each. Group I was administered with distilled water, Group II-VI were treated with paracetamol 750 mg/kg i.p. Group III-VI were test groups also treated with N. sativa aqueous extract (200 and 400 mg/kg p.o) and ethanolic extract (200 and 400 mg/kg p.o), respectively. The treatment was given daily for 7 days and on 8th all the rats were sacrificed and the blood was analyzed for hepatic and renal function tests and tissue was preserved for histopathological examination. Results: Paracetamol administration caused a marked hepatic and renal damage, which is evidenced by the increase in liver and renal function test parameters in the negative control group. N.sativa extracts prevented this damage. The protective was seen maximum in ethanolic extract followed by the aqueous extract in dosedependent manner. Conclusion: Ethanolic extract showed significant protection against paracetamolinduced and renal damage.
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Bacterial leaf blight (BLB) caused by Xanthomonas oryzae pv. oryzae (Xoo) is one of the most common devastating diseases of rice (Oryza sativa) all around the world. Thus, present study has been conducted to screen 12 aromatic rice cultivars (Atashail, Basmati, Kalizira, Uknimodhu, Zira katari, BR5, BR14, Bina dhan9, BRRI dhan34, BRRI dhan37, BRRI dhan38 and BRRI dhan50) for BLB resistant gene xa5. The genotypes were analyzed using two genetic markers (RM 122 and RM 390) by Polymerase Chain Reaction (PCR). Where, BR 14 that was resistant to BLB was used as control. Both primers generated different banding patterns. Primer RM 122 produced 6 bands whereas primer RM 390 produced 10 bands, respectively. The highest level of gene diversity value (0.8889) was observed in locus RM 390 and the lowest level of gene diversity value (0.7361) was observed in locus RM122 with a mean diversity of 0.8125. The PIC values ranged from a low of 0.7007 (RM 122) to a high of 0.8785 (RM 390) with an average of 0.7896. Using the linked primer RM 122, the bands of xa5 gene were standardized by the amplified DNAs. The DNA band of 246 bp was considered as resistance line and the DNA band of 230 bp was considered as a susceptible line. Similarly, in case of primer RM 390, 70 bp was considered as a resistance line and 112 bp was considered as susceptible line. Basmati, BRRI dhan50, Kalizira Atasail, Bina dhan9, Uknimodhu, BR 34, BR 37 and Zira Katari all of them found as partial resistant to BLB diseases. However, BRRI dhan38 was found as partial or complete susceptible cultivar.
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Background: Congenital Cardio-Vascular Malformations (CCVMs) are relatively common with a prevalence of 5-10 in every 1000 live births. CCVM represents a new-born condition that would be ideally suited to a screening program if simple and reliable methods were available. Pulse oximetry has been proposed as a screening method for the detection of congenital heart defects. Methods: Hospital based prospective non-randomized study conducted over a period of one year at the department of pediatrics in G.B. Panth hospital (Neonatology) and L.D. hospital (Neonatology). A total of 1200 asymptomatic new-borns attending G.B. Panth, neonatology/L.D. neonatology were screened with pulse oximetry. Oximetric screening for CCVM was performed by obtaining a single determination of postductal saturation at >24 hours. All new-borns underwent additional evaluation by echocardiography. Results: Out of 1200 newborns screened three had postductal saturation ≤95%. Echocardiography revealed TGA (transposition of great vessels) in one; TA (truncus arteriosus) in other and third one had structurally normal heart on echocardiography. There was one false negative screen (found in the inpatient records of G.B. Panth hospital). The sensitivity, specificity, positive predictive value and negative predictive value of pulse oximetry in screening for CCVM in asymptomatic new-borns was found to be 66.67%, 99.9%, 66.67% and 99.9% respectively. Conclusion: This screening test is simple, non-invasive and inexpensive. The sensitivity, specificity, and predictive value in this population were satisfactory, indicating that screening should be applied to larger populations, particularly in developing countries where lower rates of detection result in increased CCVM prevalence in asymptomatic new-borns.
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Background: The objective was to evaluate the efficacy and safety of α-keto analogs of essential amino acids (KAA) as a supplement in chronic kidney disease (CKD). Methods: A prospective comparative study was conducted in patients of CKD of a tertiary care center of North India. Patients were randomly divided into two interventional groups. Group I (control) was advised conservative management and placebo while Group II (KAA) given conservative management along with KAA (600 mg, thrice daily) for 12 weeks. Hemogram, renal function tests, lipid profiles were done, and adverse effects were recorded at 0, 4, 8, and 12 weeks of treatment. Results: There was progressive improvement in clinical features in both groups after 12 weeks of treatment, but KAA group showed more marked improvement as compared with the control group. Both groups showed gradual improvement in the biochemical parameters as compared to their pre-treated values, which was more marked in KAA supplemented group. There was a reduction in blood glucose, blood urea, serum creatinine, and 24 h total urine protein. There was an increase in hemoglobin, 24 h total urine volume and glomerular filtration rate. KAA group showed significant (p<0.05) improvement in lipid profiles as compared with the control group. There was no statistical difference in two groups with respect to side-effects (p>0.05). Conclusion: KAA supplementation along with conservative management is efficacious and safe in preventing the progression of disease in patients of CKD.
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Objective: To verify possible associations between polymorphisms of glutathione S-transferase Mu (GSTM1), glutathione S-transferase θ (GSTT1) and glutathione S-transferase Pi (GSTP1) genes and susceptibility to lung cancer. Methods: A total of 106 lung cancer patients and 116 controls were enrolled in a case-control study. The GSTM1 and GSTT1 were analyzed using PCR while GSTP1 was analyzed using PCR-restriction fragment length polymorphism. Risk of lung cancer was estimated as odds ratio at 95% confidence interval using unconditional logistic regression models adjusting for age, sex, and tobacco use. Results: GSTM1 null and GSTT1 null genotypes did not show a significant risk for developing lung cancer. A significantly elevated lung cancer risk was associated with GSTP1 heterozygous, mutant and combined heterozygous+mutant variants of rs1695. When classified by tobacco consumption status, no association with risk of lung cancer was found in case of tobacco smokers and nonsmokers carrying null and present genotypes of GSTM1 and GSTT1. There is a three-fold (approximately) increase in the risk of lung cancer in case of both heterozygous (AG) and heterozygous+mutant homozygous (AG+GG) genotypes whereas there is an eightfold increase in risk of lung cancer in cases of GG with respect to AA genotype in smokers. Conclusions: Carrying the GSTM1 and GSTT1 null genotype is not a risk factor for lung cancer and GSTP1Ile105Val is associated with elevated risk of lung cancer.
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Background: Asthma is common chronic disease worldwide. Methylxanthines has been used in the treatment of asthma. The study was undertaken to compare two Methylxanthines theophylline and doxofylline at doses recommended and commonly used in clinical practice in Mild Bronchial Asthma Patients. Methods: Study was conducted in patients of Mild Bronchial Asthma in TB and chest disease department of a medical college hospital. It was randomized, prospective and open label. A total of 107 patients were divided in two group .Group I was administered 400 mg theophylline SR once daily and group II was administered doxofylline 400 mg twice a day orally. Spirometric variables symptom score, and adverse effects were recorded on day 0, 7 and 21 of therapy. Data were compared and analysed using SPSS version 16. Results: Results of the study showed that there was significant improvement in spirometric variables and clinical symptom score compared to pretreatment values after medication in both groups on 7th and 21st days of treatment. But there was no statistically significant difference between improvement in theophylline and doxofylline groups with respect to spirometric variables and symptom score. There was no significant difference in two groups with respect to side effects (p>0.05). Conclusions: It is concluded in Patients of mild Bronchial Asthma Theophylline and doxofylline improve the spirometric and clinical symptoms and doxofylline has no advantage over theophylline in terms of either efficacy or safety on the doses commonly used in current clinical practice.
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OBJECTIVE: We investigated the effects of antipsychotics on immune-challenged peripheral blood mononuclear cell (PBMC) cultures. METHODS: Blood samples were collected from twelve patients with first-episode schizophrenia. The PBMCs were separated and cultures were prepared and stimulated with lipopolysaccharide (LPS) or polyinosinic:polycytidylic acid (poly[I:C]), and then separately treated with a typical antipsychotic (haloperidol) or atypical antipsychotic (clozapine, quetiapine, or risperidone). Pro-inflammatory (interferon gamma [IFN-gamma]) and anti-inflammatory (interleukin [IL]-4 and IL-10) cytokine levels were measured in the LPS- or poly(I:C)-stimulated PBMC cultures treated with antipsychotics. RESULTS: Haloperidol and quetiapine significantly increased the IL-4 levels (p<0.05) in LPS-stimulated PBMC cultures, while clozapine and quetiapine significantly enhanced the IL-4 levels (p<0.05) in poly(I:C)-stimulated PBMC cultures. Only treatment with haloperidol resulted in a significant increase in IL-10 production (p<0.05) in LPS-stimulated PBMC cultures, whereas clozapine, quetiapine, and risperidone treatment significantly increased IL-10 production (p<0.05) in poly(I:C)-stimulated PBMC cultures. All of the antipsychotics reduced the IFN-gamma level significantly (p<0.05) in LPS- and poly(I:C)-stimulated PBMC cultures. CONCLUSION: Antipsychotic treatment altered immune function by raising the levels of anti-inflammatory cytokines (IL-4 and IL-10) and suppressing the levels of pro-inflammatory cytokines (IFN-gamma).
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Humans , Antipsychotic Agents , Cell Culture Techniques , Clozapine , Cytokines , Haloperidol , Interleukin-10 , Interleukin-4 , Lipopolysaccharides , Risperidone , Schizophrenia , Quetiapine Fumarateالملخص
Delivery pain is one of the most severe pains that women experience during their life so a change can affect all dimensions of pregnant women and her family life. Aim of this study was to assess the women's knowledge of pain relief during labour, and their beliefs, fears, and misconceptions regarding epidural analgesia. It was descriptive study conducted in Obstetric and Gynaecology OPD of Liaquat University of Medical and Health Sciences, Hyderabad from September 2007 to January 2008. Women were selected randomly. All pregnant females who had delivered previously were interviewed. Primigravida were excluded from study. Information was collected on self-made questionnaire after an informed consent. Information was collected on computer software programme of SPSS 11.frequencies and percentages were calculated to express the results. Total 131 women were included in this study. Out of these 65, [49.6%] had no education while 41 [31.2%] had primary education. Majority of women [82, 62.5%] had knowledge about injections while few [12, 9.1%] women had knowledge about epidural analgesia. Seventy-nine [60.3%] had chosen the injections as preferred method during next labour. Regarding attitude towards labour pains, 61 [46.5%] feels that labour pains as severe pain. Regarding epidural analgesia 4 [3%] women thought that epidural analgesia will lead to weakness of limbs and 3 [2.2%] women thought that it will cause permanent backache. There was poor general awareness of women about the role of epidural analgesia in labour leading to a low patient demand for such services. Most of the women had gained knowledge regarding pain relief from past experience or from friends and relatives
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Humans , Female , Health Knowledge, Attitudes, Practice , Labor, Obstetric , Pregnancy , Labor Pain/therapy , Analgesia, Epidural , Awarenessالملخص
Coronary Artery Bypass Grafting (CABG) is associated with a significant morbidity and mortality and several factors have been identified as predictive of complications. These include renal dysfunction and in particular renal replacement therapy. More than 600,000 coronary artery graft procedures are performed annually in the United States. Of those patients with coronary arterial disease 10% patients undergo CABG surgery. To explore the association of renal function between off-pump and on-pump-CABG. To evaluate the degree of impairment of renal function in on-pump, 80 patients (off-pump group = 50, on-pump group = 30) who underwent CABG were recruited from cardiac surgery dept. of National Heart Foundation and Research Institute Mirpur Dhaka and National Institute of Cardiovascular Disease (NICVD). Subjects were selected according to exclusion and inclusion criteria. Purpose and procedure of the study were explained in detail and informed written consent was taken from the study subjects. All the information of the study subject including history, clinical finding were recorded in a preformed data sheet. Serum urea and creatinine were significantly higher in on-pump group patients 12 hours after CABG. Serum urea was significantly higher and serum creatinine was slightly in onpump group in comparison to off-pump group. The mean urea and creatinine were found significantly higher in on-pump group in comparison to off-pump group and CCr was slightly higher lower in on-pump but not significantly decreased.
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This cross-sectional study was carried out in 80 serologically diagnosed cases of acute viral hepatitis to assess and compare the serum hepatic enzymes & plasma proteins between four different types (A,B,C,E), 20 in each group. Hepatitis E, hepatitis B and hepatitis C were more prevalent in males than that in females. The study showed that geometric mean of S.AST of all the four types differed significantly (F= 274.94, p<0.001). Geometric mean of S.ALT, S.AST and S.ALP in cases of HCV were significantly lower than others (p<0.001). Geometric mean of S.ALT & S.AST in cases of HEV were significantly increased than others (p<0.001). But the geometric mean of S.ALP of HBV was significantly higher than others (p<0.001). On the other hand though S.ALP of HAV and HEV was lower than HBV but significantly higher than HCV (p<0.001). The mean±SD of serum albumin of HCV was decreased significantly in contrast to those of HAV and HBV (p<0.001). A:G ratio of HCV was also significantly lower than other three (p<0.001). It was revealed through the study that hepatic enzymes were most affected in cases of HEV but least affected in cases of HCV.
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To determine the frequency of factors responsible for apparently high cesarean section rate in teaching hospital, Liaquat university hospital Hyderabad and to assess maternal morbidity and fetal out come after cesarean section. Descriptive study. In obstetric and gynecology Department of Liaquat university hospital Hyderabad Sindh Pakistan from 3 rd January 2007 to 2 nd January 2008. Total 1666 deliveries were conducted in year 2007 to 2008. Out of these 584 were delivered by cesarean section and 1082 were delivered by normal vaginal delivery. Clinical record of all the patients who underwent Cesarean section was analyzed. All the patients who underwent cesarean section were included in this study while clinically diagnosed cases of ruptured uterus and proved on lapratomy were excluded from this study. A proforma of each patient was completed, regarding the relevant information of cesarean delivery and fetal outcome. Cesarean section was done on 584 [35%] patients while normal vaginal delivery was conducted on 1082 [65%] patients. A total of 149 [25.5%] patients' underwent elective cesarean section while in 435 [74.4%] patient's cesarean section was done in emergency. A total of 144 [24.7%] patients were booked while 440 [75.3%] patient's were unbooked. Most common indication of cesarean section was repeat cesarean section, which was seen in 182 [31.2%] patients. Among obstetric complications major problem encountered was massive hemorrhage, which is seen in 64 [11%] patients wounds sepsis was second most common complications. A total of 453 [77.6%] newborns were born alive and 50 [8.6%] neonates were dead which included fresh and macerated still birth. 81 [13.8%] neonates died later on in pediatric unit [END]. The rate of cesarean section in our study was 35%, which is quite high. Commonest indication of cesarean section observed in this study was previous cesarean section. Majority of patient's who underwent cesarean section were unbooked. Commonest obstetric complication was massive hemorrhage followed by wound sepsis. Perinatal mortality was also high in this study
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Humans , Female , Adult , Medical Audit , Hospitals, Teaching , Pregnancy Outcomeالملخص
Although dermatophytes are the most common pathogens of onychomycosis, yeasts and non-dermatophyte moulds can also be found as causative agents. To find out relative frequency of non-dermatophyte moulds and yeasts as causative agents in onychomycosis. Forty patients of all age groups and either sex suffering from onychomycosis were subjected to fungal cultures. Demographic and clinical features of the patients were recorded. Nail scrapings were inoculated on fungal culture media and growth pattern studied. Out of 40 patients, eight [16%] were positive for fungal culture. Amongst culture positive cases 4 [50%] were dermatophytes, all of them belonging to genus trichophyton, whereas 2 [25%] were positive for Candida spp. and 2 [25%] were positive for non-dermatophyte moulds belonging to Scopulariopsis spp. and Aspergillus spp. each. Dermatophytes remain the most common cause, but the role of yeasts and nondermatophye moulds should receive due consideration in a case of onychomycosis
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Humans , Male , Female , Arthrodermataceae , Yeasts , Fungiالملخص
A 60-year-old male patient presented with jaundice. Initial investigations showed anemia, indirect hyperbilirubinemia, raised Lactic Dehydrogenase [LDH] and increased reticulocyte count suggestive of hemolysis. Considering hemolysis low MCV and basophilic stippling on peripheral film, hemoglobin electrophoresis was done that showed Haemoglobin H [15.5%] that in the absence of family history was thought to be acquired. After bone marrow examination, the final diagnosis was Myelodysplastic Syndrome [MDS], Refractory anemia with excess of blast [RAEB] associated with acquired Haemoglobin H [Hb H] disease
الموضوعات
Humans , Male , alpha-Thalassemia/etiology , Anemia, Hemolytic , Hemoglobin H , Hyperbilirubinemiaالملخص
A number of authors have described the reasons for the shortening of the length of new lunar crescent. McNally devised a mathematical technique to find the shortened length of crescent using his formula for the width. Recently Sultan has also developed a mathematical technique to calculate the length of crescent on the basis of Blackwell contrast threshold. In the present paper a technique for calculating the "observed length" of the new lunar crescent based on the lower limit on the visible width of crescent is developed using q-value criterion of Yallop. This technique is than used to calculate the crescent length for a number of observations reported in literature since the time of Schmidt of Athens. Finally a comparison of the observed crescent lengths is done with the calculated lengths using our technique and the calculated lengths on the basis of the formulas due to Sultan and McNally. The results of this work are consistent with the observed lengths whereas those due to others are generally inconsistent
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Arithmetic Lunar Calendar is based on the concept of Leap Years and the average motion of the Moon. However, the actual motion of the Moon varies greatly due to various factors which cause the observational calendar to be different from the arithmetic calendar. Whereas, the Calendars based on prediction criterion of Yallop are the closest to the observational calendar. In this work, we compare these calendars with the actual observational calendar in practice in Pakistan for the years 2000 to 2004. It is found that on average 95% observations are according to the Yallop's criterion. The disagreement is the result of either the bad weather due to which the new Lunar crescent could not be sighted and the Lunar month began one day late, or too optimistic claims of observation and the Lunar month began one day earlier than predicted. On the other hand the disagreement between the Arithmetic Calendar and the observational one is 54%.