Effects of Ziziphus Honey on Bone Healing of the Extracted Tooth Socket by Evaluating Osteopontin Levels.

OBJECTIVE: To evaluate the effect of Ziziphus honey on the healing of post-extraction alveolar sockets by estimating the levels of osteopontin (OPN) in humans. STUDY DESIGN: Randomised controlled trial. Place and Duration of the Study: Dental section of the Lahore General Hospital, Lahore, Pakistan, from March 2020 to February 2021. METHODOLOGY: A total of 30 patients were included in the study. The mean age was 35 ± 0.28 years. The participants were adults undergoing permanent molar extraction, randomly divided into two groups, a control group and an experimental group. After tooth extractions in both groups, 1ml of Ziziphus honey was administered into the extracted tooth socket of the experimental group while no intervention was done to the control group. Saliva samples were collected on day 0 before tooth extraction and on days 3 and 7 after tooth extractions. Enzyme-linked immunosorbent assay (ELISA) technique was used to measure the levels of OPN in the saliva sample. Radiographic evaluation was also done with the help of periapical radiographs using Image J® software. To find out the significance of the outcome in experimental and control groups, an unpaired t-test was applied. A p-value <0.05 was considered statistically significant. RESULTS: A total of 30 participants were selected for the study, of which 16 were females and 14 were males. The OPN levels between the control vs. experimental groups were (22.55 ± 2.45 vs. 23.31 ± 2.38; p = 0.4) on day 0, (30.95 ± 2.96 vs. 53.29 ± 4.69; p = 0.001) on day 3, and (55.33 ± 4.52 vs. 81.90 ± 4.49; p = 0.001) on day 7. CONCLUSION: Increased salivary levels of the OPN in the experimental group with the use of Ziziphus honey suggests better bone healing as compared to the control group. KEY WORDS: Extraction tooth, Honey, Osteopontin, Ziziphus, Bone healing.

The Bronchodilator Potential of Astragalus sarcocolla: An in vitro Experiment.

OBJECTIVE: To evaluate the bronchodilatory mechanism of Astragalus sarcocolla (ASE) extract on tracheal smooth muscles of rabbits. STUDY DESIGN: In-vitro experimental study. Place and Duration of the Study: The animal house of CMH Lahore Medical College, Lahore, and Institute of Dentistry, NUMS, from October 2022 to May 2023. METHODOLOGY: Six rabbits were randomly divided into four groups. After euthanising the rabbit, the trachea was carefully dissected out and stabilised in Kreb's Henseleit solution for 30 minutes and then, stimulated by acetylcholine (Ach) 1µm, under mimicked physiological conditions. Group I served as the control group with tracheal smooth muscles stabilised with 1g tension. In Group II (positive control), tracheal smooth muscles were stimulated by potassium chloride (KCl) (80 mM and 25 mM, respectively) to get maximum tracheal smooth muscle contractions. Later, the tissue was exposed to theophylline with three molar concentrations 0.2, 0.4, 0.6, and 0.8 mM, and cumulative dose response curves were formed. In Group III (ASE group), tracheal smooth muscles were stimulated by KCl (80 mM and 25 mM) and was exposed to increasing concentration of ASE. In group IV, tissue was stimulated by KCl (25 mM) and glibenclamide (3 µM), later exposed to increasing concentration of ASE to confirm the bronchodilatory mechanism. The change in isometric contraction of the tissue was recorded using the force displacement transducer connected to a PowerLab data acquisition system. Concentration response curves were drawn, and median effective concentrations (EC50 values) and percentage inhibition were calculated. Non-linear regression was applied for the analysis of the concentration-response curves. RESULTS: ASE inhibited the KCl-induced low potassium (25 mM) contractions (EC50 = 0.38 mg/ml, 95% CI: 0.04 - 0.38, n = 6). It only partially inhibited the high potassium-induced contractions in tracheal smooth muscles. Pretreatment with glibenclamide showed a rightward shift of the dose-response curve. Theophylline and ASE significantly reduced the low K+ induced smooth muscle contractions in comparison to the control group (p <0.001, each). CONCLUSION: Astragalus sarcocolla extract produced bronchodilator effects through the activation of ATP sensitive potassium channels in isolated rabbit trachea. KEY WORDS: Astragalus sarcocolla, Bronchodilators, ATP-sensitive potassium channels, Effective concentration 50, Concentration response curves.

Comparative Analysis of IgG Antibody Titers Induced by Three Different SARS-COV-2 Vaccines in Healthy Adults of Pakistan.

Covid-19 is a contagious disease caused by severe acute respiratory syndrome corona virus 2 (SARS-CoV-2). In order to control this disease, different effective vaccines have been developed. This study is an attempt to determine the strength and duration of immunogenicity of various established vaccines. This cross-sectional, observational study was conducted to compare the efficacy of three different vaccines; Pfizer BNT 162b2, Sinovac, and CanSino, respectively, after a duration of 3 months, in the healthy adult population of Pakistan. In this study 371 healthy participants (aged 12-25 years) of both genders (male and females) were enrolled. The blood sample was drawn 90 days after the complete vaccination process. The humoral response (IgG) was analyzed by electrochemiluminescence immunoassay (ECLIA) method with Roche Anti-SARS-CoV-2 S analyzer kit. Descriptive statistical analysis was performed using IBM SPSS statistics version 22 and P < 0.05 was considered significant. The mean antibody titer in Pfizer-group was 12,536.35 U/mL, followed by 5168.68 U/mL in the Sinovac group and 4284.32 U/mL in the CanSino group. The Pfizer-group showed gender-specific significant differences, with higher antibody levels in males (P = 0.006) as compared to Sinovac and Cansino groups. The Mean IgG antibody levels of the Pfizer-vaccinated group were significantly higher than the Sinovac-vaccinated group and the CanSino-vaccinated group (P = 0.000, each). However, the mean difference between the Sinovac-vaccinated group and the CanSino-vaccinated group was not significant. Vaccine-induced seropositivity was found in the whole cohort. The mRNA-based vaccine produced the highest immune response, and thus, it is recommended for future application.

Rasagiline Pharmacokinetics in CYP1A2 Variant Healthy Smokers & Non-smokers in Different Doses.

Objectives: Rasagiline, a drug for Parkinson's disease is metabolized by CYP1A2 enzyme. The objective of the study was to investigate the influence of cytochrome P450 1A2 variants and smoking status of healthy individuals on the pharmacokinetics of rasagiline. Methods: A comparative, open label, interventional, single oral dose, pharmacokinetic study was performed on 108 healthy volunteers in UHS & UVAS, Lahore. Data collection was initiated in June 2016 and ended in January 2018. It was divided in three phases with 1, 2 and 5mg of rasagiline given to a group of 36 volunteers in each phase. Volunteers were sub-divided into six groups of AA smokers, AA non-smokers, AC smokers, AC non-smokers, CC smokers & CC non-smokers on the basis of genotyping and smoking status. Serial blood sampling was performed at 0, 0.25, 0.5, 0.75, 1, 1.5, 2, 3, 4, 6, 8 & 12 hours after administration of rasagiline tablets. Plasma concentrations were determined using High Performance Liquid Chromatography (HPLC) method. Pharmacokinetic (PK) parameters were calculated using software (APO) pharmacological analysis. Results: Analysis of variance (ANOVA) showed significant difference between AA and CC groups. Multiple group comparison with post hoc Tukey's revealed that AA-smokers had significantly less tmax (p<0.001), t1/2 (p<0.012), AUC (p<0.008) and highest Cl (p<0.001) as compared to CC-smokers. The trend was same across all three doses. Conclusion: The study concludes that the systemic metabolism of rasagiline is significantly increased in CYP1A2*AA variants while smoking status did not show consistent difference in PK parameters.

Effect Of Justicia Adhatoda (Malabar Nut) Leaf Extract On Drug-Induced Coagulopathy In Mice And In-Vitro Platelet Aggregation Of Human Blood.

BACKGROUND: Justicia adhatoda is widely used in traditional medicine for treatment of menorrhagia, piles and bleeding disorders. Oral antiplatelet and anticoagulant drugs are routinely prescribed to patients with cardiovascular diseases. These drugs have one major adverse effect that they can cause spontaneous haemorrhage, which can be fatal. Development of a haemostatic agent can help in effective management of drug-induced haemorrhages. This study was devised to observe the effect of leaf extract of Justicia adhatoda on coagulation profile in mice and to evaluate its effect on in-vitro platelet aggregation. METHODS: The study was divided into two parts. First part was designed to evaluate the effect of J. adhatoda leaf extract on coagulation parameters. Three drugs were used to induce coagulopathy viz., warfarin, aspirin and dabigatran. Bleeding time, platelet count, PT and APTT were estimated. Second part of this study was devised to observe the effect of J. adhatoda leaf extract on in vitro platelet aggregation of human. Percent aggregation was recorded by light transmission aggregometer for three minutes. RESULTS: Leaf extract of Justicia adhatoda decreased bleeding time from 6.1±2.36 minutes in normal control to 1.9±1.03 minutes in extract treated mice. There was no effect on the coagulation parameters. Platelet count increased significantly only in the aspirin treated group that received the extract to 540±46.8x103 /µl from 436.9±37.9x103 /µl of aspirin treated group. Platelet aggregation in vitro increased in a dose dependent manner. CONCLUSION: Justicia adhatoda leaf extract is effective in controlling excessive bleeding in vivo, in mice with acquired platelet defect produced by aspirin. This haemostatic effect is probably due to increased platelet aggregation as indicated by the in vitro results.

The Spasmolytic Effect of Astragalus Sarcocolla on the Intestinal Smooth Muscles of Rabbit In Vitro: Potassium Channel Opening.

Introduction Astragalus species have been widely used in Chinese herbal medicine to treat gastrointestinal and inflammatory disorders. This study was conducted to evaluate the efficacy of Astragalus sarcocolla (ASE) and to rationalize its medicinal use as an antispasmodic drug for the treatment of spasmodic gastrointestinal and inflammatory disorders associated with increased intestinal motility. Methods The ethanolic extract of ASE was studied to examine its antispasmodic effect on the isolated rabbit ileum preparations, and the contractions were recorded on PowerLab (ADInstruments, Sydney, Australia). Results ASE was able to inhibit spontaneous ileum contractions. It also completely inhibited K+ (25 mM)-induced contractions but was unable to inhibit high K+ (80 mM)-induced sustained contractions. Pretreatment of the tissue with glibenclamide, a potassium channel blocker, caused a rightward shift of the dose-response curve when stimulated with K+ (25 mM) in the presence of an increasing concentration of the extract. Verapamil at very low doses inhibited both the 25 mM and 80 mM K+-induced contractions. Conclusion The results of our study demonstrated the spasmolytic activity of ASE with the potential mechanism of activation of K+ATP, which provides a strong basis for its medicinal use in motility and inflammatory disorders of the intestine.

Development of Resistance Against Mefloquine Prophylaxis in Peace-Keeping Forces in the Central African Republic.

Objective To record the frequency of malaria-like symptoms in patients who have been given mefloquine as chemoprophylaxis and to determine the effectiveness of antimalarials against these symptoms. Methodology It was an observational study that took place at a United Nations Level 1 hospital, Kaga-Bandoro, Central African Republic. The total duration of the study was three months. Patients presenting to the clinic with multiple symptoms despite chemoprophylaxis with mefloquine were assessed through a physical examination and screening test for malaria. Malaria treatment with a six-dose regimen of artemether (20 mg), along with lumefantrine (120 mg) two tablets BD for three days, was given after informed consent to those patients and post-treatment symptoms were observed and recorded. Results Out of 61 patients, 93% of them presented with body aches, 92% with headache, 52% with shivering, 44% with vertigo, 38% with fever, sweating, and nausea/vomiting, 18% with diarrhea, and 10% with pain in the abdomen. Conclusion It had been seen that patients presented with symptoms despite standard mefloquine prophylactic therapy, which were resolved with other antimalarial drugs. The presentation of the symptoms was also not classical.

Prevalence of Self-medication for Acid Peptic Disease amongst People of Manawa, Lahore.

Introduction Acid peptic disease is a common disorder, affecting millions of people worldwide. Its pharmacological management includes proton pump inhibitors, H2 blockers, antacids and mucosal protective agents. Multiple studies in Pakistan have shown increased tendency of population for self-medication. This has serious implications regarding false diagnoses, misuse of drugs and occurrence of adverse effects. The objective of this study was to estimate the prevalence of self-medication among the people of Manawa, Lahore. Methods A cross-sectional study was conducted between January 2019 and June 2019 amongst the general population of Manawa, Lahore. Patients with the typical presentation of acid peptic disease were included in the study. A total of 500 people, fulfilling the inclusion criteria, were chosen. A questionnaire form was adapted from similar studies performed on self-medication. It was divided into two parts. First part included the social and demographic data while the second part consisted of details about the prevalence and factors related to the practice of self-medication amongst acid peptic disease (APD) patients. The data collected was transcribed into SPSS 22.0 (IBM Corp., Armonk, NY) for statistical analysis. All the categorical variables were analyzed as frequencies and percentages. No statistical comparisons were done as it was a descriptive, exploratory study. Results Out of 500 participants, 404 were females and 96 were males. Most of them were middle-aged (53%) and illiterate (68.4%). Number of participants who practiced self-medication was found to be 313 (62.6%). The highest prevalence of self-medication was found for proton pump inhibitors (43.1%), followed by antacids (23.6%), unknown homeopathic and Hakeem medicine (20.4%) and H2 blockers (12.8%). The most common reasons stated for self-medication included inability to afford medical consultation (44.2%), lack of knowledge about drug side effects (35.8%), easy access to Hakeem and homeopathic medicines (27.6% and 4.8%, respectively) and inaccessibility to doctors (19.2%). Conclusion A large majority of people in Manawa practise self-medication for acid peptic disease, owing to multiple reasons.

Relationship of Major Depression with Body Mass Index and Salivary Cortisol.

Introduction Depression is one of the most incapacitating psychiatric diseases that disturb life of millions of people round the globe. Its major causes include stressful life events, bereavement, social abuses or certain biological and genetic factors with complex causal mechanisms. Higher salivary cortisol levels for a long period lead to dyslipidemias which increase body mass index (BMI), elevate adiposity and waist-to-hip ratio (WHR). Such individuals with high quartiles of BMI have considerably higher risk of major depressive disorder. The aim of this study was to establish a correlation between major depression, BMI and salivary cortisol. Methods This cross-sectional analysis was accomplished in the Physiology Department, Sheikh Zayed Federal Postgraduate Medical Institute, Lahore as well as in Punjab Institute of Mental Health, Lahore, Pakistan, over a period of six months. A total of 60 participants aged between 18 and 60 years were included in this study; they were divided equally into two groups as normal healthy individuals with no physical or mental illness and severely depressed groups. The patients were categorized as cases of severe depression on outdoor clinical assessment and further confirmed by ICD-10. Patient's BMI was estimated by measuring height in meters (m) and weight in kilograms (kg), and then dividing weight with square height. Early morning saliva samples were collected. Estimation of cortisol levels in saliva was done through ELISA. SPSS version 20.0 (IBM Corp., Armonk, NY) was used to analyze the data and p ≤ 0.05 was considered statistically significant. Results The mean BMI in normal healthy group was 22.02 ± 4.21, while the mean BMI in severely depressive group was 24.64 ± 3.58. The difference was statistically significant (p = 0.012). The mean salivary cortisol level was significantly raised in patients with major depression (2.23 ± 1.69 nmol/L) in contrast to healthy normal individuals (1.46 ± 0.91 nmol/L), with p-value = 0.031. Conclusion BMI and depression has a very noteworthy correlation and there is a remarkable link between raised salivary cortisol, greater BMI and development of major depression.

Effect Of Three Pakistani Date-Seed Varieties On Lipid Profile Of Diet Induced Hyperlipidemic Rabbits.

BACKGROUND: Hyperlipidemia is one of the major risk factors of cardiovascular diseases. In addition to current therapeutic strategies, a lot of work is being done on nutraceutical management of this condition. This study was designed to assess the effect of date seed powder on lipid profile of diet induced hyperlipidemic rabbits. METHODS: Thirty male rabbits were divided into five groups, having six animals in each. One group was given normal rabbit chow throughout the study period of eight weeks. The remaining four groups were fed high fat diet (4% coconut oil and 1% cholesterol powder) for first four weeks in order to induce hyperlipidemia. After first four weeks, 2% date seed powder of three Pakistani varieties namely Dhakki, Khudrawi and Desi was added to the diet of three experimental hyperlipidemic groups for the next four weeks. Body weight and blood samples were taken at zero, 4th and 8th week of study. Serum was analyzed for total cholesterol, LDL-cholesterol, HDL-cholesterol and serum triglycerides. LDL/HDL ratio and AIP were calculated. RESULTS: It was observed that date seed powder of the three varieties significantly decreased total cholesterol, serum triglycerides and AIP. There was no significant change in body weight, HDL-cholesterol, and LDL/HDL ratio. LDL cholesterol was decreased significantly only by Khudrawi date seed powder. CONCLUSIONS: It was concluded that date seed powder has marked antihyperlipidemic properties. However, the difference in appearance, taste and price of different dates does not affect their lipid lowering capacity.