RESUMEN
OBJECTIVE: To compare the duration and effects of aqueous methanol Acacia-nilotica leaves extract and glibenclamide as hypoglycaemic and hypolipidaemic activity in diabetic rats. METHODS: The experimental study was conducted at Shifa International Hospital in collaboration with National Institute of Health, Islamabad, from September 2010 to August 2011.Male Sprague Dawley albino rats were taken and divided into 8 equal groups. Groups I and II were the normal and diabetic control rats. Diabetes mellitus was induced in group II to VIII by administering 110 mg/kg body weight alloxanand at day 4, fasting blood glucose level of >200 mg/dl confirmed diabetes. Acacia-nilotica leaves extract was given to group III, IV and V and glibenclamide to group VI to VIII for a period of 1-3 weeks. Blood samples were analysed for lipid profile using enzymatic calorimetric method and serum insulin by enzyme-linked immunosorbent assay on days 0, 7, 14, and 21. RESULTS: There were 64 rats in the study, with 8(12.5%) in each group. Statistically significant decreases in fasting blood glucose, total cholesterol, triglyceride, phospholipids, low density lipoprotein, very low density lipoprotein and an increase in high density lipoprotein and serum insulin levels were observed in diabetic rats compared to diabetic controls after 2 weeks of treatment with plant extract and glibenclamide (p<0.05 each).When plant extract and drug treated diabetic rats were compared, a significant difference in the levels of blood glucose, insulin, total cholesterol and triglyceride levels were noted after 2 and 3 weeks of treatment. CONCLUSIONS: Acacia-nilotica leaves extract resulted in hypoglycaemic and hypolipidaemic effect in alloxan-induced diabetic rats similar to glibenclamide.
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Acacia , Diabetes Mellitus Experimental/tratamiento farmacológico , Gliburida/uso terapéutico , Hipoglucemiantes/uso terapéutico , Fitoterapia , Aloxano , Animales , Diabetes Mellitus Experimental/sangre , Lípidos/sangre , Masculino , Extractos Vegetales/uso terapéutico , Hojas de la Planta , Ratas , Ratas Sprague-DawleyRESUMEN
BACKGROUND: In Pakistan there is a dearth of male practitioners in obstetrics and gynaecology (ObG) to cater for emergent needs. The Study was done to explore views of male medical students towards ObG as part of curriculum and to identify the problems during clerkship and its impact on selection of ObG as career. METHODS: The study used a 20-item questionnaire-based survey at Shifa College of Medicine from November 2010 to December 2011. Third and fourth year male students (n=124) who completed ObG rotation were the participants. Inquiries were made regarding patient doctor interaction under residents and faculty members, perception of gender- bias during clerkship, inclusion of ObG in curriculum and subsequently as career. Results were analyzed using binary regression analysis. RESULTS: Sixty percent students were satisfied though embarrassed and under pressure during gynaecological examination in consultant supervision. Another 61% said that ObG should be a part of curriculum (p-0.013) and necessary for male students (p-0.008). 62% of the respondents were of the view that faculty has a major role in encouraging the students to take up ObG as career. 84% students replied in negative to adopt it as profession (p 0.002). CONCLUSION: Although basic obstetric curricular objectives are important for medical practitioners, our social set up discourages male students to have concrete clinical interaction. The faculty needs to take a special supportive role to encourage learning and motivation for this specialty.
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Educación de Pregrado en Medicina , Ginecología/educación , Obstetricia/educación , Estudiantes de Medicina/psicología , Actitud , Selección de Profesión , Prácticas Clínicas , Humanos , Masculino , Pakistán , Percepción , Adulto JovenRESUMEN
Ogilvie's syndrome (OS), a massive dilation of the colon in the absence of mechanical obstruction, is a rare postsurgical complication. The high mortality rate (normally 15-31% and upto 45% after caecal perforation) explains the seriousness of this clinical situation. Early diagnosis is made by plain abdominal X-ray and CT abdomen. Conservative treatment is usually effective and surgery should be reserved for complicated cases or refractory to conservative treatment. We report a case of 25 years primigravida who developed OS, 24 hours after cesarean section, which was treated by conservative methods.
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Cesárea/efectos adversos , Seudoobstrucción Colónica/diagnóstico , Complicaciones Posoperatorias/diagnóstico , Adulto , Seudoobstrucción Colónica/etiología , Seudoobstrucción Colónica/terapia , Femenino , Humanos , Complicaciones Posoperatorias/terapia , Embarazo , Tomografía Computarizada por Rayos X , Resultado del TratamientoRESUMEN
BACKGROUND: In Pakistan maternal mortality rate (MMR) is very high and more than one in five women die from pregnancy related causes; solution to this is to have low fertility rate. The emergency contraceptives (ECs) can be used to prevent unwanted pregnancies. The aim of this study was to assess the knowledge, attitude and practice about ECs among doctors. METHODS: Institution-based cross-sectional descriptive study on knowledge, attitude and practice of ECs was conducted at Rawal Hospital from Feb to May, 2012. Data was collected using structured questionnaire and analysed using SPSS-16. RESULTS: Fifty-seven percent of the respondents were > 30 years of age, 94% were Muslim, 81% were married and 51% were women. Ninety-seven percent had heard of ECs before, only 17% knew Intra-uterine contraceptive device (IUCD) a method of EC. Sixty-one percent responded that IUCD should be removed if patient gets pregnant (p = 0.007) and according to 31% ECs were not abortifacient (p = 0.045). Regarding attitude, 55.5% of the participants supported its use (p = 0.027) and agreed to its easy accessibility (p = 0.004). Thirty-eight percent responded an increased dose of birth control pills as a form of EC (p = 0.008), while 40% did not agree that ECs are effective when taken before intercourse (p = 0.011). CONCLUSION: Knowledge and practice of ECs is very low among doctors but a positive attitude is there. Evidence-based knowledge to family physicians regarding emergency contraception is strongly recommended to reduce the chances of MMR.
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Actitud del Personal de Salud , Competencia Clínica , Anticoncepción Postcoital , Pautas de la Práctica en Medicina/estadística & datos numéricos , Adulto , Estudios Transversales , Femenino , Humanos , Masculino , Pakistán , Embarazo , Encuestas y Cuestionarios , Centros de Atención TerciariaRESUMEN
OBJECTIVES: To evaluate the hypoglycaemic and anti-platelet aggregation effect of aqueous methanol extract of Acacia Nilotica (AN) leaves compared with glyburide on streptozotocin induced diabetic rats. METHODS: Diabetes mellitus was induced in 90 out of 120 albino rats by administering 50 mg/kg body weight (b.w) streptozotocin and was confirmed by measuring fasting blood glucose level >200 mg/dL on 4th post-induction day. The rats were equally divided into 4 groups, A (normal control), B (diabetic control), C (diabetic rats treated with AN extract) and group D (diabetic rats treated with glyburide). The rats of group C and D were given 300 mg/kg b.w AN extract and 900 microgm/kg b.w glyburide respectively for 3 weeks. Blood glucose was measured by glucometer, platelet aggregation by Dia-Med method and insulin and beta-thromboglobulin by ELISA technique. RESULTS: A significant increase (p<0.05) in fasting blood glucose, beta-thromboglobulin and platelet aggregation and a significant decrease (p<0.05) in insulin levels was observed in streptozotocin induced diabetic rats than the normal controls. The rats treated with AN extract and glyburide showed a significant decrease (p<0.05) in fasting blood glucose and increase (p<0.05) in insulin levels than the diabetic control rats. However, the levels in both the treatment groups remained significantly different than the normal controls. A significant decrease (p<0.05) in beta-thromboglobulin levels was seen in diabetic rats treated with glyburide than the diabetic control rats and diabetic rats treated with AN extract. CONCLUSIONS: AN leaves extract result into hypoglycaemic and anti-platelet aggregation activity in diabetic rats as that of glyburide.
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Acacia/química , Glucemia/análisis , Diabetes Mellitus Experimental/sangre , Gliburida/farmacología , Hipoglucemiantes/farmacología , Insulina/sangre , Agregación Plaquetaria/efectos de los fármacos , beta-Tromboglobulina/análisis , Animales , Glucemia/efectos de los fármacos , Diabetes Mellitus Experimental/tratamiento farmacológico , Extractos Vegetales/farmacología , Hojas de la Planta/química , Ratas , EstreptozocinaRESUMEN
BACKGROUND: To consider new hypoglycaemic, anti-hyperlipidaemic and anti-platelet aggregation sources, aqueous methanol extract of Acacia Nilotica (AN) leaves was investigated in streptozotocin induced diabetic rats. METHODS: Diabetes mellitus was induced in 90 out of 120 male albino rats by administering 50 mg/Kg bodyweight (bw) streptozotocin intraperitonealy, and was confirmed by measuring fasting blood glucose level > 200 mg/dL on 4th post-induction day. The rats were equally divided into 4 groups, A (normal control), B (diabetic control), C (diabetics rats treated with plant extract) and group D (diabetics rats treated with glyburide). The rats of group C and D were given single dose of 300 mg/Kg bw, AN extract, and 900 microg/Kg bw glyburide respectively for 3 weeks. Blood glucose levels were measured by glucometer, platelet aggregation by DiaMed method, beta-thromboglobulin and insulin by ELISA technique, and lipid components were measured by enzymatic calorimetric method. RESULTS: Significant differences (p < 0.05) were noticed in blood glucose, serum insulin, platelet aggregation and triglyceride levels in diabetic rats treated with AN extract and glyburide as compared to diabetic controlled rats. A significant difference (p < 0.05) in beta-thromboglobulin and LDL levels was also noticed in rats treated with glyburide than the diabetic controlled rats. The levels of fasting blood glucose, beta-thromboglobulin and platelet aggregation were significantly reduced (p < 0.05) in diabetic rats treated with glyburide than AN extract treated rats. CONCLUSIONS: Administration of AN leaves extract showed hypoglycaemic and anti-platelet aggregation activity in diabetic rats as that of glyburide.
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Acacia/química , Diabetes Mellitus Experimental/tratamiento farmacológico , Gliburida/farmacología , Hiperglucemia/tratamiento farmacológico , Hiperlipidemias/tratamiento farmacológico , Hipoglucemiantes/farmacología , Extractos Vegetales/farmacología , Hojas de la Planta/química , Agregación Plaquetaria/efectos de los fármacos , Animales , Glucemia/análisis , Diabetes Mellitus Experimental/sangre , Ensayo de Inmunoadsorción Enzimática , Masculino , Ratas , Estreptozocina , beta-Tromboglobulina/análisisRESUMEN
BACKGROUND: The elevated WBC count has been accepted as part of healing response following myocardial infarction as well as a predictor of adverse cardiovascular events. The study was designed to find out correlation between WBC count and coronary risk factors, cardiac biomarkers, C-reactive protein (CRP), incidence of adverse cardiac events and mortality in patients of ACS in Pakistan. METHODS: One hundred and thirty-three patients of ACS were stratified according to WBC categories, WBC1 (< 7000/mm3), WBC2 (7100-10,000/mm3) and WBC3 (> 10,000/mm3). The WBCs were counted on admission by Sysmex cell counter, CRP by immunoturbidimetric method, and CK-MB and Trop-I by enzyme immunoassay. Adverse cardiac events and mortality were recorded for 12 months of follow up period. RESULTS: Long-term mortality in patients with ACS was 6.4% in WBC1, 18.2% in WBC2 and 40.9% in WBC3 categories, while short term mortality was 2.6%, 3.0% and 18.2% in WBC1, WBC2, and WBC3 categories respectively. Relative to patients in lower 2 WBC categories, patients in the highest category were 7 times more likely to die during 30 days (HR 7.83, p = 0.017) and more than 9 times during the total follow up period (HR 9.42, p < 0.001). Cox regression analysis showed WBC3 a strong independent predictor of mortality (HR 6.36, p = 0.016). WBC count showed a positive correlation with coronary risk factors, cardiac biomarkers and CRP. CONCLUSION: WBC count is a strong independent predictor of mortality in patients with ACS and has positive correlation with coronary risk factors, cardiac biomarkers and CRP.
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Síndrome Coronario Agudo/sangre , Recuento de Leucocitos , Síndrome Coronario Agudo/mortalidad , Biomarcadores/sangre , Proteína C-Reactiva/metabolismo , Distribución de Chi-Cuadrado , Estudios de Cohortes , Femenino , Humanos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Pronóstico , Modelos de Riesgos Proporcionales , Factores de RiesgoRESUMEN
BACKGROUND: Inflammation plays a key role in the initiation and progression of atherosclerosis, the most common cause of acute coronary syndrome. C-reactive protein (CRP) that enhances plaque inflammation is synthesized six hours after myocardial infarction. METHODS: High sensitivity C-reactive protein was measured by Immunoturbiditory method in 50 healthy controls and 100 patients of acute coronary syndrome on conservative or interventional management. RESULTS: Serum C-reactive protein levels [mg/L +/- SEM] at the time of admission were significantly raised in patients of acute coronary syndrome (11.90 +/- 2.30) as compared to controls (2.30 +/- 0.18) and further increased progressively during 24 hours of follow up period. C-reactive protein levels also increased significantly in patients who underwent interventional management (115.90 +/- 7.73) as compared to those who were on conservative management (22.28 +/- 5.54). CONCLUSION: Serum C-reactive protein levels were found to be significantly raised in patients with acute coronary syndrome as compared to controls. In addition, patients undergoing interventional management had higher C-reactive protein levels, post intervention, as compared to those on conservative management.