Journal of Bahria University Medical and Dental College
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Vasculo-Protective Cover: A Novel Action of Metformin
Get PDFType 2 diabetes is associated with multiple changes/complications in the body that affects almost every organ and system. Inthe cardiovascular system main pathology lies in the vascular endothelium leading to atherosclerosis and arteriosclerosis.Different treatment options are available for diabetes including both oral and injectable drugs. Oral drugs have better compliancelike Sulfonylureas, Alpha glucosidase inhibitors, Glitazones and Maglitinides. These groups of anti-hyperglycemic drugsmaintain blood glucose level, providing diabetics cost effective better life through a physiological route. However, it has beendocumented that these drugs do not delay vascular complications in diabetic patients. Metformin is the first line oral anti-diabeticdrug from biguanide group used to treat type 2 diabetes mellitus. It is a euglycemic agent which decreases glucose levels andhave additional benefit of decreasing the progression of vascular effects in multiple ways
Safety Profile Of Methotrexate And Leflunomide In Rheumatoid Arthritis
No full textObjective: To compare the safety profile of Methotrexate and Leflunomide in patients of rheumatoid arthritis. Material and Methods: A 24-week, single-blind, interventional, study was carried out on 274 patients of either sex, aged 29-69 years, diagnosed to have rheumatoid arthritis. One group was given tablet Methotrexate, 10 mg (four 2.5 mg tablets), once weekly and the other was put on tablet Leflunomide, 20 mg, once daily, orally. At each follow up laboratory parameters (Hb%, TLC, ESR, PC, SGPT,S Creatinine) and adverse effects were evaluated. Results: Of the 274 patients, 126 were on Methotrexate (70.63 % females, 61.11% RF positive, mean age 45.57 + 10.32 years) and 148 on Leflunomide (79.72 % females, 73.64 % RF positive, mean age 46.35 + 9.68 years). Laboratory parameters (TLC, SGPT, creatinine) between the two groups showed statistically significant results at the end of the study. Nausea was seen in 30.2% & 10.8% patients at 6 weeks and 5.6% and 0% at 24 weeks in the Methotrexate and Leflunomide groups respectively while alopecia was seen in 0% & 19.6% patients at 6 weeks and 1.6% & 24.3% at 24 weeks in the Methotrexate and Leflunomide groups respectively. All values were significant statistically. Conclusion: Leflunomide was found to have a better safety profile than Methotrexate as it produced greater improvement in laboratory parameters with lesser adverse effects in comparison to the traditionally used, first-choice, drug Methotrexate.
Comparative Study Of Verapamil And Amytriptyline In Acute Opioid Abstinence Syndrome
No full textABSTRACT: Objective: To evaluate the effectiveness of verapamil and amitriptyline in the treatment of acute opioid withdrawal syndrome in patients with chronic dependence on opioids. Materials and Methods: The study was conducted at Psychological Medicine Ward, Civil Hospital Karachi and Arshi Hospital, Naseerabad, F.B.area, Karachi. A total of forty (40) patients were admitted for ten (10) days in hospital. No treatment was given during the first two days of admission after abrupt termination of opioid to observe the acute opioid withdrawal signs and symptoms. Patients were divided into 2 groups. Each group had 20 opiate addicts. One group was given verapamil orally in a 40mg dose thrice daily and the other group was given amitriptyline orally in a 10mg dose thrice daily from day 3 to day 9 of admission. The intensity of signs and symptoms were recorded by using subjective and objective opiate withdrawal questionnaire. Urine analysis for opioids was done on day 1, 5 and 10 of admission. Results: Verapamil in comparison to amitriptyline significantly decreased the intensity of signs and symptoms of acute opioid withdrawal from day 4 to day 10 of admission. Urine analyses for opioids were positive on day 01 while zero on day 10. Conclusion:Verapamil in comparison to amitriptyline was found to be safe and effective for the treatment of signs and symptoms of acute opioid withdrawal in in-door patients without any significant side effects.
Health Promoting Schools: A Powerful Means of Improving Community Oral Health for Future Generations of Pakistan
Get PDFPublic health has shifted its focus towards social conditions that are responsible for achievement of oral health and preventionof oral diseases like dental caries, periodontal disease and oral cancer. The oral health burden on Pakistani population is alarmingwith children being the most common victim of oral dental diseases. At present knowledge and attitudes of influential professionalssuch as school teachers on oral health and school based preventive programs is poor. Health promoting school is a place whereinstitutional policies, physical and social environment, relation with the community, curriculum and personal skills makes it ahealthy setting for living, learning and working. School serves as a powerful setting for learning of children and healthybehaviors. Lifestyle developed within a school environment are said to be more sustainable. Dental professionals need to workin partnership with school teachers to change attitudes, beliefs and behavior along with provision of knowledg
Disaster Management
Get PDFAll cities are in one way or another vulnerable to someform of disaster. In particular, cities that are located inseismically active regions are vulnerable to earthquakesand volcanoes, while others are vulnerable to hurricanes,typhoons, floods, or tsunamis. Therefore, emergencyand disaster management, which consist both of preemergencyand post-emergency measures, are theimportant components of maintaining safety and securityof the people
Clinical Profile Of Acute Myocardial Infarction Patients At PNS -SHIFA Hospital Karachi
No full textObjective: To study the risk factors, complications and use of streptokinase in patients of acute myocardial infarction (MI) presenting at Coronary Care Unit (CCU) of PNS SHIFA Hospital Karachi. Materials and Methods: This study was conducted at CCU, PNS SHIFA Hospital Karachi, from January 2008 to December 2012. It is a retrospective cohort study with non-probability convenient sampling. Diagnosed MI cases were included in the study from all age groups, gender and backgrounds. Patients with other cardiac/non-cardiac diseases presenting with symptoms similar to MI were excluded. Results: Acute myocardial infarction patients were 418, out of the total 2250 admissions in CCU, 71.29% were males. 67.7% were smokers, 60.2% had sedentary life style, 56.2% patients were known hypertensive and 42.1% were known diabetics. 63.63% were eligible for streptokinase administration at the time of admission. Left ventricular failure developed in 13% patients and 6.6% went into cardiogenic shock. Conclusion: Acute myocardial infarction was found to be fairly common cardiac emergency among all cases admitted in the CCU. It has strong association with male gender, smoking, sedentary life style, hypertension, diabetes mellitus and hyperlipidemia. Left Ventricular failure was the leading complication. 63.63% were eligible for streptokinase administration and mortality rate was 5%.
Preclinical Ward Teaching Student's Perspective
No full text History taking and basic clinical examination plays a pivotal role in the training of medical undergraduates. Medical history is the information gained by a physician by asking specific questions, from the patient with the aim of obtaining information useful in formulating a diagnosis and providing medical care to the patient. The relevant complaints reported by the patient are referred to as symptoms, in contrast to clinical signs, which are seen by direct examination of the patient by the doctor. The information thus gathered, enables the doctor to make a diagnosis and plan treatment for the patient. There is a need to encourage active participation of learners by engaging all students rather than engaging a single one while others observe. Thus history taking and examination skill is central to the transformation of a medical undergraduate student into a competent health professional and must be given due emphasis in medical schools. Keywords: Medical history, clinical examination, student prospectu
Pattern of horizontal squint presentation in pediatric eye department at Civil Hospital Karachi
No full textObjective: To estimate the magnitude and types of horizontal strabismus in children presenting in pediatric ophthalmic and orthoptic clinics. Materials and Methods: A prospective analytical study was conducted on strabismic children presenting in the outpatient department of pediatric ophthalmology and orthoptic clinics at Civil Hospital Karachi from 2008 to 2012. Details of patient was recorded in orthoptic performa that includedbiodata, history of presenting illness, wearing of glasses, patching treatment , previous squint surgery and family history of strabismus. Orthoptic examination as visual acuity assessment with age appropriate tests was performed. Cover test, prism cover test, cycloplegic refraction, hand mounted Slit lamp biomicroscopy and dilated fundus examination was also performed on each patient. Results: A total of 1170 children presented in the pediatrics eye department. 1074 out of 1170 (91.79%) children were diagnosed to have horizontal strabismus. Majority 429(40%) of them were up to four years of age. 698(65%) children had horizontal esotropic strabismus while 376 (35%) had horizontal exotropic strabismus. 276 (25.69 %) esotropics had concomitant constant esotropia while 244(22.7%) exotropics had constant early onset exotropia. Statistical analysis was done by using SPSS version16 Conclusion: The magnitude of horizontal squint was found to be high in children. Esotropia with concomitant constant type was the most common type of strabismus followed by exotropia of constant early onset type
Chemically induced mice cough model
No full textCough is the most common respiratory symptom that has been experienced by every human. Both the chemically and mechanically sensitive airway nerves take part in mediating the cough reflex and establishing synapses in the brainstem's caudal two-thirds of the nucleus tractus solitaries. The sensation of an "urge to cough" is ostensibly associated with activation of broncho- pulmonary C-fibers. These C-fiber nerves become directly activated, 'sensitized' or 'hyper-activated' by chemicals such as capsaicin, bradykinin, adenosine, prostaglandin type E-2 (PGE2), citric acid, hypertonic saline solution, Sulfur dioxide (SO2). Chemically induced cough facilitates the quantification of cough and the assessment of antitussive effects of specific therapeutic agents. Sulphur dioxide gas has been used to elicit cough in various experimental animals like cats, rats and mice
Noise Induced Hearing Loss Iin Karachi An Lagnorant Prooblem
No full textPakistan has a population of over 183 million and it is the world's sixth-most-populous country1.Karachi is the biggest and most populous metropolitan city of Pakistan with an estimated population of over 23.5 million people as reported in 2013. The approximate area of Karachi is 3,527 square km (1,362 square mile) resulting in a density of more than 6,000 people per square kilometer (15,500 per square mile