A. Rashid, U. Tulain, F. Iqbal, N. Malikd, Alia Erum
Background: Anti hypertensive drugs like “Nicorandil” require frequent dosing due to their shorter half-life. Such drugs are also pH sensitive, due to which greater portions of these drugs are degraded in acidic pH of stomach resulting in lesser bioavailability. The objective of this study was to formulate graft polymeric carrier system for sustained delivery of nicorandil to minimize dosing frequency and enhance patient compliance. Materials Methods: This animal model study was conducted in Department of Pharmacy, Islamia University of Bahawalpur, Pakistan. Hydroxypropyl methyl cellulose-graft-acrylic acid hydrogels were synthesized by free radical solution polymerization with diverse weight ratios of polymer, monomer and cross linker. Total duration of study was 1.5 years from March 2013 to August 2015. The N, N-methylene bis acrylamide and potassium persulfate were used as crosslinker and initiator respectively. Hydrogels were characterized for swelling ratio, equilibrium swelling, gel content, porosity and in vitro drug release. The surface morphology of synthesized hydrogels was evaluated by using Scanning Electron Microscopy. Thermal properties of hydrogels were evaluated by Thermogravimetric Analysis and Differential Scanning Calorimetry whereas FTIR was done to examine chemical compatibility. Finally, in vivo evaluation of prepared hydrogels was carried out in rabbits using simple parallel study design to estimate various pharmacokinetic parameters.Results: HPMC-co-AA hydrogels had good pH sensitivity whereas; they demonstrated maximum and minimum swelling at pH 7.4 and 1.2 respectively. Swelling ratio, gel fraction and cumulative percent drug release were decreased with increasing crosslinker concentration while these parameters were increased with increasing AA and HPMC concentrations. A porous network was observed in the SEM images. All formulation ingredients of prepared hydrogels showed good compatibility as determined by FTIR. Results of in vivo study proved the pH sensitivity and sustained drug release of prepared hydrogels.Conclusion: The HPMC-graft-AA hydrogels showed good pH-sensitivity and sustained-release profile for model drug nicorandil.
{"title":"SYNTHESIS, CHARACTERIZATION AND IN VIVO EVALUATION OF PH SENSITIVE HYDROXYPROPYL METHYL CELLULOSE-GRAFT-ACRYLIC ACID HYDROGELS FOR SUSTAINED DRUG RELEASE OF MODEL DRUG NICORANDIL","authors":"A. Rashid, U. Tulain, F. Iqbal, N. Malikd, Alia Erum","doi":"10.46903/GJMS/18.03.875","DOIUrl":"https://doi.org/10.46903/GJMS/18.03.875","url":null,"abstract":"Background: Anti hypertensive drugs like “Nicorandil” require frequent dosing due to their shorter half-life. Such drugs are also pH sensitive, due to which greater portions of these drugs are degraded in acidic pH of stomach resulting in lesser bioavailability. The objective of this study was to formulate graft polymeric carrier system for sustained delivery of nicorandil to minimize dosing frequency and enhance patient compliance. Materials Methods: This animal model study was conducted in Department of Pharmacy, Islamia University of Bahawalpur, Pakistan. Hydroxypropyl methyl cellulose-graft-acrylic acid hydrogels were synthesized by free radical solution polymerization with diverse weight ratios of polymer, monomer and cross linker. Total duration of study was 1.5 years from March 2013 to August 2015. The N, N-methylene bis acrylamide and potassium persulfate were used as crosslinker and initiator respectively. Hydrogels were characterized for swelling ratio, equilibrium swelling, gel content, porosity and in vitro drug release. The surface morphology of synthesized hydrogels was evaluated by using Scanning Electron Microscopy. Thermal properties of hydrogels were evaluated by Thermogravimetric Analysis and Differential Scanning Calorimetry whereas FTIR was done to examine chemical compatibility. Finally, in vivo evaluation of prepared hydrogels was carried out in rabbits using simple parallel study design to estimate various pharmacokinetic parameters.Results: HPMC-co-AA hydrogels had good pH sensitivity whereas; they demonstrated maximum and minimum swelling at pH 7.4 and 1.2 respectively. Swelling ratio, gel fraction and cumulative percent drug release were decreased with increasing crosslinker concentration while these parameters were increased with increasing AA and HPMC concentrations. A porous network was observed in the SEM images. All formulation ingredients of prepared hydrogels showed good compatibility as determined by FTIR. Results of in vivo study proved the pH sensitivity and sustained drug release of prepared hydrogels.Conclusion: The HPMC-graft-AA hydrogels showed good pH-sensitivity and sustained-release profile for model drug nicorandil.","PeriodicalId":44174,"journal":{"name":"Gomal Journal of Medical Sciences","volume":"1 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2020-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41355692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The industrial revolution in 1830 led to the urbanization resulting in creation of urban slums. More complex health problems ultimately steered the concept of public health. The social revolution during the Second World War emphasized that health could only be achieved through socioeconomic improvement. Progress in the field of social sciences rediscovered that man is a social being, not only a biological animal. Social services for the improvement of life conditions have been the major factors in reducing mortality, morbidity and improving the standard of life of an individual, family and society.
{"title":"IMPORTANCE OF SOCIAL FACTORS IN HEALTH: CAUSES OF THE CAUSES","authors":"I. Ahmad","doi":"10.46903/GJMS/18.03.877","DOIUrl":"https://doi.org/10.46903/GJMS/18.03.877","url":null,"abstract":"The industrial revolution in 1830 led to the urbanization resulting in creation of urban slums. More complex health problems ultimately steered the concept of public health. The social revolution during the Second World War emphasized that health could only be achieved through socioeconomic improvement. Progress in the field of social sciences rediscovered that man is a social being, not only a biological animal. Social services for the improvement of life conditions have been the major factors in reducing mortality, morbidity and improving the standard of life of an individual, family and society.","PeriodicalId":44174,"journal":{"name":"Gomal Journal of Medical Sciences","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2020-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48485891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Hussain, S. M. Azeem, Imran Ullah, S. Ahmad, Muhammad Faisal Khan, M. Shahzad
Background: Acute small intestinal obstruction (ASIO) is one of the commonest causes of emergency hospital admissions, morbidity and mortality. Intestinal tuberculosis (ITB) is common cause of ASIO in developing countries leading to significant morbidity and mortality. Our objectives were to determine prevalence, distribution and determinants of ITB in adult indoor patients with ASIO in population of Peshawar Division, Pakistan. Materials & Methods: This cross-sectional study was conducted at Department of Surgery Peshawar Medical College, Peshawar, Pakistan from January 2019 to June 2020. The data was collected from its three affiliated hospitals; Mercy Teaching Hospital, Kuwait Teaching Hospital & Prime Teaching Hospital, Peshawar. 207 ASIO subjects were selected from population at risk consecutively. Sex, age groups and presence of ITB were variables. Prevalence and distribution were described by count, percentage and confidence intervals for proportion for population. Hypotheses for distribution were tested by chi-square goodness of fit and of association by chi-square test of association. Results: Out of 207 patients with ASIO, 128 (61.84%) were men and 79 (38.16%) women, 87 (42.03%) were in age group 18-40 and 120 (57.97%) in 41-60 years. Out of 207 patients with ASIO, 41 (19.81%) had ITB, while 166 (80.19%) had no ITB. Out of 41 ITB patients, 25 (12.08%) were men and 16 (7.73%) women, 17 (8.21%) in age group 18-40 and 24 (11.60%) in 41-60 years. The prevalence of ITB was similar to expected (p=.5695). The distribution across sex (p=.00001) was different and across age groups (p=.12501) was similar to expected. Presence of ITB was not associated to sex (p=.8992) and age groups (p=.9347). Conclusion: Prevalence of intestinal TB in adult indoor acute small intestinal obstruction (ASIO) population of Peshawar Division, Pakistan was 19.81%. Prevalence was higher in men than women and higher in 41-60 years than 18-40 years age group population. Overall prevalence of intestinal TB was similar to expected. Observed distribution across sex was different and across age groups was similar to expected. Presence of intestinal TB was not associated to sex and age groups respectively.
{"title":"PREVALENCE, DISTRIBUTION AND DETERMINANTS OF INTESTINAL TUBERCULOSIS IN ADULT INDOOR PATIENTS WITH ACUTE SMALL INTESTINAL OBSTRUCTION IN POPULATION OF PESHAWAR DIVISION, PAKISTAN","authors":"A. Hussain, S. M. Azeem, Imran Ullah, S. Ahmad, Muhammad Faisal Khan, M. Shahzad","doi":"10.46903/GJMS/18.03.832","DOIUrl":"https://doi.org/10.46903/GJMS/18.03.832","url":null,"abstract":"Background: Acute small intestinal obstruction (ASIO) is one of the commonest causes of emergency hospital admissions, morbidity and mortality. Intestinal tuberculosis (ITB) is common cause of ASIO in developing countries leading to significant morbidity and mortality. Our objectives were to determine prevalence, distribution and determinants of ITB in adult indoor patients with ASIO in population of Peshawar Division, Pakistan. Materials & Methods: This cross-sectional study was conducted at Department of Surgery Peshawar Medical College, Peshawar, Pakistan from January 2019 to June 2020. The data was collected from its three affiliated hospitals; Mercy Teaching Hospital, Kuwait Teaching Hospital & Prime Teaching Hospital, Peshawar. 207 ASIO subjects were selected from population at risk consecutively. Sex, age groups and presence of ITB were variables. Prevalence and distribution were described by count, percentage and confidence intervals for proportion for population. Hypotheses for distribution were tested by chi-square goodness of fit and of association by chi-square test of association. Results: Out of 207 patients with ASIO, 128 (61.84%) were men and 79 (38.16%) women, 87 (42.03%) were in age group 18-40 and 120 (57.97%) in 41-60 years. Out of 207 patients with ASIO, 41 (19.81%) had ITB, while 166 (80.19%) had no ITB. Out of 41 ITB patients, 25 (12.08%) were men and 16 (7.73%) women, 17 (8.21%) in age group 18-40 and 24 (11.60%) in 41-60 years. The prevalence of ITB was similar to expected (p=.5695). The distribution across sex (p=.00001) was different and across age groups (p=.12501) was similar to expected. Presence of ITB was not associated to sex (p=.8992) and age groups (p=.9347). Conclusion: Prevalence of intestinal TB in adult indoor acute small intestinal obstruction (ASIO) population of Peshawar Division, Pakistan was 19.81%. Prevalence was higher in men than women and higher in 41-60 years than 18-40 years age group population. Overall prevalence of intestinal TB was similar to expected. Observed distribution across sex was different and across age groups was similar to expected. Presence of intestinal TB was not associated to sex and age groups respectively.","PeriodicalId":44174,"journal":{"name":"Gomal Journal of Medical Sciences","volume":"18 1","pages":"107-115"},"PeriodicalIF":0.5,"publicationDate":"2020-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48562065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zeeshan Saleem, Imran Ullah, Muhammad Sarim Bin Farooq Awan, Jamal Tauqir, F. Younis, Nisar Khan, Muhammad Riaz, Huzaifa Tahir Saeed Siddiqui, A. Alam, Noman Ullah, M. Asif, M. Arif, Sadeeq Ahmad, Hamza Shafiq, Sohail Ahmad Meer, Rahmail Khan, M. Ayub
Background: Drug-resistant tuberculosis (DR-TB) is the major cause of mortality worldwide. Our objectives were to determine the distribution of DR-TB by sex, age groups, occupation, province, division, district, type of disease, type of drug resistance, treatment regimen and outcome of treatment in DR-TB population in D.I.Khan Division, Pakistan. Materials & Methods: This cross-sectional study was conducted in Department of Community Medicine, Gomal Medical College, D.I.Khan, Pakistan. A sample of 286 DR-TB patients was selected consecutively from population at risk. Sex, age groups, occupation, province, division and district were demographic while type of disease, type of drug resistance, treatment regimen and outcome of treatment were research variables. All variables being nominal were described by count, percentage & cumulative percentage with 95% confidence interval for proportion. Distribution of DR-TB patients by all the ten variables were substantiated by chi-square goodness-of-fit test. Results: Out of 286 DR-TB patients, 123 (43%) were men and 163 (57%) women. DR-TB cases were most prevalent in age group 15-44 years 172 (60.14%), housewife 140 (48.95%), Khyber Pakhtunkhwa 175 (61.19%), D.I.Khan Division 178 (62.24%) and district 121 (42.31%). Most common type of disease, drug resistance and treatment regimen was pulmonary TB 282 (98.60%), MDR 273 (95.45%) and longer treatment (n=273 MDR-TB) 246 (90.11%) respectively. Treatment success rate was 161 (56.29%). The observed prevalence by occupation, province, division, district and type of disease in our sample was similar to expected prevalence in population (p>.05 for all), while it was different from population by sex, age groups, type of drug resistance, regimen and treatment outcome (p<.05 for all). Conclusion: The prevalence of DR-TB was higher in women, age group 15-44 years, housewife, Khyber Pakhtunkhwa and D.I.Khan Division and District. Most common type of disease, drug resistance and treatment regimen was pulmonary TB, MDR and longer treatment respectively. Treatment success rate was 56.29%. The observed prevalence by occupation, province, division, district and type of disease in sample was similar to population, while it was different by sex, age groups, type of drug resistance, regimen and treatment outcome.
{"title":"DISTRIBUTION OF DR-TB BY SEX, AGE GROUPS, OCCUPATION, PROVINCE, DIVISION, DISTRICT, TYPE OF DISEASE, TYPE OF DRUG RESISTANCE, TREATMENT REGIMEN AND OUTCOME OF TREATMENT IN DR-TB POPULATION IN D.I.KHAN DIVISION, PAKISTAN","authors":"Zeeshan Saleem, Imran Ullah, Muhammad Sarim Bin Farooq Awan, Jamal Tauqir, F. Younis, Nisar Khan, Muhammad Riaz, Huzaifa Tahir Saeed Siddiqui, A. Alam, Noman Ullah, M. Asif, M. Arif, Sadeeq Ahmad, Hamza Shafiq, Sohail Ahmad Meer, Rahmail Khan, M. Ayub","doi":"10.46903/GJMS/18.03.897","DOIUrl":"https://doi.org/10.46903/GJMS/18.03.897","url":null,"abstract":"Background: Drug-resistant tuberculosis (DR-TB) is the major cause of mortality worldwide. Our objectives were to determine the distribution of DR-TB by sex, age groups, occupation, province, division, district, type of disease, type of drug resistance, treatment regimen and outcome of treatment in DR-TB population in D.I.Khan Division, Pakistan. Materials & Methods: This cross-sectional study was conducted in Department of Community Medicine, Gomal Medical College, D.I.Khan, Pakistan. A sample of 286 DR-TB patients was selected consecutively from population at risk. Sex, age groups, occupation, province, division and district were demographic while type of disease, type of drug resistance, treatment regimen and outcome of treatment were research variables. All variables being nominal were described by count, percentage & cumulative percentage with 95% confidence interval for proportion. Distribution of DR-TB patients by all the ten variables were substantiated by chi-square goodness-of-fit test. Results: Out of 286 DR-TB patients, 123 (43%) were men and 163 (57%) women. DR-TB cases were most prevalent in age group 15-44 years 172 (60.14%), housewife 140 (48.95%), Khyber Pakhtunkhwa 175 (61.19%), D.I.Khan Division 178 (62.24%) and district 121 (42.31%). Most common type of disease, drug resistance and treatment regimen was pulmonary TB 282 (98.60%), MDR 273 (95.45%) and longer treatment (n=273 MDR-TB) 246 (90.11%) respectively. Treatment success rate was 161 (56.29%). The observed prevalence by occupation, province, division, district and type of disease in our sample was similar to expected prevalence in population (p>.05 for all), while it was different from population by sex, age groups, type of drug resistance, regimen and treatment outcome (p<.05 for all). Conclusion: The prevalence of DR-TB was higher in women, age group 15-44 years, housewife, Khyber Pakhtunkhwa and D.I.Khan Division and District. Most common type of disease, drug resistance and treatment regimen was pulmonary TB, MDR and longer treatment respectively. Treatment success rate was 56.29%. The observed prevalence by occupation, province, division, district and type of disease in sample was similar to population, while it was different by sex, age groups, type of drug resistance, regimen and treatment outcome.","PeriodicalId":44174,"journal":{"name":"Gomal Journal of Medical Sciences","volume":"18 1","pages":"116-131"},"PeriodicalIF":0.5,"publicationDate":"2020-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45943881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-16DOI: 10.46903/gjms/17.03.1967
A. Awan, Iram Naz, Muhammad Khurram Mahmood, H. Uddin
Background: Pseudo-epitheliomatous Hyperplasia (PEH) is a benign proliferation of epithelium occurring in response to various neoplastic lesions, infections and inflammatory processes. It can be mistaken especially in small biopsies for an invasive oral squamous cell carcinoma (OSCC). The objective of this study was to determine the expression and comparison of immunohistochemical marker E-cadherin in OSCC and PEH lesions. Materials & Methods: This cross-sectional study was conducted in Department of Histopathology, Armed Forces Institute of Pathology, Rawalpindi, Pakistan from January 2013 to March 2016. 60 paraffin embedded cases, 30 each of PEH and OSCC were retrieved and stained with haematoxylin and eosin. They were then immune-stained with E-cadherin and expression evaluated and compared in two lesions by histopathologist. Age, sex, site of lesion and E-cadherin expression were variables. Age was described by mean and SD and other variables as frequency and percentages. Results: Mean age of OSCC group was 60.1±17.3 years and PEH group 52.7±16.6 years. OSCC group included 16 (53.33%) men and 14 (46.67%) women. PEH group included 18 (60%) men and 12 (40%) women. In OSCC group, site of lesion was buccal mucosa 12 (40%) cases, gingiva 10 (33.3%), tongue 7 (23.3%) and floor of mouth 1 (3.4%) case. In PEH group, site of lesion was buccal mucosa 12 (40%) cases, tongue 11 (36.67%), gingiva 6 (20%) and palate 1 (3.3%) case. The expression of E-cadherin was negative in all 30 cases of OSCC and positive in 29/30 (96.67%) cases in PEH. Conclusion: E-cadherin can be used as an ancillary marker in the differentiation of oral squamous cell carcinoma and pseudo-epitheliomatous hyperplasia.
{"title":"COMPARISON OF EXPRESSION OF E-CADHERIN IN ORAL PSEUDOEPITHELIOMATOUS HYPERPLASIA AND ORAL SQUAMOUS CELL CARCINOMA","authors":"A. Awan, Iram Naz, Muhammad Khurram Mahmood, H. Uddin","doi":"10.46903/gjms/17.03.1967","DOIUrl":"https://doi.org/10.46903/gjms/17.03.1967","url":null,"abstract":"Background: Pseudo-epitheliomatous Hyperplasia (PEH) is a benign proliferation of epithelium occurring in response to various neoplastic lesions, infections and inflammatory processes. It can be mistaken especially in small biopsies for an invasive oral squamous cell carcinoma (OSCC). The objective of this study was to determine the expression and comparison of immunohistochemical marker E-cadherin in OSCC and PEH lesions. \u0000Materials & Methods: This cross-sectional study was conducted in Department of Histopathology, Armed Forces Institute of Pathology, Rawalpindi, Pakistan from January 2013 to March 2016. 60 paraffin embedded cases, 30 each of PEH and OSCC were retrieved and stained with haematoxylin and eosin. They were then immune-stained with E-cadherin and expression evaluated and compared in two lesions by histopathologist. Age, sex, site of lesion and E-cadherin expression were variables. Age was described by mean and SD and other variables as frequency and percentages. \u0000Results: Mean age of OSCC group was 60.1±17.3 years and PEH group 52.7±16.6 years. OSCC group included 16 (53.33%) men and 14 (46.67%) women. PEH group included 18 (60%) men and 12 (40%) women. In OSCC group, site of lesion was buccal mucosa 12 (40%) cases, gingiva 10 (33.3%), tongue 7 (23.3%) and floor of mouth 1 (3.4%) case. In PEH group, site of lesion was buccal mucosa 12 (40%) cases, tongue 11 (36.67%), gingiva 6 (20%) and palate 1 (3.3%) case. \u0000The expression of E-cadherin was negative in all 30 cases of OSCC and positive in 29/30 (96.67%) cases in PEH. \u0000Conclusion: E-cadherin can be used as an ancillary marker in the differentiation of oral squamous cell carcinoma and pseudo-epitheliomatous hyperplasia.","PeriodicalId":44174,"journal":{"name":"Gomal Journal of Medical Sciences","volume":"17 1","pages":"70-74"},"PeriodicalIF":0.5,"publicationDate":"2020-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44679433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-16DOI: 10.46903/gjms/17.03.2070
F. Abid, Mohammad Saleem, Saleha Yasir, S. Arshad, S. Qureshi, M. Bajwa, Sana Ashiq, Samreen Tanveer, Mehiwh Qayyum, K. Ashiq
Cancer has been a fatal disease since many decades. Over the time, it is presented in multiple ways and is a matter of consideration as accounts for the high rate of mortality. The aim of the current review was to focus on the genetics, epigenetics factors and role of medicinal plants for the cure of this inimical disease. Related articles available in English language (2002-2018) were reviewed with help of different database, including PubMed, Springer Link, Medline, Google Scholar and ScienceDirect. In order to ensure credibility and accuracy of data only those articles were considered which are published in indexed journals i.e. Web of Science and Scopus. This project was conducted at the Department of Pharmacy, Government College University, Faisalabad, Pakistan from 02-01-2019 to 28-02-2019. The genetic machinery is vibrantly involved in the interpretation of the signals and is observed to be affected by various dietary factors. A sequence of modified activities is observed with use of these dietary elements. However, the modification is reviewed through the histone acetyltransferase (HAT), histone deacetylase (HDAC) and DNA methyl transferase (DNMTs), effecting the expression of gene. These modified genes, in turn then express the signals in multiple reformed ways. Different dietary elements that are used such as polyphenol, alkaloid and flavonoids are effective against cancer. The progression of disease involves genetics and epigenetics due to amplification, translocation and mutation during gene expression. Though, many studies have been conducted elaborating the role of plants and their ingredients which play a part in inhibition of cancerous cells by blockade of cell cycle and apoptosis; more in-depth investigations are still required to identify the new drug target and novel therapeutic modalities.
几十年来，癌症一直是一种致命的疾病。随着时间的推移，它以多种方式呈现，并且是一个值得考虑的问题，因为它解释了高死亡率。现就其遗传学、表观遗传学因素及药用植物在该病治疗中的作用作一综述。通过PubMed、施普林格Link、Medline、谷歌Scholar和ScienceDirect等数据库对2002-2018年的相关英文文章进行了检索。为了确保数据的可信度和准确性，只考虑那些在索引期刊(即Web of Science和Scopus)上发表的文章。该项目于2019年2月1日至2019年2月28日在巴基斯坦费萨拉巴德政府学院大学药学系进行。遗传机制活跃地参与了信号的解释，并被观察到受到各种饮食因素的影响。使用这些饮食元素可以观察到一系列的活性变化。然而，通过组蛋白乙酰转移酶(HAT)、组蛋白去乙酰化酶(HDAC)和DNA甲基转移酶(DNMTs)对基因表达的影响进行了修饰。这些被修改的基因，反过来以多种重组的方式表达信号。不同的饮食元素如多酚、生物碱和类黄酮对抗癌有效。由于基因表达过程中的扩增、易位和突变，疾病的进展涉及遗传学和表观遗传学。然而，许多研究已经详细阐述了植物及其成分通过阻断细胞周期和凋亡来抑制癌细胞的作用;还需要更深入的研究来确定新的药物靶点和新的治疗方式。
{"title":"CANCER EPIGENETICS AND THE ROLE OF DIETARY ELEMENTS","authors":"F. Abid, Mohammad Saleem, Saleha Yasir, S. Arshad, S. Qureshi, M. Bajwa, Sana Ashiq, Samreen Tanveer, Mehiwh Qayyum, K. Ashiq","doi":"10.46903/gjms/17.03.2070","DOIUrl":"https://doi.org/10.46903/gjms/17.03.2070","url":null,"abstract":"Cancer has been a fatal disease since many decades. Over the time, it is presented in multiple ways and is a matter of consideration as accounts for the high rate of mortality. The aim of the current review was to focus on the genetics, epigenetics factors and role of medicinal plants for the cure of this inimical disease. Related articles available in English language (2002-2018) were reviewed with help of different database, including PubMed, Springer Link, Medline, Google Scholar and ScienceDirect. In order to ensure credibility and accuracy of data only those articles were considered which are published in indexed journals i.e. Web of Science and Scopus. This project was conducted at the Department of Pharmacy, Government College University, Faisalabad, Pakistan from 02-01-2019 to 28-02-2019. The genetic machinery is vibrantly involved in the interpretation of the signals and is observed to be affected by various dietary factors. A sequence of modified activities is observed with use of these dietary elements. However, the modification is reviewed through the histone acetyltransferase (HAT), histone deacetylase (HDAC) and DNA methyl transferase (DNMTs), effecting the expression of gene. These modified genes, in turn then express the signals in multiple reformed ways. Different dietary elements that are used such as polyphenol, alkaloid and flavonoids are effective against cancer. The progression of disease involves genetics and epigenetics due to amplification, translocation and mutation during gene expression. Though, many studies have been conducted elaborating the role of plants and their ingredients which play a part in inhibition of cancerous cells by blockade of cell cycle and apoptosis; more in-depth investigations are still required to identify the new drug target and novel therapeutic modalities.","PeriodicalId":44174,"journal":{"name":"Gomal Journal of Medical Sciences","volume":"17 1","pages":"96-104"},"PeriodicalIF":0.5,"publicationDate":"2020-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46674256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-16DOI: 10.46903/gjms/17.03.2027
Z. Hayat, I. Ullah, Khizar Hayat, H. Khan, Fazle Raziq, H. Khan
Background: Falciparum malaria is a common disease in our area. Apart from its classical presentation, at times it may present with refractory anemia or pancytopenia. The aim of this study was to determine the refractory anemia and pancytopenia as complications of falciparum malaria and apart from peripheral blood smears the significance of rapid antigen tests and bone marrow examination in the diagnosis of falciparum malaria. Material & Methods: The descriptive study included 200 consecutive cases of fever and refractory anemia or pancytopenia from 2011 to 2014. Stratification of patients according to the clinical scenario included Group-A having fever with refractory anemia and Group-B with fever and pancytopenia. A detailed history, thorough clinical examination, and pertinent laboratory tests were performed. All patients were treated with antimalarial drugs and followed-up for eight weeks. The pre and post treatment hematologic parameters were compared. Results: Among the 200 patients, 85 were males and 115 females. The age ranged from 15 to 55 years. Stratification of patients on clinical scenario revealed 175(87.5%) patients with fever and refractory anemia (Group-A). Among these, 125(62.5%) patients were reported smear positive for P. falciparum. In the remaining 50 smear negative patients rapid antigen tests were performed and all were reported positive. In 25 patients of Group B with fever and pancytopenia, the peripheral smear for malaria was positive only in 5 patients. In the remaining 20 cases both the peripheral blood smears and rapid antigen tests were reported negative. Bone marrow examination was planned to confirm the bone marrow suppression as the cause of peripheral pancytopenia, to exclude leukemia and to identify P. falciparum. The bone marrow examination revealed P. falciparum in all these cases. All the patients had a dramatic response to treatment with antimalarials in terms of disappearance of fever and correction of anemia and bone marrow rescue with reversal of pancytopenia to normal counts. Conclusion: Plasmodium falciparum should be considered in all cases of prolonged fever with refractory anemia or pancytopenia in malaria endemic areas, even with negative smear and rapid antigen tests. Bone examination is mandatory for the diagnosis in such cases. There is dramatic response of such patients to treatment with antimalarial drugs and hematinics.
{"title":"REFRACTORY ANEMIA AND PANCYTOPENIA AS PRESENTATIONS OF FALCIPARUM MALARIA IN POPULATION OF KHYBER PAKHTUNKHWA, PAKISTAN","authors":"Z. Hayat, I. Ullah, Khizar Hayat, H. Khan, Fazle Raziq, H. Khan","doi":"10.46903/gjms/17.03.2027","DOIUrl":"https://doi.org/10.46903/gjms/17.03.2027","url":null,"abstract":"Background: Falciparum malaria is a common disease in our area. Apart from its classical presentation, at times it may present with refractory anemia or pancytopenia. The aim of this study was to determine the refractory anemia and pancytopenia as complications of falciparum malaria and apart from peripheral blood smears the significance of rapid antigen tests and bone marrow examination in the diagnosis of falciparum malaria. Material & Methods: The descriptive study included 200 consecutive cases of fever and refractory anemia or pancytopenia from 2011 to 2014. Stratification of patients according to the clinical scenario included Group-A having fever with refractory anemia and Group-B with fever and pancytopenia. A detailed history, thorough clinical examination, and pertinent laboratory tests were performed. All patients were treated with antimalarial drugs and followed-up for eight weeks. The pre and post treatment hematologic parameters were compared. Results: Among the 200 patients, 85 were males and 115 females. The age ranged from 15 to 55 years. Stratification of patients on clinical scenario revealed 175(87.5%) patients with fever and refractory anemia (Group-A). Among these, 125(62.5%) patients were reported smear positive for P. falciparum. In the remaining 50 smear negative patients rapid antigen tests were performed and all were reported positive. In 25 patients of Group B with fever and pancytopenia, the peripheral smear for malaria was positive only in 5 patients. In the remaining 20 cases both the peripheral blood smears and rapid antigen tests were reported negative. Bone marrow examination was planned to confirm the bone marrow suppression as the cause of peripheral pancytopenia, to exclude leukemia and to identify P. falciparum. The bone marrow examination revealed P. falciparum in all these cases. All the patients had a dramatic response to treatment with antimalarials in terms of disappearance of fever and correction of anemia and bone marrow rescue with reversal of pancytopenia to normal counts. Conclusion: Plasmodium falciparum should be considered in all cases of prolonged fever with refractory anemia or pancytopenia in malaria endemic areas, even with negative smear and rapid antigen tests. Bone examination is mandatory for the diagnosis in such cases. There is dramatic response of such patients to treatment with antimalarial drugs and hematinics.","PeriodicalId":44174,"journal":{"name":"Gomal Journal of Medical Sciences","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2020-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47379543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-16DOI: 10.46903/gjms/17.03.2076
Nazafatul Ain, Saira A Khan, M. Marwat, N. Khan, I. Ahmad, F. Ramzan, W. Akhtar, Hadia Fakhar, Yabqa Jehan, A. Zeb, M. Kundi, Saima Bibi, Musarat Fatima, A. Raza
Background: Global Health Estimates 2015 has shown the stroke as second leading global cause of death and 3rd leading global cause for DALYs for year 2015. The objectives of this study were to determine the frequency, distribution and determinants of hypertension in adult stroke population of D.I.Khan Division, Pakistan. Materials & Methods: This cross-sectional study was conducted in Department of Community Medicine, Gomal Medical College, D.I.Khan, Pakistan from February 1, 2017 to April 30, 2017. A sample 217 was selected with margin of error 5.59%, 90%CL and 50% prevalence of hypertension in 200,000 adults at risk of stroke population through consecutive sampling. All indoor adult patients of stroke were eligible. Sex, age groups, and residence and presence of hypertension were variables. Frequency and distribution of hypertension were analyzed by count and percentage. Hypotheses for distribution were substantiated by chi-square goodness-of-fit and of association by chi-square test of association. Results: Out of 217 patients with stroke, 123 (56.7%) were men and 94 (43.3%) were women, 86 (39.6%) were≤60 years and 131 (60.4%) were>60 years, and 105 (48.4%) were urban and 112 (51.6%) were rural. Frequency of hypertension was 132/217 (60.83%). Out of 132 patients with hypertension, men were 74 (34.10%), women 58 (26.73%), age group≤60 years 46 (21.20%), >60 years 86 (39.63%), urban 72 (33.18%) and rural 60 (27.65%). Presence of hypertension was associated to residence (p=.023) but not to sex (p=.817) and age groups (p=.072). Conclusion: Frequency of hypertension in adult stroke population of D.I.Khan Division, Pakistan was found to be similar as expected. Frequency was more in men, in older age group (of>60years) and in urban population. The presence of hypertension in adult stroke population of D.I.Khan Division was associated to residence but not to sex and age groups.
{"title":"FREQUENCY, DISTRIBUTION AND DETERMINANTS OF HYPERTENSION IN ADULT STROKE POPULATION OF D.I.KHAN DIVISION, PAKISTAN","authors":"Nazafatul Ain, Saira A Khan, M. Marwat, N. Khan, I. Ahmad, F. Ramzan, W. Akhtar, Hadia Fakhar, Yabqa Jehan, A. Zeb, M. Kundi, Saima Bibi, Musarat Fatima, A. Raza","doi":"10.46903/gjms/17.03.2076","DOIUrl":"https://doi.org/10.46903/gjms/17.03.2076","url":null,"abstract":"Background: Global Health Estimates 2015 has shown the stroke as second leading global cause of death and 3rd leading global cause for DALYs for year 2015. The objectives of this study were to determine the frequency, distribution and determinants of hypertension in adult stroke population of D.I.Khan Division, Pakistan. \u0000Materials & Methods: This cross-sectional study was conducted in Department of Community Medicine, Gomal Medical College, D.I.Khan, Pakistan from February 1, 2017 to April 30, 2017. A sample 217 was selected with margin of error 5.59%, 90%CL and 50% prevalence of hypertension in 200,000 adults at risk of stroke population through consecutive sampling. All indoor adult patients of stroke were eligible. Sex, age groups, and residence and presence of hypertension were variables. Frequency and distribution of hypertension were analyzed by count and percentage. Hypotheses for distribution were substantiated by chi-square goodness-of-fit and of association by chi-square test of association. \u0000Results: Out of 217 patients with stroke, 123 (56.7%) were men and 94 (43.3%) were women, 86 (39.6%) were≤60 years and 131 (60.4%) were>60 years, and 105 (48.4%) were urban and 112 (51.6%) were rural. Frequency of hypertension was 132/217 (60.83%). Out of 132 patients with hypertension, men were 74 (34.10%), women 58 (26.73%), age group≤60 years 46 (21.20%), >60 years 86 (39.63%), urban 72 (33.18%) and rural 60 (27.65%). Presence of hypertension was associated to residence (p=.023) but not to sex (p=.817) and age groups (p=.072). \u0000Conclusion: Frequency of hypertension in adult stroke population of D.I.Khan Division, Pakistan was found to be similar as expected. Frequency was more in men, in older age group (of>60years) and in urban population. The presence of hypertension in adult stroke population of D.I.Khan Division was associated to residence but not to sex and age groups.","PeriodicalId":44174,"journal":{"name":"Gomal Journal of Medical Sciences","volume":"17 1","pages":"81-89"},"PeriodicalIF":0.5,"publicationDate":"2020-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42466340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-16DOI: 10.46903/gjms/17.03.2007
A. Akhtar, Syed Maisam Ali, S. Naqi, T. Aziz, Wajih-ud-din Shinwari, Syed Faizan Hassan Shah
Background: Chronic suppurative otitis media (CSMO) is an important cause of preventable hearing loss, particularly in developing world. The objective of this trial was to compare efficacy of 2% acetic acid versus 0.3% ciprofloxacin ear drops in achieving dry ears in CSMO in adult population of Islamabad, Pakistan. Materials & Methods: This trial was conducted at Department of ENT, HBS Medical College, Islamabad, Pakistan from March 2018 to February 2019. With alpha 5%, beta 20% and power of study 80%, sample size was calculated 47 for each group. All adult patients of CSOM, having ear discharge for more than three months were eligible. Patients with aural poly, external auditory canal pathology, ear malignancy, having mastoid surgery in preceding 12 months or having used antibiotics in last one week were excluded. Experimental group received 2% acetic acid, twice daily while control group received 0.3% ciprofloxacin eardrops twice daily. At two weeks, achievement of dry ears was noted. Sex and age in years were matching variables. Primary end point was achieving dry ears, which was compared between the two groups using McNemar chi-square test. Results: Experimental group included 30 (63.8%) men and 17 (36.2%) women and control group included 32 (68%) men and 15 (32%) women. Mean age of experimental group 36±2.14 years was matching to the control group 36±2.59 years. Dry ears were achieved in 35 (74.47%) patients in experimental group and in 11 (23.40%) patients in control group. The efficacy of 2% acetic acid was significantly higher than 0.3% ciprofloxacin eardrops in achieving dry ears (p<0.0001) in CSMO. Conclusion: The efficacy of 2% acetic acid was significantly higher than 0.3% ciprofloxacin eardrops in achieving dry ears in chronic suppurative otitis media in adult population of Islamabad, Pakistan.
{"title":"EFFICACY OF ACETIC ACID VERSUS CIPROFLOXACIN EAR DROPS IN ACHIEVING DRY EARS IN CHRONIC SUPPURATIVE OTITIS MEDIA IN ADULT POPULATION OF ISLAMABAD, PAKISTAN: A NON-RANDOMIZED CONTROL TRIAL","authors":"A. Akhtar, Syed Maisam Ali, S. Naqi, T. Aziz, Wajih-ud-din Shinwari, Syed Faizan Hassan Shah","doi":"10.46903/gjms/17.03.2007","DOIUrl":"https://doi.org/10.46903/gjms/17.03.2007","url":null,"abstract":"Background: Chronic suppurative otitis media (CSMO) is an important cause of preventable hearing loss, particularly in developing world. The objective of this trial was to compare efficacy of 2% acetic acid versus 0.3% ciprofloxacin ear drops in achieving dry ears in CSMO in adult population of Islamabad, Pakistan. \u0000Materials & Methods: This trial was conducted at Department of ENT, HBS Medical College, Islamabad, Pakistan from March 2018 to February 2019. With alpha 5%, beta 20% and power of study 80%, sample size was calculated 47 for each group. All adult patients of CSOM, having ear discharge for more than three months were eligible. Patients with aural poly, external auditory canal pathology, ear malignancy, having mastoid surgery in preceding 12 months or having used antibiotics in last one week were excluded. Experimental group received 2% acetic acid, twice daily while control group received 0.3% ciprofloxacin eardrops twice daily. At two weeks, achievement of dry ears was noted. Sex and age in years were matching variables. Primary end point was achieving dry ears, which was compared between the two groups using McNemar chi-square test. \u0000Results: Experimental group included 30 (63.8%) men and 17 (36.2%) women and control group included 32 (68%) men and 15 (32%) women. Mean age of experimental group 36±2.14 years was matching to the control group 36±2.59 years. Dry ears were achieved in 35 (74.47%) patients in experimental group and in 11 (23.40%) patients in control group. The efficacy of 2% acetic acid was significantly higher than 0.3% ciprofloxacin eardrops in achieving dry ears (p<0.0001) in CSMO. \u0000Conclusion: The efficacy of 2% acetic acid was significantly higher than 0.3% ciprofloxacin eardrops in achieving dry ears in chronic suppurative otitis media in adult population of Islamabad, Pakistan.","PeriodicalId":44174,"journal":{"name":"Gomal Journal of Medical Sciences","volume":"17 1","pages":"90-94"},"PeriodicalIF":0.5,"publicationDate":"2020-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42644340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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