INDO AMERICAN JOURNAL OF PHARMACEUTICAL SCIENCES

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Authors: Dr. Mariam Nissa Ullah, Dr. Rida Tahir, Dr. Maryam Safdar

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3233-3235

Authors: Muzaffar Munir, Tanveer Ahmed, Farzana Muneer

Background: Anemia is the state or condition in which the volume of blood to take oxygen is less than the capacity required. This retrospective study was conducted to analyzed the immensity of Deficiency of Iron Anemia in THQ Hospital Chowk Azam Layyah, during from Feb 2017 to January 2018 to evaluate the prevalence different stages of anemic patients in this area. Aim: Objective of this study was to evaluate the prevalence of different anemic grades in patients to give better treatment and to improve quality of life of patients. Methods: Two hundred patients were included in this study who met all the criteria needed to this study. In this study we examined blood tests, CBC reports of all patients in the laboratory. Moreover, including detailed patient’s history, previous diseases, current diseases, anemia history in family, gynecological history of women were examined. Results: In all two hundred anemic patients, we found one hundred and seventy (85%) patients had deficiency of iron and 30 (15%) patients had inadequacy of non-iron (lack of other minerals) anemia. Most of the patients (58.8%) who had less volume of iron were aged of 21 to 32 Years. On basis of serum fertin level (SFL), We observed the intensity of deficiency of iron and classify into modest, mildest and acute groups. We found 120 (70.6%) patients had modest IDA (iron deficiency anemia), 20 (11.8%) patients had acute and rest (17.6%) had mildest deficiency of iron anemia. In 160 IDA patient’s women were 95 (55.9%), 40 (23.5%) were men > 19 years and 35 (20.6%) were growing children had an aged < 14 years. Conclusion: In this study, we observed deficiency of iron is the most frequent cause in patients of anemia, especially in females.

3239-3243

Authors: Muhammad Rumais Mahde, Dr. Kinza Imran, Dr. Danish Ahmed

We aimed to evaluate the impact of topical hemostatic sealants and bipolar coagulation during laparoscopic ovarian endometriotic cyst resection on ovarian reserve by comparing the rates of decrease in anti‐ Müllerian hormone. Laparoscopy has become the most common procedure in recent set-ups. It is now a major diagnostic as well as therapeutic modality for infertility, endometriosis, extrauterine pregnancy and benign ovarian tumors. The aim of the study was to share the experience of gynecological laparoscopic surgeries. Frequently repeated adnexal mass in reproductive system is endometrioma. Therapies are partially silent in the treatment of larger than 4 cm endometriomas and its removal is recommended for the pain reduction and rapid improvisation in the management of ovarian endometriomas. Generally agreed decision is conception rate. This process can be potentially difficult because of the dense adherence of the capsule. Surgical laparoscopy is among one of the choices in treatment as a conservative treatment approach combined modified cystectomy is preferred technique. It can be damaging for ovary and with additional risk factor it may also pose incomplete ablation. Keywords: Cystectomy, Combined technique, Laparoscopy and Endometrioma.

3248-3253

Authors: Bakht Ullah, Attia Khan, Rohullah

BACKGROUND: Dual antiplatelet therapy (APD) is the cornerstone of management of coronary artery disease in coronary interventions. The resistance pattern against clopidogrel in our influenza is unknown. The aim of this study was to evaluate the frequency of resistance / hypoactivation to Clopidogrel after percutaneous coronary intervention (PCI) in the Pakistani population. METHODS: The study was conducted in the Mayo hospital, Lahore for 1 year period From June 2016 to June 2017. After informed consent, patients who underwent PCI were received 4 weeks ago. All patients received 600 mg Clopidogrel 4 to 6 hours before PCI and received 75 mg Aspirin and Clopidogrel 75 mg twice daily in addition to their routine medications. Venous blood samples were collected from all selected patients and a blocking analysis test was performed on P2Y12. The test has a "Closing Time" measured within the seconds. Patients were labeled as resistant (closing time <106 seconds), hypo-receiver (closing time between 106 and 224 seconds) and receiver (closing time> 225 seconds) based on this time. Demographic data and coronary risk factors were observed for all patients. Findings: Fifty patients (38 males and 12 females) were studied. Fifteen (30%) patients responded completely to Clopidogrel-resistant, 5 (10%) hypertensive and 30 (60%) closing time criteria. None of them had a clinically significant coronary event 4 weeks after PCI. CONCLUSION: More than 1/3 of the post-PCI patients are more likely to be resistant or hypoactive to clopidogrel. Keywords: Clopidogrel, P2Y12 platelet antiaggregation.

3259-3262

Authors: Muneeba Akbar, Moqadsa Jabeen, Faiqua Nayyer, Maryam, Usama Sardar

Objective: To evaluate the effectiveness of using lactulose and rifaximin combination therapy for curing hepatic encephalopathy in adult patients and its comparison with lactulose only treatment. Method: This research was conducted at Jinnah hospital Lahore, department of internal medicine during period of seven months, from December 2014 to June 2015 after taking consent from hospital ethical committee. The study design is randomised controlled trial. Sample size of one hundred and thirty patients was calculated by using WHO calculator. All these cases were stratified into two groups consisting of sixty five patients each. 30ml lactulose 8 hourly was given to one group and the other group was given lactulose and rifaximin 550mg 12 hourly for 10 days. Informed written consent was taken from patients’ guardians. West-Haven Classification was used to determine grade two to four hepatic encephalopathy. Patients were followed up for 10 days after admission. Results: The mean age of patients was 56.06±11.2 years amongst which females were 46.9% while males were 53.1%. 58.46% patients showed reversal by taking lactulose only therapy while 67.67% patients who were given lactulose and rifaximin treatment, after ten days of follow up. P value was 0.276, which was not statistically significant. The abovementioned results show that there was no difference in effectiveness of using lactulose and rifaximin combination treatment as compared to lactulose only treatment in patients with grade two to four hepatic encephalopathy. Key words: Rifaximin, Lactulose, Hepatic encephalopathy, Chronic liver disease.

3268-3279

Authors: Dr. Sh. Muhammad Usman, Dr. Shaheryar Malik, Dr. Ammara Zafar

Prevalence of peptic ulcers disease is higher in third world countries like Pakistan where it is estimated at about 70 per cent of the population, whereas developed countries show a maximum of 40 per cent ratio. The disease is transmitted by food, contaminated groundwater, and through human saliva. Due to its lethality and high prevalence it is necessary to understand the prevention, treatment and change in life style that may help its risks. Background: The incidence and prevalence of peptic ulcer disease has decreased in recent years, most of the risk factors (NSAIDS, H. Pylori, smoking, stress and dietary habits) are modifiable. The Recent trends from the previous researches shows that excessive use of aspirin pain killers and infection from H. Pylori accounts for more than 50% of the peptic ulcer cases presented. Objective: The aim of the research was investigation of the various risk factors (modifiable and non-modifiable) prevalent in patients of peptic ulcer disease presented at Jinnah Hospital Lahore Ma teria l a nd Metho d s: Stud y Desig n: Cross Sectional Stud y Setting a nd d ura tio n: Setting: Jinnah Hospital Lahore. Duration of Study: 3 months. Inclusio n criteria : Patients diagnosed as suffering from PUD following Endoscopy or suffering from 3 of the 4 major symptoms/features (epigastric pain, family history, nausea and vomiting, heart burn). Da ta Co llectio n a nd a na lysis: A sample of 100-150 patients is recruited from Jinnah hospital, Lahore. The procedure and purpose were explained and consent was taken from study participants. Confidentiality was ensured. Participants were free to leave the study any time. It took approximately 20 minutes to complete the questionnaire. The data thus collected was analyzed with the help of SPSS (version 17). Results: The Major Risk factors (Family History, NSAIDs, H. Pylori infection, High stress levels, low socio-economic status, smoking) contribute to around 60-80% of all cases of PUD. Out of total 110 patients interviewed, 60% of cases had h/o NSAIDs use. 90% were either hypertensive or had high stress levels. 80% of the cases lived in overcrowded residencies. Endoscopy reveals H. pylori in majority of the patients. Most of the male patients were smokers. The Minor Risk factors (caffeine, nicotine, alcoholism, history of radiotherapy/chemotherapy, co morbid conditions, O Blood group, sedentary life style, unhealthy dietary habits and use of tranquilizers) contribute to around 20-40% of all cases of PUD. Co nclusio ns: The Study establishes that peptic ulcer is directly related to NSAIDs use, stressful life style, and poor socio economic status while healthy eating habits and physical exercise can help prevent PUD and its complications. Key words: Peptic ulcer, H.Pylori, NSAID’s.

3284-3287

Authors: Dr. Binyamin Butt, Dr. Rabbia Rizvi, Dr Hafiz Yasir Saaed

Objective: This study aims to determine the hand washing practice among doctors and staff nurses working in neonatology unit of a teaching hospital. Methodology: The study design is cross sectional, to assess the knowledge and practice about hand washing among pediatricians and nurses attending neonates in a tertiary care hospital in Pakistan. Questionnaire was designed and 146 patients were interviewed by the authors, their attitude towards hand washing technique was assessed by face to face interviews and response was recorded on proforma after taking informed written consent and without showing participants identity. No ethical issue certificate was obtained from Hospital ethical committee. Doctors and nurses working in different government teaching hospitals were enrolled in study. Result: Knowledge about hand washing was 94% among doctors and nurses. Practice of hand washing technique was 59.6% among Postgraduate resident doctors and in nurses it was 36%. In consultants it was 40.4%. Thus low frequency of hand washing practice can lead to healthcare provider induced infections. Conclusion: Despite of knowledge about hand washing benefits and technique among doctors and nurses practice rate was very low. Thus it’s a leading cause of hospital acquired infections in neonates. KEY WORDS: Hand washing, infections, doctors, nurses, neonates, knowledge attitude and practice (KAP).

3300-3308

Authors: Mudiganti Ram Krishna Rao*and Balasubramaniam M

The two medicinal plants namely, Moringa oleifera and Tribulus terrestris are well known for their medicinal roles ethnobotanically. The present work is to understand the presence of phytochemicals in each of them by TLC method and by GC MS analysis. The antibacterial study was also conducted for both the plants. The TLC profiles show the presence of terpenoids, steroids, flavonoids and alkaloids in both the plants. It was observed that antibacterial role of Tribulus terrestris was evident but Moringa flower extract did not show any antibacterial activity. The GC MS results show the presence of compounds such as Z-10-Tetradecen-1-ol acetate, Lyxitol, 1-O-hexyl-, 2-Butenoic acid, 2-methyl-, 2- (acetyloxy)- 1,1a,2,3,4,6,7,10,11,11adecahydro- 7,10-dihydroxy- 1,1,3,6,9-pentamethyl-4a,7aepoxy5Hcyclopenta[a]cyclopropa[f]cycloundecen-11-yl ester, [1aR- [1aR*,2R*,3S*,4aR*,6S*,7S*,7aS*,8E,10R*,11R*(E),11aS*]]- in Moringa flowers whereas molecules such as 2,2,4-Trimethyl-3-pentanol, n-Hexadecanoic acid and Z-1,6-Tridecadiene were present in Tribulus terrestris. Further work to understand the molecular mechanism of the compound found in the GC MS analysis is needed. Key words: Moringa oleifera, Tribulus terrestris, GC MS, TLC, Antibacterial.

3316-3322

Authors: Dr. Saddam Ashraf, Dr. M. Ijaz Ud Din, Dr. Mohammad Ali

OBJECTIVE: Analysis of pelvic mass patients in terms of parity, age, clinical presentation, operative procedure and pathology was as per the mass type in the tertiary hospitals of Punjab was the aim of this research. DESIGN: Research design was descriptive case series. PLACE AND DURATION: Research was carried out at DHQ Teaching Hospital Dera Ghazi Khan (Gynecology and Obstetrics Department) in the time period of January – December, 2017. PATIENTS AND METHODS: We included all the case of pelvic mass without any discrimination of parity and age, the disease was diagnosed through clinical assessment, history diagnosis and also through USG. Confirmation of pelvic mass type was made through histopathology and surgery. RESULTS: We included in our research 110 cases diagnosed with pelvic mass; among these cases 61 were (55.45%) in the age group of 30 – 50 years and one case were observed as under twenty and two were above seventy years of age. Maximum of the women were in the category of parous. Through clinical presentations we observed that 42 cases faced lower pain of the abdomen (38.18%) and 38 menstrual disturbances cases were also reported (34.54%). First clinical assessment was observed in 84 cases (76.36%) further confirmation was made through USG. In all the patients we included 104 cases (94.54%) with the help of USG. Gentile tract tumor was observed in 68 cases (61.82%); whereas, four cases were diagnosed with non-gynecological mass. Size of mass was observed (above 20 cm) in 10 cases (9.1%); however, less common observations were made about the malignant lesions below ten centimeters in size. CONCLUSION: Every case of pelvic mass without any discrimination of parity and age was treated and investigated in detail. Diagnosis of the non-gynecological masses was also made; therefore, competent surgeons were assigned the task to treat the cases of pelvic masses.

3331-3334

Authors: Hafiz Ahmad Jalal, Hafiz Ahmad Bilal, Hafiz Ahmad Kamal, Ayesha Khalid

OBJECTIVE: Research objective was the determination of the Zinc Sulphate role as an agent of hepatoprotective in the acetaminophen-induced changes of histopathological nature in the model of animals. DESIGN: Research was Observational Experimental in nature. SETTING: Research was carried out in the Pathology and Pharmacology Department Mayo Hospital Lahore from Dec, 2016 to Mar, 2017. METHODOLOGY: Our research sample was 90 albino rats with the range of weight from 18 – 32 grams and we made three groups each group consisting of thirty albino rats. Control group was A group and normal saline level was maintained in this group as 0.9%; acetaminophen was given (250 mg / kg) in B group through a single dose; Zinc Sulphate (1 – 5 mg / kg) was given to C group for a duration of 1 – 7 days before the acetaminophen (250 mg / kg) Sigle dose. After the six hours’ duration was conducted biochemical studies after giving acetaminophen to albino rats. At last step of the treatment weight of all animals was checked at than sacrificed. Histopathological and gross examination was carried out for liver and statistical evaluation of the data was carried out through Chi-Square test. RESULTS: Demonstration of the zinc’s protective effect was made through serum concentration reduction level of the enzymes of liver such as aspartate aminotransferase, lactate dehydrogenase, alanine aminotransferase and serum sorbitol dehydrogenase, including the histopathological centrilobular congestion changes, necrosis and hepatocellular degeneration. We observed through the histopathological evaluation that typical changes in pathological environment of centri-zonal necrosis, leukocyte infiltration, steatosis, edema in animals and portal tiraditos those were treated only with acetaminophen. Animal pretreatment through zinc sulphate lead the whole procedure to dependent on the dose for the avoidance of various changes. CONCLUSION: It is concluded that Zinc is responsible for the production of hepato-protective effect with the prevention of ultrastructural hepatic tissue injuries and also causes free amino acid metabolism disturbance which is a result of the acetaminophen toxic dose. Keywords: Acetaminophen, zinc, liver toxicity and hepato-protective effect.

3340-3344

Authors: Amna Arshad, Salman Agha, Tahreem Akram

Objective: compare the frequency of post-operative surgical site infection of solid interlock intramedullary nail with cannulated open interlock intramedullary nail for management of isolated femoral fracture. Methodology: A total of 100 cases (50 in each group) with Isolated femoral shaft fracture, closed femoral shaft fractures or Gustilo and Anderson classification type I open femoral shaft fractures, Solid and cannulated open interlock fixation for femur shaft fractures between 20-60 years of age of either gender were enrolled in the study. Patients with bilateral femur fractures, Ipsilateral fracture of any other bone of involved side, unfit for surgery or anesthesia with comorbid condition, conversion to intramedullary nailing from external fixator of femur and presented after 30 days of fracture were excluded from the study. Results: In our study, out of 100 cases, (50 in each group), 18%(n=9) in Group-A and 16%(n=8) in Group-B were between 20-40 years of age while 82%(n=41) in Group-A and 84%(n=42) in Group-B were between 41-60 years of age, mean+sd was calculated as 46.78+7.53 years in Group-A and 47.76+6.49 years in Group-B, 62%(n=31) in Group-A and 60%(n=30) in Group-B were male while remaining 38%(n=19) in Group-A and 40%(n=20) in Group-B were females, surgical site infection was compared in both groups and it was recorded in 26%(n=13) in Group-A and 56%(n=28) in Group-B while remaining 74%(n=37) in Group-A and 44%(n=22) in Group-B had no findings of the morbidity, p value was calculated as 0.00 showing a significant difference between the two groups. Conclusion: We concluded that the frequency of post-operative surgical site infection of solid interlock intramedullary nail is significantly lower when compared with cannulated open interlock intramedullary nail for management of isolated femoral fracture. However, our results may create awareness regarding use of solid interlock intramedullary nail for the management of femoral shaft fracture. Keywords: Femoral fracture, solid interlock intramedullary, with cannulated open interlock intramedullary nail, surgical site infection

3353-3359

Authors: Dr. Sundus Amena, Dr. Madeha Arshad, Dr. Rai Muhammad Fazal-ur-Rehman Khan

Objective: We aimed at the perinatal outcomes evaluation in the mothers having diabetes mellitus at the tertiary healthcare centers. DESIGN: Research was descriptive in nature. Place and Duration: Research was carried out in the OPD, Labor ward, Gynecology and Obstetrics, Lady Atichison Hospital, Lahore. Research was carried out from July, 2016 to June, 2017 and it took one year in its completion. Patients and Methods: We included in the research a total of 110 pregnant cases in the age limit of 20 – 40 years without considering their obstetrics history and parity. Sample was selected through convenience non-probability technique of sampling. All the women having eclampsia, pregnancy induced hypertension, antepartum hemorrhage and medical disorders were not selected in our research. A Performa was used for the documentation of patient’s information and data analysis was made with the help of SPSS – 21. Results: We observed in the cases and peri-natal complications the incidence of macrosomia as 41.8% fetuses, infant’s biochemical abnormalities were observed in the 85.3% of the cases, moderate nature to severe state birth asphyxia was observed in 33.6% and congenital malformations were noticed in the six infants associated to the mothers having diabetes. Conclusion: In the diabetic pregnancy related peri-natal difficulties of mothers having diabetes are repeated in the women with a higher incidence of parity. Macrosomia, asphyxia and biochemical abnormalities are repeated perinatal complications as observed in the setting of this research. Key Words: Diabetes Mellitus (DM), Biochemical Abnormalities, Asphyxia and Macrosomia.

3367-3372

Authors: Dr. Humna Saleem, Dr. Noreen Khalid, Dr. Arfa Nageen

Aims: The aim of our research was the experience sharing about the surgeries of gynecological laparoscopic nature in the Mayo Hospital, Lahore. Methods: We held a descriptive research from Jan, 2015 to May, 2016 for the analysis of the patients who experienced gynecological laparoscopic surgeries for their indications, procedure types and complications. Results: Our research sample was 217 patients; among them a number of the cases were in the age group of 26 – 30 years as 53 (24.4%). Ovarian Cyst cases were 111 (51.1%), ectopic pregnancy cases were 27 (12.44%). There were 8 cases treated through cholecystectomy surgeons and hysterectomy or ovarian cystectomy. Diagnostic laparoscopy cases were 32 (15%). Laparoscopic hysterectomy was carried out in 33 cases (16%). Laparotomy conversion was carried out in 8 cases (3%) and vascular injury was observed in only one case. Repeated and common postoperative complaint was pain in variable degrees, which was treated through oral and parenteral analgesics. The diet through oral way was started in 4th or 6th hour and after 24 hours movement was started. Hospital stay of two days was observed in 164 cases (75%) and above two days stay was observed in 53 cases (25%). Conclusions: Post-operative pain can be reduced through laparoscopic surgery in the setting of our research. It also decreased the rate of morbidity after the operation and lessen the stay at the hospital with immediate and prompt recovery. However, adequate expert and skilled based training is mandatory for the successful and skilled laparoscopic surgeries. Keywords: Cystectomy, Hysterectomy and Gynecological Laparoscopic Surgeries (GLS).

3381-3385

Authors: Dr. Anood Ijaz, Dr. Muhammad Abdul Rehman, Dr. Marjan Haider

Hypertension is a common preoperative anomaly in patients undergoing general surgery and may be associated with cardiovascular adverse events in the perioperative period. Objective: To know the prevalence and severity of hypertension in patients requiring general surgery in the preoperative period. Place and Duration: The study was performed in the surgery department of Nishter Hospital, Multan for the period of one year from March 2015 to March 2016. Patients and Methods: All patients undergoing general surgery in the Nishter hospital in Multan were included in the study. The pre-existing hypertension story of all patients was researched. All male patients and adult women aged 20 to 100 years were included in the study. All patients in resting state were measured first blood pressure and second blood pressure measurements in the operating room. Patients were categorized according to AHA criteria for blood pressure. Results: 590 patients (245 males and 245 females) were included in the study. Ninety-four patients (25 males, 69 females) were hypertensive (15%). 36 had stage-1, 44 had stage-2, 14 had severe hypertension. While 75 hypertensive patients were previously known, 19 patients were hypertensive during the study period. Conclusion: The overall incidence of hypertension among adult patients operated on at Sir Ganga Ram Hospital is 15 percent. In this group of patients, stage 2 hypertension was more frequent. Keywords: Prevalence, Hypertension, Surgical Patients

3391-3395

Authors: Muhammad Shahrukh Qaisrani and Tahira Komal

Hyperglycemia causes a multi-factor disorder known as diabetes. Poor control of the diabetes and hypomagnesaemia are critically associated as confusions are caused about Diabetes Mellitus (DM). Insulin receptor is affected by the key component of Magnesium. In the patients of diabetes, the factor of hypomagnesaemia is involved in resistance of the insulin through the interference of the insulin receptors integration. An inactive insulin receptor phosphorylation is responsible for this act; therefore, the whole process can be viewed as a central system through which hypomagnesaemia is added to the resistance of insulin in the cells. Objectives: This research was aimed at the probe that if low levels of the magnesium in the patients of diabetes in comparison of those patients never diagnosed with diabetes. Settings: Research was held at Quaid-e-Azam Medical College, Bahawalpur (Department of Biochemistry) Material & Method: Source of the collected data was BVH, Bahawalpur. Design of the research was observational and descriptive. Research was completed in the period of six months. Conclusion: It is concluded that there is an association of hypomagnesaemia with Type I & II DM as diabetes cases reflect clear decreased magnesium levels. Its consequences in severity of disorders can be reduced in a drastic way through the diets of magnesium fortified administrated to diabetes cases. Keywords: Frequency, Diabetics, Type-I Diabetes Mellitus (T1DM), Type-II Diabetes Mellitus (T2DM), Hypomagnesemia and Bahawalpur.

3406-3411

Authors: Dr. Awais ur Rehman, Dr. Umair Khizar, Dr. Muhammad Naeem Awan

Objective: To determine the factors associated with quitting suckling Breast feeding in children. Methodology: A cross-sectional study. Children up to the age of two were included. Information entered into a predesigned proforma. Place and Duration: The study was carried out in the Gynecology and Pediatric Department Of services Hospital, Lahore for the period of one year from July 2016 to July 2017. Findings: A total of 543 children were included. Maternal factors were 43% insufficient milk secretion and 43% insufficient rest for the first six weeks after birth. In children, diet and nutrition with a 41% formula is 36%. There is not enough milk in the first days after birth and 62% are starved after breastfeeding and 62% are widespread legends. Conclusions: Maternal and child factors and myths responsible for cessation of male nutrition, inadequate secretion of cigarettes, problems with mothers, maternal stress, infant feeding with bottle feeding and first mothers. These misconceptions should be addressed during prenatal visits. Key words: Maternal factor, Breastfeeding, myths, infant factor.

3417-3424

Authors: Kaur Manpreet*and Kumar Sandeep

Niosomes are novel drug delivery system that are having bilayer in structure and these vesicles are obtained during hydration of synthetic non-ionic surfactants, with the incorporation of cholesterol or their lipids. These vesicles present convenient, prolonged, targeted and effective drug delivery system with the ability of loading both hydrophilic and lipophilic drugs. The hydrophilic drugs are entrapped into aqueous core while the lipophilic drugs into the lipid membrane. Their potential can be enhanced by the use of novel preparations, loading and modification methods. This article reviews the current deepening and widening of interest of niosomes. Keywords: Introduction, Method of preparation, Marketed formulation, Patent citations, Opportunities and Challenges.

3430-3435

Authors: Anum Saleem,Dr Bushra Rafique, Dr. Ali Saeed

Objective: Nocardia species is comprised of strict aerobic bacilli which forms the branched hyphae in culture and tissues. Nocardia infection is not well-known but its importance cannot be underestimated due to the mortality and morbidity in organ transplant cases and immunocompromised cases. As Nocardia species is varying in the various regions, this research is targeted on the study an isolate Nocardia bacteria from immune-compromised cases which were referred to the specialists. Setting and Duration: The research was carried out in Nishtar Hospital Multan with 142 participants observed with advanced symptomatic pulmonary disease. Research was completed in the time span of 7 months. Method: In the total research sample 102 cases were assessed for sputum and Broncho alveolar lavage. In the remaining cases the collection of samples was not possible because of the accessibility issue. We prepared three thin smears to observe the samples through microscopic. Culturing of the samples was made in paraffin agar and sabouraud dextrose agar. To analyze the data, we also documented history of the patients through questionnaire. Asteroids of the Nocardia were isolated from one case who was suffering from the syndrome of Cushing having bronchogenic carcinoma. Further in-vitro studies for isolate differentiation were carried out in order to confirm the growth of organism on primary media which was Nocardia steroids complex. Conclusion: It is revealed through NaOH normal concentration 4%, which has been used for the Mycobacteria species identification, can stop the Nocardia growth. Therefore, collected samples were processed through decontamination procedure to isolate Nocardia with the help of NaOH (1%). Key Words: Pulmonary Nocardiosis, Cushing’s syndrome, Nocardia asteroids complex and immunocompromised host.

3440-3445

Authors: Dr Samra Maryam, Dr Alvina Faiz, Dr Sana Liaqat

Background: To kill someone by another person is known as homicide. Our research was aimed at the identification of cause and pattern of death on the issue of homicide specifically on autopsy in Pakistan. Material & Methods: Research is a descriptive cross-sections research that was carried out in the time of Jan, 2015 to Mar, 2017. 2025 cases of homicide (dead bodies) were studied in our research. We used a proforma for data collection in the Mayo Hospital, Lahore (Department of Forensic Medicine). Ethical permission was taken before the start of the research. The cause of death was studies with the help of internal and external examination, viscera analysis and histopathological assessment. Partially or advanced decomposed including skeletonized dead bodies observed with no external and internal injuries adequate to cause death & toxicological and histological reports that failed to reveal any ambiguous outcome were made a part of the research. Results: We performed autopsies of (2025 dead bodies), all the dead bodies were homicidal cases. The male to female ratio was such as 1375 male (67.24%) and 670 females (32.76%) were made a part of the research. The commonly observed cause the injury caused by the fire-arm causing 1230 deaths (60.14%), second common most injury was the injury of blunt weapon 367 cases (17.94%). Conclusion: Out set-up observed most of the cases of fire-arm causing homicide. Illegal possession of fire-arms is to monitored strictly and policies should be implemented to disco

3454-3458

Authors: Dr Taiba Zulfiqar, Dr Amsal Saeed, Dr Rafia Javed

Background: Young adults face the issue of urinary tract infections as a common disease. Because of the increased use of the fluoroquinolones, empirical therapy in the case of an uncomplicated infection of the urinary in the target age group has also become controversial. Our research was also aimed at the nitrofurantoin efficacy, cotrimoxazole and ciprofloxacin (trimethoprim-sulphamethaxazol); these are orally used drugs available in common. Material & Methods: Our descriptive research was held in Services Hospital, Lahore (Microbiology Department) in the time span of January – June, 2016. We included a total of 270 isolates of urinary tract infection selected from outdoor and indoor respectively 132 and 138; culturing of the specimens was also carried out in the time span of the research. We identified the isolates through conventional techniques with the help of API – 10 S. We also assessed all the isolated for ciprofloxacin, nitrofurantoin and cotrimoxazole (trimethoprim-sulphamethaxazol) along with related common antibiotics which are also used for the urinary pathogens. Results: In the total sample of the research dominant isolated was E. Coli which was cultured in the 158 cases (58.51%), after that the Klebsiella pneumonia in 48 cases (17.77%) & enterococcus spp respectively in 16 cases (5.92%). The sensitive percentage in the outdoor cases (132) was observed as nitrofurantoin (92.4%), ciprofloxacin (47.1%) and cotrimoxazole (62.1%); whereas in the indoor isolates (138) the respective sensitivity was observed as 84.0%, 34.7% and 28.9% respectively. Conclusion: The effectiveness of the Nitrofurantoin is outdoor and indoor isolates is useful in the empirical urinary tract infection which is not complicated. Keywords: Nitrofurantoin, Cotrimoxazole, Ciprofloxacin, Trimethoprim-sulphamethaxazol, Urinary Tract Infections and Urine.

3464-3470

Authors: r. Ali Saeed, Dr. Sibtain Ali Hashmi, Dr. Hasnain Abbas Naqvi

Background: Stress is physiological and mental reaction towards any events. Studies have shown that nurses are under considerable job stress, which can lead to health disorders and failure in duties. Stressors of nursing have been studied in some of quantitative studies; however, a few investigators have studied the nurses’ life experiences in this regard. Objective of the study: The objective of the study is to identify the level of occupational stress and the effect on the performance among the hospitals nurses. Methodology: Descriptive cross-sectional study was conducted at Sir Ganga Ram Hospital in Lahore. The study was carried out on 103 nurses registered by Pakistan Nursing Council. Semi-structured occupational stress questionnaire was used to obtain the data. Data processed and analyzed in SPSS. Results: The result of the study showed that the severe level of stress were 65% mild were 8% and moderate level were 27%. The investigation results built up indisputably that a staggering part of nurses' populace setting had revealed direct and stress level that may discourage their expert and social accountabilities. It is proposed that stress should be lessened by executing appropriate administration and radical changes in benefit condition climate. These outcomes may profit nurses to enhance emotional wellness and to adapt to stress level that enable nurses to guarantee quality patient care. Keywords: Nurses, stress, occupational stress, Pakistan.

3475-3480

Authors: Dr. Saira Munir, Dr. Rabbia Rizvi, Dr. Sadaf Ilyas

Objective: The research was aimed at the measurement of the health warning impact reflected on the packs of cigarette on smokers in their act of smoking. Methods: Our research was cross-sectional and it was carried out in Lahore from February to June, 2016, we focused on the male smokers and distributed a self-administrated questionnaire to all the smokers selected through continence non-probability method of sampling without accounting the educational aspect and data was analyzed through SPSS-22. Results: We selected a total of 1500 smoker, warning was observed by 1330 smokers (88.7%); 730 smokers (54.8%) found the picture significant; 630 smokers (47.3%) made an effort to reduce smoking and 430 smokers (32.4%) made a real effort to quit smoking because of the picture and warning impact. In the group of smokers who tried to quit (430), 300 smokers (69.7%) were influenced by the picture. Conclusion: There is no significant and determinant impact of the warning and picture printed on the cigarette packs being sold in Pakistan in quitting and reducing of smoking. Keywords: Cross-Sectional Research, Pictorial, Textual Health Warnings, Smokers, Lahore, Privileged and Under Privileged Societies.

3492-3498

Authors: Dr Sundus Amena, Dr Madeha Arshad,Dr Rai Muhammad Fazal-ur-Rehman Khan

Objective: We aimed at the perinatal outcomes evaluation in the mothers having diabetes mellitus at the tertiary healthcare centers. Design: Research was descriptive in nature. Place and Duration: Research was carried out in the OPD, Labor ward, Gynecology and Obstetrics Mayo Hospital Lahore. Research was carried out from July, 2016 to June, 2017 and it took one year in its completion. Patients and Methods: We included in the research a total of 110 pregnant cases in the age limit of 20 – 40 years without considering their obstetrics history and parity. Sample was selected through convenience non-probability technique of sampling. All the women having eclampsia, pregnancy induced hypertension, antepartum hemorrhage and medical disorders were not selected in our research. A Performa was used for the documentation of patient’s information and data analysis was made with the help of SPSS – 21. Results: We observed in the cases and peri-natal complications the incidence of macrosomia as 41.8% fetuses, infant’s biochemical abnormalities were observed in the 85.3% of the cases, moderate nature to severe state birth asphyxia was observed in 33.6% and congenital malformations were noticed in the six infants associated to the mothers having diabetes. Conclusion: In the diabetic pregnancy related peri-natal difficulties of mothers having diabetes are repeated in the women with a higher incidence of parity. Macrosomia, asphyxia and biochemical abnormalities are repeated perinatal complications as observed in the setting of this research. Key Words: Diabetes Mellitus (DM), Biochemical Abnormalities, Asphyxia and Macrosomia.

3520-3524

Authors: Abdolreza Gilavand and Fatemeh Espidkar

Introduction: The increasing interest of students to dentistry field of study and the increasing admission of patients for jobs related to this field of study can clearly reflect the importance of the need for specialists in this regard. Thus, this research was conducted to evaluate the educational status and job prospect of graduates of dentistry in Iran. Materials and Methods: This study was conducted analytically using content analysis technique. Results: In Iran, dentistry field of study is divided into two levels of general dentistry and specialized dentistry. The total academic year for the general dentistry is 6 years. They can also study in 10 specialized fields of endodontics, oral and maxillofacial pathology, oral and maxillofacial radiology, oral and maxillofacial surgery, orthodontics, pediatric dentistry, periodontics, prosthodontics, restorative and cosmetic dentists, oral and maxillofacial diseases, oral and maxillofacial diseases diagnosis. Problems in field of dentistry in Iran include increasing number of dentists and the reduction of job opportunities for a large number of them, especially in large cities, being exposed to infectious diseases, AIDS and hepatitis, and suffering from physical diseases such as neck arthritis and spinal problems and eye problems due to high physical activity, lack of insurance coverage for dental services for patients, leading to reduction in their admission except in emergencies. Discussion and Conclusion: In recent years, the number of students entering to dentistry schools has been increased significantly, while many facilities of these schools have remained unchanged. This problem in the future can lead to reduced quality of education and, consequently, a negative impact on oral health in the community. Keywords: Dentistry, Academic status, Job prospect, Iran.

3533- 3553

Authors: Sadia Kanwal, Sobia Kanwal, Abnas Kousar, Abdul Basit

Introduction: Autonomy means freedom to act or function independently. It is the capacity to make an informed unclear decision without the involvement of another system or operator. Objective: Determine the frequency of women’s autonomy at household level. Assess the utilization of antenatal services in married women of reproductive age (15 – 49 years) of Bahawalpur City. Materials and Methods: Study Design: Cross-sectional descriptive study. Study Setting: On judgmental basis Satellite town (Upper socio-economic group) and Shahdara (lower socioeconomic group) of Bahawalpur city. Duration: Study was conducted from May 10, 2015 to July 15, 2015. Methodology: Study Design: Cross-sectional descriptive study. Study Setting: On judgmental basis Satellite town (Upper socio-economic group) and Shahdara (lower socioeconomic group) of Bahawalpur city. Duration: Study was conducted from May 10, 2015 to July 15, 2015. Data Analysis: Data will be entered and analyzed by using statistical package for social sciences (SPSS) version 21.0. Mean and standard deviation will be calculated for numerical data like age. Frequencies and percentages will be calculated for qualitative variables that is women’s autonomy (high, medium, low) and utilization of antenatal services (poor, fair, good).

3568-3573

Authors: Bakht Ullah, Attia Khan, Rohullah

Objective: Assessment of the diagnostic evaluation and presentation of numerous vascular repair methods with associated outcomes. Methods: Research was descriptive prospective in nature and it was carried out in CMH, Rawalpindi. Research was completed in the time span of two years starting from Oct, 2008 to Dec, 2010. Vascular injured patients (54 cases) were made a part of the research in the condition of extremity after experiencing vascular surgical interventions. Patients with an irreversible ischemia or with primary amputation including escaped vascular injuries were not included in the research. Injury mechanism was evaluated in the research including type of injury, site of injury, injury mechanism, related injuries, outcomes and repair type. Data was also evaluated for the values of frequency, percentage, mean and SD. Results: In the total research sample mean age was observed as (26.8 ± 9.2 years), the age was calculated in the age group of 9 – 67 years. The ratio of male to female was as seventeen to one. Most repeated cause was penetrating trauma as 34 cases (62.9%) were noticed. Mostly affected area was the lower extremes 33 (61.1%) and most repeated vessel involvement was observed in 14 (25.9%) cases. Besides, 16 patients (29.6%) were having related fractures, while 12 cases were of concomitant venous injuries (22.2%). Common most type of repair was interposition autogenous saphenous vein graft was 42 (77.7%). Three cases were treated with Prosthetic graft (5.5%) patients. Common complication observed was the infection of wound observed in 6 cases (11.1%). Secondary amputation was observed in 3 cases (5.5%) and associated injuries deaths were observed in 2 cases (3.7%). Successful vascular reconstruction was carried out in 49 cases (90.7%). Conclusion: An in-time re-vascularization and recognition by an expert vascular surgeon is key to treat ninety percent of the limbs facing vascular injuries. Keywords: Extremity Vascular Injury, Amputation and Re-vascularization.

3590-3604

Authors: M. Prasanthi Evangelin*, Gudimetla Priyanka, Manohar Babu S

A simple, Accurate, precise method was developed for the simultaneous estimation of the Amiloride and Hydrochlorthiazide in Tablet dosage form. Chromatogram was run through BDS (250mm 4.6mm, 5µ). Mobile phase containing Buffer and Acetonitrie in the ratio of 45:55A was pumped through column at a flow rate of 1ml/min. Temperature was maintained at 30°C. Optimized wavelength for Amiloride and Hydrochlorthiazide was 296nm. Retention time of Amiloride and Hydrochlorthiazide were found to be 4.081 min and 2.554 min. %RSD of the Amiloride and Hydrochlorthiazide were and found to be 0.57 and 0.71 respectively. %Recover was Obtained as 100.40% and 99.9% for Amiloride and Hydrochlorthiazide. LOD, LOQ values were obtained from regression equations of Amiloride and Hydrochlorthiazide were 0.06ppm, 0.14ppm and 0.18ppm, 0.41ppm respectively. Regression equation of Amiloride is y = 8186x + 1334, and of Hydrochlorthiazide is y = 3525x + 408.9. Key Words: Amiloride, Hydrochlorthiazide, RP-HPLC

3617-3630

Authors: M. Prasanthi Evangelin*, Amgotu Vamsi, Manohar Babu S

Estimation of Naproxen and Esomeprazole simultaneously in tablet dosage forms by RP-HPLC method. The analytical method was developed by studying different parameters. First of all, maximum absorbance was found to be at 332nm Naproxen for and 285nm for Esomeprazole. Common wavelength will be 272nm and the peaks purity was excellent. Injection volume was selected to be 20µl which gave a good peak area. The column used for study was Inertsil C18, ODS chosen good peak shape. Ambient temperature was found to be suitable for the nature of drug solution. The flow rate was fixed at 1.0ml/min because of good peak area, satisfactory retention time and good resolution. Different ratios of mobile phase were studied, mobile phase with ratio of 45:55 Methanol: Buffer was fixed due to good symmetrical peaks and for good resolution. So this mobile phase was used for the proposed study. The present recovery was found to be 98.0-101.50 was linear and precise over the same range. Both system and method precision was found to be accurate and well within range. Detection limit was found to be 0.25 Naproxen and 0.52 for Esomeprazole. Linearity study was, correlation coefficient and curve fitting was found to be. The analytical method was found linearity over the range of 20-80ppm of the target concentration for both the drugs. The analytical passed both robustness and ruggedness tests. On both cases, relative standard deviation was well satisfactory. Keywords: Naproxen, Esomeprazole, RP-HPLC method

3638-3642

Authors: Sriram A*, Dhanapal C.K and Junior Sundresh. N

Hypertension is one of the major global risk factor among the cardiovascular diseases leads to increase in morbidity, mortality rate as well as health burdens1 . In 2020 it has been estimated that 1.32 billion world populations will suffer from hypertension. As per current prevalence rate on hypertension in India is 18.52 and ranks at 67 among worldwide. WHO statistics reported that death rate among hypertensive patients in India was 1.79%. To determine the prescribing trends of antihypertensives involved in patients with hypertension. Out of 73 encounters, 43 (59%) males and 32(41%) females were observed and documented. Most patients with hypertension between the age group of 41 to 60 were 49(67.1%). The drug prescribing pattern involved with hypertension in this study was mostly single therapy (56.1%) when compared with combination therapy (43.9%). The most commonly used drug were amlodipine (4.1%) followed by clopidrogrel (8.2%), telmisartan (6.9%). The combination therapy was used frequently with Atorvastatin and fenofibrate (15%), Atenolol and amlodipine (11%), Telmisartan and hydrochlorothiazide (6.9%). The present study shows that ACE inhibitors and ARB blockers were frequently used in most of the prescriptions. Atorvastatin consumed more in all prescriptions followed by amlodipine and diuretics (furosemide). Key words: Hypertension, ACE inhibitors, ARB blockers

3647-3652

Authors: Dr. Muhammad Hassan Sheikh, Dr. Aijaz Ali, Dr. Anila Umer

Background: Stroke is second most common cause of death worldwide. Stroke-related seizures are a neglected topic and generally considered as a benign and a harmless complication. Post stroke seizures can worsen the condition of patients so this study finds the extent of post stroke seizures in local population. Objective: To assess the frequency of generalized seizures in patients presenting with acute ischemic stroke. Material and Methods: Department of Neurology, Agha Khan University Hospital, Karachi. Design: Descriptive case series. Subject & Methods: There were 150 patients presenting with acute ischemic stroke were included in this study. They were followed-up for 15 days after stroke to assess post-stroke seizures. Results: The mean age of patients was 57.37±11.18 years. Frequency of generalized seizures in patients presenting with acute ischemic stroke was found in 6.67%. Conclusion: Generalized seizures in patients presenting with acute ischemic stroke was low. Key Words: Acute ischemic stroke, generalized seizures, cardiovascular disease.

3656-3660

Authors: Dr. Shub Noor Saeed, Dr. Hira Naveed, Dr. Taiba Zulfiqar

Objective: The study is focused on the analysis of visual consequences in patients who suffer from diabetic retinopathy. The patients involved were treated using pan retinal photocoagulation with or without sub-Tenon triamcinolone acetonide. Patients and Methods: The subjects were divided into two groups based on the treatment i.e. sub-tenon triamcinolone with pan retinal photocoagulation (Group 1) and pan retinal photocoagulation alone (Group 2). The cases were randomly distributed among both the groups. Change in visual acuity was considered to be the only major variable factor in this study. Visual acuity was checked after two months from the treatment and difference was measured from the standard readings. Results: The patients treated with a combination of sub-tenon triamcinolone and pan retinal photocoagulation showed improvement in visual acuity much greater than the patients who were treated with pan retinal photocoagulation only. The difference was statistically significant (p < 0.005). 73% of patients in Group 1 were having improved visual acuity as compared to only 6.6% of patients in Group 2. Conclusion: Sub-Tenon triamcinolone acetonide injection has proved to be an outstanding treatment in the deterrence of pan retinal photocoagulation. The visual acuity has improved much with the dose of the said injection and the visual loss caused by macular edema is minimized. Keywords: Diabetic retinopathy, sub-Tenon triamcinolone acetonide injection, Visual acuity.

3665-3668

Authors: Humera Rafique, Anam Ashraf, Binish Anwar, Syed Mohsin Mehmood, Mujeeb Ullah Makki

Introduction: The street food industry has an important role in the cities and towns of many developing countries in meeting the food demands of the urban dwellers. Street food sector operates in an unstable and precarious state because the sector lacks legal recognition. There have been noticeable increases of food vendors in Lahore. There are not regulated, they operate haphazardly without any monitoring of what they prepare and how they do it. Objectives: Objective of study was to assess personal hygiene of food selling vendors, their practices during food preparation & handling, to assess environmental hygiene around food selling area. Study Design: Descriptive study. Place and Duration of Study: Study was conducted at Lahore. Material and Methods: A study to determine hygienic and sanitary practices of vendors of street foods in Lahore was carried out using a descriptive survey design. Data was collected using in-depth interview schedules and observation checklists. Results: About 50.0% obtained food preparation skills through self-taught while 33.33% were taught by their parents. Sixty seven percent patients did not use aprons, 76.7% wore no hair covering and 93.3% handled food with bare hands. About 66.7% of the vendors had garbage and waste bins beside the food stalls. Mean nasal obstruction in the case of ventilated nasal and with Vaseline nasal pack was observed respectively as (45.62±6.17) & (77.67±4.85) and significant value of p = 0.001in each group. Conclusion: Street food vendors practiced minimal hygienic and sanitary practices. Keywords: Street foods, hygiene and sanitation.

3674-3678

Authors: Dr. Saba Javaid, Dr. Feeha Akhtar, Dr Aisha Bashir

Objective: Evaluation of an enzyme- related immunosorbent assay using filariform larvae of Strongyloidesstercoralis is to identify particular antibodies in patients with strongyloidiasis. Design: Source of Serum samples collection was people infected, with strongyloidiasis, with parasitic diseases and common people. By using crude antigen of filariform larvae, its analysis was conducted with the help of IgG-ELISA. Materials and Methods: The study was conducted at the Nishtar Hospital Multan. Subjects: 46 individuals infected with strongyloidiasis is were selected for serum sample collection. 379 cases infected with different parasitic infections and 37 ordinary people were also part of sample collection. Main outcome measures: Positive and negative predictive values, specificity and the sensitivity of the test. Result: The cut-off point value was noted as 0.537. The specificity of the test was recorded as 96.15% while test sensitivity was calculated as 93.47%. The positive predictive value was 72.88% however; negative predictive value was 99.25%. Twelve individuals with toxocariasis, three individuals with hydatidos is and one individual with ascariasis, had antibodies which were reactive in nature against larval antigen. Conclusion: A specific and sensitive diagnostic assay when ELISA method is used with filariform larval antigen. Key Words: Strongyloidesstercoralis, Strongyloidiasis, IgG-ELISA.

3683-3687

Authors: Ayesha Zaheer, Sana Hadia Qaiser, Aqsa Yaqoob

Purpose: To investigate the outcome of hemorrhoidectomy with staples in third degree hemorrhoids. Materials and methods: This study included 50 patients who underwent stapled hemorrhoidectomy. Place and Duration: The study was performed between February 2015 to February 2016in Surgical Unit of DHQ Gujranwala for the period of one year. Study Design: Prospective interventional study. Findings: In third degree hemorrhoids stapled hemorrhoidectomy (SH) was performed in 50 patients. There were minimal pain in three patients and only one patient had persistent pain and there was a small postoperative bleeding that was treated conservatively in one patient. Conclusion: In the treatment of third degree hemorrhoids SH is an effective surgical procedure. There is strong proof that SH produces less pain postoperatively and has earlier activity than other procedures. In our experience for third degree hemorrhoids SH is the preferred treatment in hospitalized patients. Key words: Third degree hemorrhoids, stapled hemorrhoidectomy (SH).

3694-3698

Authors: Dr. Ayesha Munir, Muhammad Awais Farooq, Dr. Abubakkar

Objective: To determine perinatal mortality pattern and related risk factors of obstetrics. Study Design: A retrospective study Place and Duration: From February 2016 to February 2018 the study was held in th Gynae Unit II of Nishter Hospital, Multan for the period of two years. Methodology: All patients delivered at the Gynae Unit II during the study period were included. These women were recommended to follow OPD a week after birth. Perinatal deaths, including stillbirths and early neonatal deaths (NND), have taken place within the next 7 days of birth. Those with a gestational age shorter than 28 weeks were excluded. The data were collected from the Excel perinatal mortality study page and also collected information such as age, parity, gestational age, complications during pregnancy, and the way of delivery and delivery. Perinatal data included weight, gestational age, sex of the baby, Apgar score at birth and possible causes of death. Findings: 20,231 deliveries were made in the two year period. There were 1373 perinatal deaths. 867 was still born, and 506 died within the next seven days from birth. The overall perinatal mortality rate was 67.8 / 1000 and the still birth rate was 42.9 / 1000. Mechanisms were present in 21% of the cases, prematurity in 20.3% and hypertensive disorders in 18.8% of the cases. Antepartum haemorrhage was 11.8%, maternal infections / medical problems were 6.5%, congenital anomalies were 4.4% and in newborns was 15.3%. Conclusion: Perinatal mortality association was observed due to prenatal care, early gestational age and low birth weight. Thus, providing good delivery services such as antenatal care, emergency birth and neonatal care services at birth will help reduce perinatal mortality in developing countries. Key words: Perinatal mortality, Early neonatal mortality rate, fetal mortality rate.

3705-3709

Authors: Iqra Shoukat, Dr Ammara Farooq,Dr. Iqra Akhter

Objectives: The research aim was the examination of the core stabilization exercises effects on the conventionalphysiotherapy to manage non-specified low back ache and pain also known as LBP. Methodology: The research design was comparative and experimental conducted at Mayo Hospital, Lahore (Physiotherapy Department). Our research included a total of forty cases that were diagnosed with the non-specified LBP in the age group of 18 to 65 years. All the included patients were divided into two groups randomly: Group – A (Experimental Group): The patients of this group were managed with the help of conventionalphysiotherapy and core stabilization exercises. Group – B (Control Group): The treatment of these cases was carried out with conventional physiotherapy as the sole treatment therapy. Measured outcomes were functional outcomes of physical and pain which were measured through VAS (Visual AnalogueScale). Physical outcomes in terms of function were measured through Modified Oswestery Disability Questionnaire (MODQ). Results: We applied T – Test on A group and obtained MODQ and VAS p-values which were significantly observed as (0.000 for both); whereas, in group B the p-values were also same as mentioned earlier. With the AVOVA application insignificant p-values were observed for VAS and MODQ as 0.09& MODQ as 0.018. Conclusion: Improvement was observed in both A and B groups for functional activity and pain; whereas, A group was treated with the core stabilization exercises assisted with the conventional treatment which reflected a bit of improvement in the function and pain in B group. For the attainment of better outcomes any of the mentioned intervention can be used in order to produce effective management. Keywords: Conventionalphysiotherapy, Core stabilization exercises, Lower back pain (LBP), (VAS) Visual analoguescale.

3714-3719

Authors: Bir Pawan Kumar* and Sandeep Kumar

Fast dissolving films is a novel approach that are rapidly gaining interest for the patients having difficulties in swallowing or chewing of solid dosage forms such as tablets or capsules. Fast-dissolving drug-delivery systems were first developed in the late 1970s for pediatric and geriatric patients who experience difficulties in swallowing traditional oral solid dosage forms. These films may deliver the drug in a systemically manner through sublingual or buccal route and also used for local action. The present review reflects the information regarding the ideal characteristics, method of preparation and evaluation tests employed for fast dissolving oral films. However, for future growth point of view these films sector is well-positioned. It shows that the value of overall oral thin films market will be grow significantly. Keywords: Introduction, ideal characteristics, method of preparation, evaluation parameters and marketed products of fast dissolving films.

3726-3737

Authors: Anwar Ali Jamali, Ghulam Mustafa Jamali, Ameer Ali jamali, Muhammad Ali Suhail, Bhojo Mal Tanwani, Naveed Sattar Shaikh, Naeem Mustafa Jamali, Yash Tanwani

Introduction: Iron deficiency anemia is the most frequent public health dilemma in our community. It had an extensive variety of unfavorable consequences like reduced performance, decreased intelligence, retarded growth in newborns, playgroup and school going youngsters, adult females of different age groups. Anemia also causes the impairment of physical capability, routine working ability of youngsters and grown-ups, decline in immune competency and amplified morbidity due to other diseases in every age of life are also related to Anaemia. Objective: The present clinical study was done to assess the prevalence of Iron Deficiency anemia (IDA) in adult female subjects visiting OPD at PMC Hospital Nawabshah. Study Design and Setting: Current study was cross sectional carried out in adult female patients visiting PMC Hospital Nawabshah District Shaheed Benazirabad (Nawabshah). Duration: One year from January 2017 to December 2017. Material and Methods: After taking informed written consent, brief history and clinical examination; samples were collected by simple sampling method, vacutainers (EDTA) were used for sample collection and analysed by using MEDONIC auto analyzer MERCK COMPANY. All the Red blood cell (RBC) parameters including the RBC count, Hct (Hematocrit), Hb (Hemoglobin), MCV (Mean Corpuscular volume), and MCHC (Mean Corpuscular hemoglobin concentration) were tested. All obtained data was analysed through SPSS software version 20.0. Results: Our study was based on 385 female subjects that were selected randomly from different areas attending the OPDs. The total frequency of anemic females was 203(52.7%) and non-anemic 182 (47.3%) were observed. The average Haemoglobin value of 10.5+3.88 was observed in anaemic subjects. The highest frequency of anemia was observed in young age group (20-40 years). Conclusion: The frequency of iron deficiency anemia in adult females is common in district Shaheed Benazirabad especially pregnant and lactating females are at increased risk to develop IDA in comparison to other categories. This warrants extra studies on a larger sample of healthy females to validate the findings and to care the wellbeing of these forthcoming mothers. Key words: Iron Deficiency Anaemia, Haemglobin, Red Blood Cell, Hematocrit.

3742-3746

Authors: Faiza Mujahid, Dr. Ammara Farooq, Dr. Ayesha Munir

Objectives: To compare the local infiltration of bupivacaine with placebo in a caesarean section under spinal anesthesia in terms of the purpose of the study, mean pain scores and analgesic requirement. Study schedule: Randomized controlled Place and time of study: Gynecology and Obstetrics Department, Nishter Hospital, Multan. All patients from OPD, Emergency and high risk Ward were accepted from March 2016 to March 2017. Findings: In our study, 86% (n = 43) patients in Group A and 82% (n = 41) 18 (n = 9) were between the ages of 31 and 45 years, with mean ± SD being 26.52 ± 4.54 in Group A and 26.88 + 4.16 in Group. B. The pain score comparison in both groups was calculated as 1.98 + 0.91 in Group-A, 2.8 + 1.23 in Group-B, 0.00026 in p-value and showed a significant difference between these groups. The two groups were also calculated to have a p value of 0.00057 when the analgesic requirement was compared in both groups, 32.00 mg + 51.27 and in Group-B 82.00 mg + 84.97 tramadol, respectively. there is a significant difference between the two groups. Conclusion: Local infiltration of bupivacaine with the wound was significantly more effective than placebo in relieving postoperative pain and resulted in decreased post-cesarean analgesia requirement. Key words: cesarean section, spinal anesthesia, wound infiltration, analgesia requirement.

3751-3760

Authors: Dobhal Nidhi*and Mukhopadhyay Sayantan

Transdermal drug delivery system comprises one of the most important routes for new drug delivery system. Providing a means to sustain drug release it offers a large number of advantages over conventional drug delivery system. These are self-contained, discrete dosage forms which are known to deliver drug through intact skin at a controlled rate into systemic circulation. This delivery system has undergone a large number of modifications since its introduction in 1800’s, starting from the first generation which included delivery of small, lipophilic, low dose drugs to later ones which target their effects to skin barrier layers of stratum corneum using micro needles, thermal ablation, electroporation, etc.This review also focus on the potential of ionic liquids for transdermal application. This review details about various approaches to transdermal delivery system and describes numerous pharmaceutical developments which have been employed to overcome limitation related to skin delivery system. Key words: Transdermal Drug Delivery System, Skin, Microneedle, Iontophoresis, Ionic Liquid.

3765-3771

Authors: K. Lalitha and *P.Sailaja Rao

In developing countries the gradual revival of use of medicinal plants is attributed to the safety of herbal medicines with minimal adverse effects as comparable to the synthetic drugs. The present study was aimed to evaluate the antimicrobial effect of formulated gel containing chloroform extract of M.hortensis and ethanolic extract of C. longa. An optimized topical gel (carbopol- 934, as gelling agent) formulation in combination with the two herbal drugs was prepared in the 2:3 ratio and was evaluated. The extracts were prepared using standard procedures and physicochemical parameters of the formulated gel were determined. The anti-bacterial and anti-fungal activity was done using agar well diffusion method for determination of zone of inhibition. The studies indicated that with the increase in the concentration of the extract there is increase in the zone of inhibition with both the test extracts. The present study investigated the anti-bacterial activity of chloroform extract of M.hortensis and ethanolic extract of C. longa against various bacteria such as Staphylococcus aureus, Bacillus subtilis, Escherichia coli, P.aeroginosa and Candida albicans at different concentrations. In the anti-bacterial activity, the zone of inhibition (ZOI) was highest for S.aureus and P.aeroginosa at 150 mg/ml with the chloroform extract of M.hortensis and similarly ethanolic extract of C. longa produced highest zone of inhibition for E. Coli and B.subtilis. In the anti-fungal activity, the two test extracts chloroform extract of M.hortensis and ethanolic extract of C. longa showed 19 mm and 20 mm at 150 mg/ml as comparable to the standard. From the results it can be concluded that the formulated gel exhibited a potent antimicrobial activity. Key Words: Anti-microbial, anti-fungal, zone of inhibition, herbal extracts, formulated gel.

3776-3779

Authors: Dr. Sana Altaf,Dr. Ishaq Shabbir,Umaima Faizi

Objective: To determine the awareness among mothers visiting pediatrics OPD and ward in THQ Hospita l Ahmed Pur East, Bahawalpur. To create awareness and health consciousness about hazards of not starting weaning at proper time. Study Design: Observational Cross-sectional Descriptive Study. Study Setting: Study was conducted at Pediatrics Ward THQ Hospital Ahmed Pur East, Bahawalpur. Study Duration: From August, 2017 to April 2018. Study Population: A total of 100 mothers of reproductive age (15-45 years) were selected. Questionnaire was designed based on questions relevant to the objective of the study. Data was collected with informed consent and was analyzes by SPSS version. Results: 100 mothers of reproductive age (15-45 years) were questioned. Among them 74% knew about weaning, 18% to some extent and 8% did not know at all.60% of mothers were literate and other 40% illiterate.34% of them were the resident of rural area,16% of them were the resident of semi-urban area and the rest 50% were the resident of urban area.54% knew problems associated with not starting weaning,24% to some extent 22% did not know it all. Among them 37% had income up to 10,000 PKR per month, 14% up to 20,000 PKR per month,27% up to 25,000 PKR per month,15% up to 50,000 PKR per month and 7% above 50,000 PKR per month. 78% fed mother’s milk,1% cow’s milk and other 6% formula milk.59% of them started weaning between the infant age of 4-6months,11% between 7-9 months of age, 12% between 10-12 months and rest 18% between 1-1.5 years of age. 67% continued weaning during illness, 28% stopped weaning during illness and other 5% did not know what to do. 86% continued weaning during routine vaccination, 5% discontinued weaning and rest 9% did not know what to do. Foods which were included in weaning consisted of khichri 61%,Bread 36%,Banana 23%, Halva 20%, Cereals 18%, Cereals 18%.Bisciuts 10%, Dalia 9%, Yogurts 5%,Meshed potato 3%,Meshed meat 3%,Choori 1% and Noodles 1%. Conclusion: Evaluation of awareness among mothers were evaluated and analyzed to be poor with respect to their poor economic and poor educational status. Key Words: Weaning ,Pediatrics ward , THQ Hospital Ahmed Pur East, Bahawalpur

3785-3789

Authors: Hafiza Sameeya Shehzadi, Iqra Asif, Junaid Khan Kundi

Objective: Evaluation of the effects of Buprenorphine, Pentazocine and Tramadol on Respiration. Study design: This study is prospective. Place and duration of study: The study at hand was carried out in the month of July to December 2017. Intensive Care Unit (ICU) of Mayo Hospital, Lahore was the place of this study. Patients and methods: Total 60 patients related to ASA-I&II grades undergoing elective cesarean section were selected. Their age groups range from 18-35 years. Patients allergic to Opioids and those who were having severe systematic diseases not falling in ASA 1 or 2, were not considered in the study. Non-probability convenience sampling technique was used. Selected patients were divided into 03 groups. Twenty patients were allocated to every group. Endotracheal general anesthesia was administered to all the patients. Following operation, injection Buprenorphine 0.5mg IM was received by Group "A", Pentazocine 30mg IM was received by Group "B" and Tramadol 100mg IM was received by Group "C". After giving analgesia, its effects on arterial blood gases, tidal volume, minute volume and respiratory rate, were observed after half an hour, an hour, two hours and four hours. Repetition of the doses was performed eight-hourly. Results: After thirty minutes, respiratory rate and minute volume were seen to be decreasing in case of Buprenorphine. Effect of Pentazocine was dissimilar as it decreased minute volume in five minutes and decrease of respiratory rate was in thirty minutes. However, Tramadol has neither affected respiratory rate nor minute volume. Buprenorphine and Pentazocine decreased PaO2 within thirty minutes. The rise of PaCO2 was seen after one hour with Buprenorphine, whereas Pentazocine raised the same within five minutes. No changes were seen in arterial blood gas values with Tramadol. Conclusion: Opioids possess a respiratory depressant effect which is observable from thirty to sixty minutes of IM administration. In contrary, in equal-potent doses, respiratory depression is not caused by Tramadol being a non-opioid. Keywords: Parenteral, Buprenorphine, Pentazocine, Tramadol, Blood Gas Analysis, Respiration, Analgesia, Buprenorphine, Blood Gas Analysis, Buprenorphine and Recovery room.

3796-3803

Authors: Asadullah, Sana Idrees, Hazrat Ali, Noman ul haq, *Muhammad Samsoor Zarak, Aqeel Nasim

Adherence to a drug regimen is usually defined as the extent to which patients take medication as directed by a physician. Adherence to prescription drug regimens is difficult for all patients and is especially challenging for the elderly. Adherence to medication requires a working relationship between a patient or caregiver and a physician who prescribes should be open and honest with regard to medications., i.e. the administration schedule, intended benefits, adverse effects, and costs. Therefore, this study aimed to assess the level of adherence of hypertensive patients in Quetta, by using MMAS-8 and Hill-Bone Compliance ScaleA Cross-sectional descriptive study was conducted in Sandeman Provincial Hospital and Bolan Medical Complex to assess the adherence among hypertensive patients of Quetta, Pakistan. The study has been conducted from start to end was from March 2016 to October 2016. convenience sampling technique was used to collect data. Those patients who were willing to participate and were suffering from hypertension and receiving medical treatment were included in the study. Hill bone compliance scale was used to assess the level of medication adherence. SPSS V 20 used for descriptive and inferential statistics.Respondents mean age was 45.1 years while the minimum age was 21 and maximum were 95. The MMAS-8 mean score of adherence in hypertensive patients was 3.55. and the median score was 3.0. Among 401 majorities of patients, 306 (76.6%) poorly adhered. Ninety-four (23.4%) were had moderate adherence. While only one (0.2%) were having good adherence. The mean score of hill bone compliance Scale in hypertensive patients was 24.16. and the median score was 25.0. 336 (83.4%) had imperfect adherence and 65 (16.2%) have perfect adherence.It is concluded that chronic conditions, particularly hypertension the non-adherence to treatment are one of the major contributing factors to poor management and control of hypertension. So, for better management of Hypertension patients need to be advised or consultation should be given with a special focus on medication adherence so better therapeutic outcomes will be obtained. Keywords: Medication adherence, Hypertensive patients, Hill- bone compliance scale,

3818-3829

Authors: Mudiganti Ram Krishna Rao*and Lakshmanan V

Preservation of fruits and vegetables is a challenge for farmers, sellers and processors. Many chemical preservatives are used to increase the shelf life, to reduce the spoilage, to protect from microorganisms. The present study is to address this problem with an age old traditional preservative, turmeric, as bio preservative. Aqueous solution of turmeric at 5, 10 and 25 % (w/v) concentrations were used to preserve the tomatoes and the study was undertaken for 30 days. The change in physio-chemical characteristics such as weight, pH, lycopene content, dry matter content, total phenolic content were studied. The antimicrobial role of turmeric was also studied on E. coli, Lactobacillus and Aspergillus Niger. It was observed that there was a perceptible improvement in each of the parameters studied. Thus turmeric is suggested as a cheap and affordable preservative for harvested tomatoes. Further qualitative aspects must be studied to prove the bio preservative role of turmeric on tomatoes. Keywords: Shelf life, Bio preservative, Turmeric, Tomato, Spoilage, Antimicrobial

3834-3838

Authors: Dr. Amina Inayat Ullah, Dr. Azmeena Azam, Dr. Alvina Faiz

Objective: To find correlation between serum CA-125 levels and extent of ascites in chronic liver disease patients. Methodology: It is analytical study, conducted at Shifa international hospital, Islamabad, Pakistan over a period of one year from January 2012 to December 2012. Total 130 patients with chronic liver disease were enrolled, after confirmation of presence of hepatic cirrhosis on abdominal ultrasonography. Serum cancer antigen 125 level was measured in all patients. Presence of ascites was not made necessary for patients to be enrolled in study. The amount of ascites was confirmed by clinical examination and ultrasonography. The relation of CA-125 level with extent of ascites was drawn. Results: 57% patients had chronic liver disease due to hepatitis C virus infection, Child Pugh score C was in 60% patients. Moderate correlation was present between CA – 125 level and abdominal ascites (r 0.642, p value was less than 0.001). Thus it was observed that CA – 125 levels were significantly raised in patients suffering from ascites. P – value less than 0.001, which was statistically significant. Conclusion: There is moderate correlation between extent of ascites and serum cancer antigen 125 levels in patients with chronic liver disease. Thus CA – 125 can be used as a marker for ascites in CLD patients. Key Words: Chronic liver disease, cirrhosis, liver, ascites, cancer antigen 125.

3843-3853

Authors: Syeda Fatima Zahra, Aleena Ali, Syed Basat Raza Naqvi, Syeda Nighat Fatima, Maria Safdar

Introduction: In the today’s competitive world there is a great need of quality assurance among each and every field especially education. Despite their extraordinary infrastructure many institutes fail to provide quality education to the students. In such circumstances purpose of our study was mainly focused toward having an insight of the quality of education in the field of dentistry. And also with the advent of modern educational methodologies, the learner has the major role in deciding his learning styles, so this study also focuses on what and how students want in their curriculum. Methods: This research was cross sectional and it used a questionnaire based survey to evaluate the degree of student satisfaction regarding teaching methodologies followed at their dental colleges. The data was analyzed using SPSS v 17.0. Results: The results obtained by our research showed a high degree of satisfaction among the dental students regarding their teaching methodology. The result obtained was that none of the student showed signs of high dissatisfaction but there were 16/127 i.e. 12.6% of the students who were Dissatisfied and remaining 87.4% i.e. 111/127 of the students were satisfied in which 23/127 18.1% were greatly satisfied with their teachers’ way of educating them. Conclusion: This research provided a proposal to all the dental colleges of Pakistan that they should keep a record of what the students want. This provides the student an encouragement to express their views and also enable the students to take a central role in the system of education.

3859-3863

Authors: Dr. Humaira Atta Ullah, Dr. Muhammad Adnan Shahid, Dr. Muhammad Awais Tahir

Objective: The comparison of the Hepatitis B prevalence, human immunodeficiency virus (HIV) and hepatitis C in a voluntary replacement and non-remunerated donors in Allied Hospital Faisalabad Blood Transfusion Services. The research was completed in the period of 14 months from January 2016 to February 2017. Setting: The setting of the research was the tertiary healthcare Blood transfusion service in the adjoining area of Punjab. Method: We enrolled 3430 blood donors; among these donors 3187 pints were replacement donors (92.9%) and 243 pints (7.1%) were voluntary non-remunerated. Both the groups were screened for the hepatitis B surface antigen (HBsAg), HIV1/2 antibody and hepatitis C virus (HCV) antibody with the help of an automated random access AXSYM that utilized the technology (MEIA). Results: HBsAg prevalence, HIV 1/2 antibody and HCV antibody in replacement donors (3187) was respectively observed as 2.51%, 0.25% and 5.14%. In the 243 voluntary non-remunerated donors of blood the same prevalence was observed as 0.82%, zero % and 2.46% respectively. Conclusion: HBsAg, HIV antibody and HCV antibody prevalence were less in the voluntary non-remunerated blood donors when compared with the donors of replacement. The major source of blood in Pakistan is replacement donors, we need to shift to the voluntary non-remunerated blood donors. The safe blood in Pakistan can be achieved through this way in the prevalent circumstances of Pakistan. Key Words: Hepatitis B, Blood donors, Hepatitis C and HIV.

3869-3873

Authors: Dr .Yasrab

Objective: To assess whether by MRI adenomas can be visualized when CT findings are ambiguous and to assess adrenal adenoma in patients with both MRI chemical shift and unenhanced CT. Study Design: A Retrospective study Place and Duration: The study was performed in the Radiology Department of KRL Hospital Islamabad for the period of 2 Years from March 2015 to March 2017. Materials and Method: 40 patients (42 suprarenal masses) underwent MRI with chemical shift and unenhanced CT were studied retrospectively. For each adrenal mass, adrenal-spleen chemical shift rate, Houns site units and indexed signal intensity were recorded. Qualitative assessment for signal loss in every adrenal mass in the reciprocal phase by the two-passer images was also performed and differentiated with quantitative analyzes. a measure of adenoid-rich lipid, adrenal spleen has a rate of chemical shift lower than 0.71 d, has a rate of signal intensity higher than 16.5%, and if the mass exceeds 10 h, or if the mass satisfies two of the above criteria and there are subsequent images without alteration. Results: Sensitivity and adrenal-to-spleen contrast indicate the Cicadas to identify a lipid-rich adenoma using 92% (33/36) and 17% chemical shift qualitative index signal strength decline and analysis without CT (1/6), 100% (36/36) and (6/6), 100 (36/36) and 67% (4/6) and 78% (28/36) and 83%, 100% respectively (5/6). In lipids Twentyeight (67%) are measured in rich adenomas, or below 10H, a ratio of the chemical lobe of lower than 0.72 adrenal spleen, and strength of signal index of more than 17.0%. 8 masses (19%) were not more than 10H but the adrenal spleen was less than 0.71% of the chemical and a ratio of 16.5% to an index at higher density and the tracking signal was unaltered. Conclusion: Eight of 13 suprarenal adenomas (62%), which were measured more than 10 hours in CT scan unenhanced, were definitively characterized by MRI and chemical shift. Key Words: Adenoma, MRI, CT Scan, Chemical shift, Suprarenal masses.

3880-3883

Authors: Dr. Awais ur Rehman, Dr. Imran Majeed, Dr. Hira Tariq Chaudhary

Background: Allopurinol is commonly used as antihypertensive medicine. Fenofibrate, a fibric acid derivative, is widely used in hyperlipidemia treatment. Fenofibrate reduce serum uric acid levels effectively. Objective: This study was performed to evaluate the safety and efficacy of fenofibrate in patients with hyperuricemia. Study Design: Interventional Study Place and Duration: The study was performed in the Out Patient Department of Nephrology Unit of Nishter Hospital, Multan for the period of six months from January 2017 to July 2017. Materials and methods: Sixty hyperuricemic patients with serum uric acid levels of desil- lary or higher of 7.0 mg were enrolled and assigned to receive 300 mg allofurinol or 200 mg fenofibrate for 12 weeks. The efficacy of the drug was measured in percentage of patients successfully controlling serum uric acid levels of less than 6 mg P. Dl at 90 days. The efficacy of the drug was also checked by measuring the percentage of serum uric acid levels changes at day 1 to 90 days. Safety was checked by observing side effects (AE) and laboratory investigations. Findings: The percentage comparison of cases in which uric acid level in serum was lower than 6.5 mg at 90th day in both groups was statically significant (P = 0.14). However, the percentage difference in uric acid level between 0 and 90 days was significantly highly among the two groups (p = 0.001). Although the proportion of individuals experiencing any side effects was greater in the fenofibrate group, the side effects that caused the allopurinol group to discontinue treatment were found to be higher. Conclusion: Fenofibrate 200 mg is an effective antihypertensive agent once a day. Key words: Uric acid, Fenofibrate, hyperuricemia.

3894-3898

Authors: Dr. Attiya Razzaq, Dr. Ishaq Shabbir,Hafiz Muhammad Rashid Javaid

Abstract: Objective: Nowadays, Upper gastro-intestinal motility disorders are very common. The exact numbers of victims in Pakistan are unknown so far; however, numerous cases are surfaced who are found normal on liver function test and endoscopy test. Research aim was the management of dyspepsia in the patients suffering from nausea, anorexia, vomiting, heartburn, upper abdominal pain and fullness etc. Design and Setting:Our research was descriptive in nature and it was carried out in Mayo Hospital Lahore in the timeframe of August, 2016 to August, 2017. Material and Methods:When emptying of the stomach is sluggish one, such disorders are said to be functional. The related symptoms can be as mentioned above. It seems as if this condition is not problematic but it can be of grave concern in some cases. From mild to severe, symptoms may differ. Questions of dyspepsia management and its assessment are not answered yet. Preliminary Diagnostic ability could be challenging one due to overlapping causes of symptoms. A distinct reason is rarely established in a number of cases. The preliminary investigation of dyspepsia related patients encompasses physical examination and a systematic history while giving particular attention to those elements implying the presence of illness. Patients having alarm symptoms i.e. weight loss, melena and anorexia etc. should be immediately given Endoscopy test. If the test is positive, a cost-effective preliminary approach to check the Helicobacter pylori, Management should be applicable individually. Empiric therapy with prokinetic agent or a gastric acid suppressant is suggested if the said test is negative. Results:Dyspepsia patients’ upper gastrointestinal radiographs were collected historically. Endoscopic tests, nowadays, have lost their reliability for upper endoscopic examination in authenticating or excluding ulcers, malignancies and reflux disease. Though, diagnostic gold standard for pylori infection is endoscopy with biopsy, yet, the whole procedure may be impractical and expensive. Detection of pylori can also be made in the breath with the urea breath test (UBT), in the stool with a polymerase chain reaction (PCR) test or an antigen enzyme immunoassay (EIA), in the serum with antibody titers etc. If H. pylori is detected with the UBT, breaking down of ingested carbon labelled urea into ammonia and labelled CO2, is carried out by urease produced by the organism. It can be identified in breath of patient. The UBT is costlier, more specific and more sensitive. Cost and practicality of serology is acceptable. Its specificity and sensitivity to identify H. pylori infection render it an appropriate position in the market in comparison to UBT. Positive serology test suggests inactive infection and previous H. pylori exposure. Hence, the authenticity of elimination of organism questions the test utility. The UBT is, thus, highly recommended test in this regard. urease is not further originated once H. pylori is eliminated. In younger patients, non-invasive detection of H. pylori in the feces is of poignant significance. Sensitivities reported of PCR and EIA for H. pylori are 93.70% and 88.90%. The relevant specificities are hundred percent and 94.6 %. Conclusion:It is concluded that in such cases endoscopy should be carried out in case recurrence or persistence of symptoms. The base of this appraisal is on extensive search and clinical experience and study through “MEDLINE” on research papers, conference reports on Functional Gastro-intestinal disorders and review articles. Key Words: Diagnosis, Dyspepsia, Endoscopy and Medical Management.

3912-3919

Authors: Dr. Maria Ishtiaq, Dr. Minahil shoukat, Dr. Anam ijaz

The National Action Plan for Non-Communicable Disease Prevention, Control and Health Promotion in Pakistan (NAP-NCD) fuses avoidance and control of cardiovascular illnesses (CVD) as a major aspect of a thorough and coordinated non-transferable Disease (NCD) counteractive action exertion. In this program, observation of cardiovascular hazard factors is a piece of an incorporated populace based NCD reconnaissance framework. Psychological warfare has dependably been a mutilating highlight in smooth existence of the states yet to spare numerous from torment some need to give up. . This horrendous issue obliged me to consider its to a great degree reasons that why such savagery is submitted? Why there is no inverse side to counsel for ceasing such heartless acts? What the desires of the aggressors were? Why psychological oppressors assault schools? What sort and energy of reactions is found in the particular circumstance and what remarkable measures state government got a handle on to manage the condition with same debase more reactionary drive and what are the steps taken by the government to overcome this terrorism especially on schools and education system. This study will also expose that how the nuclear weapons effects the health. The need of reconsidering approach structure and territories to be considered is additionally examined. This research writing will inform reader about effects of the Peshawar carnage and efforts of the public along with governing authorities to rectify wreckage to possible extent and safety initiatives and awareness programs for future.

3924-3928

Authors: Dr. Shabana Amir,Dr. Tehmina Hayat,Dr. Arshia Maqbool

Objective: The primary objective of the research was the establishment of the appropriateness of blood gas analysis in the neonates diagnosed with the problem of respiratory distress. Subjects & Methods: Our research was held at the NICU (Neonatal Intensive Care Unit) which is a department of Mayo Hospital Lahore. Every new-born which was hospitalized on the diagnosis of the symptoms leading to respiratory distress were made a part of the research study. We managed these neonates with as a support of respiration with oxygen. No new-born was managed with pressurized ventilation and intubation during the stay at hospital. In the available data and records of the 16 new born children hospitalized for the analysis of the blood gas were also taken in to review. Results: With an exception of two cases there was no case diagnosed with hypoxemia (PaO2 below 80 mm Hg). In the same way there were two cases who were diagnosed with the incidence of acidosis (pH below 7.30); whereas, only single case was observed with the incidence of hypercarbia (PaCO2 above 40 mm Hg). The bicarbonate measurements and the base excess among majority of the patients was observed as in the normal range. Conclusions: It was observed that the analysis of the blood gas was essentially normal in majority of the collected samples which also suggested the unnecessary and inappropriateness utilization of this costly and painful process; on the other hand, in the in the stable newborn children with the respiratory distress. On the basis of these results we also found another alternative method which a combination of the pulse oximeter was reading, clinical parameters and chest x-ray outcomes; which suggested its possible usefulness for the neonate management diagnoses with respiratory distress. The objective was to minimize and reduce the over utilization of the painful invasive procedure. Keywords: Blood gas, tachypnea, neonates, chest x-ray, pulse oximetry and non-invasive.

3934-3939

Authors: Dr. Asad Munir,Dr. Muhammad Junaid Munir,Dr. Muhammad Adnan Akbar

Objective: The assessment of the spectrum and burden of neurological illness in the setting of an intensive pediatric unit and associated motility review was the primary objective of our research. Methods: We consulted the retrospective medical records review about the children between the age of one month to sixteen years who were hospitalized in the Services Hospital, Lahore (Acute Neurological Department) in the period of April, 2015 to March, 2016. The basic diagnosis, demographic and neuro diagnostic procedures were also carried out, outcomes and therapies were also carried out on a data sheet which was well structured. Results: We studied a total of 231 cases which were admitted because of an acute neurological illness in the PICU, the mean age of the children was observed as (67 ± 50) months, 125 children were under the age of five years (54%) and 138 children were male (59.7%). Among these children a total of 144 children had neurological illness (62.3%) and 87 children were diagnosed with neurosurgical illnesses (37.7%). In acute patients of neurological illness, 119 cases were of non-traumatic-coma (51.5%) and 25 cases were of neuromuscular illness (10.8%). Above 500 neuro diagnostic procedures/ tests were carried out in our research on the children having neurological disorders. Our rate of mortality was eighteen percent which was also compared with the total mortality rate observed as twelve percent. Conclusion: In PICU the repeated and common disorders were the of acute neurological nature; which were related to the increased rate of the mortality. CNS infections, severe traumatic brain injuries and status epilepticus were mostly repeated causes of the illness of acute neurological nature in this particular cohort. Key Words: Burden, PICU, Acute Neurological illnesses and Mortality.

3945-3953

Authors: Bommana Anusha*, Girija Karike, Koppula Maheshwari, Ramya Sri Sura

The present investigation was done on lorazepam orodispersible tablets using super disintegrants. The prepared powder blend for all formulations was found to be within limits. Tablets were compressed using rotary tablet compression machine. Post compression studies like weight variation, hardness, thickness, friability, drug content, in vitro disintegration time were carried out which were found to be within limits. In vitro drug release studies revealed that Among all formulations F4 formulation were shown maximum drug release(99.99%) at 45 min. Among these three formulations F4 was considered as optimised formulation due to 2 mg of croscarmellose sodium. Key words: Lorazepam, Super disintegrants, Orodispersble tablets.

3960-3967

Authors: Socorrina Colaco, Ramesh. N, Ramakrishna Shabaraya

The objective of the study was to develop naproxen sodium SR tablets were prepared by direct compression method using hydroxy propyl methyl cellulose (HPMC K 100). To know the effect of polymer concentration invitro study performed it has been observed that as the polymer concentration increases, the drug release rate decreases, and bioavailability study carried out in healthy human subject by administering the developed sustained release and marketed immediate release tablet. The developed naproxen sodium showed confirmed longer time to reach peak concentration than marketed immediate release table, controlled and constant drug delivery system, maintains better plasma concentration than conventional tablet by which it overcome the shortcoming of conservative treatment. The rate and extent of absorption of naproxen sodium SR tablets were higher than the marketed immediate release tablet shows more competent and controlled drug release which would sustain plasma concentration level throughout and produce desired effect. Further evidenced with lower elimination rate and higher half life. Keywords: Naproxen sodium SR tablets, Marketed immediate release tablet, HPMC, LCMS-MS, Bioavailability study

3972-3975

Authors: S.Selvakumar*, S. Vimalanban and D.Sajusha

Herbal medicines and Phytochemicals can be potent agents for lung cancer chemoprevention and treatment by regulating multi-molecular targets involved in angiogenesis, metastasis, and severe side effects; only provided quality control and reproducibility issues are solved. Compared with the conventional drugs used in cancer treatment, the toxicity of medicinal plants may seem trivial; however, it is a serious public health problem. Several medicinal plants are considered toxic and can cause serious damage to the health of patients. Hence it is of interest to investigate the in vitro antioxidant analysis 0f chloroform extract of Anisomeles malabarica was analysed. Our results indicate that the antioxidant potential of Anisomeles malabarica. Key words: Anisomeles malabarica, Medicinal plants, Phytochemicals, Lung cancer, Chemoprevention

3980-3983

Authors: S. Selvakumar* and U.Madhan Kumar.

In recent times, focus on medicinal plants research has increased all over the world and a large body of evidence has collected to show immense potential of medicinal plants used in various traditional systems. For many years herbal medicines have been used and are still used in developing countries as the primary source of medical treatment. Plants have been used in medicine for their natural antiseptic properties. Therefore, research has developed into investigating the potential properties and uses of terrestrial plant extracts for the preparation of potential drugs for treating human cancers. Many plant species are alreadybeing used to treat or prevent development of cancer. Multiple researchers have identified species of plants that have demonstrated anticancer properties with a lot of focus on those that have been used in herbal medicine in developing countries. Hence, the present study envisage that the antioxidant activity of the chloroform extract of Muntingia calabura. The results of the present study indicate that the herbal plant M.calabura contains significant antioxidant activity. Key words: Muntingia calabura, Plant based medicines, Potential drugs, Chemotherapy, Side effects.

3988-3996

Authors: Rahim Ullah*, Muhamad Din, Dildar Ahmad, Shazia Raim, Mansoor Ahmed

The objective of this research was to evaluate the danger of co-virus with human immunodeficiency virus (HIV), hepatitis C virus (HCV), hepatitis B virus (HBV), and patient’s syphilis. Inability to address this weakness can cause fatalities and death because of undetected and untreated contaminations. The procedure utilized by the specialists is a 42 nm (5 × 10 6 cm) DNA particle with a deficiently twofold stranded DNA genome containing an inward center protein (Hepatitis B focal antigen [HBcAg]) and an external coat (Hepatitis B surface antigen [HBsAg] It is a hepadnavirus and is a HCV disengaged chain RNA virus (hepacivirus). HCV vaccination protein immunoassay, recombinant immunoblot test, and quantitative HCV RNA polymerase chain reaction (PCR) are show tests used to recognize HCV disease. Antibodies against HIV were screened utilizing Determine and ImmunoComb tests. Basically useless conduct is most likely by all account not the only hazard factor and the danger of blood borne viral contamination is presumably identified with poor financial conditions, medication and liquor mishandle ethnic beginning, sex. For example, ancestorism, meningitis, uveitis, optic neuritis, general loss of motion, dorsal skin and skin and skeletal bears It is demonstrated that The aftereffects of various analysts are a piece of the sequelae related with tertiary syphilis. For fundamental and subjective wounds, limit visual field microscopy and direct fluorescence vaccination gear (DFA) are tests used to break down syphilis. Non-treponemal serological tests by Fast Plasma Recover (RPR) or (VRDL) are most generally utilized for screening. In fundamental syphilis, RPR and VDRL impact are 78% and 86%, separately. Both supplementary syphilis was 100%; in tertiary syphilis it was over 95%. HBV and HCV sickness (aOR 2.81, 95% CI 1.02 to 10.12; p = 0.036), HIV and HBV disease (adjusted proportion (aOR) 3.46, 95% CI 1.29 to 9.39, p = 0.014). (AOR 3.86, 95% CI 1.07-12.55; p = 0.039) and syphilis (aOR 2.81, 95% CI 1.05 (aOR 1.81, 95% CI 1.14-2.88; p = 0.013), especially polluted by HIV - 7. 46; p = 0.039). Run for ANC cases was that ladies who were pregnant from blue to go to ANC offices inside the time allotment of the examination the standard of Ob-Gyn OPD patients was another STD tolerant who went to Ob-Gyn OPD amid the investigation time frame and was a patient who went to the intercession focus with or without sign. Keywords: HBV, HCV, syphilis disease and blood borne infection

4003-4010

Authors: Dr. Abdullah Bashir Janjua, Dr. Shaharyar Ahmed, Dr. Umar Farooq

Antihelmintics are the drugs used to eradicate or reside the number of helmintic parasites from intestinal tract or tissue of humans and other animals. The antihelmintic activity of Rauwolfia serpentina root extracts were evaluated separately on adult Indian earthworm (Pheretima posthuma). It was found that methanolic extract and aqueous extract of Rauwolfia serpentina showed antihelmintic activity at various concentration (50,100 and 200 mg/ml). The standard drug used was Albendazole (50, 100 and 200 mg/ml). The methanolic extract of Rauwolfia serpentina showed better result when compared to aqueous extract. Keywords: Antihelmintics, Rauwolfia serpentina, Albendazole and Pheretima posthuma.

4017-4023

Authors: Dr. Waseem Haider, Dr Mahnoor Ahsan, Dr Usama Razzaq

Background and Objective: Coronary heart diseases are being treated by surgical and non-surgical procedures like Coronary Artery Bypass Graft (CABG) and Percutaneous Coronary Intervention (PCI). The impact of these techniques on the patients with Chronic Kidney Disease (CKD) is a debatable issue. The risk factors (mortality and morbidity) associated with the application of these methods in CKD patients are brought to light in this study. Methods: The study was carried out at Services Hospital, Lahore from Jan 2016 to Aug 2017. A total of 159 CKD patients were selected from the revascularization center of the hospital. They had to undergo either from CABG or PCI. The main results after the treatment were loss of life, Myocardial Infarction (MI) heart attack, or stroke. We analyzed the mode of coronary revascularization having least risk factors of medical results. Results: Among 159 patients with CKD, 85 patients (53.5%) received PCI and 74 patients (46.5%) received CABG. The study revealed that patient with higher intensity of kidney disease were given PCI treatment and surgical procedure (CABG) was adopted in case of patients with mild CKD. However, the medical findings were not much different in both cases. The PCI method was preferred on the basis of factors like patients’ age, heart attack by complete blockage of artery (STEMI), heart attack by partial blockage (NSTEMI) and number of coronary arteries in patients with intense renal problems. Conclusion: The medical results seen in both cases were comparable for CKD patients. No significant difference was noticed in the patients for both methods. Therefore, Percutaneous Coronary Intervention can be agreeable and least intrusive treatment with respect to CABG, especially among patients with higher risks of kidney disease. Key Words: Chronic kidney disease, Creatinine clearance, Coronary revascularization, percutaneous coronary intervention, Coronary artery bypass graft.

4028-4031

Authors: Dr. Faiqa Shafiq, Dr. Muniba Irfan, Dr. Hussnain Abid

Objective: To determine the frequency of Hypersplenism in cases of liver cirrhosis. Methodology: This cross sectional study was conducted at Sheikh Zayed Hospital, Lahore during January to August 2017. The cases with liver cirrhosis were labelled according to clinical symptoms, deranged liver function tests and on Ultrasonography abdomen. The cases were included of both genders with age 20 years or more with child pugh class B and C. The cases with any hematological malignancy or end stage renal of cardiac failure were excluded. Hypersplenism was labelled on bone marrow examination with normal to hyper cellular marrow. Results: In the present study there were total 130 cases of liver cirrhosis. Out of these 84 (64.61%) were males and 46 (35.39%) females. The mean age was 53.45±8.23 years. Hypersplenism was observed in 65 (50%) of the cases. Hypersplenism was significantly high in male group seen in 51 (60.71%) cases with p= 0.01. There was near significant difference in terms of age groups where it was seen in 48 (56.47%) cases with age more than 50 years with p= 0.06. Hypersplenism was significantly high in cases with child pugh class C affecting 55 (56.70%) cases with p value of 0.02. Conclusion: Hypersplenism is not uncommon in liver cirrhosis and is seen significantly high in cases with child pugh class C and male gender. Key Words: Liver cirrhosis, Hypersplenism.

4035-4039

Authors: Dr. Sehrish Abbas, Dr. Usman Saleem, Dr. Fawad Ahmed Khushhal

Background: In the established hydrocephalous a common modality of the treatment is ventriculoperitoneal shunt. Our research was aimed at the determination of the age and sex distribution, cause and site and post-operative year of shunt obstruction of the ventriculoperitoneal obstruction blocked VP shunts patients. Material & Methods: Research design was descriptive and it was carried out at Mayo Hospital, Lahore in the period of Jan, 2016 to Jan, 2017. We included every blocked VP shunt patient in our research study. Age and sex were the demographic; whereas, time from the VP shunt insertion was counted in years, post-operative shunt obstruction year and cause and site of the shunt obstruction were taken as the variables of the research study. To calculate the continuous data, we calculated the values of Mean & SD; whereas, percentage and frequency were also calculated for categorical data. Results: Research sample consisted of 104 patients, 56 males (53.85%) and 48 females (46.15%). The patient’s median age factor was observed as four years (0.58 – 11.75 (IQR)). Below one-year age was involved repeatedly and it was observed in 39 patients (37.5%). Shunt obstruction occurrence was observed in 1st year of the post shunt insertion in 38 patients (36.54%). The occurrence of the Shunt obstruction was observed at the end of ventricular in 57 patients (54.80%); whereas, 47 patients (45.20%) had the blockage of distal catheter. The repeated cause of the blockage of the shunt was observed as lying in brain parenchyma and shunt tip crossing ventricle observed in 20 patients (19.23%). Conclusion: In the early years of the life the occurrence of the shunt obstruction in VP shunts is common and repeated. Its predominance is observed at the end of proximal. In the first insertion years its occurrence is observed. Key Words: Hydrocephalous; Cerebrospinal Fluid; Ventriculoperitoneal Shunt; Pleural Cavity; Peritoneal Cavity; Choroid Plexus and Slit Ventricle Syndrome.

4046-4050

Authors: Dr. Laiq, Dr. Rameez Ahmad, Dr. Sebghat Ullah

Objective: The aim of the research was the comparison of the auto transplantation of parathyroid gland with the preservation of the parathyroid gland in situ keeping in view the parathyroid gland function preservation in total thyroidectomy patients. Methods: Research design was quasi-experimental which was carried out in the time span of July, 2015 to June, 2017 at Mayo Hospital, Lahore with a sample of 388 patients experienced total thyroidectomy for numerous disorders of thyroid gland. The sample of the research was divided in to two groups A and B respectively having 97 cases of parathyroid glands who were preserved in situ and 291 patients underwent at least one auto transplant of parathyroid gland in ipsilateral sternocleidomastoid muscle. Six months follow-up was carried out for the parathyroid function assessment. We used Fisher's exact test for the comparison of both the groups. Results: Mean age of group A and B was respectively (42.46 ± 15.30) years and (39.16 ± 18.91) years. An overall proportion of male to female was (1:3.5). In the population of Group “A”, permanent hypocalcemia was developed in 3 cases (3.09%); whereas, “B” group had only 1 permanent hypocalcemia case (0.34%). Conclusion: At least one parathyroid gland auto transplantation after total thyroidectomy is a process that has always predictable outcomes linked with the lowest risk of the permanent hypoparathyroidism. Keywords: Total thyroidectomy and Parathyroid auto transplantation.

4057-4062

Authors: Dr. Usama Razzaq, Dr. Mahnoor Ahsan, Dr. Waseem Haider

Background: Poisoning trends are changing in Pakistan, travel and street associated poisoning is novel and emerging in the healthcare as a big issue. This research is first in its kind that deals with the regional issue of the travelling and street used drugs and their poisoning mode. Material & Methods: Research is cross-sectional descriptive in design and it was carried out at Services Hospital, Lahore in the period starting from July 2016 to June 2017 having a sample of one hundred cases, which were enrolled in the research after the fulfilling of prescribed criteria. At the end of the clinical assessment necessary urine test, stomach and blood samples were collected and tested in the laboratory to analyses then chemically and toxicologically. Results: The sample was of one hundred cases selected from the age limit of 15 – 65 years including 84 males (84%) and 16 females (16%). Among the used drugs sixty percent was benzodiazepines, 4% phenobarbitone, 32% opium derivatives; whereas, rat killers were used by a meager 2%, mixed opium derivatives and benzodiazepines. Delivery mode in the poison intake was through soft drinks (54%), food (8%) and fruits (38%) cases. The victimized persons included 60% passengers, 8% Taxi drivers, 20% pedestrians, females 6% attending marriages and six percent others were also affected. Conclusion: Travel and Street associated poisoning cases are emerging issue of the healthcare in Pakistan. Delivery mode is often drinks, food and fruit with a mixture of opium derivatives and benzodiazepines. This occurs because of the awareness level and educational lack, law and order in the poor state, corruption, people attitude and un-employment. Key Words: Crime; Travel; Poisons; Street drugs; Opium; Benzodiazepines and Public Health.

4072-4087

Authors: T. Mangilal, K.Chitra*, J. Naveen, M.Ravi Kumar

The aim of the present study is to formulate and evaluate Voriconazole Buccal Patches. Voriconazole is a triazole antifungal drug that is generally used to treat serious, invasive fungal infections. These are generally seen in patients who are immune compromised, and include invasive candidiasis, invasive aspergillosis, and certain emerging fungal infections. In the present study buccal drug delivery of Voriconazole was developed Matrix type of buccal patches was developed by using polymers such as Chitosan and Eudragit S 100. Buccal patches were prepared by employing solvent casting method. Propylene glycol and Tween80 were selected as both permeation enhancer and plasticizer. Drug excipient compatibility studies were carried out by using FTIR, and it was observed that there were no interactions between drug and polymers. Formulations were prepared by the varying concentrations polymers ranging from F1-F6, and all the formulations were evaluated for various physical parameters such as Physical appearance, Flatness, Weight variation, Thickness, Folding endurance, Drug content, Moisture uptake, Moisture content. All the results were found to be were found to be within the pharmacoepial limits, invitro drug release studies done by using dialysis membrane. Among all the 06 formulations F4 formulation which contain Eudragit S 100 100mg has shown 95.76% cumulative drug release within 12 hours. For F4 formulation release kinetics were plotted and the Regression coefficient value was found to be high for Korsemeyer Peppas model plot i.e., 0.999. Key words: Voriconazole, Buccal Patches, Chitosan and Eudragit S 100

4097-4106

Authors: V.A. Ghodake, B.A.Agarwal, A.R. Tekade*

A stability indicating high performance thin layer chromatography (HPTLC) method was developed and validated for determination of Donepezil hydrochloride and curcumin in in situ nasal gel. Study was performed on pre-coated silica gel HPTLC plates using toluene: methanol: glacial acetic acid (8: 2: 0.1 v/v/v) as the mobile phase. A TLC scanner set at 254 nm was used for direct evaluation of the chromatograms in the reflectance/absorbance mode. Method was validated according to ICH guidelines. The correlation coefficients of calibration curves were found to be 0.994 and 0.988 in the concentration range of 300–1800 and 120–720 ng band−1 for donepezil hydrochloride and curcumin, respectively. The method had an accuracy of 100.6 % for donepezil hydrochloride and 99.08% for curcumin. The method had the potential to determine these drugs simultaneously from dosage forms without any interference of the excipients. Donepezil hydrochloride and curcumin were also subjected to acid, base, oxidation, heat and photo-degradation studies. The degradation products obtained were well resolved from the pure drugs with significantly different Rf values. As the method could effectively separate the drugs from its degradation products, it can be used for stability-indicating analysis. Keywords: High-performance thin-layer chromatography, Donepezil hydrochloride and Curcumin, Stabilityindicating method

4114-4120

Authors: M. Ramayyappa*, G. Raveendra Babu, B. Krishna, A. Ravi Kumar

A novel stability-indicating, RP-HPLC method was developed for the simultaneous determination of the Aspirin, Atorvastatin and Clopidogrel in capsules. Chromatogram was run through BDS (150 mm X 4.6mm, 5μ). Mobile phase containing phosphate buffer pH 4.5 and acetonitrile in the ratio of (50:50, v/v) was pumped through column at a flow rate of 1ml/min. Optimized wavelength for Aspirin and Atorvastatin and Clopidogrel was 249 nm. Retention time of Aspirin, Atorvastatin and Clopidogrel were found to be 2.367 min, 5.463 min and 4.658 min, respectively. % RSD of the Aspirin, Atorvastatin and Clopidogrel were and found to be 1.01, 0.89 and 0.77 respectively. % recover was obtained as 99.79 %, 99.73 % and 100.57 % for Aspirin, Atorvastatin and Clopidogril, respectively. Limit of detection and quantification values are obtained from regression equations of Aspirin (0.8 ppm, 0.25 ppm), Atorvastatin (0.14 ppm, 0.41 ppm) and Clopidogrel (0.25 ppm, 0.76 ppm). Regression equation of Aspirin is y = 2433.x + 706.4, and of Atorvastatin is y = 17432x + 872.7and Clopidogrel is y = 2403.x + 412.3. The present method was performed the degradation studies like acid, base, oxidation, UV, thermal and neutral, results founds to be negligible. Key words: Aspirin, Atorvastatin, Clopidogrel, RP-HPLC and Estimation

4129-4142

Authors: Vazir Ashfaq Ahmed *and Divakar Goli

Objective: The goal of this study was to evaluated anti-glaucoma activity of ion-activated in-situ gel of Brimonidine Tartarate (BT) and to predict the shelf of the developed formulation. Method: sol-gel formulation was prepared by using gellan gum as an ion-activated gel-forming polymer, sterculia foetida gum and kappa carragennan as mucoadhesive agent and hydroxy propyl methyl cellulose (HPMC E50LV) as release retardant polymer. Phenyl ethyl alcohol as preservatives in borate buffer. Glaucoma was induced by marginal ear vein using 5% dextrose solution. Schiotz tonometer was use to measure the induced glaucoma. Long terms and accelerated stability studies were carried out. The formulation was characteristics for pH, clarity, sterility, in-vitro gelation studies and drug content by RP-HPLC method. Result: The mean normotensive IOP was in the range of 17.5±0.08 to 19.1±0.40 mm Hg in both the eyes. Glaucoma was induced in the both eye with 5% dextrose solution and the mean IOP in both eyes was in the range of 26.2±0.21 to 29.9±0.25 mm Hg. Student paired Ttest ( F2) vs. Distilled water) was analysed and it was found that there is a highly significant difference between the means. This indicates the test drug is effective in the form of in-situ gels. The repeated measures one –way ANOVA with Tukey's multiple comparison test indicate the data is not significant, i.e p value is greater than p<0.05. In-situ gel are able to control the induced IOP and the IOP values of treated in-situ gel are near to normal IOP reading. Student unpaired and paired T test along with one way ANOVA data shows that there is a marginal significant difference between the means of F1 and F2. With p value of <0.0060 for student unpaired, <0.0050 for student paired T test. There is no significant difference between F2 and normal IOP but there is a marginal significant difference between F1 and normal IOP. Which highlight F2 is better in controlling induced/elevated IOP compared to F1. in-situ gels were translucent, Immediate gelation was formed with in sec, as it was dropped and remained stable. The formulations were free from microorganisms at 30 °C ± 2 °C/65% RH ± 5% RH and at 40°C ± 2°C/75% RH ± 5% RH. The chromatograms were obtained with acceptable tailing factors (<2), not much variation was observed in the retention time. % drug content was found to be in the range of 9 9.46 % to 96% at 40°C ± 2°C/75% RH ± 5% RH by RP-HPLC. The shelf life (t90%) of F2 was found to be 2.5 years at 30 °C ± 2 °C/65% RH ± 5% RH .and at 40°C ± 2°C/75% RH ± 5% RH shelf life (t90%) was found to be 2 years. Conclusion: 5 % dextrose infusion through marginal ear vein is better in inducing IOP. Schiotz tonometer remains the preferred screening instrument. Brimonidine tartarate has a dual mechanism of action by reducing aqueous humor production and increasing uveoscleral outflow. So a synergistic effect can be obtained with help of in-situ gels in order to control elevated intra-ocular pressure in glaucoma. The above study highlights that formulation with sterculia foetida is better compared to kappa carragennan in controlling induced IOP. Key words: Sterculia Foetida gum, marginal ear vein, Schiotz tonometer, Brimonidine Tartarate.

4153-4157

Authors: Muhammad Kamran, Dr. Awais Butt, Shahzaib Nawaz

Objective: To have in depth knowledge about the effects of nonselective and selective inhibitory and activated agents on adenylyl cyclase in rat kidney. Design: A variety of concentrations of pharmacological agents were prepared. They include nebularine, Ap3A, forskolin, Ap4A and caffeine. Furthermore, effects of these agents were noted in relation to rat kidney adenylyl activity. Methods: Tissue of rat kidney was used in the process of preparation of crude extract. Activity of adenylyl cyclase in connection with crude extract was observed. [2-H3] ATP was used as substrate which ultimately lead to the formation of cAMP. Pharmacological agents with their prepared concentrations were tested. Prominent activator of adenylyl cyclase, forskolin, was selected as a compound. Ap4A, caffeine, nebularine, and Ap3A were utilized for comparison purpose. Results: Adenylyl cyclase activity was at peak at 100 M forskolin as per concluded results. Nebularine inhibited activity of enzyme when agent concentration enhanced up to 50 M where the inhibition started to stable. No considerable effect on the enzyme activity in kidney tissue was observed when caffeine with 10 – 300 M on the of adenylyl cyclase activity was used. No effect on adenylyl cyclase activity was noted when Ap3A over the concentration range of 10 – 300 M was used. However, an inhibition effect on the enzyme activity was noted when Ap4A with the concentration 100 M was used. Conclusion: Role of cyclic nucleotides in metabolism control and cell-signaling is undeniably significant. It stimulates inhibitors and activities of cyclase to make some likely physiological impacts. Foreskin being initiator of adenylyl cyclase, Ap4A and nebularine are established to be latent inhibitors of cyclase, which signifies their importance in curing schizophrenia, mania, seizure etc. Key Words: Ap3A, Nucleotides, Caffeine, Forskolin, Ap4A, Nebularine. Adenylyl cyclase

4165-4177

Authors: Dr. Muhammad Bilal, Dr. Shakeel Mazhar, Dr. Muhammad Rashid Ali

Background: expanded program on immunization is carried out to protect all children against nine vaccine preventable diseases; still many children don’t receive vaccination at proper age. The purpose of EPI is to initiate a collective effort to reduce the mortality results from EPI target disease by immunizing children of age less than two years. Hence, monitoring immunization coverage performance is essential for improving the quality of services and current immunization status. Study design: cross-sectional study Study setting: PAEDS Outpatient department of services Hospital Lahore. Study duration: 1st May to 30th may 2015: 1 month Materials and methods: Non probability convenient sampling technique was used. Every Mother of the child less than two years was personally interviewed and a preformed questionnaire was filled in. Data was analyzed using SPSS. Results: 88.7% children received complete immunization till required for their age at proper time according to expanded program on immunization schedule while 7.2% %children were partially immunized and 4.1 % children were non-immunized. Reasons behind incomplete immunization were 27.3% parents of children were not willing for immunization while reasons given by parents for child being not immunized were lack of information in 9.1%, false beliefs in 18.2%, vaccination center not approachable in 45.5%, child sickness in 18.2% and unavailability of vaccinator in 9.1%. Conclusion: The immunization coverage among children was found to be comparatively high and the major reasons for failure of immunization among children were inaccessibility of vaccination center, misconceptions among parents, child sickness and lack of information. Keywords: Expanded program on immunization, Coverage, Failure reasons.

4186-4190

Authors: Iqra Sagheer, Farwa Iqbal, Aqsa Zulfiqar

Objective: The research design was cross sectional survey which was carried out to find out the Restless legs syndrome (RLS) prevalence in the patients of end stage renal disease (ESRD) on hemodialysis (HD). Methods: We obtained this data from a total of 250 patients through chronic maintenance HD. For the assessment of the RLS prevalence, RLS criteria for the clinical diagnostic was made through the research group of international RLS. Results: Research sample size was 250 cases with the male and female proportion of 153 males (61.2%) and 97 females (38.8%) respectively. The factor of mean age was observed as (45.27) years. HD mean duration was (26.10) months. We found a total of 162 RLS cases (64.8%). In the total of 153 males, 87 cases (56%) were diagnosed with RLS and among in the 97 females, 75 cases (77.3%) were diagnosed with RLS. We observed in this research that significant involvement of the gender was present in the research outcomes which was linked with RLS as p-value was observed as (0.001). Concerning to group of age 159 cases (63.6%) were under 51 years of age; in this number 102 cases (64.1%) were diagnosed with RLS; whereas, 91cases (36.4%) were above or equal to 51 years and in the patients of this group 60 cases suffered from RLS (65.9%). It was noticed that no significant link was present in age group and RLS with a significant p-value as (0.776). Conclusions: The patients undergoing routine HD are observed with a common incidence of RLS. Females are commonly observed in this incidence and dominate males. Key Words: Restless legs syndrome (RLS), End stage renal disease (ESRD) and Hemodialysis (HD).

4197-4203

Authors: Dr. Umer Farooq, Dr. Mubashar Alam, Inam ur Rehman

Background: Individuals who keep on changing their jobs are impelled due to dispositional wanderlust commonly known as Hobo syndrome. Key objective of the study at hand was to identify the concept of Hobo syndrome and then its comparative analysis in three realms i.e. health, banking and development. Material & Methods:The size of sample was 228 in this comparative study. Measures employed in the study were various key aspects i.e. openness to experience scale, perceived alternative employment opportunities, job hopping measure, demographic data sheet, number of past quits and intention to search for alternative job. Post Hoc and one-way ANOVA were correlation used to examine the hypotheses. Results:Study was conducted on total 228 individuals. Every sector was allocated 76 individuals. After results, it was confirmed that there is a presence of positive relationship between perceived alternative employment opportunities and Hobo syndrome. It also validated the relationship between Hobo syndrome and openness to experience. On Hobo syndrome, banking sector employees showed greater mean score when they were compared with health and development sector. When mean differences on Hobo syndrome was compared in connection with workers of various levels of management, results were remarkable. As per these results, high mean score was displayed on Hobo syndrome by non-management employees when they were compared to senior and middle management employees. Conclusion:In Pakistan, Hobo syndrome is rampant amongst various employees related to non-management sector especially. The same is true in case of senior and middle management but it is of lesser nature as compared to nonmanagement workers. Banking sector employees have more inclination to Hobo syndrome in comparison to the employees of health and development sectors. Key Words: Job hopping, Openness to Experience, Hobo Syndrome, Perceived Alternative Employment Opportunities.

4218-4221

Authors: *Dr. Preetha S.P, Ph.D., Dr. Karthikeyan Ramaiyan, M.V.Sc., Dr. Vasudevan Ramakrishnan, M.D (Siddha), Dr. SathyaRajeswaran M.D (Siddha)

Colon cancer is the major cause of death worldwide. Pooranachandirodayam is a herbo-mineral siddha preparation used to treat chronic ailments. This study was conducted to elucidate the efficacy and probable underlying mechanism of Pooranachandirodayam in colon cancer using in vitro studies. But Pooranachandirodayam had solubility issues with the methods earlier described for in vitro studies and with different concentrations of other varying solvents. From the results of the in vitro studies, PC shows no effect on the colon cancer cells, which may be due to the inappropriate vehicle used. Keywords: Colorectal cancer - Pooranachandirodayam – solubilisation – in vitro studies

4228- 4251

Authors: Sharmila Dusia a,*, Ramanamma.L, Prasad.DSVS

A RP-HPLC for Donepezil hydrochloride in tablets was developed and validated. Donepezil hydrochloride is a reversible inhibitor of acetylcholinesterase, indicated for the treatment of mild to moderate dementia of the Alzheimer's type. The HPLC method was performed with a unisol reversed phase C18 column (150×4.6 mm, 3 µm) detection at 268 nm and a mixture of Acetonitrile: Water (50:50) as mobile phase. Typical retention time for Donepezil was 4.407 mins. The method was statistically validated for linearity, accuracy, precision and selectivity following ICH recommendations. Due to its simplicity and accuracy, the method can be used for routine quality control analysis. Keywords: Donepezil hydrochloride; Assay; HPLC; Validation.

4258-4261

Authors: Dr Bakht Zia, Dr Aqsa Maryam Marith, Dr Subhan Shahid,

Objective: To determine causes and risk factors leading to depression and mood swings among pregnant females visiting antenatal clinics of teaching hospitals in Lahore, Pakistan. Methodology: 907 pregnant females were included in study, from antenatal clinics of teaching hospitals in Lahore, Pakistan during January to December 2016. Study follows descriptive, cross-sectional design. Demographic profile was recorded on a questionnaire. The measurement tool for depression was Beck Depression Inventory (BDI). Data analysis was done using descriptive statistics, linear regression and Chi- square test. Results: The women with mean age 26.44.4 were included in study. 80.5% females had depression during antenatal period. Depression score was calculated in each trimester and it was 67.9%, 83.5% and 85.8% respectively. There was significant increase in depression as pregnancy progresses (P value 0.001).The regression analysis showed the risk factors, patient’s education (OR 4.67, 95% confidence interval, 1.97 to 11.07), husband’s education ( OR 4.67, 95% CI, 1.9 to 11.07), husband’s employment( OR 4.67, 95% CI, 1.9 to 11.07), , family size( OR 4.67, 95% CI, 1.9 to 11.07), , History of miscarriages( OR 4.67, 95% CI, 1.9 to 11.07), , number of pregnancies ( OR 4.67, 95% CI, 1.9 to 11.07). Conclusion: Depression is quite common among females during antenatal period, which increases as pregnancy progresses. The risk factors responsible for it are husband and wife’s education, family size, number of pregnancies, history of abortions, monthly income and family financial status. Screening and diagnosis of depression and provision of special care to patient improves the healthy progression of pregnancy. Key Words: depression, pregnancy, females, causes.

4266-4269

Authors: Dr. Amna Tahir, Dr. Iqra Liaqat,Dr. Rabia Javed

Objective: To determine the association between serum interleukin 6 levels and angina pectoris. Methodology: The cross sectional study was conducted at Sheikh Zayd Hospital, Lahore during February to September 2016. 40 to 60 years old diagnosed cases of angina pectoris, either males or females were added in the study population. The criteria was normal ECG waves at rest and normal cardiac enzymes level. IL-6 levels were measured in patients by collecting 3ml blood sample. More than 5ng/ml was normal level. Results: 100 angina patients were enrolled. Male to female ratio was 58 and 42 each, respectively. Mean age group was 54.29.3 years. 68 individuals had raised IL6 levels. No association between gender and IL- 6 level was noticed. However the level was higher in individuals with diabetes mellitus and hypertension, affecting 20 and 22 cases in each group. P value was 0.01 and 0.05 respectively, which was statistically significant. Conclusion: IL-6 level was raised in patients with angina pectoris, its level was significantly raised in patients with DM and hypertension. Key Words: Interleukin 6, Angina pectoris, diabetes mellitus, hypertension.

4274-4276

Authors: G. Sowjanya, E. Raja Sree, S. Disharani, M. Neeraja, Y.Lavanya, M. Niranjan babu

Objectives: Carbamazepine is most commonly used for the treatment of seizure disorders, neuropathic pain and bipolar disorders. It is associated with adverse effects such as nausea, vomiting, drowsiness, dizziness, head ache, impairement in motor coordination, aplastic anaemia, agranucytosis. Rarely life threatening cutaneous reaction such as stevensjohnson syndrome (SJS) or toxic epidermal necrolysis (TEN) due to carbamazepine therapy are more common in people with human leukocyte antigen allele HLA-B*1502. Methodology: We report a case of SJS due to carbamazepine therapy in a patient with epilepsy. Results: A 36 years old female patient from rural area was admitted in the dermatology ward in a tertiary care hospital with a chief complaints of fever, blisters, skin peeling, red eyes, painful skin, burning sensation, erythema of lips, throat pain and difficulty of swallowing for 4 days. She had a past medication history of early two month clinical course of carbamazepine for seizures. Conclusion: We high lightening the importance of early diagnosis of this cutaneous adverse reaction may help in adjusting the further therapy so as to avoid the complications. Key words: Carbamazepine, epilepsy, steven jonhson syndrome, cutaneous adverse drug reaction

4286-4289

Authors: Dr. Mohammad Ahmad Shahbaz , Dr. Ramsha Jalal, Dr. Aleena Akram

Introduction: Oral squamous cell carcinoma (OSCC) is the most common malignancy of the head and neck (excluding non-melanoma skin cancer), with more than 300,000 new cases reported annually worldwide. Objectives of the study: The basic aim of the study is to find the some important biomarkers which are useful in the diagnosis and treatment of oral tongue squamous cell carcinoma (SCC). Material and methods: The study was conducted according to the rules and regulations of ethical committee of hospital. The patients who was suffering from oral cancer was selected for this study during the time period of 2016 to 2017. 5.0 ml blood sample was taken from vein. Blood was further processed for the estimation of serum biomarkers i.e Sialic acid, NO, Vita-A, Vit-E and GSH. Results: The data represents that there is a statistical difference among control group and patients. The data shows all the expected prognostic markers which used for the assessment of OSC in humans. The value of GSH and SOD shows that these are the most important biomarkers for the analysis of OSC in humans. Conclusion: According to analysis of data it is concluded that GSH, MDA and SOD are the important diagnostic biomarkers in the assessment of OSSC. Key words: OSSC, GSH, Antioxidants, Cancer

4306-4311

Authors: Dr. Amina Manzoor, Dr. Khadija Aziz, Dr. Sualeha Zulfiqar, Dr. M. Sohaib Yousaf

Objective: The comparison of rate of hospitalization and the requirement assessment for physicians in Emergency Department to have awareness and knowledge about the poisoning cases definitive treatment was the objective of this research. Methods: In our retrospective research we assessed a total of 589 cases which were adult patients hospitalized in the Emergency Department of Mayo Hospital, Lahore in the timeframe of January, 2016 to December 2016 with the incidence of poisoning. We compared the hospitalization rates and epidemiological data among the patients having generally better medical condition, which were requiring simple intervention methods and shortly discharged from the emergency of the hospital after supervision; whereas, poor condition patients were hospitalized for a longer time duration. Data analysis was made through SPSS. Results: In the total 589 cases, 256 cases were of good medical state (43.4%); whereas, 333 cases (56.5%) were in a bad medical state. Good medical condition cases were 244 in number (95.3%) and they were managed in the Emergency Department, after necessary treatment they were discharged from the hospital; whereas, 295 patients (88.6%) of poor medical state were also discharged. A total of fifty patients (8.4%) were hospitalized and complete medical intervention and treatment was extended to them till the time of complete recovery. Conclusion: All the cases of the poisoning who were admitted in the hospital the treatment of the good and nearly poor was made in the emergency department; whereas, fifty cases were hospitalized and discharged after complete recovery. The good general medical condition was regularized with the help of definite interventions by the physicians. Keywords: Poisoning, Emergency department and Hospitalization.

4317-4323

Authors: Dr. Shahpara Alamgir, Dr. Ayesha Rehman, Dr. Muzzamil Riaz

Objective: The comparison of the adverse Feto-maternal outcomes in both the groups of Normal and overweight pregnant woman was the objective of this particular research. Methods: Design of the research was comparative cohort, which was completed in the time span of November, 2016 to October, 2018 (Mayo Hospital, Lahore) on a sample of 200 gravid ladies. Sample was divided into two main groups named as overweight and normal pregnant women of hundred cases each. Sample was comprised of pregnant women having gestational age in the range of 08 weeks – 40 weeks. Overweight and normal cases were categorized respectively as (BMI 25 – 29.9 Kg/m2) and (BMI of 18.5 – 24.9), normal cases were taken as controls. Feto-maternal outcomes were compared through Chi-square test and the pvalue was taken as (< 0.05). Results: Women selected for the research were in the age bracket of 30 – 45 years with a mean age of (30 ± 4.1 years). High frequency of pre-eclampsia was observed in overweight women in comparison to the normal group (27% vs 9%), gestational diabetes mellitus (DM) (22% vs 5%), PIH (24% vs 8%), Caesarean section (44% vs 16%), prolonged labor (4% vs 6%), Postpartum Hemorrhage (5% vs 2%) and Wound infection (3% vs 2%). The significant P-value was taken as (< 0.001). In terms of fetal complications in both the groups when compared were as Early neonatal death (11% vs 1%), Still birth (13% vs 2%), NICU admission (47% vs 10%) and shoulder dystocia (5% vs 1%). Except the incidence of shoulder dystocia outcomes were statistically significant. Conclusion: It is concluded that deleterious effects are related to the incidence of obesity on the Feto-maternal outcomes. Key Words: Outcomes, Controls, Pregnant Overweight Women and Adverse Feto-maternal.

4329-4333

Authors: Hafiza Nimra Shabbir, Aqsa Javed, Sidra Shabbir

Objectives: To know the knowledge of the diet plan in pregnant women according to food and nutrient levels and to know the level of education, the economy, and popular women's choice of food. Place and Duration: The study was performed in the Obstetrics and gynecology department of Services Hospital, Lahore for the period of one year from January 2015 to December 2015. Study Design: An Observational Study Results: 380 pregnant women were interviewed 3 times using a 24-hour diet reminder with recipes. Negotiations were made on health, nutrition and socioeconomic status and on women's weight and height measurements. The result shows nutritional status should be monitored in pregnant women and should be acknowledged to the pregnant women. Conclusions: According to the Pakistan diet, women's (unreinforced) diets were not sufficient for all nutrients except energy and fat. A low level of micronutrient intake of food outside the rice was detected. Food habits and the economy have shown that women have a negative impact on food choice, family type, education level, number of pregnancies and popular dietetics. negative. Recommended foods in proper amount, green vegetables especially, should be given to women. Nutritional recommendations provided by healthcare providers at all levels should be the same and should be local cheap foods that are widely consumed. Keywords: Pregnancy, diet intake, nutritional status.

4338-4346

Authors: Dr. Muhammad Shahid Hussain, Dr. Usman Hussain, Dr. Sameer Ahmed

Hepatitis C Virus (HCV) is affecting 170 million people annually (WHO, 2012) and Pakistan ranks high in chronic hepatitis. HCV is a leading cause of chronic liver disease and hepatocellular carcinoma rapidly transmitting as silent killer. Our objectives were to assess the knowledge of students of Punjab University (Gujranwala Campus) about contributing risk factors for HCV infection. And to impart knowledge to students regarding preventive measures in relation to associated risk factors for HCV transmission. Subjects were 100 students our study was Descriptive / cross sectional study. The following data collection tools were developed and used. A consent form was used to get the consent of the respondents wherever possible. A semi structured Questionnaire was used to get information from study population. The tools were pretested and modified according to requirements. In our study the overall questionnaire response was 100 %. Objectives: To assess the knowledge of students of Punjab University (Gujranwala Campus) about contributing risk factors for HCV infection. To impart knowledge to students regarding preventive measures in relation to associated risk factors for HCV transmission. Result and Conclusion: 35% responded that sexual contact was possible mode of transmission of HCV infection followed by 20% and 19% who believed that organ transplant and blood transfusion were the main modes of transmission of virus. 13 % answered that sharing of tooth brushes and razors were main causes of its transmission. Another 13% responded that use of injections was the source of transmission of HCV. 80% believed that infection was transmittable from mother to child. 47% think recipient of blood and blood products are at the risk of developing HCV infection. 23 % thought that people with multiple sex partners were at the risk of developing HCV infection. 70% were of opinion that Vaccination was available against HCV infection and only 28% knew that it was not available. 77% believed that spread of HCV infection could prevented by avoiding blood contacts. 10% said that prevention was possible by avoiding eating together, 5% said by avoiding hand shake and 8% said that it prevention is not possible. 92 % believed that the treatment of HCV infection was available. 8% said there is no treatment of this infection. 77 % said that recurrence of HCV infection was possible and 7 % responded with no. 17 % said that they did not know about this. Summarizing the results of this study, these findings indicate an ambivalent knowledge about HCV infection amongst Punjab University Gujranwala students, many gaps were observed, suggesting the importance of continuous education about HCV in this population to prevent HCV infection as well as discrimination and prejudice towards patients with hepatitis C.

2040-2046

Authors: Rameshpetchi Rajendran, Devikasubramaniyan*, Ramya Sri Sura, R. Swathi, R. Sainandhan Rao, K. Sindhu, D. Lavanya

A rapid and precise reverse phase high performance liquid chromatographic method has been developed for the validated of Balofloxacin, in its pure form as well as in tablet dosage form. Chromatography was carried out on a Sunfire C18 (4.6×150mm, 5µm) column using a mixture of Methanol: Water (50:50 v/v) as the mobile phase at a flow rate of 0.9ml/min, the detection was carried out at 245nm. The retention time of the Balofloxacin was 2.6 ±0.02min. The method produce linear responses in the concentration range of 35-175µg/ml of Balofloxacin. The method precision for the determination of assay was below 2.0%RSD. The method is useful in the quality control of bulk and pharmaceutical formulations. Keywords: Balofloxacin, RP-HPLC, validation.

2065-2072

Authors: Rameshpetchi Rajendran, Devikasubramaniyan*, Ramya Sri Sura, Ch.Rakesh, D.Sangeetha, B.Shilpa, D.Nagamani

A rapid and precise Reverse Phase High Performance Liquid Chromatographic method has been developed for the validated of Dosulepin in its pure form as well as in tablet dosage form. Chromatography was carried out on Xterra C18 (4.6×150mm, 5µ) column using a water (100% v/v) as the mobile phase at a flow rate of 1.0ml/min, the detection was carried out at 230nm. The retention time of the Dosulepin was 2.1 ±0.02min. The method produce linear responses in the concentration range of 5-25µg/ml of Dosulepin . The method precision for the determination of assay was below 2.0%RSD. The method is useful in the quality control of bulk and pharmaceutical formulations. Keywords: Dosulepin , RP-HPLC, validation.

2080-2087

Authors: Rameshpetchi Rajendran, Devikasubramaniyan*, Ramya Sri Sura, Ch.Brammam, G.Shyamala, J.Swarna, J.Akhil, K.Sunajani

A rapid and precise Reverse Phase High Performance Liquid Chromatographic method has been developed for the validated of Granisetron, in its pure form as well as in tablet dosage form. Chromatography was carried out on a Symmetry C18 (4.6 x 250mm, 5µm) column using a mixture of Acetonitrile and Water (50:50% v/v) as the mobile phase at a flow rate of 0.8ml/min, the detection was carried out at 285nm. The retention time of the Granisetron was 3.0 ±0.02min. The method produce linear responses in the concentration range of 20-100µg/ml of Granisetron. The method precision for the determination of assay was below 2.0%RSD. The method is useful in the quality control of bulk and pharmaceutical formulations. Keywords: Granisetron, RP-HPLC, validation.

2095-2102

Authors: Rameshpetchi Rajendran, Devikasubramaniyan*, Ramya Sri Sura, A. Arun Kumar, A.Mounika, A.Sowjanya, B.Priyanka

A rapid and precise Reverse Phase High Performance Liquid Chromatographic method has been developed for the validated of Xipamide in its pure form as well as in tablet dosage form. Chromatography was carried out on Symmetry C18 (4.6×150mm, 5µ) column using a mixture of Acetonitrile:Water(50:50v/v)as the mobile phase at a flow rate of 1.0ml/min, the detection was carried out at 245nm. The retention time of the Xipamide was 2.4 ±0.02min. The method produce linear responses in the concentration range of 10-50µg/ml of Xipamide. The method precision for the determination of assay was below 2.0%RSD. The method is useful in the quality control of bulk and pharmaceutical formulations. Keywords: Xipamide, RP-HPLC, validation.

2110-2116

Authors: Rameshpetchi Rajendran, Devikasubramaniyan*, Ramya Sri Sura, V. Sunil, M. Bhrath Kumar, P.Gopinath, S. Naresh

A rapid and precise Reverse Phase High Performance Liquid Chromatographic method has been developed for the validated of Zanamivir in its pure form as well as in tablet dosage form. Chromatography was carried out on Sunfire C18 (4.6×150mm, 5µ) column using a mixture of Methanol and water (95:5 v/v) as the mobile phase at a flow rate of 1.0ml/min, the detection was carried out at 285nm. The retention time of the Zanamivir was 2.6 ±0.02min. The method produce linear responses in the concentration range of 40-200µg/ml of Zanamivir. The method precision for the determination of assay was below 2.0%RSD. The method is useful in the quality control of bulk and pharmaceutical formulations. Keywords: Zanamivir, RP-HPLC, validation.

2124-2130

Authors: R Venkat Reddy *, Badugu Deepika, N. Sunita, M. Jaya Shankar, SK. Nadeer, K. Ravi Kumar, Santosh Illendula, G. Koteswar Rao, K.N.V. Rao, K. Rajeswar Dutt.

A new simple, accurate, rapid, precise, reproducible and cost effective spectrophotometric method for the quantitative estimation of Metformin in bulk and pharmaceutical dosage form. The developed visible spectrophotometric method for the quantitative estimation of Metformin is based on measurement of absorption at maximum wavelength 242 nm using Methanol as a solvent. The stock solution of Metformin was prepared, and subsequent suitable dilution was prepared with methanol to obtained standard curve. The standard solution of Metformin shows absorption maxima at 242 nm. The drug obeyed beer lambert’s law in the concentration range of 0 - 60 μg/ml with regression 0.999 at 242 nm. The overall % recovery was found to be 100.04% which reflects that the method was free from the interference of the impurities and other excipients used in the bulk and marketed dosage form. The low value of % RSD was indicative of accuracy and reproducibility of the method. The % RSD for inter-day and intra-day precision was found to be 0.53 and 0.51respectively which is<2% hence proved that method is precise. The results of analysis have been validated as per International Conference on Harmonization (ICH) guidelines. The developed method can be adopted in routine analysis of Metformin in bulk and tablet dosage form. Keywords: Metformin, UV Visible Spectrophotometry, Method development, Validation, , Methanol , Accuracy, Precision.

2142-2149

Authors: Ali Esmail Al-Snafi

The phytochemical analysis of Galium verum showed that the plant contained oil, iridoid glycosides, phenolics, flavonoids, carbohydrates and amino acids. The previous pharmacological studies showed that Galium verum possessed antioxidant, cytotoxic, antimicrobial, protective and endocrine effects. This review will highlight the chemical constituents and pharmacological effects of Galium verum. Keywords: Galium verum, pharmacology, chemical, constituents

2159-2166

Authors: Ali Esmail Al-Snafi

Phytochemical analysis of Helianthus tuberosus showed that it contained coumarins, unsaturated fatty acids, polyacetylenic derivatives, phenols, flavonoids, sesquiterpenes, protein, amino acid, reducing sugars, organic acids, lactones and cardiac glycoside. The pharmacological investigations revealed that Helianthus tuberosus exerted antioxidant, anticancer, antidiabetic, antifungal and α-Glucosidase inhibitory activity, as well as it produced inulin which used as functional food and possessed many medical benefits. This review will highlight the chemical constituents and pharmacological and therapeutic effects of Helianthus tuberosus. Keywords: Helianthus tuberosus, pharmacology, therapeutic, chemical constituents

2176-2182

Authors: Ali Esmail Al-Snafi

The phytochemical analysis of Hibiscus cannabinus showed the presence of phytosterols, flavonoids, polyphenols, tannins, steroids, alkaloids, saponins, lignans, essential oils, glucosides such as cannabiscitrin, cannabiscetin and anthocyanin glycoside. The pharmacological studies revealed that Hibiscus cannabinus possessed cytotoxic, anthelmintic, antibacterial, antiulcer, antidiabetic, hypolipidemic, antioxidant, immunological, haematinic and hepatoprotective effects. This review will highlight the chemical constituents, pharmacological and therapeutic properties of Hibiscus cannabinus. Keywords: chemical constituents, pharmacology, Hibiscus cannabinus

2191-2197

Authors: Ali Esmail Al-Snafi

The phytochemical analysis of Jasminum officinale indicated the presence of alkaloids, coumarins, flavonoids, tannins, terpenoids, glycosides, emodine, leucoanthcyanins, steroids, anthocyanins, phlobatinins, essential oil and saponins. Pharmacological studies revealed that the plant exerted antimicrobial, insecticidal, antioxidant, antifertility and dermatological effects. This review described and discussed the chemical constituents and pharmacological effects of Jasminum officinale. Keywords: chemical constituents, pharmacology, Jasminum officinale.

2206-2212

Authors: Ali Esmail Al-Snafi

The phytochemical analysis of Jussiaea repens revealed that the plant contained squalene, betulonicacid, betulin, betulinicacid, a mixture of [ 2 4 R]-6β-hydroxy-stigmast-4-en-3-one and [22 E, 24 R]- 6 β -hydroxy-stigmast-4,22- dien-3-one, pteleoellagic acid 3,30,40-tri-O -methyl ellagic acid, dihydroquercetin or [+]-transtaxifolin, quercetin, protocatechuic acid, afzelin, quercitrin,, methyl gallate, gallic acid and myricitrin. The previous pharmacological researches showed that Jussiaea repens possessed haematinic, hepatoprotective, anti-diabetic, anti- inflammatory, cytotoxic, antimicrobial, antioxidant effects and many effects on male and female fertility. This review discussed the pharmacological and therapeutic effects of Jussiaea repens. Keywords: Jussiaea repens, pharmacology, therapeutic, chemical constituents

2222-2229

Authors: Sk. Irfan Khan*, B. Navya, Chandan kumar, Dr.Y.Krishna Reddy, DR.K.N.V.Rao, Dr. K. Rajeswar dutt

The present study aims at developing a caffeine effervescent tablet formulation for the effective treatment of the central nervous system as it acts central nervous system stimulant of the methylxanthine class. And this dosage form is to provide the patient with the most convenient mode of administration, effervescent tablets will dissolve quickly in water and it releases CO2. And effervescent tablet contains caffeine acts as central nervous system stimulant within seconds of time it will simulate the CNS, onset of action is rapid. Caffeine is a central nervous system stimulant of methyl xanthene class. It is the worlds most widely consumed psychoactive drug. Unlike many other psychoactive substances, it is legal and unregulated in nearly all parts of the world. Caffeine also stimulates certain portions of the autonomic nervous system. So the present work was aimed at formulating effervescent tablet for caffeine, total 6 formulations were developed by using synthetic superdisintigrants like sodium bicarbonate, citric acid, spray dried lactose, magnesium carbonate, sodium starch glycolate, sodium benzoate as superdisintigrants, in a different concentration and prepared by direct compression method and prepared tablets were evaluated for precompression and post-compression parameters after conducting pre-formulation studies. All the parameters were within the pharmacopoeial limits and solution time (3mins 10 sec.), PH of solution (8), Hardness 2.5kg/cm3 , thickness 0.6cm, Average weight of 0.48 in formulation (F2) containing sodium bicarbonate and based on these parameters F2 was selected as best formulation. Key words: Central Nervous System Stimulant, Sodium Bicarbonate, Citric Acid, Spray Dried Lactose, Magnesium Carbonate, Sodium Starch Glycolate, Sodium Benzoate, Direct Compression Method.

2238-2243

Authors: B. Mounika*, M. Mahesh, M. Preethi , P. Sravani , S. Sarojini , K. Rajeswar Dutt

The aim of present work is to formulate and evaluate buccal tablets of protonix (pantoprazole sodium) which is subjected to first pass effect and having short half life. To increase the bio availability of a protonix by delivering through the buccal mucosa, as it is a potential site for direct delivery of drugs into systemic circulation. To control the drug release from the tablets by using matrix forming bioadhesive polymers, as the half life of drug is very low. To study the effect of drug : polymer ratio on drug release and other bioadhesive properties. Key words: Buccal, Protonix, Bioadhesive, Systemic circulation, Half life

2252-2259

Authors: Ameer Ali Jamali, Bella Shaikh, Anwar Ali Jamali, Ghulam Mustafa Jamali, Iqrar Ali Kanhar, Bhojo Mal Tanwani

Introduction: Celiac disease (CD) is an autoimmune disease of chronic origin affecting children as well adults and characterized by an unusual response towards gluten present in diet particularly in subjects who are genetically vulnerable. This leads injury to small intestinal mucosa and may be capable of various systemic effects. Objective: To determine the frequency of celiac disease in children presenting in the course of chronic diarrhea by using serological markers. Study Design: This study was Cross sectional. Setting: Pediatrics department, Peoples Medical College and Hospital (PMCH) at Nawabshah. Duration of Study: January 2017- December 2017. Subject and Methods: After fulfilling the inclusion criteria, 260 subjects with signs and symptoms of celiac disease visiting the department of Pediatrics, Peoples Medical College Hospital, Nawabshah were recruited in research. Results: Celiac Disease was diagnosed in 32 (12.3%) subjects with chronic diarrhea. Conclusion: Celiac Disease is commonly seen amongst subjects of chronic diarrhea and gluten-free diet is associated with considerable improvement in clinical features of Celia Disease. All subjects with chronic diarrhea must be evaluated routinely for celiac disease. Keywords: Chronic Diarrhea, Celiac Disease, Tissue Transglutaminase autoantibodies

2267-2273

Authors: Dr. Kaireddy Siva kumar*, Dr. Atla Sai keshava Reddy, Dr. D Naresh, Dr. Siddarama, D Swathi

Kidney transplantation in India is limited by the lack of cadaveric donors, limited availability of suitable livingrelated donors and economic factors. Thus the majority of patients with renal failure remain dialysis dependent. This study may give the information about the essentiality to avoid the progression of the kidney diseases by controlling the risk factors and to prevent & manage the complications associated with haemodialysis and it also provide the epidemiological data to the healthcare system, It helps in the prevention of kidney disease and planning for the provision of renal replacement therapy. This is a prospective observational study which is carried out in the dialysis unit at RIMS, Kadapa, It is a 750 bedded multi-disciplinary tertiary care teaching hospital. Our study showing results that Hypertension and Diabetes mellitus are the leading causes for the kidney diseases and Weakness and Headache are the prominent intra dialysis complications which occurred during dialysis. Awareness of haemodialysis patients on the disease, medication, diet along with the life style modifications through the patient education was found to be very helpful for the patients to control their risk factors and to improve the compliance to the dosage regimen. Key words: Haemodialysis, Incidence, Prevalence, Tertiary care teaching hospital, South India.

2281-2283

Authors: D.T.Tayade*and R.D.Isankar

In this work we synthesized a novel series of N’-substituted-N”-[4-hydroxy-3-(1H-indol-2-yl) phenyldicarbonodithioimidediamide by green synthesis parameters from N’-[4-hydroxy-3-(1H-indol-2-yl) phenyl] thiourea and substituted thioformamide. Previously such types of reactions were carried out in acetone medium but we developed new reaction condition in which percentage of acetone was reduced. During synthesis we carried out these reactions in various compositions of ethanol-acetone medium. This method has broad applications due to its efficiency for accelerating a course of organic reactions and increases yields, higher selectivity and lower quantities of byproducts. This method has consequently easier work-up and products obtained are in comparatively pure form. In 70% ethanol-acetone medium we got maximum yields. Justification and confirmations of structure of synthesized compounds were carried by usual elemental analysis, chemical characteristics and spectral studies. Keywords: N’-Substituted-N”-[4-hydroxy-3-(1H-indol-2-yl) phenyldicarbonodithioimide diamide, thioformamide

2287-2291

Authors: Muhammad Waqas*, Zahid Mehmood, Khalid Mahmood, Mohammad Azam, Ghulam Mustafa Khan2, Mohamamd Ibrahim, Amir Rasool and Sheikh Ahmed.

β-glucuronidase enzyme belongs to the hydrolase family which perform breakdown of complex carbohydrates. β- glucuronidases are large biomolecule consists of polypeptide chains and are widely included eukaryotes and prokaryotes, however their parasitic sources are extremely constrained. β-glucuronidase from fungal source could be profoundly valuable as a result of its high selectivity and stability over extensive variety of pH and temperature which makes it exceptionally reasonable for mechanical applications. Number of studies have been conducted to test the enzyme stability by immobilization which can easily be detached from biomaterials and nano particles for repeated use in the chemical reaction. β-glucuronidase is also comprehensively use in industry for protein catalyzed reactions. For this purpose enzyme was isolated and cloned from many sources such as Penicillium purpurogenum Li-3 ZnO-NP, sodium alginate, sepabeads etc. These studies revealed that β-glucuronidase shows maximum catalytic activity at pH below 7 after immobilization on biomaterials and on divalent metal ions. The catalyst turns out to be more effective and has higher fondness for the substrate. Key words: β-glucuronidase, immobilization and polypeptide chains

2296-2301

Authors: Dr. Aisha Iftikhar, Dr. Irsa Iqbal, Dr. Bahadur Iftikhar

Background: Pre-term delivery is defined as delivery of fetus before completed 37weeks of gestation, according to ultrasonography and last menstrual period. Maternal deficiency of vitamin D, as indicated by low levels of 25- Hydroxyvitamin D [25(OH)D], during pregnancy is considered to be a health problem of unusual significance, across the globe. Increased interest has been developed these days to find out the relationship between low vitamin D status and its outcome on pregnancy. Objective: To measure the association between hypovitaminosis D with pre-term labor in females presenting for normal delivery in a tertiary care hospital. Methodology: Total 630 patients fulfilling the required criteria were taken up for study from labor ward of Lady Atchison Hospital Lahore. Informed consent was obtained & patient’s demographic information recorded. Females were decided into two groups; one group for Cases and the other for Controls as mentioned in inclusion criteria. The females undergone delivery. Blood samples were drawn and were delivered to laboratory of the hospital. Reports were assessed for vit D levels. Hypovitaminosis D was labeled. Results: The age(mean) of women undergoing preterm and term delivery was 30.22±5.88 and 29.40±5.74 years. Mean levels of vitamin D in women with preterm and term delivery was 67.01±26.56 and 89.75±34.71. Among women in whom hypovitaminosis was seen 124(72.5%) women had preterm and 47(27.5%) women had term delivery. As per p-value significant association was seen statistically between hypovitaminosis and mode of delivery. Odds ratio 0f 3.70 is showing that women having hypovitaminosis they have a significantly 3.70 times more chances of preterm delivery as compared to that of women who did not have hypovitaminosis. Conclusion: Results obtained by this study show a strong association and high risk for women with hypovitaminosis D to undergo a preterm delivery. Keywords: Hypovitaminosis D, Preterm delivery, Tertiary care hospital

2306-2308

Authors: Dr. Tenveer Ahmed, Dr. Sibghat Ullah Khan, Dr Bakht Zia

Objective: To evaluate the infection in diabetes mellitus cases with Helicobacter pylori. Introduction: It has been reported that the H. pylori infection prevalence high in patients of diabetes mellitus. Place and Duration: In the pediatric department of Services Hospital, Lahore for the period of 6 months from 1st of July 2016 to 31st of December 2016 under the supervision of ethical committee. Patients and methods: This case-control study was in the pediatric department of Services Hospital, Lahore for the period of 6 months from 1st of July 2016 to 31st of December 2016 Diabetes mellitus (twice fasting blood glucose> 126 mg / dL, blood glucose> 200 mg / dL or diabetic clinical indication) was included in this study for 2 months, regardless of the duration of the illness without antibiotic therapy history. Breath urea test (UBT) was performed with ISOMAX 2000, manufactured by Canada. Forty-eight cases (M: 28, F: 21) were tested for urea breathing to detect H. pylori infection. In addition, 100 healthy controls were selected. The urea breath test was also performed at all of the children's controls. Chi-square test was used for analysis with SPSS version 10.0. Results: Forty eight cases with a mean age of work of 8.1 ± 2.6 (range 3.5-15) were included. Positive UBT test was performed in 14 (28.6%) and positive UBT in 30 (27.8%) of 108 control groups (P value> 0.05). Conclusion: Diabetic children are not at risk for high H. pylori infection, but a study with a large sample size is needed. Keywords: Helicobacter pylori, Diabetes Mellitus, Breath Urea test.

2316-2325

Authors: Mahesh Shinde*, Vikas Choure, Shahadev Rathod, Arvind Birajdar, Amit Jadhav

Cinnarizine is a H1 anti-histaminic drug and it can be used in the treatment of nausea, vomiting, motion sickness, vertigo and in menier’s disease. The purpose of present work was a development of fast dissolving oral film of cinnarizine, to overcome the limitation of current routes of administration to provide faster dissolution rate and increase the patient compliance. The amount of dose of drug calculate according to the area covered by the 15ml formulation without drug. The amount of drug was then used for the preparation of film by using solvent casting method utilizing HPMC E5 as a film forming polymer and PEG 400 as a plasticizer. The 32 factorial design was applied for optimization of concentration of polymer HPMC E5 and plasticizer PEG 400. The prepared film were evaluated for various parameters like film thickness, folding endurance, drug content, dispersion test, uniformity of weight, surface pH measurement, moisture loss study, in vitro drug dissolution study, disintegration time and stability study.in vitro drug dissolution studies were carried out using simulated salivary fluid (pH 6.8 phosphate buffer).among all the formulation, formulation (F5) which contain HPMC E5 (15%)and PEG400( 6%) were released upto 98.17% of the drug from the film within 25 sec. which exhibit faster absorption and also shows desirable characteristics of film than other formulation. Keywords: Oral fast dissolving film, cinnarizine, motion sickness, menier’s disease, HPMC E5, PEG 400, solvent casting

2335-2344

Authors: Sihem Fellah*, Abdelkader Khiari, Mohammed Kribaa, Abdelkrim Arar, Haroun Chenchouni

Two regimes of water, rainfed and irrigated with respect to rainfall and the stages of cultivation were applied on two varieties: Gta-Dur and Vitron. The period (2014-2016) was characterized by a large variability in the distribution of rainfall amounts. Precipitation recorded between December 2014 and May 2015 totaled 232 mm, while precipitation was very low in the second year (2015-2016) when precipitation amounted to 173 mm. Rainfed grain yields range from 9 quintals per hectare in 2014 to 12 the two varieties are considered less productive in rainfed, their yield remains lower than 20 quintals per hectare but presents a better stability, they are less affected by early drought. The use of water must be maximized in the form of transpiration optimize production. Therefore, reducing the evaporation and simultaneously improving water storage or holding capacity and also controlling weeds are the key-procedures in order to improve the CWP by the plant. Thus, optimizing the productivity of water in rainfed crops and improving cereal yield in cropping systems with limited water requires the maximization of precipitation for transpiration by reducing losses of soil water. Keywords: Durum wheat; supplementary irrigation, varieties; semi-arid, yield components, water productivity

2353-2359

Authors: Irina N. Gernet *, Valentina N. Pushkina, Svetlana Yu. Razmakhova, Elena A. Milashechkina, Roman P. Sergeev, Andrey G. Morozov

The paper presents the results of life quality study among first year students assigned to a special medical group. They revealed gender differences in the psychological sphere of life quality, the level of independence, social relationships and environmental relations. Most of the indicators under study are at good and very good levels among girls, as compared to young men, whose majority of indicators are at an average level. Key words: life quality, students, special medical group, gender differences.

2368-2375

Authors: Mikhalchenko A. V., Mikhalchenko V. F., Zhidovinov A. V., Yarygina E. N., Mikhalchenko D. V.

The research is devoted to studying the role of hygiene violations of an oral cavity and unsatisfactory denture care in formation of pathological process in the impression area. In total 178 patients with the diagnosis "tooth alignment stomatitis" who are constantly using removable dentures are examined. By means of a cytological method it is established that at clinical symptoms of tooth alignment stomatitis in cytogram of prints the Increase in dystrophic changes in flat epithelium cells was noted, layers of half-ruined lymphoid elements are noted, the number of microxyphil and mononuclear neutrophils under review sharply Magnifications to 60-70. It is established that the cytological method allows assessing the hygienic condition of an oral cavity in the impression area rather precisely that has important diagnostic value for defining tactics of holding treatment-and-prophylactic actions in case of tooth alignments stomatitis. Keywords: prosthetic stomatitis, oral cavity hygiene, cytological method.

2384-2391

Authors: Victoria Sumanpan*

The study aimed to find out the awareness, effect, and sustainability of the restoration of the Bitan-ag creek which project is the product of engaging the local communities and other stakeholders locally and internationally. The study utilized the descriptive research method employing survey and interview. There were 25 stakeholders involved as respondents. The research questionnaire made was validated using Cronbach alpha which r=0.92. The interpretation was that the questionnaire is very reliable. The result of the study revealed that the stakeholders were fully aware of the project through visible activities like regular meetings, information campaign and annual evaluation of the project. Print and radio announcements were likewise done as strategies for awareness and advocacy campaigns. During the interview the participants as leaders and members of the stakeholders’ groups were highly satisfied with the result of the activities acted upon by various sectors like the academe, the city government, the Department of Environment and Natural Resources – Environmental Management Bureau, the UN Habitat and the local barangays near and along the said creek. The stakeholders were satisfied with the effect of the project which is the pavement as aneasement and the regular clean-up of the creek from solid waste and siltation among others. Although the project is continual it manifested cooperation among the concerned sectors which will ultimately lead to the restoration of the Bitan-ag creek in Cagayan de Oro City. Recommendation of the study as suggested by the respondents is that there should be more participation from the other sectors like the youth group and women group and that funding’s provided for sustainability. Keywords: Bitan-ag creek, restoration, stakeholders, social engagement, solid waste

2405-2411

Authors: Subash Chandran M.P*, Jaghatha T, John Wesley I, Remya S B, Aparna P

Among the various drug delivery systems, transdermal drug delivery plays an important role. Iontophoresis, electrophoresis, sonophoresis, chemical permeation enhancers, microneedles, and vesicular constructs are different methods which supports transdermal drug delivery. Vesicular constructs includes liposomes, niosomes, virosomes, ethosomes and transfersomes. The transfersomal drug delivery system was much more efficient among all these types. Transfersomes can pass through narrow constriction of 5 to 10 times less than their own diameter, without any measurable drug loss. The transfersomal drug delivery system can be evaluated by in vitro for vesicle shape and size, entrapment efficiency, degree of deformability and number of vesicles. The deformability characteristic of transfersomes gives better drug permeability. They can act as a carrier for both low and high molecular weight drugs like insulin analgesics, anaesthetics, sex hormones, corticosteroids, etc. Keywords: Transfersomes, skin permeability, Thin film hydration technique

2422-2432

Authors: Ayesha Sultana* and D. Varun

Hypertension results from increased peripheral vascular smooth muscle tone which leads to increased arteriolar resistance and reduced capacitance of the venous system. Elevated BP is an extremely common disorder and many of the individuals have no symptoms. Chronic hypertension either systolic or diastolic can lead to congestive heart failure, myocardial infarction, renal damage and cerebro vascular accidents. The beta blockers are used individually or in a combination therapy to treat hypertension. The development of oral osmotic systems has a strong and good market potential. Atenolol is a cardio selective beta-1 blocking agent which is used to reduce systolic and diastolic B.P and it is widely used to treat hypertension, introduced in the year 1976. It reduces heart rate and cardiac output when resting and during exercise. The osmotic drug delivery system utilises the principle of osmosis and drug release is aimed to release by zero order kinetics, to prolong the release of the drug for longer duration of time, providing the treatment in controlled manner by reducing the multiple dosing of drug. Keywords: Atenolol, Beta -1 blocking agent, Diastolic, Hypertension, Systolic, Osmotic, Zero order.

2439-2445

Authors: M. Sumiya Siddique, Dr. Ahsan Shahzad, Dr. Irsa Iqbal

Objective: The principal objective of the research was the determination of the smear positive malaria frequency and patient’s socio-demographic factors who visited Civil Hospital, Khairpur (Microscopy Department) Methods: This research was cross-sectional by design and it was held in the time span of four months starting from June-September, 2016. The assessment tool was a designed questionnaire for the attainment of the research objectives in the said time period and setting of the Khairpur Hospital. Research included a total of 138 cases who were prescribed by the physicians Malaria Parasite (MP) Test, we included these patients in the research through sampling consecutive method and also interviewed all the patients about their social and demographic features. SPSS-21 was used for the data entry and analysis of the research outcomes. Results: In the total research sample (138) male to female ratio was respectively 55.5% male and remaining female. It shows the dominance of the male. Maximum numbers of patients were in the age group of forty years and the range of the age was in the limit of 25 – 40 years having 25 as the lowest and 40 as the highest limit of the age. Positive result of MP test was noticed in 6.5% patients with the repeated identification of Plasmodium Vivax (PV). Conclusion: We conclude that Malaria is an endemic in the specified areas of District, Khairpur and Plasmodium Vivax is considered as the common most species which affects the participants who visited hospital’s Microscopy Centre for the verification of MP test. There is a dire requirement of awareness about the health issues and participation of the society for the eradication of the Malaria from the communities of Khairpur. Keywords: Malaria Frequency, Endemic, Microscopy, Insecticide Treated Nets and Roll Back Malaria.

2451-2457

Authors: Dr. Amna Rashid, Dr Saba Khalid, Dr Sadia Abdulrazzaq

Objective: Aim of the research was the determination of pelvic pain frequency and bleeding per vaginal during 1st trimester. Methods: We included 150 pregnant cases in the age limit of 18 – 35 years who were in their 1st trimester of pregnancy, research design was cross-sectional and it was completed from July, 2015 to July, 2016 in the time span of one year. SPSS-20 was used for the data entry and analysis. Results: Average age was (26.33 ± 4.23), pelvic pain frequency was 29.33% and per vaginal bleeding was 12%. There was no statistical significant difference observed in the vaginal bleeding and pelvic pain in various groups of age as per the research stratification analysis. Pelvic pain rate was high in the primigravida women in comparison to the multigravida with a p-value of (0.003). Conclusion: Research concludes that significant women strength experienced vaginal bleeding and pelvic pain in the 1st trimester, for a practitioner it is important to practice sound diagnostic and clinical expertise for the treatment of pregnancy complications as these abnormalities are potent instrument of distress in the women and their partners. Keywords: Pelvic pain, 1st Pregnancy Trimester, Vaginal Bleeding and Gravidity.

2462-2466

Authors: Dr. Mamoona Batool, Dr. Shahzadi Huma Amjad, Dr. Maham Farooq, Dr. Furqan Jamal

Introduction: In orthodontics, researchers have assessed health-related quality of life (OHRQOL) in connection with orthodontic treatment outcomes; however, research on orthodontic patients QOL during their treatment is scarce. Orthodontic pain, the most cited negative effect arising from orthodontic force application, is a major concern for parents, patients, and clinicians. Studies have reported this reaction to be a major deterrent to orthodontic treatment and an important reason for discontinuing treatment. Objective of the study: The main objective and focus of the study was to find the relationship between pain and OHRQOL among patients wearing fixed orthodontic appliances. Methodology of the study: A total of 200 patients which included 120 female and 80 male patients in the adolescent age group of 13–18 years undergoing orthodontic treatment from January 2016 chosen by random selection were included for the study. Results: There was a significant correlation found between pain and the QOL of patients undergoing orthodontic treatment. Overall score of OHRQOL increased significantly in the initial phase of treatment where the incidence of severe to moderate pain was reported in 80% patients. Conclusion: Pain is very important sequelae of treatment and incorporates a vital impact on the QOL of odontology patients, particularly throughout the initial phases of treatment. Patient motivation and content by the dentist have a profounding impact in reducing the pain and discomfort, up the QOL, associated an overall improvement within the patient compliance touching the eminent outcome of the treatment. Keywords: Orthodontics, OHRQOL, pain.

2475-2482

Authors: Dr. Qurrat ul Ain, Dr. Abdul Samad, Dr. Hafiz Ahmad Atiq ur Rehman Siddiqui

Background: Intellectual curiosity is referred as willingness foe knowledge which may lead to the behaviors which is exploratory and it includes the unchanging and inherited characteristic (i.e. trait curiosity) and a state which is context dependent on a variable (i.e. state curiosity) Objective: The objective of this exploratory research was to explain medical students’ intellectual curiosity. Study Design: Cross sectional study. Study Setting: DHQ Hospital Kasur. Study Duration: April – June 2017. Inclusion criteria: Nursing students of either gender. Data Collection and analysis: 100 nursing students were given curiosity inventory of Melbourne in those where students have described themselves in order to indicate their feeling at that point of time and how they feel in general regarding curriculum. Scoring was done to see the state and trait anxiety among students regarding curriculum and gender difference was also evaluated regarding curiosity index. All the information was entered in a structured questionnaire. Date was analyzed using SPSS version: 21.0. Standard deviation and Mean on the items were calculated for state and trait anxiety for Melbourne curiosity index. Gender difference for curiosity index was also evaluated. Results: 70.0% of respondents were female and 30.0% were male. Mean State curiosity was 54.23 SD 9.923 with a minimum of 24 and maximum of 75. Mean Trait curiosity was 56.73 SD 10.71 with a minimum of 24 and maximum of 75. State and trait curiosity was dichotomized to evaluate less curious and curious students regarding curriculum. 39.0% of students were less curious (score 20 - 50) as a state curiosity regarding curriculum as compared to 29.0% for trait curiosity. 61.00% were Curious (score 51-80) as state curiosity as compare to 71.0% for trait curiosity regarding curriculum. Conclusion: In accordance to curriculum the state and trait curiosity index was high in students of medical. Key words: Medical Curriculum, anxiety, trait anxiety, state anxiety, curiosity

2488-2498

Authors: Tahar Abbaz*, Amel Bendjeddou and Didier Villemin

The optimized molecular structure of (Mono/ex-TTFs) 1-4 has been investigated theoretically using Gaussian 09 software package. This theoretical calculation was carried out by density functional theory (DFT) using B3LYP with 6-31G (d,p) basis set. The stability of the molecule arising from hyper-conjugative interaction and load delocalization has been analyzed using NBO analysis. The HOMO and LUMO energies were also evaluated for these molecules to demonstrate the chemical stability. First and second hyperpolarizability are calculated in order of their role in non-linear optics. Molecular electrostatic potential and all other calculations were performed by the same method cited above. Keywords: tetrathiafulvalenes; density functional theory; computational chemistry; electronic structure; quantum chemical calculations.

2516-2533

Authors: V. Mallikarjun*, V. Rajesh Babu, Sana Kusar, V. Rajkumar

Fast track is a process designed to facilitate the development and expedite the review of drugs to treat serious conditions and fill an unmet medical need. AIDS, Alzheimer’s, heart failure and cancer are obvious examples of serious conditions. However, diseases such as epilepsy, depression and diabetes are also considered to be serious conditions. Any drug being developed to treat or prevent a condition with no current therapy obviously is directed at an unmet need. If there are available therapies, a fast track drug must show some advantage over available therapy. Advancing the health of Americans through the development of safe and effective new drugs is an imperative at the heart of FDA’s mission. The infusion of resources provided through industry user fees has enabled FDA to adapt to rapid advances in science and to dramatically cut drug review times to speed promising therapies to patients. In the 21st century, FDA is the fastest drug review agency in the world. FDA has worked effectively to implement flexible review practices without lowering the agency’s standard for drug efficacy. This flexibility has translated into a historically high proportion of drug approvals on the first regulatory review cycle, increasing predictability for drug developers. These changes resulted in faster drug review times relative to other regulatory authorities and an increasing proportion of new medicines being introduced in the U.S. first, allowing for earlier access to innovative treatments. Recently, rapid advances in our understanding of human biology and the underlying mechanisms of some diseases have offered many new potential targets for medical product development. But we still have a long way to go in understanding the full range of diseases that confront Americans and in developing the scientific tools necessary to translate scientific discoveries into treatments and cures. Discussions are currently underway on how to close the gap between the discovery and delivery of innovative products. With so much progress already achieved at the product review stage, more attention is being focused on early stage development and the clinical trials process. While changes are appropriate and important, none should lower FDA’s evidentiary standards, otherwise patients would be exposed to unreasonable and unnecessary risks associated with insufficient information. The agency looks forward to continuing to work with others, including Congress, industry, academia, patients and advocacy groups, on these issues. Keywords: Fast track, FDA, AIDS, Alzheimer’s, heart failure

2541-2549

Authors: Vijaya Jyothi M *, A Sudheer, E Bhargav, Ravi Prasad Rao, C Naresh babu , P Vasima Nazneen, B Pradeep Kumar, S Salamma

Caralluma adscendens var. attenuata is a succulent plant grows in tropical areas. It has been reported for the presence of phenolics, flavanoids, tannins etc., which are responsible for antioxidant activity and hepatoprotection. Several biological activities like anti diabetic, anti-inflammatory and anti-ulcerogenic were also reported. The present study was aimed to evaluate invitro antioxidant property as the prime step to carryout invivo antioxidant and hepatoprotective activity of methanolic stem extract of this plant. In vitro antioxidant activity was evaluated by determination of total phenolics, flavonoids content, reductive ability and free radical scavenging activity assays. In vivo studies were performed against ethanol induced liver toxicity in rats using Silymarin as standard. In this study serum catalase, superoxide dismutase, reduced glutathione levels were quantified. The results obtained by this study revealed that the concentration of the liver protecting enzymes was not affected by ethanol when animals were coadministerd with plant extract. Rats which were pretreated with methanolic extract of Caralluma adscendens var. attenuata inhibited the stimulated serum levels of serum glutamate pyruvate transaminase (SGPT), serum glutamate oxaloacetate transaminase (SGOT), alkaline phosphatase (ALP) and total bilirubin when compared with silymarin. The research findings reveal that Caralluma adscendens var. Attenuata has significant antioxidant and hepatoprotective activities. Keywords: Alcoholism; Hepatotoxicity; Caralluma adscendens var. Attenuata; Antioxidants; silymarin; Hepatoprotection.

2563-2571

Authors: Ojha Shweta Dineshchandra*, Dr Vinay C. Darji, Jaymin Patel, Bhumi Patel

A simple, rapid, economical, precise and accurate Stability indicating RP-HPLC method for Acotiamide HCl Hydrate In its Pharmaceutical Dosage Form has been developed. A reverse phase high performance liquid chromatographic method was developed for the Acotiamide HCl Hydrate in its Pharmaceutical Dosage Form has been developed. The separation was achieved by Hypersil BDS C18 (25 cm × 0.46 cm) 5μ, column and Water (pH 4.5): Methanol: TEA (45:55:0.1) as mobile phase, at a flow rate of 1 ml/min. Detection was carried out at 222 nm. Retention time of Acotiamide HCl Hydrate was found to be 4.420 min. The method has been validated for linearity, accuracy and precision. Linearity observed for Acotiamide HCl Hydrate 5-15 μg/ml. Developed method was found to be accurate, precise and rapid for simultaneous estimation of Acotiamide HCl Hydrate in its Combined Dosage Form. The drug was subjected to stress condition of hydrolysis, oxidation, photolysis and Thermal degradation, Considerable Degradation was found in Thermal degradation. The proposed method was successfully applied for the estimation of its dosage form. Keywords: Acotiamide HCl Hydrate, Stability indicating RP-HPLC Method, Validation.

2580-2584

Authors: Azita Kaviani* and Asef Najafi

Introduction: Due to the complications of using mercury in the dentistry profession, observing mercury health principles should be at the top of the comprehensive guidelines of the clinic administration to protect the health of clinic staff and optimize the work and life environment. Thus, in this research, the knowledge and attitude and practice of dentists with regard to observing the mercury health principles were examined in Ahvaz city in southwestern of Iran. Materials and Methods: This descriptive and analytical research was conducted on 100 dentistry students in Ahvaz city by using knowledge, attitude and practice questionnaires, each containing 17, 10, and 15 questions, respectively. Data were analyzed by software SPSS. Results: based on the obtained data, the mean knowledge of the subjects was 46.40 with standard deviation of 7.5. The mean attitude of the subjects was 62.37 with standard deviation of 8.09. The mean practice of the subjects was 20.3 with standard deviation of 6. Therefore, the results revealed that knowledge and practice of dentists in Ahvaz are at undesirable level in terms of observing the principles of mercury health. Moreover, dentists had a positive attitude to observing mercury health principles and no significant relationship was found between knowledge, attitude and practice of dentists of Ahvaz with regard to observing the principles of mercury health. Discussion and Conclusion: based on the research results, it is necessary to take appropriate measures in order to enhance the knowledge of dentists, especially during the curriculum or retraining courses. Keywords: Knowledge, Attitude, Mercury Health Principles, Clinic, Dentistry.

2610-2615

Authors: Saad Al-Shahrani and Mohammad Javed Ansari*

Limited water solubility of drugs is a prevailing problem to efficient drug delivery as a huge proportion of available drugs are poorly water soluble. Poorly soluble drugs suffer with low or incomplete oral absorptions leading to low or variable bioavalibilities. Osimertinib mesylate is a novel anticancer drug for the treatment of lung cancer. It is reported to have low absorption and exposure at therapeutic doses of 80 mg which could be due to low solubility in gastrointestinal tract. It is important to evaluate pH solubility profile of the drug over the gastrointestinal pH range in order to find the most suitable region of solubility and absorption. In this study, we are reporting saturated solubility of Osimertinib mesylate in different media with specific pH conditions including different physiological buffers such as simulated gastric fluid, simulated intestinal fluid, phosphate buffer saline. Solubility study was done by classical shake flask method and samples were analyzed by double beam UV spectrophotometer in triplicate. It was found to be very slightly soluble in water with an approximate value of 924 ± 6.06 µg/ml. Of all the tested buffer media, simulated gastric fluid pH 1.2, exhibited maximum solubility, which was approximately 2.3 folds of the solubility exhibited in distilled water. Solubility data over different pH conditions were statistically evaluated using one way ANOVA and post hoc Tukey test for valid conclusions. All media had significant effect on the solubility of the drug except sodium phosphate buffer, pH 3.2 and Acetate buffer pH 5.5 with respect to distilled water. Keywords: Osimertinib mesylate, absorption, Solubility, physiological buffers.

2628-2634

Authors: Najeeb Ullah, Zafar Ahmad, Muhammad Shafee, Muhammad Rizwan, Muhammad Naeem, Hafiz Muhammad Arif, Shafiq Ahmad

Bluetongue is a disease of almost all animals particularly of domesticated and small ruminants such as goats and sheep. BT is caused by a virus known as Bluetongue virus which is a dsRNA virus and belongs to a genus Orbivirus and to a family Reoviridae, as it is transmitted by biting midges(culicoides) therefore it is insect borne disease. Bluetongue is disease of socioeconomic importance, as it has a great impact on trade at international level of livestock and its yields. In the previous era Bluetongue was only limited to the endemic areas between latitudes 40°N and 35°S; however, this traditional limit has been crossed now and bluetongue has extended to vast areas. Spread of the bluetongue disease is mainly due to the presence of specific vector in the area such as C. imicola, a significant vector of the virus in the “Old World”. Bluetongue in South Asia countries such as Iran, India, China, Afghanistan and Pakistan, is endemic and has higher prevalence rates which are recently reported. This is a review which demonstrates selective information on this harmful disease including its diagnosis by different techniques, such as c-ELISA and Real-time PCR based genotypoing. Its causative agent, history, spread, routes of transmission and range of target host, pathogenesis and diagnosis of the disease. Key words: Bluetongue, Quetta, c-ELISA, Orbivirus, Pathogenisis

2644-2649

Authors: Praseena K * and Junise.V

Objective: The aim of the work was to formulate and evaluate chitosan nanoparticle loaded with Phyllanthin. Methods: Chitosan nanoparticle loaded with phyllanthin were prepared by ionic chelation method using chitosan solution, prepared by dissolving chitosan flakes in 1.5%glacial acetic acid to this STPP (0.10 to 0.60 %W/V),phyllanthin and was added to chitosan solution. The prepared chitosan nanoparticle loaded with phyllanthin from all batches (F1-F6) were characterized for its morphology, particle size, drug loading capacity ,entrapment efficiency, invitro release study ,stability study. The chitosan nanoparticle have an average particle size of 1.0 ± 5.0µm, The % entrapment efficiency of phyllanthin was found to be 34.4-74.5%w/w. The % drug loading capacity was 34-60.5%w/w. The drug content in chitosan nanoparticle was found to be 69 -80.5%w/w. The invitro release studies of all the formulations F1-F6 was carried out and result have shows that be F6 were most stable formulation and good release. Conclusion: The evaluation results have shown that formulation F6 was found to be more stable with good release charateristics invitro and have good bioavailability. Keywords: Nanoparticle,Phyllanthus niruri,Chitosan,Ionic chelation

2656-2659

Authors: Abdolreza Gilavand and Sakineh Gilavand *

Introduction: Health systems of the world have stepped into a critical period of human-resources shortage. Shortage of qualified nurses has been posed as one of the biggest hurdles to achieving the effectiveness of health systems. Hence, the present study examined the educational status and career prospect of nursing graduates in Iran. Materials and methods: The study was done analytically benefitting from content analysis technique. Results: In Iran, it is possible to continue studies towards PhD in nursing. Concerning the job opportunities in nursing, one should note that employing nurses' in the hospitals is based on education level (undergraduate, masters, doctorate). Nursing graduates can work in hospitals, clinics, health centers, private and public nursing homes for the elderly and children as shift nurses, head nurses, clinical supervisors, infection control supervisors, educational supervisors, and hospital nursing head. It should be noted that nursing graduates can independently establish a private health center (for evaluating the health status of community members) or establishing a kindergarten. Discussion and Conclusion: Although employment conditions are available for most nursing graduates in Iran, lack of nurses is a concern for managers and a major challenge for the health system in Iran. However, benefitting from committed and specialized nurses is one of the essential components in a health-work environment. Unfavorable work environments, lack of resources, unbalanced workload, disproportionate nurseto-patient ratio, increased writing affairs, high documentation, lack of supportive management, inadequate salaries and reduced employment permits are of the major challenges the Iranian health system faces, so despite many young graduate nurses there is a severe nurse scarcity crisis. Keywords: Nursing, Academic Status, Career Prospect, Iran.

2673-2680

Authors: Abdul Saleem Mohammad*, Dr. B. Jayanthi, Dr. Fazil Ahmad

New chromatography technology for the analytical laboratory is being driven by the ever expanding need and challenge to get more and better information faster, all in an economic climate where cost control is a primary concern. At the same time, samples have become more and more complex, detection limits are being driven increasingly lower, and regulatory concerns, particularly for biotherapeutics, are being increasingly scrutinized. To answer today's challenges in the laboratory, chromatographers are taking advantage of available new technology, often in rather unique ways. To tackle a particular issue they sometimes simply apply a new approach to a problem, like a new type of column or detector, or other times use a combination of new technologies, where the end result is greater than the sum of the individual parts. From new columns and detectors to multidimensional and orthogonal applications of technology, chromatographers have an ever expanding repertoire of tools available. Keywords: Pharmaceutical drugs, chromatography, analytical laboratory, HPLC, UPLC, UHPLC.

2688-2708

Authors: Agussalim*, Masdiana AR, Gutit Enny Susanti

Culture is the work of a human being that is born along with the creation of man as well as a documented hereditary in accordance with periodization. Culture is born and develops and changes along with the changing times. The culture of a region will be very important against the level of development of public health in the region. The very culture played an important role in increasing the degree of the health of a community. The culture of the communities surrounding the areas health services must be understood by all health workers who will eventually have an impact to increase the health status of the community.This research aims to get an idea how health workers have good self-efficacy ability to culture communities in mountainous regions, the Valley, and the coast in the province of Papua. Variable; This research is divided into independent variables namely the culture of the community, the community's culture of the Valley, as well as the culture of the community in the coastal province of Papua and the Variable Dependently is the health officer self-efficacy Method; This research uses Multi Concurrent Design Method with Embedded Strategy approach where researchers use quantitative and qualitative methods together with the use of primary and secondary methods. The primary method used to obtain data, and a secondary method used to obtain data in support of the data obtained from the primary method.The research results obtained that about 32% who said very less confident and less confident as well as about 41% stating neutral in understanding the culture of papua in the context of the public beaches, valleys and mountains. Discussion; the existence of these data gives an overview that the importance of supply self-efficacy about understanding the culture in which they will be on duty or placed in a working area which is suitable Keywords: Self_efficacy, a health worker, community, culture of Papua.

2713-2720

Authors: P.Veera Lakshmi, K.P.R Chowdary, A.Prameela Rani, K. Ravi Shankar

Recently much emphasis is being laid on the development of microparticulate DDS in preference to single unit systems because of their potential benefits such as increased bioavailability, reduced risk of systemic toxicity, reduced risk of local irritation and predictable gastric emptying. The objective of the present study is to prepare and evaluate microparticulte drug delivery systems of Gliclazide using chitosan, a mucoadhesive polymer for oral controlled release. A new technique namely emulsificationdesolvation-crosslinking method was tried for the preparation of chitosan microparticles. The Chitosan- Gliclazide microparticles prepared were evaluated for various physical and drug release characteristics. Spherical Chitosan- Gliclazide microparticles could be prepared by the emulsification-desolvation-crosslinking method. The method is industrially feasible as it involves emulsification and removal of the solvent, which can be controlled precisely. The emulsification-desolvation-crosslinking method was reproducible with regard to size and size distribution of the microparticles. About 68-75 % of microparticles in each batch were in the size range 35/50 mesh (398.5µm). Encapsulation efficiency was in the range 97.1-99.5 % in the preparation of microparticles. Gliclazide release from the chitosan microparticles was slow and spread over longer periods of time. The drug release depended on the proportion of core: coat in the microparticles. A good linear relationship (R² = 0.874) between percent coat and release rate (K0) was observed. The relationship could be expressed by the linear equation, y = 11.849-0.3035 x where x is percent coat and y is release rate (K0). Gliclazide release from the chitosan microparticles prepared was by diffusion mechanism. Fickian diffusion was observed in the case of microparticles which gave relatively rapidly release (F1 and F2) and the release was by non-Fickian diffusion in the case of microparticles which gave slow release of gliclazide ( F3 and F4). Microparticles (F3) prepared using a core: coat ratio of 8:2 gave slow and controlled release of Gliclazide over 12 hours similar to that of commercial gliclazide SR tablets. A microparticle (F3) is considered as a promising microparticulate DDS for oral controlled release of Gliclazide over 12 hours for b.i.d administration. Key words: Microparticulate drug delivery systems, Chitosan, Gliclazide, Emulsification-desolvation-crosslinking method, Oral controlled release.

2728-2732

Authors: Dr. Abdur Rehman Aqeel*, Dr. Binyamin Butt, Dr. Hira Naveed, Dr. Ali Arshad

Objective: To study the effectiveness of using rifaximin for prevention of recurrent hepatic encephalopathy (HE) attacks in patients with chronic liver disease (CLD). Methods: This study was conducted at the hepatology department of Mayo Hospital, Lahore, during October 2014 to April 2015 by following randomized, triple blind, placebo-controlled trial. Total 126 patients of CLD, who during remission from hepatic encephalopathy were prescribed rifaximin 550mg, two times a day for six months or placebo was advised twice daily for six months. Patients were advised to either take drug from 6 months or till onset of hepatic encephalopathy episode. These prescriptions were advised after randomly dividing patients into two groups consisting of 63 each. Results: The participants had mean age group 40.2 ± 2.3 years and 42.8 ± 4.5 years in test group and control group, respectively. Hepatitis C was found to be more common cause of cirrhosis as compared to hepatitis B. Forty out of 63 patients remained free from hepatic encephalopathy in test group while 35 patients did not suffer HE in control group during study period. Those who suffered HE had MELD scoring from 21 to 25 in both groups. There were similar adverse reactions and deaths in both groups. Conclusion: Rifaximin has no effective role in preventing hepatic encephalopathy as compared to placebo. Key Words: Hepatic encephalopathy, rifaximin, cirrhosis, placebo, chronic liver disease, recurrence.

2737-2742

Authors: Dr. Muhammad Rizwan Khan*, Dr. Hira Naveed, Dr. Madeha Arshad, Dr. Ali Arshad

Stenosis of Left main coronary artery is a subgroup of risk for high disease of coronary artery however, its appearance may be misinterpreted by CT angiography. In five patients with clinically very suspicious and angiographically limited LMCA disease Coronary CT angiography was performed. CCTA cross-sectional image was used to measure the diameter. Objective: To know the findings of CT Angiography of Left Main Coronary Artery. Place and Duration: The Study was performed in Nishtar Hospital, Multan for the period of 1 year from Jan 2016 to Jan 2017 after the approval from the ethical committee. Patients and Methods: This is an observational Study Performed on 130 Individuals with Changes in ECG due to left main coronary artery stenosis and findings of CT Angiography were compared for the correlation. Conclusion: On our observations based study, we believe that CCTA may have very important diagnostic role in LMCA patients with lesions of CT angiographic ally uncertain or unresponsive AMC lesions and should be considered for the evaluation of patients selected for study before undergoing bypass coronary surgery. A suitable gold standard such as IVUS is required to confirm the CCTA for the main root stenosis. Key words: CT Angiography, LMCA, Stenosis.

2757-2761

Authors: Dr. Muhammad Junaid Ajmal Khan*, Dr. Yusra Ejazz, Dr. Jawiria Javid

Diarrhea is an increase in frequency of bowl movements or decrease in the form of stool (greater looseness of stool). In spite of changes in the frequency of bowl movements and looseness of stools can vary independently freely of each other. Objective: To find out the frequency of diarrhea in infants less than 6 months of age. Cross-sectional study (Descriptive Study) Methods: A hospital based descriptive study was conducted from 1st January to 1st March 2018 in Paeds ward of BVH Bahawalpur. Source of population was 100 children under six months of age. Data analysis was made manually and frequency of diarrhea was calculated. Results: The frequency of diarrhea was more in infants of 0-2 months. The frequency was low in infants who were on exclusive breast fed. The diarrheal frequency was high in infants of rural areas. Female were showing resistance to diarrhea as compared to male. Hand washing before weaning breast fed and clean water supply must be there to reduce its occurrence Conclusion: Breast feeding must be promoted to prevent diarrhea. Keywords: Diarrhea, Exclusive breast feeding, Infant

2767-2773

Authors: *Dr. Erum Javed, Dr. Muhammad Hammad Khalid, Dr. Unsa Ghafoor

OBJECTIVE: The aim of this study was to calculate the frequency of DVT in patients admitted to hospital with CHF, because DVT data in limit was obtained in Pakistani patients with CHF. In deep vein thrombosis (DVT) according to international guidelines for the treatment and prevention of DVT Congestive heart failure (CHF) is one of the major factor. Methods: This is a prospective, epidemiological study in 44 patients hospitalized for extensive surgery. Patients included in the study had DVT risk factors as per given guidelines, acute exacerbation of congestive heart failure, at least 4 days of bed rest, and over 60 years of age. Patients who received physical prophylaxis or antiplatelet drug therapy, except for patients receiving anticoagulants, were included. We excluded patients surgically or surgically injured in patients with a significant DVT history 3 months after admission to the hospital or clinically or hospital. In eligible patients, the presence of DVT was confirmed by images and ultrasonography were diagnosed by an central independent evaluation committee. Place and Duration: The study was conducted from January 2016 to January 2017 for one year at the Department of Cardiology in Multan was held at the Chaudhary Pervaiz Elahi Institute of Cardiology (CPEIC). Findings: A total of 44 patients, 19 male and 25 female, were included in the study. The average age was 80.0 ± 10.0 years and bed rest mean time was 9 ± 3.0 days. DVT was detected in 15 of these 44 patients (34%). Physical prophylaxis was performed in eight patients, but in two patients DVT was again detected. In addition, the remaining 12 patients received antiplatelet agent therapy and DVT was observed in 3 patients

2788-2792

Authors: *Dr. Yusra Ejazz, Dr. Javeria Nasim,Dr.Madeeha Javed

Objectives: Research was aimed at the death frequency determination in HCV infected patients with hepatocellular carcinoma related to the elevated levels of alpha-fetoprotein serum. Methods: Our research was cross-sectional by design and it was carried out in Isra University, Hospital, Hyderabad in the time span of Mar, 2013 to Apr, 2014. All diagnosed cases of HCV and hepatocellular carcinoma were compared. The age of the patients for comparison was selected as above thirty years. Samples of the blood were taken to carry the levels of serum Alfa-fetoprotein measurement. We entered and analyzed the data in SPSS – 19. Results: In the total sample of 165 cases the mean age was calculated as (55.49 ± 11.67) years. Mean size of the tumor was observed as (5.63 ± 2.14) cm. In total research population 31 cases (18.8%) were observed with a size of the tumor below three centimeters, 65 cases (39.4%) had the tumor size in the range of 3 – 5 cm and 69 cases (41.8%) were observed with the size of the tumor as above 5 cm. Levels of mean Alfa-fetoprotein serum was observed as (7641.0 ± 3665.32 IU/ml). Our research also observed an overall rate of mortality as 70 cases (41.9%). Mortality was significantly associated with the above 5 cm tumor size with a significant p-value of (0.016). Conclusion: Levels of Alfa-fetoprotein serum are considered as vital tool to detect hepatocellular carcinoma in the HCV patients. Keywords: Hepatitis C virus (HCV), Alpha-fetoprotein levels and Hepatocellular carcinoma.

2798-2810

Authors: Avinash V.Dhobale*, Gunesh N. Dhembre, Khalid U Shaikh, Irshad A Shaikh, Nandkishor B. Bavage, Kulkarni A.S

Solubility is not to be confused with the ability to dissolve or liquefy a substance, since this process may occur not only because of dissolution but also because of a chemical reaction Solubility is the phenomenon of dissolute on of solid in liquid phase to give a homogenous system. There are many techniques which are used to enhance the aqueous solubility. The ability to increase aqueous solubility can thus be a valuable aid to increasing efficiency and/or reducing side effects for drugs. This is true for parenterally, topically and orally administered solutions. Oral route is the most desirable and preferred method of administering therapeutic agents for their systemic effects, but poorly solubility of drug is major challenge for formulation scientist. About 40% of orally administered drugs suffer from formulation difficulties related to their water insolubility. Dissolution rate, absorption, distribution and excretion of a moiety depend upon its solubility characteristics. On the basis of solubility, drugs are classified into four classes of the BCS classification. We may define a drug as ‘poorly soluble’ when its dissolution takes longer than the transit time past its absorptive sites, resulting in incomplete bioavailability. The aqueous solubility of a drug is a prime determinant of its dissolution rate and in the case of poorly soluble drugs Solubility challenges are faced in the Class II and Class IV of the BCS system. The method is suitable for thermo labile materials. Keywords: Solubility Enhancement, bioavailability, poorly water soluble, Dissolution, solid dispersion,

2824-2828

Authors: Vikash Sharma, Raj Kumar Tiwari, Shiv Shankar Shukla, Ravindra Pandey*.

Objective: The present study is aimed to reveal the patho-physiology, epidemiology of serious complication associated with diabetes mellitus viz: Diabetic foot ulcer (DFU). In this study various conventional, herbal as well as novel treatment approaches are also focused. Another objective of the study is to provide beneficiary information to the diabetic patients who are at the risk of DFU. Review: DFU is one of the most serious complications associated with the diabetes mellitus. Characteristics of DFU are infection, leads to ulceration, and if preventive steps not taken then converted to gangrene and results in Amputation. Major contributors to the development of diabetic foot are neuropathy, poor circulation, Ischemia and susceptibility to infection. Diabetic foot ulcers occur in approximately 15% of patients with diabetes and of these, 14% to 24% of ulcers will end in amputation. Several therapies like Herbal therapy, Hyperbaric Oxygen Therapy, Low-level laser therapy, Operative Debridement are used to treat the DFU now days. Some novel approaches like larval therapy and maggot’s therapy for treatment of DFU are also included in the study. Conclusion: On the basis of present review we have come to know DFU is a serious complication if serious concern is not taken. But if a care is taken, it is curable due to various treatment approaches according to the condition of wounds. But the primary approach is control of blood glucose. Keywords: Diabetic foot ulcer, Amputation, Novel approaches, Diabetes Mellitus

2836-2861

Authors: Sonal Vaishnav H., Dr Vinay C.Darji, Jaymin G.Patel, Bhumi patel

A simple, rapid, economical, precise and accurate Stability indicating RP-HPLC method for estimation of Tiagabine Hydrochloride in their dosage form has been developed. A reverse phase high performance liquid chromatographic method was developed for the simultaneous estimation of Tiagabine Hydrochloride. in their dosage form has been developed. The separation was achieved by column C18 (250mm x 4.6 mm) Hypersil BDS and Buffer (pH 4.5): Methanol (85:15 % v/v) as mobile phase, at a flow rate of 1 ml/min. Detection was carried out at 260 nm. Retention times of Tiagabine Hydrochloride were found to be 4.210 min, respectively. The method has been validated for linearity, accuracy and precision. Linearity observed for Tiagabine Hydrochloride 5-15 μg/ml. Developed method was found to be accurate, precise and rapid for estimation of Tiagabine Hydrochloride In Their Dosage Form. The drug was subjected to stress condition of hydrolysis, oxidation, photolysis and Thermal degradation.The proposed method was successfully applied for the simultaneous estimation of both the drugs in commercial combined dosage form. Keywords: Tiagabine Hydrochloride, Stability indicating RP-HPLC Method, Validation.

2881-2896

Authors: Jyotsana Bhatt*and Sayantan Mukhopadhyay

Alzheimer’s disease is the most prevailing type of dementia worldwide with pathological hallmarks as neurofibrillary tangles and amyloid β plaque. A large number of research and studies are undergoing to determine the exact pathophysiology of the disease which may further lead to development of better treatment strategies. Based on the existing hypothesis a number of treatment and management therapies are utilised for prevention and control of disease. Conventional therapies based on AChE inhibitors (Donepezil, Rivastigmine and Galantamine) and NMDA receptor antagonist (Memantine) are most effective and frequently used but are only capable of controlling the disease progression and are not capable of treating the disease completely. New therapies include disease modifying therapies based on the concept of reducing the functioning of secretase enzymes which is primarily involved in conversion of APP into amyloid β plaque. Other promising therapies based on different hypothesis include the use of insulin, antioxidants, stem cell and also various herbal drugs which show remarkable decrease in progression of disease. This review also includes a number of compounds which are under different phases of investigation and clinical trials and may be used as an important tool for treatment of disease in near future. Key words: Alzheimer’s disease, APP, APoE-e4, Biomarkers, Secretase Inhibitors.

2912-2918

Authors: N.K.Parameswaran*, S. Manjusha, R.Senthil Malar

The Piper nigrum L. plant materials such as [leaf and seed] were collected and allowed to shade dry to remove moisture content. The dried samples were used for further studies. The powdered plant materials were filled separately in the thimble and extracted successively using a soxhlet extractor with distilled water, acetone, chloroform, DMSO, ethanol and aqueous. All the extracts were subjected to systematic phytochemical screening for the presence of phytochemical constituents. Carbohydrates, Amino Acids, Proteins, Chloride, Alkaloids, Tannins, Phlobatannins, Steroids, Phenolic compounds, saponins are traced. Antimicrobial activity of the plant extracts were tested by agar well diffusion method against four bacterial pathogens [two Gram positive and two Gram negative strains] such as E. coli, K. pneumoniae, B. cereus and Staphylococcus aureus. In this assay, the leaf and seed of Piper nigrum extracts showed inhibition activities on Gram negative bacterium such as E. coli and K. pneumoniae. The aqueous extract showed inhibitory activity only on Gram negative bacterium B. cereus and S. aureus. This present study the qualitative phytochemical analysis and antibacterial activity were analysed. Key words: Soxhlet extractor, Piper nigrum L. and Antibacterial activity

2922-2924

Authors: N.K.Parameswaran*, S. Manjusha, R.Senthil Malar

The wide spread use of herbal remedies and health care preparations obtained from commonly used traditional herbs and medicinal plants have been raised due to the occurrence of natural products with medicinal properties. Even though pharmacological industries have produced a number of new antibiotics in the last three decades, resistance to these drugs by the microorganisms have also increased. In this Present Study the bioactive compounds from the plant Piper betle were determined by using FT-IR Spectroscopic methods. Key words: Piper betle, Bioactive Compounds FT-IR.

2933-2936

Authors: S. Manjusha*, N. K. Parameswaran, R.Senthil Malar

Plants, as the source of medicine, have been playing an important role in the health services around the globe About three quarters of the world’s population relies on plants and their extracts for health care. Use of herbal medicine in Asia represents a long history of human interactions with the environment. Plants used in traditional medicine contain a wide range of ingredients that can be used to treat chronic as well as infectious diseases. The medicinal value of plants lies in some chemical substances on that body. The most important of these bioactive compounds of plants are alkaloids, tannins and phenolic compounds. In this Present Study the bioactive compounds from the plant Piper longum were determined by using FT-IR Spectroscopic methods. Key words: Piper longum, FT-IR, Spectroscopic methods

2942-2945

Authors: S. Manjusha*,N.K.Parameswaran, R.Senthil Malar

Plants are more important in human life and fulfill his every day needs. In recent developments free radicals are involved in many diseases. The World Health Organization [WHO] has adopted a major policy change wherein most developing nations have to make use of more traditional medical practices for primary health care. The Indian traditional system of medicine has identified the leaves with digestive and pancreatic lipase stimulant activities Piper longum L. leaves are used in eye drops for eye injury or infection as a baby lotion for the new born, for coughs, asthma, and constipation and to arrest milk secretion. Essential oil from leaves of this plant has been used for the treatment of respiratory catarrhs and antiseptic. Piper betle L. showed hypotensive, Cardio tonic, smooth and skeletal muscles relaxant actions. This present study raveled to determine the bioactive compounds from the Piper longum L. Key words: Bioactive compounds, Piper longum L, HPLC analysis.

2957-2963

Authors: Kavitha.K

Scutia is a natural plant, which is cultivated variety of the genus Scutia belonging to family rhamnaceae.The scientific basis for the statement that plants and their active constituents play an important role in the prevention of diseases and therapeutics. In fact the origin of many therapeutic substances from the genus scutia It is an interesting source of potential bioactive compounds like flavonoids,tannins,proteins,saponins,Alkaloids,Tri terpenoids, steroids, carbohydrates, fixed oils, glycosides with gut motility activity and CNS activity like depressant and stimulant, antioxidant, anti-inflammatory, antimicrobial, Hepatoprotective activity,anti malarial and anti proliferative , anti diabetic activity, analgesic and anti ulcer , anti tumor and anticancer activity. This work reviews the pharmacological evidence of extracts of plants from the genus scutia, giving an overview of the most studied biological effects and the known photochemical composition. Although more studies are necessary, scutia exhibits proven potential to become of important pharmacological interest. Keywords: .Genus scutia, pharmacological activity, photochemical constituents, medicinal plants.anti Proliferative activity.

2970-2978

Authors: Dharmajit Pattanayak*, Dr. Ramesh Adepu, Saumya Das, Ramya Sri Sura

Gastro retentive drug delivery system (GRDDS) is one of the novel approaches in the area of oral sustained release dosage forms. Drugs that are easily absorbed from gastrointestinal tract (GIT) and have short half-lives are eliminated quickly from the systemic circulation require frequent dosing to achieve suitable therapeutic activity.The floating drug delivery systems increase the Gastric retention time providing wide therapeutic efficacy. Mucoadhesive drug delivery systems interact with the mucus layer covering the mucosal epithelial surface, and mucin molecules and increase the residence time of the dosage form at the site of absorption. The drugs which have local action or those which have maximum absorption in gastric pH require increased duration of stay in GIT. Thus, floating and mucoadhesive drug delivery systems are advantageous in increasing the bioavailability and enhanced therapeutic activity. In this regard, this review aims to provide information of different floating and mucoadhesive approaches and their importance. Keywords: Bioadhesive, floating drug delivery, gastroretentive, mucoadhesive

2990-2995

Authors: Arpan Jadav * and Sandip Singh

We have tried to synthesize a series of 5 derivatives of Pyrimidine. Synthesis was carried out according to reactions shown in Reaction Scheme. At first, 4th position of 2,4 dichloropyrimidne was substituted by Anthranilic acid to form Synthesis of 2-(2- chloropyrimidin-4-ylamino)benzoic acid 1[C]. 5amino-1,3,4-thiadiazole 2[B] was prepared using Synthesis of 2-(2-chloropyrimidin-4ylamino)benzoic acid 1[C] and Thiosemicarbazide as starting material. Further confirmation was carried out by IR which showed the presence of amino (-NH2) band ~3422.80 cm-1, 1H NMR spectra which revealed all the corresponding peaks at δ=4-8 ppm for aromatic protons. MASS spectrum showed M+1 peak at 305.4 Various Substituted Pyrimidine derivatives (3[B-1]-3[B-5]) were prepared from substituted aniline(3[A-1]-3[A-5]) by reacting with5-[2-((2-chloropyrimidine- 4yl)amino)phenyl)-1,3,4-thiadiazol-2-amine 2[B] .The reaction was monitored by Thin-layer chromatography using suitable mobile phase such as Chloroform: Methanol (9:1); nhaxane:ethyl acetate (5:5). The Rf values were compared and found that they were different from each others. The melting point of the derivatives was determined. Spectral study of all the derivatives of substituted Pyrimidine derivatives was carried out using IR, 1H NMR, and MASS which leads us to believe that all the derivatives has been properly synthesized. Key Words: Anticancer activity, synthesis, characterisation.

3003-3013

Authors: Dr. M. Madan Mohan Rao, C. Veera Vamsi, K. Sujan Kumar, J. Lavanya, E. Sam Jeeva Kumar

Pharmacovigilance is ‘’the science and activities concerned with the detection, assessment, understanding and prevention of adverse reactions or any other drug related problems to medicines’’.‖Pharmacovigilance plays an important role in ensuring patients safety. The main aim of the study is the role of clinical pharmacist in pharmacovigilance and drug safety in Teritiary care teaching hospital. The patients were included based upon the inclusion and exclusion criteria. The Adverse reactions were assessed by using different scales and the assessed adverse reactions was reported to the pharmacovigilance centres. The study reveals that majority of the females(57%), younger age people (30%) and illiterates(57%) are affected with the drug related problems. Here by we conclude that clinical pharmacists could offer effective patient care by means of their intervention in pharmaceutical care and hence improved therapeutic outcome could be reached. Key Words: Pharmacovigilance, Adverse Drug Reactions (ADR), Clinical Pharmacist

3024-3031

Authors: Firdous bugti, Muhammad Kamran Taj*, Imran Taj, Ghulam Mohammad, Shakeel Ahmed, Farooq Shahzad , Umbreen Zafar, Summiya Baloch, Marina Panezai3, Saima Azam

The causal agent of necrotic enteritis was isolated from the bovine of kacchi district Balochistan. Total 200 fecal samples were collected, out of which 74% samples were positive and 26% were negative for Clostridium perfringens. The age wise distribution was 20 % in 6 month, 16 % in 1 year, 13% in 2 years, 11% in 3 years, 8% in 4 years and 6% in 5 years. However species wise results showed that the cattle were 54% and buffaloes were 20% affected with enterotoxaemia. The season wise result showed that the incidence of enterotoxaemia was more in spring season. Clostridium perfringens was confirmed through different biochemical tests and gram staining. Antibiograms result showed that Clostridium perfringens was sensitive against Chloramphenicol, Penicillin, Tetracycline, Glycopeptides, Quinolones, Lincosamides and Macrolides classes while resistance to Polypeptides, Flagyl and Sulfonamides classes. The animal trail showed that Clostridium perfringens affected the vital organ. The hemorrhagic lesion on lungs, kidneys, and intestine were observed at autopsy. Whereas confirmed by PCR showed clear bands of 233bp of CPE gene. Key words: Clostridium Perfringens, Bovine, Kacchi, Balochistan, PCR.

3038-3045

Authors: Dr. Hafiz Muhammad Qamer, Dr. Muhammad Wajahat Ali Khan, Dr. Sana Liaqat

Thirty-four consecutive mothers of infants, above 6 months of age attending in an OPD pediatrics at Kishwer Fazal Teaching Hospital Lahore, were interviewed using questionnaire to determine how well they were informed about weaning process. Methodology: A cross sectional survey was conducted using questionnaire method regarding definitions, age at which weaning should be initiated, foodstuffs to be included, principles to be followed and myths in context to weaning. Findings: Educated mothers have concept about weaning and started weaning at proper time while illiterate mothers have poor concept of weaning. It was found that us of total 21% infants were fed on cow milk, 16% formula milk, 32% on exclusive breast feeding and 32% were fed on mixed feeding. Conclusions: Improved health facilities, child and maternal health programs, easy access to mass media along with the increased literacy in women, it has been seen that many mothers are well aware about weaning process. Through a still few mothers are lacking knowledge. Keywords: Mother, Knowledge, Weaning Process, Infants.

3050-3055

Authors: Dr. Muhammad Muneeb Abbas, Dr. Riaz Hussain, Dr. Muhammad Awais

Objective: Our research determines the patients in terms of their clinical, demographic and hematological factors of dengue infection risk specifically in the rural communities of lower classes in 2016-17 outbreaks in Karachi. Methods: We conducted research for the data collection of clinical and epidemiological nature for the infection of dengue in the less privileged communities. The outcomes of Dengue fever, Dengue Shock syndrome and Dengue hemorrhagic fever were verified through IgM and IgG anti bodies detected through Enzyme-linked immunosorbent assays (ELISAs) method which was based on the WHO criterion. A total of 350 patients were selected through random cluster sampling method. Research was continued after ethical approval and consent of the participants. SPSS-21 was used for the data analysis. Chi-Square was applied for the categorical variables determinations. Results: In the total research sample 105 participants (30%) were rural affected cases, dengue fever was observed in 58 participants (16.6%), 30 patients (8.6%) were observed with dengue hemorrhagic fever and remaining 17 participants (4.9%) suffered from dengue shock syndrome. In the course of treatment 12 participants died, every case presented the manifestations of cutaneous and fever. Significance presence was observed in the severe pain, married and educated cases with a p-value of (0.001). Conclusion: Thirty percent cases of dengue infection were noticed in the survey while visiting the endemic areas. Associated factors of risk were severe pain, five-year education, unmarried and female cases. Patients also presented febrile illness with clinical features and hematological observations about the dengue fever. Keywords: Dengue fever, Clinical Pattern, Dengue Hemorrhagic Fever, Epidemiology, Community and Surveillance.

3062-3065

Authors: Dr. Muhammad Haseeb Ul Rasool, Dr. Maleeha Saleem, Dr. Nazarat Habib

Objective: To association of hypertension, treatment modality and socioeconomic status with lower extremity amputation in persons with diabetes mellitus. Methods: 100 patients fulfilling the inclusion criteria were recruited. %0 of them were controls and 50 of them were cases with amputation caused by diabetic lesions, admitted for treatment in the Department of Surgery for care of Diabetes Mellitus. Various treatment modalities, hypertension, and socioeconomic background were evaluated among controls and cases according to a pre-designed questionnaire during period from August, 2017 to March, 2018. Demographic data was gathered from the respondents. Frequency tables were generated regarding research variables. Results: 100 participants were interviewed about the treatment they used, hypertensive control and socioeconomic background in association with diabetic foot. Patients were allocated to either cases or control group, based on whether they had an amputation or not. There was slight male dominance in both cases and controls with males contribution 68% and 70% to sample respectively. Predominant fractions of patients’ were of age greater than 50 years. 64% of samples were from low socioeconomic background in cases, whereas among controls 74% of patients were on middle class background. Equal fraction of cases and controls had hypertension. Among cases, 58% were using oral hypoglycemics, 72% were using Insulin and 16% had taken homeopathic medications. The proportion of oral hypoglycemics, insulin and homeopathic medications were 68%, 60% and 14% among controls. Age and Hypertension did not showed any significant risk association, same holds true for gender, whereas socioeconomic background had a strong risk association with amputation. None of the treatment pattern, whether oral hypoglycemic drugs, Insulin or homeopathic medication showed any significant risk association Conclusion: Age, hypertension and medicines used failed to show any significant association with development of diabetic ulcers, leading to amputation. Whereas lower socioeconomic status had a stronger risk association with development of Diabetic Amputation. Key Words: Diabetic Foot. Diabetes Mellitus, Amputations. Glycemic Control, Complications of Diabetes Mellitus.

3071-3074

Authors: Dr. Hassan Fayyaz, Dr. Ahmad Mujtaba, Dr. Saba Javaid

Objective: To Know the Number of patients referred to tertiary hospital neonatal intensive care unit (NICU) in Lahore, disease model and outcome determination. Study Design: A descriptive study Location and duration: The study was performed in Pediatric unit I of Services Hospital, Lahore for the period of one year from February 2016 to February 2017 Method: admission is the result of all newborns' income, and the result is retrospectively reviewed. Results: During the study period, the number of patients admitted was 500. Continuous low birth weight (24.6%) with sepsis showed the highest (19.9%) respiratory distress syndrome (RDS) (18.9%), meconium aspiration syndrome (15.2%),birth asphyxia (17.02) , pneumonia (3.46), neonatal jaundice (9.44%), hyaline injury (3.4%)and congenital malformations (2.8%). 148 of the 500 patients (13.8%) were expired. The majority of the deadlines were due to sepsis (31.75%). Keywords: Descriptive Study, Patients Load, Neonatal ICU, Tertiary Care Hospital.

3082-3088

Authors: Farhan Tahir, Muhammad Sohaib, Dr. Irum Rubab

Introduction: Physical Activity is defined as any bodily movement produced by skeletal a muscle that requires energy expenditure. Physical Activity is of 2 types Vigorous Physical Activity and Moderate Physical Activity. Physical Activity is very important for every person regardless of age, ethnicity, or present state of health, virtually all individuals will benefit from regular Physical Activity. Material & methods: A Cross Sectional study was conducted at Gujranwala Medical College, Gujranwala from 20 May to 5 June, to assess the correlation between physical activity and academic performance among the students of Gujranwala Medical College, Gujranwala. In this regard I used Internal Physical Activity Quetionaire (IPAQ) was used to get responses from 100 students of GMC by simple random sampling. And then data was analyzed to check the correlation between these two parameters. Results: There were 38% students in the GMC who performed vigorous physical activity And there percentage of Failure is 50%. 37% perform moderate physical activity and there Failure percentage is 37.84%. While 25% perform no physical activity and there percentage failure is 40%. Conclusion: This study demonstrate that those students who perform moderate physical activity are performing good in the academic career and have low failure rate while those who perform vigorous or no physical activity have high failure rate. Keywords: Physical Activity; IPAQ; Academic Performance; Exercise; student’s health;

3093-3096

Authors: Dr. Aneeqa Ali, Dr. Ruqayya Irshad, Dr. Gulshan Rasheed

Objective: To determine the relationship of high BMI to testosterone levels in infertile men. Material and Method: It is a study by cross-sectional carried out from May 2016 to May 2017. The size of sample was 250 males (infertile 123 and healthy 127 and control cases of fertility) range from 30 to 60 years of age, taken from the Nishter Hospital, Multan. All volunteers were divide in groups according to the BMI criteria (WHO Ascia's Pacific region). After a thorough physical examination and medical history, were selected with intentional sampling. Analysis of semen was performed and samples of blood were taken to check testosterone in serum. analysis of Data was done using SPSS 14.0 with ANOVA and T test independently done to compare averages and to perceive the sensitivity of the tests and to assess the significant correlation in the group. Result: There is a significant negative correlation between testosterone and BMI. High BMI appears to be associated with male infertility with reduced testosterone levels. Conclusion: Obesity has been confirmed for male infertility as a risk factor in the local community. Keywords: Azospermia, BMI, Testosterone, Male Infertility, Oligospermia.

3110-3117

Authors: Ishfaq Hassan, Arif Hussain, Ammar Waqas

Objective: The objective of research was the malaria infection prevalence identification in the population of Southern Western Pakistan (Panjgur). Methods: Our research was by design cross-sectional and it identified the malaria parasites in the suspected patients’ blood slides. Total malaria suspected patients were 6119. Research was completed in the time span of July, 2006 to June, 2008 with the help pf active and passive detention methods. Statistical analysis was carried out through SPSS – 11. Results: In total malaria suspects of 6119, we found that 2346 cases (38.3%) were positive for the smear slides of malaria parasite. In the total sample population 1868 cases (79.6%) were because of the infection of Plasmodium vivax and 478 cases (20.3%) were observed with P-Falciparum. However, we also observed a seasonal variation: highest infection was P. vivax as 131 / 144 (90.9%) in the month of November and it was observed low in October as 83 / 176 (47.1%). The males were higher in prevalence as 1831 (78%). In terms of age the prevalence was observed about disease as 334 (81.2%) and 860 (80%) respectively 1 – 10 and 11 – 20 years. We observed no case of P. oval and P. malaria in the time span of research and also there was no relation of age group and infection type. Conclusion: Infection of human malaria was frequently observed in the region of research, area of Baluchistan is one of the hottest areas of Pakistan. Among clinically-suspected malaria cases high positivity rate was observed. P. vivax was highly prevalent and it posed a significant threat to the healthcare; whereas, P. falciparum can also be a serious complication in addition to the cerebral malaria. Keywords: Malaria, ACD, PCD and Panjgur.

3124-3131

Authors: Usha Pokhariya*and Prashant Mathur

The pharmacy is one of the most extensively used facility in healthcare where a large amount of money is spent for purchasing medicinal items. In pharmacies, various drugs are being stored for supporting the therapy of patients. Due to the variety of pharmaceutical items, it is a difficult task to control and manage the quantity of drug. For a better and effective service management in a pharmacy, it is required a drug that must be provided continually at correct time and quantity to sustain steady in supply. This can be accomplished by efficient inventory management of pharmacy by providing control on important drugs, and deciding on priorities in purchase and distribution. Therefore, the inventory management is ensures significant improvement for both patient care and optimal use of resources. Three important methods regarding inventory management practice were studied such as ABC (Always, Better, Control) analysis, VED (Vital, Essential, Desirable) analysis, and ABC-VED matrix analysis. Keywords- Drug Inventory Management; Pharmacy; ABC; VED

3144-3151

Authors: Purvasha S. Khot*, Jaymin Ghanshyambhai Patel, Bhumi Rajdevbhai Patel

Stability indicating RP-HPLC method for simultaneous estimation of Lercanidipine Hydrochloride and Enalapril Maleate in their Combined Dosage Form has been developed. A reverse phase high performance liquid chromatographic method was developed for the simultaneous estimation of Lercanidipine HCl and Enalapril Maleate in their combined dosage form. The separation was achieved by column C18 (250mm x 4.6 mm) Hypersil BDS and Buffer (pH 5.0): Methanol (30:70 % v/v) as mobile phase, at a flow rate of 1 ml/min. Detection was carried out at 233 nm. Retention time of Lercanidipine HCl and Enalapril Maleate were found to be 4.057 min and 6.470 min respectively. The method has been validated for linearity, accuracy and precision. Linearity observed for Lercanidipine HCl 10-30 μg/ml and for Enalapril Maleate 20-60 μg/ml. Developed method was found to be accurate, precise and rapid for simultaneous estimation of Lercanidipine HCl and Enalapril Maleate In Their Combined Dosage Form Keywords: Lercanidipine HCl, Enalapril Maleate, Stability indicating RP-HPLC Method, Validation Method

3159-3167

Authors: Naga Pranathi Abburi, Narender Boggula, Lakshmi Madhuri Yellapragada*

Recent advances in the field of nanotechnology have found interesting and important applications in clinical medicines and surgery. One promising application is the use of nano sized particles for the delivery of drugs, heat, radiation and other substance to specific types of cells (such as cancer cells). In view of steep rise in the infection caused by multi drugs resistant bacteria in recent years and the reduced efficacy of employed antibiotics-owing to their overuse or misuse, bacteria resistance has dramatically increased. In this respect, silver, which has long been recognized as having inhibitor effects on microbes, has found a major use in the form of nanoparticles. These biologically synthesized nanoparticles have proved to be highly toxic against different multi-drug resistant human pathogens. When synthesized from medicinal plant extract, this device can effectively prevent and combat strains of microbes that have developed resistance to common antibiotic drugs. Further, nanoparticles can also be coated with suitable substrates and used in chemotherapy. In certain cases, formal chemotherapeutic methods are proving to be ineffective, as a result of the development of multiple drug resistance (MDR) in cancer cells by unknown mechanisms. A prospective solution herein, involves the design of nanoparticles with proteins that specifically detect the drug resistant cells and ensure high drug concentration at the designated site. While limiting side effects to neighbouring, healthy tissues. However, conventional procedures of synthesis of silver nanoparticles such as ultraviolet irradiation, aerosol technologies were expensive and sometimes release environmentally hazardous chemicals. To circumvent these problems, biosynthesis of nanoparticles – a greener alternative – is been employed wherever suitable. This project deals with the green synthesis of silver nanoparticles from the leaf extract of common Indian plant, Azadirachta indica (Neem), Ocimum tenuiflorum (Tulsi). Key words: Silver nanoparticles, anti microbial activity, Ocimum tenuiflorum, Green synthesis, Azadirachta indica.

3177-3183

Authors: Vangala Kavitha, Pathakala Naveen, Ramavath Swathi, Alikatte Kanaka Latha*

This study investigated the gastroprotective effect of methanolic extract of Phyllanthus acidus fruit (MPA) against indomethacin-induced gastric ulcer in rats. Ulceration was induced by a single oral administration of indomethacin (80 mg/kg body weight). Wistar rats were pre-treated with ranitidine (reference drug) at a dose of 40 mg/kg body weight and MPA at doses of 125 and 250 mg/kg body weight once daily for 21 days prior to ulcer induction. After 4 h of indomethacin administration, gastric secretions, antioxidant parameters and stomach nitric oxide (NO) were evaluated. The results showed that indomethacin induced gastric ulcer was associated with a significant increase of malondialdehyde and significant decrease of the gastroprotective mediators such as glutathione (GSH) and NO compared with normal control. Pre-treatment with MPA has shown improvements in indomethacin induced ulcers. In addition, MPA reduced oxidative stress parameters, free and total acidity and gastric NO content. Collectively, MPA produced gastroprotective effect in indomethacin induced gastric ulcers by anti-secretory action and cytoprotective effect. Keywords: Peptic ulcer, indomethacin, glutathione, Phyllanthus acidus, prostaglandins.

3192-3196

Authors: R. A Satpute and *Suradkar S. W.

Groundnut (Arachis hypogaea L.) is a member of family Fabaceae grown for oilseed, food and animal feed. Groundnut contains 51% of monosaturated oil and 30% polyunsaturated and 19% saturated oil. India consumes over 10 million tonnes of edible oil per year. Present study was conducted for genetic enhancement of groundnut thorough induced mutation by gamma rays and EMS. For the purpose oil percentage, saponification, Iodine value and Protein percentage was observed after the different doses of gamma rays and EMS on two varieties of groundnut viz. TAG-24 and AK-159 and it was concluded that 10 kr dose induces good genetic variability in both varieties. Keywords:Groundnut; Gamma rays; EMS; Mutation.

3203-3208

Authors: Neha Bhardwaj*, Dr. Mukunda Goswami and Kuldeep Dwivedi

Cell line provides a valuable biological tool for carrying out investigations into physiology, virology, toxicology, carcinogenesis, and transgenesis. The operation by which cells are grown under the control conditions, generally outside their natural habitat, is called as cell culture. Cells are isolated from the animals and plants cells, these isolated cells are allowed to grow and culture in artificial media. The cell lines from different tissues of different species are valuable for studying species-specific responses to viral infection at the cellular level. Cell culture systems were developed from different tissues of P.Hypopthalmus Namely Caudal Fin, heart, swim bladder, gills and eye tissues. A total of seven explants were prepared, but only two were used to develop cell culture. Cell culture systems developed from fin and heart were successfully subcultured to establish cell lines designated as PHCF respectively. Morphological evaluation under the inverted microscope revealed that all the explants prepared from fin explants were found to be adequately attached after 18-24 hours of explant preparation. The fish cell line is dominant in vitro tool for studying epidemiology, molecular carcinogenesis, toxicology and functional genomics in fish