Showing papers in "Journal of Pakistan Medical Association in 1989"

Effects of Acacia arabica and Caralluma edulis on blood glucose levels of normal and alloxan diabetic rabbits.

Abstract: The powdered seeds of Acacia arabica and roots of Caralluma edulis were administered in doses of 2, 3 and 4 gm/kg body-weight to normal and alloxan-diabetic rabbits. The blood glucose levels were estimated before and 2, 4, 6 and 8 hours after the administration of plant suspension. The powdered seeds of Acacia arabica exerted a significant (P less than 0.05) hypoglycemic effect in normal rabbits. The hypoglycemic effect was not significant (P greater than 0.01) in alloxan diabetic rabbits. The powdered roots of Caralluma edulis did not produce any significant (P greater than 0.01) hypoglycaemic effect in normal as well as in alloxan diabetic rabbits. The doses used did not show any acute toxicity and behavioural changes. From this study it may be concluded that the powdered seeds of Acacia arabica act by initiating the release of insulin from pancreatic beta cells of normal rabbits. Moreover, Caralluma edulis did not show any hypoglycaemic effect in normal as well as in diabetic rabbits.

Trace element studies on Karachi population. Part IV: Blood copper, zinc, magnesium and lead levels in psychiatric patients with depression, mental retardation and seizure disorders.

Abstract: Blood copper, zinc, magnesium and lead levels were determined by atomic absorption spectroscopy for 15 males and 16 females suffering from depression, 6 males and 1 female with mental retardation and 3 males and 4 females with seizure disorders. They were all under no medication and belonged to low income groups. No difference in copper levels was found between the sexes in any of the groups. The levels in all the groups were significantly higher than in the normals. In depressives, males had significantly higher zinc levels than females and only female depressives had significantly different (lower) levels from normals. In both depressives and normals, males had higher magnesium levels than females but no group of patients had significantly different levels from normals. Lead levels were significantly higher in female depressives and for those with seizure disorders than for controls. At least one metal abnormality was found in 21 (67.7%) depressive, 5 (71.4%) of those with mental retardation and 6 (85.7%) with seizure disorders.

Glycaemic responses to three different honeys given to normal and alloxan-diabetic rabbits.

Abstract: Blood glucose levels of normal and diabetic rabbits were determined after oral administration of graded doses of three different types of honeys; namely honeys of Apis florea (Small-Bee) and Apis dorsata (Large-Bee) and an adulterated commercial honey. The chemical analysis showed that commercial honey was adulterated with a saturated sucrose solution as it contained lower ash but higher nonreducing sugar levels than the natural ones. Oral administration of pure small or large-bee honeys in 5 ml/kg/doses could not produce a significant (P greater than 0.05) increase in glucose levels in normal and alloxan-diabetic rabbits whereas the adulterated honey significantly raised the blood glucose levels in normal and hyperglycaemic rabbits even at this low dosage. In higher doses of 10 ml/kg and 15 ml/kg body weight, all the three honeys produced a significant (P less than 0.05 or P less than 0.001) rise in blood glucose levels of normal as well as alloxan-diabetic rabbits. It may, therefore, be suggested that pure natural honeys in low doses may be recommended as a source of carbohydrates and even as a sweetening agent in place of sucrose to the human patients suffering from diabetes mellitus (JPMA 39: 107, 1989).

Microbiological quality and public health significance of ice-cream.

Abstract: Fifty samples of ice-cream were subjected to microbiological examination. Of these 72% had total viable count over 10(6)/g while 66% had coliform count between 10(2)-10(3)/g. The micro-organisms isolated were Escherichia coli (46%), Enterobacter aerogenes (34%), Staphylococcus aureus (26%), proteus species (16%), Streptococcus faecalis (12%), Citrobacter species (10%) and Bacillus cereus (4%). The results showed that commercially prepared ice-cream sold in the market was not satisfactory for human consumption and preventive measures should be enforced for the supply of satisfactory products.

Measurements of the normal adult lumbar spinal canal.

Abstract: To assess the normal dimensions of the lumbar spinal canal, 100 normal healthy subjects of either sex between 25 and 45 years age were x-rayed for lumber vertebral column in both posteroanterior and lateral views and the canal was measured by Jones and Thomson method. The lumbar spinal canal showed constant dimensions in both sexes in all age groups when studied separately in the male and female subjects. However, no change in relative dimensions was observed between 25 and 45 years. The canal showed gradual decrease in measurement from L1 to L5 vertebral levels in both sexes but relative width of the canal was more in the females than in the males of the same age group. The normal values of the canal to vertebral body ratio (C/B) varies between 1:2.0 and 1:5.0. The ratio 1:2.0 indicates a wider canal whereas any ratio beyond 1:5.0 would be conclusive of stenosis of the lumbar vertebral canal.

Methicillin resistant staphylococcus aureus in a teaching hospital of Karachi--a laboratory study.

Abstract: A search was made for Methicillin Resistant Strains of Staphylococcus Aureus (MRSA) among staph aureus cultures isolated at a teaching hospital in Karachi. Of 100 staphylococcus aureus isolated in 1987-88, 5 were MRSA, four from admitted patients and one from outpatient. These MRSA were resistant to Gentamicin as well as to other antibiotics. The presence of MRSA in the in-patients is a serious problem as it can act as reservoir to cause outbreak of colonisation and infection. No MRSA was isolated from 50 samples studied from Quetta.

Neonatal screening for congenital hypothyroidism in Pakistan.

Abstract: Congenital hypothyroidism is a preventable cause of mental retardation. Since clinical signs of congenital hypothyroidism do not generally become obvious before three months of age, screening programmes have been introduced in North America and Europe, which consist of T4 or TSH screening on newborn infants on the third day of life. The screening for congenital hypothyroidism was initiated in Pakistan by the Aga Khan University Hospital (AKUH) in March 1987. By April 1988, 5000 neonates were screened and five cases of congenital hypothyroidism were diagnosed. The study revealed the incidence of hypothyroidism to be one case per 1000 newborns which is about 4 times more than that in the West.

Ferritin levels in professional blood donors.

Abstract: Iron stores were estimated in 333 professional blood donors by serum ferritin assay. Iron deficiency or depleted iron stores assessed by low serum ferritin levels (less than 12ng/ml) were found in 15% donors. In 51% donors the serum ferritin was within the normal range, while 34% donors had high serum ferritin levels (above 200 and upto 3580 ng/ml). Anaemia (Hb less than 13g/d1) was found in 284 (85%) donors, 51 (18%) of these had iron deficiency or low ferritin levels, 99 (35%) had high and 134 (47%) had normal serum ferritin levels. Iron deficiency in blood donors could be associated with repeated blood donations. High serum ferritin levels could be due to reasons like taking of medicinal iron much beyond the recommended dosage by self initiation. Therefore, estimation of serum ferritin has no value in professional blood donors.

Visceral leishmaniasis: a seroepidemiological study of 289 children from endemic foci in Azad Jammu and Kashmir by indirect fluorescent antibody technique.

Abstract: Between January '85 and August '87, 22 cases of VL were seen at National Institute of Health, Islamabad. Three (14.6%) came from the previously known endemic region of Gilgit, 15 (68.1%) from different localities in Azad Jammu and Kashmir (AJ&K), and 4 (17.3%) from neighbouring foci in NWFP and Punjab. Mean age of the patients was 4.2 years, (Range, 10 months to 57 years) median 2.5 years and mode 2 years. High levels of Leishmania antibodies were detected by Indirect Immunofluorescent Antibody Technique (IFAT) in all cases. Leishmania were isolated from bone marrow aspirates of 2 patients and isoenzyme characterization performed in one of these, the organism was typed as Leishmania infantum sensu stricto. Sera from 289 children residing in 5 endemic localities in AJ&K was tested for Leishmania specific antibodies by IFAT and low levels of these antibodies were detected in 15.4% of the cases.

Incidence of aflatoxin contamination in non-perishable food commodities.

Abstract: To assess the incidence of aflatoxins contamination in different commodities, a representative countrywide study was conducted. One hundred composed samples of cereals, grains, spices, condiments and refined and raw sugars were analysed for aflatoxin B1, B2, G1 and G2. The moisture contents of all the food samples were also invariably determined. Only 6% of the samples namely maize and red chillies were found to be contaminated with aflatoxin B1 and B2 respectively. The percentage of samples contaminated among maize was 41.6 and the level of aflatoxin B1 ranged between 11.12 micrograms/Kg to 82.33 micrograms/Kg. In red chillies contamination was 25% and the level of aflatoxin B2 was 41.67 micrograms/Kg.

Serum thyroid hormone levels in liver cirrhosis.

Abstract: Levels of thyroid hormones, serum thyroxine, triiodothyronine (T3), free thyroxine (FT4), free triiodothyronine (FT3) and thyrotropin (TSH) were measured in 55 patients with liver cirrhosis using radioimmunoassay techniques. Results were compared with 78 controls. The mean serum concentration of T3, FT3 and FT4 were significantly decreased in cirrhotics, while no significant change was noted in serum T4 and TSH levels. T3/T4 ratio was also lower than the normal. This indicates an impaired liver conversion of T4 to T3 in peripheral tissues. Serum T3 and FT3 showed an inverse correlation with serum bilirubin and a positive correlation with serum albumin. T3, FT3 and T3/T4 ratios were significantly low in patients who had ascites as compared to those who had no ascites. This study confirms the presence of abnormalities in serum thyroid hormone levels in cirrhosis of liver. Alteration in serum T3 and FT3 levels correlate well with the disease severity and may be useful in assessing the course and prognosis in cirrhotic patients.

Trace element studies in Karachi populations. Part III: Blood copper, zinc, magnesium and lead levels in psychiatric patients with disturbed behaviour.

Abstract: Blood levels of copper, zinc, magnesium and lead were determined in 29 males and 15 females suffering from disturbed behaviour As far as we could ascertain they were under no medication and belonged to low income groups Male patients had significantly higher levels than female patients for zinc (005 greater than P greater than 001) but there was no sexual difference for magnesium or copper In patients copper and lead levels were higher than for normals (P less than 001), but no difference could be found for Mg and Zn At least one metal abnormality was observed in 19 (655%) of the males and 9 (600%) of the female patients

The carrier state: methicillin-resistant Staphylococcus aureus. A hospital study "screening of hospital personnel" for nasal carriage of Staph aureus.

Abstract: Methicillin resistant Staph Aureus (MRSA) were studied in a 300 bedded Central Government Hospital Rawalpindi, in which 291 staff members were screened by nasal swabbing. Of 125 cases carrying staph aureus 5 (1.78%) were methicillin resistant. They were treated with Bacitracin ointment to be applied to interior nares four times a day for one week. Hexachlorophane baths daily, chlorhexidine shampoo once daily for a week, and were taken off duty from wards for one day.

Visceral leishmaniasis (kala azar) in Karachi.

Abstract: Presentation de deux cas dans une region jusqu'a present indemne de cette maladie. Les migrations de population, en particulier en provenance du Bengladesh sont peut-etre a la source de l'infection

Organophosphorus insecticide poisoning.

Abstract: A review of 755 cases of Organophosphorus Insecticide Poisoning, admitted to the department of Intensive Care at the Jinnah Postgraduate Medical Centre between 15th January, 1976 to 31st December 1985, has shown that these insecticides form a majority of the cases of acute poisoning and are associated with a comparatively higher mortality rate. Of 1900 cases, 755 were cases of organophosphorus insecticide poisoning forming 39.7% of the total poisoning cases and 16% of the total admissions to the Unit. Being easily accessible, these insecticides are frequently used as suicidal agents specially by uneducated housewives. They are highly toxic and their management is very complicated. Of 108 deaths from poisoning in the last 10 years 73 (67.6%) were due to Organophosphorus Insecticide Poisoning. This being such a common mode of poisoning in our country, we have presented here our experience of the clinical features and management of these cases.

Monitoring of harmful constituents of cigarettes and tobacco in Pakistan.

Abstract: Nicotine, tar and carbon monoxide contents of tobacco smoke have been determined and reported under standard laboratory conditions by a number of workers. To control the level of nicotine, tar and carbon monoxide in cigarettes, variations made in the manufacture have reduced amounts of these constituents. In U.K. during 1934-1940 the values of tar, carbon monoxide and nicotine per cigarette were 33, 19 and 2.0 mg respectively which decreased to 17, 17 and 1.4 mg respectively by 1979. In USA’, average tar and nicotine contents per cigarette in 1956 was 38 and 2.7 mg respectively which was reduced to 13 and 1.0mg in 1984. The contents of nicotine, tar and carbon-monoxide in tobacco smoke under standard laboratory conditions have not been reported for cigarettes available in Pakistan. This study was undertaken to determine nicotine and tar contents of various brands of cigarettes available in this country.

Noise levels and the sources of noise pollution in Karachi.

Abstract: The menace of noise is a by-product of civilization and its hazards are well known. Noise levels were measured in Karachi, at different places and at different times of the night and day, using an Amplaid noise meter. The leg for Karachi came to 80 dB (A), the General Noise Index x (G.N.I.) to 460, and the noise pollution level (N.P.L.) to 99 dB (A). These values are significantly higher (P less than 0.01) than the available international data. The sources of noise production were indentified as, the road traffic, human activity, industrial and civil works, mechanical and engineering workshops. The most noticeable sources of noise pollution in Karachi, are the autorickshaws, trail motor bikes and the fag horns of public transport (JPMA 39-62, 1989).

Surveillance of toxoplasmosis in different groups

Abstract: Two hundred and twenty three serum samples were screened for the antitoxoplasma antibodies of IgG type by a direct agglutination method, of these 78 (34.9%) were sero-positive. In high risk groups 71 (40.1%) of 177 cases were positive, while in the low risk groups 7 (15.2%) out of 46 cases were positive. Sero-positive males were more than females, and the disease increased steadily with age. Of the high risk group the prevalence of toxoplasmosis was 53.7% in immunocompromised group, 44.7% in animal handlers, 39.8% in pregnancy wastage group and 25.8% in a congenitally abnormal children. A high percentage prevalence of toxoplasmosis was noticed in high risk groups as compared with low risk group.

Serodiagnosis of amoebic liver abscess by IHA method.

Abstract: Serological test based on IHA (Indirect Haemagglutination Method) was performed in 100 cases of hepatic abscess. The test was 100% sensitive and 94% specific. The cut off point of antibody titer between normal population and patients with invasive amoebiasis was 1:128. Antibody titer in amoebic liver abscess was 1:5242 +/- 2795. A significant (P less than 0.001) correlation was found between total leucocyte count and antibody titer.

The frequency of urinary incontinence in Pakistani women.

Abstract: Urinary incontinence, especially in females causes a great degree of social and hygienic embarassment. In one of the studies, over 50% of young, healthy, nulliparous females had incontinence; of these only 5% found it troublesome. In old age, the frequency of troublesome incontinence rises to about 30%, while the figures in paediatric population are about I in every 200 children. Overall incidence of urinary incontinence in European rural areas is about 4 1%. This high frequency of urinary incontinence in European population is probably because, (a) soiling of clothes is not considered a major problem and (b) all of them use commode type of toilet. In Pakistan soiling of clothes prohibits the person from performing daily religious activities, moreover a large population uses squatting type of toilet which empties the bladder completely, therefore, the frequency of urinary incontinence is likely to be low. The present study was done in two socially different groups who use different type of toilets, and see the frequency of incontinence in these groups and compare it with other studies.

Trace element studies on Karachi populations, Part 1: Normal ranges for blood copper, zinc and magnesium for adults.

Abstract: Normal ranges in whole blood were established for copper, zinc and magnesium for a Karachi population. For copper, it is 71 - 116 micrograms/dl (mean 93.5), there being no significant difference between the sexes; for zinc, males 602.5 - 850 micrograms/dl (mean 726), females 519 - 853 (686), P less than 0.01 for males + females 563 - 859.5 (711); and for magnesium, males 2.97 - 4.80 micrograms/dl (mean 3.78), females 2.65 - 4.66 (3.50), 0.05 greater than P greater than 0.01; for males + females 2.75 - 4.80 (3.61). There were weak correlations only between pairs of blood metal levels for the population.

Peritoneal macrophages transfusion in the treatment of chronic postoperative wound infections.

Abstract: Four patients with chronic post-operative wound infections and wound gapping that failed to respond to antibiotics were treated by allogeneic macrophage transfusions. No harmful effects were observed following macrophage transfusion and the chronic infections were eradicated in the treated patients with complete healing of wounds. Haemoglobin and white cell count were increased after cell transfusion. It could be concluded that allogeneic macrophage transfusion can combat chronic resistant infections and stimulate both wound healing and haemopoiesis.

Comparison of immunogenicity of combined DPT--inactivated injectable polio vaccine (DPT - IPV) and association of DPT and attenuated oral polio vaccine (DPT + OPV) in Pakistani children.

Abstract: Two hundred children aged 2-24 months attending EPI Centre Rawalpindi General Hospital, were randomly assigned to two basic immunization schedules ie 3 doses of oral polio vaccine alongwith two doses of DPT (Conventional Schedule) and 2 doses of combined DPT - enhanced injectable polio vaccine (new simplified schedule) Comparison of the seroconversion results showed the presence of protective antibodies against all the 3 types of polio in 100% of the children in both the groups, but there was no statistical difference in the geometric mean antibody titre in the two immunization schedules After two doses of DPT-IPV or DPT vaccine alone the results demonstrated antibody levels above the protective threshold in both the groups against Diphtheria, Pertussis and Tetanus

A histological study of the effects of nonsteroidal anti-inflammatory drugs (NSAIDs) on the gastric and duodenal mucosa.

Abstract: The effect of nonsteroidal anti-inflammatory drugs (NSAIDs) on the gastric and duodenal mucosa was studied in 53 patients. On endoscopic biopsies, 87% patients showed gastritis and 90% duodenitis. Chronic superficial gastritis was the most frequent lesion in the stomach (49%); and mild duodenitis in the duodenum (54%). The antrum was the most frequently involved site in the stomach. An interesting finding in cases of duodenitis was the presence of dilated intestinal glands plugged with mucus.

Clinical profile of 100 cases of liver abscess.

Abstract: One hundred patients with liver abscess were studied for clinical features and complications. They were diagnosed by radiography, ultrasonography, serology and by needle aspiration. A variety of interesting clinical, haematological and ultrasonographic findings were observed. Literature on liver abscess was reviewed and results compared.

Efficacy of a home made quality control serum.

Abstract: With increasing automation in Clinical Laboratories, the requirements for quality control material have greatly increased in order to monitor performance. The constant use of commercial control material is not economically feasible for many countries because of non-availability or the high cost of these materials. Here we describe a simple technique to prepare Home Made Quality Control serum using blood from polycythaemic patients. This preparation is stable for about six months without any alterations in the concentration of any of the chemical constituents. Extensive use of Home Made Quality Control sera in our laboratories have saved about 69% of the amount spent on the commercial material without any compromise in quality of the laboratory performance.

Urinary tract infection

Abstract: Urinary tract infection (UTI) is defined as the presence of microbial pathogens in the urinary tract with associated symptoms Urinary tract infections (UTIs) are common, affect men and women of all ages, and vary dramatically in their presentation and sequelae They are a common cause of morbidity and can lead to significant mortality UTIs are one of the most common bacterial infections seen in primary care, second only to infections of the respiratory tract (Pushpalatha 2008) They represent the most common bacterial infection in pregnant and non-pregnant women (Foxman 2002, 2003) Eight million women visit a physician annually for evaluation of UTIs (Schappert 1994) at a direct cost of $659 million (Rosenberg 1999), and aggregate cost of $16 billion (Rosenberg 1999; Foxman et al 2000)