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OBJECTIVE: To compare the efficacy of Propranolol with steroid (oral prednisolone) in treating the children with cutaneous haemangioma in terms of frequency of size reduction. STUDY DESIGN: A Randomized Comparative Trial PLACE AND DURATION: Department of Pediatric Surgery at Children Hospital PIMS Islamabad from 9th July 2013 to 9th Jan 2014. METHODOLOGY: Total 60 children having cutaneous haemangiomas at any site were studied. Patients were randomly divided and in Group A 30 patients were given oral propranolol while 30 patients in Group B were given oral prednisolone for treating haemangiomas. Patients had an age range one month to 12 years. Patients were followed for one month to see >75% Regression in size of haemangioma in each dimension for each group. RESULTS: The >75% regression in size in Group A was 93.3% (n=28) and in Group B was 0% (n=0) with p value 0.000. CONCLUSION: Oral propranolol is more effective treatment of haemangioma than oral steroid used for same duration in terms of size reduction with no major side effects of treatment. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To determine the frequency of metabolic syndrome in acute ischemic cardiac patients and its impact on hospital outcomes. STUDY DESIGN: Descriptive case series study. Place and Duration: Coronary Care Unit (CCU), Fauji Foundation Hospital, Rawalpindi over a period of nine months i.e. from 18th Feb 2011 to 18th Nov 20110. METHODOLOGY: A total of 188 patients were admitted with first ever episode of acute ST elevated myocardial infarction (diagnosed on the basis of WHO Criteria for diagnosis of acute MI). Outcomes measured were frequency of metabolic syndrome, median duration of hospital stay, the development of clinical heart failure (classified as per Killip classification) and in-hospital case mortality. RESULTS: Among the 188 patients, 76% fulfilled the National Cholesterol Education Program ATP III criteria for metabolic syndrome. The median duration of hospital stay was five days. Increased incidence of heart failure and increased mortality was observed among patient with metabolic syndrome. CONCLUSIONS: The frequency of metabolic syndrome in acute ischemic cardiac patients was high and was found to be associated with adverse hospital outcomes, with a higher risk of development of heart failure and mortality. [ABSTRACT FROM AUTHOR]

Objective: Anticonvulsants are increasingly being used in the symptomatic management of several neuropathic pain disorders. The present observational study was designed to evaluate the efficacy, tolerability, and quality of life (QoL) of carbamazepine use for 12 weeks in patients with painful diabetic neuropathy, in Pakistan. Methods: This was a 12-week, multicenter, open-label, uncontrolled trial in adult type 2 diabetic patients (aged 18-65 years) suffering from clinically confirmed neuropathic pain (Douleur Neuropathique en 4 [DN4] score ≥4). Change in neuropathic pain at week 12 compared with baseline was assessed using the Brief Pain Inventory Scale--Short Form (pain severity score and pain interference score). QoL was determined by the American Chronic Pain Association QoL scale. Safety was assessed based on patient reported adverse events (AEs) and serious AEs. Results: Of the total 500 screened patients, 452 enrolled and completed the study. The mean (± standard deviation [SD]) pain interference score decreased from 4.5±2.0 at baseline to 3.1±1.9 at week 12 (P<0.001). The mean (± SD) pain severity score decreased from 5.8±2.0 at baseline to 3.6±2.2 at week 12 (P<0.001). There was a decrease of ≥30% in the pain severity score between visits. The mean (± SD) QoL scale score improved from 5.9±1.6 at baseline to 8.0±1.7 at week 12. A total of ten (2.2%) patients reported AEs during the study period. No patient discontinued the study due to AEs. Conclusion: In this real-life experience study, carbamazepine, when prescribed for 12 weeks to adult diabetic patients suffering from neuropathic pain, showed pain-relief effect, with reduced mean pain severity and mean pain interference scores and with improved QoL and good tolerability profile. [ABSTRACT FROM AUTHOR]

Involvement of the mediastinum and sternal bone leading to osteomyelitis is a very rare presentation of tuberculosis even in countries where tuberculosis is endemic like Pakistan. Frank presentation as discharging sinus is even more uncommon. We describe a case where a patient presented with constitutional symptoms of fever, loss of appetite, significant weight loss and an erythematous tender lesion over the sternum with a discharging sinus without any features of pulmonary tuberculosis. The case was initially not diagnosed by routine laboratory tests and the lesion was just considered as a boil until presented to tertiary care hospital as discharging sinus. Plain Radiographs showed lytic lesion on the inner aspect of sternum and histopathology of the aspirate from the lesion confirmed the presence of epithelioid granulomas and acid fast bacilli on staining. Patient responded very well to 12 months of antituberculosis treatment. [ABSTRACT FROM AUTHOR]

Background: Gastroparesis is a serious condition that can be caused by diabetes, surgery or infection, or can be idiopathic. When there is no mechanical obstruction, gastroparesis is characterized by delayed stomach emptying. Itopride, a prokinetic drug, inhibits acetylcholinesterase activity in addition to antagonizing dopamine D2 receptors., Methods: This prospective, multicentre study is based on real-world data from 988 patients with a diagnosis of diabetic gastroparesis for index (PAGI-SYM2) evaluation at baseline and week 4 of treatment for upper gastrointestinal disorder symptoms., Results: Upper gastrointestinal symptom severity scores improved significantly after 4 weeks of treatment ( p <0.001), with significant improvement across all categories of gastroparesis (very mild (37-58.6%), mild degree (24.6-31.6%), moderate (29.3-7.3%) and severe (8.8-2.6%)., Conclusion: Itopride SR (Nogerd SR) in a 150 mg once-daily dose showed promising results in reducing the severity of upper gastrointestinal disorder symptoms associated with diabetic gastroparesis. Both statistical and clinical effectiveness were observed. Moreover, the treatment demonstrated a favourable tolerability profile, with a low incidence of adverse effects., Competing Interests: Disclosure and potential conflicts of interest: NM is a full-time employee of Helix Pharma Pvt. Ltd. All authors has received support for attending meetings and/or travel from Helix Pharma. The remuneration was given to the investigators for examining and entering the data during the study duration. The authors report no other conflicts. The honesty of the study was not traded for any monetary benefit. The International Committee of Medical Journal Editors (ICMJE) Potential Conflicts of Interests form for the authors is available for download at: https://www.drugsincontext.com/wp-content/uploads/2023/09/dic.2023-6-4-COI.pdf, (Copyright © 2023 Ramzan A, Memon GF, Shaikh AA, Khoso MM, Meher T, Ghafoor A, Shehzad NA, Ahmed S, Nawaz Z, Rehan M, Saeed T, Taj W, Abbass S, Khan R, Ehsan H, Alam A, Manzoor B, Khan MN, Yahya KM, Mukhtiar F, Javed MA, Sheikh MU, Janjua D, Jabeen S, Zafar J, Khokhar RH, Nazar M, Maheshwary N, Khan MA.)