Objective: To describe the effect of mycophenolate mofetil in Pakistani children with steroid dependent and steroid resistant nephrotic syndrome. Methods: This is cross sectional retrospective review of 16 patients; 9 boys and 7 girls (11 SD/FRNS and 5 SRNS) for a period of 4.8 years. This study was conducted in Mayo hospital and Fatima Memorial hospital specialist care centre, Lahore involving urban and suburban population. Results: The median age of the group was 4 years (1.6 to 12.6 years). Seven patients had histological diagnosis of MCN, 3 had diffuse mesangial proliferation, one of membranoproliferative glomerulonephritis and 4 had FSGS. Out of 5 SRNS 4 were found to have FSGS and 1 had membranoproliferative glomerulonephritis (MPGN). A total of three patients were completely off steroids and in two patients MMF was also successfully stopped. Number of relapses /patient /year calculated by applying Wilcoxan signed rank test was found to be 4.31 + 0.87(3.00-6.00 /patient/year) before starting MMF, which dropped to 1.12 + 0.718 (0.00- 2.000 /patient/year) after starting MMF, p=0.0001. Reduction in steroid dose from mean of 0.85 + 0.18 mg/kg/day to 0.3mg/kg/day + 1.56 was achieved in 12 months, p
Hydroxychavicol (HC) is a phenolic compound of betel leaf (Piper betle). It has been reported to have antifungal properties against dermatophytes including T. rubrum. The aim of this study was to identify the effects of the HC against T. rubrum. Broth dilution method was used to determine the minimum inhibitory concentration (MIC) and minimum fungicidal concentration (MFC) of the HC. Microscopic study of the treated fungus was done by transmission electron microscope (TEM). Cytotoxicity study using pre-adipocyte (3T3-L1) cell line was performed by means of MTT cell proliferation assay. The MIC and MFC results of the HC were both 0.49 µg/ml. Microscopic study revealed the destruction of the fungal cell wall and organelles. Cytotoxicity study showed HC to be non-toxic to the tested human cell line. In conclusion, HC may potentially be used as an alternative therapeutic agent against T. rubrum infections.
Objective: This study assessed the pattern of clinical course of hematological disorders in children diagnosed by bone marrow aspiration/biopsy in a tertiary care centre. Setting: The study was conducted at the Department of Pediatrics, Lahore General Hospital, Pakistan. Design: A retrospective descriptive study. Duration of study: Jan 2006 to Dec 2010. Methods: The clinical and laboratory data of 250 patients including complete history, physical examination, investigations and bone marrow examination reports were collected and then analyzed retrospectively. On the basis of these data, relative frequency of different hematological disorders was determined. Results: A total of 250 patients were selected during this study period where their bone marrow was sent for the investigations. Out of these cases, double deficiency anemia was the commonest diagnosis (22%) followed by aplastic anemia (13.6%), megaloblastic anemia (13.2%) and iron deficiency anemia (5.6%). For hematological malignancies, acute lymphoblastic leukemia (ALL) was observed in 27 cases (10.8%) followed by acute myeloid leukemia (AML) in 12 cases (4.8%), lymphoma in 8 cases (3.2%) and chronic myeloid leukemia (CML) in only two cases. Idiopathic thrombocytopenic purpura (ITP) was reported as frequent as 13.2% (33 cases). Conclusion: The pattern of non malignant hematological disorders in children diagnosed by bone marrow aspiration/biopsy was more common than malignant conditions. Double deficiency anemia was the commonest non malignant condition followed by aplastic anemia, idiopathic thrombocytopenic purpura and megaloblastic anemia. ALL was the most common presentation of the hematological malignancy.
Trichophyton rubrum is a common pathogenic fungal species that is responsible for causing infection on
human skin, hair and nail. The antifungal-resistant strains complicate the treatment regime.
Hydroxychavicol (HC) is one of the main compounds from Piper betel leaf that have antifungal potential and
its mechanism of action has not been studied yet. The objective of this preliminary study to determine the
antifungal properties of HC against T. rubrum using transmission electron microscope (TEM) on gross and
ultrastructure of T. rubrum hypha. T. rubrum was treated with HC and miconazole (MI) at concentrations of
1.25, 2.5, 5 and 10 mg/mL for 1, 3, 5 and 7 days continuously. Generally, fungi structures became more
severely damaged at increasing treatment duration. Microscopically, the fungi’s cell wall treated with HC
showed a rough surface, shrinkage and demolition similar to the MI treated group. The fungi organelles were
also demolished and disorganized. This study revealed that HC has the ability to inhibit T. rubrum growth
and has potential to be an antifungal agent for skin infections.