Publications by authors named "Ahmed Farhan"

48 Publications

University students' behavioral intention and gender differences toward the acceptance of shifting regular field training courses to e-training courses.

Educ Inf Technol (Dordr) 2021 Sep 14:1-18. Epub 2021 Sep 14.

Department of General Courses, College of Applied Studies and Community Service, Imam Abdulrahman Bin Faisal University, Dammam, 31441 Saudi Arabia.

During the COVID-19 lockdown, all the courses at Imam Abdulrahman Bin Faisal University (IAU) were delivered fully online, including field-training courses. Since there was no previous experience in offering field-training courses in a distance format, the current study aims to identify factors that could impact students' behavioral intention to accept the e-training approach in teaching field training courses at IAU. In order to gather the data, the researchers designed a questionnaire based on the UTAUT model and they ensured the face, content, and construct validity of the questionnaire by sending it to five experts in the relevant field and by using exploratory factor analysis. Also, all the questionnaire's items were reliable since the Cronbach's alpha values were above 0.77 for all the items. A total of 397 participants provided valid responses. The result of this study indicated that Effort Expectancy (EE), Facilitating Condition (FC), Performance Expectancy (PE), and Social Influence (SI), respectively were the primary predictors for students' intention to use e-training. These factors explained 32.1% of the variance in students' behavioral intentions. As far as students' gender is concerned, there were significant differences between students' PE, FC, and SI. Based on these results, policymakers at IAU will have a clear image of the most essential factors that colleges should target to increase students' acceptance of e-training.
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http://dx.doi.org/10.1007/s10639-021-10701-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8438100PMC
September 2021

Role of green innovation, trade and energy to promote green economic growth: a case of South Asian Nations.

Environ Sci Pollut Res Int 2021 Aug 30. Epub 2021 Aug 30.

Institute of Business Studies, Kohat University of Science and Technology (KUST), Kohat, Pakistan.

The objective of this study is to contribute to the existing debate of green economic growth by empirically investigating the role of cleaner energy production, green innovation, and green trade in green economic growth in the context of South Asian countries. For this purpose, the study collects the data of South Asian Economies for 2000-2018 from different sources such as world development indicators (WDI), International Energy Statistics (IES), and Organization for Economic Co-operation and Development (OECD) statistics. The study applied Pesaran's (2007) second-generation unit root test to test the stationarity of the data. Wasteland's (2007) test of cointegration was applied to examine the long-run association among modeled variables. The study confirmed the long-run association among modeled variables that turn to be stationary at the first differences. Moreover, the study applied fully modified least square (FMOLS) and dynamic least square (DOLS) to estimate the empirical results of the study. Results of the study show that the production of clean energy, green innovation, and green trade positively contributes to the green economic growth of South Asian Economies Graphical abstract.
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http://dx.doi.org/10.1007/s11356-021-15881-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8404544PMC
August 2021

The Unforeseen Diagnosis: Hyperparathyroidism-Jaw Tumour Syndrome Case Report and Review of the Literature.

Case Rep Endocrinol 2021 20;2021:5551203. Epub 2021 May 20.

Milton Keynes University Hospital, Standing Way, Eaglestone, Milton Keynes MK6 5LD, UK.

Hypercalcaemia and its systemic sequelae are a relatively common finding amongst patients in the field of endocrinology. Primary hyperparathyroidism, a frequent cause of hypercalcaemia, is often seen among middle-aged female patients, typically resulting from an underlying single-gland adenoma. Although patients may present with symptoms (nephrolithiasis, musculoskeletal discomfort, dehydration, or mood disturbance, to name a few), hypercalcaemia is rather frequently identified incidentally. In younger patients, a familial form of primary hyperparathyroidism must be considered, with a positive diagnosis mandating familial screening. Hyperparathyroidism-jaw tumour syndrome is one such autosomal dominant familial disorder, characterised by a mutation in the cell division cycle 73 (CDC73; also known as HRPT-2) tumour suppressor gene. This disorder is characterised by multiple pleiotropic phenomena, including recurrent primary hyperparathyroidism (and the effects of hypercalcaemia), neoplasms (such as uterine, renal, mandibular, and maxillary), and infertility. A patient not conforming to the classic candidacy for primary hyperparathyroidism requires consideration for a familial cause. . We present a rare diagnostic entity-hyperparathyroidism-jaw tumour (HPT-JT) syndrome-in a 36-year-old female with recurrent primary hyperparathyroidism, frequent nephrolithiasis, and infertility for 18 years prior to the diagnosis. We aim to promote awareness amongst medical professionals of this rare, but nonetheless essential differential diagnosis through a case report and review of the literature. . Medical professionals must avoid diagnostic overshadowing and display a low threshold for genetic testing in younger patients with primary hyperparathyroidism. The importance of proper identification extends beyond the patient to their relatives and offspring.
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http://dx.doi.org/10.1155/2021/5551203DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8159647PMC
May 2021

Evaluation and HPLC characterisation of a new herbal ointment for the treatment of full-thickness burns in rats.

J Taibah Univ Med Sci 2021 Apr 13;16(2):152-161. Epub 2020 Dec 13.

Department of Pharmacognosy, Faculty of Pharmacy, Al-Azhar University, Nasr City, Egypt.

Objective: Burn injuries are among the most common accidental health problems worldwide, frequently leading to health and socio-economic challenges. Despite this, no standard protocol for managing burn injuries can overcome the adverse effects of currently used drugs. The present study sets out to develop and evaluate the efficacy of new herbal ointments in providing synergistic anti-inflammatory, antimicrobial, antioxidant, and cell-proliferating activities. It also investigates the high-performance liquid chromatography (HPLC) characterisation of these new herbal ointments.

Method: Three different concentrations of the new herbal ointment, which incorporates extracts of flower heads, arial parts of , leaves, roots, and myrrh were developed and evaluated. Ointments designed to promote burn-wound healing were prepared and compared with β-sitosterol ointment and silver sulfadiazine cream, as a commercial standards.

Results: According to statistical and histopathological analyses and visual inspections, the new herbal formulas showed faster wound healing, more tolerability, and less toxicity than the commercial standards.

Conclusion: The new herbal ointments, developed in our study, have shown promising results. The formula offers mechanical protection without any release of non-biodegradable particles. It maintains the optimum moisture and pH of the skin, while minimising scar-tissue formation. These advantages, in addition to availability, low costs, and easy handling, may support the use of this new herbal formula as an effective and safe alternative treatment, designed to promote the healing of burn injuries.
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http://dx.doi.org/10.1016/j.jtumed.2020.10.023DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8046957PMC
April 2021

Impact of economic freedom on air pollution: configuration analysis of Asia-Pacific region.

Environ Sci Pollut Res Int 2021 Sep 25;28(35):47932-47941. Epub 2021 Apr 25.

Lyallpur Business School, Government College University, Faisalabad, Pakistan.

Air pollution brings uncountable serious influences on human life during the last decade. This study is an attempt to compare economic liberalism with economic federalism in examining the problem of air pollution in the Asia-Pacific region. Economic analysts have different views with one school of thought arguing that air pollution is the cause of the failure of a free economy rather than the failure of government regulations, while another supports liberal economics and vice versa. After developing a conceptual framework, the study uses the technique of fuzzy set qualitative comparative analysis (fsQCA) to examine how the rule of law, the size of government, regulatory efficiency, and the openness of the market influence air pollution in countries across the region. The analysis identifies two solutions with government size being found to be a necessary and core condition that influences air pollution. The study thus provides insights and suggests that government spending, taxation, and other financial health policies can be used as key sources to control air pollution in the Asia-Pacific region.
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http://dx.doi.org/10.1007/s11356-021-13681-4DOI Listing
September 2021

Systematic development of a bioanalytical UPLC-MS/MS method for estimation of risperidone and its active metabolite in long-acting microsphere formulation in rat plasma.

J Chromatogr B Analyt Technol Biomed Life Sci 2020 Dec 29;1160:122433. Epub 2020 Oct 29.

Department of Pharmaceutics, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, India. Electronic address:

A systematic approach to develop a UPLC-MS/MS method was applied for quantifying of risperidone (RISP), its active metabolite, 9-hydroxy risperidone (9-OH-RISP) and internal standard (propranolol) in rat plasma. Liquid-liquid extraction was performed using methyl tert-butyl ether for quantification of drug and its active metabolite by MS detection in the positive ion mode. Acquity UPLC system with BEH C18 (2.1 mm × 100 mm, particle size 1.7 μm) column was used along with acetonitrile (0.1% formic acid)-2 mM (milli mole) ammonium acetate in isocratic condition was used as the mobile phase. Detection was performed by multiple reactions monitoring with precursor-to-product ion transitions with m/z 411.2 → 191.0 for RISP, m/z 427.2 → 207.0 for 9-OH-RISP and m/z 260.1 → 116.0 for IS. The method was validated as per the FDA guidance on bioanalytical method validation. Linearity (r = 0.999) was observed in the drug concentration ranging between 0.1 and 50 ng mL, while all other parameters were found to be within the acceptable ranges. Method robustness was optimized by Box-Behnken design to monitor the influential variables to achieve maximal recovery of the analytes in the rat plasma. Pharmacokinetic evaluation of the analytes from long-acting microparticles in rat plasma showed two peaks indicating an initial burst effect within 24 h of administration followed by controlled drug release pattern upto 45 days, while marketed formulation (Risperdal Consta®) showed no plasma concentration during the lag-time of 21 days followed by maximal drug absorption between 28 and 40 days.
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http://dx.doi.org/10.1016/j.jchromb.2020.122433DOI Listing
December 2020

Design and Implementation of an Electronic Tool to Measure Medication Adherence at the Point of Care.

Clin Diabetes 2020 Oct;38(4):382-385

Parkland Health & Hospital System, Dallas, TX.

Quality Improvement Success Stories are published by the American Diabetes Association in collaboration with the American College of Physicians and the National Diabetes Education Program. This series is intended to highlight best practices and strategies from programs and clinics that have successfully improved the quality of care for people with diabetes or related conditions. Each article in the series is reviewed and follows a standard format developed by the editors of . The following article describes a project to build a point-of-care tool for assessing patients' adherence to their prescribed medications.
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http://dx.doi.org/10.2337/cd20-0011DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7566927PMC
October 2020

Non-linear relationship between tourism, economic growth, urbanization, and environmental degradation: evidence from smooth transition models.

Environ Sci Pollut Res Int 2021 Jan 25;28(2):1426-1442. Epub 2020 Aug 25.

Department of Economics & Management Sciences, NED University of Engineering & Technology, Karachi, Pakistan.

The study aims to analyze two objectives: first is to explore the non-linear relationship between tourism development, economic growth, urbanization, and environmental degradation, and also to analyze the threshold level of the contribution of tourism development on environmental degradation in top tourist arrival destinations. We applied the newly proposed econometric method panel smooth transition regression (PSTR) framework with two regimes on yearly panel data from 1995 to 2017. Findings suggest that the relationship between tourism development and environmental degradation is non-linear and regime dependent. Furthermore, the findings indicated that the relationship above the threshold level is negative and significant, while below the threshold, tourism development is positive and significant effect on environmental degradation. Tourism development and environmental degradation also exhibit the inverted U-shape relationship meaning that at a particular point, increase in tourism development increases in environmental degradation but after a particular point, increase in tourism development decreases the environmental degradation. The economic growth and urbanization also portray a non-linear and regime-dependent relationship with environmental degradation. The study assists policies and empirical information.
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http://dx.doi.org/10.1007/s11356-020-10179-3DOI Listing
January 2021

Non-linear threshold effect of financial development on renewable energy consumption: evidence from panel smooth transition regression approach.

Environ Sci Pollut Res Int 2020 Sep 6;27(25):32034-32047. Epub 2020 Jun 6.

Department of Economics & Management Sciences, NED University of Engineering & Technology, Pakistan, Karachi, Pakistan.

Financial development is identified as one of the significant factors that affect energy consumption and has been widely discussed in the literature. However, the association between financial development and renewable energy consumption is still at its earlier stage and is limitedly explored. Therefore, the purpose of this study is to examine the non-linear association between financial development and renewable energy consumption in the top renewable energy consumption countries. The study utilized the newly introduced econometric technique panel smooth transition regression (PSTR) model with two regimes on annual panel data consisted of years 1997-2017. The result confirmed that all the financial development indicators increase renewable energy consumption but affect renewable energy consumption differently. Moreover, the economic growth and industrial structure showed a positive and significant association in both regimes, whereas the population showed a negative relationship with renewable energy consumption in a low growth regime but the association becomes positive in high growth regimes. The study suggested several policies for the top renewable consumption countries.
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http://dx.doi.org/10.1007/s11356-020-09520-7DOI Listing
September 2020

Oral Rivaroxaban in Symptomatic Deep Vein Thrombosis.

J Coll Physicians Surg Pak 2019 Sep;29(9):814-818

Department of General Medicine, Pakistan Institute of Medical Sciences (PIMS), Islamabad, Pakistan.

Objective: To evaluate the efficacy of oral rivaroxaban compared to warfarin in patients with deep vein thrombosis (DVT).

Study Design: Open label randomized controlled study.

Place And Duration Of Study: Department of General Medicine, Pakistan Institute of Medical Sciences (PIMS), Islamabad from January 2016 to January 2018.

Methodology: Patients of both genders between 18 and 60 years of age with Doppler ultrasound-confirmed DVT were included in the study. Pregnant patients and those with advanced liver, renal disease, those with a previous history of DVT, malignancy, with a platelets count of less than 50000/ul were excluded from the study. Rivaroxaban was given in a dose of 15 mg twice daily for 21 days followed by 20 mg once daily. Patients in the warfarin group were given heparin for 3 to 5 days followed by warfarin for 3 to 6 months. The primary efficacy outcome was patency of the vessel at 3 and 6 months of treatment. The principal safety outcomes were major and minor bleeding during the study period.

Results: A total of 151 patients with acute symptomatic deep vein thrombosis were enrolled in the study. Half of the patients were given warfarin and the other half rivaroxaban for 6 months. At three months, there were no significant differences observed in vessel patency in the rivaroxaban group (22.4%) as compared to warfarin group (26.7%) but after 6 months of therapy, vessel patency was significantly more in the rivaroxaban group. Adverse events did not show any significant differences Conclusion: Rivaroxaban had an efficacy superior to warfarin in terms of vessel patency after six months of therapy but adverse events were similar in both the groups.
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http://dx.doi.org/10.29271/jcpsp.2019.09.814DOI Listing
September 2019

Functionalized mesoporous silica nanoparticles in anticancer therapeutics.

Semin Cancer Biol 2021 Feb 20;69:365-375. Epub 2019 Aug 20.

Department of Pharmaceutics, School of Pharmaceutical Education & Research, Jamia Hamdard (Hamdard University), New Delhi, India. Electronic address:

The application of nanomedicines in tumor targeting and attaining meaningful therapeutic benefits for the treatment of cancers has been going on for almost two decades. Beyond the lipidic and polymeric nanomedicines-based passive and active targeting, the quest for inventing the new generation of carriers has no end. This has lead to the evolution of some of the unique carrier systems with supramolecular assembly structures. Mesoporous nanoparticulate systems (MSNPs) are the recently explored substances with favorable potential for drug delivery and drug targeting applications especially in cancer chemotherapeutics. Notwithstanding their physical properties that makes them a suitable carrier for cancer treatment, but their outstanding ability towards chemical functionalization helps in delivering the imaging agents for diagnostic applications. MSNPs can improve the dissolution rate and systemic availability of the poorly water soluble drugs due to their mesoporous structures. Besides, guest molecules including targeting ligands, biomimetic agents, fluorescent dyes, and biocompatible polymers can be efficiently encapsulated in their tunable porous structure for targeting purpose. Some special features of the MSNPs which make them one of the highly effective nanocarrier systems include their ability to encapsulate non-crystalline drugs in their mesopores, high dispersion ability as a function of large surface area and wetting properties. For anticancer drug delivery, MSNPs are worthful to provide excellent drug loading capacity and endocytotic behavior. Moreover, the external surface of MSNPs can be precisely modified for tumor-recognition and developing sensitivity of the antitumor agents towards the cancer cells. Owing to the innumerable applications of MSNPs till now in cancer treatment, the present article particularly focuses to provide an overview account with complete details on the topic to make the readers abreast with details on physiochemical and material properties of MSNPs, their applications and current innovations for the purpose.
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http://dx.doi.org/10.1016/j.semcancer.2019.08.022DOI Listing
February 2021

Bexarotene in Patients With Peripheral T-cell Lymphomas: Results of a Retrospective Study.

Clin Lymphoma Myeloma Leuk 2019 02 13;19(2):109-115. Epub 2018 Oct 13.

Lymphoma Program, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA. Electronic address:

Background: Peripheral T-cell lymphomas (PTCLs) are generally aggressive non-Hodgkin lymphomas that portend poor prognosis with currently available therapies. Bexarotene, a retinoic acid derivative, has efficacy in cutaneous T-cell lymphomas, but its activity in PTCL is unknown.

Patients And Methods: We conducted a retrospective, single-institution, review of off-label bexarotene therapy in patients with PTCL between 2005 and 2016.

Results: Twelve patients were treated with bexarotene as monotherapy: 3 patients with PTCL, not otherwise specified, and 9 patients with angioimmunoblastic T-cell lymphoma. Bexarotene doses of 300 mg/m daily or 150 mg/m were used for all patients. The treatment was well-tolerated. The most common toxicities included hypothyroidism and hyperlipidemia, which were effectively managed. The overall response rate for all patients was 58% with a median duration of response of 11 months (95% confidence interval [CI], 1.3 months to not estimable). Among patients with angioimmunoblastic T-cell lymphoma, there was a 44% overall response rate. The median progression-free survival for all patients was 2.1 months (95% CI, 1.1 months to not estimable), and the median overall survival was 14.9 months (95% CI, 2.1-73.1 months).

Conclusion: Bexarotene monotherapy is well-tolerated and has encouraging activity in PTCL that warrants further investigation in prospective clinical trials.
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http://dx.doi.org/10.1016/j.clml.2018.10.001DOI Listing
February 2019

Fabrication and Characterization of Core-Shell Nanofibers Using a Next-Generation Airbrush for Biomedical Applications.

ACS Appl Mater Interfaces 2018 Dec 28;10(49):41924-41934. Epub 2018 Nov 28.

Department of Biomedical Engineering , Indian Institute of Technology Hyderabad , Kandi , Telangana 502285 , India.

The core-shell polymeric nanofiber, owing to its better controlled release of embedded or encapsulated drugs in contrast with the single-compartment nanofibers, has been extensively studied for biomedical applications such as tissue engineering and wound healing. Electrospinning with co-axial needles is the dominant technique to fabricate nanofiber mat, however, associated with potential limitations such as high voltage requirement, costly equipment, slow deposition rate, required trained personal, not suitable in situ fabrication, and direct deposition of core-shell nanofibers on the wound at patient bedside. To address the above limitations, the work aims to introduce a novel co-axial airbrushing method to fabricate core-shell nanofibers using a simple setup and low-cost equipment, yet having a unique ability for fabrication at patient bedside and direct deposition on wound bed. Air-brush with a coaxial needle is designed to flow two different polymers solution with model biomolecules through core [PEO (polyethylene oxide)/poly-dl-lactide/PCL (polycaprolactone)] and shell (PCL/PEO) needle for the fabrication of the model core-shell nanofiber. Various processing parameters such as flow rate, air pressure, working distance, and concentration of polymer solution which affect the morphology of core-shell nanofibers were studied and found to have a prominent effect. The PCL-PEO nanofiber possesses a defined shell and core structure, tunable sustained release behavior of model proteins (bovine serum albumin and basic fibroblast growth factor; bFGF), and improved mechanical strength. In vitro interaction of human bone marrow-derived mesenchymal stem cells with core-shell fibers demonstrated the cytocompatibility and proliferative and differentiative (for bFGF loaded) properties of the core-shell nanofiber mat. Co-axial airbrushing can be used as a superior less-expensive technique for the fabrication of biomolecules/drug encapsulated core-shell fibers scaffold at patient bedside, which can mimic complex in vivo environment and could modulate cells behavior close to their in vivo condition for tissue regeneration and wound healing.
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http://dx.doi.org/10.1021/acsami.8b13809DOI Listing
December 2018

Evaluation of Antiproliferative Activity, Safety and Biodistribution of Oxaliplatin and 5-Fluorouracil Loaded Lactoferrin Nanoparticles for the Management of Colon Adenocarcinoma: an In Vitro and an In Vivo Study.

Pharm Res 2018 Jul 16;35(9):178. Epub 2018 Jul 16.

Department Biotechnology and Bioinformatics, School of Life Sciences, University of Hyderabad, Hyderabad, 500046, India.

Purpose: Colon adenocarcinoma is the most common form of gastro intestinal tract cancer, predominantly in ageing population. Chemotherapy with 5-Fluorouracil and oxaliplatin is an indispensable treatment regimen, nevertheless having limitation of systemic toxicity and lower therapeutic index. The present study is based on evaluation of anti-proliferative potential, pharmacokinetics parameters, safety profile, biodistribution and efficacy of 5-FU/oxaliplatin loaded lactoferrin nanoparticles in cell lines and wistar rats in order to overcome the above limitation.

Methods: Nanoparticles were prepared by Water-in-oil process. The anti-proliferative efficacy and mode of cellular entry was evaluated in COLO-205 cells. The pharmacokinetics and biodistribution analysis were performed in healthy rats while efficacy and safety assay were performed in ACF induced rats.

Results: 5-FU and oxaliplatin loaded nanoparticles shows enhanced antiproliferative activity as compare to free drugs in COLO-205 cells. Lactoferrin nanoparticles also improve the pharmacokinetics profile, safety parameters and efficacy of 5-FU and Oxaliplatin.

Conclusion: Lactoferrin nanoparticles demonstrated an attractive drug delivery module to manage the colon adenocarcinoma as it has improved the antiproliferative activity of 5-FU and Oxaliplatin against colon adenocarcinoma cells. Moreover, it also improves the pharmacokinetic profile and safety parameters of the same drug in wistar rat.
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http://dx.doi.org/10.1007/s11095-018-2457-7DOI Listing
July 2018

Assessment of the antioxidant, thrombolytic, analgesic, anti-inflammatory, antidepressant and anxiolytic activities of leaf extracts and fractions of Tetracera sarmentosa (L.) Vahl.

J Basic Clin Physiol Pharmacol 2018 Jan;29(1):81-93

Department of Pharmacy, International Islamic University Chittagong, Chittagong, Bangladesh.

Background: The plant under investigation (Tetracera sarmentosa) is a dicotyledonous flowering plant and belongs to the family Dilleniaceae. The goal of our investigation was to determine whether the leaf extracts of this plant held any significant medicinal properties.

Methods: Leaves of T. sarmentosa were extracted with pure ethanol (EETS) and methanol (METS), and then methanol extract fractioned with n-hexane (NHFMETS) and chloroform (CHFMETS). The extracts and fractions were tested for antioxidant activity, which was measured by using qualitative and quantitative procedures. Thrombolytic activity was evaluated by the clot lysis test. Analgesic activity was evaluated employing the acidic acid-induced writhing test, the formalin-induced paw licking test and tail immersion on Swiss albino mice. The anti-inflammatory activity test was studied using the paw edema test. Forced swimming, tail suspension, elevated plus maze and hole board model tests were used to evaluate neuropharmacological activity.

Results: All the extracts and fractions possessed antioxidant effects. All the extracts, fractions and streptokinase exhibited significant (p<0.0001) clot lysis. The extracts and fractions produced significant analgesic effects as evaluated by the acetic acid writhing test, the formalin-induced paw licking test and the tail immersion method. Similarly, carrageenan-induced inflammation was significantly antagonized by the treatments. The extracts and fractions also significantly showed neuropharmacological (antidepressant and anxiolytic) effects.

Conclusions: The overall results suggested that this plant deserves further investigation to isolate the active compounds which are responsible for these activities and to establish the mechanism of action.
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http://dx.doi.org/10.1515/jbcpp-2016-0173DOI Listing
January 2018

Depression In Type-2 Diabetic Patients Presenting To A Tertiary Care Hospital In Pakistan.

J Ayub Med Coll Abbottabad 2017 Apr-Jun;29(2):262-265

Department of General Medicine, Pakistan Institute of Medical Sciences Islamabad, Pakistan.

Background: Diabetes affects almost every system including mental health. When depression and diabetes coexist, the outcome is even worse. This study was conducted to find the prevalence of comorbid depression in diabetic patients and its association with diabetic control.

Methods: This was a descriptive cross sectional observational study conducted in the department of general medicine of Pakistan Institute of Medical Sciences, Islamabad from March to September 2014. A total of 223 adult diabetic patients 30-60 years of age were enrolled. Becks Depression score (BDI) and HDRS (Hamilton Depression Rating Score) of each patient was calculated. Patients were stratified into various categories based on their demographics, depressions scores and diabetic control (by means of HbA1C). Percentages, frequencies and means were calculated accordingly using SPSS-16.

Results: Out of a total of 223 patients, 55.6% were females while the rest (44.4%) were males. The mean age of the patients was 51 years. Majority of the patients were uneducated (35.9%). Eighty-seven% were married, Mean BMI, duration of diabetes and HbA1C were 27 Kg/m2, 8.3 years±6.1 years and 8.15±2.13% respectively. Mean BDI and HDRS were 9.97±9.42 and 6.27±6.74 respectively. 25.6% and 21.1% of the patients had at least some degree of depression when assessed by BDI and HDRS score respectively..

Conclusions: Depression is common in diabetic patients especially females, uneducated, have social issues like widows, those having long standing diabetes and those who have uncontrolled blood sugars.
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April 2019

Comparison of Lipoprotein Electrophoresis and Apolipoprotein E Genotyping in Investigating Dysbetalipoproteinemia.

J Coll Physicians Surg Pak 2017 Jun;27(6):378-379

Department of Clinical Pathology, Northampton General Hospital, Cliftonville, Northampton, UK.

Dysbetalipoproteinemia is often associated with apolipoprotein E2E2 homozygosity; however, lipoprotein electrophoresis may also be used to assist in the diagnosis. The aim of this study was to compare apolipoprotein E (apo E) genotyping and lipoprotein electrophoresis in investigating dysbetalipoproteinemia. Data were collected over a three-year period from a lipid clinic in a tertiary referral centre and reviewed for apo E genotyping and lipoprotein electrophoresis. Sixty-two patients had both apo E genotyping and lipoprotein electrophoresis. Of these, 16 patients showed broad beta band on electrophoresis. However, only 3 of them had apo E2E2 homozygosity on genotyping. Lipoprotein electrophoresis and apo E genotyping results showed poor concordance. This was primarily due to visual interpretation error of lipoprotein electrophoresis which may over diagnose dysbetalipoproteinemia.
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http://dx.doi.org/2642DOI Listing
June 2017

Usefulness of Hemodynamically Distribution of Intranodal Vessels in Differentiating Metastatic Neck Lymph Nodes - Value of Color Doppler and Spectral Wave Sonogram.

J Coll Physicians Surg Pak 2017 May;27(5):279-282

Medical Student, Quaid-e-Azam Medical College, Bahawalpur.

Objective: To evaluate the diagnostic assessment of enlarged lymph nodes, based on its perfusion pattern by taking tissue diagnosis as gold standard.

Study Design: Analytical study.

Place And Duration Of Study: Departments of Radiology and Pathology, PIMS Hospital, Islamabad, from February to May 2016.

Methodology: Color sonography of patients with clinically, palpable cervical lymph nodes were carried by senior trainee under the supervision of senior radiologist. Ultrasound guided tissue diagnosis was obtained in all suspected malignant cases. Histopathology was taken as the gold standard for determining accuracy.

Results: Accuracy, sensitivity and specificity, positive and negative predictive values of color Doppler ultrasound in detecting malignant cervical lymphadenopathy was found to be 88.46%, 86.05%, 79.31% and 92.50%, respectively with diagnostic accuracy of 86.95%, when intranodal vascular pattern on color Doppler imaging was analyzed. Using spectral wave indexes, the same values were 92.31%, 90.70%, 85.71%, 95.12%, respectively with overall diagnostic accuracy of 91.30%.

Conclusion: Color Doppler sonography is much sensitive borderline than grey scale findings alone. Furthermore, lymph nodes appearing in the detection of malignant nodes on grey scale images can be reliably diagnosed on Doppler scan.
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http://dx.doi.org/2612DOI Listing
May 2017

In vivo analgesic, antipyretic and anti-inflammatory potential of leaf extracts and fractions of Eria javanica.

J Complement Integr Med 2017 Mar;14(1)

Background The objective of the study was to evaluate the antinociceptive, antipyretic and anti-inflammatory activities of ethanolic extract, methanolic extract and n-hexane and chloroform-soluble fractions of methanolic extract of Eria javanica leaves in animal model (rat and mice). Methods The anti-nociceptive potentials of the extracts were studied using the acetic acid-induced writhing test in mice and the antipyretic activity was investigated using yeast-induced pyrexia in rats. Anti-inflammatory activity test was done on rats at a dose by using carrageenan-induced paw edema test. Results In acetic acid-induced writhing inhibition study in Swiss albino mice, the crude methanolic extract at 200 mg/kg and 400 mg/kg doses and the n-hexane soluble fraction of crude methanolic extract at 400 mg/kg showed statistically significant activity with 53.21 % (p<0.001), 50.36 % (p<0.001) and 67.86 % (p<0.001) inhibition respectively compared to control. The crude ethanolic extract showed statistically significant antipyretic activity from 1 hours and onwards after administration at doses of 200 mg/kg body weight (p<0.005 at 1st hour and p<0.001 at 2nd, 3rd and 4th hour respectively) and 400 mg/kg body weight (p<0.05 at 1st hour and p<0.001 at 2nd, 3rd and 4th hour respectively). The crude methanolic extract showed statistically significant antipyretic activity from 2 hours and onwards at 400 mg/kg body weight (p<0.05 at 2nd hour and p<0.001 at 3rd and 4th hour respectively) and 200 mg/kg body weight dose showed statistically significant antipyretic activity from 3 hours and onward(p<0.001) in Brewer's yeast-induced pyrexia test in albino Wister rats. In carrageenan-induced rat's paw edema test, crude methanolic extract showed statistically significant anti-inflammatory activity from 2nd hour and onwards. The chloroform-soluble fraction of methanolic extract also showed significant activity from 1st hour onwards. Conclusions This study thereby indicates that leaves of E. javanica possess peripheral analgesic, antipyretic and anti-inflammatory activities and therefore a suitable candidate for further study.
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http://dx.doi.org/10.1515/jcim-2016-0040DOI Listing
March 2017

The forgotten disease - Lemierres syndrome.

J Pak Med Assoc 2016 12;66(12):1652-1655

Pakistan Institute of Medical Sciences, Islamabad.

Lemierre's syndrome refers to septic thrombosis of deep veins of the neck, is a rare and often life threatening complication following upper respiratory tract infections. We present here a case of Lemierre's syndrome in a previously healthy 30 years old female who had a febrile illness for two weeks with associated dysphagia, hoarse voice and right sided neck swelling. She was investigated for retropharyngeal and parapharyngeal abscess, granulomatosis with polyangiitis, tuberculosis and thyroiditis but finally concluded as Lemierre's syndrome based on the findings of thrombosis of the deep neck veins following respiratory tract infection, septic pulmonary emboli and clinical recovery with antibiotics and supportive care. Lemierres syndrome can be fatal if diagnosis and treatment is delayed. Strong clinical suspicion leads to early diagnosis and may prevent life threatening organ dysfunction.
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December 2016

A vaginal drug delivery model.

Drug Deliv 2016 Oct 14;23(8):3123-3134. Epub 2016 Mar 14.

a Department of Pharmaceutics , Faculty of Pharmacy, Jamia Hamdard , New Delhi , India.

Efficient drug delivery at vaginal cavity is often a challenge owing to its peculiar physiological variations including vast differences in pH. Keeping in view this attribute of the target site, the current work was aimed at developing formulation strategies which could overcome this and successfully deliver molecules like itraconazole through SLNs. Optimized SLNs with the given composition was selected for further development into mucoadhesive and thermosensitive gel. Stearic acid and Compritol 888 (1:1, w/w ratio) as lipid, a mixture of 3% Poloxomer 188 and 0.5% sodium taurocholate as surfactant and organic to aqueous ratio of 10:50 was taken. Carbopol 934 and Pluronic F 127 were taken for the development of gel. Optimized gel exhibited a desired gelling temperature (35 °C); viscosity (0.920 PaS) and appreciable in vitro drug release (62.2% in 20 h). MTT assay did not show any cytotoxic effect of the gel. When evaluated in vivo, it did not exhibit any irritation potential despite appreciable bioadhesion. A remarkable decrease in CFUs was also observed in comparison with control and marketed formulation when evaluated in rat infection model. Thus, the proposed study defines the challenges for developing a suitable formulation system overcoming the delivery barriers of the vaginal site.
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http://dx.doi.org/10.3109/10717544.2016.1153749DOI Listing
October 2016

Optimized permeation enhancer for topical delivery of 5-fluorouracil-loaded elastic liposome using Design Expert: part II.

Drug Deliv 2016 May 24;23(4):1242-53. Epub 2015 Dec 24.

b Department of Pharmaceutics , Jamia Hamdard (Hamdard University) , New Delhi , India.

Objective: To prepare and optimize the topical elastic liposome (EL)-loaded carbopol-980 gel of 5-Fluorouracil (5-FU) containing permeation enhancers (azone, propylene glycol (PG) and lauryl alcohol (LA)) and further evaluation for permeation flux of 5-FU, the activation energy and irritation in the rat skin.

Methods: EL formulations were prepared using phosphatidylcholine and varied surfactants (Span 60, Span 80 and Tween-80) by rotator evaporation method and optimized by experimental design. In vitro characterizations dictated the EL containing Span 80 (lipid:surfactant = 7:3) (EL3-S80) for further optimization of gel. Different gel formulations (5% w/w) with varying concentration (1-3%) of permeation enhancers were prepared and evaluated for viscosity, spreadability, the 5-FU permeation and deposition. The activation energy using the Franz diffusion cell and the plausible irritation using the Draize test were assessed on the albino rat and rabbit, respectively.

Results And Discussion: EL3-S80 was selected as an optimized EL owing to maximum desirability (0.99) and enhanced 5-FU flux (187.86 ± 14.1 μg/cm(2)/h). EL3-S80 suspension loaded gels (0.5%) revealed reduced viscosity leading to higher spreadability than blank gel. EL containing 3% azone in gel, EL containing 3% LA in gel and EL containing 3% PG in gel portrayed 187.86 ± 14.1, 117.7 ± 13.4 and 106.7 ± 7.3 μg/cm(2)/h as enhanced 5-FU flux values, respectively as compared to drug solution (8.8 ± 0.76 μg/cm(2)/h). Furthermore, reduced value of activation energy (2.63-folds) and the non-irritancy of gel could be effective and safe.

Conclusion: ELA-3 gel formulation could be used as an effective and economic gel in cutaneous cancer and skin-related keratoses.
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http://dx.doi.org/10.3109/10717544.2015.1124473DOI Listing
May 2016

Bone-specific alkaline phosphatase by immunoassay or electrophoresis: their use in clinical practice.

J Clin Pathol 2015 Mar 24;68(3):246-8. Epub 2014 Dec 24.

Department of Clinical Pathology, Nottingham University Hospitals, Nottingham, UK.

Background: Measurement of bone-specific alkaline phosphatase (BALP) may be useful in diagnosing and monitoring metabolic bone disease. This study aimed to evaluate the BALP immunoassay and compare it with electrophoresis (densitometry) for the quantitation of BALP.

Methods: Metra BALP immunoassay kits were used for the method comparison. BALP was also quantitated by electrophoresis (densitometry) in seven patients with active Paget's disease.

Results: Immunoassay results did not correlate well with densitometrically quantitated BALP, as there was a statistically significant (p<0.01), negative bias (22%) for results obtained by immunoassay compared with those derived by densitometry. Possible interference in the immunoassay with other isoforms of alkaline phosphatase (ALP) such as liver, placental and intestinal was also observed. The Metra BALP immunoassay is quoted as having an upper dynamic limit of 140 U/L and recommends that samples only require dilution above this level; we observed inconsistent results upon dilution of samples below this level.

Conclusions: Immunoassay and electrophoresis did not correlate well for BALP quantitation. Possible interference with other isoforms of ALP was observed with the BALP immunoassay. The accuracy of the BALP immunoassay is questionable at higher concentrations.
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http://dx.doi.org/10.1136/jclinpath-2014-202766DOI Listing
March 2015

Carboplatin loaded protein nanoparticles exhibit improve anti-proliferative activity in retinoblastoma cells.

Int J Biol Macromol 2014 Sep 1;70:572-82. Epub 2014 Aug 1.

Department Biotechnology and Bioinformatics, School of Life Sciences, University of Hyderabad, India. Electronic address:

Retinoblastoma, a common neoplasm of eye in children accounts about 9-10% of all paediatric cancer. Carboplatin (carbo) is preferred chemotherapeutic regimen. In this study the prospective of carboplatin loaded apotranferrin (Apo-nano-carbo) and lactoferrin (Lacto-nano-carbo) nanoparticles have been demonstrated for the treatment of retinoblastoma. Apo-nano-carbo and Lacto-nano-carbo were prepared by sol-oil method (as a patented formula) with size of 82-92 nm and 68-81 nm, hydrodynamic size were 142±15 nm and 263±20 nm, encapsulation efficiency were 50%±2.3 and 52%±3.9 respectively. Results of pH dependent-drug release and receptor-blocking assay showed that nanoparticles may deliver drug through receptor mediated endocytosis. The carboplatin loaded nanoparticles shows greater intracellular uptake, sustained retention and thus, high anti-proliferative activity (Apo-nano-carbo IC50=4.31 μg ml(-1), Lacto-nano-carbo IC50=4.16 μg ml(-1), Sol-carbo IC50=13.498 μg ml(-1)) into the retinoblastoma cells compared to their soluble counterpart.
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http://dx.doi.org/10.1016/j.ijbiomac.2014.07.041DOI Listing
September 2014

CSF xanthochromia: correlation with brain imaging and its usefulness as an out-of-hours test.

J Clin Pathol 2014 Aug 16;67(8):736-8. Epub 2014 May 16.

Department of Clinical Pathology, Nottingham University Hospitals, Nottingham, UK.

Background: Subarachnoid haemorrhage (SAH) is a spontaneous bleed into the subarachnoid space which is investigated by CT head and cerebrospinal fluid (CSF) xanthochromia. The aim of this study was to compare CSF xanthochromia with brain imaging and evaluate the need for out of hours (OOH) testing for CSF xanthochromia.

Method: Discharge summaries and brain imaging of patients with positive xanthochromia screen were reviewed over 12 months retrospectively. Timings of CSF xanthochromia and hospital discharge of 30 consecutive patients with negative xanthochromia screen were also examined.

Results: From 289 xanthochromia requests, 23 were positive but only 2 patients had an actual bleed. In 30 consecutive negative xanthochromia results, all brain imaging results suggested no bleed. Eight of these requests were performed OOH, and as a result, 1 patient was discharged early.

Conclusions: CSF xanthochromia has a poor positive predictive value (8.7%) but has a good negative predictive value (100%) for SAH. Analysis of CSF xanthochromia OOH, in patients with negative CT head, did not speed up the discharge process from the hospital.
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http://dx.doi.org/10.1136/jclinpath-2014-202193DOI Listing
August 2014

Chylothorax diagnosis: can the clinical chemistry laboratory do more?

Ann Clin Biochem 2015 Jan 8;52(Pt 1):173-6. Epub 2014 Apr 8.

Nottingham University Hospitals, Nottingham, UK.

Background: Chylothorax is a rare anatomical disruption of the thoracic duct associated with a significant degree of morbidity and mortality. Diagnosis usually relies upon lipid analysis and visual inspection of the pleural fluid. However, this may be subject to incorrect interpretation. The aim of this study was to compare pleural fluid lipid analysis and visual inspection against lipoprotein electrophoresis.

Methods: Nine pleural effusion samples suspected of being chylothorax were analysed. A combination of fluid lipid analysis and visual inspection was compared with lipoprotein electrophoresis for the detection of chylothorax.

Results: There was 89% concordance between the two methods. Using lipoprotein electrophoresis as gold standard, calculated sensitivity, specificity, negative predictive value and positive predictive value for lipid analysis/visual inspection were 83%, 100%, 100% and 75%, respectively.

Conclusion: Examination of pleural effusion samples by lipoprotein electrophoresis may provide important additional information in the diagnosis of chylothorax.
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http://dx.doi.org/10.1177/0004563214530677DOI Listing
January 2015

Enhanced stability and permeation potential of nanoemulsion containing sefsol-218 oil for topical delivery of amphotericin B.

Drug Dev Ind Pharm 2015 May 24;41(5):780-90. Epub 2014 Mar 24.

Department of Pharmaceutical Sciences, Birla Institute of Technology , Mesra, Ranchi, Jharkhand , India .

Aim: To characterize the enhanced stability and permeation potential of amphotericin B nanoemulsion comprising sefsol-218 oil at varying pH and temperature of aqueous continuous phase.

Methodology: Several batches of amphotericin B loaded nanoemulsion were prepared and evaluated for their physical and chemical stability at different pH and temperature. Also, a comparative study of ex vivo drug permeation across the albino rat skin was investigated with commercial Fungisome® and drug solution at 37 °C for 24 h. The extent of drug penetrated through the rat skin was thereby evaluated using the confocal laser scanning microscopy (CLSM).

Results And Conclusions: The optimized nanoemulsion demonstrated the highest flux rate 17.85 ± 0.5 µg/cm(2)/h than drug solution (5.37 ± 0.01 µg/cm(2)/h) and Fungisome® (7.97 ± 0.01 µg/cm(2)/h). Ex vivo drug penetration mechanism from the developed formulations at pH 6.8 and pH 7.4 of aqueous phase pH using the CLSM revealed enhanced penetration. Ex vivo drug penetration studies of developed formulation comprising of CLSM revealed enhanced penetration in aqueous phase at pH 6.8 and 7.4. The aggregation behavior of nanoemulsion at both the pH was found to be minimum and non-nephrotoxic. The stability of amphotericin B was obtained in terms of pH, optical density, globular size, polydispersity index and zeta potential value at different temperature for 90 days. The slowest drug degradation was observed in aqueous phase at pH 7.4 with shelf life 20.03-folds higher when stored at 4 °C (3.8 years) and 5-fold higher at 25 °C (0.951 years) than at 40 °C. The combined results suggested that nanoemulsion may hold an alternative for enhanced and sustained topical delivery system for amphotericin B.
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http://dx.doi.org/10.3109/03639045.2014.902957DOI Listing
May 2015

A target-specific oral formulation of Doxorubicin-protein nanoparticles: efficacy and safety in hepatocellular cancer.

J Cancer 2013 14;4(8):644-52. Epub 2013 Sep 14.

2. Department of Biochemistry, University of Hyderabad, and Hyderabad 500046 India; ; 3. Centre for Nanotechnology, University of Hyderabad, and Hyderabad 500046 India.

Background/aims: Hepatocellular carcinoma (HCC) also known as malignant hepatoma is a most common liver cancer. Doxorubicin (Doxo) is an anti-cancer drug having activity against a wide spectrum of cancer types. Clinical Utility of doxo has been limited due to its poor bioavailability and toxicity to heart and spleen. Furthermore, cancer chemotherapeutics have limited oral absorption. Transferrin family proteins are highly abundant and plays important role in transport and storage of iron in cells and tissues. Since apotransferrin and lactoferrin receptors are highly expressed on the surface of metabolically active cancer cells, the principal objective of present study is to evaluate efficacy of doxorubicin loaded apotransferrin and lactoferrin nanoparticles (apodoxonano or lactodoxonano) in oral treatment of HCC in rats.

Study Design: HCC was induced in rats by supplementing 100 mg/L of diethylnitrosamine (DENA) in drinking water for 8 weeks. A week after the last day of DENA administration, rats were divided into four groups, each group comprising of five animals. Each group was administered with one of the drug viz., saline, doxorubicin (doxo), apodoxonano and lactodoxonano (4 mg/ kg equivalent of drug). In each case, they received 8 doses of the drug orally with six day interval. One week after the last dose, anticancer activity was evaluated by counting the liver nodules, H & E analysis of tissue sections and expression levels of angiogenic and antitumor markers.

Results: In rats treated with apodoxonano and lactodoxonano, the number of neoplastic nodules was significantly lower than that of rats administered with saline or with doxo. Apodoxonano and lactodoxonano did not exhibit decrease in mean body weight, which was markedly reduced by 22% in the case of doxo administered rats. In rats treated with nanoformulations, the number of liver nodules was found reduced by >93%. Both nanoformulations showed significantly high localization in liver compared to doxo.

Conclusions: Apodoxonano and lactodoxonano showed improved efficacy, bioavailability and safety compared to doxo for treatment of HCC in rats when administered orally.
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http://dx.doi.org/10.7150/jca.7093DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3805992PMC
October 2013

Association between tumour volume and recurrence of squamous cell carcinoma of the head and neck.

J Pak Med Assoc 2012 Nov;62(11):1129-33

Aga Khan University Hospital, Karachi, Pakistan.

Objective: To evaluate the prognostic significance of computerized tomography derived tumour volume for squamous cell cancers of the head and neck, treated primarily by surgery.

Methods: The retrospective review study comprised 72 patients with head and neck malignancies who were treated primarily by surgery at Aga Khan University Hospital, Karachi, with/without adjuvant. It was done from May 2007 to November 2008. Each patient was followed up for a minimum of one year to check for recurrence. For statistical analysis SPSS 17 was used. Frequencies, cross-tabulations with chi square tests to find associations, binary logistic regression analysis, Cox regression analysis and receiver operating characteristic curve tests were run on the data.

Results: Overall, the median tumour volume for patients with recurrent disease was 52cm3 compared to 22cm3 for those who did not have a recurrence. It was found that large tumour volume was associated with a significantly higher chance of recurrence (p = 0.009). Laryngeal cancers with volumes greater than 46cm3 and oral cancers with volumes greater than 23.1cm3 were associated with poor prognosis.

Conclusions: The primary tumour volume can represent an important prognostic factor for treatment outcome. Patients with larger primary tumour volumes should be treated more aggressively.
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November 2012
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