Various Health News from Aga Khan University

• Cardamom lowers Blood Pressure: Aga Khan University
• Clinical Pharmacology; Reports from Aga Khan University, Medical Department highlight recent research in clinical pharmacology
• Suicide; Data from Aga Khan University provide new insights into suicide
• Heart Disease; Recent findings in heart disease described by researchers from Aga Khan University
• Just three days of antibiotics tackles pneumonia in children: Aga Khan University
• Tanzania: Cancer ‘Stalks Breastfeeding Women’ – Head of Surgery Aga Khan Hospital

Clinical Pharmacology; Reports from Aga Khan University, Medical Department highlight recent research in clinical pharmacology

2 May 2008 Drug Week
2008 MAY 2 – (NewsRx.com) — “This study describes the spasmolytic, antidiarrhoeal, antisecretory, bronchodilatory and urinary bladder relaxant properties of Hyoscyamus niger to rationalize some of its medicinal uses. The crude extract of H. niger seeds (Hn.Cr) caused a complete concentration-dependent relaxation of spontaneous contractions of rabbit jejunum, similar to that caused by verapamil, whereas atropine produced partial inhibition,” scientists writing in the journal Fundamental & Clinical Pharmacology report (see also Clinical Pharmacology).

“Hn.Cr inhibited contractions induced by carbachol (1 mc M) and K+ (80 mM) in a pattern similar to that of dicyclomine, but different from verapamil and atropine. Hn.Cr shifted the Ca2+ concentration-response curves to the right, similar to that caused by verapamil and dicyclomine, suggesting a Ca2+ channel-blocking mechanism in addition to an anticholinergic effect. In the guinea-pig ileum, Hn.Cr produced a rightward parallel shift of the acetylcholine curves, followed by a non-parallel shift with suppression of the maximum response at a higher concentration, similar to that caused by dicyclomine, but different from that of verapamil and atropine. Hn.Cr exhibited antidiarrhoeal and antisecretory effects against castor oil-induced diarrhoea and intestinal fluid accumulation in mice. In guinea-pig trachea and rabbit urinary bladder tissues, Hn.Cr caused relaxation of carbachol (1 mc M) and K+ (80 mM) induced contractions at around 10 and 25 times lower concentrations than in gut,
respectively, and shifted carbachol curves to the right. Only the organic fractions of the extract had a Ca2+ antagonist effect, whereas both organic and aqueous fractions had anticholinergic effect. A constituent, beta-sitosterol exhibited Ca2+ channel-blocking action. These results suggest that the antispasmodic effect of H. niger is mediated through a combination of anticholinergic and Ca2+ antagonist mechanisms. The relaxant effects of Hn.Cr occur at much lower concentrations in the trachea and bladder,” wrote A.H. Gilani and colleagues, Aga Khan University, Medical Department.

The researchers concluded: “This study offers explanations for the medicinal use of H. niger in treating gastrointestinal and respiratory disorders and bladder hyperactivity.”

Gilani and colleagues published their study in Fundamental & Clinical Pharmacology (Gastrointestinal, selective airways and urinary bladder relaxant effects of Hyoscyamus niger are mediated through dual blockade of muscarinic receptors and Ca2+ channels. Fundamental & Clinical Pharmacology, 2008;22(1):87-99).

Additional information can be obtained by contacting A.H. Gilani, Aga Khan University, College Medical, Dept. of Biology & Biomedical Science, Nat Prod Research Division, Karachi 74800, Pakistan.

The publisher of the journal Fundamental & Clinical Pharmacology can be contacted at: Blackwell Publishing, 9600 Garsington Rd., Oxford OX4 2DQ, Oxon, England.

This article was prepared by Drug Week editors from staff and other reports. Copyright 2008, Drug Week via NewsRx.com.

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Suicide; Data from Aga Khan University provide new insights into suicide

5 May 2008 Mental Health Weekly Digest

2008 MAY 5 – (NewsRx.com) — “Previous deliberate self-harm (DSH) is the strongest predictor of suicide. Although several studies exist in other countries, characteristics of DSH have not been well-studied in Pakistan,” scientists in Karachi, Pakistan report (see also Suicide).

“To identify characteristics of deliberate self-harm in a hospital population, building on previous work carried out on this subject at this center. 284 cases admitted to the Aga Khan University Hospital, Karachi, between January 1997 and August 2003 were studied by analyzing medical records. Information was collected regarding demographics, family history, personal history, suicidal ideation, current stressors, the act of DSH and its management. The most common age group was 21-25 years of age. The majority were females (60.3%). 95.1% of patients used self-poisoning as a method of deliberate self-harm. 47.3% used benzodiazepines for self-poisoning. Precipitating factors included conflict with family, marital problems, chronic illnesses, and unemployment. Comorbid psychiatric disorders were present in 76.4% patients. Despite the difference in socio-cultural background of our patients, many of our results were found to be consistent with Western data. Our findings suggest that problem-solving therapy, stress management and improved mental health care may be effective interventions in preventing DSH. Prescription of medications should be regulated,” wrote N. Zakiullah and colleagues, Aga Khan University.

The researchers concluded: “Further studies are suggested at the community level.”

Zakiullah and colleagues published their study in Crisis – the Journal of Crisis Intervention and Suicide Prevention (Deliberate self-harm – Characteristics of patients presenting to a tertiary care hospital in Karachi, Pakistan. Crisis – the Journal of Crisis Intervention and Suicide Prevention, 2008;29(1):32-37).

For more information, contact M.M. Khan, Aga Khan University, Dept. of Psychiatry, Stadium Rd., POB 3500, Karachi 74800, Pakistan.

Publisher contact information for the Crisis – the Journal of Crisis Intervention and Suicide Prevention is: Hogrefe & Huber Publishers, Rohnsweg 25, D-37085 Gottingen, Germany.

This article was prepared by Mental Health Weekly Digest editors from staff and other reports. Copyright 2008, Mental Health Weekly Digest via NewsRx.com.

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Heart Disease; Recent findings in heart disease described by researchers from Aga Khan University

11 May 2008
Heart Disease Weekly

2008 MAY 11 – (NewsRx.com) — “Indo-Pakistani populations have one of the highest risks of coronary artery disease (CAD) in the world. A population-based, cross-sectional survey was conducted on 3143 adults aged >= 40 years from 12 randomly selected communities in Karachi, Pakistan,” scientists in Karachi, Pakistan report (see also Heart Disease).

“Apart from smoking, women had more CAD risk factors (diabetes, hypertension, obesity, dyslipidaemia) than men. Definite CAD (history and Q waves on ECG) was more prevalent in men than in women ( 6.1% vs 4.0%; p = 0.009). In contrast, ischaemic and major ECG changes were twice as prevalent in women as in men (29.4% vs 15.6%, and 21.0% vs 10.5%; p< 0.001 for each, respectively). All measures of CAD were strongly predicted by the metabolic syndrome, but that failed to account for the greater prevalence of ECG abnormalities in women than in men. The findings indicate that one in five middle-aged adults in urban Pakistan may have underlying CAD,” wrote T.H. Jafar and colleagues, Aga Khan University.

The researchers concluded: “Women are at greater risk than men.”

Jafar and colleagues published their study in Heart (Coronary artery disease epidemic in Pakistan: more electrocardiographic evidence of ischaemia in women than in men. Heart, 2008;94(4):408-413).

For additional information, contact T.H. Jafar, Aga Khan University, Clinic Epidemiology Unit, Dept. of Community Health Science, Stadium Rd., Karachi, Pakistan.

The publisher’s contact information for the journal Heart is: B M J Publishing Group, British Med Association House, Tavistock Square, London WC1H 9JR, England.

This article was prepared by Heart Disease Weekly editors from staff and other reports. Copyright 2008, Heart Disease Weekly via NewsRx.com.

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Cardamom lowers BP: AKU

KARACHI: Cardamom (Elettaria cardamomum) is traditionally used in various gastrointestinal, cardiovascular and neuronal disorders and experts from the Aga Khan University conducted a study on its use for constipation, colic, diarrhea, hypertension and as a diuretic. The study, reported Drug Week, conducted on animals, indicated that cardamom had an effect on the gut and lowers blood pressure, according to A.H. Gilani of AKU in a recently published paper in the Journal of Ethnopharmacology. The researchers concluded: “The diuretic and sedative effects may offer added value in its use in hypertension and epilepsy.” daily times monitor

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Just three days of antibiotics tackles pneumonia in children: Aga Khan University
KARACHI: Most children up to the age of 5 who are prescribed antibiotics for non-severe community-acquired pneumonia will be treated for between 7 and 14 days. But, a Cochrane Systematic Review of available research showed that treating for just three days was effective, Drug Week reported Friday. “This short duration treatment is cheaper to give, is more likely to be taken by the child and is less likely to trigger antimicrobial resistance than longer-duration regimens,” says lead researcher Professor Zulfiqar Bhutta who heads the department of Paediatrics and Child Health at the Aga Khan University in Karachi. The findings are important for the world as a whole, but will probably be of greatest benefit in resource-poor societies, where a shorter dose would be much easier for people to afford, acquire and comply with. The systematic review identified three studies that included 5,763 children younger than 5. In these trials, some of children were treated for 3 days and the rest were given the same antibiotics for 5 days. The researchers ensured that any other differences between the children were kept to a minimum. “Pneumonia accounts for the highest number of deaths in children under five in low income countries, so it is important to find the most efficient way of treating it,” says co-researcher Dr Batool Haider. This review restricted itself to research that had compared 3 days of antibiotics against 5 days. The researchers are now keen to see more well-controlled randomised studies of different durations. This would make their conclusions stronger and would also allow more severe forms of pneumonia to be studied for optimal treatment strategies. daily times monitor

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Tanzania: Cancer ‘Stalks Breastfeeding Women’ – Head of Surgery Aga Khan Hospital

The head of surgery at Aga Khan hospital, Dr Isaya Tosiri, presents a paper during a two-day medical education seminar in Dar es Salaam on Saturday.

Current studies have revealed a persistent high prevalence of breast cancer among Tanzania women, especially those breast feeding.

Most cases are reported during weekly clinics in urban hospitals despite various campaigns against the disease carried out by activists and health professionals.

This came to light at the Aga Khan Hospital in Dar es Salaam last weekend during a medical education seminar on minimum invasive surgery.

The seminar was conducted by Prof Asad Raja from the faculty of surgery at the Aga Khan University, Nairobi, in collaboration with other resident doctors.

Making his presentation, a workshop participant, Dr Athar Ali, said every week he had been attending to between 15 and 20 patients who had been diagnosed with breast cancer at the clinic.

“The condition is so alarming that it was decided to form a team of medical professionals to conduct public lectures during the clinics as part of a sensitization campaign.

“We are going to conduct other campaigns in public areas and communities where awareness programs are prepared,” said Dr Ali.

He said last year alone 120 breast cancer operations were performed and as time goes by the disease has become the most common form of cancer among women.

The workshop was told that the disease, once said to be affecting women from 40 years of age, was now gradually changing. Its victims get younger and younger.

“The best defence against this disease is early detection through physical examination. While there is no perfect solution, one can work on reducing the risk of getting it,” said Dr Ali.

The Aga Khan Hospital recently introduced a new surgical technology applying modern surgical techniques. Called laparoscopic surgery, the technology is also used to treat breast cancer patients through surgery.

According to information availed at the workshop, the operation is performed through small incisions as compared to larger incisions needed in traditional surgical procedures.

Advantages of laparoscopic surgery to the patient include reduced blood loss which also reduces the need for blood transfusion, smaller incision which reduces pain, short recovery time and less pain.

The laparoscopic procedure was first applied in humans in 1910 by Hans Christians Jacobaeus of Sweden. The Aga Khan Hospital is pioneering this surgery in Dar es Salaam.

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