Background: Polycystic ovary syndrome (PCOS) is a heterogeneous metabolic disorder affecting women of the child-bearing age. Alteration in lipid profile is one of the troublesome features faced by PCOS patients that need to be treated. Aim: The purpose of this study was to compare the effects of Probiotics, Metformin and their Combination therapy on lipid profile in women suffering from PCOS. Study Design: Single-Centered Randomized Controlled Trial. Setting: Gynecological clinic of Karachi at Tertiary care Hospital from December 2018 to May 2019. Patients and Methods: Total 78 PCOS patients of age between 18 to 40 years were involved in this trial rendering to Rotterdam criteria. After taking written and informed consent they were randomly allocated to three groups and were received: Metformin 500 mg B.D (n = 26), Probiotic Capsule 180 mg B.D (n = 26) and Combination of Metformin 500 mg B.D / Probiotic Capsule 180 mg B.D for 12-weeks. Lipid profile was measured at baseline and after 12-weeks of intervention along with the body weight. In the end, pre versus post therapy and comparison of different group’s results were analyzed. Results: Metformin and Met/Pro Combination groups resulted in a significant reduction in Total Cholesterol (TC) as compared to Probiotic group. Fall in Low-Density Lipoprotein Cholesterol (LDL-C) levels were noteworthy after Probiotics and Met/Pro treatment. Serum TG concentrations were significantly reduced in all the groups. High-Density Lipoprotein Cholesterol (HDL-C) levels were slightly elevated after Probiotics treatment, which was not statistically significant but Metformin and Met/Pro group increases it to the significant value. No substantial change was found in the Very Low-Density Lipoprotein Cholesterol VLDL-C levels in any of the three groups. Conclusion: Overall, Probiotics treatment in PCOS women for 12 weeks exhibited noteworthy changes in TG, and LDL-C levels. Metformin markedly improve Cholesterol, TG and HDL-C. However, Met/Pro improved all the lipid changes to the significant value except for VLDL-C.
Aims: To study the role of combination therapies in the treatment of rheumatoid arthritis. Study Design: This an open-label, randomized 180-days clinical trial. Place and Duration of Study: This study was conducted in the Department of Pharmacology and Therapeutics, BMSI and Medical unit ward 6, after approval of JPMC ethical committee, between March 2013 and May 2014. Methodology: We included 90 patients (69 women, 21 men; age range 28-62 years) which were divided into two groups, A and B. 44 patients of group A received methotrexate (MTX) 7.5-20 mg/ week orally and Leflunomide (LEF) 10-20 mg/ day QD orally as maximally tolerated. 46 patients of group B were given MTX 7.5-20 mg/ week orally and Hydroxychloroquine (HCQ) 200 mg twice daily orally as maximally tolerated. Results: Comparing the combination of group A with group B, group A showed highly significant improvement in mean patient’s global assessment (1.4 ± 0.66) and mean pain (1.3 ± 1.11) as compared to group B (2.4 ± 1.14, 2.2 ± 1.49). The drugs of group B showed significant improvement in mean physician’s global assessment (1.7 ± 0.92) and mean morning stiffness (49.2 ± 10.59) as compared to group A (2.8 ± 0.97, 54.4 ± 10.14). Combination treatment of group B showed significantly lower adverse effects (4.3%) as compared to group A (11.4%). Statistical analysis revealed that patients receiving both the combinations responded equally in terms of effects but group B showed significantly better in terms of adverse effects. Conclusion: Both combinations of MTX & LEF and MTX & HCQ were well tolerated but the efficacy of MTX and HCQ was significantly superior in terms of adverse effects to the combination of MTX and LEF.
Continuous obstacles behind the discovery of novel drugs for cancer therapy have necessitated the development of alternative strategy of drug repurposing—the development of old drugs for new therapeutic purposes. With an improved understanding of the hallmarks of cancer, this strategy offers a cost-effective process for the treatment of human neoplastic disease, thereby facilitating rapid clinical translation. In this regard, macrolide antibiotics (MAs), which include a wide spectrum of activities against Gram-positive bacteria, have also been proposed as anticancer drugs for multiple tumor types. Over the past few years, significant progress has been achieved in anticancer therapy, but development of resistance and unavoidable side effects have weakened these attainments. Considering this severe condition, a number of drugs with novel antitumor mechanisms are under investigations including antimicrobials that have been shown to possess anti-inflammatory, immunomodulatory, and cytotoxic effects. In this regard, both conventional and novel antimicrobials are being studied to explore their anticancer potential along with underlying mechanisms that may render them as effective anticancer drugs in the future. Hence, in the latest study, we tested the role of a macrolide antibiotic drug, Azithromycin (AZM) alone, in combination with standard chemotherapeutic agent Sorafenib (Sorafenib/AZM) and its gold conjugated nanoparticles (AuAZM) as an anti angiogenic agent in hepatoma cell line hepG2 through wound healing assay. The migratory potential of HepG2 cells after being exposed to different treatments (AZM, Sorafenib, Sorafenib/AZM, and Au-AZM at IC50 concentrations) was observed at 0, 6, 24, 48, and 72 hours. The results of our study showed that AZM exhibited highly significant reduction in wound healing with p-value (< 0.001) up till 72 hours, while Sorafenib, Sorafenib/AZM, and Au-AZM inhibited wound healing up to 48 hours (p-value < 0.001). The current study revealed a comparatively higher antiangiogenic potential of AZM in cancer cells, thereby suggesting its clinical application for cancer treatment.
Objectives: To compare the role of low dose Theophylline and Tiotropium rotacap in improving the lung functions and day to day life of patients suffering from COPD. Study Design and Setting: A Clinical trial study was conducted at Department of Pharmacology and Therapeutics, BMSI in association with Department of Chest Medicine, JPMC. Methodology: This study was planned as an open label and parallel clinical trial study. A total of 168 patients of COPD were selected for this study and only 161 patients completed the 3 months duration of the study. The enrolled patients were grouped into 2, namely A and B. Tab. Theophylline 350 mg was given to Group A in two divided doses while Tiotropium rotacap18µg through rotahaler was given to group B once a day. Results: Mean FEV1 ± SD was improved by 0.04 ± 0.02 in Theophylline therapy group while by 0.07 ± 0.01 in the Tiotropium therapy treated group and a significant difference between the changes in the two treatment groups was evident. There was a percentage improvement in PEFR of 8.9 ± 5.8 in the Theophylline therapy treated group and of 13.2 ± 4.7 in Tiotropium therapy treated group. When Tiotropium group was compared with Theophylline group for improvement in percentage change in PEFR from day 0, a significant difference was evident between the two groups. There was a significant improvement from day 0 in CAT score in Tiotropium treated groups versus Theophylline group after 3 months of therapy. Conclusion: Tiotropium rotacap was more effective as compared to low dose Theophylline in improving pulmonary functions and CAT score in patients with COPD
Over the past few years great progress has been achieved in anticancer therapy, but development of resistance and unavoidable side effects have incapacitated these fulfilments. Keeping in view this demanding condition, numerous drugs with unique antitumor mechanisms are under investigations including antimicrobials which have been shown to possess anti-inflammatory, immunomodulatory and cytotoxic effects. In this regard, both conventional and novel antimicrobials are being studied to explore their anticancer potential along with underlying mechanisms which may render them as effective anticancer drugs in near future. Moreover, the new approach of drug repurposing is also being encouraged especially in cancers in order to reduce cost and limit adverse effects. In recent times a cumulative number of studies have laid stress upon the antitumor properties of antimicrobials. Consequently, this study has been conducted to see comparative inhibitory effect of Sorafenib and its combination with a macrolide antibiotic Azithromycin on growth rate HepG2 cell line.
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