Objective: To study, analyse and compare the effects of Silymarin on glycemic control and insulin resistance in newly diagnosed type 2 diaebtes mellitus (T2DM) subjects. Study Design: Observational study. Setting: Suleman Roshan Medical College Hospital. Period: March 2019 to February 2020. Material & Methods: A sample of 200 newly diagnosed cases of T2DM were recruited accroding to inclusion criteria selected by non-probability convenient sampling. Subjects were divided into 2 groups; OHA- oral hypoglycemia agent and OHA+ Sillymarin (200 mg). Baseline fasting (FBG) and random blood glucose (RBG), glycated HbA1 (A1C), fasting insulin (FI) and insulin resitance (HOMA-IR) were detected. Silymarin therapy was continued for 3 months. Study variables were analysed after 3 months. Data was analyzed on SPSS (ver.19) at 95% confidence interval (P≤0.05) considered statistially significant. Results: Age of diabetics taking oral hypoglycemic agents (OHA) and diaebtic taking OHA+ Silymarin supplementation was noted as 50.3±13.3 49.9±14.5 years (P=0.91). 3 months Silymarin supplementation improves the fasting blood glucose, random blood glucose, glycated hemoglobin A1 (A1C), fasting insulin and insulin resistance (HOMA-IR) (P=0.0001). Conclusion: Silymarin improves blood glucose levels in type 2 diabetics that is mediated through reduction of insulin resistance.

Objective: Determine the frequency of vitamin cobalamin deficiency in macrocytic anemia cases reporting at tertiary care hospital. Study Design: Cross Sectional study. Setting: Faculty of Medicine and Allied Medical Sciences, Isra University, Hyderabad, Sindh Pakistan. Period: January 2017 to October 2018. Material & Methods: 450 cases of both genders, diagnosed as macrocytic- megaloblastic anemia were studied for the vitamin Cobalamin levels. Cases were collected through non- probability convenient sampling by inclusion and exclusion criteria. Consenting volunteers were asked for blood sampling. 5 mL blood was taken from ante – cubital fossa. Samples were centrifuged and sera were collected for the estimation of vitamin cobalamin by ELISA – assay kit. Continuous and categorical variables were entered in SPSS (version 21.0) and analyzed by Student t-test and Chi-square test respectively at 95% CI (P ≤ 0.05). Results: Male and female comprised 225 (43.3%) and 294 (56.6%) of 519 subjects. Male to female ratio was noted 1.30:1. MCV, MCH and MCHC show statistically significant difference between male and female (P<0.05). MCV in male was 96.8±9.92 fl vs. 105.5±12.04 fl in female (P=0.0001). Normal cobalamin was noted in 15.2% (n= 79) and any type of cobalamin deficiency was noted in 84.7% (n= 440) (P=0.0001). Conclusion: The present study reports frequency of 84.7% Cobalamin deficiency in macrocytic anemia reporting at Indus Medical College Hospital. Further studies are recommended by the treating physicians.

Aim: To study the comparative hepatoprotective effect of Virgin Coconut Oil (VCO) and Neem (Azadirachta indica) leaf extract in acetaminophen (Paracetamol) induced liver toxicity. Methods: About 60 mixed population of rats (male/female) of Wistar and Sprague-Dawley species were randomly selected for the proposed study and are segregated into four equal groups. Every group contains 15 animal subjects. Group A was the control group given normal diet. In Group B, the rats were treated with a single dose of 2gm / kg body weight paracetamol, orally. Simultaneously, Group C were given an oral Neem extract of 500mg/kg body weight for 2 weeks days in combination with single dose of Paracetamol, while Group D were provided with 6.7ml/Kg/body weight Virgin Coconut Oil (VCO) for 15 days. Data was analyzed using SPSS Version 20.0 with level of significance being kept at p-value ≤0.05. Results: The mean values of ALT were 23.1, 100.5, 29.85, and 31.09 U/L in Group A, B, C, and D respectively. While, the mean values of AST were 25.6 U/L (Group A), 41 U/L (Group B), 19.3 U/L (Group C), and 15.2 U/L (Group D). The ALP showed maximum response indicated by the mean values of 221 U/L, 444 U/L, 241 U/L, and 243 U/L in Group A, B, C, and D respectively. Group B suggested the paracetamol induced liver toxicity indicated by the increase in hepatic DMEs right after the acetaminophen induction. Conclusion: Azadirachta Indica and Virgin Coconut Oil displayed hepatoprotective effects on the Wistar and Sprague-Dawley rats that were subjected to Paracetamol. Keywords: hepatic, Drug Metabolizing enzymes, Acetaminophen, Virgin coconut oil, Neem extract, Paracetamol, Wistar

Objectives: Evaluate serum bilirubin in adult healthy subjects and its correlation with white blood cells as risk factor for cardiovascular disease. Study Design: Cross- sectional study. Setting: Department of Pharmacology and Medicine, Suleman Roshan Medical College. Period: January - December 2017. Material & Methods: A sample of 100 male and 100 female adult healthy subjects were recruited for study protocol. Blood glucose, Serum creatinine, Blood lipids, liver enzyme levels, White blood cell counts and Serum bilirubin levels were analyzed. Pearson`s correlation was used for the correlation coefficient and its statistical significance for the association of serum bilirubin and white blood cells. Data variables were analyzed by statistical software SPSS (ver 21.0) at 95% CI (P ≤ 0.05). Results: Mean± SD age of male and female was found 47.02±8.42 and 48.59±7.80 years respectively (P=0.071). Serum bilirubin shows statistically significant negative correlation with blood glucose (r= - 0.257, P=0.0001) and LDLc (r= - 0.155, P=0.027) and WBC (r= - 0.871, P=0.0001). Conclusion: The present study shows the elevated serum total bilirubin levels within reference range correlated negatively with total white blood cells in adult healthy population.

Objectives: Investigating the Renoprotective effects of Ascorbic acid ingentamicin induced renal injury (GIRI) in male Wistar rats. Study design: Experimental study.Place and Duration: Animal house of Al-Tibri from September 2016 to December 2016.Methodology: 60 male Wistar rats were selected by non-probability purposive sampling,and were divided into three groups; Group A- control, Group B- Gentamicin induced renalinjury (GIRI) (70 mg/kg/bwt i.m) daily , and Group C- GIRI + AA (Ascorbic acid - 0.2 mg/kg/bwt) daily. Cardiac puncture was performed by a Disposable Syringe for blood sampling.Sera were used for biochemical testing. Renal tissue was stained with H & E for histologicalexamination. Statistix 8.1 software (USA) was used for data analysis at P≤ 0.05. Results:Blood urea and serum creatinine were elevated in the group B (GIRI) compared to GIRI+AAand the controls (P=0.0001). Serum superoxide dismutase, glutathione peroxidase, andcatalase were low in GIRI compared to GIRI+AA and control groups. Renal tissue in ascorbicacid treated rats showed improved tissue architecture. Conclusion: It is concluded that theAscorbic acid exerts Renoprotective effects in gentamicin induced renal injury in rat model.