Awareness regarding the importance of vitamin D and prevention of its deficiency among female undergraduate medical students

Background: Vitamin D deficiency is a common nutritional disorder that has assumed epidemic proportion. One of the major reasons for the worldwide spread of this disorder has been deficient awareness about the importance of vitamin D, its benefits on health, and prevention of deficiency state across different populations. Vitamin D deficiency (VDD) is widely prevalent in this part of the country (Kashmir valley, India), the prevalence being higher in females. This study was conducted to assess the awareness of female medical students regarding the importance of vitamin D and the prevention of its deficiency among them.Methods: This cross-sectional study was carried out among 113 female medical students. A self-administered questionnaire consisting of two parts was used to collect data. The first part was for identifying socio-demographic characters and the second half was a 12-question, multiple-choice survey focussing on vitamin D. Data was entered and analysed using computer software MS Excel.Results: The results of the study showed that the participants had good knowledge regarding some aspects while knowledge for other aspects was poor. The majority of participants had adequate knowledge about main source/dietary source of vitamin D, the site of synthesis, effect of vitamin D on bone health, main effects of deficiency on bone health, identification of high-risk groups and importance of supplements in management of deficiency. However, majority had inadequate knowledge about the epidemic state of VDD, RDA, time/duration of sun exposure and other effects of deficiency.Conclusions: The present study showed that there are some gaps in awareness about vitamin D, its benefits, and management of deficiency among female medical students

The Effect of Telephone Support on the Severity of Nausea and Vomiting in the First Trimester of Pregnancy in the Primiparous Women

Objective: to evaluate the effect of telephone support on the severity of nausea and vomiting in the first trimester of pregnancy in the primiparous women. Study Design: Randomized Control Trail. Study Place and Duration: Department of Obstetrics and Gynecology Bahawal Victoria hospital and primary health care facilities Bahawalpur, from January 2018 to June 2018. Material and methods: A total number of 72 patients referred to gynecology department of Nishtar hospital were included in this study. Patients were divided into two equal groups. Case group received telephone support while control group received standard care for the complaints of nausea and vomiting in pregnancy. There are 36 patients in each group. PUQE (pregnancy unique quantification of emesis\nausea) criterion was used to assess the severity of nausea and vomiting during pregnancy. Three outcome variables were assessed in order to evaluate the efficacy of the telephone support in case group, PUQE score, PUQE score severity and quality of life score. For continuous data independent t-test was applied, for nominal data chi-square test and for quality of life score Mann Whitney U-test was used. P value less than or equal to 0.05 was taken as statistically significant. Results: PUQE questionnaire was given to each patient and score was calculated. Mean PUQE score was 7.42±3.25 in the cases and 9.94±3.40 in the controls, the difference being statistically significant (p=0.002). Mild NVP, moderate NVP and severe NVP were observed in 20 (55.5%), 10 (27.8%) and 6 (16.7%) of the cases; and 8 (22.2%), 18 (50%) and 10 (27.8%) of the controls, respectively. The difference in PUQE severity was statistically different between the two groups (p=0.015). The quality of life score was also statistically much better (p=0.028) in the cases (8 (6-9)) than in the controls (7 (4.25-8)). Conclusion: Telephone support was significantly associated with better PUQE score and better quality of life score as compared to the standard care. But severity of PUQE score was not statistically significant when case and control groups were compared. Keywords: Nausea, Vomiting, Telephone, Primiparous, Pregnanc

Terminalia arjuna restores the levels of alkaline phosphatase and aspartate aminotransferase of acetaminophen intoxicated mice

Background: Herbal medicines are natural and comparatively safer than conventional treatments and are well-documented for carrying little potential for harm.  Therefore, phytonutrients have occupied a central stage in the therapeutics. Terminalia arjuna, a medicinal plant, has been reported to have homeostatic, laxative, diuretic, antidiabetic, anticancer and cardiotonic actions.Methods: The current study was designed to investigate the protective role of T. arjuna leaf extract at three dose levels (100, 250, 500 mg/kg body weight) against acetaminophen (250 mg/kg body weight) induced liver damage.Results: The administration of hepatotoxin (Acetaminophen) resulted in disturbance of hematological and serological profile including alkaline phosphatase (ALP) and aspartate aminotransferase (AST) which was assayed in control and drug treated experimental models. Treatment with T.  arjuna leaf extract for 7 days restored the normal levels of markers and response was dose dependent.Conclusion: This study adds to the very limited existing literature regarding hepatoprotective effect of T. arjuna against acetaminophen toxicity. It is also important to get a step closer to development of accessible, authoritative, and independent information resources about herbal medicines and wide-ranging health disorders, which are currently lacking in Pakistan.Keywords: Hepatoprotective; Terminalia arjuna; ALP; AST   

Hepatoprotective Effect of Berberis Lycium in Αlpha-Naphthylisothiocyanate Induced Cholestatic Mouse Models

Cholestasis is characterized by the obstruction of bile flow from hepatocytes to the intestine. It results in accumulation of bile acids in the liver, which cause oxidative stress, inflammation, apoptosis, fibrosis, and cirrhosis. Till now, the treatment options against cholestasis are limited. Therefore, there is an utmost requirement to develop and evaluate the drugs with potential anti-cholestatic effects. In the current study, the drug-induced cholestasis mouse models were generated via oral administration of α-naphthylisothiocyanate (ANIT). The mice were placed into three groups of six animals each. Group I was the control group and was given saline. The cholestasis model Group II was given saline for 19 days. On 19th day (48 hours before sacrifice) they received a single dose of ANIT (75 mg/kg). Group III served as the plant extract treatment group and received root extract for 19 days. On nineteenth day (48 hours before sacrifice) they received a single dose of ANIT (75 mg/kg). On 21st day, mice were sacrificed for analysis of serum biochemistry and liver histology. The results revealed that Berberis lycium extract has hepatoprotective properties, as serum level of AST (aspartate aminotransferase) and ALT (alanine transaminase) are significantly lower in the plant treatment group compared to the cholestasis model group. Furthermore, liver histology validated the serological results since the hepatocyte architecture in the plant treatment group was similar to that of control group. In conclusion, the data exhibit that B. lycium possess protective activities against ANIT induced cholestasis

Berberine ameliorates the progression of primary sclerosing cholangitis by activating farnesoid X receptor

Primary sclerosing cholangitis (PSC) is a rare cholestatic disease characterized by biliary infiltration, hepatic fibrosis and bile duct destruction. To date, treatment options for PSC are very limited. Therefore, the current study is aimed to investigate the therapeutic potential of berberine (BBR) against PSC. The disease was induced by feeding the mice with 3,5-diethoxycarbonyl-1,4-dihydro-2,4,6-collidine (DDC) for four weeks. The serum biochemistry and liver histology were analyzed. Furthermore, the expression of farnesoid X receptor (FXR) was also evaluated by real-time PCR. The results indicated that berberine prevents the progression of PSC by modulating the expression of FXR which ultimately regulates other genes (including Cyp7A1 and BSEP) thus maintaining bile acids homeostasis. Furthermore, the docking analysis showed that berberine interacts with the binding pocket of FXR to activate the protein thus acting as an FXR agonist. In conclusion, data indicate that berberine protects the liver from PSC-related injury. This effect might be due to the modulation of FXR activity