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Open access

Amjad Hussain, Muhammad Ali Syed, Nasir Abbas, Sana Hanif, Muhammad Sohail Arshad, Nadeem Irfan Bukhari, Khalid Hussain, Muhammad Akhlaq and Zeeshan Ahmad

Abstract

A novel mucoadhesive buccal tablet containing flurbiprofen (FLB) and lidocaine HCl (LID) was prepared to relieve dental pain. Tablet formulations (F1-F9) were prepared using variable quantities of mucoadhesive agents, hydroxypropyl methyl cellulose (HPMC) and sodium alginate (SA). The formulations were evaluated for their physicochemical properties, mucoadhesive strength and mucoadhesion time, swellability index and in vitro release of active agents. Release of both drugs depended on the relative ratio of HPMC:SA. However, mucoadhesive strength and mucoadhesion time were better in formulations, containing higher proportions of HPMC compared to SA. An artificial neural network (ANN) approach was applied to optimise formulations based on known effective parameters (i.e., mucoadhesive strength, mucoadhesion time and drug release), which proved valuable. This study indicates that an effective buccal tablet formulation of flurbiprofen and lidocaine can be prepared via an optimized ANN approach.

Open access

Muhammad Ali Khalid, Jawaid Iqbal, Hassan Liaquat Memon, Farina M. Hanif, Muhammad Osama Tariq Butt, Nasir Hassan Luck and Zain Majid

Abstract

Background and Objectives

Gastrointestinal symptoms are common in patients with end stage renal disease (ESRD) among which dyspepsia is frequently observed. The aim of the study was to determine the frequency and associations of dyspepsia in ESRD patients using the Leeds questionnaire.

Methods

All ESRD patients on maintenance hemodialysis were consecutively enrolled in the study. Leeds questionnaire was used to interrogate the patients for the assessment of dyspepsia. Mean and standard deviation were calculated for age, body mass index (BMI), disease duration and number of hemodialysis sessions. Independent t-test and Chi square tests were used for statistical analysis.

Results

Total number of patients was 200, out which 118 (59.3%) were male. The mean age was of 41.4 years. According to the Leeds questionnaire, dyspepsia was present in 62 (63.9%) patients. Younger patients (age 20–40 years) more frequently had dyspeptic symptoms (61.5% patients), retrosternal pain (156 patients, 78.0%), regurgitation (127 patients, 63.5%), dysphagia (67 patients, 33.5%), and nausea (142 patients, 71.0%). Patients presented with intermittent pattern of symptoms in 179 (89.5%) cases, while continuous symptoms in 6 (3.0%). Dyspepsia was associated with aspartate aminotransferase (AST) levels > 25 U/L (P = 0.001), alanine aminotransferase (ALT) levels > 28U/L (P = 0.000) and gamma glutamyl transferase (GGT) levels > 34 U/L (P = 0.002). On multivariate analysis, urea, creatinine, and presenting symptoms of dysphagia and belching showed significant statistical association with dyspepsia.

Conclusion

Dyspepsia is a common problem affecting patients with end stage renal disease and is associated with raised serum AST, ALT and GGT in such patients.

Open access

Jawaid Iqbal, Muhammad Ali Khalid, Farina M. Hanif, Rajesh Mandhwani, Syed Mudassir Laeeq, Zain Majid and Nasir Hassan Luck

Abstract

Background

Renal dysfunction is one of the dreaded complications of cirrhosis. MELD is a validated chronic liver disease (CLD) severity scoring system. Urinary (U) Na/K ratio closely correlates with renal dysfunction in terms of low GFR in cirrhotic patients.

Patients and Methods

All consecutive patients with decompensated cirrhosis between the age of 18 to 70 years, of either gender, presenting in the outpatients’ department of Sindh Institute of Urology and Transplantation, Karachi, from June 2015 to June 2017 were included. The MELD score was calculated and the UNa/K ratio less than 1 was taken as surrogate marker of renal dysfunction. Statistical analysis was performed by SPSS (version 20.0).

Results

A total of 71 patients were enrolled. The mean age was 43.79 years and majority were male (67.6%). The most common cause of liver cirrhosis was HCV, found in 42 (59.2%) patients. The mean CTP score was 10.48 ± 2.069 (range: 6–14) with majority of the patients following in class C, that is, 48 (67.6%). Mean MELD score was 21.75 ± 8.96 (range: 8–43). In 57 patients (80.3%), MELD score was > 15.The mean serum creatinine and mean serum sodium were 1.5 ± 1.1 mg/dl (range: 0.37–5.3) and 133.79 ± 6.9 mmol/L (range: 112–152), respectively. Mean urinary sodium and urinary potassium were 38.60 ± 46.64 mmol/L (range: 5–181) and 38.15 ± 23.9 mmol/L (range: 4.3–112), respectively. In majority of study population, UNa/K ratio was below 1, that is, in 52 patients (73.2%). Statistically significant correlation was documented between MELD score and UNa/K ratio (ɤ = 0.34, P = 0.004).

Conclusion

The inverse correlation between MELD scores and UNa/K ratio indicates that patients with CLD and higher MELD scores might have renal dysfunction. This finding however should be corroborated by large scale studies.

Open access

Muhammad Saeed, Mohamed E. Abd El-Hack, Muhammad Arif, Mohamed M. El-Hindawy, Adel I. Attia, Khalid M. Mahrose, Itrat Bashir, Farman A. Siyal, Muhammad A. Arain, Sarfraz Ali Fazlani, Khawar Hayat, Chao Sun and Ahmed E. Noreldin

Abstract

The present investigation aimed to study the effect of the partial replacement of distiller’s dried grains with solubles (DDGS) instead of soybean meal (SBM) with or without vitamin E supplementation in laying hen diet on egg quality criteria, egg analysis, blood chemistry and productive performance traits. A 4×2 factorial design experiment was carried out involving four substitution levels of DDGS (0, 25, 50 and 75%) and two levels of vitamin E (0 and 250 mg /kg diet) through 22-42 weeks of age. No significant differences were noticed between the control and 25 or 50% DDGS substitution in the percentage of eggs produced and egg output. The fewest number of produced eggs and the lightest egg output were observed in 75% DDGS group. Yolk index, shell percentage, and Haugh unit scores were affected (P>0.01) by DDGS levels. Albumin percentage showed increase (P>0.01) in vitamin E treated groups. The impact of the combination of DDGS and vitamin E was significant (P>0.01) on all egg quality traits excepting shell percentage. The 75% DDGS diet gave the highest values of egg nutrients. Vitamin E had a positive effect on egg crude protein, ether extract, and nitrogen free extract which increased by 10.39, 10.28 and 7.85%, respectively. The combination of vitamin E addition and DDGS levels was highly significant (P>0.01) on all egg nutrients. Hens fed the 50% DDGS diet had more concentrations of lipids profile in their blood than those fed control and other DDGS diets. All serum lipid profile inclined to increase due to vitamin E supplementation. The interaction between DDGS and vitamin E had significant (P>0.05 or 0.01) influence on all serum metabolites excepting calcium. It could be concluded that vitamin E could enhance nutrient content of eggs and preserve blood lipids from lipid peroxidation. The interaction between 75% DDGS replaced SBM with 200 mg vitamin E/kg diet accomplished the best results regarding nutrient content of eggs.