Statins are used for treatment of hypercholestremia. Common adverse reports associated with use of statins are generalized bodyache, rhabdomyolysis, muscles weakness and gastrointestinal disorders. The current work is an attempt to explain how smooth muscles of gastrointestinal tissues are affected by the current statins (Simvastatin, atorvastatin, fluvastatin and rosuvastatin). Effects of the current statins were studied on spontaneous activity of isolated rabbits’ jejunal preparations. Different molar concentrations (10−12–10−2M) of the statins were applied on spontaneously contracting rabbits’ jejunal preparations. As statins relaxed spontaneous activity, so we tested the statins on KCl (80 mM) induced contractions in similar test concentrations. Positive relaxant statins were tested again through construction of Calcium Concentration Response Curves (CCRCs) in the absence and presence of the statins using verapamil, a standard calcium channel blocker. CCRCs of statins were compared with CCRCs of verapamil. Simvastatin, atorvastatin, fluvastatin and rosuvastatin relaxed the spontaneous and KCl-induced contractions. IC50 for simvastatin on spontaneous rabbit’s jejunal preparations is −5.08 ± 0.1 Log 10 M. Similarly, IC50 for KCl-induced contractions is −4.25 ± 0.01 Log 10 M. Mean IC50 (Log 10 M) for atorvastatin on spontaneous rabbit’s jejunal preparations and KCl-induced contractions are −5.19 ± 0.07 and −4.37 ± 0.09, respectively. Fluvastatin relaxed spontaneous activity of rabbits’ jejunal preparations with an IC50 (Log 10 M) −4.5 ± 0.03. Rosuvastatin relaxed spontaneous as well as KCl (80 mM) induced contractions with respective IC50 (Log 10 M) −3.62 ± 0.04 and −4.57 ± 0.06. In case of CCRCs, tissues pre-treated with 4.6 μg/ml of simvastatin, have IC50 = −1.84 ± 0.03 [log (Ca++) M] vs control IC50 = −2.54 ± 0.04 [log (Ca++) M]. Similarly, atorvastatin, fluvastatin and rosuvastatin produced significant right shift in IC50 for CCRCs (P ≤ 0.05). In case of verapamil, IC50 for control curves is −2.45 ± 0.06 [log (Ca ++) M], while IC50 in presence of verapamil (0.1 μM) is −1.69 ± 0.05 [log (Ca ++) M]. Statins produced right shift in the IC50 of CCRCs. The effects of statins are like that of effects of verapamil, a standard calcium channel blocker. Our findings suggest that current statins have calcium antagonistic effects that act on voltage gated calcium channels that may provide a rationale for cause muscle weakness and gastrointestinal disorders.

Objective: The study aimed to explore and evaluate the effectiveness of Vitamin E in preventing or minimizing glycogen depletion in hepatocytes associated with alcoholic liver damage. Study Design: Experimental study. Settings: The study was conducted in the department of anatomy and animal facility of Peshawar Medical College, Peshawar Pakistan. Duration: February 2022 to April 2023. Methods: The study included eighteen male domestic rabbits (Oryctolagus cuniculus), classified according to the duration of the experiment. Rabbits in "Category E8" were exposed to an 8-week time frame, while those in "Category E4" experienced a 4-week experimental duration. Each classification was further segmented into three sections: "Control Group A" which was administered normal saline as a placebo; "Experimental Group B" received a 30% ethanol solution in distal water (30ml per kg/day) through a nasogastric tube; and "Experimental Group C" treated with a 30% ethanol solution in distal water (30ml per kg/day) administered along with "Vitamin E" (50mg dissolved in 2ml distal water per kg/day). Liver tissue specimens from all subjects underwent staining with PAS stain to quantify glycogen (carbohydrates) in hepatocytes. Results: A statistically significant variance in glycogen depletion within hepatocytes was noted between animals treated with vitamin E and those not treated with vitamin E in both E4 and E8 categories. Nonetheless, vitamin E treated rabbits exhibited higher glycogen levels compared to their non-vitamin E treated counterparts. Conclusion: In the realm of alcohol-induced liver damage, vitamin E provides the expected protective benefits by safeguarding glycogen (carbohydrate) stores within hepatocytes.

Background: Cytochrome P450 plays a pivotal role in metabolizing drugs, hormones, and vitamins with genetic variability influencing enzymatic activity. Genetic consortiums categorize variables such as CYP3A4-rs2242480 and rs2740574 as third-level evidence, indicating the need for further research into their health implications and pharmacogenetic relevance in carbamazepine metabolism. This study explores the distribution patterns of selected genes and their correlation with gender in our study population, aiming to advance personalized treatment approaches. Methods: Using Sanger sequencing, Pashtun patients diagnosed with epilepsy and treated with carbamazepine monotherapy were genotyped for CYP3A4-rs2242480 and rs2740574 polymorphisms. The genetic variations were identified through Finch TV and analyzed for gender correlations. Results: Minor Allele Frequency (MAF) of CYP3A4-rs2242480 and rs2740574 in 223 Pashtun patients with epilepsy was 27.8% and 1.7%, respectively. The genotype frequency of CYP3A4-rs2242480 was as follows: CC at 53.8%, with females 35% & males 65%; CT at 36.7%, with females 36.5% & males 63.4%; and TT at 9.4%, with females 47.6% & males 52.3%. For CYP3A4-rs2740574, the genotype frequencies were 0% CC, 3.6% CT, and 96.4% TT. Among individuals with the CT genotype, the distribution was evenly split between males (50%) and females (50%). For those carrying the TT genotype, females comprised 36.2% of the group, while males made up 63.7%. Conclusion: The study uncovered genotype distributions of carbamazepine-metabolizing enzymes in the previously unexplored Pashtun population, revealing significant differences in CYP3A4-rs2740574 and rs2242480 frequencies compared to global ethnic groups. Also, no significant association was observed between genotype distribution patterns across genders.

Objective: Antibiotics play a crucial role in treating Urinary Tract Infections (UTIs) but due to resistance, the effectiveness of antibiotics is waning. Re-examining old antibiotics is one approach that can address the issue of antimicrobial resistance. The current study aims to evaluate susceptibility pattern of relatively older antibiotic Co-trimoxazole and its comparison with Levofloxacin, Nitrofurantoin and Fosfomycin. Material and Methods: This cross-sectional study was conducted in Mardan Medical Complex, Mardan, and Postgraduate Medical Education Department of Khyber Girls Medical College, Peshawar from April 2022 to September 2022. Both male and female patients, above the age of 15 years with recurrent uncomplicated urinary tract infection were included in the study. The samples were inoculated onto CLED (Cystine-Lactose-Electrolyte-Deficient) Agar, a differential culture medium. The grown bacteria were identified, using Gram staining and BIOMÉRIEUX® API® 10 S kits. Minimum inhibitory concentrations (MIC) were determined by Agar dilution method; as per standard protocol. The results were compared among Co-trimoxazole, Levofloxacin, Nitrofurantoin and Fosfomycin using Statistical tests. Results: A total of 680 samples were received, in which 158 samples were culture positive. Gender distribution of females and males were 63.3% and 36.7%, respectively. Most of the patients were presented in the age group of 21-40 years followed by 41-60 years. The isolated organisms were E.coli (74.1%), Klebsiella (10.8%), Pseudomonas 8(5.1%), Enterococci (6.3%), Proteus species (2.5%) and Citrobacter (1.3%). According to MIC, Co-trimoxazole was sensitive against 77.2% isolates, Levofloxacin 52.5%, Nitrofurantoin 86.7% and Fosfomycin 90.5%. While comparing antibiotics, Co-trimoxazole displayed significantly higher susceptibility than Levofloxacin (p value 0.004), while in comparison with Nitrofurantoin and Fosfomycin, Co-trimoxazole had lower susceptibility with respective p values of 0.000 and 0.007. Conclusion: Study revealed that susceptibility of Co-trimoxazole was significantly higher than Levofloxacin, but lower than Nitrofurantoin and Fosfomycin. KEY WORDS Antibiotic, Susceptibility, Recurrent uncomplicated urinary tract infections, Minimum inhibitory concentration

Objective: To assess the effect of Erythropoietin on serum ferritin levels in dialysis-dependent Chronic Kidney Disease patients receiving iron therapy. Study Design: Observational study. Setting: Dialysis Unit of the Nephrology Department, Khyber Teaching Hospital, Peshawar. Period: September 2023 to March 2024. Methods: The study included adults aged 18 years and older who were diagnosed with chronic kidney disease (CKD) stages 3 to 5, undergoing dialysis, and receiving iron therapy with and without Erythropoietin. Patients with recent infections or acute renal failure were excluded from the study. Data analysis was conducted using SPSS software, where quantitative variables were reported as mean and standard deviation. Categorical variables were compared using the Chi-square test, with statistical significance defined as a p-value of less than 0.05. Results: The mean age of the 329 patients in this study was 41.28 years, with a standard deviation of 12.67. Among the participants, 54.1% were male and 45.9% were female. Of the total, 319 patients (97%) were receiving hemodialysis, while 10 patients (3%) were on peritoneal dialysis. Out of the 329 patients, 204 (62%) were undergoing erythropoietin therapy. Findings indicate that patients receiving erythropoietin had significantly higher serum ferritin levels, with a p-value of less than 0.05. Additionally, among erythropoietin users, 31.37% had hemoglobin levels below 7 g/dL, 55.4% had levels between 7 and 10 g/dL, and 13.2% had hemoglobin levels ranging from 10 to 14 g/dL. Conclusion: Our study concludes that approximately 62% of dialysis-dependent chronic kidney disease patients were receiving erythropoietin, and these patients exhibited higher hemoglobin and serum ferritin levels compared to those who were not taking the medication.