Objectives: To compare the efficacy of Duloxetine with Amitriptyline in Terms of Reduction in Frequency of Pain in The Management of Patients of Diabetic Neuropathy. Study Design: Randomized Control Trial. Setting: Medical OPD of ABWA Medical College Hospital Faisalabad. Period: Six Months from 01-01-2019 to 30-06-2019. Material & Methods: A total of 200 cases (100 in each group) between the age 20-65 years of any gender, ≥ 5 years history of diabetes, symptoms of peripheral neuropathy for at least six months, having HbA1c >7.5% were included. Two groups were formed Group A was given 60mg Duloxetine each day and Group B was given 75mg amitriptyline in a single dose. After 3 weeks, an additional three weeks supply of medication was dispensed and patient were scheduled to return at week 6 for the final evaluation that recorded by me in terms of reduction in pain score and also assessed for 50% reduction in pain score from base line that was labeled as reduced. Results: 62%(n=62) in Group-A and 35%(n=35) in Group-B were treated effectively, which shows a significant difference between the two groups. Conclusion: The duloxetine was more effective than amitriptyline in terms of reduction of pain in diabetic neuropathy.

Objective: Study the role of prophetic variables and their role in breast cancer patients especially those underwent surgical procedures. Study Design: Cross-sectional study Place and Duration: Institute of Molecular Biology and Biotechnology (IMBB), The University of Lahore. Martials and Methods: Twenty diagnosed patients of breast cancer facing surgical procedure were selected from the surgical department, Jinnah hospital, Lahore and twenty normal females were included in the study. Complete blood count (CBC) of the selected individuals was performed. Other biochemical markers Malondialdehyde (MDA), 8-hydroxy-2-deoxyguanosine (8-OHdG), 4-Hydroxynonenol (4-HNE), Isoprostanes F2α (IsoP- F2α), Interleukin-6 (IL-6), Matrix metalloproteinases-9 (MMP-9), Tumor Necrosis factor-alpha (TNF-α), Prostaglindin-E2 (PGE-2) were measured by commercially available kits. Results: The mean weight, BMI, WBCs, platelet count, lymphocyte and neutrophil value were higher in patients compared to the controls with statistically significant differences (p< 0.05). However, the mean MDA, 8-OHdG, 4-HNE, Iso-P2α, IL-6, MMP-9, TNF-α and PGE-2 value significantly higher than the control subjects (p < 0.05). Conclusion: Findings of the study demonstrated the significant role of the said prophetic variables that were having their medicinal importance in the invagination of breast cancer among the patients undergone surgical interventions. It shows the significant increases in the levels of discussed markers that show increased oxidative stress leading to cell damage that can be observed within the studied group. Therefore, early investigation of the said variables and ruling out the true causes could help in addressing the oncological complications that one undergoes after being through the surgical interventions and in providing the best possible treatments Keywords: Epidermal growth factor receptor, metastatic invasion, breast cancer surgery, matrix metalloproteinase, DNA adduct

Objective: Study the upregulation of Interleukin levels and their potential role in the pathogenesis of radicular cysts Study Design: Cross-sectional study Place and Duration: Institute of Molecular Biology and Biotechnology (IMBB), The University of Lahore, (9-10 Months) Martials and Methods: Hundred samples were extracted from both diseased and healthy individuals and tissue homogenates were prepared. MDA and LPS were estimated with the help of spectrophotometric method. IL1, IL-6, TNF-α and MMP-9 were determined by their commercial ELISA kits. Results: Malondialdehyde (MDA) was significantly (p=0.033) higher (3.99±0.99 Vs .95±0.011) in diseased group as compared to control. Higher levels of IL-1 (pg/ml) (6.59±1.56 Vs 4.56±1.23), IL-6 (pg/ml) (7.65±1.41 Vs 5.99±0.219) and TNF-α (pg/ml) (31.55±4.55 Vs 20.55±3.28) were recorded in the diseased group. In the group of patients, MMP-9 remained significantly increased when compared with the healthy controls in the case of subjects it remained (93.25±6.48 ng/ml) while in controls they were (47.22±5.29 ng/ml). Likewise in the case of LPS it was significantly increased in the group of radicular cyst (17.25±4.26 pg/ml) as compared to healthy controls (125.25±9.28 pg/ml). Conclusion: Present study indicates the significant correlation of LPS with the pathogenesis of radicular cyst. Moreover, it indicates that as the oxidative stress is increased, it increases the expression of several ILs and MMP-9 that contribute in the pathogenesis of radicular cyst. Further studies may describe the role of lipopolysaccharide and other potential variables to enable better understanding about bone resorption mechanism in periapical cyst development. Keywords: Interleukins, Lipopolysaccharides (LPS), Malondialdehyde (MDA), MMP-9, Radicular Cyst.

Objective: Study role of the selected inflammatory markers and their importance in the development and progression of rheumatoid arthritis. Study Design: Cross-sectional study Place and Duration: Institute of Molecular Biology and Biotechnology, The University of Lahore, (11-months) Methodology: A total of 50 patients diagnosed with rheumatoid arthritis in the Department of Orthopedics (Allama Iqbal Medical College, Jinnah Hospital, Lahore-Pakistan) and 50 healthy individuals of the age of 35-45 were included into the study. Glutathione, Catalase, Maliondialdehyde, Superoxide dismutase, Glutathione peroxidase, Nitric oxide (NO) and vitamin C, E and A was estimated spectrophotometrically. Serum C-Reactive Protein, IL-21, TNF-α, AOPPs, AGE’s and MMP-3 was measured by ELISA method using Human-ELISA kits (Glory) Results: A statistically noteworthy raise of all the biomarkers level in serum of rheumatoid arthritis (RA) was seen (p=0.001) comparable with healthy individuals. The correlation between joint damage progression diagnostic biomarker AGE and MMP-3 levels (r=0.485, 95% p=0.001) was highly significant. CRP and IL-21 also showed highly significant raise in joint inflammation (r=0.359, p=0.001). The results significantly depicted that model of MMP-3 levels at the onset of the disease and CRP and IL-21 were the robust interpreters of the erosion development. Similarly, antioxidants including Vitamin E, Vitamin C and Vitamin A were decreased in levels of (p<0.011), (p<0.011) and (p<0.022) respectively in RA subjects than in control subjects. Vitamin E, C and A are the most imperative free radical foragers within membrane. They also act as the major line of resistance against free radicals. Conclusion: Development of pain in joints in rheumatoid arthritis condition is due to the increase in the oxidative stress which is the key contrivance in the pathogenesis of RA. Keyword: Reactive oxygen species, Oxidative stress, oxidation of lipid peroxides, Rheumatoid arthritis, Osteoarthritis, osteocyte damage.

Objectives: record the rate of thrombocytopenia in cases presenting with chronic liver disease(CLD) due to Hepatitis C virus. Methodology: A total of 300 patients who were diagnosed with CLD caused by HCV and were over the age of 18 were part of this trial. The enroleld cases were admitted from Deptt. of Medicine, Rawalpindi Medical University. All patients diagnosed using AST, ALT levels of liver function test and reported by the radiologist was labeled as havign CLD. A thrombocyte count and an ELISA test for HCV were performed on the blood sample that was supplied to the laboratory from patients who had been diagnosed with CLD to determine presence/absence of thrombocytopenia. Results: Patients were in majority in age group 41-60 yrs i.e. 62%(n=186), mean age 42.63+8.57 yrs, 60 percent males (n=180) and there are 40 percent female subjects (n=120). Thrombocytopenia was found in 26 percent of CLD patients (n=78), while 74 percent of CLD patients (n=222) did not have any signs of thrombocytopenia. Conclusion: Higher rate of thrombocytopenia was observed in CLD cases due to hepatitis C virus. It needs attention for its early detection and management. Keywords: Chronic liver disease, hepatitis C virus, thrombocytopenia, HCV, CLD