Paricalcitol, a new Vit. D analogue is thought to be more potent than Calcitriol and has also been reported to cause less hypercalcemia. We report one‐year follow‐up on patients (N = 74) from one inner city dialysis unit. Patients were stratified in groups A, B, C, D depending on intact Paratharmone (iPTH) levels i.e., < 100, 100–300, 300–600, > 600 respectively. Serum Ca, PO4, alkaline phosphatase (ALK), albumin (ALB), hemoglobin (Hb) was measured monthly and serum iPTH was checked quarterly. The results are as follows: Group # PTH Ca PO4 ZPR Hb EPO pg/dl mg/dl mg/dl mcg/hd g/dl U/kg/hd A656.83*9.745.32011.72255.8†B22197.01**9.045.532.48¶12.12137.55C29422.89**9.45.734.54¶¶11.86128.87D171253.4**9.887.2112.51¶¶12.174.35†† PTH: p < 0.05 = *vs**, ZPR(zemplar): p < 0.05¶ vs¶¶, mcg: microgram EPO(erythropoietin): p < 0.05 = † vs††, Mean age, weight, URR, ALB., ALK. and iron indices were not statistically different in all groups. Mean duration of hemodialysis (HD) was 34, 30, 57 & 65 months in groups A, B, C, D respectively. None of these patients had symptomatic bone disease. Seven patients were changed to low Ca (1.0 meq/L) bath secondary to hypercalcemia (Ca > 11.5) & severe hyperparathyroidism (HPT). This data suggest that severe HPT is frequent despite aggressive Paricalcitol therapy in the inner city HD population. More effective noncalcium phosphate binders and/or calcimimetic agents may be needed in addition to dietary and medication compliance in group D to control severe HPT. Interestingly patients with low PTH (< 100) showed relative epogen resistance while patients in group D required smaller epogen doses. There was inverse relationship between ZPR & EPO dosage. The effect of ZPR on EPO responsiveness needs to be confirmed in larger study.

Background:Tumor lysis syndrome is a metabolic derangement which is seen in patients with malignancy and receiving drugs for cancer treatment. It can arise in children or older cancer patients and is considered life threatening. Anticancer drug therapy is most commonly used method to treat cancer. Aim: To investigate the role of electrolytes and vitamins (A, C and E) in cancer patients suffering from tumor lysis syndrome during anticancer therapy. Study design: Prospective clinical study Methods: The study enrolled fifty diagnosed patients of Tumor lysis syndrome.Informed consent was taken from patients.Twenty patients, clinically healthy, age and sex-matched were selected as a control in the present study. 5cc blood was withdrawn from enrolled cases. The obtained samples were centrifuged at the speed of 4000-5000rpm for 10-15 minutes to obtain serum. The levels of Electrolytes (Na+, K+), and Vitamins A, C, E were estimated. Results: Study showed elevated serum levels of sodium (Na+) (28.26) in comparison withcontrol normal persons (21.26) and this is significant statistically (0.02<0.05). Serum Potassium levels among Tumor lysis syndrome (TLS) cases was (13.26) as observed in normal controlled persons (14.26) and results were significant statistically (0.03<0.05). Vitamin A level in Tumor lysis syndrome(TLS) cases decreased outstandingly (102.20) in contrast to normal control study persons.(188.26) and this is significant statistically (0.026<0.05). The values for Vitamin E in Tumor lysis syndrome cases was (4.26) and in controlled normal individuals (7.26) and proved significant statistically (0.015<0.05). Conclusion: Present study showed inverse relationship between Vitamins and electrolytes in TLS. Increased level of electrolyte imbalances and decreased vitamin levels is the reason responsible for the development of tumor lysis syndrome. Keywords: TLS, Vit A, Vit C, Vit E, Na+,K+

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Introduction: Diabetes Mellitus is a common metabolic syndrome characterized by persistently elevated blood glucose levels. Canagliflozin is an SGLT-2 inhibitor that controls hyperglycemia by reducing the reabsorption of filtered glucose and excreting it in the urine. Zinc sulphate exhibits some beneficial role in diabetes mellitus but has not been compared to canagliflozin individually and in combination. Aims & Objectives: To observe the effects of treatment with canagliflozin and zinc sulphate on pancreatic histology in streptozotocin induced type-2 diabetic rat model. Place and duration of study: The study was conducted in the Department of Pharmacology, KEMU and PGMI, Lahore for the period of two months. Material & Methods: It was an animal experimental study of eight weeks duration in which 48 adult healthy albino rats of male gender were divided into six groups and were provided the high fat diet throughout the study period. Groups A and B were maintained as healthy and diseased controls respectively. Groups B, C, D, E and F were administered single I/P dose streptozotocin (35mg/kg) at day 22 for inducing diabetes. Upon confirmation of diabetes after a week the rats were further treated as per group designation orally for 4 weeks , individually or in combination with full or half doses of canagliflozin (10 mg /kg/day, 5mg/kg/day ) and zinc sulphate (30mg/kg/day, 15mg/kg/day) . All animals were euthanized at the completion of study duration. The pancreatic tissue was taken out and examined for the histopathological changes (size and number of pancreatic islets, karyolysis and ballooning degeneration). Results: There was a marked improvement in the size and number of islets as well as the inflammatory changes in the combined treatment group (with canagliflozin in full as well as half dose of zinc sulphate) as compared to the groups given zinc sulphate and canagliflozin separately. Conclusion: Combined treatment with canagliflozin and zinc sulphate has a better protective effect on the pancreatic tissue in diabetes than either of them used alone.

Introduction: Kidney stones are the 3rd major health problem affecting the urological system. Industrial chemical ethylene glycol can generate calcium oxalate crystals in kidneys. Allopurinol has been used to treat the hyperuricemia but can be effective against calcium oxalate kidney stones too. Seeds of Cucumis melo were traditionally utilized as antioxidant and diuretic, so can be studied as litholytic agent against stones as well. Aims & Objectives: To assess and compare the litholytic effect of ethanolic extract of Cucumis melo seeds against ethylene glycol induced urolithiasis with allopurinol in rats. Place and Duration of study: This experimental study was conducted in Pharmacology Department of FPGMI, Lahore for the period of 2 months. Material & Methods: Four groups of 10 rats in each group were made. Calcium oxalate urinary stones were induced by 0.75% ethylene glycol for 28 days in male rats. Groups 1&2 served as negative and positive control while experimental groups 3&4 received Allopurinol 50mg/kg and Cucumis melo seed’s ethanolic extract (EECMS) in dose of 400mg/kg from 15th day to 28th day respectively. At the end of study, kidney weight, urinary calcium, oxalate and phosphorus along with histological examination of kidneys were used as measuring criteria of litholytic effect of seeds of Cucumis melo and was compared to allopurinol. Data analysis was performed using SPSS 20.0 & presented in mean±s.d .Post-hoc Tukey’s test and ANOVA were used for comparison between data groups Results: After 13 days of treatment experimental groups Groups 3 (Allopurinol 50mg/kg) and 4 (EECMS 400mg/kg) showed remarkable decreased mean urinary calcium, oxalate, phosphorus levels( mg/dl) and kidney weights(gm) of urinary calcium(10.55±1.53, 8.28±1.42), oxalate (18.3±0.78, 17.58±1.38), phosphorus (4.3±0.85, 3.59±1.49) and reduced kidney weights(1.43±0.22, 1.37±0.29) respectively(p value <0.001) as compared to diseased control group 2. Thus exhibiting Cucumis melo seed’s ethanolic extract has better litholytic role than allopurinol which also proved to be efficacious. Histopathological examination of kidney also showed dissolution of calcium oxalate stones. Conclusion: Seeds of Cucumis melo extract have better litholytic effect on calcium oxalate kidney stones than allopurinol with improvement noted in the renal histological profile.