Background and Aim: Stroke patients are most commonly susceptible to pulmonary infection that adversely affects the duration of hospitalization and clinical outcomes. Stroke affecting the respiratory system and causing neurological damage contributed to higher morbidity and mortality rate due to complications such as stroke-associated pneumonia (SAP). Early identification of high risk stroke patients and their management are imperative to reduce the prevalence of stroke-associated pneumonia. The present study aim was to determine the prevalence of stroke-associated pneumonia in stroke patients. Methodology: This cross-sectional descriptive case series was carried out on 226 stroke patients in the Department of Neurology, Fauji Foundation Hospital, Rawalpindi from January 2020 to December 2021. Stroke patients aged 30 to 70 years of either gender diagnosed with stroke were enrolled. Cough, fever and non-homogenous opacities observed on chest X-rays were used for the diagnosis of stroke. Patients with a history of pneumonia were excluded. Detailed history and complete examination was obtained for stroke diagnosis followed up for 1 month. SPSS version 25 was used for data analysis. Results: Of the total 226 stroke patients, there were 118 (52.2%) males and 108 (47.8%) females. The overall mean age was 48.62±8.45 years. Age-wise distribution of all patients were as follows; 72 (31.9%) 30-40 years, 106 (46.8%) 41-50 years, 32 (14.2%) 51-60 years, and 16 (7.1%) 61-70 years. The prevalence of stroke-associated pneumonia was 46 (20.4%). The incidence of diabetes mellitus, hypertension, ischemic heart disease, atrial fibrillation, congestive cardiac failure, and thrombophilia state was 48 (21.2%), 36 (15.9%), 28 (12.4%), 19 (8.4%), 14 (6.2%), and 8 (3.5%) respectively. Diabetes mellitus patients were more susceptible to stroke-associated pneumonia followed by hypertension and cardiac diseases. The incidence of stroke-associated pneumonia was 33 (14.6%) among patients having 6 to 12 hours stroke length against 13 (5.8%) with shorter duration. Conclusion: The present study found that the prevalence of stroke-associated pneumonia was 20.4% among stroke patients. Diabetes, hypertension, cardiac diseases, atrial fibrillation among stroke patients are the different risk factors that develop stroke-associated pneumonia. Early identification and better management could prevent the stroke-associated pneumonia in stroke patients. Keywords: Prevalence, Stroke-associated pneumonia, Stroke

Thirty male BALB/c mice were randomly divided into five groups (n=6). Group A received 0.2 ml normal saline intraperitoneally served as control for MTX. Group B received 0.2 ml distilled water orally for 7 days served as control for oral silymarin. Group C received single intraperitoneal injection of MTX 20 mg/kg. Group D received silymarin 25 mg/kg orally for seven days. Group E received silymarin 25 mg/kg orally for 7 days with MTX 20 mg/kg intraperitoneally at day 4. Blood samples for measuring serum ALT (Alanine Transaminase), AST (Aspartate transaminase) and ALP (Alkaline Phosphatase) along with liver samples for hepatic histological examination were taken after 24 hours of last dose. Results: Silymarin show hepatoprotective effect against MTX induced hepatotoxicity. Conclusion: Silymarin has hepatoprotective potential when administered along with MTX. Key words:Hepatoprotective, Hepatotoxicity, Methotrexate, Silymarin.

Objectives: To evaluate the protective role of silymarin against methotrexate(MTX) induced hepatotoxicity in mice. Study design: Randomized controlled trial on animalmodel. Period: 06 months from March 2016 to August 2016. Settings: Department ofPharmacology and Therapeutics, Army Medical College, Rawalpindi. Material and Methods:Thirty male BALB/c mice were randomly divided into five groups (n=6). Group A received 0.2 mlnormal saline intraperitoneally served as control for MTX. Group B received 0.2 ml distilled waterorally for 7 days served as control for oral silymarin. Group C received single intraperitonealinjection of MTX 20 mg/kg. Group D received silymarin 25 mg/kg orally for seven days. GroupE received silymarin 25 mg/kg orally for 7 days with MTX 20 mg/kg intraperitoneally at day 4.Blood samples for measuring serum ALT (Alanine Transaminase), AST (Aspartate transaminase)and ALP (Alkaline Phosphatase) along with liver samples for hepatic histological examinationwere taken after 24 hours of last dose. Results: Silymarin show hepatoprotective effect againstMTX induced hepatotoxicity. Conclusion: Silymarin has hepatoprotective potential whenadministered along with MTX.

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