BackgroundIn this study Aesculus indica fruit was subjected to isolation of phytochemicals. Two antioxidants quercetin and Mandelic acid were isolated in pure state. The free radical scavenging and acetyl choline esterase inhibitory potential of the crude extract and sub fractions were also determined.ResultsThe antioxidant capacity of crude extract, fractions and isolated compounds were determined by DPPH and ABTS methods. Folin-Ciocalteu reagent method was used to estimate the total phenolic contents and were found to be 78.34 ± 0.96, 44.16 ± 1.05, 65.45 ± 1.29, 37.85 ± 1.44 and 50.23 ± 2.431 (mg/g of gallic acid) in crude extract, ethyl acetate, chloroform, n-hexane and aqueous fractions respectively. The flavonoid concentration in crude extract, ethyl acetate, chloroform, n-hexane and aqueous fraction were; 85.30 ± 1.20, 53.80 ± 1.07, 77.50 ± 1.12, 26.30 ± 1.35 and 37.78 ± 1.25 (mg/g of quercetin) respectively. The chloroform fraction was more potent against enzymes, acetyl choline esterase and butyryl choline esterase (IC50 = 85 and 160 μg/ml respectively). The phenolic compounds in the crude extract and fractions were determined using HPLC standard method. Chlorogenic acid, quercetin, phloroglucinol, rutin, mandelic acid and hydroxy benzoic acid were detected at retention times 6.005, 10.062, 22.623, 30.597, 35.490 and 36.211 in crude extract and different fractions. The ethyl acetate fraction was rich in the targeted compounds and was therefore subjected to column isolation. The HPLC chromatogram of isolated compounds showed single peak at specified retention times which confirms their isolation in pure state. The isolated compounds were then characterized by FTIR and NMR spectrophotometric techniques.ConclusionThe Aesculus indica fruit extracts showed antioxidant and anticholine esterase inhibitory potentials. Two bioactive compounds were isolated in the pure form ethyl acetate fraction. From results it was concluded that the fruit of this plant could be used to minimize oxidative stress caused by reactive oxygen species.Electronic supplementary materialThe online version of this article (10.1186/s12858-018-0095-7) contains supplementary material, which is available to authorized users.

IntroductionParaphenylene diamine (PPD) ingestion is manifesting as one of the more common ways of committing suicide in Southern Punjab, Pakistan, especially Bahawalpur. PPD is an ingredient of a compound commonly known “Kala Pathar” which means “Black Stone” in Urdu. It is readily available in the market at low cost and is used to dye hair and fur. Its intoxication inhibits cellular oxidation and affects the muscles causing rhabdomyolysis. This leads to myoglobinuria followed by renal failure and edema of face and throat resulting in respiratory difficulty. Very little is known about the impact of PPD intoxication on liver tissue.ObjectiveThe purpose of the study was to find out the frequency of acute hepatitis following PPD intoxication.MethodsWe reviewed the medical records of 109 patients with PPD intoxication admitted to Medical Unit-2, Bahawalpur Victoria Hospital from January 1, 2015, to June 30, 2015, in a descriptive, cross-sectional study. We noted the frequency of acute hepatitis and other complications, and we recorded the demographic features, clinical features, and outcomes of these patients.ResultsOur study included 32 men (29%) and 77 women (71%). The mean age was 22 ± 3.4 years, and most patients were young women aged 15 to 24 years. Suicidal ingestion was the leading cause of admission for 101 patients (93%). The most common clinical presentation was cervicofacial edema (95%), throat pain (88%), dysphonia (95%), cola-colored urine (100%), and oliguria (95%). Rhabdomyolysis (86%), acute hepatitis (51%), and acute renal failure (63%) were the most common clinical conditions following poisoning. Overall mortality was noted in 39 patients (36%) while all other patients achieved complete clinical recovery (64%). In patients with mortality, 20 of 39 (51%) developed acute hepatitis. Most patients (95%) in our study underwent tracheostomy.ConclusionThe frequency of acute hepatitis in PPD intoxication is high in this population, especially in young women. Measures need to be instituted regarding the management of acute hepatitis in PPD intoxication to improve patient outcomes. Workups in patients with PPD poisoning should include regular monitoring of aspartate aminotransferase and alanine aminotransferase to observe any damages to the liver so that acute hepatitis can be managed in a timely fashion.

Background: Diabetic patients show serious complications of chronic liver disease. The monitoring of glucose in diabetic patients with chronic liver disease is very challenging. Generally, the glycaemic control monitoring in chronic liver disease patients is the same as in a person who does not have any liver disease. Flash glucose monitoring system is a way to measure glucose levels of body without pricking the body. It is an innovative method of measuring glucose levels. A flash glucose monitor is a small sensor. This sensor is a small sticky chip and is attached on the skin of the arm. One side of the chip has a small needle that goes inside the skin. It records glucose levels throughout day and night continuously. Levels of glucose can be assessed whenever wanted. Materials and Methods: The study was conducted in the Medical Ward 1, Bahawal Victoria Hospital, Bahawalpur and the Department of Pathology, Quaid-e-Azam Medical College, Bahawalpur from 1st January 2018 to June 2020. Freestyle Libre Sensor flash glucose monitoring system (by CoolPlus Medical) was used to measure glucose of subcutaneous interstitial fluid. The disposable sensor was applied to the back of the arm for up to 14 days. Sensor is calibrated by the factory with no automatic alarms. Results: We noticed that the results of the patients who had co-existing disease of chronic hepatitis and diabetes mellitus had same results of glucose readings when measured by flash glucose monitoring system and by finger prick for glucose measurement by glucometer. Conclusion: Flash glucose monitoring system is way better than self monitoring blood glucose method by glucometer in diabetic patients with chronic liver disease. Keywords: Diabetes, glucose, monitoring, chronic liver disease, complications