April to September 2013. Methods: Total 28 rabbits of weight 1-1.5kg of either sex were used in this study. Which were divided randomly into four equal groups: Group I was control group. In group II silymarin (50mg/kg/day orally) was administered, in group III isoniazid (50mg/kg/dayorally) was given; and in group IV, effects of combination therapy of isoniazid and silymarin were observed. Before starting the drug therapy, at day 0 and one day after the end of study period i.e., at day 19, body weight of each animal was recorded. Rabbits were sacrificed on 19 th day and the required liver sample was taken for histopathological examination. The data feeding and analysis at the end of study was done on computer package SPSS (Statistical packages of social science) version 16. Results: No mortality was recorded in any group. In group II (silymarin treated) animals in this group exhibited no any histological changes in the hepatic lobule except few inflammatory cells 28.5% were seen in the portal tract. The liver microscopic examination in group III (Isoniazid treated), animals showed the disturbed architecture of the lobule. There were no fatty changes, whereas ballooning degeneration was 42.9%, hepatocytes necrosis was 71% and portal inflammation was 71.4% which was very severe. Animals in group IV, given combination of silymarin and isoniazid showed the intact architecture of the hepatic lobule, in which 14.29% ballooning degeneration, whereas necrosis of hepatocytes and portal inflammation was mild in nature which may be due to hepatoprotective role of silymarin. Conclusion: Silymarin has hepatoprotective effects when given in combination with isoniazid.

Anterior-lateral Vs Anterior-posterior Electrode Positioning for Cardioversion of Atrial Fibrillation and Atrial Arrhythmias: A Systematic Review and Meta-analysis Introduction: Multiple randomized controlled trials (RCTs) have compared the efficacy of anterolateral (AL) and anteroposterior (AP) electrode positioning for cardioversion of atrial fibrillation and other atrial arrhythmias with conflicting results. We hypothesized that AP electrode positioning will have a superior efficacy for cardioversion due to better alignment of the energy vector with the atria. Methods: A systematic search was conducted in the MEDLINE and Embase databases utilizing the Ovid interface. Results were screened to identify RCTs comparing AL and AP position of electrodes for cardioversion for atrial arrhythmias. Studied outcomes included the success of cardioversion, number of shocks, and mean shock energy required for successful cardioversion to sinus rhythm. Mantel-Haenszel aggregated risk ratios (RR) with 95% CIs were calculated. Results: A total of 14 RCTs were included comprising 2445 patients (1329 AL, 1116 AP). There was no statistically significant difference between the two groups with respect to successful cardioversion (RR 1.02 [0.97-1.06]; p = 0.43), first shock success (RR 1.14 [0.99-1.32]; p = 0.06), second shock success (RR1.08 [0.94-1.23]; p = 0.29), mean shock energies (mean difference 6.49 [17.33-30.31]; p = 0.59). We additionally compared success at high; >150 J (RR 1.02 [0.92-1.14] and low; <150 J (RR 1.09 [0.97-1.22]; p = 0.64) cardioversion energies which also did not show any significant difference. Conclusions: There is no significant difference in the efficacy between AL vs. AP electrode position for cardioversion of atrial arrhythmias.

Objectives: To observe healthy effects of silymarin on liver histopathology againstliver damage, caused by isoniazid in rabbits. Study Design: Interventional study. Setting:Animal House of Jinnah Postgraduate Medical Centre, Karachi. Period: April to September2013. Methods: Total 28 rabbits of weight 1-1.5kg of either sex were used in this study. Whichwere divided randomly into four equal groups: Group I was control group. In group II silymarin(50mg/kg/day orally) was administered, in group III isoniazid (50mg/kg/dayorally) was given;and in group IV, effects of combination therapy of isoniazid and silymarin were observed. Beforestarting the drug therapy, at day 0 and one day after the end of study period i.e., at day 19, bodyweight of each animal was recorded. Rabbits were sacrificed on 19th day and the required liversample was taken for histopathological examination. The data feeding and analysis at the endof study was done on computer package SPSS (Statistical packages of social science) version16. Results: No mortality was recorded in any group. In group II (silymarin treated) animals inthis group exhibited no any histological changes in the hepatic lobule except few inflammatorycells 28.5% were seen in the portal tract. The liver microscopic examination in group III(Isoniazid treated), animals showed the disturbed architecture of the lobule. There were no fattychanges, whereas ballooning degeneration was 42.9%, hepatocytes necrosis was 71% andportal inflammation was 71.4% which was very severe. Animals in group IV, given combinationof silymarin and isoniazid showed the intact architecture of the hepatic lobule, in which 14.29%ballooning degeneration, whereas necrosis of hepatocytes and portal inflammation was mildin nature which may be due to hepatoprotective role of silymarin. Conclusion: Silymarin hashepatoprotective effects when given in combination with isoniazid.

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Aim To study the comparative effect of acetaminophen with aqueous Neem leaf extract (Azadirachta Indica) and vitamin E mediated liver toxicity on the basis of liver enzymes. Methods: A total of sixty (60) Wistar rats of either sex were divided equally into four groups. Each groupwas made up of 15 animals. Group A was the control group. Animals in Group B were treated with a single oral dose of 2 mg / kg b / w Paracetamol. Group C animals with 500 mg / kg b / w oral Neem extract for 15 days with oral administration of 2 mg / kg b / w oral Paracetamol. In Group D, animals received the same dose of Paracetamol and 100 mg / kg b / w intra-peritoneal vitamin E for 15 days, respectively. The liver enzymes ALT,AST, and ALP were then evaluated. Data was analyzed using SPSS Version 20.0 with level of significance being kept at p-value ≤0.05 Results: In the 4 groups, The ALT values were 22.8 (Group A), 100 (Group B), 29.11 (Group C), and 31.16 U/L (Group D). The AST values were 25 (Group A), 40 (Group B), 20 (Group C), and 15 (Group D) U/L. The ALP values were 220 (Group A), 445 (Group B), 242 (Group C), and 244 (Group D) U/L. There was significant increase in liver enzymes were found in Group B after induction of Paracetamol toxicity, however, hepatoprotective effects could be seen in the intervention Group C and D Conclusion: Azadirachta Indica and Vitamin E showed hepatoprotective effects on the Wistar rats that were subjected to Paracetamol Key words: Azadirachta Indicaleaf extract, Vitamin E, Paracetamol, Wistar rats