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Home > Therapeutic Effects and Safety Profile of Atorvastatin on Psoriasis Severity Associated With Cardiovascular Risk

Therapeutic Effects and Safety Profile of Atorvastatin on Psoriasis Severity Associated With Cardiovascular Risk

Thesis Info

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Author

Ali Asad

Program

PhD

Institute

University of Karachi

City

Karachi

Province

Sindh

Country

Pakistan

Thesis Completing Year

2018

Thesis Completion Status

Completed

Subject

Pharmacology

Language

English

Link

http://prr.hec.gov.pk/jspui/bitstream/123456789/9644/1/Farah%20Asad_2018_UoK.pdf

Added

2021-02-17 19:49:13

Modified

2024-03-24 20:25:49

ARI ID

1676727604830

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Several studies occurs on anti-hyperlipidemic drug Atorvastatin and its pleotropic effects. However its relationship with Psoriasis and association of cardiovascular risk in comparison of standard therapy with large sample size has not been studied in Pakistan. Topical Betamethasone is the first line treatment in the management of all grades of Psoriasis as a monotherapy and in combination therapy. Beyond lipid lowering mechanism Atorvastatin have pleiotropic effect through direct inhibition of small GTPase protein (Rho, Rac, Ras and Rab). These protein control multiple signaling pathways involve in pathogenesis of immuno-inflammatory diseases like Psoriasis. Statin modulates the altered expression of these prenylated proteins. Psoriasis is important disease for researcher because it serves as a model disease to study the basic principle of immune mediated inflammation that is the reason by which in clinical trial it acts as a model for new research studies. Psoriasis is associated with other co-morbidities, the most important is cardiovascular risk. OBJECTIVE: Present study demonstrates that Atorvastatin has dual action on severity of psoriasis and cardiovascular risk (CVR). METHODS: This was an interventional study conducted in Pharmacology Department of BMSI, JPMC with the collaboration of Pathology Department, BMSI, JPMC and Dermatology Department of JPMC. This research project consist of two phases one was the preclinical conducted on ninety adult Wistar Albino rats divided into three groups, Group A (Control), Group B (Doxorubicin induced toxicity) and Group C (Atorvastatin pretreated). Other was the clinical study on mild to moderate xxvi plaque type psoriatic patients. 225 psoriatic patients enrolled in this study those who fulfilled the inclusion and exclusion criteria. The inclusion criteria were, both male and female age ranging from 25-65 years, PASI score <12, hs C-RP ≥ 3. These patients further divided into three groups. Group A prescribed tab. Atorvastatin 80mg for first three month followed by 40mg for next three months. Group B prescribed Placebo and topical Betamethasone valerate 0.1% twice daily for 3 months and once a day for the next 3 months (three weeks apply than one week interval and for sensitive area 50% betamethasone in soft paraffin). Group C prescribed tab. Atorvastatin 40mg for the first three months followed by 20 mg for next three months plus topical Betamethasone valerate 0.1% once daily for 6 months (three weeks apply than one week interval and for sensitive area 50% betamethasone in soft paraffin). The efficacy and safety profile of drug assists preclinically by biopsy of rats myocardium and clinically by PASI, hsCRP, DLQI, Lipid Profile, LFTs and CPK.
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سماحت اور رہبانیت: شاہ ولی اللہ کا موقف

The hall mark of Shah Waliullah has been advocate moderation and the communal spirit of Isla shuns worldly attitude and abhors rejection of the wor and offers a middle path. There is no extremism in Isla and Shah Wali Ullah has preached the same. The juris the Sufis and the Muhaddisseen have taken up a differe line of thinking regarding "Tassawwuf" --- yet th essential spirit of Islam is the path of moderation. T spiritualism and physical world has to be kept in balance— with moderation and balance. It is this aspect of Sha Waliullah's writings that has been highlighted in th article.

Molecular Characterization of Syndromic and Nonsyndromic Forms of Deafness Using Molecular Genetic Approaches

Hearing loss is a common neurosensory impairment, which has a significant genetic etiology. A hearing loss affects 1 in 1000 newborns and 1 in 300 children by the age of 4 years (Chang 2015). It has been estimated that 1% of almost 30,000 protein coding genes in human are associated with hearing phenotype (Friedman and Griffith 2003). The mechanism of hearing is not fully understood because of the challenges associated with studying inner ear architecture, but nonetheless some of the key genes encoding distinct mechanisms of hearing have been explored by using genetic tools. Recent studies in the field of human genetics have been influential in identifying some of the proteins underlying mechanisms essential for sound transduction, as for example, hair cells electromotility, mechanotransduction, development of inner and outer hair cells, and the molecular composition of the ribbon synapse. Using a genetic approach, this thesis research project explored novel genes involved in non-syndromic and syndromic forms of hearing loss. Participants from 85 families that are segregating moderate to severe degree of hearing loss are included in this study. The affected individuals from 85 different families were initially screened for mutations of GJB2 and HGF. Genetic variants of these two genes are common in the Pakistani population and there is only one protein-coding exon of GJB2 and two common intronic mutations of HGF which are easily sequenced for mutations. I have identified twenty five novel mutations in genes that have been associated with hearing loss and all of the identified novel mutations are predicted to be pathogenic according to multiple in silico tools and have an allele frequency less than 0.005%. Mutations of MYO15A, GJB2 and HGF are the three-major contributors to deafness in this cohort of eighty-five families. In this thesis research project, I have successfully utilized some of the latest techniques in genetics that includes Whole Exome Sequencing (WES), genome wide SNP genotyping, and Whole Genome Sequencing (WGS) and was able to identify novel genes involved in syndromic and non-syndromic forms of deafness. In family PKDF1400, I completed genome wide SNP genotyping of affected and unaffected individuals. Genotyping data revealed a significant linkage score on chromosome 19p13.2 that encompasses DFNB68 locus. Individuals from PKDF1400 were then subjected to WES and I identified a missense pathogenic variant of S1PR2 (p.Tyr140Cys). Sanger sequencing of the single nucleotide variant revealed co segregation with the phenotype in PKDF1400. This thesis project has contributed data in identifying a novel gene underlying DFNB68 form of deafness (Santos-Cortez et al. 2016). I also identified a variant of SGO2 that is necessary for fertility in a Perrault syndrome proband of family PKDF063, which was ascertained from Pakistan. Whole exome sequencing of affected and unaffected members of PKDF063 revealed a truncating mutation of SGO2 p.(Glu485Lysfs*5) associated with the proband’s infertility phenotype. This is the first report of an association of SGO2 with human infertility (Faridi et al. 2017). I was successful in identifying a rare truncating mutation in family PKDF461 using Whole genome sequencing. PKDF461 was ascertained as a family segregating non syndromic hearing loss. The family has significant linkage of deafness to the DFNB8/10 interval which was further narrowed after analyzing WGS data that revealed a novel nonsense mutation of KCNE1 (p.Tyr46*). Mutations of KCNE1 are associated with Jervell and Lange Nielson syndrome (JLNS2) but this is the first truncating mutation of this gene.Overall, this thesis research project has identified novel gene for human hearing and fertility and has expanded the genotype-phenotype spectrum associated with Perrault syndrome and Jervell and Lange Nielson syndrome. This study has contributed twenty five novel genetic variants in several different genes that are critical for normal auditory function. Overall, this research project utilized cutting-edge genomic technologies that have revealed molecular genetic explanations for hereditary hearing loss in human families and was successful in identifying novel genes for non-syndromic and syndromic forms of hearing loss.