Therapeutic potential of medicinal plants against Leishmaniasis: a public healh concern / Potencial terapeútico de plantas medicinales contra la Leishmaniasis: un problema de salud pública

Leishmaniasis is an important disease affecting global public health which is spread by sand fly having different species. Various chemical drugs are used to treat and control Leishmaniasis including pentavalent antimonials, antimicrobial and antibiotics. Due to emergence of drug resistance, these therapeutic options are losing effectiveness in attaining success. Furthermore, these drugs are expensive and have toxic effects on liver and kidneys. There has been an emerging interest and excellent response by using plant based drugs and extracts to control Leishmaniasis. Different medicinal plants including Glycyrrhiza glabra, Allium sativum, Peganum harmala and Nigella sativa have shown excellent anti-leishmanial activity. Therefore, medicinal plants can help in effective drug development against Leishmaniasis diseases in both animals and humans which will be safer and health protective.

La Leishmaniasis es una enfermedad importante que afecta la salud pública mundial y que es transmitida por las moscas de la arena, que tienen diferentes especies. Se utilizan varios medicamentos químicos para tratar y controlar la Leishmaniasis, incluidos los antimoniales pentavalentes, antimicrobianos y antibióticos. Debido a la aparición de resistencia a los medicamentos, estas opciones terapéuticas están perdiendo eficacia para lograr el éxito. Además, estos medicamentos son costosos y tienen efectos tóxicos en hígado y riñones. Ha habido un interés emergente y una excelente respuesta mediante el uso de extractos y medicamentos a base de plantas para controlar la Leishmaniasis. Diferentes plantas medicinales como Glycyrrhiza glabra, Allium sativum, Peganum harmalay Nigella sativahan mostrado una excelente actividad anti-leishmanial. Por lo tanto, las plantas medicinales pueden ayudar en el desarrollo de fármacos eficaces contra las enfermedades de la leishmaniasis tanto en animales como en seres humanos, lo que será más seguro y proteja la salud.

Effectiveness of agricultural extension's farmer field schools (FFS) in Pakistan: the case of citrus growers of Punjab province / Eficácia das escolas de extensão agrícola de campo (FFS) no Paquistão: o caso dos produtores de frutas cítricas da província de Punjab

ABSTRACT: Citrus is one of the major exported fruits of Pakistan. Especially Kinnow cultivar is famous across the globe because of its aroma and taste. The overall production of citrus is reported as half of the potential because of the non-adoption of research-based practices and lack of agricultural extension services and training of the citrus growers. In the last few years, the department of agricultural extension has started training programs called Farmer Field Schools (FFS) for citrus growers in the major citrus growing zone of the Punjab province, i.e., Sargodha region. This research was conducted in the Sargodha district to evaluate the knowledge and skills gained by the farmers from the FFS. The interview schedule was designed for the purpose of data collection. The data was collected from 120 farmers randomly selected from 15 FFS in the study area. All the respondents were participants of the FFS. The data was analyzed using Statistical Package for Social Sciences (SPSS). The Results of the study showed that 40% of the farmers learned about citrus verities, one-third of respondents learned about the management of new plants/orchards, 28% of the respondents got knowledge about the cultivation of fruits, and one-fourth of respondents acquired knowledge and skills about layout and management of citrus orchards. These findings conclude that training course has a positive influence on farmers' farm management skills; hence emphasize on its persistence and further improvement by the concerned authorities.

RESUMO: Os citros são as principais frutas exportadas do Paquistão, especialmente, a cultivar Kinnow é famosa em todo o mundo por causa de seu aroma e sabor. A produção geral de citros é relatada como a metade do potencial devido a não adoção de práticas baseadas em pesquisas e a falta de serviços de extensão agrícola e treinamento dos citricultores. Nos últimos anos o departamento de extensão agrícola iniciou programas de treinamento chamados Farmer Field Schools (FFS) para citricultores na maior zona de cultivo de citros da província de Punjab, no distrito de Sargodha. Esta pesquisa é conduzida no distrito de Sargodha para avaliar o conhecimento e as habilidades adquiridas pelos agricultores da FFS. O cronograma de entrevistas foi elaborado para fins de coleta de dados. Os dados foram coletados de 120 agricultores aleatoriamente de 15 FFS na área de estudo. Todos os entrevistados eram participantes da FFS. Os dados foram analisados ​​por meio do programa estatístico "Statistical Package for the Social Sciences (SPSS"). Os resultados do estudo mostraram que 40% dos agricultores aprenderam informações importantes sobre citros, um terço dos entrevistados aprenderam sobre o manejo de novas plantas / pomares, 28% dos entrevistados aprenderam sobre o cultivo de frutas e um quarto dos entrevistados adquiriu os conhecimentos e habilidades sobre layout e manejo de pomares de citros. Essas descobertas concluem que o curso de treinamento tem uma influência positiva nas habilidades de gestão das propriedades; portanto, suporta a necessidade de sua persistência e melhorias adicionais pelas autoridades para alavancar ainda a produtividade essa atividade no futuro.

Potential of botanical driven essential oils against Haemonchus contortus in small ruminants / Potencial de aceites esenciales botánicos contra Haemonchus contortus en pequeños rumiantes

The livestock sector is continuously facing problems in controlling parasitic diseases especially Haemonchosis due to emergence of anthelminthic resistance and failure in vaccination control programmes. Therefore, to increase milk and meat production and emerging demand of meat free from drug residues development of new alternative approaches are appealing for prevention and control of Haemonchosis in small ruminants. Among alternatives, plants driven essentials oils have shown promising results in control of Haemonchus contortus infection at various concentrations by different assays including egg hatch assay, larval development assay, larval exsheathment assay and adult motility assay. Essential oils are complex mixtures of various impulsive or volatile compounds which have potential to control Haemonchosis. The current study reviews the therapeutic effects of essential oils of plants against Haemonchus contortus and to be used them against Haemonchus contortus for future perspectives.

El sector ganadero enfrenta continuamente problemas para controlar las enfermedades parasitarias, especialmente la hemoncosis, debido a la aparición de resistencia antihelmíntica y al fracaso en los programas de control de vacunación. Por lo tanto, para aumentar la producción de leche y carne, y la demanda emergente de carne libre de residuos de medicamentos, el desarrollo de nuevos enfoques alternativos es atractivo para la prevención y el control de la hemoncosis en pequeños rumiantes. Entre las alternativas, los aceites esenciales producidos por las plantas han mostrado resultados prometedores en el control de la infección por Haemonchus contortus a diversas concentraciones mediante diferentes ensayos, incluido el análisis de eclosión de huevos, el desarrollo de larvas, el análisis de vaciado de larvas y el ensayo de motilidad en adultos. Los aceites esenciales son mezclas complejas de varios compuestos impulsivos o volátiles que tienen potencial para controlar la hemonchosis. Este estudio revisa los efectos terapéuticos de los aceites esenciales de las plantas contra Haemonchus contortus y evalúa sus perspectivas futuras como agentes para combatir las enfermedades causadas por este parásito.

Acaricidal and insecticidal effects of essential oils against ectoparasites of veterinary importance / Efectos acaricidas e insecticidas de los aceites esenciales contra los ectoparásitos de importancia veterinaria

Ectoparasitism in animals has become an issue of great concern that needs to be resolved to prevent huge economic losses occurring to livestock industry all over the world. Synthetic adrugs have been playing a major role in controlling ectoparasites, but their frequent and irrational use has resulted in drug resistance to routinely used chemicals and their residual effects on food and environment. Therefore, this approach of using chemical acaricides and insecticides is losing its popularity and effectiveness in controlling ectoparasites. So, the development of alternative approaches in ectoparasite management is currently required. Among alternative protocols, plants and their essential oils have played remarkable role in controlling different ectoparasites (ticks, flies, mites, lice) of veterinary importance. Essential oils have been proved to be cheaper, more effective and safer therapeautic agents against different ectoparasites of livestock importance.

En los animales el ectoparasitismo se ha convertido en un tema de gran preocupación que debe resolverse para evitar que se produzcan grandes pérdidas económicas para la industria ganadera en todo el mundo. Los aditivos sintéticos han desempeñado un papel importante en el control de los ectoparásitos, pero su uso frecuente e irracional ha dado como resultado la resistencia a los fármacos utilizados habitualmente y efectos residuales sobre los alimentos y el medio ambiente. Por lo tanto, el enfoque basado en el uso de acaricidas e insecticidas químicos está perdiendo popularidad y efectividad en el control de los ectoparásitos. Por lo tanto, actualmente se requiere el desarrollo de enfoques alternativos en el manejo de ectoparásitos. Entre los protocolos alternativos, las plantas y sus aceites esenciales han jugado un papel notable en el control de diferentes ectoparásitos (garrapatas, moscas, ácaros, piojos) de importancia veterinaria. Se ha demostrado que los aceites esenciales son agentes terapéuticos más baratos, más efectivos y más seguros contra diferentes ectoparásitos de importancia ganadera.

Cypermethrin-induced Repeated-dose Immuno-toxicity in Oryctolagus Cuniculus: An Investigation into Pathology of Spleen and Blood

Background: Cypermethrin is a pyrethroid insecticide widely used in agriculture and medicines. Its toxicity effects on spleen and blood in male and female rabbits is studied in this research. Methods: Age- and weight-matched does/females (n=24) and bucks/males (n=24) of Japanese White rabbits were subjected to intraperitoneal cypermethrin administration @50, 100 and 150 mg.kg-1 b.wt. in groups B, C and D, respectively.  The experimental rabbit does and bucks were tested for hematology alterations after each of 5 CY-treatments, at days 1, 8, 15, 22 and 29.  One rabbit doe and one rabbit buck were sacrificed fortnightly (days 15, 29, 43, 57 and 71) to obtain spleen for histological studies. Results: CY-treated rabbit bucks developed anemia, leukopenia, neutropenia, monocytosis, eosinophilia and basocytopenia mostly in dose and time dependent manner.  In contrast, rabbit does show transient but significant leukocytosis, neutropenia, lymphopenia, monocytosis, eosinophilia and basophilia only in high dose group.  Moreover, spleen histology revealed congestion, depletion of white pulp with increased red pulp and hemosiderin deposition in CY treated rabbit bucks, but not rabbit does. Conclusions: This study concludes that immuno-toxicity by cypermethrin insecticide is not similar in male and female subjects.

Marker Assisted Molecular Investigation of Kappa-Casein Gene in Bos Indicus Sindhi Genetic Group Using HINFI Restriction Enzyme

Background: Present research aimed to determine molecular genotype of kappa-casein gene in female Red Sindhi cattle. This gene has great influence on the technologically advanced milk properties. Methods: Blood specimens (n=50) from females of this cattle breed at a well-managed farm in Sindh-Pakistan were collected and commercial kit was employed for DNA extraction. Genotype determination of κ-casein gene and alleles was done through PCR-RFLP technique by using primer; PCR products were digested upon HINFI restriction enzyme. The digested fragments were analyzed by electrophoresis on agarose gel using ethidium bromide to increase visibility. The bands were examined under ultra violet-light to study polymorphic locus on DNA fragments. Results: Digestion upon HINFI restriction enzyme of 350bp fragment indicated three patterns. The 1st (homozygote genotype BB), 2nd (homozygote genotype AA) and 3rd (heterozygote genotype AB) patterns yielded major fragment(s) of 1) 266bp, 2) 134bp and 132bp and 3) 134bp, 132bp and 266bp, respectively. Each of the three patterns yielded one minor fragment of 84bp. The genotype frequency for homozygote AA and the allelic frequency of allele A were higher than the same for homozygote genotype BB and the allelic frequency of allele B, respectively. Conclusions: An accurate profile of genetic make-up and alternate forms of κ-casein genes in Sindhi cattle is likely to help researchers, policy makers, immunologists, dietitians, neonatologists, community physicians and managerial as well as production level officials to exploit it to full potential.

Hepatitis B Seroconversion after Vaccination in Infants in Rural and Urban Areas of Rawalpindi, Pakistan.

Purpose: This study was designed to evaluate the immunogenicity of hepatitis B vaccine in infants of rural and urban Pakistan and to find out the vaccine efficacy. Methods: A sample of 400 subjects was taken by simple random method from the rural and urban areas (200 from Rural and 200 from urban areas) of Rawalpindi District Pakistan. The serum samples were analyzed by Enzyme Linked Immunosorbant assay (ELISA) for the quantitative determination of antiHBs antibodies. Results: As 88 (22%) infants out of the total 400 were found to be seropositive at baseline. The post vaccination results showed that about 15 (7.53%) of infants had inadequate levels of antibodies (i.e. <10 IU/L). Overall 92.46% infants showed a positive response to the vaccine. The females showed higher titers of antiHBs against vaccination as compared to that of males. Infants of urban areas showed higher titers as compared to that of rural areas. Conclusion: Our results reinforces that the Hepatitis B vaccine has a good tolerability and is highly immunogenic among infants. It is recommended that serosurvey of HBsAg and vaccine coverage at country level should be done.

Nasopharyngeal angiofibroma? Does tumor stage influence recurrence in nasopharyngeal angiofibroma?

Juvenile nasopharyngeal angiofibroma [JNA] is an uncommon tumor constituting less than 1% of all head and neck tumors. Tumor has an aggressive local behavior if left untreated. Surgery is the mainstay of treatment with no common consensus on a single approach. Tumour stage and surgical approaches are the major determinants of tumour recurrence. To evaluate the influence of stage of tumor in recurrence in nasopharyngeal angiofibroma. Descriptive study. Department of ENT and Head and Neck Surgery, PIMS, Islamabad and Ayub medical institution, Abbottabad. Jan 2010 to Jan 2014. Consisting of 34 diagnosed cases of nasopharyngeal angiofibroma. CT-scan was done in all patients and were treated surgically except one patient who was irradiated. All patients were followed up for one year. Among 34 patients, 24 patients were classified as stage III, 4 were in stage II and 5 were in stage IVa and one in stage IVb. 17.6% [6/34] of patients had disease recurrence. Stage IVb was treated by radiotherapy while the rest were treated surgically. Patients were followed up for one year both by clinical examination and imaging. Recurrence was found in 5 operated patients and residual disease in stage IV b. 1 [20%] patient of stage Iva disease and 4 [16%] patients of stage III disease had disease recurrence. Disease recurrence/ residual is directly related to the tumour stage in nasopharyngeal angiofibroma

l Comparison of Efficacy of Topical Ofloxacin and Gentamycin in Tubotympanic Type of Chronic Suppurative Otitis Media

Objectives: To compare the eficacy of 0.3% topical ofloxacin 4 drops thrice daily with topical gentamycin 0.3%, 4 drops thrice daily in patients with active tubotympanic type of CSOM. Study Design: Randomized controlled trial study. Place and Duration of Study: This study was carried out in the Department of ENT and Head and Neck Surgery, HMC, Peshawar from Jan 2012 to July 2012. Materials and Methods: This Randomized controlled trial was conducted, consisting of 134 patients with ear discharge for more than three months which were randomly allocated to two groups each consisting of 67 patients. Patients in group A received gentamycin 0.3% in a dosage of four drops thrice daily, while patients in group B received 0.3 % ofloxacin four drops thrice daily for ten days. Patients were followed for two weeks after therapy for ear symptoms assessment, otoscopy and examination under microscopy. Results: A total of 134 patients of chronic suppurative otitis media were included in the study. Results showed that the rate of resolution of ear discharge [otorrhea] is significantly higher in patients treated with topical Ofloxacin than gentamycin [98.5% vs 89.6%]. [Pc0.05] Conclusion: Topical Ofloxocin is a better choice in management of CSOM than topical Gentamycin in terms of resolution of ear discharge.

Prevalence and Antimicrobial Susceptibility Pattern of Methicillin-Resistant Staphylococcus aureus and Coagulase-Negative Staphylococci in Rawalpindi, Pakistan.

Methicillin resistant Staphylococcus aureus (MRSA) and methicillin resistant coagulase negative staphylococci (MRCoNS) are the important nosocomial infectious agents. There is a growing concern about the rapid rise in the resistance of Staphylococcus aureus to presently available antimicrobial agents. The aim of this study was to evaluate the prevalence rate of MRSA and MRCoNS and their rate of resistance to different antistaphylococcal antibiotics used broadly for treatment. Out of the total 350 staphylococcal isolates from different clinical specimens 148 isolates (60.40%) were identified as MRSA by oxacillin screen agar method, and 46 isolates (43.80%) were screened as MRCoNS. All the MRSA and MRCoNS isolates were tested for antibiotic resistance pattern by disc diffusion method for 16 different antibiotics. All the isolates of MRSA and MRCoNS were multi-drug resistant. Antibiotic resistance pattern of these isolates was high against penicillin. All the MRSA strains were resistant to penicillin and oxacillin (100%), followed by cephalothin and nalidixic acid (89.18%), cotrimoxazole (86.48%), erythromycin (85.81%), cephalaxin and cephradine (83.10%), levofloxacin (80.40%), imipenem (77.70%), gentamicin (76.35%), tetracycline (59.45%), ciprofloxacin (44.59%), chloramphenicol (18.24%) and rifampicin (10.13%). The MRCoNS strains also showed closely similar drug resistance pattern with 97.82% isolates being resistant to penicillin, followed by oxacillin (95.65%), cephalothin (86.95%), cephradine (82.60%), levofloxacin and nalidixic acid (80.43%), erythromycin, cephalaxin and imipenem (78.26%), cotrimoxazole (73.91%), gentamicin (69.56%), ciprofloxacin and tetracycline (63.04%), chloramphenicol (13.04%) and rifampicin (6.52%). However, all the MRSA and MRCoNS isolates, even those with very high oxacillin MIC (>130 μg/ml) were uniformly susceptible to vancomycin. Chloramphenicol and rifampicin also showed excellent activity against methicillin-resistant isolates. Overall, data presented in this study indicated a slightly higher methicillin resistant rate in MRSA compared to MRCoNS strains. Multi-drug resistance rates in our MRSA and MRCoNS isolates were, 58.10 and 32.60%, respectively. Application of ß-lactamase production method revealed that 84% of MRSA and 87% of MRCoNS strains tested positive for the ß-lactamase production. This study indicated a high level prevalence of MRSA and MRCoNS strains resistance against widely used antimicrobial agents. An appropriate knowledge on the current antibiotic susceptibility pattern of MRSA and MRCoNS is essential for appropriate therapeutic regime determination.

Efficacy of topical clotrimazole in treatment of otomycosis

Otomycosis is a common condition affecting external ear and ears with chronic suppurative otitis media, and has a tendency for recurrence. Objective of this study was to determine the efficacy of topical clotrimazole in the treatment of otomycosis. This descriptive study was conducted at the outpatient department of ENT, Ayub Teaching Hospital Abbottabad, from Jul 2012 to Dec 2012. A total of 101 patients were included in this study. The results were compared and analysed regarding age, gender, presenting complaints and efficacy of clotrimazole. A total of 101 patients of otomycosis were included in the study. Male to female ratio was 0.71:1. Patients of 15 years and above were included in the study. Adults were more affected by otomycosis than the younger age group. The efficacy of clotrimazole in treatment of otomycosis was observed in 89 [94.12%] while in 12 [5.88%] patients no efficacy was seen. Age and gender have no role in efficacy of Clotrimazole in treatment of Otomycosis. Topical clotrimazole is effective in the treatment of Otomycosis

Early complications of elective and emergency tracheostomy

Tracheostomy is a life saving procedure when it is performed for an appropriate indication and surgical technique. The aim of this study was to compare the early complications of elective and emergency tracheostomy in our setup. This comparative study was conducted at the ENT Department, Hayatabad Medical Complex [HMC] from March 2009 to March 2010. A total of 100 patients included in this study were divided in to two equal groups, group A undergoing elective tracheostomy and group B undergoing emergency tracheostomy. The results of hundred patients were compared and analysed from stand point of age, sex, disease pattern, operative procedure and postoperative complications associated with tracheostomy. A total of 100 patients were included with age ranging from 17 to 88 years. The average age was 35 years in elective cases and was 32 years in emergency cases. The male to female ratio was 2.9:1 in elective cases and 4.6:1 in emergency cases. The overall complications rates were 38% in elective cases and 56% in emergency cases. Early complications of emergency tracheostomy are more common than elective tracheostomy.

Pattern of change in the frequency of Helicobacter pylori with perforated duodenal ulcer

Peptic ulcers were believed to be caused by stress, dietary factors, and gastric acid, but the link between H. pylori and peptic ulcers was identified in 1983. To see the frequency of Helicobacter pylori infection in patients with perforated duodenal ulcer and advise eradication therapy in these patients. This cross sectional study was conducted in Surgical Unit Hayatabad Medical Complex, Peshawar, during January 2007-June 2008. A total of 50 cases were included in the study. All cases presenting to our unit with acute perforated duodenal ulcer were recruited. After resuscitation and baseline investigations, all underwent emergency laparotomy via upper midline incision, after thorough peritoneal lavage, the perforation margins were freshened and closed over an omental patch. Serum from every patient was tested for H. pylori and accordingly managed. Out of the 50 cases, 45 were males, and 5 were females. Age ranged from 20- 80 years old. All patients underwent emergency laparotomy. Postoperatively, all were started on PPI treatment and serum testing for H. pylori was done. Thirty-four [68%] turned out positive and 16 [32%] were found to be negative for H. pylori. There is still a high frequency of H. pylori infection in patients with perforated duodenal ulcer. But comparing these results with the various data available, there is a significant decline in H pylori positive perforated duodenal ulcer patients

Penile fracture: experience at Ayub teaching hospital

Penile fracture is a relatively rare traumatic rupture of the tunica albuginea of one or both corpora cavernosa of an erect penis. It is a real urological emergency which needs early assessment and surgical management. Twelve [12] cases of penile fracture were reviewed from July, 1997 to July, 2007 in the Department of Urology, Ayub Teaching Hospital Abbottabad. All cases presented with classical history of penile fracture and the diagnosis was made on the basis of history and clinical examination only. All the patients underwent immediate surgical repair with well preserved potency and excellent overall results. Penile fracture has typical signs. Standard treatment consists of immediate surgical repair of penile fracture with a low incidence of late complications. Post op complications including urethral strictures and erectile dysfunction should be ruled out by regular follow-up

Type 2 diabetes mellitus: how well controlled in our patients?

Type 2 Diabetes mellitus has reached epidemic proportions worldwide and Pakistan is no exception. This study was done to see the glycaemic control of our diabetic patients by estimating Glycosylated haemoglobin and Fasting blood glucose as poor control leads to significant complications causing enormous human suffering and socioeconomic burden. This Cross-sectional study was conducted on Type 2 diabetic patients coming to medical OPD and medical B ward of Ayub Teaching Hospital between March-September 2007 fulfilling the inclusion criteria. Among 100 patients with type 2 diabetes forty two had HbA[1]c more than 7.5%, while seventy had fasting blood glucose more than 120 mg/dl. All patients with HbA[1]c more than 7.5% had increased fasting blood glucose. While thirty out of seventy patients with fasting blood glucose more than 120 mg/dl had HbA[1]c less than 7.5%. None of the patients with fasting blood glucose less than 120 mg/dl had HbA[1]c more than 7.5%. Significant number of patients [42%] had poor control of diabetes as revealed by HbA[1]c, with FBG showing poor control in even more patients, i.e., 70%. However their blood glucose estimation was not frequent enough as required. Blood glucose results can be spuriously high and may lead to frequent change/ increase in the dose of hypoglycaemic medications. This can lead to poor compliance as well as psychological trauma to patients. HbA[1]c on the other hand is easy to interpret, reflects long term glycaemic control and cost effective. We recommend its more frequent use along with blood glucose for better glycaemic control and decreased chances of complications