Diarrhea management in children of developing countries by mothers and general practitioners

Despite continuous improvement and advancement of treatment, diarrhoeal disease is the second leading cause of death in children under the age of five years globally and is a major cause of concern in developing countries. Research suggests that lack of proper and timely management leads to increased mortality and morbidity. The aim of this review is to assess the knowledge, attitude and practices of mothers/caregivers and general practitioners [GPs] toward management of diarrhoea in children under the age of five years in developing countries. A systematic review was performed using observational evidence.A thematic approach was used for the analysis of the data and narrative synthesis methodology to summarise the review findings

Results suggest that oral rehydration salts solution are not considered a sufficient cure for childhood diarrhoea and, are given,mostly with traditional medicines and unnecessary non-prescribed drugs. Health care seeking and feeding practices were also found to be very poor. Prescribing practices among GPs were influenced by professional knowledge as well as a number of factors, such as, fear of losing patients, loss of prestige, family demands, and external pressures like hospital work load and pharmaceutical interests. Barriers of recommended childhood diarrhoea management were linked to lay beliefs, economic constraints, and lack of education

Application of hematological indices for the differential diagnosis of beta thalassemia trait and iron deficiency anemia

Objective: To apply various hematological indices for the differential diagnosis of Beta-Thalassemia trait [Beta-TT] and iron deficiency anemia [IDA]

Methodology: This retrospective descriptive study was conducted at Dar-ul-Sehat Hospital, Gulistan -e- Johar, Karachi. We retrospectively analyzed complete blood count [CBC] of 2480 patients, who came to the OPD for various problems during the year 2014 from January to December so as to identify hypochromic microcytic patients. Mentzer's index [MI], Shine and Lal index [S and L index] and Ehsani's formula were applied on the CBC report of identified microcytic hypochromic patients

Results: It was found that among a total of 2840 patients, 385 [13.55%] patients were suffering from hypochromic microcytic anemia identified on their CBC report. These included 44 males [6.74%], 300 females [33.33%] and 41 [14.48%] children. Application of Mentzer's index [MI], Shine and Lal index [S and L index] and Ehsani's formula screened the hypochromic microcytic patients into patients suffering from ß-Thalassemia trait and Iron deficiency Anemia

Conclusion: Application of hematological indices can be taken as the most useful method fordifferentiating Beta-TT from IDA by simply considering CBC report

Assessment of parents' attitude toward EPI [expanded program on immunization] in tertiary care hospitals of Karachi

Objective:To assess parents' attitude toward EPI [Expanded program on Immunization] in three Tertiary Care Hospitals of Karachi

Materials and Methods:This cross sectional hospital based study was conducted at three tertiary care hospitals of Karachi,PNS SHIFA Hospital, Jinnah Postgraduate Medical Center [JPMC] and Liaquat National Hospital [LNH] from a period of 20th July to 20th September, 2015. A structured questionnaire based interview was conducted on150 parents of children less than 5 year of age visiting for vaccination at these three tertiary care hospitals.Data was analyzed using SPSS version 23

Results:A total of 150 parents were interviewed, out of which 93 [62.0%] parents vaccinated their child immediately after birth, 148[98.7%] parents considered EPI as beneficial for their child's health, 113 [75.3%] parents were found to be aware of the complete vaccination schedule, 56[37.3%] parents had appropriate knowledge regarding vaccines and diseases enlisted on the EPI card, 139 [92.7%] parents kept the record of vaccination schedule, 143[95.3%] parents didn't ignored vaccination due to increased number of children and 21[14%]parents had fear regarding vaccination program

Conclusion:Parent's attitude toward EPI was positive. However, knowledge about vaccines and diseases and vaccines enlisted on EPI card was low

Socio cultural determinants of low contraceptive use and high unmet needs in married females of Urban Karachi

Objective:To explore knowledge, attitudes and practices regarding contraceptive use in females and to determine the socio cultural barriers that influence contraceptive uptake and contribute to significant unmet needs of family planning

Materials and Methods:This hospital based cross sectional survey was carried out from March 2015 to September 2015 at the Gynaecology and Obstetrics outpatient clinics [OPD] of two hospitals of Karachi, Liaquat National Hospital and PNS SHIFA Hospital. 383 females of age 18-49 years were enrolled after taking informed written consent. Knowledge, attitude and practices on contraception were evaluated with the help of predesigned questionnaire

Results: Mean age of participants was 30.12+ 3.05, youngest being 18 years old, while the eldest was 49 years old. Majority [64%] of the participants were housewives.Knowledge about contraceptive methods was found in 97.1%. Media was found to be main source of information. Regarding contraceptive practices, 48% women were currently using some method of contraception. Among these the most widely used method was condoms [46%]. 52% women were not currently using any method of contraception. Husband and mother in law opposition were found to be the strongest reason for not using any contraception

Conclusion:Inspite of having good knowledge, utilization of contraceptives were less because of preference for a large family norm, religious myths, cultural barriers and family opposition

Herbal treatment of diabetes

Diabetes has become one of the most challenging health problems of the 21st century, with increasing prevalence throughout the world. Drugs recently used for the treatment of diabetes have several adverse effects. There is an immense need to explore plant resources to develop a better oral hypoglycemic agent.More than 400 plants are found to have hypoglycemic effect like Acacia Arabia, Aeglemarmelos, Alium cepa, Alium sativum,Azadirachta indica,Caesalpinia bonducella, Coccinia indica,Eugenia jambolana,Mangifera indica, Momordica charantia and Ocimum sanctum. These are found to act by various mechanisms to produce antidiabetic effect. Moreover, various biologically active compounds with hypoglycemic effect are identified from these plants. including alkaloids, flavonoids, glycosides and polysaccharides. This commentary presents an overview of antidiabetic plants and their suggested hypoglycemic mechanisms

Basic concepts of diabetes mellitus

Pakistan is at the seventh position on diabetes prevalence rates. Many risk factors are linked to the development of type 2 diabetes like increased body mass index [BMI], altered body lipids, increased blood pressure, smoking, less physical activity ,bad dietary habits, family history, and also some genes. Environmental factors together with a genetic tendency for diabetes set off an autoimmune response that causes damage of the pancreatic Beta-cells over prolong duration leading to type 1diabetes. Failure of Beta cell compensation for insulin resistance causes impaired glucose tolerance that can exhibit as type 2diabetes.Diabetes Mellitus either type 1 or type 2 can lead to various acute and chronic complications. Diagnosis can be made on levels of blood glucose concentration, urine ketone test, glycosylated hemoglobin [HbA1c], glycated serum protein and glycated serum albumin. Type 1 diabetic patients are directly given insulin. Patients with type 2 diabetes may be managed with diet and exercise. However when diet and exercise fail to control raised blood sugar level, an oral antidiabetic agent is started. This may be added with more drug[s] from the same family and or insulin depending upon the glycemic index of the patient.Type 2 diabetes is a progressive disease in which ultimately the function of Beta cells decreases, and eventually exogenous insulin may be required to maintain blood sugar level. This review thoroughly describes the prevalence, classification, etiology, pathophysiology,complications, diagnostic criteria and treatment of Diabetes Mellitus

Effect of herbal syrup linkus on acute and gross toxicity and electrolytes in blood and organs

Objective: To evaluate the effect of herbal syrup Linkus on acute and gross toxicity and electrolytes level in blood and organs

Materials and Methods: This interventional study was carried out in the department of Pharmacology, Faculty of Pharmacy,University of Karachi after approval from BASR-KU. In this study twenty-eight healthy rabbits of either sex weighing 0.90 kg to 1.2 kg. All animals were equally divided into four groups, one served as control group while, remaining three groups received herbal syrup Linkus at three different doses. Acute toxicity was tested in mice by Lorke's method whereas effect on gross toxicity, blood and organ electrolytes was evaluated in Rabbits

Results: Herbal syrup Linkus exhibited LD50 values greater than 5 gm / kg per 24 hrs. No gross toxicity and mortality was observed during the whole experimental period. Non significant changes were observed in blood and organ electrolytes [Calcium, Potassium and Sodium] level

Conclusion: Herbal syrup Linkus has produced no toxic effect at the administered doses neither showed any significant change in the electrolytes level in the blood and vital organs

Health hazards of electronic media devices in children

Use of electronic devices among children is common and is increasing day by day. Exposure to electronic devices such as television, computer and cell phones is documented to be associated with lot of adverse health effects. The problems encountered in children are sleep difficulties, bad dietary habits, lower physical activity, obesity, appearance of psychological symptoms including depression, lack of social interaction etc. Parents need to be counseled regarding adverse health effects and limiting the screen time of their children to these electronic devices

Evaluation of cardiovascular safety of herbal cough syrup

Background: Herbal medicine or phytotherapy is the science of using herbal remedies for the treatment of diseases. Nowadays increasing number of people are using herbal medicines because of lower level of side effects and toxicity associated with them. Pharmacologists must be knowledgeable about their safety. Present study was carried out to evaluate the cardiovascular safety of herbal cough syrup. The syrup contains Glycerrhiza glabra, Piper longum, Adhatoda vasica, Viola odorata, Hyssopus officinalis, and Alpinia galanga. All these ingredients are said to have antitussive properties without any cardiovascular toxic effects

Objective: To evaluate cardiovascular safety of herbal cough syrup

Methods: Twenty eight rabbits of either sex, weighing 670g-1200g were divided into four groups, with 7 rabbits in each group. Group I was the control group and received 0.3 ml of water, group II, III and IV received herbal syrup normal dose [0.57ml/kg], moderate dose [5ml/kg], and high dose [10ml/kg] respectively once daily, orally for a period of 45 days following which blood samples were collected through cardiac puncture, centrifuged and serum was analyzed on Vitalab eclipse automatic analyzer for cardiac and lipid profile

Results: In comparison to control group there were no significant changes in cardiac and lipid profile of all groups. Overall results did not reveal any significant toxicity

Conclusion: The Herbal Syrup is safe as an antitussive and reveals no significant cardiovascular toxicity

In-vitro assessment of antibacterial activity of methanol extract of brassica oleracae against selected bacterias

OBJECTIVE: To evaluate in- vitro antibacterial activity of methanol extract of Brassica Oleracae study against selected bacterias

DESIGN: The study was conducted in the Department of Pharmacology, Faculty of Pharmacy, University of Karachi, Pakistan

METHOD: The agar diffusion method was used to measure zones of inhibition in millimeter [mm] against organisms Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus, Escherichia coli and Proteus. Values of growth inhibitory zones are expressed as mean + SD [standard deviation] of three triplicates i.e n=3

RESULTS: The methanol extract of Brassica oleracae exhibited distinct zones of inhibition at all the concentrations i.e 10mg/ml, 20mg/ml, 40mg/ml, and 100mg/ml towards all bacterial strains under study i.e staphylococcus aureus, staphylococcus epidermidis, streptococcus, Escherichia coli and proteus against the methanol control which did not show any growth inhibitory zone. Methanol extract of Brassica oleracae showed widest inhibitory zone toward E.coli [16.98+0.00] followed by proteus [13.10+0.55], streptococcus [12.00+0.00], staph epidermidis [11.10+1.3] and staph aureus [11.02+0.67] at the concentration of 100mg/ml of extract, in comparison to methanol control which did not manifest any growth inhibitory zone [0.00]. The diameters of zones of inhibition were found to increase in size with increase in concentration of extract. However, the antibacterial activity against streptococci was almost same at 20mg/ml and 40mg/ml of concentration of extract [9.33+0.17 and 9.10+0.00 respectively]. Results were also compared with the standard antibacterial agent against chloramphenicol at a concentration of 100 microg /ml

CONCLUSION: These results suggest that of Brassica Oleracae may be use as anti-bacterial agent, thus providing ailing mankind a wonderful gift from nature