effects of new polyherbal Unani formulation AJMAL06 on serum creatinine level in chronic renal failure

This study was conducted to evaluate the efficacy of Unani Ajmal06, an herbal formulation for management of chronic renal failure [CRF]. The therapeutic evaluations of three different formulations such as Itrifal Kashneezi, Jawarsih Zarooni Sada medicines were conducted on number 35 CRF patients clinically diagnosed cases of chronic kidney failure. It was found that herbal coded Ajmal06 was effective for the treatment of CRF in 70% of the patients treated. SPSS tests on sign and symptoms indicated the efficacy of Ajmal06 in lowering serum creatinine level in 70% of patients of chronic renal failure. In clinical response of BUN exhibited 75% of patients improved where as in case of fatigue [70%], edema [90%], leg pain [76%] improved these types of conditions with significant p value

Ways to manage hepatitis C without cirrhosis: treatment by comparison of coded eastern medicine hepcinal with interferon alpha 2b and ribavirin

Hepatitis C virus [HCV] infection is a serious and significant global health problem in the Pakistan and elsewhere. In majority of cases HCV infection remains asymptomatic but in advance cases it may progress to fibrosis of liver, shrinkage of liver cells or failure of liver. The hepatitis C may progress to cause liver cirrhosis that mostly develop in 20% of the affected patients in 20 years with an increased risk in male, alcoholic drink, immune-compromised and who acquire HCV infection after the age of 40 years. This was an open-label prospective study conducted on 66 clinically and immunologically diagnosed cases of HCV infection. In Hepcinal treated group, there were significant improvement in HCV associated symptoms compared to control group [p<0.05]. While Interferon therapy resulted in significant improvement in serological response [55.88%] compared to Hepcinal treated patients [46.88%]. It was concluded that Hepcinal has shown better clinical response but no significant serological response [p=0.3244] and it might be an alternative therapy to treat hepatitis C infection and to prevent its progression into chronic ailment

Comprehensive review on treatment of HIV

HIV or AIDS is a major threat for humanity in the world especially in developing countries. The causative factor of the syndrome is HIV, which infects and destroys one of the cellular components of the immune system, the T cells, causing deficiency in the immunological surveillance and ultimately leading to AIDS. According to WHO, around 35 million people were living with HIV in 2013 and since the start of epidemic 39 million people have died due to AIDS. Center for disease control and prevention estimated in 2014 that 1,201,100 people aged 13 and above were suffering from HIV infection Worldwide. The most effective approach is the highly active antiretroviral therapy [HAART] containing the combined use of drugs having different mechanisms of action. However, complete eradication of HIV from the body does not occur by HAART, but it lead to long term toxicity occurs and emerges as drug resistant. Despite the recent development of various new antiretroviral compounds, there is still a need to develop need to search for new alternatives which are equally efficient and less expensive as compared to the contemporary treatment available. This review provides an overview and a summary of herbal medicines for HIV infection and summarized the efficacy and medicinal use of different plants used in the treatment of HIV infection. The objective of this review is to enlighten the recent advances in the exploration of medicinal plants used for treatment of HIV/AIDS

Surgical site infection in diabetic and non-diabetic patients undergoing laparoscopic cholecystectomy

Objective: To compare the frequency of surgical site infections in patients with type II diabetes undergoing laparoscopic cholecystectomy as compared with non-diabetic patients

Study Design: Cohort study

Place and Duration of Study: Surgical Unit 2, Services Hospital, Lahore, from May to October 2012

Methodology: Patients were divided into two groups of 60 each, undergoing laparoscopic cholecystectomy. Group A comprised non-diabetic patients and group B comprised type II diabetic patients. Patients were followed postoperatively upto one month for the development of SSIs. Proportion of patients with surgical site infections or otherwise was compared between the groups using chi-square test with significance of p < 0.05

Results: In group A, 35 patients were above the age of 40 years. In group B, 38 patients were above the age of 40 years. Four patients in group A developed a surgical site infection. Seven patients in group B developed SSIs [p = 0.07]

Conclusion: Presence of diabetes mellitus did not significantly affect the onset of surgical site infection in patients undergoing laparoscopic cholecystectomy

Concise review on the insight of hepatitis C

Hepatitis C is the disease of liver caused by hepatitis C virus [HCV]. Due to its widespread impact on human population, there is continued surge for new therapeutic agents to treat and reduce HCV. Hence, nowadays HCV is considered as global burden throughout the world. Advancements in therapeutic invention and clinical outcomes are dependent on HCV genome and diversity in nature, pathogenesis, dietary factors, social, economic and environmental factors. In this review we have focused mainly on HCV genome, its history and clinical outcomes from its discovery to present day research. In this article the authors have reviewed the published data from year 1997 to 2014. The topics of main concerns were hepatitis C with diverse nature and recent advances in the treatment of chronic hepatitis C. The authors used MeSH terms "Hepatitis C Virus [HCV]", recent advances in the treatment of "HCV", "HCV and Immunity", "vaccination", or "Interferon therapy" to search the PubMed database. All relevant studies identified were included and are described according to the subheadings. Recent advancement in molecular biology and experimental techniques has opened new insights into the pathophysiology of HCV which is helping in combating this life threatening disease. Although the response to current treatment regimen for HCV is improved however complete recovery from the disease is still a challenge which requires more extensive studies from basic science research to large multicenter clinical trials

Diaphyseal femoral fractures; outcome treated with close vs open

The femur fractures usually happen with oomph forces like motor vehicle accidents. To assess the mode of injury and complications of the management, in diaphyseal femoral fractures, in comparison of close versus open intramedullary interlocking nail [IMN]. Experimental and comparative study. April 2013 to March 2014. Department of Orthopaedic Surgery, Peoples University of Medical and Health sciences, Nawabshah. The cases were divided into two groups A and B. Group A was treated by open nailing [n = 20] and group B by close nailing [n = 20], all the cases were operated within 48 hours of admission. All the data were recorded on well structured proforma. Serial radiographies were performed at 3, 6, 12 weeks, and 6 months; additional radiographies were performed as needed postoperatively. Knee, ankle, and hip motions were begun and protected weight bearing was started on the second day postoperatively and increased gradually to full WB depending on x-ray findings of callus formation. The patients were followed for two years. Results of open and closed I.M.N were assessed and the complications if any were observed over a mean follow-up period of two years. The mean age in group A was 29.40 years and the mean age in group B was 30.45 years. Out of 40 cases, 32[80.0%] were males with male to female ratio 1:4. Mean +/- SD hospital stay was 19.80 +/- 14.60 days in group A, and 17.90 +/- 5.95 days in group B [p value 0.55]. Average time between injury and admission was 1.53 days [n = 40], in the group A it was 1.05 days, and in the group B it was 2.0 days [p value 0.03]. The average of time between injury and operation in the group A was 8.75 days, and in the group B, it was 8.20 days, [p value 0.71]. The average of time between admission and discharge in the group A was 11.0 days, and in the group B was 9.15 days, [p value 0.55]. Mean +/- SD union time was 11.70 +/- 6.45 weeks, in group A and 11.90 +/- 5.77 weeks, in group B. [p value 0.91]. All the patients had full ranged of hip motion and 2 [10.0%] patients of group A had mild limitation of knee motion with a flexion ranges between 80 and 110 degrees. Final functional results based on Thoresen BO criteria16. Excellent results were observed in 19 [47.5%] cases, out of them 5[25.0%] were in group A and 14[70.0%] were in group B. Good results were found in 13[32.5%] patients, out of these 7[35.0%] were in group A and 6[30.0%] were in group. Fair and poor results were detected in 4[10.0%] cases of group A. Road traffic accidents by motorcycle was found the commonest [47.5%] cause of femur fracture, a few complications were observed in open interlocking nailing as compared to closed interlocking nails

Comparison of open mesh hernioplasty verses laparoscopic intraperitoneal onlay mesh for ventral hernias

Objective: compare the outcome of laparoscopic intraperitoneal on lay mesh [IPOM] with open mesh repair in ventral hernias

Material and Methods: seventy patients were divided into two groups of 35 each. Group A= I POM repair and Group B = Mesh hernioplasty

Results: the mean+/-SD age was in group A 44.54+/-7.06 years and 46.40+/-7.14 in group B. Twelve [34%] patients were male in group A, 14 [40%] patients were in group Band 23 [66%] patients were female in group A and 21 [60%] were female in group B with male to female ratio 1: 1.91. There were only 3 [8%] patients had postoperative pain in group A and 10 [28%] patients were in group B [p<0.05] which is statistically significant. In comparison postoperative early surgical site infection in both groups, there was no patient on 3rd postoperative day in both groups. On 10th postoperative day 1 [3%] patient had surgical site infection in group A and 6 [17%] patients had postoperative early surgical site infection in group B [p<0.05] which is statistically significant

Conclusion: laparoscopic approach appears to be as effective, safe, feasible, and cosmetically good procedure. It has fewer rates of early surgical site infection and postoperative pain. Laparoscopic repair is good alternative to the open repair in the treatment of ventral hernias

Comparative clinical evaluation on herbal formulation Pepsil, Safoof-e-Katira and Omeprazole in gastro esophageal reflux disease

This study was conducted to evaluate the role of Unani herbal drugs Pepsil and Safoof-e-katira on the gastro esophageal reflux disease [GERD]. This was multicentre r and omized case control study conducted at Matab Hakeem Muhammad Noor-ud-din, Burewala; Aziz Muhammad din Medical and Surgical Centre, BurewalaandShifa-ul-mulk Memorial Hospital, Hamdard University Karachi. The patients were selected according to inclusion and exclusion criteria. In test group-1 the male female ratio was 40%, 60%; test group-2 was 42%, 58% and in control group was 44%, 56% respectively. The observed symptoms in the study were increased appetite [TG-1-95%, TG-2-95% and CG-89%], difficulty in swallowing [TG-1-93%, TG-2-96% and TC-94%], belching/burping [TG-1-97%, TG-2-97% and CG-95%], vomiting [TG-1-90%, TG-2-96% and CG-89%], heart burn [TG-1-100%, TG-2-100% and CG-98%], palpitation [TG-1-100%, TG-2-100% and CG-97%], epigastric pain [TG-1-97%, TG-2-97% and CG-90%], abdominal cramps [TG-1-97%, TG-2-98% and CG-95%], tenesmus [TG-1-100%, TG-2-100% and CG-97%], flatulence [TG-1-100%, TG-2-75% and CG-95%], wakeup during sleep [TG-1-94%, TG-2-87% and CG-94%]. The p-value of the results of the symptoms was 0.000 except flatulence where the value was 0.001. The statistical results of the study prescribed that all the drugs studied [Pepsil, Safoof-e-katiraandOmeprazole] are highly significant. The herbal coded drug Pepsil showed no side effects and unani herbal drug safoof-e-katira showed minimum result of 75% in the patients while Omeprazole resulted with some side effects. In the result it can be concluded that the herbal coded drug Pepsil is a potent herbal drug for gastro esophageal reflux disease.

Comparison of laparoscopic total extraperitoneal repair with Lichtenstein repair in inguinal hernia

Objective: To compare the laparoscopic inguinal hernia repair with Lichtenstein repair in terms of hospital stay and postoperative pain

Study design: Randomized clinical trial

Place and Duration of study: Department of Surgery Services Hospital Lahore, from September 2013 to May 2014

Methodology: Inguinal hernia patients were admitted electively. They were randomly assigned into groups A and B. The group A patients were treated with laparoscopic total extraperitoneal repair [TEP] and group B patients underwent Lichtenstein's repair. Patients were evaluated for 24 hours discharge rate and postoperative pain

Results: A total of 100 patients were included with 50 patients in each group. Group A patients had short hospital stay [discharged within 24 hours - 68.08%] as compared to group B [31.91% -p <0.001]. From 2[nd] to 6[th] postoperative week group A patients had significantly less postoperative pain as compared to group B [p <0.05]

Conclusion: Laparoscopic TEP repair was safe with early hospital discharge and less postoperative pain

Comparative clinical study on the efficacy of biocor plus compared with simvastatin for the management of hypercholesterolemia

Hypercholestriolemia is major risk factor that enhances the incidence of cardiovascular disease and coronary artery disease. The present study was conducted to normalize the lipid profile in the blood by using Biocor Plus for hypercholesterolemia compared with Simvastatin. It was prospective randomized case control study conducted on 70 diagnosed patients of hypercholesterolemia at Sohail Memorial Hospital, Karachi and Amir Habib Medical Center and Maternity Home, Karachi. Patients of both genders [30-70 years] with clinical diagnosis of Hypercholesterolemia. Sample sizes for this study included total of 70 subjects. There was statistically significant difference when comparing the effectiveness of test drug, Biocor Plus to control drug, Simvastatin for the treatment of primary hypercholesterolemia. This is clearly evident that the herbal coded test drug, Biocor Plus possesses a therapeutic value for the treatment of primary hypercholesterolemia. There were no untoward or significant side effects associated with the use of Biocor Plus that proved its good acceptability by the patients. Moreover there was subjective feeling of wellbeing regarding breathlessness and chest tightness or pressure in the patients taking Biocor Plus. This makes an interesting point to focus on this effective alternative drug for primary hypercholesterolemia

Harmonic Scalpel versus electrocautery in axillary dissection in Carcinoma Breast

Objective: To compare the results between harmonics scalpel and electrocautery use in axillary dissection for carcinoma breast

Study Design: Randomized controlled trial

Place and Duration of Study: Department of Surgery, Services Hospital, Lahore, from December 2013 to June 2014

Methodology: Eighty patients fulfilling the inclusion criteria were selected and equally divided in two groups. Axillary dissection for carcinoma breast was performed by using the harmonic scalpel in one group and by using electrocautery in the other group. Total mean axillary drain output and frequency of axillary numbness were noted in both groups and compared

Results: All the patients were females with mean age of 53.52 +/- 9.8. Mean axillary drain output in harmonic scalpel group was 167.75 +/- 43.90 as compared to 310.00 +/- 60.09 in electrocautery group while only 12.5% of patients were positive for axillary numbness in harmonic scalpel group as compared to 100% of patients who were positive for electrocautery group

Conclusion: Use of harmonic scalpel in axillary dissection resulted in decreased total mean axillary drain output and lowered frequency of axillary numbness when compared to utilizing electrocautery

Clinical efficacy of polyherbal formulation Eezpain spray for muscular pain relief

The topical herbal formulation Eezpain spray consisting of natural ingredients that have been clinically proved for its analgesic and anti-inflammatory activity. The designed formulation on application knee and wrist joints, back of neck and shoulder, forearms and lower back exhibited significant efficacy. A total of 20 subjects both male and female applied Eezpain spray consisting of Gaultheria oil, Eucalyptus oil, Turpentine oil, Clove Oil, Menthol and Camphor. All the active materials are cited that these have analgesic activity in myalgia and neuralgia. The study design was prospective and opens as pilot study followed the inclusion and exclusion criteria. All the sign and symptoms were noted at baseline and at the end of 14 days treatment performance was evaluated. The statistical analysis was done by using Microsoft Excel2007 and SPSS version 18.0. It is concluded that Eezpain spray has shown efficacy in mild to moderate cases on applying locally to the affected parts to relieve pain from different ailments

Comparative clinical efficacy and safety of coded herbal medicine dermovix in the management of patients with atopic dermatitis versus allopathic medicine

Atopic dermatitis [AD] is defined as a chronic, highly pruritic inflammatory condition of skin. It is estimated that this disease may lead significant morbidity and also adversely affects the quality of life. Atopic dermatitis responds well to home treatment. Proper skin care reduces the need for medicines. Topical creams and oral antihistamines can be used to suppress the symptoms. The clinical trial was conducted on 60 patients in which 30 are control and 30 are test by taking written consent from them. Dermovix significantly improved skin symptoms associated with AD. This Dermovix ointment was safe and well tolerated in specified age group patients. Overall results of individual group were analyzed by using Paired sample t-test and level of significance of all the symptoms was calculated. Both the drugs showed similar efficacy and the calculated p value was p<0.05. Except in case of dry skin the test drug had shown not significant p value i.e. 0.407. When we compare all these and their effects and patients' complaints then Test group have shown better results because of no side effects

Diaphyseal tibial fractures; closed intramedullary interlocking nailing

To determine the outcome and consequences of close intramedullary interlocking nailing in diaphyseal tibial fractures and to observe the hospital stay and complications in this method of treatment. The study was conducted in department of orthopaedic unit-I at Liaquat University Hospital Jamshoro/Hyderabad during Jan 2011 to June 2012. The present study constituted on 43 patients, 3 cases were dropped during follow up and the rest 40 cases completed 1 year post operative follow up. After having routine laboratory investigations and necessary x - rays, the stable patients were operated for intramedullary interlocking nailing on routine operating days. The patients were assessed according to the criteria mentioned in follow up proforma from date and time of arrival to final visit in review clinic and results were tabulated. Among 40 patients, 38 [95%] were males and 02 [5%] females. The age ranges from 17 to 50 years with mean age of 32.23 years. There were 25 close fractures [62.5%] 15 open fractures [37.5%], among these 13 [32.5%] were Gustilo type I and 2 [5%] were of type II. The mode of injury in majority [75%] of cases was road traffic accident. Good union achieved in 39 cases [97.5%] in 17.53 weeks. But only 1 [2.5%] case unfortunately went in infected non union and was converted into Illizarove external Fixation. The main complication observed after surgery was loosening of screw in 3 [7.5%] cases. Deep infection was observed in the medullary cavity in 3[7.5%] cases [table-V]. It has been observed in analyzing the functional outcome of these patients that majority [80%] of cases was able to sit on bed in 12-24 hours and was able to stand in 24-48 hours. In next 24 hours after surgery 75% of patients were pain free. The mean hospital stay in these cases was 8.53 days and by the 48th week all of cases were able to join their job except one case in which non union observed due to infection. The data from the current study reveals that intramedullary interlocking nailing of closed and open grade I and II fractures is a safe technique. It combines a high rate of union with a low complication rate, less hospitalization and early return to job

Analysis of syphilis and associated risk factors in pregnant women belongs to remote areas of sukkur

To determine and analysis of Syphilis and Associated Risk Factors in Pregnant Women Belongs to Remote Areas of Sukkur. Cross sectional study. This study was conducted on women belongs to peripheral areas of sukkur over a period of fifteen months, which beginning in May, 2012. Patient's 5ml whole blood was collected through venepuncture technique. Data were collected by all women answered a questionnaire and by investigating Blood Sample VDRL test and FTA-ABS test. The study was conducted in a confidential manner and numbers were used to identify the participant. Total 200 Pregnant women were included in the present study. Mean age of women was 25.4 years while range was 18 to 39 years. Out of the 200 samples, 6 [3.0%] were positive for active syphilis. Majority was belonging to low socioeconomic group of population. Active syphilis infection in pregnant women belongs to remote areas with low socioeconomic level were significantly disquieting. Alarming results of this study suggestive that seropositive status is often discovered in routine serological studies during pregnancy at health centers and efficient prolonged treatment of mother were available

Laparoscopic repair of peptic ulcer perforation: our initial experience

Objective: to evaluate our experience of laparoscopic peptic ulcer repair at National Hospital, Lahore over a one-year period

Material and Methods: a prospective case series study. The National Hospital and Medical Centre, Lahore. Four patients operated from January 2013 to December 2013. Post-operative pain, average hospital stay. Intra-operative and postoperative complications and outcome

Results: average operating time was 95 minutes, Average hospital stay 3.75 days. No intraoperative or operative postoperative complications documented so far

Conclusion: laparoscopic perforated duodenal ulcer repair is an excellent surgical option in selected patients without any added risk of complications

Association of tea and other addicitive substances with gallstone disease in southern Sindh, Pakistan

To evaluate any association of consumption and / or use of tea, paan, supari, naas, naswar, smoking, coffee and alcohol with gallstone disease. Case - Control study The study was carried out at different hospitals of Hyderabad and adjoining areas [Liaquat University Hospital, Jamshoro, Memon Charitable Hospital, Hyderabad, Wali Bhai Rajputana Hospital, Hyderabad, Naseem Medical Center, Hyderabad, and Isra University Hospital, Hyderabad] during January 1999 to December 2001. 160 hospitalized gallstone patients and 112 patients admitted in eye wards were taken as controls [age, sex and locality matched with negative personal and family history]. The justification of taking eye patients as controls lie in the fact that these patients have no gastrointestinal problem which could be associated with gallstones. All were interviewed through a standard questionnaire developed for that purpose. The consumption and / or use of tea, paan, naas / naswaar, alcohol and coffee were common among both the groups. Smoking was found to be the main risk factor for gallstone patients. Smokers as against non-smokers were however at risk 1.89 [95% CI, 0.68-5.26, p=0.105] to develop gallstones. Similarly consumers of more than 1 cup of tea per day were seen to be at higher risk [4.07, 95% CI; 1.71-9.64, p=0.001] for gallstone disease. No association of Supari, Naas and Naswar intake was found with the occurrence of gallstones. A significant inverse association [0.49 CI; 0.34-0.5, p=0.04] of paan, [0.39 CI; 0.11-0.52, p=0.00] alcohol, and [0.36 CI; 0.24-0.98, p=0.04] coffee was found with gallstone disease. Tea consumption is positively and Paan, alcohol and coffee consumptions are negatively associated with gallstone disease in Southern Sindh, Pakistan

Quantitative analysis of stress and cholesterol levels in university teachers and housewives of hyderabad-Pakistan

To evaluate environmental, psychological and physiological stresses in university teachers and housewives and correlate it with serum total cholesterol, HDL cholesterol, LDL cholesterol and triglyceride levels. Eighty females from middle socioeconomic groups [40 university teachers and 40 housewives] aged between 30-45 years were selected for this study. All subjects were selected from Hyderabad and its adjoining areas. Environmental, psychological and physiological stress levels were measured using Likert scale. Total cholesterol, LDL cholesterol and HDL cholesterol were measured by CHOD-PAP method and triglyceride levels were measured by GPO method. Housewives had high levels of total cholesterol, LDL cholesterol and triglyceride but low levels of HDL cholesterol than the university teachers. Environmental, psychological and physiological stresses were also significantly high in housewives as compared to university teachers. High levels of total cholesterol, LDL cholesterol, triglyceride and low levels of HDL cholesterol in housewives correlated to their stressful lifestyle

Analysis of total and available elements in medicinal plant moringa oleifera using atomic absorption spectrophotometer

Plant based medicaments have been man's prime therapeutic weapons to rescue him from the clutches of diseases. The role of elements particularly trace elements in health and disease is now well established. In this work, investigations have been made about a very important plant Moringa oleifera, which has traditionally played an important role particularly in the rural areas. It is a cheap source of protein, mineral rich food and an effective medicine against diseases. The aqueous extract of its leaves reduces blood pressure within a few minutes. In the present paper the analysis of Moringa oleifera for mineral elements was performed by using atomic spectrophotometer. The decoction of each part of the plant was also analyzed for different essential and trace elements. The samples of this plant were collected from surroundings of Hyderabad and voucher specimens were prepared following the standard herbarium techniques. Each part of this medicinal plant contains considerable amount of K, Mg, Zn, and Ca. These elements help to reduce the effect of hypertension