A Review on Guggulu [Commiphora Wightii (ARN.) Bhand.], its Phytochemical Constitution and Mode of Action

The history of human medicine goes back theoretically to the sheer onset of civilizations and evolved with the corresponding circumstances. Natural ingredients, that are plant based, animal based or mineral based have been incorporated since ages in the management of health and disease. The presently popular and universally accepted modern medicine has developed slowly and methodically, over generations of scientists with their application of scientific studies and an enormous amount of research. The popularity and acceptance of modern medicine may be huge today; however, the base of its research and resources stay put in traditional system of medicine itself. Even today the future of medicine in general has a tremendous scope for natural product-based drug and formulations and hopefully will prove to be more holistic, customized with a wise amalgamation of ancient and modern medicinal fundamentals and skills so as to give maximum benefit to the present and future human generations. Ayurveda, translated as the “Science of Life”, the ancient medicinal system of the Indian subcontinent, remains the oldest of all form of medications. Ayurveda incorporates a holistic approach to medicine and makes it highly personalized. There are around 45,000 species of plants with various medicinal properties attributed to them. This paper aims at understanding the composition, chemical constitution and exact mode of action of Guggulu.

Traumatic Spinal Injury Associated with All-Terrain Vehicle (ATV) Accidents: A 10-Year Retrospective Analysis of the Coachella Valley / 대한신경손상학회지

Objective@#The use of all-terrain vehicles (ATVs) and associated injuries have significantly increased in the last decade. This study aimed to determine the frequency of ATV-associated spinal cord injuries (SCIs) in the Coachella Valley, California, and provide recommendations for data reproducibility in other areas with a similarly substantial level of ATV usage and injuries. @*Methods@#This retrospective analysis included data obtained through screening the trauma database of a level II trauma center for ATV-related injuries between January 1, 2010 and January 1, 2020. @*Results@#Our data suggest that more than one-third of patients admitted to the trauma center over a 10-year period suffered from spinal injury. Injuries to the spine were further categorized as including the spinal cord (radiographically or clinically) or only including the bony or ligamentous elements of the spine. Injury was more common in men and predominantly located in the thoracic spine. Injuries such as epidural hematoma, vertebral artery, and cord contusion were common, with many patients requiring neurosurgical intervention. @*Conclusion@#Highlighting the implicit dangers of ATV accidents on the spine could help identify outcomes and variables predictive of spinal injuries and spinal cord injuries necessary for patient management. Additionally, our study sets the framework by which legislating bodies could replicate the study for proper legislation and recommendations that may help prevent such injuries.

Anti-uropathogenic activity, drug likeness, physicochemical and molecular docking assessment of (E-)-N0-(substituted-benzylidene)-2-(quinolin-8-yloxy) acetohydrazide

Objective: To deal with the anti-uropathogenic and in silico screening of (E-)-N'- (substituted-benzylidene)-2-(quinolin-8-yloxy)acetohydrazide analogues in order to search the potential anti-uropathogenic agents. Methods: Three (E-)-N'-(substituted-benzylidene)-2-(quinolin-8-yloxy)acetohydrazide analogues were synthesized. Structure elucidation was done using various spectroscopic techniques including infrared radiation, 1hydrogen-nuclear magnetic resonance, carbon- 13 nuclear magnetic resonance, etc. Physicochemical score, bioactivity score and molecular docking studies were carried out using Lipinski's rule of five, Molinspiration (web based software), Autodock 4.2 tools. In vitro anti-uropathogenic activity was carried out against four pathogens named as Staphylococcus aureus (S. aureus), Staphylococcus epidermidis, Proteus mirabilis and Escherichia coli by disc diffusion method and macrodilution test following their morphological and biochemical characterization. Results: The formation of (E-)-N'-(substituted-benzylidene)-2-(quinolin-8-yloxy)acetohydrazide is confirmed from the spectroscopic results. All the compounds were found in compliance with Lipinski's rule of five and exhibited bioactivity score from -0.50 to 0.00. Docking results revealed that compound-1 is forming one hydrogen bond with TYR 576 and two hydrogen bond with GLU 569, while compound-2 is forming one hydrogen bond with ARG 599, and compound-3 forming 0 hydrogen bond. The anti-uropathogenic evaluation exhibited that compound one exhibited better activity against S. aureus, while it was found to possess moderate to good activity against both Gram-positive bacteria and Gram-negative bacteria excluding S. aureus. Conclusions: Our study revealed that compound one exhibited better activity than the standard in case of S. aureus and moderate to good activity against rest of the pathogens. Molecular docking, physicochemical and bioactivity studies strongly supported the experimental results. From the well obtained results it was concluded that compound-1 can lead as potential anti-uropathogenic agents.

Andrographia paniculata a Miracle Herbs for cancer treatment: In vivo and in vitro studies against Aflatoxin B1 Toxicity

The history of natural products used in ancient times and in folk medicine these days, around the world, is the basis for the use of many therapeutic drugs in modern day medicine. Andrographia paniculata belongs to the family Acanthaceae or Kalmegh and is commonly known as 'king of bitters'. It is extensively used as home remedy for various diseases in Indian traditional system as well as in tribal system in India for multiple clinical applications. In our present work, extracts of these ayurvedic plants were tested for their anticlastogenic, and anticarcinogenic properties against Aflatoxin Bl induced toxicity. We used the in vitro method i.e. human lymphocytes culture and in vivo method in bone marrow cells of albino mice, while the parameters studied included chromosomal aberrations [CA], sister chromatid exchanges [SCEs] and cell growth kinetics [RI] both in the presence as well as in the absence of exogenous metabolic activation system for in vitro studies, whereas total aberrant cells and the frequencies of aberrations were used for in vivo methods A. paniculata extracts significantly reduced chromosomal aberrations from 35.0%, 62.0% and 69.0% level [at 24, 48, and 72 h due to Aflatoxin B1] to 21.72%, 44.0% and 52.0%, similarly sister chromatid exchanges were reduced from 14.60 per cell to 7.50 per cell at 48 h of treatments and replication index was enhanced in vitro for each concentration and duration of treatment. In conclusion A. paniculata extracts significantly reduced the number of aberrant cells and frequencies of aberration per cell at each concentration and duration of exposure in vivo; similarly it reduced chromosomal aberrations and sister chromatid exchanges and replication index was enhanced in vitro that was statistically significant at < 0.05 level

Terminalia arjuna, a herbal remedy against environmental carcinogenicity: An in vitro and in vivo study

Medicinal plants have been a major source of therapeutic agents from ancient times to cure diseases. The evaluation of rich heritage of traditional medicine is essential. The bark of Terminalia arjuna is rich in polyphenols [60-70%] including flavonoids and tannins. The aim of the present investigation is to highlight the anticarcinogenic and antimutagenic potential of extracts of T. arjuna. In this experiment we have used human lymphocyte culture and bone marrow cells of albino mice as assay system. The parameters studied included chromosomal aberrations [CA], sister chromatid exchanges [SCEs] and cell growth kinetics [RI] both in the presence and in the absence of exogenous metabolic activation system for in vitro experiment, whereas total aberrant cells and the total frequencies of aberrations were taken for in vivo study. The role of T. arjuna extracts in reducing metaphase aberrations due to aflatoxin B[is quite significant, the reduction varying from 23.49%, 42.47%, and 59.65% down to 12.32%, 28.00%, and 36.88% respectively at the highest dose [TA[4]] for the three different durations viz., 24, 48 and 72 h. Similarly the number of sister chromatid exchanges got reduced from a higher level of 15.00 +/- 1.40 per cell to 7.70 +/- 0.50 per cell with S9 mix at 48 h of treatment. The replication index was enhanced from 1.33 to 1.55 in vitro. Similar trends were noticed in the in vivo experiments i.e., effective reductions in clastogeny ranging from 15.22% to 54.82% from the mutagen treated positive control and the total frequencies in aberrant cells got reduced from 429 due to AFB1 to 141 due to 5th concentration of Terminalia extracts at 32 h of exposure. The ameliorating potential of Terminalia extracts was dose and time dependant

Pre-hospital deaths at islamabad tertiary care hospital a five year audit

Objective: To assess various causes of preventable pre hospital deaths at a tertiary care hospital in Islamabad and sensitize health care providers to establish good pre-hospital emergency services

Study Design: A Retrospective Descriptive study

Place And Duration: Federal Government Services Hospital Islamabad. From 1st January 2006 to 30th December 2010

Methodology: After going through the relevant hospital record and inquest reports of different police stations 5 years data was collected. A proforma was designed to incorporate data regarding the date on which dead bodies were brought to the hospital, name, age, gender, mode of death and site of injury/ injuries were recorded and analyzed. Comparison between continuous variables were performed. Exclusion and inclusion criteria were observed

Results: 235 dead bodies brought to accident and emergency department. Numbers of Pre hospital deaths were 32 during 2006, 49 during 2007 and 2008, 51 during 2009 and 54 during 2010. Traumatic Pre hospital deaths were 79.15 % [n= 186] while non- traumatic deaths were 20.85% [n=49]. Traumatic Pre hospital deaths included road traffic crashes deaths 45.95 %[ n=108], firearm injuries 19.57% [n=46], blunt injuries 2.55% [n=6], sharp edge injuries 2.12% [n=5], poisoning 3.82 %[ n=9], burns 1.7% [n=4], electric current shock 2.12 % [n=5], ligature strangulation 0.85 % [n=2] and hanging 0.42% [n=1]. Non-traumatic Pre hospital deaths were due to ischemic heart disease 14.04% [n=33], drowning 5.53% [n=13] and cause of death couldn't ascertained in three cases 1.27%. The most common victims of prehospital deaths were youth of 16 - 30 years 48.51 %[ n=114] followed by the age group from 31- 50years were 25.10 %[ n= 59]

Intermittent victims are people of extreme ages. Gender distribution is 83.82% [n= 197] males and 16.18% [n=38] females

Conclusion: Pre-hospital deaths due to Road traffic accidents are the highest followed by violence among traumatic deaths while deaths due to coronary heart diseases are the highest among non-traumatic deaths

Histological effects of tocotrienol on intima thickness in aorta of diabetic mice

To compare the thickness of intima in aorta of diabetic mice being fed on normal laboratory diet, high fat diet and high fat diet with tocotrienol. Experimental study. Army Medical College, Rawalpindi and National Institute of Health, Islamabad from November 2009 to June 2010. Forty five female BALB/c mice were randomly divided into three groups. All the animals were made diabetic by intraperitoneal injection of streptozotocin [STZ] 40 mg/kg body weight. Group I was given normal laboratory diet, group II high fat diet and group III was given tocotrienol along with high fat diet for 32 weeks. At the end of experiment the mice were sacrificed. The hearts of animals were dissected out and ascending aortae were removed. The specimen was fixed in 10% formol calcium and processed for paraffin embedding. Five micrometer thick sections were made. Haematoxylin and eosin and verhoeff staining was done. Thickness of intima and intracellular lipid depositions were noted. In contrast to group I, the intima thickness increased in groups II and III. Statistically significant increase in the thickness of intima was found in the aortae of diabetic animals in group II [high fat diet], when compared with group I [laboratory diet]. The thickness of intima increased significantly in group III when compared with group I. When group II [high fat diet] and III [high fat diet + tocotrienol] were compared, a significant decrease in intima thickness was noted in group III. In diabetics who consume high fat diet, there is a definite increase in the thickness of intima in aorta which can be prevented by giving tocotrienol

Clinical audit of glaucoma patients admitted in khyber teaching hospital Peshawar June 2002 May 2006

To determine the demographic pattern, types of glaucoma and to evaluate the different types of surgical procedures performed in terms of efficacy and safety. The medical records of admitted pts. for glaucoma during June 2002 to May 2005 [4 years] were studied in detail to see type of glaucoma; Management and their outcome. The main objective was intraocular pressure at the time of admission and discharge. Demographic pattern and therapeutic efficacy was determined. Out of 16425 patients hospitalized for various eye diseases, 775 [4.7%] patients with 1042 eyes suffered from various types of glaucoma 542 [69.93%] of patients were having primary glaucoma while 256 [31.07%] eyes were secondary types. Primary glaucoma is classified as primary angle closure glaucoma 38.5% primary open glaucoma 27.35%, congenital glaucoma 7.6% and absolute glaucoma 1.82%. Among secondary type, traumatic glaucoma was 6.42% lens induced glaucoma 5.37% steroid induced 4.35% neovascular glaucoma 3.45% pseudoexfoliatry type 2.5% and uveitic 2.01%. The numbers of male patients were more than female. The mean age at the time of admission was 42.6 years.Trabeculectomy was the main surgical operation [76.83%] Other surgical interventions were paracentasis with peripheral iridectomy, cyslocryopexy, lens extraction and pupulloplasty. Trabeculectomy was the most successful surgery in 84.41% for primary type of glaucoma. For secondary glaucoma paracentasis for hyphema related glaucoma, cyclorcyopexy, with or without cataract extraction for steroid induced glaucoma. Main post operative complications were shallow anterior chamber 12.65%, hyphema 10.27%, and uveitis 5.6%. Primary glaucoma is the leading cause of hospitalization followed by secondary glaucoma Trabeculectomy with or without antifibrotic agent is still the operation of choice and successful in 90% of cases. For secondary glaucoma, cause is treated and the various surgical offered are successful in 95% of cases

Unusual soft tissue tumours of the abdominal wall

To highlight the importance of remembering unusual tumours in the differential diagnosis of Soft Tissue Tumours of the Abdominal wall. Retrospective, decriptive study conducted between June 2000 to June 2003. Hamdard University Hospital and other private hospitals in Karachi. All patients presenting with Unusual Soft Tissue tumours of the Abdominal wall. The biodata, symptoms and signs of these patients were recorded and analyzed. They were extensively investigated; besides routine investigations Ultrasound, CT Scan and MRI were done where indicated. All the tumors were surgically excised and the diagnosis was confirmed on histopathology and immunohistochemical studies. Ten patients, six females and four males, aged 16-59 years, were seen with Unusual Soft tissue Tumours of the Abdominal Wall. Most of them [90%] presented with a swelling, while some had pain [30%] and fever [10%].Surgical excision and histopathology revealed them as desmoid tumour [n-6], rhabdomyosarcoma [n-2], urachal remnant tumour [n-1] and port-site metastatic tumour [n-1]. There was no recurrence in all the patients, except the one with urachal remanant. He died inspite of further excision, radio and chemotherapy. Abdominal wall tumours are rare. They may be innocent like the lipoma, or may show variable behavior like the desmoid tumour, or may be very aggressive like the rhabdomyosarcoma. They need proper clinical workup before embarking upon surgery, which should be wide surgical excision as they show aggressive infiltration in the surrounding tissues. They also require proper follow-up as they are famous for recurrence

Congenital genu recurvatum with dislocation of the knees: a case report

Ababy girl was born with severe deformity of the knees. Clinically and radiologically she was diagnosed as congenital dislocation of the knees. Gentle manipulation followed by malleable splints corrected the deformity in three weeks. A follow up at the age of one year showed normal position of the knees

Spinal epidural abscess; a study of 7 conscutive cases of spinal epidural abscess

It is a study of seven consecutive cases of spinal epidural abscess. Period of study is 4 years from Feb 1995 to Feb 1999. it was carried out in Department of Neurosurgery B.V. Hospital Bahawalpur. All available investigations were carried out to diagnose the condition preoperatively but definite diagnosis was made only at the time of surgery. Main radiological investigation was myelography. In one patient, C.T. myelogram was also performed. All the seven patients were subjected to surgical decompression of spinal cord and removal of pus and granulation tissue from epidural space. Five patients out of seven improved satisfactorily. The remaining two did not show any improvement at all. Purpose of study is to find out the incidence of spinal epidural abscess in our patients and out come of surgical treatment. Conclusion drawn is that the surgical decompression of spinal cord is the mainstay of treatment for spinal epidural abscess and outcome is batter if surgery is instituted immediately after the development of the disease

Supracondylar fractures of the humerus in children [comparative study of the conservative and operative treatment]

One hundred and five children with displaced extension-type supracondylar fractures of the humerus treated by conservative and operative method were reviewed in this study. Forty nine patients were treated by manipulative reduction and immobilisation in a plaster cast and forty patients had closed reduction and Kirschner wire fixation. The other sixteen patients were treated by open reduction and internal fixation. The results of treatment by these three methods were assessed clinically and compared. After a mean period of 4.6 years [ranged two to eight years] follow up; according to Flynn's clinical grading there were highest percentage [75%] of excellent result achieved by closed reduction and percutaneous K-wire fixation followed by open reduction and internal fixation [61%] and closed reduction and plaster cast [52%]. In the light of our experience and of the good results we recommend that percutaneous Kirschner wire fixation is the method of choice in the management of displaced supracondylar fractures of the humerus in children

Merits of posterior lumbotomy approach to the upper urinary tract

Posterior lumbotomy incision is anatomically the most straightforward approach to the kidney and the upper ureter. A brief description of the operative technique is followed by a report of the author's experience with this approach in 38 operations on the upper urinary tract. The access provided was judged to be adequate in 35 [92%] patients although twelve patients [31.5%] required upward extension of the incision for the access to become adequate. Thirty-three patients [87%] were mobile and did not require analgesia by third postoperative day. Average hospital stay was 6 days. Complications occurred in seven patients [21%]. There was no hospital mortality. This incision is recommended for relatively simple operations of upper urinary tract like pyelolithotomy and ureterolithotomy

Characteristics of patients, who escape from government mental hospital, Peshawar

The characteristics of 24 patients, who absconded from Government Mental Hospital, Peshawar between 1st July 1990 and 31st December 1990 were studied. All were male with a mean age of 25 years. The majority were from lower social class, who were admitted on a semi-voluntary basis. The predominant psychiatric diagnoses were heroin addiction [50%] and schizophrenia [38%]. The mode of "escape" in most cases [92%] could not be ascertained. No attempt was made to contact the police in any such incident