Medicinal plants and management of diabetes mellitus: a review

Diabetes is a metabolic disorder characterized by chronic hyperglycemia and associated with dysfunction and failure of various body organs. Alarming increase in prevalence rate has made this disorder a major health problem globally. The available treatment modalities are not sufficient to combat diabetes and associated complications. A number of medicinal plants have a significant antidiabetic potential against diabetes mellitus. We have listed the use of important medicinal herbs for the treatment and management of diabetes in this review

Hormonization of traditional medicine with modern medicine.

To evaluate the contemporary role of traditional medicine in maintaining health, to develop a scientific approach to policy–making in traditional medicine, and, ultimately, to assess how traditional medicine can be harmonized with modern medicine. There is dire need for identifying research requirements in traditional medicine on the past research, barriers to the acceptance of traditional medicine, research methodology and evidence–based medicine. In the course of these discussions, we concluded that there were challenges to the harmonization of traditional and modern medicine. Better access to information, facilitating appropriate clinical trials, improving rigour in clinical trials, improving education and collaboration of practitioners and researchers, and respecting traditional practices in research were all identified as important steps towards achieving harmonization. We should be believed that evidence–based research could be an essential step towards the harmonization. Findings of well–designed and well–performed research should be disseminated as widely as possible. This should include the preparation and dissemination in English and native languages of rigorous systematic reviews based on the research literature from various countries. Research that establishes the value of traditional medicine in promoting health and wellness beyond treating diseases should be encouraged. Clinical trials of widely used and established traditional remedies should be encouraged and undertaken prior to obtaining the results of extensive ‘pre–clinical’ basic research. This is done by support training in research methodologies by encourage in conducting of high quality research.

Xanthine oxidase inhibition by some medicinal plants.

Xanthine oxidase inhibitory activity has been reported from different plants such as Cinnamomum cassia, Chrysanthemum indicum, Lycopus europaeus, Polygonum cuspidatum, Acacia confuse, Coccinia grandis, Datura metel, Strychnos nux-vomica, Vitex negundo, Coccinia grandis, Vitex negundo, Fraxinus angustifolia, Pistacia lentiscus, Hyptis obtusiflora, H. lantanaefolia, Artemisia vulgaris, Caesalpinia sappan, Blumea balsamifera, Chrysanthemum sinense, Tetracera scandens, C. sinense, Allium Cepa, Pistacia integerrima, Caesalpinia sappan and Caesalpinia sappan. This review very clearly specify that plants could be utilized for the inhibition of xathine oxidase and out of them Clerodendrum floribundum, Eremophila maculata, Stemodia grossa Benth, Eucalyptus deglupta, Syzygium malaccense and Larix laricina exhibited 84%, 61%, 57%, 51%, 64%, 86 % xanthine pxidase inhibition at concentration of 50 μg/ml, 50 μg/ml, 50 μg/ml, 44.5 μg/ml, 51 μg/ml, 6.26mg/dl respectively.

Evaluation of discolouration of some composite restorative materials

This in-vitro study was conducted to investigate the stain resistance of direct composite resin restorative materials with different polishing systems [diamond finishing and polishing burs, aluminium oxide disks and abrasive impregnated disks] in comparison to the material cured against a mylar strip. The composite resin materials investigated included Clearfil AP-X [hybrid], Filtek Z-250 [hybrid], Definite [Ormocer], and Silux Plus [microfill]. Forty disk specimens [10mm x 2mm] of each composite resin were prepared. Ten mylar cured specimens were assigned for each polishing system and ten were used as controls with no further treatment after curing. A spectrophotometer [Spectraflash 500] was used to determine the initial colour and the colour change after one week immersion. All specimens were stored in tea separately for one week at 39[degree sign] C. Post immersion colour measurements were undertaken to assess colour change [delta E]. One way ANOVA showed that there was statistically significant difference between the different composites and the polish groups for discoloration at p<0.05. All the composites tested showed significant discoloration when polished with Diamond burs. The least discoloration was found when specimens were polished with soflex except with Z-250 which discoloured less under mylar than soflex but the difference was not significant. Among the materials tested AP-X showed the least discoloration

Frequency of intestinal parasites among food-handlers in Khartoum, Sudan

Food-handlers [n = 1500] attending the public health laboratory in Khartoum, Sudan, for annual check-ups were screened for intestinal parasites by 3 different techniques [direct faecal examination, formol-ether concentration and floatation] to evaluate the adequacy of annual screening. Results showed that 29.4% of food-handlers were harbouring intestinal protozoa in stool samples: Entamoeba coli in 15.3%, Giardia lamblia in 9.7%, and Enta. histolytica in 4.3%. Moreover, 2.7% of food-handlers harboured intestinal helminths: Hymenolepis nana [1.6%], Schistosoma mansoni [0.7%], Taenia saginata [0.3%] and Strongyloides stercoralis [0.1%]. We recommend more frequent screening of food-handlers and that the direct faecal smear technique is efficient for the detection of such parasites

Coagulation disturbances in pregnancy and post delivery period in Sudan

Coagulation problems during pregnancy and after delivery are major health problems leading to fatal complications. Coagulation complications in pregnancy are related to hypertension [PIH], placenta previa or gestational diabetes as well as some chronic problems that effect pregnancy like heart disease and asthma. The study was intended to measure the coagulation profiles, prior and post delivery, to find out coagulation hazards among those ladies compared to non-pregnant ladies as control group. A descriptive comparative study was conducted from Jan to June 2007 using 70 blood samples obtained from non-pregnant ladies [control] and 140 blood samples obtained from 70 ladies during pregnancy and after delivery. The coagulation tests [prothrombin time, activated partial thromboplastin time, thrombin time and platelets count] were performed on all samples by the same manner. Results showed that prothrombin time, activated partial thromboplastin time, thrombin time and platelets count prior and post delivery were significantly decreased compared to control, unlike platelets which were increased rather than in control without statistical significance. Also the coagulation profiles were significantly affected by the type of delivery [cesarean section and normal], while not affected by mothers' age, circumcision, history of abortion and diabetes mellitus. There is observable effect of weight and contraceptive. It is concluded that the coagulation profile prior and post delivery were significantly decreased compared to control, while platelets were increased more than that counted in control. It is recommended to investigate pregnant ladies for coagulation profile before and after delivery and treatment should be offered to ladies with high risk

Some markers of oxidative stress and antioxidant status in patients with psoriasis

Psoriasis is a common, chronic inflammatory skin disease with unknown etiology. It has been suggested that increased reactive oxygen species [ROS] production and deficient function of antioxidant systems activities may be involved in the pathogenesis of the disease. The goal of this study was to determine the role of lipid peroxidation, assess the antioxidant activity in psoriasis patients and to correlate it with severity of the disease. In this study malondialdehyde [MDA], super oxide dismutase [SOD] enzyme activity, and total antioxidant oxidative capacity [AOC%], Vit E and beta carotene levels in 24 patients with psoriasis were investigated and compared with those of 12 control subjects. Clinical severity of the disease was determined according to the Psoriasis Area Severity Index [PASI] scores in patients. Our results showed that MDA as a marker of oxidative stress was significantly higher in psoriatic patients, while AOC%, SOD, Vit E and beta carotene as markers of antioxidant status were significantly lower in psoriatic patients compared to control. However, there was no correlation between PASI score and plasma AOC% and erythrocyte SOD levels. In conclusion our results may provide some evidence for the role of ROS production associated with decrease antioxidant potential in psoriasis

Clinical and biochemical changes in Egyptian patients with Sjogren Larsson syndrome

The Sjogren-Larsson syndrome [SLS] is an inborn error of lipid metabolism, characterized clinically by congenital ichthyosis, mental retardation and spasticity. It is a rare autosomal recessive condition resulting from fatty aldehyde dehydrogenase deficiency, which is involved in lipid synthesis and catabolism. This study included nine patients with SJL, their ages ranged from 2.6 to 12 years [6.4 +/- 2.2]. All the patients were subjected to full clinical examination and biochemical investigations including the estimation of the level of fatty aldehyde dehydrogenase in leucocytes and total cholesterol, triglycerides, low-density lipoproteins [LDL], high-density lipoproteins [HDL], low-density lipoprotein oxidizability and 5-lipooxygenase in plasma. Neurophysiologic examinations including magnetic resonance image [MRI], electro encephalogram [EEG], and visual evoked potential [VEP] were done. The study aims to outline the clinical signs and symptoms together with the biochemical characteristics of SLS. Our findings provide evidence for defective 5-lipoxygenase degradation, fatty aldehyde dehydrogenase deficiency, while lipid profile and low density lipoproteins oxidizability were significantly increased in SLS patients. These findings suggest that fatty aldehyde dehydrogenase plays a major role in detoxification and in the turn over of fatty aldehydes and lipids and offer non-invasive diagnostic tools. Moreover, they provide a powerful rationale for therapeutic trials aimed at inhibiting 5-lipoxygenase synthesis

Diabetic foot ulcer-a prospective study

OBJECTIVE: To detect 'Feet at Risk' early, its early diagnosis and treatment of foot ulceration to prevent amputation. SETTING AND METHOD: One hundred patients with diabetic foot problems were seen at Baqai Institute of Diabetology and Endocrinology from 06-01-97 to 14-04-99. Each Patient was examined for peripheral pulses, sensations and reflexes, for dryness of skin, deformity, callus and nail disorders and were photographed on first visit. There were 65% males and 35% females included in this study. Ninety nine patients were type II diabetics, 38% were either smokers or had other addictions [or were addicted to tobacco]. Awareness about risk factors causing foot problems was lacking among all patients. Fifty% patients were on oral hypoglycaemic agents, 48% were insulin treated, while 2% were on diet and exercise alone. Glycaemic control was poor in 70%, fair in 16% and was good in 14%, 31% were overweight and 5% patients were underweight. Duration of diabetes was greater than ten years in 58%, toes were affected in 44%, sole/metatarsal in 18%; rest included malleoli, heel etc. Eleven patients had ulcers on both feet. Neuropathic ulcer were 42%, neuro ischaemic 58%, Sixty nine% patients were in the age group between 40-60 years. Cause unknown 29% blisters and boil 14%, trauma/cutting 17%, burns 8%, dry skin/callus 10%. Fundal changes were present in 37%; proteinuria in 37%, ischaemic heart disease in 20%, hypertension 18%, In 60% more than one antibiotic was used. Foot ulcers of fifty nine patients healed on conservative management, six patients had below knee amputation, fifteen had toe amputation; nine were still on treatment, eleven lost contact. Lack of awareness, poor glycaemic control and duration of diabetes were the main factors causing diabetic foot problems. This study also confirmed that microvascular complications should be screened in patients with diabetic foot ulcers. Foot care education would be the most important way of dealing with this major problem

Obliteration of the post-pneumonectomy empyema space with pectoral muscle flaps

This is a case presentation of a 54 year old male who underwent left pneumonectomy in 1980 in Belgium. Post-operatively he developed an empyema of the post-pneumonectomy space which became a chronic discharging cavity. In 1991, a permanent pleuro-cutaneous window was created to allow free drainage, at the Aga Khan University Hospital in Karachi. In October 1994, the post-pneumonectomy space was obliterated using pectoral muscle flaps, with an excellent result over a twelve month follow up

Use of cefixime in treatment of enteric fever in children

The study was conducted with a view to highlight increasing resistance in bacterilogically proven Salmonella infection and evaluate usefulness of Cefixime in treatment of Enteric fever in children. Design: Prospective study of 50 consecutive cases of uncomplicated Salmonella infection. Setting: Paediatric consultation clinic at Dr. Zia Uddin Memorial Hospital, Nazimabad, Karachi. Subjects: Fifty culture proven Enteric fever cases upto 15 years of age. Main outcome measures: Salmonella sensitivity pattern and usefulness of Cefixime in Enteric fever as regards efficacy, cost and side effects. Salmonella sensitivity to commonly used antibiotics emerged as Chloramphenicol 45%. Co-Trimoxazole 44%, Amoxycillin 50%, Ceftriaxone 96%, Cefotaxime 94%, Aztreonam 82% and Cefixime 82%. With Cefixime period of defervescence was 6.7 days [range 4-10]. Clinical response occurred in 82% cases with 6% replase rate. Increasing resistance of Salmonella is highlighted. Cefixime emerged as more effective [as compared to first line drugs], less expensive [than parenteral 3rd generation Cephalosporins and Aztreonam] and safe [with no fear of potential toxicity like that induced by the Quinolones] for treatment of uncomplicated Salmonella infection

Laparoscopy in appendicitis: a reasonable innovation

One hundred twenty four patients suffering from acute appendicitis and complicated appendicitis were operated by laparoscopy in selected cases. Cases of generalized peritonitis and complicated appendicitis were operated by laparoscopy in selected cases. Cases of generalized peritonitis, fixed appendicular masses, hemodynamically unstable patients and children below 10 years of age were excluded from laparoscopic procedures in the work. Laparoscopic appendectomy was safe and successful in 110 cases [88.71%]. No mortalities occurred in the group of patients. Morbidity included one case of postoperative right iliac fossa abscess treated by open drainage, postoperative pyrexia without sonographic evidences of collection in 6 cases lasted for 3-6 days and sepsis at the site of trocar puncture in 4 cases, all were treated conservatively. All patients were given broad spectrum antibiotics for 3-7 days. Laparoscopy in acute appendicitis and selected cases of complicated appendicitis could be a reasonable alternative to open laparotomy

Effect of bacteriophage lysogeny on the efficacy of two bacterial larvicide formulations under field conditions

Two types of man-made ditches were selected for carrying out this experiment; one polluted with nitrogenous matters [sewage water] and second filled with accumulated irrigated clear non-chlorinated water. No phages were detected in samples collected from both types of ditches. However, phage[s] specific to only B. sphaericus was [were] detected after spraying the two types with both B. thuringiensis H-14 and B. sphaericus commercial formulations. The detection of phage[s] was observed after three days post-spraying in the polluted ditch and after one week in the non-polluted one. This observation was explained by a possible transduction of naturally existed phage[s] on other spore forming bacteria to the sprayed B. sphaericus only, as its commercial formulation is based on spores which germinate to produce vegetative cell, while B. thuringiensis H-14 contains only the O- endotoxin as active ingredient, and also due to the increase of the number of bacteria in the sprayed ditches due to the recycling of B. sphaericus in the aquatic breeding places

Comparative inhibitory action of 4 standard bacteriophages on the larvicidal activity of certain mosquito pathogenic bacteria against culex pipiens larvae

Four bacteriophages [CP-51, CP-54, Yousten-4 and Yousten-14] were assayed against 7 entemopathogenic bacterial strains. The two CP ones, indicating variability of the host range of the tested phages was suggested to be related to the environmental characteristics of the tested strains. On testing the susceptibility of 5 bacterial strains to the phage Yousten-4 at different cultural ages, a correlation was found between incubation time and level of bacterial susceptibility to the tested phage. This observation was explained to be due to the number of vegetative cells and/or sporulation

field survey of bacteriophage contamination of mosquito breeding places, inhibiting bacterial insecticide

Twelve geographically different mosquito breeding places were described and sampled for the detection of naturally existed bacteriophage viruses which could transduct and lysate 5 entomopathogenic bacteria. The surveyed places are classified into seepage, sewage, and irrigation breeding water. Bacterial free filtrates of the collected samples were assayed against the tested bacteria in vitro and against 3rd instar Culex pipiens larvae as well. Nine out of the twelve places could demonstrate the presence of phages. Bacillus thuringiensis H-14 was found susceptible to phage[s] present in polluted and irrigated water of 5 locations, while B. thuringiensis Berliner was susceptible to only a specific phage of one breeding place [pollutes, sewage water]. With regard to Bacillus sphaericus strains 1593 and 114, bacteriophages of sewage and irrigated water could lysate them and these phages are characterized by being of a moderate host range, except one phage which showed high specificity with strain 114 and was detected in a polluted sewage water sample collected from Daqahlia Governorate. The detected phages proved to lysate both B. thuringiensis H-14 and B. sphaericus 1593 on their larvicidal action through a series of bioassay experiment, almost all results indicate the presence of a significant inhibitory activity

Isolation, purification and ultrastructure of bacteriophages from natural mosquito breeding places in Egypt

Two bacteriophages were isolated from field collected samples representing two different mosquito breeding places. The phage AB-1 [isolated from Abheit Village, Fayoum Governorate "seepage water"] and the phage GA-2 [isolated from El-Gabal El-Asfer, Qalyoubia Governorate "sewage drain water"] were purified. Both bacteriophages were ultrastructurally described with respect to their morphology, dimensions, phases of bacterial attack and lysogeny. No major differences were observed between both isolated phages in relation to specificity, however, they were isolated from two different types of breeding places and two different geographic areas as well. This study may assume a wide host range of the isolated phages and reflect how bacterial insecticides used for mosquito larval control could be inhibited by such bacteriophage

Influcence of low energy laser treatment on antigen induced experimental arthritis

This study was performed to evaluate the effect of low energy laser irradiation on arthritis induced by type II collagen in rats 10 rats were used as normal control and 50 were utilized for induction of arthritis, 10 of them were not irradiated [arthritic control group] 20 were subjected to local laser application [experimental group] and 20 were exposed to sham laser irradiation [sham laser irradiated group]. Animals of arthritic control group were sacrificed 2 weeks after induction of arthritis Animal of experimental and sham laser irradiation group were subjected to clinical and radiographic examination before and after irradiation. Then they were sacrificed to evaluated histopathological changes in ankle joints after laser application, compared to arthritic control group. Our data reveal improvement of clinical radiographic and histopathological changes after laser therapy

need of surgery for epilepsy [a neurologist's point of view]

Epilepsy is the commonest neurological problem beside apoplexy, encountered by neurologists around the globe. Surgery is beside apolexy, receiving increasing attention in epilepsy, specially in the intractable type; but unfortunately the case is reverse in our country. In Pakistan we have around one million epileptics, out of which approximately 30% have focal epilepsies and roughly 50% of them might be having well defined single seizure focus. If facilities for diagnosis surgical therapeutics are made available, surgery may solve a considerable extent of the problem