Effect of combination therapy of Nigella sativa and trigonella foenum-graecum on body mass index in type-2 diabetes mellitus patients

Objective: To evaluate the effect of combination therapy of Nigella sativa and Trigonella foenum-graecum seeds on body mass index [BMI] in type 2 diabetic patients.

Setting: This clinical trial was conducted in the diabetic outpatient clinics of Isra University Hyderabad and Liaquat University of Medical and Health Sciences Jamshoro, from March to August 2008

Design:A randomized clinical trial

Subjects and Methods: For this study, Type 2 diabetic patients on glibenclamide, who gave written consent to volunteer in the study, were randomly divided into two groups. Fifty patients in group A [control group] were kept on glibenclamide, while 50 patients in group B [test group] were given capsules containing combined powders of N. sativa and T. foenum-graecum seeds in addition to their routine dose of glibenclamide. Patients in both groups were treated for 3 months. BMI was calculated for every patient at the start and after 3 months of therapy

Results: A favorable impact of combination therapy with N. sativa and T. foenum-graecum seeds in reducing BMI was noted in the test group in comparison to the control group, but overall differences between groups were not statistically significant

Conclusion: This study indicates that combination therapy of N. sativa and T. foenum-graecum has some effectiveness in controlling BMI in type 2 diabetic patients. Further study with an adequate sample size is recommended

Pattern of obstructed labour at a public sector University Hospital of Sindh, Pakistan

Objective: to determine the frequency, risk factors, complications and outcome of obstructed labour in our setup

Study design: a retrospective study

Setting: obstetrics and Gynaecology Unit IV, Liaquat University Hospital, Jamshoro - Pakistan from January 2004 to December 2006 [three years]

Methods: patients' records, labour room registers, operation theatre books and perinatal records were reviewed retrospectively to gather information about patients admitted with obstructed labour

Results: out of 2126 hospital deliveries during the study period, 44 [2.1%] were admitted with obstructed labour as an emergency. Only 13 [29.5%] had received antenatal care at some stage of pregnancy. Thirty-two [72.2%] patients belonged to rural areas. Mean duration of labour was 15.9+/-11.6 hours. Cephalo-pelvic disproportion in 22 [49.3%] cases was the most common risk factor of obstruction, followed by malposition/malpresentation in 19 [43.3%] cases. Caesarean section was the most common mode of delivery [81.1%]. Three [6.8%] patients had ruptured uterus. Still birth rate was very high i.e. 14 [31%] and neonatal deaths were 4 [9%], while 26 [49%] babies survived with minor problems

Conclusion: obstructed labour still poses a great maternal and foetal problem in our setup. Malpractice by untrained persons is a major factor. Most of these cases are preventable by proper antenatal care provided by properly trained persons

Dengue virus outbreak in the year 2006 at a tertiary care centre in Sindh

Objective: To investigate the outcome of 116 patients with suspected / confirmed diagnosis of Dengue fever at our tertiary care setup. Design: A descriptive study Setting: Liaquat University Hospital Hyderabad / Jamshoro. Study was carried out between October and December 2006

Methods: This study was conducted on 116 patients who were admitted in Liaquat University Hospital. Case definition was high grade fever with leucopenia and thrombocytopenia

Results: Only 52 out of 116 patients were confirmed as having Dengue IgM antibodies. The highest sufferers of Dengue fever were young adults. Almost all cases developed mild to moderate thrombocytopenia and leucopenia. Most patients recovered spontaneously in less than 10 days. Only 3 patients expired

Conclusion: Dengue fever is endemic in sub-Saharan region and in South Asia including Pakistan. Out-breaks occur from time to time. The current outbreak being the 3[rd] episode in the last 13 years points towards the importance of comprehensive research for the prevention and control of the disease. Although case fatality rates are low however it must be considered as public health problem and serious efforts shall be undertaken for public awareness and vector control

Perinatal mortality and related obstetric risk factors at a tertiary care hospital of Hyderabad

Objective: To determine perinatal mortality rate and its related obstetric risk factors in our setup. Design: Observational study. Setting: Department of Obstetrics and Gynaecology [Unit-I], Liaquat University Hospital Hyderabad, from January to December 2006

Patients and Methods: All perinatal deaths including stillbirths [SBs] and early neonatal deaths [ENNDs] within 0-7 days of birth after 24 weeks of gestation were studied during the study period, while Pregnancies <24 weeks of gestation were excluded from the study. The relevant information was collected through a pre-designed proforma which contained variables including maternal demographics, obstetric risk factors and other details

Results: A total number of 2224 deliveries were analysed for perinatal mortality. Out of these, there were 224 perinatal deaths giving a PNMR of 100.7/1000 births. There were 196 SBs and 28 ENNDs. Among these, 88% women were unbooked. Commonest risk factors was antepartum haemorrhage [27.67%], followed by hypertensive disorders of pregnancy [23.21%] and mechanical factors affecting labour [14.28%]. Congenital abnormalities were found in 9.8% of PNDs while maternal medical disorders were seen in 6.25% cases. In 3.5% cases, chorioamnionitis/ neonatal septicaemia was the underlying cause and multiple pregnancies were seen in only 02 [0.89%] cases. However, in 32 [14.28%] cases, no cause was found

Conclusion: The high perinatal mortality rate in present study is comparable to the figures from other institutions. Main reason being lack of antenatal and pre-pregnancy care where from almost all obstetric risk factors can be picked up and treated / prevented

Role of serum leptin level as a marker of severity of pre eclampsia

To explore the possibility of serum leptin being a marker of severity of pre-eclampsia, so that risk of imminent eclampsia and eclampsia can be reduced. This observational study was conducted at a private hospital of Hyderabad from 31st July to 1st December 2007. Forty primipara with same age, body mass indices and gestational age were included in this study. Twenty women had raised blood pressure in third trimester of pregnancy and 20 women with a normal blood pressure in third trimester of pregnancy. The exclusion criteria included history of diabetes, twin pregnancy, chronic hypertension, liver or renal disease. After counselling and affordability of laboratory testing their blood sample was taken for serum leptin, uric acid, serum creatinine and urine for albumin. The serum leptin level was measured by radio-immunoassay [RIA] kits. All data was filled in a pre-designed proforma after taking detailed history and examination. Statistical analysis was performed on SPSS. Student's t-test was applied where applicable. Mean systolic and diastolic blood pressure between pre-eclamptic and control group showed a marked difference [p<0.001] ranging from 149.50 +/- 3.44 and 104.40 +/- 3.03 as compared to control 107 +/- 1.56 and 74.50 +/- 1.49 respectively, similarly proteinuria was present in 20 [100%] cases of pre-eclampsia and 07 [35%] of normotensive women. Mean serum leptin level was significantly high in preeclampstic [79.380 +/- 3.287], when compared with a control group [27.825 +/- 1.050]. Mean serum uric acid in pre-eclamptic [5.040 +/- 0.147] showed significant changes than control [3.600 +/- 0.141], while serum creatinine level was insignificant in both groups. It has been observed that Mean +/- SEM value of serum leptin level was much higher in severe pre-eclamptics [76.418 +/- 5.056] than in women with mild pre-eclampsia [40.856 +/- 2.807]. All the parameters correlated positively and significantly with increased blood pressure. Elevated plasma leptin concentration appears to be a marker of pre-eclampsia independently or along with other parameters of pre-eclampsia could be used to reduce the severity of pre-eclampsia thus avoiding risk effects of pre-eclampsia to mother and foetus. This study still needs more research work to prove our results

Sturge weber syndrome

Six cases of sturge weber syndrome are reported which presented at Plastic Surgery ward of Liaquat University Hospital Jamshoro, Pakistan. It includes characteristics of patients, management of cases and their outcome. Male female ratio was same in these cases and their age was above 30 years. Outcome of the management of this syndrome was found dependent upon case to case. As Sturge Weber Syndrome is a very rare congenital anomaly, hence, its awareness among the plastic surgeons, neurosurgeons and eye surgeons is important