Ethnomedicinal uses of the Ferns of Shishikoh Valley, District Chitral, Pakistan

The indigenous communities of Shishikoh valley are often using various ferns taxa regularly. The current research work was intended for documenting the ethnomedicinal knowledge of ferns. A total of 18 taxa were recorded that belonged to 9 genera and 6 families being used in the treatment of different ailments. Pteridaceae was the leading family with 6 taxa (33.33%), followed by Aspleniaceae with 4 taxa (22.22%), Athyriaceae and Equisetaceae each with 3 taxa (16.67%) followed by Dryopteridaceae and Marsileaceae each with 1 taxon (5.56%). The reported ferns taxa were used as anthelminthic, anti-rheumatic, astringent and wound healing agents and in the treatment of different ailments such as asthma, bronchitis, diarrhea, dysentery, gonorrhea, hepatitis, infertility, influenza, kidney disorders, measles, oral ulcer, oral thrush, pneumonia, pyelonephritis, pharyngitis, scorpion bite, sinusitis, tonsillitis and tuberculosis. Ethnomedicinal knowledge is a valuable source for the innovation of different allopathic, homeopathic and herbal drugs that are used for the treatment of different ailments. The fern species may be used commercially for medicinal purposes through sustainable way. Their proper cultivation and awareness about medicinal values among local community leads to discover new drugs

EVALUATION OF IN VITRO ANTIOXIDANT ACTIVITY AND ESTIMATION OF TOTAL PHENOL AND FLAVONOID CONTENT OF ETHANOLIC LEAF EXTRACT OF IRIS KASHMIRIANA

Objective: The main aim of this study was to determine the in vitro antioxidant activity of Iris kashmiriana ethanolic leaf extract and also total phenol and flavonoid content was evaluated.Methods: Total phenol content (TPC) was determined by Folin–Ciocalteu method, total flavonoid content (TFC) was estimated by aluminum trichloride spectrophotometer method. Furthermore, antioxidant activity was revealed by 1,1-diphenyl-2-picrylhydrazyl (DPPH) assay, hydrogen peroxide (H2O2) scavenging activity, and reducing power assay.Results: The ethanolic leaf extract of I. kashmiriana showed TPC of 13.25±0.57 μg/100 μg gallic acid equivalents and TFC of 33.61±3.37 μg/100 μg rutin equivalents. The DPPH assay revealed IC50 of 0.418 mg/ml and for H2O2 radical scavenging IC50 was 0.476 mg/ml for the plant extract while as reducing power assay revealed concentration-dependent absorption values which clearly determine the antioxidant property of plant.Conclusion: From the results, it is apparent that I. kashmiriana ethanolic leaf extract possessed potential antioxidant activity which can be used to cure wide range of diseases

Metastatic Hepatic Epithelioid Hemangioendothelioma In 10 Years Old Boy; A Rare Case Report

OBJECTIVES Epithelioid Hemangioendothelioma is an infrequent vascular neoplasm of intermediate malignant potential oddly affecting children. It is primarily noted in soft tissues, the stomach, breast, spleen, brain, and liver. No definite risk factor is identified in children. However, following WWTR1-CAMTA1 and YAP1-TFE3 gene fusions are frequently seen in these tumours. We present a case of very rare childhood Epithelioid Hemangioendothelioma of the liver in a ten-year-old boy. A 10-year-old boy presented with abdominal pain, mild weight loss, and abnormal liver function tests. Radiologically, hepatic, pulmonary, and bony lesions are noted. The biopsy report showed Epithelioid Hemangioendothelioma confirmed by an Immunohistochemical panel. Due to the lack of facilities in our centre, palliative treatment was given to the patient. Surgical resection, liver transplant, and radiofrequency ablation were impossible due to widespread hepatic and pulmonary disease. The patient was resistant to any medical treatment. The patient died at the seventh-month follow-up. HEHE is a scarcely seen tumour with no definite management protocol. Surgical resection is the preferred treatment for resectable tumours. In non-resectable extensive bifocal tumours, like in our case, the preferred treatment is radio-frequency ablation and hepatic transplant. The overall survival is trivial due to the non-compliant nature of the disease

Renovascular hypertension: factors affecting the outcome following surgical revascularisation

This study was conducted at the Aga Khan University Hospital, Karachi, Pakistan to evaluate factors that affect outcome following revascularisation in patients with renovascular hypertension. We included all the patients diagnosed to have renovascular hypertension, confirmed by renal angiography, between July 1997 and September 2000. Of the total 15 patients, nine were males and six were females. Eleven patients received venous grafts, three received polytetraflouroethyline (PTFE) grafts while one patient underwent angioplasty and stenting. All were followed-up for a period of nine months (median) with the range from 2 to 84 months. A total of 33.3% of the study patients were completely cured, as they became normotensive without anti-hypertensive therapy after operation, while 27% showed marked improvement in blood pressure control post-operatively. Thus, extended cure or improvement of renovascular hypertension was achieved in 60% of patients. Normal pre-operative serum creatinine level, high pre-operative unstimulated peripheral renin levels and renal vein renin ratio of at least 1.75:1 were the most significant predictive factors for favorable outcome (p \u3c 0.012). The pre-operative severity and duration of hypertension as well as degree of disparity in kidney sizes did not predict the post-operative improvement in renal function and blood pressure control

Pre-operative renal function and selective renal vein rennin levels as markers of favourable outcome in renovascular hypertension

Objective: To evaluate factors that affect outcome following revascularization in patients with renovascular hypertension. Methods: This study was conducted at the Aga Khan University Hospital. It included all the patients diagnosed to have Renovascular hypertension confirmed by renal angiography between July 1996 to September 2000. Using ANOVA (Analysis of variance) and paired-sample t-test, several preoperative factors were evaluated for their ability to predict postoperative improvement of blood pressure and renalfunction. For descriptive purpose patients were divided into cured, improved and failure groups. Results: Of the total 15 patients, 9 were males and 6 were females. Before the surgical procedure, 13 patients were on 3 or more antihypertensive drugs. Eleven patients received vein grafts, three patients had PTFE (polytetraflouroethyline) grafts while one patient underwent angioplasty and stenting. The patients had a median follow-up period of nine months with a range of 2 to 84 months. Five were completely cured, as they became normotensive without antihypertensive therapy after operation, whereas four showed marked improvement in BP control postoperatively, requiring two antihypertensive drugs. Six patients showed no improvement requiring 3 or more drugs. Extended cure or improvement of renovascular hypertension was achieved in nine patients. Normal preoperative serum creatinine level, high preoperative unstimulated peripheral renin levels and renal vein renin ratio of at least 1.75:1 were the most significant predictive factors for favorable outcome. Conclusion: This study confirms the long term effectiveness and safety of renovascular reconstruction in the relief of severe hypertension. The results further suggest that normal preoperative renal function, high renal vein renin ratio and high preoperative unstimulated peripheral renin levels are associated with the most favourable postoperative outcome (p \u3c0.01). Preoperative severity and duration of hypertension and degree of disparity in kidney sizes do not affect the overall results in terms of postoperative improvement in renal function and blood pressure control (p=0.734)

Knowledge and awareness about chronic kidney disease among undergraduate students in International Islamic University Malaysia Kuantan Campus

Chronic kidney disease (CKD) causes 70% of all death globally. The prevalence of CKD has shown an increasing trend for the past 20 years in Malaysia. Thus, determining the knowledge and awareness of CKD among healthcare students in preparing them to be a good healthcare provider in the future is important. This study aimed to determine the association between knowledge and awareness about CKD among International Islamic University Malaysia (IIUM) undergraduate students. A crosssectional study was conducted among 108 students using simple random sampling method. The questionnaire was given to the class representative to be self-administered to interested students. It had close-ended questions consisting of Part A to Part D. The scoring given for correctly answered items was one and the total score for Part C was 7 marks. Most of the students were female (70.4%). The mean knowledge score of CKD was 3.65 (SD = 1.12) with nearly half of the students (43.5%) classified as having poor knowledge. Most respondents were aware about CKD (99.1%) and have heard about it from medical personnel (48.1%) and the Internet (25.9%). Further analysis showed that only courses taken by the respondents were significantly associated with knowledge on CKD (p = 0.039). The level of knowledge among undergraduate students is still poor, yet they are aware about the existence of CKD and its aetiology. Therefore, the health sciences curriculum should emphasise on CKD management from a multidisciplinary aspect of care. It is recommended to conduct similar research among different student populations to create awareness and obtain important baseline findings

Pattern of herbal and dietary supplement usage and conventional medication adherence among patients with chronic kidney disease: a survey finding

Introduction: There is widespread use of herbal and dietary supplements worldwide among patients despite robust clinical evidence of its efficacy. This may lead to adverse effects, such as diabetes,hypertension, stroke, cardiovascular risk and kidney problems due to inappropriate self-prescription. This study was performed to determine the prevalence of herbal and dietary supplements usage among patients with chronic kidney disease and its association with the socio-demographic background and the conventional medication adherence. Materials and methods: A survey was conducted among 78 chronic kidney disease patients attending the Nephrology Clinic, Hospital Tengku Ampuan Afzan, Kuantan, Pahang. Data were collected using a questionnaire and analyzed using descriptive statistics, Chi Square Test and Fisher’s Exact Test. The p-value was set to be less 0.05 for its level of significance. Results: Most of the patients aged more than 50 years (89.7%), female (53.8%), unemployed (41%) and from lower socioeconomic earners (75.6%). Only 5.2% of respondents reported using herbal and dietary supplements. There was no association between socio-demographic background with the herbal and dietary supplements usage. Similarly, there was no association between herbal and dietary supplements usage and the conventional medication adherence. Conclusion: This study provides a good baseline on the usage of herbal and dietary supplements use among chronic disease patients. It can be concluded that the level of awareness among the patients is good. Nevertheless, a larger study shall be performed in the future to explore the pattern of association

5-HT1A Receptor Function Makes Wound Healing a Happier Process

Skin wound healing is a multistage phenomenon that is regulated by cell–cell interplay and various factors. Endogenous serotonin is an important neurotransmitter and cytokine. Its interaction with the serotonin 1A receptor (5-HTR1A) delivers downstream cellular effects. The role of serotonin (5-hydroxytryptamine, 5-HT) and the 5-HT1A receptor has been established in the regeneration of tissues such as the liver and spinal motor neurons, prompting the investigation of the role of 5-HT1A receptor in skin healing. This study assessed the role of 5-HT1A receptor in excisional wound healing by employing an excisional punch biopsy model on 5-Ht1a receptor knockout mice. Post-harvest analysis revealed 5-Ht1a receptor knockout mice showed impaired skin healing, accompanied by a greater number of F4/80 macrophages, which prolongs the inflammatory phase of wound healing. To further unravel this phenomenon, we employed the 5-HT1A receptor agonist [(R)-(+)-8-Hydroxy-DPAT hydrobromide] as a topical cream treatment in an excisional punch biopsy model. The 5-HT1A receptor agonist treated group showed a smaller wound area, scar size, and improved neovascularization, which contributed to improve healing outcomes as compared to the control. Collectively, these findings revealed that serotonin and 5-HT1A receptor play an important role during the healing process. These findings may open new lines of investigation for the potential treatment alternatives to improve skin healing with minimal scarring