SAMAN MUFRIT (OBESITY) CONCEPT AND MANAGEMENT IN THE LIGHT OF UNANI LITERATURES

Obesity is a term used to describe body weight that is much higher than what is thought to be healthy for his or her height. It has become a serious public health problem. It affects 32.2% of the population. The worldwide prevalence of obesity is 1.6 billion and is reached epidemic proportions mostly in high income groups. Changes in dietary habits and sedentary lifestyles are known to be associated with changes in health and increased prevalence of chronic diseases. During the past decades efficacious strategies have been developed for prevention of these changes. These strategies involve general lifestyle changes, which include healthy diet, optimal weight, physical activity, no alcohol consumption. In the management strategies, Unani medicine plays an important role. Details about Saman Mufrit (Obesity) are described in various classic literatures of Unani medicine. For example Ibn Sina has mentioned a chapter on the disadvantages of obesity (Oyub al-Saman al-Mufrit) and a chapter on regimen of weight decrease (Tahzeel). Number of herbs is documented in Unani classics to reduce weight which includes Luk-e-Maghsool, Muqil (Commiphora mukul Linn.), Kharkhask (Tribulus terrestris Linn.), Haldi (Curcuma longa Linn.) and Zeera Siyah (Carum carvi, Linn.) etc. These herbs are the most common traditional Unani medicines used for weight loss, but there is a need to explore the efficacy of these drugs in a scientific manner. This paper focuses on the management of obesity through three basic fundamentals which are Ilaj bil Ghiza (diet therapy), Ilaj bil Tadbeer (regimental therapy) and Ilaj bil Dawa (drug therapy)

The role of the general practitioner in the screening and clinical management of chronic viral hepatitis in six EU countries

Introduction Chronic viral hepatitis is still a major public health concern in the EU. In order to halt the progression of the disease and to prevent onward transmission, timely recognition and accurate clinical management are crucial. The aim of the present study was to investigate the role of the general practitioner (GP) in the screening of persons at risk and in the clinical management of chronic viral hepatitis patients in six EU countries.Methods An online survey among GPs and secondary care specialists was conducted in the UK, Germany, the Netherlands, Hungary, Italy, and Spain. In the GP survey we aimed to find out how commonly risk groups are screened, using a four-point Likert scale. In both surveys, we measured whether GPs are involved in monitoring clinical indicators in patients undergoing antiviral treatment and explored whether patients in four clinical scenarios are referred back to primary care.Results Between five and 10 experts per professional group were reached except for Spain (GPs: n=2; Specialists: n=4) and, in the case of the GP survey, Hungary (GPs: n=4) and Germany (GPs: n=4). Migrants are variably or not routinely screened for Hepatitis B/C in the majority of cases. The majority of GPs reported that hepatitis B/C screening is routinely offered to people who inject drugs. In Hungary, Italy and in the Netherlands screening sex workers is not regularly practiced. As to whether GPs offer screening to men having sex with men, responses varied between variably and commonly practiced in Germany, the Netherlands and Italy, while in Hungary the practice seems to be sporadic; in the UK, while screening for hepatitis B seems to be common practice among GPs, hepatitis C testing is only occasionally offered to this risk group. Most GPs (>44%) in all countries except in Hungary reported that it is very common practice to offer hepatitis B/C screening to HIV patients.The role of the GPs in monitoring hepatitis cases and the referral of cases back to the GPs varied within and between countries. GPs are unlikely to monitor clinical outcomes other than side effects in patients undergoing treatment. Patients who have had a sustained virological response are usually referred back to GPs, whereas patients who do not respond to treatment are rarely referred back to primary care.Discussion The GPs decision to offer screening to risk groups often seems to be an individually motivated choice of the health care professional. Raising awareness among GPs about the disease, for example through the adoption of effective strategies for the dissemination and implementation of the existing guidelines for general practice, is highly needed. The role of GPs and specialists involved in the management of chronically infected patients should also be clarified, as the professionals opinion sometimes differed markedly even within the two professional groups

Public Health Implications of Human Papilloma Virus Vaccination: With Reference to the German Situation

Background: Cervical cancer constitutes a major burden of disease with nearly 500,000 new cases each year, 83% of which are seen in the developing world. More than 6500 cases of invasive cervical cancer are diagnosed in Germany annually with the mean age at diagnosis being 52 years. It constitutes 3.4% of all cancers in women, yet it accounts for 25% of cancers in the 25 –35 year age group. Human Papillomavirus (HPV) infection which is the most common sexually transmitted infection has been proposed as the first ever necessary cause of a human cancer associated with more than 99.7% of cervical cancers. Of the more than 130 genotypes identified 15 types have been labelled as high risk types. In view of the promising research results of prophylactic HPV VLP vaccines, this review aims to explore the public health potential which the introduction of such a prophylactic vaccine could have in the German context and to identify the influencing factors. Discussion: Impact of HPV vaccination on cervical cancer incidence at population level will depend on the length of induced immunity, number and interval of booster doses required, vaccine coverage of population at risk, societal acceptance and costs involved. If results from the large scale trials are similar to the phase II trials and model calculations hold true, given a high vaccine coverage a HPV vaccination would have a profound effect in reducing the burden of cervical disease in Germany

Evaluating health systems' preparedness for emerging infectious diseases: a novel conceptual and analytic framework.

In this article we present a novel conceptual framework for systematically assessing the national health system capacity to respond to pandemic influenza. This framework helps to determine how health systems and pandemic programmes interact, whether, where and which weak points exist, and how and where pandemic response health programmes can be improved effectively. This new conceptual framework draws upon two existing approaches for assessment and evaluation, the Systemic Rapid Assessment Toolkit (SYSRA) and the Hazard Analysis of Critical Control Points (HACCP). SYSRA is a systematic approach to analyse the interplay between communicable disease programmes and the broader health systems context within which they operate and the HACCP methodology builds upon a systematic analysis of process steps within a programme in order to identify likely hazards and to develop control measures to address them. The analytical framework that we have developed from the novel conceptualisation is simple, can be applied rapidly, and should, we believe, be low cost to implement. Thus, this provides a means for developing a contextual understanding of the broader health system in which a pandemic infectious disease programme operates, and for identifying frailties in programmes that need to be responded to