Evaluation of clinical trials of ethnomedicine used for the treatment of diabetes: A systematic review

Diabetes mellitus (DM) is a widespread metabolic disorder with a yearly 6.7 million deaths worldwide. Several treatment options are available but with common side effects like weight gain, cardiovascular diseases, neurotoxicity, hepatotoxicity, and nephrotoxicity. Therefore, ethnomedicine is gaining the interest of researchers in the treatment of DM. Ethnomedicine works by preventing intestinal absorption and hepatic production of glucose as well as enhancing glucose uptake in muscles and fatty tissues and increasing insulin secretion. A variety of plants have entered clinical trials but very few have gained approval for use. This current study provides an evaluation of such clinical trials. For this purpose, an extensive literature review was performed from a database using keywords like “ethnomedicine diabetes clinical trial”, “clinical trials”, “clinical trial in diabetes”, “diabetes”, “natural products in diabetes”, “ethno-pharmacological relevance of natural products in diabetes”, etc. Clinical trials of 20 plants and natural products were evaluated based on eligibility criteria. Major limitations associated with these clinical trials were a lack of patient compliance, dose-response relationship, and an evaluation of biomarkers with a small sample size and treatment duration. Measures in terms of strict regulations can be considered to achieve quality clinical trials. A specific goal of this systematic review is to discuss DM treatment through ethnomedicine based on recent clinical trials of the past 7 years

Role of HRCT for Rapid Triage of Patients with COVID-19 Pneumonia

Background:   To assess the diagnostic performances of HRCT for COVID 19 pneumonia for efficient triage of patients, in comparison with RT-PCR reverse transcription polymerase chain reaction test.   Method:   It is retrospective comparative study conducted in Benazir Bhutto hospital affiliated with Rawalpindi medical university from March 25th to April 25th, 2021.  HRCT of 500 patients were selected from central computer server and their RT-PCR results were also obtained from the HMS system of the hospital. HRCT were reported as “Definitely COVID positive”, “Possible COVID positive” or “COVID negative” by experienced radiologists. Sensitivity, Specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated using the final RT-PCR test as standard of reference. Results:   RT-PCR test of 207 patients was positive, whereas 293 were reported negative. HRCT was reported as “Definitely COVID positive” in 222 cases (44.4 %), “Possible COVID positive” in 24 cases (4.8%) and “COVID negative” in 254 cases (50.8%). Comparing only Definitely COVID positive category with RT-PCR results sensitivity, specificity. PPV and NPV were 90.3%, 88%,84.2% and 92.8%   Conclusion:   CT chest is the most reliable, sensitive and rapid tool for triaging of patients as COVID positive or negative in busy emergency departments as compared to RT-PCR which is time consuming and has limitations such as faulty sampling technique, limited kits and variable sensitivit

Self-reported health and smoking status, and body mass index: a case-control comparison based on GEN SCRIP (GENetics of SChizophRenia In Pakistan) data

Introduction Individuals with schizophrenia are at a high risk of physical health comorbidities and premature mortality. Cardiovascular and metabolic causes are an important contributor. There are gaps in monitoring, documenting and managing these physical health comorbidities. Because of their condition, patients themselves may not be aware of these comorbidities and may not be able to follow a lifestyle that prevents and manages the complications. In many low-income and middle-income countries including Pakistan, the bulk of the burden of care for those struggling with schizophrenia falls on the families.Objectives To determine the rate of self-reported physical health disorders and risk factors, like body mass index (BMI) and smoking, associated with cardiovascular and metabolic disorders in cases of schizophrenia compared with a group of mentally healthy controls.Design A case-controlled, cross-sectional multicentre study of patients with schizophrenia in Pakistan.Settings Multiple data collection sites across the country for patients, that is, public and private psychiatric OPDs (out patient departments), specialised psychiatric care facilities, and psychiatric wards of teaching and district level hospitals. Healthy controls were enrolled from the community.Participants We report a total of 6838 participants’ data with (N 3411 (49.9%)) cases of schizophrenia compared with a group of healthy controls (N 3427 (50.1%)).Results BMI (OR 0.98 (CI 0.97 to 0.99), p=0.0025), and the rate of smoking is higher in patients with schizophrenia than in controls. Problems with vision (OR 0.13 (0.08 to 0.2), joint pain (OR 0.18 (0.07 to 0.44)) and high cholesterol (OR 0.13 (0.05 to 0.35)) have higher reported prevalence in controls. The cases describe more physical health disorders in the category ‘other’ (OR 4.65 (3.01 to 7.18)). This captures residual disorders not listed in the questionnaire.Conclusions Participants with schizophrenia in comparison with controls report more disorders. The access in the ‘other’ category may be a reflection of undiagnosed disorders