SINGLE-BLIND, RANDOMIZED, CONTROL TRIAL OF A UNANI COMPOUND FORMULATION IN ILTEHAB TAJAWEEFE ANAF MUZMIN

Objective: The objective of the study was to establish the efficacy and tolerability of oral Unani formulations with inhalation of Kalonji and to provide safe, effective, and economical treatment for Iltehab Tajaweefe Anaf Muzmin (chronic rhinosinusitis [CRS]). Methods: A randomized single-blind, comparative study of 40 patients of CRS. The patients were randomly allocated to two groups each consisting of 20 patients. In Group A, oral Unani formulation of Katan (Linum usitatissimum), Filfil Siyah (Piper nigrum), and honey was given 6 g BD with steam inhalation of Kalonji (Nigella sativa) and Tab Alaspan 1 BD with Karvol Plus inhalation was given in Group B. Results: Statistical analysis of the data was done using paired t test by comparing the visual analog scale score of all major and minor symptoms before and after treatment. The result is statistically highly significant in Group A (p<0.0001) and it is significant in Group B. (p<0.01). Conclusion: It may be concluded that the oral Unani formulation with inhalation of Kalonji has statistically highly significant effect on major and minor symptoms of CRS. A multicentric trial of the test drug on larger sample size for a longer duration is required to establish the efficacy of the formulation on CRS

Molecular Epidemiology of Bovine Babesiosis in Punjab, Pakistan

Background: Babesiosis is endemic in Pakistan and is one of the most important bovine diseases that causes huge economic losses and high mortality in young animals. This disease is transmitted by a protozoan parasite babesia which belongs to genus Babesia (Apicomplexa: Piroplasmida: Babesiidae). This disease is very much prevalent in summers followed by rainy season because humid environment is favorable for the growth of these parasites. An epidemiological and molecular study was conducted to unveil the prevalence and associated risk factors of Babesia bigemina (B. bigemina) and Babesia bovis (B. bovis) in selected districts i.e., Faisalabad, Toba Tek Singh and Jhang of Punjab, Pakistan.Materials, Methods & Results: A total of 518 (Cattle = 360, Buffalo = 158) blood samples were collected. The samples were analyzed by polymerase chain reaction (PCR) and nested PCR (n-PCR) targeting apocytochrome b-genes (CYTb). Chi-square test for univariate analysis was used to analyze the data. The overall prevalence in summer based upon microscopic analysis was 20.55% (37/180) and 13.92% (11/79) in cattle and buffaloes respectively and in winter was 8.80% (16/180), 5.06% (4/79)) in cattle and buffaloes respectively. The samples were further analyzed through conventional PCR (c-PCR) and nested PCR (nPCR). The overall results of conventional PCR in summer showed that 72 cows and buffaloes were infected with babesiosis. The conventional PCR based results of summer showed that prevalence of babesiosis was 29.44% (53/180) in cows and 24.05% (19/79) buffaloes. The results of cPCR during the winter season showed that 12.77% (23/180) and 13.92% (11/79) buffaloes were positive for babesiosis. The overall results of conventional PCR in winter showed that 34/259 cows and buffaloes were infected with babesiosis. On the other hand, the nested PCR results of summer season showed that the prevalence of babesiosis in cows was 32.22% (58/180) and 29.11% (23/79) in buffaloes. In total, 81 cows and buffaloes were infected with babesiosis during summer season. The nPCR results of winter showed that 15% (27/180) cows and 20.25% (16/79) buffaloes were infected with babesiosis. In total, 43 cows and buffaloes were infected with babesiosis. The results have shown that sensitivity of n-PCR is more as compared to conventional PCR. This study is the first molecular evidence of B. bigemina and B. bovis and its associated risk factors in Punjab province, Pakistan.Discussion: Dairy sector in Pakistan is one of the fastest growing sectors. Despite of remarkable growth, dairy industry is facing many problems one of them is tick borne diseases (TBDs). TBDs are more prevalent in tropical and subtropical areas of the world and leads to huge economic losses to dairy industry in terms of decreased milk, meat and wool production. Babesiosis is characterized by increased fever, decreased production, poor quality wool, anemia, hemoglobinuria, paleness of mucous membrane. The risk factors analysis of summer and winter data revealed that, adult animals were more prone to babesiosis (24.00%) [P = 0.032] and (8.50%) [P = 0.048]. In both seasons (summer and winter), females were more infected with babesiosis (20.19% and 8.17%) [P = 0.049 and P =0.021] as compared to males, high prevalence in females was might be due to that females were reared for longer period of time. Babesiosis was more occurred in non-cemented floor system (26.01% and 13.51%) [P = 0.028 and P = 0.044] in summer and winter, respectively. Disease was found more prevalent in closed housing system in summer and winter (27.27% and 10.93%) [P = 0.043 and P = 0.034] as compared to open housing. Weak animals were more infected with babesiosis (30.84%) [P = 0.045] and (12.80%) [P = 0.042] in summer and winter, as compared to healthy ones. The animals with high tick infestations were more suffered with babesia infection (25.49% and 13.34%) [P = 0.036 and P = 0.003] in both seasons as compared to less tick burden. Keywords: apocytochrome gene, babesiosis, bovine, nPCR, PCR, season

SANKHAHOLI (( Evolvulus alsinoides Linn.)): A REVIEW

ABSTRACT: The Sankhaholi (Evolvulus alsinoides Linn.) of family  Convolvulaceae which is commonly known as sankhpushpi, in traditional system of medicine including Unani Medicine. It is a perennial herb with a small woody branched root stock which contains alkaloids: shankhapushpine and evolvine. Fresh plant of sankhholi contains volatile oil. It also contains a yellow neutral fat, an organic acid and saline substances. Therapeutic uses of Sankhaholi Evolvulus alsinoides Linn, mentioned in the Unani Medicine are Alexiteric (Mufarreh), Cardiac  tonic  (Muqawwi-e Qalb), Brain tonic  (Muqawwi-e Dimag), Digestive (Hazim)  Musaffi-e- Khoon (Blood purifier),General tonic (Muqawwi-e-am), Diuretic (Mudirr-e-Baul), Anti Inflammatory (Muhallil-e-waram), Hypoglycemic (Dafa-e-Ziabitus), Antihypertensive (Dafye Imtella). It is also used in headache, asthma, hyperlipidemia etc. The present article reviews the pharmacological actions and therapeutic uses of Sankhaholi ( Evolvulus alsinoides Linn.) present in Unani literature supported with the available clinical and animal studies.Keywords: Sankhaholi Evolvulus alsinoides Linn. Sankhpushpi, Unani Medicin

Mixotrophic cultivation of Scenedesmus dimorphus in sugarcane bagasse hydrolysate

Overuse of the fossil fuels to fulfill existing energy requirements has generated various environmental problems like global warming. Emergence of environmental issues due to burning of the fossil fuel resources has provoked researchers to explore alternative sources of fuel. In this scenario, microalgal biofuels could present a promising alternative fuel if produced cost-effectively without competing for freshwater resources and arable land. Aim of the present study was to grow microalgae by employing lignocellulosic waste for production of lipids. Scenedesmus dimorphus NT8c was chosen based on its ability to tolerate heat, rapid growth, and ease of harvesting by overnight settling. Biochemical composition and growth parameters of microalgae were analyzed when cultivated mixotrophically on sugarcane bagasse hydrolysate, a low-value agricultural by-product, that is, currently underutilized. Despite a slight increase in turbidity in the medium, S. dimorphus NT8c cultures raised mixotrophically in 5 g/L sugarcane bagasse hydrolysate displayed significantly higher growth rates compared to photoautotrophic cultivation with an overall biomass productivity of 119.5 mg L d, protein contents of 34.82% and fatty acid contents of 15.41%. Thus, microalgae cultivated mixotrophically are capable of photosynthesizing while metabolizing and assimilating organic carbon, significant increases of biomass and lipid productivity can be achieved. However, high supplementation with organic carbon can result in unfavorable levels of turbidity and bacterial growth, reducing microalgal biomass productivity

Post-auricular leech therapy reduced headache & migraine days in chronic migraine

Background: Migraine is an exceedingly common disorder that causes substantial pain, disability and societal burden. Unfortunately, conventional treatments are insufficient, inadequate, or associated with significant risks, such as overuse, abuse or addiction. The Unani system of Medicine has been treating migraine since centuries. Leech therapy (Irsale Alaq) has been employed successfully in severe persistent headache, mania and insomnia since decades. Aim: The purpose of our study was to evaluate the impact of post auricular leech therapy in migraine and to collect data to warrant further clinical trials. Methods: We conducted a case series on 7 patients who had failed conventional oral treatments for the migraine. After informed consent, post auricular leech therapy was done.  Patients were asked to keep detailed headache calendars, documenting the number of headache days, migraine days, the intensity of headaches/ migraines and analgesic usage. We compared these parameters before and after 2 months of therapy. Results: We observed a reduction in the number of headache & migraine days and amount of painkillers used without any adverse effects. (P≤ 0.01) Improvement in quality of life was also observed. Discussion: We reviewed the literature related to the medicinal leeches (Hirudo medicinalis), used for the treatment in these cases. Leech saliva contains certain potent anesthetic, anti-inflammatory and vasodilator substances, suggesting plausible mechanisms of action in these cases. Conclusion: The preliminary findings indicate the safe and potential therapeutic role of leech therapy. So further trials should be carried out to explore the therapeutic potential of this therapy in chronic migraine. Keywords: Chronic Migraine, leech therapy, hirudo medicinalis, headache, Unani Medicine, complementary Medicine

Dengue Fever: A General Perspective

Dengue Fever or commonly known as Dengue, a mosquito-borne arboviral infection has emerged as havoc around the globe. Annually, about 50 million infections are reported, resulting in 22,000 deaths and almost 2.5 billion people are reported living at risk. Dengue infection is caused by Dengue Virus (DENV), which is a member of genus Flavivirus and comprised of ten proteins; three proteins, capsid (C), membrane (M), and envelope (E), play structural role and seven are identified as non-structural that direct DENV replication. Four distinct serotypes: DENV-1, DENV-2, DENV-3 and DENV-4 are transmitted via Aedes mosquitoes. Clinically, Dengue patients can be categorized into three groups according to WHO 2009 revised classification. Typical symptoms of dengue include: extreme fatigue; sudden fever (from 3-7 days), headache, joint, muscle, and back pain; vomiting and diarrhea, appetite loss; skin rash along minor bleeding. Aedes aegypti is geographically distributed in tropical areas and breeds in artificially filled water containers i.e. drums, tyres, flower vases plastic food containers, tin cans, etc. Due to four viral serotypes and non-availability of the model animal for dengue, producing vaccines is a challenging task. Thus, Dengue can be managed using various vector control strategies through physical, chemical and biological means

Fraxinus

Fraxinus, a member of the Oleaceae family, commonly known as ash tree is found in northeast Asia, north America, east and western France, China, northern areas of Pakistan, India, and Afghanistan. Chemical constituents of Fraxinus plant include various secoiridoids, phenylethanoids, flavonoids, coumarins, and lignans; therefore, it is considered as a plant with versatile biological and pharmacological activities. Its tremendous range of pharmacotherapeutic properties has been well documented including anticancer, anti-inflammatory, antioxidant, antimicrobial, and neuroprotective. In addition, its bioactive phytochemicals and secondary metabolites can be effectively used in cosmetic industry and as a competent antiaging agent. Fraxinus presents pharmacological effectiveness by targeting the novel targets in several pathological conditions, which provide a spacious therapeutic time window. Our aim is to update the scientific research community with recent endeavors with specifically highlighting the mechanism of action in different diseases. This potentially efficacious pharmacological drug candidate should be used for new drug discovery in future. This review suggests that this plant has extremely important medicinal utilization but further supporting studies and scientific experimentations are mandatory to determine its specific intracellular targets and site of action to completely figure out its pharmacological applications

Evaluation of gut modulatory and bronchodilator activities of Amaranthus spinosus Linn.

Background The aqueous-methanolic extract of Amaranthus spinosus (A. spinosus Linn.,) whole plant, was studied for its laxative, spasmolytic and bronchodilator activities to validate some of its medicinal uses. Methods The crude extract of A. spinosus was studied in-vivo for bronchodilator and laxative activities and in-vitro using isolated tissue preparations which were mounted in tissue baths assembly containing physiological salt solutions, maintained at 37°C and aerated with carbogen, to assess the spasmolytic effect and to find out the possible underlying mechanisms. Results In the in-vivo experiments in mice, the administration of A. spinosus increased fecal output at doses of 100 and 300 mg/kg showing laxative activity. It also inhibited carbachol-induced bronchospasm in anesthetized rats at 1, 3, 10 and 30 mg/kg indicative of bronchodilator activity. When tested on isolated gut preparations, the plant extract showed a concentration-dependent (0.01-10.0 mg/ml) spasmogenic effect in spontaneously contracting rabbit jejunum and guinea-pig ileum. The spasmogenic effect was partially blocked in tissues pretreated with atropine (0.1 μM). When tested on K+ (80 mM)-induced sustained contractions in isolated rabbit jejunum, the plant extract caused complete relaxation and also produced a shift in the Ca++ concentration-response curves (CRCs) towards right, similar to diltiazem. In rabbit trachea, the plant extract completely inhibited K+ (80 mM) and carbachol (CCh, 1 μM)-induced contractions at 1 mg/ml but pretreatment of tissue with propranolol (1 μM), caused around 10 fold shift in the inhibitory CRCs of the plant extract constructed against CCh-induced contraction. The plant extract (up to 0.3 mg/ml) also increased both force and rate of spontaneous contractions of isolated guinea-pig atria, followed by relaxation at higher concentration (1.0-5.0 mg/ml). The cardio-stimulant effect was abolished in the presence of propranolol, similar to that of isoprenaline. Activity-directed fractionation revealed that the spasmolytic component(s) was separated in the organic fraction, whereas the spasmogenic component was concentrated in the aqueous fraction. Conclusion These results indicate that A. spinosus possesses laxative activity partially mediated through cholinergic action. The spasmolytic effect was mediated through calcium channel blocking (CCB), while bronchodilator activity through a combination of β-adrenergic and CCB pathways, which may explain the traditional uses of A. spinosus in gut and airways disorders

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation

A Study on Teachers’ Sense of Self-Efficacy in Defence Authority Educational Institutions, Karachi, Pakistan

The purpose of this study was to investigate the extent to which teacher efficacy is understood by the Defence Authority Institution's teachers and the extent teacher efficacy behaviors were practiced in the Defence Authority Institutions. A survey research design was chosen for this quantitative study, which focuses on teachers’ perceptions about teacher efficacy in Defence Authority Institutions schools. Data was collected through the Teacher Sense of Efficacy Scale (TSES) which is a 24-item measure of three subscales: Efficacy in Student Engagement, Instructional Strategies, and Classroom Management developed by Tschannen-Moran and Hoy (2001), and it is also called the Ohio State Teacher Efficacy Scale (OSTES). This scale was used to collect data from the teachers of Defence Authority Institutions schools to examine their perceptions about teacher efficacy. Data were collected from 393 Defence Authority Institution's teachers. The survey consisted of two sections. Part 1 requested demographic data and Part 2 contained 24 items of the TSES (Long Form instrument). Eight findings emerged after analyzing the data. These findings indicated that the teachers had a strong understanding of teacher efficacy and practiced teacher efficacy behaviors associated with improving the teaching and learning process. However, the findings also illustrated that the Defence Authority Institutions needed to include teacher efficacy as part of a sustained professional development program. Recommendations were provided to facilitate the improvement and strengthening of teacher efficacy across the Defence Authority Institutions of Pakistan