Effect of topical honey application along with intralesional injection of glucantime in the treatment of cutaneous leishmaniasis

<p>Abstract</p> <p>Background</p> <p>Leishmaniasis is an endemic disease in Iran. Although many treatments have been suggested for this disease, there hasn't been an effective and safe treatment yet. Regarding the healing effect of honey in the chronic ulcers and its reported therapeutic effect in cutaneous leishmaniasis, we performed a study to better evaluate the efficacy of honey in cutaneous leishmaniasis and its final scar.</p> <p>Methods</p> <p>In a prospective clinical trial, 100 patients with confirmed cutaneous leishmaniasis were selected and randomized into 2 groups. Group A were treated with topical honey twice daily along with intralesional injection of glucantime once weekly until complete healing of the ulcer or for maximum of 6 weeks. Group B were treated with intralesional injection of glucantime alone until complete healing of the ulcer or for a maximum of 6 weeks, too. The patients were followed for 4 months. The collected data were analyzed statistically using statistical tests including Chi-square, Mann Whitney and Kaplan – Mayer tests.</p> <p>Results</p> <p>In this study, 45 patients that had cutaneous leishmaniasis were treated with intralesional glucantime alone and 45 patients were treated with topical honey and glucantime . Ten patients left out the study. In the glucantime alone treated group, 32 patients (71.1%) had complete cure whereas in the group treated with both glucantime & topical honey, 23 patients (51.1%) achieved complete cure. This difference was significant statistically (p = 0.04).</p> <p>Conclusion</p> <p>Further studies to better clarify the efficacy of honey in cutaneous leishmaniasis is needed. We suggest that in another study, the efficacy of honey with standardized level of antibacterial activity is evaluated against cutaneous leishmaniasis.</p

Trends in the management of inguinal hernia in Karachi, Pakistan: a survey of practice patterns

INTRODUCTION: The study was conducted to identify and document the various aspects of elective inguinal hernia repair performed by general surgeons working in the different university hospitals of Karachi, Pakistan. METHODS: This questionnaire-based survey, carried out over a two-year period, involved 84 general surgeons of Karachi. The respondents were divided into groups and comparative analysis was carried out. RESULTS: 65 respondents (77.4 percent) were male and 19 (22.6 percent) were female. Mean years and standard deviation since post graduation were 7.7 and 7.3 years, respectively. 60 respondents (71.4 percent) reported the routine use of prophylactic antibiotics in all inguinal hernia repairs. 34 respondents (40.5 percent) quoted spinal anaesthesia as their preferred type of anaesthesia, 46 respondents (54.8 percent) chose to perform the procedure as a day case, and 49 respondents (58.3 percent) reported mesh repair as their preferred type of repair. 60 respondents (71.4 percent) did not recommend the laparoscopic approach to hernia repair. Surgeons associated with private hospitals were found more likely to choose mesh as their preferred method of inguinal hernia repair (p-value is 0.007), but less likely to use prophylactic antibiotics (p-value is 0.05) and respondents with more than ten years of postgraduate experience were found more likely to perform hernia repairs on an inpatient basis (p-value is 0.045). CONCLUSION: Various aspects of management of inguinal hernias are still determined by the preference of the operating surgeon. Day case management of hernia repairs, routine use of prophylactic antibiotics, use of mesh and open repair of hernias were the practice of the majority of surgeons, although differences were noted in specific groups of surgeons