Anti-anxiety Properties of Selected Medicinal Plants.

Exploration of new drugs targeting anxiety treatment is a major concern worldwide. Medicinal plants are being used as a potential source of novel drugs for anxiety disorders. The objective of this review is to provide information about the healing outcomes of anxiety treatment with natural products. Valeriana officinalis, Citrus aurantium, Commelina benghalensis, Achyranthes aspera, Mimosa pudica, Achillea millefolium, Nymphaea alba, Leonurus cardiac, Camellia sinensis, Turnera aphrodisiaca, Crataegus oxyacantha and Piper methysticum showed promising effects on anxiety in animal models. In clinical studies, passion flower, kava, valerian, St John's wort, and hwagandha showed the most positive results. More studies are needed for the exploration of the antianxiety of medicinal plants. In drugs derived from natural sources have explored many components that are playing an essential role in curing anxiety disorders and associated complications.

Epidemiology, etiology, diagnosis and treatment of prostate cancer.

Prostate cancer is more common in men over the age of 65 years. There are 15% cases with positive family history of prostate cancer Worldwide. Prostate cancer is the second leading cause of death among the U.S. men. Prostate cancer incidence is strongly related to age with the highest rates in older man. Globally millions of people are suffering from this disease. This study aims to provide awareness about prostate cancer as well as an updated knowledge about the epidemiology, etiology, diagnosis and treatment of prostate cancer.

Antioxidant activity and inhibitory effect of some commonly used medicinal plants against lipid per-oxidation in mice brain.

BACKGROUND: The present study compares the protective properties of aqueous extracts of six medicinal plants, Phyllanthus emblica, Terminalia chebula (black and yellow), Terminalia arjuna, Balsamodendron Mukul and Alium sativum against lipid per-oxidation in mice brain. METHODS: The antioxidant activities were analyzed by lipid per-oxidation assay, 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical assay, total antioxidant activity and metal chelation. RESULTS: The extracts (fruits and bark) showed inhibition against thiobarbituric acid reactive species (TBARS) induced by pro-oxidant (10 µM FeSO4) in mice brain. Moreover, the free radical scavenging activities of the extracts was evaluated by the scavenging of DPPH radical (IC50, 23.23 ± 1.2 µg/ml (Phyllanthus emblica), 20.24 ± 0.9 µg/ml (Terminalia chebula yellow) and 17.33 ± 1.1 µg/ml (Terminalia chebula black), 19.44 ± 0.45 µg/ml (Terminalia arjuna), 56.59 ± 2.1 µg/ml (Balsamodendron Mukul) and < 200 µg/ml (Alium sativum). CONCLUSION: The higher antioxidant and inhibitory effect of Terminalia chebula black in this study could be attributed to its significantly higher phenolic content, Fe(II) chelating ability, reducing ability and free radical scavenging activity. Therefore oxidative stress in brain could be potentially prevented by the intake of these plants.

Peritonsillar abscess: clinical presentation and efficacy of incision and drainage under local anaesthesia.

BACKGROUND: Peritonsillar abscess (PTA) is one of the most commonly encountered abscess in the head and neck region. The aims of this study were to list the frequency of the disease by age, sex and laterality, and to list the presentation of the disease by symptoms, signs and complications, and to determine the efficacy of incision and drainage (I&D) procedure under local anaesthesia (LA) in terms of hospital stay and recurrence. METHODS: This descriptive study was conducted at the Department of Otorhinolaryngology and Head & Neck Surgery, District Headquarters Hospital, Lakki Marwat, from 1st June 2007 to 30th May 2010. Adult patients (> 15 years) of both sexes with unilateral peritonsillar abscess were included sequentially. Children (15 years or less), patients with acute follicular tonsillitis or peritonsillitis and those who refused incision and drainage under LA were excluded. All patients received the same antibiotic Amoxicillin/Clavunate and underwent I&D procedure under LA. RESULTS: Sixty patients were included in the study, 42 male and 18 female. Mean age of the patients was 30.02 +/- or = 9.42 (range 16-50 years). It was more on the left side (35, 58.35%). Forty-four (73.35%) patients gave an antecedent history of tonsillitis. Three (5%) patients presented with complications. Mean hospital stay was 1.55 +/- 1.00 (range 1-5 days). All patients underwent I&D with no recurrence. Interval tonsillectomy was performed in 38 selected cases after 6 weeks. CONCLUSION: Incision and drainage under LA still remains the gold standard procedure for peritonsillar abscess in our setup.

Cardiac surgery in octogenarians.

In Europe and North America, cardiac surgery can be done successfully on octogenarians, but differences in patient selection, surgical and bypass techniques prevent us from concluding similarly in Pakistan. This study investigated the short and long-term outcomes of cardiac surgery in octogenarians operated over a 5 years period at The Aga Khan University Hospital, from January 2001 to December 2006. Seventeen octogenarians, (mean age 81.7 ± 2.3) underwent coronary artery bypass graft (CABG). Thirty-days hospital mortality was reported in only 1 patient. Surgical complication of any kind was reported in 13 (76.5%) patients with pleural effusion being the commonest in hospital complication seen in 11 (64.7%) patients. About 13 (92.9%) patients were satisfied with the results of the surgery and reported post-surgery improvement in quality of their life. Cardiac surgery has an important role in the management of elderly patients with medically refractory cardiac symptoms, but the implications of widespread cardiac surgery in the elderly need to be addressed.

Cardiac surgery in nonagenarians: single-centre series and review.

BACKGROUND: Cardiac surgery is widely believed to be an excessively high-risk intervention for very elderly patients with coronary artery or valvular disease. However, as life expectancy and the prospect of sustained quality of life into older age increase, this assumption should be challenged so that surgery is not denied to patients who may derive significant symptomatic benefit with acceptable levels of operative risk. OBJECTIVE: To evaluate outcomes from cardiac surgery in nonagenarian patients. DESIGN: Analysis of prospectively collected single-centre data and review of outcomes reported in the literature. RESULTS: Twenty-three patients (13 males) aged 90 years or more underwent open cardiac surgery between 1998 and 2007. Four patients died within 30 days of surgery (surgical mortality 17.4%) and all-cause in-hospital morbidity was 74%. Actuarial survival at 1 and 5 years was estimated at 72 and 54%, respectively. Comparison of patients' survival against age-matched life tables for the English population found a standardised mortality ratio of 0.57 (95% CI: 0.24-0.99; one-sample log-rank test chi(2) = 3.93; p < 0.05) representing a significant survival benefit associated with surgery. The majority of patients reported symptomatic improvement reflected by significant decreases in angina and dyspnoea scores. Six single-centre series of nonagenarians and 3 reviews from national databases in the US and UK were identified in the literature. Pooled surgical mortality was 12.7% (95% CI: 8.7-17.3%) with no significant heterogeneity (chi(2) = 4.12; p = 0.77; I(2) = 0). CONCLUSION: Cardiac surgery in the elderly carries higher operative risk than in younger patients. However, in selected nonagenarians, surgery can be performed with acceptable morbidity and early mortality, and patients gain significant symptomatic relief and survival benefit.

Extrapleural hydatid disease of chest: a case of recurrent hydatid disease.

Hydatid disease is a parasitic infestation by a tapeworm of the genus Echinococcus. We present the case of 34-year-old female who complained of chest pain and had a past history of hydatid cyst resection four times in last 15 years. She was found to have extrapleural hyatid cysts of chest that were removed via thoracotomy. The patient fully recovered and experienced an uneventful follow-up.

Rhabdomyosarcoma embryonal type: in a three and a half year old girl.

Rhadomyosarcoma is the most common tumour of the soft tissues in infants and children. We report a case of a 3 1/2 year old girl who presented with a swelling over the neck. Swelling was diagnosed as Rhabdomyosarcoma (embryonal type). Tumour mass was found to be unresectable initially. The patient was subjected to multiple courses of checmotherapy, which shrunk the tumour significantly. There was simultaneous development of cystic lesions in upper lobe of right lung. Excision of the remnant rhabdomyosarcoma mass and biopsy of right lung with cystectomy of right upper lobe cystic lesion was performed. The patient fully recovered and experienced an uneventful 6 months of follow-up.

Extensive primary malignant thymoma involving pericardium, pleura, diaphragm and lungs--a case report.

Malignant thymoma is an extremely rare entity. According to a study, the annual incidence of malignant thymoma was estimated to be 0.15 per 100,000 person-years. We present the case of a 42-year-old female who came to us with a Type AB, Masaoka stage III malignant (invasive) thymoma with widespread involvement of the mediastinum.

Chylopericardium--a rare complication after ventricular septal defect repair.

Chylopericardium is a rare complication of cardiac surgery. It may be caused by a lesion in the thoracic duct or its tributaries or by thrombosis in the confluence of the jugular and left subclavian veins, obstructing the drainage of the thoracic duct. The treatment may be conservative or surgical, depending on the duration and on the volume of the effusion. We report the case of a 1 1/2 year-old male, who, in the late postoperative period of VSD repair, was hospitalized with low-grade fever and breathlessness for one week due to the presence of chylopericardium. The clinical findings and treatment performed are discussed.

Body Dysmorphic Disorder: gender differences and prevalence in a Pakistani medical student population.

BACKGROUND: Body dysmorphic disorder (BDD) is a psychiatric disorder characterized by a preoccupation with an imagined or slight defect which causes significant distress or impairment in functioning. Few studies have assessed gender differences in BDD in a non clinical population. Also no study assessed BDD in medical students. This study was designed to determine the point prevalence of BDD in Pakistani medical students and the gender differences in prevalence of BDD, body foci of concern and symptoms of BDD. METHODS: The medical students enrolled in a medical university in Karachi, Pakistan filled out a self-report questionnaire which assessed clinical features of BDD. BDD was diagnosed according to the DSM-IV criteria. RESULTS: Out of the 156 students, 57.1% were female. A total of 78.8% of the students reported dissatisfaction with some aspect of their appearance and 5.8% met the DSM-IV criteria for BDD. The male to female ratio for BDD was 1.7. Regarding gender differences in body foci of concern, the top three reported foci of concern in male students were head hair (34.3%), being fat (32.8%), skin (14.9%) and nose(14.9%), whereas in females they were being fat (40.4%), skin (24.7%) and teeth (18%). Females were significantly more concerned about being fat (p = 0.005). Male students were significantly more concerned about being thin (p = 0.01) and about head hair (p = 0.012). CONCLUSION: BDD is fairly common in our medical student population, with a higher prevalence in males. Important gender differences in BDD symptomatology and reported body foci of concern were identified which reflected the influence of media on body image perception. The impact of cultural factors on the prevalence as well as gender differences in BDD symptomatology was also established.

Chamberlain mediastinotomy for diagnosis of adenoid cystic carcinoma of trachea.

Primary tracheal tumours are extremely rare. Bronchoscopy is the standard diagnostic procedure of obtaining biopsy of a tracheal mass, however it becomes challenging if the obstructing lesion is placed distally along the trachea occluding greater than 90% of the airway. We report the case of a 25-year-old male who suffered from severe tracheal stenosis. The lesion was biopsied through a chamberlain mediastinotomy, under local and mask anaesthesia and was found to be primary adenoid cystic carcinoma.

Anthropometric correlates of blood pressure in normotensive Pakistani subjects.

Obesity and hypertension are two major inter-related cardiovascular risk factors. Decrease in adiposity is one of the most effective preventive measures not only in decreasing the overall cardiovascular risk but also the blood pressure. This cross-sectional study measured the effect of various measures of adiposity on blood pressure in normal healthy subjects of Pakistani origin. 400 normotensive subjects (247 males and 153 females) were included in this study. Along with data on co-morbid conditions, two blood pressure readings and several anthropometric measurements were recorded. Age and gender specific analysis was done. Following the WHO cutoffs for Asians, about 52% of our sample population was found to be overweight or obese. Age was not associated with blood pressure indices in males; however it was strongly associated with all blood pressure indices in females. Greater Body Mass Index (BMI), Waist Circumference (WC) and Waist to Height Ratio (WHTR) were associated with higher Systolic and Diastolic Blood pressure. Increasing age was also associated with higher levels of BMI, WC and WHTR. Anthropometric variables however, were more strongly associated with blood pressure indices than age in this sample population. In conclusion, we found WC and WHTR to be strongly associated with blood pressure indices in normotensive Pakistani males.