Unani Medicines for Glycemic Control in Type 2 Diabetes Mellitus: A Systematic Review.

Background: Diabetes, especially Type-2 diabetes mellitus (T2DM), poses a significant global health challenge. Complementary and alternative medicine, such as Unani Medicine, has gained popularity for managing T2DM. Objective: This systematic review aims to evaluate the efficacy and safety of Unani medications in T2DM management. Methods: A comprehensive literature search was conducted across multiple electronic databases to identify relevant clinical trials. Inclusion criteria focused on original research articles examining the efficacy and safety of Unani medications in patients with T2DM. Data extraction and quality assessment were performed using established criteria, and meta-analyses were conducted to assess the efficacy of Unani medications on glycemic control. Results: Five randomized controlled trials met the inclusion criteria. Meta-analyses revealed that Unani medications significantly reduced fasting blood glucose and postprandial blood glucose levels compared to control groups. However, the impact on HbA1c levels was not statistically significant. No adverse effects were reported. Conclusion: The findings of this review suggest that Unani medications hold promise in the management of T2DM, as evidenced by significant reductions in fasting and postprandial blood glucose levels. However, further investigation, particularly focusing on compounds like Qurs Gulnar, is essential to unravel their mechanisms and ascertain their long-term efficacy. Moreover, enhancing study quality would provide valuable insights into the role of Unani Medicine as a complementary or alternative therapy for T2DM. These efforts are critical for establishing Unani Medicine's place in the comprehensive management of T2DM.

"I would prefer to be dead than to live this way": Lived experiences of stigma and discrimination against khwaja sira in Swat, Pakistan.

Due to their identification as third gender people, khwaja sira have historically been subjected to experiences of social marginalization. However, the extant literature has not fully explored the lived experiences of stigma and discrimination against khwaja sira in the Swat Valley of Khyber Pakhtunkhwa, Pakistan. To address this gap, we conducted 45 interviews with khwaja sira in Mingora, Swat, Khyber Pakhtunkhwa to better understand their experiences of gender-nonconformity stigma and discrimination in various social contexts, including within their families, in accessing health care, and within education and work contexts. Applying Minority Stress Theory and utilizing thematic content analysis, the present study identified three dimensions of gender-nonconformity stigma: (1) internalized stigma, namely feelings of shame and embarrassment; (2) perceived stigma, namely opinions others had of khwaja sira regarding lack of employability or engagement in sex work; and (3) enacted stigma, namely exclusion from families, in educational settings, in religious spaces, and in healthcare settings. Findings should inform future social intervention and community practice engagements with khwaja sira communities in Pakistan.

Conceptual Understanding of Preventive Strategies for Metabolic Disorders in Unani Medicine: A Narrative Review.

Background: The global burden of metabolic disorders is increasing at an alarming rate. These disorders have a huge impact in terms of human suffering and economic implications. There is an urgent need for effective strategies, including the use of traditional systems of medicine, to reduce the burden of these diseases. Objective: The objective of this article is to compile information on preventive strategies for metabolic disorders found in Unani medicine. Methods: A literature survey of classical Unani texts was conducted to understand the conceptual framework in Unani medicine underlying preventive strategies for metabolic disorders. Electronic databases such as PubMed, ScienceDirect, and Google Scholar were searched to obtain the evidence needed to validate the Unani medicine viewpoint. Results: Unani scholars have described a set of clinical conditions caused by the insufficiency of the nutritive faculty. These conditions correlate in many ways with metabolic disorders. Cold dystemperament of the liver is considered to be the cause of insufficiency of nutritive faculty. Therefore, care and protection of the liver is considered as the main preventive approach for metabolic disorders in Unani medicine. Several epidemiological studies have also reported a strong relationship between non-alcoholic fatty liver disease and metabolic syndrome. Conclusion: The broad set of approaches (based on its theoretical foundations) used by Unani scholars to maintain the nutritive faculty in its optimal functional state seems to be an effective measure for the prevention of metabolic disorders.

"Having a guru is like having a licence": analysing financial relationships between khwaja sira gurus and chelas in Swat, Pakistan.

The focus of this study was on identifying themes regarding the financial relationships between gurus (leaders) and chelas (disciples) in khwaja sira communities in Khyber Pakhtunkwa, Pakistan. We interviewed 45 khwaja sira in Mingora, Swat on their experiences of guru-chela culture. All interviews were digitally audio recorded, then translated and transcribed directly from Pashto into English. Transcripts of the interviews were analysed using thematic content analysis in a manner informed by both social reproduction theory and notions of Islamic capital. We identified four major themes related to relationships within guru-chela culture: (1) financial relationships are highly structured; (2) financial exchanges can be mutually beneficial; (3) systems of payment and debt can be exploitative; and (4) financial ties to gurus continue throughout the life course of khwaja sira. Findings show how financial interactions within guru-chela relationships are reflective of larger social forces, reproducing kinship structures, systems of Islamic gift-giving, and capitalist processes occurring within Pakhtun society.

Unani medicinal herbs as potential air disinfectants: an evidence-based review.

OBJECTIVES: Indoor air quality has a significant impact on our health and quality of life, as people spends 80-90% of their time indoors. Fumigation of several medicinal herbs has been recommended by Unani scholars to improve air quality, but their efficacy in air purification is still unknown. Hence, this article aims to discuss the applicability of proposed medicinal herbs in the light of current researches. METHODS: A manual literature survey of classical Unani texts was conducted to collect information about the herbs recommended for air purification. In addition, research databases such as PubMed, Google Scholar, and ScienceDirect were extensively searched for evidence on the efficacy and mechanism of action of the suggested herbs in air purification. RESULTS: In classical Unani texts, authors have found descriptions of 26 herbs that have been recommended for improving air quality. In-vitro studies have confirmed the antimicrobial activity of 19 of these herbs. Moreover, the efficacy of Styrax benzoin, Commiphora myrrha and Acorus calamus fumigation on aerial microbes have also been validated by studies. CONCLUSIONS: The findings of the literature review clearly demonstrated that the herbs recommended by Unani scholars for air purification have broad-spectrum antimicrobial activity, indicating that these herbs could be a potential candidate for air disinfectant. Therefore, authors recommend the further researches on proposed herbs to validate their efficiency against airborne pathogens in the vapour phase.

Public health approach of Unani medicine to cope and stay safe in hot environmental conditions.

The rising episodes of deadly heat waves have intensified the need for a heat protection strategy. The Unani system of medicine offers ways to stay healthy in different climatic conditions. Hence, this article aims to discuss the applicability of health protection measures suggested by Unani scholars for hot weather conditions in the light of current researches. The manual literature survey of classical Unani texts was conducted to collect information on health safety measures for hot weather. A substantial search of scientific databases such as "Google Scholar" and "Medline" for proposed measures in combination with "heat-stroke", "heat exhaustion" and "heat rash" was also conducted to identify their possible activity in heat-related illnesses. The guidelines for summer seasons in the classical Unani literature are described under the title tadabir-i-mavsam. Unani scholars have discussed in detail the pathophysiological effects of heat and the measures to stay healthy by regulating the body system through lifestyle, diet and herbs. Most of the measures proposed by them are backed up by evidences. However, some measures have not yet been evaluated for their therapeutic or prophylactic efficacy in heat-related illnesses. On the basis of findings, the authors advocate the adoption of evidence-based measures and propose further investigation of those measures that are not well supported by the evidence or have not yet been evaluated.

Bioactive Nutrient Fortified Fertilizer: A Novel Hybrid Approach for the Enrichment of Wheat Grains With Zinc.

Zinc (Zn) is a critical micronutrient that synergizes nutrient use efficiency, and improves plant growth and human health. Low Zn bioavailability in soils affects produce quality and agricultural productivity worldwide ultimately inducing deficiency in humans and animals. Zn deficiency is a leading cause of malnutrition in underdeveloped countries where a widespread population depends upon staple cereals for daily intake of calories. Modern cereal cultivars are inherently low in Zn, eventually, plants need to be enriched with soil application of ZnSO4, but due to higher fixation losses, it becomes an inefficient source. Rhizosphere microbiome contains Zn-solubilizing bacteria (ZSB) that improve Zn bioavailability, thus increase the root function, Zn uptake, and plant growth. Niha Corp developed a hybrid process of bioactive nutrient fortified fertilizer (BNFF), which has been used to formulate Zabardast Urea (ZU) by coating bioactive Zn (BAZ) and ZSB on urea. Data obtained for 15 wheat varieties from 119 farmer field demonstration plots and eight replicated trials on 42 locations across multi-environment conditions conclude that ZU significantly improved the plant biomass and yield by 12% over non-Zn control and produced grains with 57 µg/g Zn contents, which can meet a major part of the recommended dietary allowance (RDA) of humans. The study recommends that this microbe-mediated hybrid invention (ZU) is a feasible approach to boost Zn bioavailability and Zn use efficiency, with enhanced yield and quality that may contribute to improve human health. To the best of our knowledge, this is the first wide-scale field testing of Zn enrichment in the grains of bread wheat using an innovative BNFF Urea Z technology.

Toxicity profile and objective response of paclitaxel in metastatic breast cancer.

OBJECTIVE: To evaluate the efficacy and toxicity of 1-hour weekly Paclitaxel in metastatic breast cancer along with evaluation of overall survival. DESIGN: A phase II interventional trial. PLACE AND DURATION OF STUDY: Oncology Department, Combined Military Hospital, Rawalpindi, between August 2001 to July 2003. PATIENTS AND METHODS: Thirty-six patients were enrolled in the study. All patients with histologically confirmed and bi-dimensionally measurable metastatic breast cancer who had received previously either chemotherapy or hormone therapy were included in the study. Paclitaxel was administered in 1-hour weekly infusion in a dose of 100 mg/m2 for 12 doses. RESULTS: All patients had received previous chemotherapy with either CAF or CMF. Twenty-five patients had also received hormone therapy, 61% had two or more metastatic sites involved, and lung was the common site of involvement. Complete response was observed in 4 (11.1%) patients, partial response in 14 (38.8%) patients, with an overall response rate of 50.0%. Clinical benefit was 94.4% and median overall survival was 11 months. Treatment was well-tolerated with no grade 3 or 4 toxicity. Common side effects were arthralgias, myalgias and neutropenia. CONCLUSION: Treatment with 1-hour weekly infusion of Paclitaxel is a well-tolerated chemotherapy with a substantial degree of efficacy in patients with metastatic breast cancer.

Efficacy of letrozole for advanced breast cancer in postmenopausal patients.

OBJECTIVE: To evaluate the clinical benefit and tolerability of letrozole after tamoxifen failure in locally advanced, recurrent or metastatic breast cancer in postmenopausal patients. DESIGN: A phase II non-randomized trial. PLACE AND DURATION OF STUDY: Oncology Department, Combined Military Hospital, Rawalpindi, from March 1999 to February 2001 over a period of 2 years. PATIENTS AND METHODS: One hundred and seventeen patients with tamoxifen failure were treated with letrozole 2.5 mg once daily, through oral route. All the accrued patients were either estrogen/progesterone receptor positive or unknown with KPS of more than 50%. Patients who had prior hormone therapy other than tamoxifen, or more than one chemotherapy for recurrent or advanced disease were not enrolled in the study. Time to progression (TTP) was the primary objective, whereas objective response (OR), duration and rate of clinical benefit (complete response + partial response + stable disease >6 months), tolerability and effects on quality of life were the secondary end points. RESULTS: The clinical benefit was 47.0% with an objective response of 28.2%. The objective response and median time to progression in soft tissue disease was better than in the visceral and bone disease. The median time to progression for patients having positive estrogen receptor / progesterone receptors (ER / PR) was 9.5 months which is slightly higher than in patients having unknown ER / PR status. The treatment with letrozole was well-tolerated with side effects observed in only 14 patients. CONCLUSION: Letrozole is an effective hormone therapy after tamoxifen failure since it has significant clinical benefit and objective response. It can be safely used as second line hormone therapy in postmenopausal patients with locally advanced or metastatic breast cancer.

Management of oromandibular cancers.

OBJECTIVE: To emphasize the role and importance of multidisciplinary approach in the management of oral cavity cancers involving the mandible. DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: The Departments of Plastic and Reconstructive Surgery, ENT / Head and Neck Surgery and Radiation Oncology, Combined Military Hospital, Rawalpindi. Duration spans over a period of six years. SUBJECTS AND METHODS: A total of 63 patients who had biopsy-proven oromandibular tumors, after thorough assessment / staging in Joint Head and Neck Oncology Clinic, underwent resection and reconstruction for malignant oral cavity tumors involving the mandible were included in the study. All the resected tumor specimen were sent for histopathology. All the post-resection defects were properly classified and reconstructed by the plastic surgery team. Postoperatively, all the patients underwent adjuvant full dose radiotherapy at the Department of Radiation Oncology. Complications were recorded and managed accordingly. At one year follow-up all the available patients were assessed for functional and aesthetic restoration and recurrences. RESULTS: Out of 63 patients there were 40 males and 23 females (ratio 1.7 : 1) with an average age of 50 years. Tumor-free resection margins could be achieved in 56 patients. In 88% cases tumor was a Squamous cell carcinoma. Radical neck dissections were carried on in 27 patients. Radial forearm free flap was used in 27 patients, pectoralis major myocutaneous flap in 19, free fibula osteocutaneous flap in 10, rectus-abdominis myocutaneous free flap with Implant was used in 3 patients to reconstruct the post-resection defects. There was only one total flap loss and 3 partial flap losses. Implant exposure was encountered in 4 instances with 3 major and 5 minor fistulae. At one year follow-up, 56 patients were available. Thirty-seven patients had intelligible speech, 15 patients were taking normal diet and in 33 patients there was a satisfactory mandibular contour restoration. Seven patients had recurrences, 2 were not traceable and 5 patients had died by that time. CONCLUSION: A multidisciplinary collaboration is the key to effectively manage this group of extremely debilitating malignancies.