Phytochemical analysis and hepatoprotective effect of polyherbal formulation on CCl4 induced hepatotoxicity in mice.

The potent phytotherapeutic modalities against the hepatotoxicity have motivated us to explore numerous plants and polyherbal preparations because conventional drug discovery is more expensive and tedious. So, this study was conducted to evaluate the hepatoprotective potential of a polyherbal formulation (PHF), comprising of Solanum nigrum, Silybum marianum, Atrmesia absinthium, Achillea millifolium and Cichorium intybus against carbon tetrachloride(CCl4) induced hepatotoxicity in experimental rats. CCl4intoxicationinduced vacuole formation and fastdegeneration so selective liver enzymes including alanine aminotransferase (ALT) and aspartate aminotransferase (AST), alkalinephosphatase (ALP) and total bilirubin in rat's plasma,as well as liver histological architecture, were used to evaluate the effect of herbal treatments with different doses (ranging 100-500 mg/kg) for two weeks. Statistical analysis showed that PHF significantly (P<.05) improved the level of liver enzymes as well as improve the liver architecture comparative to control groups. It could be concluded from current findings that PHF prepared from Solanum nigrum, Silybum marianum, Atrmesia absinthium, Achillea millifiloium and Cichorium intybus have some hepatoprotective activities.

Complications of chronic suppurative otitis media: challenge for a developing country.

OBJECTIVES: This study aims to investigate the frequency and management of complications of chronic suppurative otitis media (CSOM). PATIENTS AND METHODS: Out of 376 patients with CSOM, 44 patients (25 males, 19 females; mean age 48.5±3.5 years; range 21 to 76 years) meeting study criteria were enrolled in this descriptive cross sectional study which was conducted at the Department of Ear Nose and Throat, Head and Neck Surgery, Postgraduate Medical Institute, Lady Reading Hospital Peshawar. All newly diagnosed patients having CSOM with complications were enrolled. The complications were treated first. Intracranial abscesses were evacuated by neurosurgeons. Radical and modified radical mastoidectomy were performed. RESULTS: Majority of the patients presented in the second and third decade of life (21-30 years: 27.27%, 31-40 years: 18.18%). Most of the patients (59.1%) had lower socioeconomic status. Canal wall down mastoidectomy was the most common (79.5%) procedure performed. Cholesteatoma was the most common operative finding (100%). Among extracranial complications, subperiosteal abscess was the most common finding (38.63%), while extradural abscess outnumbered (22.72%) in intracranial complications. CONCLUSION: Complications of CSOM commonly affect younger people with low socioeconomic status. Collaborating with neurosurgeons may assist in the successful management of this infection.

Assessment of forest cover and carbon stock changes in sub-tropical pine forest of Azad Jammu & Kashmir (AJK), Pakistan using multi-temporal Landsat satellite data and field inventory.

This study aimed at estimating temporal (1989-2018) change in forest cover, carbon stock and trend in corresponding CO2 emissions/sequestration of a sub-tropical pine forest (STPF) in AJK, Pakistan. Our field inventory estimation shows an average above ground biomass (AAGB) accumulation of 0.145 Kt/ha with average carbon stock (ACS) value of 0.072 Kt/ha. Landsat TM, ETM+ and OLI images of 1989, 1993, 1999, 2005, 2010, 2015 and 2018 were used to extract vegetation fractions through Linear Spectral Mixture Analysis (LSMA) and forest area was calculated for respective years. Based on the forest area and estimated ACS value, the biomass carbon stock with corresponding CO2 emissions/sequestration was worked out for each time and change in forest carbon stock was determined for different time periods from 1989 to 2018. Our analysis shows net increase of 561 ha in forest cover and 40.39 Kt of ACS along with increase in corresponding CO2 sequestrations of 147.83 Kt over the study period. The results based on combination of remote sensing and field inventory provide valuable information and scientific basis to plan and ensure sustainable forest management (SFM) through reforestation, protection and conservation to enhance and maintain adequate forest cover and reduce CO2 emissions.

Upper Gastrointestinal Manifestation of Bezoars and the Etiological Factors: A Literature Review.

A gastric bezoar is a compact mass of indigestible foreign materials that accumulate and consolidate in the stomach; however, it can be found in other sites of the gastrointestinal tract. The causative manner of this condition is complex and multifactorial. The main purpose of the review was to raise awareness among clinicians, particularly gastroenterologists, that patients with certain risk factors or comorbid conditions are predisposed to gastric bezoar formation. Early diagnosis and prompt intervention are crucial to avoid bezoar-induced complications. Upper gastrointestinal endoscopy is the standard diagnostic and therapeutic method for gastric bezoars. However, for large size bezoars, surgical intervention is needed.

Etiological aspects of intragastric bezoars and its associations to the gastric function implications: A case report and a literature review.

RATIONALE: Intragastric bezoar is a stony mass found trapped in the stomach, though it can occur in other locations of the gastro-intestinal tract. The etiology of intragastric bezoar is multifactorial, includes certain risk factors and predisposing factors such as coexisting medical disorders, anatomic abnormalities, and gastric motility disorders, which contribute to the development of intragastric bezoar. PATIENT CONCERNS: In this report, we present a rare case of intragastric bezoar with epigastric pain after prolonged consumption of jujubes. To our knowledge, this is the first case of intragastric bezoar to be reported after jujubes ingestion. DIAGNOSES: An upper gastrointestinal (GI) endoscopy performed which revealed an 8 × 5-cm intragastric diospyrobezoar with an adjacent necrotic pressure ulcer of size 0.8 × 0.5-cm without signs of bleeding. INTERVENTIONS: For therapeutic intervention, Coca-Cola ingestion and lithotripsy were applied. OUTCOMES: The therapeutic course was uneventful. There was no recurrence during 1-year follow-up. LESSONS: In our literature, jujube emerged as a new player. A bezoar composed of unripened fruit content in the stomach, could be the cause of chronic abdominal pain, dyspepsia, gastric reflux or heartburn. Moreover, this study provides a detailed overview of recently published literature regarding intragastric manifestations of bezoar, etiological factors, diagnostic and therapeutic approaches.

Management of foreign bodies of upper digestive tract.

The objective of this study was to determine the management of rigid esophagoscopy for extraction of foreign bodies (FBs) upper digestive tract in a tertiary care hospital. This descriptive study was conducted at the Department of ENT, Head and Neck Surgery, Postgraduate Medical Institute, Lady Reading Hospital Peshawar from January 2008 to December 2010. This study included 380 patients. After taking detailed history, thorough examination and investigations, a well informed consent was obtained. Rigid esophagoscopy was performed under general anesthesia. The data was analyzed using the statistical program for social sciences (SPSS version 17). Our study with total duration of 3 years included 380 cases constituting 227 male and 153 female, with male:female ratio of 1.48:1. The age of the patients ranged from 1 to 80 years with mean age of 39.39 ± SD 6.81 years. The clinical features of these patients were mainly dysphagia for solids (72.89%) followed by throat pain (18.15%). Site of impaction of FBs was that in 303 cases (79.73%) cricopharynx, in 61 cases (16.05%) mid-esophagus and in 16 cases (4.21%) pyriform fossa was involved. Rigid esophagoscopy was performed in all cases and a variety of FB was extracted from upper digestive tract. The commonest FB was coin 58.42% followed by meat bolus 17.10%. It is concluded from this study that the commonest FB upper digestive tract in children is coin while in adults is meat bolus in this part of the world. Rigid esophagoscopy is still the technique of choice for its extraction and its complication can be minimized if performed by expert hands.

Sinonasal teratocarcinosarcoma.

A 20 years old Afghan male was suffering from left sided nasal obstruction with headache for one year. On examination, patient had reddish, fleshy mass in left nasal cavity. Carotid angiography was inconclusive so incision biopsy was taken from nasal mass and it was reported as teratocarcinosarcoma. CT scan of PNS was done which showed heterogeneous mass in nasal cavity, paranasal sinuses with intracranial extension. The patient was operated. The approach was a combination of lateral rhinotomy with trans-basal sub-frontal craniotomy. He was treated by Co 60 and received a tumour dose of 56 Gy radiation. He is being followed regularly every 2 months after his final radiotherapy session and he is disease-free so far.