ABSTRACT
This study aims at reporting the indigenous knowledge of the medicinal flora from the inhabitants of surroundings of the World's largest artificial planted forest "Changa Manga", Pakistan. Data were collected by direct interviews and group meetings from 81 inhabitants including 32 local healers having information regarding the use of indigenous medicinal plants over a period of one year. Different statistical tools were applied to analyze the data including Frequency citation (FC), Relative frequency citation (RFC), Use Value, Factor of informants consensus and fidelity level. This study reported 73 plant species belonging to 37 plant families and 46 genera. The majority of plant species belong to compositae family. The most commonly used medicinal plants were P. hysterophorus L., P. dactylifera L., S. indicum L, P. harmala L., P. emblica L., and A. indica A.Juss. The greatest number of species was used to cure gastrointestinal disorders. The highest fidelity level (68.18%) was of E. helioscopia to cure gastrointestinal disorders. Maximum fresh uses (17) were reported by C. dactylon (L.) Pars. While the highest number of species reporting fresh uses in similar number was 13. In this study, five novel plants are being reported for the first time in Pakistan for their ethnomedicinal worth. Our data reflect unique usage of the medicinal plants in the study area. The statistical tools used in the study proved useful in pointing the most important and disease category specific plants. High use value plant and the new reported medicinal plants might prove an important source of the isolation of pharmacologically active compounds.
Este estudo tem como objetivo relatar o conhecimento indígena sobre a flora medicinal dos habitantes do entorno da maior floresta artificial plantada do mundo, a Changa Manga, no Paquistão. Os dados foram coletados por meio de entrevistas diretas e reuniões em grupo de 81 habitantes, incluindo 32 curandeiros locais, com informações sobre o uso de plantas medicinais indígenas durante o período de um ano. Diferentes ferramentas estatísticas foram aplicadas para analisar os dados, incluindo citação de frequência (FC), citação de frequência relativa (RFC), valor de uso, fator de consenso dos informantes e nível de fidelidade. Este estudo relatou 73 espécies de plantas pertencentes a 37 famílias de plantas e 46 gêneros. A maioria das espécies de plantas pertence à família Compositae. As plantas medicinais mais utilizadas foram P. hysterophorus L., P. dactylifera L., S. indicum L., P. harmala L., P. emblica L. e A. indica A. Juss. O maior número de espécies foi usado para curar distúrbios gastrointestinais. O maior nível de fidelidade (68,18%) foi de E. helioscopia para cura de distúrbios gastrointestinais. Os usos máximos em fresco (17) foram relatados por C. dactylon (L.) Pars. enquanto o maior número de espécies relatando usos frescos em número semelhante foi de 13. Neste estudo, cinco novas plantas estão sendo relatadas pela primeira vez no Paquistão por seu valor etnomedicinal. Nossos dados refletem o uso exclusivo das plantas medicinais na área de estudo. As ferramentas estatísticas utilizadas no estudo mostraram-se úteis para apontar as plantas mais importantes e específicas da categoria de doença. Plantas de alto valor de uso e as novas plantas medicinais relatadas podem ser uma importante fonte de isolamento de compostos farmacologicamente ativos.
Subject(s)
Humans , Plants, Medicinal , Forests , Gastrointestinal Diseases , Indigenous Peoples , Medicine, Traditional , PakistanABSTRACT
Background: Bleeding during functional endoscopic sinus surgery (FESS) remains a challenge for both surgeons and anaesthesiologists despite several modalities available for improving the surgical field. This study was conducted to evaluate the effect of oral clonidine premedication on blood loss and the quality of the surgical field in FESS. Methods: This prospective placebo controlled trial was performed on 120 patients (ASA I, ASA II). Patients undergoing endoscopic sinus surgery for chronic sinusitis and nasal polyposis were randomly allocated to receive either oral clonidine 0.005mg/kg or identical-looking placebo tablets 90 min before arrival at the operating room. During general anaesthesia, the hemodynamic endpoint of the anaesthetic management was maintenance of hypotension (Mean Arterial Presure) at ≤ 65 mmHg for producing a bloodless surgical field. The control of MAP was attained with inspired concentration increments of halothane up to maximum of 1.5 vol % as needed. Intraoperative bleeding was assessed on a six – point scale from 0 (= no bleeding) to 5 (= severe bleeding). Data were compared with chisquare test, fisher's exact test and Student t-test. Results: There was less bleeding volume in the clonidine group (mean±SD) than in the placebo group (140.7±65.4 Vs 199.2±104.4, P<0.05). Frequency of bleeding severity scores 3 and 4 (troublesome with repeated suction) were lower in the clonidine group than in the placebo group (13.3 Vs 33.3%, P< 0.05). ). Accordingly, the surgeon was more satisfied with the surgical field in the clonidine group than with that in the placebo group. Conclusion: In conclusion, premedication with oral clonidine can effectively reduce bleeding during endoscopic sinus surgery.
ABSTRACT
107 Atkinson intubations were performed in 101 patients including 25 females and 76 males with a mean age of 72 years [range:44-95 years]. Average hospital stay for tube insertion was 4.29 days [range 1-27 days]. 41% patients never required a second admission. 41% patients required one more admission, while 19% patients needed a further 2-6 admissions. Total hospital stay after insertion of the tube, including subsequent admissions, averaged 12 days [range 1-82 days]. Procedure related mortality was 10.3% and morbidity was 13.08% There was little effect of age, sex, size of Atkinson tube used and preoperative treatment with radiotherapy on morbidity or mortality. The longest survival was 517 days and the mean survival was 95.6 days. Forty three patients died at home while 34 patients died in an acute hospital ward. A review of literature is given on the subject. We conclude that Atkinson tubes provide adequate and reliable palliation of dysphagia in carcinoma of oesophagus at a reasonable cost even in the elderly. The procedure however is associated with considerable mortality and morbidity. Expandable wire mesh memory stents are likely to replace the Pulsion tubes once their prices come down. At the present moment, per oral Pulsion Atkinson intubation [or intubation with any similar pulsion tube available locally] is the realistic method of choice for relief of dysphagia due to in-operable carcinoma of the oesophagus in the vast majority of patient population in countries like Pakistan