Objective: The purpose of this research was to examine the efficacy of Silymarin in treating newly diagnosed cases of type II diabetes mellitus (T2DM), specifically with regard to glycemic control and insulin resistance. Study design: An observational, randomized, placebo- controlled study. Place and duration: Medicine department of Dr. Akbar Niazi Teaching Hospital (ANTH), Islamabad for the duration from August 2021 to January 2022. Methods: The sixty individuals with a recent diagnosis of type 2 diabetes were chosen at random. There were a total of 60 patients, split evenly between 2 groups of 30. For 90 days, those in Group A took a silymarin capsule containing 200 mg, whereas those in Group B had a placebo capsule looking very similar to the real thing. Fasting blood glucose (FBG), random blood glucose (RBG), glycated haemoglobin A1C (A1C), fasting insulin (FI), and homeostasis model assessment of insulin resistance (HOMA-IR) were measured before and after therapy. The data was examined after 90 days. Statistical analysis was performed using SPSS-20.0. If the probability value was less than 0.05, it was considered significant. The Chi-squared test was employed for statistical analysis. Results: Mean age of the patients of group A (silymarin) was 50.5 years while mean age of group B (controlled) patients was 51.0 years. In both the groups, females were more in numbers as 80% in silymarin group and 70% in controlled group. There was no significant difference showed on the basis of age, gender, BMI, education, family history and employment. Silymarin therapy for 12weeks improved the levels of RBG, RBG, HbA1c, FSI and HOMA-IR. A significant difference p-value<0.001 was showed in these variables between the two groups at baseline and after 90days treatment. Conclusion: The treatment of Silymarin supplementation of 200mg three time a day for newly diagnosed type II diabetic patients had a beneficial effect on improving the blood glucose levels and decreased insulin resistance as compared to standard treatment alone.
Background and Aim: Numerous investigations around the globe verified the increasing trend of medicine and complementary use in pregnant women. Pregnant women are not informed of potential teratogenic effects from traditional medicines; some herbal products may cause birth defects in humans. Pregnant women's use of traditional medicine has not yet been evaluated in Pakistan. The present study aimed to determine the incidence of herbal use among pregnant women attending family care centers. Material and Methods: This hospital-based cross-sectional study was conducted on 320 pregnant women attending Family care centers in Jamshoro Hyderabad and Mirpur AJK for the duration of six months from January 2022 to June 2022. Pregnant women attending antenatal care and volunteering to respond were enrolled and those with mental illness and were unwilling to respond were excluded. Herbal medicine self-medication was a dependent variable whereas gestational age, sociodemographic details, and herbal medicine history were independent variables. A questionnaire was designed for determining prior history of herbal use, types of herbal medicine, herbal used in current pregnancy. SPSS version 26 was used for data analysis. Results: Of the total 320 pregnant women, the incidence of herbal use was 86 (26.9%). Based on age, pregnant women were grouped as follows: 64 (20%) in 17-25 years, 148 (46.2%) in 26-35 years, and 108 (33.8%) 35-45 years. The prevalence of herbal usage in the first, second, and third trimesters was 62 (72.1%), 9 (10.5%), and 8 (9.3%), respectively, among 86 herbal-using pregnant women. About 7 (8.1%) pregnant women used herbs in all trimesters. Garlic (Allium sativum) 32 (37.2%), Ginger (zingiberofcinale) 40 (46.5%), Eucalyptus 6 (7%), and tenaadam 8 (9.3%) were different types of herbs used by pregnant women. Conclusion: The present study found that about 26.9% pregnant women used herbal medicine during pregnancy. Majority of women used herbal medicine in the first trimester followed by second and third. Ginger was the most commonly used herbal medicine followed by garlic and tenaadam. Nausea, morning sickness, and vomiting was the most prevalent clinical indications. Keywords: Herbal Medicine, Prevalence, Trimester, Pregnant women
Background and Aim: Globally, congenital anomalies (CA) are a major contributing factor for neonate’s admission in NICU causing neonatal morbidity and mortality particularly in developing countries. Congenital anomalies generally indicate the morphogenesis defect in an early neonate’s life. The leading cause for perinatal mortality is congenital anomalies that arise with advancement of delivery and care for newborn babies. The present study aimed to evaluate the prevalence and pattern of congenital anomalies among neonates admitted to neonatal unit. Methodology: This retrospective study was carried out on 1620 neonates (newborns to age 28 days) admitted to the neonatal unit of Services Hospital, Lahore from April 2020 to March 2022. The incidence, risk factors, and pattern of congenital anomalies were measured. Detailed examinations such as radiological, laboratory, ultrasonography, and echocardiography were recorded. Different outcomes such as hospital stay, morbidity, and mortality were determined with 95% confidence intervals. SPSS version 25 was used for data analysis. Results: Of the total 1620 admitted neonates, the prevalence of neonates with congenital anomalies were 112 (6.9%). Out of 112 neonates diagnosed with congenital anomalies, 64 (57.1%) were male and 48 (42.9%) were females. The incidence of cesarean and other modes of delivery were 74 (66%) and 38 (34%) respectively. Cardiovascular system malformation was the most prevalent affected system in 36 (31.9%) neonates followed by central nerve system 28 (25%), genitourinary system 19 (17%), musculoskeletal system 16 (14.3%), gastrointestinal tract 6 (5.4%), digestive system 4 (3.6%), and syndromes and skin 3 (2.7%). Congenital anomalies were significantly increasing over time. The incidence of discharged, referred to higher centers for intervention, and expired babies were 77 (68.8%), 19 (16.7%), and 16 (14.3%) respectively. Conclusion: The present study found that the prevalence of congenital anomalies was 6.9%. Cardiovascular system malformation was the most prevalent congenital anomaly followed by the central nerve system. The overall mortality rate was 14.3% caused by congenital anomalies. A better health care strategies and management must be developed in terms of early detection, supplementation facilitation, decreasing drug usage, and better antenatal care to prevent the impacts of congenital anomalies on neonates. Keywords: Prevalence, Pattern, Congenital anomalies, neonates
Background and Aim: Stroke is defined as the sudden onset of neurological deficits caused by vascular supply disruption to brain-specific region, contributing as a major factor for mortality and morbidity worldwide. Globally, approximately two-thirds cases of stroke are caused by hypertension as a major risk factor. The purpose of the current study was to determine the prevalence of stroke patients with newly diagnosed hypertension admitted to tertiary care hospital. Materials and Methods: This cross-sectional study was carried out on 205 stroke patients admitted to the Department of General Medicine, Benazir Bhutto Hospital and Holy Family Hospital, Rawalpindi from April 2021 to March 2022. Prior to study conduction, ethical approval was taken from the institute research and ethical committee. Written informed consent was obtained from each individual. All the participants underwent physical examination after using antihypertensive medication besides detailed history. Blood pressure was measured using standard mercury Sphygmomanometer. Patient having blood pressure ≥ 140/90 mm Hg was considered as hypertensive after measurement with difference of 10 minutes time span. SPSS version 25 was used for data analysis. Results: The overall mean age was 59.6 ± 8.5 years. Of the total 205 stroke patients, there were 140 (68.3%) males and 65 (31.7%) females. Out of 205 patients, 60.5% were rural and 39.5% were urban. The literacy rate was 63.9%. Family history of smoking, diabetes mellitus (DM), and hypertension (HTN) among study population were found in 83 (40.5%), 76 (37.1%), and 71 (34.4%) respectively. Based on computed tomography presentations, the prevalence of newly diagnosed hypertension (HTN) was 122 (59.5%). Out of 122 newly diagnosed hypertensive stroke patients, the incidence of ischemic stroke and hemorrhagic was 67 (54.9%) and 55 (45.1%) respectively. The mean value of diastolic and systolic blood pressure was 86.32 ± 12.62 and 125.59 ± 19.97 mm of Hg respectively. Conclusion: The present study concluded that the prevalence of newly diagnosed hypertension was found higher among stroke cases. Early diagnosis of hypertension by proper screening and effective treatment can reduce the mortality and morbidity caused by stroke and hypertension. Keywords: Hemorrhage, HTN, Ischemia, Stroke.
Background and Aim: Stroke is the most prominent cause of morbidity and mortality worldwide especially in developing countries. The stroke outcome mainly related to the presence of complications and severity. Stroke associated pneumonia is the post stroke infection significantly associated with a longer hospitalization, increased risk of hospital mortality, and functional outcomes. There is scarcity of data regarding stroke associated pneumonia on a local basis in the developing countries. Therefore, present study aimed to find out the prevalence and effect of stroke associated pneumonia on in-hospital stay, mortality, and function outcome. Methodology: This observational prospective study was conducted on 500 stroke patients in the Department of Neurology and Medicine, Jinnah Hospital, Lahore from April 2021 to March 2022. Prior to study conduction, written informed consent and ethical approval was taken. All the participants were recruited for this study. Stroke was diagnosed based on relevant clinical history, brain imaging either by CT scan or MRI, and focused physical examination. Stroke patients of either gender above 18 years age with acute ischemic or hemorrhagic stroke and given written consent were included. All those patients who are already having disability due to previous stroke and other neurological or non-neurological issues were excluded from study. Baseline characteristics were recorded. SPSS version 25 was used for data analysis. Results: Of the total 500 stroke patients, there were 232 (46.4%) male and 268 (53.6%) females. The overall mean age was 62.4 ± 12.6 years. The prevalence of ischemic and hemorrhagic stroke was 334 (66.8%) and 166 (33.2%) respectively among 500 stroke patients. Hemiparesis was the most prevalent neurological findings 464 (92.8%) followed by facial palsy 432 (86.4%) and swallowing disturbance 262 (52.4%). About 186 (37.2%) stroke patients were complicated by stroke associated pneumonia. Multivariate regression analysis was used and revealed that stroke associated pneumonia could be developed in older age patients > 70 years Adjusted odd ratio AOR= 3.862 (1.21-12.86) (p=0.031) who suffered from swallowing disturbance AOR= 4.728, (2.415-9.102) (p<0.001), epileptic seizures AOR= 2.749 (1.315-5.681) (p<0.001), and moderate to severe stroke AOR= 6.183 (2.036-17.647) (p<0.001) (NIHSS=16-21). Conclusion: The present study concluded that prevalence of SAP was 37.2%. Stroke associated pneumonia is a significant medical issue or complications in stroke patients. Furthermore, older stroke patients with epileptic seizure, swallowing disturbance, and stroke severity from moderate to severe were the risk factors for increasing stroke associated pneumonia. Close monitoring and effective intervention might be needed for high risk SAP in stroke patients. Keywords: Stroke associated pneumonia, Functional outcome, Mortality, Hospital stay, Stroke
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