MANAGEMENT OF HUMUZAT-E-MEDA (HYPERACIDITY) WITH JAWARISH AMLA & HABB-E-PAPITA- A MULTI CENTRIC STUDY

Background – Hyperacidity is one of the most common diseases seen in all ages. Hyperacidity simply means an increased level of acid in the stomach. Unani system of medicine has a treasure of formulations for the treatment of hyperacidity. Methods- Present open labeled,multi-centric, single arm validation was conducted to evaluate the safety and efficacy of Unani pharmacopeial drug Jawarish Amla and Habb-e-Papita in Humuzat-e-Meda (Hyperacidity). Patients with symptoms of hyperacidity like retro-sternal burning,epigastric pain with retro-sternal heaviness,acidic brash,anorexia, nausea and vomiting were included. Patients with known duodenal ulcers, peptic ulcer, gastric surgery gastric carcinoma, Crohn's Diseases, Zollinger Ellison Syndrome, cardiac disorders, respiratory ailments, Diabetes Mellitus, pregnant and lactating females were excluded. Unani formulations,Jawarish Amla 10 g and Habb e Papita 2 tablets were given twice daily after meals for 6 weeks. Clinical & haematological parameters were assessed before and after the treatment to evaluate the safety and efficacy of the drug. Results– No significant changes are observed after 28 days and 84 days during the therapy in the safety profiles of laboratory investigations such as complete haemogram, LFT, KFT. There is significant improvement in the sign and symptoms associated withHumuzat-e-Meda (Hyperacidity). Conclusion- Unani compound formulations Jawarish Amla and Habb-e-Papita are safe and effective in the management ofHumuzat-e-Meda (Hyperacidity).

Dysplastic Progression to Adenocarcinoma is Equivalent in Ulcerative Colitis and Crohn’s Disease

Background We sought to determine the rate of progression from dysplasia to adenocarcinoma in ulcerative colitis [UC] vs Crohn’s diseases [CD] and describe the risk factors unique to each. Methods All adult patients [≥18 years] with a known diagnosis of either UC or CD who underwent a surveillance colonoscopy between January 1, 2010 and January 1, 2020 were included. Results A total of 23 751 surveillance colonoscopies were performed among 12 289 patients between January 1, 2010 and January 1, 2020; 6909 [56.2%] had a diagnosis of CD and 5380 [43.8%] had a diagnosis of UC. There were a total of 668 patients [5.4%] with low-grade dysplasia [LGD], 76 patients [0.62%] with high-grade dysplasia [HGD], and 68 patients [0.55%] with adenocarcinoma in the series; the majority of the dysplastic events were located in the right colon. Significantly more UC patients had a dysplastic event, but the rate of LGD and HGD dysplasia progression to adenocarcinoma was not significantly different in CD or UC [p = 0.682 and p = 1.0, respectively]. There was no significant difference in the rate of progression from LGD/HGD to adenocarcinoma based on random biopsies vs targeted biopsies of visible lesions [p = 0.37]. However, the rate of progression from LGD vs HGD to adenocarcinoma was significantly greater for HGD [p < 0.001]. Conclusion While more UC patients were found to have neoplasia on colonoscopy, the rate of progression from LGD and HGD to adenocarcinoma was equivalent in UC and CD, suggesting that endoscopic surveillance strategies can remain consistent for all IBD patients.