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(Volume 2, Issue 1, 2014) Review on Clinical Evaluation of Herbal Vol 2 (1), June 2014; 48-57 ISSN 2311-4673 Journal of Pharmacy and Pharmaceutical Sciences (Volume 2, Issue 1, 2014) Review on Clinical Evaluation of Herbal and Allopathic Drugs for the Treatment of Infective Diarrheial Diseases (Shigellosis) Tasneem Qureshi¹, Aftab Saeed², Khan Usmanghani³ ¹Department of Basic Clinical Sciences, Faculty of Eastern Medicine, Hamdard University, Karachi-74600, Pakistan, 0322-3464702 ²HRIUM, Faculty of Eastern Medicine, Hamdard University, Karachi-74600, Pakistan ³Clinical Pharmacy and Health Care, Faculty of Pharmacy, Jinnah University for Women, Block 5C, Nazimabad, Karachi-74600, Pakistan, Consultant Herbion Pakistan (Pvt.) Ltd., Karachi, Pakistan Address for correspondence: A-952, Block H, North Nazimabad, Karachi-74700, Pakistan ABSTRACT Dysentery is characterized by intense abdominal cramps accompanied by frequent and intense diarrhoea with bloody mucous stool. The word dysentery has been derived from Greek words dys and enteron meaning “bad bowels”. Micro-organisms that cause gastrointestinal diseases must survive the harsh acidic environment of the stomach. Shigella spp. and Escherichia coli O104:H4 are gastrointestinal bacteria that do not form special resistant structures but can survive at pH 2.5 for at least 2 hours. Studies with human volunteers have shown that when as few as 10-500 Shigella are ingested, they can survive passage through the stomach and cause dysentery. Over the last three decades, multidrug resistant Shigella was responsible for widespread epidemics of Shigellosis on the Indian subcontinent and in other developing countries, leading to high mortality. As Shigellosis is highly contagious it is crucial to develop a rapid method for eradication of the pathogen in order to limit and control outbreaks. Keywords: Culture Media, Dysentery, Multi Drug Resistance, Shigellosis, Shigella. INTRODUCTION the rectum, tenesmus is less, excretion is possible by least tenesmus and patient remains asymptomatic. Dysentery: In rectal dysentery, defecation The term dysentery is specifically used for the passage of stool with pain and cramps. Dysentery is painful with small fecal matter and tenesmus and is of two kinds one is limited to rectum, while other patient gets fatigued easily [1]. is confined to transverse colon, which is in contact or proximal to the rectum. Difference in both is Types: obvious as dysentery occurs due abrasion and muco- Waseem Ahmed Azmi [2] described the types of purulent discharge. There is no discomfort found in dysentery as under: *Corresponding author: [email protected] 48 Vol 2 (1), June 2014; 48-57 Acute Dysentery/Zaheer Had: out in stool. Initial stage, stool yellow colored accompanies cramps, mucus watery diarrhea, anorexia, later on Amoebic Dysentery/Zaheer Amoebae: other symptoms appear like recurrent feeling of Organisms affect the intestinal lining by activating defecation, straining tenesmus during defecation, the proteolytic fermentation. That can lead to stool with blood, mucus, membranous scales and inflammatory and edematous conditions. Intestinal obstruent matter, in serious conditions patient use elasticity is reduced eventually resulting in ulceration to defecate 10- 40 times with extreme pain and and stool accompanies blood and scales. cramps, heaviness in rectal area, colonic pain that Inflammatory Dysentery/Zaheer Warmi: increases on palpation, fever, skin hot and dry, Intestinal and rectal swelling along with heaviness, insomnia, facial and eyes look reddish, dysuria with pinching pain and cramps. Tenesmus is also present reddish coloration and burning micturation, pulse and strain on bladder lead to dysuria, fever, and pulse brisk and hard, lethargy. dicrotic. Chronic Dysentery/Zaheer Muzmin: Infectious Dysentery/Zaheer Wabaiee: Less cramps, alternate situations of constipation and Spread by person to person. Skin papules, itching, diarrhea, tongue reddish and lustrous sometimes inflammation are common. Usually patient goes to cracks, diarrhea usually somewhat watery along with syncope after every defecation. acrid smell, membranous scales, pus and blood and facial expressions lethargic and yellowish. Zaheer Sifli: Abdominal heaviness, pain and cramps. Dry chick Real Dysentery/Zaheer Sadiq: beans sized stool. History of intake of dry foods and Symptoms similar to acute dysentery and some medicines. scholars claim to be the same. In diarrhea bilious/acidic phlegm being excreted along with Cold Temperamental Dysentery/Zaheer Bardi: blood. In case of bilious matter there will be a needle History of taking cold foods and other stuffs. Patient like pinching pain, dominant hotness and thirst, pulse feels to be relieved by taking hot temperamental will be brisk and continuous. Diarrhea accompanies therapies. blood, bilious matter and ulceration. Cold temperamental therapies will comfort the patient, The humor that can produce dysentery is the one phlegmatic matter will accompanies mucus, flatulence with caustic (escharotics) property. Transverse colon without ulceration, pulse will be feeble. and rectum either have been exposed to laceration or about to be lacerated under effect of the said Unreal Dysentery/Zaheer Kazib: humor. This humor exhibits the activity of caustic Intestinal obstruction results in painful and straining or escharotics property which leads to increase defecation. There will be tenderness all over, sensitivity to the effected parts. If the abrasive action continuous pain scanty stool with mucus and blood is restricted to transverse colon then dysentery will only on straining like the residue of goats, due to be less severe and it will not cause strain in the distal flatus will produce cramps. intestinal portion. Bacillary Dysentery/Zaheer Asawi: Dysentery is the ulceration of transverse colon and It is colonic dysentery, sometimes inner portion of it becomes worse when accompanying intestinal intestinal epithelial lining gets affected. In this case wounds. According to Galen, in dysentery and colic intestinal membrane becomes edematous that results pain there is intense pain without diarrhea. He stated in tissue death. These membranous scales are excreted this just to review the assimilation of Maghas (colic). 49 Vol 2 (1), June 2014; 48-57 Nevertheless there is a immense difference between along with fatty substances is the indication of Coloni (colic pain) and Maghas (colic). Likewise ulceration of lower intestinal tract. Dysentery patient between Coloni (colonic pain) and dysentery, due feels to defecate frequently. Secretion of mucus to the fact that in zaheer (dysentery), patient has to substances before stool is because of ulceration in strain to defecate. Whereas in coloni(colic pain) rectal region, secretion of mucus after stool is the there is no stool on defecation. Maghas(colic) that indication of healing [3]. is the flatus moving around along with mucus giving the sense to defecate, which is either less or none in Micro-organisms that cause gastrointestinal diseases quantity. must survive the harsh acidic environment of the stomach. Shigella species and Escherichia coli are Zaheer (dysentery) symptom is that mukhati shai gastrointestinal bacteria that do not form special (mucous scales) are secreted and the anal area is resistant structures but can survive at pH 2.5 for at effected by intense pain with Lazaa (burning), sozish least 2 hours [4]. (irritation), back khichaoo(stress) and tamaddud (distention). Intestinal acrid smell ulceration with In bacterial infections, disease is a result of microbial low heat and smelly sediment like stool are the sign growth in body tissues rather than of the ingestion and symptoms of Zaheer. of food and drink already contaminated by preformed toxins resulting from microbial growth. Bacterial In long incubation period, dysenteric diarrhea smelly infections such as salmonellosis and shigellosis substance is secreted. But in dysentery no smelly usually have longer incubation periods (12 hours to substance is secreted because in dysentery ulcer is 2 weeks) than bacterial toxicity reflecting the time located near the rectal region. While in dysenteric needed for the microorganism to grow in the host diarrhea ulceration is distant from rectal area. [5]. Dysentery mostly occurs in phlegmatic humor, because tahaddar is the result of putrid phlegm in When the pathogen reaches the colon, it translocate the amaa mustaqeem (transverse colon). Due to through the epithelial barrier by way of the M cells putrification patient feels to defecate frequently. In that overlay the solitary lymphoid nodules [6]. zaheer (dysentery) there is intense spasm and cramps because phlegm sticks to intestinal wall and it needs M cells count is enhanced throughout chronic to be defecated by force as compared to bilious intestinal inflammation detecting apoptosis as well. humor. Bilious intestinal ulcerations are acute and There is a correlation seem to be in M cell damage lethargic condition occurs due to its excess heat. and amplifying uptake of pathogens at some stage in intestinal inflammation. Epithelial barrier is busted Intestinal ulceration due bilious irritation and heat in the inflammatory process for the M cells to play persist and is of 2 weeks duration. Salty phlegm a vital function [7]. When Shigella get in touch with ulceration is confined to 30 days whereas melancholic the principal M cells it effects the underlying ulceration occurs for 40 days or more. If ulceration macrophages moreover provoke cell demise. The is confined to rectal area without abdominal cramps, infected macrophages
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