Middle East Journal of Family Medicine

Khan Usmanghani, Afzal Ahmed, Halima Nazar, Ejaz Mohuddin, Muhammad Sakhi Sarwar
Department of Medicine & Allied Sciences, Department of Basic Clinical Sciences, Faculty of Eastern Medicine, Shifa-UL-Mulk Memorial Hospital Hamdard University, Karachi, Pakistan

Address correspondence to:
Khan Usmanghani, ugk@yahoo.com
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ABSTRACT

The open, clinical, randomized trial has been carried out on the designed, proprietary clinically and proven different anti-malarial medicines to analyze their efficacy and side effects. A random controlled clinical trial was conducted to quantify the effect of coded herbal formulation SCAT with Qurs Bukhareen, Qurs Humma Jadeed and Amodiaquine ain endemic areas of Bund Murad near Hamdard University, Karachi and the urban population of Karachi. Patients at Matab Hamdard Aram Bagh and Shifa-ul-Mulk Memorial Hospital For Eastern Medicine were included in this clinical study. The duration of treatment was from January 2001 to June 2004.

The drugs were prescribed to 264 patients categorizing them into different agse from 10 years to 63 years. Three selected drugs were administered to attain a successful response to malaria, especially caused by Plasmodium vivax and Plasmodium falciparium. Herbal formulation SCAT was administered to 88 patients, among them 56 patients who were suffering from Plasmodium vivax and 32 who were suffering from Plasmodium falciparum. In the Amodiaquine group 75 patients were treated, with 41 of Plasmodium vivax and 34 patients from Plasmodium falciparum infected malaria. Qurs Humma Jadeed was evaluated on 56 patients, 42 from Plasmodium vivax and 14 patients from Plasmodium falciparum infected cases. Similarly Qurs Bukhareen was given to 45 patients, 35 of Plasmodium vivax and 10 patients screened for Plasmodium falciparum. The response of the treatment on symptomatology of malaria such as rigors, bitter taste in mouth, headache, anorexia, nausea, vomiting, malaise, myalgia, abdominal pain, burning micturition, splenomegaly and hepatomegaly were also analyzed.

A comparative evaluation of the anti-malarial treatment by other medicine shows that Unani therapy is safer and proficient in its activity. After statistical analysis Coded formulation SCAT was remarkably effective for the associated malarial symptoms. Coded formulation SCAT was more cost effective than the other medicines. The statistical analysis through chi-square test (p< 0.05) significantly proved the SCAT efficacy. The statistical analysis of all the variables conclusively proved that SCAT has furnished overall good efficacy, more suitable and superior for the prevention and treatment of malaria. The clinical data generated clearly proved that SCAT is the drug of choice for malaria especially caused by Plasmodium vivax and Plasmodium falciparum.

Objective : To evaluate the efficacy and side effects of herbal coded medicine "SCAT Capsule" for the treatment of malaria along with a comparative study of other herbal medicines Qurs Humma Jadeed and Qurs Bukhareen, an allopathic medicine Amodiaquine Tablet.

Aim of Study: Malaria is a public health problem in Pakistan and increasing trends have been observed in the last two decades. The bulk of malaria-related morbidity and mortality in endemic areas like Pakistan is concentrated in children below the age of 5 years and in pregnant women. To reduce the risk of malarial disease an appropriate effective curative and prophylactic treatment is required. Herbal treatment SCAT Capsule is an economical, safe and effective anti-malarial treatment. The purpose of this study was to prove the efficacy and safety of herbal medicine.

Key words: Malaria, Plasmodium vivax, Plasmodium falciparum.
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Malaria is a disease of the blood that is transmitted to people by infected mosquitoes. Malaria is very common throughout the world. In Pakistan, the main risk is at home and to persons traveling to tropical and subtropical countries where malaria is more prevalent. Malaria is caused by any one of four species of one-celled parasites, called Plasmodium. The parasite is spread to people by the female Anopheles mosquito, which feeds on human blood. Although four species of malaria parasites can infect humans and cause illness, only malaria caused by Plasmodium falciparum is potentially life threatening. A person gets malaria from the bite of an infected female mosquito. The mosquito bite injects young forms of the malaria parasite into the person's blood. The parasites travel through the person's bloodstream to the liver, where they grow to their next stage of development. In 6 to 9 days, the parasites leave the liver and enter the bloodstream again. They invade the red blood cells, finish growing, and begin to multiply quickly. The number of parasites increases until the red blood cells burst, releasing thousands of parasites into the person's bloodstream. The parasites attack other red blood cells, and the cycle of infection continues, causing the common signs and symptoms of malaria. Malaria caused by Plasmodium falciparum can cause kidney or liver failure, coma, and death. Although infections with other malaria parasites cause less serious illness, parasites can remain inactive in the liver and cause a reappearance of symptoms months or even years later.

The seriousness of the worldwide re-emergence of malaria is made worse by the spread of parasites that are resistant to anti-malaria drugs. Parasites, like bacteria and viruses, can develop resistance to the drugs used to prevent or treat infection. Malaria parasites are increasingly resistant to chloroquine, the drug most widely used for prevention and treatment. Chloroquine-resistant strains have been reported from areas in Africa, Asia, and the Americas. Pakistan is anexception for drug resistance [1]. Thus, alternative anti-malarial drugs are needed urgently. Coded herbal formulation SCAT Capsule has yet to be registered however it does have anti-malarial action. Therefore, there is a great need of a safe drug that has less resistance with good efficacy. After an extensive bioactivity literature search from NAPALERT data coded herbal formulation SCAT is designed [2,3,4, 5]. SCAT Capsule is a combination of four plants named as; Artemisia vulgaris (Afsanteen), Sisymbrium irio (Khaksi), Tinospora cordifolia (Satgilo) and Caesalpinea bonducela (Karanjwa).

Patients were administered drugs daily for two weeks. The treatment groups were assigned the following regimens: group 1, SCAT Capsule Cap (two capsules twice daily); group 2, Amodoquine (two tablets twice daily); group 3, Qurs Humma Jadeed (one tablet thrice daily) and group 4, Qurs Bukhareen (one tablet thrice daily). All the patients then joined one of the active treatment groups according to randomization. Randomization was performed by the research investigator and was from a computer-generated table of numbers in permuted blocks of five. Patients were allocated treatment sequentially in order of study numbers.

Comparative study between SCAT and the other drugs such as Amodiaquine, Qurs Humma Jadeed, and Bukhareen exhibit the anti-malarial effects on Plasmodium vivax. A comparative evaluation of the anti-malarial treatment by other medicine shows that Unani therapy is safer and proficient in its activity. After statistical analysis Coded formulation SCAT was remarkably effective for the associated malarial symptoms. The statistical analysis through chi-square test (p< 0.05) significantly proved the SCAT efficacy. In the statistical analysis of all the variables it was conclusively proved that SCAT has furnished overall good efficacy, more suitable and superior for the prevention and treatment of malaria. The clinical data generated, clearly proved that SCAT is the drug of choice for malaria especially caused by Plasmodium vivax and Plasmodium falciparum.

Table 18. Comparative data for the complaint of VOMITING (Plasmodium falciparum)
Level of Improvement	Complete Improvement	Slight Improvement	No Improvement
SCAT	100%	0%	0%
Amodiaquine	75%	25%	0%
Qurs Humma Jadeed	100%	0%	0%
Qurs Bukhareen	75%	25%	0%

Table 19. Comparative data for the complaint of MYALGIA (Plasmodium falciparum)
Level of Improvement	Complete Improvement	Slight Improvement	No Improvement
SCAT	100%	0%	0%
Amodiaquine	94%	6%	0%
Qurs Humma Jadeed	67%	33%	0%
Qurs Bukhareen	50%	25%	25%

Table 20. Comparative data for the complaint of SWEATING (Plasmodium falciparum)
Level of Improvement	Complete Improvement	Slight Improvement	No Improvement
SCAT	97%	3%	0%
Amodiaquine	87%	13%	0%
Qurs Humma Jadeed	69%	23%	8%
Qurs Bukhareen	33%	44%	23%

Table 21. Comparative data for the complaint of MALAISE (Plasmodium falciparum)
Level of Improvement	Complete Improvement	Slight Improvement	No Improvement
SCAT	97%	3%	0%
Amodiaquine	87%	13%	0%
Qurs Humma Jadeed	67%	25%	8%
Qurs Bukhareen	37%	38%	25%

Table 22. Comparative data for the complaint of ABDOMINAL PAIN (Plasmodium falciparum)
Level of Improvement	Complete Improvement	Slight Improvement	No Improvement
SCAT	86%	14%	0%
Amodiaquine	67%	33%	0%
Qurs Humma Jadeed	100%	0%	0%
Qurs Bukhareen	0%	50%	50%

Table 23. Comparative data for the complaint of BURNING MICTURITION (Plasmodium falciparum)
Level of Improvement	Complete Improvement	Slight Improvement	No Improvement
SCAT	91%	9%	0%
Amodiaquine	75%	25%	0%
Qurs Humma Jadeed	100%	0%	0%
Qurs Bukhareen	67%	0%	33%

CONCLUSION

Coded formulation SCAT that was utilized in Unani Medicine was proved effective for the treatment and prevention of parasitic disorder like malaria caused by Plasmodium vivax and Plasmodium falciparum. Coded formulation SCAT also provided hepato-protective as well as spleno-protective support. So in this context it is proved as a safe medicine. A comparative evaluation of the anti-malarial treatment by other medicine shows that Unani therapy is safer and proficient in its activity. The data presented in the dissertation showed that Coded formulation SCAT was also effective against malarial resistant strains and it does not produce resistance to the treatment. After statistical analysis Coded formulation SCAT was remarkably effective for the associated malarial symptoms. Coded formulation SCAT was more cost effective then the other medicines.