Presentation on Management of Benign Hyperplasia of Prostate with Polyherbal Unani Formulation

1. Management of Benign Hyperplasia
of Prostate with Polyherbal Unani
Formulation- An Open Ended Pilot
Study
Dr. Younis Munshi (BUMS, MD)
Scientist-4
Regional Research Institute of Unani Medicine,
Kolkata

2. Introduction:
•Benign prostatic hyperplasia (BPH) is a
nonmalignant enlargement of the prostate, common
problem of aging for men.
• It has been proposed that the disorder has two
phases, one that involves no clinical signs and the
other that manifests clinical signs.
• Signs and symptoms related to BPH are related to
lower urinary tract or we call it LUTS.

3. LUTS:
•Nocturia, dribling of urine, incomplete emptying,
hesitancy, weak stream, frequency, urgency are the
symptoms which are called as LUTS.
•Sometimes the LUTS are related to other diseases
also so there is dire need of differential diagnosis,
those disease are Cystitis, Over Reactive Bladder etc.

4. This is one of the most common problems in older
men, and by the seventh decade affect nearly 75% of
them [Litwin MS, et al 2007].
Autopsy studies have observed the histological
prevalence of 8% in 4th
decade 50% in 6th
decade and
80% in 9th
decade of life
Incidence:

5. •It is estimated that in the USA 30–90% of patients
seen by urologists for putative BPH may be taking
some form of alternative therapy [Gerber GS, et al
1998, Lowe FC et al, 1996].
•A number of different herbal therapies have been
documented useful for BPH including Seronoa
repens (Saw palmetto berry extract), Hypoxis
rooperi (South African star grass), Pygeum
africaneum (African plum), Secale cerale (Rye
pollen), Soy, showing improvement in signs and
symptoms when compared with placebo [Raj C. et
al-2008].
Treatment Options:

6. In India Ayurveda and Unani alternative medical
system have a long history and are very popular. The
popularity is based on the fact that these systems use
natural products having good efficacy with
insignificant or no side effects.
The Unani Medicine with therapeutic properties,
are being used as a way of treatment with reasonable
success rate.
Treatment Options:

7. An open ended pilot study was conducted in the OPD of Regional
Research Institute for Unani Medicine (RRIUM) Srinagar from 2008-
2009 to evaluate the efficacy of this combination treatment on BPH
patients. Patients attending OPD of RRIUM with the history of increased
urination frequency, urgency, urgency incontinence, and voiding at night
(nocturia), were evaluated for BPH. 30 patients aged between 39 and 71
with a mean age 50.04 ± 10.56 fulfilling the criteria were selected for
this study. The experimental strategy was explained to them fallowed by
written consent. Diagnosis was made by the physicians based on
complaints of LUTS and Ultrasonography. The patients were given
500mg capsule Siras thrice in a day and two Habbi Muqil (250 mg
tablets) thrice in a day for the duration of two and half month. The
follow up appointments were made after every 15 days. International
prostatic symptoms Score (IPSS) was utilize to observe the changes.
Methodology:

9. Total score: 0-7 Mildly symptomatic; 8-19 moderately symptomatic; 20-35 severely symptomatic.

10. Results & Discussion:
The results thus obtained were evaluated and were
very encouraging as evident from the tables. The mean
body mass index was 25.72 ± 3.61 and the mean of
disease distribution was 14.40 ± 10.95. The mean
IPSS before treatment was 15.6 ± 6.68 which was
reduced to 3.33 ± 3.38 with P Value <.0001 which
proves the significance of the treatment

11. Results & Discussion:
Pre-Treatment Mean IPSS 15.60±6.68 6 to 30
1st
Fallow up 12.32±6.22 4 to 28
2nd
Fallow up 9.32±6.60 2 to 26
3rd
Fallow up 5.92±4.23 2 to 17
4th
Fallow up 4.42±3.62 1 to 15
5th
Fallow up 3.33±3.38 0 to 14
IPSS score before the treatment and during the treatment
(Table-1).

12. Results & Discussion:
Pretreatment Quality of
Life
3.76 ± 1.98 0 to 6
Posttreatment Quality of
Life
1.42 ± 1.42 0 to 6 P Value <.0001
The quality of life index for Urology was evaluated on specially
formulated questionnaire and there was marked improvement in quality
of life index after the completion of the treatment (Table-2).
Comparison of life quality before and after the treatment (Table-2).

13. Different scientific studies on experimental drug.
The poly-herbal formulation used in the study has different
effect and are widely being used in the Unani System of
Medicine for different ailments.
The latest studies have shown that Saponins of Albizia
lebbeck bark show antifertility activity in male rats. This
activity may be due to the disturbances induced by the
saponins in testicular somatic cell functions [R.S. Guptaa, et
al, 2005].
Administering the A. lebbek rise in plasma cortisol has been
observed and the action is similar to ACTH, it may be through
the pituitary or by direct action on the adrenal gland.[Tripathi
P, et al 1983]
Results & Discussion:

14. One of the study revealed a differential cytotoxic activity of
the petroleum ether extract (IC =5 μg/mL) of the resinous₅₀
exudates of Commiphora species against two mouse cell lines
KA31T and NIH3T3 (untransformed and transformed mouse
fibroblasts, respectively).[Ayyad SE, et al 2015]
The results denote that Comiphora species extract has
significant analgesic, anti-inflammatory and anti-
hyperlipidemic effects and reduces body weight gain and
improves blood lipids profile. These results affirm the
traditional use of C. Species for the treatment of pain,
inflammations, and hyperlipidemia.[Shalaby MA, et al. 2014]
Different scientific studies on experimental
drug.

15. Terminalia chebula significantly increased Pain Threshold
time and Pain Tolerance time compared to Placebo. Study
medications were well tolerated[Kumar CU, et al. 2015].
T. chebula has also been reported to display potent
antibacterial activity against a microbial panel (Aneja and
Joshi 2009).
Different scientific studies on experimental
drug.

16. So from the above studies there seems that the medicine used
in the study have some anti-inflammatory effect. Also Albezia
lebbek has some effect on hormones and different enzymes
responsible for the enlargement of Prostate. While as Habbe
Muqil being anti-inflammatory in can be of help for the
patients suffering from Hyperplasia of Prostate.
Further studies are needed in this direction so that a
comprehensive Unani drug is developed to overcome this
disease which is one of the most common geriatric problems
of the developing as well as developed world
Conclusion…...