Giant peptic ulcer perforation- omentopexy versus omental plugging: a comparative study

Background: Giant peptic ulcer perforation is a life-threatening surgical emergency with high mortality rate. This study compares two different surgical techniques omentopexy and omental plugging for the treatment of giant peptic perforation.Methods: This study was a prospective study comparing the efficacy of omental plugging and omentopexy. The study was done at Emergency Department of General Surgery in Nalanda Medical College and Hospital, Patna over one-year period from October 2017 to September 2018. Patients were randomly allocated to two groups: one for omental plugging (cases) and other for omentopexy (controls).Results: A prospective non-randomized study of 12 patients with giant peptic perforation (≥2 cm in diameter) was carried out over a period of 24 months. The highest incidence was seen in males over 50 years of age. Biliary leak rates were 33% in the omentopexy group compared to no leak in the omental plugging group. This rate when calculated on standard error of proportion was significant at 5% level (p<0.05). Mortality rate was higher in omentopexy group compared to omental plugging group.Conclusions: Omental plugging seems to be associated with low rates of biliary leak compared to omentopexy and hence should be the procedure of choice in giant peptic ulcer perforation compared to omentopexy.

Comparative pharmacognostic evaluation of althaea officinalis and alcea rosea root

Althaea [Family Malvaceae], a small genus comprising about 15 species distributed in the temperate regions. The official drug Khatmi or Marshmallow, botanically equated to the roots of A. officinalis, the only species of this genus found in India. Alcea rosea L. syn. Althaea rosea [L.] Cav., a substitute of Khatmi is also grown as ornamental plant in Indian gardens. The root, constitute the drug Khatmi and used as demulcent and emollient. The roots are useful in inflammation, irritation of alimentary canal and urinary and respiratory organs The decoction of root is used as an expectorant in whooping cough, hoarseness of voice and bronchitis. It is also reported to be used for fomentation in inflammatory tumors, burns, bruises, sprains etc. as a poultice. Hence, in the present paper, comparative pharmacognostic evaluation of A. officinalis and A. rosea has been undertaken. The root of both the species can be identified on the basis of macro-microscopic characters, physicochemical parameters and TLC finger print profiles. The macroscopic studies showed that the root of A. officinalis are strongly longitudinally furrowed, often spirally twisted with short-medium fracture but in A. rosea these are finely longitudinally furrowed, straight with medium-hard fracture. Microscopically both these species can be differentiated on the basis of size and number of mucilage canals and distribution of fibres. The comparative TLC profiles showed common as well as differentiating bands for example 4 significant bands of orangish-brown colour at Rfs. 0.11, 0.13, 0.37 and 0.41 were only visible in A. officinalis

Chemical and biological properties of Stevia rebaudiana

The sweet herb of Paraguay, Stevia rebaudiana Bertoni is likely to become a major source of high potency sweetener for the growing natural food market in the future. Hence, the authors presented an exhaustive review of Stevia in the present communication and included its botanical description, geographical distribution, cultivation, chemical and biological properties, toxicology and plant tissue culture work reported on the plant

Towards rational regulation and legislation of herbal medicines

Though modern medicine is well developed in most of the world, large sections of the population in developing countries still rely on heral medicines and other natural products for their primary care. In recent years public interest in Industrialized countries has increased greatly towards the natural therapies with the expanding use of medicinal plants and herbal medicine. Traditional medicinal products have evolved against widely different ethnological, cultural, climatic, geographical and even philosophical backgrounds; nevertheless they face many regulatory challenges in ensuring their safety and efficacy. The efforts of WHO in the development of modern guidelines in this field have been very helpful in recognition of the role of herbal remedies in health care and in supporting their potential use in national health care system in different parts of the world

Regulation of rat liver NADP+ -isocitrate dehydrogenase during aging.

In an attempt to understand the mechanism of aging in relation to the differences in enzyme regulation, the induction and kinetic properties of NADP+ -isocitrate dehydrogenase of the liver of immature (6 weeks), mature (13 weeks), adult (33 weeks) and old (85 weeks) female rats were studied. The specific activity of the cytoplasmic and mitochondrial NADP+ -isocitrate dehydrogenase increased up to the adult age (33 weeks) and decreased in the old rats (85 weeks). Overiectomy decreased and estradiol administration induced activity of both the mitochondrial and eytoplasmic enzyme in the liver ol immature, mature and adult rats but had no significant effect in old rats. However, the activity of mitochondrial NADP+ -isocitrate dehydrogenase decreased and eytoplasmic NADP+ -isocitrate dehydrogenase increased following ovariectomy in old rats (85 weeks). Hormone-mediated induction of enzyme activity was actinomycin D sensitive. The Km for isocitrate and NADP, Ki value for oxalomalate, heat stability and electrophoretic mobility of the purified enzyme from the cytosol fraction of the liver of immature and old rats were similar. It can he concluded that the enzyme does not change structurally with age.