Pott’s Disease– When & How to Operate?

Background: Pott’s disease is a rare form of extrapulmonary tuberculosis that manifests in a variety of clinical patterns. Delays in diagnosis and treatment can lead to serious complications. About 10-40% of patients with spinal tuberculosis may have a neurological deficit. Urgent measures are needed to halt the progression of the disease and deformity, especially to prevent and overcome paraplegia. In regards to management, every case is different and has a unique procedure. It includes simple medical management, simple decompression and debridement, anterior approach, and posterior approach, etc. Surgical decompression of the cord and instrumentation are needed in many cases besides chemotherapy. Although the anterior approach is used for cervical Pott’s disease but this procedure is very time-consuming and technically difficult in the lumbar and dorsal spine, especially in compromised patients and morbidity is more. The posterior approach alone is enough for achieving adequate decompression, debridement, reduction, fusion, reconstruction of the body, and maintaining sagittal alignment in the dorsal and lumbar Pott’s spine. The aim of the study was to describe the treatment modality and observe the outcome of treatment methods and incidence rate of infection sites among the patients of Potts spine. Material & Methods: This retrospective study was conducted at the Department of Neurosurgery, Bangabandhu Sheikh Mujib Medical University, Bangladesh. The study duration was 7 years, from March 2016 to January 2023. During this period, a total of 30 cases of Pott’s disease were included in the study following inclusion and exclusion criteria. Results: 53.33% had been from the youngest age group of 15-34 years, and 80 % were male. Very few participants had been female in the present study. Back pain was the primary complication for 50% of cases, while spinal infection was observed in the cervical region for 16.67% of cases, 43.33% had infections in the dorsal region, and 30 % in the lumbar region. 10.00% of the participants had been treated with non-surgical methods, with only anti-TB medication for 18 months or more. Posterior decompression was the most common treatment method, with 23.33% having only posterior decompression, and 40.00% having posterior decompression with the use of additional instruments. Conclusion: The study observed that Pott’s disease was most common among young adult males, and the most common sites of spinal infections were in the dorsal and lumbar regions in the present study population, contradictory to the general findings. Decompression treatment, with and without additional instruments, was the most common form of treatment among the present study population.

Antipyretic effects of hydro-methanol extract ofMelia azedarach Linn, seeds and Cucumis melo Linn, seeds in experimental rabbits

To investigate the antipyretic activity of hydro-methanol extract of Melia azedarach Linn. [HMEMA] seeds and Cucumis melo Linn. [HMECM] seeds in experimental animals. Baker's yeast was used to induce fever in rabbits which were divided into six groups. The animal groups were thereafter administered distilled water [control], paracetamol [reference standard, 150mg/kg], HMEMA [250mg/kg], HMEMA [500mg/kg], HMECM [250mg/kg] and HMECM [500mg/kg] respectively. HMEMA and HMECM were also phytochemically screened for tannins, alkaloids, phenols, flavonoids, saponins and cardiac glycosides. Results indicate that hydro-methanol extract of M. azedarach Linn. Seeds [250mg/kg and 500mg/kg] significantly [p<0.001, p<0.05 respectively] reduced the elevated body temperature in dose dependant manner. Insignificant to no antipyretic effect was produced by hydro-methanol extract of Cucumis melo L. seeds. Phytochemical analysis of the HMEMA showed the presence of flavonoids, saponins, tannins, phenols, alkaloids and cardiac glycosides While HMECM was positive for flavonoids, phenols and saponins. The result shows that there exists a potential benefit in utilizing Melia azedarach L. seeds in treating fever. This property can be attributed to the presence of phytochemical constituents present in the hydro-methanol extract ofMelia azedarach L. seeds and the exact mechanism need to be evaluated

Medicinal plants combating against hypertension: a green antihypertensive approach

Hypertension [HTN] or high blood pressure is a medical condition that accounts 9.4 million deaths all over the world every year. It is leading cause of morbidity and mortality worldwide. It increases the risk of cardiovascular diseases, including heart failure, diffuse atherosclerosis, cognitive impairment and dementia. Clinically, synthetic antihypertensive drugs have been used to treat hypertension. However, the efficacy of these drugs is low and also produces side effects which include dry mouth, dizziness, emotional distress, gastrointestinal disturbance, visual disorders etc. These distressing side effects adversely affect health-related quality of life. Therefore, there is a need to search natural, cheaper and non-toxic compound. Plant are widely use in traditional systems of medicine for the treatment of several diseases. About 80% of the world population relies on traditional medicine for primary healthcare. In the last three decades, a lot of research has been done on local medicinal plants for hypotensive and antihypertensive potentials. Plants are the rich source of secondary metabolites which have been found in vivo to have antihypertensive properties. The current study is focused on reviewing the antihypertensive property of medicinal plants and their metabolites. In the current review, we conducted a literature search using Elsevier, Science direct, Springer Link [Springer], Pub Med and Google Scholar. The search included the keywords [plants], [medicinal plants], [plant extracts], cross-referenced with the keywords [hypertension] [antihypertensive activity]. The use of plant origin natural compounds as cardio protective and antihypertensive agents is an interesting strategy for discovering bioactive products. Plants are rich in a variety of secondary metabolites, such as flavonoids, alkaloids, tannins and terpenoids. These have been found in vivo to have antihypertensive effects. The present review therefore; stand for a good basis to choose exact molecules belonging to the indicated categories that in the forthcoming future will become useful therapeutic tools