Systemic therapy with bromelain-trypsin-rutoside combination in inflammation: A narrative review of the pharmacodynamics

Inflammation and wound healing are attended by interactions of numerous cell types, mediators, cytokines, and the vascular system. Any imbalance in these interactions can set off a cascade of processes, often working in different directions, and which continue till homeostasis is restored. Systemic enzyme therapy with trypsin-bromelain-rutoside combination has long been used as dietary supplements or pharmaceuticals commercially to counter various inflammatory conditions. The clinical benefits are believed to be due to the multipronged action of the combination, which include anti-kinin, antioxidant, antiplatelet, anti-chemokine, pro-fibrinolytic, and pro-fibrotic activities; with more recent evidence indicating inhibition of pro-inflammatory signal transduction. The primary modes of action of the individual agents on different components and processes involved in inflammation have been evaluated and elucidated, using various in vitro, animal model, and clinical studies. A narrative review of the evidence collected over the years has been provided.

An evaluation of genesis and impaction of 3rd molar in Adolescents.

In the process of evolution the jaw has become smaller, allowing less room for the 3rd molars and causing numerous dental problems. Research now indicates that in many of cases there is complete agenesis of 3rd molars which may be because of environmental influence on human evolutionary process. An objective of this study is to asses genesis and impaction of 3rd molar in adolescents of Ahmedabad city. This study was done in 100 adolescents (age 15-19 years) of Ahmedabad city during January 2013 to July 2013. Genesis or agenesis and impaction of 3rd molar was confirmed by Orthopantomogram (OPG) and data was analyzed using Fisher’s exact test in GraphPad Prism software (6.0.3). Out of 100 adolescents, 66 have presence of tooth-buds of all four 3rd molars, while in 23 cases OPG shows absence of tooth-bud (agenesis) of one of the four 3rd molars, in 6 cases tooth-buds of two out of the four 3rd molar were absent, in 3 cases tooth-buds of three out of four were found to be absent and in 2 cases all the four 3rd molar tooth-buds were absent. Gender difference was not significant. Different pattern of impaction was found in 38 subjects. Agenesis & impaction of 3rd molar may be a part of evolutionary process which has undergone because of changes in food habits from coarse abrasive diet to soft western diet.