ABSTRACT
Abstract Introduction: After post-septoplasty nasal packing removal, a certain proportion of nasal secretion occurs, leading to local and sometimes systemic infections. Objective: The aim was to determine if standardized dry ivy leaf extract application after nasal packing removal influences the reduction of nasal secretion and diminish the occurrence of local infections. Methods: The study included 70 post-septoplasty patients (divided into two equal groups) whose nasal packing was removed on the third day after the procedure. Group I was treated with standardized dry ivy leaf extract syrup along with regular nasal irrigation for the five days after the nasal packing removal whereas the Group II had only nasal lavage. On the sixth day after nasal packing removal, the quantity of nasal secretion was determined using a visual analog scale and nasal endoscopic examination. Results: The group treated with standardized dry ivy leaf extract syrup had significantly lesser nasal secretion both by subjective patients' assessment (p < 0.001) and by nasal endoscopic examination (p = 0.003). The post-surgical follow up examination on the sixth day after nasal packing removal showed no development of local infection in the Group I, while in the Group II a local infection was evident in five patients (14.29%) and antibiotic therapy was required. Conclusion: The use of the standardized dry ivy leaf extract after nasal packing removal significantly lowers the proportion of nasal secretion.
Resumo Introdução: Após a remoção do tampão nasal pós-septoplastia, ocorre produção de secreção nasal, predispondo infecções locais e, por vezes, sistêmicas. Objetivo: O objetivo foi determinar se a aplicação do extrato padronizado de folhas de hera seca após a remoção do tampão nasal influencia a redução da secreção nasal e diminui a ocorrência de infecções locais. Método: O estudo incluiu 70 pacientes pós-septoplastia (divididos em dois grupos iguais) cujo tampão nasal foi retirado no terceiro dia após o procedimento. O grupo I foi tratado com xarope padronizado de extrato de folha seca de hera juntamente com irrigação nasal regular por cinco dias após a remoção do tamponamento nasal, enquanto ao grupo II foi recomendado apenas lavagem nasal. No sexto dia após a remoção do tampão nasal, a quantidade de secreção nasal foi determinada pela escala EVA (escala visual analógica) e pelo exame endoscópico nasal. Resultados: O grupo tratado com xarope de extrato seco de folhas de hera apresentou secreção nasal significativamente menor tanto pela avaliação subjetiva dos pacientes (p < 0,001) quanto pelo exame endoscópico nasal (p = 0,003). O exame de acompanhamento pós-cirúrgico no sexto dia após a remoção do tampão nasal não mostrou desenvolvimento de infecção local nos pacientes do grupo I, enquanto que no grupo II, cinco apresentaram sinais de infecção local (14,29%) com necessidade de antibioticoterapia. Conclusão: O uso do extrato padronizado de folhas secas de hera após a remoção do tampão nasal reduz significativamente a produção de secreção nasal.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Young Adult , Postoperative Care/methods , Rhinoplasty/methods , Plant Extracts/therapeutic use , Hedera/chemistry , Nasal Septum/surgery , Epistaxis/prevention & control , Nose/microbiology , Plant Leaves/chemistry , Postoperative Hemorrhage/prevention & control , Phytotherapy , Anti-Bacterial Agents/therapeutic useABSTRACT
In visceral leishmaniasis (VL), development of alternative safe therapeutic strategy is gaining paramount wherein natural components of plant origin have prominence. We explored Coccinia grandis (L.) Voigt, a medicinal plant known in traditional folk medicine, for its antileishmanial efficacy. SDS-PAGE analysis of the C. grandis leaf extract (Cg-Ex) showed few protein bands about 14-66 kDa among which three (64.8, 55.8 and 15.3 kDa) were identified as serine protease inhibitors by reverse zymography. Since the virulence of Leishmania is also attributed by serine proteases, objective of the present study was to evaluate in vitro antileishmanial activity of Cg-Ex, targeting Leishmania donovani serine protease(s). Inhibition study of Cg-Ex in gelatin-zymogram and spectrophotometric assay revealed its strong inhibitory activity against bovine trypsin rather than chymotrypsin, and also showed significant inhibition of L. donovani serine protease(s). Further, studies with Cg-Ex were extended to estimate its antileishmanial efficacy with half maximal inhibitory concentration (IC50) at 308.0 ± 2.42 µg/ml along with significant morphological alterations. The results have demonstrated the potential of the serine protease inhibitor rich fraction of the C. grandis leaf extract against visceral leishmaniasis.
ABSTRACT
PURPOSE: Leptomeningeal collateral, in moyamoya disease (MMD), appears as an ivy sign on fluid-attenuated inversion-recovery (FLAIR) images. There has been little investigation into the relationship between presentation of ivy signs and old brain lesions. We aimed to evaluate clinical significance of ivy signs and whether they correlate with old brain lesions and the severity of clinical symptoms in patients with MMD. MATERIALS AND METHODS: FLAIR images of 83 patients were reviewed. Each cerebral hemisphere was divided into 4 regions and each region was scored based on the prominence of the ivy sign. Total ivy score (TIS) was defined as the sum of the scores from the eight regions and dominant hemispheric ivy sign (DHI) was determined by comparing the ivy scores from each hemisphere. According to the degree of ischemic symptoms, patients were classified into four subgroups: 1) nonspecific symptoms without motor weakness, 2) single transient ischemic attack (TIA), 3) recurrent TIA, or 4) complete stroke. RESULTS: TIS was significantly different as follows: 4.86+/-2.55 in patients with nonspecific symptoms, 5.89+/-3.10 in patients with single TIA, 9.60+/-3.98 in patients with recurrent TIA and 8.37+/-3.39 in patients with complete stroke (p=0.003). TIS associated with old lesions was significantly higher than those not associated with old lesions (9.35+/-4.22 vs. 7.49+/-3.37, p=0.032). We found a significant correlation between DHI and motor symptoms (p=0.001). CONCLUSION: Because TIS has a strong tendency with severity of ischemic motor symptom and the presence of old lesions, the ivy sign may be useful in predicting severity of disease progression.
Subject(s)
Adolescent , Adult , Aged , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Young Adult , Brain/metabolism , Cerebral Arteries/pathology , Collateral Circulation , Disease Progression , Magnetic Resonance Imaging/methods , Meninges/pathology , Moyamoya Disease/complications , Severity of Illness Index , StrokeABSTRACT
OBJECTIVE: MR perfusion and single photon emission computerized tomography (SPECT) are well known imaging studies to evaluate hemodynamic change between prior to and following superficial temporal artery (STA)-middle cerebral artery (MCA) anastomosis in moyamoya disease. But their side effects and invasiveness make discomfort to patients. We evaluated the ivy sign on MR fluid attenuated inversion recovery (FLAIR) images in adult patients with moyamoya disease and compared it with result of SPECT and MR perfusion images. METHODS: We enrolled twelve patients (thirteen cases) who were diagnosed with moyamoya disease and underwent STA-MCA anastomosis at our medical institution during a period ranging from September of 2010 to December of 2012. The presence of the ivy sign on MR FLAIR images was classified as Negative (0), Minimal (1), and Positive (2). Regions were classified into four territories: the anterior cerebral artery (ACA), the anterior MCA, the posterior MCA and the posterior cerebral artery. RESULTS: Ivy signs on preoperative and postoperative MR FLAIR were improved (8 and 4 in the ACA regions, 13 and 4 in the anterior MCA regions and 19 and 9 in the posterior MCA regions). Like this result, the cerebrovascular reserve (CVR) on SPECT was significantly increased in the sum of CVR in same regions after STA-MCA anastomosis. CONCLUSION: After STA-MCA anastomosis, ivy signs were decreased in the cerebral hemisphere. As compared with conventional diagnostic modalities such as SPECT and MR perfusion images, the ivy sign on MR FLAIR is considered as a useful indicator in detecting brain hemodynamic changes between preoperatively and postoperatively in adult moyamoya patients.
Subject(s)
Adult , Humans , Anterior Cerebral Artery , Brain , Cerebral Arteries , Cerebrum , Hemodynamics , Moyamoya Disease , Perfusion , Temporal Arteries , Tomography, Emission-Computed, Single-PhotonABSTRACT
O mercado brasileiro de fitoterápicos apresenta diversos produtos broncodilatadores e expectorantes produzidos com extratos da espécie hera (Hedera helix L. - Araliaceae), os quais apresentam distintas composições em termos de quantidade de extrato seco e de marcador por ml. Visando contribuir ao entendimento dessas diferenças, realizou-se levantamento da literatura clínica sobre a espécie com foco nos aspectos de concentração de extratos e quantidade de marcadores. Verificou-se existirem mundialmente três diferentes formatos comerciais de extratos de hera, preparados com relação droga-extrato de 3-6:1, 5-7,5:1 e 4-8:1, gerando diferentes teores de marcador por cento. Os dois primeiros formatos estão presentes no mercado brasileiro, apresentam base clínica eficaz e segura, demonstrando que a espécie em questão mostra faixa variável de ação. O estudo multicêntrico de maior evidência clínica foi realizado por Fazio e colaboradores (2009), utilizando produto com concentração de marcadores que somente são fornecidas, no Brasil, pelos fitoterápicos de formulação do tipo 5-7,5:1, enquanto produtos no formato de formulação 3-6:1 apresenta teores abaixo do mínimo utilizado nesse estudo multicêntrico. O perfil de segurança dos vários tipos de produtos à base de Hedera helix é muito bem estabelecido, com mínimas ocorrências de efeitos adversos, basicamente gastrointestinais.
ABSTRACT
Anthracnose symptoms severely occurred up to 50% on leaves of English ivy growing in greenhouses in Cheongwon area of Korea during disease survey in April, 2000. The symptoms developed as concentric spots with dot-like acervuli on leaves of the plant. A total of 24 isolates of Colletotrichum sp. were obtained from the spotted lesions and identified as Colletotrichum trichellum based on the morphological and cultural characteristics. Leaf spots similar to the original anthracnose symptoms were induced on the host leaves by artificial inoculation with the isolates of the fungus. This is the first record of C. trichellum causing anthracnose of English ivy in Korea.