Ethanol Extract of Glycyrrhiza uralensis Fisch: Antidiarrheal Activity in Mice and Contraction Effect in Isolated Rabbit Jejunum / 中国结合医学杂志

OBJECTIVE@#To evaluate the antidiarrheal effect of ethanol extract of Glycyrrhiza uralensis Fisch root (GFR) in vivo and jejunal contraction in vitro.@*METHODS@#In vivo, 50 mice were divided into negative control, positive control (verapamil), low-, medium- and high-dose GFR (250, 500, 1,000 mg/kg) groups by a random number table, 10 mice in each group. The antidiarrheal activity was evaluated in castor oil-induced diarrhea mice model by evacuation index (EI). In vitro, the effects of GFR (0.01, 0.03, 0.1, 0.3, 1, 3, and 10 g/L) on the spontaneous contraction of isolated smooth muscle of rabbit jejunum and contraction of pretreated by Acetylcholine (ACh, 10 µmol/L) and KCl (60 mmol/L) were observed for 200 s. In addition, CaCl2 was accumulated to further study its mechanism after pretreating jejunal smooth muscle with GFR (1 and 3 g/L) or verapamil (0.03 and 0.1 µmol/L) in a Ca2+-free-high-K+ solution containing ethylene diamine tetraacetic acid (EDTA).@*RESULTS@#GFR (500 and 1,000 mg/kg) significantly reduced EI in castor oil-induced diarrhea model mice (P<0.01). Meanwhile, GFR (0.01, 0.03, 0.1, 0.3, 1, 3, and 10 g/L) inhibited the spontaneous contraction of rabbit jejunum (P<0.05 or P<0.01). Contraction of jejunums samples pretreated by ACh and KCl with 50% effective concentration (EC50) values was 1.05 (0.71-1.24), 0.34 (0.29-0.41) and 0.15 (0.11-0.20) g/L, respectively. In addition, GFR moved the concentration-effect curve of CaCl2 down to the right, showing a similar effect to verapamil.@*CONCLUSIONS@#GFR can effectively against diarrhea and inhibit intestinal contraction, and these antidiarrheal effects may be based on blocking L-type Ca2+ channels and muscarinic receptors.

Determining the protective effects of Ma-Mu-Ran Antidiarrheal Capsules against acute DSS-induced enteritis using 16S rRNA gene sequencing and fecal metabolomics / 中国天然药物

Ma-Mu-Ran Antidiarrheal Capsules (MMRAC) is traditional Chinese medicine that has been used to treat diarrhea caused by acute enteritis (AE) and bacillary dysentery in Xinjiang (China) for many years. However, the potential therapeutic mechanism of MMRAC for AE and its regulatory mechanism on host metabolism is unclear. This study used fecal metabolomics profiling with GC/MS and 16S rRNA gene sequencing analysis to explore the potential regulatory mechanisms of MMRAC on a dextran sulfate sodium salt (DSS)-induced mouse model of AE. Fecal metabolomics-based analyses were performed to detect the differentially expressed metabolites and metabolic pathways. The 16S rRNA gene sequencing analysis was used to assess the altered gut microbes at the genus level and for functional prediction. Moreover, Pearson correlation analysis was used to integrate differentially expressed metabolites and altered bacterial genera. The results revealed that six intestinal bacteria and seven metabolites mediated metabolic disorders (i.e., metabolism of amino acid, carbohydrate, cofactors and vitamins, and lipid) in AE mice. Besides, ten altered microbes mediated the differential expression of eight metabolites and regulated these metabolisms after MMRAC administration. Overall, these findings demonstrate that AE is associated with metabolic disorders and microbial dysbiosis. Further, we present that MMRAC exerts protective effects against AE by improving host metabolism through the intestinal flora.

Enhancement of dissolution rate of racecadotril by liquisolid compact technology

Abstract The current investigation was used to improve the rate of dissolution of an anti-diarrheal drug i.e., racecadotril (RT) at low pH conditions (i.e., in the stomach) by reducing the water secretion and electrolyte in to the intestine by liquisolid tablets. Different formulations (liquisolid) were prepared using Avicel PH 102 as a carrier. Aerosil 200 as a coating material and sodium starch glycolate used as a disintegrant. Polyethylene glycol 200 was used as a non-volatile vehicle to dissolve the drug. FTIR, DSC, XRD and dissolution studies were conducted to characterise liquisolid tablets. Characterisation studies indicated that no interactions between carrier and drug. Solid state characterization had shown a reduction in crystallinity that further supports increment in solubility and dissolution. The optimised formulation showed a significant increase in dissolution i.e., 99.54±0.62% in 30 min compared to directly compressible tablets (38.47±0.26%). The % dissolution efficiency of racecadotril liquisolid tablets 76.86% compared to marketed tablet (27.56%) and conventional direct compression tablet (17.11%). Significant reduction in mean dissolution time of racecadotril from liquisolid tablets (6.84 min) compared to direct compression tablet (44.57 min), indicating faster release of drug and faster onset of action. Formulation of liquisolid tablets could enhance solubility, dissolution and bioavailability of racecadotril

Evaluation of smooth muscle relaxant potential of Bismarckia nobilis (Hildebr. & Wendl.) in diarrhea, hypertension and asthma by ex-vivo and in-vivo method / Evaluación del potencial relajante en músculo liso de Bismarckia nobilis (Hildebr. & Wendl.) en diarrea, hipertensión y asma por métodos ex vivo e in vivo

To explore the mechanistic basis behind smooth muscle relaxant prospective of Bismarckia nobilis in gastrointestinal, respiratory and cardiovascular ailments. The methanolic extract of B. nobilis and sub-fractions have been evaluated in vitro rabbit isolated tissues, in vivo castor oil-induced diarrhea in rats and charcoal meal activity in mice. The B. nobilis extract relaxed spontaneous and K+(80 mM)- induced contractions in rabbit isolated jejunum preparations, CCh (1 µM) and K+ (80 mM)-induced contractions in tracheal and bladder preparations, PE (1 µM) and K+ (80 mM)-induced concentrations in aorta preparations, likewise verapamil. Spasmolytic activity of dichloromethane fraction is stronger as compared to aqueous fraction. In vivo castor oil-induced diarrhea in rats and charcoal meal activity in mice further supported spasmolytic activity. B. nobilis extract possess anti-spasmodic, anti-diarrheal, airway relaxant and vasodilator activities possible mediated through calcium channel blocking mechanism, justifying therapeutic utility of B. nobilis in diarrhea, asthma and hypertension.

El objetivo de trabajo fue explorar el mecanismo de acción relacionado con el efecto relajante del músculo liso inducido por Bismarckia nobilis (B. nobilis) en enfermedades gastrointestinales, respiratorias y cardiovasculares. El extracto metanólico de B. nobilis y subfracciones fue evaluado in vitro en tejidos aislados de conejos. Además se evaluó diarrea in vivo inducida con aceite de ricino en ratas y la actividad de harina de carbón vegetal en ratones. El extracto de B. nobilis relajó tanto las contracciones espontáneas como las inducidas por K+(80 mM) en preparaciones de yeyuno aisladas de conejos, las contracciones inducidas por PE (1 µM) y K+(80 mM) inducidas en preparaciones de aorta; de manera similar a verapamilo. La actividad espasmolítica de la fracción de diclorometano es más potente en comparación con la fracción acuosa. La diarrea inducida in vivo por el aceite de ricino en ratas y la actividad de la harina de carbón vegetal en ratones apoyaron aún más la actividad espasmolítica. El extracto de B. nobilis posee actividades antiespasmódicas, antidiarreicas, relajantes de las vías respiratorias y vasodilatadoras, posibles a través del mecanismo de bloqueo de los canales de calcio, lo que justifica la utilidad terapéutica de B. nobilis en la diarrea, el asma y la hipertensión.

Diagnóstico y manejo de la colitis microscópica / Diagnosis and management of microscopic colitis

Microscopic colitis (MC) is a clinical condition characterized by chronic watery diarrhea, normal colonic mucosa and characteristic histological findings. It is composed of two main entities: collagenous colitis (CC) and lymphocytic colitis (LC). Its incidence has been increasing, currently accounting for between 8 to 16% of studies for chronic diarrhea. It is more frequent in elderly women and is strongly associated with other autoimmune disorders. Its pathogenesis is not very well understood, but it supposes the immune activation secondary to the exposure of the colonic mucosa to different luminal antigens, mainly drugs. Management includes suspension of the potential causative agent and the use of anti-diarrheal medications. Oral budesonide has proven to be effective in induction and maintenance of remission, but with a high rate of recurrence upon discontinuation. Immune-modulators drugs such as azatioprine and metrotrexate have been tested in patients dependent to corticoids with variable results. Antibodies against tumor necrosis factors (TNF) are under studies, with promising results.

La colitis microscópica (CM) es una condición clínica caracterizada por diarrea crónica acuosa con mucosa colónica normal y hallazgos histológicos característicos. Está compuesta por dos entidades principales: la colitis colágena (CC) y la colitis linfocítica (CL). Su incidencia ha ido en aumento, siendo en la actualidad la responsable del 8 a 16% de los casos por diarrea crónica. Es más frecuente en mujeres de edad avanzada con una fuerte asociación a otras enfermedades autoinmunes. Su etiopatogenia no es del todo conocida, pero se cree juega un rol la activación inmune secundaria a la exposición de la mucosa colónica a diferentes antígenos luminales, principalmente fármacos. Dentro del manejo se incluye la suspensión del potencial agente causal y el uso de fármacos antidiarreicos. La budesonida oral ha demostrado alta efectividad en la inducción y mantención de la remisión, pero con una alta tasa de recurrencia al suspenderla. Fármacos inmunomoduladores como azatioprina y metrotrexato se han probado en pacientes corticodependendientes con resultados variables. El uso de anticuerpos monoclonales anti factor de necrosis tumoral (TNF) se encuentra en estudio, con resultados prometedores.

Management of Acute Gastroenteritis in Children: A Survey among Members of the Korean Society of Pediatric Gastroenterology, Hepatology, and Nutrition / 대한소아소화기영양학회지

PURPOSE: No national survey has yet described the guidelines followed by Korean pediatricians to treat acute gastroenteritis (AGE). An online survey was performed to investigate the management of AGE followed by members of The Korean Society of Pediatric Gastroenterology, Hepatology, and Nutrition, and the results were compared between pediatric gastroenterologists (PG) and general pediatricians (GP). METHODS: Questionnaires were sent to pediatricians between June 2 and 4, 2018 regarding the type of hospital, indications for admission, antiemetic and antidiarrheal drugs and antibiotics prescribed, and dietary changes advised. RESULTS: Among the 400 pediatricians approached, 141 pediatricians (35.3%) responded to the survey. PG comprised 39% of the respondents and 72.7% worked at a tertiary hospital. Both PG and GP considered diarrhea or vomiting to be the primary symptom. The most common indication for hospitalization was severe dehydration (98.8%). Most pediatricians managed dehydration with intravenous fluid infusions (PG 98.2%, GP 92.9%). Antiemetics were prescribed by 87.3% of PG and 96.6% of GP. Probiotics to manage diarrhea were prescribed by 89.1% of PG and 100.0% of GP. Antibiotics were used in children with blood in diarrheal stool or high fever. Dietary changes were more commonly recommended by GP (59.3%) than by PG (27.3%) (p<0.05). Tests to identify etiological agents were performed primarily in hospitalized children. CONCLUSION: This survey assessing the management of pediatric AGE showed that the indications for admission and rehydration were similar between GP and PG. Drug prescriptions for diarrhea and dietary changes were slightly commonly recommended by GP than by PG.

Antidiarrheal activity of extracts from Maytenus gonoclada and inhibition of Dengue virus by lupeol

ABSTRACT Diarrhea is an infectious disease caused by bacterial, virus, or protozoan, and dengue is caused by virus, included among the neglected diseases in several underdeveloped and developing countries, with an urgent demand for new drugs. Considering the antidiarrheal potential of species of Maytenus genus, a phytochemical investigation followed by antibacterial activity test with extracts of branches and heartwood and bark of roots from Maytenus gonoclada were conducted. Moreover, due the frequency of isolation of lupeol from Maytenus genus the antiviral activity against Dengue virus and cytotoxicity of lupeol and its complex with β-cyclodextrins were also tested. The results indicated the bioactivity of ethyl acetate extract from branches and ethanol extract from heartwood of roots of M. gonoclada against diarrheagenic bacteria. The lupeol showed potent activity against Dengue virus and low cytotoxicity in LLC-MK2 cells, but its complex with β-cyclodextrin was inactive. Considering the importance of novel and selective antiviral drug candidates the results seem to be promising.

Antidiarrheal activity of hexane extract of Citrus limon peel in an experimental animal model / 中西医结合学报

<p><b>OBJECTIVE</b>Acute diarrhea is one of the major illnesses that cause death in children, despite clinical interventions and the use of oral rehydration therapy. Thus, there is need to discover other effective, affordable and accessible treatments for this disease. Therefore, this study was carried out to investigate the effects of hexane extract of Citrus limon peel (HECLP) on castor oil-induced diarrhea in rats.</p><p><b>METHODS</b>Diarrhea was induced in male albino Wistar rats weighing 100-150 g. The antidiarrheal activity of HECLP at different oral dosages (5, 10 and 20 mg/kg) was investigated by counting the number of wet fecal pellets. Animals were further treated with propranolol, prazosin, nifedipine and atropine to assess the effects of receptor blockers on the activities of the extract. The effects of HECLP on castor oil-induced enteropooling and the intestinal transit time of activated charcoal were also evaluated.</p><p><b>RESULTS</b>Each of the 3 doses of C. limon significantly reduced (P < 0.05) the number of wet fecal pellets produced by animals, with 20 mg/kg HECLP producing the highest percentage inhibition (34.2%). Wet fecal pellet inhibition by the standard drug loperamide (3 mg/kg p.o.) was 68.4% relative to the negative control. Blockage of β adrenergic receptors by propanolol abolished the antidiarrheal effects of HECLP. Intestinal fluid accumulation was inhibited by 68.7% and 78.5% by 20 mg/kg HECLP and loperamide respectively. Furthermore, 20 mg/kg HECLP significantly (P < 0.05) reduced the percentage intestinal transit time (21.4% ± 1.42%), relative to the control (34.2% ± 4.29%); atropine (5 mg/kg, intraperitoneal injection) significantly (P < 0.001) reduced the percentage intestinal transit time to 11.2% ± 0.85%.</p><p><b>CONCLUSION</b>These results suggest that C. limon peel possesses antidiarrheal effects through antisecretory and antimotility mechanisms that act through the β adrenergic system.</p>

Phytochemical and biological investigations of methanol extract of leaves of ziziphus mauritiana lam / Investigaciones fitoquímicas y biológicas de extractos metanólicos de hojas de ziziphus mauritiana lam

Seven compounds were isolated from the methanol extract of leaves of Ziziphus mauritiana. The structures of the isolated compounds were elucidated as y-fagarine (1), beta-sitosterol (2), stigmasterol (3), alfa-amyrin (4), lupeol (5), beta-amyrin (6) and betulin (7) by extensive spectroscopic studies and by co-TLC with authentic samples. This is the first report of isolation of compounds 1-7 from this plant species. The extractives from leaves were investigated for thrombolytic, membrane stabilizing, antimicrobial, antidiarrheal and analgesic potentials along with sleep inducing property on animal model. The thrombolytic and membrane stabilizing activities were assessed by using human erythrocyte comparing with standard streptokinase and acetylsalicylic acid, respectively. The methanolic extract reduced frequency of diarrheal faeces when compared to the standard loperamide. In castor oil induced diarrhea in mice a dose dependent decrease of gastrointestinal transits were observed. In radiant heat tail-flick method the methanol extract showed moderate antinociceptive activity, compared to standard morphine.

Siete compuestos fueron aislados del extracto metanólico de hojas de Ziziphus mauritiana. Las estructuras de los compuestos aislados fueron identificadas como y-fagarina (1), beta-sitosterol (2), estigmasterol (3), alfa-amirina (4), lupeol (5), beta-amirina (6) y betulina (7 ) por medio de extensivos estudios espectroscópicos y por co-TLC con muestras auténticas. Este es el primer informe de aislamiento de los compuestos 1-7 a partir de esta especie vegetal. Los extractos de las hojas fueron investigados por efectos trombolíticos, estabilizadores de membrana, antimicrobianos, antidiarreicos y potenciales analgésicos junto a la propiedad de inducir sueño en el modelo animal. Las actividades trombolíticos y la estabilización de la membrana se evaluaron mediante el uso de eritrocitos humanos comparando con estreptoquinasa estándar y el ácido acetilsalicílico, respectivamente. El extracto metanólico redujo la frecuencia de las heces diarreicas en comparación con el estándar de loperamida. En la inducción por aceite de ricino de diarrea en ratones, se observó una disminución dosis dependiente de los tránsitos gastrointestinales. En el método del coletazo producido por calor radiante, el extracto metabólico mostró una actividad antinociceptiva moderada, en comparación con la morfina estándar.

Efecto antidiarreico del extracto hidroalcohólico de las hojas de Schinus molle L. "molle", Ayacucho - 2014 / Antidiarrheal effect of the hydroalcoholic extract of the leaves of Schinus molle L. "molle", Ayacucho - 2014

Las enfermedades diarreicas continúan siendo uno de los principales problemas de salud pública en los países de desarrollo, siendo las causas principales de mortalidad y morbilidad en el mundo, afectando a todo grupo de edad, los más afectados son los niños menores de 5 años. El presente trabajo de investigación se realizó para determinar el efecto antidiarreico del extracto hidroalcohólico de las hojas de Schinus molle L. "molle", estas fueron recolectadas en el distrito de Accos Vinchos, provincia de Huamanga, departamento de Ayacucho. El estudio se realizó en los laboratorios de Farmacia y Bioquímica de la Facultad de Ciencias de la Salud de la Universidad Nacional de San Cristóbal de Huamanga, con el objetivo de evaluar el efecto antidiarréico del extracto hidroalcohólico de las hojas de Schinus molle L. "molle", en cobayos machos, durante los meses de octubre a marzo de 2015. Los metabolitos presentes en el extracto hidroalcohólico de las hojas fueron compuestos fenólicos y/o taninos, flavonoides, triterpenos y esteroides, catequinas, resinas, saponinas, azúcares reductores y cumarinas. Se usaron 25 cobayos de 500 y 600 g de peso distribuidos aleatoriamente en cinco tratamientos: Agua destilada (blanco), Loperamida (estándar), extracto hidroalcohólico de las hojas de Schinus molle L. "molle" a 1 00, 200 y 300 mg/kg de peso. Los resultados muestran que el extracto hidroalcohólico de las hojas de Schinus molle L. "molle" a 100 mg/Kg de 39,1 %, a 200 mg/Kg de 34,8%, a 300 mg/Kg de 92.7%, teniendo similar efecto antidiarreico el de 300 mg/Kg frente al estándar Loperamida 2 mg/Kg que representa el 1 00% del efecto antidiarreico. Se concluye que el extracto hidroalcohólico de las hojas de Schinus molle L. "molle" a dosis de 300 mg/Kg de peso, tiene mayor efecto antidiarreico estadísticamente similar a la Loperamida.

Extracts of passion fruit peel and seed of Passiflora edulis (Passifloraceae) attenuate oxidative stress in diabetic rats / 中国天然药物

This study was aimed at evaluating the anti-diabetic potential of passion fruit Passiflora edulis (EPE) extracts in diabetic rats, following Streptozotocin (STZ) induced oxidative stress. Thirty adult Wistar rats were divided into five groups, with six rats in each group. The control rats were injected intraperitoneally with citrate buffer (pH 4.5). The remaining groups of rats were administered single dose of 45 mg·kg(-1) of STZ by intraperitoneal route to induce diabetes. The diabetic animals were treated with 250 and 500 mg·kg(-1) of EPE and glibenclamide 0.6 mg·kg(-1) for fifteen days by oral route. Blood glucose, end organ oxidative stress marker, and anti-oxidants were assayed. Further, histopathological investigation of pancreas was studied at the end of the experimentation. The results revealed that subacute administration of EPE significantly (P < 0.001) controlled the blood glucose level in the diabetic rats. In addition, EPE extract protected the end organs by restoring the anti-oxidants enzyme, significantly increasing super oxide dismutase level (SOD) and decreasing catalase (CAT) and TBARS level in visceral organs. In conclusion, that EPE extracts showed anti-diabetic and anti-oxidant potential against streptozotocin-induced diabetes.

Influence of length of preserved ileocecum on the efficacy of laparoscopic subtotal colectomy antiperistaltic cecorectal anastomosis in the treatment of slow transit constipation / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the influence of length of preserved ileocecum on the efficacy of laparoscopic subtotal colectomy antiperistaltic cecorectal anastomosis (LSCACRA) in treating slow transit constipation (STC).</p><p><b>METHODS</b>Clinical data of 81 STC patients who received LSCACRA between April 2007 And December 2011 in the 150th Center Hospital of PLA were continuously collected. Patients were divided into two groups: 10 cm to 15 cm ascending colon preserved above ileocecal junction(10-15 cm group, n=41), and 2 cm to 3 cm ascending colon preserved above ileocecal junction (2-3 cm group, n=40). The Wexner constipation scale (WCS), Wexner incontinence scale(WIS), gastrointestinal quality of life index(GIQLI), abdominal pain intensity scale(NRS), abdominal pain frequency scale and abdominal bloating frequency scale in the two groups were determined and compared before and 6, 12, 24 months after operation.</p><p><b>RESULTS</b>No postoperative incontinence was found in all the patients. There were no significant differences in evacuation frequency between two groups at 6th and 12th month after surgery (all P>0.05). Two years after operation, barium enema emptying time examination revealed 2-3 cm group was (17.7±9.5) h, which was remarkably shorter than (21.2±20.7) h in 10-15 cm group (P=0.011). The WCS, GIQLI, NRS and abdominal pain frequency scale of two groups were improved obviously at 6th, 12th and 24th month after surgery (all P<0.01). Above parameters in 2-3 cm group were superior to 10-15 cm group (all P<0.01), but abdominal bloating frequency scale was not significantly different between the two groups (P>0.05). As compared with before operation, NRS in 2-3 cm group 6, 12, 24 months after operation reduced remarkably (all P<0.01), but did not improve obviously in 10-15 cm group (P>0.05).</p><p><b>CONCLUSION</b>The shorter length of ascending colon preserved above ileocecal junction can improve the efficacy of LSCACRA in the treatment of STC and the prognosis of patients. Two to three cm length of ascending colon preserved above the ileocecal junction should be recommended.</p>

Adición de subsalicilato de Bismuto a la terapia triple erradicadora de la infección por Helicobacter pylori: efectividad y efectos adversos / Addition of Bismuth subsalicylate to triple eradication therapy for Helicobacter pylori infection: efficiency and adverse events

Determinar la eficacia y los efectos adversos de la adición del Subsalicilato de bismuto a la terapia triple en la erradicación de la infección del Helicobacter Pylori. Materiales y métodos: Estudio experimental controlado doble ciego. Se trabajó con 54 pacientes con diagnóstico de Helicobacter Pylori atendidos entre febrero-marzo 2012. El grupo experimental tuvo 29 pacientes a los que se les agregó subsalicilato de bismuto, a la terapia triple convencional y 24 pacientes a los que se añadió placebo. Resultados: La edad promedio fue 47 +/- 14,9 años, el 66,7% fueron mujeres. Se realizó test de aliento en ambos grupos para el control post tratamiento, obteniendo un test de aliento negativo en el 89.7% en el grupo de estudio y 80% en el grupo placebo (p=0,319). Los efectos adversos de los pacientes que recibieron tanto subsalicilato de Bismuto como aquellos que fueron tratados con Placebo fueron: diarrea en ambos grupos (10,3% primer grupo y 16% en el segundo grupo) p=0,537, Heces oscuras 37,9% en el primer grupo mientras que en el segundo grupo no hubo este tipo de consecuencia, (p=0,001). El dolor abdominal se presentó en el 20,7% del primer grupo y en el 52% del segundo grupo (p=0,016). Las náuseas se presentaron solo en el 3% del grupo placebo. (p=0,055). Conclusiones: No se encontró diferencias estadísticas con la adición de Bismuto al esquema de la terapia triple para erradicar el Helicobacter Pylori Comparado con placebo. (p=0,319).Los efectos adversos fueron menores en el grupo que recibió bismuto...

To establish the efficiency and adverse effects of the addition of bismuth subsalicylate to triple eradication therapy for Helicobacter pylori infection. Material and methods: Double blind controlled experimental trial. The study population consisted of 54 patients with Helicobacter pylori infection: 29 were allocated to the experimental group, who received the usual triple plus bismuth subsalicylate therapy, and 24 received the triple therapy plus placebo. Results: The average age was 47+/-14.9 years, 66.7% of the patients were women. Both groups underwent the breath test: it was negative in 89.7% of the patients from the experimental group and 80% of the patients from the placebo group (p=0.319). The adverse events of both groups were: diarrhea (10.3% in the experimental group vs 16% in the placebo group; p=0.537), dark feces (37.9% in the experimental group vs 0% in the placebo group; p=0.001), abdominal pain (20.7% in the experimental group vs 52% in the placebo group; p=0.016). Nausea only were present in 3% of the patients of placebo group p=0.055). Conclusions: The association of bismuth subsalicylate to the triple therapy scheme for the erradication of Helicobacter pylori was effective in 89.7% of patients, whereas 80% of efficiency was obtained in the placebo group (p=0.319). The adverse events were lesser in the experimental group...

Antidiarrhoeal evaluation of rhizomes of Cryptocoryne spiralis Fisch. ex Wydler: Antimotility and antisecretory effects.

The antidiarrhoeal activity of Cryptocoryne spiralis rhizomes extract (250, 500, 750 mg/kg, po) was evaluated using faecal excretion, castor oil-induced diarrhoea, small intestinal transit, intestinal fluid accumulation, gastric emptying and PGE2 induced enteropooling models in rats. In addition, various biochemical estimations, histopathological studies and antibacterial evaluations on strains responsible for diarrhoea were also performed. The results illustrated a significant reduction in normal faecal output rate after 5th and 7th h of treatment, while castor oil-induced diarrhoea model depicted a protection of 55.44% at same dose level from diarrhoea. The other models except, gastric emptying test demonstrated more pronounced effect at same dose level. A significant inhibition in nitric oxide, increase in carbohydrates, protein, DNA, Na+ and K+ level with minimum degeneration of colonic fibrous tissues and potent antibacterial activity were also observed. The antidiarrhoeal potential of C. spiralis may be as a result of antimotility and antisecretory type effect mediated through nitric oxide pathway.

Medicinal potential of Passiflora foetida L. plant extracts: biological and pharmacological activities / 中西医结合学报

<p><b>OBJECTIVE</b>To investigate analgesic, antidiarrhoeal and cytotoxic activities of the ethanol extract of Passiflora foetida L. (Passifloraceae) by three experimental methods.</p><p><b>METHODS</b>Analgesic activity of the ethanol extract of Passiflora foetida L. (EEPF) acetic acid-induced writhing inhibition in mice. The method of castor oil-induced diarrhoea in mice was utilized to evaluate antidiarrhoeal activity. The cytotoxic activity of EEPF was explored with a brine shrimp lethality bioassay.</p><p><b>RESULTS</b>The extract showed 68.75% and 30.00% inhibition of writhe at the doses of 500 and 250 mg/kg body weight, respectively. The extract increased the mean latent period prior to diarrhoeal onset to about 1.55 h and 1.17 h, and decreased the mean number of stools to 4.4 and 5.6 at the doses of 500 and 250 mg/kg body weight. The extract also demonstrated cytotoxic activity in the brine shrimp lethality assay, and the median lethal concentration for brine shrimp nauplii was 80 μg/mL.</p><p><b>CONCLUSION</b>The results suggest that the plant extract has analgesic and antidiarrhoeal activities, supporting its uses in traditional medicine. The results also demonstrate that the plant extract possesses cytotoxic activities.</p>

Antidiarrhoeal, anti-inflammatory and analgesic activities of Symplocos racemesa roxb. Bark

The antidiarrheal activity of the drug Symplocos racemosa was performed in-vivo on isolated rabbit intestine. The effects of crude extract and fractions were observed at different doses. The overall response of the crude extract on isolated tissue of rabbit intestine was decreased in the tone of smooth muscle. Further studies were carried out on different fractions [ethylacetate, chloroform, n-butanol and aqueous] of crude extract of S. racemosa. The standard drugs were also used for further screening of the fractions of S. racemosa. Hot plate, writhing test, formalin test and carrageenan-induced paw edema in mice and rats were performed for determination of analgesic and anti-inflammatory activities respectively on S. racemosa bark extract. The results exhibited significant anti-inflammatory and analgesic effect at 300 and 500mg/kg doses

Perceptions regarding oral rehydration solutions for the management of diarrhea in Guatemalan children: implications for diarrheal management in the Americas / Ideas con respecto a las soluciones de rehidratación oral en el tratamiento de la diarrea de los niños guatemaltecos: repercusiones sobre el tratamiento de la diarrea en las Américas

OBJECTIVE: To describe knowledge and perceptions regarding the use of oral rehydration solution (ORS) for the management of diarrheal diseases among formal and informal health care providers and community caregivers in the Guatemalan department of Santa Rosa, and to recommend strategies to increase ORS use for management of diarrhea in children. METHODS: From July to September 2008, in-depth, semi-structured interviews were conducted with formal health care providers; open-ended interviews were conducted with informal health care providers; and focus group discussions and pile sorting were carried out with community caregivers. RESULT: The study participants attributed episodes of diarrhea in children to culturally recognized or folk ailments (empacho, cuajo, and varillas) that are primarily treated by traditional healers. There were knowledge deficits about 1) dehydration as a manifestation of diarrhea, and 2) management of dehydration, including the use of ORS and the need to continue feedings during diarrheal episodes. Caregivers perceived bottled/ready-made ORS products and the more expensive over-the-counter antidiarrheal medications as superior to ORS packets in the treatment of diarrhea. CONCLUSIONS: In Guatemala, folk etiologies of disease differ from those of the biomedical establishment and influence the decisions made by caregivers when treating ill children, including those related to the use of ORS. Public health campaigns addressing the treatment and management of diarrheal diseases in Santa Rosa should recognize the ailments known as empacho, cuajo, and varillas and target them for ORS use by community caregivers as well as health care providers in both the formal and informal health sectors.

OBJETIVO: Describir los conocimientos y las ideas que tienen las personas que prestan atención de salud en el sector convencional, el sector no convencional y los cuidadores de la comunidad con respecto al uso de las soluciones de rehidratación oral en el tratamiento de las enfermedades diarreicas, en el departamento guatemalteco de Santa Rosa y recomendar estrategias encaminadas a aumentar la utilización de estas soluciones en el tratamiento de la diarrea en los niños. MÉTODOS: De julio a septiembre del 2008 se llevaron a cabo entrevistas exhaustivas semiestructuradas a los profesionales de salud y entrevistas con preguntas abiertas a los proveedores no convencionales de atención sanitaria y se organizaron debates en grupos de opinión y ejercicios de ordenamiento de tarjetas con los cuidadores de la comunidad. RESULTADOS: Los participantes en el estudio atribuyeron la causa de los episodios de diarrea en los niños a dolencias culturalmente aceptadas o populares (empacho, cuajo y varillas), que tratan principalmente los curanderos. Se observaron deficiencias en los conocimientos acerca de 1) la deshidratación como una manifestación de la diarrea y 2) el tratamiento de la deshidratación, incluido el uso de las soluciones de rehidratación oral y la necesidad de continuar la alimentación durante los episodios diarreicos. Los cuidadores consideraron las soluciones de rehidratación embotelladas o preparadas y los medicamentos antidiarreicos de venta libre, que son más costosos, como mejores opciones para el tratamiento de la diarrea que las soluciones de rehidratación oral. CONCLUSIONES: En Guatemala, el concepto popular y el de las instituciones biomédicas sobre la causa de las enfermedades es diferente e influye sobre las decisiones que toman los cuidadores al tratar a los niños enfermos, por ejemplo, las relacionadas con el uso de soluciones de rehidratación oral. Las campañas de salud pública que abordan el tratamiento y el manejo de las enfermedades diarreicas en Santa Rosa deben incorporar las dolencias conocidas como empacho, cuajo y varillas y fomentar el uso de las soluciones de rehidratación oral en estos casos, por parte de los cuidadores de la comunidad, los profesionales de salud del sector convencional y los proveedores de atención del sector no convencional.

Hojas de Psidium guajava L / Psidium guajava L. leaves

Introducción: la especie Psidium guajava L., se utiliza tradicionalmente como antidiarreico. Los pacientes rechazan la tintura 20 por ciento en las diarreas por su sabor desagradable. Objetivo: evaluar el estado del arte en la utilidad de los extractos de las hojas de esta especie. Métodos: se realizó una extensa revisión en bases de datos internacionales. Se revisaron las bases HighWire, DOAJ, EBSCO, Scielo, Scopus, Chemical abstract, Medline, PudMed, Pharmaceutical Abstract entre los años 1753 y 2012. Resultados: se reporta la composición química y existen ensayos preclínicos y clínicos que confirman actividad antidiarreica. No se reportan efectos tóxicos. Existen pocas formas farmacéuticas para esta especie. Conclusiones: las hojas de guayaba son inocuas. Hay que realizar más estudios para garantizar la eficacia. Se deben preparar otras variantes terapéuticas para su uso como antidiarreico

Introduction: the s Psidium guajava L. species (guava), is used traditionally as antidiarrheal. The patients reject the 20 percent tincture because of its unpleasant flavor. Objective: to evaluate the state of the art in the usefulness of the guava leaf extracts. Methods: an extensive review of the national and international databases such as HighWire, DOAJ, EBSCO, Scielo, Scopus, Chemical abstract, Medline, PudMed Pharmaceutical Abstract from 1753 to 2012. Results: the chemical composition of the guava leaves was reported. There are preclinical and clinical assays that confirm their antidiarrheal effect. No toxic effects were reported. The pharmaceutical forms of this species are limited. Conclusions: the leaves of this plant are innocuous. It is necessary to conduct more studies to guarantee the effectiveness of this species. Other therapeutic variants of this species should be prepared to use them as antidiarrheal agents

Disminución de tránsito intestinal y ausencia de toxicología aguda preclínicas de la decocción de partes aéreas frescas de Phania matricarioides (Spreng. ) Griseb / Reduction of the intestinal transit and lack of preclinical acute toxicology of decoction from Phania matricarioides (Spreng. ) Griseb fresh aerial parts

Introducción: la decocción de partes aéreas frescas de Phania matricarioides (Spreng. ) Griseb (manzanilla), se emplea tradicionalmente en Cuba para afecciones digestivas como malas digestiones y diarrea aguda simple; no se encontraron estudios de validación preclínica del efecto antidiarreico y su seguridad. Objetivos: evaluar la acción sobre el tránsito intestinal y la toxicología aguda oral y tópica en modelos preclínicos de la decocción de partes aéreas frescas de Phania matricarioides. Métodos: se colectaron las partes aéreas frescas de Phania matricarioides y se realizó decocción (30 y 50 por ciento). Se aplicó el modelo experimental: tránsito intestinal en ratones con una sola administración de la decocción al 30 por ciento en dosis de 1,0, 5,0 y 10,0 g de material vegetal/kg de peso corporal por 1 día; y en dosis de 1,0 y 5,0 g de material vegetal/kg de peso corporal por 4 días. El estudio toxicológico oral y tópico (decocción 50 por ciento) se efectuó en los modelos: clases tóxicas agudas y toxicidad dérmica aguda en ratas con dosis de 2 000 mg/kg de peso corporal e irritabilidad dérmica primaria en conejos. Resultados: la decocción administrada por 1 día no modificó de forma significativa el tránsito intestinal, la administración por 4 días disminuyó de forma significativa y dosis dependiente el tránsito intestinal (5,0 g/kg). en el estudio toxicológico no se produjo ninguna muerte, no se evidenciaron signos de toxicidad ni lesiones macroscópicas en los órganos de las ratas, el aumento de peso fue el esperado. El índice de irritación primaria reflejó 0. Conclusiones: los resultados permiten validar el efecto antidiarreico de la decocción de partes aéreas frescas de Phania matricarioides para afecciones digestivas y no clasifica como tóxico

Introduction: Phania matricarioides (Spreng. ) Griseb (chamomile) fresh aerial part decoction is traditionally used in Cuba to treat digestive disorders as upset stomach and simple acute diarrheas. However, there were no previous preclinical validation studies on the antidiarrheal effect and safety of this species. Objectives: to evaluate the action of decoction from Phania matricarioides fresh aerial parts on the intestinal transit and the oral and topical acute toxicology in preclinical models. Methods: the fresh aerial parts of this plant were harvested and decoction was obtained (30 and 50 percent). The experimental model of intestinal transit in mice, with 30 percent decoction being administrated once at doses of 1.0, 5.0 and 10.0 g of vegetal material/kg of bodyweight for one day, and at doses of 1.0 and 5.0 g/kg for 4 days, was applied. The oral and topical toxicological study (50 percent decoction) was conducted in the models acute-toxic and acute dermal toxic classes in rats at a dose of 2000 mg/kg of bodyweight and primary dermal irritability in rabbits. Results: the decoction administered for one day did not significantly change the intestinal transit, but the administration for 4 days did significantly change, depending on dose, the intestinal transit (5.0 g/kg). There was no death in the study, there were neither signs of toxicity nor macroscopic lesions in the rats' organs, whereas the weight gain behaved as expected. The index of primary irritation was null. Conclusions: the results allow validating the antidiarrheal effect of Phania matricarioides fresh aerial parts decoction on digestive disorders and it is not toxic