Protective Effect of Mormodica balsamina Leaf Extract on the Gastric Morphology of Experimental Rats Against Ethanol Induced Gastric Ulcers / Efecto Protector de los Extractos de Hojas de Mormodica balsamina en la Morfología Gástrica de Ratas Experimentales Contra Úlceras Gástricas Inducidas por Etanol

SUMMARY: Mormodica balsamina is a valuable medicinal plant that is used to treat wounds and inflammation; its leaves are also used as an antibiotic and in the treatment of stomach pain. This study was conducted to determine the anti-ulcer activity of methanolic leaf extract of Mormodica balsamina on ethanol-induced ulcer in albino rats. A total of 32 rats were used for the study. Groups I and II served as the baseline and negative controls respectively, while groups III-VII served as the test groups. Group I was untreated, while group II received 1ml/kg body weight of the vehicle (2 % DMSO). Three test groups (III - V) received methanol extracts (75 mg, 150 mg, 300 mg/kg body weight respectively) while the other three test groups (VI - VIII) received aqueous extracts (75 mg, 150mg, 300 mg/kg body weight respectively) via oral gavage for seven days prior to ulcer induction. The rats were sacrificed, stomachs excised and ulcers scored. Histological sections were produced and examined. Findings revealed that M. balsamina extracts protected the rats' gastric epithelia from ethanol induced ulceration to varying degree with the high dose (150 and 300 mg/kg) of both extracts offering the best preservation (42 % and 50 % ulcer protective index respectively) when compared to untreated animals. Histological findings correlated with calculated ulcer indices, with treated animals having less severe gastric mucosal lesions. In conclusion, extracts of M. balsamina may possess reasonable antiulcer activities in rats against ethanol induced gastric ulcer.

Mormodica balsamina es una valiosa planta medicinal que se utiliza para tratar heridas e inflamaciones; sus hojas también se utilizan como antibiótico y en el tratamiento del dolor de estómago. Este estudio se realizó para determinar la actividad antiulcerosa del extracto metanólico de hojas de Mormodica balsamina sobre la úlcera inducida por etanol en ratas albinas. Se utilizaron un total de 32 ratas para el estudio. Los grupos I y II sirvieron como referencia y controles negativos respectivamente, mientras que los grupos III-VII sirvieron como grupos de prueba. El grupo I no se trató, mientras que el grupo II recibió 1 ml/kg de peso corporal del vehículo (2% de DMSO). Tres grupos de prueba (III - V) recibieron extractos de metanol (75 mg, 150 mg, 300 mg/ kg de peso corporal respectivamente) mientras que los otros tres grupos de prueba (VI - VIII) recibieron extractos acuosos (75 mg, 150 mg, 300 mg/kg de peso corporal respectivamente) por sonda oral durante siete días antes de la inducción de la úlcera. Se sacrificaron las ratas, se extirparon los estómagos y se puntuaron las úlceras. Se realizaron y examinaron secciones histológicas. Los resultados revelaron que los extractos de M. balsamina protegieron el epitelio gástrico de las ratas de la ulceración inducida por etanol en diversos grados, y la dosis alta (150 y 300 mg/kg) de ambos extractos ofreció la mejor conservación (42 % y 50 % de índice de protección contra úlceras, respectivamente) en comparación con los animales no tratados. Los hallazgos histológicos se correlacionaron con los índices de úlcera calculados, y los animales tratados tenían lesiones de la mucosa gástrica menos graves. En extractos de M. balsamina puede poseer actividades antiulcerosas razonables en ratas contra la úlcera gástrica inducida por etanol.

Monteverdia ilicifolia: um protetor gástrico / Monteverdia ilicifolia: a gastric protector / Monteverdia ilicifolia: protector gástrico

Monteverdia ilicifolia, conhecida popularmente como espinheira-santa, é uma planta da família Celastraceae de relevante ação terapêutica devido às suas propriedades medicinais, principalmente a sua atividade gastroprotetora, possuindo efeitos comprovados sobre acidez e úlceras estomacais. Desta forma o objetivo deste trabalho foi encontrar na literatura evidências para o uso terapêutico da M. ilicifolia, como uma alternativa frente aos fármacos sintéticos disponíveis na indústria farmacêutica voltados para o tratamento de problemas estomacais. Foi utilizado no presente trabalho a base de dados Google acadêmico. Os distúrbios estomacais afetam milhares de pessoas, influenciando de forma negativa na qualidade de vida da população e gerando prejuízos ao sistema de saúde. Os fármacos com atividade sobre a secreção da acidez gástrica são as medicações mais prescritas para essas enfermidades, destacando-se os antagonistas do receptor H2 de histamina e os inibidores da bomba de prótons, amplamente utilizados para o tratamento de úlceras e gastrite. Com o tempo, esses medicamentos passaram a ser indiscriminadamente utilizados, prática que põem em risco a saúde íntegra dos pacientes, mediante aos diversos efeitos adversos que esses medicamentos podem causar. As plantas medicinais têm sido aplicadas na terapia de diversas doenças em toda a história da humanidade. Nesse contexto, a espinheira-santa surge como uma alternativa segura e eficaz para a prevenção e tratamento dessas patologias. Dentre os compostos bioativos que podem desempenhar a atividade gastroprotetora, destacam-se os taninos, triterpenos e flavonóides. Os estudos analisados demonstram que a M. ilicifolia possui relevante ação terapêutica, com potencial para substituir os fármacos usualmente empregados no tratamento de úlceras e gastrite.

The Monteverdia ilicifolia, popularly known as espinheira-santa, is a plant of the Celastraceae's family with relevant therapeutic action due to its medicinal properties, mainly its gastroprotective activity, and possesses proven effects on acidity and stomach ulcers. The aim of this work was to find in the literature evidence for the therapeutic use of M. ilicifolia, as an alternative to the synthetic drugs available in the pharmaceutical industry for the treatment of stomach problems. The academic Google database was used in this work. Stomach disorders affect thousands of people, negatively influencing the population's quality of life and causing damage to the health system. The drugs with activity on gastric acid secretion are the most prescribed medications for these diseases, especially histamine H2 receptor antagonists and proton pump inhibitors, widely used for the treatment of ulcers and gastritis. Over time, these drugs began to be used indiscriminately, a practice that jeopardizes the health of patients, due to the various adverse effects that these drugs can cause. Medicinal plants have been applied in the therapy of various diseases throughout human history. In this context, the espinheira-santa emerges as a safe and effective alternative for the prevention and treatment of these pathologies. Among the bioactive compounds that can perform a gastroprotective activity, tannins, triterpenes, and flavonoids stand out. The analyzed studies demonstrate that M. ilicifolia has relevant therapeutic action, with the potential to replace the drugs usually used in the treatment of ulcers and gastritis.

Monteverdia ilicifolia, conocida popularmente como espinheira-santa, es una planta de la familia Celastraceae de relevante acción terapéutica por sus propiedades medicinales, principalmente su actividad gastroprotectora, con efectos probados sobre la acidez y las úlceras estomacales. Así, el objetivo de este trabajo fue encontrar evidencia en la literatura para el uso terapéutico de M. ilicifolia, como alternativa a las drogas sintéticas disponibles en la industria farmacéutica destinadas al tratamiento de problemas estomacales. En este trabajo se utilizó la base de datos académica de Google. Los trastornos estomacales afectan a miles de personas, influyendo negativamente en la calidad de vida de la población y provocando daños en el sistema de salud. Los fármacos con actividad sobre la secreción ácida gástrica son los más prescritos para estas enfermedades, especialmente los antagonistas de los receptores H2 de histamina y los inhibidores de la bomba de protones, muy utilizados para el tratamiento de úlceras y gastritis. Con el tiempo, estos medicamentos comenzaron a utilizarse de forma indiscriminada, práctica que pone en riesgo la salud de los pacientes, debido a los diversos efectos adversos que estos fármacos pueden ocasionar. Las plantas medicinales se han aplicado en la terapia de diversas enfermedades a lo largo de la historia humana. En este contexto, la espinheira-santa surge como una alternativa segura y eficaz para la prevención y el tratamiento de estas patologías. Entre los compuestos bioactivos que pueden realizar actividad gastroprotectora destacan los taninos, los triterpenos y los flavonoides. Los estudios analizados demuestran que M. ilicifolia tiene una acción terapéutica relevante, con potencial para reemplazar los fármacos habitualmente utilizados en el tratamiento de úlceras y gastritis.

Antiulcerogenic effects of selected African nightshades (Solanum nigrum Linn. ) genotypes on the rat stomach: a morphologic and morphometric study / Efectos antiulcerogénicos de genotipos seleccionados de solanáceas Africanas (Solanum nigrum Linn. m) en el estómago de ratas: un estudio morfológico y morfométrico

Solanum nigrum (SLN), commonly known as African nightshade, is used as a vegetable as well as in the management and treatment of various ailments including gastric ulcers. We analyzed, both grossly and microscopically using H&E, Masson's trichrome and PSA staining methods, the protective effects of aqueous leaf extracts of three Kenyan SLN genotypes namely S. scabrum (SSB), S. sarrachoides (SSR) and S. villosum (SVL) on ethanol-induced gastric lesions in rats. There was evidence of gastro-protection by all the three genotypes with the SSB showing the highest ulcer inhibition score (76.37 %) followed by SSR (72.51 %) and SVL (63.30 %). SLN-pretreated rats showed less areas of gastric mucosal surface erosion. Additionally in the pretreated animals, the depth of the ulcers were markedly reduced, reaching only the gastric pit region except in those treated with SVL where the ulcers penetrated slightly more deeply to affect the gastric glands. Compared with controls, the mean microscopic ulcer index decreased 5.07, 3.55 and 2.37-fold in rats pretreated with SSB, SSR and SVL extracts respectively. Results of this work show extracts of the three SLN genotypes to have antiulcerogenic potential but at varied strengths, thus confirming earlier reports that phytoconstituents and hence the efficacy of a medicinal plant may be influenced by genetic factors.

Solanum nigrum (SLN), comúnmente conocida como la solanácea africana, se usa como vegetal, para el tratamiento de diversas dolencias incluyendo las úlceras gástricas. Analizamos de forma macro y microscópica, de forma macroscópica y microscópica, utilizando para ello tinciones de H&E, tricrómico de Masson y PSA los efectos protectores de extractos acuosos de hojas de tres genotipos SLN de Kenia: S. scabrum (SSB), S. sarrachoides (SSR) and S. villosum (SVL) en lesiones gástricas inducidas por etanol en ratas. Hubo evidencia de gastroprotección por parte de los tres genotipos con el SSB mostrando el puntaje más alto de inhibición de la úlcera (76,37 %) seguido de SSR (72,51 %) y SVL (63,30 %). Las ratas tratadas previamente con SLN mostraron menos áreas de erosión de la superficie de la mucosa gástrica. Además, en los animales pretratados, la profundidad de las úlceras se redujo notablemente, llegando solo a la región del fondo gástrico, excepto en aquellos tratados con SVL donde las úlceras penetraron un poco más profundamente para afectar las glándulas gástricas. En comparación con los controles, el índice medio de úlcera microscópica disminuyó 5,07, 3,55 y 2,37 veces en ratas pretratadas con extractos de SSB, SSR y SVL, respectivamente. Los resultados de este trabajo muestran que los extractos de los tres genotipos de SLN tienen potencial antiulcerogénico en diferentes concentraciones, lo que confirma informes anteriores que los fitoconstituyentes y la eficacia de una planta medicinal pueden estar influenciados por factores genéticos.

Actividad gastroprotectora, tamizaje fitoquímico y actividad atrapadora de radicales libres de Aloysia Gratissima (Verbenaceae) / Phytochemical screning, gastroprotective activity and free radical scavenging activity of Aloysia gratissima (Verbenaceae)

Se evaluó la actividad gastroprotectora de la infusión proveniente de las hojas de Aloysia gratissima (Verbenaceae), especie nativa de interés medicinal que se desarrolla en el sudoeste bonaerense, utilizando un modelo de inducción de úlceras gástricas con etanol en ratones. Se realizó un tamizaje fitoquímico para detectar la presencia de compuestos que podrían ser responsables de la actividad gastroprotectora de la planta. Se determinó el contenido de fenoles totales y la capacidad atrapadora de radicales libres mediante el método del Folin-Ciocalteu y del 2,2'-difenil-1-picrilhidrazilo (DPPH), respectivamente. Los ensayos demostraron que la infusión de la planta, administrada por vía oral en dosis de 100, 500 y 1000 mg/kg, ejerció una gastroprotección significativa frente a la inducción de úlceras. Se detectó una actividad atrapadora de radicales libres de 47,5%, similar a la sustancia de referencia (BHT). El estudio fitoquímico detectó la presencia de flavonoides y otros polifenoles, sustancias con reconocida capacidad antioxidante. Estos metabolitos ejercen efectos protectores en diferentes modelos experimentales de inducción de úlceras mediante mecanismos que pueden involucrar la neutralización de radicales libres, lo que podría explicar la actividad gastroprotectora de la planta. Estos hallazgos requieren estudios adicionales de A. gratissima como una posible terapia frente a la úlcera gástrica. (AU)

The gastroprotective activity of the infusion from the leaves of Aloysia gratissima (Verbenaceae), a native species of medicinal interest growing in South West Buenos Aires, was evaluated in an ethanol-induced gastric ulcer model in mice. Phytochemical screening was carried out in order to determine the presence of compounds that could be responsible for the pharmacological effects of the plant. Total phenolic content and the free radical scavenging activity of the plant were determined using the Folin-Ciocalteu and the 2,2'-diphenyl1-picrylhydrazyl (DPPH) method, respectively. Assays demonstrated that the infusion, orally administered at 100, 500, and 1000 mg/kg doses, exerted a significant gastroprotection effect against ulcer induction (P<0,05). A free radical scavenging activity of 47.5% -similar to the reference substance (BHT)- was detected. Phytochemical screening revealed the presence of antioxidant compounds such as flavonoids and other phenolic compounds. These compounds exert protective effects in different experimental models of ulcer induction that could involve free radical neutralization, which could explain the gastroprotective activity of the plant. These promising results support additional studies of A. gratissima as a potential therapy against gastric ulcer. (AU)

Gastroprotective and antioxidant effects of Eremurus spectabilis Bieb. methanol extract and its isolated component isoorientin on indomethacin induced gastric ulcers in rats

Abstract Purpose: To investigate the gastroprotective effect of methanol extract of E. spectabilis and its major component isoorientin. Methods: Effects of isoorientin and methanol extract of E. spectabilis were investigated in indomethacin-induced gastric damage model on rats. Famotidine was used as the standard antiulcer drug. Numerical density of ulcer areas and oxidative status were determined on stomach tissues of rats. Results: All doses of isoorientin and methanol extract decreased MDA level and increased SOD activity and GSH levels in the stomach tissue of rats. When numerical density of ulcer areas were analized, the 500 mg/kg dose of methanol extract (84%) exhibited a similar effect to 20 mg/kg dose of standart drug famotidine (87%). Conclusions: The gastroprotective effects of E. spectabilis and its major constituent isoorientin in rats for the first time. Detailed analyses suggested that potential antioxidant activity of both plant extract and isoorientin mediates the gastroprotective effect.

Ulcères gastriques et duodenaux à Cotonou: aspects épidémiologiques, cliniques, endoscopiques et thérapeutiques

L'ulcère gastrique ou duodénal (UGD) est une affection plurifactorielle. Une prévalence de 16,6% en avait été rapportée en 2005 au Bénin. Le but de notre étude est de décrire les aspects épidémiologiques, cliniques, endoscopiques et thérapeutiques des UGD observés de nos jours à Cotonou. Patients et méthodes : Il s'agissait d'une étude prospective, transversale, descriptive et analytique. Elle a colligé du 1er octobre 2015 au 30 avril 2016, tous les sujets de plus de 15 ans ayant présenté un UGD à l'endoscopie dans les services des maladies digestives de l'hôpital de Zone de Mènontin et de l'hôpital d'Instruction des Armées de Cotonou. Résultats : Sur 411 patients inclus, 30 avaient un UGD soit une prévalence de 7,3 %. Les ulcères duodénaux étaient observés chez des sujets jeunes avec un âge moyen de 38 ± 6,9 ans ; tandis que les ulcères gastriques étaient observés chez des sujets plus âgés avec un âge moyen de 58 ± 7 ans. La sex-ratio était de 2,8. Les épigastralgies étaient la principale manifestation présente dans 70% des cas. La localisation de l'ulcère était gastrique dans 36,7%, duodénale dans 53,3 %, double dans 10% des cas. Les principales causes étaient la consommation de médicaments gastro-toxiques et l'Helicobacter pylori. Les Inhibiteurs de la pompe à protons étaient prescrits dans tous les cas et l'éradication de l'Helicobacter pylori faite dans 94,7% des cas avec une évolution favorable à 2 mois de contrôle. Conclusion : la prévalence des UGD a diminué de plus de 50% en onze ans à Cotonou. L'amélioration du niveau d'hygiène et la sensibilisation contre l'automédication pourraient davantage contribuer à réduire cette prévalence

Flavonoids and anti-oxidant activity mediated gastroprotective action of leathery murdah, terminalia coriacea (roxb.) Wight & arn. Leaf methanolic extract in rats / A ação gastroprotetora antioxidante e flavonoide de extrato metanólico de folhas de Leathery Murdah, Terminalia coracea (Roxb.) Wight & Arn. em ratos

ABSTRACT BACKGROUND Leathery Murdah, Terminalia coriacea (Roxb.) Wight & Arn. from family Combretaceae is used in Ayurveda and Siddha traditional systems of medicine to heal ulcers. OBJECTIVE The present study was conducted to assess the gastroprotective effect and understand the fundamental mechanism of action of Leathery Murdah, Terminalia coriacea (Roxb.) Wight & Arn. Leaf Methanolic Extract. METHODS The test extract was screened for anti-ulcer activity by Aspirin induced ulcerogenesis in pyloric ligation and ethanol induced gastric ulcers at three doses - 125, 250, and 500 mg/kg, p.o. using Ranitidine 50 mg/kg and Misoprostol 100 μg/kg as standard drug in respective models. Seven parameters were carefully examined, that is, ulcer index, total protein, mucin, catalase, malondialdehyde, and superoxide dismutase levels and histopathology. High Performance Liquid Chromatographic - Ultra Violet profiling and Liquid Chromatography - Mass Spectral analysis of crude Terminalia coriacea leaves methanolic extract were carried out as a part of chemical characterization to identify bioactive compounds. RESULTS All the test doses exhibited significant gastroprotective function, particularly the higher doses demonstrated improved action. The results revealed a significant increase in the levels of catalase, superoxide dismutase, and Mucin with reduction in ulcer index, the levels of total protein, and malondialdehyde. Histopathological observations also illustrated the gastroprotective effect of Terminalia coriacea leaves methanolic extract. CONCLUSION Terminalia coriacea leaves methanolic extract exhibited strong anti-oxidant and anti-secretory activities mediated gastroprotection besides inducing the gastric mucosal production. The observed pharmacological response can be attributed to the flavonoidal compounds namely - Quercetin-3-O-rutinoside, Luteolin-7-O-glucoside, Myricetin hexoside, Quercetin-3-O-glucoside, Isorhamnetin-3-O-rhamnosylglucoside and Isorhamnetin-3-O-glucoside identified in the extract for the first time with High Performance Liquid Chromatographic - Ultra Violet and Liquid Chromatography - Mass Spectral analysis.

RESUMO CONTEXTO Leathery Murdah, Terminalia coriacea (Roxb.) Wight & Arn. da família Combretaceae é usada nos tradicionais sistemas da medicina Ayurveda e Siddha para cicatrização de úlceras. OBJETIVOS O presente estudo foi realizado para avaliar o efeito gastroprotetor e para esclarecer o mecanismo fundamental da ação do extrato metanólico de folhas de Leathery Murdah, Terminalia coracea (Roxb.) Wight & Arn. MÉTODOS O extrato teste foi testado para ação antiulcerogênica induzida pela Aspirina através da ligação pilórica e úlceras gástricas induzidas por etanol em três doses - 125, 250 e 500 mg/kg, via oral, utilizando-se Ranitidina 50 mg/kg e Misoprostol 100 μg/kg como drogas padrão nos respectivos modelos. Sete parâmetros foram cuidadosamente analisados tais como índice ulcerogênico, níveis de proteínas totais, de mucina, de catalase, de malondialdeído e de superoxido dismutase, além da histopatologia. A análise do perfil espectroscópico pela Cromatografia Líquida de Alta Eficiência - Ultravioleta e análise crua pela Cromatografia Líquida - Espectrometria de Massas foram realizadas como parte da caracterização química para identificar os componentes bioativos. RESULTADOS Todas as doses utilizadas exibiram função gastroprotetora, em particular as doses mais elevadas. Os testes revelaram aumentos significantes de catalase, superóxido dismutase e mucina, com diminuição do índice ulcerogênico, dos níveis de proteínas totais, e de malondialdeído. As observações histopatológicas também ilustraram o efeito gastroprotetor do extrato metanólico de folhas de Terminalia coracea. CONCLUSÃO O extrato metanólico de folhas de Terminalia coracea mostrou forte atividade antioxidante e antissecretória além de induzir a produção de mucosa gástrica. A resposta farmacológica observada pode ser atribuída aos compostos flavonoides denominados Quercetin-3-O-rutinosideo, Luteolin-7-O-glucosideo, Myricetin hexosideo, Quercetin-3-O-glucosideo, Isorhamnetin-3-O-rhamnosylglucosideo e Isorhamnetin-3-O-glucosideo, identificados no extrato pela primeira vez pelas análises de Cromatografia Líquida de Alta Eficiência - Ultravioleta e Cromatografia Líquida - Espectrometria de Massas.

Mecanismos de ação relacionados à atividade antiúlcera de Kalanchoe pinnata (Lam.) Pers. (Crassulaceae) / Mechanisms of action underlying antiulcer activity of Kalanchoe pinnata (Lam.) Pers. (Crassulaceae).

Kalanchoe pinnata (Lam.) Pers. (Crassulaceae) é uma espécie muito empregada na medicina tradicional no Brasil e em outras partes do mundo, especialmente Índia, países da África e China. É indicada popularmente para diversos fins incluindo o tratamento de úlceras gástricas. A análise fitoquímica revelou a presença de vários constituintes, em especial os flavonoides. O tratamento de úlcera gástrica convencional apresenta diversos efeitos colaterais e, na maioria das vezes, não evita a recidiva da lesão. Dessa maneira, é interessante encontrar uma terapêutica mais segura e efetiva. Com o objetivo de avaliar a segurança, foi realizado ensaio de citotoxicidade do extrato bruto, in vitro, com valor de IC50 igual a 0,926 mg/mL, sendo possível predizer um valor de LD50 (1341,46 mg/kg). Já em relação ao ensaio de citotoxicidade, in vitro, da fração acetato de etila não foi encontrado um valor de IC50. Resultados de fototoxicidade, in vitro, mostraram que o extrato bruto e fração acetato de etila de K. pinnata não possuem potencial fototóxico. A contagem microbiana na droga vegetal para bactérias aeróbias/mesófilas foi de 6,9 x 104 UFC/g e a contagem de bolores e leveduras foi de 2,4 x 103 UFC/g, ambos valores dentro do limite estabelecido pela OMS. Análise de endotoxinas também foi realizada para o extrato bruto (<4,0.105 UE/kg) e fração acetato de etila (<2,7.105 EU/kg) de K. pinnata. Referente à fitoquímica, diversos flavonoides foram identificados no extrato bruto e fração acetato de etila de K. pinnata. Paralelamente ao estudo fitoquímico foi verificado que a atividade gastroprotetora do extrato bruto envolve a ação das prostaglandinas e grupamentos sulfidrila. Já o mecanismo de gastroproteção da fração acetato de etila é dependente de prostaglandinas e óxido nítrico. A atividade cicatrizante do extrato bruto de K. pinnata também foi avaliada. De acordo com os resultados macroscópicos, as doses de 200mg/kg e 400 mg/kg reduziram a área de lesão, com uma taxa de 33% e 39%, respectivamente, após 7 dias de tratamento (p<0,05). Análise histológica dos grupos tratados com o extrato bruto (200 e 400 mg/kg) indicou melhor recuperação da lesão, verificada pela regeneração da mucosa gástrica e pelo restabelecimento da arquitetura glandular. As enzimas antioxidantes (catalase, superóxido dismutase e glutationa peroxidase) e a expressão de VEGF foram avaliadas no mecanismo de cicatrização de úlceras gástricas. Os resultados mostraram que a atividade antiulcerogênica foi mediada pela ação antioxidante da enzima SOD. Não foi evidenciado in vivo o aumento da expressão de VEGF e nem o sequestro do radical peroxil nos animais tratados com o extrato bruto. Os resultados dos ensaios in vitro (ORAC) mostraram uma maior capacidade de sequestro de radicais peroxil da fração acetato de etila (1192,35 ± 112,61 µmol equivalente de Trolox/g de amostra seca) quando comparado com o extrato bruto (431,32 ± 7,17 µmol equivalente de Trolox/g de amostra seca). A atividade anti Helicobacter pylori também foi avaliada, no entanto, o extrato bruto não apresentou atividade anti H.pylori. Ademais, o extrato bruto demonstrou um potencial anti-inflamatório, pois foi observada uma redução nos níveis de TNF-α e L-selectina, após o tratamento em neutrófilos estimulados com LPS. Analisando os resultados sugere-se que K. pinnata possui um potencial terapêutico no combate de úlceras gástricas e possivelmente, anti-inflamatório, sendo que os flavonoides podem estar relacionados com o efeito biológico observado.

Kalanchoe pinnata (Lam.) Pers. (Crassulaceae) is a commonly used species in traditional medicine in Brazil and in other parts of the world, especially India, Africa and China, for the treatment of various diseases, including gastric ulcers. Phytochemical analysis revealed the presence of several constituents in this plant, especially flavonoids. The available pharmaceutical products to treat peptic ulcer have several side effects and, in most cases, do not prevent recurrence of the gastric lesions. Therefore, it is important to find a safer and more effective therapy. In order to evaluate safety, the in vitro cytotoxicity assay of crude extract from K. pinnata was performed. The IC50 value was 0,926 mg/mL corresponding to LD50 value (1341, 46 mg/kg). It was not determined IC50 value in vitro cytotoxicity assay for ethyl acetate fraction from K. pinnata. Neither the crude extract nor ethyl acetate fraction from K. pinnata showed phototoxicity. Microbial counting was performed on the K. pinnata-based drug in order to investigate microbiological contamination. The microbial count for aerobic / mesophilic bacteria was 6.9 x 104 CFU/g, and yeast count was 2.4 x 103 CFU/g, both values in agreement with the limits established by WHO. Endotoxin analysis was also performed for the crude extract (<4,0.105 UE/kg) and for ethyl acetate fraction (<2,7.105 UE/kg) from K. pinnata. In the phytochemical analysis several flavonoids were identified in the crude extract and ethyl acetate fraction of K. pinnata. In parallel to the phytochemical study, it was verified that the gastroprotective activity of the crude extract of K. pinnata involved prostaglandins and sulfhydril compounds. On the other hand, the mechanism of gastroprotection of the ethyl acetate fraction of K. pinnata is dependent on prostaglandins and nitric oxide. The healing activity of the crude extract of K. pinnata was also evaluated. According to the macroscopic results the dose of 200 mg/kg and 400mg/kg reduced the injury area, with a rate of 33% and 39%, respectively, after 7 days of treatment (p <0.05). Histological analysis showed regeneration of the gastric mucosa and re-establishment of the glandular architecture in groups treated with the crude extract (200 and 400 mg/kg). Antioxidant enzymes (catalase, superoxide dismutase and glutathione peroxidase) and VEGF expression were evaluated in the mechanism of gastric ulcer healing. The results showed that the antiulcerogenic activity was mediated by SOD. It was not demonstrated an increase in VEGF expression and nor in the in vivo sequestration of the peroxyl radical in the animals treated with crude extract. The results of in vitro assay (ORAC) showed a greater sequestering of peroxyl radical to the ethyl acetate fraction (1192,35 ± 112,61 µmol equivalent of Trolox/g of ethyl acetate fraction) when compared to the crude extract (431,32 ± 7,17 µmol equivalent of Trolox/g of crude extract) of K. pinnata. The anti Helicobacter pylori activity was also evaluated; however, the crude extract did not show anti H. pylori activity. However, the crude extract of K. pinnata demonstrated an anti-inflammatory potential, because TNF-α and L-selectin levels were reduced after treatment in LPS-stimulated neutrophils. The analysis of the results suggests that K. pinnata has a therapeutic potential against gastric ulcers and possible anti-inflammatory properties, and the flavonoids may be linked to the biological effect.

Therapeutic effect of low molecular weight chitosan containing sepia ink on ethanol-induced gastric ulcer in rats

ABSTRACT PURPOSE: To evaluate the role of low molecular chitosan containing sepia ink (LMCS) in ethanol-induced (5 ml/kg) gastric ulcer in rats. METHODS: Animals were divided into four groups (n = 12): normal group (Normal), negative control group (Con), experiment group (LMCS) and positive control Omeprazole group (OMZ). Gastric empty rate was detected in the first 7 days. Rats were sacrificed at 7, 14 and 21 day for histology and ELISA detections. RESULTS: Gastric empty was no significant differences among the groups (P > 0.05). Histological observation showed gastric mucosal LMCS treated had better healing effect. Hydroxyproline (Hyp) was significantly increased from 7 day (P < 0.05). LMCS significantly inhibited malondialdehyde (MDA) generation for lipid peroxidation from 7 day (P < 0.05). LMCS significantly promoted the activity of superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx) at the earlier stage (P < 0.05). OMZ had the similar effects above. As for myeloperoxidase (MPO), LMCS significantly decreased and restored it to normal levels from 7 day (P < 0.05), it is earlier than OMZ which is from 14 day. CONCLUSION: LMCS can improve gastric mucosa tissue repair, exert significant influences on oxidative and antioxidant enzyme activities and neutrophil infiltration.

Úlcera gástrica perforada ¿qué camino a seguir?: presentación de un caso y revisión de la literatura / Gastric ulcer perforated which path to follow?: report of a case and review of the literature

OBJETIVO: exponer un caso de ulcera gástrica perforada, clasificación, medios diagnóstico-terapéutico; resultados inmediatos, y repercusiones a largo plazo. SEDE: Hospital Municipal Los Pinos, Segundo Nivel La Paz, Bolivia DISEÑO: presentación de caso clínico INTRODUCCIÓN: la úlcera gástrica es pérdida circunscrita de tejido, se produce en áreas lábiles expuestas al jugo gástrico CASO CLÍNICO: paciente femenino de 78 años, realizado estudios imagenologicos y laboratoriales, evidencia cuadro compatible con ulcera gástrica perforada. Se realizó resección de bordes de la ulcera para biopsia, ulcerorrafia y parche de epiplón. El reporte patológico fragmentos de mucosa gástrica compatible con metaplasia intestinal e hiperplasia regenerativa atípica. Se solicita endoscopia digestiva alta informa: gastritis erosiva y biopsia para H. Pylori (+). Se inicia tratamiento para erradicación, nuevo control endoscópico el cual es normal y biopsia para H. Pylori (-). DISCUSIÓN: estudios básicos; como radiografía de tórax o abdomen mantienen vigencia en el diagnóstico de esta entidad. La cirugía puede ser por vía abierta o laparoscópica pero el estado clínico y la enfermedad comorbida dictan que procedimiento seguir; además debe erradicarse el H. pylori, porque se asocia en 70% a la úlcera gástrica.

OBJECTIVE: to present a case of gastric ulcer perforated classification, therapeutic means; immediate results and long-term impact. VENUE: Municipal Hospital Los Pinos, second level La Paz, Bolivia DESIGN: presentation of clinical case INTRODUCTION: gastric ulcer is circumscribed tissue loss, occurs in labile areas exposed to gastric juice clinical case: 78-year-old female patient, imaging and laboratory, evidence box compatible with gastric ulcer perforated. Held resection of edges of the ulcer for biopsy, suture of ulcer and patch of omentum. The report compatible with intestinal metaplasia and regenerative hyperplasia, atypical gastric mucosa pathological fragments. Apply for upper endoscopy reports: erosive gastritis and biopsy for H. Pylori (+). Begins treatment for eradication, new endoscopic control which is normal and biopsy for H. Pylori (-). DISCUSSION: basic studies; as x-ray of thorax or abdomen remains effective in the diagnosis of this entity. Surgery can be open or laparoscopic but clinical status and disease mobility dictate that procedure followed, also must be eradicated H. pylori, because he is associated gastric ulcer in 70%.

Zinc-Induced Gastric Ulcer: Case Report on Two Patients with Wilson’s Disease.

Zinc has been developed as an effective and nontoxic therapy in Wilson’s disease. Zinc salts are generally well tolerated. Mild gastrointestinal discomfort is the major observed side effect and may be dependent on the zinc salt employed. Here, we report two Wilson’s disease patients who presented with severe gastric ulceration few months after beginning treatment with zinc acetate 50 mg three times a day. Our patients were not taking any ulcerogenic drugs and had no evidence of Helicobacter pylori infection. In both patients, zinc acetate was replaced by penicillamine and proton pump inhibitor therapy was initiated with complete resolution of gastrointestinal symptoms. To our knowledge, this is the first report of zinc acetate-induced gastric ulceration, which should be looked for in Wilson’s disease patients who develop abdominal discomfort while on this drug.

Anti-ulcer actviity of leguminosae plants / Atividade anti-úlcera de plantas leguminosas

Context Ulcer is the most common gastrointestinal disturbance resulting from an inadequate gastric mucosal defense. Several drugs are available in the market to address the disease; however, these drugs are associated with unnecessary side effects. Objectives Previous research have confirmed the efficacy of plant extracts for possible treatment of the disease. This research aims to evaluate the anti-ulcer properties of medicinal plants. Methods Methanol extracts from the leaves of Intsia bijuga, Cynometra ramiflora, Tamarindus indica, Cassia javanica, Cassia fistula, Bauhini purpurea, Senna spectabilis, Senna siamea and Saraca thaipingensis were evaluated for their anti-ulcer activity using HCl-ethanol as ulcerogen. Results All extracts showed inhibitory activity with I. bijuga, T. indica, S. spectabilis and S. thaipingensis exhibiting more than 50% inhibition. S. thaipingensis showed the highest activity at 80%. S. spectabilis and S. thaipingensis were partitioned further into hexane, ethyl acetate and aqueous fractions. The aqueous and ethyl acetate fractions of S. spectabilis showed significant increased in its activity while the hexane and ethyl acetate fractions of S. thaipingensis gave higher activity than its aqueous portions. Conclusions We conclude that plant extracts are potential sources of new anti-ulcer agents. .

Contexto A úlcera é o distúrbio gastrointestinal mais comum que resulta de uma inadequada defesa da mucosa gástrica. Vários medicamentos estão disponíveis no mercado para tratar a doença, no entanto, estas drogas podem se associar a efeitos colaterais desnecessários. Objetivos Pesquisas anteriores confirmaram a eficácia de extratos de plantas como possível tratamento da doença. Esta pesquisa teve como objetivo avaliar as propriedades anti-úlcera de plantas medicinais. Métodos Extratos alcoólicos das folhas da Intsia bijuga, Cynometra ramiflora, Tamarindus indica, Cassia javanica, Cassia fistula, Bauhini purpurea, Senna spectabilis, Senna siamea e Saraca thaipingensis foram avaliados pela sua atividade anti-úlcera usando o HCl-etanol como ulcerogênico. Resultados Todos os extratos apresentaram atividade inibitória; I.bijuga, T. Índica, S. spectabilis e S. thaipingensis mostraram mais de 50% de inibição. A S. thaipingensis mostrou a maior atividade, atingindo 80%. S. spectabilis e S. thaipingensis foram divididos mais em hexano, acetato de etila e frações aquosas. As frações aquosas e acetato de etila de S. spectabilis mostraram aumento significativo em sua atividade, enquanto que as frações hexano e acetato de etila de S. thaipingensis resultaram em maior atividade do que em partes aquosas. Conclusões Pode-se concluir que os extratos vegetais são fontes potenciais de novos agentes anti-úlcera. .

Gastroprotective Activity of Methanol Leaves Extract of Barleria prionitis Linn. on Ethanol and Indomethacin Induced Ulcer in Rats.

Aims: Barleria prionitis L. (Family Acanthaceae) is a medicinal plant found road side in India and whole plant or its various parts like leaves, root, bark, stem and flowers are used traditionally for various treatments like toothache, inflammation, boils, glandular swellings and ulcer. Leaf juice is useful in gastric ulcer. Here, we attempt to prove the use of this plant as gastroprotective agent. Study Design: This study was conducted to evaluate the antiulcer activity of methanol extract obtained from the leaves of Barleria prionitis Linn. Place and Duration of Study: The experiments were conducted at Pharmacology lab of Institute of Pharmaceutical Sciences, Kurukshetra University during the period of July 2012 to December 2012. Material and Methods: Antiulcer activity was performed using the protocols of ulcer induced by ethanol and indomethacin at two different doses (250 and 500mg/kg). Parameters like volume of gastric juice, pH, free acidity, total acidity, aspartate amino transferase (AST) and alanine amino transferase (ALT) were also determined in ethanol induced ulcer model. Results: The reduction in ulcer index in Barleria prionitis treated animals was found to be statistically significant (P=.05), when compared with control groups in both the models. Significant changes were observed in total acidity only at dose 500mg/kg only and changes were significant in AST, ALT levels at both the doses. Other parameters showed non-significant results. Conclusion: The results of the present study show that the methanolic extract of Barleria prionitis L. possess antiulcer activity. This work supports the traditional use of this plant in treating gastric ulcer.

Estudo comparativo da atividade antiinflamatória, ulcerogênica e citotóxica do S-ibuprofeno e ibuprofeno racêmico / Comparative study of anti-inflammatory, ulcerogenic and cytotoxic activities of racemate and S-ibuprofen

Ibuprofen is widely commercialized in racemic form. Although metabolic chiral inversion occurs through the conversion of R(-)-ibuprofen to S(+)-ibuprofen and the latter enantiomer is considered the active form, clinical trials involving the administration of a racemate to S-enantiomer dosage ratio of 1:0.5 have demonstrated that S(+)-ibuprofen is as efficacious as the racemic formulation. Moreover, the R(-)-enantiomer has been implicated in adverse gastrointestinal effects found with the racemic form, but the mechanisms involved in this process are not yet fully understood. The aim of the present study was to evaluate the anti-inflammatory activity of a racemate to S(+)-ibuprofen dosage ratio of 1:0.5 using the carrageenan air pouch model of inflammation and determine both ulcerogenic activity and the chiral conversion rate in rats. An in vitro study of the cytotoxicity of racemate and S(+)-ibuprofen in gastric cells was also performed. Although the plasma level of S(+)-ibuprofen was raised after racemate administration, no significant difference was found in anti-inflammatory activity, as assessed by exudate formation, PGE2 production and leukocyte migration to the air pouches. Fewer gastric lesions were found after S(+)-ibuprofen administration, despite the low gastric PGE2 content. In the in vitro study, the racemic compound proved more cytotoxic than S(+)-ibuprofen. The present findings suggest that the S-enantiomer of ibuprofen could be considered a therapeutic alternative to minimize gastrointestinal side effects, since the chiral inversion of R(-)-ibuprofen to S(+)-ibuprofen did not result in an improved anti-inflammatory response.

O Ibuprofeno é normalmente comercializado na forma racêmica. Embora ocorra inversão quiral convertendo a forma R(-)- em S(+)-ibuprofeno e, a última seja considerada a forma ativa, a administração da proporção 1:0,5 (racemato: S-enantiômero) demonstrou que o S(+)-ibuprofeno é mais eficaz que a formulação racêmica. Adicionalmente, o R(-)-enantiômero está envolvido nos efeitos adversos gastrintestinais descritos para a formulação racêmica, embora os mecanismos não sejam complemente compreendidos. O objetivo deste estudo foi avaliar a atividade antiinflamatória da proporção 1:0,5 (racemato:S-ibuprofeno) utilizando o modelo experimental de bolsa de ar, a atividade ulcerogênica e a taxa de conversão quiral em ratos. Também estudamos in vitro, a citotoxicidade provocada pelo racemato e S(+)-ibuprofeno em células gástricas. Embora os níveis plasmáticos de S(+)-ibuprofeno tenham aumentado após a administração do racemato, a atividade antiinflamatória avaliada pela formação de exsudato, produção de PGE2 e migração de leucócitos para a bolsa de ar não foram diferentes. As lesões gástricas foram reduzidas após a administração de S(+)-ibuprofeno, apesar da inibição de PGE2 gástrica. In vitro, o composto racêmico foi mais citotóxico que o S(+)-ibuprofeno. Nossos resultados sugerem que o S-enantiômero do ibuprofeno pode ser considerado uma alternativa terapêutica visando a redução dos efeitos colaterais gastrintestinais, visto que a inversão quiral do R(-)- para o S(+)-ibuprofeno não resultou em melhora do efeito antiinflamatório observado.

Evaluation of antiulcerogenic activity of aqueous extract of Brassica oleracea var. capitata (cabbage) on Wistar rat gastric ulceration / Avaliação da atividade antiúlcera do extrato aquoso de Brassica oleracea var. capitata (repolho) em úlceras gástricas de ratos Wistar

CONTEXT: The cabbage (Brassica oleraceae var. capitata) is an herbaceous and leafy plant which belongs to the Brassicaceae family, native to coastal southern and Western Europe. Used in cooking for its nutritional value also has known anti-inflammatory activity. OBJECTIVE We studied the antiulcerogenic activity of aqueous extract of Brassica oleracea var. capitata (AEB) in order to validate ethnobotanical claims regarding the plant use in the gastric disorders. METHOD: Acute gastric ulcers were induced in rats by the oral administration of acetylsalicylic acid. The gastroprotective potential of the AEB (0.250, 0.500 and 1.000 mg.kg-1/body weight) was compared with omeprazole (20 mg.kg-1/body weight). RESULTS: The stomach analysis indicated that treatment with AEB inhibited the gastric damage. The gastroprotective activity as evidenced by its significant inhibition in the formation of ulcers induced by chemical agent with a maximum of 99.44 percent curation (250 mg.kg-1 body weight) in acetylsalicylic acid-induced ulcers. CONCLUSIONS: The AEB demonstrated good antiulcerogenic activities which justify the inclusion of this plant in the management of gastric disorders. Further experiments are underway to determine which antiulcer mechanisms involved in gastroprotection.

CONTEXTO: O repolho (Brassica oleracea var. capitata) é uma planta de folhas herbáceas pertencente à família Brassicaceae, nativa na costa sul e oeste da Europa. Usado na culinária por seu valor nutritivo, possui conhecida atividade anti-inflamatória. OBJETIVO: Avaliar a atividade antiulcerogênica do extrato aquoso de Brassica oleracea var. capitata (AEB), a fim de validar os conhecimentos etnobotânico do uso da espécie em distúrbios gástricos. MÉTODO: Úlceras gástricas foram induzidas em ratos pela administração oral de ácido acetilsalicílico. O potencial gastroprotetor de AEB (0,250, 0,500 e 1,000 mg.kg-1/peso) foram comparados com omeprazol (20 mg.kg-1/peso). RESULTADOS: As análises dos estômagos indicaram que o tratamento com AEB inibiu a progressão da lesão gástrica. A atividade gastroprotetora foi evidenciada por sua significativa inibição da progressão da úlcera induzida por agentes químicos, com o máximo de 99,44 por cento eficácia (250 mg.kg-1/peso) frente a úlceras gástricas induzidas por ácido acetilsalicílico. CONCLUSÕES: O AEB demonstrou atividade cicatrizante de úlceras gástricas, o que justifica a inclusão da espécie em tratamentos de distúrbios gástricos. Estudos futuros estão em andamento para determinar quais os mecanismos antiulcerogêncios estão envolvidos com a gastroproteção.

Anti-ulcer & antioxidant activities of Hedranthera barteri {(Hook F.) Pichon} with possible involvement of H+, K+ ATPase inhibitory activity.

Background & objective: Hedranthera barteri (HB) is used in folk medicine as a vermifuge, laxative and an anti-inflammatory agent. The aim of this study was to evaluate the anti-ulcer and antioxidant properties of the dichloromethane fraction of HB root (DMHBR). Methods: Anti-ulcerogenic activity was assessed in cold-restraint (CRU), aspirin (ASP), alcohol (AL), pyloric ligation (PL) induced gastric ulcer models in rats and histamine-induced duodenal ulcer (HST) in guinea pigs. The effect of DMHBR (100 mg/kg) on gastric juice for free and total acidity, peptic activity and mucin secretion, using the pylorus ligated model, were evaluated. The H+, K+-ATPase activity was assayed in gastric microsomes, spectrophotometrically. The in vitro anti-oxidant assays were explored through DPPH, nitric oxide, hydroxyl radical, superoxide anion scavenging assays. Results: DMHBR reduced the incidence of ulcers in CRU (63.3%), PL (58.5%), ASP (52.7%), HST (75.0%) and AL (53.87%). Also, reductions were observed in the free acidity (49.4%), total acidity (45.8%) and peptic activity (32.9%) with increase in the mucin secretion by 81.6 per cent. DMHBR (60-100 μg/ml) inhibited the H+,K+-ATPase activity with IC50 of 89.64 μg/ml compared with omeprazole (10-50 μg/ml ) with IC50 of 32.26 μg/ml. DMHBR showed antioxidant activity with IC50 values of DPPH (397.69 μg/ml), nitric oxide (475.88 μg/ml), hydroxyl radical (244.22 μg/ml) and superoxide anion radical (285.20 μg/ml). Interpretation & conclusion: DMHBR showed anti-ulcer activity against experimentally-induced peptic ulcer models and exhibited both cytoprotective and anti-secretory property. It exhibited a proton pump inhibition activity and its anti-ulcer properties may be partly ascribed to its antioxidant activities.

Evaluation of the anti-ulcer activity of NR-ANX-C (a polyherbal formulation) in aspirin & pyloric ligature induced gastric ulcers in albino rats.

Background & objectives: The aetiology of gastric ulcers is not completely understood and continuous use of anti-ulcer agents leads to many side effects. In this study we evaluated the anti-ulcer efficacy of a polyherbal formulation with potent antioxidant activity in aspirin and pyloric ligature induced gastric ulcers in rats. Methods: The efficacy of the polyherbal formulation NR-ANX-C (composed of the extracts from Withania somnifera, Camellia sinensis, Ocimum sanctum, shilajith and triphala) was evaluated in terms of antioxidant potential as assessed in terms of protection from lipid peroxidation and the antiulcer activity as seen by the area of gastric lesions, gastric juice volume, gastric pH, total acidity and total adherent gastric mucus content. Results: In our study, NR-ANX-C (25 and 50 mg/kg) was more efficacious than ranitidine in reducing ulcer index in both the models. At the highest dose tested (50 mg/kg), NR-ANX-C was comparable to omeprazole in preventing ulcer formation in the pyloric ligature model. NR-ANX-C showed a dose- dependent decrease in gastric juice volume and total acidity in both the models. A dose-dependent increase in gastric pH and total adherent gastric mucus was also seen in NR-ANX-C treated groups. The extent of lipid peroxidation was also reduced in the test drug treated groups. Interpretation & conclusion: Based on our findings, we presume that the cytoprotective, anti-secretary and antioxidant properties of NR-ANX-C were responsible for its anti-ulcer activity. These findings suggest the potential for use of NR-ANX-C as an adjuvant in the treatment of gastric ulcer.

Influencia da ranitidina e pantoprazol no pH gastrico em pacientes septicos / Ranitidine is unable to maintain gastric pH level above 4 in septic patients

Objetivo: Avaliar a capacidade da ranitidina e do pantoprazol em elevar e manter o pH gástrico = 4 em pacientes sépticos. Material e métodos: Foram estudados 20 pacientes internados na UTI, com diagnóstico de sepse/choque séptico, em ventilação mecânica. Dez receberam ranitidina (50 mg em bolo 8/8 horas) e outros 10 pacientes receberam pantoprazol 40 mg, em bolo de 12/12 horas. O pH gástrico foi medido de forma contínua por 48 horas. Foi realizada endoscopia digestiva alta antes e após o estudo e encaminhado para análise um fragmento obtido por biópsia e pesquisa de Helicobacter pylori. Resultados: O grupo ranitidina permaneceu por 46,27 ± 38,21 % e o grupo do pantoprazol 81,57 ± 19,65% do tempo estudado com pH gástrico = 4 (p=0,04). No subgrupo de ranitidina sem atrofia gástrica o pH esteve = 4 em 15,97 % e em cinco casos com atrofia em 79,44% do tempo estudado. No subgrupo do pantoprazol que realizou biópsia, quatro pacientes não apresentavam atrofia gástrica e o tempo de pH =4 foi de 81,17%. Em um paciente com atrofia da mucosa gástrica, o pH gástrico se manteve =4 durante todo o período do estudo. Conclusões: A ranitidina intravenosa, usada para profilaxia de úlcera de estresse, não foi capaz de manter o pH gástrico acima de quatro em pacientes sépticos. Todos os casos do grupo ranitidina, onde o pH foi mantido acima de quatro, apresentavam hipotrofia ou atrofia gástrica. O pantoprazol manteve o pH acima que quatro por período maior de tempo durante o estudo.

Purpose: To evaluate whether ranitidine and pantoprazole are able to maintain gastric pH = 4 in septic patients. Material and methods: Twenty intensive care unit (ICU) patients from a University teaching hospital, with sepsis. Ten patients received ranitidine (50 mg as an intermittent bolus t.i.d.) and ten received pantoprazole (40 mg as an intermittent bolus b.i.d.). Gastric pH was measured continuously for 48 hours. Endoscopy of the upper digestive tract, gastric biopsy and investigation for Helicobacter pylori were carried out prior to and at the end of the study. Results: pH values = 4 were maintained for 46.27 ± 38.21 % and 81.57 ± 19.65% of observation time in the ranitidine and pantoprazole groups, respectively (p=0.04). In the subgroup of ranitidine without atrophy gastric pH was = 4 at 15.97% and in five cases with atrophy in 79.44% of the time studied observation time. In the subgroup of pantoprazole who underwent biopsy, four patients did not have mucosal atrophy and gastric pH was = 4 for 81.17% of the time. In one patient with mucosal atrophy, gastric pH remained = 4 for the entire study period. Conclusions: Intravenous ranitidine was unable to maintain gastric pH above 4 in septic patients. All cases in the ranitidine group in whom pH remained above 4 were found to have mucosal gastric hypotrophy or atrophy. Pantoprazole successfully maintained pH above 4.

Gastric ulcer healing effects of Nigella sativa; a comparative experimental study with cimetidine

Nigella sativa seeds have been in use as a natural remedy for over 4000 years in various parts of the world. These seeds are reported to benefit almost every system of the body; the present study was conducted to see the healing effects of Nigella Sativa in experimentally produced gastric ulcers with comparison to Cimetidine. It was an experimental study on 40 albino rats, performed in animal house of Postgraduate Medical Institute, Lahore. The animals were given Aspirin [0.2 gm/kg body weight] to produce ulcers. Four animals were killed after 2 weeks to confirm gastric ulcers by histopathology. The remaining animals [36] were equally divided in two groups and the 3 subgroups according to time schedule [2-6 weeks] for the treatment with Nigella Sativa [30 mg/kg body weight] and Cimetidine [15 mg/kg body weight]. Rats were anaesthetised and sacrificed at the end of experimental periods and the stomachs were removed, rinsed in lukewarm distilled water. Gross and microscopic examinations were performed to evaluate the results. On gross examination of stomach, 14/18 [78%] albino rats of group "A" [taking Nigella Sativa] did not reveal any abnormality due to complete response to Nigella sativa as compared to 17/18 [94%] of group "B" [taking Cimetidine]. On microscopic examination of stomach, 13/18 [72%] albino rats of group "A" [taking Nigella Sativa] revealed complete recovery as compared to 16/18 [89%] of group "B" [taking Cimetidine]. We concluded that Nigella sativa is equally effective in healing of gastric ulcer as is Cimitidine therefore we suggest the use of the N-sativa in the therapy of gastric ulcer disease in routine practice

Rebamipide May Be Comparable to H2 Receptor Antagonist in Healing Iatrogenic Gastric Ulcers Created by Endoscopic Mucosal Resection: A Prospective Randomized Pilot Study

Endoscopic mucosal resection (EMR) results in the formation of iatrogenic gastric ulcers and the optimal treatments for such ulcers are still unclear. We aimed to evaluate the efficacy of rebamipide in the management of EMR-induced ulcers by comparing it with an H2 receptor antagonist. After EMR, patients were randomly assigned into either rebamipide or famotidine groups. All patients received a one-week lansoprazole 30 mg q.d. therapy followed by three-week famotidine (20 mg b.i.d.) or rebamipide (100 mg t.i.d.) therapy. Four weeks after the treatments, ulcer sizes, stages, bleeding rates, and ulcer-related symptoms were compared using endoscopy and a questionnaire. A total of 63 patients were enrolled in this study. Finally, 51 patients were analyzed, 26 in rebamipide and 25 in famotidine group. Baseline characteristics were not significantly different between the two groups. Four weeks after EMR, the two groups were comparable in terms of ulcer reduction ratio (P=0.297), and ulcer stage (P=1.000). Moreover, no difference was observed with regard to ulcer-related symptoms, drug compliance, adverse drug event rates, and bleeding rates. Our data suggest that rebamipide is not inferior to famotidine in healing iatrogenic gastric ulcers, and could be a therapeutic option in the treatment of such ulcers.