Hepatoprotective and hepatocurative effects of Spilanthes acmella Murr against paracetamol induced hepatotoxicity

Hepatotoxicity is appreciably escalating health dilemma worldwide and the degree of the problem has encouraged importance in the exploration for hepatotherapeutic agents from plants. In the current research work, the hepatoprotective/hepatocurative activity of methanolic extract of Spilanthes acmella Murr aerial parts in paracetamol induced hepatotoxicity was investigated in rabbits by the analysis of different liver enzymes including ALT, AST, ALP along with histopathological investigations. In first phase of the study, paracetamol toxicated rabbits were treated with extract and standard drug jatepar TM. The hepatotoxicant [paracetamol] significantly increased the levels of aspartate transaminase, alanine transaminase, alkaline phosphatase compared to normal control. Spilanthes acmella Murr at [400 mg/kg] reversed the elevation in the level of ALP, AST and ALT caused by the hepatotoxicants and jetepar[R] TM [standard] also reversed the deleterious effects of the hepatotoxicants. In second phase of this study, extract of Spilanthes acmella Murr was given to rabbits for ten days then paracetamol was administered in one group and level of liver parameters was paralleled with regular control group and the group that was receiving the extract. It is concluded that methanolic extract of Spilanthes acmella Murr aerial parts possesses hepatocurative and hepatoprotective activity

Two stage brachio-basilic transposition fistula provides superior patency for chronic haemodialysis: our experience in SIMS/ SHL

Background: Adequate vascular access is of utmost importance for hemodialysis treatment. Upper arm fistulae, obesity and deep or tortuous veins may impair cannulation and can cause significant complications and inconvenience for the technicians and patients

Objective: We intended to present the technique of superficialization [transposition] of the brachiobasilic fistula [BBF] and its clinical outcome regarding patency and complications

Materials and Methods: Twenty two brachiobasilic fistulas were fashioned in 20 patients between October 2010 to November 2011.The second stage superficialization [transposition] was carried out at a median of 59.1 days [range: 40-90 days] after fistula formation and involved mobilizing the arterialized basilic vein through a curved longitudinal incision on the antero-medial aspect of the arm and transposing it beneath skin

Results: During the study period 20 brachiobasilic fistulas [BBF] were fashioned in 20 patients. There were 8 [40%] males and 12 [60%] females. The mean age was 53.45years + 12.34 years [range: 21-70years]. The patency rates were 90% at 6 months. Surgical complications of transposition were infection in 2 [10%] patients and lymphocoele in 4 [20%] patients

Conclusion: Transposition of brachiobasilic fistulas is technically feasible and relatively safe procedure. Patency rates at 6 months are excellent

Vesical calculus: a complication of intravesical migration of intrauterine device [IUD]

Introduction: Migration of intrauterine contraceptive device [IUD] into urinary bladder is not very common. Secondary stone formation is a rare complication. It occurs as a result of complete migration of the IUD into urinary bladder. To date, more than 80 cases of IUD migration to the bladder have been reported in the literature with varying stone sizes. A series of 15 cases to whom an IUD migrated from the uterus to the bladder and resulted in formation of a stone over it

Methods: A cohort of fifteen women was treated for bladder stones over migrated IUD within June 2004 to May 2012. Detailed history was maintained, diagnosis was established by pelvic ultrasonography and/or X-rays pelvis. All cases were managed by endoscopy. All cases undergo Cystoscopy and litholapexy

Results: The mean age of participants was 39.7+5.29 years [28-49]. Major objection in almost all cases was lower urinary tract symptoms; which were not responding to medical treatment, six patients had few episodes of macroscopic hematuria. The interval between insertion of IUD and onset of symptoms ranged from 2 to 5 years. In twelve cases IUD was embedded in urinary bladder wall and an entire intravesical IUD in rest 3 with calculus formation in all of them. Stones were crushed along with retrieval of IUD as a result of which mild hematuria was reported in 4 cases. Patients remained with Foley catheter from 7 - 14 days. Postoperative recovery was uneventful

Conclusion: Intrauterine contraceptive device [IUD] perforation to the bladder, with stone formation, is an uncommon event. Clinically it is difficult to reach its diagnosis but persistence of lower urinary tract symptoms in women with IUD should raise the suspicion of intravesical migration. Sonologist can define intravesical migrated IUD. Endoscopy proved a better and safe procedure with a very low complication rate

Emphysematous pyelonephritis: a case report

Emphysematous pyelonephritis is a severe, acute necrotizing renal parenchymal and perirenal infection with formation of gas. Emphysematous pyelonephritis predominantly affects females with uncontrolled diabetes and can occur in insulin-dependent as well as non-insulin dependant patients. CT scan is the modality of choice for the staging of the parenchymal gas and to rule out obstruction. We present a case of 83-year old female with uncontrolled diabetes mellitus who presented with dysu-rea and right flank pain in the emergency department. She was diagnosed as a case of emphysematous pyelonephritis. She was treated successfully in the urology department by antibiotics and percutaneous drainage

Lisfranc's dislocation and fracture in the Charcot Foot

Diabetic patients may present with Lisfranc's Fracture Dislocation which may be confused with osteomyelitis. Rapid diagnosis and early intervention can prevent deformity. We suggest that the diagnosis of Charcot's foot should be considered in any diabetic patient with unilateral swelling of lower extremity and/or foot