Chemical profile and in vivo anti-hyperlipidaemic activity of chloroform fraction of Zygophyllum indicum in Triton X-100 induced hyperlipidaemic rats.

Anti-hyperlipidaemic effect of chloroform fraction of aerial parts of Zygophyllum indicum (Fagonia indica Burm.f.) was studied in rats. Adult Wistar albino rats were distributed into five groups. Rats of all groups except group I were given an intraperitoneal injection (Triton X-100) to induce hyperlipidaemia. Groups (I and II) served as normal and hyperlipidaemic control groups respectively. Group III and group IV were administered with 250 and 500 mg/kg chloroform fraction of the plant respectively after 18 h of inducing hyperlipidaemia. Group V was given 10 mg/kg of the standard atorvastatin. Chloroform fraction had significant (p < 0.05) hypolipidaemic effects on lipid profile and biochemical parameters with a protective effect on the liver in comparison to group II. F. indica with hypolipidaemic effect is useful in the management of hyperlipidaemia. Chloroform fraction with its constituents can be used as an antihyperlipidaemic supplement in developing countries for the development of novel therapeutic agents.

Dry ripe fruit of Aegle marmelos as anti-ulcer agent against ethanol induced gastric mucosal injury.

Aegle marmelos is cost-effective valuable South Asian tree. The folklore data reported its wide range pharmacological effects. In spite of vast reported work on various parts, the dry ripe fruit extract has not yet been studied for gastric ulcers. Present study is planned to investigate its potential protective effects against ethanol-induced gastric injury in rats. In current study the gastro protective effect of ethanolic crude extract of A. marmelos dried ripe fruit at 200, 400 and 800mg/kg body weight were studied in albino rats. Ranitidine used as standard drug (50mg/kg body weight). Absolute ethanol increase the degree of ulceration (UI) in rats while a significant improvement in the level of inhibition against ulceration was observed in test and standard groups as compare to control. Pre-fed test drug exhibited a significant reduction in the sore area (UI), accelerate % age protection and increased of gastric content in dose dependence manner. Test drug at 800mg/kg dose showed marked deduction in mean UI 3.0, significant increase in protection 83% with pH 7.3 (p<0.01). Standard drug exhibited 3.25 UI, 81% protection with pH 7.1. In conclusion, it was found that dry ripe fruit of A. marmelos possesses a significant anti-ulcer effect in rats.

Removing Outer Gloves as a Method to Reduce Spinal Surgery Infection.

STUDY DESIGN: A retrospective cohort study was performed to analyze the effect of a specifically timed glove change on infection rates in lumbar spinal fusion. OBJECTIVES: Postoperative infection is a frequent and taxing complication following posterior lumbar spine fusion with instrumentation. This procedure is associated with infection rates up to 9%. The most common organism responsible for infection is Staphylococcus aureus which, along with many of the other common causative organisms, is often part human skin flora. This implicates the surgeon's gloves as the mode of transfer for these organisms from the patient's skin to the wound. The authors conducted a retrospective study to determine if a simple glove change before handling instrumentation could significantly reduce the rate of postoperative infection for this procedure. MATERIALS AND METHODS: A total of 389 patients requiring lumbar spine fusion were enrolled retrospectively and divided into 2 groups: a control group of 179 patients treated with standard protocol for the procedure (group A) and a treatment group of 210 patients in whom, after initially double gloving, the outer pair of gloves was removed before handling the instrumentation. Infection rates were compared up to 1 year postoperatively. RESULTS: There was a statistically significant reduction of infection rate from 3.35% in group A (control) to 0.48% in group B (P=0.0369). CONCLUSION: This study shows that the removal of an outer pair of gloves before handling instrumentation may be a simple, cost-effective, and practical way to reduce the burden of postoperative infection following lumbar spinal fusion.

Screening of solvent dependent antibacterial activity of Prunus domestica.

Fruit of Prunus domestica was extracted in ethanol. The ethanol extract was further extracted with two solvents ethyl acetate and chloroform. The crude ethanol extract and two fractions (ethyl acetate and chloroform) were screened for their antibacterial activity using the agar well diffusion method .They were tested against nine bacteria; five Gram positive bacteria (Staphylococcus aureus, Streptococcuc intermedius, Bacillus cereus, Bacillus pumilus) and four Gram negative bacteria (Eschrichia coli, Proteus mirabilis Shigella flexneri, Salmonella typhi and Klebsiela pneumoniae). The susceptibility of microorganisms to all three fractions was compared with each other and with standard antibiotic (Ampicillin) Among all fractions ethyl acetate exhibited highest antibacterial activity (average zone of inhibition 34.57mm ± 1.3) while ethyl alcohol exhibited least antibacterial activity (average zone of inhibition 17.42mm ± 3.3). Minimum inhibitory concentration of ethanol, ethyl acetate and chloroform fractions was found in the range of 78 µ g/ml to 2500 µ gl/ml against gram positive and gram negative bacteria.

A US-based survey on ventriculostomy practices.

BACKGROUND: The incidence of ICP monitoring has increased over the years and the indications for placement have expanded. Although ventriculostomy and ICP monitor placement are among the most commonly performed neurosurgical procedures, the current practice patterns have rarely been studied. METHODS: A 10-question survey was sent to 2006 neurosurgeons and 1060 neurosurgery residents in the US. Demographic information and data regarding estimated success rates of ventriculostomies, the steps taken in failure and use of technological aids used was sought. RESULTS: 479 neurosurgeons and 108 residents responded to our survey (response rates 23.9% and 10.2%, respectively). No catheter misplacements were reported by 19.8% respondents in the previous year whereas 2.2% reported misplacing more than 30%. With regards to ventriculostomy for patients with slit ventricles, image guidance was used by 51.7%; freehand technique was preferred by 41.6% and the Ghajar guide was used by 6.7% of respondents. We found that 56.9% of respondents abandoned free-hand placement after 3 failed passes. After abandoning free-hand cannulation, respondents used an ICP bolt or similar intra-parenchymal pressure monitoring device in trauma patients. Other approaches included leaving the catheter in place and readjusting it after repeating a CT scan. CONCLUSIONS: This survey sheds light on the current practice of ventriculostomy placement. Both residents and neurosurgeons admit to multiple attempts and frequent catheter misplacement. In order to consider a change in practice, respondents cited an increase in available data about guidance systems and ability to accommodate abnormal ventricular anatomy as primary requirements. A prospective study could help establish true evidence based practice for this common neurosurgical procedure.

A simple method to reduce infection of ventriculoperitoneal shunts.

OBJECT: Postoperative shunt infection is the most common and feared complication of ventriculoperitoneal (VP) shunt placement for treatment of hydrocephalus. The rate of shunt infection is highest in the 1st postoperative month. The most common organisms responsible for shunt infection include coagulase-negative Staphylococcus and Staphylococcus aureus. This suggests a transfer of patient's skin flora via the surgeons' glove as a possible means of infection. The authors conducted a study to determine if the rate of postoperative shunt infections could be reduced simply by changing gloves before handling the shunt catheter. METHODS: A total of 111 neonates born with congenital hydrocephalus requiring a VP shunt were enrolled retrospectively and divided into 2 groups: a control group of 54 neonates treated with standard protocol VP shunt placement (Group A) and a treatment group of 57 neonates in whom, after initially double gloving, the outer pair of gloves was removed before handling the shunt catheter (Group B). Shunt infection rates were compared up to 6 months postoperatively. RESULTS: There was a statistically significant reduction of infection rate from 16.33% in Group A (control) to 3.77% in Group B (p = 0.0458). CONCLUSIONS: The study shows that a changing of gloves before handling the shunt catheter may be a simple and cost-effective way to reduce the burden of postoperative shunt infections.

Spontaneous thrombosis of congenital extrahepatic portosystemic shunt (Abernethy malformation) simulating inguinal hernia incarceration.

Tender lumps in the inguinal region are often explored emergently to treat suspected hernial strangulation. We discuss the case of an adult male who presented acutely with a tender inguinal swelling and raised inflammatory markers and was therefore deemed as requiring surgical exploration. However preoperative abdominal computerized tomography (CT) revealed an extensive thrombosing congenital venous malformation of portosystemic origin with extension into the symptomatic inguinal canal. A potentially lethal exsanguination from surgery was thus avoided.