Technological study of preparing gel from semi-solid extract of Cacalia hastata L.

Most of the drugs which are used for wound healing are imported in Mongolia. It is required to develop drug formulation and increase local productions used for the treatment of wound healing. For the purpose of solving the above problems, we aimed to prepare new drug formulation from Cacalia hastata L. for the treatment of wound healing. Cacalia hastata L. is a medicinal plant, member of the family Asteraceae. Cacalia hastata L. is widely used for the Mongolian traditional medicine to treat wound healing, gastric ulcer, poisoning fever, liver fever, bile fever, oral cavity, and gynecological diseases. We prepared Cacalia gel from semi-solid extract of Cacalia hastata L. using various excipients such as gel former, solvent, neutralizer, antimicrobial preservative, and humectant. Gel formulation was standardized by such criteria, as the amount of biologically active compound, appearance (color, smell), pH, viscosity, and bacterial contamination. Stability testing of gel formulation was studied by long-term method. The quality of the Cacalia gel which was stored in room temperature, its appearance, viscosity, and amount of biological active compound were stable. The stability testing of the gel formulation from Cacalia hastata L. is continued.

Ulaanbaatar procedure for tubularization of the glans in severe hypospadias.

PURPOSE: We developed a new procedure for the repair of proximal hypospadias in which the distal urethra is constructed as part of the first of 2 stages, and reviewed the results of 34 cases. MATERIALS AND METHODS: We performed stage 1 of the Ulaanbaatar procedure in 35 children 0.6 to 11 years old (average age 2.5), and stage 2 in 20. The meatus was at the posterior third of the shaft in 14 children, at the penoscrotal junction in 16 and in the perineum in 5. Three patients had a previous operation, and none had Byars flaps formed. Followup was less than 2(1/2) years for stage 1 and less than 1(1/2) years for stage 2. In 2 stage 2 procedures a free graft was also used to augment the proximal part of the urethroplasty. RESULTS: Urethral fistula did not develop in any patient, a minor early stricture occurred in 2 patients and 1 urethral diverticulum occurred in 1 patient after stage 2. In all patients the glans and meatus were more normal compared to other 2-stage procedures after the first operation, and the cosmetic result was usually satisfactory. CONCLUSIONS: The Ulaanbaatar technique provides an alternative approach to the formation of the glans urethra in severe hypospadias. It does not have the risks associated with a single stage procedure but has the benefit of enabling tunneling of the urethra through the glans, thus facilitating a favorable cosmetic outcome and an easy stage 2.

Reconstruction of the hypospadiac hooded prepuce.

PURPOSE: The role of foreskin reconstruction as part of distal hypospadias repair remains uncertain. Thus, we wished to define better the indications with a view to improving the success of this cosmetic alternative. We reviewed the outcome in a group of patients who underwent foreskin reconstruction to highlight the criteria for likely success. MATERIALS AND METHODS: The records of 51 boys who underwent foreskin reconstruction from 1996 to 2001 were reviewed from a total hypospadias repair group of 223. Boys who underwent foreskin reconstruction were 4 months to 9 years old (median age 9.3 months). Surgery included a meatal advancement and glanuloplasty procedure in 22 patients, Mathieu urethroplasty in 2, King-Duplay repair in 2 and a meatotomy in 1, while in 24 with a normal glans meatus foreskin plasty was the only surgery. Cases in which the foreskin was required for chordee release and those in which the gap between the ventral aspects of the foreskin was wide were excluded from foreskin reconstruction. Also, patients were selected by intraoperative assessment of the ability to approximate the foreskin in the midline at the level of the coronal groove. If this maneuver can be performed without placing the foreskin under tension, the foreskin is considered suitable for reconstruction. All patients received regional and general anesthesia plus intraoperative antibiotics. After suitable urethroplasty the technique of foreskin reconstruction was generally similar for all types of the condition. RESULTS: The result was excellent in 36 patients (70.6%) with a normal-appearing foreskin that retracted easily. There was a good result in 8 patients (15.7%) with a satisfactory meatus at the tip of the glans and a retractable foreskin but minor foreskin deformity. Only 3 patients had a minor complication, including a fistula through the prepuce in 2 and wound infection in 1. No boy had a complication due to urethroplasty and there were no urethral fistulas. CONCLUSIONS: Our study shows that foreskin reconstruction is successful, particularly if the proximal, coronal groove portion of the prepuce can be easily approximated manually and the procedure can be combined with a range of distal repairs. We would recommend reconstruction of the prepuce if parents would prefer their son to be uncircumcised, providing that the foreskin is suitable for preservation.