Spasmolytic Effects of Aqueous Extract of Mixture from Aframomumum Melegueta (K Schum) – Citrus Aurantifolia (Christm and Panzer) on Isolated Trachea from Rat

The spasmolytic properties of the aqueous extract of Aframomum melegueta (K Schum) and Citrus aurantifolia (Christm and Panzer) (AMCA) mixture were tested on isolated rat trachea. Inhibition of the contraction was observed the in presence of the AMCA (EC 50 = 1.80 ± 0.48 mg/mL) after a pre contraction of the trachea by acetylcholine (10-5 M). With propranolol (10-6 M), the spasmolytic activity of the mixture was inhibited and the concentration-response curve shifted to the right. The EC50 value was then 2.60 ± 0.41 mg/mL. AMCA also inhibited contraction induced by KCl (4.10-2 M) with EC50 value = 1.86 ± 0.65 mg/mL. These results clearly show the relaxing effect of the aqueous extract on the isolated rat trachea. This effect involved some β-adrenergic receptor inhibition.Key words: Aframomum melegueta; Citrus aurantifolia; extract; bronchodilatory; spasmolytic, Rat trachea

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone

Propriétés anti-inflammatoires des extraits aqueux de Sterculia setigera Delile et du mélange Aframomum melegueta K. Schum – Citrus aurantifolia Christm et Panzer

Sterculia setigera, Aframomum melegueta et Citrus aurantifolia sont des plantes couramment utilis&eacute;es en m&eacute;decine et pharmacop&eacute;e traditionnelles africaines pour traiter plusieurs affections dont la toux et l&rsquo;asthme.L&rsquo;objectif du pr&eacute;sent travail est d&rsquo;&eacute;valuer, sur Cavia porcellus (Cochon d&rsquo;Inde), les propri&eacute;t&eacute;s antioed&eacute;mateuse, analg&eacute;sique et antipyr&eacute;tique des extraits aqueux de ces plantes. L&rsquo;administration de ces extraits aqueux par voie orale avant l&rsquo;induction de l&rsquo;oed&egrave;me, inhibe cet oed&egrave;me significativement en fonction de la dose et du temps comparativement &agrave; l&rsquo;indom&eacute;tacine. Les r&eacute;sultats issus de l&rsquo;&eacute;tude de l&rsquo;activit&eacute;&nbsp;&nbsp; antalgique/analg&eacute;sique montrent que l&rsquo;administration des extraits avant l&rsquo;induction de la douleur par le test de Foot Soaking &agrave; 50 &deg;C, l&rsquo;att&eacute;nuesignificativement. L&rsquo;extrait de Sterculia setigera administr&eacute; par voie orale a fait baisser consid&eacute;rablement la temp&eacute;rature apr&egrave;s une heure. L&rsquo;analyse phytochimique de ces extraits r&eacute;v&egrave;le la pr&eacute;sence des alcalo&iuml;des, destanins, des flavono&iuml;des, des anthocyanes, des leuco-anthocyanes, des mucilages et des compos&eacute;s r&eacute;ducteurs dont les propri&eacute;t&eacute;s peuvent &ecirc;tre mises &agrave; profit dans le traitement de l&rsquo;inflammation. Ces diff&eacute;rents r&eacute;sultatsconfirment que les extraits aqueux de Sterculia setigera et du m&eacute;lange Aframomum melegueta - Citrus aurantifolia ont des propri&eacute;t&eacute;s anti-inflammatoires