Antiulcerogenic, Anti-Secretory and Cytoprotective Effects of Piper Cubeba (L.) on Experimental Ulcer Models in Rat

This paper evaluated anti-gastric ulcer and anti-secretory effects of a popular spice Piper cubeba L, (Family: Piperaceae) in rats. The gastric ulcer protective potential of an aqueous suspension of Piper cubeba (PCS) was evaluated against different acute gastric ulcer models in rats induced by pyloric ligation (Shay), hypothermic restraint stress, indomethacin and by necrotizing agents (80% ethanol, 0.2 M NaOH and 25% NaCl) induced gastric mucosal injury. Piper cubeba aqueous suspension (PCS) at the doses 250 and 500 mg/kg body weight administered orally (intraperitoneally in Shay rat model) showed a dose-dependent ulcer protective effects in all the above models. Besides, the PCS offered protection against ethanol-induced depletion of gastric wall mucus (GWM); replenished the reduced non-protein sulfhydryls (NP‑SH) concentration and significantly replenished malondialdehyde (MDA) contents in the gastric tissue. Ethanol induced histopathological lesions of the stomach wall characterized by mucosal hemorrhages and edema was reversed by Piper cubeba aqueous suspension treatment. Pretreatment of rats with Piper cubeba provided significant protection of gastric mucosa through its antioxidant capacity and/or by attenuating the offensive and by enhancing the defensive factor

Acute pancreatitis

The past few years have witnessed a tremendous progress in our knowledge regarding the pathogenesis, diagnosis, prognostic evaluation and classification of acute pancreatitis. The role of ischemia, lysosomal enzymes, oxygen free radicals, polymorphnuclear cells-byproducts and inflammatory mediators in the pathogenesis of pancreatic necrosis and multiple organ failure has been emphasized. Furthermore, the recent knowledge about agents infecting pancreatic necrosis, routes of infection, bacteriological examination of fine needle aspirate and appropriate antibiotics have changed the concept of acute pancreatitis. New diagnostic tests such as rapid urinary trypsinogen-2 test and inflammatory mediators including polymorphnuclear elastase, C-reactive protein and interleukin-6 contribute to early diagnosis, prognostic evaluation and initiation of an appropriate therapy

Gallstones

Gallstone prevalence is correlated with geographical and ethnic variations. It is more preva-lent in Western communities. There are evidences for a high prevalence in Saudi Arabia. According to their chemical constitutes, stones are classified into cholesterol, mixed and pig-ment stones. Three main factors, saturation, gallbladder function and nucleation defect are implemented in the pathogenesis of stone formation. Majority of gallstones patients are asymptomatic. Dyspeptic symptoms are not specific. Ultrasonography has become the method of choice for screening and diagnosis of gallstones. Cholecystoscintigraphy is accu-rate in the diagnosis of acute cholecystitis, biliary obstruction and bile leak. Treatment of gallstones will be discussed in the following issue

Does <i>Helicobacter pylori</i> affect portal hypertensive gastropathy?

<i>Helicobacter pylori (H. pylori)</i> is a major etiological factor of peptic ulcer disease (PUD). It is supposed to be a risk factor for the more frequently encountered PUD in patients with liver cirrhosis. Several investigators have evaluated the effect of <i> H. pylori</i> on liver cirrhosis, portal hypertensive gastropathy (PHG) and encephalopathy with controversial results. Some reports have shown a higher seroprevalence and suggested a synergistic effect of <i> H. pylori</i> on liver cirrhosis and PHG. However, this increased prevalence is associated with a negative histology and is not influenced by the cause of cirrhosis, PHG, Child class or gender. Most studies have not found any correlation between <i> H. pylori</i> and PHG. In contrast, other studies have reported a markedly lower prevalence of <i> H. pylori</i> in cirrhotics with duodenal ulcer compared to controls. The aim of this article is to review the relationship between <i> H. pylori</i> infection and portal hypertensive gastropathy and the role of <i> H. pylori</i> eradication in cirrhotic patients

Treatment of acute pancreatitis

There is no specific treatment for acute pancreatitis. Majority of patients with acute pancreatitis respond to medical therapy. Supportive measures and close observations represent the cornerstone of the medical therapy. Failure to respond to medical treatment may indicate choledocholithiasis or infected necrosis. Endoscopic papillotomy with stone retrieval is beneficial in patients with severe biliary pancreatitis. Image-guided fine needle aspiration and bacteriological examination of aspirate is reliable in detecting infection and deliniating causative pathogen. Surgical debridement is the method of choice for treatment of infected necrosis. In contrast, in pancreatic abscess, surgery is preserved for those, who do not respond to percutaneous drainage combined with antibiotics. The benefit of antisecretory and antiproteolytic agents is debatable. A combination of antioxidants, calcium channel antagonists and antibiotics may play a major role in the treatment of acute pancreatitis in the future

Spices, herbal xenobiotics and the stomach: Friends or foes?

Spices and herbal remedies have been used since ancient times to treat a variety of disorders. It has been experimentally demonstrated that spices, herbs, and their extracts possess antimicrobial, anti-inflammatory, antirheumatic, lipid-lowering, hepatoprotective, nephroprotective, antimutagenic and anticancer activities, besides their gastroprotective and anti-ulcer activities. Despite a number of reports on the toxicity of herbs and spices, they are generally accepted as safer alternatives to conventional therapy against gastric ulcers. To this end, it is also believed, that excessive consumption of spices may favor the pathogenesis of gastric and duodenal ulcer and some studies have substantiated this common perception. Based on various in vivo experiments and clinical studies, on the effects of spices and herbs on gastric ulcers, it has indeed been shown that certain spices do possess remarkable anti-ulcer properties mediated by antisecretory, cytoprotective, antioxidant, and anti-Helicobacter pylori effects and mechanisms regulated by nitric oxide, prostaglandins, non-protein sulfhydryl molecules and epidermal growth factor expression. Accordingly, their consumption may attenuate and help prevent peptic ulcer disease. In the present review, the beneficial effects of spices and herbal nutritive components on the gastric mucosa are discussed against the paradigm of their deleterious potential

Severe acute pancreatitis: Pathogenetic aspects and prognostic factors

Approximately 20% of patients with acute pancreatitis develop a severe disease associated with complications and high risk of mortality. The purpose of this study is to review pathogenesis and prognostic factors of severe acute pancreatitis (SAP). An extensive medline search was undertaken with focusing on pathogenesis, complications and prognostic evaluation of SAP. Cytokines and other inflammatory markers play a major role in the pathogenesis and course of SAP and can be used as prognostic markers in its early phase. Other markers such as simple prognostic scores have been found to be as effective as multifactorial scoring systems (MFSS) at 48 h with the advantage of simplicity, efficacy, low cost, accuracy and early prediction of SAP. Recently, several laboratory markers including hematocrit, blood urea nitrogen (BUN), creatinine, matrix metalloproteinase-9 (MMP-9) and serum amyloid A (SAA) have been used as early predictors of severity within the first 24 h. The last few years have witnessed a tremendous progress in understanding the pathogenesis and predicting the outcome of SAP. In this review we classified the prognostic markers into predictors of severity, pancreatic necrosis (PN), infected PN (IPN) and mortality