Phytochemical screening and susceptibility of bacteria pathogens to extracts of Evolvulus alsinoides

The in vitro antibacterial activity of ethanolic and aqueous extract of the whole plant (leaves and twigs) of Evolvulus alsinoides was investigated on gram-positive and gram-negative bacteria by agar well diffusion technique. The results indicate that glycosides, alkaloids, saponins, tannins, flavonoids and volatile oil were better extracted in ethanol than water. The ethanolic extract of the plant had MIC values ranging from 16mg/ml to 512.5mg/ml. The least MIC was 16mg/ml against Salmonella typhi while Bacillus cereus and Staphylococcus aureus showed the highest MIC of 512.5 mg/ml. In the aqueous extract the MIC ranged between 512.5mg/ml to >1025mg/ml. Salmonella typhi, Micrococcus luteus and Staphylococcus aureus were not inhibited by the water extract.Key words: Evolvulus alsinoides, Phytochemical Screening, Antibacterial, Activity

Right colon interposition in corrosive esophageal long segment stricture: Our local experience

Background: Aim of our study is to highlight technical details in pedicled right colon interposition locally in cases of long segment corrosive  esophageal stricture. Lesion results from cicatrization of burns wound inflicted by chemicals. Restoration of swallowing is of paramount importance.Materials and Methods: It was a retrospective study involving adult and adolescent patients who had surgery because of corrosive esophageal stricture between January 2001 and December 2010. Hospital records were reviewed for age, sex, radiological findings, detail of anesthesia, operative procedure, and follow up. The steps which included mobilization of colon with intact marginal blood supply, safeguarding the middle colic artery that forms the pedicle, and doing three anastomoses that were leak proof were ascertained.Result: There were 12 males (70.5%) and six females (29.4%) and age ranged from 14 to 45 years. Caustic soda caused the problem among 10 (58.8%) patients while liquid acid battery was involved in three (17.6%) patients. The rest were distributed equally between native concoction and unknown substance. All were done under general anesthesia and mean duration of the procedure was 306.8 ± 54.6 min with an average intra operative blood loss of 823.1 ± 428.5 m. Sixteen (94.1%) had successful pedicle isolation and 15 (82.3%) patients had neither dysphagia nor reflux at follow.up.Conclusion: Securing a pedicled right colon based on middle colic artery was a critical step. This surgical technique should be used to restore  swallowing among patients with long segment esophageal stricture. Key words: Colon interposition, corrosive esophageal stricture, nutrition, vascular pedicl

Prospective Randomized Controlled Trial to Analyze the Effects of Intermittent Pneumatic Compression on Edema Following Autologous Femoropopliteal Bypass Surgery

Background: Patients who undergo autologous femoropopliteal bypass surgery develop postoperative edema in the revascularized leg. The effects of intermittent pneumatic compression (IPC) to treat and to prevent postreconstructive edema were examined in this study. Methods: In a prospective randomized trial, patients were assigned to one of two groups. All patients suffered from peripheral arterial disease, and all were subjected to autologous femoropopliteal bypass reconstruction. Patients in group 1 used a compression stocking (CS) above the knee exerting 18 mmHg (class I) on the leg postoperatively for 1 week (day and night). Patients in group 2 used IPC on the foot postoperatively at night for 1 week. The lower leg circumference was measured preoperatively and at five postoperative time points. A multivariate analysis was done using a mixed model analysis of variance. Results: A total of 57 patients were analyzed (CS 28; IPC 29). Indications for operation were severe claudication (CS 13; IPC 13), rest pain (10/5), or tissue loss (7/11). Revascularization was performed with either a supragenicular (CS 13; IPC10) or an infragenicular (CS 15; IPC 19) autologous bypass. Leg circumference increased on day 1 (CS/IPC): 0.4%/2.7%, day 4 (2.1%/6.1%), day 7 (2.5%/7.9%), day 14 (4.7%/7.3%), and day 90 (1.0%/3.3%) from baseline (preoperative situation). On days 1, 4, and 7 there was a significant difference in leg circumference between the two treatment groups. Conclusions: Edema following femoropopliteal bypass surgery occurs in all patients. For the prevention and treatment of that edema the use of a class I CS proved superior to treatment with IPC. The use of CS remains the recommended practice following femoropopliteal bypass surgery

Identification of Drug Therapy Problems among Elderly in-patients of a Nigerian Teaching Hospital

Categorizing and identifying drug related problems will enable the practitioner with the co-operation of the patient to construct a care plan to resolve the drug therapy problems (DTPs). The aim of this study was to investigate the occurrence of drug related problems among elderly in-patients and to identify those at risk of DTPs. A two-fold study combining retrospective and prospective was carried out in a teaching hospital using elderly inpatients prescriptions and self assessment questionnaires. Ninety in-patient prescriptions (from case notes) were randomly selected for the retrospective study. Majority of the patients were males 54(60%). Most occurring disease was diabetes mellitus 9 (10.5%) followed by hypertension 8 (9.3%). Major therapeutic groups associated with drug related problems were cardiovascular drugs 113 (21.5%) and central nervous system drugs 92 (17.5%). Promethazine 7 (33.3%) occurred most as a potentially inappropriate medication using the Beers Criteria. Drug related admissions was 12 (13.3%) while drug related problems that occurred include major Polypharmacy 60 (66.7%), unnecessary drug therapy 29 (32.2%), adverse drug reactions 28 (31.1%), need for additional therapy 27 (30%) and non compliance 13 (14.4%). Twelve inpatients were assessed for the prospective study. Hypertension 5 (26.3%) was the highest diagnosis. Out of the 120 responses of the self assessment questionnaire, 99 (82.5%) were ‘No’ indicating a reduced risk. Drug therapy problems were evident in this survey especially in the retrospective study. This calls for pharmaceutical care intervention in the elderly.Keywords: Drugs, Problems, Elderly in-patientsNigerian Journal of Pharmaceutical Research, Vol. 9 No 1 pp. 49 – 56 (February 2011