Evaluation of the aqueous extract of Boswellia dalzielii stem bark for antimicrobial activities and gastrointestinal effects

The aqueous extract of Boswelli dalzielii Hutch (family: Burseraceae) was investigated for therapeutic properties using aspirin-induced ulceration in rats, gastrointestinal motility in mice and castor oil-induced diarrhoea in rats. The median lethal dose (LD50) of the extract was carried out via the oral route in mice. Antimicrobial and preliminary phytochemical screening of the extract was also investigated. The extract did not show toxicity signs or death at doses O.O5) protection against castor oil-induced diarrhoea in rats. No antimicrobial effects were shown by the extract (200 mg/kg) against any of the tested organisms. Tannins were detected in the aqueous extract. The above results show that B. dalzielii stem bark probably contains some active ingredients that could be developed for such gastrointestinal problems as have been claimed by traditional medical practitioners. Key words: . African Journal of Biotechnology Vol.3(5) 2004: 284-28

Contemporary review of risk-stratified management in acute uncomplicated and complicated diverticulitis

BACKGROUND: Acute colonic diverticulitis is a common clinical condition. Severity of the disease is based on clinical, laboratory, and radiological investigations and dictates the need for medical or surgical intervention. Recent clinical trials have improved the understanding of the natural history of the disease resulting in new approaches to and better evidence for the management of acute diverticulitis. METHODS: We searched the Cochrane Library (years 2004-2015), MEDLINE (years 2004-2015), and EMBASE (years 2004-2015) databases. We used the search terms "diverticulitis, colonic" or "acute diverticulitis" or "divertic*" in combination with the terms "management," "antibiotics," "non-operative," or "surgery." Registers for clinical trials (such as the WHO registry and the https://clinicaltrials.gov/) were searched for ongoing, recruiting, or closed trials not yet published. RESULTS: Antibiotic treatment can be avoided in simple, non-complicated diverticulitis and outpatient management is safe. The management of complicated disease, ranging from a localized abscess to perforation with diffuse peritonitis, has changed towards either percutaneous or minimally invasive approaches in selected cases. The role of laparoscopic lavage without resection in perforated non-fecal diverticulitis is still debated; however, recent evidence from two randomised controlled trials has found a higher re-intervention in this group of patients. CONCLUSIONS: A shift in management has occurred towards conservative management in acute uncomplicated disease. Those with uncomplicated acute diverticulitis may be treated without antibiotics. For complicated diverticulitis with purulent peritonitis, the use of peritoneal lavage appears to be non-superior to resection

A genomic analysis of the archaeal system Ignicoccus hospitalis-Nanoarchaeum equitans

Sequencing of the complete genome of Ignicoccus hospitalis gives insight into its association with another species of Archaea, Nanoarchaeum equitans

On the mechanisms governing gas penetration into a tokamak plasma during a massive gas injection

A new 1D radial fluid code, IMAGINE, is used to simulate the penetration of gas into a tokamak plasma during a massive gas injection (MGI). The main result is that the gas is in general strongly braked as it reaches the plasma, due to mechanisms related to charge exchange and (to a smaller extent) recombination. As a result, only a fraction of the gas penetrates into the plasma. Also, a shock wave is created in the gas which propagates away from the plasma, braking and compressing the incoming gas. Simulation results are quantitatively consistent, at least in terms of orders of magnitude, with experimental data for a D 2 MGI into a JET Ohmic plasma. Simulations of MGI into the background plasma surrounding a runaway electron beam show that if the background electron density is too high, the gas may not penetrate, suggesting a possible explanation for the recent results of Reux et al in JET (2015 Nucl. Fusion 55 093013)

Effect of the relative shift between the electron density and temperature pedestal position on the pedestal stability in JET-ILW and comparison with JET-C

The electron temperature and density pedestals tend to vary in their relative radial positions, as observed in DIII-D (Beurskens et al 2011 Phys. Plasmas 18 056120) and ASDEX Upgrade (Dunne et al 2017 Plasma Phys. Control. Fusion 59 14017). This so-called relative shift has an impact on the pedestal magnetohydrodynamic (MHD) stability and hence on the pedestal height (Osborne et al 2015 Nucl. Fusion 55 063018). The present work studies the effect of the relative shift on pedestal stability of JET ITER-like wall (JET-ILW) baseline low triangularity (\u3b4) unseeded plasmas, and similar JET-C discharges. As shown in this paper, the increase of the pedestal relative shift is correlated with the reduction of the normalized pressure gradient, therefore playing a strong role in pedestal stability. Furthermore, JET-ILW tends to have a larger relative shift compared to JET carbon wall (JET-C), suggesting a possible role of the plasma facing materials in affecting the density profile location. Experimental results are then compared with stability analysis performed in terms of the peeling-ballooning model and with pedestal predictive model EUROPED (Saarelma et al 2017 Plasma Phys. Control. Fusion). Stability analysis is consistent with the experimental findings, showing an improvement of the pedestal stability, when the relative shift is reduced. This has been ascribed mainly to the increase of the edge bootstrap current, and to minor effects related to the increase of the pedestal pressure gradient and narrowing of the pedestal pressure width. Pedestal predictive model EUROPED shows a qualitative agreement with experiment, especially for low values of the relative shift

Intracorporeal anastomoses in emergency laparoscopic colorectal surgery from a series of 59 cases: where and how to do it - a technical note and video

Aim: Laparoscopy offers the benefits of minimally invasive surgery and faster recovery. Acute surgical patients may potentially benefit from the great advantages of emergency laparoscopy, which is more clinically relevant in acute than elective patients. Fashioning a laparoscopic intracorporeal anastomosis (ICA) after emergent colorectal resection, whenever technically feasible and not contraindicated by the patient's general and haemodynamic condition, is a most challenging technical skill. Method: During the period 2010–2016, 59 patients underwent a laparoscopic procedure for colorectal emergency in an acute care setting by a single operating surgeon with advanced laparoscopic skills and specific expertise in both colorectal surgery and acute care surgery. This series includes 32 laparoscopic right colectomies (12 for obstruction and 20 for perforation/peritonitis) and 27 left colectomies (6 for obstruction and 21 for perforation/peritonitis). Twenty-eight ileocolic side-to-side ICA, and 27 left colonic ICA (3 colocolic, 24 colorectal) were performed. Results: Reasonably good postoperative outcomes were observed in the entire series of 59 laparoscopic colectomies performed in an urgent setting. Overall, the major morbidity rate in the entire group was 16.9% (10/59) with an incidence of intra-abdominal abscess of 11.8% (7/59); the overall leak rate was 3.4% (2/59). The re-operation rate was 3.4% (2/59). A video included in the Supporting Information shows five different sites and techniques for ICA and describes technical details with tips and tricks. All patients shown in the video had an uneventful postoperative recovery and were managed postoperatively according to enhanced recovery after surgery protocols. Conclusion: This case series illustrates all possible sites and techniques for colonic ICA in an emergency setting. All colorectal and acute care surgeons should have laparoscopic suturing skills

Carbon-coated microbeads anal injection in outpatient treatment of minor fecal incontinence

Abstract PURPOSE: Anal bulking agents are injected to pose a stronger obstacle to the involuntary passage of feces and gas. This prospective, multicenter study was designed to evaluate the safety and efficacy of Durasphere anal injection for the treatment of fecal incontinence. PATIENTS AND METHODS: Thirty-three unselected patients with incontinence (24 females; mean age, 61.5 +/- 14 (range, 22-83) years) underwent anal bulking agent submucosal injection with carbon-coated microbeads (Durasphere) in the outpatient regimen. The causes of incontinence were obstetric lesions in 18.2 percent, iatrogenic in 36.4 percent, rectal surgery in 12.1 percent, and idiopathic in 33.3 percent. Previous unsuccessful treatments for fecal incontinence included diet and drugs in 16 patients, biofeedback training in 7 patients, sacral nerve modulation in 6 patients, sphincteroplasty in 2 patients, artificial bowel sphincter in 1 patient, and PTQ macroplastique bulking agent in 1 patient. Under local anesthesia and antibiotic prophylaxis, a mean of 8.8 (range, 2-19) ml of Durasphere were injected into the submucosa by using a 1.5-inch, angled, 18-gauge needle. RESULTS: After a median follow-up of 20.8 (range, 10-22) months, the median Cleveland Clinic continence score decreased significantly from 12 to 8 (P < 0.001) and the median American Medical System score from 89 to 73 (P = 0.0074), but the Fecal Incontinence Quality of Life did not change significantly (74 to 76, P = not significant). Anal manometry significantly improved (resting pressure increasing from 34 to 42 mmHg; P = 0.008) and squeezing pressure from 66 to 79 mmHg (P = 0.04). Two patients complained of moderate anal pain for a few days after the implant, one patient had asymptomatic leakage of the injected material through a mucosa perforation, and two had distal migration of the Durasphere along the dentate line. CONCLUSIONS: Anal bulking agent injection is a safe treatment and can mitigate the severity of fecal incontinence by increasing anal pressure but does not significantly improve the quality of lif

Endometriosis Index: A software-derived score to predict the presence and severity of the disease

Objective: To develop a clinical index that will positively predict the presence of endometriosis. Design: Prospective single-center observational study. Setting: A hospital-based institute. Patients: 120 patients affected by chronic pelvic pain, infertility or with clinical suspicion of endometriosis. Interventions: Electronic processing of clinical data with software-assistance at the end of each consultation and digital video recording of surgeries. Main Outcome Measures: Endometriosis Index (EI), the score calculated using clinical parameters correlated with macroscopic/microscopic presence or absence of endometriosis. Results: Endometriosis was staged and treated in 95 cases, the remaining 25 women presented benign pathology with no endometriosis. Patients with positive operative findings of endometriosis had a mean (± standard deviation) pre-operative EI score of 22 ± 12, while mean EI value of patients with no operative findings of endometriosis was 8 ± 6 (p<0.001). Cumulative distribution of EI shows increasing values from controls to peritoneal, ovarian and deeply infiltrating endometriosis (DIE) (p for trend <0.001). A logistic model showed an OR = 24.7 (95%CI=8.3 to 73.7) of having DIE for women with EI score > 28 (75th percentile value) versus women with EI score ≤ 28; with EI score > 28 this noninvasive test was predictive of DIE with a sensitivity of 72.4% and a specificity of 90.1%. Conclusions: These data suggest that a dedicated Endometriosis Index is effective in identifying patients who would benefit from early surgical management. We propose the use of this non-invasive tool to reduce the delay between the onset of symptoms and a surgical diagnosis of endometriosis