Adaptogenic and nootropic activities of aqueous extract of Vitis vinifera (grape seed): an experimental study in rat model

BACKGROUND: The aerial parts of Vitis vinifera (common grape or European grape) have been widely used in Ayurveda to treat a variety of common and stress related disorders. In the present investigation, the seed extract of V. vinifera was evaluated for antistress activity in normal and stress induced rats. Furthermore, the extract was studied for nootropic activity in rats and in-vitro antioxidant potential to correlate its antistress activity. METHODS: For the evaluation of antistress activity, groups of rats (n = 6) were subjected to forced swim stress one hour after daily treatment of V. vinifera extract. Urinary vanillylmandelic acid (VMA) and ascorbic acid were selected as non-invasive biomarkers to assess the antistress activity. The 24 h urinary excretion of vanillylmandelic acid (VMA) and ascorbic acid were determined by spectrophotometric methods in all groups under normal and stressed conditions. The nootropic activity of the extract as determined from acquisition, retention and retrieval in rats was studied by conditioned avoidance response using Cook's pole climbing apparatus. The in vitro antioxidant activity was determined based on the ability of V. vinifera to scavenge hydroxyl radicals. RESULTS: Daily administration of V. vinifera at doses of 100, 200 and 300 mg/kg body weight one hour prior to induction of stress inhibited the stress induced urinary biochemical changes in a dose dependent manner. However, no change in the urinary excretion of VMA and ascorbic acid was observed in normal animals at all the doses studied. The cognition, as determined by the acquisition, retention and recovery in rats was observed to be dose dependent. The extract also produced significant inhibition of hydroxyl radicals in comparison to ascorbic acid in a dose dependent manner. CONCLUSION: The present study provides scientific support for the antistress (adaptogenic), antioxidant and nootropic activities of V. vinifera seed extract and substantiate the traditional claims for the usage of grape fruits and seeds in stress induced disorders

Blood ammonia levels in liver cirrhosis: a clue for the presence of portosystemic collateral veins

<p>Abstract</p> <p>Background</p> <p>Portal hypertension leads to the formation of portosystemic collateral veins in liver cirrhosis. The resulting shunting is responsible for the development of portosystemic encephalopathy. Although ammonia plays a certain role in determining portosystemic encephalopathy, the venous ammonia level has not been found to correlate with the presence or severity of this entity. So, it has become partially obsolete. Realizing the need for non-invasive markers mirroring the presence of esophageal varices in order to reduce the number of endoscopy screening, we came back to determine whether there was a correlation between blood ammonia concentrations and the detection of portosystemic collateral veins, also evaluating splenomegaly, hypersplenism (thrombocytopenia) and the severity of liver cirrhosis.</p> <p>Methods</p> <p>One hundred and fifty three consecutive patients with hepatic cirrhosis of various etiologies were recruited to participate in endoscopic and ultrasonography screening for the presence of portosystemic collaterals mostly esophageal varices, but also portal hypertensive gastropathy and large spontaneous shunts.</p> <p>Results</p> <p>Based on Child-Pugh classification, the median level of blood ammonia was 45 mcM/L in 64 patients belonging to class A, 66 mcM/L in 66 patients of class B and 108 mcM/L in 23 patients of class C respectively (p < 0.001).</p> <p>The grade of esophageal varices was concordant with venous ammonia levels (rho 0.43, p < 0.001). The best area under the curve was given by ammonia concentrations, i, e., 0.78, when comparing areas of ammonia levels, platelet count and spleen longitudinal diameter at ultrasonography. Ammonia levels predicted hepatic decompensation and ascites presence (Odds Ratio 1.018, p < 0.001).</p> <p>Conclusion</p> <p>Identifying cirrhotic patients with high blood ammonia concentrations could be clinically useful, as high levels would lead to suspicion of being in presence of collaterals, in clinical practice of esophageal varices, and pinpoint those patients requiring closer follow-up and endoscopic screening.</p

Contraception Following Abortion And The Treatment Of Incomplete Abortion

Family planning counseling and the provision of postabortion contraception should be an integrated part of abortion and postabortion care to help women avoid another unplanned pregnancy and a repeat abortion. Postabortion contraception is significantly more effective in preventing repeat unintended pregnancy and abortion when it is provided before women leave the healthcare facility where they received abortion care, and when the chosen method is a long-acting reversible contraceptive (LARC) method. This article provides evidence supporting these two critical aspects of postabortion contraception. It suggests that gynecologists and obstetricians have an ethical obligation to do everything necessary to ensure that postabortion contraception, with a focus on LARC methods, becomes an integral part of abortion and postabortion care, in line with the recommendations of the International Federation of Gynecology and Obstetrics and of several other organizations. © 2014 International Federation of Gynecology and Obstetrics.126SUPPL. 1S52S55Faúndes, A., Strategies for the prevention of unsafe abortion (2012) Int J Gynecol Obstet, 119 (SUPPL. 1), pp. 68-S71Schreiber, C.A., Sober, S., Ratcliffe, S., Creinin, M.D., Ovulation resumption after medical abortion with mifepristone and misoprostol (2011) Contraception, 84 (3), pp. 230-233Lähteenmäki, P., Luukkainen, T., Return of ovarian function after abortion (1978) Clin Endocrinol, 8 (2), pp. 123-132Boesen, H.C., Rørbye, C., Nørgaard, M., Nilas, L., Sexual behavior during the first eight weeks after legal termination of pregnancy (2004) Acta Obstet Gynecol Scand, 83 (12), pp. 1189-1192(2010) Medical Eligibility Criteria for Contraceptive Use, , World Health Organization 4th ed. WHO GenevaLähteenmäki, P., Influence of oral contraceptives on immediate postabortal pituitary-ovarian function (1978) Acta Obstet Gynecol Scand Suppl, 76, pp. 1-43Lähteenmäki, P., Rasi, V., Luukkainen, T., Myllyä, G., Coagulation factors in women using oral contraceptives or intrauterine contraceptive devices immediately after abortion (1981) Am J Obstet Gynecol, 141 (2), pp. 175-179Martin, C.W., Brown, A.H., Baird, D.T., A pilot study of the effect of methotrexate or combined oral contraceptive on bleeding patterns after induction of abortion with mifepristone and a prostaglandin pessary (1998) Contraception, 58 (2), pp. 99-103Niswonger, J.W., London, G.D., Anderson, G.V., Wolfe, L., Oral contraceptives during immediate postabortal period (1968) Obstet Gynecol, 32 (3), pp. 325-327Peterson, W.F., Contraceptive therapy following therapeutic abortion: An analysis (1974) Obstet Gynecol, 44 (6), pp. 853-857Tang, O.S., Gao, P.P., Cheng, L., Lee, S.W., Ho, P.C., A randomized double-blind placebo-controlled study to assess the effect of oral contraceptive pills on the outcome of medical abortion with mifepristone and misoprostol (1999) Hum Reprod, 14 (3), pp. 722-725Tang, O.S., Xu, J., Cheng, L., Lee, S.W., Ho, P.C., The effect of contraceptive pills on the measured blood loss in medical termination of pregnancy by mifepristone and misoprostol: A randomized placebo controlled trial (2002) Hum Reprod, 17 (1), pp. 99-102Gaffield, M.E., Kapp, N., Ravi, A., Use of combined oral contraceptives post abortion (2009) Contraception, 80 (4), pp. 355-362Fine, P.M., Tryggestad, J., Meyers, N.J., Sangi-Haghpeykar, H., Safety and acceptability with the use of a contraceptive vaginal ring after surgical or medical abortion (2007) Contraception, 75 (5), pp. 367-371Kurunmäki, H., Contraception with levonorgestrel-releasing subdermal capsules, Norplant, after pregnancy termination (1983) Contraception, 27 (5), pp. 473-482Kurunmäki, H., Toivonen, J., Lähteenmäki, P.L., Luukkainen, T., Immediate postabortal contraception with Norplant: Levonorgestrel, gonadotropin, estradiol, and progesterone levels over two postabortal months and return of fertility after removal of Norplant capsules (1984) Contraception, 30 (5), pp. 431-442Ortayli, N., Bulut, A., Sahin, T., Sivin, I., Immediate postabortal contraception with the levonorgestrel intrauterine device, Norplant, and traditional methods (2001) Contraception, 63 (6), pp. 309-314Timonen, H., Luukkainen, T., Immediate postabortion insertion of the copper-T (TCu-200) with eighteen months follow-up (1974) Contraception, 9 (2), pp. 153-160Moussa, A., Evaluation of postabortion IUD insertion in Egyptian women (2001) Contraception, 63 (6), pp. 315-317Stanwood, N.L., Grimes, D.A., Schulz, K.F., Insertion of an intrauterine contraceptive device after induced or spontaneous abortion: A review of the evidence (2001) BJOG, 108 (11), pp. 1168-1173Grimes, D., Schulz, K., Stanwood, N., Immediate postabortal insertion of intrauterine devices (2002) Cochrane Database Syst Rev, 3, p. 001777El Tagy, A., Sakr, E., Sokal, D.C., Issa, A.H., Safety and acceptability of post-abortal IUD insertion and the importance of counseling (2003) Contraception, 67 (3), pp. 229-234Pakarinen, P., Toivonen, J., Luukkainen, T., Randomized comparison of levonorgestrel- and copper-releasing intrauterine systems immediately after abortion, with 5 years' follow-up (2003) Contraception, 68 (1), pp. 31-34Suvisaari, J., Lähteenmäk, P., Detailed analysis of menstrual bleeding patterns after postmenstrual and postabortal insertion of a copper IUD or a levonorgestrel-releasing intrauterine system (1996) Contraception, 54 (4), pp. 201-208Gillett, P.G., Lee, N.H., Yuzpe, A.A., Cerskus, I., A comparison of the efficacy and acceptability of the Copper-7 intrauterine device following immediate or delayed insertion after first-trimester therapeutic abortion (1980) Fertil Steril, 34 (2), pp. 121-124Bednarek, P.H., Creinin, M.D., Reeves, M.F., Cwiak, C., Espey, E., Jensen, J.T., Post-Aspiration IUD Randomization (PAIR) Study Trial Group. Immediate versus delayed IUD insertion after uterine aspiration (2011) N Engl J Med, 364 (23), pp. 2208-2217Grimes, D.A., Lopez, L.M., Schulz, K.F., Stanwood, N.L., Immediate postabortal insertion of intrauterine devices (2010) Cochrane Database Syst Rev, 6, p. 001777Steenland, M.W., Tepper, N.K., Curtis, K.M., Kapp, N., Intrauterine contraceptive insertion postabortion: A systematic review (2011) Contraception, 84 (5), pp. 447-464Betstadt, S.J., Turok, D.K., Kapp, N., Feng, K.T., Borgatta, L., Intrauterine device insertion after medical abortion (2011) Contraception, 83 (6), pp. 517-521Shimoni, N., Davis, A., Ramos, M.E., Rosario, L., Westhoff, C., Timing of copper intrauterine device insertion after medical abortion: A randomized controlled trial (2011) Obstet Gynecol, 118 (3), pp. 623-628Sääv, I., Stephansson, O., Gemzell-Danielsson, K., Early versus delayed insertion of intrauterine contraception after medical abortion - A randomized controlled trial (2012) PLoS One, 7 (11), p. 48948Lähteenmäki, P., Toivonen, J., Lähteenmäki, P.L., Postabortal contraception with norethisterone enanthate injections (1983) Contraception, 27 (6), pp. 55-62Cameron, S.T., Glasier, A., Chen, Z.E., Johnstone, A., Dunlop, C., Heller, R., Effect of contraception provided at termination of pregnancy and incidence of subsequent termination of pregnancy (2012) BJOG, 119 (9), pp. 1074-1080Hardy, E., Bahamondes, L., Osis, M.J., Costa, R.G., Faúndes, A., Risk factors for tubal sterilization regret, detectable before surgery (1996) Contraception, 54 (3), pp. 159-162Holman, C.D., Wisniewski, Z.S., Semmens, J.B., Rouse, I.L., Bass, A.J., Population-based outcomes after 28,246 in-hospital vasectomies and 1,902 vasovasostomies in Western Australia (2000) BJU Int, 86 (9), pp. 1043-1049Hillis, S.D., Marchbanks, P.A., Tylor, L.R., Peterson, H.B., Poststerilization regret: Findings from the United States Collaborative Review of Sterilization (1999) Obstet Gynecol, 93 (6), pp. 889-895Langston, A.M., Joslin-Roher, S.L., Westhoff, C.L., Immediate postabortion access to IUDs, implants and DMPA reduces repeat pregnancy within 1 year in a New York City practice (2014) Contraception, 89 (2), pp. 103-108Heikinheimo, O., Gissler, M., Suhonen, S., Age, parity, history of abortion and contraceptive choices affect the risk of repeat abortion (2008) Contraception, 78 (2), pp. 149-154Peipert, J.F., Madden, T., Allsworth, J.E., Secura, G.M., Preventing unintended pregnancies by providing no-cost contraception (2012) Obstet Gynecol, 120 (6), pp. 1291-1297Rose, S.B., Lawton, B.A., Impact of long-acting reversible contraception on return for repeat abortion (2012) Am J Obstet Gynecol, 206 (1), pp. 37e1-37e6Ames, C.M., Norman, W.V., Preventing repeat abortion in Canada: Is the immediate insertion of intrauterine devices postabortion a cost-effective option associated with fewer repeat abortions? (2012) Contraception, 85 (1), pp. 51-55Heikinheimo, O., Gissler, M., Suhonen, S., Can the outcome of the next pregnancy be predicted at the time of induced abortion? (2009) Hum Reprod, 24 (4), pp. 820-826Winner, B., Peipert, J.F., Zhao, Q., Buckel, C., Madden, T., Allsworth, J.E., Effectiveness of long-acting reversible contraception (2012) N Engl J Med, 366 (21), pp. 1998-2007Secura, G.M., Allsworth, J.E., Madden, T., Mullersman, J.L., Peipert, J.F., The Contraceptive CHOICE Project: Reducing barriers to long-acting reversible contraception (2010) Am J Obstet Gynecol, 203 (2), pp. 115e1-115e7(2009) Committee for the Study of Ethical Aspects of Human Reproduction and Women's Health, , International Federation Of Gynecology And Obstetrics FIGO London(2013) Consensus Statement. Post Abortion Family Planning: A Key Component of Postabortion Care, , https://www.glowm.com/pdf/PAC-FP-Joint-Statement-November2013- final_printquality.pdf, International Federation Of Gynecology And Obstetrics (figo), International Confederation Of Midwives (icm), International Council Of Nurses (icn)United States Agency For International Development (usaid)White Ribbon Alliance (wra)Department For International Development (dfid)et a

Seasonal denitrification potential in wetland sediments with organic matter from different plant species

Vegetation both physically and biochemically influences denitrification in wetlands. Litter from various plant species supplies various amounts and qualities of organic carbon to denitrifying bacteria, and may thus affect denitrification capacity. We explore whether there is seasonal variation in the denitrification potential in stands of Glyceria maxima, Phragmites australis, Typha latifolia, and Potamogeton pectinatus (the stands differed in terms of which species was predominant). Experiments and measurements investigated whether denitrification potential was related to organic matter and its availability to denitrifying bacteria, suitability for bacterial growth, and amount in the wetland. Availability of organic material, as measured in the slurries, was highest in the G. maxima and P. pectinatus samples, with the highest availability in May and August. However, when the samples were closer to wetland conditions, i.e., intact sediment cores containing litter and organic sediment, the denitrifying capacity was highest in the cores from G. maxima stands, but lowest in P. pectinatus cores. In addition, the denitrification potential of the intact cores was highest in November. Differences in denitrification capacity between the slurries and intact sediment cores, considering the organic material of the plant species and the seasonal pattern, were attributed to differences in the amount of plant litter generated

Evaluation of satisfaction with a model of structured contraceptive counseling : Results from the LOWE trial

Introduction: Intervention trials of structured contraceptive counseling have proved to increase use of long-acting reversible contraceptives (LARCs) and decrease numbers of unintended pregnancies. However, these interventions have not been evaluated from a user perspective. This study aimed to evaluate both healthcare providers’ and participants’ satisfaction with an intervention used in a large trial in Sweden. Material and methods: A cross-sectional study on the intervention group from a cluster randomized trial conducted at 28 clinics in Stockholm, Sweden. Clinics were randomized (1:1 allocation ratio) to provide either structured contraceptive counseling (intervention) or standard contraceptive counseling (control). The intervention consisted of four parts; an educational video to be seen by the participant prior to contraceptive counseling, key questions to be asked by the healthcare provider, an effectiveness chart, and a box of contraceptive models. Eligible participants were 18 years or older, sexually active without a wish to conceive, and with the main purpose of contraceptive use being pregnancy prevention. Healthcare providers completed an electronic semi-structured survey to evaluate the intervention. This study analyses provider and participant satisfaction with the counseling material used in the intervention and if the intervention was found to be supportive in contraceptive counseling and contraceptive choice. Trial registration: ClinicalTrials.gov (NCT03269357). Results: Fourteen intervention clinics enrolled 658 participants from September 2017 to May 2019. Response rate among providers was 88.0% (55/62) and among participants 97.1% (639/658). Providers found the intervention to be supportive in their counseling. Each separate part of the intervention package received high ratings from both providers and participants. Participants found the educational video and the effectiveness chart to be more helpful than the box of contraceptive models in their contraceptive choice. Providers reported the time taken to complete the intervention outside the study to be time-neutral to standard counseling, and most providers wished to continue to use all parts of the intervention package. Conclusions: The intervention of structured contraceptive counseling had high provider and participant satisfaction. The structured counseling package could be used in several clinical settings to improve quality in contraceptive counseling and to enhance informed decision making about use of contraceptive methods. © 2021 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley &amp; Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG