Anti-inflammatory and Anti-helminthic potential of Methanolic and Aqueous extract of Polygonum alpinum rhizomes

Aim: The present research work was carried out to evaluate the anti-inflammatory and anthelminthic activity of the extracts of Polygonum alpinum rhizomes. Methods: Fresh rhizomes of the P. alpinum were collected, washed and shade dried. The methanolic and aqueous extracts were first tested for phytochemical screening. In-vitro anti-inflammatory activities of crude extracts were evaluated by HRBC (Human Red Blood Cell) membrane stabilization method and percentage inhibition of protein denaturation method. Similarly anti-helminthic activity was evaluated using earthworms of 6-8 cm in length and 0.3-0.4 cm in width and the results were compared with standard drug Albendazole. Results: Phytochemical analysis of the extract reveals the of presence of Carbohydrates, Cardiac glycosides, Coumarins, proteins,  amino acids, flavonoids, saponins, steroids, terpenoids, tannins and phenolics. The methanolic extract showed potent membrane stabilizing and significantly inhibit protein denaturation as compared to standard indomethacin. Methanolic extract at the concentration of 125μg/mL showed 81.29% membrane stabilizing activity as compared to aqueous extract 64.72%. Standard indomethacin showed 95.56 % activity at the same concentration. Similarly, methanolic extract at 500μg/mL showed 72.70% inhibition of protein denaturation as compared to aqueous extract 64.72%. Standard indomethacin showed 88.26% inhibition of protein denaturation at the same concentration. Both the methanolic and aqueous extracts showed dose dependent anthelminthic activity as compared to standard Albendazole. Conclusion: These results suggest that both the extracts from P. alpinum have promising anti-inflammatory and anthelmintic activity and that more broadly; plant extracts are a potential rich source of anti-inflammatory and anthelmintics to combat these diseases

Surgical Outcome of Renal Cell Carcinoma with Tumor Thrombus Extension into Inferior Vena Cava and Right Atrium (Beating Heart Removal of Level 4 Thrombus): A Challenging Scenario

Aim: “To evaluate oncological and surgical outcomes of different levels of tumor thrombus and tumor characteristics secondary to renal cell carcinoma (RCC)”. Materials and Methods: Retrospective review from 2013 to 2020 of 34 patients who underwent radical nephrectomy with thrombectomy for RCC with tumor thrombus extending into the inferior vena cava (IVC) and right atrium (RA) at our center. Level I and most level II tumors were removed using straight forward occluding maneuvers with control of the contralateral renal vein. None of the patients had level III tumor extensions in our study group. For level IV thrombus, a beating heart surgery using a simplified cardiopulmonary bypass (CPB) technique was used for retrieval of thrombus from the right atrium. Results: “Of the 34 patients with thrombus”, 19 patients had level I, 12 patients had level II, none had level III, and three patients had level IV thrombus. Two patients required simplified CPB. Another patient with level IV thrombus CPB, was not attempted in view of refractory hypotension intraoperatively. Pathological evaluation showed clear-cell carcinoma in 67.64%, papillary carcinoma in 17.64%, chromophobe in 5.8%, and squamous cell carcinoma in 8.8% of cases. Left side thrombectomy was difficult surgically, whereas right side thrombectomy did not have any survival advantage. Mean blood loss during the procedure was 325 mL, ranging from 200 to 1000 mL, and mean operative time was 185 min, ranging from 215 to 345 min. The immediate postoperative mortality was 2.9%. Level I thrombus had better survival compared to level II thrombus. Conclusion: Radical nephrectomy with tumor thrombectomy remains the mainstay of treatment in RCC with inferior venacaval extension. The surgical approach and outcome depends on primary tumor size, location, level of thrombus, local invasion of IVC, any hepato-renal dysfunction or any associated comorbidities. The higher the level of thrombus, the greater is the need for prior optimization and the adoption of a multidisciplinary approach for a successful surgical outcome

Traumatic diaphragmatic rupture, a diagnostic dilemma in the presence of eventration: a case report

Eventration of the diaphragm is the condition where the muscle is permanently elevated, but retains its continuity and attachments to the costal margins. Traumatic diaphragmatic rupture is a recognized consequence of high velocity blunt trauma to the abdomen usually a result of motor vehicle accident. Multi-slice CT and Magnetic Resonance Imaging in the pre-operative evaluation of trauma patients, diaphragmatic rupture can be still overlooked if not evaluated with the fair degree of clinical suspicion, more so if it is associated with an eventration of diaphragm - as was in our case

Pattern, presentation and management of vascular injuries due to pellets and rubber bullets in a conflict zone

Background: Rubber bullets and pellet guns are considered non-lethal low-velocity weapons. They are used to disperse a mob during street protests. The present study was undertaken to analyze the pattern, presentation and management of vascular injuries caused by these weapons. Patients and Methods: This was a prospective study of patients with features of vascular injuries due to pellets and rubber bullets from June 2010 to November 2010. All patients with features of vascular injuries due to these non-lethal weapons were included in the study. Vascular injuries caused by other causes were excluded from the study. Results: A total of 35 patients who presented with features of vascular injury during this period were studied. All of them were males. The mean age was 22 years. Fifteen patients were revascularized primarily, 19 patients needed reverse saphenous vein graft and, in one, patient lateral repair was done. There were two mortalities in our series. Wound infection was the most common complication. The amputation rate was around 6%. Conclusion: Pellet and rubber bullets can cause serious life-threatening injuries. Vascular injury caused by these weapons need no different approach than other vascular injuries. Early revascularization and prompt resuscitation prevents the loss of limb or life

Cumulative effect of gibberellic acid and phosphorus on crop productivity, biochemical activities and trigonelline production in Trigonella foenum-graecum L.

Fenugreek (Trigonella foenum-graecum L.) is an antidiabetic plant. Its bioactive compound, trigonelline, is known to counter diabetes through insulin secretion, modulation of β cell regeneration and quick activity of glucose metabolism related enzymes. A pot experiment was conducted in the natural conditions of net house of the Department of Botany, Aligarh Muslim University, Aligarh (UP), India, to evaluate the effect of four concentrations of GA3 (0, 10−7 M, 10−6 M and 10−5 M), alone and in combination with phosphorus (40 kg P ha−1), on growth, biochemical and yield attributes of fenugreek. Compared to control, the combination of GA3 and phosphorus (P40 + 10−6 M GA3) significantly increased the activities of nitrate reductase (30.8%) and carbonic anhydrase (30.7%) enzymes; it also enhanced the seed yield (140.6%) and the content of total chlorophyll (28.5%) and carotenoids (26%). There was also significant increase (19.51%) in the content of seed trigonelline

Amelioration of experimental hyperlipidemia in rats by Portulaca oleracea Linn from Kashmir Himalaya

Background: Traditionally, Portulaca oleracea Linn. treats abscesses and dysentery as well as liver disease. Additionally, recent studies have reported its effectiveness as a neuroprotective, analgesic, anti-inflammatory, bronchodilator, anti-cancer, antioxidant, and curative, in addition to its pharmacological effects. Aim and Objective: To assess the phytochemical constituents quantitatively & qualitatively and lipid-lowering potential of different extracts of Portulaca oleracea L. from Kashmir Himalaya. Methods: Portulaca oleracea L. was extracted with chloroform, methanol, and aqueous solvents. Qualitative and quantitative phytochemical screening was carried and antihyperlipidemic activity was evaluated in experimental hyperlipidemic rats fed with cholesterol in coconut oil for 14 days. Results: Chloroform, methanol, and aqueous extracts showed the presence of alkaloids, sapon ins, tannins, cardiac glycosides, terpenes, flavonoids, phenolic compounds, proteins, and carbohydrates. Quantitatively the dried plant powder contains alkaloids 0.72 g%, saponins 1.0 g%, phenolics 1.09 g%, tannins 0.91 g%, carbohydrates 0.53 g%, proteins 0.25 g% and lipids 0.87 g%. The aqueous extract was found to decrease the plasma total cholesterol, triglyceride, low-density lipoprotein-cholesterol, very lowdensity lipoprotein-cholesterol levels, LDL-C/HDL-C ratio and significantly elevated the high-density lipoprotein-cholesterol levels as compared to methanol and chloroform extracts against cholesterol-induced hyperlipidemic rats. Conclusions: The results reveal that the Portulaca oleracea L. from the Kashmir region possesses alkaloids, saponins, phenolics, tannins, carbohydrates, proteins and lipids and aqueous extract of Portulaca oleracea L. at a dose of 200 mg/kg body weight possess highly significant antihyperlipidemic action than methanolic and chloroform extracts at similar doses

Spontaneous pneumothorax

Background: Spontaneous pneumothorax is classified into primary spontaneous pneumothorax (PSP) and secondary spontaneous pneumothorax (SSP). PSP occurs without any cause, usually as a result of the rupture of subpleural blebs. SSP is related to the presence of underlying lung disease. The pathological consequences depend primarily on the site of pneumothorax and the condition of the underlying lung. Material and Methods: Data related to 84 patients with 126 episodes of pneumothorax presenting from January 1998 to December 2000 were retrospectively reviewed to assess the clinical manifestations and therapy of spontaneous pneumothorax. Results: There were 52 patients with 80 episodes of PSP and 32 patients with 46 episodes of SSP. The common causes for SSP were tuberculosis (18 patients with 29 episodes) and emphysema (7 patients with 10 episodes). The age of presentation was 27±11 years for PSP and 58.8±15.2 years for SSP (p<0.01). The commonest clinical manifestation with PSP was chest pain (86.25 %)whereas dyspnoea was the commonest manifestation with SSP (84.78%). Seventy-three (91.25%) episodes of PSP and 37 (80.43%) episodes of SSP were managed with non-operative treatment. Thoracotomy was done in 7 (8.7%) and 9 (19.5%) episodes of PSP and SSP respectively. The overall recurrence rate of PSP was 31.25% and 26.08% in SSP. No recurrence was seen with open thoracotomy in both groups of patients. Conclusions: We conclude that patients with both PSP and SSP should be managed initially with nonoperative treatment. Thoracostomy tube drainage is the mainstay of treatment. Patients with SSP are generally debilitated from the respiratory standpoint and may have other significant comorbid diseases. Effective treatment must be individualized

Right anterolateral thoracotomy a minimally invasive approach to mitral valve replacement

Background: The objectives of this study were to analyze the results of the right anterolateral thoracotomy approach for primary mitral valve replacement with reference to length of incision, surgical exposure, mean cross-clamp time, mean bypass time, intensive care unit (ICU) stay, hospital stay, overall comorbidity sepsis, dehiscence, healing cosmesis and cost-effectiveness. Materials and Methods: Thirty-three patients were operated for mitral valve disease in the Department of Cardiovascular and Thoracic Surgery at the Sher-i-Kashmir Institute of Medical Sciences from September 2009 to August 2011 and all patients underwent mitral valve replacement. Results: Of the 33 patients, 13 were male (40.6%) and 19 were female (59.4%). The length of incision was 14.8 ± 2.3 cm and, in thoracotomy, there was a significantly lesser duration of ICU stay the entire hospital stay. Scar visibility was around 25% in case of thoracotomy. Conclusion: Approach through a right anterolateral thoracotomy proved to be easy to perform while maintaining maximum security for the patients. Besides its better cosmetic result, especially in female patients, this approach proved to have several advantages. It offered a better exposure to the mitral apparatus even in patients with small left atrium, allowing mitral valve replacement to be performed easily. The shorter hospital stay and cost-effectiveness of thoracotomy approach is an additional relief to the family