Intraperitoneal drain placement and outcomes after elective colorectal surgery: international matched, prospective, cohort study

Despite current guidelines, intraperitoneal drain placement after elective colorectal surgery remains widespread. Drains were not associated with earlier detection of intraperitoneal collections, but were associated with prolonged hospital stay and increased risk of surgical-site infections.Background Many surgeons routinely place intraperitoneal drains after elective colorectal surgery. However, enhanced recovery after surgery guidelines recommend against their routine use owing to a lack of clear clinical benefit. This study aimed to describe international variation in intraperitoneal drain placement and the safety of this practice. Methods COMPASS (COMPlicAted intra-abdominal collectionS after colorectal Surgery) was a prospective, international, cohort study which enrolled consecutive adults undergoing elective colorectal surgery (February to March 2020). The primary outcome was the rate of intraperitoneal drain placement. Secondary outcomes included: rate and time to diagnosis of postoperative intraperitoneal collections; rate of surgical site infections (SSIs); time to discharge; and 30-day major postoperative complications (Clavien-Dindo grade at least III). After propensity score matching, multivariable logistic regression and Cox proportional hazards regression were used to estimate the independent association of the secondary outcomes with drain placement. Results Overall, 1805 patients from 22 countries were included (798 women, 44.2 per cent; median age 67.0 years). The drain insertion rate was 51.9 per cent (937 patients). After matching, drains were not associated with reduced rates (odds ratio (OR) 1.33, 95 per cent c.i. 0.79 to 2.23; P = 0.287) or earlier detection (hazard ratio (HR) 0.87, 0.33 to 2.31; P = 0.780) of collections. Although not associated with worse major postoperative complications (OR 1.09, 0.68 to 1.75; P = 0.709), drains were associated with delayed hospital discharge (HR 0.58, 0.52 to 0.66; P < 0.001) and an increased risk of SSIs (OR 2.47, 1.50 to 4.05; P < 0.001). Conclusion Intraperitoneal drain placement after elective colorectal surgery is not associated with earlier detection of postoperative collections, but prolongs hospital stay and increases SSI risk

Folk remedies for insect bites from Gundlabrahmeswaram Wild Life Sanctuary, Andhra Pradesh

436-437The investigation provides information on folk remedies used for different insect bites by the tribal people inhabiting in and around the forests of Gundlabrahmeswaram wild life sanctuary. A list of hither to unknown and little known crude drugs used for different insect bites along with mode of administration is provided

The THERAPEUTIC IMPORTANCE OF GUMS IN FOLK MEDICINE FROM EASTERN GHATS, ANDHRA PRADESH: Traditional uses of gums

Objective: The objective of the present study is to collect ethnobotanical information of gums of medicinal plants from Eastern Ghats of Andhra Pradesh. Methods: Intensive ethnobotanical field trips were conducted in the forests of Eastern Ghats to collect firsthand information on therapeutic importance of gums used in folk medicine. Results: The present report deals with the therapeutic importance of gums in folk medicine used by local tribes inhabiting in and around the forests of Eastern Ghats of Andhra Pradesh. The results of the present study revealed that 21 crude drugs belong to 19 genera and 14 families of higher plants. The critical review of literature on crude drugs with reference to that of Eastern Ghats revealed that 13 crude drugs are hitherto not known to the science. 24 herbal formulations are commonly prepared by the local people to cure 14 human ailments. Out of 21 crude drugs reported in the present study, 10 crude drugs have pharmaceutical importance, namely drug delivery agents (Acacia), disintegrate in tablets (Sterculia), thickeners in oral liquids (Acacia and Mangifera), dilutents, binders, gelling agents in gels (Butea, Neem, and Moringa), and protective colloids in suspensions (Anogeissus) and bases in suppository. Conclusion: Natural gums of plant origin have multifarious pharmaceutical applications. In view of the potential crude drugs with promising therapeutic properties used by the tribal people, there is a need to take up the phytochemical and pharmacological investigations

Herbal remedies for eye infections used by the tribals of Nallamala forests, Andhra Pradesh

765-767A survey was conducted to gather information about utilization of plant resources for the treatment of eye infections, prevalent in tribal habitations of Nallamala forests, Andhra Pradesh. The intensive foray yielded 33 species belonging to 29 genera and 22 families of flowering plants. The medico- botany along with formulations and dosimetry of the crude drugs were reported