The effect of aqueous stem bark extract of Erythrinamildbraedii on carbon tetrachloride induced liver damage in rats

This study evaluated the curative effects of aqueous stem bark extact of Erythrina mildbraedii in CCL4 induced liver damage. With the exception of group 1 (positive control), CCL4 was administered at a dose of 150 mg/kg to groups II, III, IV and V.Administration of CCL4 caused profound hepatic damage as indicated by elevation in serum levels of liver transaminases, alkaline phosphatase, total and direct bilirubin. There was depletion of serum proteins and albumin. Administration of aquoeus stem bark extract of Erythrina mildbraedii at daily oral doses of 50,100, 150mg/kg reversed these biochemical aberrations to a significant level. The curative effects of stem bark extracts of Erythrina mildbraedii were further substantiated by histopathological examination of the liver hepatocytes . The result of the study suggested that aqueous stem bark extract of Erythrina mildbraedii posses hepatocurative effects.Keywords: Carbontetrachloride, Erythrina mildbraedii, liver enzymes, hepatotoxicity

The effect of aqueous stem bark extract of Erythrina mildbraedii on acetaminophen induced nephrotoxicity in rats

This study was carried out to determine the curative effect of aqueous stem bark extract of Erythrina  mildbraedii in rats induced with nephrotoxicity using  800mg/kg Acetaminophen. Acetaminophen  administration resulted in significant increase in the serum level of urea, creatinine, Na+, K+, Cl- and a  significant  decrease in the level of HCO3 - . Administration of different doses (50, 100, & 150mg/kg) of aqueous stem bark extract of Erythrina mildbraedii ameliorated the  effect of Acetaminophen indicated by a significant  decrease in the level of urea, creatinine, Na+, K+ , Cl- and an increase in the level of HCO3 - when compared to  control rats. The histopathology showed a restoration of the renal architectures after administration of the  aqueous stem bark extract.Keywords: Acetaminophen, Erythrina mildbraedii, nephrotoxicity, aqueous extract

Acute Toxicity Study and Hepatocurative Effect of Aqueous Stem Bark Extract of Parkia Biglobosa in Wister albino Rats

Parkia biglobosa plant is widely is used in folk medicinal practices to treat and/or manage various diseases including diabetes, malaria, diarrhea and pains. The current research seek to establish the toxicity profile and hepatocurative ability of aqueous stem bark extract of the plant. Twelve (12) rats were used for Oral LD50 determination, and were grouped into four (4) groups of three rats (3) each. The first three groups were administered with 10 mg/kg, 100 mg/kg and 1000 mg/kg body weight of the extract respectively, while the last group was subdivided into three groups of one rat each and were administered with 2500mg/kg, 3500mg/kg and 5000mg/kg body weight of the extract respectively. For the hepatocurative studies, twenty five (25) experimental rats were divided into five groups of five (5) rats each. Group I served as normal rats, Group II served as test Control while Groups III to V were induced with liver damage and administered with 50mg/kg, 100mg/kg and 150mg/kg of the extract respectively. The LD50 was found to be greater than 5000mg/kg, while phytochemical screening revealed the presence of Flavanoids, Glycosides, Tanins, Saponins, Steroids and Phenols, with the absence of Anthraquinones. For the hepatocurative study, a significant (p<0.0.5) increase in serum albumin and liver enzymes (AST, ALT and ALP) was observed in test control compared to normal control. Upon administration of the extract, a significant (p<0.0.5) fall in Albumin, AST, ALT and ALP was recorded in a dose dependent pattern. No significant difference (p>0.05) was observed between groups in total protein, direct and total bilirubin. The research concludes that the extract is practically non-toxic and possess strong hepatocurative ability which might be due to the phytochemicals present. Keywords: Acute toxiicity; CCl4; Liver; P. biglobosa; Phytochemical and wistar rats. DOI: 10.7176/JNSR/13-16-04 Publication date:September 30th 202

Prospective observational cohort study on grading the severity of postoperative complications in global surgery research

Background The Clavien–Dindo classification is perhaps the most widely used approach for reporting postoperative complications in clinical trials. This system classifies complication severity by the treatment provided. However, it is unclear whether the Clavien–Dindo system can be used internationally in studies across differing healthcare systems in high- (HICs) and low- and middle-income countries (LMICs). Methods This was a secondary analysis of the International Surgical Outcomes Study (ISOS), a prospective observational cohort study of elective surgery in adults. Data collection occurred over a 7-day period. Severity of complications was graded using Clavien–Dindo and the simpler ISOS grading (mild, moderate or severe, based on guided investigator judgement). Severity grading was compared using the intraclass correlation coefficient (ICC). Data are presented as frequencies and ICC values (with 95 per cent c.i.). The analysis was stratified by income status of the country, comparing HICs with LMICs. Results A total of 44 814 patients were recruited from 474 hospitals in 27 countries (19 HICs and 8 LMICs). Some 7508 patients (16·8 per cent) experienced at least one postoperative complication, equivalent to 11 664 complications in total. Using the ISOS classification, 5504 of 11 664 complications (47·2 per cent) were graded as mild, 4244 (36·4 per cent) as moderate and 1916 (16·4 per cent) as severe. Using Clavien–Dindo, 6781 of 11 664 complications (58·1 per cent) were graded as I or II, 1740 (14·9 per cent) as III, 2408 (20·6 per cent) as IV and 735 (6·3 per cent) as V. Agreement between classification systems was poor overall (ICC 0·41, 95 per cent c.i. 0·20 to 0·55), and in LMICs (ICC 0·23, 0·05 to 0·38) and HICs (ICC 0·46, 0·25 to 0·59). Conclusion Caution is recommended when using a treatment approach to grade complications in global surgery studies, as this may introduce bias unintentionally

The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis

© 2017 British Journal of Anaesthesia Background: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. Methods: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals. Results: We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32–0.77); P\u3c0.01], but no difference in complication rates [OR 1.02 (0.88–1.19); P=0.75]. In a systematic review, we screened 3732 records and identified 11 eligible studies of 453 292 patients including the ISOS cohort. Checklist exposure was associated with both reduced postoperative mortality [OR 0.75 (0.62–0.92); P\u3c0.01; I2=87%] and reduced complication rates [OR 0.73 (0.61–0.88); P\u3c0.01; I2=89%). Conclusions: Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine

Critical care admission following elective surgery was not associated with survival benefit: prospective analysis of data from 27 countries

This was an investigator initiated study funded by Nestle Health Sciences through an unrestricted research grant, and by a National Institute for Health Research (UK) Professorship held by RP. The study was sponsored by Queen Mary University of London