Urinary bladder paraganglioma: a clinical dilemma in diagnosis and management: our experience at a tertiary care center

Urinary bladder paraganglioma (UBP) are rare neuroendocrine tumors with variable biological behavior. High index of suspicion in the preoperative evaluation would enable the clinician to formulate appropriate management of the rare tumors. Clinical and pathological data of seven cases evaluated and treated as per a devised protocol for suspected bladder paraganglioma from 2008 to 2019 was retrospectively reviewed. Among the seven cases, UBP’s were predominantly seen in middle aged men. Most of these presented with storage symptoms (85.71%; n=7) and gross painless hematuria (42.85%; n=3). Three patients were hypertensives and post-micturition syncope was seen in two patients. Among the seven patients two patients had functionally active tumors confirmed by elevated urinary and serum markers for catecholamine excess. Functional tumors, nonfunctional tumors involving uretero-vesical junction or broad based polypoidal tumor were considered for partial cystectomy. Other small nonfunctional tumors underwent trans-urethral resection of bladder tumour (TURBT). Follow up protocol included repeat ultrasound, check cystoscopy and completion TURBT at one month and annually thereafter. Repeat urinary catecholamines at 1 month was done in functional UBP. Cystoscopic examination of a bladder lesion which are solid, sessile and predominantly intramural, a prior to a definitive planned surgery may differentiate UBP from urothelial cancer. Most of the non-functional UPB are diagnosed by histopathological examination.  In symptomatic cases, functional evaluation with biochemical estimation of catecholamine excess allow better treatment planning and avoiding intraoperative hemodynamic instability. Due to high recurrence rate life-long follow-up despite complete excision is strongly recommended

Pharmacological evaluation of Hibiscus abelmoschus against scopolamine-induced amnesia and cognitive impairment in mice

Objective: Progressive loss of memory has a prominent role in devastating neurodegenerative diseases such as amnesia, dementia and Alzheimer's disease. The present study was, thus, designed to investigate the potential of Hibiscus abelmoschus (H. abelmoschus) in scopolamine-induced amnesic Swiss Albino mice. Materials and Methods: Phytochemical and acute toxicity studies of H. abelmoschus ethanolic extract (HAEE) were performed. Memory loss was induced by scopolamine (1 mg/kg, i.p), a muscarinic antagonist, and evaluated by using Morris water maze (MWM), elevated plus maze (EPM) and modified passive avoidance tests on Swiss Albino mice. Besides this, locomotor activity, serum biochemical parameters such as total cholesterol and triglyceride levels were evaluated. Lipid peroxidation (LPO), glutathione (GSH) level and catalase (CAT) activity were also checked. HAEE at a dose of 200 and 400 mg/kg body weight administered orally to the animals. Donepezil hydrochloride (1 mg/kg) was taken as standard. Results: Pre-treatment of mice with HAEE significantly reversed scopolamine-induced memory impairments, as evidenced by a significant decrease in escape latency in the MWM task, transfer latency in EPM task and an increase in step-down latency in the modified passive avoidance task. HAEE also exhibited a remarkable cholesterol and triglyceride-lowering property in the present study. Moreover, treatment with HAEE (200 and 400 mg/kg, p.o) to scopolamine-induced rats significantly decreased the LPO and increased the GSH and catalase levels. Conclusion: The memory restorative effects of H. abelmoschus in amnesia may involve its multiple functions including antioxidative and lipid-lowering properties and the presence of phytoconstituents. Thus, H. abelmoschus may act as memory enhancer and may also be useful as a supportive adjuvant in the treatment of impaired memory functions

Pathophysiological status and nutritional therapy of peptic ulcer: An update

Peptic ulcer (PU) is the most common disease of gastrointestinal tract (GIT) which affects the stomach and duodenum. It is characterized by an imbalance between the aggressive and defensive factors. Lifestyle and eating habits play an important role in the case of PU. According to the latest World Health Organization data published in April 2011, PU disease deaths in India reached 108,392 or 1.20% of the total deaths. The age-adjusted death rate is 12.37/100,000 of population, which leads India to 5th rank in the world. The aim of this review was to summarize the scientific data, herbal research, nutritional therapy, precautions, and pharmacological/nonpharmacological treatment regarding PU. The update conclusion regarding PU therapy was concluded with the help of published scientific data on Pub Med, Google Scholar, Med Know, Elsevier and other online resources. Natural remedies are found to be safe (minimum side effects) whereas, in allopathic treatment, antacids with the combination of proton pump inhibitors can better control PU. A balanced dietary plan should be advised by health care professionals or providers to patients suffering from PU. Following good habits and avoiding spicy food make our GIT healthy. Hence, a better lifestyle automatically cures the PU. Better knowledge with balanced lifestyle is an excellent treatment of PU

Antimicrobial effects of leaves of Indian herbal plants with reference to peptic ulcer

Objective: Gastrointestinal (GI) diseases affect a large part of the population. Peptic ulcer (PU) which is very common disease affects the stomach and duodenum. Many microbial species such as Staphylococcus aureus, Bacillus subtilis, Escherichia coli, Pseudomonas aeruginosa, Aspergillus tubingensis etc are responsible for PU directly or indirectly. Materials and Methods: The aim of this study was to find out the effects of aqueous and ethanolic extracts of leaves of Quisqualis indica, Elaeocarpus ganitrus and Prosopis cineraria on PU-associated microorganism. Minimum inhibitory concentration (MIC) and the synergistic effects of selected plant extracts with renowned standards (ciprofloxacin, norfloxacin, ketoconazole, and fluconazole) were estimated. Disc diffusion and solid dilution methods were used for the determination of antimicrobial effects and MIC. Results: Studies revealed that the plant extracts were highly effective against selected microbes. Escherichia coli was found to be the least affected microbial species. Different infectious diseases of GI tract might be cured using formulations having these selected plant extracts. The zone of inhibitions (ZOI) was observed ranging from 2.3 ± 0.57 to 12.3 ± 0.59 mm. The maximum ZOI was observed (12.3 ± 0.59 mm) for ethanolic extract of Elaeocarpus ganitrus against Pseudomonas aeruginosa. Conclusion: The herbal extracts were found to be highly promising against selected microbial species associated with PU

Botanical, phytochemical and pharmacological aspects of Livistona chinensis: A traditional Chinese plant

Introduction: Livistona chinensis (L. chinensis) or Chinese fan palm is a tropical and subtropical plant that is commonly planted across the world. Its fruits are fleshy, green in appearance, and contain a firm seed. The biochar produced from Chinese fan palm fruit is an excellent source for the adsorption of colours from bodies of water for subsequent disposal. Biosorption is a great and environmentally beneficial method of removing contaminants from the environment. Traditional Chinese medicine (TCM) practitioners utilised it to treat cancer. Experiments have indicated that extracts of L. chinensis fruits and seeds have antiproliferative and antiangiogenic effects. Flavanoids, phenolic acids, terpenes, alkaloids, and other compounds are found in L. chinensis. Methodology: The online database including Google Scholar, Scopus, PubMed, and Web of Science were searched using different keywords: L. chinensis phytochemistry, pharmacology and toxicology. The purpose of this review was therefore to summarize the previously reported phytochemicals, pharmacological status of the chosen Chinese plant species. Results: Our findings show that Livistona chinensis includes a wide range of physiologically active chemicals, such as flavonoids and terpenoids. Furthermore, past research has shown that L. chinensis plant extracts and extracted principles have substantial pharmacological action, including anti-tumour, anti-inflammatory, antioxidant, anti-melanogenic, and other properties. Discussion: According to the research listed below, L. chinensis has a high potential for developing medicines and supplements for prophylactic as well as therapy of cancer, ulcer, diabetes, and other diseases. Furthermore, clinical research has demonstrated that jujube is a safe and effective plant for human consumption, and as such, it should be included in dietary intakes as well as active ingredients in pharmaceutical formulations. Conclusion: L. chinensis is a great source of bioactive compounds that may be put into human meals and show promise in the treatment of minor to life-threatening medical conditions. This review will inspire other scientists to conduct more research on the selected plant species, particularly in the areas of toxicity and bioactivity