Investigation for anti-inflammatory and anti-thrombotic activities of methanol extract of Capparis ovata buds and fruits

Ethnopharmacological relevance

Capparis ovata Desf. has wide natural distribution in Turkey and it is consumed in pickled form. Flower buds, root bark, and fruits of the plant are used traditionally due to their analgesic, anti-inflammatory, wound healing, anti-rheumatismal, tonic, and diuretic effects.

Aim of the study

The aim of this study was to investigate the possible anti-inflammatory and anti-thrombotic effects of methanol extracts prepared from flower buds (CBE) and fruits (CFE) of C. ovata.

Materials and methods

Anti-inflammatory effects of CBE and CFE were assessed using carrageenan-induced and prostaglandin E₂-induced mouse paw edema models. For the anti-thrombotic effect evaluation, carrageenan-induced tail thrombosis model was performed in mice. The extracts were administered intraperitonally (i.p.) at the doses of 100, 200, and 300 mg/kg. The anti-inflammatory effect of Capparis extracts were tested in comparison to 10 mg/kg diclofenac and anti-thrombotic activity to 10 and 100 IU heparin.

Results

CBE at the doses of 200, and 300 mg/kg and CFE at the doses of 100, 200, and 300 mg/kg showed significant anti-inflammatory activity and CFE reached therapeutic concentration early than CBE in carrageenan inflammation model. In prostaglandin E₂ inflammation model, CBE and CFE exhibited significant inhibitory effects. The C. ovata extracts did not show remarkable anti-thrombotic effect.

Conclusions

Based on the results obtained, it can be concluded that fruits of C. ovata have more potent anti-inflammatory effect than flower buds. It has been suggested that inhibition of cyclooxygenase pathway is one of the mechanisms of the activity. C. ovata may be potentially used as therapeutic agents for inflammatory diseases.     

Management of peripartum hysterectomies performed on patients with placenta percreta in a tertiary central hospital

Objective: The main objective of this study is to analyse the circumstances and management of peripartum hysterectomies performed on patients with placenta percreta.

Methods: This study included 37 patients who were diagnosed with placenta percreta, a condition in which the placenta invades the uterine wall, and who therefore underwent a peripartum hysterectomy. Their demographic characteristics, history of past caesareans, uterine surgery and curettage, duration of hospitalization, admission to an intensive care unit, neonatal outcomes, skin and uterus incision type, hypogastric artery ligation (HAL), complications, quantities of transfused ES (erythrocyte suspensions), and FFP (fresh frozen plasma), maternal morbidity and mortality and postoperative pathology results were retrospectively reviewed.

Results: All pregnant patients who underwent a caesarean hysterectomy due to placenta percreta had a history of caesarean section and also of placenta praevia totalis. Bilateral HAL was performed in two patients (5.4%), owing to uncontrollable bleeding during the bladder dissection. The complications most frequently observed were bladder injury (13.5%), followed by infection (8.1%) and relaparotomy (5.4%). There was no mortality. Twenty-three (62.2%) of the patients had ES and 11 patients (29.7%) had FFP transfusions. According to the histopathology findings, 33 of the 37 patients (89.1%) reportedly had placenta percreta, three patients had placenta increta, and one patient had placenta accreta. Analysis of the neonatal status at birth showed that the gestational age was, on average, the 35th week. The birth weight was normal in relation to the gestational week, but the first and fifth minute Apgar score, which measures the physical condition of an infant, was found to be lower than the normal range.

Conclusions: If a pregnant patient undergoes uterine surgery or has a history of a caesarean with placenta praevia, she is likely to have placenta percreta. In placenta percreta cases with bladder invasion; careful suturing of the high-volume vessels on the posterior wall of the bladder, through the bladder serosa is important in reducing the amount of bleeding and preventing future fistula formation.