Anti-inflammatory and anti-arthritic effects of 3-hydroxy, 2-methoxy sodium butanoate from the leaves of Clerodendrum phlomidis L.f.

Introduction

The leaves of Clerodendrum phlomidis L.f. have been used in the Indian traditional system of medicine to treat several inflammatory diseases and arthritis. The aim of the present study was to assess the anti-inflammatory and anti-arthritic activities of the leaves of C. phlomidis and to isolate the active principle by bioactivity guided fractionation.

Materials and methods

To find the anti-inflammatory constituents from this plant, fractionations were performed with concurrent bioassays. Carrageenan-induced inflammation and Freund complete adjuvant (FCA)-induced arthritic rat models were used. The anti-inflammatory and anti-arthritic activities of the isolated compound were studied by assessing the histology of the joints, levels of lysosomal enzymes, protein-bound carbohydrates, acute phase protein, etc., in plasma, as well as by estimating the levels and expression of pro-inflammatory cytokines in the joints.

Results

Repeated fractionations and bioassays yielded a novel bioactive compound: 3-hydroxy, 2-methoxy-sodium butanoate. Treatment with this compound reduced the paw edema induced by carrageenan and FCA dose dependently. The levels of lysosomal enzymes and protein-bound carbohydrates decreased significantly upon treatment with the compound. The level of plasma acute phase protein was also decreased compared with control animals. Protein levels and mRNA expression of pro-inflammatory cytokines TNF, IL-1 and IL-6 in the joints were decreased significantly in a dose-dependent manner and the histopathological data also added evidence of the anti-arthritic property of the compound.

Conclusion

The 3-hydroxy,2-methoxy sodium butanoate isolated from plant leaves displays considerable potency in anti-inflammatory action and has a prominent anti-arthritic effect. This is the first report of this natural compound with bioactivity.     

Radiology of the hand

This is an overview of radiological imaging of the hand highlighting the various imaging modalities used in the work-up and diagnosis of a range of orthopaedic and rheumatological disorders. The biomechanics and anatomy of the human hand is extremely complex, and a good understanding is required to diagnose pathology. In this article we explain the anatomy and highlight pathology of the hand from a radiological perspective with respect to plain film, CT, ultrasound and MR imaging. Trauma of the hand is extremely common and radiology plays an important role in the diagnosis of treatable injuries including fractures, dislocations and ligament tears. Plain radiography and CT are excellent at evaluating bony injury (e.g. Rolondo or Bennett's fracture) whereas ultrasound and MR are better at evaluating soft tissue injury (e.g. Stener lesion). The hands are a common location for degenerate and inflammatory arthropathies which all have hallmark radiological features. Radiology also plays an important role in the diagnosis and work-up of bone lesions in the hand including enchondromas, osteoid osteomas and chondrosarcomas.     

Tetralogy of Fallot with restrictive ventricular septal defect by accessory tricuspid leaflet tissue

In tetralogy of Fallot septal defect is usually large because of malalignment of outlet septum, restrictive defect has been reported rarely. We present a case of tetralogy of Fallot with accessory tricuspid leaflet tissue restricting ventricular septal defect. The report includes echocardiographic and catheter images of this rare presentation of tetralogy of Fallot.     

Surgical management of pneumosinus dilatans frontalis in the setting of chronic rhinosinusitis and type III frontal Cell

Pneumosinus dilatans (PD) represents a rare lesion of unknown etiology in which progressive enlargement of an air-filled paranasal sinus results in cosmetic and functional complications. The absence of pathologic mucosa has traditionally been considered a hallmark of this disorder. A 24-year-old man presented with 2 years of chronic rhinosinusitis and recurrent, acute episodes of severe forehead pain with worsening outward prominence of the frontal sinus during air travel. Computed tomography and findings at surgery were notable for diffuse nonpolypoid inflammatory changes of the paranasal sinuses, a type III frontal sinus cell, and PD of the frontal sinus with severe deformity and thinning of the anterior table. A bicoronal approach was used for frontal sinus obliteration and cranioplasty. Excellent cosmetic and functional results were noted at the last follow-up. To our knowledge, this is the first report of PD frontalis presenting in the setting of chronic rhinosinusitis. Surgical management of this disorder requires consideration of both the functional and cosmetic issues.