Effect of adeno-tonsilectomy on hearing threshold and middle ear pressure

Out of 50 children (100 ears) undergoing adeno-tonsillectomy, 34 ears had hearing threshold 20–50 dB (20dB is normal) and 32 ears showed negative middle ear pressure of 100 to 400 mmH₂O (100 mmH₂O is normal). Post-operatively only 7 ears had hearing threshold of 20–30 dB and negative middle ear pressure of 100 to 200 mmH₂O. Thus adenoidectomy improves eustachian tube functions.     

Antileishmanial action of Tephrosia purpurea linn,extract and its fractions against experimental visceral leishmaniasis

Tephrosia purpurea (family: Fabaceae), which is used in traditional remedies for the treatment of febrile attacks, enlargement and obstruction of liver, spleen, and kidney, was found to have significant antileishmanial activity, and has been extensively fractionated to locate the abode of activity. A fraction (F062) obtained from N‐butanol extract of T. purpurea showed consistent antileishmanial activity at 50 mg/ kg × 5 days by oral route against Leishmania donovani infection in hamsters. Activity was further confirmed in a secondary model, i.e., Indian langur monkeys (Presbytis entellus). Thus, the fraction F062 from this plant possesses potential to produce significant antileishmanial activity by oral route without producing any toxic side effects. Drug. Dev. Res. 60:285–293, 2003. © 2003 Wiley‐Liss, Inc.     

Nonoperative management of bile leaks following liver transplantation

The biliary anastomosis has been called ‘the Achilles heel’ of liver transplantation (Rabkin JM, Orloff SL, Reed MH . Transplantation 1998: 65 [2]: 193; Davidson BR, Rai R, Kurzawinski TR . Br J Surg 1999: 86 [4]: 447). Biliary complications after liver transplantation reportedly occur at an incidence of 20–30%, 10–15% as bile leaks. The management of bile leaks, especially early bile leaks, is controversial. In the present study, we report our experience with the management of bile leaks after liver transplantation.
In this retrospective study, we reviewed 85 liver transplants over a 3‐yr period. In 79, the biliary anastomosis was choledochocholedochostomy (CDCD) over a small‐caliber T‐tube, while choledochojejunostomy (CDJ) was used in 7. Over a mean follow up period of 13.5 months (median 10 months), 10 patients (12%) experienced a clinically significant bile leak within the first 3 months after liver transplantation.
The early leaks, occurring within 1 month of transplant, were successfully managed by observation (Davidson BR, Rai R, Kurzawinski TR . Br J Surg 1999: 86 [4]: 447) or endoscopic retrograde cholangiopancreatography (ERCP) and the placement of a biliary stent for a duration of 6–12 wk (Randall HB, Wachs ME, Somberg KA . Transplantation 1996: 61 [2]: 258). One of these resulted from accidental dislodgement of the T‐tube on postoperative day 1; one resulted from necrosis at the CDCD anastomosis and required CDJ; the remaining four resulted from leaks along the T‐tube track.
One of the late leaks occurred following the planned removal of the T‐tube at 3 months after liver transplantation; the other two were leaks along the T‐tube track. All were successfully treated by ERCP and stent placement, though in one case, ERCP was initially unsuccessful because of the inability to advance a guidewire, necessitating a fluoroscopically aided guide wire placement during a mini laparotomy. ERCP was then successfully performed with the placement of a stent. Table 1 Conclusions: Our experience indicates that most bile leaks after liver transplantation, including early leaks, can be successfully managed nonoperatively. Most will require intervention, but ERCP and stent placement are usually sufficient.

Post-traumatic maxillary sinus mucocele.

Two cases of post-traumatic maxillary sinus mucoceles are described. In both scenarios, the patients had sustained severe facial injuries many years prior to presentation. Proptosis and globe displacement were identified clinically, and both patients had radiographic evidence of a maxillary sinus mucocele. Maxillary sinus mucoceles may occur as a late complication of facial fractures even if the draining ostium is normal.     

Anti-obesity and hypoglycemic effect of ethanolic extract of Murraya koenigii (L) leaves in high fatty diet rats

ObjectiveTo evaluate the hypoglycemic and anti-obesity activities of of Murraya koenigii leaves.MethodThe study was performed in high fatty diet induced obesity rats. After 15 days baseline period the treatments animals were received ethanolic extract of Murraya koenigii leaves (300 and 500 mg/kg) in high fatty diet rats. All the treatments were given for one month. On 30th day all the fasted animals received an intraperitoneal injection of glucose (1 g/kg) for glucose tolerance test. At the end of study body weight, total cholesterol, triglycerides, and blood glucose level were measured.ResultsThe results demonstrate clearly that repeated oral administration of Murraya koenigii leaves evoked a potent anti-hyperglycaemic activity in high fat diet obese rats. Postprandial hyperglycaemic peaks were significantly lower in plant-treated experimental groups. In other hand, high fatty diet group increased the both total cholesterol and triglycerides levels as compared to control group. While administration of Murraya koenigii leaves significantly decreased in both cholesterol as well as triglycerides.ConclusionsWe can conclude that Murraya koenigii leaves evokes potent anti-hyperglycaemic and anti-obesity effects. This fact could support their use by the diabetes patient for controlling body weight as well as maintains the glycemic level.