Atypical presentation of gangrenous cholecystitis: A case series

Gangrenous cholecystitis (GC) is a serious complication of acute cholecystitis that has been associated with increased morbidity. Patient with GC can present with a wide variety of non-specific clinical, laboratory, and imaging characteristics, making the diagnosis challenging. This disease requires emergent treatment, which is why a quick and reliable diagnosis is essential for the wellbeing of the patient. The authors herein present a case of GC in a patient whose initial complaint was intractable hiccups, and provide a thorough review of the literature of cases of GC with atypical presentations.     

Troleandomycin: Effectiveness in steroid-dependent asthma and bronchitis

The steroid dose-reducing capacity of troleandomycin (Tao), a macrolide antibiotic, was substantiated by a double-blind crossover study of 74 corticosteroid-dependent asthmatic and bronchitic subjects. Fifty were marked responders, 13 probable responders, and 11 nonresponders. Responders also improved in their sputum production, pulmonary function measurements, need for aerosolized bronchodilators, and subjective evaluations. Tao was effective when used concomitantly with methylprednisone. At a dose of up to 16 mg. of methylprednisolone per day, along with 250 to 500 mg. of Tao per day, patients could either retain a normal serum cortisol level or increase this to normal values 24 to 48 hours after the last dose. Hepatic function abnormalities were usually mild and transient but 10 had increased alkaline phosphatase levels, prompting discontinuation in some patients. The mechanism of action is not known, but in 11 of 14 marked responders on Tao, the threshold dose of methacholine required to produce a 20 per cent fall in Fev₁ was substantially increased. The antibiotic property of Tao did not explain improvement.     

Serum enzymatic changes modulated using trypsin: chymotrypsin preparation during burn wounds in humans

The levels of marker enzymes for liver function, namely transaminases (SGPT, SGOT), creatine phosphokinase (CPK), alkaline phosphatase (ALP) and lactate dehydrogenase (LDH) were estimated in the sera of burn patients by administering trypsinchymotrypsin preparation and comparing with an untreated group. Neutrophil proteolytic activity was also measured by assaying the lysosomal enzymes, namely neutrophil clastase and cathepsin D. Our earlier studies have already proved the efficacy of the above enzyme preparation to burn patients on the enhancement of vascular responses during the acute phase of the burn injury. These beneficial responses were brought about by the modulation of acute phase proteins expressed in the liver. Hence, it is of interest to study the changes in the above mentioned liver enzymes and certain lysosomal enzymes in the serum during the first 10 days of burn injury. The levels of liver and lysosomal enzymes markedly decreased in the treated group when compared with the untreated group. The enzyme studies clearly indicated that the initial rise in the liver enzymes was minimized in the treated group when compared with the untreated group and this helped in reducing the stress to the liver in the treated cases. The increase in the activity of ₁-antitrypsin and ₂-macroglobulin and decreased levels of C-reactive protein are atributed to the reduction of proteolytic enzyme levels in the treated group and minimizing the degradative changes during wound repair.     

Potentiation of carbon tetrachloride hepatotoxicity in rats by pretreatment with polychlorinated biphenyls.

Pretreatment of male rats with Aroclor 1254 at a dose of 25 mg/kg i.p. for 6 days resulted in potentiation of the hepatotoxicity of inhaled carbon tetrachloride (CCl4) as evidenced by a decrease in liver glucose-6-phosphatase and elevations of serum glutamic oxalacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT), isocitrate dehydrogenase, and sorbitol dehydrogenase. Aroclor 1254 alone did not demonstrate hepatotoxicity. Aroclor 1254 administration resulted in large increases in cytochrome c reductase, cytochrome P-450 (448) AND P-Nitroanisole demethylation. Subsequent exposure to CCl4 vapor resulted in over 70% decreases in the latter two parameters. The potentiation was dose-dependent with a dose of 5 mg/kg or higher being effective. Aroclor 1260 administration gave results similar to those of Aroclor 1254, but Aroclor 1221 enhanced CCl4 toxicity to a lesser extent.     

The administration of monosodium L-glutamate to neonatal and pregnant rhesus monkeys

Monosodium L-glutamate (MSG) was administered, in 3 series of experiments, to infant rhesus monkeys of both sexes in single oral doses at the rate of 2 to 4 g/kg body weight: after observation for approx. 4 h, during which there was no evidence of vomiting or other malreaction, and subsequent perfusion, examination was made by light and electron microscopy for evidence of changes in the hypothalamic region. In a fourth experiment the new-born progeny of the mothers that had received 4 g/kg body weight/day MSG during the last one-third of pregnancy were similarly examined after having seen removed at birth and observed for 3 h. There was no evidence in any instance of any change that could be attributed to MSG as described by Olney and Sharpe, although there were artefacts in some inadequately fixed areas as recorded by Reynolds and her co-workers.It is concluded that the negative effect of high oral doses, taken into account with the results of investigation by Olney and others, is consistent with the safety-in-use of MSG as a food flavour enhancer.     

A novel chitosan based antimalarial drug delivery against Plasmodium berghei infection

Chitosan is a natural polysaccharide that has attracted significant scientific interest during the last two decades and chitosan based nanodrug delivery systems seem to be a hopeful and viable strategy for improving disease treatment. This study aims to evaluate the potency of the polymer based nanochloroquine in application for attenuation of Plasmodium berghei infection in Swiss mice and effectiveness against the parasite induced oxidative stress and deoxyribo nucleic acid (DNA) damage in lymphocytes. Nanoparticle was prepared by ionotropic gelation between chitosan and sodium tripolyphosphate. The chloroquine was treated by the actual drug content of effective nanochloroquine and the nanodrug was charged with its effective dose for fifteen days, after successive infection development in Swiss mice. Gimsa staining of thin smear and flow cytometry analysis was pursued to reveal the parasitemia. Different oxidative markers, inflammatory markers, antioxidant enzymes level and also lymphocytic deoxyribo nucleic acid damage study were performed. The present study reveals the potency of the nanodrug which has been found as more prospective than only chloroquine treatment to combat the parasite infection, oxidative stress as well as inflammation and DNA damage. From the study, we conclude this nanodrug may be applicable as potent therapeutic agent than only chloroquine.     

Enzymatic,antimicrobial and toxicity studies of the aqueous extract of Ananas comosus (pineapple) crown leaf

Ethnopharmacological relevance

Various parts of the plant pineapple (Ananas comosus) are used in traditional medicine worldwide for treatment of a number of diseases and disorders. In folk medicine, pineapple leaf extract was used as an antimicrobial, vermicide, purgative, emmenagoogue, abortifacient, anti-oedema and anti-inflammatory agent. Compared to the fruit and stem extracts of pineapple, information about its leaf extract is limited. The potential of pineapple crown leaf extract as an ethno-medicine has been evaluated in terms of its enzymatic activities related to wound healing, antimicrobial property and toxicity.

Materials and methods

Major protein components of the extract were revealed by 2-D gel electrophoresis followed by MS/MS analysis. Zymography, DQ-gelatin assay were performed to demonstrate proteolytic, fibrinolytic, gelatinase and collagenase activities. DNase and RNase activities were revealed from agarose gel electrophoresis. Antimicrobial activity was evaluated spectrophotometrically from growth inhibition. Sprague-Dawley rat model was used to measure acute and sub-acute toxicity of the extract by analyzing blood markers.

Result

The extract contains several proteins that were clustered under native condition. Proteomic studies indicated presence of fruit bromelain as major protein constituent of the extract. It showed nonspecific protease activity, gelatinolytic, collagenase, fibrinolytic, acid and alkaline phosphatase, peroxidase, DNase and RNase activities along with considerable anti-microbial property. The leaf extract did not induce any toxicity in rats after oral administration of acute and sub-acute doses.

Conclusion

Pineapple leaf extract is nontoxic, contains enzymes related to damage tissue repairing, wound healing and possibly prevents secondary infections from microbial organisms.     

Development of safety profile evaluating pharmacokinetics, pharmacodynamics and toxicity of a combination of pioglitazone and olmesartan medoxomil in Wistar albino rats

Pioglitazone (PIO), an antidiabetic drug and olmesartan medoxomil (OLM), an antihypertensive drug were administered orally alone and in combination to Wistar albino rats for evaluation of pharmacokinetics, pharmacodynamics and repeated dose 28-day oral toxicity of individual drugs and their combination. Pharmacokinetic study was performed by orally administering PIO and OLM at single dose of 3 and 2mg/kg, respectively alone and in combination analyzing the plasma samples using LC-MS/MS. Antidiabetic activity evaluation was done in type-2 diabetes mellitus induced animals at same dose level as in pharmacokinetic study daily for 30 days. PIO and/or OLM were administered orally to animals at daily doses of 50, 100 and 150 mg/kg for 28 days for toxicity study. There was no significant alteration in the pharmacokinetic parameters of either drug indicating absence of any pharmacokinetic interaction when co-administered. Positive pharmacodynamic interaction between PIO and OLM was established in this study. Two drugs in combination showed no evidence of potentiation of 28-day repeated dose toxicity in animals. Again, drugs, alone and in combination, caused only minor changes in clinical-laboratory tests and histopathological change was not found in the experiment performed. In conclusion, PIO and OLM combination can primarily be stated as safe in terms of present toxicity and pharmacokinetics findings.     

Activity of liver enzymes in multiple sclerosis patients with Hot-nature diet and co-supplemented hemp seed,evening primrose oils intervention

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