Evaluation of Phytochemical and Anti-diarrheal Activity of Methanol Stembark Extract of Combretum hypopilinum Diels (Combretaceae)

Introduction: The plant Combretum hypopilinum has many medicinal uses in Africa. Infusion of fresh or dry leaves are commonly taken as cholagogic, diuretic, and purgative and also to treat gastrointestinal disorders, including diarrhoea, dysentery, and stomach achesObjective: To carry out phytochemical and antidiarrheal studies on the methanol stembark extract of C. hypopilinum.Methods: The C. hypopilinum stembark (1kg) were extracted with methanol using cold maceration method for 9 days. The solvent was removed by rotary evaporator and the extract was partitioned with n-hexane, chloroform and ethyl acetate to give the n-hexane, chloroform, and ethyl acetate fractions respectively. The extract was subjected to preliminary phytochemical screening, acute toxicity study and antidiarrheal activity using animal models.Result: The following metabolites: carbohydrates, alkaloids, phenol, steroids, terpenes, saponins, flavonoids and tannins were revealed when the phytochemical screening of the plant extract was carried out. The oral median lethal dose (LD50) of crude extract in mice and rats was estimated to be above 5000 mg/kg. The antidiarrheal activity carried out at dose 150, 300 and 600 mg/bw i.p. using castor oil induced diarrheal, gastric-transit time and anti-enteropooling tests in mice and rats. The extract significantly (P<0.05) inhibited diarrheal in mice and rats with highest protection/ inhibition of 93.1% and 87.9% at doses of 600 and 300 mg/kg (dose dependently) which compared with atropine sulphate (86.2%) respectively, in the castor-oil induced diarrheal test in mice. The extract also significantly (P<0.05) inhibited diarrheal in charcoal meal test with the highest % protection of 24.38% at dose 600 mg/kg and compared with loperamide (28.80%). The anti-enteropooling test in rats showed 68% inhibition of diarrheal as compared to atropine sulphate with 78% inhibition.Conclusion: The results indicated that the methanol stembark extract of Combretum hypopilinum possesses significant dose dependant antidiarrheal activity (p<0.05) in all the antidiarrheal tests. Thus, the traditional use of the plant for the treatment of diarrheal is highly justified in this study.

Effectiveness of Improved Use of Chewing Gum During Capsule Endoscopy in Decreasing Gastric Transit Time: A Prospective Randomized Controlled Study

Background/Aim: Chewing gum throughout small bowel capsule endoscopy (SBCE) increases completion rates (CRs) but decreases small bowel transit time (SBTT) and diagnostic yield (DY). We determined the effects of chewing gum early during SBCE on gastric transit time (GTT), SBTT, CR, DY, and gastroscopy intervention.Methods: We prospectively enrolled patients (ages 16–80 years) undergoing SBCE between January and June 2019. Patients were randomized to a chewing gum group (103 patients) and a control group (102 patients). Patients in the former group chewed one piece of gum for ~15 min every 30 min during the first hour of SBCE. Two gastroenterologists blinded to the study group examined the data.Results: GTT was shorter in the chewing gum group (19.0 min, interquartile range: 17.0–52.0 min) than in the control group [42.5 min (23.25–60 min); P = 0.01]. SBTT was similar in the two groups [318.5 min (239.5–421.3 min) vs. 287.0 min (216.0–386.0 min); P = 0.08]. Gastroscopy rate was lower in the chewing gum group (15.53 vs. 32.35%, P = 0.005). CR (95.15 vs. 89.22%, P = 0.114) and DY (66.02 vs. 59.80%, P = 0.359) did not differ between the groups. The number of abnormal-lesion types detected per patient was higher in the chewing gum group [1.0 (0.0–2.0) vs. 2.0 (0.0–2.0); P = 0.049].Conclusions: Chewing gum early during SBCE significantly reduced GTT and gastroscopy intervention, with no influence on SBTT (Trial number: NCT03815136).

Gastroretentive Drug Delivery System of Levo-Salbutamol Sulphate: Formulation and in vitro Evaluation

In order to prepare the sustained release tablet with levo-salbutamol sulphate we have used these excipients methylcellulose, PVPK30, magnesium stearate, talc, isopropyl alcohol, microcrystalline cellulose, lactose, HPMCK100, HPMCK4M. Here our approach was for making the sustained released matrix tablet by two ways, one is to make the tablet granules floating and the second one is by retarding the release of the levo-salbutamol sulphate from the matrix. We have already discussed the relationship with delaying the gastric transit time and the active drug absorption, if the tablet granules are floating in our introduction part. Since the above mentioned excipients are floating in nature so formulations with those excipients are supposed to be floating. We also showed a list of excipients those are used in the preparation of floating tablets. Now the second observation which was the release rate, among the three different formulations (mentioned in the introduction) we found different types of release. Since our objective is to prepare a sustained released tablet which will give a prolong release time, in that prospect two among the three formulations were disqualified (though we have not done the kinetic study). We observed desired effect in the formulation-2 during the preparation of experiment.

SalmonellaNeck Abscess as an Opportunistic Infection in Diabetes Mellitus

Salmonellaneck infections represent an uncommon cause of focal salmonellosis. While the incidence of nontyphoid salmonellosis is estimated at over 2 million cases annually, extraintestinal manifestations account for less than 1% of cases. This paper describes two patients withSalmonellaneck abscesses as the initial presentation of diabetes mellitus. The first patient was diagnosed as havingSalmonella entericaserotype Enteritidis sternocleidomastoid pyomyositis and the second patientSalmonella entericaserotype Typhimurium parapharyngeal abscess. Both patients had elevated hemoglobin A1c levels and had not been previously diagnosed with diabetes mellitus.Salmonellaspp. should be on the differential as a causative pathogen in patients presenting with neck abscesses and poorly controlled glucose levels. Diabetes may be a risk factor for salmonellosis due to decreased gastric acidity and prolonged gastric transit time. Prompt incision and drainage accompanied by antibiotics remains the treatment of choice for infected neck abscesses.