Antispasmodic Drugs Research Articles

EFFECT OF DASHMOOLA TAIL ANUVASAN BASTI ON UDAVARTA YONIVYAPAT W.S.R. TO DYSMENORRHEA – A Case Study.

“EFFECT OF DASHMOOLA TAIL ANUVASAN BASTI ON UDAVARTA YONIVYAPAT W.S.R. TO DYSMENORRHEA – A Case Study.”
 
 AUTHOR: - Vd. Ishwari Sunil Dhavale
 PG Scholar,
 Prasuti Tantra & Stree Rog Dept., YMT AMC, Kharghar.
 dhavale.ishwari05@gmail.com
 
 Co-AUTHOR:-
 Vd. Mangesh L. Patil 
 PG Guide,
 Reader, Prasuti Tantra & Stree Rog Dept., YMT AMC, Kharghar.
 
 
 
 ABSTRACT:-
 
 Menstruation is a normal physiological process. Accompanied with intolerable pain, it is called as Dysmenorrhea. Dysmenorrhea is one of the most common disorders which suffer 60% of women between 15-45 ages. It causes severe pain & discomfort in everyday activities for several days each month. Uses of modern medicines like anti-inflammatory, anti-spasmodic drug, hormonal therapy are still unsatisfactory in giving relief and may cause unwanted effects.
 Ayurvedic classics defined Udavarta Yoni vyapat; here the menstruation is accompanied with severe pain. It disappears on beginning of menstruation. According to Ayurveda menstruation is controlled & governed by Apan vayu. Due to movement of Apan vayu in opposite direction or disturbance obstruction in the flow of vayu may cause severe pain just prior to menstruation called as Udavarta yoni vyapat.
 There are many treatments for Udavarta Yoni vyapat in Ayurveda, which are non-hormonal, non-surgical & most effective without side effect. Among these Dashmoola Tail Anuvasan Basti mentioned in Charak Samhita was selected in present study.
 
 KEY WORD:- 
 Udavarta yoni vyapat, Dashmoola Tail Matra Basti.

Surgical treatment of foreign body embolus in the Middle cerebral artery secondary to neck injury

Background: We report a case of a foreign body embolus to the middle cerebral artery and reviewed similar cases previously reported. Methods: A 30-year-old man was seen 72 days after a penetrating neck injury with a 1-month history of numbness in the left limb and impairment of the fine movement in the left hand. Radiological examination revealed a foreign body in the M2 portion of the right middle cerebral artery (MCA). The patient received arteriotomy and in situ suturing. Results: During the operation, we found a metallic foreign body at the bifurcation of the M2 upper trunk of the right MCA, narrowed distal blood vessels and thinned vessel walls. The foreign body was surrounded by granulation tissue. Both foreign body and granulation tissue were removed slowly followed by in situ suturing. Indocyanine green angiography confirmed arterial patency. Three days after the surgery, the patient developed numbness and weakness in the left arm, with a muscle strength of grade 4. Computed tomography showed partial infarction in the right temporal lobe. Then, antispasmodic drugs were used. Muscle strength recovered by 14 days after the operation. Conclusions: In the subacute stage, surgery can be conducted to remove intra-arterial foreign bodies along with their surrounding granulation tissue if computed tomography perfusion suggests a decreased blood flow reserve capacity.

Systematic review of interventions for the prevention and treatment of postoperative urinary retention.

BackgroundPostoperative urinary retention (PO‐UR) is an acute and painful inability to void after surgery that can lead to complications and delayed hospital discharge. Standard treatment with a urinary catheter is associated with a risk of infection and can be distressing, undignified and uncomfortable. This systematic review aimed to identify effective interventions for the prevention and treatment of PO‐UR that might be alternatives to urinary catheterization.MethodsElectronic databases were searched from inception to September 2017. Randomized trials of interventions for the prevention or treatment of PO‐UR were eligible for inclusion. Studies were assessed for risk of bias using the Cochrane (2.0) tool. Two reviewers were involved at all review stages. Where possible, data were pooled using random‐effects meta‐analysis. The overall quality of the body of evidence was rated using the GRADE approach.ResultsSome 48 studies involving 5644 participants were included. Most interventions were pharmacological strategies to prevent PO‐UR. Based on GRADE, there was high‐certainty evidence to support replacing morphine in a regional anaesthetic regimen, using alpha‐blockers (number needed to treat to prevent one case of PO‐UR (NNT) 5, 95 per cent c.i. 5 to 7), the antispasmodic drug drotaverine (NNT 9, 7 to 30) and early postoperative mobilization (NNT 5, 4 to 8) for prevention, and employing hot packs or gauze soaked in warm water for treatment (NNT 2, 2 to 4). Very few studies reported on secondary outcomes of pain, incidence of urinary tract infection or duration of hospital stay.ConclusionPromising interventions exist for PO‐UR, but they need to be evaluated in randomized trials investigating comparative clinical and cost effectiveness, and acceptability to patients.

NONANTIBIOTICS ENHANCE THE ANTIBACTERIAL ACTIVITY OF CEFTRIAXONE AGAINST METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS

Objectives: Antibiotic resistance is one of the most persistent issues worldwide nowadays, and methicillin-resistant Staphylococcus aureus (MRSA) infection is one such issue where the standard therapeutic procedures involving powerful antibiotics have failed in controlling the infection.Methods: In the present study, the antibacterial potency of the nonantibiotics troxipide (TR), mebeverine hydrochloride (Hcl), and their combinations with ceftriaxone (CEF) against MRSA has been investigated using microbiological assays of microplate dilution method and combination index interpretations of the nonantibiotics with β-lactam antibiotic CEF and the zone of inhibition method.Results: The nonantibiotics ME and TR inhibited resistant strain tested in vitro in the checkerboard assay, where the results showed that CEF and TR exhibited minimum inhibitory concentration (MIC) at concentrations of 50 μg/ml and 318 μg/ml, respectively. Interestingly, CEF when combined with TR reduced the MIC to 8 μg/ml and 78 μg/ml. According to the results, CEF with TR exhibited synergistic interactions at the fractional inhibitory concentration of 0.36–1.4. ME and TR and its combinations, CEF with ME, and CEF with TR have considerable anti-MRSA efficacy, with synergism though at 36 h of incubation.Conclusion: ME and TR being antispasmodic and antiulcer drugs can also be used against MRSA infections, which could prove to be favorable in the reduction of dosage of antibiotics such as CEF, and cutting down the need for additional administration of antibiotics to the patients affected with multiple complications such as gastrointestinal ulcer, spasm difficulties, and infection.

Silencing of quinolinic acid phosphoribosyl transferase (QPT) gene for enhanced production of scopolamine in hairy root culture of Duboisia leichhardtii

Scopolamine is a pharmaceutically important tropane alkaloid which is used therapeutically in the form of an anesthetic and antispasmodic drug. The present study demonstrates enhanced scopolamine production from transgenic hairy root clones of Duboisia leichhardtii wherein the expression of quinolinate phosphoribosyl transferase (QPT) gene was silenced using the QPT-RNAi construct under the control of CaMV 35 S promoter. The RNAi hairy roots clones viz. P4, P7, P8, and P12 showed the enhanced synthesis of scopolamine with significant inhibition of nicotine biosynthesis. Optimization of culture duration in combination with methyl jasmonate elicitor in different concentrations (50 µM-200 µM) was carried out. Maximum synthesis of scopolamine had obtained from HR clones P7 (8.84 ± 0.117 mg/gm) on the 30th day of cultivation. Conspicuously, elicitation with wound-associated hormone methyl jasmonate enhanced the yield of scopolamine 2.2 fold (19.344 ± 0.275 mg/gm) compared to the culture lacking the elicitor. The transgenic hairy roots cultures established with RNAi mediated silencing of quinolinate phosphoribosyl transferase gene provides an alternative approach to increase the yield of scopolamine in fulfilling the demand of this secondary metabolite.

Network-based drug repositioning: A novel strategy for discovering potential antidepressants and their mode of action

Current target-oriented paradigm for novel antidepressant discovery has been difficult to succeed and the failures always bring huge economic losses. Although abundant ledge of disease related genes and drug action targets has been accumulated, the successful application of the knowledge for new drug discovery is limited. Here, we predicted and validated potential antidepressants and molecular targets from DrugBank recorded drugs using a novel network-based drug repositioning approach. This approach predicted relationships between drug and targets through network-based integration of drug chemical similarity, therapeutic similarity and protein–protein interactions. We predicted genome-wide relations of drugs and targets, and then screened drugs that connect to depression-related targets of known antidepressants. Six drugs were predicted and experimentally validated to have antidepressant-like effects in the tail suspension test (TST) and forced swimming test (FST) in mice. Alverine, which is a gastrointestinal antispasmodic drug, was further validated to display antidepressant-like effects in the learned helplessness and chronic unpredictable stress models of depression. Four targets, including serotonin transporter, norepinephrine transporter, serotonin 1A receptor and serotonin 2A receptor, were included in the predictable system and confirmed as primary sites of action for alverine. The results suggest that alverine may be an effective antidepressant drug and the network-based drug repositioning may be a promising drug discovery paradigm for complex multi-genetic diseases such as depression.

Repeat ultrasonography and MRCP after the pain had subsided in patients who presented with acute abdomen caused by a single common bile duct stone

Objective To analyze the clinical value of repeat ultrasonography and MRCP in patients who presented with acute abdomen caused by a single common bile duct stone after the pain had subsided. Methods The clinical data of 46 patients who were diagnosed to have a single common bile duct stone and presented with acute abdomen admitted to the Department of Hepatobiliary and Pancreatic Surgery and Minimally Invasive Surgery in Zhejiang Provincial People's Hospital were retrospectively studied. The patients were treated with anti-infection, antispasmodic and choleretic drugs with other conservative symptomatic and supportive therapy. Ultrasound and MRCP examinations were carried out before and after conservative treatment of the acute abdominal pain. Results 26 (56.5%) patients with a single stone in the common bile duct passed the stone spontaneously. Of these patients, 11 patients were discharged home and were treated conservatively, 15 patients underwent LC, and 20 (43.5%) patients still had choledocholithiasis. Of these 20 patients, 12 underwent ERCP+ EST, followed by LC; while the remaining 8 patients had a history of cholecystectomy, 6 and 2 patients underwent ERCP+ EST and LCBDE, respectively. Conclusion A single common bile duct stone in patients who presented with acute abdomen may pass the stone spontaneously as shown in this study using ultrasound and MRCP examinations. Key words: Acute abdominal pain; Choledocholithiasis; Surgical treatment; Endoscopic the-rapy; MRCP

Interaction of pirenzepine with bovine serum albumin and effect of β-cyclodextrin on binding: A biophysical and molecular docking approach

Studying the interaction of therapeutic molecules with serum albumin is important to understand their biopharmaceutics, pharmacokinetics and toxicity as well as their relation with the structure and function of protein. The biomolecular interaction of an anti-spasmodic drug, pirenzepine with bovine serum albumin (BSA) was investigated using multi-spectroscopic, calorimetric and docking studies. Fluorescence quenching of BSA on interaction with pirenzepine revealed the static mode of quenching. Pirenzepine exhibited a moderate binding to serum albumin with the binding constant value in the order of 104 M−1. Based on the Forster's non-radiative energy transfer theory, the average binding distance between BSA and pirenzepine was calculated. Competitive site marker experiments demonstrated that pirenzepine binds to the sudlow site III located in subdomain IB of BSA. Circular dichroic spectroscopy indicated secondary structural changes in BSA while three-dimensional fluorescence spectroscopy showed the microenvironmental perturbations in the structure of BSA on interaction with pirenzepine. Moreover, thermodynamic parameters obtained from isothermal titration calorimetry suggested that the interaction between pirenzepine and BSA was spontaneous and hydrophobic interactions played the major role in stabilizing the complex. Additionally, the effect of inclusion compound, β-cyclodextrin on pirenzepine-BSA interaction was studied. As pirenzepine is involved in drug-drug interactions, β-cyclodextrin forms an inclusion complex with pirenzepine and prevents drug-drug interactions, thereby, enhancing the therapeutic effect of pirenzepine. Some common metal ions have also been found to interfere with pirenzepine-BSA interaction. The above experimental results further corroborated the molecular modelling studies.

The pharmacoeconomic analysis of the assortment and availability indicators of combinations of spasmolithic medicines used in the symptomic treatment of irritable bowel syndrome

Irritable Bowel Syndrome (IBS) is one of the most common gastrointestinal diseases, which belongs to the group of functional gastrointestinal disorders (FGID) and is characterized by a prolonged recurrent, often lifelong course. Despite the benign nature and the absence of the threat of disability or death, IBS negatively affects the performance, the quality of life of patients and requires significant expenditure of the healthcare system on the treatment of this group of diseases. Aim. To analyze the assortment and availability indicators of the combined antispasmodic drugs (CASD) presented at the pharmaceutical market of Ukraine during 2014-2017. Materials and methods. The combined antispasmodic drugs available at the Ukrainian pharmaceutical market were analyzed according to the data of the information retrieval systems “Morion” and Compendium online. For the analysis of socioeconomic availability the solvency index Ca.s was calculated. Information on the average wage was obtained on the website of the State Statistical Service of Ukraine. Results. As of 2017, the pharmaceutical market in Ukraine consisted of 50 TN of fixed CASD. Combinations were available in a wide range of TN and, in particular, by the diversity of different combinations of active medicinal substances. The affordable price range provided an opportunity to choose CASD taking into account safety and therapeutic effectiveness. The main assortment of combined antispasmodics for the treatment of IBS at the domestic pharmaceutical market was formed mainly due to drugs of foreign manufacture compared to monopreparations with the spasmolytic effect. By the indicator of socioeconomic availability almost all CASD during the study period belonged to the group of highly available drugs. Conclusions. Within 2014-2017, there were minor changes in the range of available combinations at the pharmaceutical market of Ukraine. There were new combinations that appeared for the first time, but there were also those which manufacture was discontinued. The most numerous combination of TN from all the subgroups of drugs was the INN antispasmodic drugs in combination with analgesics by ATC code A03D A02 Pitophenone and analgesics, which in 2017 had 25 TN. The price characteristics on CASD significantly expanded socioeconomic availability for Ukrainian consumers. Most of the CASD belonged to the segment of highly available antispasmodic combinations. Among the medium available drugs some TN were noted in the number of INN by the ATC code combination A03D A02 Pitophenone and analgesics (Metamizol sodium + Pitophenone + Fentiveriene bromide) and by the ATC code combination A03A A08 ** Dicycloverin and analgesics (Dicycloverin + Paracetamol).

Analysis of assortment and availability indicators of spasmolytic drugs for gastrointestinal tract functional disorders in Ukraine

Gastrointestinal tract (GIT) functional disorders are one of the most urgent problems in modern gastroenterology, which is due to the widespread nature of this pathology and the problems associated with it. They form a group of heterogeneous (different in nature and origin) clinical states, manifested by various symptoms and disorders of gastrointestinal tract functions, and are not accompanied by structural, metabolic or systemic changes. According to the results of numerous epidemiological studies, up to 50-60 % of adults and up to 30-40 % of children who apply to gastroenterologists suffer from various functional disorders in the digestive system. The World Health Organization (WHO) states: over the past 60 years, the incidence of these disorders has increased 24-fold. Aim. To analyze the range, prices and availability indicator Ca.s. of anesthetic drugs in Ukraine during 2014-2016, and to determine the dynamics of these characteristics for the study period. Results. In 2016 there were 9 INN on the Ukrainian pharmaceutical market , 69 trade names (TN) of drugs were detected. The structural analysis of antispasmodics assortment (2016) showed the largest TN assortment is characteristic of INN: Drotaverin – 30 TN; Simethicone – 16 TN; Papaverine – 10 TN. Medicines are presented on the market in a wide assortment and in an affordable price range, which enables the physician to choose a drug based on its effectiveness and safety. Spasmolytics are presented in a variety of forms: tablets, capsules, syrups, rectal suppositories, oral drops (in the form of emulsions), and solutions / suspensions for the preparation of injections. The most common form of release in this pharmacological group is the pill. In the process of analysis the antispasmodics drugs assortment during the period of 2014-2016, a tendency was observed in the decreased number of foreign manufactured medicines, but there was a slight increase in domestic drug production. By the indicator of economic availability, most generic drugs used for treatment functional disorders in gastrointestinal tract, are highly available. In most cases, imported medicines are in average availability. Conclusions. During the three years studies, the number of domestic generic drugs increased, which are more accessible to Ukrainian consumers, and the number of imported medicines is slightly decreased. The range of prices varied from low to high, and this gave the opportunity to individually choose drugs based on the active ingredients, dosage forms and prices. It ranged from 4.35 to 266.31 UAH, and within the limits of one INN Drotaverin. The study of antispasmodic drugs availability allowed us to establish the vast majority of SLS is represented by highly available medicines, and only some of the INNs are mediated by spasmolytic action medications of mebeverine, drotaverin and pinaverium bromide.

IN VITRO ANTICONVULSANT EFFECT OF ETHYL ACETATE FRACTION OF TITANUS LEAF (LEEA AEQUATA L.) ON ISOLATED COLON

Objective: The excessive activity of the parasympathetic nervous system in the intestinal smooth muscle is important role in the increased intestinal motility, so antispasmodic medications are needed that can decrease intestinal motility such as atropine. Treatment may also use medicinal plants that are cheaper and easy to obtain, and also believed to have smaller side effects than modern antispasmodic drugs. This study aimed to determine the anticonvulsant or relaxation effects of the ethyl acetate fraction of titanus leaf (EAFTL) against contracted guinea pig colon.Methods: The parameters measured are smooth muscle relaxation. Before testing, guinea pig colon was equilibrated for 45 min to obtain a stable condition in Tyrode’s solution with a temperature of 37°C aerated with carbogen gas (O2:CO2) with a ratio of 95%:5%. The relaxing effect of the colon was tested after inducing by acetylcholine chloride; then, each colon was given cumulative concentration of EAFTL and atropine sulfate. The concentration of acetylcholine chloride required to increase the contraction of the guinea pig colon was 1.76×10−4 Mol. The cumulative concentration of EAFTL given was 0.5–4 mg/Ml and cumulative concentration of atropine sulfate given was 6.95×10−6–2.08×10−2 mg/Ml.Results: The EAFTL has a relaxing effect. Statistical analysis of EAFTL at a concentration of 4 mg/Ml (100.000±1.7417) in reducing the smooth muscle of colon contraction induced by acetylcholine chloride 1.76×10−4 Mol (p>0.005), has not statistically significant compared to that of atropine sulfate 6.95×10−3mg/Ml (105.7292±0.8161).Conclusion: EAFTL has relaxing effect on the smooth muscle of the colon.

Quality of life in patients with irritable bowel syndrome in Qaliobeya Governorate, Egypt

Objective The aim of this study was to assess the effect of irritable bowel syndrome (IBS) on health-related quality of life (QOL). Background There has been an underestimation of the impact of IBS on an individual's functioning and QOL. The general health status of both young and elderly individuals with IBS is generally found to be poorer than that of the general population. Patient and methods This cross-sectional study included 400 IBS patients who attended to randomly selected family health center and two family health units of Qaliobeya Governorate in Egypt. All IBS patients who attended to the selected family health center and units and fulfilled the criteria of ROM III were included in the study sample. QOL was assessed through the 34-item, IBS-QOL questionnaire. Results Older patients (≥30 years), female sex, receiving antispasmodic drugs, being overweight, and low socioeconomic standard were associated with better QOL. Patients who suffered dyspepsia, stomach pain, and flatulence encountered lower QOL. Conclusion QOL in patients with IBS is affected by age, sex, BMI, and presence of symptoms such as dyspepsia, flatulence, and stomach pain that may awake the patients at some nights.

Copper-Mediated Trifluoromethylation-Allylation of Arynes.

An unprecedented three-component copper-mediated vicinal trifluoromethylation-allylation of arynes is described. A wide range of structurally diverse trifluoromethylated allylarenes can be quickly assembled in one step. The application of the method has been demonstrated in the expedient synthesis of the CF3-containing analogue of the antispasmodic drug papaverine. The new reactivity of the [CuCF3] reagent, which is generated from the inexpensive industrial byproduct fluoroform, is revealed with unique advantages.

Efficacy of phloroglucinol for treatment of abdominal pain: a systematic review of literature and meta-analysis of randomised controlled trials versus placebo.

Phloroglucinol is a musculotropic anti-spasmodic drug. It is frequently prescribed in many European countries with a considerable cost for health services. The purpose of this study was to review the existing randomised controlled trials (RCT) comparing the efficacy of phloroglucinol treating abdominal pain versus placebo. A literature search was carried out up to May 2017 to select RCT comparing the effect of phloroglucinol versus placebo with intensity of abdominal pain as an endpoint. Studies concerning obstetric or gynaecologic-related pain were not included. Three RCT were included and then analysed for risk of bias and meta-analysed. Only one RCT found that phloroglucinol was superior to placebo, although with a high risk of bias. The meta-analysis found a risk ratio of 1.10 (95% CI 0.95, 1.27) with no statistical significance. There is insufficient data to justify the wide-spread prescription of phloroglucinol for alleviating abdominal pain.

Formulation Development and Evaluation of Mebeverine extended release Pellets

The present study was aimed to formulate and evaluate extended release Mebeverine hydrochloride pellets using surface layering technique. Mebeverine hydrochloride, an anti-spasmodic drug being highly water soluble with a half-life of 2h is suitable to develop extended action for treatment of irritable bowel syndrome. The drug polymer compatibility was defined by the FTIR studies in preformulation study. Calibration curve for the drug is plotted and checked the physicochemical properties. Five formulations (F1-F5) of Mebeverine hydrochloride pellets were prepared using different quantities of talc and other standard excipients. The prepared pellets were subjected to micrometric properties study and physicochemical characterization. In vitro drug release studies were performed for the pellets for 1.5, 3, 6, 12hrs. The optimized formulation F5 showed 93.32% drug release after 12h showing that talc act as rate controlling agent. Scanning electron microscopy (SEM) studies revealed that the prepared pellets for Mebeverine hydrochloride are spherical in shape. The release profile for optimized formulation F5 was comparable with that of marketed formulation (MEVA SR) for Mebeverine hydrochloride. Accelerated stability study for the selected formulation was performed and resulted with unchanged results. Absorption kinetics showed that the drug release of the selected formulation follow First order kinetics with zero order mechanism.

In vitro analysis of antispasmodic activity of ethanolic stem extracts of Uvaria rufa Blume and Anomianthus dulcis (Dunal) J. Sinclair on excised rat’s ileum

Irritable bowel syndrome (IBS) is a symptom of functional gastrointestinal disorders. It is commonly experienced as abdominal cramp, diarrhea, and constipation. The diagnosis and treatment of IBS were mostly conducted by synthetic medicines including antispasmodic drugs that have many side effects and are so expensive. The aim of the present study was to explore the antispasmodic activity of Uvaria rufa Blume and Anomianthus dulcis (Dunal) J. Sinclair extracts on isolated rats’ ilia which later compared to atropine as reference drug. The ethanolic extracts from the stem of A. dulcis and U. rufa were investigated for their antispasmodic activities against acetylcholine-induced rats’ ilia contraction in vitro experiment. The results of this study showed that both ethanolic extracts of U. rufa and A. dulcis have an antispasmodic efficiency at all concentrations of 200, 300, 400, and 500 μg/ml on excised rats’ ilia. They produced the highest relaxation of 92.71 ± 5.97 and 98.53 ± 0.61% in A. dulcis and U. rufa extracts, respectively, while atropine produced 112.84 ± 5.61% at concentration of 10.0 μg/ml. These results suggest that U. rufa and A. dulcis could be used as antispasmodic agents for IBS treatment.

Localization and Organization of Scopolamine Biosynthesis in Duboisia myoporoides R. Br.

Tropane alkaloids (TAs), especially hyoscyamine and scopolamine, are important precursors for anticholinergic and antispasmodic drugs. Hyoscyamine and scopolamine are currently obtained at commercial scale from hybrid crosses of Duboisia myoporoides × Duboisia leichhardtii plants. In this study, we present a global investigation of the localization and organization of TA biosynthesis in a Duboisia myoporoides R. Br. wild-type line. The tissue-specific spatial distribution of TAs within D. myoporoides is presented, including quantification of the TAs littorine, 6-hydroxy hyoscyamine, hyoscyamine, scopolamine and, additionally, hyoscyamine aldehyde as well as scopolamine glucoside. Scopolamine (14.77 ± 5.03 mg g-1), and to a lesser extent hyoscyamine (3.01 ± 1.54 mg g-1) as well as 6-hydroxy hyoscyamine (4.35 ± 1.18 mg g-1), are accumulated in leaves during plant development, with the highest concentration of total TAs detected in 6-month-old plants. Littorine, an early precursor in TA biosynthesis, was present only in the roots (0.46 ± 0.07 mg g-1). During development, the spatial distribution of all investigated alkaloids changed due to secondary growth in the roots. Transcripts of pmt, tr-I and cyp80f1 genes, involved in early stages of TA biosynthesis, were found to be most abundant in the roots. In contrast, the transcript encoding hyoscyamine 6β-hydroxylase (h6h) was highest in the leaves of 3-month-old plants. This investigation presents the spatial distribution of biochemical components as well as gene expression profiles of genetic factors known to participate in TA biosynthesis in D. myoporoides. The results of this investigation may aid in future breeding or genetic enhancement strategies aimed at increasing the yields of TAs in these medicinally valuable plant species.

Diagnostic Problem About Taeniasis

The prevalence of taeniasis can touch 12% of general population and the mortality rate is not neglected if this parasitic disease is associated with infectious diseases. Our objective for this case report is to recruit young searchers for developing research about the prevalence and molecular studies about Taenia saginata or Taenia solium in our country. Old man 62 years old from French had been admitted in our Hospital with abdominal pain, vomitus and thrill, anorexia, hematuria, thirst and fever 38° C. Before his stay in Madagascar, he had poliomyelitis and constipation or false need. He had had some habits to take one bottle of beer per day and to eat uncooked beef and pork. Clinical manifestations had been dehydration signs without pruritus and neurological manifestations. Biological analysis showed important cholestasis and high elevation of transaminases. Viral hepatitis markers B- C, serological bilharziasis and stool culture were negatives but serological amoebiasis was positive. He presented hypereosinophilia and hyperleucyturia. Staphylococcus aureus was found in urinary tract. The stool examination showed eggs of Taenia solium. Treatment with Praziquantel 4 tablets, antispasmodic drug 3 tablets and Ofloxacin 200mg 2 tablets per day increased the symptoms and permitted evacuation of all part of Taenia saginata one day after (size was estimated between four and ten meters). Secnidazole 1, 5 gram per day (FlagentylÒ) during ten days was prescribed in his house after Praziquantel. Finally, all symptoms disappeared and the patient recommended strongly something to eat. In conclusion, Taenia saginata associated with liver necrosis, cholestasis and Staphylococcus aureus in urinary tract is the diagnosis. In the microscopic examination practice, it is very difficult to recognize eggs of Taenia saginata and Taenia solium and it is unusual to have the total evacuation of this parasitic disease. So, we must promote research about this in 22 Regions in Madagascar after usual parasitic emission of one slice segment.

Preparation and evaluation of mebeverine hydrochloride as mucoadhesive buccal tablet for local anesthesia

Purpose: To formulate and evaluate an antispasmodic drug, mebeverine hydrochloride (Mbv-HCl), as a local anesthetic mucoadhesive buccal tablet.Methods: Mbv-HCl loaded tablets were formulated, using a direct compression technique, with varying polymer concentrations including carbopol 934P alone, carbopol 934P/hydroxypropyl methylcellulose (HPMC) mixture, or carbopol 934P/chitosan mixture. The tablets were evaluated for physicochemical characteristics, in-vitro drug release, bioadhesive strength, swelling, ex-vivo residence time, ex-vivo permeation, drug permeation through the buccal membrane of sheep, and stability.Results: The results indicate that formulation F4, which contains HPMC/carbopol 934P (3:1), showed the best in-vitro drug release profile. The release kinetics for all the formulations fitted well with Hixson- Crowell kinetic model. Bioadhesive strength, surface pH, and swelling index of F4 were 41.52, 6.36, and 231.2 %, respectively. Maximum residence time ex-vivo was exhibited by formulation F4, showing a maximum residence time of about 330 min with 80 % of Mbv-HCl permeated in 6 h ex-vivo. F4 was stable after storage for 60 days at 25 oC/60 % RH and 40 oC/75 % RH, with non-significant change (p < 0.05) in drug content, bioadhesive strength and in vitro release.Conclusion: The optimized mucoadhesive buccal formulation is promising for delivery of Mbv-HCl, and displays high bioadhesion and adequate permeability through sheep buccal membrane to achieve a local anesthetic action.Keywords: Mebeverine hydrochloride, Buccal, Mucoadhesive tablet, Swelling index, Bioadhesive strength, Local anesthetic

Magnetic resonance imaging for detection of parametrial invasion in cervical cancer: An updated systematic review and meta-analysis of the literature between 2012 and 2016.

To review the diagnostic performanceof MRI for detection of parametrial invasion (PMI) in cervical cancer patients. MEDLINE and EMBASE databases were searched for studies providing diagnostic performance of MRI for detecting PMI in patients with cervical cancer. Studies published between 2012 and 2016 using surgico-pathological results as reference standard were included. Study quality was evaluated using QUADAS-2. Sensitivity and specificity of all studies were calculated. Results were pooled and plotted in a hierarchical summary receiver operating characteristic plot. Meta-regression and subgroup analyses were performed. Fourteen studies (1,028 patients) were included. Study quality was generally moderate. Pooled sensitivity was 0.76 (95% CI 0.67-0.84) and specificity was0.94 (95% CI 0.91-0.95). The possibility of heterogeneity was considered low: Cochran's Q-test (p = 0.471), Tau2 (0.240), Higgins I2 (0%). With meta-regression analysis, magnet strength, use of DWI, and antispasmodic drugs were significant factors affecting heterogeneity (p < 0.01). Subgroup analysis for studies solely using radical hysterectomy as reference standard yielded pooled sensitivity and specificity of 0.73 (95% CI 0.60-0.83) and 0.93 (95% CI 0.90-0.95), respectively. MRI shows good performance for detection of PMI in cervical cancer. Using 3-T scanners and DWI may improve diagnostic performance. • MRI shows good performance for detection of parametrial invasion in cervical cancer. • Subgroup of studies using only radical hysterectomy showed consistent results. • Using 3-Tesla scanners and diffusion-weighted imaging may improve diagnostic performance.