Antispasmodic Agent Research Articles

Raise up of Scopolamine in Hairy Roots Via Agrobacterium rhizogenes ATCC15834 as Compared with Untransformed Roots in Atropa komarovii.

Atropa komarovii generates tropane alkaloids and three other compounds such as hyoscyamine. Racemate atropine and scopolamine (hyoscine) are the main alkaloids with anticholinergic, antispasmodic, and sedative agents. A proficient convention has been reported for the formation of transgenic Atropa komarovii by the use of Agrobacterium rhizogenes. Root culture, by utilizing leaves explants was contaminated by Agrobacterium rhizogenes ATCC 15834, a strain with the paired vector. The hairy roots after contamination for three weeks were specifically shaped from the cut edges of the leaves. The PCR intensification demonstrated that rol B genes of Ri plasmid of Agrobacterium rhizogenes were coordinated and communicated into the genome of the changed hairy roots. Examination of HPLC revealed that hairy roots can produce scopolamine and hyoscyamine and it was appeared that scopolamine content was essentially expanded in changed roots and hyoscyamine was extremely expanded in non-transgenic roots. According to the results, it was perceived that the scopolamine content in hairy roots was raised significantly compared to the control roots. It was evidenced that hairy roots gather a great number of metabolites that have a commercial significance. Thus, later on we can enhance efficiency for example by building up the biosynthetic route overexpression of gene codifying enzymes in the metabolic route for expanding valuable secondary metabolites in the plant cures.

Comparison of Fatty Meal, Drotaverine and Hyoscine for Duodenal Anti-motility and Cannulation During ERCP- A Randomised Controlled Trial

Introduction: Endoscopic Retrograde Cholangiopancreatography (ERCP) is a technically demanding procedure that requires considerable amount of training to be performed safely. Successful cannulation of the ducts depends on the expertise of the endoscopist. Conventionally, cannulation is facilitated with the help of smooth muscle relaxants like Hyoscine-N-butyl bromide or Drotaverine which impair duodenal contractions and facilitate sphincter of oddi relaxation. Aim: To compare the effect of Fatty meal versus Drotaverine hydrochloride versus Hyoscine-N-butyl bromide on duodenal contraction rate, ease of identification of the papillary orifice, time for cannulation, and adverse effects of agents used on haemodynamic parameters. Materials and Methods: The study was conducted at Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai,Tamil Nadu, India, where 60 patients admitted for ERCP with normal appearing ampulla, were taken-up for the study. Patients were subjected randomly into the three groups viz., Hyoscine group, Drotaverine group and Fatty meal group. In Fatty meal group, 200 mL of semi skimmed milk (1.7% fat) was given orally one hour prior to the procedure to allow for gastric emptying. A 20 mg of intravenous Hyoscine-N-butyl bromide and 40 mg of intravenous Drotaverine hydrochloride were administered 15 minutes before procedure in Hyoscine and Drotaverine group, respectively. Statistical analysis was done by Chi-square test and Analysis of Variance (ANOVA) test and using Statistical Package for the Social Sciences (SPSS) 16.0 version software. A p-value <0.05 was considered significant. Results: The difference in duodenal motility, cannulation time and success of the procedure did not show a statistically significant p-value between the three groups. The identification of ampulla was easy with the fatty meal group. The statistical analysis for intraprocedural change in pulse rate and Blood Pressure (BP) variation showed a significant p-value for Hyoscine group compared to the other two groups. The change in pulse rate for Hyoscine vs. Drotaverine vs. Fatty meal group during the procedure was 51.5±12.8 vs. 24.2±8.4 vs. 24.4±8.8 per minute, respectively. The variation in BP during the procedure was 18.3/15.7±7.7/9.0 mmHg vs. 9.0/8.7±5.7/5.6 mmHg vs. 10.4/8.6±4.6/3.3 mmHg for Hyoscine vs. Drotaverine vs. Fatty meal group respectively. Conclusion: Fatty meal is not inferior to the conventionally used Hyoscine-N-butyl bromide or Drotaverine for its anti-motility effect on the duodenum during ERCP. The cannulation time is no different within the groups. Fatty meal, the action of which is physiological may be used as a suitable alternative to antispasmodic pharmacological agents which have potential adverse effects.

Operation of the percutaneous endoscopic gastrostomy-jejunostomy tube without endoscopy in patients with Parkinson’s disease on levodopa-carbidopa intestinal gel infusion therapy

IntroductionTube-related adverse events (AEs) occur frequently in patients with Parkinson’s disease (PD) receiving levodopa-carbidopa intestinal gel therapy. Endoscopy has become evasive since the beginning of the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to evaluate methods that use the percutaneous endoscopic gastrostomy-jejunostomy (PEG-J) tubes without endoscopy. MethodsWe included 19 patients in this study. The contrast agent was injected into the PEG-J tube to clarify the AEs related to the use of the tube. When the kink of the PEG-J tube was found, it was pulled approximately 5–10 cm. When placing or replacing the PEG-J tube, the percutaneous endoscopic gastrostomy (PEG) tube was pushed into the gastrostomy hole to bring its tip closer to the pylorus before a new PEG-J tube was inserted into it. ResultsThe mean patient age was 63.1 ± 9.9 years, while the mean duration of PD was 16.7 ± 6.3 years. Tube-related AEs included PEG-J tube kinks (32 events), connector failures (20 events), and PEG-J tube entanglements without/with bezoars (9 events/5 events). All PEG-J tube kinks were resolved by tube manipulation with a fluoroscopic guide. In 66 of 85 events (77.6%), the PEG-J tube was placed or replaced without endoscopy. We believe that the use of the antispasmodic agent just before PEG-J operation reduced this rate. ConclusionOur methods were able to resolve most AEs associated with PEG-J tube use without endoscopy.

Antinociceptive and Relaxant Effects of Aqueous Extract of the Aerial Part of Ziziphora clinopodioides

Background and Aim: Plants from Iranian biomes, such as Ziziphora clinopodioides has been used as natural medicines by local populations in the treatment of several diseases such as asthma and stomachache and hypertension. In this study we investigated the antinociceptive and spasmolytic effects of aerial parts of aqueous extract of Ziziphora clinopodioides (APAEZC). Methods: The extract was injected to male mice 15 min before the onset of experiments intraperitoneally. Writhing and hot-plate tests were applied to study the analgesic effect of APAEZC and compared with that of diclofenac sodium (30 mg/kg, i.p.) or morphine (8 mg/kg, i.p). For evaluating spasmolytic effect of the extract, 5 cm of smooth muscle from ileum of rats were removed and set up for recording the isotonic contractions. Control contractions were obtained by adding acetylcholine (10-4M) to each tissue preparation and the spasmolytic action of different APAEZC concentrations (0.1, 0.2 and 0.3%) on maximum contraction induced by acetylcholine were evaluated 5 min later. Results: APAEZC exhibited a significant (P<0.05) antinociceptive effect in both chronic and acute pain in all doses in mice and also showed a significant spasmolytic effect at dose 0.2 (P<0.05) and dose 0.3% (P<0.01). Conclusion: The findings of this study indicated that APAEZC have analgesic and relaxant effects. These results support the traditional claim of Ziziphora clinopodioides as an antinociceptive and antispasmodic therapeutic agent.

Anticancer Activity of Fermented Solenostemm Aargel Extract and/or Low Dose Gamma Radiation Against Hepatocellular Carcinoma

For many decades the terrestrial plants are represent an infinitive source of bioactive substances as well as pharmaceutical components which play a main role in the discovering ,developing and manufacturing of anticancer and antibiotic drugs.Solenostemmaargel is a desert plant widely used in Arabic countries as antispasmodic, anti-inflammatory and anti-rheumatic agent. It also has anti-tumor activity. Aim: the present study was oriented to investigatethe hepato-protective effect of fermentedSolenostemmaargelleave extract (100amg/kg b.wt) and/or low dose γ-radiation (0.5Gy) againsthepatocellular carcinoma (HCC)developedin rats by injection of diethylnitrosamine. Results: the data obtained revealed that thepro-apoptotic agents (caspase 3 and cytochrome c) undergoes significant elevation in HCC rats received plant extract and/or γ-radiation compared to HCC rats.While,the vascular endothelial growth factor (VEGF), hypoxia inducible factor-α (HIF-α)and monocytichemotactic protein-1(MCP-1) were significantly decreased. Also, the activity of cyclooxygenase-2 (COX-2) was significantly decreased. Moreover, the histopathological analysis revealed that a mild improvement .In conclusion, the improvement emerged in HCC rats could be attributed to the potency of extract and/or γ- radiation by induce apoptosis and reduce angiogenesis.

Effect of Samryungbaekchul-san Combined with Otilonium Bromide on Diarrhea-Predominant Irritable Bowel Syndrome: A Pilot Randomized Controlled Trial.

Conventional and herbal drugs are frequently used together to treat many disorders. Samryungbaekchul-san (SRS, a herbal formula) and otilonium bromide (OB, an antispasmodic agent) are widely used to treat diarrhea-predominant irritable bowel syndrome (D-IBS) in Eastern Asian countries. However, there have been no studies on the co-administration of SRS and OB. Therefore, we aimed to preliminarily assess the feasibility of SRS combined with OB for D-IBS treatment in a pilot double-blind, four-arm, parallel-group, randomized controlled trial (RCT), including 80 patients diagnosed with D-IBS according to the Rome III criteria. The patients were randomly assigned to four treatment groups and were administered drugs for eight weeks after a two-week preparatory period. Follow-up was conducted four weeks after the administration period. The primary outcome was evaluated by using a global D-IBS symptom improvement score; no statistically significant difference was observed between the groups. However, multiple logistic regression analysis of primary outcome scores shows that SRS significantly improved D-IBS symptoms (p < 0.05). For secondary outcomes, better results were observed in the SRS + OB group, in terms of symptoms, including abdominal pain, discomfort, frequency of abdominal pain, and stool form than in OB alone or placebo groups (p < 0.05). In conclusion, the co-administration of SRS and OB might be an effective and safe strategy for the treatment of D-IBS. Large-scale RCTs are warranted to further confirm and clarify these findings.

Characterization of human serum albumin's interactions with safranal and crocin using multi-spectroscopic and molecular docking techniques

Interaction mechanisms of human serum albumin (HSA) with safranal and crocin were studied using UV–Vis absorption, fluorescence quenching and circular dichroism (CD) spectroscopies as well as molecular docking techniques. Changes in absorbance and fluorescence of HSA upon interactions with both compounds were attributed to their binding to amino acid chromophores located in subdomains IIA and IIIA. Fluorescence secondary inner filter effect was excluded using 278 nm and 340 nm as the wavelengths of HSA's excitation and fluorescence while safranal and crocin absorbed at 320 nm and 445 nm, respectively. Stern-Volmer model revealed a static quenching mechanism involve the formation of non-fluorescent ground state complexes. Stern-Volmer, Hill, Benesi-Hilbrand and Scatchard models gave apparent binding constants ranged in 4.25 × 103 - 2.15 × 105 for safranal and 7.67 × 103 - 4.23 × 105 L mol−1 for crocin. CD measurements indicated that 13 folds of safranal and crocin unfolded the α-helix structure of HSA by 7.47–21.20%. In-silico molecular docking revealed selective exothermic binding of safranal on eight binding sites with binding energies ranged in −3.969 to −6.6.913 kcal/mol. Crocin exothermally bound to a new large pocket located on subdomain IIA (sudlow 1) with binding energy of −12.922 kcal/mol.These results confirmed the formation of HSA stable complexes with safranal and crocin and contributed to our understanding for their binding characteristics (affinities, sites, modes, forces … etc.) and structural changes upon interactions. They also proved that HSA can solubilize and transport both compounds in blood to target tissues. The results are of high importance in determining the pharmacological properties of the two phytochemical compounds and for their future developments as anticancer, antispasmodic, antidepressant or aphrodisiac therapeutic agents.

Crystal structure, Hirshfeld surface, spectroscopic analyses, electronic properties, NLO profile and thermochemical study of an antispasmodic agent trimebutine

Absolute molecular geometry of trimebutine was determined with single crystal X-Ray diffraction (SCXRD). The C–H⋯O and C–H···π interactions within crystal packing were supported by Hirshfeld surface analysis. Spectral properties of trimebutine were investigated by using analysis techniques such as FT-IR, micro-Raman, NMR chemical shift and UV–Vis. spectroscopies. In order to investigate vibrational profile of the important functional groups within the compound, the detailed assignments of vibrational wavenumbers were performed by using potential energy distribution. Theoretical investigations on structural, spectroscopic, electronic, non-linear optical and thermochemical features were carried out with the DFT/B3LYP method at the 6–311++G(d,p) basis set. The 13C and 1H NMR chemical shifts of each atom within the compound were studied both experimentally and theoretically. The UV–Vis. spectroscopic analysis of trimebutine was used to evaluate intra-molecular electronic transitions. The HOMOs and LUMOs analyses were done to determine the nature and origin of the π→π* and n→π* electronic transitions. Additionally, the global reactivity descriptors were defined depending upon energy values of HOMO and LUMO. The π→π* and n→π* hyperconjugative interactions between donor and acceptor groups were investigated by NBO analysis. According to the computed αtotal, Δα and β0 values in the static state of trimebutine single crystal, it exhibits an excellent non-linear optical material property. Thermochemical features were calculated and studied in the gas phase of the compound.

Antispasmodic Activity of Prenylated Phenolic Compounds from the Root Bark of Morus nigra.

Black mulberry is a widely acknowledged ancient traditional medicine. Its extract and constituents have been reported to exert various bioactivities including antimicrobial, hypotensive, analgesic etc. effects. While black mulberry preparations are also used as antispasmodic agents in folk medicine, no related studies are available on its isolated constituents. Through an extensive chromatographic purification, seven phenolic compounds were isolated from the methanol extract of Morus nigra root bark, including morusin (1), kuwanon U (2), kuwanon E (3), moracin P (4), moracin O (5), albanol A (6), and albanol B (7). A complete NMR signal assignment of moracin P and O was achieved, and related literature errors confusing the identity of moracin derivatives are hereby clarified. Compounds 2, 5 and 7 were identified as strong antispasmodic agents on isolated rat ileum and tracheal smooth muscles, while compound 3, a methoxy derivative of 2, was inactive. Moracin O (5) inhibited the ileal and tracheal smooth muscle contractions with Emax values of 85% and 302 mg, respectively. Those actions were superior as compared with papaverine. Our findings demonstrate that prenylated arylbenzofurans, geranylated flavonoids and Diels-Alder adducts from Morus nigra are valuable antispasmodic agents. Compounds 2, 5 and 7 are suggested as marker compounds for quality control of antispasmodic mulberry preparations. Moracin O (5) is a new lead compound for related drug development initiatives.

Anti-Inflammatory Activity of Cymbopogon schoenanthus Essential Oil in Animal Models

Background and objectives: The species of Cymbopogon are generally used as anti-bacterial, anti-fungal, anti-malarial, and anti-spasmodic agents, as well as in cold treatment.Due to the presence of piperitone in Cymbopogon schoenanthus, we were prompted to evaluate were prompted to assess the anti-nociceptive and anti-inflammatory properties of its essential Oil. Methods: The analgesic activity of C. schoenanthus (50, 100, and 200 mg/kg, i.p.) were examined using writhing, hot-plate, and formalin tests. The control and standard groups respectively received vehicle, morphine (5 mg/kg, i.p.), and mefenamic acid (30 mg/kg). The anti-inflammatory effect of C. schoenanthus (50, 100, and 200 mg/kg) was then assessed by carrageenan method at time intervals of 30 min and 1, 2, 3, and 4 h. Results: Cymbopogon schoenanthus essential oil was analyzed by GC-MASS and 31 constituents were identified which represented 86.8% of the oil. The major component of the essential oil was piperitone (62.0%). The administrated doses of C. schoenanthus essential oil could not decrease the number of writhes and hot-plate latency in the mice, compared to the control group. However, it exhibited an analgesic effect, especially in the chronic phase of formalin test. In carrageenan test, all administrated doses of C. schoenanthus essential oil significantly reduced the paw edema, compared to the control (p<0.05). The anti-inflammatory activity of the essential oil (50, 100, and 200 mg/kg) was comparable with that of mefenamic acid (30 mg/kg). Conclusion: The results suggest that C. schoenanthus essential oil possesses biologically active constituents that have significant activity against acute inflammation.

Bioactive Compounds and Health Benefits of Artemisia Species

Artemisia L. is a genus of small herbs and shrubs found in northern temperate regions. It belongs to the important family Asteraceae, one of the most numerous plant groupings, which comprises about 1000 genera and over 20000 species. Artemisia has a broad spectrum of bioactivity, owing to the presence of several active ingredients or secondary metabolites, which work through various modes of action. It has widespread pharmacological activities and has been used as traditional medicine since ancient times as an anthelmintic, antispasmodic, antirheumatic, and antibacterial agent and for the treatment of malaria, hepatitis, cancer, inflammation, and menstrual-related disorders. This review comprises the updated information about the ethnomedical uses and health benefits of various Artemisia spp. and general information about bioactive compounds and free radicals.

Factors associated with polyp detection during colonoscopy: A retrospective observational study

The polyp detection rate (PDR) is an important quality indicator for colonoscopy. Several factors have been shown to be associated with PDR. However, whether the moderate sedation is a factor for polyp detection remains controversial. This study aims to assess factors associated with polyp detection including the moderate sedation factor during colonoscopy. Patients who underwent colonoscopy from June 1, 2014 to May 31, 2015 were enrolled into this retrospective study. Patients with poor colon preparation and failure to reach the cecum were excluded. The clinical factors, including patient's sex, age, midazolam/fentanyl sedation, indications, endoscopist colonoscopy volume, and use of antispasmodic agent were evaluated by multivariate analysis. A total of 3373 patients were included in this study. The mean age was 55.8 years, and 1980 patients (58.7%) were male. Among the 3373 patients, 2513 (74.5%) underwent midazolam/fentanyl-based sedated colonoscopy. The multivariate analysis showed that male sex, age over 50 years old, midazolam/fentanyl sedation and indications of screening and surveillance were significantly associated with polyp detection. Moreover, when stratified by sex and age, the midazolam/fentanyl sedation was associated with polyp detection in male patients and patients over 50 years old. This study has highlighted the role of midazolam/fentanyl sedation administered by colonoscopists as a modifiable factor that may increase polyp detection during colonoscopy.

Anti-obesity effect of argel (Solenostemma argel) on obese rats fed a high fat diet

Ethnopharmacological relevanceSolenostemma argel (Argel) is a desert plant commonly used in Egyptian and Sudanese traditional medicine to suppress appetite, for treatment of diabetes, and as an antispasmodic and anti-inflammatory agent. Previously the anti-diabetic, hypolipidemic and lipase inhibitory activities of Argel were reported in animal studies and in-vitro assays. However, its specific mechanism of action as an anti-obesity agent has not been studied before. Aim of the studyAssessment of the possible anti-obesity effect of Solenostemma argel on diet-induced obesity and elucidation of its mechanism of action, as well as, standardization of the active plant extract. Materials and methodsThe ethanolic extract (EtOH-E) and its fractions (CH2Cl2-F: methylene chloride and BuOH-F: n-butanol) were prepared from the aerial parts of S. argel and studied at two dose levels; 200 and 400 mg kg−1 in a model of high fat diet (HFD) fed rats. The animals (72 Male Wister rats) were assigned into 9 groups: group (i) fed with normal diet and groups (ii-iv) fed with high fat diet (HFD) for 16 weeks and treated with orlistat, EtOH-E, CH2Cl2-F and BuOH-F in the beginning of the 8th week. At the end of the experiment, blood samples were analysed for lipid and liver biomarkers, glucose and insulin levels, as well as, adipokines and inflammatory markers. Liver and adipose tissues were examined histopathologically and their homogenates were used to determine levels of oxidative stress markers and lipogenesis-related genes. Body weight was monitored weekly during the experiment. ResultsOur data showed that consumption of S. argel significantly controlled weight gain, attenuated liver steatosis, improved the lipid profile, modulated adipokines activities, increased β-oxidation gene expression, as well as, decreased the expression of lipogenesis-related genes and ameliorated inflammatory and lipid peroxidation derangement. The ethanolic extract was also standardized using LC–MS analysis for its content of stemmoside C. ConclusionsThe current study revealed that S. argel is a promising Egyptian natural drug, rich in pregnane glycosides, and could be considered a new therapeutic candidate targeting obesity.

Effects of L-Menthol and Carbon Dioxide on the Adenoma Detection Rate during Colonoscopy: L-Menthol and Carbon Dioxide on Colonoscopy

Background and Aims: We examined the efficacy of the combined use of L-menthol spraying (L-mentholS) as an antispasmodic agent and carbon dioxide insufflation (CO₂I) on the adenoma detection rate (ADR) in a prospective, single-center trial with a 2 × 2 factorial design. Methods: We randomly assigned 611 patients scheduled to undergo colonoscopy to 4 groups: (1) the L-mentholS + CO₂I (n = 153), (2) L-mentholS + air insufflation (AI; n = 156), (3) CO₂I (n = 153), and (4) AI (n = 149) groups. We used 20 mL of 0.8%-L-menthol solution for the L-mentholS. The primary outcome was the difference in the ADR, and the secondary outcomes were the differences in colonic peristalsis and abdominal pain. ­Results: The ADRs were not different among the groups: 1/2/3/4; 39.9%/43.6%/41.2%/51.0%. CO₂I was associated with a significant decrease in the ADR (OR 0.57; 95% CI 0.35– 0.93) with a multiple logistic regression. The interaction between L-mentholS and CO₂I was associated with a suppression of the decrease in the ADR. Both L-mentholS and CO₂I were associated with a significant decrease in abdominal pain, and L-mentholS was associated with a significant improvement of peristalsis. Conclusions: The fact that CO₂I was associated with significant decreases in the ADR was a problem. The combined use of L-mentholS and CO₂I could help to suppress the decrease in the ADR.

Effects of Salvia Officinalis Extract on the Breast Cancer Cell Line

Background: Common sage (Salvia officinalis L., Lamiaceae) is an aromatic and medicinal plant well known for its antioxidant properties. This plant belongs to Lamiaceae family and has many pharmaceutical properties. Some in vivo studies have shown the biological antioxidant effects of sage. As a member of Salvia officinalis Labiatae, sage is also known as “Maryam flower” in Iran. Sage importance lies in its therapeutic potential. It has been exploited as an anti-spasmodic, astringent, sedative, anti-hyperglycemic, and anti-inflammatory agent in Iranian medicine. Objective: Studying the anticancer effects of the compounds in Salvia officinalis extracts, such as cineol and camphor. Methods: Cancer was induced by DMBA (dimethyl-benzantheracene) dissolved in sunflower oil for 4 weeks. The case group was treated with sage leaf hydroalcoholic extract for 4 weeks; while the controls received distilled water. Result: Angiogenesis is a key process in cancer spread and metastasis. The hydroalcoholic extract of garden sage halted angiogenesis in the breast cell line of both human and mouse models; the highest impact was observed in hexane extract. Findings indicated the therapeutic effects of garden sage (i.e. its in vitro anti-angiogenesis activity and anti-migratory properties). Conclusion: Saliva officinalis can potentially prevent breast cancer.

Efficacy of Naftopidil as a Medical Expulsive Therapy in Japanese Men With Ureteral Stones: A Prospective Randomized Controlled Study.

BackgroundNaftopidil combined with an antispasmodic agent and a supplement that facilitates stone expulsion has reportedly produced an increased rate of ureteral stone expulsion. A randomized controlled study was conducted to determine the efficacy of naftopidil as a medical expulsive therapy for male patients with ureteral stones.MethodsMale patients (n = 500) with stones from the upper to the lower ureter were randomized to one of four groups and followed for 1 month to assess spontaneous passage of stones. The control group received only analgesics. The other three groups received daily doses of 240 mg flopropione, an antispasmodic agent and 1,350 mg extract of Quercus salicina Blume/Quercus stenophylla Makino (QS), a supplement that facilitates stone expulsion; 50 mg naftopidil; or 50 mg naftopidil in combination with 240 mg flopropione and 1,350 mg QS. Stone expulsion and characteristics were evaluated by urinalysis; kidney, ureter and bladder X-ray; ultrasound; and computed tomography.ResultsThe probability of expulsion of ureteral stones < 6 mm increased 1.570-fold (95% confidence interval (CI): 1.039 - 2.374, P < 0.05) with naftopidil compared to control; the probability of expulsion of a lower ureteral stone < 6 mm increased 1.778-fold (95% CI: 1.066 - 2.965, P < 0.05) with naftopidil compared to control. None of the stones > 6 mm spontaneously passed.ConclusionsFor relatively small ureteral stones < 6 mm, analgesic treatment combined with naftopidil would be the first choice. However, for relatively large ureteral stones > 6 mm, it appears that analgesia is sufficient for initial treatment of ureteral stone.

Evaluation of centrally acting skeletal muscle relaxant activity of aqueous extract of Withania somnifera (ashwagandha) roots in albino mice

Background: Skeletal muscle relaxants are used to treat both muscle spasm and spasticity, acting both as antispasmodic and antispasticity agents. In past studies some polyherbal formulations containing ashwagandha have shown skeletal muscle relaxant activity and fat extract of ashwagandha showed skeletal muscle relaxant activity in experimental animal models. This study is designed to evaluate the skeletal muscle relaxant activity of aqueous extract of Withania somnifera (ashwagandha) roots in albino mice, as the literature regarding them is limited.Methods: Standard drug (diazepam) and different doses of Aqueous extract of ashwagandha (50, 100,150mg/kg) were given orally to albino mice. Skeletal muscle relaxant activity was assessed by Rota-rod apparatus. The fall off time from the rotating rod was noted for each group after 1 hour of drug administration. The difference in fall off time from the rotating rod between the standard and treated mice was taken as an index of muscle relaxation.Results: The test extract at doses (50mg/kg, 100mg/kg and 150mg/kg) showed highly significant reduction in the time spent by the animals on revolving rod in rota rod test when compared to baseline (p &lt;0.0001). As compared with diazepam, aqueous extract (150mg/kg) showed almost equal reduction in the time spent by the animals on revolving rod in rota rod test.Conclusions: This study indicates that the aqueous extract of ashwagandha possess central skeletal muscle relaxant activity. The results are promising for further investigation of efficient skeletal muscle relaxant activity.

Modulatory Effect of Lippia alba Essential Oil on the Activity of Clinically Used Antimicrobial Agents on Salmonella typhi and Shigella dysenteriae Biofilm

The essential oil obtained from the leaves of Lippia alba (Mill.) N.E. Brown (Verbenaceae) has shown great pharmacological potential as an analgesic, antispasmodic, and antimicrobial agent. The aim of this study was to evaluate the modulatory effect of Lippia alba essential oil (LaEO I) on the activity of clinically used antimicrobial agents on Salmonella enterica serovar Typhi (Salmonella typhi) and Shigella dysenteriae biofilms. The Minimum Inhibitory Concentration of LaEO I (MICLaEO I) was determined by the microdilution method, and the effect of LaEO I on the activity of clinically used antimicrobials was assessed by the Checkboard method. The values obtained from MICLaEO I and ciprofloxacin were used to evaluate the effect of time of exposure on cell viability. LaEO I main components were geranial (34.2%), neral (25.9%), and myrcene (12.5%). The MICLaEO I was 1 mg/mL for both strains. LaEO I positively modulated the action of ciprofloxacin, cefepime, and ceftriaxone. After the first hour of treatment with MICLaEO I, the cell viability of the strains showed a 5 log10 CFU/mL reduction, and the LaEO I-CIP association was able to inhibit growth during the first 6 h of the test. Regarding the anti-biofilm activity, MICLaEO I was able to reduce the biofilm mass of Salmonella typhi by 61.2% and of Shigella dysenteriae by 38.9%. MICLaEO I was not able to eradicate the preformed biofilm; however, there was a reduction in the biofilm microbial viability. LaEO I has the potential to be used as an antimicrobial agent and interferes with biofilm formation; also, it is able to reduce cell viability in preformed biofilm and synergistically modulate the activity of ciprofloxacin.

Stiff person syndrome with Anti-GAD65 antibodies within the national veterans affairs health administration.

Stiff person syndrome (SPS) is a neurological disorder characterized by muscle rigidity primarily in the truncal muscles, commonly associated with autoantibodies to the glutamic acid-decarboxylase 65 kD receptor (GAD65). There is limited epidemiological information on patients with SPS. We performed a retrospective case review using the National United States Veterans Affairs Health Administration electronic medical record system. We analyzed prevalence, demographics, disease characteristics, and treatment outcomes in SPS patients who were anti-GAD65 antibody positive. Fifteen patients met our criteria. Point prevalence was 2.06 per million, and period prevalence was 2.71 per million. Men to women ratio was 14:1. All patients benefitted from treatment with symptomatic antispasmodic agents. Ten of 15 patients received intravenous immunoglobulin, with a majority demonstrating stable or improved modified Rankin scores. This investigation was a large North American epidemiological study of SPS with predominantly male patients. Symptomatic therapy was beneficial for most patients, with less clear sustained benefit of immunotherapy. Muscle Nerve 58:801-804, 2018.

Inhibitory effect of lidocaine on colonic spasm during colonoscopy: A multicenter double‐blind, randomized controlled trial

Colonic spasm can interfere with colonoscopy, but antispasmodic agents can cause complications. This study aimed to assess the inhibitory effect of topical lidocaine compared with a placebo control. In five tertiary-care hospitals in Japan, 128 patients requiring endoscopic resection of a colorectal lesion were enrolled and randomly and double-blindly allocated to colonoscopy with topical administration of 2% lidocaine solution 20mL (LID, n=64) or normal saline 20mL (control, n=64). During colonoscopy, the assigned solution was applied with a spray catheter near the lesion and the area was observed for three minutes. primary endpoint was the inhibitory effect at three time-points (1, 2 and 3 minutes after dispersion), using a three-point scale (excellent, fair, poor). Secondary endpoints were rebound spasm and adverse events. All endpoints were scored in real time. Serum lidocaine levels were measured in 32 patients (LID 16, control 16). There were no significant differences between groups in patient demographics. At all time-points, the proportion of patients with "excellent" scores was greater in LID group than control group, with significant differences observed at 2 minutes (p=0.02) and 3 minutes (p=0.02). In LID group, the rate of "excellent" scores increased by 12.5% at 2 minutes and was maintained at 3 minutes. Rebound spasm did not occur in LID group, compared with 15.6% of control group (p=0.001). There were no adverse events in LID group. All serum lidocaine levels were below detectable levels. Topical lidocaine is an effective and safe method for suppressing colorectal spasm during colonoscopy (UMIN000024733).