Ulcer Healing Research Articles

A systematic review and meta-analysis assessing the impact of pentoxifylline on the healing and recurrence of venous leg ulcers.

Venous leg ulcers (VLU) are the most severe manifestation of venous insufficiency and carry a poor prognosis because of delayed healing and recurrent ulceration. Pentoxifylline (PTX) is an example of a vasoactive medication that can be used alongside compression therapy to help improve ulcer healing rates. A previous review highlighted improved healing of VLU with PTX, although no analysis was made for complete ulcer healing and recurrence following treatment. A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The EMBASE, MEDLINE and Cochrane databases were searched for all relevant English-language human studies between January 1980 and August 2023. Two independent authors screened and reviewed all articles for inclusion, performed data extraction and assessed methodological quality according to Cochrane's risk of bias tool. Primary outcomes included complete ulcer healing and recurrence rates in the ipsilateral limb. Ten studies were eligible for analysis, of which nine were randomised trials and one was an observational cohort study. There were a total of 1,025 participants, with 515 having received PTX. In those receiving 1200mg PTX, venous leg ulcers healed in 62% (315 participants). Compared to controls, PTX administration was associated with a significantly higher likelihood of complete ulcer healing (OR 2.56, 95% CI 1.97-3.32, p < .001). The rate and time of ulcer recurrence were not recorded in any of the studies included. The evidence demonstrates that PTX may have a significant beneficial impact on the rate of complete ulcer healing. Little evidence is currently present in the literature evaluating the recurrence rates of ulcers following PTX treatment. Large scale, high quality RCTs with an adequate follow-up period are needed to evaluate this and assess whether treatment with PTX shows a significant benefit in prevention of recurrence in venous ulcers.

Electrospun 11β-HSD1 Inhibitor-Loaded Scaffolds for Accelerating Diabetic Ulcer Healing.

Diabetic ulcers (DUs) are a common and severe complication of diabetes, characterized by impaired wound healing due to a complex pathophysiological mechanism. Elevated levels of 11β-hydroxysteroid dehydrogenase type I (11β-HSD1) in wounds have been demonstrated to modulate glucocorticoid activity, leading to delayed skin cell proliferation and restricted angiogenesis, ultimately hindering wound healing. In this study, we propose an electrospun poly(ε-caprolactone) (PCL) nanofiber scaffold doped with the 11β-HSD1 inhibitor BVT2733 (BPs) to prevent 11β-HSD1 activity during the diabetic wound healing process. The electrospun scaffold loaded with BVT2733 is designed to achieve localized inhibition of 11β-HSD1 in DUs. This scaffold exhibited a porous morphology and desirable drug-loading capacity, meeting the requirements for wound coverage and effective delivery of BVT2733 BPs. In vitro studies demonstrated that the sustained release of BVT2733 from the scaffold promoted skin cell proliferation and migration while stimulating angiogenesis by upregulating HIF1-α/VEGF expression. The therapeutic effect of the scaffold was further confirmed in a full-thickness wound model using diabetic mice. The mice treated with the scaffolds exhibited an accelerated wound healing rate, increased neovascularization, enhanced collagen deposition, and regeneration of skin appendages within 2 weeks postinjury. The findings here provide evidence for the use of 11β-HSD1 inhibitor-integrated biomaterials in treating DUs and represent a novel biological platform for modulating dysregulated mechanisms in DUs.

Enhancing Diabetic Foot Ulcer Healing: The Role of Channa striata Extract Nutrition in Accelerating Inflammatory, Proliferative, and Maturation Phases

Background: Diabetic foot ulcers pose a severe complication for individuals with diabetes mellitus, necessitating effective therapeutic support such as albumin nutrition throughout the wound healing process. Derived from Channa striata, a commonly consumed source of albumin in Indonesia, this extract can potentially expedite wound healing.Objective: This study aims to evaluate the efficacy of Channa striata extract nutrition in accelerating the inflammatory, proliferative, and maturation phases of diabetic foot ulcer healing.Methods: This quantitative study employed a pra-experimental design using a single-group pretest-posttest approach. The study involved 30 diabetic patients who were administered a daily dose of 550 grams of Channa striata extract over four weeks. The Bates Jensen Assessment Tool (BWAT) assessed wound progress.Results: Results revealed that the average participant age was 60.2 years, with an average diabetic history of seven years. The average wound duration was 8.7 weeks; 66.7% of the participants were female; 70% had Non-Insulin Dependent Diabetes Mellitus (NIDDM); and 56.7% were at stage IV. The study found a significant difference in BWAT scores before and after the administration of Channa striata extract in diabetic foot ulcer patients.Conclusion: This study supports the effectiveness of Channa striata extract as an adjunct therapy in expediting the wound-healing phases in diabetic foot ulcers.

Radial cortex transverse distraction help to treat the Raynaud’s phenomenon

Raynaud’s phenomenon is a condition that causing vasospasm of the digital extremities and have a great influence on the quality of patients life. Distraction osteogenesis is accompanied with vascularization and regeneration of surrounding soft tissues. There have been no previous reports of using radial cortex transverse distraction for the treatment of RP. Since January 2019 to January 2023, 6 patients with RP accepted radial cortex transverse distraction. They were failed to conventional treatment for at least six months before the surgery. All the patients were followed-up over 1 year. The bone cortex healed without osteomyelitis or fractures. The ulcer of finger healed in one month. The pain and skin pale released after the surgery. The VAS score declined from 6 to 2 and the finger SpO2 improved. Radial cortex transverse distraction facilitated finger ulcer healing, salvage the hand and improved Raynaud symptoms. These findings suggest that radial cortex transverse distraction may be an effective procedure to treat the Raynaud’s phenomenon.Level of Evidence II Therapeutic study.

Degree of sulfation of freeze-dried calcium alginate sulfate scaffolds dramatically influence healing rate of full-thickness diabetic wounds.

Diabetic foot ulcer (DFU) is a chronic and non-healing wound in all age categories with a high prevalence and mortality in the world. An ideal wound dressing for DFU should possess the ability of adsorbing high contents of exudate and actively promote wound healing. Here, we introduced the calcium alginate sulfate as a new biomaterial appropriate for use in wound dressing to promote the healing of full-thickness ulcers in a diabetic mouse model. In this regard, alginate sulfate (Alg-S) solutions with different degree of substitution (DS) of 0.2, 0.5, and 0.9 were synthesized, freeze-dried, crosslinked by calcium cations, purified by washing and refreeze-dried. Primary analyses including swelling ratio, porosity content and mechanical properties revealed that all Alg-S scaffolds possess necessities for use as a wound dressing. After confirming the cytocompatibility of both alginate and alginate sulfate-based scaffolds by MTT assay, they were used as wound dressing for healing of full-thickness ulcers in diabetic mice. The results of wound healing process confirmed that calcium alginate sulfate scaffolds can heal the wounds faster than both alginate-treated and non-treated wounds. Furthermore, the histological analyses of healed tissues reveled normal regeneration of the skin tissue layers and collagen deposition similar to the healthy tissue.

Diabetic foot ulcer healing potential of Tagetes erecta L. flower extract on successive administration in alloxan-induced diabetic rats via modulation of liver functions

Diabetes mellitus is a prevalent endocrine disorder characterized by inadequate insulin production by the pancreas or improper utilization of insulin by the body, which imposes severe health complications, including cardiovascular, kidney, and neurological disorders with a high potential of foot ulcers. Globally, diabetes is responsible for over 70 % of limb amputations. Alloxan was used to induce diabetes in rats while foot ulcers were induced by the excision method in diabetic rats. Diabetes was confirmed by measuring the parameters like blood glucose, body weight changes, urine excretion, and other biomarker levels after oral administration of Tagetes erecta L. flower extract (TEFE) at different doses. During the work, it was observed that TEFE demonstrated a dose-dependent effect on blood sugar level from 370.2 mg/dl to 113.00 mg/dl and healing of diabetic foot ulcers in a 13 days animal model (p < 0.01). There is significant decline in SGOT, SPGT and ALP levels when compared with diseased group animals. Decrease in wound size was observed when TEFE was administered to diabetic foot ulcer rats. These exciting results steered to enumerate the possible role of TEFE in Diabetes mellitus through a panel of mechanisms of action like inhibition of free radical generation, modulation of liver enzymes and metabolism of glucose etc. The above findings support the hypoglycaemic and diabetic foot ulcer healing potential of TEFE. Moreover, further investigation is required to completely understand the possible mechanism of TEFE.

539 Mitochondria-encoded Circ-mtRNR2 improves the impaired skin wound healing of Diabetic Foot Ulcer by regulating fibroblast function and mitochondrial superoxide production

539 Mitochondria-encoded Circ-mtRNR2 improves the impaired skin wound healing of Diabetic Foot Ulcer by regulating fibroblast function and mitochondrial superoxide production

Medicinal Herbs for the Treatment of Peptic Ulcers

: Peptic ulcers are common gastrointestinal disorders characterized by the erosion of the stomach lining, duodenum, or esophagus. Conventional treatments, such as proton pump inhibitors and antibiotics for Helicobacter pylori eradication, have been the mainstay of therapy. However, the emergence of drug resistance and potential side effects have led to the exploration of alternative and complementary approaches, including medicinal herbs. This comprehensive review examines the potential use of medicinal herbs in the management of peptic ulcers. Ten herbal remedies, including Liquorice, Slippery Elm, Marshmallow Root, Aloe Vera, Chamomile, Ginger, Turmeric, Meadowsweet, Fenugreek, and Cabbage, are analyzed for their therapeutic properties and scientific research findings. These herbs have demonstrated anti-inflammatory, antimicrobial, and mucoprotective effects that may support ulcer healing and symptom relief. Herbal formulations, such as teas, capsules, tablets, and extracts, offer convenient delivery methods for patients seeking herbal remedies. However, safety considerations and potential herb-drug interactions must be carefully monitored. Integrating herbal remedies with conventional treatments presents a comprehensive approach to peptic ulcer management. By combining these therapies, patients may experience enhanced therapeutic outcomes and improved quality of life. Dietary recommendations also play a crucial role, with the inclusion of soothing and beneficial foods, while avoiding trigger foods that may exacerbate symptoms. As the evidence base grows, collaborative efforts between traditional herbal medicine practitioners and mainstream medical professionals are vital to ensure safe and effective integration.

Inadequate Efficacy of Biologics for Treating Proximal Ileal Lesions in Crohn's Disease; a prospective multicenter study.

While biologic therapy has revolutionized the treatment of Crohn's disease (CD), surgery remains unavoidable in cases involving ileal complications. We aimed to evaluate the efficacy of biologics on proximal ileal lesions using balloon-assisted enteroscopy (BAE). This open-label multicenter prospective study was conducted at tertiary referral centers in Japan. We enrolled 253 patients with active ileal CD who were treated with biologics (infliximab/adalimumab/ustekinumab/vedolizumab). BAE was performed at week 0 and week 26, and endoscopic findings were centrally assessed. We evaluated the rate of endoscopic remission (defined as having a maximum mSES-CD <4) at week 26 and patient prognosis (CD-related hospitalization and surgery). At baseline, 74 (29.2%) patients had proximal ileal ulcerations without terminal ileal ulcerations. The second BAE showed that endoscopic remission was achieved in 91 (36.0%) patients. Of the patients with complete ulcer healing of the terminal ileum, 28.6% (22/77) had residual ulcers in the proximal ileum. The rate of endoscopic remission in the proximal ileum (50.9%) was relatively lower compared to the colon (63.4%) and terminal ileum (56.7%), a trend consistently observed across all treatment agents. After a median follow-up of 134 weeks, residual ulcerations in the proximal ileum were associated with a poorer prognosis (P=0.0126 for hospitalization and P=0.0014 for surgery). A substantial proportion of patients with CD exhibited ulcerations in the proximal ileum which correlated with a poorer prognosis. These lesions proved challenging to heal, regardless of the type of biologic used.

Enhancing Photothermal Therapy for Antibiofilm Wound Healing: Insights from Graphene Oxide-Cranberry Nanosheet Loaded Hydrogel in vitro, in silico, and in vivo Evaluation.

Diabetic foot ulcers present a formidable challenge due to colonization by biofilm-forming microorganisms, heightened oxidative stress, and continuous wound maceration caused by excessive exudation. To address these issues, we developed a robust, stretchable, electro-conductive, self-healing, antioxidant, and antibiofilm hydrogel. This hydrogel was synthesized through the crosslinking of polyvinyl alcohol (PVA) and chitosan (CH) with boric acid. To enhance its antimicrobial efficacy, graphene oxide (GO), produced via electrochemical exfoliation in a zinc ion-based electrolyte medium, was incorporated. For optimal antibiofilm performance, GO was functionalized with cranberry (CR) phenolic extracts, forming a graphene oxide-cranberry nanohybrid (GO-CR). The incorporation of GO-CR into the hydrogel significantly improved its stretchability (280% for PVA/CH/GO-CR compared to 200% for PVA/CH). Additionally, the hydrogel demonstrated efficient photothermal conversion under near-infrared (NIR) light, enabling dynamic exudate removal, which is expected to minimize retained exudate between the wound and the dressing, reducing the risk of wound maceration. The hydrogel effectively reduced levels of lipopolysaccharide (LPS)-induced skin inflammation markers, significantly lowering the expression of NLRP3, TNF-α, IL-6, and IL-1β by 39.2%, 31.9%, 41%, and 52.3%, respectively. Histopathological and immunohistochemical analyses further confirmed reduced inflammation and enhanced wound healing. The PVA/CH/GO-CR hydrogel exhibits multifunctional properties that enhance wound healing ulcers. Its superior mechanical, antibacterial, and anti-inflammatory properties and ability to promote angiogenesis make it a promising candidate for effective wound management in diabetic patients.

Hyperbaric oxygen therapy for healing chronic foot wounds in diabetic patients: Randomised clinical trial

Introduction: foot wounds are highly prevalent in diabetic patients and can lead to limb amputation; thus, this pathology requires comprehensive treatment. Objective: the primary objective of this study was to evaluate the effectiveness of Hyperbaric oxygen therapy in improving the healing of diabetic foot ulcers. The secondary objective was to evaluate whether it reduces the number of amputations and enhances the quality of life. Methods: this non-blind randomized clinical study included diabetic patients who presented chronic foot ulcers classified as Wagner grades 2, 3, and 4. The sample consisted of 30 patients, 17 allocated to the control group and 13 to Hyperbaric oxygen therapy group. Hyperbaric oxygen therapy was applied once a day, five days a week for seven weeks; each session lasted 90min at 2.5 atmospheres absolute. The SF-36 quality of life questionnaire was administered to both groups. Results: the evaluation of foot wound healing in diabetic patients showed a better result in the Hyperbaric oxygen therapy group less than six months of follow-up (p = 0.04). There were two minor amputations in the control group with p=0.60. Furthermore, the quality of life was improved in the Hyperbaric oxygen therapy group compared to the control, with a statistically significant difference in most domains, except for mental health. Conclusions: our findings suggest that Hyperbaric oxygen therapy positively impacts the healing of foot wounds in diabetic patients who have undergone less than six months of follow-up. Data regarding the method’s benefit related to the reduction of minor or significant amputations are insufficient. Regarding quality of life, we obtained results that support the use of Hyperbaric oxygen therapy. Registration number RBR-7bd3xy (http://www.ensaiosclinicos.gov.br).

Outcome and risk factors of ulcer healing after gastric endoscopic submucosal dissection: A systematic review and meta-analysis.

Endoscopic submucosal dissection (ESD) is widely utilized for the treatment of large adenomas, submucosal lesions, and early gastric cancer. A significant artificial ulcer typically forms after ESD. Delayed or incomplete healing of these ulcers can result in complications such as delayed bleeding and perforation. However, a comprehensive review of the outcomes and risk factors related to ulcer healing following ESD is currently lacking. To assess ulcer healing outcomes and identify risk factors associated with delayed ulcer healing. Databases retrieved by computer include PubMed, EMBASE, The Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wan Fang Data, and VIP. The study collects reports on ESD post-surgical ulcer healing outcomes and risk factors, using Stata 16.0 and RevMan 5.0 software for meta-analysis. Our analysis included 12 studies, involving a total of 3430 patients. The meta-analysis revealed an overall healing rate of 65.55% for ulcers following ESD [odds ratio (OR) = 2.71; 95% confidence interval (CI): 2.45-3.00]. The healing rate within eight weeks was 48.32% (OR = 0.76; 95%CI: 0.35-1.66), while the rate beyond eight weeks was 88.32% (OR = 6.73; 95%CI: 3.82-11.87). Risk factors included Helicobacter pylori (H. pylori) infection (OR: = 5.32; 95%CI: 1.90-14.87; P = 0.001), ulcer size (OR = 2.08; 95%CI: 1.19-3.61; P = 0.01), lesion site (OR = 2.08; 95%CI: 1.19-3.11), and pathological type (OR = 1.64; 95%CI: 1.06-2.52). Diabetes (OR = 0.56; 95%CI: 0.05-5.80; P = 0.63) and duration of operation (OR = 1.00; 95%CI: 0.99-1.01; P = 0.96) were not significant factors. The healing rate of ulcers following ESD is high after eight weeks. Risk factors affecting the healing process include H. pylori infection, ulcer size, lesion site, and pathological type.

Utilization of osteopathic manipulation treatment in healing of pressure ulcers

Pressure ulcers (PUs), caused by prolonged pressure on the skin and tissue, affect millions annually in the US, resulting in significant emotional and financial burdens for patients. The healthcare system bears a substantial cost burden annually, primarily due to stage 3 and 4 ulcers. Through noninvasive techniques, osteopathic manipulative treatment (OMT) targets lymphatic system dysfunction and homeostasis to expedite patient recovery, with documented applications in conditions such as low back pain, pneumonia, and lower extremity wounds by optimizing lymphatic flow. However, the potential of OMT in managing PUs still needs to be thoroughly explored. This pilot study involved lymphatic OMT performed three times a week on patients admitted with community-or healthcare-acquired sacral PUs present for at least one week. Ulcer growth rates were calculated based on volume at baseline and in the third week following the first manipulation. Each patient was provided descriptive comparisons of albumin levels, body mass index (BMI), and demographic data, including age, sex, and race. At week three, following the initiation of treatment, decreased ulcer volume based on growth rate was observed in 75% of patients in our OMT group compared to 25% of patients in our control group. Our OMT pilot study suggests that adding OMT to standard therapy is safe and feasible, and it may accelerate the healing rate of sacral PUs while decreasing the cost burden on the healthcare system.

Passive Movement Exercise of the Lower Limbs May Facilitate Wound Healing in Patients With Diabetic Foot Ulcers.

Diabetic foot ulcers are a frequent and serious complication of diabetes with a high risk of amputation. Exercise has been shown to promote wound healing; however, patients with non-healing foot ulcers have limited ability to exercise due to the foot ulcer. Other strategies are therefore warranted. We evaluated the effect of eight weeks of two-leg passive movement exercise on wound healing in patients with non-healing diabetic foot ulcers. Twenty-one patients were included in the study and randomized into either a control or a passive movement exercise intervention group. The primary outcome measure was the wound area. Sixteen participants completed the trial. Wound sizes for the passive movement intervention group were 274 mm2 and 58 mm2 at baseline and week 8, compared to 148 mm2 (p=0.31) and 136 mm2 (p=0.51) in the control group (week 16; 7 mm2 vs. 23 mm2, p=0.55). The mean wound area percentual reduction between baseline and week 8 was higher in the intervention group (76% vs. 36%, difference 40%, p=0.062). The two-leg passive movement intervention showed a non-significant difference in wound healing and was well tolerated by patients with diabetic foot ulcers. Although the study shows potential, the results should be interpreted with its limitations of being underpowered and potentially confounded. We encourage larger randomized controlled trials to be conducted, to elucidate whether the two-leg passive movement intervention can be used to accelerate wound healing in non-healing ulcers.

Autologous cell therapy for ischemic diabetic foot: a meta-analysis of randomized controlled trials for the development of the Italian guidelines for the treatment of diabetic foot syndrome.

To assess the efficacy and safety of autologous cell therapy (ACT) in patients with ischemic diabetic foot ulcers (DFU). The present meta-analysis was designed to support the development of the Italian Guidelines for the Treatment of Diabetic Foot Syndrome (DFS). A Medline and Embase search were performed up to Feb 1st, 2024 collecting all RCTs including diabetic patients or reporting subgroup analyses on diabetic patients with ischemic foot ulcers comparing ACT with placebo/no therapy/standard of care (SoC), with a duration of at least 26 weeks. Prespecified endpoints were: major amputation (principal) and minor amputation, ulcer healing, time-to-healing, transcutaneous oxygen pressure (TcPO2), ankle-brachial index (ABI), pain, and all-cause mortality (secondary). Any ACT was allowed, irrespective of cell product type and route of administration (intra-arterial and intramuscular). Seven studies fulfilled all inclusion criteria, all using intramuscular transplantation as route of administration, but only 2 had a follow-up greater than 26 weeks. Participants treated with ACT had a significantly lower risk of major amputations in comparison with SoC/placebo (MH-OR 0.47 [0.24, 0.92], p = 0.03). ACT was also associated with a significantly higher rate of ulcer healing (MH-OR: 10.1 [3.5, 29.6], p < 0.001), greater increase of TcPO2 and ABI values (WMD: 17.57 [13.02, 22.12], p < 0.001), and reduction of pain (WMD: -1.83 [-2.32, -1.34], p = 0.003). ACT must be considered as a potential therapy for patients with ischemic diabetic foot ulcers. Further studies are needed to better clarify their role in the treatment and management of DFS.

Efficacy of nutritional support in combination with standard Buruli ulcer treatment: A case study in Côte d’Ivoire

BackgroundBuruli ulcer (BU) is an infectious skin disease caused by Mycobacterium ulcerans. It primarily affects disadvantaged rural populations and mainly impacts children who are chronically malnourished being especially vulnerable. In Côte d’Ivoire, the estimated prevalence of BU in children is 30 %. Malnutrition may further deteriorate the nutritional status of these individuals. This study aimed to compare the healing time of BU patients treated with the standard protocol (SP) of 8 weeks of rifampicin and clarithromycin combined with wound care versus those treated with the standard protocol plus nutritional support using Skin Renewal Medicine-1 (SPSRM-1) (UNHWA Medical Centre, Seoul, Republic of Korea). Additionally, the study measured the effects of SRM-1 on the patients’ nutritional status. MethodThis was a prospective, randomized, single-blind paired interventional study conducted in BU-endemic health districts of Côte d’Ivoire. This 12-month study had two arms: the standard protocol versus the test treatment (SPSRM-1). SRM-1 is a cereal-based nutraceutical composed of 60 % cereal, 25 % vegetable, and 15 % plant concentrate. Patients included in the study had uncomplicated category I and II ulcerations without comorbidities. Nutritional status including haemoglobin, albumin levels, and body mass index (BMI) was evaluated from enrolment to the end of the study, alongside ulcer healing rates. ResultsSixty BU wound patients were enrolled: 30 in the control group and 30 in the test group, with a mean age of 22 years. Of the patients, 28.3 % were malnourished, and 42 % had hypoalbuminemia. At the primary endpoint, 6 patients (20.0 %) in the SPSRM1 and 5 patients (16.7 %) in the SP group achieved complete epithelialization, with a reduction rate of 0.7 % per day in the SPSRM1 group compared to 0.3 % per day in the SP group. Patients who received SRM-1 had a higher BMI than those who did not, with a mean difference of 1.72 kg/m2 favouring the test group. Haemoglobin and albumin levels also showed improvement at the secondary endpoint compared to the control group. ConclusionThis study demonstrated the potential benefit of adding nutritional support to improve BU treatment outcomes, by shortening the healing time of ulcerations. However, further studies with larger sample sizes are necessary to confirm these findings.

Refractory gastrointestinal bleeding caused by splenic artery pseudoaneurysm rupture.

A 64-year-old man was admitted for hematemesis. Esophagogastroduodenoscopy revealed a gastric ulcer with a visible vessel on the posterior wall of the gastric body. After admission, the patient developed multiple episodes of massive hematemesis. During emergent esophagogastroduodenoscopy, he developed hemodynamic instability due to spurting bleeding. On day 18 of hospitalization, hemostasis was achieved using hemostatic forceps; however, contrast-enhanced computed tomography performed on the same day revealed a small splenic artery pseudoaneurysm (SAP) that had not been previously detected. To prevent fatal re-bleeding, interventional radiology was performed, and coil embolization was applied proximal to the pseudoaneurysm. The patient recovered without further hematemesis. One month later, exposed coils were observed from the healing ulcer, and celiac trunk angiography confirmed splenic artery thrombosis. Despite multiple attempts at endoscopic intervention, the patient developed recurrent hematemesis, suggesting that the gastric ulcer had eroded into the splenic artery, forming the SAP and causing significant hemorrhage. Although SAPs secondary to gastric ulcers are extremely rare, early recognition is critical because they carry a high risk of rupture and mortality. Endoscopic procedure alone may be insufficient, and an endovascular approach is a standard treatment to prevent life-threatening re-bleeding.

Clinical effects of anweiyang capsule and Pinellia decoction for eradication of Helicobacter pylori and healing of peptic ulcers

Peptic ulcers are a prevalent and often chronic condition within the digestive system, frequently prone to recurrence. This study aims to evaluate the clinical effects of Anweiyang capsule combined with Pinellia Heart-Draining Decoction on Helicobacter pylori eradication, ulcer healing rates, and improvement of Traditional Chinese Medicine (TCM) syndromes in patients with peptic ulcers. A total of 100 patients were randomly assigned to an observation group (n = 50), receiving the herbal combination, and a control group (n = 50), receiving standard Western medical treatment. The total effective rate was significantly (P < 0.05) higher in the observation group (96%) compared to the control group (80%). After 4 weeks of treatment, serum procalcitonin (PCT) and C-reactive protein (CRP) levels decreased, while prostaglandin E2 (PGE2) levels increased in both groups; however, the observation group exhibited better results (P < 0.05). The observation group achieved a H. pylori eradication rate of 94% and an ulcer healing rate of 82%, compared to 64% and 56% in the control group, respectively. Improvement in TCM syndrome scores was more significant in the observation group (P < 0.05). Moreover, the incidence of adverse reactions was significantly (P < 0.05) lower in the observation group (4%) compared to the control group (18%). In conclusion, Anweiyang capsule combined with Pinellia Heart-Draining Decoction significantly enhances the eradication rate of H. pylori and the ulcer healing rate without substantially increasing the risk of adverse reactions, demonstrating its safety and reliability for patients.

Management of Dustavrana by Chedana Karma and application of Madhu - A Case Study

Dusta Vrana management is most complicated problem encountered by medical practitioner all over the globe, that is non-healing, rapidly growing, disturb the day to day activities of patients, without early and optimal intervention it may ends with amputation of affected limb to save the life, This study reveals that Chedan (debridement) of necrotic patches followed by application of Madhu gives tremendous result in healing of ulcers, As per Sushruta Samhita, Lakshana of Dusta Vrana are Dourganda, Putisrava, Twak Mamsadi Kotha etc., In this case we had Lakshanas like Twak Kotha, Dourganda, Atiputisrava, Kandu etc. In Sushruta Samhita, Chikitsa Sthana 1st chapter Sushruta describes Shasti Upakrama for Vrana Chedana and Madhu Lepana is one among them. Chedana is mainly indicated for Dustavrana, Kotha etc., Honey has properties like Vrana Shodana, Vrana Ropana, Vvrana Sandhaniya. A 45 year male patient with wound over lateral aspect of thigh, knee joint and over lateral aspect of tibia associated with pain, itching fever since 1 week. Patient also had a history of admission in allopathic hospital under diagnosis of cellulitis, where in fasciotomy / fasciectomy was done. As the patient didn’t get relief so he approached our hospitals Shalya Tantra OPD. Patient had no comorbidity like diabetic mellitus, hypertension and patient was treated with Chedana Karma and application of Madhu along with Shamana Aushadi which has been discussed here.

Protective effects of quercetin against tongue injury and oxidative stress triggered by irinotecan: a histopathological, biochemical and molecular study

Abstract Introduction About 80% of patients receiving chemotherapeutics suffer from side effects related to the gastrointestinal tract. Irinotecan (CPT-11) is a chemotherapeutic agent usually used in treating solid tumors. Quercetin (QRT), a bioflavonoid, is an antioxidant and scavenger reactive oxygen species scavenger. Objective The current study explored the possible protective effects of QRT against mucosal tongue injury caused by CPT-11. Methods The study included four equal groups: group 1/control, group 2/QRT, group 3/CPT-11, and group 4/CPT-11 + QRT. Results CPT-11-induced tongue injury in the form of non-healed ulcers, absent lingual papillae, mononuclear cells infiltration, marked deposition of collagen fibers, and overexpression of CD86 and tumor necrosis factor- α (TNF-α). The increased malondialdehyde levels, decreased superoxide dismutase and total antioxidant capacity revealed that there was an oxidative stress. Also, there was a decreased countenance of Ki-67 and Bcl-2 and an increased countenance of NF-κB. The QRT-treated group showed complete ulcer healing, with histological features almost like the control group, along with minimal collagen fiber deposition, decreased reactivity to CD86 and TNF-α and improvement of oxidative stress status and the molecular study results as well. Conclusion QRT possess protective properties against CPT-11-triggered tongue injury.