Treatment For Pain Relief Research Articles

Interpretation of a clinical practice guideline on the management of chronic pain associated with temporomandibular joint disorders

Temporomandibular disorders (TMD) are a heterogeneous group of diseases that affect the temporomandibular joint, chewing muscle system, dental occlusion, and even various structures throughout the body, with significant characteristics of biological-psychological-social pattern. TMD related chronic pain, as the most important clinical symptom, can result in negative emotions seriously affecting patients' quality of life and physical and mental health. Although a variety of therapies have been previously reported to treat TMD related chronic pain, there is a lack of widely recognized therapies. Professor Jason W Busse (from Michael G DeGroote National Pain Centre, McMaster University, Hamilton ON, Canada) took the lead and collaborated with multiple internationally renowned schools/hospitals of stomatology to develop an international consensus on the management of chronic pain associated with TMD, a clinical practice guideline, which took two years and was published in December 15th, 2023 in a global top journal of clinical research The British Medical Journal. This clinical practice guideline explored the comparative effectiveness of available therapies for chronic pain associated with TMD, conditionally recommended the specific intervention for different treatment or pain relief, proposed a comprehensive, agreed, and standardized clinical practice guideline. This present article describes the methodology and key elements of the clinical practice guideline to help clinicians fully understand and appropriately apply this guidance, which could provide the references for clinical practice of TMD associated chronic pain in China.

Uncaria Rhynchophylla and hirsuteine as TRPV1 agonists inducing channel desensitization

Ethnopharmacological relevanceUncaria rhynchophylla (UR) is recognized for its therapeutic applications in treating hypertension and inflammation. However, the specific molecular mechanisms how UR and its bioactive constituents modulate inflammatory pathways remain unknown. This study investigates the effects of UR extract and its constituent, hirsuteine (HST), on TRPV1 channel modulation which is related to hypertension and inflammation. Materials and methodsElectrophysiological recordings and calcium imaging experiments were conducted to assess TRPV1 activation by UR extract and HST in HEK293T cells and sensory neurons. ResultsUR extract and HST activated TRPV1 in HEK293T cells, with repeated applications causing channel desensitization. HST application on TRPV1-positive sensory neurons significantly reduced electrical activity compared to capsaicin. ConclusionThis study demonstrated UR extract and HST are a novel TRPV1 agonists inducing channel desensitization and a potent agent for treatment of TRPV1 dependent pain relief.

Functional and Radiological Outcome of Simultaneous Bilateral Total Knee Replacement in a Tertiary Care Centre : A Quasi-prospective Study.

Osteoarthritis (OA) is the most frequent joint disease with a prevalence of 5313 per 100,000 persons in India. OA of the knee is a major contributor to mobility impairment, particularly among women. In these patients, total knee replacement (TKR) is widely accepted as the gold standard treatment for pain relief and restoration of function. Now, patients have the option of undergoing either a simultaneous bilateral TKR or a staged TKR. The former has shown significant advantages such as shorter rehabilitation, cost efficacy and shorter hospital stay. This study aimed to assess the functional and radiological outcome of simultaneous bilateral TKR in a tertiary care centre. 30 adult patients above the age of 55 years with severe OA knee who underwent simultaneous bilateral TKR between 2022-2023 were included in this prospective study. Preoperatively, they were assessed with radiographs including full length scannograms. Mean Anatomical Axis, Mean Mechanical Axis and Mechanical Axis Deviation (Varus) were calculated based on the scannograms by a single observer. The same observer administered the oxford knee score (OKS) preoperatively to all patients. Regular clinical and radiological follow up was done. After 1 year follow up, the same observer administered the Oxford Knee Score (OKS) to the operated knee. With a female preponderance among the study subjects (56.7%), the majority of the cases in our cohort were characterised as Grade IV Kellgren-Lawrence radiological grade of Osteoarthritis (76.66%) and were found to have tricompartmental involvement (70%). The mean anatomical axis for the right and left lower limb were 4.56±5.17 and 9.68±1.72 respectively. The mean mechanical axis deviation (Varus) for the right and left lower limb were 31.6±15.1 and 52.0±13.9 respectively. Preoperatively, mean mechanical axis for the right and left lower limb were 9.95±4.31 and 14.2 ±0.67 respectively. Postoperatively, mechanical axis was restored to near-normal values (3-5 degrees). Significant improvement in mean OKS from a preoperative value of 18.30 ± 3.46 to postoperative value of 33.50 ± 5.32 was noted at 1 year. Treatment of severe bilateral OA knee with simultaneous single staged bilateral TKR ensures good functional outcome , early mobility with minimal complications.

Effect of transcutaneous electrical nerve stimulation therapy on condylar position and myofascial pain in patients with temporomandibular joint disorders-A pilot clinical trial.

Temporomandibular joint disorders (TMD) are a type of disorder that affects the temporomandibular joint, muscles, and nerves leading to persistent facial pain. Transcutaneous electrical nerve stimulation (TENS) therapy is an alternative treatment for pain relief in TMD patients. The aim of the study was to assess the condylar position changes and pain levels occurring in TMD patients after TENS therapy. According to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) criteria, a total of seven patients with TMD were included in this study. Routine diagnostic investigations were taken for each patient along with joint vibration analysis (JVA), electromyography (EMG), and a cone beam computed tomography (CBCT) at rest position. Using the Dolphin software (version 11.95), the temporomandibular joint spaces were measured on the CBCT for the right and left sides individually for each patient. These patients were then subjected to TENS therapy, and an EMG reading was taken post-TENS therapy to evaluate the effect on muscle strain. A CBCT was taken after the TENS therapy to assess its effect on the condylar position. The statistical significance of the pre- and post-temporomandibular joint spaces and the EMG readings post-TENS therapy were assessed using paired t-tests, respectively. There was a change in the anterior, middle, and posterior dimensions observed radiographically, before and after TENS. However, the results were found to be statistically significant only in the anterior region on the right joint space (P = 0.03) and posterior region of the left joint space (P = 0.04). TENS therapy has been found to bring about a change in the condylar position and pain intensities by relieving inadvertent muscle activity in the temporomandibular region. Therefore, further studies with larger sample sizes and control are required to fully ascertain the role of inadvertent muscle activity on the TMJ.

Midterm Clinical Outcomes of a Resurfacing Capitate Pyrocarbon Implant: A Case Series

Abstract Purpose Scaphoid nonunion advanced collapse (SNAC), scapholunate advanced collapse (SLAC), and Kienbock's disease are some of the most common pathologies to result in arthritis of the wrist in patients with a relatively high functional demand. An option for treatment where there are not two cartilage surfaces suitable for articulation to allow either a proximal row carpectomy (PRC) or partial fusion is to perform a PRC combined with resurfacing of the capitate using a pyrocarbon implant (RCPI). The purpose of this study was to examine the medium-term survivorship, clinical-, and patient-reported outcomes of the RCPI in a case series of patients. Methods Survivorship was assessed in 46 patients at approximately 21 months or greater (range = 21–144, median follow-up = 67). Of these, 36 patients completed patient-reported outcome measures (Visual Analogue Scales, Disabilities of the Arm, Shoulder and Hand–short form, Patient-Rated Wrist Evaluation, Global Rating of Change) at 21 months or greater. Patient population was 42% (n = 16) female, average age was 59 (range = 25–79), and majority had the operation on their right hand (78%, n = 35). Results Implant survival can be confirmed until most recent follow-up at a median of 60 months (range = 21–144), with Kaplan–Meier analysis indicating an 83% survival probability at 10 years. Complications at 21 months or greater were observed in 11 patients (24%), with 9 (20%) patients receiving further surgery (7 wrist fusions, 1 ulnar nerve decompression, and 1 distal radioulnar joint replacement [RCPI in situ]). Time to revision was a mean of 20 months (range = 4–39). Comparison between passive range of motion at 21 months to 4 years and >5 years showed no significance (p > 0.5), suggesting 2- to 4-year outcomes are maintained midterm. Conclusions The RCPI extends the indications for PRC where there is unsatisfactory cartilage on the proximal capitate, the lunate facet of the radius, or both. It provides a safe and effective treatment for pain relief and improved functional use of the hand for SLAC and SNAC arthritis without the increased morbidity of more complex arthroplasty or total wrist arthrodesis. Level of Evidence IV, case series

The Effectiveness of Virtual and Augmented Reality in Surgical Pain Management: A Systematic Review of Randomized Controlled Trials.

Satisfactory management of postoperative pain remains challenging. Nonpharmacological modalities such as virtual and augmented reality (VR/AR) offer potential benefits and are becoming increasingly popular. This systematic review evaluates the effectiveness and safety of VR/AR interventions on postoperative pain and recovery. MEDLINE, Embase, CINAHL, Web of Science, and CENTRAL databases were searched from inception to July 27, 2023, for randomized controlled trials (RCTs), published in English, evaluating the use of VR/AR interventions for surgical pain relief. Study selection and data extraction were performed by pairs of reviewers independently and in duplicate, and potential risk of bias was determined using the Risk of Bias-version 2 (RoB 2) tool. Our outcomes included pain relief, reduction of anxiety, satisfaction, and adverse effects. Due to substantial heterogeneity, a narrative synthesis without meta-analysis was performed. We included 35 trials among 2257 citations, categorized as surgery (n = 12), minor procedures (n = 15), and postoperative physiotherapy (n = 8). Surgical group included various surgeries, with 11 using immersive VR predominantly in the postoperative period, and most reporting no differences in pain, but potential for reduced anxiety and sedation requirements. In the minor procedures group, most studies reported decreased pain and anxiety during the procedural performance. Two studies reported increased heart rate, while 2 others reported better hemodynamic stability. Home-based AR physiotherapy achieved (n = 6) similar pain and functional outcomes after knee replacement, with 1 large study (n = 306) reporting reduction of mean costs by $2745 for provision of 12 weeks physiotherapy. There were some concerns around potential bias for most studies, as the nature of interventions make it challenging to blind assessors and participants. No important adverse effects were noted using VR/AR technology. Evidence from RCTs indicates that the use of immersive VR during minor procedures may reduce procedural pain, decrease anxiety, and improve satisfaction. However, small studies, inconsistent effect, and variation in the application of interventions are important limitations. Evidence to support the application of AR/VR for major surgeries is limited and needs to be further investigated. Use of home-based physiotherapy with AR likely has economic advantages, and facilitates virtual care for appropriate patients who can access and use the technology safely.

Botulinum toxin type a (BOTOX) in the management of glossopharyngeal neuralgia- A case series

Glossopharyngeal neuralgia [GPN] is a rare, debilitating neurologic condition characterized by intermittent pain radiating to the tongue, pharynx or ear that can be triggered by talking, swallowing or chewing. With an incidence of only 0.2-0.7 persons/100,000/year, the diagnosis is extremely challenging and often gets misdiagnosed and undiagnosed. Many treatment options have been tried by various clinicians in the past, such as medical therapy (antidepressants, opiods, antiepileptics, steroids, and membrane-stabilizing agents), nerve blocks with or without additives, gamma knife radiosurgery, radiofrequency ablation and microvascular decompression. Each of the aforementioned treatment modalities has its own merits and limitations. In the pursuit of delivering optimal treatment for pain relief in GPN and to improve patient's quality of life, we have explored the use of Botulinum toxin type A [BOTOX (Allegran®)]. BOTOX has been widely used in the treatment of chronic facial pain such as headaches, migraine, and trigeminal neuralgia. However, the use of BOTOX in the management of GPN has not been reported in the literature. Despite the small number of cases in our series, BOTOX therapy in GPN appears to be promising. However, further research with larger sample sizes and longer follow-up periods is needed to fully establish its efficacy and safety profile

Enhancing contrast distribution with the far lateral approach in lumbar transforaminal epidural steroid injections: A retrospective analysis.

Herniated intervertebral disc (HIVD) with radiculopathy is a common degenerative spine disorder. Transforaminal epidural steroid injection (TFESI) is one of the pain relief treatments for lumbar radiculopathy recommended by evidence-based guidelines. Adequate contrast distribution is correlated with better pain control, but the best approach has not been confirmed yet. To confirm the distribution of contrast medium injected with a new approach of TFESI, that is, far lateral lateral recess approach (FLLR-TFESI). Patients receiving TFESI due to HIVD with radiculopathy between 2010 January and 2020 August were retrospectively enrolled. While the FLLR-TFESI was taken as the experimental group, the conventional approach was viewed as the control group. The baseline characteristics, the pattern of contrast enhancement under fluoroscopic guidance, and the complications of these patients were collected and analyzed. A total of 380 patients were analyzed (143 in control group and 237 in experimental group). The two groups were balanced in most baseline characteristics, except disc extrusion (p = 0.01) and scoliosis (p = 0.04). The FLLR-TFESI have a better contrast distribution (p < 0.01), even after adjustment (p < 0.001). No intrathecal injection was noted, but higher rate of intra-disc injection was noted in FLLR-TFESI group (10% vs. 3%, p = 0.008). The FLLR-TFESI has a superior contrast enhancement and distribution in comparison to conventional approach. Prospective study to confirm the study result as well as the clinical benefits is suggested in the future.

Pain Relief Interventions in Australian Livestock Husbandry: A Review of Animal Welfare and Pain Duration.

In veterinary medicine and livestock production, ensuring good animal husbandry is vital for the physical and emotional wellbeing of animals under our care. Pain poses challenges for assessment and mitigation, especially in species unable to express pain overtly. This review examines current pain mitigation interventions in routine husbandry, focuses on the duration of pain after procedures and implications for animal welfare. Pain behaviours have been observed for days or weeks after regular husbandry procedures, and many studies have noted pain-related behaviour persisting until study finalisation, suggesting potential undocumented pain beyond study completion. Current products registered in Australia for pain mitigation in livestock primarily target immediate pain associated with procedures. The future of pain relief in livestock demands longer-acting solutions to address post-procedural pain adequately. Providing pain relief for at least 72 h post surgery is recommended, but current products require retreatment intervals to achieve this, posing practical challenges, especially in livestock. Methods of pain relief provision, such as voluntary consumption of medicated feed, transdermal medication delivery and long-acting formulations offer potential solutions for prolonged pain relief, with research ongoing in these areas. There is a need for further research and development of longer-acting pain relief to ensure optimal welfare of livestock.

Comparison of clinical and functional outcomes of physical therapy alone versus additional intraarticular injection of platelet rich plasma in treatment of frozen shoulder in Indian population

Background: Frozen shoulder (adhesive capsulitis) involves significant restriction of shoulder motion due to an inflammatory process and typically follows stages of pain, stiffness, and recovery over 2-3 years. This study explores the efficacy of platelet-rich plasma (PRP) injections, alongside conventional physiotherapy, as a non-operative treatment to enhance recovery in patients with adhesive capsulitis. Methods: This prospective, randomized, open, blinded, single-center clinical study involving 50 patients with adhesive capsulitis, comparing intra-articular PRP injections and physical therapy with physical therapy alone over 24 weeks. Primary outcomes were assessed using the shoulder pain and disability index (SPADI) and visual analog scale (VAS), with follow-ups at 6, 12, and 24 weeks to evaluate pain, function, and patient satisfaction. Results: In adhesive capsulitis (AC), intra-articular platelet-rich plasma (IA-PRP) injections with physical therapy (PT) provided superior pain relief, functional improvement, and higher treatment satisfaction after 24 weeks compared to PT alone. The IA-PRP group also showed better VAS scores and reduced acetaminophen use, indicating more effective pain management. Conclusions: In AC, IA-PRP injections showed greater pain relief and improved shoulder mobility compared to PT alone after 12 weeks. PRP's effectiveness highlights its potential, especially when corticosteroids are unsuitable, though longer-term studies are needed to confirm these results.

Deep Peroneal Neurectomy for Midfoot Arthritis: A Comprehensive Review, Surgical Technique, and Case Series

Patients with painful midfoot arthritis unsuccessfully treated with conservative measures have been historically left with the surgical option of midfoot arthrodesis as a definitive treatment. In recent years, excision of the deep peroneal nerve has been offered as a potential alternative. Existing literature on the outcomes of patients undergoing deep peroneal neurectomy for the treatment of midfoot arthritis is limited and piecemeal. In this comprehensive review, technique guide, and retrospective case series, we consolidate the evidence around deep peroneal neurectomy for midfoot arthritis, review operative technique, and determine the outcomes of 4 patients who underwent deep peroneal neurectomy from February 2021 to December 2022 using Patient-Reported Outcome Measurement Information System Physical Function and Pain Interference scores. Four original articles from National Center for Biotechnology Information Medline, published through May 2023, were included. The outcomes of patients treated with deep peroneal neurectomy for midfoot arthritis are discussed. In our case series, the average amount of time between surgery and final postoperative Patient-Reported Outcome Measurement Information System scores was 289 days. The average preoperative physical function score was 36.8. Three patients showed a minimal clinically important difference in physical function; postoperative average was 41.3. Three patients had a minimally clinical important reduction in pain levels (average preoperative pain interference score was 65.8; average postoperative pain interference score was 59.3). One patient underwent a revision neurectomy for inadequate pain relief, and another sought additional treatment for inadequate pain relief. All patients returned to walking in a shoe within 1 month. The outcomes of our case series are similar to those of previously published case series, which demonstrate satisfactory results and acceptable complication rates. For patients with symptomatic midfoot arthritis, deep peroneal neurectomy can be an effective treatment option to reduce pain and improve physical function while requiring minimal postoperative recovery time.

Effect of Transcutaneous Electrical Nerve Stimulation on Gait Parameters in Dogs with Osteoarthritis.

Osteoarthritis is a common degenerative disease in dogs, often manifested as pain, joint swelling, and lameness. Despite the lack of scientific evidence for its treatment efficacy, transcutaneous electrical nerve stimulation (TENS) is used in dogs as a pain-relieving treatment. This randomised single-blinded cross-over study investigated the effect of TENS on gait parameters in fifteen dogs with osteoarthritis. Stance time, swing time, stride time, stride length, peak vertical force (%BW), vertical impulse (%BW*sec), and symmetry indices were obtained using a pressure-sensitive mat. TENS treatment of 80 Hz and 100 µs with an individually selected amplitude was conducted for 45 min once daily for a treatment period of seven or ten days. No significant differences were seen between TENS and placebo for any of the gait parameters. Hence, in this study, TENS did not affect gait parameters, compared to placebo. Further studies are needed to confirm the observations.

ECAP-controlled closed-loop versus open-loop SCS for the treatment of chronic pain: 36-month results of the EVOKE blinded randomized clinical trial

IntroductionThe evidence for spinal cord stimulation (SCS) has been criticized for the absence of blinded, parallel randomized controlled trials (RCTs) and limited evaluations of the long-term effects of SCS in...

Pain management in chronic pancreatitis

Pain in chronic pancreatitis (CP) is difficult to manage. Many patients suffer from inadequate pain relief, completely incapacitating them in their daily activities. Historically, despite their well-known adverse effects, opioids have been the pillar of treatment regimens in painful CP. The management is now gradually evolving with a better understanding of the underlying pathophysiology of CP-related pain. Clinicians should follow a holistic approach to the management of CP-associated pain, which must involve lifestyle changes that are coupled with analgesic medications and other pain-relieving interventions. Furthermore, there is no easy cure for vanquishing CP-associated pain. Each patient must be evaluated on a case-by-case basis by a multidisciplinary team to decide which treatment option is best suited for that individual.

Anti-inflammatory Activity of Polyphenols from Labisia pumila Leaves Extract

Non-Steroidal Anti-inflammatory Drugs (NSAIDs) represent a class of pharmaceutical agents that are frequently misused and misconstrued within the medical landscape. While demonstrably efficacious in providing transient pain relief, NSAIDs do not effectively address the fundamental etiology of pain and are associated with a spectrum of potential adverse effects. Labisia pumila var alata also known as "Kacip Fatimah" has been traditionally used which is attributed to its antioxidant properties. Nonetheless, little attempt has been made to examine its antioxidant and anti-inflammatory characteristics. This study determined the molecular interactions and inhibitory activity profiles of L. pumila methanolic extract (LPE) against the corresponding enzymes via in chemico and in silico approaches. In chemico analysis was done on antioxidant activity and anti-inflammatory properties of L. pumila. The findings indicated that LPE exhibit the potent anti-inflammatory activity. Through high-performance liquid chromatography, it was shown that LPE had the highest gallic acid concentration at 10.74 ± 2.23 mg/mL. LPE did not exhibit cytotoxicity up to 100 µg/mL and displayed optimal protective against UVB-irradiation at 50 µg/mL towards HSF1184 Fibroblast cell line. LPE exhibited potent anti-inflammatory activity as it inhibited elastase and COX-2. Molecular docking studies indicated that gallic acid has a good affinity for collagenase (˗5.68 kcal/mol), elastase (˗4.88 kcal/mol) and COX 2 (˗4.91 kcal/mol). These findings collectively suggested that L. pumila extract has significant potential for the formulation of the natural anti-inflammatory remedies which offer a safer alternative treatment for pain relief, especially for long-term use replacing the conventional NSAIDs medicines.

Effective Natural Language Processing Algorithms for Early Alerts of Gout Flares from Chief Complaints

Early identification of acute gout is crucial, enabling healthcare professionals to implement targeted interventions for rapid pain relief and preventing disease progression, ensuring improved long-term joint function. In this study, we comprehensively explored the potential early detection of gout flares (GFs) based on nurses’ chief complaint notes in the Emergency Department (ED). Addressing the challenge of identifying GFs prospectively during an ED visit, where documentation is typically minimal, our research focused on employing alternative Natural Language Processing (NLP) techniques to enhance detection accuracy. We investigated GF detection algorithms using both sparse representations by traditional NLP methods and dense encodings by medical domain-specific Large Language Models (LLMs), distinguishing between generative and discriminative models. Three methods were used to alleviate the issue of severe data imbalances, including oversampling, class weights, and focal loss. Extensive empirical studies were performed on the Gout Emergency Department Chief Complaint Corpora. Sparse text representations like tf-idf proved to produce strong performances, achieving F1 scores higher than 0.75. The best deep learning models were RoBERTa-large-PM-M3-Voc and BioGPT, which had the best F1 scores for each dataset, with a 0.8 on the 2019 dataset and a 0.85 F1 score on the 2020 dataset, respectively. We concluded that although discriminative LLMs performed better for this classification task when compared to generative LLMs, a combination of using generative models as feature extractors and employing a support vector machine for classification yielded promising results comparable to those obtained with discriminative models.

Nursing students' empathic communication: Role in recognizing and treating chronic pain patients

ObjectiveA substantial body of research supports what many nurses know from experience: empathy is at the heart of providing quality care. The major objective of this study was to identify unique mechanisms through which higher empathy translates into greater intentions to treat patients in pain employing novel methodology. MethodsUsing an ecologically-valid scenario methodology, student nurses (N = 156) reviewed the narrative of a patient in chronic pain. They completed standard, valid measures of empathy toward the patient, perception of the patient's pain, and intention to provide pain-relieving treatment. Nursing student’s personality traits were assessed and perception of patients’ age and sex were experimentally manipulated. ResultsEmpathy was associated with higher intention to treat the patient in chronic pain irrespective of patients’ age or sex. A moderated-mediation analysis confirmed that nursing students with higher empathy perceived the patient in the scenario as being in greater pain. This was correspondingly associated with higher intention to provide treatment. Nursing students’ trait Extraversion was a moderator. ConclusionEmpathy not only improves rapport between patients and providers but is related to intentions to provide pain-relieving treatment. Practice implicationsThe clinical and educational importance of empathy in patient-provider relationships are discussed.

A prospective comparative study of the intraoperative difficulties during laparoscopic cholecystectomy in patients taking homeopathic medications for cholelithiasis versus cholelithiasis patients with no history of homeopathic medication

Background: Gallstone disease is one of the most prevalent gastrointestinal diseases with a substantial burden to health-care systems. Patients present with right upper quadrant pain, dyspepsia, nausea or vomiting. Owing to the side effects of allopathic drugs, many patients resort to homeopathic treatment for relief of pain. There are several homeopathic drugs that decrease the pain of cholecystitis as well as high cholesterol in these patients but cannot cure them off the disease. Finally, they come to general surgeon for cholecystectomy. We have noticed that performing laparoscopic cholecystectomy (LC) in these patients is difficult and time consuming. Aims and Objectives: To determine whether or not homeopathic medicine intake for treatment of cholelithiasis act as an independent factor that leads to intraoperative difficulties during LC. Materials and Methods: Study design: A prospective randomized comparative study. Study period: July 2022–December 2023 (18 months). Study groups: Group H = Patients with history of (H/O) intake of homeopathic medicines for treatment of cholelithiasis = 60 patients, Group N = Patients with no H/O homeopathic medicine intake = 60 patients. Results: Twenty-six (43.33%) patients in Group H and 11 (18.33%) patients in Group N had a difficult LC. 7 (11.67%) patients in Group H and 1 (1.67%) patient in Group N had dense adhesions around the gallbladder (GB). 13 (21.67%) patients of Group H and 3 (5%) patients of Group N had a Frozen Calot’s Triangle (fibrosis and difficult Calot’s triangle dissection). This was statistically significant. Conclusion: Our study proved that intake of homeopathic medications for the treatment of cholelithiasis leads to dense adhesions around GB as well as fibrotic adhesions leading to difficult Calot’s triangle dissection leading to a difficult LC.

Chaenomelin, a New Phenolic Glycoside, and Anti-Helicobacter pylori Phenolic Compounds from the Leaves of Salix chaenomeloides.

Salix chaenomeloides Kimura, commonly known as pussy willow, is a deciduous shrub and tree belonging to the Salicaceae family. The genus Salix spp. has been known as a healing herb for the treatment of fever, inflammation, and pain relief. The current study aimed to investigate the potential bioactive natural products from S. chaenomeloides leaves and evaluate their antibacterial activity against Helicobacter pylori. A phytochemical investigation of the ethanol (EtOH) extract of S. chaenomeloides leaves led to the isolation of 13 phenolic compounds (1-13) from the ethyl acetate (EtOAc) fraction, which showed antibacterial activity against H. pylori strain 51. The chemical structure of a new phenolic glycoside, chaenomelin (1), was established by a detailed analysis of 1D and 2D (1H-1H correlation spectroscopy (COSY), heteronuclear single-quantum coherence (HSQC), and heteronuclear multiple-bond correlation (HMBC)) nuclear magnetic resonance (NMR), high-resolution electrospray ionization mass spectroscopy (HR-ESIMS), and chemical reactions. The other known compounds were identified as 5-O-trans-p-coumaroyl quinic acid methyl ester (2), tremulacin (3), citrusin C (4), benzyl 3-O-β-d-glucopyranosyl-7-hydroxybenzoate (5), tremuloidin (6), 1-[O-β-d-glucopyranosyl(1→2)-β-d-glucopyranosyl]oxy-2-phenol (7), arbutin cinnamate (8), tremulacinol (9), catechol (10), 4-hydroxybenzaldehyde (11), kaempferol 3-rutinoside (12), and narcissin (13), based on the comparison of their NMR spectra with the reported data and liquid chromatography/mass spectrometry (LC/MS) analysis. The isolated compounds were evaluated for antibacterial activity against H. pylori strain 51. Among the isolates, 1-[O-β-d-glucopyranosyl(1→2)-β-d-glucopyranosyl]oxy-2-phenol (7) and arbutin cinnamate (8) exhibited antibacterial activity against H. pylori strain 51, with inhibitions of 31.4% and 33.9%, respectively, at a final concentration of 100 μM. These results were comparable to that of quercetin (38.4% inhibition), which served as a positive control. Generally, these findings highlight the potential of the active compounds 7 and 8 as antibacterial agents against H. pylori.

Preliminary Study on Paris xuefengshanensis in Ethnobotany

The plants of the genus Paris L. in the family Melanthiaceae have high medicinal value. Paris xuefengshanensis H.Li, Z.Wang &amp; G.W.Hu, sp. nov. ined., found in Ma'lin Yao Township, Xinning County, Hunan Province, China, is a new species with traditional uses and cultivation in the local area. The main goal of this study is to understand the traditional knowledge of the Yao ethnic villagers in Malin Township, Xinning County, regarding the use of Paris xuefengshanensis through ethnobotanical field surveys. This includes gathering information on local names, uses, and methods of utilization. Additionally, the research aims to review the current status of pharmacological studies on plants belonging to the Paris genus through literature research. Research on the pharmacological activities of the genus Paris mainly focuses on its anti-tumor, anti-inflammatory, and hemostatic activities. Additionally, it possesses sedative and analgesic properties, as well as antibacterial, anti-myocardial ischemia, antioxidant, and immune-regulating effects. The survey results found that Paris xuefengshanensis is effective in treating unidentified swellings, snake bites, contusions, and carbuncles. It also has certain effects in pain relief and tumor treatment.