Assessment of in-vitro cholinesterase inhibitory and thrombolytic potential of bark and seed extracts of Tamarindus indica (L.) relevant to the treatment of Alzheimer's disease and clotting disorders.

BACKGROUND: Low level of acetylcholine (ACh) is an important hallmark of Alzheimer's disease (AD), a common type of progressive neurodegenerative disorder. Effective treatment strategies rely mostly on either enhancing the cholinergic function of the brain by improving the level of ACh from being a breakdown by cholinesterase enzymes. Again atherothrombosis is major life-threatening cerebral diseases. Traditionally Tamarindus indica (L.) has widely known for its medicinal values. Our aim is to investigate the cholinesterase inhibitory activities as well as thrombolytic activities of the bark and seeds crude methanolic extracts (CMEs) in the treatment of AD and clotting disorder. MATERIALS AND METHODS: The crude methanol extract was prepared by cold extraction method and was assessed for acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE) inhibitory activities by the Ellman's method. For thrombolytic activity clot lysis method was applied. RESULTS: To compare both the fractions, extracts from the bark got more AChE inhibitory activity than the seed with the inhibitory concentration 50% IC50 values of 268.09 and 287.15 µg/ml, respectively. The inhibitory activity of BuChE was quiet similar to that of AChE as IC50 values of both the fractions were 201.25 and 254.71 µg/ml. Again in-vitro thrombolytic activity of bark was 30.17% and of seed it was 22.53%. CONCLUSION: The results revealed that the CME of bark and seed both have moderate cholinesterases inhibitory activities as well as thrombolytic activities, worth of further investigations to identify the promising molecule(s) potentially useful in the treatment of AD as well as in clotting disorders.

Role of intraoperative PTH monitoring and surgical approach in primary hyperparathyroidism.

AIMS: The use of intraoperative PTH monitoring (IOPTH) in combination with preoperative imaging has been useful to surgeons performing minimally invasive parathyroidectomy principally for adequacy of excision. However, its role within patients with equivocal imaging remains less clear particularly regarding the reduction of bilateral neck explorations. This study investigated the influence of IOPTH monitoring on the type of surgical approach adopted for patients with primary hyperparathyroidism (PHPT). Specifically, determining its impact amongst patients with equivocal imaging results. METHODS: 165 patients undergoing parathyroidectomy for PHPT at a single institution by a single surgeon, between 2008 and 2012, were included. Patients were divided into 2 groups, IOPTH monitoring and non-IOPTH monitoring. They were sub-classified according to their imaging strengths: strongly positive, equivocal and negative imaging. The percentages of patients undergoing focused, unilateral and bilateral operations were determined. RESULTS: 108 patients had IOPTH monitoring and 57 patients did not based on the availability of IOPTH monitoring. Patients with strongly positive imaging had a higher frequency of focused operation in both groups; IOPTH 73.4% and non-IOPTH 71.4%. Patients with negative imaging results had a higher frequency of bilateral operations; IOPTH 77.8% and non-IOPTH 72.7%. In patients with equivocal imaging results more focused/unilateral operations were performed with IOPTH monitoring 66.6% versus non-IOPTH 25%. The use of intraoperative PTH increased the likelihood of a unilateral procedure with equivocal imaging compared to those with negative imaging p = 0.04. CONCLUSION: IOPTH monitoring is most useful as an adjunct to preoperative imaging when imaging results are equivocal allowing for more focused/unilateral operations to be performed.