Scientific investigation of crude alkaloids from medicinal plants for the management of pain.

BACKGROUND: Tissue damage is associated with pain, which is an alarming sign. Aspirin and morphine have been widely used in recent decades for management of pain. Medicinal herbs have been in use for treatment of different diseases for centuries. Many of these herbs possess analgesic activity with relatively less incidences of adverse effects. The strong positive correlation of alkaloids in medicinal plants for analgesic activity persuades an intention to determine possible analgesic activity of total alkaloids extracted from the selected medicinal plants using animal models to answer its possible mechanisms. METHODS: Crude alkaloids from selected medicinal plants (Woodfordia fruticosa, Adhatoda vasica, Chenopodium ambrosioides, Vitex negundo, Peganum harmala and Broussonetia papyrifera) were extracted as per reported literature. The test crude alkaloids were screened foracute toxicity study. Writhings induced by acetic acid, tail immersion method and formalin-induced nociception assay procedures were used for possible analgesic effects of the crude alkaloids. RESULTS: Crude alkaloids were safe up to dose of 1250 mg/kg body weight in mice. The alkaloids significantly reduced the abdominal constrictions, and increased the time for paw licking response in both phases with a significant raise in latency time in nociception models (P ≤ 0.05). Moreover, the antinociceptive response was significantly attenuated by pretreatment with naloxone suggesting involvement of the opioid receptors for possible antinociceptive action. CONCLUSIONS: Crude alkaloids of Woodfordia fruticosa and Peganum harmala showed prominent analgesic potentials through inhibition of peripheral as well as central nervous system mechanisms. Further work is required for isolation of the pharmacologically active constituents.

Residual Level Of Deltamethrin Induced Gastritis And Preventive Role Of Curcumin On Stomach Mucosa.

BACKGROUND: Benefits of Curcumin for health have been explained by different experimental models and clinical trials. It is a very potent antioxidant. Curcumin was found to play a preventive and curative role in both acute and chronic gastritis. Deltamethrin is a useful pesticide when applied with caution to crops. However, it also has noxious effects on gastric mucosa once ingested with sprayed crops. Its maximum permissible limit, MRL (Maximum Residual Level) as pesticide food residues is 5 mg/kg body weight as defined by WHO. However, there is still a potential to cause harm at these levels and maybe a serious potential health hazard. The present study aimed to: (a) determine the prevalence and severity of gastritis induced by deltamethrin when administered at MRL doses and (b) To observe the preventive effect on gastric mucosa against the action of Deltamethrin present as a residual pesticide in different vegetables and fruits. METHODS: In this two-phase subacute toxicity study of seven weeks, forty Sprague Dawley rats were divided into eight subgroups. Control groups were kept on a normal diet and sesame oil. Out of the two treatment groups, one group was given deltamethrin (5 mg/kg body weight) orally along with curcumin 100 mg/kg body weight. The second group was first given deltamethrin (5mg/kg body weight) and curcumin (200mg/kg). All were culled at its end. The stomach samples were collected and processed to obtain histology slides for analysis via microscopy and micrometry. Grading was done to look for changes according to the "Visual Analogue Scale and Operative Link on Gastritis Assessment (OLGA)". RESULTS: The experimental deltamethrin group when compared to control groups, revealed mild changes in stomach histomorphology while curcumin-treated both groups; Group D (100 mg/kg) and Group E (200 mg/kg) showed no changes. CONCLUSIONS: Administration of Deltamethrin even in maximum residual dose (permissible) is proven to be toxic. Curcumin is hence proven to protect the gastric mucosa against the toxic effects of deltamethrin ingested in residual form.

Real-World Evidence to Evaluate the Efficacy and Safety of Vonoprazan in Gastrointestinal Disorders in the Pakistani Population.

BACKGROUND AND AIM: While proton pump inhibitor (PPI) therapy has proven to be effective in managing gastroesophageal reflux disease (GERD), a notable portion of patients who experience GERD symptoms may not respond to this treatment. Research suggests that roughly 30% of individuals with a presumed GERD diagnosis may continue to experience symptoms, whether partially or completely, even when receiving PPI therapy. The aim of this study was to assess the treatment of gastrointestinal diseases with a novel potassium-competitive acid blocker (P-CAB), vonoprazan, in terms of its effectiveness and safety in the Pakistani population. METHODS: This prospective, multicenter, observational study was conducted in Pakistan. This study included 1,642 patients from January 2023 to August 2023, aged 18 years, with gastrointestinal disorders. All demographic data, medical history, GERD severity assessment questionnaire (GerdQ), and laboratory parameters, including stool assessment for Helicobacter pylori (H. pylori), were observed. Patients were orally treated with vonoprazan at doses of 10 mg or 20 mg, once or twice daily. Statistical analysis was done by one-way ANOVA. RESULTS: Out of 1,642 patients, 840 (51.2%) were males and 802 (48.8%) were females, with a mean age of 39.81±14.61 years. The mean GerdQ score at baseline was 20.37±15.87, 7.24±8.15 at the second week of treatment, and 3.70±6.31 at the fourth week of treatment (p<0.001). 90.74% of patients achieved H. pylori eradication. Most patients were acid regurgitation and heartburn-free for >70% of days. Most of the patients, 1,283 (78.13%), exhibited good treatment compliance. Mild adverse events were reported in 37 (2.3%) patients. CONCLUSIONS: The use of vonoprazan significantly reduced the likelihood of GERD by improving symptoms and was also highly effective in the elimination of H. pylori infections. Vonoprazan was generally well tolerated.

Correction: Real-World Evidence to Evaluate the Efficacy and Safety of Vonoprazan in Gastrointestinal Disorders in the Pakistani Population.

[This corrects the article DOI: 10.7759/cureus.48994.].

Proximal Femur Histo-Morphological Changes Among Hip Fracture In Elderly Patients.

BACKGROUND: Hip fracture causes high morbidity in elderly. Decreased bone mineral density is associated with hip fracture risks. The study is conducted to identify relationship of histomorphological changes in proximal femur in the cases of hip fractures in elderly with histomorphological changes in proximal femur. METHODS: A total of 30 elderly patients with hip fracture were studied in this case series. The study was carried out in Orthopaedic and Pathology departments at Mardan Medical Complex from May 2014 to October 2014. Specimen during surgery, were collected for histopathological study. RESULTS: Bone biopsy of hip fracture cases revealed cortical thinning, reduced number of osteocytes, thinning and fragmentation of trabeculae. CONCLUSIONS: This study concluded that bone micro architectural changes seems to be associated with the risk of hip fracture.

A Comparison Of Skeletal Age Of Thalassaemic Patients Of 9-15 Years With Chronological Age By Radiography.

BACKGROUND: Thalassemia is inherited disorder characterized by haemolytic anaemia, due to complete absence or reduced ß-globin chain synthesis, stimulating pathological bone marrow overstimulation and altered erythropoiesis. The change in bone mass ultimately results into miss interpretation of bone age once assed from x-ray radiograph. The aims compare skeletal age of thalassaemic children of 9-15 years with chronological age by x-ray wrist bones. METHODS: This was cross sectional analytical study; the study was conducted in conjunction with Fatimid Hospital Peshawar Pakistan and Out Patients Department (OPD) of paediatrics for minor illness (other than Thalassemia) Khyber Teaching Hospital August 2014 to January 2015. A total 156 samples were selected convenient sampling to make comparison of bone age and chronological age between thalassaemic children (age 9-15years) and age sex matched normal control. A structure data collection check list was used to collect data X-ray findings (bone age). SPSS 20 was used for statistical analysis. RESULTS: The results showed a total of 156 children with their mean age 11.9±2.2, male were 97 (62.2%) and females 59 (37.8%). Out of thalassaemic (n=76) majority 49 (62.8%) were male as compared to female 29 (37.2%). The mean chorological age among both of group were not significantly different (p=0.67). However, the bone age was significantly different from each other (p=0001). Pearson's correlation analysis revealed that was strong correlation between erupt teeth and bone age (r=0.462, p=0.0001). CONCLUSION: Skeletal age assessment was found to be suboptimal along with chronological age in children and adolescents suffering from thalassemia.