ABSTRACT
Background@#Intrapleural fibrinolytic therapy (IPFT) has been used as an effective agent since 1949 for managing complicated pleural effusion and empyema. Several agents, such as streptokinase, urokinase (UK), and recombinant tissue plasminogen activator (rt-PA), have been found to be effective with variable effectiveness. However, a head-tohead controlled trial comparing the efficacy of the most frequently used agents, i.e., UK and rt-PA (alteplase) for managing complicated pleural effusion has rarely been reported. @*Methods@#A total of 50 patients were randomized in two intervention groups, i.e., UK and rt-PA. The dose of rt-PA was 10 mg, and that of UK was 1.0 lac units. UK was given thrice daily for 2 days, followed by clamping to allow the retainment of drugs in the pleural space for 2 hours. rt-PA was instilled into the pleural space twice daily for 2 days, and intercostal drainage was clamped for 1 hour. @*Results@#A total of 50 patients were enrolled into the study, of which 84% (n=42) were males and 16% (n=8) were females. Among them, 30 (60%) patients received UK, and 20 (40%) patients received alteplase as IPFT agents. The percentage of mean± standard deviation changes in pleural opacity was –33.0%±9.9% in the UK group and –41.0%±14.9% in the alteplase group, respectively (p=0.014). Pain was the most common adverse side effect, occurring in 60% (n=18) of the patients in the UK group and in 40% (n=8) of the patients in the alteplase group (p=0.24), while fever was the second most common side effect. Patients who reported early (within 6 weeks of onset of symptoms) showed a greater response than those who reported late for the intervention. @*Conclusion@#IPFT is a safe and effective option for managing complicated pleural effusion or empyema, and newer agents, such as alteplase, have greater efficacy and a similar adverse effect profile when compared with conventional agents, such as UK.
ABSTRACT
A poisonous plant is defined as a plant that when touched or ingested in sufficient quantity can be harmful or fatal. Many plants are harmful to people when consumed or through skin contact with plant chemicals. Poisonous medicinal herbs are used to treat a variety of illnesses, including diabetes, cancer, infection, and fungal growth. According to the review, numerous phytochemical components that have diuretic, purgative, laxative, anti-allergic, and other significant therapeutic effects have been identified from a variety of medicinal plants. If utilized appropriately, poison can be life-giving, calming to the three Doshas, encouraging, and regenerating. The poisonous plants categorized in Visha and Upvisha in Ayurveda texts. Agadtantra is an important branch of Astanga Ayurveda. Importance of this branch has been described in our Vedas, Epics, and Samhita. Proper description, classification, clinical features, and management of any kind of Visha has been described in this branch. Name of some poisonous plants are Dhatura, Vatsanabha, Bhallataka, Bhanga, Kuchala, Vacha and Gunja etc. Shodhana process is the only bridge between Visha and Aushadhi. Shodhana is the process by which physical, chemical and natural impurities are removed. It will intensify the potency, effectiveness of drug, nullify the toxicity. The aim of this review article is to provide a brief overview of the numerous medicinal uses of some poisonous plant.