Efficiency of natural oils as alternative adjuvants to mineral oils in inactivated avian influenza vaccine formulation.

1. The effectiveness of inactivated vaccines depends on selecting the suitable adjuvant for vaccine formulation. The potency of vaccines with low antigen content can be improved with the appropriate adjuvant. This could allow production of more doses and lower the production cost.2. This study evaluated the efficiency of vaccines prepared using oil extracted from natural sources including argan oil, almond oil, sesame seed oil, pumpkin oil, cactus oil and black seed oil as alternative adjuvants for improving the protection capacity of inactivated influenza virus vaccine as compared to commonly used mineral oils.3. Each vaccine formulation was evaluated for stability, safety and immunogenicity in chickens, as well as for reducing the viral shedding after challenge infection.4. The cactus, sesame and pumpkin seed oil-based vaccines were found to be potent and successfully induced the production of humoral immunity in vaccinated chickens.

Antimicrobial activity of essential oils of Curcuma longa and Syzygium aromaticum against multiple drug-resistant pathogenic bacteria.

The present study was conducted to investigate the antimicrobial potential of essential oils of Curcuma longa and Syzygium aromaticum against multidrug-resistant pathogenic bacteria. Four identified bacterial isolates including Methicillin-resistant Staphylococcus aureus (MRSA), Escherichia coli, Klebsiella pneumoniae, and Acinetobacter baumannii were selected and their antibiotic sensitivity was checked by disc diffusion assay. C. longa and S. aromaticum were subjected to steam distillation to obtain their essential oils. The crude essential oils were fractioned by employing column chromatography. Crude essential oils and their fractions were evaluated for their antibacterial activity by agar well diffusion assay and minimum inhibitory concentrations were calculated. All the selected bacterial isolates showed resistance to three or more than three antibiotic groups and were declared as multidrugresistant (MDRs). Crude essential oils of C. longa and S. aromaticum exhibited antimicrobial activity against all selected isolates but S. aromaticum activity was better than the C. longa with a maximum 19.3±1.50 mm zone of inhibition against A. baumannii at 1.04 µL/mL MIC. GC/MS analysis revealed the abundance of components including eugenol, eugenyl acetate, b- caryophyllene, and a- Humulene in both crude oil and fractions of S. aromaticum. While the main components of C. longa essential oil were Ar-tumerone, a-tumerone, b- Tumerone, I-Phellandrene, a-zingibirene, b- sesquiphellandrene, and p- Cymene. This study highlights that plant-based essential oils could be a promising alternative to antibiotics for which pathogens have developed resistance. C. longa and S. aromaticum carry compounds that have antimicrobial potential against multiple drug-resistant bacteria including MRSA. E. coli, K. pneumoniae and A. baumannii.

Antibacterial activity of plant essential oils against indigenously characterized methicillin-resistant Staphylococcus aureus (MRSA).

Plant essential oils were evaluated for antimicrobial activity against Methicillin-resistant Staphylococcus aureus (MRSA). The isolates (n=03) were procured from Institute of Microbiology, UVAS Lahore, Pakistan. After biochemical and 16S rRNA gene-based PCR characterization, accession numbers were retrieved from NCBI i.e. MW344063.1, MW344064.1 and MW344065.1. These isolates exhibited molecular positivity by multiplex PCR for mecA, coa and eta toxin genes. Moreover, these isolates exhibited resistance to cefoxitin, ampicillin, amoxicillin, penicillin, amoxicillin clavulanate, ciprofloxacin, erythromycin and gentamicin. The antibiotic resistant isolates were evaluated for antimicrobial activity of plant essential oils. The highest zone of inhibition (mean ZOI±S.D.) was measured for Cinnamomum verum (22.67±1.52 mm) followed by Eucalyptus globulus (18.67±2.51 mm) and Syzygium aromaticum (12.67±2.51 mm). Lowest mean MIC value (0.33±0.11 mg/mL) was recorded for E. globulus . Eucalyptus globulus was processed for fractionation by column chromatography and n-hexane, chloroform, n-hexane + chloroform and ethyl-acetate fractions were evaluated for antibacterial activity. Lowest mean MIC (10.04±5.80 mg/mL) was recorded for E. globulus n-hexane fraction. Cell survival percentage of BHK21 cell line was 51.7% at 54.87mg/mL concentration of E. globulus n-hexane fraction. Through gas chromatography-mass spectrometry (GC-MS) analysis of n-hexane fraction, benzene was found abundant (29.9%) as active compound. It was concluded that E. globulus n-hexane fraction exhibited significantly promising results against MRSA .

A survey on traditional plants used in Al Khobah village.

The use of traditional medicine for treatment of various diseases is a common practise in most of the developing countries including the Kingdom of Saudi Arabia especially in rural areas. In this survey, Al Khobah village was selected to study the status of Traditional Medicine. Al Khobah village is located on the Southern boarders of the kingdom and characterized by diverse topography and moderate weather. The plants with medicinal uses were collected, identified and their methods of preparation and uses were recorded. After gathering all these information from the local people, literature survey was conducted on each plant to get information about pharmacological activities and weather they support the traditional use or not. The survey revealed that the uses of some plants are consistent with the experimental data in the literature. Some other plants were studied; however, they still need pharmacological investigation to prove the claimed uses. Other plant did not subject to any scientific investigation.

Serum Zinc, Copper, Magnesium & Phosphorus Level in Children with Severe Acute Malnutrition (SAM).

Malnutrition is widely prevalent among hospitalized children in most developing countries including Bangladesh. Though malnutrition accounts for the high rate of under 5 mortality sometimes it is overlooked. Keeping in this in mind A comparative cross sectional study was done in Mymensingh Medical College Hospital from 1st October 2009 to 31st May 2011. Children aged 1-5 years with presence of one or more criteria WHM <70%, WHZ-score <-3SD, Bipedal edema & Mid upper arm circumference <110mm were taken as study group and children aged 1-5 years with normal growth allowable normal range of variation is between 3rd and 97th centile curve or median (50th centile) ±2SD of weight for age growth chart (CDC growth chart, USA, 2000) were taken as reference group. Persistent diarrhea, Patients taking medications containing zinc, copper, magnesium, phosphorus & calcium, PEM with shock were excluded from study group. Nutritional assessment was done according to WHO criteria of SAM. Serum Zinc, Copper Magnesium and Phosphorus level were determined by Atomic Absorption Spectrometry using UNICAM - AA Spectrometer, model no. 969, Spain. Total 120 study populations were taken. Ninety Out of 120 were taken as a study group (SAM) & 30 were reference group. In reference group serum Zn, Cu, Mg, P value was 103.80±8.86µg/dl, 135.92±13.57µg/dl, 2.31±0.18mg/dl, 3.96±0.22mg/dl respectively. In study group serum Zn, Cu, Mg, P value was 60.33±11.08µg/dl, 80.60±15.46µg/dl, 1.47±0.22mg/dl, 2.00±0.52mg/dl respectively. All these results show that there is significant difference between study group & reference group. Considering the decreased level of these parameters, close biochemical monitoring and follow up should be emphasized for the children with SAM.

Effect of organic amendment on stem canker and black scurf disease of potato (Solanum tuberosum) / Efeito da alteração orgânica sobre o cancro da haste e doença dos tuberculos pretos da batata (Solanum tuberosum)

An experiment was conducted at Tuber Crops Research Centre, BARI, Bogra during 2008-2009 to evaluate the organic amendment for controlling the stem canker and black scurf of potato. The different kinds of organic amendments were: T1 =Poultry refuse (PR) at 4 t ha-1, T2 =PR at 5 t ha-1, T3 =PR at 6 t ha-1, T4 =Mustard oil cake (MOC) at 300kg ha-1, T5 =MOC at 500kg ha-1, T6 =Neem oil cake (NOC) at 300kg ha-1, T7 =NOC at 500kg ha-1, T8 =Sawdust burning and T9 = Control. The experiment was laid out in a randomized complete block design (RCBD) with four replications. The organic amendment significantly influenced the disease incidence, yield attributes and yield of potato. The lowest disease incidence (17.5%) and per cent disease index (9.99) were found in T3 (poultry waste at 6 t ha-1). The minimum russet, deformed and Sclerotia infected tubers were also recorded in poultry waste at 6 t ha-1. The highest healthy tubers and tuber yield were found in the same treatment. Therefore, poultry manure 6 t ha-1 along with recommended dose of chemical fertilizer can be recommended to produce healthy tubers and maximum tuber yield of potato.

O experimento foi conduzido no (Centro de Pesquisa em Tubérculos ) Tuber Crops Research Centre, Bari, Bogra durante 2008-2009 para avaliar a alteração orgânica e controlar o cancro da haste e Black Scurf da batata. Os diferentes tipos de alterações orgânicas foram: T1 = Poultry recusar (PR) a 4 t ha-1, T2 = PR a 5 t ha-1, T3 = PR em 6 t ha-1, T4 = bolo de óleo de mostarda (MOC) em 300 kg ha-1, T5 = MOC em 500 kg ha-1, T6 = bolo de óleo de Neem (NOC) em 300 kg ha-1, T7 = NOC em 500 kg ha-1, T8 = queima de serragem e T9 = Controle. O delineamento experimental foi em blocos casualizados (RCBD) com quatro repetições. A alteração orgânica influenciou significativamente a incidência da doença, os atributos de rendimento e produtividade da batata. A menor incidência da doença (17,5%) por cento do índice de doença (9,99) foram encontrados em T3 (resíduos de aves a 6 t ha-1). O russet mínimo, deformado e Sclerotia tubérculos infectados também foram registrados em resíduos de aves a 6 t ha-1. O rendimento mais elevado tubérculos saudáveis e tubérculos foram encontrados no mesmo tratamento. Portanto, aviário 6 t ha-1, juntamente com a dose recomendada de fertilizante químico pode ser recomendado para a produção de tubérculos saudáveis e rendimento máximo dos tubérculos de batata.

Selection, characterisation and evaluation of potential probiotic Lactobacillus spp. isolated from poultry droppings.

Aim of the present study was to characterise and evaluate probiotic potential of lactobacilli isolated from indigenous poultry. Lactobacilli were isolated from poultry droppings and identified by genus specific polymerase chain reaction and 16S rRNA gene sequencing. Isolates were characterised in vitro by their ability to tolerate low pH and bile salts, phytase activity, antimicrobial activity, antibiotic susceptibility profile, and autoaggregation and coaggregation with poultry gut pathogens. In vivo evaluation of selected isolates was done by their effect on the body weight gain and immune response of broiler chicks. Total of 90, one-day old chicks, were randomly divided in 9 groups and given selected lactobacilli alone and in combinations (108 cfu/bird, daily) from day 7 to day 35. Body weight gain and humoral immune response to New Castle Disease Virus (NDV) vaccine were determined weekly. Three lactobacilli isolates (SMP52, SMP64 and SMP70) were selected as potentially probiotic bacteria on the basis of in vitro characterisation and identified as Lactobacillus crispatus, Lactobacillus casei and L. crispatus, respectively. Chicks supplemented with 'SMP52', 'SMP64', 'SMP70' and 'SMP64+SMP70' and a commercial probiotic product (Protexin) showed significantly higher mean weight gain per bird (1,584±35.2, 1,629±30.6, 1,668±34.7, 1,619±29.5 and 1,576±31.7 g/bird, respectively) as compared to negative control group (1,394±26.7 g/bird), on day 35. SMP 70 also showed significantly higher geometric mean titre against NDV vaccine at day 21 as compared to negative control. It is concluded that L. crispatus SMP52, L. casei SMP64 and L. crispatus SMP70 are potential probiotic candidates which alone or in different combinations may increase body weight of broilers.

Advanced trends in controlling Helicobacter pylori infections using functional and therapeutically supplements in baby milk.

Helicobacter pylori is a common human pathogen infecting about 30 % of children and 60 % of adults worldwide. It is responsible for diseases such as gastritis, peptic ulcer and gastric cancer. H. pylori treatment based on antibiotics with proton pump inhibitor, but therapy failure is shown to be higher than 20 % and is essentially due to an increasing in prevalence of antibiotic-resistant bacteria, which has led to the search for alternative therapies. In this study, we discuss the usage of natural extracts mixture as alternative or complementary agents in controlling H. pylori infection so here, we focused on the plant extracts of (Cloves, Pepper, Cumin, Sage, Pomegranate peel, Ginger, Myrrh and Licorice). To that end, Phytochemical constituents detection like Tannins, Glycosides, Alkaloids, Flavonoids, Terpenoids, Saponins, Phenolic compounds, Reducing sugars, Volatile oils, Amino acids and Proteins was demonstrated. Each plant extract was examined individually or in combination for its antimicrobial activity against H. pylori. Out of the used extracts, four mixes were prepared and tested against H. pylori. The antibacterial activities of the four mixes, represented by the diameter of inhibition clear zone, recorded 21, 39, 23 and 28 mm. The most potent mix (mix2) was chosen and mixed with baby milk as a new combination for H. pylori infections treatment in babies.

In vitro cytotoxicity screening of wild plant extracts from Saudi Arabia on human breast adenocarcinoma cells.

This study investigated the in vitro anticancer activities of a total of 14 wild angiosperms collected in Saudi Arabia. The cytotoxic activity of each extract was assessed against human breast adenocarcinoma (MCF-7) cell lines by using the MTT assay. Among the plants screened, the potential cytotoxic activity exhibited by the extract of Lavandula dentata (Lamiaceae) was identified, and we analyzed its anticancer potential by testing antiproliferative and apoptotic activity. Our results clearly show that ethanolic extract of L. dentata exhibits promising cytotoxic activity with an IC50 value of 39 µg/mL. Analysis of cell morphological changes, DNA fragmentation and apoptosis (using an Annexin V assay) also confirmed the apoptotic effect of L. dentata extract, and thus, our data call for further investigations to determine the active chemical constituent(s) and their mechanisms of inducing apoptosis.

Molecular authentication of the medicinal herb Ruta graveolens (Rutaceae) and an adulterant using nuclear and chloroplast DNA markers.

Dried parts of different plant species often look alike, especially in powdered form, making them very difficult to identify. Ruta graveolens, sold as a dried medicinal herb, can be adulterated with Euphorbia dracunculoides. The genomic DNA was isolated from the leaf powder (100 mg each) using the modified CTAB method. Internal transcribed spacer sequences of nuclear ribosomal DNA (nrDNA-ITS), and chloroplast spacer sequences (rpoB and rpoC1) are regarded as potential genes for plant DNA barcoding. We amplified and sequenced these spacer sequences and confirmed the sequences with a BLAST search. Sequence alignment was performed using ClustalX to look for differences in the sequences. A DNA marker was developed based on rpoB and rpoC1 of the nrDNA-ITS for the identification of the adulterant E. dracunculoides in samples of R. graveolens that are sold in local herbal markets. Sequence-characterized amplified region markers of 289 and 264 bp for R. graveolens and 424 bp for E. dracunculoides were developed from dissimilar sequences of this nrDNA-ITS to speed up the authentication process. This marker successfully distinguished these species in extracted samples with as little as 5 ng DNA/µL extract.

Phytochemical investigation and medicinal evaluation of fixed oil of Balanites aegyptiaca fruits (Balantiaceae).

ETHNOPHARMACOLOGICAL RELEVANCE: Balanites aegyptiaca (Balantiaceae), mainly the fruit, is used by traditional healers and herbalists for treating many diseases in Africa and Asia. AIM OF THE STUDY: Investigation of fixed oil composition of fruits and evaluation of its biological activity. MATERIALS AND METHODS: Oil content was identified using GC and GC/MS. In vitro examination of the oil biological activity (including cytotoxicity, antimutagenicity, antiparasitic, antiviral and antimicrobial activities) was performed. RESULTS: The oil contained 54.53% unsaturated fatty acids and 1.14% sterols. The oil exhibited anticancer activity against lung, liver and brain human carcinoma cell lines. It also had antimutagenic activity against Fasciola gigantica induced mutagenicity besides anthelmintic activity against hepatic worms (Schistosoma mansoni and Fasciola gigantica). Preliminary screening showed that the oil had antiviral activity against Herpes simplex virus. It also had antimicrobial activity against selected strains of Gram-positive bacteria, Gram-negative bacteria and Candida. CONCLUSION: The results showed remarkable biological activity of Balanites aegyptiaca fixed oil and proved its importance as natural bioactive source.

Pinus pinaster seedlings and their fungal symbionts show high plasticity in phosphorus acquisition in acidic soils.

Young seedlings of maritime pine (Pinus pinaster Soland in Aït.) were grown in rhizoboxes using intact spodosol soil samples from the southwest of France, in Landes of Gascogne, presenting a large variation of phosphorus (P) availability. Soils were collected from a 93-year-old unfertilized stand and a 13-year-old P. pinaster stand with regular annual fertilization of either only P or P and nitrogen (N). After 6 months of culture in controlled conditions, different morphotypes of ectomycorrhiza (ECM) were used for the measurements of acid phosphatase activity and molecular identification of fungal species using amplification of the ITS region. Total biomass, N and P contents were measured in roots and shoots of plants. Bicarbonate- and NaOH-available inorganic P (Pi), organic P (Po) and ergosterol concentrations were measured in bulk and rhizosphere soil. The results showed that bulk soil from the 93-year-old forest stand presented the highest Po levels, but relatively higher bicarbonate-extractable Pi levels compared to 13-year-old unfertilized stand. Fertilizers significantly increased the concentrations of inorganic P fractions in bulk soil. Ergosterol contents in rhizosphere soil were increased by fertilizer application. The dominant fungal species was Rhizopogon luteolus forming 66.6% of analysed ECM tips. Acid phosphatase activity was highly variable and varied inversely with bicarbonate-extractable Pi levels in the rhizosphere soil. Total P or total N in plants was linearly correlated with total plant biomass, but the slope was steep only between total P and biomass in fertilized soil samples. In spite of high phosphatase activity in ECM tips, P availability remained a limiting nutrient in soil samples from unfertilized stands. Nevertheless young P. pinaster seedlings showed a high plasticity for biomass production at low P availability in soils.

Synthesis and antiviral screening of some thieno[2,3-d]pyrimidine nucleosides.

Some cyclic and acyclic nucleosides of thieno[2,3-d]-pyrimidine derivatives were synthesized via the reaction of compounds 1 and 2 or 3 and 4 with 2-chloroethyl methyl ether or 2,3,4, 6-tetra-O-acetyl-alpha-D-glucopyranosyl bromide. Nucleosides 9, 10, 15, and 16 were tested as antiviral agents against herpes simplex virus type-1 (HSV-1) and hepatitis-A virus (HAV). Compound 15 showed the highest effect on HSV-1 than the other three compounds, while the four tested compounds did not show any activity against HAV.

Chemical and biological evaluation of the essential oils of different Melaleuca species.

The essential oils of the fresh leaves of M. ericifolia, M. leucadendron, M. armillaris and M. styphelioides were isolated by a hydrodistillation method and analysed by a gas chromatography/mass spectrometry (GC/MS) technique. The essential oil of M. ericifolia contained methyl eugenol (96.84%) as a major constituent, whereas M. leucadendron was rich in 1,8-cineole (64.30%). The essential oil of M. armillaris was rich in 1,8-cineole (33.93%) followed by terpinen-4-ol (18.79%), whereas M. styphelioides was rich in caryophyllene oxide (43.78%) and (-) spathulenol (9.65%). The essential oils of these species possessed antimicrobial and antifungal activities. M. ericifolia exhibited the highest inhibitory effects against Bacillus subtiles and Aspergillus niger. The antiviral activities of the essential oils against Herpes simplex virus type 1 (HSV-1) were studied in African green monkey kidney cells (Vero) by a plaque reduction assay. The volatile oil of M. armillaris was more effective as a virucidal (up to 99%) than that of M. leucadendron (92%) and M. ericifolia (91.5%). The effects of the essential oils on the antioxidant system status in carbon tetrachloride treated animals were studied. The essential oil of M. armillaris exhibited a marked antioxidant effect, it improved vitamin E, vitamin C and superoxide dismutase parameters so it can be used as a free radical suppressor.

Microspore culture in Corchorus olitorius: effect of growth regulators, temperature and sucrose on callus formation.

Culture of isolated microspores and of anthers on media containing IAA directed free microspore development to an embryogenic pathway in C. olitorius. The first division of microspores on transfer to culture media was symmetrical in contrast to the asymmetrical division seen in normal development in vivo. Initially, 10-30% microspores divided symmetrically, but only 0.2-1% of the dividing microspores continued dividing and produced multicellular microcalli. About 30% of these microcalli produced callus but only on medium with 2.0 mg/L zeatin and 0.1 mg/L IAA. Incubation in the dark at temperatures of 35 degrees C for 1 day and then 25 degrees C was found effective for induction of first embryonic division in Corchorus. The frequency of microspore callus formation was higher on medium containing either 3% or 5% sucrose. Addition of colchicine and addition of activated charcoal to the above medium did not enhance microspore division in Corchorus olitorius. On transfer to different media most calli produced roots but regeneration of shoots and embryos was not induced.

Synthesis and nematocidal activity of diarylnonanoids related to malabaricones.

Twenty diarylnonanones were synthesized and their nematocidal activity was examined. Among those, the p-hydroxy compound 16 exhibited the strongest activity comparable to the natural diarylnonanoids, malabaricones A and C. Diarylundecanoid 57 also showed appreciable activity.

Crigler-Najjar syndrome in Saudi Arabia.

Crigler-Najjar (CN) syndrome is a congenital familial nonhemolytic jaundice associated with high level of unconjugated bilirubin due to deficient uridine diphosphate glucuronosyltransferase (UDPG-T) activity in the liver. The aim of this report is to emphasize the need for increased awareness of this potentially fatal condition unless diagnosed early and managed appropriately. Between 1986-1994, 12 patients (8 males and 4 females) were diagnosed at our hospital with CN syndrome. Jaundice was detected in the first few days of life in all but one, in whom detection was delayed for two weeks and resulted in kernicterus. Exchange transfusions were necessary in six cases. Consanguinity was present in 11 patients, eight of whom were the offspring of first cousins. None of the patients responded to phenobarbital therapy alone, which reflects the severity of their disease. Six patients required only phototherapy while the remaining six patients required a combination of phenobarbital and phototherapy. Percutaneous liver biopsy, performed in 10 patients, showed minimal and focal cholestasis in eight, while the remaining two had a normal histological picture. Almost complete absence of the activity of UDPGT in the liver was reported in seven cases. Kernicterus developed in five cases. It is concluded that CN syndrome remains a potentially fatal condition unless diagnosed early and managed appropriately. The recent adoption of liver segment transplantation, whether orthotopic or living-related, has saved affected patients the daily long hours of phototherapy. One of our patients successfully underwent living-related segmental liver transplantation.

Effect of n-3 fatty acids from fish oil on hemostasis, blood pressure, and lipid profile of dialysis patients.

Dialysis patients have an inordinate risk of cardiovascular events. Fish oils, rich in n-3 fatty acids, are believed to be beneficial in the prevention of atherosclerosis and thrombosis. Hence, the use of fish oils deserves consideration as a preventative or therapeutic intervention in dialysis patients. The suggestion has been made that n-3 fatty acids could increase the risk of bleeding, and thus, the safety of the use of these agents in dialysis patients must be established before long-term studies are undertaken. This study addresses the effect of n-3 fatty acids on the hemostatic profile of dialysis patients. Sixteen patients on chronic dialysis therapy were randomized to fish oil (MaxEPA) or placebo (olive oil) in a double-blind cross-over study. They received 3.6 g of n-3 fatty acids for 4 wk. Bleeding times were 4.8 +/- 0.4 min on MaxEPA and 4.5 +/- 0.3 min on placebo. Platelet aggregation to low-dose ADP or collagen also remained unchanged. There was a trend to lower serum triglyceride levels (2.7 +/- 0.5 versus 3.4 +/- 0.6 mmol/L, fish oil versus placebo) that did not reach statistical significance. Gastrointestinal side effects occurred in 10 of the 16 subjects and were severe in 5 patients. These side effects occurred in both the olive oil and the fish oil groups. The study had a 95% chance of detecting a clinically doubling significant increase in bleeding time, i.e., beta error less than 5%. In conclusion, n-3 fatty acids do not introduce a clinically important risk of bleeding for patients with end-stage renal disease.

Efficacy of therapeutic suggestions for improved postoperative recovery presented during general anesthesia.

There have been claims that the postoperative course of patients may be improved by presentation during general anesthesia of therapeutic suggestions which predict a rapid and comfortable postoperative recovery. This study evaluated the effectiveness of such therapeutic suggestions under double-blind and randomized conditions. A tape recording predicting a smooth recovery during a short postoperative stay without pain, nausea, or vomiting was played during anesthesia to about half the patients (N = 109), while the remaining, control patients were played a blank tape instead (N = 100). The patients were primarily undergoing operations on the fallopian tubes, total abdominal hysterectomy, vertical banding gastroplasty, cholecystectomy, and ovarian cystectomy or myomectomy. The anesthesia methods consisted of either isoflurane with 70% nitrous oxide in oxygen to produce end-tidal concentrations of 1.0, 1.3, or 1.5 MAC; or 70% nitrous oxide in oxygen combined with high or low doses of opioids. Assessments of the efficacy of the therapeutic suggestions in the recovery room and throughout the postoperative hospital stay included: the frequency of administration of analgesic and antiemetic drugs; opioid doses; the incidence of fever; nausea, retching, and vomiting; other gastrointestinal and urinary symptoms; ratings of pain; ratings of anxiety; global ratings of the patients' physical and psychological recoveries by the patients and their nurses; and length of postoperative hospital stay. There were no meaningful, significant differences in postoperative recovery of patients receiving therapeutic suggestions and controls. These negative results were not likely to be due to insensitivity of the assessments of recovery, as they showed meaningful interrelations among themselves and numerous differences in recovery following different types of surgery. Widespread utilization of therapeutic suggestions as a routine operating room procedure seems premature in the absence of adequate replication of previously published positive studies.

Colonoscopic diagnosis and medical treatment of ten patients with colonic tuberculosis.

Ten patients with tuberculous enterocolitis were diagnosed colonoscopically. In four, the diagnosis was confirmed by positive acid fast stain or the presence of caseating granuloma in colonic biopsy material or ileal washings. In one other patient a cervical lymph gland revealed acid-fast bacilli. He was the only patient with extraintestinal disease, indicating that primary tuberculous colitis is probably more common than secondary in Saudi Arabia. In the other five patients the colonoscopic diagnosis was confirmed by a complete response to antituberculous triple therapy. Six patients had hypertrophic, two ulcerohypertrophic and two widespread ulcerative lesions. Colonoscopy with biopsies has definite advantages over barium enema in diagnosis. After thus excluding malignancy, Crohn's disease remains the most important differential diagnosis. A ten-week therapeutic trial of antituberculous treatment is recommended in patients from high-risk populations with a typical history and colonoscopic picture to avoid the morbidity and mortality of diagnostic laparotomy.