Traditional uses, hepatoprotective potential, and phytopharmacology of Tinospora cordifolia: a narrative review.

OBJECTIVES: Despite significant advancements in modern medicine, effective hepatoprotective medication with minimal side effects is still lacking. In this context. Tinospora cordifolia, an Indian Ayurvedic liana, has attracted much attention. KEY FINDINGS: Traditionally, T. cordifolia has been found to be effective in the treatment of jaundice; according to the literature, T. cordifolia is a hepatoprotective agent, and the CCl4 model is the most frequently used to evaluate its potential. Its hepatoprotective effects might be attributed to alkaloids (berberine, palmatine, and jatrorrhizine) and sinapic acid. Berberine decreases inflammation by inhibiting the proinflammatory cascade triggered by TNF-α and reduces nitrosative stress by inhibiting iNOS. T. cordifolia also exhibits anticancer, anti-inflammatory, antimicrobial, antioxidant, and other activities; it is safe at concentrations up to 2000 mg/kg. Its biological action can be attributed to polyphenols, alkaloids, steroids, terpenoids, and glycosides. T. cordifolia has also been found to be an active ingredient in several polyherbal formulations used to treat chemical-mediated hepatotoxicity. CONCLUSION: T. cordifolia's hepatoprotective effects are mediated by the inhibition of lipid peroxidation, the management of oxidative stress, and other factors. T. cordifolia can be used to manage liver disorders and as a hepatoprotective supplement in the food industry. The bioprospecting of its alkaloids can lead to the development of novel formulations against hepatic ailments.

Evaluation of the Effect of Vitamin D Levels During the Last Trimester of Pregnancy on Fetomaternal Outcomes in Patients With Preeclampsia.

Introduction Preeclampsia is a multisystem disorder with hypertension after 20 weeks of gestation. Among many predictors of preeclampsia, vitamin D being one of them is under many studies for establishing a correlation between levels of vitamin D and preeclampsia. Objective To observe a relation between vitamin D levels and preeclampsia and assess related fetomaternal outcomes. Method It is an observational study at the tertiary care center. One hundred twenty patients, out of which 60 were taken as cases with BP>140/90, and 60 were taken as controls with normal BP in a tertiary care center from January 1, 2020, to June 30, 2021. All investigations were sent, and the mode of delivery and the fetomaternal outcome were assessed. Results Compared to normal pregnant patients, preeclamptic patients have significantly lower levels of vitamin D with a p-value of <0.001, which is significant. Conclusion There is a relationship between vitamin D levels and preeclampsia. However, the effects of supplementation of vitamin D on fetomaternal outcomes need further studies.

Comparison of bipolar plasmakinetic transurethral enucleation and resection of prostate gland in patients receiving anticoagulants and/or platelet aggregation inhibitors.

BACKGROUND: The aim of this study was to evaluate the safety and efficacy of bipolar plasmakinetic enucleation of the prostate (BPEP) and bipolar plasmakinetic transurethral resection of prostate (B-TURP) for patients on oral anticoagulants (OA) and/or platelet aggregation inhibitors (PAI) with benign prostatic obstruction (BPO) and having a gland size of >60 g. METHODS: Patient database of our hospital for the period of May 2012 to September 2017 was retrospectively reviewed for BPH patients with a gland size of >60 g who either underwent BPEP or B-TURP and were on OA and/or PAI. Patient demographic, perioperative, and follow-up data were analyzed. RESULTS: There were no significant differences between the two surgical groups preoperatively. The mean operative time was lower in the BPEP group however, no statistical difference was found between them (P=0.77). There was significant difference in the mean resected tissue weight (52.11±17.92 vs. 77.19±17.78 g, P value ≤0.001), irrigation time and total hospital stay in favor of BPEP group. The blood loss observed in the B-TURP group and BPEP group was 2.57±0.36 and 1.45±0.44 g/dL, respectively, which was statistically significant (P<0.033). Eight and three patients of B-TURP and BPEP groups needed blood transfusion respectively. All patients were followed up for 12 months postoperatively. Both groups resulted in a significant improvement from baseline in terms of IPSS, QoL, Q-max, and PVRU volume values. No significant difference was found between them, however. CONCLUSIONS: Both procedures are safe and effective options in patients who are on OA and/or PAI but BPEP is better in terms of low clot retention rate, less irrigation time and decreased hospital stay.

Management of Large Prostate Gland in Men with Impaired Renal Function: Comparison of Safety, Efficacy and Outcomes of Monopolar, Bipolar Transurethral Resection and Open Prostatectomy.

OBJECTIVE: The purpose of the study was to compare the safety, efficacy and outcome of monopolar transurethral resection of prostate (M-TURP), bipolar transurethral resection of prostate (BP-TURP) and open prostatectomy (OP) exclusively involving large prostate glands in men with renal impairment. METHODS: Data of patients with gland size >90 g and serum creatinine >1.5 mg/dl, who were managed surgically at our institution from April 2009 to March 2014 were analyzed retrospectively. International Prostate Symptom Score (IPSS), quality of life (QoL) scores, PVR, serum creatinine and Q-max were recorded preoperatively and postoperatively at each follow-up visit. Follow-up was performed at 1, 3, 6 and 12 months. RESULTS: M-TURP, BP-TURP and OP were the 3 types of surgeries performed. Preoperative characters were similar in all the groups. Hemoglobin drop, transfusion rates, irrigation time, catheter time and hospital days were significantly more in the OP group. Changes in sodium levels and incidence of transurethral syndrome were found to be more in the monopolar group. The follow-up data indicate a significant improvement in the IPSS, QoL, PVR and Q-max in all the groups. CONCLUSION: This category of patients can be managed safely and efficiently by all the 3 procedures, although BP-TURP has an advantage in terms of shorter catheterization, hospitalization and fewer complications like transurethral resection syndrome.

A novel thermotolerant Pediococcus acidilactici B-25 strain for color, COD, and BOD reduction of distillery effluent for end use applications.

The present study was aimed to characterize physico-chemical and microbial population of distillery effluent and isolate a novel thermotolerant bacterium for color, COD, and BOD reduction of spentwash. The level of alkalinity, TSS, DO, COD, BOD, TN, ammonical nitrogen, nitrate nitrogen, phosphorous, potassium, chloride, and calcium of spentwash (SW), bioreactor effluent (BE), and secondary treated effluent (STE) were well above the permissible limits. The level of color, TS, and TDS were under the permissible limits for STE but not for SW and BE. The microbial population was higher in BE. The results revealed that effluent was highly polluted and require suitable treatment before discharge. A novel thermotolerant bacterium, identified as Pediococcus acidilactici, was isolated which exhibited maximum 79 % decolorization, 85 % COD, and 94 % BOD reduction at 45 °C using 0.1 %, glucose; 0.1 %, peptone; 0.05 %, MgSO4; 0.05 %, K2HPO4; pH 6.0 within 24 h under static condition. The ability of this strain to decolorize melanoidin at minimum carbon and nitrogen supplementation warrants its possible application for effluent treatment at industrial level. In addition, it is first instance when melanoidin decolorization was reported by P. acidilactici. This study could be an approach towards control of environmental pollution and health hazards of people in and around the effluent distillery unit.