Hypoglycaemic and antidiabetic activity of acetonic extract of Vernonia colorata leaves in normoglycaemic and alloxan-induced diabetic rats.

The aqueous extract of Vernonia colorata (Willd.) Drake (Composeae) leaves is used by African traditional medicine practitioners as a remedy for the treatment of diabetes. Our previous studies have shown the hypoglycaemic activity of the aqueous extract of Vernonia colorata leaves (300 mg/kg, per os) in normoglycaemic rats. The aim of the present study was to investigate the hypoglycaemic and antidiabetic activity of acetonic and hexanic extracts of the leaves of Vernonia colorata in order to further discriminate the type of extract which provides a better antidiabetic activity. Experiments were performed in normoglycaemic and alloxan-induced diabetic rats. The acetonic extract of the leaves of Vernonia colorata (AELVC) (100 mg/kg, per os) induced a significant decrease of blood glucose in normoglycaemic rats. The glycaemia varied from 4.72+/-0.11 to 3.72+/-0.22 mmol/l (p<0.05, n=5) 3 h after AELVC administration per os. In contrast, the hexanic extract of the leaves of Vernonia colorata (HELVC) increased significantly the glycaemia in normoglycaemic rats. Like glibenclamide, AELVC has an antihyperglycaemic effect in oral glucose tolerance test (OGTT) and alloxan-induced diabetic rats. These results have shown that: (i) AELVC and HELVC have an opposite effect on basal blood glucose in normoglycaemic rats, suggesting that the mechanisms of action of both above-mentioned extracts are different; (ii) AELVC has also an antidiabetic activity in hyperglycaemic rat models.

[Antidiabetic activity of the leaves of Vemonia colorata (Wilid.) Drake (Composees) in alloxan-induced diabetic rats]. / Activité antidiabétique des feuilles de Vernonia colorata (Willd.) Drake (Composees) sur un modèle de diabète alloxanique chez le rat.

Vemonia colorata is distributed through Africa (Benin, Cameroon, Senegal, Togo etc...). Its leaves are commonly used by african tradipractitioners for treating diabetes. However, the antidiabetic activity of the leaves of V. colorata had never been investigated in experimental conditions. The present study aimed to test the aqueous extract of the leaves of V. colorata for its effects in normoglycaemic and alloxan-induced diabetic rats in comparison to glibenclamide antidiabetic activity. Such glibenclamide, the aqueous extract of V. colorata (300 mg/kg, per os) induced a significant hypoglycaemic effect in normoglycaemic rats. The blood glucose varied from 0.77 +/- 0.01 to 0.58 +/- 0.01 g/l (p < 0.05, n = 5). It also reduced significantly the fasting glucose level of the hyperglycaemic rats induced with oral administration of glucose (4 g/kg). In alloxan-induced diabetic rats, glibenclamide (0.2 mg/kg, per os) lowered significantly the blood glucose from 2.40 +/- 0.30 to 0.70 +/- 0.40 g/l (p < 0.05, n = 5). As well as glibenclamide, the aqueous extract of V. colorata (300 mg/kg, per os) decreased the blood glucose in alloxanic rats from 2.80 +/- 0.10 to 1.00 +/- 0.20 g/l (p < 0.05, n = 5). The aqueous extract of the leaves of V. colorata possesses both hypoglycaemic and antidiabetic effect in normoglycaemic and alloxan-induced diabetic rats. This may indicate the ethnopharmacological basis of the use of V. colorata leaves in traditional medicine for treating diabetes.

[Food habits and oral hygiene of students. Investigation of 150 students in university housing]. / Habitudes alimentaires et d'hygiène orale des étudiants. Enquête auprès de 150 étudiants en résidence universitaire.

The objective of this study is to describe the food intake and the oral hygiene habits of 150 Senegalese students living in a university campus. According to Miller, we realised a four days survey. We noted an increase of sugar drinks; tea is the most consumed drink. The results showed also that the toothbrush as means of oral hygiene supplanted the traditional means such as "cure dents" or water rinse with finger.

Adenocarcinoma of the distal bile duct. A clinicopathologic outcome analysis after curative resection.

BACKGROUND/AIMS: Primary distal bile duct adenocarcinomas (DBDAs) are unusual neoplasms, necessitating pancreaticoduodenectomy for cure. The aims of this study were to evaluate the prognostic importance of lymphatic and perineural invasion, long-term outcome of patients after resection, and differences in outcome with hilar cholangiocarcinoma and pancreatic carcinoma. METHODS: The medical records and histopathological slides of 15 patients (8 men and 7 women) with documented DBDA after curative pancreaticoduodenectomy were reviewed. RESULTS: Nine standard and 6 pylorus-preserving pancreaticoduodenectomies were performed. TNM staging included 1, 3, 2, 8, and 1 patient in stages I, II, III, and IVA and IVB, respectively. Lymphatic and perineural invasion was present in 4 (27%) and 9 (60%) patients, respectively. With multivariate analysis only serum bilirubin was a significant prognostic factor. Median survival was 21 months, and 2- and 5-year actuarial survivals were 40 and 20%, respectively. Median survival with adjuvant therapy (n = 6) was 21 months, with 5-year survival of 33%. Five-year actuarial survivals when lymphatic or perineural invasion was present were 0 and 11%, respectively. CONCLUSION: DBDA is aggressive, but entails a better prognosis than pancreatic ductal or more proximal bile duct carcinoma. Lymphatic and/or perineural invasion worsen survival.

[Effect and mechanism of action of Tinospora bakis roots on biliary secretion using in vivo models]. / Etude de l'effet et du mécanisme d'action des racines de Tinospora bakis sur la sécrétion biliaire àpartir de modèles in vivo.

The aim of this study is to determine the choleretic properties of lyophilized aqueous extract of Tinospora bakis roots. For thus, we have used healthy and cholestatic Wistar rats. After administration of the extract (4 mg/100 g of weight) biliary flow, biliary acids flow, biliary glutathione and glucose concentrations were measured by specific methods. Comparative results between treated rats and non treated rats show: For healthy rats: a significant increase of biliary flow, biliary acids flow in the group of treated rats versus non treated healthy rats. There were no significant difference in the glutathione and glucose concentrations. For cholestatic rats: we noted also significant increase of biliary flow, biliary acids flow and glutathione concentration in the treated rats group. These results suggest that Tinospora bakis has a choleretic effect in vivo which depends on biliary acids and/or glutathione concentration.

[A baobab solution for the prevention and treatment of acute dehydration in infantile diarrhea]. / Une solution de pain de singe pour la prévention et le traitement de la déshydratation aiguë due aux diarrhées infantiles.

OBJECTIVE: The purpose of this study was to compare the clinical efficacy of a local solution based on "pain de singe", fruit of baobab (Adansonia digitata), and the WHO standard solution in the treatment of children with acute diarrhea and resulting mild to moderate dehydration. METHODOLOGY: A prospective clinical trial comparing the local solution to the standard WHO solution was conducted; in children of 6 months or older (mean age = 16.6 +/- 8.8 months), 79 received the WHO solution and 82 the local solution, and were followed for a period ranging from 4 to 48 hours. Evolution of diarrhea and weight gain were evaluated as variables of interest. RESULTS: WHO solution was found to be superior, but not statistically significant in term of duration of diarrhea and weight gain. DISCUSSION: The pain de singe based solution presents additional advantages: nutritional, economic and cultural; we recommend it to promote use of TRO at home.

Gastric acid secretion and vitamin B12 absorption after vertical Roux-en-Y gastric bypass for morbid obesity.

OBJECTIVE: This study sought to determine the basal and peak-stimulated acid secretion from the proximal gastric pouch and its relationship to absorption of free and food-bound vitamin B12 after gastric bypass for morbid obesity. SUMMARY BACKGROUND DATA: Gastric bypass can be performed safely and provides acceptable weight loss, but concerns remain about possible long-term complications such as vitamin B12 malabsorption. The authors hypothesized that by constructing a small pouch of gastric cardia, acid secretion into the pouch would be low, leading to maldigestion of food-bound vitamin B12 with subsequent malabsorption. METHODS: Basal and pentagastrin-stimulated peak acid outputs from the proximal gastric pouch were measured in ten patients after vertical Roux-en-Y gastric bypass using a perfused orogastric tube technique. Absorption of free and food-bound 57Co-vitamin B12 was evaluated separately using 24-hour urinary excretion. RESULTS: Basal (mEq/hr, mean +/- standard error of the mean [SEM]) and peak-stimulated (mEq/30 min) acid secretions from the proximal gastric pouch were markedly decreased compared to those for age- and sex-matched hospital control subjects (0.01 +/- 0.01 vs. 4.97 +/- 0.66 and 0.08 +/- 0.04 vs. 12.11 +/- 1.34, respectively; p < 0.001 for each). While absorption of free vitamin B12 was not statistically different from that of control subjects (11 +/- 2 vs. 15 +/- 2%; p > 0.05), absorption of food-bound vitamin B12 was decreased (0.8 +/- 0.2 vs. 3.7 +/- 0.5%; p < 0.01). CONCLUSIONS: After vertical Roux-en-Y gastric bypass for morbid obesity, acid secretion is virtually absent and food-bound vitamin B12 is maldigested and subsequently malabsorbed. The results of this study suggest that postoperative vitamin B12 supplementation is important and can be achieved with either monthly parenteral vitamin B12 or daily oral crystalline preparations.

Management of barium enema-induced colorectal perforation.

Unless recognized and treated promptly, colorectal perforation induced by barium enema examination is a life-threatening complication. Between 1977 and 1986, 13,000 barium enemas were performed at the Mayo Medical Center. Colorectal perforation occurred in five patients (overall incidence: 0.04%). The two colonic perforations were managed by immediate celiotomy with resection in one and primary repair in the other. The three rectal perforations were managed conservatively in two patients and by proximal diversion in one. All patients recovered. Perforations were believed to be related to the tip of the enema catheter or presumably to excessive hydrostatic pressure. In contrast to other reports, barium enema-induced colorectal perforation is not always fatal when recognized early and treated aggressively. Localized, contained extraperitoneal rectal perforation may be managed conservatively in selected patients.

Complications of acute diverticulitis of the colon: improved early diagnosis with computerized tomography.

We have evaluated the diagnostic role of computerized tomography in 42 patients suspected clinically of having a complication of acute diverticulitis (abscess, colovesical fistula, or both). Diverticular abscesses were confirmed at operation in 10 patients. All 10 patients were diagnosed preoperatively on computerized tomography by the triad of diverticula, a segmentally thickened colon, and extravisceral fluid collection with (6 patients) or without (4 patients) associated gas. Contrast enema study suggested the presence of a diverticular abscess in only two of eight patients studied. Colovesical fistulas were confirmed in 12 patients. Eleven of 12 were diagnosed preoperatively on computerized tomography by the triad of air in the bladder, thickened colon adjacent to an area of thickened bladder, and the presence of colonic diverticula. Contrast enema examinations demonstrated the fistula in only three of eight patients studied. The remaining 20 patients proved to have uncomplicated acute diverticulitis. Findings on computerized tomography included the presence of a segmentally thickened colon with diverticula but without the findings of an abscess or a colovesical fistula. Computerized tomography correctly visualized acute diverticular complications in 21 of 22 patients and it excluded an abscess or fistula in all 20 patients with uncomplicated acute diverticulitis who were suspected of having a diverticular complication. Computerized tomography is the most sensitive and specific test for diagnosing complications of acute diverticulitis. It should be an early consideration in patients with suspected diverticular abscesses or fistulas so that appropriate therapy is not delayed.

Ricinoleic acid causes secretion in autotransplanted (extrinsically denervated) canine jejunum.

To examine the role of extrinsic nerves and hormones in intestinal secretion of fluid, we studied the effect of ricinoleic acid on absorption by isolated, autotransplanted jejunal loops in four dogs. Compared to perfusion with control solution, the addition of ricinoleic acid caused reversible secretion of water and electrolytes and inhibition of glucose absorption, as previously described in the innervated intestine. In contrast, oral castor oil caused diarrhea but had no effect on absorption from the denervated loop. Thus, the secretory action of ricinoleic acid is maintained without the influence of extrinsic nerves; in addition, further support is added to the proposal that hormones do not mediate secretion in this model. These findings support a local mechanism for the secretion induced by ricinoleic acid.