Effect of co-administration of metformin and extracts of Costus pictus D.Don leaves on alloxan-induced diabetes in rats.

Background and aim: The present study evaluates the antidiabetic effects of aqueous (CPAQ) and methanolic (CPME) extract of Costus pictus D. Don singly and/or in combination with metformin in alloxan-induced diabetic rats. Experimental procedure: CPAQ and CPME (400 mg/kg dose), metformin (120 mg/kg) and two different combinations of plant extracts and metformin (200 + 60 mg/kg and 400 mg/kg + 60 mg/kg) were orally given to alloxan-induced diabetic rats for 21 days. At 0, 7, 14, and 21 days, body weight and blood glucose levels were measured. Results and conclusion: After 21 days of treatment, biochemical profiling and histopathology analysis were carried out. CPAQ and CPME, when administrated separately, could decrease blood glucose levels (P ≤ 0.05). CPME showed more promising results (P ≤ 0.05) compared to the diabetic control group. Extracts co-administrated with metformin showed dose-dependent significant recovery of hypoglycemic activity of metformin. Fasting blood glucose levels, body weight, protein, and lipid profile of the treatment group were compared to the diabetic and normal control groups. Animal groups co-administered with CPME and metformin showed more significant effects on the recovery of tissue damages. The synergistic effect of plant extracts with metformin has positive effects on all the parameters and enhanced the efficiency and reduction of blood glucose levels.

Assessment of genetic diversity in Costus pictus accessions based on RAPD and ISSR markers.

Costus pictus, belonging to the family Costaceae, is one of the valuable medicinal plants with its anti-diabetic property. Despite ever-increasing demand from the pharmaceutical industry, this species is being less exploited at molecular level. Hence, an effort has been made in the present study to characterize the 15 accessions of C. pictus collected from different geographical regions of India through random amplified polymorphic DNA (RAPD) and inter-simple sequence repeats (ISSR) markers. A total of 25 RAPD and 20 ISSR primers were used in the present study. The RAPD analysis generated 343 loci, of which 124 were polymorphic with an average of 4.96 loci per primer. While, ISSR primers produced 177 loci, of which 77 were polymorphic with an average of 3.85 loci per primer. The similarity coefficients ranged from 0.86-0.99, 0.84-0.95 and 0.86-0.96 for RAPD, ISSR and combined RAPD-ISSR, respectively. The UPGMA dendrogram generated using these data showed low level of divergence among the accessions from South and West regions. Further, accession-specific bands were also revealed by RAPD and ISSR markers which might be contributed to specific trait. This investigation was an understanding of genetic variation within the C. pictus accessions. The present finding indicates that both the marker tools RAPD and ISSR combined or individually can be used in determining the genetic relationship between the accessions. It may be concluded that data of hereditary differences appeared among the C. pictus accessions could be utilized for their conservation and reproducing programs.

The efficacy and safety of epidural-based analgesia in a case series of patients undergoing lung transplantation.

OBJECTIVE: Successful pain management after lung transplantation is critical to ensure adequate respiratory effort and graft expansion. The authors investigated whether thoracic epidural analgesia (TEA) provided adequate pain control after lung transplantation without added morbidity. DESIGN: Retrospective review. SETTING: University teaching hospital. PARTICIPANTS: One hundred twenty-three patients who presented to this institution for lung transplantation from January 2008 to June 2013. INTERVENTIONS: Patient demographics, postoperative pain scores, and epidural-related complications were abstracted from the institutional electronic database. The authors used the previously validated Quality of Recovery (QoR) score and Visual Analog Scale (VAS) as measures of recovery. MEASUREMENTS AND MAIN RESULTS: Of the 123 patients who underwent lung transplantation in this time frame, 119 patients had thoracic epidurals placed for postoperative analgesia. The mean age was 49.4 years (range, 18-73), and 60 (50.4%) were male. The most common indications for transplant were pulmonary fibrosis (33.6%), cystic fibrosis (26.1%), and chronic obstructive pulmonary disease (20.2%). The median length of stay in the intensive care unit and duration of mechanical ventilation were 21 and 1.2 days, respectively. Eight (6.7%) patients experienced postoperative pulmonary compromise (eg, pneumonia, prolonged intubation). No serious complications were associated with TEA placement. On days 1, 3, and 7 after TEA placement, the mean QoR was 7.6, 9.4, and 9.7, and the mean VAS was 2.5, 2.1, and 2.0, respectively. CONCLUSIONS: In this case series, the authors observed excellent analgesia and no serious complications associated with TEA. Therefore, an epidural-centric approach to pain control after lung transplantation should be considered in appropriate patients.

Iliac vein compression syndrome: an underdiagnosed cause of lower extremity deep venous thrombosis.

Iliac vein compression syndrome (CS) is a rare cause of deep venous thrombosis. It is caused by an anatomic anomaly in which the right common iliac artery overlies the left common iliac vein causing mechanical compression. Subsequent endothelial changes within the vessels have the potential to spur thrombus formation. Aggressive diagnostic and therapeutic interventions must be implemented upon suspicion to avoid long-term complications. We report on a 19 year old male who presented with ICS. We discuss the clinical presentation, diagnosis, and current treatment options.