Prashant Tiwari

Gynecologic-tract sparing extra peritoneal retrograde radical cystectomy with neobladder

OBJECTIVE We report on a series of female patients with transitional cell carcinoma of the bladder who underwent extraperitoneal retrograde radical cystectomy sparing the female reproductive organs with neobladder creation. MATERIALS AND METHODS 14 female patients between the ages of 45 and 72 years who underwent gynecologic-tract sparing cystectomy (GTSC) with neobladder between 1997 and 2002 were retrospectively reviewed. Our surgical technique is also described. Radical cystectomy is accomplished by a retrograde method sparing the uterus, adnexa, vagina and distal urethra. An orthotopic neobladder was constructed using small bowel or sigmoid colon, brought extraperitoneally, and anastomosed to the distal urethra. RESULTS Operating time ranged from 4.5 to six hours with a mean of 5.3 hours. Ten patients were able to void satisfactorily while four required self-catheterization for complete emptying of the bladder. Seven patients were continent day and night and another 7 reported varying degrees of daytime and nighttime incontinence. One patient died of metastases and another of pelvic recurrence. There were no urethral recurrences. Patient satisfaction with the procedure was high. CONCLUSIONS Gynecologic-tract sparing cystectomy with orthotopic neobladder is a viable alternative in female patients with muscle invasive traditional cell carcinoma of the bladder, providing oncological safety with improved quality of life. Our extraperitoneal technique, which is an extension of our successful experience with retrograde extraperitoneal radical cystectomy in men, minimizes intraoperative complications and simplifies the management of post-operative morbidity with the neobladder.

Basic and modern concepts on cholinergic receptor: A review

Cholinergic system is an important system and a branch of the autonomic nervous system which plays an important role in memory, digestion, control of heart beat, blood pressure, movement and many other functions. This article serves as both structural and functional sources of information regarding cholinergic receptors and provides a detailed understanding of the determinants governing specificity of muscarinic and nicotinic receptor to researchers. The study helps to give overall information about the fundamentals of the cholinergic system, its receptors and ongoing research in this field.

Antibacterial activity and physicochemical evaluation of roots of Butea monosperma

Abstract Objective To evaluate the antibacterial activity of the petroleum ether extract of root of Butea monosperma ( B. monosperma ). Method In vitro antibacterial activity of petroleum ether i.e. B. monosperma was studied against Staphylococcus faecalis ( S. faecalis ), Sterptococcus faecalis ( S. faecalis ), Aeromonas hydrophilia ( A. hydrophilia ), Salmonela typhae ( S. typhae ), Stphylococcus cohni ( S. cohni ), Escherichia coli ( E. coli ) and Serratia ficaria ( S. ficaria ) by using well diffusion method. Results Petroleum ether extract of root of B. monosperma exhibited a prominent inhibitory effect against bacterial strains. Conclusion From the result it can be concluded that the B. monosperma extract has potent in vitro antibacterial activity.

Analgesic and anti-inflammatory properties of the fruits of Vernonia anthelmintica (L) Willd.

Objective To evaluation of analgesic and anti-inflammatory properties of the fruits of Vernonia anthelmintica (L) Willd. (V. anthelmintica).

Evaluation of hepatoprotective activity of alcoholic and aqueous extracts of Selaginella lepidophylla

Abstract Objective To screen Selaginella lepidophylla ( S. lepidophylla ) that are used in traditional medicine for their claimed hepatoprotective properties. Methods Alcoholic and aqueous extracts of S. lepidophylla were evaluated for their hepatoprotective activity using CCl 4 and paracetamol induced acute hepatic injury model. Results Treatment with CCl 4 and paracetamol significantly increased liver weight and volume compared to the normal group. Pretreatment with silymarin alcoholic and aqueous extracts significantly prevent increase in liver weight and volume. Conclusions From the present experimental study it can be concluded that alcoholic and aqueous extract of S. lepidophylla exhibited significant hepatoprotective activity against CCl 4 and paracetamol induced hepatotoxicity in rats, as result showed in physical, biochemical and histopathological parameters.

Evaluation of anxiolytic effect of Syzygium aromaticum: a traditional herb of India

Abstract Objective To evaluate the anxiolytic effect of Syzygium aromaticum ( S. aromaticum ). Methods Anxiolytic activity of S. aromaticum was evaluated by using two method i.e. elevated plus maze and light-dark model. Results Hydroalcholic extract of S. aromaticum exhibited a prominent anxiolytic effect. Conclusions The hydroalcholic extract of S. aromaticum showed statistically significant anxiolytic effect.

Toxic epidermal necrolysis: an update

Toxic epidermal necrolysis (TEN), also known as Lyells syndrome, is a rare, life-threatening dermatological condition that is usually induced by reaction to medications. It is characterized by the detachment of the top layer of skin (the epidermis) from the lower layers of the skin (the dermis) all over the body. There is broad agreement in medical literature that TEN can be considered a more severe form of Stevens Johnson syndrome, and debate whether it falls on a spectrum of disease that includes erythema multiforme. Some authors consider that there is an overlap between the two syndromes (usually between 10% and 30% of skin detachment). This article deals with history, epidemiology, diagnosis, pathophysiology treatment and management of TEN.

Multiple sclerosis: an overview

Abstract Multiple sclerosis (MS) is an autoimmune disease in which bodys immune system eats away the protective sheath that covers nerves which interferes with the communication between brain and the rest of body. Ultimately this may result in deterioration of the nerves themselves a process thats irreversible. Symptoms vary widely, depending on the amount of damage and the type of nerves affected. Patients with severe cases of multiple sclerosis may lose the ability to walk or speak. Multiple sclerosis can be difficult to diagnose early in the course of the disease because symptoms often come and go sometimes disappearing for months. Theres no cure for multiple sclerosis. However treatments can help treat attacks, modify the course of the disease and treat symptoms.

Plants altering hormonal milieu: A review

The aim of the present review article is to investigate the herbs which can alter the levels of hormones like Follicle stimulating hormone, Prolactin, Growth hormone, Insulin, Thyroxine, Estrogen, Progesterone, Testosterone, and Relaxin etc. Hormones are chemical signal agents produced by different endocrine glands for regulating our biological functions. The glands like pituitary, thyroid, adrenal, ovaries in women and testes in men all secrete a number of hormones with different actions. However, when these hormones are perfectly balanced then people become healthy and fit. But several factors like pathophysiological as well as biochemical changes, disease conditions, changes in the atmosphere, changes in the body, diet changes etc. may result in imbalance of various hormones that produce undesirable symptoms and disorders. As medicinal plants have their importance since ancient time, people have been using it in various ways as a source of medicine for regulation of hormonal imbalance. Moreover, it is observed that certain herbs have a balancing effect on hormones and have great impact on well-being of the people. So, considering these facts we expect that the article provides an overview on medicinal plants with potential of altering hormone level.

Neuroleptic drug induced hyperprolactinaemia: Pathophysiology, safety and acceptability

Abstract Hyperprolactinaemia has been an expected and derelict side effect of neuroleptic medication for decades. Neuroleptic drugs differ in efficacy and side effects such as movement disorders and prolactin elevation because of varying mechanisms of action. A neuroleptic drugs which categorizes the drugs according to efficacy risk of movement disorders and risk of prolactin elevation. Statistics on the safety and acceptability of neuroleptic agents such as risperidone, olanzapine, quetiapine, ziprasidone and clozapine, are stationary increase because these agents are relatively new compared with conventional neuroleptic. Nearly all side effects of neuroleptic agents are dose related and therefore should use the lowest effectual dose for the entity. In evaluating the risk of neuroleptic medication, we should determine the occurrence of its common side effects and uneasiness connected with these side effects. Throughout the course of action patients should be monitor regularly for the surfacing of side effects.