Pre-procedural cleansing of the bowel can maximize the effectiveness and efficiency of colonoscopy.Yet,efficacy of the current gold standard colonic preparation method-high-volume oral administration of purgative agen...Pre-procedural cleansing of the bowel can maximize the effectiveness and efficiency of colonoscopy.Yet,efficacy of the current gold standard colonic preparation method-high-volume oral administration of purgative agents 12-24 h prior to the procedure-is limited by several factors,such as patient compliance(due to poor palatability and inconvenience of the dosing regimen)and risks of complications(due to drug interactions or intolerance).Attempts to resolve these limitations have included providing adjunctive agents and methods to promote the colonic cleansing ability of the principal purgative agent,with the aim of lessening unpleasant side effects(such as bloating)and reducing the large ingested volume requirement.Several promising adjunctive agents are bisacodyl,magnesium citrate,senna,simethicone,metoclopramide,and prokinetics,and each are being investigated for their potential.This review provides an up to date summary of the reported investigations into the potencies and weaknesses of the key adjuncts currently being applied in clinic as supplements to the traditional bowel preparation agents.While the comparative analysis ofthese adjuncts showed that no single agent or method has yet achieved the goal of completely overcoming the limitations of the current gold standard preparation method,they at least provide endoscopists with an array of alternatives to help improve the suboptimal efficacy of the main cleansing solutions when used alone.To aid in this clinical endeavor,a subjective grade was assigned to each adjunct to indicate its practical value.In addition,the systematic review of the currently available agents and methods provides insight into the features of each that may be overcome or exploited to create novel drugs and strategies that may become adopted as effective bowel cleansing adjuncts or alternatives.展开更多
AIM To assess the cleansing efficacy and safety of a new Colon capsule endoscopy(CCE) bowel preparation regimen.METHODS This was a multicenter,prospective,randomized,controlled study comparing two CCE regimens. Subjec...AIM To assess the cleansing efficacy and safety of a new Colon capsule endoscopy(CCE) bowel preparation regimen.METHODS This was a multicenter,prospective,randomized,controlled study comparing two CCE regimens. Subjects were asymptomatic and average risk for colorectal cancer. The second generation CCE system(Pill Cam? COLON 2;Medtronic,Yoqneam,Israel) was utilized. Preparation regimens differed in the 1 st and 2 nd boosts with the Study regimen using oral sulfate solution(89 m L) with diatrizoate meglumine and diatrizoate sodium solution("diatrizoate solution")(boost 1 = 60 m L,boost 2 = 30 m L) and the Control regimen oral sulfate solution(89 m L) alone. The primary outcome was overall and segmental colon cleansing. Secondary outcomes included safety,polyp detection,colonic transit,CCE completion and capsule excretion ≤ 12 h. RESULTS Both regimens had similar cleansing efficacy for the whole colon(Adequate: Study = 75.9%,Control = 77.3%;P = 0.88) and individual segments. In the Study group,CCE completion was superior(Study = 90.9%,Control = 76.9%;P = 0.048) and colonic transit was more often < 40 min(Study = 21.8%,Control = 4%;P = 0.0073). More Study regimen subjects experienced adverse events(Study = 19.4%,Control = 3.4%;P = 0.0061),and this difference did not appear related to diatrizoate solution. Adverse events were primarily gastrointestinal in nature and no serious adverse events related either to the bowel preparation regimen or the capsule were observed. There was a trend toward higher polyp detection with the Study regimen,but this did not achieve statistical significance for any size category. Mean transit time through the entire gastrointestinal tract,from ingestion to excretion,was shorter with the Study regimen while mean colonic transit times were similar for both study groups.CONCLUSION A CCE bowel preparation regimen using oral sulfate solution and diatrizoate solution as a boost agent is effective,safe,and achieved superior CCE completion.展开更多
Rumex nepalensis Spreng.(Polygonaceae) commonly known as Nepal Dock has wide-spectrum therapeutic potencies and is extensively used for centuries in traditional medicine systems. The leaves of this plant are edible an...Rumex nepalensis Spreng.(Polygonaceae) commonly known as Nepal Dock has wide-spectrum therapeutic potencies and is extensively used for centuries in traditional medicine systems. The leaves of this plant are edible and a rich source of natural antioxidants. They act as a possible food supplement and are largely used in pharmaceutical industry. Extracts and metabolites from this plant exhibits pharmacological activities including anti-inflammatory, antioxidant, antibacterial, antifungal, antiviral, insecticidal, purgative, analgesic, antipyretic, anti-algal, central nervous system depressant, genotoxic, wound healing and skeletal muscle relaxant activity. Due to its remarkable biological activities, it has the potential to act as a rich source of drug against life threatening diseases. However, more studies are needed to scientifically validate the traditional uses of this plant, beside isolating and identifying their active principles and characterizing the mechanisms of action. We present herein a critical account of its botany, ecology, traditional uses, phytoconstituent profile and major pharmacological activities reported in recent years and therefore will provide a source of information on this plant for further studies.展开更多
Objective:To investigate the modulating role of methanol extract of Tephrosia vogelii leaves on acetylcholine(ACh)-induced contraction of isolated rabbit jejunum.Methods: Rabbit jejunum segment was removed and placed ...Objective:To investigate the modulating role of methanol extract of Tephrosia vogelii leaves on acetylcholine(ACh)-induced contraction of isolated rabbit jejunum.Methods: Rabbit jejunum segment was removed and placed in an organ bath containing Tyrode's solution, and its contractions were recorded isometrically.Results: ACh(2.0 × 10-10 g/m L) and the extract(2.0 × 10-4 g/m L) individually increased the frequency of contraction(mean ± SEM) of the isolated smooth muscle tissue by 47.6% ± 9.5% and 77.8% ± 66.5%, respectively. When ACh and the extract were combined, the frequency of contraction of the tissue was increased by 222.2% ± 25.9%, representing a 366.7% increase(P < 0.001) over the effect of ACh alone. Similarly, ACh(2.0 × 10-9 g/m L) and the extract individually increased significantly(P < 0.001) the amplitude of contraction of the tissue by 685.7% ± 61.1% and 455.2% ± 38.1%, respectively. When ACh and the extract were combined, the amplitude of contraction of the tissue rose by 1263.8% ± 69.0%, representing 84.3% increase over the ef ect of ACh alone. Conclusions: The findings demonstrate that methanol extract of Tephrosia vogelii leaves potentiates the contractile ef ect of ACh on intestinal smooth muscle, supporting the traditional claim that the plant is purgative.展开更多
文摘Pre-procedural cleansing of the bowel can maximize the effectiveness and efficiency of colonoscopy.Yet,efficacy of the current gold standard colonic preparation method-high-volume oral administration of purgative agents 12-24 h prior to the procedure-is limited by several factors,such as patient compliance(due to poor palatability and inconvenience of the dosing regimen)and risks of complications(due to drug interactions or intolerance).Attempts to resolve these limitations have included providing adjunctive agents and methods to promote the colonic cleansing ability of the principal purgative agent,with the aim of lessening unpleasant side effects(such as bloating)and reducing the large ingested volume requirement.Several promising adjunctive agents are bisacodyl,magnesium citrate,senna,simethicone,metoclopramide,and prokinetics,and each are being investigated for their potential.This review provides an up to date summary of the reported investigations into the potencies and weaknesses of the key adjuncts currently being applied in clinic as supplements to the traditional bowel preparation agents.While the comparative analysis ofthese adjuncts showed that no single agent or method has yet achieved the goal of completely overcoming the limitations of the current gold standard preparation method,they at least provide endoscopists with an array of alternatives to help improve the suboptimal efficacy of the main cleansing solutions when used alone.To aid in this clinical endeavor,a subjective grade was assigned to each adjunct to indicate its practical value.In addition,the systematic review of the currently available agents and methods provides insight into the features of each that may be overcome or exploited to create novel drugs and strategies that may become adopted as effective bowel cleansing adjuncts or alternatives.
文摘AIM To assess the cleansing efficacy and safety of a new Colon capsule endoscopy(CCE) bowel preparation regimen.METHODS This was a multicenter,prospective,randomized,controlled study comparing two CCE regimens. Subjects were asymptomatic and average risk for colorectal cancer. The second generation CCE system(Pill Cam? COLON 2;Medtronic,Yoqneam,Israel) was utilized. Preparation regimens differed in the 1 st and 2 nd boosts with the Study regimen using oral sulfate solution(89 m L) with diatrizoate meglumine and diatrizoate sodium solution("diatrizoate solution")(boost 1 = 60 m L,boost 2 = 30 m L) and the Control regimen oral sulfate solution(89 m L) alone. The primary outcome was overall and segmental colon cleansing. Secondary outcomes included safety,polyp detection,colonic transit,CCE completion and capsule excretion ≤ 12 h. RESULTS Both regimens had similar cleansing efficacy for the whole colon(Adequate: Study = 75.9%,Control = 77.3%;P = 0.88) and individual segments. In the Study group,CCE completion was superior(Study = 90.9%,Control = 76.9%;P = 0.048) and colonic transit was more often < 40 min(Study = 21.8%,Control = 4%;P = 0.0073). More Study regimen subjects experienced adverse events(Study = 19.4%,Control = 3.4%;P = 0.0061),and this difference did not appear related to diatrizoate solution. Adverse events were primarily gastrointestinal in nature and no serious adverse events related either to the bowel preparation regimen or the capsule were observed. There was a trend toward higher polyp detection with the Study regimen,but this did not achieve statistical significance for any size category. Mean transit time through the entire gastrointestinal tract,from ingestion to excretion,was shorter with the Study regimen while mean colonic transit times were similar for both study groups.CONCLUSION A CCE bowel preparation regimen using oral sulfate solution and diatrizoate solution as a boost agent is effective,safe,and achieved superior CCE completion.
基金supported by the VK’s lab from Savitribai Phule Pune University in the form of Research Grant(No.:OSD/BCUD/392/132)
文摘Rumex nepalensis Spreng.(Polygonaceae) commonly known as Nepal Dock has wide-spectrum therapeutic potencies and is extensively used for centuries in traditional medicine systems. The leaves of this plant are edible and a rich source of natural antioxidants. They act as a possible food supplement and are largely used in pharmaceutical industry. Extracts and metabolites from this plant exhibits pharmacological activities including anti-inflammatory, antioxidant, antibacterial, antifungal, antiviral, insecticidal, purgative, analgesic, antipyretic, anti-algal, central nervous system depressant, genotoxic, wound healing and skeletal muscle relaxant activity. Due to its remarkable biological activities, it has the potential to act as a rich source of drug against life threatening diseases. However, more studies are needed to scientifically validate the traditional uses of this plant, beside isolating and identifying their active principles and characterizing the mechanisms of action. We present herein a critical account of its botany, ecology, traditional uses, phytoconstituent profile and major pharmacological activities reported in recent years and therefore will provide a source of information on this plant for further studies.
基金Supported by the University Board of Research Grant,Ahmadu Bello University,Zaria,Nigeria(Grant No.DAPM/BOD/06)
文摘Objective:To investigate the modulating role of methanol extract of Tephrosia vogelii leaves on acetylcholine(ACh)-induced contraction of isolated rabbit jejunum.Methods: Rabbit jejunum segment was removed and placed in an organ bath containing Tyrode's solution, and its contractions were recorded isometrically.Results: ACh(2.0 × 10-10 g/m L) and the extract(2.0 × 10-4 g/m L) individually increased the frequency of contraction(mean ± SEM) of the isolated smooth muscle tissue by 47.6% ± 9.5% and 77.8% ± 66.5%, respectively. When ACh and the extract were combined, the frequency of contraction of the tissue was increased by 222.2% ± 25.9%, representing a 366.7% increase(P < 0.001) over the effect of ACh alone. Similarly, ACh(2.0 × 10-9 g/m L) and the extract individually increased significantly(P < 0.001) the amplitude of contraction of the tissue by 685.7% ± 61.1% and 455.2% ± 38.1%, respectively. When ACh and the extract were combined, the amplitude of contraction of the tissue rose by 1263.8% ± 69.0%, representing 84.3% increase over the ef ect of ACh alone. Conclusions: The findings demonstrate that methanol extract of Tephrosia vogelii leaves potentiates the contractile ef ect of ACh on intestinal smooth muscle, supporting the traditional claim that the plant is purgative.
