Introduction: Hyperpyrexia, algesia and inflammation are pathological disorders which are treated with synthetic as well as herbal medications. The basic aim of the present study is to evaluate the ethnopharmacological activities of phytoconstituents that are present in C. colocynthis (fruit extract) by using in vivo and in silico studies. background: Hyperpyrexia, algesia and inflammation are pathological disorders which are treated with synthetic as well as herbal medications Method: Thirty-six albino rats were used in our studies with an average weight between 150-170g. Anti-inflammatory activity was investigated using carrageenan (an extract from a red seaweed) that induced edema in albino rat paws. However, in antipyretic and analgesic activity studies, yeast and acetic acid were used to cause pyrexia or algesia, respectively. Different doses of acetone fruit extract were used to treat inflammation, pyrexia and algesia. Results: Our results showed that the maximum percentage inhibition of acetonic fruit extract in anti-inflammatory and analgesic activities was observed at 70% and 100%, respectively, with 400 mg/kg doses, and in pyretic activity the maximum inhibitory percentage was 86% with a 100mg/kg dose. In in silico analysis, we have shown that bioactive compounds (α-spinasterol, ascorbic acid and chlorogenic acid) found in fruit extract have outstanding inhibition properties that involves proteins PTGS2, TLR2 and TRPV4. C. colocynthis fruit extract shows results that are statistically significant (p<0.005) and comparable to a reference drug. Acetonic fruit extract of C. colocynthis can be used as a natural and safe remedy with no side effects. Conclusion: In silico studies on chlorogenic acid, ascorbic acid and α-spinasterol have shown that these are inhibitory compounds that can be used for boosting the immune response. result: Our results showed that maximum percentage inhibition of acetonic fruit extract in anti-inflammatory and analgesic activities were observed at 70% and 100%, respectively, with 400 mg/kg doses, and in pyretic activity the maximum inhibitory percentage was 86% with a 100mg/kg dose. In in silico analysis, we have shown that bioactive compounds (α-spinasterol, ascorbic acid and chlorogenic acid) found in fruit extract have outstanding inhibition properties that involves proteins PTGS2, TLR2 and TRPV4. C. colocynthis fruit extract shows results that are statistically significant (p&lt;0.005) and comparable to a reference drug. other: nil
The annual incidence of upper extremity deep venous thrombosis (DVT) is 0.4 in 10,000 people annually accounting for 4-10% of all DVT. Upper extremity DVT is divided into primary and secondary. Around 80% of the cases consist of secondary DVT caused by indwelling catheters, cardiac hardwares, and cancer. One of the primary causes is Paget-Schroetter Syndrome. This is the development of upper extremity clot caused by strenuous activity like rowing, baseball, and heavy lifting. We present a young farmer with acute pulmonary thromboembolism due to Paget-Schroetter Syndrome. CASE PRESENTATION: A 26-year-old male farmer presented with right arm throbbing pain and edema for a week. It was aggravated by abduction and extension above 90 degrees and alleviated by resting. It was associated with weakness resulting in difficulty holding his phone or brushing his teeth. Vital signs were within normal limits. Physical examination significant for 1þ edema on the right upper extremity and right axilla. Pulses were 2þ in all extremities. Pain was reproducible on passive right arm abduction and extension. Chest CTA showed acute thrombus in the segmented vessel of the right lower lobe and pulmonary arterial segment of the right upper lobe. Right upper extremity venous Doppler showed acute occlusive deep vein thrombosis in the right subclavian, axillary, brachial veins. Venogram confirmed axillary vein occlusion. CTA of upper extremity showed focal concentric narrowing of right subclavian artery at the junction of right clavicle and right first rib. Patient underwent balloon angioplasty and catheter directed thrombolysis with EKOS. He was discharged on Rivaroxaban with plans for first rib resection on the outpatient setting.DISCUSSION: Paget-Schroetter syndrome (PSS) also known as Effort thrombosis is an acute thrombosis of the axillarysubclavian vein associated with strenuous activity. Those repetitive movements cause microtrauma on the subclavian vein endothelium triggering the coagulation cascade. This can be accompanied by venous stasis caused by anatomical thoracic outlet obstruction from cervical rib, scalenus tendon hypertrophy, or costoclavicular ligament. The major complication of this disease is Pulmonary Embolism which has been reported up to 10% of the presentations. CONCLUSIONS:It is important to identify PSS as the cause of PE, since it requires a more aggressive treatment beside anticoagulation, which includes catheter directed thrombolysis, thoracic outlet decompression, and physical therapy. Conservative management with anticoagulation by itself could lead to disability. Increasing awareness will ensure early recognition and proper treatment.
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