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BackgroundPost-transplant anastomotic biliary strictures remain refractory to endoscopic therapy in a considerable number of cases. The aim of this meta-analysis was to compare fully-covered self-expandable metal and plastic stents in the management of post-transplant biliary strictures.MethodsA meta-analysis was performed using a random effects model; results were expressed as odds ratio (OR) and mean standardized difference. The primary outcome was stricture resolution, while recurrence rate after stent placement, treatment time, and safety of the procedure were the secondary outcomes.ResultsThrough a systematic literature review until October 2017, we identified 7 studies, of which 4 were randomized controlled trials. Stricture resolution was slightly higher with metal stents, with no statistical difference between the two procedures (OR 1.38, 95% confidence interval [CI] 0.60-3.15; P=0.45) and low heterogeneity (I2=6%). Stricture recurrence showed a non-significant trend in favor of plastic stents (OR 1.82, 95%CI 0.52-6.31, P=0.35). Endoscopic retrograde cholangiopancreatography with placement of metal stents offered a significant improvement in terms of reduced treatment time (mean standardized difference: -3.58 months, 95%CI -6.23 to -0.93; P=0.008), but with more frequent complications, although not significantly so (OR 2.34, 95%CI 0.75-7.25; P=0.14). Sensitivity analysis confirmed all the findings.ConclusionMetal stents appear to be a promising tool that can decrease treatment time, although there is still no clear evidence of their superiority over plastic stents in terms of efficacy.

Microcrystalline cellulose (MCC) derived from Saccharum officinarum stem was evaluated for its powder flow and compaction properties in order to assess its suitability as a potential direct compression excipient in tablet formulations. Alpha (α) cellulose obtained from different sodium hydroxide and bleaching treatments of dried shred S. officinarum stem pulp was hydrolyzed with 2.5 N hydrochloric acid (2.5 N HCl) to obtain MCC which was coded MCC-Sacc. This was compared with a commercial brand, Avicel PH 102. The results of powder flow parameters such as bulk, tapped and particle densities (0.41 ± 0.01, 0.54 ± 0.01 and 1.52 ± 0.10 g/mL respectively), porosity (78.69 ± 0.20 % ), Carr's index (31.47 ± 0.75 %), Hausner's quotient (1.47) and angle of repose (31.00 ± 1.00 °) indicate poor flowability. Kawakita model assessment of powder showed good densification and cohesiveness. Compacts of MCC-Sacc showed good uniformity of weight, friability, disintegration and mechanical strength. The Heckel model showed good plasticity and slippage of the material. Values obtained were comparable to Avicel PH 102 in terms of compressibility and mechanical strength, hence MCC-Sacc has a good potential for use as a pharmaceutical excipient in the direct compression method of tablet formulation.

Purpose: To identify the chemical constituents of the n-hexane extract of the sclerotia of Lentinus tuber-regium (synonym Pleurotus tuber regium) using gas chromatography-mass spectroscopic (GC-MS) techniques. Methods: The n-hexane extract of the sclerotia of Lentinus tuber regium was obtained by exhaustive Soxhlet extraction and analysed using gas chromatography-mass spectroscopic (MS) techniques. The structures of the identified constituents were confirmed on the basis of their fragmentation pattern in : cholesterol, α-ergostenol, anthraergostatetraenol, stigmasterol, and alpha-ergosta-4,6,8(14),22-tetraen-3-one. The major constituents characterised are 6,8(14),. Conclusion: This study shows that L tuber-regium is a veritable source of mono-and poly-unsaturated fatty acids, and ergosterol/provitamin D derivatives which may explain, in part, some of its reported nutraceutical benefits.