Ayurvedic medicine and anaesthesia

Teodorico Borgognoni's Formulary for Thirteenth Century Anesthetic Preparations

Teodorico Borgognoni was born in Lucca in 1205 and was appointed bishop of Bitonto and Cervia in 1262 and 1270. Following his father, he learned the art of surgery and collected relevant recipes in his most important work, entitled Cyrurgia seu filia principis. Among the disciplines reported in this work, the most interesting and innovative is anesthesia. The recipes in this field contribute to Borbognoni's consideration as the forerunner of modern anesthesia. Such recipes have been reported in other manuscripts from the Middle Ages, like Manuscript No. 1939. In the present work, we investigate the traditional preparations handed down in this manuscript, focusing on type of preparation and botanical ingredients. The results highlight that exploited ingredients can be divided into three groups: the first comprises plants already known for their narcotic effects, the second includes ingredients acting as an adjuvant for absorption or reducing the metabolism, and the last group includes ingredients not associated with biological activity to explain their presence in anesthetic recipes. This third group is of particular interest for future biological investigations. Our goal is to rekindle attention to the work of Teodorico Borgognoni on traditional preparation for anesthetic purposes: a topic often underestimated by ethnobotanical surveys.

Selected root plant supplementation reduces indices of exercise-induced muscle damage: A systematic review and meta-analysis

This systematic review and meta-analysis examined the effects of selected root plants (curcumin, ginseng, ginger and garlic) on markers of muscle damage and muscular performance measures following muscle-damaging protocols. We included 25 studies (parallel and crossover design) with 353 participants and used the PEDro scale to appraise each study. Forest plots were generated to report on standardised mean differences (SMD) and p-values at 24 and 48 hours following the muscle-damaging protocols. The meta-analysis showed that the supplemental (SUPP) condition showed significantly lower levels of indirect muscle damage markers (creatine kinase, lactate dehydrogenase and myoglobin) and muscle soreness at 24 hours and 48 hours (p < 0.01) than the placebo (PLA) condition. The inflammatory markers were significantly lower for the SUPP condition than the PLA condition at 24 hours (p = 0.02), although no differences were identified at 48 hours (p = 0.40). There were no significant differences in muscular performance measures between the SUPP and PLA conditions at 24 hours and 48 hours (p > 0.05) post-exercise. According to our qualitative data, a number of studies reported a reduction in oxidative stress (e.g., malondialdehyde, superoxide dismutase) with a concomitant upregulation of anti-oxidant status, although other studies showed no effects. Accordingly, selected root plants minimised the level of several biomarkers of muscle damage, inflammation and muscle soreness during periods of exercise-induced muscle damage. However, the benefits of these supplements in ameliorating oxidative stress, increasing anti-oxidant status and accelerating recovery of muscular performance appears equivocal, warranting further research in these outcome measures.

A Recipe for Improved Nonsurgical Cosmetic Outcomes: Know Your Herbs and Spices

The nonsurgical cosmetic arena continues to grow, with more people consistently seeking minimally invasive procedures for facial rejuvenation. However, although these prospective patients are not seeking surgical correction to obtain their results, there is still the potential for nonsurgical procedures to yield adverse events posttreatment. Patients often do not realize that their dietary regimens may affect their nonsurgical cosmetic outcomes. For example, many patients desiring these types of treatments are often found to be taking prescription medications, herbs, and spices on a daily basis that may have the capacity to potentiate adverse outcomes such as bleeding and/or bruising. For these reasons, it is important for clinicians to be inclusive while taking health histories and to properly educate their patients so that administered treatments have the best chance of yielding the desired results. The focus of this article is to provide health care providers information on many of the herbs and spices that have the potential to negatively impact nonsurgical cosmetic outcomes.

Simultaneous bilateral computer assisted total knee arthroplasty: the effect of intravenous or intraarticular tranexamic acid

The use of tranexamic acid (TA) in total knee arthroplasty is well documented. However, there is limited evidence to suggest the use of TA in simultaneous bilateral computer assisted total knee arthroplasty (CATKA). We, therefore, studied the effect of TA, in simultaneous bilateral computer assisted total knee arthroplasty, in terms of blood transfusion, routes of administration and complications. We divided 90 patients into three groups. Group I patients received intravenous normal saline alone (IVNS group). Group II received intravenous TA alone (IVTA group). Group III received intraarticular TA alone (IATA group). Our study confirms that there is significant benefit of using TA but no difference between the intravenous or intraarticular routes of administration.