The persistence of human diseases challenges the current state of the discovery and production of synthetic drugs. Plants are recognized as a great resource to discover chemical compounds that can be used for drug development. In the Philippines, Ehretia microphylla (tsaang gubat) is recognized by the Department of Health as one of the ten recommended medicinal plants. This article aims to provide a comprehensive review of the traditional use, phytochemical constituents, pharmacologic activities as well as the non-clinical and clinical studies leading to the NIRPROMP formulation of the tsaang gubat tablet indicated for biliary and gastrointestinal pain. Among the phytochemical constituents observed were flavonoids, phenolics, triterpenes, and alkaloids. Evidence for other pharmacologic properties such as antibacterial, anti-angiogenesis, anti-oxidant, anti-inflammatory, anti-allergy, folliculogenesis, wound healing and anti-cancer activities are presented. Currently, tsaang gubat tablet has been granted a full patent for its invention as a tablet for relieving symptoms of biliary and gastrointestinal colic and is registered with the Philippine Food and Drug Administration for these indications. The tsaang gubat tablet is listed in the Philippine National Formulary after the conduct of in vitro, in vivo and Phase I-III clinical trials. Future platforms for research include the reformulation of the existing tsaang gubat drug for other indications, determination of the molecular mechanism of action and plans for plant conservation.
Phytochemicals ; Colic

In the pediatric literature, excessive crying has been reported solely in association with 3-month colic and is described, if at all, as unexplained crying and fussing during the first 3 months of life. The bouts of crying are generally thought to be triggered by abdominal colic (over-inflation of the still immature gastrointestinal tract), and treatment is prescribed accordingly. According to this line of reasoning, excessive crying is harmless and resolves by the end of the third month without long-term consequences. However, there is evidence that it may cause tremendous distress in the mother-infant relationship, and can lead to disorders of behavioral and emotional regulation at the toddler stage (such as sleep and feeding disorders, chronic fussiness, excessive clinginess, and temper tantrums). Early treatment of excessive crying focuses on parent-infant communication, and parent-infant interaction in the context of soothing and settling the infant to sleep is a promising approach that may prevent later behavioral and emotional disorders in infancy.
Colic ; Crying ; Humans ; Infant

To define indications of primary treatment in ureteroscopic stone manipulation with comparing the success rates and complications of A(11.5F rigid ureteroscopy from March 1989 to April 1993) and B(7.5F rigid ureteroscopy from May 1993 to February 1995) groups, 216 ureteroscopies were performed for ureteral stone removal between March 1989 and February 1995 in our urologic department. The overall success rates of ureteroscopic stone manipulation were obtained and compared according to stone locations, sizes and anesthesia or not. The overall success rate was 85.6%(80% in group A and 94.2% in group B respectively). The success rates in each group A and B were 60% and 77.8% in the upper ureter, 100% and 66.7% in the middle ureter, 80.0% and 95.9% in the lower ureter. There were the more success rates and the less complication rates in group B than group A. The success rates of stone removal are increased and the complications are decreased remarkably in group B(especially in the lower ureter stone). The rapid relief of ureteral obstruction and colic is possible immediately after ureteroscopic stone manipulation. So, we conclude that ureteroscopic stone manipulation is primarily indicated in the treatment of lower ureteral stones.
Anesthesia ; Colic ; Ureter ; Ureteral Obstruction ; Ureteroscopes ; Ureteroscopy

PURPOSE: The objective of this study were to evaluate the location of ureteral stones and the diameter of the ureter in patients with renal colic. MATERIALS AND METHODS: We retrospectively reviewed the records of 95 consecutive patients who presented to the emergency department with renal colic in whom urinary stones were diagnosed by computed tomography between January 2009 and August 2009. The size and location of the stones were investigated. The length and diameter of unaffected ureters were also measured. RESULTS: The mean size of the stones was 4.87+/-3.49 mm (range, 0.9-22 mm). Stones were located at ureterovesical junction (UVJ) in 44 cases (46.3%), proximal ureter in 29 (30.5%), distal ureter in 16 (16.8%), ureteropelvic junction (UPJ) in 5 (5.2%), and the ureter crossing external iliac vessel (UEIV) in 1 case (1%). The mean length of the ureter was 226.8+/-20.8 mm (range, 175-286 mm). The mean diameter of the ureter was 3.40+/-0.61 mm (range, 1.9-5.3 mm). The mean diameter of the UEIV was 3.28+/-0.59 mm (range, 2.2-5.3 mm). CONCLUSIONS: The UPJ and UEIV were not common sites of ureteral stones. The smaller the stones, the closer to the UVJ that the stones were located. Spontaneous passage of the stones was most frequently observed for stones in the UVJ. The UEIV was not significantly narrower than the other parts of the ureter.
Colic ; Emergencies ; Glycosaminoglycans ; Humans ; Renal Colic ; Retrospective Studies ; Ureter ; Ureteral Calculi ; Urinary Calculi

PURPOSE: To evaluate the efficacy and safety of the ureteroscopic management of ureteral stones immediately after a first colic attack. MATERIALS AND METHODS: We retrospectively analyzed the data of 226 patients with obstructive ureteral stones who underwent ureteroscopy with stone retrieval. The 67 patients in group A underwent ureteroscopy within 48 hours of admission to our emergency department, whereas the 159 patients in group B underwent ureteroscopy more than 48 hours after admission. The chi-square test was used to evaluate and compare stone-free status, auxiliary procedures, and complications and the Kruskal-Wallis and Fisher's exact tests were used to analyze qualitative data. RESULTS: Mean stone sizes in groups A and B were 2.41+/-1.62 mm and 4.11+/-2.64 mm, respectively. No patient experienced a major complication during or after the procedure. Stone-free rates were 89.55% and 89.93%, respectively. CONCLUSIONS: Emergency ureteroscopy in cases of obstructive ureteral stones is both safe and effective and offers the advantages of immediate stone fragmentation and the relief of acute-onset colic pain.
Colic ; Emergencies ; Humans ; Retrospective Studies ; Ureter ; Ureteral Calculi ; Ureteroscopy

Incorporation of laparoscopic techniques into the gastrointestinal surgeon's armamentarium has led to a renewal of interest in the anatomy of mesenteric arteries because hemorrhagic complications can be a major cause of conversion and/or morbidity during laparoscopic intestinal surgery. BACKGROUND: Since a colonic resection with laparoscopic techniques has become a common procedure, the limited exposure currently provided in laparoscopic intestinal resection demands a precise knowledge of mesenteric vascular anatomy to avoid such complications and to expedite the procedure. Historically, It was thought that the arterial supply to the right colon consisted of three arterial branches (middle colic artery, right colic artery, ileocolic artery) arising independently from the superior mesenteric artery (SMA). However, on recent reports and clinical observations, two colonic arteries only arising independently from the SMA are more common than three colonic arteries. METHODS: We reviewed 40 cases of angiography which focused on the SMA and it's branches. RESULTS: We found the ileocolic artery in 39 of 40 cases, the middle colic artery in 39 of 40, and the right colic artery in 19 of 40. Based on the existence of the right colic artery in our review, about half (47.5%) of the cases had a right colic artery directly arising from this SMA. CONCLUSION: This knowledge may help lower the risk of vascular complications during laparoscopic intestinal surgery.
Angiography* ; Arteries* ; Colic ; Colon* ; Mesenteric Arteries ; Mesenteric Artery, Superior*

Bleeding is the most common and serious complication of thrombolysis in ST elevation myocardial infarction. Most bleeding cases are associated with an intervention or operation, but spontaneous bleeding such as gastro-intestinal bleeding or intracranial hemorrhage can happen. This is a report on the case of a 76-year-old female patient with retroperitoneal hemorrhage due to spontaneous right colic artery branch bleeding after thrombolysis in ST elevation myocardial infarction.
Arteries ; Colic ; Female ; Hemorrhage ; Humans ; Intracranial Hemorrhages ; Myocardial Infarction

Antibiotics related colitis is a well recognized disease entity which in its severest form may result in pseudomembranous colitis, whereas in another form, acute hemorrhagic colitis without pseudomembrane, related to the use of penicillin-type antibiotics is rarely reported. The clinical features of hemorrhagic colitis associated with antibiotics was characterized that the bloody diarrhea, often with abdominal cramping pain begins 2~7 days after starting the antibiotics and rapidly recovered after its withdrawal. Pathogenesis of this disease is not entirely clear. It has been believed that right-sided hemorrhagic colitis is one of the main forms of colitis associated with antibiotics, especially ampicillin derivatives or cephalosporin, but recent reports presented left-sided colitis. We experienced 2 cases of hemorrhagic colitis developed on the left colon after the introduction of quinolone.
Ampicillin ; Anti-Bacterial Agents* ; Colic ; Colitis* ; Colon ; Diarrhea ; Enterocolitis, Pseudomembranous

PURPOSE: The aim of this study was to evaluate the effect of tamsulosin on expulsion of ureteral stones after extracorporeal shock wave lithotripsy (ESWL). MATERIALS AND METHODS: Seventy-six patients(39 with upper ureteral stones and 37 with lower ureteral stones) treated with ESWL for stones <10mm were randomly divided into two groups. Tamsulosin(0.2mg orally once daily) was administered to group 1; group 2 received no medications. All patients were evaluated with respect to the number of episodes of ureteral colic, the expulsion rates of stones after ESWL, and the mean number of sessions of ESWL until complete expulsion of stones. RESULTS: The complete expulsion rates of upper and lower ureteral stones did not differ significantly between groups 1 and 2 during each session of ESWL; however, the mean session of ESWL was lower in group 1 than in group 2. For upper ureteral stones, 1.8 sessions were necessary per patient in group 1, while 2.3 sessions were required for the patients in group 2(p=0.039). For lower ureteral stones, 2.0 sessions were necessary per patient in group 1, while 2.9 sessions were required for the patients in group 2(p=0.032). There were significant decreases in the number of episodes of pain in group 1 with lower ureteral stones(p=0.014). There were no side effects associated with tamsulosin. CONCLUSIONS: The use of tamsulosin in the treatment of upper and lower ureteral stones after ESWL can decrease the mean number of sessions of ESWL and the number of episodes of pain, but cannot improve the expulsion rate. Further research regarding the cost-effectiveness of tamsulosin after ESWL is needed.
Calculi ; Humans ; Lithotripsy ; Renal Colic ; Shock ; Sulfonamides ; Ureter

PURPOSE: It was known that alpha-1 receptors are present in ureteral smooth muscle. We aimed to reveal the effect of an alpha-blocker (tamsulosin) and terpene mixture (Rowatinex(R)) on the expulsion of ureter stone (size less than 1cm), as well as its affect on the relief of pain. Material and Methods: The patients were classified into group A in which the size of the ureter stone less than 4mm (144 subjects) and group B in which the size of stone was between 4mm and 10mm (48 patients). Each study group was also further divided into 3 sub-groups: group 1 with analgesics only, group 2 with Rowatinex(R) as well as analgesics, and group 3 with 0.4mg of tamsulosin as well as analgesics. RESULTS: It was shown that the expulsion rates of ureter stone in sub-group 1 of group A, at the end of first week, was statistically lower (p<0.05) compared to that of sub-group 2 with Rowatinex(R). It was also shown that compared to sub-group 1, the expulsion rate of ureter stone at the end of first week in sub-group 3 was statistically significant (p<0.05). Compared to the consumed amount of analgesics in group A, it was revealed that sub-group 2 and sub-group 3 used statistically fewer ampules of than sub-group 1 (p<0.05). CONCLUSIONS: Our study clearly showed that both alpha-blocker and Rowatinex(R) are effective means of controlling colicky pain and they speed up excretion of ureter stones that are less than 4mm in size, at the end of first week. Therefore, we conclude that an alpha-blocker and Rowatinex(R) should be considered as an adjuvant regimen and this is beneficial for patients with ureter stone less than 4mm in size.
Analgesics ; Colic ; Humans ; Muscle, Smooth ; Terpenes ; Ureter* ; Ureteral Calculi