Laparoscopic cholecystectomy, though an uncommon surgical procedure in paediatric age group is still associated with a higher risk of post-operative bile duct injuries when compared with the open procedure. Small leaks from extra hepatic biliary apparatus usually lead to the formation of a localized sub-hepatic bile collection, also known as biloma. Such leaks are rare complication after laparoscopic cholecystectomy, especially in paediatric age group. Minor bile leaks can usually be managed non-surgically by percutaneous drainage combined with endoscopic retrograde cholangio-pancreatography (ERCP). However, surgical exploration is required in cases not responding to non-operative management. If not managed on time, such injuries can lead to severe hepatic damage. We describe a case of an eight-year-old girl who presented with biloma formation after laparoscopic cholecystectomy who was managed by ERCP.
Bile ; Bile Ducts ; Child* ; Cholangiopancreatography, Endoscopic Retrograde ; Cholecystectomy ; Cholecystectomy, Laparoscopic* ; Drainage ; Female ; Humans ; Stents*

OBJECTIVEAyurvedic formulations are preferred over other formulations as well as commercialized on broad level to treat various ailments. The World Health Organization has established certain guidelines for quality control of heavy metals and pesticide residues. Bacopa monnieri, a popular herb with immunomodulator and memory-enhancing properties is the chief constituent of several Ayurvedic formulations, which include Brahmi Vati (BV), Brahmi Ghrita (BG) and Saraswat Churna (SC), etc. In view of the World Health Organization guidelines, two products of each formulation from six different manufacturers were purchased from Ayurvedic Pharmacy, Bulanala-Varanasi, India for testing heavy metal and pesticide residue.

METHODSIn the present study, all the formulations--BV, BG and SC--were selected for estimation of four heavy metals namely lead (Pb), cadmium (Cd), chromium (Cr) and nickel (Ni) by a plasma emission spectrophotometer. Organochlorine pesticidal residues were estimated for dichlorodiphenyl trichloroethane, isomers of hexachlorocyclohexane (HCH) and α-endosulfan, etc. in total 12 samples of test formulations containing Bacopa monnieri L. using gas chromatography technique.

RESULTSOut of 12 samples, Pb, Cd, Cr and Ni were present in all samples but below the permissible limit. Although atrazine, aldrin, dialdrin were in below detection limit, but other pesticides were detected in some samples as oxamyl, hexachlorocyclohexanes (α-HCH, β-HCH and γ-HCH), dichlorodiphenyl trichloroethane and dichlorodiphenyl dichloroethylene.

CONCLUSIONThe presence of heavy metals in the formulations was low to cause toxicity. However evaluation of heavy metals and pesticide residue in every batch is necessary.

Bacopa ; chemistry ; Chemistry, Pharmaceutical ; Medicine, Ayurvedic ; Metals, Heavy ; analysis ; Pesticides ; analysis

OBJECTIVETo prepare the Praval bhasma (PB) and to perform its characterization.

METHODSThe preparation was performed strictly as per method prescribed in Ayurvedic formulary of India followed by preliminary tests including Nischandratva, Rekhapurnatvam, Varitaramtavm, Nisvadutvam and Amla pariksha. The physicochemical characterization was done with the use of instrumental techniques such as Fourier transform infrared (FTIR) spectroscopy, scanning electron microscopy (SEM), X ray diffraction (XRD), and energy dispersive X-ray (EDAX).

RESULTSThe FTIR bands appearing in final product spectra showed a significant shift in infrared vibration frequency as well as intensity when compared with the raw material, which was indicative of formulation of bhasma. The XRD analysis revealed that raw material contained CaCO3 whereas in case of final product of bhasma, CaO was identified. SEM analysis revealed the difference in particles size of bhasma (10-15 μm) and raw material (100-150 μm). The EDAX analysis showed presence of different concentration of carbon in both the samples.

CONCLUSIONIt may be concluded that modern analytical techniques may be involved to evaluate the quality aspects of PB. The findings of the present research work may be helpful for further formulation and standardization of PB in routine analysis.

Animals ; Anthozoa ; chemistry ; Biological Factors ; adverse effects ; chemistry ; isolation & purification ; Chemistry, Pharmaceutical ; Female ; Medicine, Ayurvedic ; Mice ; Microscopy, Electron, Scanning ; Quality Control ; Spectroscopy, Fourier Transform Infrared ; X-Ray Diffraction