Volume 26, Issue 6

Background: Stem bark and leaves of Lophira alata (Family: Ochnaceae) have been used traditionally for their anti-psychotic, anti-convulsant and anxiolytic properties. Since no existing data was found on the neurobehavioural properties, this study was carried out to evaluate some neurobehavioural properties of the aqueous extract of the stem bark of L. alata in animal models. Methods: The oral mean lethal dose (LD 50 ) of the extract was estimated, and preliminary phytochemical screening was conducted. Lophira alata extract (200, 400 and 800 mg/kg, p.o.) was investigated for antidepressant effect using the forced swim and tail suspension tests, and the anxiolytic potential was assessed using the stair case and hole board tests. Pentylenetetrazole-induced convulsion test was used to investigate the anticonvulsant potential of the extract. Results: The LD 50 was estimated to be >5000 mg/kg. Oral administration of L. alata extract produced a significant (p<0.05) non-dose-dependent decrease in the period of immobility in both the forced swim and tail suspension tests. While a significant decrease (p<0.05) in episodes of grooming was recorded in the staircase test, the number of head dips was not significantly reduced (p>0.05) in the hole board test. In the pentylenetetrazole-induced convulsion, a non-dose-dependent increase in onset of tonic-clonic seizures and protection from death was recorded. Conclusions: The results obtained suggest that the aqueous stem bark extract of L. alata possesses neurobehavioural properties which may account for its use in ethnomedicine.

Background: A study was undertaken to analyze the nature and magnitude of autonomic dysregulation that starts early in the offspring of a hypertensive parent and also whether obesity in them add an additional risk for future hypertension. Methods: Forty normotensive subjects aged 18–25 years with at least one hypertensive parent constitute the study group. The study group was divided into obese and non-obese depending on their body mass index (non-obese with BMI 18.50–24.99 kg/m 2 ; obese with BMI≥30 kg/m 2 ). Twenty age-matched normotensive, without parental history subjects constitute the control group. Anthropometric parameters, heart rate, systolic and diastolic pressures were recorded. Heart rate variability indices like total power, LF, HF, LF/HF, SDNN, RMSSD, and PNN50% were studied. One-way ANOVA was used for simultaneous multiple group comparison followed by post hoc Tukey’s test for groupwise comparison. The Pearson correlation coefficient was used to assess the relationship between BMI and other variables. Results: Subjects who were obese with parental history of hypertension showed significantly higher heart rate, diastolic blood pressure, LF, LF/HF ratio and reduced total power, HF, SDNN, RMSSD, and PNN50% compared to the other groups with normal BMI. HF and all the time domain indices showed negative correlation and LF a positive correlation with BMI. Conclusions: In the obese offspring of hypertensive parents, HRV markers, which represent a vagal dominance were reduced substantially, and indices of sympathetic activity were increased. So obesity in a normotensive offspring of a hypertensive parent is an additional risk factor for the future development of hypertension as it further dysregulates the autonomic control of the heart.

Background: The aim of this study was to evaluate the effect of methanol extract of Mangifera indica on serum concentration of creatine kinase, total white blood cell (WBC) count and lymphocyte counts and the micro-anatomical architecture of the heart in chinchilla rabbits in order to find its safe and toxic levels. A total of 24 Chinchilla rabbits aged 10–14 weeks, divided into four experimental groups were orally administered the doses of none, 500, 1000 and 1500 mg/kg body weight of the methanol extract of M. indica , respectively, for 28 days. Methods: The modified International Federation of Clinical Chemistry (IFCC) method was used to estimate the serum concentration of creatine kinase (CK (-MB)) while the haematology auto-analyser was used to estimate the total WBC count and lymphocyte count. The estimated values were subjected to analysis of variance using the SPSS software application (version 16) and expressed as mean±standard deviation. Tissue sections were stained by phosphotungstic acid haematoxylin and haematoxylin and eosin staining techniques. Results: The result showed significant increases in serum concentrations of CK (-MB) (12.05±3.11–21.55±9.93 U/L) and total WBC count (5.33±0.66–6.51±0.38 103/μL) when the control group was compared with the treated groups (p<0.05). A significant dose-dependent decrease in the weight of the heart (0.053±0.00–0.041±0.003 kg) was also observed (p<0.05). An insignificant increase was observed in the lymphocyte count (4.47±0.94–5.18±0.76 103/μL) in the blood when compared with the control group (p>0.05). Significant differences were also observed in the body weight of the treated groups (p<0.05). The histopathological findings include atheroma, attenuated vasculature, lymphoplasmacytic infiltrates, necrotic and fibrotic vascular walls. Conclusions: Thus, M . indica is indicated to have some health benefits at 500 mg/kg and shows toxicity on the micro-architecture of the heart at a concentration of ≥1000 mg/kg.

Background: A prospective study of patients with acute coronary syndrome (ACS), who met the inclusion criteria, was carried out. It was conducted in the cardiology department of tertiary care referral hospital in Kerala. An attempt was made to identify and determine the prevalence of cardiovascular risk factors in patients presenting with ACS and to evaluate the current treatment practice pattern of ACS and to compare it with standard treatment guidelines, thereby improving the quality of life of patients. Methods: Data of patients who met the inclusion criteria were collected in specially designed data collection form. The form included the patient data such as demographics, risk factors, procedures performed during the hospital stay, and in-hospital and discharge drug therapy. Patients with ACS included those with ST-elevation myocardial infarction (STEMI), non-ST elevation myocardial infarction (NSTEMI), and unstable angina (UA). Descriptive statistics were performed. All statistical analysis was done using Statistical Package for Social Sciences (SPSS) software version 16.0. Results: A total of 100 patients were studied having mean age of 62.57 years±12.18 years. Fifty-one percent were having NSTEMI, 33% were having STEMI, and 16% were having UA. Hypertension (63%) and diabetes (51%) were more prevalent in both men and women. Smoking among males was consistently high (48.6%), being highest among adults. Cardiac procedures performed include percutaneous transluminal coronary angioplasty (PTCA) in 45%, coronary angiogram (CAG) in 20%, and coronary artery bypass graft surgery (CABG) in 7%. In-hospital medications were antiplatelets (100%), thrombolytics (28%), statins (97%), anticoagulants (80%), nitrates (73%), β-blocker (32%), angiotensin-converting enzyme inhibitor (6%), angiotensin receptor blocker (9%), potassium opener (7%), vasodilator (1%), calcium channel blocker (9%), α-blocker (7%), and α+β blocker (7%). Conclusions: The contemporary profile of treatment patterns for patients with ACS indicates an improved adherence to the guidelines. The alarmingly high rate of modifiable risk factors remains a cause of concern and a challenge that needs to be tackled, as better control of cardiovascular risk factors is expected to have a favorable impact on the incidence of ACS.

Background: Novel hepatoprotectives are needed to address the increasing cases of liver problems worldwide. Pterocarpus erinaceus Poir (Fabaceae) ethanol stem bark extract (PE) and its constituent flavonoid, homopterocarpin (HP), were investigated for their protective property in acetaminophen-induced oxidative stress and liver damage. Methods: Adult male albino rats were divided into nine groups. Seven groups were pretreated with PE (50-, 100-, and 150 mg/kg), HP (25-, 50-, and 75 mg/kg) or silymarin (25 mg/kg), respectively, once daily for 5 consecutive days and then administered acetaminophen (2 g/kg) on the 5th day. The control and acetaminophen-intoxicated groups received normal saline throughout the experimental period, with the latter group additionally receiving 2 g/kg acetaminophen on the 5th day. Administrations were performed po. Results: In the acetaminophen-intoxicated group, there were significant increases (p<0.05) in serum activities of alanine aminotransferase (31.72±3.3 vs. 22.1±1.2 U/I), aspartate aminotransferase (185.1±10.1 vs. 103.83±13.3 U/I), bilirubin level and hepatic malondialdehyde (2.32±0.3 vs. 1.42±0.1 units/mg protein), accompanied with significant decreases (p<0.05) in hepatic reduced glutathione level (0.10±0.01 vs. 0.23±0.03 units/mg protein) and glutathione peroxidase activity (2.51±0.2 vs. 3.25±0.2 μmol H 2 O 2 consumed/min/mg protein) compared with the control. Conclusions: PE and HP ameliorated most of the observed biochemical alterations with HP appearing to show more potency. The results suggest that the flavonoid, homopterocarpin contributes to the hepatoprotective and antioxidant potentials of P. erinaceus extract.

Background: The energy status of the cell is regulated by the energy sensing network constituted by AMP-activated protein kinase (AMPK), the NAD + -dependent type III deacetylase silence information regulator T1 (SIRT1) and peroxisome proliferator-activated receptor-γ coactivator-1α (PGC-1α). This study investigates the potential effect of 5-aminoimidazole-4-carboximide-1-b-D-ribofuranoside (AICAR), an AMPK activator on insulin signaling and energy sensing network in insulin resistant rats. Methods: Adult male albino Wistar rats with body weight of 150–180 g were fed high-fructose diet (HFD) for 60 days to induce insulin resistance. Rats fed HFD were divided into two and were treated or untreated with AICAR (0.7 mg/kg bw, i.p.) for the last 2 weeks. Results: Insulin resistant rats displayed increased glucose and insulin levels and reduced tyrosine phosphorylation of insulin resistance receptor and insulin receptor substrate 1. The downstream signaling and glucose transport were also affected. Phosphorylation of AMPK, SIRT1 protein abundance and mRNA expression of PGC-1α were reduced. Treatment with AICAR reduced hyperglycemia and hyperinsulinemia and improved the activation of the key molecules of insulin signaling. Improved action of energy sensing network was noted after AICAR treatment. AICAR showed higher binding affinity with Akt (−8.2 kcal/mol) than with AMPK or insulin receptor (−8.0 kcal/mol) in the in silico study. Conclusions: The findings suggest that AICAR, the AMPK activator, influences insulin signaling proteins and molecules involved in energy modulation during insulin resistance.

Background: The aims of the present study were to assess whether the antidiabetic activity of mature coconut water (MCW) is mediated through L-arginine-nitric oxide pathway in diabetic rats, and to study the effects of MCW on blood coagulation. Methods: Diabetes was induced in male Sprague-Dawley rats by injecting them with alloxan (150 mg/kg body weight). MCW (4 mL/100 g body weight) and L-arginine (7.5 mg/100 g body weight) was given orally for 45 days. L-NAME was given at a dose of 0.5 mg/kg body weight. Concentrations of blood glucose, plasma insulin, glycosylated hemoglobin (HbA 1c ), L-arginine, urine volume and urinary creatinine levels, activity of nitric oxide synthase (NOS), and arginase as well as the abnormalities in hemostasis and thrombosis were measured in all the experimental groups. Results : Treatment with MCW and L-arginine reduced the concentration of blood glucose and HbA 1c in diabetic rats. MCW and L-arginine treatment exhibited significant antithrombotic activity in diabetic rats, which was evident from the reduced levels of WBC, platelets, fibrin, and fibrinogen. MCW and L-arginine treatment prolonged the prothrombin time in diabetic rats and reduced the activity of Factor V. In addition to this, the activity of nitric oxide synthase, liver and plasma arginine content, and urinary nitrite were higher in MCW-treated diabetic rats whereas L-NAME treatment inhibited the beneficial effects induced by MCW and arginine. Conclusions: The results clearly indicate that L-arginine is a major factor responsible for the antidiabetic and antithrombotic potential of coconut water, and is mediated through the L-arginine-nitric oxide pathway.

Background: Glucose-lowering effects of Moringa oleifera extracts have been reported. However, the mechanism for its hypoglycemic effects is not yet understood. This study investigated the effect of oral administration of methanolic extracts of M. oleifera (MOLE) on glucose tolerance, glycogen synthesis, and lipid metabolism in rats with alloxan-induced diabetes. Methods: MOLE was screened for key phytochemicals and its total flavonoids and phenolic contents were quantified. Diabetes was induced by intraperitoneal injection of 120 mg/kg BW alloxan. Normal and diabetic control rats received saline, while rats in other groups received 300 or 600 mg/kg body weight of MOLE or metformin (100 mg/kg body weight of metformin) for 6 weeks. Food intake and body weight were monitored throughout the experiment. Intraperitoneal glucose tolerance was assessed and serum glucose, insulin, and lipids were measured at the end of the experiment. Liver and muscle glycogen synthase activities, glycogen content, and glucose uptake were determined. Results: Administration of MOLE did not affect food intake but inhibited weight loss, significantly (p<0.01) improved glucose tolerance, and increased serum insulin levels by 1.3–1.7-fold (p<0.01). MOLE treatment significantly (p<0.001) reduced serum concentrations of triglyceride, total cholesterol, and low-density lipoprotein (LDL)-cholesterol and enhanced serum level of high-density lipoprotein (HDL) by 2.4- to 3.2-fold (p<0.001). Glycogen synthase activities and glycogen contents were higher in MOLE-treated rats compared with rats receiving metformin or saline and the extract improved glucose uptake by 49%–59% (p<0.01). Conclusions: These results showed that hypoglycemic effects of MOLE might be mediated through the stimulation of insulin release leading to enhanced glucose uptake and glycogen synthesis.

Background: Considering the antihyperglycemic and antioxidant activities of herbs, this study has evaluated the morphological changes, hypoglycemic effect, and comparative ameliorating effects of Costus afer Ker Gawl leaf and glibenclamide on pancreatic injury induced by alloxan. Methods: Thirty adult male albino rats that were divided into six groups of five weight-matched animals each were used in the study. Groups 1 and 2 served as controls, whereas groups 3–6 were alloxan-induced diabetic groups treated with different doses of the extract (375, 750, and 1125 mg/kg C. afer ) and glibenclamide, respectively. The glucose level was measured daily, whereas the weight of the animal was monitored on a weekly basis for 21 days. The oral glucose tolerance test was measured on overnight fasted rats after glucose load at 0, 30, 60, 90, and 120 min. The histopathology of the pancreas was also investigated. Results: The phytoconstituents of C. afer Ker Gawl leaves include glycosides, tannins, saponins, terpenoid, phenolic compound, flavonoids, and alkaloids. Costus afer possessed significant hypoglycemic (p<0.05) effect and reversed the histopathologic damage of pancreases in alloxan-induced diabetic rats comparable to those of glibenclamide. Conclusions: Costus afer leaves possess both antidiabetic and tissue protective properties on pancreases of investigated rats.

Background: Globally, Moringa oleifera is used by different communities to treat various ailments including modulation of the immune system though with limited scientific evidence. The aim was to study the immunomodulatory activity of M. oleifera methanolic leaf extract in Wistar albino rats. Methods: An experimental laboratory-based study was done following standard methods and procedures. Nine experimental groups (I, II, III, IV, V, VI, VII, VIII, IX) each comprising of six animals were used. Group I received normal saline. Groups II to IX received 200 mg/kg bwt cyclophosphamide at the beginning of the study. Group III received 50 mg/kg bwt of an immunostimulatory drug levamisole. Groups IV to IX were dosed daily for 14 days with extract at doses of 250, 500, and 1000 mg/kg bwt, respectively, using an intragastric tube. Complete blood count (CBC), delayed-type hypersensitivity reaction (DTH), neutrophil adhesion test, and hemagglutination antibody titer were determined using standard methods and procedures. Statistical analysis was performed using GraphPad prism 5.0a Software. Results: There was an increment in WBC, lymphocyte, and neutrophil counts at a dose of 1000 mg/kg bwt similar to the levamisole-positive control group. The neutrophil adhesion was statistically significant (p≤0.05) for treatment groups that received 1000 mg/kg bwt (29.94%) and 500 mg/kg bwt at 17.28%. The mean percentage increment in footpad thickness was highest (26.9%) after 8 h of injection of antigen in the footpad of rats dosed 500 mg/kg bwt and this later reduced to 25.6% after 24 h. There was a dose-dependent increment in the mean hemagglutination antibody titer to sheep red blood cells (SRBC) from 10.73±0.57 HA units/μL for the 250 mg/kg bwt to 26.22±1.70 HA units/μL for the 1000 mg/kg bwt. Conclusions: Methanolic leaf extract of M. oleifera caused a significant immunostimulatory effect on both the cell-mediated and humoral immune systems in the Wistar albino rats.

Background: This study was performed in order to provide a scientific basis for the conventional use of Emilia sonchifolia in the traditional Indian Ayurvedic medicine possibly through modulation of the host immune defense. Methods: Emilia sonchifolia methanolic extract (25 mg/kg body weight) was administered intraperitoneally in mice, and hematological parameters, relative organ weights, bone marrow cellularity, and α-esterase activity were assessed. Humoral immune response was evaluated by hemagglutinating antibody (HA) titer and plaque forming cell (PFC) assay. Blastogenesis assays of lymphoid organs were done in the presence and absence of various mitogens such as phytohemagglutinin, concanavalin A, pokeweed mitogen, and lipopolysaccharide. Cytotoxic T lymphocyte (CTL) production was assessed by Winn’s neutralization test. The levels of cytokines interleukin-2 (IL-2) and interferon-γ (IFN-γ) were evaluated by ELISA. Results: Emilia sonchifolia significantly enhanced the total white blood cell count (9995±535 cells/mm 3 ), bone marrow cellularity, α-esterase activity, and weight of lymphoid organs (p<0.001). The effect on humoral immune response was evident from the enhanced HA titer and increased number of PFCs (p<0.001). The blastogenic effects of mitogens were also stimulated to significant levels by E. sonchifolia treatment. Emilia sonchifolia treatment augmented cell-mediated immune response by enhancing the killing activity of CTLs and by enhanced production of IL-2 and IFN-γ. Conclusions: From these results, it was very evident that E. sonchifolia , an indigenous medicinal plant, is a potent immune response modulator, and the present report is so far the first study to demonstrate the immunoregulatory activity of E. sonchifolia.

Background: Inflammasomes are protein complexes that mediate the process of inflammation and tissue injury by regulating the level of cytokine production. Pancreatitis is a major gastrointestinal disorder characterized by painful inflammation in the pancreas. The aim of this study was to evaluate whether thymoquinone (TQ) exerts anti-inflammatory activity by influencing the expression of the apoptosis-associated speck-like protein (ASC) complex of NOD-like receptor pyrin domain containing 3 (NLRP3) inflammasomes in rats subjected to experimental pancreatitis. Methods: Male albino Wistar rats were randomly separated into four groups. Rats in groups 1 and 2 were fed with a normal diet for 90 days, and rats in groups 3 and 4 were administered with ethanol (EtOH) 8–12 g/kg/day orally and fed with a high-fat diet (HFD) for 90 days. In addition, rats in groups 2 and 4 were administered with 100 mg/kg body weight of TQ from the 31st day. The serum lipase (L)/amylase (A) ratio; the oxidative stress markers; the GSH/GSSG ratio; the mRNA expression of ASC, caspase-1, IL-1β, IL-18, and TNF-α; and the protein expression of ASC and caspase-1 in the pancreas were assessed. Results: We observed a significant increase in the serum L/A ratio and oxidative stress, a decrease in the GSH/GSSG ratio, and a GST activity in EtOH- and HFD-fed rats. The mRNA expression of IL-1β, IL-18, and TNF-α was significantly reduced in TQ-coadministered rats than that in EtOH- and HFD-fed rats. The upregulation of mRNA and the protein expression of ASC and caspase-1 were significantly reduced in TQ-coadministered rats. Conclusions: TQ exerts the anti-inflammatory activity probably by downregulating the ASC expression to minimize the maturation of proinflammatory cytokines.

Background: The aim was to study and compare knowledge, attitude and practices regarding self-medication in healthcare and nonhealthcare university students. Methods: Suitably constructed, structured and pretested questionnaires were distributed to 350 students in each group; data were documented in SPSS software version 20.0 and analyzed using χ 2 -test and multivariate logistic regression analysis. Results: Completed questionnaires only were analyzed, which were 314 and 310 in healthcare and nonhealthcare groups, respectively. The majority of students practiced self-medication (84.4% vs. 68.1%; p<0.001) with the most common indications being fever (46.4% vs. 37.9%; p<0.001) and cough and common cold (30.9% vs. 37%; p=0.004). Most commonly self-medicated drugs were antipyretics (67.9% vs. 52.6%; p=0.03) and multivitamins (28.7% vs. 16.8%; p<0.001). A few of them experienced adverse drug reactions due to self-medication (6.8% vs. 1.9%; p<0.001). Independent risk factors for self-medication were younger age group (OR=2.93, CI 95% 1.09–7.85), storage of medicines at home (OR=2.49, CI 95% 1.21–5.12), healthcare students (OR=2.54, CI 95% 1.72–3.74), higher knowledge scores (OR=1.65, CI 95% 1.08–2.52), those consuming homeopathic preparations (OR=9.19, CI 95% 1.24–68.11), multivitamins (OR=6.7, CI 95% 2.88–15.6) or health supplements (OR=6, CI 95% 2.15–16.74), participants who strongly agreed that self-medication is a part of self-care (OR=3.97, CI 95% 1.56–10.09), and those self-medicating with an old prescription for same illness (OR=0.04, CI 95% 0.01–0.15) or over advice from home (OR=0.11, CI 95% 0.04–0.3). Conclusions: Though self-medication is common in university students, there is a dearth in their knowledge regarding the same. This highlights the need for increasing awareness among students regarding hazards of self-medication.