Volume 12, Issue 2 -

Ayurveda described diabetes mellitus (DM) as Madhumeha . This ancient evidence-based system of medicine enumerated various herbs and formulations for its management, which needs scientific validation. Whereas translational “bedside to bench” approach in biomedical research is an upcoming concept, its application in traditional and complementary medicine can be interesting. The intersecting concepts in the field Ayurveda and translational research needs “omics” approach. The Ayurvedic biology concepts about DM have its close relations with present systems biology approach. Metabolic changes causing tissue damage connected with genetic and immunological irregularities leading to insulin resistance coincide with ancient knowledge. Combinatorial therapy according to Prakriti type as elucidated by Ayurgenomics should be carried on for further research. “Bedside to bench” approaches in research utilizing metabolomics and pharmacogenomics approach can be a major step towards changing the therapeutic strategy towards diabetes. Prameha which is described as the pre-diabetic state is a novel concept in Ayurvedic etiopathogenesis, while metabolomic parameters like lipid level in urine can be a thrust area of research to have a pre-diabetic screening method in high-risk populations. This tradition-guided research paradigm can open up novel opportunities in traditional knowledge-inspired systems biology and drug discovery against diabetes.

Background : Public interest in and demand for complementary and alternative medicine (CAM) services have increased in recent years throughout the Western world. The aim of the study was to assess trends in publications on CAM in the medical literature between 1963 and 2012 and to compare them with overall trends in publications on medical issues. Methods : A search of the literature was conducted on CAM and integrative medicine using the PubMed and Google Scholar search engines with key search terms. Results : Articles on CAM began to appear in the medical literature 50 years ago. Over the years there has been an increase in the number of publications. On PubMed the increase was from 15,764 to 144,288 articles from 1963 to 2012. In the decade between 1963 and 1972 publications on CAM comprised 0.81 % of all the articles appearing in PubMed. Over the course of the 50 years, the percentage increased more than twofold to 1.92 % from 2003 to 2012. On Google Scholar there were 27,170 citations related to CAM between 1963 and 1972. This increased to 2,521,430 between 2003 and 2012. Conclusions : Over the last 50 years there has been an increase in scientific publications on CAM in general, and on specific CAM treatments in particular.

Background : Rheumatoid arthritis is an inflammatory autoimmune disorder. Withania somnifera Dunal (Solanaceae) (WS), is a common medicinal plant used in traditional systems of medicine for the treatment of arthritis, and is an ingredient of anti-arthritic polyherbal formulations such as Habb-e-Asgand ® and Arthritin™. In the present study, we evaluated the antioxidant and anti-arthritic activity of aqueous extract of WS root (WSAq) in collagen-induced arthritic (CIA) rats. Methods : CIA rats were treated by using three doses of WSAq (100, 200, 300 mg/kg b. wt., orally) and methotrexate (MTX, 0.25 mg/kg b. wt. i.p.) as a standard reference drug for 20 days. The anti-arthritic effect was assayed by measuring the arthritic index, autoantibodies such as rheumatoid factor (RF), anti-cyclic citrullinated peptide antibody (a-CCP), anti-nuclear antibody (ANA), anti-collagen type II antibody (a-CII) and inflammatory marker like C-reactive protein (CRP). The oxidative stress parameters were also measured. Results : Treatment with WSAq resulted in a dose-dependent reduction in arthritic index, autoantibodies and CRP (p<0.05) with maximum effect at dose of 300 mg/kg b. wt. and the results were comparable to that of MTX-treated rats. Similarly, oxidative stress in CIA rats was ameliorated by treatment with different doses of WSAq, as evidenced by a decrease in lipid peroxidation and glutathione- S -transferase activity and an increase in the glutathione content and ferric-reducing ability of plasma (p<0.05). Conclusions : The results showed that WSAq exhibited antioxidant and anti-arthritic activity and reduced inflammation in CIA rats and suggests the potential use of this plant in the treatment of arthritis.

Background : The aim of this study was to evaluate the efficacy of ethanol extract of Terminalia chebula in the treatment of hot water-induced burn wounds and to compare the results with silver sulfadiazine (SSD) in rats. Methods : Five groups of ten rats were burned with hot water. Animals were administrated with topical cream at control, normal saline, 5 %, 10 % T. chebula extracts and standard SSD creams. Several parameters were assessed, including wound area, visual inspection of wound, bacteriology assessment, percentage of wound contraction and histopathological examination. Results : The average area of wound on 10th day was 11.2 ± 3.3, 11 ± 3.2, 8.5 ± 2.3, 9.5 ± 4.2 and 5.1 ± 2.2 cm 2 for SSD1 %, base cream, normal saline, herbal extract 5 % and 10 %, respectively. T. chebula 10 % cream exhibited lower wound size than SSD1 % and control groups at 10th day post burn injury. On day 15, the percentage of wound contraction in T. chebula was 5 % and 10 % more than 18 % and 53 % in comparison to SSD1 % group, respectively. Histopathological results exhibited well-formed horizontally oriented collagen fibers for appropriate tension. Strength of scar on burned tissue was better in T. chebula 5 % and 10 % as compared with control and SSD groups. Conclusions : The results of this study showed that T. chebula extract was capable of accelerating wound healing in rats by wound contraction, and had beneficial effects more than SSD 1 % cream in the management of burn injury.

Background : The protective effect of a developed drink from blends of selected fruits on the sperm quality of alloxan-induced diabetic rats was investigated. Methods : Diabetes was intraperitoneally induced with alloxan; the formulated drink blend was orally administered 2.5 or 5 mL/day. Treatment lasted for 14 days and the rats were humanely sacrificed by cervical dislocation. The antioxidant status via assessment of reduced glutathione (GSH), catalase (CAT), superoxide dismutase (SOD) and lipid peroxidation (LPO) was carried out on the testis, while sperm cells were analyzed for sperm motility, counts and abnormality. Results : Induction of diabetes led to a significant (p<0.05) decrease in GSH level, elevated SOD and CAT activities, significant (p<0.05) decrease in the sperm quality parameters studied. However, treatment with the formulated drink led to a significant (p<0.05) reduction of LPO, SOD and CAT activities as well as increase in GSH level. Conclusions : This study shows an improvement in testicular antioxidant activities and sperm qualities by single and double doses of the formulation, suggesting its protective potential against testicular toxicity in diabetic rats.

Background : Effective diet/drug combinations may show additive or synergistic effects in reducing endothelial risk factors vis-à-vis monotherapies. The study evaluated the effect of combined therapy of Telmisartan and omega 3-fatty acids in sodium arsenite-induced vascular endothelial dysfunction (VED) in rats. Methods : Forty-eight male Wistar rats (180–220 g) were randomized into eight groups; control, sodium arsenite (1.5 mg/kg/day) exposed, sodium arsenite exposure followed by treatment with Telmisartan, omega 3-fatty acids, the combination and/or endothelial modulators for 2 weeks depending on the allocated group. VED was assessed by estimating vascular reactivity. Serum thiobarbituric acid-reactive substances (TBARS), nitrite/nitrate levels, reduced glutathione (GSH) levels, superoxide dismutase (SOD) activity, serum cholesterol and triglyceride levels were also determined. Results : Sodium arsenite produced VED by attenuating acetylcholine-induced endothelial relaxation (% R max = 45.36), decreasing levels of serum nitrite/nitrate (9.28 μM/mg protein), GSH (16.06 μg/mg of protein), SOD activity (30.69 units/mg protein) and increasing TBARS (0.19 µM/mg protein) compared with control group. The combined therapy with Telmisartan (10 mg/kg/day) and omega 3-fatty acids (180 mg/kg/day) (% R max =80.93, 13.09 µM/mg protein, 25.93 μg/mg of protein, 57.84 units/mg protein and 0.08 µM/mg protein, respectively) significantly abolished the respective derangements induced by sodium arsenite. Further, this combination significantly prevented rise in serum cholesterol and triglyceride levels that was induced by sodium arsenite. However, the ameliorative effects of this combination were abated by N -omega-nitro-L-arginine methyl ester (L-NAME) and glibenclamide. Conclusions : Combined therapy of Telmisartan and omega 3-fatty acids attenuated VED, by activating enzyme nitric oxide synthase (eNOS) through opening of ATP-sensitive K + channels.

Background : Earlier studies in our laboratory demonstrated the anti-inflammatory activity of Buchholzia coriacea Engl. (Capparaceae) leaf extract, a herbal remedy used to treat disorders of inflammation. This study was undertaken to evaluate its anti-inflammatory mechanism(s). Methods : The effects of methanol leaf extract of B. coriacea (200 and 400 mg/kg) on vascular permeability and leukocyte migration were studied in rodents, while activity on complement system and membrane stabilization were evaluated in vitro . Results : The extract (200 and 400 mg/kg) inhibited acetic acid-induced increase in vascular permeability in a non-dose-related manner and significantly (p<0.05) reduced the total and differential leukocyte counts, respectively, in a dose-related manner. It also significantly (p<0.05) inhibited complement-induced hemolysis of sheep red blood cells (40–72 %) and moderately inhibited heat- (6 %) and hypotonic solution-(24 %) induced hemolysis in vitro in a non-dose-related manner. Conclusions : Results demonstrated that the anti-inflammatory activity of B. coriacea leaf extract is mediated through inhibition of increase in vascular permeability, leukocyte migration and complement system, and enhanced membrane stabilization.

Background : The aim of this study was to investigate the effect of Aloe vera gel extract on plasma total antioxidant capacity (TAC) and oral pathogenic bacteria in healthy volunteer. Methods : Fifty-three healthy volunteers were participated and interviewed for history of allergy, current systemic diseases and medications. Participants were received 250 mL of A. vera gel extract daily for 14 consecutive days. At days 0 and 15 of the experiment, blood samples were collected and analyzed for biochemical markers. The plasma TAC was evaluated by ferric reducing ability of plasma technique. The biochemical markers, including aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP), total protein (TP), serum albumin (ALB), serum globulin (GLB), total bilirubin (TB), blood urea nitrogen (BUN), serum creatinine (Cr) and creatinine clearance (CrCl) were measured. The antibacterial effect of A. vera gel extract against Lactobacillus spp. and Streptococcus mutans was also investigated. Statistical analysis was performed using paired t -test to compare between baseline and 14 days post-intervention. Results : Neither allergy nor side effects of A. vera gel extract was detected. After 14 days of A. vera gel extract consumption, plasma TAC was significantly greater than that of baseline (p=0.001). ALP, TB, TP and GLB were significantly increased (p<0.05) which were still within normal range. AST, ALT, ALB, BUN, Cr and CrCl were not significantly different. A. vera gel extract significantly reduced the number of Lactobacillus spp. (p<0.05), not S. mutans . Conclusions : Our data revealed that A. vera gel extract significantly increased plasma TAC, and decreased the number of Lactobacillus spp. without any clinical side effects.

Background : Ginger ( Zingiber officinale ) is one of the functional foods which contains biological compounds including gingerol, shogaol, paradol and zingerone. Ginger has been proposed to have anti-cancer, anti-thrombotic, anti-inflammatory, anti-arthritic, hypolipidemic and analgesic properties. Here, we report the effect of ginger supplementation on glycemic indices in Iranian patients with type 2 diabetes. Methods : A double-blind, placebo-controlled, randomized clinical trial was conducted on 20–60 -year-old patients with type 2 diabetes who did not receive insulin. Participants in the intervention and control groups were received 3 g of powdered ginger or placebo (lactose) (in capsules) daily for 3 months. Glycemic indices, total antioxidant capacity (TAC), malondialdehyde (MDA), C-reactive protein (CRP), serum paraoxonase, dietary intake and physical activity were measured at the beginning and end of the study, and after 12 h fasting. Results : Comparison of the indices after 3 months showed that the differences between the ginger and placebo groups were statistically significant as follows: serum glucose (–19.41±18.83 vs. 1.63±4.28 mg/dL, p<0.001), HbA 1c percentage (–0.77±0.88 vs. 0.02±0.16 %, p<0.001), insulin (–1.46±1.7 vs. 0.09±0.34 μIU/mL, p<0.001), insulin resistance (–16.38±19.2 vs. 0.68±2.7, p<0.001), high-sensitive CRP (–2.78±4.07 vs. 0.2±0.77 mg/L, p<0.001), paraoxonase-1 (PON-1) (22.04±24.53 vs. 1.71±2.72 U/L, p<0.006), TAC (0.78±0.71 vs. –0.04±0.29 µIU/mL, p<0.01) and MDA (–0.85±1.08 vs. 0.06±0.08 µmol/L, p<0.001) were significantly different. Conclusions : This report shows that the 3 months supplementation of ginger improved glycemic indices, TAC and PON-1 activity in patients with type 2 diabetes.

Background : Conventional plant-based therapies act as an important therapeutic tool for the treatment of worm infections all over the world and continuous evaluation of medicinal plants to find new potential lead compounds should be carried out. Methods : In-vitro analysis was conducted to evaluate the probable anthelmintic effect of crude aqueous and hydroalcoholic extracts of Ananas sativus leaves , Erythrina variegata barks and Alocasia indica rootstocks, against adult Paramphistomum cervi (Trematoda) and Haemonchus contortus (Nematode). Results : Among all three concentrations (25, 50, and 100 mg/mL), the hydroalcoholic leaf extract of A. sativus exhibited paralysis and death time ranged between 7.26 to 26.76 min and 15.40 to 35.55 min respectively for P. cervi while that for H. contortus was 14.70 to 42.43 min and 23.43 to 56.34 min, respectively. Moreover, aqueous extract exhibited paralysis and death time ranged between 7.66 to 28.72 min and 18.30 to 33.00 min, respectively, for P. cervi whereas paralysis and death time ranged between 23.34 to 37.88 min and 31.08 to 58.30 min respectively for H. contortus . Both extracts of E. variegata bark and A. indica tuber showed comparatively less significant anthelmintic activity. All results were statistically significant (p<0.001). Conclusions : A. sativus leaf displayed favorable anthelmintic activity on both P. cervi and H. contortus , whereas E. variegata barks and A. indica rootstocks showed insignificant result.