Effects of polyphenol-rich traditional herbal teas on obesity and oxidative stress in rats fed a high-fat–sugar diet

Hibiscus rosa-sinensis and Zingiber officinalis teas are traditionally used for the therapies of various diseases, including obesity. The present research work was planned to appraise the potential of polyphenol-rich extracts of selected herbal plants in obesity and related biochemical parameters of high-fat–sugar diet-induced obese rats. Three herbal teas were prepared from Hibiscus rosa-sinensis flowers and Zingiber officinalis rhizomes and their mixture (3:1, respectively). Total phenolic contents (TPC) of Hibiscus rosa-sinensis and Zingiber officinalis extracts were found to be 5.82 and 1.45 mg/g of dry plant material, measured as GAE, while total flavonoid contents (TFC) were 9.17 and 1.95 mg/g of dry plant material, measured as CE, respectively. Two doses (250 and 500 mg/kg BW) of each tea were administered and body weight, BMI, kidney, liver, and atherogenic indices, TC, TG, HDL, LDL, VLDL, BT, AST, ALT, AP, SC, MDA, SOD, GSH, and TAC of rats groups were measured. Data showed that higher doses of Hibiscus rosa-sinensis significantly reduced the rat's BMI (0.50 g/cm2) in comparison with the high-fat–sugar diet group (0.79 g/cm2). All treatment groups, especially H-500 group, showed a significant decrease in the elevated kidney and liver weights and atherogenic index in comparison with HFSDC groups. Higher doses of Hibiscus rosa-sinensis significantly decreased the levels of AST, ALT, AP, and SC in comparison with the HFSDC group. A significant decrease in the levels of serum TC, TG, LDL, and VLDL was observed in all the treatment groups in comparison with the HFSDC group. Furthermore, all the teas, especially higher doses of Hibiscus rosa-sinensis, prevented the alterations in MDA, SOD, and GSH levels of experimental groups, thus showing the potential against oxidative stress. It can be concluded from these results that Hibiscus rosa-sinensis teas exhibited strong protective effects against obesity and oxidative stress, especially at higher doses

Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial

Background Post-partum haemorrhage is the leading cause of maternal death worldwide. Early administration of tranexamic acid reduces deaths due to bleeding in trauma patients. We aimed to assess the effects of early administration of tranexamic acid on death, hysterectomy, and other relevant outcomes in women with post-partum haemorrhage. Methods In this randomised, double-blind, placebo-controlled trial, we recruited women aged 16 years and older with a clinical diagnosis of post-partum haemorrhage after a vaginal birth or caesarean section from 193 hospitals in 21 countries. We randomly assigned women to receive either 1 g intravenous tranexamic acid or matching placebo in addition to usual care. If bleeding continued after 30 min, or stopped and restarted within 24 h of the first dose, a second dose of 1 g of tranexamic acid or placebo could be given. Patients were assigned by selection of a numbered treatment pack from a box containing eight numbered packs that were identical apart from the pack number. Participants, care givers, and those assessing outcomes were masked to allocation. We originally planned to enrol 15 000 women with a composite primary endpoint of death from all-causes or hysterectomy within 42 days of giving birth. However, during the trial it became apparent that the decision to conduct a hysterectomy was often made at the same time as randomisation. Although tranexamic acid could influence the risk of death in these cases, it could not affect the risk of hysterectomy. We therefore increased the sample size from 15 000 to 20 000 women in order to estimate the effect of tranexamic acid on the risk of death from post-partum haemorrhage. All analyses were done on an intention-to-treat basis. This trial is registered with ISRCTN76912190 (Dec 8, 2008); ClinicalTrials.gov, number NCT00872469; and PACTR201007000192283. Findings Between March, 2010, and April, 2016, 20 060 women were enrolled and randomly assigned to receive tranexamic acid (n=10 051) or placebo (n=10 009), of whom 10 036 and 9985, respectively, were included in the analysis. Death due to bleeding was significantly reduced in women given tranexamic acid (155 [1·5%] of 10 036 patients vs 191 [1·9%] of 9985 in the placebo group, risk ratio [RR] 0·81, 95% CI 0·65–1·00; p=0·045), especially in women given treatment within 3 h of giving birth (89 [1·2%] in the tranexamic acid group vs 127 [1·7%] in the placebo group, RR 0·69, 95% CI 0·52–0·91; p=0·008). All other causes of death did not differ significantly by group. Hysterectomy was not reduced with tranexamic acid (358 [3·6%] patients in the tranexamic acid group vs 351 [3·5%] in the placebo group, RR 1·02, 95% CI 0·88–1·07; p=0·84). The composite primary endpoint of death from all causes or hysterectomy was not reduced with tranexamic acid (534 [5·3%] deaths or hysterectomies in the tranexamic acid group vs 546 [5·5%] in the placebo group, RR 0·97, 95% CI 0·87-1·09; p=0·65). Adverse events (including thromboembolic events) did not differ significantly in the tranexamic acid versus placebo group. Interpretation Tranexamic acid reduces death due to bleeding in women with post-partum haemorrhage with no adverse effects. When used as a treatment for postpartum haemorrhage, tranexamic acid should be given as soon as possible after bleeding onset. Funding London School of Hygiene & Tropical Medicine, Pfizer, UK Department of Health, Wellcome Trust, and Bill & Melinda Gates Foundation

Fagonia arabica L.: A Review of its Phytochemistry, Pharmacology and Traditional Uses

Background: Fagonia arabica, belonging to family Zygophyllaceae, is a medicinal plant widely distributed in the desert areas of the world, including Saudi Arabia, Pakistan, India and South Africa. The present review aims to explore the published information on the traditional uses, ethnobotanical knowledge, phytochemistry and various biological activities like antioxidant, antimicrobial, thrombolytic activities and anticoagulant effects of Fagonia arabica with critical analysis on the gaps and future perspectives. Method: A literature survey was performed by searching the digital libraries and the scientific databases including Scopus, Google Scholar, SciFinder, ACS, Web of Science and published books. Results: Fagonia arabica plant has been reported to have a wide range of traditional uses in sore mouth, smallpox, hematological, neurological, endocrinological, inflammatory, cooling agent in stomatitis, vertigo and endothermic reaction in the body. Several bioactive constituents, including glycosides, flavonoids, terpenoids, saponins, alkaloids and trace elements, were recorded from Fagonia arabica plant. The isolation and identification of two flavonoid glycosides (kaempferol-7O-rhamnoside and acacetin-7-O-rhamnoside) were also reported. Fagonia arabica has been studied for its wide range of biological activities, which include antioxidant, antimicrobial, cardioprotective and anticoagulant. Conclusion: It is apparent from the literature that Fagonia arabica plant possesses a wide range of medicinal and pharmacological uses and has been studied for its various pharmacological activities and medicinal applications. Critical analysis reveals that the plant has huge potential for pharmaceutical and pharmacological applications

Variation in Phenolic Profile, Antioxidant, and Anti-Inflammatory Activities of Salvadora oleoides Decene. and Salvadora persica L. Fruits and Aerial Part Extracts

(1) Background: The objective of this study was to investigate the potential of Salvadora oleoides (S. oleoides) and Salvadora persica (S. persica) polyphenols as antioxidant and anti-inflammatory agents. (2) Methods: Aerial parts and fruits of S. oleoides and S. persica were collected from the periphery of District Bhakkar, Punjab, Pakistan. Methanol extracts were prepared using the Soxhlet extraction technique. Extract yield varied from 8.15 to 19.6 g/100 g dry plant material. RP-HPLC revealed the detection of thirteen phenolic aids and five flavonoids. Gallic acid, hydroxy benzoic acid, chlorogenic acid, and cinamic acid were the major phenolic acids, whereas catechin, rutin, and myricetin were the flavonoids detected. (3) Results: Maximum total phenolic contents (TPCs) (22.2 mg/g of dry plant material) and total flavonoid contents (TFCs) (6.17 mg/g of dry plant material) were found in the fruit extract of S. persica, and the minimum TPC (11.9 mg/g) and TFC (1.72 mg/g) were found in the aerial part of S. oleoides. The fruit extract of S. persica showed the highest DPPH radical scavenging activity. In vivo anti-inflammatory activity of all the extracts was performed on albumin-induced rat paw edema that was comparable with the standard indomethacin; S. persica fruit extract showed remarkable anti-inflammatory activity. Analgesic activity of aerial part and fruit extracts of S. oleoides and S. persica was investigated using a mouse model, and the results showed that maximum possible analgesia of fruit extracts of S. persica was 53.44%, which is better than the PC group (52.98%). (4) Conclusions: The variations in the antioxidant, anti-inflammatory, and analgesic activities of methanolic extracts of S. oleoides and S. persica were found to be significant, and they have therapeutic potential as antioxidant, analgesic, and anti-inflammatory agents

Antioxidant, Anti-Obesity, and Hypolipidemic Effects of Polyphenol Rich Star Anise (<i>Illicium verum</i>) Tea in High-Fat-Sugar Diet-Induced Obesity Rat Model

Star anise (Illicium verum Hook. fil.) is commonly utilized as a culinary and medicinal fruit and is most famous in indigenous systems of medicine. The present research work aims to appraise and validate the potential of polyphenol-rich star anise tea (SAT) on oxidative stress, obesity and related biochemical parameters in high-fat-sugar-diet (HFSD)-induced obesity model in rats. SAT was prepared using the traditional method in warm water. The Reverse Phase High Pressure Liquid Chromatography (RP-HPLC) analysis was performed for the simultaneous determination of phenolic acids and flavonoids in SAT. Two doses (250 and 500 mg/kg body weight) were selected to investigate the anti-obesity potential of SAT using HFSD-induced obese rat model. Major (>5 mg/100 mL) phenolic acids in SAT were p-coumeric acid, gallic aid, cinamic acid, chlorogenic acid and ferulic acid while catechin and rutin were the major flavonoids detected in the SAT. SAT exhibited 51.3% DPPH radical scavenging activity. In vivo study showed that higher doses of SAT (500 mg/kg body weight) significantly reduced the body weight increase (74.82%) and BMI (0.64 g/cm2). Moreover, significant reductions in the levels of serum total cholesterol, triglyceride, LDL and VLDL were recorded in all the treatment groups in comparison to the HFSDC group. Furthermore, SAT reduced the alterations in MDA, SOD and GSH levels of experimental groups thus showing the potential against oxidative stress. The SAT-500 group showed a significant decrease in the elevated kidney and liver weights and atherogenic index in comparison to the HFSDC group. The present study proved that SAT exhibited strong protective effects against obesity and oxidative stress, especially at higher doses

Genome-Wide Association Study of Serum Creatinine Levels during Vancomycin Therapy

<div><p>Vancomycin, a commonly used antibiotic, can be nephrotoxic. Known risk factors such as age, creatinine clearance, vancomycin dose / dosing interval, and concurrent nephrotoxic medications fail to accurately predict nephrotoxicity. To identify potential genomic risk factors, we performed a genome-wide association study (GWAS) of serum creatinine levels while on vancomycin in 489 European American individuals and validated findings in three independent cohorts totaling 439 European American individuals. In primary analyses, the chromosome 6q22.31 locus was associated with increased serum creatinine levels while on vancomycin therapy (most significant variant rs2789047, risk allele A, β = -0.06, p = 1.1 x 10^-7). SNPs in this region had consistent directions of effect in the validation cohorts, with a meta-p of 1.1 x 10^-7. Variation in this region on chromosome 6, which includes the genes <i>TBC1D32/C6orf170</i> and <i>GJA1</i> (encoding connexin43), may modulate risk of vancomycin-induced kidney injury.</p></div

Meta-analysis results for chromosome 6 SNP associations to peak creatinine during vancomycin therapy.

<p>RAF—Risk Allele Frequency; SE—Standard Error.</p><p>*—Imputed SNP in Mayo and VGER cohorts.</p><p>Meta-analysis results for chromosome 6 SNP associations to peak creatinine during vancomycin therapy.</p

Association of genome-wide SNPs to peak creatinine while on vancomycin therapy in the primary cohort.

<p>A) Manhattan plot, where each dot represents a genotyped SNP, arranged along the x-axis by position of the SNP on each chromosome. The y-axis plots-log10(p-value) for the linear regression analysis of peak creatinine, adjusted for sex, age at time of vancomycin therapy, height, weight, vancomycin dose / dosing interval, vancomycin trough, and baseline serum creatinine measurements as described in the methods. B) LocusZoom plot of 6q22.31 locus, including genotyped and imputed SNPs. Each dot represents a SNP, arranged by position on chromosome 6 along the x-axis, and the color indicates degree of linkage disequilibrium with the index SNP, rs2789047. The left y-axis plots-log10(p-value) for each SNP. The blue line indicates estimated recombination rate, quantified on the right y-axis. Known genes in the region are indicted below the x-axis.</p

Identification of primary cohort.

<p>Electronic medical records data were searched to identify 5,665 individuals exposed to vancomycin. Automated and manual algorithms were used to determine if each satisfied inclusion / exclusion criteria, as described in the methods, resulting in 882 confirmed cases. After exclusion of those without DNA, those who failed quality control (QC), and those of non-European-American ancestry, 745 individuals remained. Of those, 489 had serum creatinine measurements for the primary analysis.</p

Cohort demographics for primary and validation cohorts investigated by genome-wide association for the outcome of peak serum creatinine during vancomycin therapy.

<p>*Median (interquartile range)</p><p>^N, %.</p><p>Cohort demographics for primary and validation cohorts investigated by genome-wide association for the outcome of peak serum creatinine during vancomycin therapy.</p