Anti-inflammatory and analgesic properties of Ocimum sanctum: a comparative study using animal models

Background: Ocimum sanctum commonly known as Tulsi has been used for thousands of years in the Ayurveda for its diverse healing properties. This study was conducted to evaluate the anti-inflammatory and analgesic activity of O. sanctum aqueous leaf extract in thermal and chemical induced pain and inflammatory animal models.Methods: Wistar albino rats (150-200 g) and swiss albino mice (25-30 g) were randomly divided into 4 groups of 6 animals each. The control group, test group, and standard drugs group received normal saline, O. sanctum extract (100 mg/kg), aspirin, and celecoxib respectively, by oral feeding. The anti-inflammatory effect was assessed by carrageenan induced rat paw edema and cotton pellet induced granuloma in rats. Analgesic effect was assessed by hot plate method and acetic acid induced writhing method in mice.Results: In carrageenan induced rat paw edema, maximum inhibition by O. sanctum, aspirin, and celecoxib were 13.43%, 30%, and 32%, respectively, and time to reach maximum inhibition for O. sanctum was 2 hrs. In cotton pellet induced granuloma, percentage inhibition by O. sanctum, aspirin, and celecoxib were 23.85%, 45.84%, and 42.77%, respectively. In hot plate method, maximum inhibition by O. sanctum, aspirin and celecoxib were 143.92%, 288.18%, and 260.59%, respectively. In acetic acid induced writhing method, percentage protection by O. sanctum, aspirin, and celecoxib were 50.2%, 71.4%, and 66.5%, respectively.Conclusion: The current study demonstrates statistically significant anti-inflammatory and analgesic activity of O. sanctum

Change from baseline as an outcome illustrates escape behaviour of rats in hot plate method

Background: The Hot Plate test is a thermal hyperalgesia model to assess the analgesic activity of many compounds. Traditional analysis compares reaction times with controls, reports only analgesic activity without considering escape reflex. Escape reflex to pain sensation also provides an indirect measure of analgesic activity. However, it requires repeated exposure of rats to hot plate. We explored the learning activities and escape behaviour of rats by calculating the change from baseline of reaction times.Methods: Male Wister strain albino rats, weighing between 150-200mg were used for assessment of hot-plate induced hyperalgesia. Author analysed the analgesic activity of aspirin (100mg/Kg) and compared with animals receiving saline. Aspirin and saline were administered 1hr orally before the commencement of the experiment. The reaction time was recorded at every 30 min up to 6hrs.Results: With traditional analysis, we can observe that the onset of action, peak action and duration of analgesic activity of aspirin was at 0.5, 2.0 and 5.0 hours respectively. Peak inhibition of reaction time was seen at 2 hours with a magnitude of 474%. When we applied a statistical procedure, absolute change from baseline statistics, we found that animals treated with aspirin also exhibited escape reflex after fading of drug response and animals treated with saline demonstrated early (0.5hr) escape behaviour from the hot plate and continued throughout the rest of the experiment.Conclusions: Change from baseline as an outcome illustrates escape behaviour of rats in hot plate method and it should be employed along with percentage inhibition during assessment of analgesic activity

Bronchodilator activity of Ocimum sanctum Linn. (tulsi) in mild and moderate asthmatic patients in comparison with salbutamol: a single-blind cross-over study

Background: Bronchial asthma is one of the commonest chronic inflammatory diseases. The drugs available to treat bronchial asthma such as, beta-2 agonists, though very effective are associated with adverse effects. Therefore, the Ocimum sanctum (Tulsi) which was shown to have antiasthmatic activity in Ayurveda, is evaluated in this study.Objectives: To evaluate the bronchodilator activity of Ocimum sanctum Linn. in mild and moderate asthma and compare its efficacy with the standard bronchodilator drug, Salbutamol.Methods: This is a single-blind cross-over study. Capsules of Ocimum sanctum Linn. (200 mg, twice daily) and Salbutamol sulphate (2 mg, twice daily) were administered in 41 patients. Each drug was administered for a period of one week with a washout period of one week between the two drug schedules. FEV1 and PEFR were recorded in these patients to assess the bronchodilator activity before the drug administration, on 4th and on 7th day of administration of Ocimum sanctum and the parameters obtained were compared with that of the standard drug, Salbutamol.Results: Ocimum sanctum 200mg twice daily produced significant improvement in both FEV1 and PEFR values, on 4th and 7th day and also produced improvement in symptoms of asthma. On comparing the results with that of Salbutamol 2mg twice daily, the bronchodilator activity of Ocimum sanctum was found to be less efficacious, where Salbutamol produced very highly significant improvement in FEV1 and PEFR values on both 4th and 7th day.Conclusions: Our results suggest that Ocimum sanctum Linn. possesses significant bronchodilator activity in mild and moderate bronchial asthma

Anti-stress activity of Ocimum sanctum and alprazolam in animal models

Background: Stress is the physiological, psychological and behavioral response by individuals when they perceive a lack of equilibrium between the demands placed upon them and their ability to meet those demands, which over a period of time leads to ill health. There are several ways of coping with stress. Some techniques of time management may help a person to control stress.Methods: Forced swim test- mice were randomized into two groups according to the body weights. Each group contains six animals. Each individual animal was allowed to swim inside the jar (25-12-25 cm) containing fresh water up to 15 cm height. Mice were allowed swim for 6 min. After initial struggle to escape the animal became immobile. Total immobility period was measured. Rotarod test- mice were randomized into two groups according to body weights. Each group contains six animals. Rats were placed on the lanes. Latency period was recorded at which each rat falls off the rod.Results: In first experiment, anti-stress activity of Ocimum sanctum in mice was demonstrated by measuring the immobility period during forced swim test and in the second experiment the measurement of the latency period of rats in rotarod apparatus was performed. Both the experimental procedures were compared with standard anti stress drug alprazolam.Conclusions: The present study suggests that Ocimum sanctum possess significant anti stress activity but less when compared to alprazolam

A double-blind randomized placebo-controlled study of low dose mirtazapine once daily in patients of major depressive disorders on escitalopram

Background: The SSRIs being used as 1st line therapy in treatment of depression have delayed therapeutic effect which makes the patient vulnerable to an increased risk of suicide and decreased adherence to the treatment and will prematurely discontinue the therapy. The present study was conducted to evaluate if low dose mirtazapine-escitalopram combination therapy has any add on benefit over monotherapy with escitalopram.Methods: In a single-centered, comparative study involving patients with depression attending the out-patient after screening and exclusion, 60 eligible patients were randomly assigned to receive tablet mirtazapine 7.5 mg plus tablet escitalopram 10 mg intervention or tablet escitalopram 10 mg plus placebo intervention in a double-blind 6-week treatment phase. The primary outcome measure was the change in the 17-item Hamilton Depression Rating Scale (HDRS) and Montgomery-Asberg Depression Rating Scale (MADRS) score from baseline. Participants were evaluated at baseline, 1st, 2nd,4th and 6th week. Results were analyzed using Chi-Square test for adverse effects and independent t-test analysis for efficacy parameter.Results: In the analysis of results at 6th week the numbers of patients achieved remission in mirtazapine group are more with a p-value of 0.018 which is significant and the numbers of responders in mirtazapine group are also more which is statistically significant on chi-square test. There is no significant difference was observed between the two groups with reference to occurrence of adverse effect.Conclusions: Adding low dose mirtazapine has an added benefit in terms of efficacy and getting remission early with more number of responders in the treatment of major depression

Analgesic and anti-inflammatory properties of the aqueous extract leaves of Murraya koenigii linn in small animal models

Background: The present study was carried out to evaluate the analgesic activity of aqueous extract leaves of Murraya koenigii linn in Albino rats using tail flick method, Eddy’s hot plate methods and anti-inflammatory activity in Carrageenan induced paw edema in rats.Methods: The analgesic activity was evaluated using Eddy’s hot plate induced hyperalgesia and tail flick method, which served as thermal induced pain, where the animal were placed on the hot plate and the reaction time to (lick the paw/jump out) from the hot plate was observed, 0, 30, 60, 90 mins. Murraya 300 mg, 600 mg/kg/body weight (BW) and ibuprofen (5 mg/kg BW) was administered per oral. The anti-inflammatory activity was measured by Carrageenan induced paw edema volumes at 0, 1, 2, 3 and 4 hrs using mercury plethysmometer, which served as chemical induced pain models.Results:  The mean reaction time in Murraya at a dose of 600 mg/kg at 0 min 5.45±0.72, at 30 mins 6.52±1.03, at 60 mins 7.6±0.81, at 90 mins 8.8±0.63 respectively. The mean reaction time increased significantly with Murraya at dose of 600 mg/kg when compared with control.In the ibuprofen group, the mean reaction time at 0 hr was 0.28±0.04, at 1 hr 0.34±0.05, at 2 hrs 0.46±0.03, at 3 hrs 0.61±0.05, at 4 hrs 0.76±0.05. The mean reaction time Murraya in group 600 mg/kg at 0 hr 0.27±0.04, at 1 hrs 0.39±0.03, at 2 hrs 0.48±0.06, at 3 hrs 0.68±0.05, at 6 hrs 0.80±0.03, respectively.Conclusions: The results indicate that the aqueous extract of Murraya (leaf) extract revealed significant analgesic and anti-inflammatory in thermal and chemical induced pain models

Assessment of Morus alba (Mulberry) leaves extract for anti-convulsant property in rats

Background: The mulberry tree, a plant of the family Moraceae and the genus Morus, has been widely cultivated to feed silkworms. Various parts of Morus alba linn used as an Anti-inflammatory, hypoglycemic, cardioprotective, hepatoprotective, free radical scavenging activity and neuroprotective agent. The plant contains flavonoids, moranoline, albanol, morusin coumarine, and stilbene, which have. In this study, anticonvulsant property of Morus alba leaves extract (MAE) was evaluated by using MES and PTZ induced convulsion in rats.Methods: Effects of MAE were evaluated in experimental models of electro convulsions, maximal electro shock (MES) and chemoconvulsion induced by pentylenetetrazole (PTZ) in rats (n=6), which were treated intraperitonially with doses of 100, 200 and 400mg/kg.Results: The duration of tonic hind limb extension (seconds) with MAE in MES induced convulsions at dose of 100, 200, 400 mg/kg is 8.33±1.21, 6.83±1.16 & 3.16±0.98 respectively. In the dose of 400 mg/kg of MAE showed highly significant results by reducing the duration of tonic hind limb extension in MES induced convulsions. And onset of jerky movements (seconds) with MAE in PTZ induced convulsions at dose of 100, 200, 400mg/kg is 157.83±8.99, 195.66±17.02 and 295.50±21.10 respectively. In the dose of 400mg/kg of MAE showed highly significant results by delaying the onset of convulsions.Conclusions: Results indicate that the MAE have anticonvulsant effects in MES induced convulsions and in PTZ induced convulsions

Profile of vascular age and vascular response among elderly patients receiving antihypertensive therapy

Background: Normally the age of the arteries is same as that of the chronological age of the patient. In Hypertensive patients, complex interactions occur between prohypertensive factors, accelerating vascular age. Furthermore, prohypertensive factors to some extent are responsible for non-response to therapy at optimal doses. We assessed the correlation between response to therapy and vascular age in elderly hypertensives, in addition to vascular age and vascular response.Methods: In this study, we analysed the clinical records of both male and female hypertensive patients above 60 years old. We collected the details of age, gender, body mass index, systolic blood pressure (treated and untreated), diabetes and smoking. Vascular age was calculated using a composite score of these six prohypertensive risk factors. Accelerated vascular age was then derived using the formula vascular age minus chronological age. The optimal vascular response was considered if the patient's therapeutic blood pressures are less than 140/ 90mmHg.Results: In the present study, data from 517 elderly hypertensive patients were analysed, the mean chronological age, vascular age and accelerated vascular age was 66.74±6.6, 79.46±0.42 and 13.46±6.08 years. Only 32.7% were responders to anti-hypertensive treatment. The pattern of usage of anti-hypertensives in our patients is CCBs 39.10% followed by 30.90% ARB, 22.50% ACEI and 8.90% diuretics. The response in 20.50% of patients was achieved with a single drug, in 9.90% with two drugs and only in 2.30% of patients using three drugs. We found that 78.72% of our study population had vascular age more than ten years of chronological age, among them 66.6% between 60-69 years of chronological age were non-responders. We found a significant correlation (P<0.05) between vascular age and non-response to treatment.Conclusions: The majority (98.6%) of our patients had vascular age more than 80 years due to various risk factors of cardio vascular disease. Non-responsiveness to therapy showed a significant relationship with vascular age

Adverse drug reactions in paediatric patients in a tertiary care hospital in India: a prospective observational single centre study

Background: Adverse drug reactions (ADRs) are a major source of concern in adult and paediatric population. Monitoring ADRs in children is vital as they differ from adults in pharmacokinetic and pharmacodynamics responses. Strict ethical guidelines in clinical trials result in extrapolation of data from studies done in adults. Further, ADRs reported in adults do not predict those in children. Incidence of ADRs in children is 2.9% emphasizing the need for systematic monitoring. Studies at institutional level can generate valuable data among paediatric population. Hence, the current study was taken up to assess the clinical pattern of ADRs, their causality, severity and preventability.Methods: This is a prospective observational single centre study. Suspected cases of ADRs were collected and assessed for the clinical pattern, causality, severity and preventability factors along with gender-wise distribution.Results: A total of 118 ADRs were reported in our study. Most of the ADRs (46.67%) occurred below 1 year of age with male preponderance (53.4%). Skin was the most common organ involved (91.5%). Majority (78.8%) of ADRs were due to anti-infectives for systemic use (J). Vaccines were the most commonly implicated agents (55.9%) followed by antibiotics (22.9%). Severe reaction like DRESS syndrome was reported due to antiepileptics (including levetiracetam) requiring hospitalisation. Majority of ADRs were probable (92.4%), moderate (73.7%) and definitely preventable (61%).Conclusions: A wide range of ADRs are possible in paediatric population. Adequate knowledge about ADRs is essential and caution has to be exercised even while prescribing drugs which are considered safe in children

A randomized open label parallel group study comparing the safety, effectiveness and adherence between 2% fusidic acid cream versus 1% retapamulin ointment in children with impetigo

Background: Impetigo is a contagious bacterial skin infection that affects both adults and children. Topical antibacterials such as mupirocin and fusidic acid are the most commonly used in both primary and secondary impetigo. Clinical trials have shown high efficacy of retapamulin in the treatment of secondary impetigo. However, its use in primary impetigo is limited. To this purpose, we compared the safety, efficacy and adherence to treatment of fusidic acid with retapamulin in primary impetigo.Methods: A total of 50 patients with a clinical diagnosis of primary impetigo, between 2-12 years of age, having 0.05). Both drugs were well tolerated.Conclusions: Both fusidic and retapamulin showed similar clinical success in patients with primary impetigo. Since fusidic acid has anti-inflammatory property and its treatment is cost-effective, it can be considered as first-line treatment and retapamulin in fusidic acid-resistant impetigo