Drug therapy and disease management: An opinion

The Impact of Memantine and One-­on-One Caregiver Contact on Antipsychotic Medication Prescribed to Elderly Veterans with Dementia: Potential Global Care Strateg

Phytochemical constituents of Cassia fistula

Since the advent of modern drug treatments, traditional medicine has greatly receded in occidental societies. Moreover, only a limited number of medicinal plants have received detailed scientific scrutiny thereby prompting the World Health Organisation to recommend that this area be comprehensively investigated. Cassia fistula Linn is used extensively in various parts of the world against a wide range of ailments, the synergistic action of its metabolite production being most probably responsible for theplant’s beneficial effects. This paper reviews the primary and secondary metabolite composition of vegetative and reproductive plant parts and cell cultures thereby derived, with emphasis on potent phenolic antioxidants such as anthraquinones, flavonoids and flavan-3-ol derivatives. This paper also appraises the antioxidant and free radical propensities of plant parts and cell culture extracts. The data so far generated clearly sets the basis for a clearer understanding of the phytochemistry of the plant and derived cultures and opens the possibility of the potential utilization of the phenolic rich extracts from medicinal plants in food system or as prophylactics in nutritional/food supplement programs. Thus traditional medicinal plant- derived antioxidants may protect against a number of diseases and reduceoxidation processes in food systems. In order to establish this, it is imperative to measure the markers of baseline oxidative stress particularly in human health and disease and examine how they are affectedby supplementation with pure compounds or complex plant extracts from the traditional medicinal plants

Cancer: Global Health Perspectives

Chemotherapy to patients with cancer remains an effective mode of treatment of the disease, but it is associated with many side effects including mild or dose-­‐limiting toxicities such as alopecia, myelosuppression, gastrointestinal dysfunctions, neurologic toxicities, and immune suppression which results in infections and cancer cell proliferation. Although economic analysis of treatment in health care systems may be applied to the full range of interventions that make up a cancer service, the economic impact of cancer in health care systems remains one where much attention, in the context of complementary medicine, needs to be directed. Predicting the cost-­‐ effectiveness of developing prevention, screening and treatment strategies continue to be the focus strategies to optimize cancer care. KEY WORDS: Cancer; Global health perspectives; Palliative care; Stem cell cancer; Dietary components and chemopreventio

Metabolic Homeostasis, Biomarkers and Medical Education Assessment

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Rethinking conventional approaches to the detection, management and amelioration of disease

The linear-leafed water primrose (Ludwigia hyssopifolia), with its distinctive yellow flowers and matted undergrowth, is easily recognized along paddy fields and tropical wetlands especially in South and South-East Asia. Also known as the seedbox because of its distinctive dimorphic seeds, it has the potential of being an invasive pest and is classed a ‘serious’ or ‘principal’ weed in many countries. It is used locally for composting and in the concoction of traditional remedies in an unscientific and informal manner. In common with other plants of the willow herb or evening primrose family, this weed could turn out to have immense and economically viable pharmaceutical potential. Das et al have reported moderate anti-tumor and antibacterial activities in extracts and in an alkaloid piperine from L. hyssopifolia and Mohammad et al demonstrated anti-­‐diarrheal properties in a methanol extract. It is noteworthy along the same line that the work by Luximon‐Ramma, et al on Mauritian Exotic fruits strongly advocated the use of the red and yellow Psidium cattleianum Sabine ‘Chinese guava’, in nutritional programs due to their exceptionally high antioxidant potencies attributed to their rich vitamin C and phytophenolic profiles. These plants are also generally considered as invasive causing havoc amidst the protected endemics of the island and sing an ecological conservation approach, indeed legitimate, to safeguard threatened plants from extinction, the systematic removal of Chinese Guava trees may deprive us of important sources of active nutritional biofactors. In a study that features in this issue of the Archives Of Medical And Biomedical Research, Scientists at the University Of Dhaka have further formalized the pharmacotherapeutic potential that this much-­‐derided weed may hold. They studied the effects of hexane, ethyl acetate and methanol extracts of whole plant parts of Ludwigia hyssopifolia on carrageenan-induced paw edema, acetic acid‐induced writhing, and diuresis in mice. The Hexane extract and ethyl acetate extract showed significant inhibition of experimental paw edema. All three fractions significantly inhibited writhing and, in comparison to furosemide, exhibited good diuretic activity

Alterations in the antioxidant status of patients suffering from diabetes mellitus and associated cardiovascular complications

In view of the high prevalence of type 2 diabetes mellitus, this study aimed at determining the total plasma antioxidant capacity of type 2 diabetic patients with and without macrovascular complications. The erythrocyte catalase level was also evaluated because of the implication of catalase as a risk factor in diabetes. 90 age-­‐, gender-­‐ and body mass index-­‐matched subjects were used for this study and divided into healthy subjects (Group I, n=30), diabetic patients (Group II, n=30) and diabetic patients with cardiovascular complications (Group III, n=30). Blood samples collected from 90 eligible subjects were analyzed for glucose, HbA1c, urea, creatinine, total cholesterol, triglyceride, HDL and  LDL cholesterol levels. Blood antioxidant activity and erythrocyte catalase levels were assessed. The mean antioxidant status values of Groups II and III were found to be significantly lower than that of Group I (p < 0.05). A significant decrease was also observed in the mean catalase level of Groups II and III as compared to Group I (p < 0.05) while a significant increase in fasting blood glucose level, glycated hemoglobin, triglycerides and urea was observed in Groups II and III compared to Group I. These data suggest that the in vivo antioxidant defense was highly compromised in patients with diabetes and associated cardiovascular complications although they were on medication, thereby suggesting the potential contributory beneficial effects of exogenous antioxidants. Furthermore, a reduction in catalase level may suggest the role of increasing hydrogen peroxide concentration in the disease progression.KEY WORDS: Antioxidant; Erythrocyte catalase; Cardiovascular complications; Type 2 diabetes mellitu

Gyrase inhibitors induce an oxidative damage cellular death pathway in Escherichia coli

Modulation of bacterial chromosomal supercoiling is a function of DNA gyrase-catalyzed strand breakage and rejoining. This reaction is exploited by both antibiotic and proteic gyrase inhibitors, which trap the gyrase molecule at the DNA cleavage stage. Owing to this interaction, double-stranded DNA breaks are introduced and replication machinery is arrested at blocked replication forks. This immediately results in bacteriostasis and ultimately induces cell death. Here we demonstrate, through a series of phenotypic and gene expression analyses, that superoxide and hydroxyl radical oxidative species are generated following gyrase poisoning and play an important role in cell killing by gyrase inhibitors. We show that superoxide-mediated oxidation of iron–sulfur clusters promotes a breakdown of iron regulatory dynamics; in turn, iron misregulation drives the generation of highly destructive hydroxyl radicals via the Fenton reaction. Importantly, our data reveal that blockage of hydroxyl radical formation increases the survival of gyrase-poisoned cells. Together, this series of biochemical reactions appears to compose a maladaptive response, that serves to amplify the primary effect of gyrase inhibition by oxidatively damaging DNA, proteins and lipids

Cytisus scoparius link - A natural antioxidant

BACKGROUND: Recent investigations have shown that the antioxidant properties of plants could be correlated with oxidative stress defense and different human diseases. In this respect flavonoids and other polyphenolic compounds have gained the greatest attention. The plant Cytisus scoparius contains the main constituent of flavone and flavonals. The present study was undertaken to evaluate the in vitro antioxidant activities of extract of aerial part of Cytisus scoparius. METHODS: The plant extract was tested for DPPH (1, 1-diphenyl, 2-picryl hydrazyl) radical scavenging, nitric oxide radical scavenging, superoxide anion radical scavenging, hydroxyl radical scavenging, antilipid peroxidation assay, reducing power and total phenol content. RESULTS: The extract exhibited scavenging potential with IC(50 )value of 1.5 μg/ml, 116.0 μg/ml and 4.7 μg/ml for DPPH, nitric oxide and superoxide anion radicals. The values were found to lesser than those of vitamin C, rutin, and curcumin, as standards. The extract showed 50% protection at the dose of 104.0 μg/ml in lipid peroxidation induced by Fe(2+)/ ascorbate system in rat liver microsomal preparation. There is decrease in hydroxyl radical generation with IC(50 )value of 27.0 μg/ml when compared with standard vitamin E. The reducing power of the extract depends on the amount of extract. A significant amount of polyphenols could be detected by the equivalent to 0.0589 μg of pyrocatechol from 1 mg of extract. CONCLUSION: The results obtained in the present study indicate that hydro alcoholic extract of aerial part of Cytisus scoparius is a potential source of natural antioxidants

Increased oxidative stress associated with the severity of the liver disease in various forms of hepatitis B virus infection

BACKGROUND: Oxidative stress can be defined as an increase in oxidants and/or a decrease in antioxidant capacity. There is limited information about the oxidative status in subjects with hepatitis B virus infection. We aimed to evaluate the oxidative status in patients with various clinical forms of chronic hepatitis B infection. METHODS: Seventy-six patients with hepatitis B virus infection, in whom 33 with chronic hepatitis, 31 inactive carriers and 12 with cirrhosis, and 16 healthy subjects were enrolled. Total antioxidant response and total peroxide level measurement, and calculation of oxidative stress index were performed in all participants. RESULTS: Total antioxidant response was significantly lower in cirrhotics than inactive HbsAg carriers and controls (p = 0.008 and p = 0.008, respectively). Total peroxide level and oxidative stress index was significantly higher in cirrhotic (p < 0.001, both) and chronic hepatitis B subjects (p < 0.001, both) than inactive HbsAg carriers and controls. Total antioxidant response was comparable in chronic hepatitis B subjects, inactive HbsAg carriers and controls (both, p > 0.05/6). Total peroxide level and oxidative stress index were also comparable in inactive HBsAg carriers and controls (both, p > 0.05/6). Serum alanine amino transferase level was positively correlated with total peroxide level and oxidative stress index only in chronic hepatitis B subjects (p = 0.002, r = 0.519 and p = 0.008, r = 0.453, respectively). CONCLUSION: Oxidative stress occurs secondarily to increased total lipid peroxidation and inadequate total antioxidant response and is related to severity of the disease and replication status of virus in hepatitis B infection

The Interaction of Hypotaurine and Other Sulfinates with Reactive Oxygen and Nitrogen Species:A Survey of Reaction Mechanisms

Considerable strides have been made in understanding the oxidative mechanisms involved in the final steps of the cysteine pathway leading to taurine. The oxidation of sulfinates, hypotaurine and cysteine sulfinic acid, to the respective sulfonates, taurine and cysteic acid, has never been associated with any specific enzyme. Conversely, there is strong evidence that in vivo formation of taurine and cysteic acid is the result of sulfinate interaction with a variety of biologically relevant oxidants. In the last decade, many experiments have been performed to understand whether peroxynitrite, nitrogen dioxide and carbonate radical anion could be included in the biologically relevant reactive species capable of oxidizing sulfinates. Thanks to this work, it has been possible to highlight two possible reaction mechanisms (direct and indirect reaction) of sulfinates with reactive oxygen and nitrogen species.The sulfinates oxidation, mediated by peroxynitrite, is an example of both reaction mechanisms: through a two-electron-direct-reaction with peroxynitrite or through a one-electron-indirect-transfer reaction. In the indirect mechanism, the peroxynitrite homolysis releases hydroxyl and nitrogen dioxide radical and in addition the degradation of short-lived adduct formed by peroxynitrite and CO2 can generate carbonate radical anion. The reaction of hypotaurine and cysteine sulfinic acid with peroxynitrite-derived radicals is accompanied by extensive oxygen uptake with the generation of transient intermediates, which can begin a reaction by an oxygen-dependent mechanism with the sulfonates, taurine, and cysteic acid as final products. Due to pulse radiolysis studies, it has been shown that transient sulfonyl radicals (RSO2(•)) have been produced during the oxidation of both sulfinates by one-electron transfer reaction.The purpose is to analyze all the aspects of the reactive mechanism in the sulfinic group oxidation of hypotaurine and cysteine sulfinic acid through the results obtained from our laboratory in recent years