Ethnopharmacological Use and Biological Activities of Tragia involucrata L.

Plants have been utilized as medicines to treat various ailments since ancient times. Formulations made by plant materials have been used in traditional, complementary, and alternative medicine and remain widespread in both developing and developed countries. In developing countries, traditional medicines are widely practiced due to its accessibility and affordability, while in developed countries, complementary and alternative medicine are widely popular due to the adverse effects of chemical drugs. Tragia involucrata Linn. (family: Euphorbiaceae) is a highly used medicinal plant used in both Sri Lankan and Indian traditional medical systems. Since this plant is a weed, it is being extensively destroyed due to the lack of knowledge regarding the medicinal value of this plant. Hence, the objective of this study was to collect data on the medicinal value of this plant by correlating its scientifically validated biological activities with its ethnopharmacological uses. An attempt was made to gather as much information available regarding the ethnopharmacological uses and scientifically validated biological activities of Tragia involucrata through authentic traditional texts, scientific journals, and other authentic texts regarding medicinal plants. Thus, the review provides an insight to the capability of Tragia involucrata to be used as a monoherbal formulation for diseases pertaining to multiple systems of the body. With all the scientifically validated biological activities and the ethnopharmacological uses, Tragia involucrata may qualify as a potent candidate to be developed into a phytomedicine to be utilized as both a preventive and as a therapeutic agent

Ezetimibe added to statin therapy after acute coronary syndromes

BACKGROUND: Statin therapy reduces low-density lipoprotein (LDL) cholesterol levels and the risk of cardiovascular events, but whether the addition of ezetimibe, a nonstatin drug that reduces intestinal cholesterol absorption, can reduce the rate of cardiovascular events further is not known. METHODS: We conducted a double-blind, randomized trial involving 18,144 patients who had been hospitalized for an acute coronary syndrome within the preceding 10 days and had LDL cholesterol levels of 50 to 100 mg per deciliter (1.3 to 2.6 mmol per liter) if they were receiving lipid-lowering therapy or 50 to 125 mg per deciliter (1.3 to 3.2 mmol per liter) if they were not receiving lipid-lowering therapy. The combination of simvastatin (40 mg) and ezetimibe (10 mg) (simvastatin-ezetimibe) was compared with simvastatin (40 mg) and placebo (simvastatin monotherapy). The primary end point was a composite of cardiovascular death, nonfatal myocardial infarction, unstable angina requiring rehospitalization, coronary revascularization ( 6530 days after randomization), or nonfatal stroke. The median follow-up was 6 years. RESULTS: The median time-weighted average LDL cholesterol level during the study was 53.7 mg per deciliter (1.4 mmol per liter) in the simvastatin-ezetimibe group, as compared with 69.5 mg per deciliter (1.8 mmol per liter) in the simvastatin-monotherapy group (P<0.001). The Kaplan-Meier event rate for the primary end point at 7 years was 32.7% in the simvastatin-ezetimibe group, as compared with 34.7% in the simvastatin-monotherapy group (absolute risk difference, 2.0 percentage points; hazard ratio, 0.936; 95% confidence interval, 0.89 to 0.99; P = 0.016). Rates of pre-specified muscle, gallbladder, and hepatic adverse effects and cancer were similar in the two groups. CONCLUSIONS: When added to statin therapy, ezetimibe resulted in incremental lowering of LDL cholesterol levels and improved cardiovascular outcomes. Moreover, lowering LDL cholesterol to levels below previous targets provided additional benefit