AN AYURVEDIC PERSPECTIVE OF PANDUROGA -A REVIEW

Pandu Roga was well known to Indian people science since Vedic Period. It is described in full length by all the Acharyas of Ayurveda as a specific disease with its own Pathogenesis and treatment. In Panduroga change the color of the body like pallor of skin, sclera, nail, tongue etc. due to Rakta-alpata means Hemoglobin level decrease than the normal level. It is related with both important Dhatu Rasa and Rakta. We can correlate this disease to Anaemia in modern science. Anaemia is the world’s second leading cause of disability and is responsible for about 1 million deaths a year. It is therefore important for Ayurvedic scholar to search scientific reason behind the disease. With this research interest the present study has been undertaken thoroughly review of Panduroga. Three general principles of treatment have been mentioned in Charaka Samhita. They are Daivavyapashraya, Yuktivyapashraya and Satvawajya. Here only Yuktivyapashraya Chikitsa has been mentioned. Single drugs which have been used in Pandu are - Lauha Bhasma, Mandura Bhasma, Pure Kaseesa, Shilajita, Vardhamana Pippali etc. Compound drugs which are of vegetable origin e.g. Triphala, Phalatrikadi Kwatha, Punarnavashtaka Kwatha, Vidangavaleha etc. Here also made some efforts to discuss every aspect of Panduroga in Ayurvedic point of view

Evaluation of the effect of piperine per se and its interaction with ondansetron on haloperidol induced catalepsy in Albino mice

Background: This study aims to evaluate the per se effect of piperine and its interaction with ondansetron on haloperidol induced catalepsy in swiss albino mice.Methods: The piperine crystals were separated from crude extract of Piper nigrum. Catalepsy was induced by haloperidol (1mg/kg, i.p.). Control group received 2% gum acacia (10ml/kg), standard group ondansetron (0.5mg/kg), test group piperine (10mg/kg) and combination group ondansetron plus piperine (0.5mg/kg + 10mg/kg), per oral, respectively. In acute study, drugs were administered only once, one hour prior to the haloperidol administration. Whereas in chronic study, catalepsy was determined on the seventh day of treatment.Results: In acute study, from 60 min onwards after haloperidol administration, ondansetron and ondansetron plus piperine group resulted in significantly lower cataleptic scores than the control treated group. On the other hand, 120 min onwards ondansetron group showed significantly lower cataleptic scores (24.62) as compared to the ondansetron plus piperine group (31.50). In the chronic study, from 60 min onwards, ondansetron and the ondansetron plus piperine resulted in significantly lower cataleptic scores than the control treated group. Also the combination of ondansetron plus piperine was more significantly protective compared to ondansetron alone (P <0.05).Conclusions: Piperine has the potential to be used as a bioenhancer when combined with other drugs which would reduce the dose of drugs and thereby adverse effects. It may act probably by enhancing the bioavailability as well as by inhibiting the metabolic pathways of other drugs

STUDY OF CNS ACTIVITIES OF PIPERINE PERSE AND ITS BIOENHANCING EFFECT ON VARIOUS DRUGS IN EXPERIMENTAL ANIMAL MODELS

Objective: Study of CNS activities of piperine perse and its bio-enhancing effect on various drugs in experimental animal models.Methods: The CNS effects of piperine and its interaction with various drugs were evaluated by maximal electroshock convulsion model, pentobarbitone-induced sleeping time, anxiolytic activity, muscle relaxant activity and antidepressant activity using tail suspension and forced swimming test using standard procedures in experimental animal models. piperine at a dose of 10 and 20 mg/kg orally was used to evaluate CNS activities.Results: The results revealed that piperine perse posses only anticonvulsant activity and other significant CNS effects were not observe. But when it was combined with various drugs piperine increases the effect of the standard drug.Conclusion: Piperine 10 mg/kg has the potential to be used as a bio-enhancing agent when combined with other drugs. Bio-enhancing effect of piperine will decrease the dose of the standard drug, thereby decreasing the risk of their toxicity.Keywords: Piperine, Bio-enhancing, MES, Anxiolytic test, Tail suspension test, Forced swimming test, Motor co-ordination, Righting refle

Evaluation of antidepressant activity of l-methylfolate per se and its interaction with escitalopram in mice

Background: Depression is a worldwide illness in the current population. Low levels of L-methylfolate are linked to depression. Present study evaluates the anti-depressive activity of acute and chronic administration of L-methylfolate per se in forced swimming test (FST) and tail suspension test (TST) and its interaction with escitalopram in albino mice.Methods: For this 30 swiss albino mice were divided randomly into five groups (n=6) as group I (control,10ml/Kg, p.o) - 2% suspension of gum acacia, group II - escitalopram suspension (10mg/kg, p.o), group III- L-methylfolate suspension (3mg/kg, p.o), group IV- L-methylfolate (3mg/kg, p.o) plus escitalopram (5mg/kg, p.o), group V- L-methylfolate(3mg/kg, p.o) plus escitalopram(10mg/kg, p.o), for forced swimming test. In tail suspension test again, mice were divided in five groups as above except that the dose of L-methylfolate was reduced to 1.25mg/kg. The pharmacologically validated models forced swimming test and tail suspension test were performed in mice to evaluate acute and chronic antidepressant activity of L-methylfolate and its combination with escitalopram respectively, after performing an acute toxicity study.Results: L-methylfolate and L-methylfolate plus escitalopram (10mg/Kg and 5mg/Kg, p.o) showed acute and chronic antidepressant activity in albino mice in FST and TST respectively. In human L-methylfolate is only active form of folic acid that readily crosses the blood brain barrier and utilized by the CNS. It regulates the bioavailability of critical cofactor BH4, required by enzymes synthesizing monoamines whose deficiency leads to depression.Conclusions: Hence, this study suggests antidepresant activity of L-methylfolate per se and as adjuvant with escitalopram when initiated from initiation of antidepressant therapy. Also, L-methylfolate opens the possibility of reducing the dose of antidepressant when used as adjuvant

Evaluation of antianxiety effect of cinnamaldehyde in swiss albino mice

Background: Cinnamon is one of the best known spices used as an herbal medicine. Cinnamaldehyde (CNM) the volatile oil, which was present in the essential oil of the bark, is the important constituents of cinnamon. Cinnamon has been investigated for its various effects like peptic ulcer protection, antioxidant property, inhibition of tau aggregation, anti-inflammatory activity, effect on cardiovascular system, anti-nociceptive activity, hepato-protective effects, hypolipidemic and antidiabetic activites. The present study was aimed to evaluate the anxiolytic effect of CNM per se and its interaction with diazepam in swiss albino mice.Methods: Anxiolytic activity was evaluated by elevated plus maze method. A group of 36 healthy mice of either sex weighing 20-30 grams were divided at random into six groups (n=6). CNM and diazepam were dissolved in tween twenty 20% to maintain uniformity of the solvent and given orally. Group I was given twenty 20% (10 ml/kg, p.o.), group II diazepam (0.5 mg/kg, p.o.), group III diazepam (1 mg/kg, p.o.), group IV cinnamaldehyde (100 mg/kg, p.o.), group V cinnamaldehyde (200 mg/kg, p.o.), group VI cinnamaldehyde and diazepam (100 mg/kg and 0.5 mg/kg, p.o.).Results: Cinnamaldehyde per se showed no anxiolytic effect at any dose (p<0.05). The standard drug diazepam has shown significant anxiolytic activity on elevated plus maze. Whereas combination of diazepam 0.5 mg/kg and cinnamaldehyde 100 mg/kg showed significant increase in the time spent in open arms as compared to all groups (p<0.05).Conclusions: CNM per se did not show any effect on anxiety but enhanced the action of diazepam when co-administered

Antibacterial Evaluation of Plant Extracts: an insight into Phytomedicine

This study was carried out to evaluate the antibacterial activity of petroleum ether, methanol and aqueous extract of the two plant Ocimum sanctum and pepper nigrum extract using agar well diffusion and broth dilution method against gram-positive bacterial strains (B. firmus, B. megaterium and B. cereus) and gram-negative bacterial strains (Escherichia coli, Enterobacter sp. and Klebsiella pneumoniae). The results indicate that petroleum ether extract compare to methanol and aqueous extract of O. sanctum and P. nigrum exhibited significant antibacterial activity against gram-positive bacteria with minimum inhibitory concentration (MIC) ranging from 0.13 to 0.21x 10-4 mg/well concentration. Moreover, gram-negative bacteria were less susceptible against petroleum ether, methanol and aqueous extract of O. sanctum and P. nigrum and their MIC ranging from 0.13 to 0.21x 10-2. The most susceptible organism to the organic extracts from both studied plants was B. firmus and the most resistant organism was Enterobacter sp. The result obtained with B. cereus and K. pneumoniae were particularly interesting, since it was inhibited by antibiotic ampicillin used and susceptibility was observed with the individual extracts, where higher antibacterial activity with petroleum ether and aqueous extracts of O. sanctum and P. nigrum respectively.  The presence of phytochemicals such as alkaloids, tannins, saponin, triterpenoids, steroids and glycosides in the extracts of these plants supports their traditional uses as medicinal plants for the treatment of various ailments. The present study reveals potential use of these plants for developing new antibacterial herbal drugs against pathogenic microorganisms

Antibacterial Evaluation of Plant Extracts: an insight into Phytomedicine

This study was carried out to evaluate the antibacterial activity of petroleum ether, methanol and aqueous extract of the two plant Ocimum sanctum and pepper nigrum extract using agar well diffusion and broth dilution method against gram-positive bacterial strains (B. firmus, B. megaterium and B. cereus) and gram-negative bacterial strains (Escherichia coli, Enterobacter sp. and Klebsiella pneumoniae). The results indicate that petroleum ether extract compare to methanol and aqueous extract of O. sanctum and P. nigrum exhibited significant antibacterial activity against gram-positive bacteria with minimum inhibitory concentration (MIC) ranging from 0.13 to 0.21x 10-4 mg/well concentration. Moreover, gram-negative bacteria were less susceptible against petroleum ether, methanol and aqueous extract of O. sanctum and P. nigrum and their MIC ranging from 0.13 to 0.21x 10-2. The most susceptible organism to the organic extracts from both studied plants was B. firmus and the most resistant organism was Enterobacter sp. The result obtained with B. cereus and K. pneumoniae were particularly interesting, since it was inhibited by antibiotic ampicillin used and susceptibility was observed with the individual extracts, where higher antibacterial activity with petroleum ether and aqueous extracts of O. sanctum and P. nigrum respectively.  The presence of phytochemicals such as alkaloids, tannins, saponin, triterpenoids, steroids and glycosides in the extracts of these plants supports their traditional uses as medicinal plants for the treatment of various ailments. The present study reveals potential use of these plants for developing new antibacterial herbal drugs against pathogenic microorganisms

Analysis of X-knife and surgery in treatment of arteriovenous malformation of brain

Background: The goal of treatment in arteriovenous malformation (AVM) is total obliteration of the AVM, restoration of normal cerebral function, and preservation of life and neurological function. Aim: To analyze the results of X-knife and surgery for AVM of the brain. The endpoints for success or failure were as follows: success was defined as angiographic obliteration and failure as residual lesion, requiring retreatment, or death due to hemorrhage from the AVM. Materials and Methods: From May 2002 to May 2007, 54 patients were enrolled for this study. Grade I AVM was seen in 9%, grade II in 43%, grade III in 26%, grade IV in 9%, and grade V in 13%. Thirty-eight patients were treated by microsurgical resection out of which Grade I was seen in 5 patients, Grade II was seen in 17 patients, Grade III was seen in 9 patients and Grade V was seen in 7 patients. Rest of the sixteen patients were treated by linear accelerator radiosurgery out of which Grade II was seen in 6 patients, Grade III was seen in 5 patients and Grade IV was seen in 5 patients. The follow up was in range of 3-63 months. In follow up, digital subtraction angiography/ magnetic resonance angiography (DSA/MRA) was performed 3 months after surgery and 1 year and 2 years after stereotactic radiosurgery (SRS). Results: Among the patients treated with X-knife, 12/16 (75%) had proven angiographic obliteration. Complications were seen in 4/16 (25%) patients. Among the patients treated with microsurgical resection, 23/38 (61%) had proven angiographic obliteration. Complications (both intraoperative and postoperative) were seen in 19/38 (50%) patients. Conclusions: Sixty-one percent of patients were candidates for surgical resection. X-knife is a good modality of treatment for a low-grade AVM situated in eloquent areas of the brain and also for high-grade AVMs, when the surgical risk and morbidity is high

Predictive role of fragmented QRS in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention

Objective: Fragmented QRS (fQRS), as defined by additional spikes in the QRS complex of a 12-lead electrocardiogram (ECG), is a marker of scarred myocardium. In patients with coronary artery disease (CAD), fQRS is a predictor of heart failure (HF) and other major adverse cardiac events (MACE). The study was aimed to evaluate the role of fQRS in prediction of HF in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). Methods: In a prospective, non-randomized, small observational study, we enrolled 188 consecutive patients with STEMI undergoing primary PCI. Patients were grouped according to the presence or absence of fQRS and their in-hospital, 1 and 6-month MACE outcomes were assessed. Results: Of the 188 patients, fQRS were noted in 92 (48.94%) patients. Patients with fQRS were more likely to have Killip class II/III/IV. Patients with fQRS had a significantly higher corrected QT interval, lower left ventricular ejection fraction (LVEF), and higher N-terminal pro brain natriuretic peptide (NT-pro BNP) at 24 hours and 48 hours compared to patients without fQRS. The in-hospital (P=0.001), 30-day (P=0.03) and 6-month (p=0.01) MACE were higher in patients with fQRS. On logistic multiple analysis, fQRS in anterior leads (OR=3.70, CI=1.68-10.02, p=0.001), fQRS in more than 2 leads (OR=5.20, CI=1.51-12.83, p=0.01), NT-proBNP (OR=1.05, CI=1.03-1.08, p=0.02) and Killip class II/III/IV were found to be significant predictors for HF hospitalization. Conclusion: Our findings suggest that fQRS can be a predictor for HF in patients with STEMI and provide a simple and readily available technique for predicting prognosis. Larger studies are required to validate these findings

Significance of myocardial injury on in-hospital clinical outcomes of in-hospital and COVID-19 patients

Introduction: Acute Myocardial injury defined by increased troponin I level is associated with poor in-hospital outcomes and cardiovascular complications in patients with COVID-19. The current study was designed to determine the implications and clinical outcome of myocardial injury in COVID-19. Methods: This retrospective study included hospitalized COVID-19 patients. Myocardial injury was defined by high sensitivity Troponin I (hs-TNI)≥26ng/l. Cardiac biomarkers, inflammatory markers and clinical data were systemically collected and analyzed. Hazard ratio for in-hospital mortality and logistic regression for predictors of acute myocardial injury were analyzed. Results: Of the 1821 total patients with COVID-19, 293(16.09%) patients died and 1528 (83.91%) patients survived. Patients who died had significantly higher association with presence of cardiovascular risk factors, severe CTSS ( CT severity score ) and myocardial injury as compared to survived group. 628 (34.5%) patients had evidence of myocardial injury and they had statistically significant association with cardiovascular risk factors, in-hospital mortality, procalcitonin; higher hospital, and ICCU stay. We found significant hazard ratio of diabetes (HR=2.66, (CI:1.65-4.29)), Severe CT score (HR=2.81, (CI:1.74-4.52)), hs-TNI≥26 ng/l (HR=4.68, (CI:3.81-5.76)) for mortality. Severe CTSS score (OR=1.95, CI: 1.18-3.23, P=0.01) and prior CVD history (OR=1.65, CI:1.00-2.73, P=0.05) were found significant predictors of myocardial injury in regression analysis. Conclusion: Almost one third of hospitalized patients had evidence of acute myocardial injury during hospitalization. Acute myocardial injury is associated with higher hospital and ICCU stay, mortality, higher in-hospital infection which indicates more severe disease and the poor in-hospital outcomes