Role of Low-Level Laser Therapy in the Management of Temporomandibular Joint Arthralgia.

To study the efficacy of low-level laser therapy in the management of temporomandibular joint arthralgia. Design Interventional study (pre-post study), Setting Meenakshi Medical College And Hospital, Research Institute. Subjects 50 patients with temporomandibular joint arthralgia were evaluated for pain, mouth opening and clicking sound while mouth opening before and after treatment. Method Patients are subjected to undergo low-level laser therapy with Infrared and red rays with a therapeutic dosage ranging from 8 J/cm2 to 15 J/cm2 up to 3-5 sessions for a month each session lasts for 15-20 min. The patients are to be followed up regularly after 1, 3, 6 and 8 months in the study.The study measured the range of mouth opening in patients before and after undergoing low-level laser therapy. Before treatment, the range of mouth opening was from 2.78 to 3.97 cm, with a mean value of 2.78 cm and a standard deviation of 0.22. After treatment, the range of mouth opening was from 2.78 to 3.97 cm, with a mean value of 3.97 cm and a standard deviation of 0.24. The study also measured the VAS score for pain, with a mean and standard deviation of 7.9 ± 0.73 before treatment and 0.88 ± 0.718 after treatment. There was a significant difference between the pretreatment and post-treatment VAS scores, with a P-value of 0.05. Low-level laser therapy is an effective non invasive treatment modality for temporomandibular joint arthralgia. The patients who underwent this procedure had symptomatic relief and no remissions were observed.

Impact of COVID-19 lockdown on the atmospheric boundary layer and instability process over Indian region.

The abrupt reduction in the human activities during the first lockdown of the COVID-19 pandemic created unprecedented changes in the background atmospheric conditions. Several studies reported the anthropogenic and air quality changes observed during the lockdown. However, no attempts are made to investigate the lockdown effects on the Atmospheric Boundary Layer (ABL) and background instability processes. In this study, we assess the lockdown impacts on the ABL altitude and instability parameters (Convective Available Potential Energy (CAPE) and Convective Inhibition Energy (CINE)) using WRF model simulations. Results showed a unique footprint of COVID-19 lockdown in all these parameters. Increase in the visibility, surface temperature and wind speed and decrease in relative humidity during the lockdown is noticed. However, these responses are not uniform throughout India and are significant in the inland compared to the coastal regions. The spatial variation of temperature (wind speed) and relative humidity shows an increase and decrease over the Indo Gangetic Plain (IGP) and central parts of India by 20% (100%) and 40%, respectively. Increase (80%) in the ABL altitude is larger over the IGP and central parts of India during lockdown of 2020 compared to similar time period in 2015-2019. This increase is attributed to the stronger insolation due to absence of anthropogenic activity and other background conditions. At the same time, CAPE decreased by 98% in the IGP and central parts of India, where it shows an increase in other parts of India. A prominent strengthening of CINE in the IGP and a weakening elsewhere is also noticed. These changes in CAPE and CINE are mainly attributed to the dearth of saturation in lower troposphere levels, which prevented the development of strong adiabatic ascent during the lockdown. These results provide a comprehensive observation and model-based insight for lockdown induced changes in the meteorological and thermo-dynamical parameters.

Anthropogenic influence on the changing risk of heat waves over India.

The overarching goal of this paper is to shed light on the human influence on the changing patterns of heat waves in India using the Heat Wave Magnitude Index daily (HWMId). The HWMId obtained from the observational data sets shows a large increase in the heat waves during the past decades. Investigating the effects of natural (e.g., solar variations and volcanic forcings) and anthropogenic (e.g., greenhouse gas emissions, anthropogenic, land use, and land cover) forcings revealed that the anthropogenic factors have cause a two-fold increase in the occurrence probability of severe heat waves in central and mid-southern India during twentieth century. The spatial distribution of maximum HWMId values under natural and all forcings (including anthropogenic) indicates that in most places human activities have increases the frequency, duration and intensity of extreme heat waves. Under the Representative Concentration Pathway (RCP) 4.5, the risk of heat waves is projected to increase tenfold during the twenty-first century. More than ~ 70% of the land areas in India is projected to be influenced by heat waves with magnitudes greater than 9. Furthermore, we find a significant relationship between heat waves and deficits in precipitation. Results show that concurrent heat waves and droughts are projected to increase in most places in India during the twenty-first century.

Do Regional Nerve Blocks Before Bimaxillary Surgery Reduce Postoperative Pain?

PURPOSE: Any elective surgery should be as atraumatic to the patient as possible to allow for a comfortable postoperative recovery. The present study was performed to evaluate the efficacy of preoperative regional blocks in reducing pain, discomfort, and analgesic use in patients scheduled to undergo bimaxillary surgery. PATIENTS AND METHODS: A prospective, double-blind, randomized controlled trial was conducted to include all patients aged 16 to 30 years requiring bimaxillary surgery. We excluded patients with syndromes and systemic conditions. The primary predictor variable was the maxillary and mandibular nerve blocks (extraoral lateral pterygoid method) administered preoperatively in the operating room using 0.25% bupivacaine hydrochloride. Standard anesthetic and postoperative protocols were followed. The primary outcome variable was postoperative pain. The secondary outcome variables were postoperative discomfort, analgesic consumption, duration of surgery, and blood loss. The unpaired t test and Mann-Whitney U test were used for statistical analyses, with P < .05 considered to indicate statistical significance. RESULTS: A total of 110 patients were included in the study (55 in the control group and 55 in the test group), of whom 61 were female and 49 were male. Postoperative pain, recorded using a visual analog scale was significantly lower (P < .001) in the test group compared with the control group. Secondary outcome variables such as postoperative discomfort and analgesic consumption were also significantly lower in the test group. A significant positive correlation was present between the duration of surgery and pain measured at 6, 12, 24, and 48 hours postoperatively in both groups. CONCLUSIONS: From our results, it can be established that the administration of preoperative regional blocks using 0.25% bupivacaine immediately before bimaxillary surgery can effectively minimize patients' postoperative pain, discomfort, and consumption of analgesics.

Domestic violence against women: A hidden and deeply rooted health issue in India.

BACKGROUND: Domestic violence was identified as a major contributor to the global burden of ill health in terms of female morbidity leading to psychological trauma and depression, injuries, sexually transmitted diseases, suicide, and murder. AIMS: The study was conducted to find out the prevalence of different types of lifetime domestic violence against women, factors associated with it, and care-seeking behavior. SETTINGS AND DESIGN: An observational cross-sectional study conducted at a slum of Burdwan district of West Bengal, India. METHODS AND MATERIAL: Study was done among 320 ever-married women of 15-49 years of age using a predesigned pretested proforma from March 2019 to December 2019 by face-to-face interview. STATISTICAL ANALYSIS USED: Data were compiled and analyzed by EpiInfo 6 and SPSS 20 version. RESULTS AND CONCLUSIONS: The overall prevalence of any form of violence during the lifetime among the study population was 35.63%. Verbal/psychological violence was the most common form of domestic violence (91.23%) followed by physical (82.46%) and sexual violence (64.91%). Slapping and/or beating, kicking, and object throwing were the major forms of physical violence; humiliation (88.46%) was the commonest form of psychological violence and most common form of sexual violence was forced sexual intercourse (51.35%). About 20% of the study population faced violence every day. Older age, lower age at marriage, longer duration of marriage, lower education of husband and wife, lower family income, unemployment of the husband, and alcohol consumption of husband were associated with the occurrence of domestic violence. We have found that the prevalence of domestic violence in this group of population is high. The alarming issue is that approximately one-third of women (32.46%) who faced violence in their lifetime had never sought any help. The findings indicate to develop appropriate and culturally relevant public health interventions to increase awareness.

Retrospective analysis of a TMJ ankylosis protocol with a 9 year follow up.

OBJECTIVE: Temporomandibular joint ankylosis (TMJa) is a debilitating condition that causes difficulty in mastication, speech and mouth opening. Its treatment poses surgical and rehabilitative challenges along with a high incidence of reankylosis. This study was designed to assess the long-term outcomes with a new two phase physiotherapy protocol following conservative resection of the ankylotic mass. MATERIALS AND METHODS: 143 patients who were treated for TMJa were initially recruited, among whom 98 were inducted into the study and retrospectively evaluated using clinical records and 3-dimensional computed tomography. All the patients underwent a minimal pre auricular incision and conservative interpositional gap arthroplasty with collagen membrane. This was followed by the new two phase physiotherapy protocol with the use of a bite block. The primary outcome measures were the maximum interincisal distance, vertical ramus height and complications. The patients were followed up at monthly intervals during the first year, quarterly intervals during the second year, and at intervals of 6 months during subsequent follow-up years. The mean follow up period was 6.38 ± 2.36 years after ankylotic release. Paired student t test was used for statistical analysis. RESULTS: The mean scores for mouth opening at T1, T2 and T3 were statistically significantly different at all intervals (p < 0.0005). The mean scores for ramal length were statistically significantly different at T1 and T2 interval (p < 0.0005) and insignificant at T2 and T3 interval. No reankylosis was observed in patients who followed the physiotherapy protocol. CONCLUSIONS: In the management of TMJa, the success of the conservative surgical technique with interpositional arthroplasty is less dependent on the longevity and rigidity of the interpositional material but more indebted to the patient compliance in following the proposed physiotherapy protocol.

Historical and Projected Surface Temperature over India during the 20th and 21st century.

Surface Temperature (ST) over India has increased by ~0.055 K/decade during 1860-2005 and follows the global warming trend. Here, the natural and external forcings (e.g., natural and anthropogenic) responsible for ST variability are studied from Coupled Model Inter-comparison phase 5 (CMIP5) models during the 20th century and projections during the 21st century along with seasonal variability. Greenhouse Gases (GHG) and Land Use (LU) are the major factors that gave rise to warming during the 20th century. Anthropogenic Aerosols (AA) have slowed down the warming rate. The CMIP5 projection over India shows a sharp increase in ST under Representative Concentration Pathways (RCP) 8.5 where it reaches a maximum of 5 K by the end of the 21st century. Under RCP2.6 emission scenarios, ST increases up to the year 2050 and decreases afterwards. The seasonal variability of ST during the 21st century shows significant increase during summer. Analysis of rare heat and cold events for 2080-2099 relative to a base period of 1986-2006 under RCP8.5 scenarios reveals that both are likely to increase substantially. However, by controlling the regional AA and LU change in India, a reduction in further warming over India region might be achieved.

Rare features associated with Mobius syndrome: Report of two cases.

Mobius syndrome is a rare congenital disorder with the preliminary diagnostic criteria of congenital facial and abducent nerve palsy. Involvement of other cranial nerves, too, is common. Prevalence rate of this syndrome is approximately 1 in 100,000 neonates. It is of unknown etiology with sporadic occurrence. However, data regarding the occurrence rate in India is limited. Features such as orofacial malformations, limb defects, and musculoskeletal, behavioral, and cognitive abnormalities might be associated. A thorough evaluation to identify the condition and establishing an adequate treatment plan is of utmost important in this condition. We are reporting clinical and radiographic features of Mobius syndrome in two cases along with unusual findings of limb and neck deformity.

Web-based KAP Intervention on Office Ergonomics: A Unique Technique for Prevention of Musculoskeletal Discomfort in Global Corporate Offices.

AIMS: The purpose of this study was to evaluate web-based Knowledge, Attitude and Practice (KAP) intervention on office ergonomics - a unique method for prevention of musculoskeletal discomfort (MSD) - in corporate offices that influences behavior modification. BACKGROUND: With the increasing use of computers, laptops and hand-held communication devices globally among office employees, creating awareness on office ergonomics has become a top priority. Emphasis needs to be given on maintaining ideal work postures, ergonomic arrangement of workstations, optimizing chair functions, as well as performing desk stretches to reduce MSD arising from the use of these equipment, thereby promoting safe work practices at offices and home, as in the current scenario many employees work from home with flexible work hours. Hence, this justifies the importance of our study. OBJECTIVE: To promote safe working by exploring cost-effective communication methods to achieve behavior change at distant sites when an on-site visit may not be feasible. MATERIALS AND METHODS: An invitation was sent by the Medical and Occupational Health Team of a multinational corporation to all employees at their offices in Sri Lanka, Singapore, and Malaysia to take up an online Nordic questionnaire, a screening tool for musculoskeletal symptoms, shared in local languages on two occasions - baseline evaluation (n = 240) and a follow-up evaluation after 3 months (n = 203). After completing the baseline questionnaire, employees were immediately trained on correct postures and office ergonomics with animation graphics. The same questionnaire was sent again after a 12-week gap only to those employees who responded to the baseline questionnaire on initial assessment. STATISTICAL ANALYSIS USED: Data collected were analyzed using the Statistical Package for the Social Sciences (SPSS) version 20.0 software and variables were compared using odds ratio as well as Chi-square test. RESULTS: Of the 203 employees who responded, 47.35% had some musculoskeletal symptoms. Among them 58.7% had lower back pain, 46.9% had upper back pain, 44.1% had wrist pain, 39.5% had shoulder pain, and 37% had knee pain. The percentages are high as some participants had multiple complaints i.e. 2 or 3 complaints. However, only 40% of these employees had ongoing symptoms at the time of evaluation (past 7 days). A subsequent 3-month evaluation after web-based intervention showed a significant 41-50% decline in ongoing symptoms. CONCLUSIONS: We conclude that newer technology using web-based animation graphics is a highly efficient technique to create office ergonomics awareness and has the potential to become a best practice in countries where language is a communication barrier and an on-site visit may not be feasible due to meagre resources.

First two bilateral hand transplantations in India (Part 2): Technical details.

INTRODUCTION: This article deals with two patients who underwent bilateral hand transplantation following amputation of both upper limbs at the distal third of the foream. MATERIALS AND METHODS: The first patient had a history of loss of hands in a train accident , with possiblity of a run over element during the injury. The second patient lost his both hands in a mine blast. The preoperative work up included detailed clinical and psychological evaluation. The donor retrieval was similar in both the cases and the donors were housed in our own instittution. The donor preparation, recipient preparation and the transplant procedure was similar except for the need of primary tendon transfers in the left hand of the first patient. RESULTS: The first patient needed a free flap transfer to cover compromised skin flap on the left hand on the second day. The second hand transplant was uneventful. Both the recipients are now back to their normal daily routines. CONCLUSIONS: Hand transplantation is a potentially life altering procedure, but to optimise the results, it is imperative that there is a meticulous planning and diligent execution with utmost importance to the detail coupled with a synchronised team effort.

First two bilateral hand transplantations in India (Part 4): Immediate post-operative care, immunosuppression protocol and monitoring.

INTRODUCTION: Being able to counter immune-mediated rejection has for decades been the single largest obstacle for the progress of vascular composite allotransplantation (VCA). The human immune system performs the key role of differentiating the 'self ' from the 'non-self '. This, although is quintessential to eliminate or resist infections, also resists the acceptance of an allograft which it promptly recognises as 'non-self'. MATERIALS AND METHODS: Pre-operative evaluation of the recipient evaluation included immunological assessment in the form of panel reactive antibodies (PRA), human leucocyte antigen (HLA) typing, donor-specific antibody detection assays (DSA) and complement-dependent cytotoxicity assays (CDC). Induction immunosuppression was by thymoglobulin and the maintenance by the standard triple-drug therapy. RESULTS: Both the recipients were managed by the standard triple drug therapy and have had only minor episodes of rejections thus far which have been managed appropriately. DISCUSSION: Induction immunosuppression was by thymoglobulin and the maintenance by the standard triple-drug therapy. Various groups have tried various other formulations and regimes as well. CONCLUSION: A comprehensive plan has to be drawn up for immunological screening, selection and the post-operative immunosuppressant usage. The ultimate goal of these immunosuppression modalities is to achieve a state of donor-specific tolerance.

First two bilateral hand transplantations in India (Part 1): From vision to reality.

INTRODUCTION: Vascularized composite tissue allotransplantation is a relatively new concept, which was unavailable in the Indian subcontinent till a bilateral hand transplant was carried out successfully in January 2015. MATERIALS AND METHODS: The setting up of the transplant programme involved obtaining legal clearances, creating public awareness, harnessing the institutional facilities, drawing up protocols, assembling the surgical team, managing immunological issues, rehabilitation and preparing the ancillary services. RESULTS: Both, the first and second bilateral hand transplants were resounding successes with both the recipients getting back to their original daily routines. CONCLUSIONS: The organisation of the hand transplant programme was a large task, which necessitated intensive planning, and cooperation from various teams within and outside the institution. Exemplary team-work was the key to the phenomenal success of these path breaking endeavors in the subcontinent.

First two bilateral hand transplantations in India (Part 3): Rehabilitation and immediate outcome.

INTRODUCTION: This report covers the strategies adopted for rehabilitation for the first and second dual hand transplants performed in India. MATERIALS AND METHODS: The team, under a trained physiatrist, including physiotherapy and occupational therapy personnel, was involved in the management of both these patients. The management protocol was developed considering previous reports as well as our management strategies in the rehabilitation of the replanted hands. The involvement of the team with the patients started in the 1st week itself and continued on a daily basis for the entire year. RESULTS: Outcome analysis was performed at 6 months and 1 year using the disability of shoulder and hand evaluation and hand transplant scoring system. Functional magnetic resonance imaging was done at the end of 1 year to assess the cortical integration of the transplanted hand. CONCLUSION: Despite more than 110 hands being transplanted worldwide, hand transplant remains an experimental procedure. It is still not considered the "standard of care" for hand amputees. Outcome analyses performed worldwide do indicate that the procedure can provide a substantial improvement in the quality of life for the hand amputee, especially the bilateral amputees.

Effective Office Ergonomics Awareness: Experiences from Global Corporates.

BACKGROUND: Use of laptops and hand-held devices increase the risk of musculoskeletal disorders (MSDs). More time spent on this activity adopting faulty postures, higher the risk of developing such injuries. This study addresses training on office ergonomics with emphasis on sustainable behavior change among employees to work in safe postures, as this is a top priority in the corporate environment, today. AIM: To explore training intervention methods that ensure wider coverage of awareness on office ergonomics, thereby promoting safer working and suggesting sustainable programs for behavior change and job enrichment. MATERIALS AND METHODS: A cross-sectional study was conducted (2012 - 2017), encompassing corporate office employees of multinational corporations selected from India, Dubai (U.A.E), Nairobi (East Africa), Durban (South Africa), South East Asian countries (Philippines, Vietnam, Indonesia, Singapore, Malaysia, Thailand and Sri Lanka).Participant employees (n = 3503) were divided into two groups to study the effect of interventions'; i.e., (a) deep training: 40 minute lecture by the investigator with a power point presentation (n = 1765) using a mock workstation and (b) quick training: live demonstrations of 10 minutes (n = 1738) using a live workstation. RESULTS: While deep training enhanced awareness in 95.51% and quick training in 96.59% globally, the latterwas much appreciated and educated maximum employees. From statistical analysis, quick training was found superior in providing comprehensive training and influencing behavior modification in India, but all over the world it was found highly superior in knowledge enlargement, skills enrichment in addition to providing comprehensive training (P < 0.05). In countries, located to West of India, it significantly influenced behavior modification. CONCLUSION: As because few employees attend deep training lectures, the quick 10-minute program is highly promising as it is practical, replicable, yields increased awareness with wider employee coverage in a much shorter time, instilling a feeling of caring and confidence amongst them towards a robust office ergonomics program. This could lead to propose as a best practice for corporate offices globally.

Field of Psychiatry: Current Trends and Future Directions: An Indian Perspective.

Attempting to predict future is dangerous. This is particularly true in medical science where change is a result of chance discoveries. Currently, practicing psychiatrists are aware of deficiencies in psychiatric practice. However, we have a number of genuine reasons for optimism and excitement. Genetics, novel treatment approaches, new investigative techniques, large-scale treatment trials, and research in general medicine and neurology will give better insights in psychiatric disorders and its management. Psychiatric services in rural India can be reached by telemedicine. There are some threat perceptions which require solving and remedying. Subspecialties in psychiatry are the need of the hour. There is also a requirement for common practice guidelines. Mental Health Care Bill, 2013, requires suitable amendments before it is passed in the Indian Parliament. Research in psychiatry is yet to be developed as adequate resources are not available.

Effect of external volume expansion on the survival of fat grafts.

INTRODUCTION: External volume expansion (EVE) is one method, which has been utilised for increasing the survival of adipose tissue grafts. EVE releases positive pressure from the graft and also induces intense levels of edema that decreases diffusion of metabolites essential for graft survival initially. The ideal timing of external volume expansion in relation to the injection of the fat to facilitate survival is not yet clear. AIMS AND OBJECTIVES: This study was undertaken to evaluate and compare the efficacy of external volume expansion applied at variable time points in relation to the injection of the fat. MATERIALS AND METHODS: Athymic mouse was the animal model and human lipo-aspirate mixed with PRP was used as graft. An indigenous dome shaped silicone device was fabricated to deliver a negative pressure of -30 mm of Hg. The EVE was applied at variable time intervals. At the end of 4 weeks visual, histological and radiological features of the injected fat were compared. The adipose tissue was stained with human vimentin to ascertain the origin of the retained fat. RESULTS: All the grafts, which had EVE, had significantly better volume retention and vascularity. The groups which underwent a delayed EVE or prior expansion followed by concomitant graft injection and expansion showed the most optimal vascularity and graft retention. CONCLUSIONS: A delayed EVE or prior expansion followed by concomitant graft injection and expansion may be the most ideal combinations to optimize graft take. However, on account of the relatively small sample size, there was a limitation in drawing statistically significant conclusions for certain variables.

Twofold processing for denoising ultrasound medical images.

Ultrasound medical (US) imaging non-invasively pictures inside of a human body for disease diagnostics. Speckle noise attacks ultrasound images degrading their visual quality. A twofold processing algorithm is proposed in this work to reduce this multiplicative speckle noise. First fold used block based thresholding, both hard (BHT) and soft (BST), on pixels in wavelet domain with 8, 16, 32 and 64 non-overlapping block sizes. This first fold process is a better denoising method for reducing speckle and also inducing object of interest blurring. The second fold process initiates to restore object boundaries and texture with adaptive wavelet fusion. The degraded object restoration in block thresholded US image is carried through wavelet coefficient fusion of object in original US mage and block thresholded US image. Fusion rules and wavelet decomposition levels are made adaptive for each block using gradient histograms with normalized differential mean (NDF) to introduce highest level of contrast between the denoised pixels and the object pixels in the resultant image. Thus the proposed twofold methods are named as adaptive NDF block fusion with hard and soft thresholding (ANBF-HT and ANBF-ST). The results indicate visual quality improvement to an interesting level with the proposed twofold processing, where the first fold removes noise and second fold restores object properties. Peak signal to noise ratio (PSNR), normalized cross correlation coefficient (NCC), edge strength (ES), image quality Index (IQI) and structural similarity index (SSIM), measure the quantitative quality of the twofold processing technique. Validation of the proposed method is done by comparing with anisotropic diffusion (AD), total variational filtering (TVF) and empirical mode decomposition (EMD) for enhancement of US images. The US images are provided by AMMA hospital radiology labs at Vijayawada, India.

Management and Treatment Outcomes of Maxillofacial Fibro-osseous Lesions: A Retrospective Study.

INTRODUCTION: Fibro-osseous lesions are a diverse group of bone disorders and include developmental, reactive or dysplastic diseases and neoplasms. They share overlapping clinical, radiographic and histopathologic features and demonstrate a wide range of biological behaviour. AIM: To evaluate the characteristics, treatment and outcome of benign fibro-osseous lesions of the jaws. PATIENTS AND METHOD: All patients with fibro-osseous lesions of the jaws treated at the department of Oral and Maxillofacial Surgery of the Kamineni Institute of Dental Sciences from 2007 to 2013 were included in this study. RESULTS: Six males and four females were treated. Juvenile ossifying fibroma was most often encountered (40 %), and the mandible was the most frequent location (70 %). Main clinical feature in most of the cases was a painless expansile swelling with facial asymmetry, and radiologically mixed (radiolucent and radiopaque lesions) were seen in majority of cases. All cases were surgically treated and histopathologically confirmed. Segmental ostectomy was performed in six cases; maxillectomy was done in one case and excision along with margin in three cases. Mean follow-up was of 3.3 years with no recurrence. CONCLUSIONS: Fibro-osseous lesions, although sharing similar microscopic features, exhibit a variety of clinical behavior rendering their treatment highly individualized. Radical treatment is the choice to achieve an outcome without recurrence.

Psychiatry in Mumbai: What can be done to Expand Services?

Mumbai and its suburbs constitute a huge population. There are limited services here in the field of psychiatry, mainly located in major hospitals and teaching centres. There is a need to decentralize services. Psychiatrists themselves have limited resources to plan out community-based services, or set up centres, which would cater to all the requirements of the local population. Hence, it is necessary that a group like the Bombay Psychiatric Society make collective efforts to urge government and municipal authorities to create such facilities at different centres in the city and suburbs.

Pharmacological evaluation for anti-asthmatic and anti-inflammatory potential of Woodfordia fruticosa flower extracts.

CONTEXT: Woodfordia fruticosa Kurz. (Lythraceae) flowers are ethnopharmacologically acclaimed in the Indian medicinal system to treat asthma. OBJECTIVE: To evaluate W. fruticosa flower extracts for anti-asthmatic effect. MATERIALS AND METHODS: Ethyl acetate, acetone, methanol, and hydro-alcohol extracts of W. fruticosa flowers were obtained successively and standardized. Ability of extracts to stabilize free radicals and compound-48/80-induced mast cell degranulation was evaluated. In vitro anti-inflammatory potential of extracts at 100 and 200 µg/ml by membrane stabilization and in vivo inhibition of rat paw edema up to 5 h (100 and 200 mg/ml; p.o.) was evaluated. In vitro bronchorelaxant effect was examined against histamine- and acetylcholine (1 µg/ml; independently)-induced guinea pig tracheal contraction. Extracts were evaluated for bronchoprotection (in vivo) ability against 0.1% histamine- and 2% acetylcholine-induced bronchospasm in guinea pigs at 100 and 200 mg/ml; p.o. RESULTS: Standardization studies revealed that the methanol extract exhibited highest polyphenolic (62.66 GAE), and flavonoid (6.32 RE) content and HPLC fingerprinting confirmed the presence of gallic acid (Rt 1.383). IC50 values for DPPH scavenging and metal chelation by the methanol extract were 40.42 and 31.50 µg/ml. Methanol and ethyl acetate extracts at 100 µg/ml exhibited 06.52 and 07.12% of histamine release. Methanol, ethyl acetate, and hydro alcohol extracts at 200 mg/kg demonstrated 32.73, 29.83, 26.75% and 32.46, 9.38, 26.75% inhibition of egg albumin and carrageenan-induced inflammation, respectively. Methanol extract exhibited 100% bronchorelaxation and 48.83% bronchoprotection. CONCLUSION: Woodfordia fruticosa flower (WFF) extracts exhibited anti-asthmatic effect by demonstrating bronchoprotection, bronchorelaxation, anti-inflammatory, antioxidant, and mast cell stabilization ability.