Synthesis, characterization & evaluation of venom neutralization potential of silver nanoparticles mediated Alstonia scholaris Linn bark extract.

OBJECTIVE: The venom neutralization potential of silver nanoparticle(AgNP-AS) mediated bark extract of Alstonia scholaris Linn R.Br was investigated in the study. METHODS & MATERIALS: AgNP-AS was synthesized with respect to optimal temperature, pH of extract. UV-vis, FT-IR, XRD, TEM, SEM studies were used to characterize silver nanoparticles of Alstonia scholaris Linn(AgNP-AS). The potential of AgNP-AS in neutralization of venom lethality, rise in myotoxicity markers(LDH) and proinflammatory cytokines(IL6, TNFα) were evaluated in animal models. RESULTS: AgNP-AS was synthesized optimally with AgNO3 (2 mM); extract concentration, 0.2 gm/l (1% w/v); extract (pH 9) and optimal temperature (40 °C). The colour change and synthesis of AgNP-AS was validated by UV-vis analysis at 432 nm. Transmission electron microscopy of AgNP-AS showed that the particle size for AgNP-AS was 14 nm-20 nm. FT-IR revealed peaks at 3445 cm-1, 1646 cm-1, 1346 cm-1 and 1108 cm-1. From the dynamic light scattering studies the hydrodynamic diameter (115.87 nm) and zeta potential(-29.8 mV) were estimated. The EDAX exhibited a peak for silver validating that the synthesized silver was pure. The biosynthesized (AgNP-AS) could significantly neutralize Viper russelli venom(VRV) induced rise in serum lactate dehydrogenase(LDH) and proinflammatory cytokines(IL6, TNFα) in animal models. CONCLUSION: The culmination of nanotechnology with herbal medicine might endow with a really constructive tool in coming up with future drugs with fewer toxicity.

Herbs and herbal constituents active against snake bite.

Snake bite, a major socio-medical problem of south east asian countries is still depending on the usage of antisera as the one and only source of treatment, which has its own limitations. In India, mostly in rural areas, health centres are inadequate and the snake bite victims mostly depend on traditional healers and herbal antidotes, as an alternative treatment. The present review has been focussed on the varied folk and traditional herbs and their antisnake venom compounds, which might be a stepping stone in establishing the future therapy against snake bite treatment and management.

Incidence and treatment of snakebites in West Bengal, India.

OBJECTIVE: Snake envenomation is a major cause of death and disability in the developing countries. In India and neighboring countries, the four venomous snakes of concern include - Indian cobra(Naja naja), Common Krait (Bungarus caeruleus); Russell's Viper (Daboia russelli); Saw Scaled Viper (Echis carinatus). We describe the management protocol for snakebite treatment in a tertiary care hospital of Paschim Medinipur district, West Bengal based on case reports of subjects admitted and treated in Ghatal Subdivisional Hospital(GSH) during 2013-2016. METHODS &MATERIALS: We developed a structured data collection form to record demographic and clinical details of patients hospitalized at GSH between 1 January 2013 through 31 December 2016. RESULTS: Snake bite cases in Ghatal Subdivisional hospital(GSH) were assessed during the period 2013-2016. A total 18 deaths due to snakebite has been reported from this tertiary care hospital during the period. Total patients admitted in this hospital with snakebite is 1160 during the period 2013-2016. In 80% of the cases the lower extremities were affected. Preliminary first aid was provided in 45% cases. About 65% of the affected victims suffered snakebite in the morning hours. Some of the recommended drugs that were prescribed by the physicians of GSH were neostigmine, atropine, adrenaline, hydrocortisone, Amoxicillin. WBCT20 and Urea, Creatinine level were routinely performed. CONCLUSION: Hospital studies are a key source of information about snake bites. The ready availability and appropriate use of AVS, close monitoring of patients, the institution of ventilator support and if required, early referral to a larger hospital all help to reduce the mortality. Thus knowledge of the varied clinical manifestations of snake bite is important for effective management in hospitals by a complete health care team.

Ameliorating effect of Alstonia scholaris L. bark extract on histopathological changes following viper envenomation in animal models.

OBJECTIVES: The primary symptoms associated with snake envenomation are both systemic and local. The local symptoms are characterized by pain, swelling, haemorrhage and myonecrosis at the site of bite. The present study investigates the ameliorating effect of the aqueous bark extract of Alstonia scholaris bark on viper venom induced histopathological and biochemical changes in liver and kidney of swiss albino mice models. METHODS & MATERIALS: Swiss albino mice (20 ± 2)g were treated with sublethal doses(0.5 µg and 1 µg) of Vipera russelli venom(VRV) intraperitonially The following groups were assigned in the study-Group I(saline control); Group II & III(Venom treated-0.5 µg ie » LD50 and 1 µg ie 1/2 LD50) and Group IV &V(Venom-0.5 µg and 1 µg respectively incubated with Aqueous Alstonia scholaris (AAS) extract; 200 mg/kg bw) and Group VI (Antivenom serum (AVS) (2 mg/ml) followed by 1 µg Vipera russelli venom (VRV). The animals were sacrificed and their organs were immersed in Bouin's fixative for 24 h and stained with haematoxylin/eosin and observed under the microscope. The serum samples were collected from the animals and tested for serum Alanine transaminase (ALT) and Aspartate transaminases (AST) following the method of Reitman & Frankel(1957) and serum creatinine. RESULTS: The histological alterations observed in Group II and III liver sections were mainly pyknosis, karyorrhexis, cytoplasmic vacuolation, necrosis, fatty changes and hepatocytes atrophy. Sinusoidal dilatation, amyloidosis, portal vein thrombosis which was significantly reduced by AAS extract in Groups IV and V. A venom dose of 1 µg induced tubular cell acidophilia indicating cell damage, peritubular congestion, degenerating changes in the proximal tubules in the form of cytoplasmic vacuolations, partially destroyed bowman's capillaries with dilated Bowman's space in Group III that was significantly reduced by Aqueous Alstonia scholaris (AAS) (200 mg/kg bw) extract in Groups IV and Group V.AVS gave significant protection against venom induced action in Group VI. CONCLUSION: The present paper thus highlights the histopathological changes associated with Vipera russelli venom and systemic venom neutralization potential of Aqueous Alstonia scholaris (AAS) in animal models.

A retrospective study of clinico-epidemiological profile of snakebite related deaths at a Tertiary care hospital in Midnapore, West Bengal, India.

OBJECTIVE: Snakebite is one of the neglected tropical diseases that World Health Organization (WHO) aimed to eradicate. The objective of the study is to investigate the mortality and morbidity due to snakebite at Midnapore Medical College & Hospital in Paschim Medinipur district, West Bengal, India. METHODS & MATERIALS: This is a record-based, retrospective, descriptive epidemiological study conducted from January 2012 to December 2016 at Midnapore Medical College and Hospital(MMCH), Paschim Medinipur district, West Bengal. The incidence and determinants of snakebite related mortality with reference to types of envenomation, age, sex, site of bite, clinical manifestations of snakebite, bite to hospital and bite to AVS treatment time, first aid and management of snakebite were investigated during the study. The data was analyzed by SPSS (Version 18) software.All results were expressed as percentage. RESULTS: Total number of snakebite deaths in Midnapore Medical College and Hospital(MMCH) was 222 from the period 2012-2016. Number of males was 134(60.36%) and female 88 (39.63%). Maximum snakebite deaths occurred in the age group of 31-40 years during agricultural and outdoor activities. Most of the snakebites occurred during June-September. Out of the 222 cases of snakebite, 182(82%) cases were due to viper envenomation. Maximum number of cases(n = 162) were detected in the interval between 4.00 PM to 8.00 PM. The bite to hospital time was found to be 180 ± 3.5 mins (n = 190 cases) and bite to AVS injection time was found to be 240 ± 3.5 mins (n = 190 cases). The mean bleeding time was 12.55 ± 3.2 min (n = 190 cases). The mean clotting time was found to be 20.1 ± 2.55 min (n = 190 cases). The symptoms of envenomation included local signs of inflammation(100% cases), blisters and necrosis (45% cases), renal failure (20% cases), coagulopathies(57% cases), ptosis(10% cases), dysphagia(2%) and respiratory distress(15% cases). The WHO protocol for snakebite management was followed for treatment of snakebite victims. CONCLUSION: Snake bite is a neglected, life-threatening emergency in developing countries such as India and demands immediate anti-venom therapy. Hospital studies are a key source of information about snake bites. The ready availability and appropriate use of AVS, close monitoring of patients, the institution of ventilator support and if required, early referral to a larger hospital all help to reduce the mortality. Thus knowledge of the varied clinical manifestations of snake bite is important for effective management in hospitals by a complete health care team.

A hospital based epidemiological study of snakebite in Paschim Medinipur district, West Bengal, India.

OBJECTIVE: Snakebite is a serious medical problem in Paschim Medinipur district, West Bengal, India. In the present study, hospital based data on snakebite cases and deaths were collected from 10 blocks of the district to obtain a picture of this neglected public health issue. METHODS: Retrospective data of snakebite and deaths from 2012 to 2016 was collected from the 5 Rural hospitals (RH) and 5 Block level Primary Health Centres(BPHC) of the ten blocks of Paschim Medinipur district in a prescribed format addressing issues including the demographic factors regarding the victims, seasonal pattern, history of snakebite in previous 5 years, outcome of the bite, any reporting of death. RESULTS: A total number of 1633 snakebites were reported in the study during the period of 2012-2016. The hospital data from the ten blocks reported 17 deaths due to snakebite in the given period. It was found that about 34% of the snake bites occurred from June to September. The age-wise distribution of snakebite cases show that majority of snakebite affected cases were within the age of 21-45 years. Males(62%) suffered more than the females(38%). The case fatality rate reported from the hospital based data was 1.04%. 60% of the snakebites occurred during morning to noon hours. The clinical manifestation of snakebite included regional edema in the affected limb, hypotension, malaise, vomiting, abdominal pain and diarrhea. The bite to hospital time was found to be 120 ± 6.5 mins(n = 750 cases) and bite to ASV injection time was found to be 270 ± 3.5 mins(n = 750 cases). CONCLUSION: Snakebite is a neglected health issue in Paschim Medinipur district. Lack of snakebite data is due to under reporting. In the present study we have attempted to investigate the official data available on snakebite from 10 blocks of Paschim Medinipur district which has been identified for high snakebite incidence.

Evaluation of the anti-inflammatory activities of Quillaja saponaria Mol. saponin extract in mice.

OBJECTIVE: Quillaja saponaria bark contains a high percentage of triterpene saponins and has been used for centuries as antiinflammatory and analgesic agent in Chilean folk medicine. In the Present study the anti-inflammatory activities of the aqueous extract of commercially partially purified saponin from Quillaja saponaria Mol. in in vivo animal models. METHODS & MATERIALS: Aqueous extract of the plant material was prepared by cold maceration. The anti-inflammatory activity of a commercial Quillaja saponaria Mol. (QS) saponin extract was investigated by carragenan induced mice paw edema model for acute inflammation (Winter, 1962) [16]. RESULTS: The anti-inflammatory activity was evaluated by carragenan in paw edema model in swiss albino mice (18-20 g). The anti-inflammatory activity was found to be dose dependent in carragenan induced paw edema. QS was found to significantly (p < 0.05) reduce the carragenan induced mice paw edema (38.59%; 20 mg/kg bw) as compared to carragenan control. The percentage inhibition of standard anti-inflammatory drug indomethacin was (55%; 10 mg/kg, bw). CONCLUSION: The results of the present study demonstrate that the aqueous extract of Quillaja saponaria saponins (QS) possess significant anti-inflammatory activity.

Ethnobotanical survey of folklore plants used in treatment of snakebite in Paschim Medinipur district, West Bengal.

OBJECTIVE: To investigate and collect information from traditional health healers/tribal communities on the use of medicinal plants for treatment of snakebite. METHODS: The ethno-medicinal study was conducted in 8 villages of the Paschim Medinipur district of West Bengal in 2012-2013 through questionnaire and personal interviews. Following the method of Martin, information about medicinal plants used in snake bite, precise plant parts used, methods of treatment and administration was enquired from the tribal communities (Santhals, Mundas, Lodhas, Bhumijs, Oraon Kherias) of the region. RESULTS: The present study enumerates 20 ethnomedicinal plant species belonging to 16 families used by the tribal communities and medicinal healers of Paschim Medinipur district, West Bengal in treatment of snakebite. Each plant species has been listed alphabetically according to its botanical name, family, vernacular name, part(s) used, mode of preparation/administration. CONCLUSIONS: The importance of traditional medicinal system among the tribal communities of Paschim Medinipur district of West Bengal has been highlighted in the present study.