Antidiabetic activity of a polyherbal formulation (DRF/AY/5001).

The herbal formulation, DRF/AY/5001, elicits hypoglycemic/antidiabetic effects in both normal and experimentally induced hyperglycemic (epinephrine and alloxan) rats. Further, herbal formulation treatment can significantly alter the pattern of glucose tolerance in normal and diabetic rats. It is possible that the herbal formulation may act through both, pancreatic and extra-pancreatic mechanism(s). The DRF/AY/5001 also elicited a significant antioxidant effect in alloxan diabetic rats as reflected by its ability to inhibit lipid peroxidation and to elevate the enzymatic antioxidants in pancreatic tissue. The histopathological studies during the long-term treatment have shown to ameliorate the alloxan induced histological damage of islets of Langerhans. The inhibitory effects on biochemical and histological parameters induced by herbal formulation at a dose of 600 mg/kg were almost comparable to that of standard drug, glibenclamide (4 mg/kg). The present study demonstrates that herbal formulation exhibits promisisng antidiabetic activity and helps to maintain good glycemic and metabolic control.

Anti-inflammatory, antiarthritic and analgesic activity of a herbal formulation (DRF/AY/4012).

Anti-inflammatory, antiarthritic and analgesic effect of a herbal product (DRF/AY/4012) was evaluated in animal models. Herbal product treatment induced a dose dependent anti-inflammatory activity in acute inflammatory models (carrageenin and egg-albumin induced rat hind paw edema). It also elicited promising anti-inflammatory activity in chronic inflammatory models (cotton pellet granuloma and Freund's adjuvant induced polyarthritis in rats). Further, the product inhibited the increased level of serum lysosomal enzyme activity viz. serum glutamic oxaloacetic transaminase, serum glutamic pyruvic transaminase, alkaline phosphatase and the lipid peroxidation in liver. In Freund's adjuvant induced polyarthritis, herbal product reduced the increased level of hydroxy proline, hexosamine and total protein content in edematous tissue. The product also exhibited mild to moderate analgesic activity in acetic acid induced writhing in mice. The LD50 value of the herbal product was more than 16 gm/kg by oral route in mice. The product has distinct advantages over the existing agents and deserves further developmental studies.

Phytotoxicity of volatile oil from Eucalyptus citriodora against some weedy species.

A study was undertaken to explore the phytotoxicity of volatile essential oil from Eucalyptus citriodora Hook. against some weeds viz. Bidens pilosa, Amaranthus viridis, Rumex nepalensis, and Leucaena leucocephala in order to assess its herbicidal activity. Dose-response studies conducted under laboratory conditions revealed that eucalypt oils (in concentration ranging from 0.0012 to 0.06%) greatly suppress the germination and seedling height of test weeds. At 0.06% eucalypt oil concentration, none of the seed of test weeds germinated. Among the weed species tested, A. viridis was found to be the most sensitive and its germination was completed inhibited even at 0.03%. Not only the germination and seedling growth, even the chlorophyll content and respiratory activity in leaves of emerged seedlings were severely affected. In A. viridis chlorophyll content and respiratory activity were reduced by over 51% and 71%, respectively, even at a very low concentration of 0.06%. These results indicated an adverse effect of eucalypt oils on the photosynthetic and energy metabolism of the test weeds. A strong negative correlation was observed between the observed effect and the concentration of eucalypt oil. Based on the study, it can be concluded that oil from E. citriodora possess strong inhibitory potential against weeds that could be exploited for weed management.

Modification of medical outcome study (MOS) instrument for quality of life assessment & its validation in HIV infected individuals in India.

BACKGROUND & OBJECTIVE: Several instruments have been developed specifically to assess the quality of life (QOL) in HIV infected individuals. No information is available in this aspect from India. The present study was thus carried out to assess the QOL among HIV infected persons, to study their relationship with socio-demographic characteristics and stages of disease progression, and to examine change in QOL over time. METHODS: One time assessment of QOL on 100 and repeat evaluation on 20 HIV infected persons enrolled in an ongoing longitudinal prospective study of clinical progression was done. Medical Outcome Study (MOS-QOL) core instrument was modified to suit the Indian cultural settings and interview-administered. RESULTS: The overall scale had Cronbach alpha 0.75. Instrument showed significant positive inter-domain correlations and linear association between QOL scores and CD4 counts. QOL was markedly affected in the domains of physical health, work and earnings, routine activities, and appetite and food intake. Women had significantly lower QOL scores despite having less advanced disease. The QOL scores decreased with drop in CD4 counts mainly in the physical health domains. Generally, the QOL scores were high in the follow up visit compared to baseline. INTERPRETATION & CONCLUSION: The modified MOS scale with Cronbach alpha of more than 0.7 and linear relationship between CD4 counts and the QOL scores indicated that the instrument was reliable and valid for evaluation of QOL in HIV infected persons in India. Comparative lower scores in the domains of physical health indicate medical intervention to greatly benefit the HIV infected persons. Longitudinal studies need to be undertaken to assess the impact of introduction of anti retroviral therapy (ART) through the national programme on disease progression and changes in QOL.

Continuous ambulatory peritoneal dialysis (CRPD)--an initial Indian experience.

Continuous ambulatory peritoneal dialysis (CAPD) is a widely accepted mode of renal replacement therapy. CAPD is largely underutilised in India. Twenty patients of chronic renal failure (CRF) were started on CAPD-10 on the standard straight set, 10 on the Y-set. The efficacy of CAPD was evaluated by assessment of laboratory parameters at the onset and after three months of CAPD. Significant improvements in blood, urea, serum creatinine, serum bicarbonate, serum calcium, serum phosphorous, haemoglobin level and blood pressure were observed. There was a significant deterioration in the serum lipid and protein levels on CAPD. Peritonitis was a major complication observed. On the standard set the incidence of peritonitis was one episode per 5.92 patient months compared to one episode per 19.33 patient months with the Y-set (P value = 0.05). Peritonitis occurred more frequently in the summer months. At the end of one year, 70% patients continued on CAPD, with 3 deaths, one each due to malnutrition, myocardial infarction and tunnel infection. Three patients switched over to other replacement therapies. To conclude, CAPD can emerge as a safe, viable mode of renal replacement in developing countries like India.

The cardiovascular and hemodynamic effects of erythropoietin in chronic renal failure.

OBJECTIVE: Left ventricular hypertrophy (LVH) has been identified as an independent risk factor for mortality in patients with chronic renal failure (CRF) and anemia has been proposed to contribute to LVH. The cardiovascular and hemodynamic effects of correction of anemia with recombinant human erythropoietin (rHU EPO) was assessed in a 12 week prospective study in patients with CRF. METHODS: Biochemical parameters and echocardiography were studied at the start and after three months therapy with EPO in 24 patients with CRF--11 predialysis (Group I) and 13 dialysis (Group II). RESULTS: The mean haemoglobin (Hb)--g/dl increased significantly from 7.5 +/- 1.0 to 10.1 +/- 1.1 in group I and from 6.7 +/- 0.6 to 9.4 +/- 0.8 in group II (p < 0.05) on EPO therapy. The left ventricular mass index (LVMi)--g/m2 reduced significantly from 185.6 +/- 44.6 to 158.3 +/- 4.1 in group I and from 158.0 +/- 26.9 to 131.6 +/- 22.1 in group II (p < 0.05 in both). The interventricular septal thickness (IVST) also showed a significant decline in both groups, 1.17 +/- 0.06 to 1.14 +/- 0.05 (group I) and 1.09 +/- 0.25 to 1.01 +/- 0.21 (group II), p < 0.05 in both. The thickness of the left ventricular posterior wall remained unchanged. The left ventricular end diastolic and systolic diameters (LVEDD and LVESD) significantly reduced from their baseline values in both the groups (p < 0.05). The diastolic filling parameters across the mitral valve remained unchanged in both the groups. The cardiac index (CI)--L/min/m2 decreased from 3.53 +/- 0.3 to 3.03 +/- 0.27 in group I and from 3.31 +/- 0.64 to 2.80 +/- 0.60 in group II (p < 0.05) and the total peripheral resistance (TPR)--dynes/cm5/sec increased from 1567 +/- 164.8 to 1883 +/- 190.7 in group I and from 1618 +/- 375.7 to 2004 +/- 437.3 in group II. The differences in all the parameters at the start and after 3 months of EPO were comparable in groups I and II. The mean arterial pressure (MAP) changed insignificantly in both the groups. CONCLUSIONS: To conclude, this study has shown that the decrease in LVMi with EPO reflects the role of anemia in the genesis of LVH and that the correction of anemia with EPO in CRF results in regression of LVMi and has a favourable effect on cardiovascular hemodynamics.

Anaemia, iron studies and erythropoietin in patients of chronic renal failure.

OBJECTIVE: The use of erythropoietin (EPO) for the amelioration of anemia has dramatically changed the quality of life of the patients with chronic renal failure (CRF). The efficacy of a low dose EPO therapy was assessed in the prospective 6 week trial. METHODS: Assessment of hematological parameters and iron stores was done in 40 patients of CRF: Group A--20 patients of CRF receiving 40 U/kg EPO biweekly for 6 weeks and Group B--20 patients of CRF not receiving EPO. The parameters were studied at the start and at 2, 4 and 6 weeks of the study. RESULTS: A statistically significant rise in mean haemoglobin levels (7.27 +/- 1.26 g/dl to 8.60 +/- 1.66 g/dl); mean packed cell volume (21.4 +/- 4.04% to 25.4 +/- 6.54%) and mean reticulocyte count (1.28 +/- 0.4% to 2.14 +/- 0.86%) was observed on EPO therapy. Patients on EPO developed a significant decline in serum iron, serum ferritin levels, bone marrow iron stores; and a hypochromic-microcytic picture on the peripheral blood film suggestive of iron deficiency. Iron deficiency at the start, chronic infections like tuberculosis and inadequate haemodialysis were identified as causes of hyporesponsiveness to EPO therapy. Low dose EPO therapy was not associated with any major adverse effects. CONCLUSIONS: Low dose EPO (40 U/kg, biweekly) therapy is safe and effective in the management of anaemia of CRF.