Add-on therapy of herbal formulation rich in standardized fenugreek seed extract in type 2 diabetes mellitus patients with insulin therapy: An efficacy and safety study

Objective: To assess the safety and efficacy of herbal formulation rich in standardized fenugreek seed extract (IND-2) add-on therapy in type 2 diabetes mellitus (T2DM) patients who were on insulin treatment in prospective, single arm, open-label, uncontrolled, multicentre trial. Methods: T2DM patients (n=30) with aged 18-80 years who were stabilized on insulin treatment with fasting blood sugar (FBS) level between 100-140 mg/dL received IND-2 capsules (700 mg, thrice a day) for 16 weeks. The primary endpoints were an assessment of FBS at week 2, 4, 6, 8, 12 and 16. Secondary end-points include post-prandial blood sugar level, glycosylated Hb (HbA1c), reduction in the dose of insulin and number of hypoglycemic attacks, and improvement in lipid profile at various weeks. Safety and adverse events (AEs) were also assessed during the study. Results: Study was completed in twenty T2DM patients, and there was no significant reduction in FBS and post-prandial blood sugar level after add-on therapy of IND-2. However, add-on therapy of IND-2 significantly reduced (P<0.01) the HbA1c values, requirements of insulin and hypoglycemic events as compared with baseline. Total cholesterol, high-density lipoproteins-cholesterol, and low-density lipoprotein-cholesterol levels were significantly increased (P<0.01) after IND-2 add-on therapy. Body weight and safety outcomes did not differ significantly in IND-2 add-on therapy group at week 16. Additionally, add-on therapy of IND-2 did not produce any serious adverse events. Conclusions: The results of present investigation suggest that add-on therapy of IND-2 with insulin in T2DM patients improves glycaemic control through a decrease in levels of HbA1c and number of insulin doses needed per day without an increase in body weight and risk of hypoglycemia. Thus, IND-2 may provide a safe and well-tolerated add-on therapy option for the management of T2DM.

Assessment of perception of undergraduate medical students & teachers about pharmacy practical classes in pharmacology.

Background: Pharmacology and pharmacy practice has undergone a sea change over the last century. The most notable change in pharmacy in modern times has been the virtual disappearance of the preparation and compounding of medicines. Pharmacy practical classes still form a part of the MCI curriculum in Pharmacology undergraduate teaching in many states of India including West Bengal. This study was undertaken to assess the attitude of students as well as teachers towards continuation of these practical classes in the curriculum and possible alternatives. Methods:102 students and 12 teachers participated in the study answering a structured and pre-tested questionnaire anonymously. Results: The results showed that nearly 84% students and 50% teachers wanted these practical classes to continue citing various reasons. The most popular alternative to these classes remain demonstration of clinical effects of drugs which was supported by 88.23% students and 91.66% teachers. Conclusion: Pharmacy practical classes can be continued in pharmacology curriculum. But the better beneficial alternatives can also be considered which may be more beneficial to the students.

Immunomodulatory effects of fruits of Barringtonia racemosa Linn.

Background: Barringtonia racemosa (B. racemosa) is used medicinally in treatment of diarrhoea, asthma, coughs, jaundice. It is also used as an analgesic and antipyretic. This plant has also significant anti-tumor activity. However, systematic evaluation of its immunomodulatory effects has not been reported. In present study the hydroalcoholic extract of fruits of B. racemosa has been evaluated for its immunomodulatory properties in animal models. Methods: Extract of Fruits of B. racemosa was prepared from fruit powder and methanol by macerations and filtration. Healthy albino Wistar rats of either sex having 110-160 g body weight were used for this study. 1. Delayed type hypersensitivity reaction (DTH) using Sheep red blood cells (SRBCs): After immunization with SRBC effect of cyclophosphamide and hydroalcoholic extract of B. racemosa was seen on paw volume changes in rats challenged with SRBC by using digital Plethysmometer. 2. Humoral antibody response to SRBC: Animas were immunized with SRBC and treated with cyclophosphamide and hydroalcoholic extract of B. racemosa. Serum of these animals was observed for haemagglutination titer. Results: Fruits extract at the dose of 5 mg/kg i.p. showed significant decrease in DTH response as compared to that of control group animals. However, the effect of extract was less potent as compared to that of cyclophosphamide treated group. In haemagglutination titer assay, antibody titer in case naïve control, SRBC treated, cyclophosphamide treated and extract treated groups was 1:1, 1:32, 1:8 and 1:16 respectively. Conclusions: The hydroalcoholic extract of this fruits was found to inhibit SRBCs induced DTH in rats. Similarly, SRBCs induced antibody titer was also reduced.

Histogenesis of human fetal kidney.

Background: The normal histogenesis of human kidney during fetal life gives us information regarding histological maturation of kidney Objectives: - Present study aims at establishing details of histogenesis of human kidney with time of appearance of various microscopic elements. Methods: - The present study was conducted on kidneys of 59 human foetuses of gestational age ranging from16 to 38 weeks. The pieces of kidneys were processed and paraffin blocks were formed. Sections of kidney were cut which were studied with light microscope after staining. Results: - The subcapsular nephrogenic zone became narrow with increasing fetal age and disappeared at 38 weeks of gestation. In cortex, differentiation occurs from centre to periphery as indicated by more number of mature renal corpuscles and well differentiated proximal convoluted tubule, distal convoluted tubules in deeper part than superficial part of cortex. As the fetal age increases, the number of well differentiated tubules seen in medulla went on increasing. The histological structure of kidney was almost similar to kidney at 35 weeks of gestation. Conclusion:-This may help us in understanding various renal disorders. This study can also be used for determination of age of fetus.

Placental morphometry in relation to birth weight of full term newborn babies.

Background: In obstetrics the relationship of birth weight and the perinatal outcome has long been appreciated, however an often neglected parameter is the placental changes. Placenta is a vital organ for maintaining pregnancy and promoting normal foetal development. Foetal outcome is adversely influenced by pathological changes observed in placenta. Objectives: To assess the morphology of placenta in normal and low birth weight babies. To correlate the morphometric analysis with birth weight between the two groups. Study design: Cross-sectional descriptive study. Study setting: Department of Anatomy, Chalmeda Anandrao Institute of Medical Sciences, Karimnagar, Andhra Pradesh from January to June 2011. Methods: Total 374 human placentae from uncomplicated pregnancies were studied for the morphology and compared between low birth weight babies and normal weight babies. Results: The morphometric parameters of placenta like, weight, volume were significantly lower in low birth weight group compared to normal group. Placental weight and placental volume had significant correlation with the birth weight of new born. Conclusion: The placental weight increased according to the birth weight. Placental parameters and its ratio to birth weight were significantly associated with some adverse pregnancy outcomes.