Vitamin D3 and B12 supplementation in pregnancy.

AIM: To assess the efficacy of vitamin D3 or B12 supplementation during pregnancy. METHODS: Pregnant women at 6-14 weeks in the intervention arm received oral high dose intermittent vitamin D3 and/or low dose B12 supplementation if they had vitamin D or vitamin B12 deficiency. The control arm received prescribed dietary instruction only. An additional observational arm for those mothers at booking with normal vitamin D and vitamin B12 level was also recruited. All groups received standard care during pregnancy. RESULTS: The primary endpoint of either vitamin D or B12 at term was not met. At baseline 25% participants in both the interventional and control arms had severe D deficiency (<30 nmol/l), reducing to under 3.4% in both groups. No maternal differences in vitamin D or B12 levels were found at delivery between the intervention, control, or observational groups. No significant difference in any of the pregnancy or birth outcomes was observed between three groups. CONCLUSIONS: In this study, oral supplementation of high dose intermittent vitamin D or low dose vitamin B12 regime failed to correct the relevant nutritional deficiencies in Bangladeshi pregnant women as per protocol. Both dietary supplementation and high dose vitamin D corrected severe vitamin deficiency.

The effect of community groups and mobile phone messages on the prevention and control of diabetes in rural Bangladesh: study protocol for a three-arm cluster randomised controlled trial.

BACKGROUND: Increasing rates of type 2 diabetes mellitus place a substantial burden on health care services, communities, families and individuals living with the disease or at risk of developing it. Estimates of the combined prevalence of intermediate hyperglycaemia and diabetes in Bangladesh vary, and can be as high as 30% of the adult population. Despite such high prevalence, awareness and control of diabetes and its risk factors are limited. Prevention and control of diabetes and its complications demand increased awareness and action of individuals and communities, with positive influences on behaviours and lifestyle choices. In this study, we will test the effect of two different interventions on diabetes occurrence and its risk factors in rural Bangladesh. METHODS/DESIGN: A three-arm cluster randomised controlled trial of mobile health (mHealth) and participatory community group interventions will be conducted in four rural upazillas in Faridpur District, Bangladesh. Ninety-six clusters (villages) will be randomised to receive either the mHealth intervention or the participatory community group intervention, or be assigned to the control arm. In the mHealth arm, enrolled individuals will receive twice-weekly voice messages sent to their mobile phone about prevention and control of diabetes. In the participatory community group arm, facilitators will initiate a series of monthly group meetings for men and women, progressing through a Participatory Learning and Action cycle whereby group members and communities identify, prioritise and tackle problems associated with diabetes and the risk of developing diabetes. Both interventions will run for 18 months. The primary outcomes of the combined prevalence of intermediate hyperglycaemia and diabetes and the cumulative 2-year incidence of diabetes among individuals identified as having intermediate hyperglycaemia at baseline will be evaluated through baseline and endline sample surveys of permanent residents aged 30 years or older in each of the study clusters. Data on blood glucose level, blood pressure, body mass index and hip-to-waist ratio will be gathered through physical measurements by trained fieldworkers. Demographic and socioeconomic data, as well as data on knowledge of diabetes, chronic disease risk factor prevalence and quality of life, will be gathered through interviews with sampled respondents. DISCUSSION: This study will increase our understanding of diabetes and other non-communicable disease burdens and risk factors in rural Bangladesh. By documenting and evaluating the delivery, impact and cost-effectiveness of participatory community groups and mobile phone voice messaging, study findings will provide evidence on how population-level strategies of community mobilisation and mHealth can be implemented to prevent and control noncommunicable diseases and risk factors in this population. TRIAL REGISTRATION: ISRCTN41083256 . Registered on 30 Mar 2016 (Retrospectively Registered). TRIAL ACRONYM: D-Magic: Diabetes Mellitus - Action through Groups or mobile Information for better Control.

Hypoglycaemic and antioxidant activities of Ficus racemosa Linn. fruits.

The effects of Ficus racemosa Linn. fruit extract and fraction on fasting serum glucose levels of normal, type 1 and type 2 diabetic model rats are presented. The aqueous 80% EtOH extract and its water soluble fraction of F. racemosa fruit did not show any serum glucose lowering effect on non-diabetic and type 2 diabetic rats at the fasting condition, whereas the extract showed significant hypoglycaemic effect on the type 1 diabetic model rats. Both the extract and fraction were consistently active in both non-diabetic and types 1 and 2 diabetic model rats when fed simultaneously with glucose load. On the contrary, they were ineffective in lowering blood glucose levels when fed 30 min prior to glucose load. The 1-BuOH soluble part of the ethanol extract exhibited significant antioxidant activity in DPPH free radical scavenging assay. 3-O-(E)-Caffeoyl quinate (1) was isolated for the first time from this plant, which also showed significant antioxidant activity.

Antifungal Activity of Plant Extracts against Candida Species from Oral Lesions.

Seventy five patients with oral lesions attending the different departments of Rajah Muthiah Medical College and Hospital, Annamalai University were screened for Candida. Forty six (61.3%) Candida strains were isolated from the oral lesions. Of the 46 Candida strains, Candida albicans accounted for 35 (76.08%), Candida glabrata for 5 (10.86%), Candida tropicalis and Candida krusei for 2 (4.34%) each and Candida parapsilosis and Candida guilliermondii for one (2.17%) each. Antifungal activity of ethanol extracts of five plant species that included Syzygium jambolanum, Cassia siamea, Odina wodier, Momordica charantia and Melia azedarach and two algal species, Sargassum wightii and Caulerpa scalpelliformis were tested against 25 isolated strains by disc diffusion method. Antifungal activity was observed at 100 mg/ml for Syzygium jambolanum, Cassia siamea and Caulerpa scalpelliformis and at 10 mg/ml for Sargassum wightii.

Antidiabetic activity of Caesalpinia bonducella F. in chronic type 2 diabetic model in Long-Evans rats and evaluation of insulin secretagogue property of its fractions on isolated islets.

Caesalpinia bonducella F., is a shrub widely distributed throughout the coastal region of India and is ethnically used by the tribal people of Andaman and Nicober Island as a remedy of symptoms of diabetes mellitus. This ethnic report prompted the detail investigation of hypoglycemic activity of Caesalpinia bonducella seeds, initially on physiological hyperglycemic model and then on type 1 and type 2 sub-acute diabetic animal models which has already been reported. Evaluation of different extracts from Caesalpinia bonducella in chronic type 2 diabetic model alongwith insulin secretagogue activity of five fractions isolated from the Caesalpinia bonducella seed kernel are presented in this paper. Both the aqueous and ethanolic extracts showed potent hypoglycemic activity in chronic type 2 diabetic model. Two fractions BM 169 and BM 170 B could increase secretion of insulin from isolated islets.

Urinary iodine status and thyroid dysfunction: a Bangladesh perspective.

Iodine deficiency is endemic in Bangladesh. Compulsory iodization of table salt was introduced since 1993 to prevent and improve thyroid disorders in the country. Urinary iodine status, thyroid function and antithyroid antibodies were studied in 397 newly diagnosed thyroid patients and 94 age-sex matched controls. Among thyroid patients, 96 were hyperthyroid, 185 euthyroid and 116 hypothyroid. Mean and median urinary iodine were higher (p=0.075) in thyroid patients (26.13+/-0.91 and 23.03) than controls (22.65+/-1.47 and 18.59); in hyperthyroid and euthyroid than hypothyroid (p=0.020); in multinodular (28.08+/-2.80 and 26.94) and diffuse (27.35+/-1.19 and 26.71) goitre than uninodular (23.91+/-2.37 and 19.14) and nongoitrous (NG, 21.5+/-2.05 and 18.27) (p=0.098) patients but no sex difference (p=0.466). Antimicrosomal (26.7%) and antithyroglobulin (34%) antibodies were more frequently positive among thyroid patients than controls (6.4% and 12.8% respectively) (p=0.00002 and p=0.00005 respectively). Antibody positivity was higher in diffuse (82/228) and multinodular (20/47) goitre than nongoitrous (20/56) and uninodular (13/66) goitre (p=0.046) as well as in hypothyroid (55.2%) and hyperthyroid (36.5%) than euthyroid (19.5%) patients (P<0.001). Urinary iodine correlated neither with antimicrosomal (thyroid patients: p=0.597 and control: p=0.112) nor with antithyroglobulin (thyroid patients: p=0.388 and control: p=0.195) antibody. Thyroid autoimmunity and dysfunction seems common; and interaction of salt iodization with iodine status and thyroid disorders may be important in Bangladesh.

Chemomodulatory action of Brassica compestris (var sarason) on hepatic carcinogen metabolizing enzymes, antioxidant profiles and lipid peroxidation.

The effect of two different doses (400 and 800 mg/kg body wt/day for 15 days) of a 95% ethanolic extract of the seeds of Brassica compestris (var sarason) was examined on carcinogen metabolizing phase-I and phase-II enzymes,antioxidant enzymes and glutathione content and lipid peroxidation in the liver of Swiss albino mice. Positive control mice were treated with butylated hydroxyanisole (BHA). Significant elevation in the levels of cytochrome p450 (p<0,.05), cytochrome b5 (p < 0.05) glutathione s-transferase (p<0.01), DT-diaphorase (p<0.05), superoxide dismutase (p<0.01), catalase (p < 0.001) and reduced glutathione (p<0.001) was noted in the group treated with 800 mg/kg body wt. of Brassica extract in comparison with the negative control group. Brassica compestris acted as a bifunctional inducer since it induced both phase - I and phase - H enzyme systems. Since phase-I and phase-II enzymes are considered to be reliable markers for evaluating the chemoprevention efficacy of particular test materials,these findings are suggestive of potential chemopreventive roles for Brassica seed extract.

Effect of soluble dietary fibre fraction of Trigonella foenum graecum on glycemic, insulinemic, lipidemic and platelet aggregation status of Type 2 diabetic model rats.

The soluble dietary fibre (SDF) fraction of Trigonella foenum graecum (Tf-sdf) has previously been shown to reduce postprandial elevation in blood glucose level of Type 2 model diabetic rats by delaying the digestion of sucrose. The Tf-sdf has now been investigated for its chronic effect on serum fructosamine, insulin and lipid levels, and on platelet aggregation in Type 2 diabetic rats. Tf-sdf was administered orally twice daily at a dose of 0.5 g kg(-1) for 28 days. It lowered the serum fructosamine level (P<0.05) with no significant change in the insulin level as compared with the control. Atherogenic lipids, i.e. triglycerides, cholesterol and LDL-cholesterol were found to decrease significantly in Tf-sdf fed rats (P<0.01). HDL-cholesterol showed an opposite trend (P=0.024), but serum non-esterified fatty acid (NEFA) values paralleled the atherogenic lipids (P=0.001). No significant effect on platelet aggregation (%) was found although there was a tendency to lower the aggregation (P=0.069). It is concluded that Tf-sdf has a beneficial effect on dyslipidemia and has a tendency to inhibit platelet aggregation in Type 2 model diabetic rats.

Modulatory influence of Brassica compestris Linn var sarson on phase-II carcinogen metabolizing enzymes and glutathione levels in mice.

The present study reports the modulatory influence of 95% ethanolic extract from the seeds of B. compestris on the activity of phase-II enzymes such as glutathione S-transferase (GST), DT-diaphorase (DTD) and reduced glutathione (GSH) level in the skin, lung, kidney and forestomach of the mouse. Oral treatment with the seed extract at 800 mg/kg body wt. for 15 days significantly elevated GST in lung and forestomach and DT-diaphorase in forestomach and skin and GSH level in lung, kidney forestomach and skin. The lower dose 400 mg/kg body wt was effective only in inducing GST and DT-diaphorase activity in forestomach and reduced glutathione level in lung. The findings suggest that B. compestris seed extract may block or suppress the events associated with chemical carcinogenesis at least in part, by inducing metabolic detoxification of the carcinogen.

Advanced studies on the hypoglycemic effect of Caesalpinia bonducella F. in type 1 and 2 diabetes in Long Evans rats.

Caesalpinia bonducella, widely distributed throughout the coastal region of India and used ethnically by the tribal people of India for controlling blood sugar was earlier reported by us to possess hypoglycemic activity in animal model. This prompted us to undertake a detail study with the aqueous and ethanolic extracts of the seeds of this plant in both type 1 and 2 diabetes mellitus in Long Evans rats. Significant blood sugar lowering effect (P < 0.05) of C. bonducella was observed in type 2 diabetic model. Special emphasis was given on the mechanistic study by gut absorption of glucose and liver glycogen.

Characterization of the hypoglycemic effects of Trigonella foenum graecum seed.

The whole powder of Trigonella foenum graecum seeds and its extracts were tested for their hypoglycemic effect on normal and diabetic model rats. The powder, its methanol extract, and the residue remaining after methanol extraction had significant hypoglycemic effects when fed simultaneously with glucose. The water extract of the methanol extractive-free residue of the seed powder showed significant hypoglycemic activity at different prandial states. The Soluble Dietary Fibre (SDF) fraction showed no effect on the fasting blood glucose levels of nondiabetic or NIDDM model rats. However, when fed simultaneously with glucose, it showed a significant hypoglycemic effect (p < 0.05) in NIDDM model rats. Chemical analysis showed that the major constituent of the SDF is a galactomannan. The results confirm the involvement of SDF in the hypoglycemic effect of T. foenum graecum seeds. However, compound(s) other than SDF is (are) also involved in the hypoglycemic activity.

Hypoglycemic effects of three plants from eastern Himalayan belt.

Rhizome of Costus speciosus, tuber of Nephrolepsis tuberosa, and bulb of Stephania hernandifolia, used by the local people and traditional healers in the Eastern Himalayan belt, were studied for their effects on serum glucose levels in nondiabetic and diabetic rat models at different prandial states. The results showed that in nondiabetic rat C speciosus and N tuberosa had no significant effect in the fasting or postprandial state when freeze-dried juices were fed simultaneously with glucose. However, when fed 30 min before the glucose load both C speciosus (p < 0.05) and N tuberosa (p < 0.003) showed hypoglycemic effect. To the contrary, S hernandifolia increased the serum glucose levels of nondiabetic rats in all the series of experiments (p < 0.05 or p < 0.01). In NIDDM model rats N tuberosa opposed the rise in serum glucose level when it was fed 30 min before the glucose load (p < 0.02), whereas S hernandifolia had a tendency to raise the serum glucose level. In IDDM model rats, none of these three freeze-dried juice showed any effect in the fasting state. However, C speciosus showed significant hypoglycemic effect (p < 0.002) when the juice was fed with simultaneous glucose load. In marked contrast to the findings with nondiabetic and NIDDM model rats S hernandifolia showed significant hypoglycemic effect (p < 0.05-0.006) in both the stages (fed simultaneously with, and 30 min before the glucose load) of prandial states of the IDDM model rats. The results indicated that these three plants have interesting possibilities as a source of oral hypoglycemic agents.

Studies on hypoglycemic effects of fruit pulp, seed, and whole plant of Momordica charantia on normal and diabetic model rats.

Extracts of Momordica charantia fruit pulp, seed, and whole plant were tested for their hypoglycemic effects on normal and diabetic rat models. The results show that during the oral glucose tolerance test the peak blood glucose values in rats are obtained much earlier (15-45 min) than in human subjects (around 60 min). Pulp juice of M. charantia lowered fasting blood glucose levels in normal rats (p < 0.05 at 120 min); the effect was more pronounced with the saponin-free methanol extract of the pulp juice (p < 0.05 at 60 min and p < 0.01 at 120 min). The pulp juice also had a significant hypoglycemic effect in the glucose-fed normal rats when the extract was fed 45 minutes before the oral glucose load [percentage increments over basal value (M +/- SE): 85 +/- 10 in the control group vs. 54 +/- 7 in the pulp juice group, p < 0.01]. In the IDDM model rats the pulp juice had no significant effect on blood glucose levels either in fasting or postprandial states. In the NIDDM model rats the saponin-free methanol extract of juice produced a significant hypoglycemic effect both in fasting (p < 0.05 at 120 min) and in postprandial states (sum of percentage increments over basal value: 140 +/- 26 in the control vs. 71 +/- 7 in the pulp juice group, p < 0.05). Methanol extracts of seed and of whole plant, and saponin-free methanol extract of whole plant produced no hypoglycemic effects in normal or IDDM model rats either in fasting or in postprandial states.(ABSTRACT TRUNCATED AT 250 WORDS)

Evaluation of indigenous plants in the treatment of acute shigellosis.

The clinical efficacy of three indigenous plants was compared with that of ampicillin and placebo in a randomized double blind clinical trial. Eighty-two men with shigellosis were studied. Sixteen patients received dried unripe fruit powder of 'bel' (Aegle marmelos), 19 received dried powdered plant of 'thankuni' (Hydrocotyle asiatica), 15 received a similar preparation of 'gandhavadulia' (Paederia foetida), 15 received ampicillin and 17 received a placebo. Treatment with indigenous plants did not show any clinical improvement or bacteriological cure as compared to ampicillin. The natural history of shigellosis was obtained by documenting the response of the indigenous plants and placebo treated groups.

Coccinia indica in the treatment of patients with diabetes mellitus.

Coccinia indica is a creeper which grows wildly in Bangladesh and in many parts of the Indian sub-continent. The plant has been used since ancient times as an antidiabetic drug by physicians who practice the Indian system of medicine known as Ayurvedha. We have conducted a double blind control trial with preparation from the leaves of the plant on uncontrolled, maturity onset diabetics. The trial lasted for six weeks for an individual patient. Out of the 16 patients who received the experimental preparations 10 showed marked improvement in their glucose tolerance while none out of the 16 patients in the dummy group showed such a marked improvement. This difference is highly significant (kappa 2 with Yates' correction = 11.7, P < 0.001).

An experiment to determine the active therapeutic moiety of sulphasalazine.

Sulphasalazine (S.A.S.P.) is of proven value in the treatment of ulcerative colitis, but its mode of action is unknown. When it is taken by mouth, nearly all the dose reaches the colon intact, where it is split by bacteria into sulphapyridine (S.P.) and 5-aminosalicylic acid (5-A.S.A.). An experiment was devised to determine whether the therapeutic property of S.A.S.P. is a function of the parent molecule or of these two principal metabolites. Retention enemas of S.A.S.P., S.P., and 5-A.S.A. were administered to volunteer patients with sigmoidoscopic evidence of active ulcerative colitis. The experiment was conducted as a blind controlled therapeutic trial, each patient having one of the test enemas daily for two weeks. Pronounced histological improvement was observed in approximately 30% of the patients receiving S.A.S.P. or 5-A.S.A., and in only 5% of those receiving S.P. It is concluded that the active therapeutic moiety of S.A.S.P. IS 5-A.S.A. and that the S.P. functions as a carrier ensuring that the 5-A.S.A. is liberated within the colon.