Anti-rheumatic potential vis-à-vis aconitine and hypaconitine content analysis in different Aconitum spp. from Sikkim Himalayas (India).

Aconitum spp. are important medicinal plants mentioned in Ayurveda as Ativisa or Vatsanabha. The present study aims to evaluate anti-rheumatic potential in seven Aconitum species and correlation with aconitine and hypaconitine content. Anti-rheumatic potential was analyzed through in vitro xanthine oxidase inhibition, anti-inflammatory and ROS scavenging assays; and quantification of aconitine and hypaconitine with RP-HPLC method validated as per ICH guidelines. The findings reveal that A. palmatum possessed the most promising response (IC50 =12.68±0.15 µg/ml) followed by A. ferox (IC50 =12.912±1.87 µg/ml) for xanthin oxidase inhibition. We observed a wide variation in aconitine and hypaconitine content ranging from 0.018 %-1.37 % and 0.0051 %-0.077 % respectively on dry weight basis. Aconitine and hypaconitine showed moderate positive correlation (r=0.68 and 0.59 respectively) with anti-rheumatic potential. The study identifies potential alternative species of Aconitum that can help in sustainable availability of quality raw material.

Epidemiological study of snakebite cases in Sikkim: Risk modeling with regard to the habitat suitability of common venomous snakes.

BACKGROUND: Snakebite envenoming is listed as category 'A' Neglected Tropical Disease. To achieve the target of WHO (World Health Organization) 2019, it becomes necessary to understand various attributes associated with snakebite including community awareness, improvisation of medical facilities and to map the potential distribution of venomous snakes responsible for the bite. Hence this study is conducted in Sikkim, India to understand the epidemiology of snakebite in Sikkim. The potential distribution and risk mapping of five common venomous snakes are done for effective management of snakebite cases. METHODS AND FINDINGS: The snakebite cases registered in six district hospitals and four PHCs (Primary Health Centers) of Sikkim were collected from the year 2011 to 2018. Community survey was also conducted to supplement the data. Ecological Niche Modeling (ENM) was performed to predict the potential habitat of five common venomous snakes of Sikkim. The risk modeling of snakebite cases was done at the level of Gram Panchayat Unit (GPU) using Geographically Weighted Regression (GWR) and Ordinary Linear Square (OLS) model. We found higher number of male victims inflicted with snakebite envenomation. The potential distribution of the five venomous snakes showed satisfactory mean AUC (Area under Curve) value. Both the models showed significant positive association of snakebite cases with habitat suitability of the venomous snakes. Hospital data revealed no death cases whereas community data reported 24 deaths. CONCLUSIONS: Death from snakebite reflected in community data but not in hospital data strongly indicates the people's belief in traditional medicine. Though people of Sikkim have rich traditional knowledge, in case of snakebite traditional practices may be ineffective leading to loss of life. Sensitizing people and improving medical facilities along with proper transport facilities in rural areas might significantly reduce the snakebite casualties in the state.

Rich yet undocumented ethnozoological practices of socio-culturally diverse indigenous communities of Sikkim Himalaya, India.

AIM OF THE STUDY: The indigenous people of Sikkim Himalaya possess indispensable traditional knowledge including the use of flora and fauna due to their close association with nature. The present study aims to explore the rich and undocumented ethnozoological practices of different indigenous communities of the Sikkim Himalaya. MATERIALS AND METHODS: Data was collected using semi-structured questionnaire interviews among the traditional healers and indigenous communities of Sikkim. A total of 91 respondents covering all four districts of Sikkim were interviewed from September 2017-April 2018. RESULTS: This study recorded a total of 59 species belonging to nine taxonomic groups used for traditional ethnozoological practices by the indigenous communities of Sikkim. Mammals represented 58% of the total animals followed by birds (22%). Among the total, 71% of animal species were used for zootherapy whereas 29% were used for religious customs or shamanistic practices. Almost 64% species were used for treatment of more than one disease and the chief mode of preparation was by boiling the body parts. Among different parts used in traditional medicine, meat was most preferred while horns and hairs were mostly used for religious purposes. CONCLUSION: Present findings suggest that traditional medicine including zootherapy still serves as a source of primary healthcare in rural areas of Sikkim and provides an identity to the culture of a region. We recommend documentation of more such traditional medicinal systems along with scientific validation of traditional practices with modern tools. Biodiversity Management Committees (BMCs), the legally formed bodies at local level, may be entrusted in documentation of such practices which might contribute significantly in the conservation of traditional practices and also preserves the associated traditional knowledge as per the provision of Biological Diversity Act of India.

Major ginsenoside contents in rhizomes of Panax sokpayensis and Panax bipinnatifidus.

This study compared eight major ginsenosides (Rg1, Rg2, Rf, Re, Rd, Rc, Rb1 and Rb2) between Panax sokpayensis and Panax bipinnatifidus collected from Sikkim Himalaya, India. High-performance liquid chromatographic analysis revealed that all major ginsenosides were present in the rhizomes of P. sokpayensis except ginsenoside Rc, whereas ginsenoside Rf, Rc and Rb2 were not detected in P. bipinnatifidus.

Integrating ethnobiological knowledge into biodiversity conservation in the Eastern Himalayas.

Biocultural knowledge provides valuable insight into ecological processes, and can guide conservation practitioners in local contexts. In many regions, however, such knowledge is underutilized due to its often-fragmented record in disparate sources. In this article, we review and apply ethnobiological knowledge to biodiversity conservation in the Eastern Himalayas. Using Sikkim, India as a case study, we: (i) traced the history and trends of ethnobiological documentation; (ii) identified priority species and habitat types; and, (iii) analyzed within and among community differences pertaining to species use and management. Our results revealed that Sikkim is a biocultural hotspot, where six ethnic communities and 1128 species engage in biocultural relationships. Since the mid-1800s, the number of ethnobiological publications from Sikkim has exponentially increased; however, our results also indicate that much of this knowledge is both unwritten and partitioned within an aging, gendered, and caste or ethnic group-specific stratum of society. Reviewed species were primarily wild or wild cultivated, native to subtropical and temperate forests, and pend IUCN Red List of Threatened Species assessment. Our results demonstrate the value of engaging local knowledge holders as active participants in conservation, and suggest the need for further ethnobiological research in the Eastern Himalayas. Our interdisciplinary approach, which included rank indices and geospatial modelling, can help integrate diverse datasets into evidence-based policy.

Assessment of traditional knowledge of the antidiabetic plants of Darjeeling and Sikkim Himalayas in the context of recent phytochemical and pharmacological advances.

Darjeeling and Sikkim Himalayas, a part of Eastern Himalayan Hotspot, is characterized by its richness of plant diversity. Herbal medicine has been one of the most popular and reliable healing practices among the different ethnic groups of this region for ages. However, the lack of documentation practice by the traditional healers has led to obscurity regarding the efficacy of herbal medicine among the present generation, though they have to depend on the same quite often. Meanwhile, several reviews have attempted to document the plants used for the treatment of diabetes from this region, but interestingly, very few research works can be obtained regarding the characterization of antidiabetic properties of the plants of this region. Therefore, it demands a better understanding of the potentiality of these plants in the purview of scientific evidence. This review article reports 55 such plant species which have been reported to be frequently used in the treatment of hyperglycemia and our objective was to validate the potentiality of the plants in the light of recent phytochemical and pharmacological researches being carried out locally or elsewhere.

Caterpillar Mushroom, Ophiocordyceps sinensis (Ascomycetes): A Potential Bioresource for Commercialization in Sikkim Himalaya, India.

Ophiocordyceps sinensis has a long history of use in Tibetan traditional medicine and traditional Chinese medicine as a powerful tonic and aphrodisiac. The species is inextricably linked to the trade of medicinal and aromatic plants in East Asia. Its demand has increased substantially in the international market, and its collection and trade have significantly improved the socioeconomic status of the people in some regions. Nonetheless, in Sikkim this resource is still untapped formally, but it is traded illegally. Formal legalization and the community's involvement will ensure the conservation and sustainability of the species, as well as proper management of harvesting areas and monitoring of pressure on Yartsa Gunbu to exploit it.

Long-term conditions, self-management and systems of support: an exploration of health beliefs and practices within the Sikh community, Birmingham, UK.

OBJECTIVE: The global prevalence of non-communicable diseases (NCDs), such as diabetes mellitus and coronary heart disease, continues to rise. Internationally, people of South Asian origin (i.e. by birth or heritage) are much more likely to develop and live with NCDs compared to the general population. The South Asian diaspora population is highly heterogeneous, varying by socioeconomic status, migration history, religion and ethnicity. This article reports the findings of a study to explore the types of support accessed by Punjabi Sikhs living in Birmingham and the Black Country, UK, who were living with NCDs. DESIGN: The study sought to develop a greater understanding of past experiences of accessing support and the importance of relationships in the mobilisation of resources for self-management. It was nested within a larger programme of research which explored attitudes to prevention of chronic diseases in local communities in the region. Seventeen Punjabi Sikh men and women were recruited through purposive sampling. Narrative interviews were conducted and analysed by the research team. Sociological theories on systems of support and social relations were consulted to inform the interpretation of data. RESULTS: The study findings suggest that participants interpreted chronic disease self-management in relation to four primary systems of support: health services for disease management; multiple sources of care, including traditional Indian medicines and the Internet, for symptom management; community groups for lifestyle management; and the family for emotional and physical care. Within these systems of support, participants identified barriers and facilitators to the maintenance of a healthy lifestyle. We focus on intra-group diversity; exploring the intersection of views and experiences by age, gender, generation and caste. CONCLUSION: The findings have implications for the design and delivery of primary care and community services which support the prevention and management of NCDs in an increasingly diverse population.

Chemical characterization and assessment of antioxidant potentiality of Streptocaulon sylvestre Wight, an endangered plant of sub-Himalayan plains of West Bengal and Sikkim.

BACKGROUND: S. sylvestre Wright is an extremely rare plant, found only in the sub-Himalayan Terai region of West Bengal and neighboring Sikkim foot-hills. The plant has never been evaluated for any pharmaceutical properties. The phytochemical status of the plant is still unknown. Therefore, the aim of the study was to explore the antioxidant and free radical scavenging activities and analysis of bioactive compounds present in S. sylvestre. METHODS: S. sylvestre methanolic extract (SSME) was evaluated for different free radical scavenging activities such as hydroxyl radical, nitric oxide, singlet oxygen, hypochlorous acid, peroxynitrite, superoxide radical and hydrogen peroxide scavenging etc. Iron chelating capacity and inhibition of lipid peroxidation were studied in addition to the assessment of haemolytic activity and erythrocyte membrane stabilizing activity (EMSA). Chemical characterization of SSME were performed by high performance liquid chromatography (HPLC) and gas chromatography-mass spectrometry (GC-MS). RESULTS: The results indicate that SSME possess potent antioxidant activity with IC50 value of 113.06 ± 5.67 µg/ml, 63.93 ± 4.16 µg/ml and 142.14 ± 6.13 µg/ml for hydroxyl radical, superoxide radical and hypochlorous acid, respectively. HPLC analysis revealed presence of different phenolic secondary metabolites such as gallic acid, ferulic acid, p-coumaric acid, syringic acid, myricetin, quercetin etc. GC-MS analysis displayed the predominance of γ-sitosterol, vitamin E and squalene in SSME. CONCLUSION: The present study provides a convincing evidence that S. sylvestre not only possess potent antioxidant activity but also can be used as a source of natural bioactive phytochemicals in the future.

Isolation and identification of new phytoconstituents from the fruit extract of Amomum subulatum Roxb.

The fruits of Amomum subulatum Roxb. (Zingiberaceae) (large cardamom), cultivated in the northern Himalayas, are used to treat stomach disorders, pulmonary diseases and liver complaints. Phytochemical investigation of the fruits led to the isolation of four new chemical compounds characterised as geranil-3(10)-en-9-olyl octadec-9-enoate, geranil-3(10)-en-9-carboxyl-ß-D-arabinopyranoside, geranilan-9-carboxy-α-L-arabinopyranoside and stigmast-5-en-3ß-ol-3ß-D-arabinopyranosyl-2'-(3″-methoxy) benzoate-3'-octadec-9‴,12‴,15‴-trienoate, along with the known compounds oleodilinolein and glyceryl trilinoleniate on the basis of spectral data analysis.

Economic evaluation of iodine deficiency disorder control program in Sikkim: a cost-benefit analysis.

BACKGROUND: Iodine deficiency disorders (IDDs) are the most common cause of preventable brain damage globally. The strategy of prevention and control of iodine deficiency is based on iodine supplementation. Edible salt iodization and iodized oil injections are the two most commonly used vehicles for iodine supplementation. The objective of the study was to conduct a cost-benefit analysis of the two programs of iodine supplementation, i.e., iodized salt program (ISP) and iodized oil program (IOP) against no preventive program (NPP) option. MATERIALS AND METHODS: The study was conducted in 1990 in the state of Sikkim in India. The costs were calculated on the assumption of universal coverage of ISP and coverage of IOP among all children aged 0-14 years and women in the age group of 15-44 years. Direct and indirect cost of ISP and direct cost of IOP was computed based on the costs of year 1991. The discount rate taken was 10% and all the costs were converted to the year 2010 using wholesale price index (WPI) data. Consequences in terms of health effects, Social/emotional effects, and resource use were included. RESULTS: The discounted cost of ISP and IOP was Rs. 59,225,964 and Rs. 46,145,491, respectively. In ISP, 64.1% of the total cost was required for salt iodization, 17.6% for monitoring, and 18.3% for communication. In IOP, 50.9% of the costs were required for iodized oil; rest was for syringes and needles, manpower expenses, travel, and communication. Total resource saving was Rs. 95,566,220 for ISP and Rs. 92,177,548 for IOP. Incremental benefit for ISP was Rs. 36,340,256 and Rs. 46,032,057 for IOP. The cost-benefit ratio for ISP was 1.61 and 2.00 for IOP. CONCLUSION: IOP has a higher cost-benefit ratio for prevention of IDDs than ISP in the state of Sikkim, India.

Evaluation of medicinal plants as part of Tibetan medicine prospective observational study in Sikkim and Nepal.

OBJECTIVE: Medicinal plants are the primary ingredients of Tibetan medicinal formulae. The aim of the present study was to evaluate the spectrum of medical complaints treated by a Tibetan doctor in Sikkim and Nepal, and to determine which plants the doctor used most frequently to treat these complaints. DESIGN: Two prospective observational studies were carried out at two locations (Sikkim and Nepal). Patients who visited the participating Tibetan doctor were included consecutively. Medical symptoms, Tibetan syndrome diagnoses, and treatments were documented. The most frequently used plants were identified retrospectively. RESULTS: A total of 238 patients were included (Sikkim: n = 135, 62.2% women, mean age 33.9 3.4 years; Nepal: n = 103, 54.4% men, mean age 42.9 2.4 years). The most frequent medical complaint was pain (Sikkim: 46% of patients; Nepal: 51% of patients). The most frequent Tibetan syndrome diagnosis was Bad-kan in Sikkim (20.7% of patients; a cold disorder affecting the lower body) and a combination of Bad-kan and mKhris-pa in Nepal (28.2%; a mixed cold/hot disorder affecting the lower and middle body). A total of 71 different Tibetan medicines were prescribed, including 138 different plants. Of these 138 plants, 81 typically grow at high and medium altitudes, and 57 grow in tropical and subtropical areas. Nevertheless, most (93%) of the prescribed formulae contained high-altitude plants. CONCLUSIONS: For the first time, information on medical complaints and treatments has been evaluated systematically for patients receiving treatment from a Tibetan doctor. These data provide a good foundation for further research on Tibetan medicine. Further studies should go a step farther and include follow-up data and information about the effectiveness and safety of Tibetan medicines.

Religious beliefs about causes and treatment of epilepsy.

BACKGROUND: It has been acknowledged that religious and complementary therapies are commonly used among South Asian communities in the UK. However, little is known about their religious beliefs in relation to epilepsy and the type of South Asian therapies that they use to treat the condition. AIM: To explore the influences of spiritual and religious beliefs on explanation of the cause of epilepsy, and the choice of treatment in people of South Asian origin who have epilepsy. DESIGN OF STUDY: Qualitative study using interviews with patients, carers, health professionals, and focus groups of people from minority ethnic communities. SETTING: Bradford and Leeds. METHOD: Semi-structured individual interviews with 20 Muslims, six Sikhs, and four Hindus with epilepsy; 16 nominated carers (family members, friends); 10 health professionals (specialist GPs, neurologists, specialists nurses, social workers, community GPs); and two focus groups with a total of 16 South Asians without epilepsy. RESULTS: It was found that over half of responders attributed their illness to fate and the will of God, or as punishment for sins of a past life. Some patients had experienced prejudice from people who believed that their epilepsy was contagious. A strong network of traditional healers was found, providing a parallel system of health care in the UK and on the Indian subcontinent. People turned to religiospiritual treatments in desperation for a cure, often under the influence of their families after the perceived failure of Western medicine. Such treatments were viewed as complementary rather than as an alternative to Western medication. Younger people in particular expressed considerable scepticism about the effectiveness of these traditional South Asian treatments. CONCLUSIONS: In this study's South Asian sample, patients commonly turned to traditional healers in search of better health. Health professionals should be aware of the belief systems of these patients and understand the types of treatments in common use. Although these treatments might potentially compete with Western health care, they are used as an adjunct rather than a substitute. Patients have a 'healthy' scepticism about the effectiveness of such treatments, and adherence to medical therapy does not appear to be affected.

Anti-inflammatory activity of Indian black tea (Sikkim variety).

In this study, the anti-inflammatory (in reference to the cardinal signs of inflammation) and other related pharmacological activities of the hot water extract of black tea (Camellia sinensis, Sikkim variety) were evaluated along with certain standard drugs. The extract showed significant inhibitory activity against carrageenin, histamine, serotonin and prostaglandin-induced pedal inflammation. The extract inhibited exudative inflammation. The tea extract also inhibited cotton pellet-induced granuloma formation and adjuvant-induced polyarthritis. Black tea extract showed significant inhibition against glucose oxidase-mediated inflammation. The present observations establish the efficacy of this particular variety of black tea, both in the exudative and proliferative forms and as well in the chronic phase of inflammation.

(-)-Epigallocatechin-3-gallate in Camellia sinensis leaves from Himalayan region of Sikkim: inhibitory effects against biochemical events and tumor initiation in Sencar mouse skin.

Recently, we and others showed that the components of green tea may be useful cancer chemopreventive agents. It has been suggested that (-)-epigallocatechin-3-gallate (EGCG), the major constituent in green tea, may possess antitumor-promoting and/or anticarcinogenic effects in rodent tumor bioassay systems. During the chemical analysis of various green tea products, we found a traditionally preserved preparation of green tea used by tribes in the Himalayan region of Sikkim, India that was rich in EGCG. EGCG was isolated from this tea product, and its inhibitory effects were evaluated against the binding of topically applied 3H-labeled polycyclic aromatic hydrocarbons (PAHs) to epidermal DNA and 12-O-tetradecanoylphorbol-13-acetate (TPA) caused induction of epidermal ornithine decarboxylase (ODC) activity in Sencar mice, the short-term markers of tumor initiation and tumor promotion, respectively. Preapplication of EGCG resulted in significant inhibition (p less than 0.05) in the binding of [3H]PAH to epidermal DNA. Similarly, the topical application of EGCG resulted in significant inhibition (p less than 0.005) in TPA-caused induction of epidermal ODC activity. In further studies, we assessed the anti-skin tumor-initiating effect of EGCG in Sencar mice in an initiation-promotion protocol. The application of EGCG before challenge with 7,12-dimethylbenz[a]anthracene as tumor initiator resulted in significant reduction both in percentage of mice with tumors and number of tumors per mouse compared with a non-EGCG-pretreated group of animals. The results of the present study suggest that the green tea preparation from Sikkim may be a good source for the isolation of EGCG and that this compound may have significant potential as a cancer chemopreventive agent.