Adjunct therapy of Ayurvedic medicine with anti tubercular drugs on the therapeutic management of pulmonary tuberculosis.

BACKGROUND: Pulmonary tuberculosis (PTB) is an age old disease described in Vedic Medicine as 'Yakshma'. Later on, in Ayurveda it earned a prefix and found way into mythology as 'Rajayakshma'. After the discovery of streptomycin, the therapeutic management of PTB received a major breakthrough. The treatment module changed remarkably with the formulation of newer anti-tubercular drugs (ATD) with appreciable success. Recent resurgence of PTB in developed countries like United States posed a threat to the medical community due to resistant strains. Consequently, WHO looked toward traditional medicine. Literature reveals that Ayurvedic treatment of PTB was in vogue in India before the introduction of ATD with limited success. Records show that 2766 patients of PTB were treated with Ayurvedic drugs in a tertiary care hospital in Kolkata in the year 1933-1947. OBJECTIVES: To evaluate the toxicity reduction and early restoration by adjunct therapy of Ayurvedic drugs by increasing the bio-availability of ATDs. MATERIALS AND METHODS: In the present study, treatment response of 99 patients treated with ATD as an adjunct with Aswagandha (Withania somnifera) and a multi-herbal formulation described in Chikitsa-sthana of Charaka samhita i.e. Chyawanprash were investigated. Hematological profile, sputum bacterial load count, immunoglobulin IgA and IgM, blood sugar, liver function test, serum creatinine were the assessed parameters besides blood isoniazid and pyrazinamide, repeated after 28 days of treatment. RESULTS: The symptoms abated, body weight showed improvement, ESR values were normal, there was appreciable change in IgA and IgM patterns and significantly increased bioavailability of isoniazid and pyrazinamide were recorded. CONCLUSION: This innovative clinical study coupled with empowered research may turn out to be promising in finding a solution for the treatment of PTB.

Effect of Ayurvedic mercury preparation Makaradhwaja on geriatric canine--a preliminary study.

Makaradhwaja, an alchemical Ayurvedic mercury preparation is used as stimulant and vitalizer. Towards veterinary practices, the acceptability, tolerability and toxicity studies were undertaken in geriatric pet dogs aged more than 10 years irrespective of breed and sex for future use. Makaradhwaja (2.5 mg/kg) was used with honey once daily for 30 days. Before and after treatment, blood was collected for hematological studies as well as liver, kidney function and anti-oxidant activity. In control group, honey itself showed no appreciable change whereas, Makaradhwaja lowered neutrophil and total leucocyte count. Serum cholesterol, urea, glucose, alanine amino transferase, aspartate amino transferase, sodium, phosphorus and calcium were decreased. Haemoglobin and serum creatinine were significantly increased. There was appreciable physical, behavioral and body weight change including quality of life. The dose was used in replication of human dose (125 mg/50 kg). Anti-oxidant study showed significant increase of lipid per oxidation in experimental group while the values of ABTS radical cation decolorisation assay although decreased but did not show any significant changes. Decrease of serum urea and increase of serum creatinine could not be explained on single dose response. Different dose study could only explain the optimum dose to be required in canine practices.

A study on evalution of antidepressant effect of imipramine adjunct with Aswagandha and Bramhi.

Depressive disorders increase the risks of self-harm or even suicide in patients. Indigenous drugs are being tried to treat such patient along with conventional antidepressant drugs. This study was planned to investigate the antidepressant action of Ashwagandha and Bramhi and also to confirm its efficacy in the behavioural despair animal model of depression. Normal saline as control (5 ml/kg), Imipramine as standard (16, 32, 64 mg/ kg) and Ashwagandha (50, 100, 150 mg/kg), Bramhi (20, 40, 80 mg/kg) as test drugs were introduced to the albino rats weighing between 200-250 gm for 2 weeks, 1 hr before electric shock in Learned helplessness test (LHT) and swimming in Forced swimming test (FST). Effects of individual drugs as well as their combination were evaluated. Avoidance response, escape failure and immobility period in case of Imipramine and Ashwagandha showed highly significant (p < 0.01) result on individual use. There was no significant result in case of Bramhi used alone except in escape failure and immobility period (FST), where at higher doses it showed significant (p < 0.01) result. But combination of Bramhi and Ashwagandha in low doses with low dose of Imipramine gave a highly significant result (p < 0.01) in all the parameters. Ashwagandha had significant antidepressant action, but Bramhi had not when used alone. Combination of these two indigenous drug with Imipramine showed high efficacy in animal model.

A clinical study on the management of generalized anxiety disorder with Centella asiatica.

Centella asiatica is reputed for its beneficial effects in various neurological disorders. The present investigation was undertaken to evaluate the role of 70% hydro-ethanolic extract of Centella asiatica (CA) on generalized anxiety disorder (GAD) in man. Hamilton's Brief Psychiatric Rating Scale (BPRS) was used to screen the subjects. Thirty-three participants (18 male and 15 female; average age 33 yrs) were medicated with the CA in a fixed dose regime (500 mg/capsule, twice daily, after meal). They were thoroughly investigated using standard questionnaires based on psychological rating scale at baseline (day 0), mid-term (day 30) and final (day 60). The scale also includes a number of direct queries about current levels of experienced stress. The observations revealed that, CA not only significantly (p<0.01) attenuated anxiety related disorders but it also significantly (p<0.01) reduced stress phenomenon and its correlated depression. CA further significantly (p<0.01) improved the willingness for adjustment and cognition. Results indicated that Centella asiatica may be useful in the treatment of GAD and may be used as a promising anxiolytic agent in near future.

Clinical evaluation of spermatogenic activity of processed Shilajit in oligospermia.

The safety and spermatogenic activity of processed Shilajit (PS) were evaluated in oligospermic patients. Initially, 60 infertile male patients were assessed and those having total sperm counts below 20 million ml(-1) semen were considered oligospermic and enrolled in the study (n = 35). PS capsule (100 mg) was administered twice daily after major meals for 90 days. Total semenogram and serum testosterone, luteinising hormone and follicle-stimulating hormone were estimated before and at the end of the treatment. Malondialdehyde (MDA), a marker for oxidative stress, content of semen and biochemical parameters for safety were also evaluated. Twenty-eight patients who completed the treatment showed significant (P < 0.001) improvement in spermia (+37.6%), total sperm count (+61.4%), motility (12.4-17.4% after different time intervals), normal sperm count (+18.9%) with concomitant decrease in pus and epithelial cell count compared with baseline value. Significant decrease of semen MDA content (-18.7%) was observed. Moreover, serum testosterone (+23.5%; P < 0.001) and FSH (+9.4%; P < 0.05) levels significantly increased. HPLC chromatogram revealed inclusion of PS constituents in semen. Unaltered hepatic and renal profiles of patients indicated that PS was safe at the given dose. The present findings provide further evidence of the spermatogenic nature of Shilajit, as attributed in Ayurvedic medicine, particularly when administered as PS.

Effect of Pueraria tuberosa tuber extract on chronic foot shock stress in Wistar rats.

The present study was undertaken to explore the protective effects of tuberous root extract of Pueraria tuberosa on chronic foot shock stress (CS) induced physiological, neurobehavioral and neuropathological alterations. Male Wistar rats (120-150 g) were divided into seven groups, consisting of ten animals in each. Group I served as normal, group II as positive control, while group III-VII as test drug treated. P tuberosa tuber extract (PTE) was given to rats of groups III-VI at the doses of 50, 100, 200 and 400 mg/kg respectively, while group VII treated with Withania somnifera rhizome extract (WSE) (100 mg/kg) as reference drug. Group II (stress control) received only equivalent volume of distilled water (0.5 ml/100 g) orally. All the drugs were given orally once/day for 14 consecutive days. The last dose was given 1 h before study. Simultaneously, all the animals (except group I) were subjected to 1 h of foot-shock (2 mA) through a grid floor for those 14 days in a standard conditioning chamber with the escape route closed [Chronic stress (CS)]. Thereafter, the rats were placed on open-field and plus maze apparatus for studying the behavioral patterns of them, and the anxiolytic effects of the putative drug. Sexual activities of the animals were also studied. Finally, the animals were sacrificed and their ulcer formation in gastric mucosa was noted. Weights of adrenals and spleen were also taken. Further, plasma corticosterone levels were estimated spectroflurometrically. Results indicated that, CS significantly altered the behavioral patterns, decreased the sexual urge and activities, damaged the gastric mucosal layers, enhanced plasma corticosterone levels and increased adrenal glands and spleen weights. PTE and WSE showed significant anxiolytic activity, protected the gastric mucosa, lowered plasma corticosterone level (indicating HPA axis inhibition) and negated the hypertrophy of adrenals and spleen. PTE also enhanced the sexual urge and activities in animals exposed to chronic stress. The findings suggest significant anxiolytic and anti-stress properties of PTE, confirming the clinical efficacy of the plant mentioned in Ayurveda (Indian system of traditional medicine).

Controlled programmed trial of Ocimum sanctum leaf on generalized anxiety disorders.

Ocimumn sanctum, an Indian medicinal plant, has been on trial for its role in generalized anxiety disorder (GAD) in hospital based clinical set-up. Hamilton's brief psychiatric rating scale (BPRS) and thorough clinical investigations were used to screen the subjects. Thirty-five subjects (21 male and 14 female; average age 38.4 years) were medicated with the plant extract in a fixed dose regime (500 mg/capsule, twice daily, p.o. after meal). They were thoroughly investigated clinically and using standard questionnaires based on different psychological rating scale at baseline (day 0), mid-term (day 30) and final (day 60). The observations exhibited that, O. sanctum significantly (p<0.001) attenuated generalized anxiety disorders and also attenuated its correlated stress and depression. It further significantly (p<0.001) improved the willingness to adjustment and attention in human. Therefore, it may be concluded that O. sanctum may be useful in the treatment of GAD in human and may be a promising anxiolytic agent in near future.

Antiulcerogenic activity of Satavari mandur--an Ayurvedic herbo-mineral preparation.

Satavari mandur (SM) is a herbo-mineral preparation containing Asparagus racemosus, which finds mention in ancient Indian texts for treatment of gastric ulcers. The ulcer protective effect of SM, 125-500 mg/kg given orally, twice daily for three, five and seven days, was studied on cold restraint stress-induced gastric ulcer in rats. The effective regimen was found to be 250 mg/kg given for five days and hence was used for further experiments. SM showed significant protection against acute gastric ulcers induced by pyloric ligation but was ineffective against aspirin- and ethanol-induced ulcers. Further, gastric juice studies showed that, SM significantly increased the mucosal defensive factors like mucus secretion, but had little or no effect on offensive factors like acid and pepsin secretion.

Induction of antioxidative enzyme by the ayurvedic herb Desmotrichum fimbriatum Bl. in mice.

The herb Desmotrichum fimbriatum Bl. (family: Orchidaceae), sold as Jibanti in West Bengal, is used in 'Rasayana therapy' in Ayurveda. Its effect on the modulation of the two antioxidant enzymes peroxidase and catalase has been studied in mice liver during 'cold water swim' (CWS) stress using appropriate controls. The drug, i.e. the aqueous ethanolic extract of the herb (whole plant) was found to increase peroxidase titre in the hepatic cells of normal mice. But in the stressed group, the drug displayed no effect on the peroxidase content, while it elicited an elevation of the catalase content. infinity-Tocoferol was used as the standard drug. These data suggested that the drug can ameliorate the peroxidative damage caused in mice by CWS stress.

Chemical and pharmacological evaluation of different ayurvedic preparations of iron.

Ayurvedic preparations of metallic iron commonly categorised as different 'putas' of 'Louha Bhasma' was chemically analysed and pharmacologically investigated in iron deficiency anemia. Atomic absorption spectral (AAS) study of different putas of Louha Bhasma revealed the presence of various proportions of important metals along with varied concentration of iron in it. The effect of a representative puta viz. 50 puta of Louha Bhasma in the management of agar gel diet and phlebotomy induced iron deficiency anemia in animal model was found to be statistically highly significant (P < 0.001) in comparison to the control and standard drug Fefol treated groups.

Effect of calcium-channel blocking drugs on focal ventricular arrhythmias induced by sub-epicardial epinephrine infusion in cats.

Sub-epicardial infusion of epinephrine (EP) in the dose of 3 x 10(-3) M in 2.5 x 10(-3) M CaCl2-0.9% NaCl (calcium-saline vehicle) at the rate of 10 microliters in the right ventricular myocardium of mongrel cats weighing between 2.8 and 3.3 kg, produced uniform, reversible and reproducible focal ventricular arrhythmia (VA) of varrying intensity and duration. Infusion of two calcium-channel blocking agents, verapamil (VP) and nifedipine (ND) at the site of arrhythmogenesis, in equimolar concentration of 3 x 10(-3) M alongwith EP in the same vehicle reduced the incidence, duration, peak and mean frequencies of arrhythmias while, the latent period of onset of arrhythmias increased significantly. Verapamil in equimolar concentration of 3 x 10(-3) M was found to be more effective than nifedipine in antagonizing EP-induced ventricular arrhythmias.

Role of 5-hydroxytryptamine in toxaemia of pregnancy.

5-HT concentration in blood of 24 randomly selected pregnant women presenting with signs and symptoms of toxaemia of pregnancy were estimated and compared with 30 normal pregnant women. As such 5-HT level increases with the progress of pregnancy and in toxaemia group in comparison to normal pregnancy. A change in the degree of oedema from moderate to severe could bring a statistically significant change in blood pressure and serum 5-HT level. Increased 5-HT plays a role in toxaemia as well as in normal pregnancy and some of the toxic effects observed in toxaemia of pregnancy are due to the effects of 5-HT.

Effect of lidocaine and quinidine on focal ventricular arrhythmias induced by subepicardial epinephrine in cats.

Subepicardial infusion of epinephrine (EP) in the dose of 3 x 10(-3) M in 2.5 x 10(-3)M CaCl2-0.9% NaCl (calcium-saline vehicle) at the rate of 10 microliters/min in the right ventricular myocardium of mongrel cats weighing between 2.7 and 3.3 kg produced uniform reversible and reproducible focal ventricular arrhythmias of varying intensity and duration. Infusion of two antiarrhythmic agents, lidocaine (LD) and quinidine (QD) in the same site of arrhythmogenesis in equimolar concentration of 3 x 10(-3) M along with EP in the same vehicle reduced incidence, duration, peak and mean frequencies of arrhythmias while the latent period of onset of arrhythmias increased significantly. In present study, quinidine, in equimolar concentration of 3 x 10(-3) M was found to be more effective than lidocaine in antagonizing EP-induced ventricular arrhythmias.

Simple anthropometry and peak expiratory flow rate in elite South Asian athletes.

The athletes (n = 40) of South Asian Federation (SAF) Games were examined each taking a very short time. The athletes were runners (short distance, long distance and marathon), jumpers and throwers who were persuaded for the purpose. The throwers and the jumpers respectively comprised the oldest and youngest group of athletes in the study. The throwers were observed to be the tallest (mean height 179.96 +/- 1.49 cm) and heaviest (mean weight 92.27 +/- 3.81), whereas the long distance runners were of short height (mean value 162.80 +/- 2.61 cm) and light weight (mean value 50.41 +/- 2.58 kg). The highest mean values of PEFR (lit/min) were noted among the throwers (596.60 +/- 27.53) followed by marathon (590.0 +/- 32.18) and long distance runners (588.0 +/- 27.35). The lower values of PEFR were noted among the short distance runners (528.60 +/- 15.83) and jumpers (525.70 +/- 22.60). The PEFR values, when arranged according to height, were noted to be insignificantly increasing with the increase in age. The overall values of height, weight and PEFR were all found to be higher in these elite sportsmen when compared with their non-sportsman Indian counterparts.

Five minutes' field study on each Indian hockey player in a coaching camp.

Peak expiratory flow rate (PEFR) was measured using portable Wright's peak flow meter on 21 male hockey players of Indian national hockey team probables attending a zonal coaching camp. The mean PEFR was observed to be 580.95 +/- 43.34 1/minute. The PEFR in hockey players were higher than those recorded in inter-university 'kabaddi', basketball players and football goalkeepers. All the group of players had shown higher mean PEFR than those of age matched healthy Indian males.

Pulse rate, pre-competition tension and performance in 10,000 meter elite runners of both sexes.

Five male and 3 female runners who participated in 10,000 meter distance run in South Asian Federation (SAF) Games, 1987 were volunteered for this pilot study. The pulse rate at rest, 1 hour prior to competition and post-run for 30 min at 5 min intervals were recorded. It was observed that the runners who showed less rise of pulse prior to competition, performed better. This might be attributed to less pre-competition tension in them which helped the athletes to perform better.

Uterine and placental 5-HT profile in different gestational period of albino rats.

Possible role of 5-HT in pregnancy was investigated in albino rats by biological estimation of uterine and placental 5-HT contents in different periods of gestation in normal and drug treated rats. Uterine 5-HT level increased steadily from day-1 of gestation to reach the peak on day-7; thereafter, the level continued to decline throughout the period till day-20 when 5-HT level was lowest. From day-20, a mild secondary rise started and remained persistent even after parturition. The results show that a critical level of 5-HT in early gestational period is necessary for conception. Manipulation of endogenous 5-HT do not influence duration of gestation.