Evaluation of the merit of the methanolic extract of Andrographis paniculata to supplement anti-snake venom in reversing secondary hemostatic abnormalities induced by Naja naja venom.

Increasing evidence suggests a sizable involvement of hemotoxins in the morbidity associated with envenomation by the Indian spectacled cobra, Naja naja (N.N). This study investigates the ability of Indian polyvalent anti-snake venom (ASV), methanolic extract of Andrographis paniculata (MAP) and their combination in reversing the hemostatic abnormalities, viz. activated partial thromboplastin time(aPTT), prothrombin time(PT) and thrombin time(TT) in citrated plasma. These parameters were assessed in 2 groups of experiments. Group 1: Without the prior incubation of plasma with venom and Group 2: With prior incubation of plasma with venom for 90 min at 37°C. Venom caused significant (p < 0.001) prolongation in aPTT (175%), PT (49%) and TT (34%) in Group 1 and ASV could completely bring them back to normal. MAP showed a concentration-dependent reversal in aPTT, normalization of PT and prolongation of TT. When low concentration of ASV was supplemented with MAP, their combined effect in normalizing aPTT and PT improved by 37% and 26% respectively when compared to ASV alone. In Group 2, venom caused significant (p < 0.001) prolongation in aPTT (231%), PT (312%) and TT (245%). ASV had limited effect in reversing aPTT (52%), TT (31%) but completely normalized PT. MAP was marginally effective in reversing the prolonged aPTT and PT but caused further prolongation of TT. Combination of ASV and MAP was more effective than ASV alone in reversing venom-induced increase in aPTT (52%) and PT (29%). The study proved that, a drastic reduction of ASV by 70%, could be effectively supplemented by MAP in combating hemostatic abnormalities induced by NN venom.

Anti-snake venom and methanolic extract of Andrographis paniculata: a multipronged strategy to neutralize Naja naja venom acetylcholinesterase and hyaluronidase.

The study investigates the ability of methanolic extract of Andrographis paniculata (MAP) to supplement polyvalent anti-snake venom (ASV) in inhibiting neurotoxic enzyme acetylcholinesterase (AChE) and 'spreading factor' hyaluronidase from Naja naja (N.N) venom. AChE and hyaluronidase activity were measured in 100 or 200 µg of crude venom, respectively, and designated as 'control'. In Test Group I, enzyme assays were performed immediately after the addition of ASV/MAP/ASV + MAP to the venom. Inhibition of AChE by ASV (100-367 µg) was 12-17%, and of hyaluronidase (22-660 µg) was 33-41%. Under the same conditions, MAP (100-400 µg) inhibited AChE and hyaluronidase to the extent of 17-33% and 17-52%, respectively. When ASV (220 µg) and MAP (100-200 µg) were added together, AChE and hyaluronidase were inhibited to a greater extent from 39-63 to 36-44%, than when either of them was used alone. In Test Group 2, the venom was incubated with ASV/MAP/ASV + MAP for 10-30 min at 37 °C prior to the assay which enhanced AChE inhibition by 6%, 82% and 18% respectively, when compared to Test Group I. Though there was no change in inhibition of hyaluronidase in the presence of ASV, MAP could further increase the extent of inhibition by 27% and ASV + MAP upto 4%. In Test Group III, venom and substrate were incubated for 90 min and hyaluronidase activity was measured after the addition of inhibitors. Here, ASV + MAP caused increased inhibition by 69% compared to ASV alone. The study confirms the ability of phytochemicals in MAP to contribute to a multipronged strategy by supplementing, thereby augmenting the efficacy of ASV.

Can the methanolic extract of Andrographis paniculata be used as a supplement to anti-snake venom to normalize hemostatic parameters: A thromboelastographic study.

ETHNOPHARMACOLOGICAL RELEVANCE OF ANDROGRAPHIS PANICULATA: The whole plant (including leaves and roots) is used in traditional Ayurveda and Siddha medicine to treat various clinical conditions such as fever, respiratory tract infections, colic pain, liver disorders, diabetes, hypertension, and inflammation. It is also used as an antidote for snake-bite, poisonous bites of insects and recommended as a dietary supplement to boost immunity. AIM OF THE STUDY: In-vitro thromboelastographic evaluation of the efficacy of methanolic extract of Andrographis paniculata (MAP) and polyvalent anti-snake venom (ASV) in neutralizing the Naja naja (N.N) venom-induced changes in hemostatic parameters. MATERIALS AND METHODS: Thromboelastographic evaluation of hemostatic parameters was initiated by adding 3µg N.N venom to citrated whole blood from healthy volunteers. The effect of different concentrations of ASV and MAP in neutralizing the toxicity of N.N venom were studied in two groups. In group 1 experiments, citrated whole blood (340µl) was mixed with N.N venom (3µg), immediately followed by successive addition of ASV (5µl, 8µl and 15µl) or MAP (15µg, 30µg, 60µg and 120 µg) or combination of ASV and MAP (3µl ASV+30µg MAP and 3µl ASV+60µg MAP). In group 2 experiments, N.N venom was incubated with whole blood for 90 minutes at 37°C, followed by successive addition of ASV (5µl, 10µl, and 15µl) or MAP (30µg and 60µg) or combination of ASV and MAP (5µl ASV+30µg MAP and 5µl ASV+60µg MAP). RESULT: In Group 1 experiments, N.N venom caused significant (p<0.05) increase in R-time, K-time, LY30% and a decrease in angle and MA. Optimum effect on hemostatic parameters was observed at a concentration of 8µl ASV, where all the deleterious effects of the venom were completely reversed. Similarly, the addition of MAP to the assay system could reproduce results as ASV, in reversing the deleterious effects of the venom. This occurred in a concentration-dependent manner, from 15µg-60µg, with the optimum results at 60µg. When ASV concentration was reduced to 3µl and supplemented with MAP (30µg or 60µg), the positive supplementary effect of MAP was demonstrated. In Group 2 experiments, N.N venom caused significant (p<0.05) changes in all TEG parameters, with most deleterious changes observed in MA and LY30% compared to Group 1 experiments. ASV when added in increasing concentrations (5-15µl), had beneficial effects only on K-time, angle, and MA. When added together with ASV, MAP (30µg or 60µg) could significantly (p<0.05) supplement the effect of ASV (5µl) in improving R-time, K-time, and angle. CONCLUSION: This in-vitro study demonstrates the effectiveness of MAP as a supplement to ASV in combating the deleterious effects of N.N venom on hemostasis. However, further in-vivo experiments in animal models are required to substantiate these effects.

Comparative Assessment of the Effects of Hatha Yoga and Physical Exercise on Biochemical Functions in Perimenopausal Women.

INTRODUCTION: Menopause is a transitional phase in which some women experience discomfort, while others may exhibit variety of symptoms. The power of yoga therapy in relieving stress, enhancing health, improving fitness and managing symptoms of a variety of disorders is remarkable. AIM: The current study was designed to study the effect of Hatha yoga therapy and regular physical exercise on the Fasting Blood Sugar (FBS), Glycated Haemoglobin (GHB), Thyroid Stimulating Hormone (TSH), serum cortisol and total plasma thiol levels in perimenopausal women. MATERIALS AND METHODS: The study included 216 women with perimenopausal symptoms, 111 in test group (Hatha yoga) and 105 in control group (physical exercise). The duration of intervention was 45 minutes every day for 12 weeks. Blood samples were collected in the pre and post intervention period. Statistical significance was defined as p<0.05. RESULTS: FBS and GHB (p≤0.05) showed a significant decrease after yoga therapy. Cortisol levels significantly (p≤0.05) increased in the post intervention period in the control group. However, it is maintained in the test group between the two time periods. The total plasma thiols level showed a rise in the post intervention period, significant rise (p≤0.001) in control group but not significant in the test group. The TSH levels were not altered in any group. CONCLUSION: It is concluded that exercise helps in maintaining the sugar levels but calming effects of yoga practice is important in relieving stress and enhancing health in perimenopausal women.