Histological changes in the kidneys of experimental diabetic rats fed with Momordica charantia (bitter gourd) extract.

Momordica charantia (MC) or bitter gourd is widely known for its antidiabetic properties. The aim of the present study was to observe the protective effect of MC extract on the kidneys of streptozotocin-induced diabetic rats. Eighteen male Sprague-Dawley rats (n=18) weighing 200+/-50 g were taken for the study. The study comprised of three groups i.e. a non-diabetic, diabetic untreated and diabetic treated with MC extract, with each group comprising of six (n=6) rats. Diabetes was induced in the overnight fasted rats by intramuscular injection of streptozotocin (50 mg/kg body weight). The MC extract (50 mg/kg body weight) was administered via oral gavage. Both the kidneys were collected on the tenth day following treatment. Histological study using Verhoeff's van Gieson (VvG) and Periodic Acid-Schiff (PAS) stains were performed. The kidneys of the diabetic rats showed thickening of the basement membrane of the Bowman's capsule, edema and hypercellurarity of the proximal tubules, necrosis and hyaline deposits. These features were found to be reversed when the MC extract was administered to the experimental animals. The MC extract acted as an antioxidant thereby preventing the oxidative damage involved in the diabetic kidney. The administration of MC extract prevents oxidative damage in diabetic nephropathy.

The effect of topical extract of Momordica charantia (bitter gourd) on wound healing in nondiabetic rats and in rats with diabetes induced by streptozotocin.

BACKGROUND: Momordica charantia (MC; bitter gourd) is a traditional herb commonly used for its antidiabetic, antioxidant, contraceptive and antibacterial properties. It is also used for the rapid healing of wounds. AIM: To observe the topical effect of MC extract on the wound-healing process in rats with diabetes induced by streptozotocin. METHODS: In total, 72 Sprague-Dawley rats were used for the study. The animals were subdivided into two groups: a nondiabetic group (n = 36) and a group with diabetes induced by streptozotocin (n = 36). Both groups were subdivided further into a nontreated control group (n = 18), and a topically treated group with MC extract administered daily (n = 18). The wound was inflicted with a 6-mm punch-biopsy needle on the dorsal aspect of the thoracolumbar region. The animals were killed on the days 1, 5 and 10 after wound creation. The rate of wound closure and the total protein content was estimated. Histological study of the wound tissue at days 5 and 10 was also performed. RESULTS: The diabetic group exhibited delayed wound healing as compared to the normal group. Interestingly, the diabetic group treated with topical MC extract showed better results than the nontreated group. CONCLUSION: Results show that administration of MC extract improves and accelerates the process of wound healing in diabetic animals.

The potential role of herbal products in the treatment of Parkinson's disease.

Parkinson's disease (PD) is a multifactorial disorder of the nervous system in which there is a progressive loss of dopaminergic neurons. There is a disturbance in the movement in PD and these include resting tremors, rigidity, bradykinesia or akinesia, disturbance, posture and freezing (motor block). The substantia nigra and other parts of the brain are commonly affected. The disorder could be related to oxidative stress and there is an important role of reactive oxygen species (ROS). A number of herbal products contain active components which are known to possess antioxidant action. Hence, the potential role of herbal products in treating PD cannot be undermined. In the present narrative review, the main aim is to discuss the pathogenesis of PD, define the role of different potential herbal extracts on its pathogenesis which may form the basis of treatment. We also discuss in detail the active chemical compounds present each herb which are effective in the treatment of PD. These herbs include Baicalei, Erythrina velutin, Resveratrol, Peganum Harmal, Curcuma longa (Zingiberaceae), Carthamus tinctorius L. (Safflower), Pueraria lobate, Juglandis Semen (Walnut), Tianma Gouteng Yin (TGY), Lycium barbarum L fruit, Mucuna pruriens (Velvet bean), Chunghyuldan (CHD), Paeoniae Alba Radix. The present review may be beneficial for designing future drugs for effective treatment of PD.

Brightness discrimination and contrast sensitivity in chronic glaucoma--a clinical study.

The visual acuity, the difference in sensitivity of the two eyes to light (brightness ratio), and contrast sensitivity were assessed in 28 patients with chronic open angle glaucoma and compared with those of 41 normal controls of similar ages and visual acuity. The results obtained were related to the results of Tübingen visual field analysis in patients with glaucoma. Twenty-four of the 28 glaucoma patients (86%) had a significant disparity in brightness ratio between the two eyes. This was found to match the frequency of visual field loss. Moreover, there was a significant relationship between the interocular differences in brightness sense and the difference in the degree of visual field loss between the two eyes. Of the glaucoma patients 39% had sum contrast sensitivities outside the normal range for age-matched normal controls. No significant correlation was found between the interocular difference in brightness sense and the visual acuity or the interocular difference in sum contrast sensitivity. It is concluded that, in the presence of a normal visual acuity, the brightness ratio test warrants evaluation as a potential screening test for chronic open angle glaucoma.

Neurodevelopmental outcome of Malaysian very low birth weight infants: predictive value of cranial ultrasound appearances.

The aim of the study was to determine the predictive value of cranial ultrasound scans done in the neonatal period for neurodevelopmental outcome of the Malaysian very low birthweight (VLBW, < 1500 grams) infants assessed at 12 months of corrected age. Of the 101 infants studied, 68 (67.3%) were neurodevelopmentally normal at one year of age, 18 (17.8%) had major and 15 (14.9%) had minor neurodevelopmental impairment. Neurodevelopmental outcome was normal in 66/88 (75.0%) infants who did not have severe intraventricular haemorrhage (IVH) or periventricular intraparenchymal echo densities (PVE) in the first week of life, and in 57/73 (78.1%) with uncomplicated scans at discharge. In contrast, 11/13 (84.6%) with parenchymal echo densities or severe intraventricular bleed in the early neonatal period and 17/28 (60.7%) with complicated scans at discharge had adverse sequelae. There was a significant association between lesions seen on cranial ultrasound in the neonatal period and subsequent neurodevelopmental impairment. Late neonatal ultrasound scans appear to be a better predictor of short-term neurodevelopmental outcome than early scans.

A comparative study of branch retinal vein occlusion and central vein occlusion amongst Malaysian patients.

A retrospective study of 95 patients with retinal vein occlusion was carried out to determine the clinical presentation and pattern of distribution in the local Malaysian population. There was no significant difference found in its distribution with regards to sex. In comparing branch retinal vein occlusion with central retinal vein occlusion, no significant differences were found in its racial distribution. Branch retinal vein occlusion occurred more commonly among the older patients whereas the converse is true for central retinal vein occlusion. Reduced vision represents the commonest mode of presentation. Hypertension, diabetes mellitus, hyperlipidaemia and haematological disorders are important associated systemic conditions.

Higher division of the tibial nerve in the leg: gross anatomical study with clinical implications.

BACKGROUND AND OBJECTIVES: Tibial nerve is a branch of the sciatic nerve and it is the main nerve innervating the muscles of the back of the leg. The tibial nerve divides into medial and lateral plantar nerves. The level of division may be important for surgical purpose. The main aim of the present study was to observe the exact level of division of the tibial nerve and discuss its clinical implications. MATERIALS AND METHODS: A total of 20 cadaveric limbs (irrespective of left or right side) were taken randomly. The posterior compartment of the thigh and leg was dissected to trace the tibial nerve and its branches. The specimens were subjected to measurements with respect to an arbitrary horizontal line passing through tip of medial malleolus and the calcaneum. All the specimens were photographed. RESULTS: In 5 cases (25%), the tibial nerve divided deep to the flexor retinaculum. In 15 cases (75%) cases, the tibial nerve divided at a distance of 3.5 cm - 6.5 cm (average 5 cm) above the medial malleolus. CONCLUSION: The tibial nerve and its divisions are important for performing successful nerve blocks and insertion of plates while treating fractures. Variations may account for the various discrepancies between the electromyographic tests and clinical tests.

Use Piper sarmentosum as an effective antidiabetic supplement in South East Asia: a review.

Herbs with antidiabetic activity have a potential role to play. Herbal medicines have been widely used in South East Asia because of lesser side effects and cost effectiveness. The main aim of this review article was to disseminate important information regarding the use of herbal products in oxidative stress involved in diseases like diabetes mellitus. The article highlights some of the traditional medicinal plants which have been widely used in South East Asia with special emphasis on Piper sarmentosum. Piper sarmentosum have been reported to possess varying degree of hypoglycemic, antidiabetic and other additional properties. The antioxidant properties of the herbs may be effective in controlling the oxidative damage produced during diabetes mellitus. The review article highlights the positive role of traditional herbs towards diabetes mellitus and also describes its complications.

Tocotrienol rich fraction (TRF) supplementation protects against oxidative DNA damage and improves cognitive functions in Wistar rats.

AIM: Oxidative stress is caused by imbalance between the productions of reactive oxygen species (ROS) and antioxidant defense mechanisms. Palm oil antioxidants such as tocotrienol rich fraction (TRF) is known to have neuroprotective effects on neurones by acting against free radical induced neuronal cell death. This study was undertaken to elucidate the effect of TRF on oxidative DNA damage and cognitive functions in experimental rats. MATERIALS AND METHODS: A total of 20 male Wistar rats (aged 3 months) were divided into 2 groups: (i) control group fed with distilled water and (ii) experimental group fed with TRF (200 mg/ kg body weight) for 8 months. DNA damage was determined using Comet assay. Antioxidant enzymes like superoxide dismutase (SOD), glutathione peroxidase (GPx) and catalase (CAT) were assessed in the blood. The Morris Water Maze (MWM) test was used to evaluate the cognitive functions. RESULTS: DNA damage was significantly reduced in the experimental group supplemented with TRF compared to the control group (p <0.05). In the group supplemented with TRF, the percentage of DNA damage was 2.87 ± 0.48% compared to 5.96 ± 0.43% in the control group. SOD, GPx, and CAT enzyme activities increased in experimental group. Results from MWM showed improvement in cognitive functions as determined by latency to target platform, swim path and average speed between TRF and control groups. CONCLUSIONS: Continuous supplementation of TRF for 8 months reduced DNA damage and exhibited positive influence in spatial learning and memory.

Wound healing in diabetes mellitus: traditional treatment modalities.

The healing of wound is a complex process which requires the interactions of different cells and extracellular molecules. The normal wound healing process can be divided into four overlapping phases i.e. haemostasis, inflammation, proliferation and remodeling. In diseased condition like diabetes mellitus, the wound healing process is grossly impaired, resulting in chronic wounds which fail to heal. In the past decades, several researchers have tested various traditional medicines obtained from the plants for their wound healing properties. Such traditional plants are Aloe vera, Calotropis procera, Portulaca oleracea, Acalypha langiana, Plagiochasma appendiculatum and Momordica charantia. Perhaps one of the most popular and easily available plant is Momordica charantia (bitter gourd). The present article presents an extensive review on the impaired wound healing process in diabetes mellitus and highlights the use of traditional medicines in diabetic wounds.

Comparison of Chlorella vulgaris dressing and sodium alginate dressing: an experimental study in rats.

BACKGROUND AND AIMS: Chlorella vulgaris (CV) is a green microalgae enriched with nutrients, vitamins, minerals and chlorophyll. The aim of our study was to evaluate the potential wound healing effects of CV as a dressing while comparing it to sodium alginate dressing. MATERIALS AND METHODS: Fifteen Sprague-Dawley rats were divided into three groups consisting of control (normal-wound with no dressing), CV and sodium alginate dressings. Wound was created on the dorsal surface of rats using a 6-mm sterilized punch biopsy. The wounds were examined on days 3, 6, 9 and 12 for dryness, exudation, contraction, period of epithelialization, complete wound closure and scar formation. All rats were sacrificed on day 12 and the granulation tissue formed on the wound was excised for the histological examination using Hematoxylin and Eosin stain (H&E). RESULTS: The wound's size treated with CV dressing was significantly reduced (p<0.05) compared to the control and sodium alginate treated wounds. H&E staining showed that CV dressing minimized the formation of scar tissue during the healing process. Although there was no statistically significant difference in the complete wound closure and period of epithelialization among the groups, a significant difference was observed regarding the dryness, exudation and scar formation in the wound. CONCLUSION: CV extract can be used as an effective supplement for wound dressing.

The effect of Piper betel extract on the wound healing process in experimentally induced diabetic rats.

BACKGROUND: Piper betel (PB) possesses antimicrobial, antifungal, antioxidant and wound healing properties due to its powerful antioxidant effect. Diabetes mellitus (DM) is a metabolic disorder which is associated with complications like impaired wound healing, nephropathy and neuropathy. The main aim of the study was to study the wound healing properties of PB. MATERIALS AND METHODS: A total of 33 male Sprague-Dawley rats (250-300 g) were taken and divided into 3 groups: Group I (control) comprising of 14 rats; Group II (diabetic untreated) comprising of 9 rats; Group III (diabetic treated) comprising of 10 rats. After 10 days of acclimatization, the animals were fasted overnight and diabetes was induced by administration of streptozotocin (45 mg/Kg body weight in a single dose, through tail vein) to group II and III animals. Four 6 mm-diameter full thickness skin excision wounds were created and PB extract (50 mg diluted in 0.1 ml of normal saline) was applied locally for 10 days in group III. The group I and II received normal saline (0.1 ml) for 10 days. The total protein content and the wound contraction rate were determined. RESULTS: The wound contraction rate of group III (35.03 +/- 2.96) was higher as compared to group II (18.40 +/- 3.87) with p = 0.014. The total protein content for group III was 106.39 +/- 4.46 as compared to group II (72.86 +/- 12.86) with p = 0.050. CONCLUSION: PB acted as a protective agent in the early phase of wound healing by increasing total protein content and wound contraction rate.

A histological study of the structural changes in the liver of streptozotocin-induced diabetic rats treated with or without Momordica charantia (bitter gourd).

AIM: Diabetic liver is associated with biochemical, physiological and pathological changes. The aim of the present study was to evaluate the histological changes following administration of Momordica charantia (MC) in the streptozotocin (STZ) induced diabetic rats. MATERIALS AND METHODS: Eighteen Sprague-Dawley rats (n=18) were taken for this study. The animals were divided into 3 groups:- non-diabetic (n=6), untreated diabetic (n=6) and diabetic treated with MC extract (n=6). Diabetes was induced in the experimental rats via intravenous injection of streptozotocin (45 mg/kg body weight). MC extract (50 mg/kg body weight) was administered orally to the treated diabetic rats 10 days following induction. The liver tissues were collected on the 10th day following treatment and the histological study was performed using different staining methods which included hematoxylin and eosin (H&E), Verhoeff's van Gieson (VvG) and periodic acid Schiff (PAS). RESULTS: The liver of the diabetic rats showed involvement of the hepatocytes with features of inflammation. The portal triad in the diabetic liver showed extensive involvement in terms of accumulation of mucopolysaccharide deposits. Liver damage in the diabetic animals showed features of healing with administration of the MC extract. CONCLUSIONS: The MC extract due to its antioxidant role may be helpful in reversing the changes in the liver in diabetes mellitus.

Duration of oxygen therapy and exchange transfusion as risk factors associated with retinopathy of prematurity in very low birthweight infants.

One hundred and thirteen consecutive infants with a very low birthweight of less than 1500 g were followed prospectively for 6 months to determine the incidence of retinopathy of prematurity (ROP) and associated risk factors. Of this group, 36 (31.9%) infants developed ROP (13 infants had stage 1 ROP, nine had stage 2, six had stage 3, six had stage 4, and two had cicatricial stage ROP). Stepwise logistic regression analysis of various potential risk factors (birthweight, gestation, duration of oxygen therapy, duration of ventilation, highest documented PaO2 and exchange transfusion) showed that only two risk factors were significantly associated with the development of ROP. These risk factors were: the duration of oxygen therapy (p = 0.0005) and exchange transfusion during the neonatal period (odds ratio 5.754, 95% confidence interval 1.002 to 32.997, p = 0.049). The equation of the regression model is: log (odds of developing ROP) = -0.8395 + 0.1447 (OXY)- 0.8750 (ET), where OXY is the duration of oxygen therapy in days, ET = -1 when there was a history of exchange transfusion, and ET = 1 when there was no history of exchange transfusion.

Comparison of morbidities in very low birthweight and normal birthweight infants during the first year of life in a developing country.

OBJECTIVE: To compare the morbidities in the very low birthweight (VLBW; < 1500 g) and normal birthweight (NBW; > or = 2500 g) Malaysian infants during the first year of life. METHODOLOGY: Prospective observational cohort study of consecutive surviving VLBW infants and randomly sampled NBW infants born in the Kuala Lumpur Maternity Hospital between 1 December 1989 and 31 December 1992. Infants were followed up regularly during the first year of life, after correction for prematurity. RESULTS: Compared with NBW infants (n = 106), VLBW infants (n = 127) had significantly higher risk of failure to thrive (odds ratio [OR] = 8.0, 95% confidence intervals [CI]: 1.1 to 354.3), wheezing (OR = 3.7, 95% CI: 1.6 to 9.3), rehospitalization (OR = 2.3, 95% CI: 1.1 to 5.0), cerebral palsy (OR = 8.6, 95% CI: 2.0 to 77.6), neurosensory hearing loss (OR = 12.0, 95% CI: 1.7 to 513.6) and visual loss (7.9 vs 0%, P = 0.002). The mean mental developmental index (MDI) and mean psychomotor developmental index (PDI) at 1 year of age were significantly lower among VLBW infants (MDI 99 [SD = 28], PDI 89 [SD = 25]) than NBW infants (MDI 106 [SD = 18], PDI 101 [SD = 18]) (95% CI for difference between means being MDI: -14.1 to -1.7; and PDI: -17.6 to -6.0). Logistic regression analysis showed that among VLBW infants: (i) male sex, Malay ethnicity and bronchopulmonary dysplasia were significant risk factors associated with wheezing; (ii) longer duration of oxygen therapy during the neonatal period, seizures after the post-neonatal period and wheezing were significant risk factors associated with rehospitalization; and (iii) longer duration of oxygen therapy during the neonatal period was a significant risk factor associated with adverse neurodevelopmental outcome during the first year of life. CONCLUSIONS: Compared with NBW infants, VLBW Malaysian infants had significantly higher risks of physical and neuro-developmental morbidities.

Relationship between head growth and neurodevelopmental outcome of Malaysian very low birthweight infants during the 1st year of life.

A prospective study was carried out to (i) compare head growth patterns of 103 very low birthweight (VLBW, < 1500 g) Malaysian infants and 98 normal birthweight (NBW, 2500- < 4500 g) controls during the 1st year of life; and (ii) examine the relationship between neurodevelopmental outcome at 1 year of age and occipito-frontal head circumferences (OFC) at birth and at 1 year of age in VLBW babies. When compared with those of NBW infants at birth, mid-infancy and 1 year of age, the mean OFC ratios (observed/expected OFC at 50th percentile) of VLBW infants were significantly lower (p < 0.001). Small-for-gestational-age (SGA) VLBW babies had significantly lower mean OFC ratios than their appropriate-for-gestational-age (AGA) VLBW counterparts at birth (p < 0.001), but this difference was no longer seen at mid-infancy or at 1 year of age. Logistic regression analysis showed that abnormal late neonatal cranial ultrasound findings (odds ratio 8.5, 95% confidence interval 4.12-22.07; p < 0.001) and each additional day of oxygen therapy (odds ratio 1.15, 95% confidence interval 1.00-4.45; p = 0.045) were significant risk factors associated with neurodevelopmental disability at 1 year of age, while mean OFC ratios at birth or at 1 year of age were not. Poor postnatal head growth per se did not predict disability, but probably reflected the consequences of "brain injury" as evidenced by abnormal brain scans.