A randomized, double blind, placebo controlled, multicenter clinical trial to assess the efficacy and safety of Emblica officinalis extract in patients with dyslipidemia

BACKGROUND

Dyslipidemia is one of the most frequently implicated risk factors for development of atherosclerosis. This study evaluated the efficacy of amla (Emblica officinalis) extract (composed of polyphenols, triterpenoids, oils etc. as found in the fresh wild amla fruit) in patients with dyslipidemia.

METHODS

A total of 98 dyslipidemic patients were enrolled and divided into amla and placebo groups. Amla extract (500 mg) or a matching placebo capsule was administered twice daily for 12 weeks to the respective group of patients. The patients were followed up for 12 weeks and efficacy of study medication was assessed by analyzing lipid profile. Other parameters evaluated were apolipoprotein B (Apo B), apolipoprotein A1 (Apo A1), Coenzyme Q10 (CoQ10), high-sensitive C-reactive protein (hsCRP), fasting blood sugar (FBS), homocysteine and thyroid stimulating hormone (TSH).

RESULTS

In 12 weeks, the major lipids such as total cholesterol (TC) (p = 0.0003), triglyceride (TG) (p = 0.0003), low density lipoprotein cholesterol (LDL-C) (p = 0.0064) and very low density lipoprotein cholesterol (VLDL-C) (p = 0.0001) were significantly lower in amla group as compared to placebo group. Additionally, a 39% reduction in atherogenic index of the plasma (AIP) (p = 0.0177) was also noted in amla group. The ratio of Apo B to Apo A1 was reduced more (p = 0.0866) in the amla group as compared to the placebo. There was no significant change in CoQ10 level of amla (p = 0.2942) or placebo groups (p = 0.6744). Although there was a general trend of FBS reduction, the numbers of participants who may be classified as pre-diabetes and diabetes groups (FBS > 100 mg/dl) in the amla group were only 8. These results show that the amla extract used in the study is potentially a hypoglycaemic as well. However, this needs reconfirmation in a larger study.

CONCLUSIONS

The Amla extract has shown significant potential in reducing TC and TG levels as well as lipid ratios, AIP and apoB/apo A-I in dyslipidemic persons and thus has scope to treat general as well as diabetic dyslipidemia. A single agent to reduce cholesterol as well as TG is rare. Cholesterol reduction is achieved without concomitant reduction of Co Q10, in contrast to what is observed with statins.

TRIAL REGISTRATION

Registered with Clinical Trials Registry- India at www.ctri.nic.in (Registration number: CTRI/2015/04/005682 ) on 8 April 2015 (retrospectively registered).

A pharmacoinformatic approach on Cannabinoid receptor 2 (CB2) and different small molecules: Homology modelling, molecular docking, MD simulations, drug designing and ADME analysis

CB2 receptor belongs to the family of G-protein coupled receptors (GPCRs), which extensively controls a range of pointer transduction. CB2 plays an essential role in the immune system. It also associates in the pathology of different ailment conditions. In this scenario, the synthetic drugs are inducing side effects to the human beings after the drug use. Therefore, this study is seeking novel alternate drug molecules with least side effects than conventional drugs. The alternative drug molecules were chosen from the natural sources. These molecules were selected from cyanobacteria with the help of earlier research findings. The target and ligand molecules were obtained from recognized databases. The bioactive molecules are selected from various cyanobacterial species, which are selected by their biological and pharmacological properties, after, which we incorporated to the crucial findings such as homology modelling, molecular docking, MD simulations along with absorption, distribution, metabolism, and excretion (ADME) analysis. Initially, the homology modelling was performed to frame the target from unknown sequences of CB2, which revealed 44% of similarities and 66% of identities with the A2A receptor. Subsequently, the CB2 protein molecule has docked with already known and prepared bioactive molecules, agonists and antagonist complex. In the present study, the agonists (5) and antagonist (1) were also taken for comparing the results with natural molecules. At the end of the docking analysis, the cyanobacterial molecules and an antagonist TNC-201 are revealed better docking scores with well binding contacts than the agonists. Especially, the usneoidone shows better results than other cyanobacterial molecules, and it is very close docking scores with that of TCN-201. Therefore, the usneoidone has incorporated to MD simulation with Cannabinoid receptors 2 (CB2). In MD simulations, the complex (CB2 and usneoidone) reveals better stability in 30 ns. Based on the computational outcome, we concluded that usneoidone is an effectual and appropriate drug candidate for activating CB2 receptors and it will be serving as a better component for the complications of CB2. Moreover, these computational approaches can be motivated to discover novel drug candidates in the pharmacological and healthcare sectors.

Traditional plants used for the treatment of gynaecological disorders in Vedaranyam taluk, South India - An ethnomedicinal survey

Gynaecological disorder is one of the most severe conditions under reproductive health. So we investigate and collect information from traditional practitioners on the use of medicinal plants for treatment of Gynaecological disorder in Vedaranyam taluk, Nagappattinam district of South India. The field study was carried out for a period of January 2014-January 2015 in Vedaranyam taluk, Nagappattinam district of South India. This is the first traditional medicine study in which statistical calculations about plants are done by RFC, CI, UV and ICF in the study area. The ethnomedicinal information was collected through interviews, informal meetings, open and group discussions and overt observations with semi-structured questionnaires among traditional practitioners. A total of 66 species of plants distributed in 62 genera belonging to 44 families were identified as commonly used ethno medicinal plants by traditional practitioners in Vedaranyam taluk for the treatment of 36 ailments based on the reproductive systems treated. Leaves were the most frequently used plant parts and most of the medicines were prepared in the form of paste and administrated orally. We know the most important species according to their use value such as Moringa oleifera, Smailax zeylanica and Achyranthes aspera were recorded. The present study, we have highlighted some claims which are high use in the study area. Further pharmacological studies of these plants may provide some important drugs for the treatment of common gynaecological disorders.

Estimation of serum lactate dehydrogenase in smokeless tobacco consumers

STATEMENT OF PROBLEM

Salivary and serum lactate dehydrogenase (LDH) levels have been correlated with potentially malignant lesions. Salivary LDH levels require special testing and can be expensive. The need for a simple and cost-effective analysis tool is essential to detect the oral malignant lesions to benefit rural populations.

AIM

The aim of this study is to estimate the serum LDH in patients with oral lesions due to the consumption of smokeless tobacco.

MATERIALS AND METHODS

Thirty-five patients with lesions were selected for this study while twenty patients served as a control. Levels of serum LDH were assessed. Age- and sex-matched controls (n = 10) with no smokeless consumption habit and with the habit but without lesion (n = 10) also had their blood drawn to assess the basal level of LDH. The results were then analyzed through the two-tailed t-test and Chi-square analysis using the SPSS statistics software.

RESULTS

The mean LDH value of patients with habit and lesion is 446.8 U/L; the mean LDH value for patients with habit but without the presence of a lesion is 421.2 U/L, and the mean LDH value for patients without a habit or lesion is 269.4 U/L. The patients having the habit of using smokeless tobacco had higher LDH values compared to the other two groups, and it is found to be statistically significant (p < 0.05).

CONCLUSION

Serum LDH values increased in patients with the habit of chewing smokeless tobacco.