Effect of ethanol extract of an ayurvedic preparation (Pathyadya Churna) on arthritis in rats

OBJECTIVES

To study the anti-arthritic activity of Pathyadya Churna ethanol extract (PCE) in rats.

MATERIALS AND METHODS

Formaldehyde (2% v/v) or complete Freund's adjuvant (CFA 0.l mL) was injected in the left hind paw of male Wistar rats to develop arthritis. These rats were treated with three doses (135, 270, and 540 mg/kg) of PCE and one dose (10 mg/kg) of indomethacin. Anti-arthritic activity of the extract was assessed by noting paw volumes, rheumatoid factor (RF), blood parameters, and histological changes.

RESULTS

PCE treatment reduced paw swelling in arthritis caused by both formaldehyde and CFA. In CFA-treated rats, a significant decrease (P < 0.001) was seen in hemoglobin (13.92 g/dL to 9.97 g/dL), red blood cell count (7.32 million/mm(3) to 6.58 million/mm(3)), and packed cell volume (44.04% to 30.56%). There were also significant (P < 0.001) elevations in white blood cell count (8220/-11,420/mm(3)), platelets (2.46-4.15 lakhs/mL), erythrocyte sedimentation rate (3.76-8.03/60 min), RF (7.17-26.77 IU/mL), triglycerides (71.69-96.60 mg/dL), total cholesterol (96.85-145.05 mg/dL), low-density lipoprotein (53.11-109.60 mg/dL), and very low-density lipoprotein (14.34-19.32 mg/dL). In CFA-induced arthritic rats, high-density lipoprotein decreased significantly (29.40 mg/dL to 16.13 mg/dL). Marked changes were noted in the histology of ankles. Treatment with PCE significantly reversed all these hematological and histological changes in a dose-dependent manner.

CONCLUSIONS

PCE has a significant anti-arthritic activity in rats and is free from toxic effects.

Anti-arthritic activity of a classical Ayurvedic formulation Vatari Guggulu in rats

In India, Vatari Guggulu has been traditionally used in the Ayurvedic system of medicine to treat rheumatoid arthritis (RA). The current study was undertaken to evaluate anti-arthritic activity of alcoholic extract of Vatari Guggulu in rats. Arthritis was induced by administration of formaldehyde (2%v/v) or Complete Freund's Adjuvant (CFA) into the sub-plantar surface of left hind paw of the animals. The extract was administered to the rats by oral gavages in different doses. Joint swelling was measured in formaldehyde induced arthritis. Various physical, biochemical and histopathological parameters were determined in CFA induced arthritis. Vatari Guggulu extract (VGE) produced significant (P < 0.05) inhibition of joint swelling in both formaldehyde and CFA induced arthritis. The treatment also brought to normalcy the increased white blood cell (WBC) count, rheumatoid factor (RF), erythrocyte sedimentation rate (ESR), cholesterol, triglycerides and LDL with an enhancement of haemoglobin (Hb) levels and red blood cell (RBC) count. These effects were found to be dose dependent. These effects were comparable with standard drug indomethacin. Histo-pathological studies of the ankles of VGE treated animals exhibited significant improvements. VGE did not show any toxic symptoms even at a dose of 2000 mg/kg in acute toxicity studies on rats. Thus, Vatari Guggulu, a classical Ayurvedic formulation of the Indian System of Medicine, exhibited significant anti-arthritic activity in formaldehyde and CFA induced arthritis in rats. This study corroborates the claims of Ayurveda on Vatari Guggulu.

Development and validation of a RP-HPLC method for the simultaneous determination of Embelin, Rottlerin and Ellagic acid in Vidangadi churna

Vidangadi churna is a popular Ayurvedic formulation described in the chapter Krimicikitsa of the Ayurvedic literature Cakradatta for the treatment of Krimiroga. The preparation is a composite mixture of the fine powder of fruits of Vidang (Embelia ribs), glandular trichomes of the fruits of Kamala (Mallotus philippensis), mature fruits of Harde (Terminalia chebula), Saindhava and Yavakshara. The use of reversed phase C18 column eluted with gradient mobile phase of acetonitrile and water enabled the efficient separation of the chemical markers in 22 min. Validation of the method was performed in order to demonstrate its selectivity, accuracy, precision, repeatability and recovery. All calibration curves showed good linear correlation coefficients (r²>0.995) within the tested ranges. Three markers in Vidangadi churna were quantified with respect to Embelin (0.647%, w/w), Rottlerin (4.419%, w/w), and Ellagic acid (0.459%, w/w). Intra-and inter-day RSDs of retention times and peak areas were less than 3.12%. The recoveries were between 99.66% and 102.33%. In conclusion, a method has been developed for the simultaneous quantification of three markers in Vidangadi churna. The RP-HPLC method was simple, precise and accurate and can be used for the quality control of the raw materials as well as formulations.

The relationship between the quality of prescribing and practice appointment rates with asthma management data in those admitted to hospital due to an acute exacerbation

Specific targeting of patients with a previous asthma hospitalisation could be more focused if predictors could be identified. This study was an observational retrospective analysis using ridge and linear multivariate regression analysis. Patient asthma management data were extracted from the hospital and general practice notes of those that had been admitted with an acute exacerbation of their asthma over a 5-year period. From the prescribing data, the annual doses of preventer (P) and reliever (R) medication were converted to defined daily doses then divided to give a P:R ratio. Preliminary statistical analysis was used to identify any association between either the P:R ratio or for the number of general practitioner (GP) practice appointments (PA) and their asthma management data. Multivariate regression analysis was applied to the P:R ratio and to PA to determine a model between each of these and asthma management data/events. GPs gave consent to access the data of 115 (out of 440) asthmatics, age >5 years, admitted to a district general hospital for asthma exacerbations between 1994 and 1998. The multivariate analysis revealed that PA was associated with oral prednisolone rescue courses (PRCs) and age whilst the P:R ratio was associated to PRCs and more reliever usage but not preventers. Patients with low preventer usage with respect to their reliever medication should be targeted for medication review as these were the patients prescribed more prednisolone courses and their increased PAs reflect this. This could decrease visits to the doctor and acute exacerbations.

The effect of dietary supplements on the nPCR in stable hemodialysis patients

OBJECTIVE

To investigate whether (1) dietary supplements raise the normalized protein catabolic rate (nPCR) and/or further improve the nutritional status of stable hemodialysis patients who have both a low nPCR and a low dietary protein intake, <1.2 g/kg body weight/day; and if (2) protein intake measured by nPCR reflects protein intake measured by estimated food diaries in stable patients.

DESIGN

Prospective experimental study with a single intervention group.

SETTING

Hospital outpatient hemodialysis unit.

SUBJECTS

Seventeen stable chronic hemodialysis patients (10 men, 7 women) were studied over 8 months.

INTERVENTION

Subjects with both a low nPCR and dietary protein intake <1.2 g/kg body weight/day received dietary supplements for the first 2 months. Measurements to assess protein intake and nutritional status were taken at baseline and repeated at the end of 2 months, and at 6 months postintervention.

MAIN OUTCOME MEASURE

nPCR, dietary protein intake using 7-day estimated food diaries, serum urea, serum albumin, serum creatinine, serum bicarbonate, dialysis adequacy (Kt/V), and body mass index (BMI).

RESULTS

Dietary supplements significantly increased both the nPCR and the total protein intake at 2 months (1.21 +/- 0.26, 1.10 +/- 0.12, respectively) compared with baseline (0.95 +/- 0.18, 0.75 +/- 0.19, respectively) and 8 months (0.99 +/- 0.12, 0.78 +/- 0.21, respectively), P <.0001, respectively. There was no change in the nutritional status of the subjects. There was a significant difference between the nPCR and the dietary protein intake at baseline, P <.004; at 2 months, P <.047; and at 8 months, P <.001.

CONCLUSION

Dietary supplements can significantly increase the nPCR and dietary protein intake in stable hemodialysis patients with a low nPCR and dietary protein intake. Because a low nPCR is associated with a high morbidity and mortality rate, it may be prudent to supplement such patients. The use of the nPCR to quantify dietary protein intake in stable hemodialysis patients should be used with caution.

The effect of dietary intervention on weight gains after renal transplantation

OBJECTIVES

To determine the effect of early intensive dietary intervention and follow-up on weight gains in newly transplanted renal patients. To provide appropriate dietary advice posttransplant that included advice to reduce weight gains.

DESIGN

Group A was studied prospectively and group B was studied retrospectively over a period of 1 year posttransplant.

SETTING

Hospital transplant unit: inpatient ward and outpatient clinic.

PATIENTS

Thirty-three transplant patients were studied: Group A consisted of 11 patients (9 men, 2 women) transplanted consecutively over 2 months, with a mean age of 39 years. Group B consisted of 22 patients (14 men, 8 women) who had been transplanted consecutively 4 years before the study, with a mean age of 40 years. Both groups had functioning grafts (serum creatinine <200 micromol/L [2.2 mg/dL]) over the study period, and similar triple immunosuppressive therapy (prednisolone, cyclosporine, and azathioprine).

INTERVENTION

Group A received intensive, individualized dietary advice in stages, with regular follow-up for the first 4 months posttransplant. Thereafter group A did not receive any dietary advice or follow-up for the 8 months leading up to 1 year posttransplant. Group B had not received any dietary advice or follow-up posttransplant.

MAIN OUTCOME MEASURE

Weight gained and body mass index (BMI) at 4 months and at 1 year posttransplant.

RESULTS

The mean weight (BMI) for group A at baseline, 4 months and at 1 year posttransplant was 67 +/- 13 kgs (24.1 +/- 3.9 kg/m2), 69 +/- 12 kgs (24.6 +/- 3.5 kg/m2), and 73 +/- 12 kgs (26.1 +/- 3.4 kg/m2), respectively. The mean weight (BMI) for group B at baseline, 4 months and at 1 year posttransplant were 67 +/- 11 kgs (23.7 +/- 3.4 kg/m2), 74 +/- 9 kgs (26.3 +/- 3.3 kg/m2), and 79 +/- 12 kgs (27.9 +/- 4 kg/m2), respectively. Analysis of group A showed no significant difference in weight gained and BMI with dietary advice and follow-up at 4 months posttransplant compared with baseline. There was a significant difference in weight gain and BMI at 1 year posttransplant compared with 4 months posttransplant (P = .002, P = .002, respectively). Analysis between groups showed a significantly lower weight gain in group A compared with group B both at 4 months and at 1 year posttransplant (P = .01, P = .01 respectively). Group A had a significantly lower BMI than group B at 4 months and at 1 year posttransplant (P = .003, .006, respectively). At 1 year posttransplant, group A had a mean weight gain of 5.5 kg per patient compared with a mean of 11.8 kg per patient in group B.

CONCLUSION

Early intensive dietary advice and follow-up is effective in controlling weight gains in the first year posttransplant. Dietary advice should be an important part of posttransplant treatment.

A novel macrolactam-trisaccharide antifungal antibiotic. Taxonomy, fermentation, isolation, physico-chemical properties, structure elucidation and biological activity

A novel secondary metabolite SCH 42282 (1), with antifungal activity was isolated from the fermentation broth of a soil actinomycete identified as a Microtetraspora sp. The active compound was separated from the fermentation broth by butanol extraction and purified on a silica gel column and by multi-coil counter current chromatography. The compound was identified as a novel macrolactam trisaccharide related to SCH 38518 (4). The structure was established by hydrolysis of the parent compound and spectroscopic studies of the acetate derivative. The compound is active against Candida spp. (Geometric Mean MIC's. 18 micrograms/ml) but less active SCH 42729 (3). the disaccharide (Geometric Mean MIC's, > or = 10.7 micrograms/ml and SCH 38518 (4), the monosaccharide (Geometric Mean Mic's, 3.8 micrograms/ml.

A family of novel macrocyclic lactones, the saccharocarcins produced by Saccharothrix aerocolonigenes subsp. antibiotica. II. Physico-chemical properties and structure determination

Six novel tetronic acid analogs were isolated from the fermentation broth of the actinomycete Saccharothrix aerocolongenes subsp. antibiotica SCC1886. The structures of these saccharocarcins were determined by their spectral data, and chemical degradation. All six compounds are derived from two modified tetronic acid homologs which differ from other tetronic acids by having an ethyl or propyl side chain at C-23 and a methyl group at C-16. They are all characterized by a novel sugar-amide at C-17.

Inhibition of c-fos proto-oncogene induction by Sch 52900 and Sch 52901, novel diketopiperazine produced by Gliocladium sp

Sch 52900 (1) and Sch 52901 (2), two new inhibitors of c-fos proto-oncogene induction, have been isolated from the fermentation of broth of the fungal culture (SCF-1168), Gliocladium sp. Along with compounds 1 and 2, a known compound verticillin A (3) was also obtained from the culture. Structure elucidation of 1 and 2, accomplished by analysis of spectral data in comparison with the data of 3, revealed both 1 and 2 were found to be closely related to the verticillin family of diketopiperazines. All three compounds prevented serum-stimulated transcription of the human c-fos promoter, using a fos/lac Z reporter gene assay, with IC50 values of 1.5, 18 and 0.5 microM of 1, 2 and 3, respectively. Northern analysis revealed the exposure of cells to compound 3 causes inhibition of both phorbol ester-induced c-fos induction of serum-induced JE induction in the absence of inhibiting RNA synthesis, as measured by [3H]uridine incorporation. There results suggest that this class of compounds exerts antitumor activity by blocking a signal transduction pathway that is common to and necessary for the induction of at least a subset of immediate early genes involved in cell proliferation.

Phospholipase D inhibitors from a Myrsine species

The phospholipase D-inhibitory activity of a methanol extract from the leaves of a New Zealand plant, Myrsine australis, has been attributed to two new saponins 1 and 2. Compound 1 was assigned as 3-0-[-beta-D-xylopyranosyl-(1-->2)-0-beta-D-glucopyranosyl-(1-->4)- -[0-beta-D -glucopyranosyl-(1-->2)]-alpha-L-arabinosyl]-16alpha-hydroxy-+ ++13beta,28-epoxyoleanane and 2 as 3beta-0-[-beta-rhamnopyranosyl-(1-->2)-0-beta-D-glucopyranosyl-(1-->4)-[ 0-beta-D-glucopranosyl]-alpha-L-arabinopyranosyl]-16alpha -hydroxy-13beta, 28-epoxyleanane. Compounds 1 and 2 showed IC50 values of 3 and 2 microM, respectively, versus phorbol 12-myrisate-13-acetate-stimulated phosphlipase D in human promyelocytic leukemic (HL-60) cells. Compounds 1 and 2 also inhibited fMLP (formyl-Met-Leu-Phe) stimulated phospholipase D with IC50 values of 8 and 24 microM, respectively.

Isolation and structure of two novel muscarinic receptor antagonists

The structures of two novel muscarinic receptor antagonists, 1 and 2, were determined by their spectral data and high-resolution mass measurements of their degradation products. Both are aliphatic long-chain compounds and contain amide and keto functionalities. The major microbial metabolite [1] contains three terminal guanidino groups and the minor compound [2] has two terminal guanidino groups.

A novel macrolactam-disaccharide antifungal antibiotic. Taxonomy, fermentation, isolation, physico-chemical properties, structure elucidation and biological activity

A novel natural product (1), with antifungal activity was isolated from the culture broth of an actinomadurae. The active compound was separated from broth by n-butanol extraction and purified by silica gel and multicoil counter current chromatography. Physico-chemical data suggested the structure of this compound to be a novel macrolactam disaccharide related to Sch 38518 (3). The structure was determined by spectroscopic studies on the acetate derivative. It was active against Candida spp. (MIC's, 4 approximately 64 micrograms/ml) but less than the monosaccharide, Sch 38518 (MIC's, 1 approximately 16 micrograms/ml).

A novel class of platelet activating factor antagonists from Phoma sp

Four novel platelet activating factor (PAF) antagonists, Sch 47918, Sch 49026, Sch 49027 and Sch 49028, were isolated from the fermentation broth of the fungal culture, Phoma sp. (ATCC 74077). The structures of these compounds were elucidated by spectroscopic methods. The structure and stereochemistry of the first isolated component, Sch 47918, were confirmed by single crystal X-ray diffraction analysis. Sch 49028, the most active component, was found to inhibit PAF-induced human platelet aggregation in vitro with an IC50 of 1.26 microM. However, this compound was inactive in vivo at 5 mg/kg, iv against PAF-induced bronchospasm in guinea pigs.

SCH 45752--an inhibitor of calmodulin-sensitive cyclic nucleotide phosphodiesterase activity

A highly potent inhibitor of calmodulin-sensitive phosphodiesterase (PDE) activity was isolated from the culture broth of an unidentified fungal isolate, SCF-125. A chemically defined medium was developed for production of this compound. The PDE inhibitor was isolated from the fermentation filtrate by adsorption on a macro-reticular resin and further purified by gel filtration chromatography and reverse-phase HPLC. The major PDE inhibitor was identified as cephalochromin, a bis-naphthopyrone, by spectral data analysis. The compound, SCH 45752, inhibited calmodulin-sensitive PDE activities with IC50 values of 40-47 nM. It inhibited the activities of calmodulin-independent PDE and various protein kinases with higher IC50 values (2-40 microM). SCH 45752 does not appear to be a calmodulin antagonist. Furthermore, SCH 45752 affects smooth muscle contraction at a concentration of 30 microM; it potentiated the relaxing effect of sodium nitroprusside on carotid artery media contracted by histamine. Thus SCH 45752 is one of the most potent inhibitors of calmodulin-sensitive PDE activity known, and it is capable of exerting a pharmacological effect in at least one intact tissue model.

Electrosurgical management of hyperplastic tissue

Electrosurgery is a safe, effective modality for tissue management in conjunction with restorative dentistry. It can be used to remove redundant tissue to gain access for tooth preparation, develop a gingival trough around the margins of a prepared tooth for an accurate impression, control hemorrhage, remove opercula, and plane and reshape tissue of an edentulous area for the construction of a hygienic and esthetic pontic.

Kijanimicin (Sch 25663), a novel antibiotic produced by Actinomadura kijaniata SCC 1256. Fermentation, isolation, characterization and biological properties

A novel antibiotic complex has been isolated form the fermentation broth of a new species of Actinomadura, A. kijaniata SCC 1256. The complex was separated form the broth by a solvent extraction procedure and consists of 1 major component, designated kijanimicin, and 3 minor components. Kijanimicin was isolated form the complex by column chromatography and/or preparative high pressure liquid chromatography. Structurally the compound is a unique, large acid enol antibiotic and possesses an unusual in vitro spectrum of activity against some Gram-positive and anaerobic microorganisms. In vivo it has also shown interesting activity against malaria.

Correlation between micro-otoscopy, micropneumatoscopy and otoadmittance tympanometry

The micro-otoscopic, audiometric and tympanometric findings were correlated in 204 ears seen in a Veterans Administration Hospital ear clinic. Otoscopy, audiometry and tympanometry were done during the same clinical visits. In most cases pneumo-otoscopy with the microscope also was performed. Because we were unable to standardize pressures, we found pneumo-otoscopy of limited value. The data in this series were analyzed from two different points of view to determine the accuracy of the tympanometer in detecting and identifying ear disease. First the otoscopic results were compared with the tympanometric findings. Second, the procedure was reversed and various tympanometric findings were compared to the otologic diagnosis. Otophotographs were obtained in many of the ears to record findings. An otologic evaluation consists in physical and functional examinations and is not complete without both elements. It is important to remember that the tympanogram does not measure hearing loss. Tympanic membrane abnormalities can invalidate measurements of acoustic impedance and lead to a false interpretation of tympanometric findings.