Jagruti A. Patel

Pharmacological review on Centella asiatica: a potential herbal cure-all.

In recent times, focus on plant research has increased all over the world. Centella asiatica is an important medicinal herb that is widely used in the orient and is becoming popular in the West. Triterpenoid, saponins, the primary constituents of Centella asiatica are manly believed to be responsible for its wide therapeutic actions. Apart from wound healing, the herb is recommended for the treatment of various skin conditions such as leprosy, lupus, varicose ulcers, eczema, psoriasis, diarrhoea, fever, amenorrhea, diseases of the female genitourinary tract and also for relieving anxiety and improving cognition. The present review attempts to provide comprehensive information on pharmacology, mechanisms of action, various preclinical and clinical studies, safety precautions and current research prospects of the herb. At the same time, studies to evaluate the likelihood of interactions with drugs and herbs on simultaneous use, which is imperative for optimal and safe utilization of the herb, are discussed.

Hepatoprotective activity of ethanolic extracts of bark of Zanthoxylum armatum DC in CCl4 induced hepatic damage in rats

AIM OF THE STUDY Zanthoxylum armatum DC is described as a hepatoprotective in Ayurveda, the Indian system of medicine. However, there is no scientific basis or reports in the modern literature regarding its usefulness as a hepatoprotective agent. The present study was carried out to evaluate the hepatoprotective activity of ethanolic extract of bark of Zanthoxylum armatum DC in CCl(4) induced hepatotoxicity in male Wistar rats. MATERIALS AND METHODS Ethanolic extracts at doses of 100, 200, and 400mg/kg were administered orally once daily for 7 days. The hepatoprotective activity was assessed using various biochemical parameters like alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, serum bilirubin, total protein and serum antioxidant enzymes along with histopathological studies of liver tissue. RESULTS The substantially elevated serum enzymatic levels of serum transaminases, alkaline phosphatase and total bilirubin were significantly restored towards normalization by the extracts. Bark extracts significantly increased the levels of antioxidant enzymes: superoxide dismutase, catalase and glutathione. Phytochemical analysis revealed presence of isoquinoline alkaloid, berberine, as well as flavonoids and phenolic compounds, which have been known for their hepatoprotective activities. CONCLUSIONS Zanthoxylum armatum DC possesses significant protective effect against hepatotoxicity induced by CCl(4) which may be attributed to the individual or combined action of phytoconstituents present in it.

Herb-drug interactions: A review and study based on assessment of clinical case reports in literature

Objective : To conduct a systematic review of literature on interactions between conventional drugs and various herbs. Materials and Methods : We carried out a literature survey to assess published herb-drug interaction information in clinical case reports and case series to check the report reliabilities. Results : From 133 cases of suspected interactions, 67% cases were classified as possible interactions, 27% cases were unable to be evaluated and only 6% of the cases were well-documented. St. Johns wort was the most common herb involved (37 cases) in drug interactions. Warfarin was the most common drug (34 cases) interacting with various herbs. Conclusion : Herb-drug interactions are a stark reality today. Hence, proper reporting of cases, careful vigilance, evidence-based appraisal and constantly updated reviews of such herb-drug interactions are very important to promote systematic research.

Antibiotic susceptibility patterns of Pseudomonas aeruginosa at a tertiary care hospital in Gujarat, India.

Objectives: The present study was undertaken to assess the antibiotic susceptibility patterns of Pseudomonas aeruginosa at a tertiary care hospital in Gujarat, India. Due to significant changes in microbial genetic ecology, as a result of indiscriminate use of anti-microbials, the spread of anti-microbial resistance is now a global problem. Materials and Methods: Out of 276 culture positive samples, 56 samples of Pseudomonas aeruginosa were examined and 10 different types of specimen were collected. Microbial sensitivity testing was done using disk diffusion test with Pseudomonas species NCTC 10662, as per CLSI guidelines. Results: The highest number of Pseudomonas infections was found in urine, followed by pus and sputum. Pseudomonas species demonstrated marked resistance against monotherapy of penicillins, cephalosporins, fluoroquinolones, tetracyclines and macrolides. Only combination drugs like Ticarcillin + Clavulanic acid, Piperacillin + Tazobactum, Cefoperazone + Sulbactum, Cefotaxime + Sulbactum, Ceftriaxome + Sulbactum and monotherapy of amikacin showed higher sensitivity to Pseudomonas infections; however, the maximum sensitivity was shown by the Carbapenems. Conclusion: From the present study, we conclude that urinary tract infection was the most common hospital acquired infection. Also, co-administration of β -lactamase inhibitors markedly expanded the anti-microbial sensitivity of semi-synthetic penicillins and cephalosporins. The aminoglycoside group of antibiotics - amikacin - demonstrated maximum sensitivity against pseudomonas species. Therefore, use of amikacin should be restricted to severe nosocomial infections, in order to avoid rapid emergence of resistant strains. Periodic susceptibility testing should be carried out over a period of two to three years, to detect the resistance trends. Also, a rational strategy on the limited and prudent use of anti-Pseudomonal agents is urgently required.

The role of peroxisome proliferator-activated receptors in human disease

Increasing attention has been focused on the role of peroxisome proliferator-activated receptors (PPARs) in the past decade. Compelling data have begun to unite work from various arenas, such as epidemiology and vascular biology. Clinical trials with synthetic PPAR agonists have exhibited therapeutic benefits in treating various chronic diseases like atherosclerosis, diabetes mellitus and cardiovascular diseases. The PPARs, a family of nuclear receptors (NRs), are a set of three receptor sub-types encoded by distinct genes. They function as lipid sensors to regulate a broad range of genes in many metabolically active tissues. The discovery of PPAR-specific ligands has led to a significant advancement in our understanding of the structure of these receptor proteins and molecular mechanisms of their ligand dependent activation. Herein, we have tried to delineate the role of PPARs as molecular targets for the development of new drugs to treat human metabolic diseases.

Prevalence of head and neck cancers in Ahmedabad, Gujarat

IntroductionHead and neck cancer constitute one of the commonest cancers in India. Use of smokeless tobacco (pan masala, gutka, zarda, etc.) is the maximum in Gujarat, especially in and around Ahmedabad, and it is responsible for a large majority of these cancers.Aim and objectiveThe present study was carried out to study the patient’s characteristics, prevalence, treatment modalities and histopathological subtypes of head and neck cancer in and around Ahmedabad.MethodsA cross-sectional and observational study was carried out at the Head and Neck Services Department of Aastha Oncology Associates, Medi-Surge Hospitals, Ahmedabad, from December 2006 to May 2007. Patients were made to fill up the Case Record Form (CRF) with their informed consent. Proforma of the CRF included patient’s age, gender, income, education, family history, lifestyle, signs and symptoms, various investigations, treatment options and adverse effects during treatment and follow up. Preponderance of cancer was found in males (86%) with maximum prevalence in age group 41–60 years (69%). 58% cases were habitual tobacco chewers. Majority of head and neck cancers constituted the tongue, buccal mucosa and alveolus cancers. Radiotherapy and surgery were major treatment options in 44% patients. Blood parameters profile in all the three treatment groups was found to be lower than the control group.ConclusionWe conclude that a properly structured and site specific data like this pin points to the magnitude and pattern of head and neck cancer problem in India and it can augment the National Cancer Registry Program.