K. K. Pillai

Further studies on antioxidant potential and protection of pancreatic beta-cells by Embelia ribes in experimental diabetes.

This study was designed to examine the antioxidant defense by ethanolic extract of Embelia ribes on streptozotocin-(40 mg/kg, intravenously, single-injection) induced diabetes in Wistar rats. Forty days of oral feeding the extract (100 mg/kg and 200 mg/kg) to diabetic rats resulted in significant (P < .01) decrease in blood glucose, blood glycosylated haemoglobin, serum lactate dehydrogenase, creatine kinase, and increase in blood glutathione levels as compared to pathogenic diabetic rats. Further, the extract also significantly (P < .01) decreased the pancreatic thiobarbituric acid-reactive substances (TBARS) levels and significantly (P < .01) increased the superoxide dismutase, catalase, and glutathione levels as compared to above levels in pancreatic tissue of pathogenic diabetic rats. The islets were shrunken in diabetic rats in comparison to normal rats. In the drug-treated diabetic rats, there was expansion of islets. The results of test drug were comparable to gliclazide (25 mg/kg, daily), a standard antihyperglycemic agent. The study concludes that Embelia ribes enhances the antioxidant defense against reactive oxygen species produced under hyperglycemic condition and this protects β-cells against loss, and exhibit antidiabetic property.

Histamine and selective H3-receptor ligands: a possible role in the mechanism and management of epilepsy

The interaction of selective histamine H3-receptor agonist R(alpha)-methyl-histamine (RAMH) and antagonist thioperamide (THP) with some antiepileptic drugs [AED; phenytoin (PHT), carbamazepine (CBZ), sodium valproate (SVP), and gabapentin (GBP)] was studied on seizures induced by maximal electroshock (MES) and pentylenetetrazole (PTZ) in mice. It was found that subeffective dose of THP in combination with the subeffective doses of PHT and GBP provided protection against MES and/or PTZ-induced seizures. Further, RAMH reversed the protection afforded by either PHT or GBP on MES and/or PTZ seizures. In another set of experiments, the histamine content was measured in the whole brain and in different brain regions including cerebral cortex, hypothalamus, brain stem and cerebellum following convulsant (MES and PTZ) and AED treatment. It was seen that while MES exhibited a tendency to enhance brain histamine levels, PTZ showed the opposite effect. AEDs either increased (PHT and GBP) or decreased (SVP) brain histamine content in different regions to varying degrees. The results indicate a role for histamine in seizures and in the action of AEDs and suggest that selective H3-receptor antagonists may prove to be of value as adjuncts to conventional AEDs.

Evaluation of hepatoprotective potential of jigrine post-treatment against thioacetamide induced hepatic damage

Jigrine a polypharmaceutical herbal formulation containing aqueous extracts of 14 medicinal plants developed on the principles of unani system of medicine is used for liver ailments. The hepatoprotective potential of jigrine post-treatment at the dose of 0.5 ml/kg per day p.o. for 21 days was evaluated against thiocetamide induced liver damage in rats. Biochemical parameters like AST, ALT in serum and TBARS and glutathione in tissues were estimated to assess liver function. Data on the biochemical parameters revealed hepatoprotective potential of jigrine post-treatment against thioacetamide induced hepatotoxicity in rats. Silymarin used as reference standard also exhibited significant hepatoprotective activity on post-treatment against thioacetamide-induced hepatotoxity in rats. The biochemical observations were supplemented with histopathological examination of rat liver sections.

Effect of Ethanolic Extract of Embelia ribes on Dyslipidemia in Diabetic Rats

Diabetes mellitus has been treated orally with herbal remedies based on folk medicine since ancient times. Embelia ribes burm (Myrsinaceae), known commonly as vidanga, was used in Ayurveda for its anthelmintic activity. Ayurveda describes vidanga as pungent, causes increase in digestive fire, and cures flatulence and colic. A single study reported the antihyperglycemic activity of decoction of E. ribes in glucose-induced hyperglycemic albino rabbits. In the present study, the lipid-lowering and antioxidant potential of ethanolic extract of E. ribes burm was investigated in streptozotocin (40 mg/kg, IV, single injection)-induced diabetes in rats. Twenty days of orally feeding the extract (200 mg/kg) to diabetic rats resulted in significant (P < 0.01) decrease in blood glucose, serum total cholesterol, and triglycerides, and increase in HDLcholesterol levels when compared to pathogenic diabetic rats. Further, the extract also lowered the liver and pancreas thiobarbituric acid–reactive substances (TBARSs) values (P < 0.01) when compared to TBARS values of liver and pancreas of pathogenic diabetic rats. The results of test drug were comparable to gliclazide (25 mg/kg, orally), a standard antihyperglycemic agent. This is the first pilot study to provide biochemical evidence of potential of E. ribes in diabetic dyslipidemia.

Effect of thioperamide on oxidative stress markers in middle cerebral artery occlusion model of focal cerebral ischemia in rats

In view of the recent evidence for the involvement of histamine in cerebral ischemia, the present study evaluated the effect of thioperamide (THP), a selective histamine H3-receptor antagonist, on middle cerebral artery occlusion (MCAO) induced focal cerebral ischemia in rats. The rats were subjected to 2 h of MCAO followed by 22 h reperfusion after which the grip strength, locomotor activity and spontaneous alternation performance were assessed. Animals were then killed and oxidative stress markers were estimated in the whole brain. An elevation of thiobarbituric acid reactive substance (TBARS) and a reduction in glutathione (GSH) and antioxidant enzymes, such as glutathione-S-transferase (GST), glutathione peroxidase (GPx), glutathione reductase (GR) and superoxide dismutase (SOD), was observed following MCAO, the last two being statistically insignificant. Pretreatment with THP (5.5 mg/kg i.p. and 11 mg/kg i.p.) significantly reversed the MCAO-induced increase in TBARS, but could not reverse the other parameters. Paradoxically, it further reduced the levels of GPx, GR and SOD. No significant changes were observed in the catalase levels and in the grip strength and spontaneous alternation behavior of rats. Locomotor activity was reduced slightly, but reversed on pretreatment with THP. The dual effect of THP on oxidative stress requires further investigation and raises doubts on its possible use in cerebral ischemia.

Antipsychotic-like profile of thioperamide, a selective H3-receptor antagonist in mice.

Experimental and clinical evidence points to a role of central histaminergic system in the pathogenesis of schizophrenia. The present study was designed to study the effect of histamine H3‐receptor ligands on neuroleptic‐induced catalepsy, apomorphine‐induced climbing behavior and amphetamine‐induced locomotor activities in mice. Catalepsy was induced by haloperidol (2 mg/kg p.o.), while apomorphine (1.5 mg/kg s.c.) and amphetamine (2 mg/kg s.c.) were used for studying climbing behavior and locomotor activities, respectively. (R)‐α‐methylhistamine (RAMH) (5 μg i.c.v.) and thioperamide (THP) (15 mg/kg i.p.), per se did not cause catalepsy. Administration of THP (3.75, 7.5 and 15 mg/kg i.p.) 1 h prior to haloperidol resulted in a dose‐dependent increase in the catalepsy times (P < 0.05). However, pretreatment with RAMH significantly reversed such an effect of THP (15 mg/kg i.p.). RAMH per se showed significant reduction in locomotor time, distance traveled and average speed but THP (15 mg/kg i.p.) per se had no effect on these parameters. On amphetamine‐induced hyperactivity, THP (3.75 and 7.5 mg/kg i.p.) reduced locomotor time, distance traveled and average speed (P < 0.05). Pretreatment with RAMH (5 μg i.c.v.) could partially reverse such effects of THP (3.75 mg/kg i.p.). Climbing behavior induced by apomorphine was reduced in animals treated with THP. Such an effect was, however, reversed in presence of RAMH. THP exhibited an antipsychotic‐like profile by potentiating haloperidol‐induced catalepsy, reducing amphetamine‐induced hyperactivity and reducing apomorphine‐induced climbing in mice. Such effects of THP were reversed by RAMH indicating the involvement of histamine H3‐receptors. Findings suggest a potential for H3‐receptor antagonists in improving the refractory cases of schizophrenia.

Modulation of pentylenetetrazole-induced seizures and oxidative stress parameters by sodium valproate in the absence and presence of N-acetylcysteine

In view of a role of oxidative stress in epilepsy and the evidence for the involvement of peroxidative injury in sodium valproate (SVP)‐induced adverse effects on liver and kidneys, we investigated whether the combination of SVP with N‐acetylcysteine (NAC), an antioxidant, may help us to achieve maximal efficacy in terms of seizure control, with minimal toxicity on liver and kidneys. Pentylenetetrazole (PTZ)‐induced seizures were used to evaluate the anticonvulsant effect of drugs. Biochemical estimations included the determination of oxidative stress markers like thiobarbituric acid‐reactive substances in brain tissue and glutathione (GSH) levels in liver and kidney tissues. Aspartate aminotransferase and alanine aminotransferase concentrations in the serum were also determined to assess liver function. In our study, NAC exhibited a nondose‐dependent anticonvulsant effect. The concurrent administration of NAC with SVP significantly prolonged the latency to jerks, myoclonus and clonic generalized seizures. No significant oxidative stress was evident in brain tissue following PTZ‐induced seizures, though an elevation of serum transaminase enzymes was seen. SVP at the dose studied did not produce any significant oxidative stress on the liver and kidneys, while treatment with NAC elevated liver and kidney GSH levels. The concurrent administration of NAC with SVP had beneficial effects on liver and kidney cells.

Drug utilization of oral hypoglycemic agents in a university teaching hospital in India

Background:  India has witnessed a rapidly exploding epidemic of diabetes in recent years and currently leads the world with the largest number of diabetic subjects in a single country. World Health Organization estimates that in 2000, 31·7 million individuals were affected by diabetes in India and these numbers will rise to 79·4 millions by the year 2030. In view of the above situation, drug utilization review of antidiabetic medicines in Indian healthcare settings has a valid significance to promote rational drug use in diabetics.

Recent advances in adjunctive therapy for epilepsy: focus on sodium channel blockers as third-generation antiepileptic drugs.

Voltage-gated sodium channel blockers like phenytoin and carbamazepine have long been used in the treatment of epilepsy. Brain sodium channels continue to be an important target of many newer second-generation (fosphenytoin, oxcarbazepine, lamotrigine, felbamate, topiramate, zonisamide) and third-generation (eslicarbazepine, brivaracetam, carisbamate, fluorofelbamate, elpetrigine, lacosamide, rufinamide, safinamide, vinpocetine) antiepileptic drugs (AEDs). Some of the newer drugs show either state-dependent antiepileptic action or sodium channel subtype selectivity, although most agents do not differentiate between these channel subtypes. The present review highlights the preclinical and clinical efficacy, pharmacokinetics, drug interactions and adverse event profiles. It also addresses AED selection of sodium channel blockers that constitutes the third generation of AEDs.

Effects of folic acid and lamotrigine therapy in some rodent models of epilepsy and behaviour

It has been suggested that a folic acid (FA) deficiency induced by antiepileptic drugs might be the basis for the neuropsychiatric toxicity associated with these drugs. In the present study, lamotrigine (LTG), one of the newer antiepileptic drugs, was evaluated for its effect on epilepsy, mood and memory in mice. Further, the effect of the addition of FA to LTG therapy was also investigated. The increasing current electroshock seizure test was used to evaluate the anticonvulsant effect of drugs, while the forced swimming test (FST) and spontaneous alternation behaviour (SAB) models were employed for assessing the effects on mood and memory, respectively. LTG exhibited a dose‐dependent increase in seizure threshold, whereas FA did not have any effect. LTG did not affect, whereas FA decreased, behavioural depression in the FST in mice. Neither LTG nor FA affected memory scores in the SAB test. The combination of LTG and FA significantly reduced depression while enhancing the effects on memory and seizure threshold. The present observations have confirmed the antiepileptic action of LTG in yet another rodent model of epilepsy. Further, the results clearly demonstrate the additional benefits on epilepsy, mood and memory brought about by the inclusion of FA in the LTG regimen.