Shivananda B. Nayak

Evaluation of wound healing activity of Allamanda cathartica. L. and Laurus nobilis. L. extracts on rats

BackgroundAllamanda cathartica. L. is a perennial shrub used in traditional medicine for treating malaria and jaundice. Laurus nobilis. L. is a tree and has been used for its astringent, healing and diuretic properties. The objective of this study was to investigate the aqueous extracts of Allamanda and Laurus nobilis to evaluate their wound healing activity in rats.MethodsExcision and incision wound models were used to evaluate the wound healing activity of both the extracts on Sprague Dawley rats. In each model, animals were divided into four groups of 10 animals each. In both the model, group 1 served as control and group 2 as reference standard. In an excision wound model, group 3 animals were treated with Allamanda (150 mg kg-1 day-1) and group 4 animals were treated with Laurus nobilis (200 mg kg-1 b.w day-1) for 14 days respectively. In the case of incision wound model, group 3 and 4 animals were treated with the extracts of Allamanda and Laurus respectively for 10 days. The effects of vehicles on the rate of wound healing were assessed by the rate of wound closure, period of epithelialisation, tensile strength, weights of the granulation tissue, hydroxyproline content and histopathology of the granulation tissue.ResultsThe aqueous extract of Allamanda promoted wound healing activity significantly in both the wound models studied. High rate of wound contraction (P < .001), decrease in the period of epithelialisation (10.2 ± 0.13), high skin breaking strength (440.0 ± 4.53), significant increase in the weight of the granulation tissue (P < .001) and hydroxyproline (P < .001) content were observed in animals treated with the aqueous extract of Allamanda. Histological studies of the granulation tissue from the Allamanda treated group showed the presence of a lesser number of inflammatory cells, and increased collagen formation than the control. In Laurus nobilis treated animals, the rate of wound contraction, weight of the granulation tissue and hydroxyproline content were moderately high (P < .05). The histological study of the granulation tissue of the Laurus nobilis treated animals showed larger number of inflammatory cells, and lesser collagen when compared with the Allamanda treated group of animals. However, it was better than the control group of animals.ConclusionThe data of this study indicated that the leaf extract of Allamanda possesses better wound healing activity than the Laurus nobilis and it can be used to treat different types of wounds in human beings too.

Relationship between adiponectin, inflammatory markers and obesity in type 2 diabetic and non-diabetic Trinidadians.

Aim: To determine and study the relationship between adiponectin and inflammatory markers in obese, non-obese, type 2 diabetic and non-diabetic Trinidadians. Methods: It was a cross-sectional study comprised of 133 subjects of Trinidadians. Anthropometric indices were measured and adiponectin, inflammatory marker levels, lipid profiles and glucose were measured in fasting blood samples. Results: Adiponectin levels were significantly lower (P = 0.003) in diabetics (n = 60) than non diabetics (n = 73). No correlation between adiponectin and inflammatory markers was found. Adiponectin levels were negatively correlated with BMI adjusting for age and diabetic status, and gender (β = −0.200, P = 0.020; β = −0.235, P = 0.004). Conclusions: No correlation exists between adiponectin and inflammatory markers. Adiponectin levels are lower in type 2 diabetic Trinidadians than in non-diabetics and decreases with increasing adiposity, using BMI as the marker.

Wound Healing Activity of the Fruit Skin of Punica granatum

The skin of the fruit and the bark of Punica granatum are used as a traditional remedy against diarrhea, dysentery, and intestinal parasites. The fruit skin extract of P. granatum was tested for its wound healing activity in rats using an excision wound model. The animals were divided into three groups of six each. The experimental group of animals was topically treated with P. granatum at a dose of 100 mg/kg every day for 15 days, while the controls and standard group animals were treated with petroleum jelly and mupirocin ointment, respectively. Phytochemical analysis of the extract revealed the presence of saponins, triterpenes, tannins, alkaloids, flavonoids, and cardiac glycosides. Extract-treated animals exhibited 95% reduction in the wound area when compared with controls (84%), which was statistically significant (P<.01). The extract-treated wounds were found to epithelize faster compared with controls. The hydroxyproline content of extract-treated animals was significantly higher than controls (P<.05). The fruit skin extract did not show any antimicrobial activity against the microrganisms tested. P. granatum promotes significant wound healing in rats and further evaluation of this activity in humans is suggested.

Does insulin resistance co-exist with glucocorticoid resistance in the metabolic syndrome? Studies comparing skin sensitivity to glucocorticoids in individuals with and without acanthosis nigricans

BackgroundThe metabolic syndrome is associated with increased risk for both diabetes and coronary artery disease, which insulin resistance alone does not satisfactorily explain. We propose an additional and complementary underlying mechanism of glucocorticoid resistance.ResultsUsing acanthosis nigricans (AN) and skin vasoconstrictor (SVC) response to topically applied beclomethasone dipropionate as markers of insulin and glucocorticoid resistance, respectively, we compared anthropometric, biochemical, pro-inflammatory markers and the SVC response in subjects with AN in two studies: STUDY 1 was used to compare subjects with AN (Grade 4, n = 32), with those without AN (n = 68) while STUDY 2 compared these responses among a cross-section of diabetic patients (n = 109) with varying grades of AN (grade 0, n = 30; grade 1, n = 24; grade 2, n = 18; grade 3, n = 25; grade 4, n = 12).FindingsIn both studies there was an inverse relationship between AN Grade 4 and the SVC response, (P < 0.001). In STUDY 1, AN Grade 4 was associated with age, waist circumference, BMI, fasting blood glucose, plasma lipids and hs-CRP (P < 0.05). SVC was an independent predictor of CRP and those with combined AN and a negative SVC response, CRP levels were highest. In Study 2 when the SVC response in subjects with type 2 diabetes mellitus with varying degrees of AN was studied, it showed that for any degree of AN, the SVC response is more likely to be negative and was independent of gender and ethnicity.ConclusionAn absent SVC response represents a new biomarker for the metabolic syndrome and the exaggerated inflammatory response, which characterizes the metabolic syndrome, may be an outcome of deficient glucocorticoid action in vascular tissue.

Association of troponin T and altered lipid profile in patients admitted with acute myocardial infarction

Objective: To determine whether elevated levels of troponin T are associated with altered lipid profile. Methods: Data were collected from 205 patients each of whom presented elevated troponin T levels. Results: 195 patients presented with suspected myocardial infarction, 10 patients did not. Of which 68 had medium, 107 high and 20 presented with very high troponin T levels. The proportions were significantly different (p = 0.000215). Regression analysis showed that troponin T level was a useful quadratic predictor of total cholesterol (p = 0.000), triglycerides (p = 0.003), and low density cholesterol (p = 0.000); and a useful linear predictor of TC/HC ratio (p = 0.001). Conclusions: The occurrence of myocardial infarction is associated with elevated troponin T levels; troponin T is positively correlated with total cholesterol, triglycerides, LDL and TC/HC ratio and negatively correlated with HDL. TC/HC ratio was not found to be a useful predictor of the likelihood of MI.

Do current standards of primary care of diabetes meet with guideline recommendations in Trinidad, West Indies?

AIMS Primary care management of diabetes was examined using the Caribbean Health Research Council (CHRC) guidelines. METHODS We retrospectively examined a cross-section of 646 type 2 people with diabetics over 12 months with 1st visit between 1997 and 2005. RESULTS There were more women (65.8%) than men (34.2%) with age range between 29 and 89 years. Blood pressure and weight were evaluated in >95% of patients at each centre. Waist circumference and BMI were not measured at any time and HbA(1)c was infrequently measured (1.6-7%) over the 12 months. Information on family history (87.5%), smoking and alcohol (78.1%), exercise (21.4%), socioeconomic status (19.4%) and education (0.3%), and fasting blood sugar (97.2%), lipid profile (51.8%) and serum creatinine (37.9%) were assessed at the 1st visit. At follow-up patients were advised on treatment compliance (47.2%), diet (34.2%), exercise (18.5%) and rarely on home monitoring of blood glucose (0.3%). Peripheral sensations, pedal pulses (6%), visual acuity (3.3%), fundoscopy (12.1%) and ECG (3.9%) were scarcely examined at the annual visit. CONCLUSIONS Current management of diabetes in primary care in Trinidad falls short of Caribbean guideline recommendations. The CHRC and Ministry of Health should jointly educate caregivers of diabetes to implement the guidelines, with annual audits to identify shortfalls in management.

Association between altered lipid profile, body mass index, low plasma adiponectin and varied blood pressure in Trinidadian type 2 diabetic and non-diabetic subjects.

BACKGROUND The obesity and hypertension have become the causes for the development type 2 diabetes. There is a limited study done on the contribution of body mass index (BMI) to blood pressure (BP) in the Caribbean population. Aim of our study was to determine the associations between lipid profile, BMI, adiponectin, and BP in Trinidadian type 2 diabetic patients with regards to age and ethnicity. MATERIALS AND METHODS This was a cohort study comprised of 266 subjects (85 males and 181 females) attending primary and tertiary healthcare settings in central Trinidad. Of which, 126 diabetic subjects were matched with 140 non-diabetic subjects. Along with clinical history and anthropometry, adiponectin and lipid profile were measured in fasting blood samples. RESULTS The diabetic group had higher triglycerides, very low density lipoprotein (VLDL), and BP values which were statistically significant (P < 0.05) when compared to non-diabetic subjects. The high-density lipoprotein cholesterol (HDL-c) and adiponectin were lower in diabetic subjects. HDL-c showed significant changes for ethnicity (P = 0.013) and gender (P = 0.043). The mean adiponectin concentrations were found to be significantly different among the ethnic groups (P = 0.001). Systolic pressure varied significantly with age (P = 0.018). As age increased, BP also increased. Ethnic groups had a significant difference in diastolic pressure (P = 0.027). East Indians had the highest mean diastolic pressure (80.74 ± 10.29) when compared to all other ethnic groups. CONCLUSION HDL-cholesterol, low levels of adiponectin, and varied BP are associated in Trinidadian type 2 diabetic subjects with regards to age, gender, and ethnicity.

Controlling Lipids AIDS in the Prevention of Type 2 Diabetes, Hypertension, and Cardiovascular Diseases

Background: Abnormal lipid profiles are a characteristic feature of persons with chronic conditions in which the diabetic populations are recognized as the dominant group, regardless of gender and ethnicity worldwide. This study was conducted to identify and evaluate the abnormalities of serum lipid profiles in both nondiabetic and diabetic persons. Methods: This study was a case–control investigation conducted between 2013 and 2015. The study enrolled 266 patients from the North Central and South West Regional Health Authorities of Trinidad. Of the 266 patients recruited, 126 were diabetic and 140 were nondiabetic. Results: Our study observed that dyslipidemia was present among the nondiabetic populations as the nondiabetics had 55 women and 20 men with high cholesterol, 22 women and 14 men with high triglyceride (TG), 30 women and 25 men with low high-density lipoprotein cholesterol (HDL-C), 42 women and 21 men with high low-density level-cholesterol (LDL-C), 13 women and 8 men with high very low-density lipoprotein (VLDL), and also 30 women and 11 men with body mass index (BMI) over 30 kg/m2. We also observed that diabetic women had significantly lower TGs (P = 0.019) and higher HDL-C (P = 0.001) and LDL (P = 0.003) when compared with the diabetic men. In addition, the nondiabetic females also had higher HDL-C (P = 0.045) when compared to their male counterparts. Both diabetic and nondiabetic women exhibited significantly higher BMI of P = 0.000. A negative correlation was obtained among TGs and HDL (r = −0.356, n = 83, P = 0.001) and a positive correlation was observed among LDL and HDL (r = 0.230, n = 86, P = 0.035). Conclusions: This study observed the incidences in the abnormalities of serum lipid profiles in both nondiabetic and diabetic persons. It also presents the high occurrence of nondiabetic women with dyslipidemia as they presented with high cholesterol, high TG, low HDL-C, and high VLD-L with BMI over 30 kg/m2.

Effects of Jasminum multiflorum leaf extract on rodent models of epilepsy, motor coordination and anxiety

Jasmine flowers and leaves are used extensively in folk medicine in different parts of the world to treat a variety of diseases. However, there are very few published reports on the neuropsychiatric effects of Jasmine extracts. Hence, the objectives of the present study were to examine the effects of an alcohol extract of Jasminum multiflorum leaves on topically-applied bicuculline (a model of acute simple partial epilepsy) and maximal electroshock (MES, a model of generalized tonic-clonic seizure) in male Sprague-Dawley rats. The objectives also included an examination of the anxiolytic properties of the extract using an elevated plus maze and the effect of the extract on motor coordination using a rotarod treadmill. Phytochemical analysis of the extract showed the presence of three flavonoids and four additional compounds belonging to the steroid, terpenoid, phenol or sugar classes of compounds. The Jasmine alcohol extract, diluted with water and given orally or intraperitoneally, reduced the number of bicuculline-induced epileptiform discharges in a dose-dependent manner. The extract did not cause a significant increase in the current needed to induce hind limb extension in MES experiments. The extract significantly affected motor coordination when injected at 500mg/kg but not at 200mg/kg. At the latter dose, the extract increased open-arm entries and duration in the elevated plus maze to a level comparable to that of diazepam at 2mg/kg. We conclude that Jasmine leaf extract has a beneficial effect against an animal model of acute partial complex epilepsy, and significant anxiolytic effect at a dose that does not affect motor co-ordination.

Adiponectin in Diabetic Subjects Without Any Micro- or Macrovascular Complications: A Review.

Adipose tissue is an important endocrine organ responsible for the secretion of adipokines, which play important roles in glucose and lipid homeostasis. Type 2 diabetes (T2D) has been proven as a major result from fat accumulation thus leading to insulin insensitivity. This adipose specific secreted protein has important inflammatory properties that are present in the circulation and involved in the regulation of insulin sensitivity,1 thus making it an important modulator for T2D. The main purpose of this article is to understand the levels of adiponectin for diabetic subjects without any complications and its necessity for managing obesity. In a recent published article,2 a cross-sectional study of 229 cases of T2D and 205 healthy individuals of age 30-70 years was presented from the Dakshina Kannada district of Karnataka, India. Clinical examinations were done for the assessment of cardiovascular and abdominal system. Estimations of adiponectin levels were done using ELISA technique. Anthropometric variables were measured by standard procedure and HbA1c tested via immunoturbidometry. The results obtained were analyzed using SPSS 10.0, Student’s unpaired t test. Pearson correlation was analyzed between the parameters of the study population. The results showed the mean value of adiponectin of the diabetic study population was significantly less (15.98 + 6.02) when compared to normal subjects (18.14 + 8.32). An increase in the values for the nondiabetic population was seen in both female and male groups (P = .008). Negative correlations were observed between glycated hemoglobin and adiponectin in the diabetic group (P = –.361) and for body mass index (BMI) compared with adiponectin in normal group (P = −0.302). In addition, males in normal population had higher adiponectin levels than female but showed the opposite in the diabetic group as males in the diabetic had lower than females. With the use of observational research methods to determine the validity of this study, we relate to prospective studies showing how the levels of adiponectin have been supported as being lower in diabetic subjects2,3 when compared to normal as a good glycemic index in diabetic subjects helps to increase the levels of adiponectin. Though an inverse relation was observed between BMI and adiponectin in healthy individuals, the relation was lost in obese diabetic subjects free from micro- or macrovascular complications. Studies have produced negative correlations; however, they are inconsistently inversely correlated with BMI.1,3,4 Studies have also shown plasma adiponectin levels being negatively regulated by adiposity.5 Obese subjects express significantly lower levels of adiponectin in nondiabetic patients, and a strong correlation between adiponectin and systemic insulin sensitivity has been well established both in vivo and in vitro, in mice, other animals, and humans. A rise in adiponectin levels showed weight loss and across diverse populations from 13 prospective studies are associated with a lower risk of T2D.5 However adiponectin’s potential remains substantially weak since adiponectin is independent of obesity in diabetic patients from these studies. This very important adipocytokine is abundant, and it has important applications, but if it is to act as a marker for adiposity, more research is needed to support the value bounding this theory. The benefit of this study design allowed researchers to compare many different variables at the same time. The study also showed reproducibility as the measurements used were regarded as valid by other investigators. The quality of measurements and outcomes was controlled, and since all the patients were accounted for the study statistically showed completeness. However, longitudinal studies are required for a more definite understanding of cause and effect for clinical applications of adiponectin. From recent studies high serum adiponectin concentration and low BMI are significantly associated with the mortality in an elderly cohort of all cause and cardiovascular disease.6 Adiponectin administration also shows a promising pathway for managing obesity clinically; however, it remains to be determined whether adiponectin can be used effectively and safely as pharmacologic means to treat obesity in humans whether through pharmaceutical or lifestyle interventions. T2D in the world has reached epidemic proportions, and replenishment of adiponectin might represent a novel treatment for insulin resistance (IR) and T2D since it appears to be an important modulator. Future studies should therefore evaluate adiponectin as it is a target for the reduction of T2D. With the global increase in the incidence of diabetes, new strategies to prevent the complications are urgently needed.