Cocos nucifera and metformin combination for modulation of diabetic symptoms in streptozotocin induced diabetic rats

Background: Cocos nucifera, belonging to Arecaceae family, holds quite an importance in the Indiantraditional medicinal system. C. nucifera inflorescence (CnI) has been reported in the literature to beuseful in the treatment of diarrhoea, dysentery, diabetes, and dyspepsia. In this study, we aimed toevaluate the efficacy of CnI as an adjuvant with metformin in ameliorating Type-2 diabetes mellitus (T2-DM).Objectives: To evaluate antidiabetic activity of CnI in combination with metformin in Streptozotocin (STZ)induced diabetic rats.Materials and methods: Diabetes was induced in male Wistar rats using streptozotocin (45 mg/kg; i.p.).Plasma glucose level (PGL) was estimated after 72 h of STZ injection. Ethanolic extract of CnI (250 mg/kgand 500 mg/kg) per se and in combination with metformin (22.5 mg/kg) was administered orally oncedaily to rats for a period of 28 days. PGL level was estimated on 7th, 14th and 21st day followed by OralGlucose Tolerance Test (OGTT) and PGL both on the 28th day of treatment. DPPH assay was performed toevaluate antioxidant activity of CnI extract.Results: Extract of CnI (250 mg/kg and 500 mg/kg alone and the combination of extract (250 mg/kg)along with metformin (22.5 mg/kg) significantly decreased PGL (p < 0.0001) on 7th, 14th, 21st and 28thdays. Histopathological analysis of pancreatic tissue showed that treatment with CnI extract per se and incombination with metformin improved the damaged architecture of pancreas.Conclusion: The combination therapy of CnI and metformin produced a significant antidiabetic effectthan that of the extract alone and provides a scientific rationale for their use in antidiabetic therapy as anadjuvant.© 2017 Transdisciplinary University, Bangalore and World Ayurveda Foundation. Publishing Services byElsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Effectiveness Of Balance Exercise Program In Total Knee Arthroplasty: Meta-analysis

Background: Balance is essential for maintaining postural stability while performing functional activities and for falls avoidance in patients with TKA.There are very few RCTs done to assess functional improvement after TKA. Hence, this study was undertaken to find out evidence on physiotherapy treatment in TKA and analyze it.Methods: We searched Medline, CINAHL, PEDro from the year 2001 to 2015 for RCT involving evaluations of physiotherapy exer-cise in adults with a knee replacement. Search criteria’s were pain, stiffness, adherence and attrition. The inclusion criteria were studies which included physiotherapy exercise for balance specific exercises which compared various functional training and functional training with balance exercise in TKA. Result: Searches identified 20 randomized trials related to TKA and physiotherapy. Only three were fulfilled the inclusion criteria. Functional training with bal-ance exercises found to be effective in patients with total knee arthroplasty. Conclusion: After total knee replacement, interventions including physiotherapy along with balance exercises showed improvement in pain, stiffness and func-tional performance in mobility.

Stability indicating method development and validation for simultaneous estimation of atorvastatin calcium and celecoxib in bulk and niosomal formulation by RP-HPLC

The present work describes development and validation of a specific, sensitive, precise and stability-indicating high-performance liquid chromatographic method of analysis of atorvastatin calcium and celecoxib, both as a bulk drug and in niosomal formulation. The analysis has been performed by using Cosmosil-C18 column (4.6 mm´250 mm, 5 m) at 25 °C using acetonitrile: ammonium acetate buffer pH 5.0: methanol (50:25:25 v/v/v) as mobile phase. The detection was carried out at 277nm with a flow rate of 1.0mL/min. The retention times of Atorvastatin calcium and Celecoxib were 6.195 and 3.989min, respectively. The method was validated according to ICH guidelines, for specificity, precision, linearity, accuracy and robustness. Atorvastatin calcium and Celecoxib were subjected to stress conditions of hydrolysis, oxidation, photolysis and thermal degradation. The degradation was observed in oxidation and acid hydrolysis. The linearity for atorvastatin calcium and celecoxib were in the range of 100-500 µg/mL. The recovery study of atorvastatin and celecoxib were found to be in the range of 98.96 - 99.92% and 98.90-100%, respectively. The proposed method was validated and successfully applied to the estimation of Atorvastatin calcium and Celecoxib in combined in-house niosomal formulation.

O presente trabalho descreve o desenvolvimento e a validação de método de análise por cromatografia de alta eficiência específico, sensível, preciso e indicador de estabilidade de atorvastatina cálcica e celecoxibe, ambos como fármaco e como formulação niosômica. A análise foi realizada utilizando coluna Cosmosil-C18 (4,6 mm´250 mm, 5 m) a 25 °C, e acetonitrila: tampão acetato de amônio pH 5,0: metanol (50:25:25 v/v/v) como fase móvel. A detecção foi realizada a 277 nm, com fluxo de 1,0 mL/min. Os tempos de retenção de atorvastatina cálcica e de celecoxibe foram 6,195 e 3,989 min, respectivamente. O método foi validado de acordo com as regras da ICH para especificidade, precisão, exatidão e robustez. A atorvastatina cálcica e o celecoxibe foram submetidos a condições de estresse por hidrólise, oxidação, fotólise e degradação térmica. A degradação foi observada por oxidação e hidrólise ácida. Observou-se a linearidade da atorvastatina cálcica e do celecoxibe na faixa de 100-500 µg/mL. A recuperação da atorvastatina e do celecoxibe foi observada na faixa de 98,96-99,92% e 98,90-100%, respectivamente. O método proposto foi validado e aplicado com sucesso para a determinação de atorvastatina cálcica e celecoxibe em formulação niosômica caseira combinada.

Pharmacodynamic evaluation for antiplasmodial activity of Holarrhena antidysentrica (Kutaja) and Azadirachta indica (Neemb) in Plasmodium berghei infected mice model

OBJECTIVE@#To investigate in-vivo anti-plasmodial activity of aqueous extracts of plants selected based on the symptomology mentioned in Ayurveda.@*METHODS@#The aqueous extracts of Holarrhena antidysentrica (H. antidysentrica) (Kutaja) and Azadirachta indica (A. indica) (Neemb) for their antiplasmodial potential in Plasmodium berghei (P. berghei) infected mice was assessed using Peters four day suppressive test. Both the extracts were administered at 2 dose levels, full dose (1 000 mg/d) and minimized dose (200 mg/d). 10(6)P. berghei infected RBCs were injected on day '0' and treated from day '0' till day '3' post-infection. Tail blood smears were collected, giemsa stained and analyzed. The mice were observed for survival and parasitemia was assessed till 50% of mice in control survived.@*RESULTS@#It was observed that the percentage of parasitemia increased gradually in all the groups, with maximum in control group (Day 3-35, Day 9-46.98) and minimum in Chloroquine arm (Day 3-14.06, Day 9-19.92). The percentage of parasitemia was compared using Mann-Whitney U test depicting that all test groups exhibited reduction in parasitemia as compared to control (P-value<0.002 for all groups). These groups showed similar percentage of survival as Chloroquine.@*CONCLUSIONS@#The present investigation demonstrated the anti-plasmodial effects of H. antidysentrica and A. indica, which are two most commonly used medicinal plants in Ayurved for treatment of fever.

A prospective observational study to assess quality of life and prescription pattern in osteoarthritis patients at tertiary health centre in Mumbai.

Background: Osteoarthritis (OA) is a major cause of disability and is focused in "Bone and Joint Decade" declared by WHO which substantially affect different dimensions of quality of life. The aim of present study was to find the disease pattern in OA patients, monitoring prescription pattern to assess prognosis of osteoarthritis by WOMAC index. Materials and Methods: An observational study on prospective data collected for the evaluation of Quality of Life (QOL) in OA was conducted at tertiary health care centre in Mumbai. Patients with a diagnosis of OA were enrolled. The patient's history and clinical examination was based on classification criteria of the American College of Rheumatology; drugs prescribed were noted on case record form. Same procedure was carried out for the first and second follow-ups at 6 th and 12 th weeks respectively. Results: The patients belong to primary OA (84%) as compared to secondary OA (16%). Females (70.56% and 10%) were affected more commonly than males (13.44% and 6%). Knee Joint was worst affected in 76%, followed by hip joint in 16% and shoulder, ankle, wrist, elbow joint each having 2% (n=1) involvement. NSAIDs continued to dominate prescriptions given to 84% of patients followed by antiarthritic drugs and calcium supplements in 54% cases. The WOMAC score was higher in most of patients. After medication hydroxy chloroquine sulfate has shown maximum reduction in average WOMAC sore followed by paracetamol, indomethacin and diclofenac sodium. Conclusion: Osteoarthritis has a significant impact on quality of life, only partly ameliorated by anti-arthritic drugs, as assessed by the WOMAC scale in this study population. Further, a study with larger sample size is needed to further support our findings.