A Pilot Study on Wound Healing using an Antibacterial Steroidal Saponin

"Cost effective primary and secondary wound care is needed and have significant importance in current medicine. The steroidal saponin Flabelliferin B with a UV active binder attached (FB); isolated from palmyrah (Borassus flabellifer L.) has a known structure and proven antibacterial activity. The objectives of the study were to (i) study the effects of FB on male Wistar rats in relation to toxicity by wound healing (ii) study the toxicity of FB by the eye tests on rats and rabbits (iii) test the allergenic reactions by topical application of FB on healthy human skin by the ""patch test"" (iv) evaluate the feasibility of full scale clinical trial of the FB on infected wounds of humans. Toxic or other adverse effects on animals were not observed. Allergic reactions were also not observed on normal healthy human skin by the patch test. Having obtained ethical approval a prospective clinical trial was carried out in Colombo South Teaching Hospital. An ointment of 2FB was tested on wounds and ulcers with no subcutaneous tissue involvements. Human volunteers (n = 14) were employed in this study. Wound healing rates after treatment of FB ointment were monitored by measuring the percentage decline in wound area with time using normal standard hospital treatment as control. Microbiological tests by swabbing were carried throughout these experiments. The rate of wound healing was not significantly different from current hospital treatment (p = 0.512) and no allergic or other adverse symptoms were shown. It is concluded that it may be possible to use FB in treatment of wounds and ulcers with no subcutaneous involvement"

Prevalence of hypertension, diabetes and obesity: baseline findings of a population based survey in four provinces in Sri Lanka.

OBJECTIVE: To determine the prevalence of selected cardiovascular risk factors in adult Sri Lankan population in four provinces. DESIGN: Cross-sectional, based on a stratified cluster sampling method. SETTINGS: Four provinces, namely the Western, North Central, Southern and Uva. PATIENTS: Six thousand and forty seven participants (2692 men) between the age of 30 and 65 years were surveyed. MEASUREMENTS: Risk factors measured included height, weight, waist and hip circumference. Waist to hip ratio and body mass index were calculated, and overweight (23 kg/m2) and obesity (> or = 25 kg/m2) determined. Hypertension (systolic blood pressure > or = 140 mmHg or diastolic blood pressure > or = 90 mmHg or use of anti-hypertensive medications), and diabetes mellitus (fasting serum plasma glucose level > or = 7 mmol/L or use of anti-diabetic medications) and impaired fasting glycaemia (> or = 6.1 to < 7 mmol/L) were also determined. RESULTS: The prevalence of hypertension as defined was 18.8% (CI 14.5-23.1) for men and 19.3% (CI 12.2-26.4) for women. The prevalence of diabetes was 14.2% (CI 11.9-16.5) for men and 13.5% (CI 6.9-20.1) for women while impaired fasting glycaemia was 14.2% for men and 14.1% for women. The mean body mass index was 21.5 kg/m2 (SD = 3.7) in men. It was lower than that in women, 23.3 kg/m2 (SD = 4.5). The prevalence of obesity was 20.3% in men and 36.5 % in women. Regional differences were seen in the mean fasting blood glucose and prevalence of diabetes, and mean BMI and prevalence of obesity were highest in Western province. Mean blood pressure and prevalence of hypertension were highest in the Uva Province. Southern Province had the lowest prevalence of hypertension and diabetes, and North Central Province had lowest anthropometric measures of obesity. CONCLUSIONS: The prevalence of the selected cardiovascular risk factors is common in the adult Sri Lankan population surveyed. Regional differences exist in the prevalence of these risk factors. The prevalence of high level of risk factors requires urgent public health action.

Heart attacks: exploring new preventive strategies.

Ischaemic heart disease is an emerging public health problem in Sri Lanka. Implementation of programs for lifetime control and prevention of established coronary risk factors such as smoking, hyperlipidaemia, hypertension, diabetes and hereditary risk are costly and unaffordable in countries such as Sri Lanka with limited resources for health care. Other potential risk factors which are less expensive with regard to prevention require investigation. This paper summarises several studies done over the past decade at Peradeniya, to investigate three such potential coronary risk factors of IHD, namely homocysteine, vitamin C and dietary fat.

Effect of drug treatment on electroneurological measures of peripheral nerve function in leprosy patients.

OBJECTIVE: To investigate whether drug treatment improves the electroneurological measures of affected peripheral nerve function in leprosy patients. DESIGN: Clinical status of patients determined on the first visit by an investigator administered, pre-designed questionnaire, followed by measurement of motor conduction velocity (MCV) and distal latency (DL) of ulnar, median, common peroneal and posterior tibial nerves bilaterally in patients referred consecutively from the dermatology unit and leprosy clinic, Teaching Hospital, Galle. MCV and DL measurements were repeated after 6 to 12 months of treatment. SETTING: Department of Physiology, Faculty of Medicine, University of Ruhuna, Galle. SUBJECTS: 24 diagnosed leprosy patients; tuberculoid, lepromatous and borderline in clinical type. INTERVENTIONS: Based on clinical typing. Tuberculoid (paucibacillary) type rifampicin 600 mg monthly and dapsone 100 mg daily for six months. Lepromatous and borderline (multibacillary) type rifampicin 600 mg and clofazimine 300 mg monthly and dapsone 100 mg and clofazimine 50 mg daily for 24 months. RESULTS: DL in all 4 nerves and MCV in 3 nerves tested were significantly different (p > 0.001) to those for the normal population and remained so after 6 to 12 months of treatment. The DL in the ulnar nerve showed significant improvement (p < 0.05) after treatment. When analysed in each patient individually, before and after treatment, the MCV showed an improvement in 48 to 72% of patients and the DL in 41 to 59%, but differences were not significant. CONCLUSIONS: Electroneurological recovery (return to normal state) of the affected peripheral nerves of leprosy patients does not occur after 6 to 12 months of drug treatment. The significant (p < 0.05) improvement (becoming better) of ulnar nerve DL indicates that, if at all, electroneurologically detectable improvement of nerve function occurs in the early stages of nerve damage, and that it may take longer than one year after starting treatment.