ABSTRACT
Objective: To determine the safety and efficacy of H.suaveolens extract for therapy of influenza in healthy adults. Methods: The study was randomized double blind placebo controlled study conducted in 15 community and general hospitals from May to August 2006. The study subjects were healthy adults who had influenza-like symptoms and positive preliminary diagnostic test for influenza A or B from respiratory secretions. They were randomized to receive H.suaveolens extract 500 mg 3 times daily or the placebo 3 times daily for 7 days. The subjects were evaluated for the severity of symptoms related to influenza, adverse effects of the medications and the presence of influenza viruses from respiratory secretions at entry, day 4 and day 7 after treatment. Results: There were 39 subjects in the placebo group and 46 in the H.suaveolens group. There was a significant improvement in symptoms of the patients in both groups on day 4 and day 7 when compared with that at entry. However, the average duration of fever of the patients in both groups was not significantly different (3.1 days in the placebo group vs. 3 days in the H.suaveolens group, p=0.749). The recovery rates of influenza A and influenza B viruses from respiratory secretions of the subjects on day 4 and day 7 after treatment in both groups were not significantly different. A trend of less positive culture for influenza A virus in the patients receiving H.suaveolens extract (32.5%) compared with those receiving a placebo (47.1%) was observed. The compliance to medications was satisfactory. No serious adverse effects due to study medications were observed. Conclusion: H.suaveolens extract 1.5 grams per day for 7 days is safe but it is not effective in relieving influenza-related symptoms in adults with influenza. The lack of efficacy of H.suaveolens extract might be due to an insufficient dosage of the extract.
ABSTRACT
A study to determine the utilization of calculated low density lipoprotein (c-LDL) cholesterol and measured low density lipoprotein (m-LDL) cholesterol was conducted. The test results of total cholesterol, triglyceride, HDL-cholesterol and m-LDL-cholesterol from the same individuals aged > or = 18 years who had the tests done at the Department of Clinical Pathology, Faculty of Medicine Siriraj Hospital during January to December 2004 were retrieved. The c-LDL-cholesterol level was computed using Friedewald formula. There were two data sets i.e. the m-LDL-cholesterol cut-off level derivation data set (784 subjects) and the m-LDL-cholesterol cut-off level validation data set (800 subjects). The study results revealed: 1) 2.6% of the subjects had blood triglyceride > 400 mg/dl hence c-LDL-cholesterol could not be computed, 2) the correlation between c-LDL-cholesterol levels and m-LDL-cholesterol levels from both data sets was very good (r > 0. 95, p < 0. 001), 3) the m-LDL-cholesterol levels were usually higher than c-LDL-cholesterol levels, 4) the m-LDL-cholesterol cut-off level derivation data set showed that m-LDL-cholesterol < 87, > 143, > 188, > 233 and > 254 mg/dl were highly correlated with c-LDL-cholesterol < 100, > or = 100, > or = 130, > or = 160 and > or = 190 mg/dl respectively, 5) an application of m-LDL-cholesterol cut-off levels derived from the m-LDL-cholesterol cut-off level derivation data set to the m-LDL-cholesterol cut-off level validation data set showed that m-LDL-cholesterol < 87, > 143, > 188, > 233 and > 254 mg/dl had accuracy in predicting c-LDL-cholesterol < 100, > or = 100, > or = 130, > or = 160 and > or = 190 mg/dl of 100%, 99. 7%, 100%, 100% and 100% respectively, 6) the use of m-LDL-cholesterol levels as a guide for initiating lipid-lowering agents based on cut-off values of c-LDL-cholesterol levels led to an overuse of lipid-lowering agents in 3.6% to 42.9% of the patients and 7) Nomogram for transforming m-LDL-cholesterol to c-LDL-cholesterol was developed as well as a formula for transforming m-LDL-cholesterol to c-LDL-cholesterol (c-LDL-cholesterol = 0.89 x m-LDL-cholesterol). Therefore, m-LDL-cholesterol assay has a very limited use in managing individuals with suspected or known dyslipidemia. The use of m-LDL-cholesterol level as a guide for management of abnormal LDL-cholesterol conditions leads to an overuse of lipid lowering medications and an enormous expense of m-LDL-cholesterol assay.