Safety and efficacy of an herbal formulation in patients with renal calculi - A 28 week, randomized, double-blind, placebo-controlled, parallel group study

Background: Urolithiasis is a growing problem worldwide. Many a times, asymptomatic stones are keptunder observation. Many herbal preparations are available for the same, but they lack proper scientificdocumentation.Objective: To study the anti-urolithiatic effect of an herbal preparation, Subap Plus (IP) capsules in patients with asymptomatic renal calculi of size ranging from 4 to 9 mm.Material and methods: This was a prospective, randomized, double-blind, placebo-controlled clinical trialconducted in a tertiary care hospital in Pune, India.Patients with asymptomatic renal calculi of 4e9 mm size were randomized (1:1, block randomization) toone of the group Subap Plus (treatment group) or placebo (placebo group). The study outcome includedchange in visual analog scale (VAS), change in the surface area and density of calculi and their expulsion.Statistical analysis was performed using student's t-test and Chi-square test.Results: A total of 120 patients were screened and 84 were enrolled who met the eligibility criteria, ofwhich 65 patients completed the trial (treatment, n ¼ 34; placebo, n ¼ 31). The VAS score significantlydecreased in the treatment group (6.9e1.8) than placebo group (7.2e6.8) (p < 0.001). The surface areaand density were decreased by 47.58% (p < 0.008) and 43.01% (p < 0.001), respectively, in the treatmentgroup than the placebo group. The expulsion of calculi was significantly higher in the treatment groupthan placebo group (20.59 vs. 3.23%, p < 0.03).Conclusion: Patients treated with herbal formulation showed better expulsion rate and reduction insurface area and density than the placebo group.© 2018 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/).

Need for bringing in a change in biochemistry curriculum to make it clinically oriented?

OBJECTIVES: This study was conducted to (a) assess the views of medical students and doctors regarding relevance of biochemistry training, (b) explore if they have any suggestion to bring in any improvement in contents of biochemistry curriculum and mode of teaching. METHODS: In 1997-98, a structured questionnaire was filled up by 114 medical students and 118 doctors. RESULTS: As many as 62/114 (55%) medical students and 40/118 (34%) doctors believed that it is not important to remember minute details of biochemical reactions (p value < 0.0001). Among medical students, 108/110 (98.2%) agree that a clinician should be invited to seminars for developing skills of interpretation of laboratory investigations; whilst 110/118 (93.2%) doctors expressed similar view, p value ns. Approximately 92% responders favored that departments biochemistry and physiology should co-ordinate on the topics of common interest in order to save time and effort. What is the most informative and effective way of teaching biochemistry?' in response to this question only 0.9% responders opted lecture as the best option. Seminars with active participation of medical students was preferred by 93.2% responders. About 6.9% responders reckoned that symposium prepared by a more than one teacher. In response to the question whether it is possible to cover pre-clinical subjects in 12 months so as to allow spiral mode of curriculum, 73% of all the responders agreed that it would be good idea, there was no difference of opinion among the doctors and medical students. On the other hand, 27% were strongly opposed to this suggestion. CONCLUSIONS: We suggest that there is a need to modify the contents, methods of teaching, and curriculum organization of training in clinical biochemistry. How best the curriculum can be made problem oriented needs to be debated among medical educationists.

Toxicological profile of aureofungin: a potent plant antifungal antibiotic.

Aureofungin is a heptaene type of antifungal antibiotic used for controlling plant fungal infections and diseases, during pre and post harvesting period of various crops. Acute and subacute oral toxicity of aureofungin in rats was studied along with haematological, urine analysis and other biochemical parameters related to liver and kidney organ functions. The results of these studies indicate mild toxic symptoms at higher doses which were reversible following its withdrawal.

Inhibition of lipid peroxidation by piperine during experimental inflammation in rats.

Carrageenin induced rat paw oedema shows a direct co-relationship with liver lipid peroxidation and not with kidney or brain. Pretreatment with piperine or oxyphenylbutazone reduced the liver lipid peroxidation, acid phosphatase and oedema induced by carrageenin. However, no such co-relationship was observed with treatment of these anti-inflammatory agents in control animals. It is, therefore, suggested that the inhibition of these liver enzymes is non specific in nature.

Effect of piperine on pentobarbitone induced hypnosis in rats.

Piperine (1-peperoyl piperidine), a major alkaloid isolated from Piper nigrum Linn, potentiated pentobarbitone sleeping time in dose dependant manner, with peak effect at 30 min. Blood and brain pentobarbitone levels were higher in piperine treated animals. Piperine treatment in rats, treated chronically with phenobarbitone, significantly potentiated pentobarbitone sleeping time, as compared to the controls. There was no alteration in barbital sodium sleeping time. It is possible that, piperine inhibits liver microsomal enzyme system and thereby potentiates the pentobarbitone sleeping time.