Prescription analysis of hypolipidaemic agents in the department of cardiology in a tertiary care hospital

ABSTRACTBackground: The objective of the present study was to evaluate the prescribing pattern of hypolipidaemic drugs in the outpatient department of cardiology in a tertiary care hospital.Methods: A cross-sectional study was conducted in the department of cardiology for the period of 3 months. A total of 526 prescriptions were analyzed for variants such as the disease patterns, the type of hypolipidaemic drugs which are prescribed for those diseases, the prescribing daily dose of the hypolipidaemic drugs and the prescribing daily dose/daily defined dose ratio of the drugs.Results: On evaluation of the prescriptions, it was conferred that both the patients of normal lipid profile (34.77%) and abnormal lipid profile (65.18%) were prescribed hypolipidaemic drug. Diabetes with hypertension (35.74%) was the most common disease for which hypolipidaemic drugs were prescribed. Atorvastatin (30.98%) was the most common drug which was prescribed as monotherapy, whereas atorvastatin with aspirin and clopidogrel (17.49%) was the most common drug prescribed in combination.Conclusions: Use of statin has become very prevalent with increasing trends of use in both normal and abnormal lipid profile patients, suggesting consideration of rational use of statins to follow good prescribing pattern so that morbidity and mortality can be prevented.

Linking of different ethnicities, races and religions to lipid profile patterns and hypolipidaemic drug usage patterns in coronary artery disease patients

Background: Coronary artery disease (CAD) is the consequence of atherosclerosis in which inadequate blood flow in the coronary arteries leads to myocardial necrosis. The impact of ethnic on CAD might be underestimated within Indian communities. There have never been any studies done associating them to lipid profile patterns in the Indian setup hence this study is the first of its kind to work towards attending the absence of data in this direction.The study aimed to evaluate the presence of ethnic differences in lipid profile patterns and hypolipidemic drug use in CAD patients.Methods: An 8-week cross-sectional prospective study was conducted in the cardiology OPD of a tertiary care hospital. Adult CAD patients prescribed with at least one hypolipidaemic drug, having their lipid profile values and willing to give informed consent were selected. The prescription pattern was noted, and the lipid profile values of the patients classified as per ATP III guidelines by NCEP. Atherogenic dyslipidaemia was considered when patients had triglyceride levels >150 mg/dl and HDL<40 mg/dl. The collected data was analyzed using SPSS. P value less than 0.05 was considered as statistically significant.Results: A total of 123 patients enrolled. Out of these, 115 were Hindus and among Hindus, most were Brahmins (34). The most prescribed hypolipidaemic drug was Rosuvastatin. Thirty six patients had high triglyceride levels out of which 35 were Hindus. Low HDL (<40 mg/dl) was present in 70 patients out of which 64 were Hindus. Atherogenic dyslipidaemia was seen in 44 patients. Majority of them belonged to the age group of 51-60 years (43.2%) and were Patels. Total cholesterol and LDL were high in 1 and 2 Jains respectively. Lipid values were higher in Tier-3 city patients.Conclusion: Hindu patients in this study showed a poorer lipid profile while among the castes, Jains and Patel’s fared poorly. It was seen that atherogenic dyslipidemia is on a rise in the Indian population.

The Effect of Ethanolic Seed Extract of Citrullus lanatus (Watermelon) on Blood Glucose Level and Lipid Profile of Diabetic Wistar Rats

Aims: This study investigated the effect of ethanolic seed extract of Citrullus lanatus (ESECL) on blood glucose level and lipid profile in Alloxan-induced diabetic male Wistar rats. Study Design and Methodology: 30 male adult wistar rats were grouped randomly into six experimental groups of five rats each. Diabetes was induced by intraperitoneal injection of 100 mg/kg of alloxan monohydrate, dissolved in normal saline, while the normal control group (group 1) was given the vehicle only. Three days after induction of diabetes, were treated further for four weeks with ESECL at doses of 100, 200 and 400 mg/kg for groups 4, 5, and 6 respectively. Animals in Group 3 were treated with Glibenclamide (2.5 mg/kg), while group 2 served as the negative control group. Results: Administration of ESECL caused significant decrease in blood glucose levels in groups 4, 5 and 6 compared to rats of group 2 (p=0.00125). There was also significant decrease in the levels of cholesterol (TC) , triglycerides (TG), low density lipoprotein (LDL), with increase in high density lipoprotein (HDL) in Groups 4, 5 and 6, compared to Group 2 rats (p=0.00125). The results obtained from the rats of the group receiving extract were similar to that obtained from Groups 3. Conclusion: Thus, this study suggests that this extract could possibly normalize abnormalities in blood glucose levels and lipid profiles in diabetic conditions in a dose dependent manner.

Evaluation of the effect of lycopene on lipid profile, serum antioxidant enzymes and blood sugar level in New Zealand white rabbits

Background: Dyslipidaemias are the major cause of increased atherogenesis. Lycopene is a pigment that imparts red colour to fruits and vegetables like tomatoes. Risk of cardiovascular diseases has been shown to decrease with dietary intake of tomatoes. Although the antioxidant and hypolipidaemic properties of tomatoes have been studied extensively, beneficial effect of pure lycopene supplement as hypolipidaemic is still debatable So, we aimed to evaluate the effect of pure lycopene powder on lipid profile, serum antioxidant enzymes and blood sugar level in hyperlipidaemic rabbits.Methods: Adult male New Zealand White rabbits (1.5-2.5kg) were divided into three groups of six each. Group I-High Fat Diet (HFD) (5ml/kg). Group II-HFD (5ml/kg) + lycopene (10mg/kg) orally. Group III-HFD (5ml/kg) + lycopene (20mg/kg) orally. Blood samples were taken from all rabbits for baseline estimations of serum lipids, serum superoxide dismutase (SOD) and blood sugar. Same tests were performed after six weeks.Results: There was significant decrease in the levels of serum TC, LDL-C, TG and VLDL and an increase in serum HDL-C and antioxidant SOD with lycopene administration. However, significant increase in HDL was not seen with lycopene 10mg. TG and VLDL levels were significantly less with 20mg lycopene compared to 10mg lycopene. There was however no change in blood sugar level with lycopene.Conclusions: Pure lycopene supplement showed significant hypolipidaemic and antioxidant activity. However, it did not show significant effect on blood glucose levels.

CHRONIC TOXICITY ASSESSMENT OF HIPOLIPIDAEMIC HERBAL EXTRACT / Монголын эм зүй, эм судлал

Aim of the study: The present study was car- ried out to evaluate the safety of a hipolipidaemic herbal extract by determining its potential toxicity after chronic administration in rats.Materials and Methods: The hipolipidaemic herbal extract was administered orally at doses of 50, 150 mg/kg daily for 90 days to rats. Bio- chemical and morphological parameters were determined after 90 days of daily administration. Results: In the chronic study in rats, daily oral administration of the extract for up to 90 days did not result in death or significant changes in the biological, biochemical and morphological parameters. Conclusions: The results showed that the hypolipidaemic herbal extract had no toxicity in oral chronic administration and indicate that the herbal formula could be considered safe for oral medication. Key words: Herbal hypolipidaemic extract, chronic toxicity. Introduction In the present time, there has been a great in- crease in the use of herbal remedies in the treat- ment of diseases [1, 2]. Many traditional plants with therapeutic lipid-lowering properties are claimed to be useful in the treatment of hyperlipi- demia and associated pathologies [3, 4, 5]. The hipolipidaemic herbal composition (extract) con- sists of ten herbs: fruits of Rosa canina L., Cra- taegus sanguinea Pall., Elettaria cardamonum L.and Malus baccata L., roots and rhizomae of Glycyrrhiza glabra L., Zingiber officnale, såminà Lini usitatissimi L., folia Îrthosiphoni staminei Benth. and other. Chronic toxicity study of this hipolipidaemic herbal extract was performed in rats in order to evaluate the safety. Material and methods Wistar rats of both sexes aged 1-1.5 months toxicity assessment. Animals were divided into 3 groups (I–III) of 10 each (5 females and 5 males). The extract, dissolved in distilled water, was ad- ministered by daily oral for 90 days, to rats of groups II-III (doses of 50, 150 mg/kg, respec- tively). I group was control (distillate water). The animals were observed for signs of toxicity and mortality throughout the experimental period. The body weigh were recorded weekly. At the end of the 90-day experiment, rats of each group were sacrificed by decapitation under anaesthe- sia (sodium thiopental 50 mg/kg). Blood was col- lected for biochemical studies respectively. The organs (brain, heart, lung, liver, spleen, kidneys) were weighted and compared with the value of control. Organ samples (kidney, pancreas, lung and liver) were fixed in 10% formalin for histo- pathological examination.

Effects of Emblica Officinalis (AMLA) on Serum Lipids and Atherogenesis in Albino Rats Fed with High Fat Diet.

Objective: To evaluate the effects of Emblica officinalis (Amla) extract on serum lipids and atherogenesis, in albino rats fed with high fat diet. Materials and Methods: Healthy albino rats of Wistar strain (150-200 gm each) were randomized into five groups of six animals each- Group A (received normal diet), Group B (received normal diet + Emblica officinalis extract 1 gm/kg BW) Group C (received high fat diet consisting of vanaspati ghee and coconut oil at a ratio of 3:2, at a dose of 10 ml/kg/day), Group D (received high fat diet + Emblica officinalis extract 1 gm/kg BW) and Group E (received high fat diet + simvastatin 1.8 mg/ kg BW). Treatment period was 8 weeks. At the end of 8 weeks, lipid profile was evaluated by estimating total cholesterol, serum triglyceride, serum LDL, serum HDL and atherogenic index. Results: Ethanolic extract of Emblica officinalis showed significant antihyperlipidaemic activity (P< 0.01) with significant improvement in atherogenic index (p<0.01). Conclusion: Present study suggests that Emblica officinalis extract at a dose of 1 gm/kg BW exerts antihyperlipidaemic effect comparable to that of simvastatin. It also possesses hypolipidaemic activity.

Hypolipidaemic and antioxidant effects of fruits of Musa AAA (Chenkadali) in alloxan induced diabetic rats.

Hypolipidaemic and antioxidant effects of ethanol extract of mature green fruits of Musa AAA (Chenkadali) was evaluated in alloxan induced diabetic rats. The effect of extract at two doses, 500 mg/kg body weight and 1000 mg/kg body weight was analysed and compared with a standard drug, glibenclamide. Rats administered with alloxan showed significantly increased levels of serum triacylglycerol, total cholesterol and alanine amino transferase (ALT) activity. Lipid peroxides increased significantly while reduced glutathione (GSH) decreased considerably in liver and pancreas. Oral administration of the ethanol extract of fruits of Musa AAA (Chenkadali) significantly decreased the levels of serum triacylglycerol, cholesterol and ALT activity. Significant decrease was also observed in the level of lipid peroxides while GSH content increased substantially in liver and pancreas. The effect was dose independent and rats treated with 500 mg/kg body weight showed comparable levels of serum triacylglycerol, cholesterol, ALT activity and liver lipid peroxides to that of normal control and glibenclamide treated groups. Although, there was no significant difference, treatment with 500 mg/kg body weight of the extract showed a higher content of GSH and lower level of lipid peroxides in pancreas compared with glibenclamide. Histopathological examination of pancreas and liver revealed regeneration of islet cells and hepatocytes respectively, which correlate with the biochemical findings. The present study shows that ethanol extract of mature green fruits of Musa AAA (Chenkadali) has antioxidant and hypolipidaemic properties and may be used for treating diabetes mellitus.

Dietary spices in health and diseases (II).

Dietary spices influence various systems in the body such as gastrointestinal, cardiovascular, reproductive and nervous systems resulting in diverse metabolic and physiologic actions. As inheritors of a long tradition of the use of spices in diet as well as in indigenous medicines we know that these are treatments often honed over centuries with well-established reputations for efficacy. A rigorous review of these manifold beneficial effects may provide a fair basis for prescription in many clinical conditions where confirmed modern drug treatments do not exist or as adjunct therapy to reduce the dosage or the risk of side effects. This essay attempts to adjudicate the traditional use of dietary spices based on factual research evidence for their multivalent actions as health promoting dietary additives as well as putative therapeutic agents.

Effect of hypocholesterolemic agents of plant origin on catecholamine biosynthesis in normal and cholesterol fed rabbits.

The effect of lipid lowering agents of plant origin garlic oil and guggulipid on the levels of catecholamine and dopamine ß-hydroxylase activity of normal and cholesterol fed rabbit tissues has been studied. The catecholamine levels and enzyme activity were found to be decreased in cholesterol (500 mg/kg body wt) fed animals. The feeding of garlic oil (5 mg/kg body wt) and guggulipid (100 mg/kg body wt) an exudate of Commiphora mukul, to normal rabbits caused significant increase in the dopamine-ß-hydroxylase activity and catecholamine levels, while the feed helped the hypercholesterolemic rabbits to recover the decrease in catecholamine biosynthesis.