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OBJECTIVE To investigate the improvement effects and possible mechanism of Phyllanthus emblica water extracts on lipid metabolism disorder and insulin resistance （IR） in diabetic model rats. METHODS IR model of male SD rats was established and randomly divided into model group， positive control group， P. emblica water extracts high-dose， medium-dose and low-dose groups， and another blank group was set up， with 10 rats in each group. P. emblica water extracts high-dose， medium- dose and low-dose groups were given P. emblica water extract diluent at the doses of 800， 400 and 200 mg/kg respectively； positive control group was given pioglitazone solution 2.7 mg/kg； blank group and model group were given the same volume of normal saline， by intragastrical administration， once a day， for consecutive 4 weeks. The general state of rats was observed， and the body mass and the levels of serum lipid metabolism indexes [triacylglycerol （TG）， total cholesterol （TC）， low-density lipoprotein cholesterol （LDL-C）， high-density lipoprotein cholesterol （HDL-C）] were measured； fasting insulin of serum （FINS）， insulin resistance index （IRI） and insulin sensitivity index （ISI） were measured and calculated by enzyme-linked immunosorbent assay （ELISA）. The pathological morphology of liver tissue was observed by hematoxylin-eosin staining； the expression of glycogen in the liver was observed by periodic acid-Schiff staining， and the staining area was calculated； the protein expressions of peroxisome proliferator-activated receptor γ （PPARγ）， nuclear factor κB（NF-κB） and AMP-activated protein kinase （AMPK） were detected by Western blot. RESULTS Compared with blank group， the rats in the model group had obvious symptoms of polydipsia， polyphagia and polyuria， and the serum levels of TC， TG， LDL-C， FINS and IRI were significantly increased （P＜0.05）， while ISI was significantly reduced （P＜ 0.05）； the structure of hepatic lobule was obviously disordered， the liver cells were deformed and enlarged， and there were many lipid deposits and fat vacuoles； PAS staining area of glycogen was significantly reduced（P＜0.05）； the protein expression levels of PPARγ and p-AMPK were significantly decreased （P＜0.05）， while the protein expression level of NF-κB was significantly increased （P＜0.05）. Compared with model group， the mental state of rats， liver histopathological morphology and glycogen expression were improved significantly in P. emblica water extracts high-dose and medium-dose groups； the levels of the above indicators were significantly reversed（P＜0.05）. CONCLUSIONS P. emblica water extracts may improve glucose and lipid metabolism disorders， liver function and IR in IR model rats， and regulate IR by activating the PPARγ/AMPK/NF-κB signaling pathway.
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Phyllanthi Fructus is a highly unique medicine and food homologous item, which exhibits distinctive flavor, notable nutritional value, and abundant pharmacological activity. It has enormous potential in the creation of health products and pharmaceuticals. However, due to the unique laws of quality formation and transfer of Phyllanthi Fructus, its appearance, shape, chemical compositions, nutrients, and sensory flavors are frequently greatly influenced by botanical resources, the processing and storage conditions. As a result, the current quality evaluation model is difficult to meet the needs of Phyllanthi Fructus as a medicine and food homologous item in the development of diversified products. This paper constructs the hierarchical utilization mode of Phyllanthi Fructus based on its unique quality formation and transmission laws, explores the quality evaluation model for food-oriented use and medicinal-oriented use, respectively, and systematically describes the quality evaluation idea under diversified application scenarios. This paper aims to serve as a reference for the construction of a quality evaluation model suitable for the medicine and food homologous item of Phyllanthi Fructus.
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@#[Objective] To explore the application of Quality by Design (QbD) tools in assessing geographical variations of Phyllanthus emblica (P. emblica) from five distinct Indian states. [Methods] In the current experiment, the Box-Behnken design with a reduced quartic model and 105 runs was employed with the use of the Design Expert software for randomized response surface mapping. Three different extraction methods (Soxhlet, maceration, and sonication) along with three solventst [distilled water, methanol, and water-methanol mixture (50 : 50 v/v)] were considered in the present study. The anti-oxidant activities, total flavonoid content (TFC), and total phenolic content (TPC) in the P. emblica were determined and analysed by gas chromatography-mass spectrometry (GC-MS) to identify the major components. [Results] The QbD overlay plot showed that the extractive value of the P. emblica was no less than 30% w/w, 2,2-diphenyl-1-picrylhydrazyl (DPPH) no less than 60% mcg/mL (micrograms per millilitre), TFC no less than 75 mg QE/g (milligrams of quercetin equivalents per gram), and TPC no less than 80 mg GAE/g (milligrams of gallic acid equivalents per gram). Moreover, the GC-MS data confirmed the presence of variation in the bioactives of P. emblica extracts. [Conclusion] The model was significant in describing the variation in extractive value, DPPH, TFC, and TPC. The QbD approach may tend to prioritize thoroughness in the extraction process, ultimately resulting in improved quality in the extracted products.
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Phyllanthus emblica is a kind of traditional medicine and medicinal and edible plant, with rich variety resources and high development value. It is a key poverty alleviation variety in China at present. As P. emblica processing industry is rising gradually in recent years, in order to fully develop and utilize its industrial resources, this paper systematically introduces current comprehensive development and utilization of P. emblica, discusses the problems in P. emblica processing industry, and puts forward comprehensive development and utilization strategies and industrial models in terms of cultivation, breeding, grading, quality evaluation and waste recycling, so as to provide a certain reference for promoting the high-quality development of P. emblica industry in China.
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China , Medicine , Medicine, Traditional , Phyllanthus emblica , Plant Breeding , Plant ExtractsABSTRACT
Phyllanthi Fructus is a dried and ripe fruit that comes from Phyllanthus emblica of Euphorbiaceae. It is a characteristic Chinese and Tibetan medicine and one of homologous varieties of medicine and food with the breeding potential and development value. Abundant patents of P. emblica have been applied in recent years, which have advantages in food and beverages with rich downstream product development. However, the upstream industry chain has weak patent protection with low patents conversion rate, and the basic research of patent application is weak. Therefore, technological breakthroughs and technical protection in the upstream and middle reaches of the industrial chain should be strengthened. At the same time, the quality of patents should be improved, the status of varieties of P. emblica should be enhanced, the collaboration between industry, university and research institute should be strengthened and the basic and applied research should be improved. Based on the Incopat global patent database, the combination of patent analysis method and SWOT analysis method was used to analyze the status and development trends of domestic and foreign patents applications in P. emblica industrial chain, with a view to providing a reference for the development and utilization of P. emblica in the new era, industry chain patent layout and related industries, and the improvement of international competitiveness.
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Objective: To study the chemical constituents and its anti-inflammtory activity effect of Phyllanthus emblica. Methods: The chemical constituents of P. emblica were isolated and purified by silica gel column chromatography, ODS column chromatography, Sephadex LH-20 column chromatography, semi-preparative high-performance liquid chromatography and recrystallization method. Through their spectra data, physical and chemical properties analysis, the structures of those compounds with high content were identified. LPS-induced RAW264.7 inflammatory cell model was established to evaluate the effect of compounds in P. emblica on proinflammatory factors (NO, IL-6, TNF-α, and MCP-1) of RAW264.7 inflammatory cells. Results: Totally, 14 compounds were isolated from P. emblica. and idetified as isovanillic acid (1), trans-cinnamic acid (2), p-hydroxybenzaldehyde (3), coniferyl aldehyde (4), quercetin (5), kaempferol-3-O-α-L-rhamnose (6), naringenin (7), 2-hydroxy-3-methyl phenylpropiolate (8), hydroquinone (9), myricetin (10), 2-furoic acid (11), methyl gallate (12), protocatechuic acid (13), gallic acid (14). The experiment of anti-inflammatroy effects showed that those compounds had different inhibitory effects on the production of inflammatory factors NO, IL-6, TNF-α and MCP-1. Conclusion: Compounds 1, 3, 4, 8-11 and 13 are isolated from P emblica for the first time. The anti-inflammatory effect of P. emblica is related to its phenolic acids.
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<p><b>BACKGROUND</b>Gastroesophageal reflux disease (GERD) is one of the most common gastrointestinal complaints. GERD, caused by the reflux of stomach contents into the esophagus, leads to troublesome symptoms such as heartburn and regurgitation. It is classified into two types: erosive esophagitis, characterized by visible esophageal mucosa erosion in endoscopy, and non-erosive reflux disease (NERD). GERD is a chronic and recurrent disease that impairs the quality of life and imposes socioeconomic and therapeutic burdens to both patients and society.</p><p><b>OBJECTIVE</b>Due to the failure of the conventional treatments for GERD and to the traditional use of Amla (Phyllanthus emblica L.), in addition to beneficial effects shown in recent studies, we evaluated the safety and efficacy of Amla tablet for improvement of symptoms of patients with NERD.</p><p><b>DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS</b>We designed a double-arm, randomized, double-blind, placebo-controlled clinical trial. Sixty-eight patients who had classic symptoms of GERD (heartburn, regurgitation and epigastralgia) for at least three months before the start of the trial were randomized in two parallel groups. Patients in the Amla group received two 500 mg Amla tablets twice a day, after meals, for 4 weeks. In the control group, patients received placebo tablets similar to the Amla prescription.</p><p><b>MAIN OUTCOME MEASURES</b>The patients were visited at baseline, and at the end of the 2nd and 4th weeks of intervention; their symptoms were measured on a frequency and severity scale for the symptoms of NERD, according to the quality of life in reflux-associated disease questionnaire.</p><p><b>RESULTS</b>Frequencies of heartburn and regurgitation in both groups of the study were significantly reduced after intervention (P < 0.001). Repeated measures logistic regression analysis showed that, in the Amla group, there was a more significant reduction in regurgitation frequency, heartburn frequency, regurgitation severity and heartburn severity during the study period, compared with the placebo group (P < 0.001).</p><p><b>CONCLUSION</b>This randomized double-blind, placebo-controlled clinical trial demonstrated that Amla could reduce frequencies of heartburn and regurgitation and improve heartburn and regurgitation severity in patients with NERD.</p><p><b>TRIAL REGISTRATION</b>Iranian Registry of Clinical Trials IRCT2016061428469N1.</p>
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OBJECTIVE:To establish a method for simultaneous determination of 5 constituents in Phyllanthus emblica,and to conduct principal component analysis and cluster analysis of contents of 5 polyphenolic constituents in P. emblica from different producing areas of Guangxi. METHODS:HPLC method was adopted to determine the contents of gallic acid,epigallocatechin, corilagin,terminalia biphenyl acid and ellagic acid in P. emblica. The determination was performed on Agilent Eclipse XDB column with mobile phase consisted of acetonitrile-0.1％ phosphoric acid aqueous solution (gradient elution) at the flow rate of 1.0 mL/min. The detection wavelength was set at 220 nm,and column temperature was 25 ℃. The sample size was 20 μL. The results of content determination was processed by principal component analysis and cluster analysis. RESULTS:The linear range of gallic acid, gallocatechin, corilagin, chebulagic acid and ellagic acid were 1.994-31.90, 0.1598-2.556, 4.533-45.33, 14.75-88.49, 2.956-47.30 μg/mL(r≥0.9998),respectively. The limits of detection were 0.0256,0.0271,0.0529,0.1867,0.1331 μg/mL;the limits of quantitation were 0.0851,0.0893,0.1706,0.6152,0.4419 μg/mL,respectively. RSDs of precision,stability(24 h) and reproducibility tests were all<2.0％(n=6 or n=7). The average recoveries were 96.19％-101.49％(RSD=0.98％-1.41％, n=6). 12 batches of samples had 3 main components. They could be divided into 2 categories. P. emblica from Rong county of Yulin city in Guangxi Zhuang Autonomous Region had highest comprehensive principal component score and best quality. CONCLUSIONS:Established method is simple,accurate and reliable,and can be used for the simultaneous determination of gallic acid,gallocatechin,corilagin,chebulagic acid and ellagic acid in P. emblica. The quality of P. emblica from different producing areas in Guangxi is different.
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In this study, molecular interactions of the ligands, quercetin, gallic acid, and metformin with various diabetes mellitus-related protein targets, such as glycogen phosphorylase and peroxisome proliferator-activated receptor gamma, were assessed. It was revealed that quercetin possesses good binding affinity to both targets. Quercetin is a major constituent of methanolic extracts of Phyllanthus emblica fruit. The antihyperglycemic effect of quercetin in streptozotocin (STZ)-induced diabetic rats was examined. The isolated quercetin administered at a dose of 75 mg/kg body weight produced a maximum decrease of 14.78％in blood glucose levels in the diabetic rats after 7 days of treatment. Furthermore, quercetin doses of 50 and 75 mg/kg were shown to significantly improve the profiles of triglycerides, high-density li-poprotein, very-low-density lipoprotein, low-density lipoprotein, and total cholesterol at the end of the study in STZ-induced diabetic rats. The administration of quercetin (25, 50, and 75 mg/kg body weight) daily for 28 days in STZ-induced diabetic rats resulted in a significant decrease in blood glucose and urine sugar levels, with a considerable rise in plasma insulin and hemoglobin levels. Therefore, quercetin is a potential drug with antidiabetic and antihyperglycemic action mediated by changes in the levels of glucose, cholesterol, and triglycerides as indicated by in silico and in vivo studies.
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Objective To explore the protective effect of gallic acid in Phyllanthus emblica on high glucose－induced apoptosis of pancreatic islet β cells, and to provide a reference for the discovery of natural compounds for the treatment of diabetes. Methods In vivo experimental model, wistar male rats were used as in vivo subjects and 50 mg/kg STZ was injected intraperitoneally. After the model was successfully established, 25 mg/kg of gallic acid was given orally, and the positive drug was Sitagliptin. After 4 weeks of administration, the blood was taken and the pancreas was removed for HE staining. Western blot was used to measure the expression of NLRP3 and TXNIP in pancreatic tissue in high sugar state. In vitro model, insulinoma cell line INS－1 cells were used as in vitro targets to establish high levels. In sugar－induced apoptosis model, INS－1 cells were cultured in glucose－free RPMI 1640 complete medium supplemented with 25 mmol/L glucose. Gallic acid was used as the test sample. Experiments were divided into normal controls, high－sugar models, and low, medium and high levels of gallic acid groups. The cell viability was measured by MTT assay. The mRNA expression of NLRP3 and TXNIP in INS－1 cells was detected by QPCR and Western blot, and the expression of NLRP3 and TXNIP protein was detected.Results (1) INS－1 cells were cultured in a medium with glucose concentration of 25mmol/L for 48h, and the apoptosis rate was increased compared with the control group (P＜0.01), indicating that the apoptosis model was established successfully under high glucose conditions. (2) 10, 5, and 2.5 μmol/L GA were used to treat the control group and the high glucose model group cells respectively. The survival rate of the control group did not change significantly (P＞0.05) . Compared with the control group, the expression of NLRP3 and TXNIP in INS－1 cells in the high glucose model group was significantly different (P＜0.05);the protein expression level was significantly downregulated after GA treatment, and there was a statistical difference (P＜0.05) . Compared with the control group, the expression of NLRP3 protein in INS－1 cells in the high glucose model group was statistically different (P＜0.01), and the protein expression level was significantly downregulated after GA treatment (P＜0.01) ; The protein expression level was up－regulated (P＜0.05);the protein expression level after GA treatment was significantly down－regulated (P＜0.05); (4) The expression of NLRP3 and TXNIP mRNA in INS－1 cells was increased in the high glucose model group compared with the control group (P＜0.01) ; The expression of protein was significantly down－regulated after GA treatment (P＜0.01) . Conclusion The cells were cultured for 48 h in glucose－free RPMI 1640 complete medium supplemented with 25 mmol/L glucose. GA has no effect on the proliferation of normal INS－1 cells. GA protects INS－1 cells from apoptosis under high glucose conditions. The mechanism may be related to GA down－regulation of NLRP3 and TXNIP gene expression.
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This study was aimed to optimize the extraction method for total polyphenol from Phyllanthus emblica through multi-target orthogonal experiment,in order to provide data reference for its industrial production.The comprehensive evaluation indexes included the extraction yield,extraction percentage of total polyphenol,chebulagic acid,gallic acid,mucic acid-2-O-gallate,were verified.The ethanol concentration,solid-liquid ratio and extraction time were crucial indexes for orthogonal design.The results showed that the best extraction process was using 10 times dosage 70％ ethanol,to extract the medical material three time,90 minutes for every time.It was concluded that the extraction technology was reliable.This method was stable,quick and simple.It laid a fundamental foundation for the extraction method exploration.
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This article was aimed to study the stability of tannin parts in Phyllanthus emblica L.in artificial gastric and intestinal juice,in order to provide a foundation for in vivo studies of Phyllanthus emblica L.HPLC-UV was used to determine the contents of main ingredients.The results showed that stability of main ingredients of tannin parts in Phyllanthus emblica L.,including gallic acid (GA),corilagin and ellagic acid (EA),in the artificial gastric juice.The content change was not obvious.The residual content was within 100％.The half-life was above 90 h.They were unstable in the artificial intestinal juice.The content was first increased and then decreased.The residual content was 100-300％.The half-life was above 10 h.It was concluded that the tannin parts in Phyllanthus emblica L.was stable in artificial gastric juice.And content changes of main components were not obvious.The tannin parts in Phyllanthus emblica L.were unstable in artificial intestinal juice.The main ingredients were first increased and then decreased.It was speculated that macromolecule can hydrolyze tannin part into small molecules.Hnwever,as time increases,all components may be decomposed.
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Phyllanthus emblica L.,related to common Tibetan medicine,has a function on clearing heat and cooling blood,promoting digestion and invigorating stomach,and producing saliva and slaking thirst.The compound of Dasanguo,made of Phyllanthus emblica,F.terminalia billericae and F.chebula,was a widely used preparation in Tibetan medicine,and was also a basic formula in other prescriptions.This study summarized the untilization of Phyllanthus emblica in traditional Tibetan medicine and elucidated the effects of Phyllanthus emblica in the compounds of Tibetan medicine,which provided a reference for the studies of Tibetan medicine and its modern application.
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Phyllanthus emblica L.has a long history and is abundant in the world.It was used for treating various diseases in nearly twenty countries or nations in regard to traditional medicine system.By retrieving Tibetan medicine in classical books,recent literatures and clinical studies,the application of Phyllanthus emblica in traditional Tibetan medicine system was introduced,including its utilization in hypertension,indigestion,abdominal distension,cough and arthralgia and their related diseases.In the sight of modern pharmacological research,the theory Tibetan medicine of explained Phyllanthus emblica scientifically.Its related researches and development prospects were also deliberated for further researches and various applications,which demonstrated the value of the development of new drugs and health products.
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Phyllanthus emblica L.and Terminalia chebula Retz.were the most common Tibetan medicines.The combination of Phyllanthus emblica L.,Terminalia chebula Retz.and Term inalia bellirica (Gaertn.) Roxb.was known as Triphala,which was the basis of the most frequently-used prescriptions.The present study summarized and made a further comparison between Phyllanthus emblica L.and Terminalia chebula Retz.over chemical constituents and pharmacological activities,which provided evidence for their clinical use and the basic theory.
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Phyllanthus emblica L.is related to traditional tibetan medicine,containing diversified pharmacological and physiological functions,such as anti-tumor effects,anti-inflammatory effects,anti-oxidation funtions,slow down in glycemia and blood pressure and the prevention of cardio-cerebral vascular diseases,etc.In this study,the research progress on the anti-tumor efficacy of monomer compounds and the extraction of Phyllanthus emblica L.were reviewed,providing references for the anti-tumor studies of Phyllanthus emblica L.
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ABSTRACT Phyllanthus emblica Linn. (amla) is used in Ayurveda, the ancient Indian system of medicine and its major constituent is vitamin C which has effective free radical scavenging property. The purpose of this study was to evaluate the in vitro antioxidant activity and the bioavailability profile of vitamin C in amla and its combinations with piperine and ginger in comparison to synthetic vitamin C using New Zealand rabbits. In vitro antioxidant activity studies of synthetic vitamin C, amla, amla with piperine and amla with ginger were carried out using different models such as 2,2-Diphenyl-1-picrylhydrazyl, Nitric Oxide, Hydrogen peroxide scavenging methods, Total reductive capability and Oxygen Radical Absorbance Capacity estimation. The study results showed that synthetic vitamin C, amla, amla with piperine and amla with ginger possess significant in vitro antioxidant activity. For bioavailability studies, synthetic vitamin C, amla, amla with piperine and amla with ginger 100 mg/kg, were administered orally and the serum samples were analyzed by HPLC at 0, 1, 2, 3, 4, 6, 8, 10, 12 and 24 hours. Bioavailability studies revealed that amla with piperine combination has higher concentration of vitamin C when compared to synthetic vitamin C. This is probably due to presence of piperine, which is a bioavailability enhancer. The present study supports the fact that amla with piperine combination can be an alternative to synthetic vitamin C.
RESUMO Phyllanthus emblica Linn. (amla) é utilizada na medicina Ayurveda, medicina da Índia antiga e seu principal constituinte é a vitamina C, que possui propriedade sequestrante de radicais livres. O propósito deste estudo foi avaliar a atividade antioxidante in vitro e o perfil de biodisponibilidade da vitamina C na amla e suas combinações com piperina e gengibre em comparação com a vitamina C sintética, utilizando coelhos da Nova Zelândia. Os estudos de atividade antioxidante in vitro de vitamina C sintética, amla, amla com piperina e amla com gengibre foram realizados utilizando-se diferentes modelos para sequestrantes, como 2,2-difenil-1-picrilidrazil, óxido nítrico, peróxido de hidrogênio, capacidade redutiva total e a estimativa da capacidade de absorvância do radical oxigênio. Os resultados do estudo mostraram que vitamina C sintética, amla, amla com piperina e amla com gengibre possuem atividade antioxidante in vitro significativa. Para os estudos de biodisponibilidade, administraram-se oralmente vitamina C sintética, amla, amla com piperina e amla com gengibre 100 mg/kg e as amostras de soro foram analisadas por CLAE em 0, 1, 2, 3, 4, 6, 8, 10, 12 e 24 horas. Os estudos de biodisponibilidade revelaram que a associação de amla com piperina tem maior concentração de vitamina C, quando comparada com a vitamina C sintética. Este efeito é provavelmente devido à presença de piperina, que é intensificador de biodisponibilidade. O presente estudo apoia o fato de que a associação de amla e piperina pode ser uma alternativa para a vitamina C sintética.
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Rabbits , Ascorbic Acid/analysis , Phyllanthus emblica , Piper nigrum , Ginger , Antioxidants/pharmacokineticsABSTRACT
Valproic acid (VPA), widely used in treating epileptic patients, can damage reproductive parameters causing male infertility. This study aimed to investigate protective effect of Phyllanthus emblica L. branch (PE) extract on rat testicular damage induced with VPA. Male rats were divided into 6 groups (control, VPA, 250 mg/kgBW PE only, and 50, 100, 250 mg/kgBW PE+VPA, respectively). Animals were pretreated with PE for 23 days and co-administered with VPA for 10 days before all reproductive parameters were determined. The results showed all doses of PE significantly protected the decrease testicular weight and testosterone level in VPA rats. PE significantly improved the decrease sperm concentration in VPA treated rats. Moreover, testicular histology of PE+VPA groups showed declining of testicular histopathologies as compared to VPA group. Therefore, it seems that PE branch extract can prevent testicular damages including male reproductive parameters in rats induced with VPA.
El ácido valproico (AVP) es utilizado frecuentemente en el tratamiento de pacientes epilépticos y puede dañar los parámetros reproductivos que causan la infertilidad masculina. Este estudio tuvo como objetivo investigar el efecto protector de la rama Phyllanthus emblica L. (PE) sobre el daño testicular de ratas inducidas con AVP. Ratas machos fueron divididas en 6 grupos (control, AVP, PE 250 mg/kg peso corporal, APV+ PE 50, 100, 250 mg/kg peso corporal, respectivamente). Los animales fueron pretratados con PE durante 23 días y se administró AVP durante 10 días antes de medir todos los parámetros reproductivos. Los resultados mostraron que todas las dosis de PE protegen significativamente el peso y los niveles reducidos de testosterona testicular en ratas con AVP. El extracto de PE mejoró significativamente la concentración de espermatozoides en ratas tratadas con AVP. Por otra parte, la histología testicular de los grupos PE+AVP mostró disminución de la histopatología testicular en comparación con el grupo tratado sólo con AVP. Por lo tanto, parece que el extracto de la rama PE puede prevenir daños testiculares incluyendo los parámetros reproductores masculinos en ratas inducidas con AVP.
Subject(s)
Animals , Male , Rats , Phyllanthus emblica/chemistry , Plant Extracts/pharmacology , Testis/drug effects , Testis/pathology , Valproic Acid/toxicity , Anticonvulsants/toxicity , Epididymis/drug effects , Epididymis/pathology , Rats, Wistar , Sperm CountABSTRACT
Introducción: el melasma es una hiperpigmentación común que afecta principalmente a las mujeres, comprometiendo su percepción estética y su autoestima, con un impacto significativo en su entorno psicológico, social y cultural. Se han postulado múltiples tratamientos con aparente eficacia; sin embargo, algunos productos se han asociado con complicaciones cutáneas y sistémicas, que han generado que las regulaciones sean más estrictas para la preparación y la distribución de este tipo de tratamientos. Objetivo:determinar si el uso de un producto despigmentante en gel ayuda en el aclaramiento del melasma. Metodología: mediante un diseño abierto no controlado y no aleatorizado se realizaron evaluaciones instrumentales con ayuda de un mexameter®en un área tratada (con melasma) y otra control (sin melasma) en el día en que se inició la aplicación del producto y a los 15, 30 y 60 días post-aplicación. Resultados: después de 60 días de aplicación del producto bajo condiciones normales de uso en un grupo de 30 voluntarias diagnosticadas con melasma, se evidenció una reducción estadísticamente significativa en las medidas instrumentales del índice de melanina de 340,1 ± 111 al inicio a 288,5 ± 85,4 en la octava semana. En la evaluación de la percepción de las voluntarias, el 72,4 % refirió un efecto despigmentante muy bueno, el 89,7 % notó beneficios adicionales como piel más hidratada, más tersa, más suave, al 82,8 % les gustó mucho el producto y el 96,6 % volvería a usarlo. Conclusión: este estudio permitió determinar la eficacia despigmentante del producto emclarex®puesto que mostró un 57,7 % de disminución del índice de melanina en el 89,7 % de los voluntarios diagnosticados con melasma, después de 60 días de uso.
Introduction: Melasma is a common hyperpigmentation that primarily affects women compromising their aesthetic perception and self-esteem, with a significant impact on their psychological, social and cultural environment. Multiple treatments have been proposed with apparent effectiveness; however, some products have been associated with numerous cutaneous and systemic complications that have generated that are stricter regulations for the preparation and distribution of this type of treatment. Objective: To determine whether the use of a skin lightening gel product helps in clearance of melasma. Methodology: By uncontrolled open design nonrandomized, instrumental evaluations were performed using a Mexameter®in a treated area (with melasma) and other control (without melasma) on day 1 and at 15, 30 and 60 days postapplication started. Results: After 60 days of application of the product under normal conditions of use in a panel of 30 volunteers diagnosed with melasma, it showed a statistically significant reduction in instrumental measurements of melanin index of 340.1 ± 111 at baseline to 288.5 ± 85.4 in the eighth week. In assessing the perception of the volunteers, 72.4 % reported a very good skin lightening effect, 89.7 % saw additional benefits like more hydrated skin, smoother, softer, 82.8 % liked the product and 96.6 % would use it. Conclusion: This study showed the skin-lightening efficacy of the Emclarex®product since it showed a 57.7 % decrease in melanin index in 89.7 % of the volunteers diagnosed with melasma, after 60 days of use.
ABSTRACT
Introducción: la extravasación del plasma es la manifestación más severa de la enfermedad producida por los virus del dengue y que con mayor frecuencia conduce al estado de choque. Se caracteriza por derrames serosos a nivel de diversas cavidades y aumento del hematocrito. Se realizó el presente estudio con el objetivo de determinar los factores sociodemográficos, clínicos y de laboratorio que más se asocian a la presencia de extravasación plasmática en los pacientes con dengue. Materiales y métodos: estudio observacional analítico transversal, analizado bajo la metodología de casos y controles, a partir de registros clínicos de pacientes con dengue. Se utilizaron prueba Chi cuadrado de Pearson, prueba exacta de Fisher, prueba no paramétrica U de Mann-Whitney y un modelo de regresión logística multivariado de factores asociados. Fueron calculados los Odds Ratio con su intervalo de confianza al 95 %. Se consideró un nivel de significancia de 5 %. Resultados: fueron analizados un total de 350 registros, de los cuales 128 presentaron signos de extravasación plasmática (36,6 %). Después de ajustar por factores de confusión se observó que las variables que más se asocian a presencia de extravasación plasmática en los pacientes con dengue fueron el dolor abdominal, la leucopenia y las melenas. Conclusión: estos hallazgos clínicos y de laboratorio deben ser priorizados en su vigilancia en la atención al paciente con dengue, para identificar los casos con mayor probabilidad de extravasación plasmática para su manejo oportuno y adecuado.
Introduction: Plasma leakage is the most severe complication caused by dengue virus infection and is also the mechanism that frequently leads to dengue shock syndrome. Plasma leakage is characterized by ascites, pleural and pericardial effusion and increased hematocrit level. The present study was conducted to identify socio-demographic, clinical and laboratory factors that more are associated to the presence of plasma leakage in dengue infected patients. Materials and methods: A cross sectional analytic study was performed on clinical records from dengue infected patients using the casecontrol methodology. Pearson's chi-square test or Fisher's exact test, Mann-Whitney's non-parametric U test and a multivariate logistic regression model of associated factors were used to evaluate the data. Odd Ratios with 95 % confidence intervals were calculated and significance level of 5 % was considered. Results: A total of 350 clinical records were analyzed, 128 cases (36.6 %) presented signs of plasma leakage. After adjustments by confounding factors, we observed that abdominal pain, leukopenia and melena were the variables that explain the presence of plasma leakage in dengue infected patients. Conclusion: During the follow-up of dengue infected patients priority should be given to the survey of these clinical and laboratory findings in order to identify the cases with higher probabilities of developing plasma leakage, allowing achieving more timely and appropriate management.