RÉSUMÉ
Dehydration in non-diarrheal illnesses often goes unnoticed and there are no consensus treatment recommendations for management of dehydration in non-diarrheal illnesses. A multi-disciplinary committee of 10 experts from India gathered on virtual platform in September 2020 to develop consensus recommendation on current treatment strategies for managing oral fluid electrolyte and energy in pediatric patients during non-diarrheal illnesses and to identify unmet needs and gaps. A pre-meeting questionnaire-based voting system was adopted to reach consensus followed by a discussion between panel members. In absence of consensus, the topic was opened for debate to arrive at an aligned recommendation. Key clinical challenges include identifying dehydration in acute illnesses and recommending appropriate quantity and type of oral fluids based on symptom severity. This consensus statement provides guidance on management of dehydration in non-diarrheal illnesses including recommendation on oral fluid, electrolytes, and appropriate energy management in pediatric population. Oral fluid, electrolyte and energy supplementation were recommended based on symptoms in acute non-diarrheal illness increased insensible losses and/or decreased intake. Oral rehydration fluids should be prescribed accurately and at the right-time for countering dehydration, ideally early in the course of illness. Prescribing pattern should be precise and like intravenous fluids. Carbonated drinks and canned juices should not be recommended. Plain water may not be optimal in replacing electrolytes especially for anorexic patients who can only tolerate fluids. These clinical practice statements provide guidance for oral fluid, electrolytes, and energy recommendations for pediatric patients with various acute illnesses beyond diarrhea.
RÉSUMÉ
Background: Current medications for dementia and enhancement of learning and memory are limited hence we need to explore traditional medicinal systems like Ayurveda to investigate agents that can improve learning and enhance memory. Objective: The present study was carried out to evaluate effects and mechanisms of Ayurveda drug formulations, Tinospora cordifolia (Tc) and Phyllanthus emblica (Pe) with and without Bhavana samskara on learning and memory of mice. Materials and Methods: After approval of Animal Ethics Committee, Swiss albino mice were divided into seven groups, administered orally: Distilled water, Rivastigmine (2.4 mg/kg), Tc (100 mg/kg), Pe (300 mg/kg), formulation 1 (Tc + Pe: 400 mg/kg) and formulation 2 (Tc + Pe + Ocimum sanctum: 400 mg/kg) daily for 15 days. Piracetam (200 mg/kg) was injected daily intraperitoneally for 8 days. The mice underwent a learning session using elevated plus maze. Memory was tested 24 hours later. Results: Mice pretreated with all the drugs showed a trend toward reducing transfer latencies but values were comparable to vehicle control. In all drug‑treated groups, a significant reduction in transfer latency was observed after 24 h. Improvement in learning and memory by both formulations were comparable to individual plant drugs, Tc and Pe. Conclusion: The plant drugs showed improvements in learning and memory. The fixed‑dose formulations with Bhavana samskara, showed encouraging results as compared to individual agents but the difference was not statistically significant. Hence, the concept of Bhavana samskara could not be explored in the present study. However, these drugs showed comparable or better effects than the modern medicinal agents thus, their therapeutic potential as nootropics needs to be explored further.
RÉSUMÉ
Background: There has been a steady rise in number of patients suffering from dementia including dementia associated with Alzheimer’s disease. Effective treatment of Alzheimer’s disease dementia is an unmet medical need. Objective: To evaluate effects of formulation containing combination of Phyllanthus emblica (Pe) and Tinospora cordifolia (Tc) with and without Ocimum sanctum (Os) on learning and memory performance of normal and memory impaired rats in complex maze and compare with effects of Tinospora cordifolia and Phyllanthus emblica alone. Materials and Methods: Wistar rats; either sex (100–150 g) were divided in seven groups Control, Piracetam, Rivastigmine, Tc, Pe, Formulation 1 (Tc + Pe), and Formulation 2 (Tc + Pe + Os).The study was divided in four parts: In part 1 memory enhancement was tested in normal rats. In part 2, 3, and 4 the effects of drugs were tested in Scopolamine‑, Diazepam‑, and Cyclosporine‑induced amnesia. Hebb–Williams maze was used to test for learning and memory. Time required to trace food and number of errors in maze were noted. Results: In normal rats, all test drugs showed significant reduction in time required to trace the food and number of errors after 24 h compared with vehicle control. Formulations 1 and 2 reduced the time required to trace food and number of errors and the results were comparable with positive control groups and comparators Tc and Pe. Formulations 1 and 2 reversed amnesia produced by Scopolamine, Diazepam, and Cyclosporine when compared with vehicle control and showed comparable results with those of positive control groups and comparators Tc and Pe. Conclusion: Formulations 1 and 2 demonstrated nootropic activity and both the formulations showed comparable nootropic activity with that of Tc and Pe alone.