Neuroprotective role of Bacopa monnieri extract in modulating depression in an experimental rat model.

BACKGROUND: Depression is a common illness with no definite treatment. METHODS: The study involved 2 experimental periods; 45-day (P1) followed by 30-day (P2). 40 adult albino rats were randomly divided into 4 groups. Grp 1 received saline orally while Grp 2 reserpine inraperitoneally (ip) during P1 and P2. Grps 3 and 4 received reserpine during P1, followed by reserpine plus B. monnieri, and reserpine plus citalopram ip during P2, respectively. Forced swimming test (FST) was performed at beginning and end of P1 and P2. Animals were sacrificed by end of P2 and brain taken for histopathological examination and ELISA estimation of serotonin, dopamine, norepinephrine, BDNF, MCP-1, FAS, and Bcl-2. RESULTS: During P1, reserpine prolonged immobility time (IT) in FST in Grps 2, 3, and 4. IT was subsequently lowered in Grps 3 and 4 but remained elevated in Grp 2 by end of P2. Serotonin, dopamine and norepinephrine were lowered in Grps 2, 3, and 4, but in Grps 3 and 4, levels were comparable to Grp1. BDNF and Bc1-2 were reduced in Grps 2, 3, and 4, with higher levels in Grps 3 and 4 than Grp 2. MCP-1 and FAS were elevated in Grps 2, 3, and 4, but levels were lower in Grps 3 and 4 than in Grp 2. Histopathology showed congested cerebral cortex in Grp 2 and normal cortex in other groups. LIMITATIONS: Only adult male rats were involved and effects of co-administration of B. monnieri and citalopram were not characterized. CONCLUSION: B. monnieri improves depression comparable to citalopram in reserpine-induced depression.

High haemoglobin levels in early pregnancy and gestational diabetes mellitus among Sudanese women.

A longitudinal study was carried out to investigate the prevalence and risk factors (including haemoglobin levels) for gestational diabetes mellitus (GDM) in Khartoum, Sudan. The study was carried out at Saad Abuelela Hospital (Khartoum, Sudan) during February to November 2017. Pregnant women in early pregnancy (gestational age <14 weeks) were enrolled in the study. The detailed medical and obstetrics history was recorded for each participant using a questionnaire. The women were then followed up, where a 75-g oral glucose tolerance test was performed at 24 - 28 weeks of gestation. Of 290 women, 259 (89.3%) completed the follow-up. The mean (standard deviation [SD]) of the age, gravidity and gestational age at enrolment were 28.02 (5.7) years, 2.37 (2.42) and 10.86 (2.63) weeks, respectively. Forty-eight women (18.5%) had GDM. Binary regression showed that while age, parity, residence, education and body mass index (BMI) were not associated with GDM, a high haemoglobin level was the only factor associated with GDM (OR = 1.52, 95% confidence interval [CI] = 1.07 - 2.16, p = .019). Women with haemoglobin > 10.8 g/dl were at a higher risk of GDM (OR = 2.52, 95% CI = 1.02 - 6.27, p = .044). There is a high prevalence of GDM, especially among women with high haemoglobin levels.Impact statementWhat is already known on this subject? Gestational diabetes mellitus (GDM) is one of the most common complications during pregnancy, contributing significantly to maternal, perinatal morbidity and mortality and can lead to adverse consequences for the health of both mother and offspring later in life. The rate of GDM varies with the various settings and populations, and a prevalence of 1-14% has been reported depending on the population studied. High haemoglobin levels were recently reported to be associated with GDM.What do the results of this study add? There is a high prevalence of GDM in Khartoum, Sudan, especially among women with high haemoglobin levels in early pregnancy.What are the implications of these findings for clinical practice and/or further research? Haemoglobin levels could be used as reliable markers to detect GDM. These markers could be used in the prevention of GDM.

Maternal early pregnancy serum level of 25-Hydroxyvitamin D and risk of gestational diabetes mellitus.

OBJECTIVE: To assess if early pregnancy (≤14 weeks of gestation) 25-hydroxyvitamin D (25(OH)D) level is associated with risk of gestational diabetes mellitus (GDM). METHODS: A nested case-control study (60 women in each arm) was conducted at Saad Abualila Hospital (Khartoum, Sudan) during the period of January to November 2017. Clinical and obstetrical data were gathered, 25(OH)D concentration was measured at the first prenatal visit, and a 75-g oral glucose tolerance test was performed at 24-28 weeks of gestation. RESULTS: Compared with women without GDM, in women with GDM, the median of the 25(OH)D level was significantly lower (7.3 [interquartile range 5.7-8.8] ng/mL versus 8.4 [interquartile range 6.6-11.9] ng/mL, P=0.001). All women in the study (with and without GDM) had vitamin D deficiency (25(OH)D<20 ng/mL). The results of the logistic regression showed that a low 25(OH)D level was the only factor associated with GDM (odds ratio [OR] 0.83, 95% confidence interval [CI] 0.73-0.95, P=0.010). Women with 25(OH)D less than 6.0 ng/mL were at a higher risk of GDM (OR 3.2, 95% CI 1.29-8.12, P=0.012). CONCLUSION: A low 25(OH)D level in early pregnancy was associated with increased risk of GDM. This finding might be useful in predicting GDM.

Heart rate variability and hematological parameters in pregnant women.

BACKGROUND: There are few researches on hematological parameters (hemoglobin, red cell distribution width [RDW], white blood cells [WBCs], mean platelets volume [MPV], and heart rate variability [HRV]). There are no published data on this concept (HRV and hematological parameters) during pregnancy. METHODS: A cross-sectional study was conducted at Saad Abul Ela hospital in Khartoum, Sudan during the period of July to August 2018. Pregnant women with singleton, a live baby, were enrolled in this study. Clinical history and examination were performed. HRV (autonomic modulation) was assessed using time and frequency domain HRV indices. RESULTS: One hundred and five pregnant women were enrolled. The median (quartile) of the age, parity, and gestational age was 30.0 (25.0-35.0) years, 1.0 (0-3.0), and 38.0 (32.0-39.0) weeks, respectively. While there were positive correlations between hemoglobin and low frequency (LF), RDW and high frequency (HF), WBCs and HF Norm, WBCs and LF/HF, MPV and HF Norm, LF Norm and LF/HF, there was no significant correlation between the hematological (hemoglobin, WBCs, RDW, and MPV) and HRV parameters. Linear regression analysis showed no significant association between age, parity, gestational age, body mass index, hemoglobin, RDW, and HRV variables. The Log10 WBCs were negatively associated with Log10 HF (ms2 /Hz). MPV was positively associated with LF Norm and negatively associated with HF Norm. CONCLUSION: The study failed to show significant associations between age, parity, gestational age, hemoglobin, RDW, and HRV variables. The WBCs were negatively associated with HF. MPV was positively associated with LF Norm, and it was negatively associated with HF Norm.

Regular consumption of green tea improves pulse pressure and induces regression of left ventricular hypertrophy in hypertensive patients.

This study characterized the effects of regular green tea (GT) and hot water (HW) ingestion on systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP), and left ventricular hypertrophy (LVH) in two equal, sex- and age-matched groups; Grp1 and Grp2 (n = 100 each; age 53 ± 4 years) of hypertensive patients. Grp1 had regular GT treatment, followed by HW ingestion, whereas Grp2 had HW ingestion followed by GT treatment for periods of 4 months each. Electrocardiographic (ECG) and echocardiographic assessments of LVH were made before and at the end of both periods. SBP was lowered significantly by 6.6%; DBP by 5.1%, and PP by 9.1% by the end of month 4 of GT treatment in Grp1. Upon GT cessation and HW ingestion, SBP, DBP, and PP returned to pretreatment levels over 4 months. In Grp2, SBP, DBP, and PP were reduced insignificantly by 1.5%, 1.0%, and 2.3% by the end of the 4th month of HW ingestion. Conversely, over 4 months of GT treatment, SBP, DBP, and PP were significantly lowered by 5.4%, 4.1%, and 7.7% from the baseline values, respectively. ECG and echocardiographic evidence of LVH was shown in 20% of Grp1 and 24% of Grp2 patients before intervention. This was significantly lowered to 8% and 10% in Grp1 and Grp2 by GT treatment. However, this increased to 16% following HW ingestion in Grp1. HW ingestion did mot induce regression of LVH in Grp2. Thus, regular GT ingestion has cardiovascular protective effects.

Effects of Roselle on arterial pulse pressure and left ventricular hypertrophy in hypertensive patients.

OBJECTIVE: To characterize the effects of regular Roselle ingestion on blood pressure and left ventricular hypertrophy (LVH) in patients with established moderate essential hypertension. METHODS: This non-randomized quasi-experimental study was conducted in Kafr El-Shaikh, Egypt, for 8 weeks, from September 2012 to November 2012. The effects of a 4-week period of regular Roselle ingestion followed by a 4-week recovery period on systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP), and heart rates (HR) was studied in 2 equal, gender- and age-matched groups (n=50 each; average age - 50+/-5 years) of normotensive subjects, and patients with moderate essential hypertension. Electrocardiographic assessments of LVH were also made prior to, and at the end of both treatment and recovery periods. RESULTS: Pulse pressure (PP) significantly fell from baseline values by 10.9% (normotensive group [NG]), 21.2% (hypertensive group [HG]); SBP by 10% (NG), 19.6% (HG); DBP by 9.5% (NG), 18.7% (HG), and HR by 14.6% (NG), 17.1% (HG) by the end of week 4 of treatment. Following treatment cessation, SBP, DBP, PP, and HR returned to pretreatment levels over 4 weeks. Before intervention, none of the normotensive subjects, but 14 hypertensive patients showed LVH. However, Roselle treatment was associated with regression of LVH in 10 patients with only 4 patients showing LVH after 4 weeks of treatment. This became 10 patients 4 weeks after ceasing treatment. CONCLUSION: These findings empirically suggest favorable cardiovascular effects of Roselle in patients with established moderate essential hypertension.