A botanical extract blend of Mangifera indica and Sphaeranthus indicus combined with resistance exercise training improves muscle strength and endurance over exercise alone in young men: a randomized, blinded, placebo-controlled trial.

Resistance exercise training (RET) is used to improve muscular strength and function. This study tested the hypothesis that RET alongside daily supplementation of a Sphaeranthus indicus and Mangifera indica extract blend (SMI) would augment bench press (BP) and leg extension (LE) strength and repetitions to failure (RTF) compared to RET alone. Ninety-nine men (age 22 ± 3) completed the trial after randomization into one of four groups: (A1) 425 mg SMI plus one RET set; (A2) 850 mg SMI plus one RET set; (P1) placebo plus one RET set; and (P2) placebo plus two RET sets. RET sets were 6-8 BP and LE repetitions at 80% of a progressive one repetition maximum (1-RM), performed 3x/week for 8 weeks. Strength and RTF were evaluated at baseline and days 14, 28, and 56 while serum values of total testosterone (TT), free testosterone (FT), and cortisol (C) values were evaluated at baseline and day 56. RET significantly (p < 0.05) increased 1-RM, RTF, and T measures above baselines regardless of group assignment, but the increases were greater in the supplemented groups. At week 8, A1 bench pressed more than P1 (71.5.5 ± 17.5 kg vs. 62.0 ± 15.3 kg, p = 0.003), while A2 pressed 13.8 ± 3.0 kg more (95% CI 5.7-21.8, p < 0.001) than P1 and 9.9 ± 13.0 kg more (95% CI 1.7-18.2, p = 0.01) than P2. Also at week 8, the mean LE 1-RM of A1 (159.4 ± 22.6 kg) and A2 (162.2 ± 22.9 kg) was greater (p < 0.05) than that of P1 (142.2 ± 25.6 kg) and P2 (146.5 ± 19.7 kg). Supplementation improved RTF, TT, and FT values over those measured in exercise alone (p < 0.05), while C levels in A2 (9.3 ± 3.8 µg/dL) were lower than P2 (11.7 ± 3.8 µg/dL, p < 0.05). Daily supplementation with SMI was well tolerated and may help optimize muscle adaptive responses to RET in men.

Adverse Drug Reactions Attributed to Fondaparinux and Unfractionated Heparin in Cardiovascular Care Unit: An Observational Prospective Pilot Study in a Tertiary Care Hospital.

INTRODUCTION: This study was carried out to collect and analyze the adverse drug reactions (ADRs) reported with use of anticoagulants, heparin and fondaparinux. These drugs are vital in the treatment of unstable coronary artery diseases and emergencies. MATERIALS AND METHODS: A cross-sectional study with active reporting of ADRs from cardiology and medicine department was conducted. The type of reaction was assessed by Rawlins and Thomson criteria, causality by Naranjo probability scale, severity by modified Hartwig criteria, and preventability by Schumock and Thornton criteria. RESULT: Of the 67 patients observed, 16 showed ADRs. Fifteen reactions were attributable to unfractionated heparin and one to fondaparinux following assessment by the Naranjo causality scale. Severity of the ADRs assessed by modified Hartwig criteria showed that although 12 of 16 (75%) were mild, 4 (25%) were moderate in severity. Modified Schumock and Thornton criteria showed that 9 of 16 (56.25%) reactions could not have been prevented whereas 5 (31.25%) were probably preventable and 2 (12.5%) were definitely preventable. CONCLUSION: Incidence of ADRs with fondaparinux was lower than with heparin, hence emphasizing its better safety profile. The study also highlights the need for nurses and other caretakers in the coronary care unit to enquire for and report ADRs, particularly with high-potency medicines that are associated with an equally high potential to induce ADRs.

Factors Contributing Towards Poor Asthma Control in Patients on Regular Medication.

INTRODUCTION: In-spite of the availability of effective medications, it is observed that patients with bronchial asthma on treatment are poorly controlled. An objective evaluation of asthma control especially with respect to inflammation and the factors contributing towards poor control is crucial in obtaining relief of symptoms. AIM: 1) To measure the asthma control using modified Mini Asthma Quality Of Life Questionnaire (MAQOL) and sputum eosinophil count; 2) To identify the role of factors viz. age, duration of asthma, severity, compliance, technique of inhalation and knowledge of asthma action plan on asthma control. MATERIALS AND METHODS: Total 50 asthmatic patients on regular medication were included in the study after obtaining written informed consent. The asthma-control was evaluated based on history, clinical symptoms, need for short-acting bronchodilators, FEVs1 and sputum eosinophil count with the help of modified MAQOL. A global score of <80% was considered as poor control. The proportion of patients under each factor, in poorly-controlled group (PC) was compared with the well-controlled group (WC). The results were analysed using descriptive statistics and unpaired student's t-test. RESULTS: Of the total, 33 (66%) patients were in PC category with a mean global asthma score of 58.46 ± 2.881 vs 85.2 ± 1.19 in the WC group (34%) (p<0.05). The mean age in PC was 41.41 ± 2.413 vs 29.00 ± 2.157(p<0.05) in the WC. The mean duration of asthma was 16.76 ± 2.761 in PC vs 7.882 ± 2.065 years in WC (p<0.05). The severity score was 7.265 ± 0.4434 in PC vs 6.706 ± 0.64 in WC. Eight patients in PC and six in WC were unaware of the treatment plan. One in PC group and three in WC were unaware of technique of inhalation. One in PC group and three in WC were non-compliant. Mean sputum eosinophil count was 7.441 ± 1.081 in PC vs 5.176 ± 1.201 in WC. CONCLUSION: MAQOL is useful in evaluating asthma-control. Sputum eosinophil count correlates with asthma-control. Duration of asthma, age and severity contributed significantly to the poor control of asthma. There is a need for an objective monitoring in asthma and the treatment strategies need to be modified accordingly.

Multiple Adverse Effects of Systemic Corticosteroids: A Case Report.

Corticosteroids are among the effective treatments available for many medical conditions. Adverse effects such as osteoporosis, cataract and muscle weakness are widely recognized on long term administration and have considerable public health implications. Many reports are available that have dealt with individual adverse effects.Here, we report a case of a 55-year-old female, with systemic glucocorticoid induced bilateral cataract, osteoporosis, diabetes mellitus and hypothalamic pituitary axis (HPA) suppression. These were induced through self -medication. She presented to the hospital for the treatment of acute exacerbation of bronchial asthma.

Effect of Tinospora cordifolia on experimental diabetic neuropathy.

OBJECTIVES: To evaluate the effect of aqueous extract of stem of Tinospora cordifolia (TC) on hyperalgesia in streptozotocin induced diabetic rats and in- vitro aldose reductase inhibition. MATERIALS AND METHODS: Wistar albino rats, rendered diabetic with streptozotocin, were divided into 5 groups, namely the diabetic control treated with vehicle (DC), standard control which received glibenclamide+metformin (SC), test groups treated with 100, 200and 400 mg/kg b.w. of Tinospora cordifolia (TC1, TC2 and TC3 respectively). A group of five normal animals served as normal control (NC). Fasting blood glucose, body weight and reaction time to tail flick were measured one week after induction of diabetes. The animals were then treated orally for two weeks after which the same parameters were repeated. In-vitro aldose reductase inhibition assay was carried out at concentrations of 5, 10, 25, 50, 100 and 200 mcg/ml of Tinospora cordifolia using rat lens from normal rats. The in-vivo results were analysed with Mann Whitney test. RESULTS: The DC group demonstrated a decrease in the reaction time (hyperalgesia) compared to NC while a significant increase in the reaction time was observed with SC, TC2 and TC3 groups (p<0.05) as compared to the DC group. TC1 and TC2 showed a significant reduction in body weight compared to their baseline values (p<0.05). There was no significant change in the fasting blood glucose (FBS) in any of the groups. In-vitro aldose reductase inhibition was observed with TC with an IC(50) of 103 mcg/ml. CONCLUSIONS: Tinospora cordifolia prevents the hyperalgesia in experimental diabetic neuropathy. It has an aldose reductase inhibitory activity in-vitro which may contribute to the beneficial effects.

Competence of ethics committees in patient protection in clinical research.

Research Ethics Committees (RECs) are responsible for the protection of patients' rights and wellbeing. In this paper, we describe the findings of a survey of ethics committee members in a south Indian state. 29 members of 11 RECs responded to a questionnaire of 56 questions on their knowledge of and attitudes towards ethics review and the practices of the RECs to which they belonged.