International Journal of Basic & Clinical Pharmacology
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High levels of cardiac and oxidative stress biomarkers ameliorated following treatment with aspirin, vitamin C, and Justicia secunda hydromethanol leaf extract on epinephrine induced-myocardial infarction in male Wistar rats
Get PDFBackground: Myocardial infarction is an increasing cardiac disorder globally. This study investigated the ameliorative potentials of Justicia secunda hydromethanol leaf extract on epinephrine-induced myocardial infarction in male Wistar rats.
Methods: Twenty-four rats weighing (70-170 gm) were assigned into 6 groups (n=4). Group A was control, group B received epinephrine (0.08 mg/kg) intraperitoneally for 2 days; groups C-F received epinephrine followed by oral treatments: Aspirin (2 mg/kg), Justicia secunda (1 mg/kg), Justicia secunda (2 mg/kg) and vitamin C (2 mg/kg) respectively for 14 days.
Results: There was a significant elevation of lactate dehydrogenase and troponin T and disruption in electrolyte balance, indicative of myocardial injury. Treatment with Justicia secunda (2 mg/kg), aspirin, and vitamin C significantly reduced LDH and troponin T levels (p<0.01), improved antioxidant status (increased SOD, CAT, GSH; decreased MDA), and slightly normalized electrolytes. Justicia secunda (2 mg/kg), exhibited improvement in high-density-lipoproteins and reduction in low-density-lipoprotein levels.
Conclusions: Treatment with Justicia secunda (particularly at 2 mg/kg), aspirin, and vitamin C ameliorated the epinephrine-induced myocardial infarction. Hence, if these results apply to humans, using Justicia secunda in management of myocardial infarction and oxidative stress should be encouraged as a potential natural adjunct
A prospective, randomized, open-label study to compare the efficacy and safety of metformin versus metformin and fluoxetine in patients of type 2 diabetes mellitus with mild depression
Get PDFBackground: Type 2 diabetes mellitus (T2DM) and depression often occur together, increasing morbidity and mortality. While metformin shows potential antidepressant effects, its comparative efficacy and safety versus metformin-fluoxetine (MF) combination in T2DM patients with mild depression required further study.
Methods: This prospective, randomized, open-label study involved 60 patients (18-65 years) with T2DM and mild depression (HDRS 8-13) over 90 days. Group A received metformin 500 mg twice daily (n=30), while group B received metformin 500 mg twice daily plus fluoxetine 40 mg daily (n=30). Primary outcomes included glycemic parameters (FPG, HbA1c) and depression scores (HDRS, CGI). Safety, quality of life, and compliance were also assessed.
Results: Baseline parameters were comparable between groups. Both groups showed highly significant improvements (p<0.001) in glycemic control and depression scores. Over 60 days, group A showed 20% HDRS improvement versus group B’s 10%; CGI-I was 3.33% in A versus 0% in B. By 90 days, HDRS improvement was 100% in group A versus 93.33% in B, while CGI-S and CGI-I improvements were 100% for both groups. No significant intergroup differences were observed for efficacy (p>0.05). Expected adverse effects were lower with metformin (28.33%) versus fluoxetine therapy (66.67%), all mild. Both groups demonstrated highly significant (p<0.001) QOL improvement and good compliance (≥85%).
Conclusions: Both treatments effectively improved glycemic control and depression symptoms. Metformin monotherapy demonstrated comparable efficacy and safety to the combination therapy of metformin and fluoxetine for managing mild depression in T2DM patients
A comparative analysis of fluoxetine and amitriptyline in depression: assessing effectiveness and adherence in a rural hospital setting
Get PDFBackground: Fluoxetine and amitriptyline are commonly prescribed antidepressants. However, the superior option in terms of effectiveness and adherence remains unclear. Medication non-adherence significantly impacts treatment outcomes. This study aims to compare the two drugs in terms of effectiveness and adherence, and to assess their correlation.
Methods: This is a single-centered, prospective observational study, conducted in the psychiatric outpatient department (OPD) of the Government Medical College and Hospital, Nagapattinam, over six months (23 July 2024 to 22 January 2025). It included 126 patients newly diagnosed with depression. Patients receiving either fluoxetine or amitriptyline were enrolled. Effectiveness was measured using the 17-item Hamilton depression rating scale (HAM-D), calculating score reduction from baseline to endpoint. The four-item Morisky scale (MMAS-4) was applied to assess the medication adherence of the participants. Data were analysed with statistical package for the social sciences (SPSS) version 24, applying descriptive analysis, independent t-test and Pearson correlation as appropriate.
Results: Depression was more prevalent among women. Most participants were married and unemployed. Fluoxetine showed a greater mean reduction in HAM-D scores compared to amitriptyline. It also demonstrated higher medication adherence. A statistically significant positive correlation between effectiveness and adherence was observed for both drugs.
Conclusions: Better clinical outcomes were associated with higher medication adherence. Fluoxetine was superior to amitriptyline in both effectiveness and adherence. These findings highlight the importance of adherence in improving depression treatment outcomes
Comparative effectiveness of oral antibiotic regimens for urinary tract infections in outpatients: a systematic review
Get PDFUrinary tract infections (UTIs) are one of the most prevalent bacterial infections encountered in outpatient clinical practice, especially among women. The treatment of uncomplicated UTIs predominantly involves oral antibiotic therapy; however, the increasing prevalence of antimicrobial resistance presents a significant challenge in selecting the most effective regimen. This systematic review critically evaluates and compares the effectiveness and safety of various oral antibiotic regimens used for the treatment of uncomplicated UTIs in outpatient populations. The study synthesizes evidence from randomized controlled trials (RCTs), cohort studies, and observational studies to identify antibiotics that provide superior symptom resolution, microbiological cure, and lower recurrence rates, while considering patient demographics, local antimicrobial resistance patterns, and adverse effect profiles. The findings suggest that fluoroquinolones, particularly norfloxacin and ofloxacin, demonstrate lower treatment failure rates compared to trimethoprim-sulfamethoxazole (TMP-SMX) and ciprofloxacin. However, the review also emphasizes the need for caution in the use of fluoroquinolones due to their associated side effects and rising resistance. This study aims to guide clinicians in making evidence-based antibiotic choices to optimize patient outcomes and support antimicrobial stewardship efforts in outpatient care
Incidence of xerostomia and effectiveness of oral xyletol in xerostomia management among hemodialysis patients
Get PDFBackground: Xerostomia or dryness of the mouth, is a frequent complaint among patients undergoing chronic haemodialysis (HD). However, its incidence and severity in dialysis populations, particularly in tropical regions like India, remain poorly documented. Xerostomia may contribute to intradialytic weight gain (IWG) by influencing fluid intake behaviours, but its role in this context is unclear. This study is aimed to assess the incidence of xerostomia in dialysis patients and evaluate the effectiveness of oral XYLETOL in its management.
Methods: This prospective study included CKD stage 5D patients aged 18-75 years, on dialysis for at least 3 months. Xerostomia was assessed using a validated questionnaire, with scores ≥25 indicating significant xerostomia. Patients consenting to further evaluation were administered oral XYLETOL tablets (2 tablets, three times daily, 2 hours after meals) for four weeks. Xerostomia inventory scores were reassessed after treatment and compared with baseline scores. Secondary assessments included intradialytic weight gain (IWG) and hypotension episodes.
Results: The study demonstrated that oral XYLETOL tablets effectively reduced xerostomia symptoms in HD patients with significant scores (≥25). Post-treatment xerostomia scores showed notable improvement compared to baseline. However, no significant impact was observed on IWG, indicating that the benefits were confined to symptom relief rather than on hemodynamic changes.
Conclusions: Xerostomia in HD patients has multiple contributing factors, including advanced age, systemic diseases, medication use, fluid intake restrictions and salivary gland fibrosis. Early identification of risk factors is crucial for effective management. While XYLETOL is beneficial for reducing xerostomia
Preclinical hematological profile studies of an ayurvedic medicine Rohitakarista after chronic administration to male Sprague-Dawley rats
Get PDFBackground: Rohitakarista (RHT) is a classical Ayurvedic formulation, traditionally used for the treatment of splenomegaly, particularly among rural populations.
Methods: The acute toxicity study of RHT in male Sprague-Dawley rats showed no mortality even at 80 ml/kg body weight. For chronic toxicological evaluation, rats were divided into two groups (n=10 per group). One group received RHT suspension orally at 40 ml/kg body weight daily for 41 consecutive days, while the control group received water. At the end of the treatment period, blood samples were collected to evaluate 25 different hematological parameters.
Results: RHT-treated rats showed a significant increase in absolute neutrophil count (153.96%, p=0.05) and neutrophil percentage (84.60%, p=0.04), alongside a significant decrease in lymphocyte percentage (24.62%, p=0.04). Red blood cell count (13.34% decrease, p=0.03), hemoglobin level (12.94% decrease, p=0.04), and hematocrit (14.29% decrease, p=0.01) were also significantly reduced. Non-significant but noticeable changes included increased WBC count (23.80%), eosinophils (216.67%), monocyte percentage (84.06%), and platelet count (17.71%). Other parameters such as MCV, MCH, MCHC, RDW, ESR, bleeding time, clotting time, and platelet indices showed minor and nonsignificant variations.
Conclusions: Chronic RHT administration led to significant hematological changes, particularly in neutrophil and erythrocyte indices, suggesting potential immunological and anemic risks. Further biochemical and histopathological studies are recommended to better understand its overall safety profile
Methanolic extract from the fruit kernel of Mangifera indica (Anacardiaceae) improves blood count, serum iron levels and transaminases in anemic rats
Get PDFBackground: Mangifera indica (Anacardiaceae), known for its many therapeutic potentialities is used in traditional Ivorian medicine to treat anemia. The aim of this study was to evaluate the effects of methanolic extract from the fruit kernel of Mangifera indica (EMMI) on blood pressure, iron and transaminase levels in rat’s anaemic by phenyl hydrazine (50 mg/kg, per os).
Methods: The determination of iron, tannins, polyphenols and total flavonoids in EMMI samples was performed, using specific reagents. Different groups of rats were treated with EMMI (100, 500 and 1000 mg/kg) or Folifer (50 mg/kg) by gavage for 14 days. The determination of hematological and biochemical parameters following the different treatments was carried out, using an URIT 3000 PLUS machine.
Results: Phytochemical analyses show that EMMI (10 mg/ml), is rich in polyphenols (38.97±0.04 mg GAE/g), flavonoids (26.83±0.02 mg QE/g), tannins (33.87±0.06 mg TAE/g). and iron (52.91±0.01 mg/100 g). The observed anti-anaemic effects were dose-dependent. After 14 days of treatment, EMMI (1000 mg/kg) induced normalization of RBC, Hb, Hct and serum iron levels (p<0.001), with a decrease in ASAT and ALAT levels respectively of about 28 and 34% in anaemic rats (p<0.001). These effects were comparable to those of Folifer (p>0.5).
Conclusion: Altogether, this study showed that EMMI normalizes blood count, serum iron and transaminases in rats made anaemic by administration of phenyl hydrazine. This beneficial effect would be attributed to its richness in secondary metabolites and iron
From rodents to pigs: critical evaluation of animal models in cutaneous wound healing research studies
Get PDFAnimal models are vital to elucidate the mechanisms of skin wound repair and to evaluate new-fangled therapeutics in preclinical setting. However, the choice of model has a profound effect on translational relevance. This review synthesizes evidence from key methodological and comparative studies for a critical evaluation of strengths, limitations and appropriate use of commonly used animal models, in particular rodents, pigs and companion animals. We highlight the importance of matching the choice of models to specific research questions, wound pathophysiology and desired clinical outcomes
Integrative hypoxia preconditioning: linking iron– hypoxia-inducible factor pathways and oxygen-based therapies from high-altitude physiology to clinical application: a comprehensive review
Get PDFHypoxia, once seen solely as a threat, is now recognized as a potent driver of human adaptation. From Himalayan sojourners to critically ill patients, survival under low oxygen relies on a shared molecular axis the hypoxia-inducible factor (HIF)-iron-erythropoietin (EPO) network. Iron acts as the pivotal regulator, as prolyl hydroxylase enzymes that degrade HIF require ferrous iron, directly linking oxygen sensing to erythropoiesis. At high altitude, hepcidin suppression and erythroferrone induction mobilize iron stores for hemoglobin synthesis, while genetic variants such as EPAS1 and EGLN1 fine-tune erythropoietic response to prevent excessive polycythemia. Controlled hypoxia or hyperbaric oxygen preconditioning at sea level similarly activates HIF and Nrf2-mediated antioxidant defences, improving mitochondrial efficiency and tissue resilience. Clinically, HIF-prolyl hydroxylase inhibitors like roxadustat exploit this pathway to manage renal anemia. Emerging concepts in adaptive oxygen medicine including portable hyperbaric therapy and intermittent hypoxia training translate altitude physiology into therapeutic strategy. Thus, oxygen is redefined not only as a vital substrate but as a modifiable signal coordinating iron metabolism, redox balance, and cellular adaptation, a continuum linking acclimatization, preconditioning, and healing
The role of probiotics in managing premenstrual syndrome: insights into beneficial bacterial strains
Get PDFPremenstrual disorders (PMDs), encompassing premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD), affect a significant number of women globally. Despite various hypothesized causes like hormonal shifts, serotonin imbalances, and lifestyle factors, the precise etiology remains unclear. Recent research emphasizes the crucial role of the gut microbiota in influencing mental and physical health, particularly through the gut-brain axis, which facilitates neuroendocrine communication. The gut microbiome's impact on endocrine, metabolic, and immune systems is significant, linking variations in gut microbiota diversity to conditions such as major depressive disorder (MDD) and metabolic disorders. Probiotics, known for modulating gut microbiota, show promise in managing PMDs and primary dysmenorrhea by influencing microbial diversity, metabolite profiles, and inflammatory pathways. Studies indicate that certain probiotic strains regulate cytokine production, enhance immunological tolerance, and may alleviate symptoms of hormone-related disorders. Traditional treatments for primary dysmenorrhea, including NSAIDs and hormonal therapy, often have adverse effects and limited efficacy, making probiotics a safer and potentially more effective alternative. Further research is essential to fully understand the molecular mechanisms of probiotics. However, current evidence suggests they could significantly improve women's reproductive health, reduce premenstrual symptoms, and offer a novel approach to managing primary dysmenorrhea, thereby enhancing the quality of life for affected women