Haematinic evaluation of <i> Lauha bhasma</i> and <i> Mandura bhasma</i> on HgCl₂ -induced anemia in rats

An Evaluation of the Efficacy, Safety, and Tolerability of Abhraloha Compared With Oral Ferrous Ascorbate on Iron Deficiency Anemia in Women: A Randomized Controlled, Parallel-Group, Assessor-Blind Clinical Trial

Background and objective Iron deficiency anemia (IDA) is a common condition in women for which ferrous ascorbate (FA) is often prescribed, which can lead to multiple side effects. Abhraloha is an Ayurvedic medicine that has been used for decades in India to treat IDA. In this study, we aimed to evaluate the efficacy and safety of Abhraloha with regard to change in hemoglobin (Hb) levels as compared to the standard treatment using FA in participants with IDA. Materials and methods We conducted a single-center, pragmatic, prospective, randomized, active-controlled, two-arm, parallel-group, assessor-blind study to evaluate the efficacy and safety of Abhraloha with regard to change in Hb levels as compared to the standard treatment using FA in participants suffering from IDA. The eligible participants were randomized and were advised to take either Abhraloha (two tablets twice a day) or FA (one tablet twice a day) for eight weeks; they were asked to follow up after 14 days for re-evaluation. On visit 1 and during the study period, the physician assessed the participants on the Pandurog scale and subjective variables. Descriptive statistics were used with unpaired T-test/Mann-Whitney U test for comparison between the groups. The Wilcoxon signed-rank test was used for within-group analysis, and the chi-square test/Fisher's exact test was employed for categorical data. Results Based on our findings, Abhraloha tablets significantly increased all the variables including the Pandurog scale after eight weeks of treatment. Abhraloha reduced total iron-binding capacity (TIBC) and peripheral smear lymphocyte (PSL), which is consistent with an improvement in IDA. There was a statistically significant increase in Hb, red blood cell (RBC) count, packed cell volume (PCV), mean corpuscular volume (MCV), and mean corpuscular hemoglobin (MCH) in the Abhraloha group as compared with the FA group at eight weeks. The Abhraloha group also exhibited a statistically significant improvement in all the subjective variables. Abhraloha was found to be safe and well-tolerated among the participants. Conclusions Abhraloha possesses hematinic activity and it improves all the blood indices. It is associated with significantly fewer adverse effects compared to oral iron therapy, which proves that it can be safely used for the treatment of IDA.

Evaluation of Punarnavadi Mandura for haematinic activity against mercuric chloride-induced anemia in albino rats

Background

Punarnavadi Mandura, a compound Ayurvedic formulation, is one of the most commonly used medicine in the treatment of anemia (Pandu) in Ayurveda. The safety profile of this formulation is well established; however, no pharmacological study has been reported to provide the scientific basis for its use in the treatment of anemia.

Aim

To evaluate the hematinic effect of Punarnavadi Mandura against mercuric chloride-induced anemia in albino rats.

Materials and methods

The test drug (Punarnavadi Mandura) was suspended in distilled water and administered orally in a dose of 450 mg/kg for 30 days in rats. Anemia was induced by simultaneous administration of mercuric chloride (9 mg/kg) for 30 consecutive days. Body weight was noted for each animals. At the end, haematological parameters, anaemia markers like serum iron, ferritin, and total iron binding capacity (TIBC), as well as relative weight of organs and histopathology investigation, were examined.

Results

Exposure of mercuric chloride to rats for 30 days resulted in a significant decrease of body weight, an increase in the weight of the liver and kidney and a decrease in hemoglobin content. It also decreased serum ferritin to a significant extent and increased serum TIBC. Histopathology of the liver shows macro fatty changes, vacuolization, marked necrosis, and severe degenerative changes, while the kidney shows cell infiltration. All these changes were significantly attenuated by the administration of Punarnavadi Mandura.

Conclusion

The present data indicate that Punarnavadi Mandura has possessing marked cytoprotective activity, significantly attenuated the HgCl2-induced adverse changes on red blood cell related parameters, and showing hematinic activity in albino rats.

Dhatri Lauha in the management of iron deficiency anemia: A prospective open-label single-arm multi-center trial

Background

The burden of iron-deficiency anemia (IDA) remains persistently high in India due to the poor tolerability of oral iron supplementation. Therefore, more focus is required to explore traditional medicine for safe and effective options for managing IDA.

Aim

To assess the clinical safety and efficacy of Dhatri Lauha in patients with IDA.

Materials and methods

An open-label, prospective, single-arm, multi-center trial was conducted at 12 centers with a sample size of 40 participants per study site. Patients with IDA aged 18-60 years with hemoglobin levels in the range of 6-10gm/dl, mean corpuscular volume (MCV) <80 fl, mean corpuscular hemoglobin concentration (MCHC) <34 μg/dl, serum ferritin <30 μg/dl and serum iron <50 μg/dl were included in the study. Dhatri Lauha 500 mg capsule was administered twice daily with lukewarm water after meals for 45 days. The primary outcome measure was the change in hemoglobin (Hb%) level from baseline to day 45. Secondary outcome measures included the change in MCV, MCHC, serum iron and ferritin levels, incidence of adverse events, and change in safety parameters (liver and kidney function tests). The mean (statistical) change in outcome measures from baseline to day 45 was compared using a paired sample t-test.

Results

Out of 458 participants enrolled in the study, 400 contributed to the final analysis. A significant difference was observed in the outcome parameters such as Hb%, MCV, MCHC, serum ferritin, and serum iron levels (P < 0.001) after 45 days of treatment. Mean Hb% changed from 8.46 ± 1.14 g/dl at baseline to 9.18 ± 1.61 g/dl on day 45 (P < 0.001). LFT and KFT were within the normal limits after the study period. No participant withdrew from the study due to adverse events.

Conclusions

Dhatri Lauha is a safe intervention and can be expected to improve hemoglobin levels, red blood cell parameters, and iron stores in patients with IDA. Future RCTs with a larger sample size, standard care as control and a longer follow-up may produce more accurate and reliable results.

Efficacy of Pandughni Vati & Punarnavadi Mandura Vati in the managment of Pandu w.s.r. iron deficiency anemia in children- An open labelled comparative clinical trial

Background:

Anemia is a public health problem worldwide, and its prevalence in India is higher than any other south asian countries. Iron deficiency anemia (IDA) is having larger share out of all types of anaemia’s. Symptomatology of IDA resembles with Kapha dominant variety of Pandu. PandughniVati (PV) and PunarnavadiMandura (PM) Vati mentioned in Ayurveda are being used in clinical practice since long.

Aim:

To assess the efficacy of PandughniVati and compare its clinical efficacy with Punarnavadi Mandura Vati in the management of Pandu ws.r. iron deficiency anemia in children.

Materials and methods:

Present clinical study was a randomized trial for management of iron deficiency anemia aged 2–16 years. Out of total 91 patients enrolled, 60 completed the study and divided into two groups. In group A, Pandughni Vati (trial drug) and in group B, Punarnavadi Mandura Vati in the management of Pandu ws.r. iron deficiency anemia in children. (standard drug) were given to 30-30 patients respectively for a duration of 90 days in age specific doses. Patients were assessed by clinical signs and symptoms of Pandu and investigation parameters like complete blood count, serum iron, serum ferritin and total iron binding capacity (TIBC) on baseline and after 90 days of treatment. Statistical analysis was carried out by Sigma Stat software.

Results:

On comparison, highly significant difference was found between two groups in subjective parameters such as Panduta (pallor), Daurbalya (weakness), Hriddrava (palpitation), Akshikuta Shotha (periorbital oedema), Pindikodweshtana (leg cramps) and Shwasa (breathlessness) whereas objective and saturation percentage except serum ferritin.

Conclusion:

The study revealed that, both the drugs; Pandughni Vati and Punarnavadi Mandura Vati were equally effective in the management of IDA so, it could be concluded that Pandughni Vati, can be used as mineral-free, safe, easily obtainable, palatable, cost-effective alternative drug of choice in alternative of Punarnavadi Mandura in iron deficiency anemia in children.

Standard manufacturing procedure of Teekshna lauha bhasma

BACKGROUND

Lauha bhasma is one of the herbo-metallic preparations used in Ayurveda, a traditional Indian system of medicine for treating various ailments such as anemia, diarrhea, hyperlipidemia and diabetes.

OBJECTIVE

To establish standard manufacturing procedure of Teekshna lauha bhasma and analyze its physico-chemical properties.

MATERIALS AND METHODS

The preparation of T. lauha bhasma (calx of iron [Fe] turning) involves samanya shodhana, vishesha shodhana followed by bhanupaka, sthalipaka and putapaka with Triphala kwatha as a medium under temperature of 650 °C in electric muffle furnace (EMF) and maintained for 1 h. T. lauha bhasma were subjected to different physico-chemical characterization using X-ray fluorescence spectrophotometer and scanning electron microscopy.

RESULTS AND DISCUSSION

The results suggest that these steps are necessary to obtain a good quality of bhasma and also make it acceptable for trituration during Bhasmikarana process. It is found that T. lauha bhasma was prepared properly in 20 puta at a temperature of 650 °C. The particle size of 20 puta T. lauha bhasma is 100-500 nm in range.

CONCLUSION

Pharmaceutical procedures given in Ayurvedic texts are necessary to prepare pakwa jambu phala varna T. lauha bhasma that complies with all the classical bhasma pariksha and modern analytical parameters in 20 puta at a temperature of 650 °C maintained for 1 h in EMF.

Studies of lipid profile, liver function and kidney function parameters of rat plasma after chronic administration of "Sulavajrini Vatika"

The successful use of Ayurvedic medicines is for many years but there is no guideline for studying the toxicity of these preparations through preclinical or clinical investigations. The present study was conducted to evaluate the effect of conventionally prepared Sulavajrini Vatika (SBB), an Ayurvedic formulation on various biochemical parameters of experimental animals after chronic administration. The animal used was albino rats (Rattus norvegicus: Sprague-Dawley strain) and SBB was administered orally at a single dose of 100 mg kg(-1) b.wt. day(-1), up to 62 days. During the study, forty rats, equally of both sexes, were randomly grouped into four where one male and one female group were used as control and other groups were used as test. Among the lipid components, Triglyceride (TG) was decreased very high significantly in both sexes of animal. The decrease of Total Cholesterol (TC), Very Low Density Lipoprotein (VLDL) and high-density lipoprotein (HDL) were also highly significant. Low Density Lipoprotein (LDL) decreased in all SBB treated group. In the liver function parameters, the total protein and albumin content were increased very high significantly in both sexes of rat. But the bilirubin was decreased insignificantly in male and female rats. Serum Glutamic Pyruvic Transaminase (GPT), Glutamic Oxaloacetic Transaminase (GOT) and Alkaline Phosphatase (ALP) were decreased in all treated animals and it was very high significant. In case of kidney function parameters, creatinine was increased very high significantly but the urea was decreased very high significantly in both sexes of rat. The decrease in uric acid was not significant in none of the sexes of rat. The present study confirms that SBB can be contributory for the complications in diabetics with hyperlipidemia and nephropathy as it lowers most of the lipids components and improves liver function and kidney function parameters.