Further studies on the clinical efficacy of Solanum xanthocarpum and Solanum trilobatum in bronchial asthma

The clinical efficacy of two herbs S. xanthocarpum and S. trilobatum in a dose of 300 mg tds for 3 days was investigated in mild to moderate bronchial asthma. Their effect was compared with standard bronchodilator drugs, salbutamol (4 mg) and deriphylline (200 mg). The respiratory function was assessed by measuring the peak expiratory flow rate (PEFR) using a mini peak flow meter. In addition, improvement in lung function was assessed by physical examination (rhonchi and crepitation) and other symptoms such as cough, breathlessness and sputum. S. xanthocarpum and S. trilobatum produced a progressive improvement in the ventilatory function of asthmatic individuals over 3 days. The scores for rhonchi, cough, breathlessness and sputum were decreased by these drug treatments. The improvement in PEFR and the reduction in other symptom scores clearly indicate a bronchodilator effect, a decrease of oedema and secretions in the airway lumen. The response to these herbs can be considered to be equivalent to that of deriphylline but less than salbutamol. No untoward effects were reported during the study. The present study further confirms the traditional use of these herbs in bronchial asthma.

Antipyretic, antinociceptive and anti-inflammatory activity of Premna herbacea roots

The alcoholic extract of the roots of Premna herbacea was investigated for its antipyretic, antinociceptive and anti-inflammatory potential in animal models. The extract, when administered orally to mice has been found to be safe up to a dose of 8.0 g/kg. A significant antipyretic effect has been observed in rabbits while mild antinociceptive effects were evidenced in mice when tested by chemical as well as thermal methods. The extract did not exhibit any anti-inflammatory activity in acute but significantly reduced the chronic inflammation.

Perturbations in eosinophil homeostasis following treatment of lymphatic filariasis

Treatment of patients with patent Wuchereria bancrofti infection results in an acute clinical reaction and peripheral eosinophilia. To investigate the dynamics of the eosinophil response, changes in eosinophil activation and degranulation and plasma levels of eosinophil-active chemokines and cytokines were studied in 15 microfilaremic individuals in south India by sequential blood sampling before and after administration of 300 mg of diethylcarbamazine (DEC). Clinical symptoms occurred within 24 h. Plasma interleukin-5 (IL-5) and RANTES levels peaked 1 to 2 days posttreatment, preceding a peak peripheral eosinophil count at day 4. Major basic protein secretion from eosinophils paralleled IL-5 secretion, while levels of eosinophil-derived neurotoxin peaked at day 13 after treatment. Expression of the activation markers HLA-DR and CD25 on eosinophils rose markedly immediately after treatment, while expression of VLA-4 and alpha4beta7 showed an early peak within 24 h and a second peak at day 13. Thus, the posttreatment reactions seen in filarial infections can be divided into an early phase with killing of microfilariae, clinical symptomatology, increases in plasma IL-5 and RANTES levels, and eosinophil activation and degranulation and a later phase with expression of surface integrins on eosinophils, recruitment of eosinophils from the bone marrow to tissues, and clearance of parasite antigen.

Anti-inflammatory activity of Aglaia roxburghiana var. beddomei extract and triterpenes roxburghiadiol A and B

The alcoholic extracts of the aerial portion and fruits of Aglaia roxburghiana (W.& A.) Miq. var. beddomei and the triterpenes roxburghiadiol A and B isolated from this plant were investigated for their anti-inflammatory activity in rats by carrageenin induced rat paw oedema and cotton pellet granuloma methods. They were also studied for their effect on mast cell degranulation induced by compound 48/80. Potent anti-inflammatory activity was observed for the extracts of the aerial portion and fruits of A. roxburghiana as well as for the triterpenes roxburghiadiol A and B. The mast cell degranulation induced by compound 48/80 was significantly reduced by A. roxburghiana extracts and the triterpenes. The triterpenes roxburghiadiol A and B may play a significant role in the observed anti-inflammatory effect of A. roxburghiana.

A pilot study on the clinical efficacy of Solanum xanthocarpum and Solanum trilobatum in bronchial asthma

Solanum xanthocarpum and Solanum trilobatum are widely used to treat respiratory diseases in southern Indian traditional medicine (Siddha). A pilot study was undertaken to investigate the clinical efficacy and safety of a single dose of the above herbs in mild to moderate bronchial asthma. The respiratory functions (FVC, FEV1, PEFR and FEF25-75%) were assessed by using a spirometer prior to and 2 h after oral administration of 300 mg powder of whole plant of either S. xanthocarpum or S. trilobatum. Standard bronchodilator drugs, salbutamol (4 mg) and deriphylline (200 mg) were used for comparison. Treatment with either S. xanthocarpum or S. trilobatum significantly improved the various parameters of pulmonary function in asthmatic subjects. However, the effect was less when compared to that of deriphylline or salbutamol. No untoward effects were reported during the study. The results of the present study confirm the traditional claim for the usefulness of these herbs in bronchial asthma. More detailed studies are required to investigate the mechanism of action and therapeutic utility of S. xanthocarpum and S. trilobatum.

Antinociceptive, anti-inflammatory and antipyretic effects of ethanol extract of Clerodendron serratum roots in experimental animals

The alcoholic extract (50, 100 and 200 mg/kg, p.o) of Clerodendron serratum roots produced a significant antinociceptive, anti-inflammatory and antipyretic activities in animal models. The results support the traditional claims of C. serratum as a remedy for pain, inflammation and fever.

Long-term persistence of cellular hyporesponsiveness to filarial antigens after clearance of microfilaremia

The persistence of parasite-specific cellular hyporesponsiveness after clearance of blood microfilariae (mf) was studied in 18 individuals who had been treated with a single dose of ivermectin, diethylcarbamazine, or a combination 2-3 years previously and who had initially cleared their parasitemia. At recruitment into the present study, 50% were again mf+ and 50% remained mf-. There were no significant differences between the mf+ and mf- groups in the amount of interferon-gamma (IFN-gamma) produced by peripheral blood mononuclear cells in response to adult or microfilarial antigens, although IFN-gamma production in response to purified protein derivative was greater in the mf+ group (geometric mean [gm] = 3,791 pg/ml; P = 0.02) than in the mf- group (gm = 600 pg/ml). These data suggest that although microfilaremic individuals may temporarily regain the ability to produce IFN-gamma to parasite antigens post-treatment, they subsequently revert to a state of hyporesponsiveness to mf-containing antigens that appears to be independent of the recurrence of microfilaremia and the response to nonparasite antigens.

Pharmacognostical studiies on aglaia roxburghiana miq. Var. Beddomei

Morphological, anatomical, quantitative microscopy powder microscopy, physical constant preliminary phytochemical analysis and fluorescence analysis of the leaves of Aglaia roxburghiana Var. Beddome were carried out.

Ultrasonographic diagnosis of subclinical filariasis

Asymptomatic persons with lymphatic filariasis may harbor microfiliariae in the circulation, and despite the lack of symptoms, these patients may have occult pathologic lesions and renal abnormalities. Earlier investigators have shown that it is possible to detect live adult filarial worms and dilation of lymphatic channels with ultrasonography. It is also possible to assess response to therapy. Using sonography, we detected twirling motions in dilated lymph channels and characteristic sonographic findings associated with presence of adult filariae. On follow-up examination we also found evidence of loss of worm activity after chemotherapy.

Skin changes in chronic lymphatic filariasis

Seventeen men and 31 women with unilateral lower limb lymphoedema attributed to chronic lymphatic filariasis were examined in the filarial out-patient clinic of the Government General Hospital, Madras, India. Skin changes such as skin fold thickening, hyperkeratosis, hypo- or hypertrichosis, pachydermia, pigmentary changes, chronic ulceration, epidermal and sub-epidermal nodules, and clinical intertrigo were observed and compared between the different lymphoedema grades. These lesions are not specific to chronic lymphatic filariasis, and have been described in other conditions displaying lymphostasis. They are thought to be favoured by secondary infections, which should be dealt with appropriately to prevent the progression of the disease and the onset of elephantiasis.

Kinetics of serum and cellular interleukin-5 in posttreatment eosinophilia of patients with lymphatic filariasis

Peripheral blood eosinophil counts and serum levels and in vitro production of eosinophilopoietic cytokines were assessed before and at frequent intervals after diethylcarbamazine treatment of Bancroftian filariasis. Eosinophil counts peaked at day 7 after the start of treatment (359% +/- 118% of pretreatment levels) and declined to pretreatment levels by day 17. Serum interleukin (IL)-5, undetectable in 14 of 15 patients before treatment, rose sharply but transiently, with peak levels (32 +/- 7 pg/mL) 2 days after diethylcarbamazine treatment. Granulocyte-macrophage colony-stimulating factor and IL-3 were not detectable in serum at any time. In vitro mitogen-induced IL-5 levels decreased significantly in 7 of 9 patients 3 days after treatment when serum IL-5 was at near-peak levels. By day 10 IL-5 values increased in 8 of 9 patients compared with treatment values (P < .02). These data define the temporal relation between serum IL-5 levels and the subsequent development of eosinophilia and suggest that lymphocytes are the source of IL-5.

A controlled trial of ivermectin and diethylcarbamazine in lymphatic filariasis

Ivermectin is a new antifilarial drug that can be given in a single oral dose. To compare the efficacy and side effects of ivermectin with those of diethylcarbamazine, the standard antifilarial treatment, we conducted a randomized, double-blind trial in 40 South Indian men with lymphatic filariasis caused by Wuchereria bancrofti. Patients were randomly assigned to one of three treatments: a single low dose of ivermectin (mean [+/- SE], 21.3 +/- 0.7 micrograms per kilogram of body weight; n = 13) followed by placebo for 12 days; a single high dose of ivermectin (mean, 126.2 +/- 3.7 micrograms per kilogram; n = 13) followed by placebo for 12 days; or diethylcarbamazine for 13 days (6 mg per kilogram per day for 12 days preceded by 3 mg per kilogram for 1 day; n = 14). Eleven patients were initially assigned to receive placebo and after five days were reassigned to one of the three treatment groups. At day 12 there was complete clearance of microfilariae from the blood in all 26 men who took ivermectin and in 11 of the 14 men who took diethylcarbamazine. At six months the numbers of detectable microfilariae (as a percentage of the pretreatment values) were 18.3 percent after low-dose ivermectin and 19.5 percent after high-dose ivermectin, as compared with 6.0 percent after diethylcarbamazine (P less than 0.05). The side effects were confined to the first five days and were similar in the three treatment groups. We conclude that in lymphatic filariasis, the clinical response to a single dose of ivermectin compares favorably with that after the standard 12-day course of diethylcarbamazine. Given the practical advantages of single-dose administration, ivermectin should become a useful medication for the control of bancroftian filariasis.

Ivermectin for the treatment of Wuchereria bancrofti filariasis. Efficacy and adverse reactions

Ivermectin treatment was evaluated for efficacy and side effects in 40 patients in South India who had microfilaremia and bancroftian filariasis. Ivermectin was administered once orally at four dose levels (range, 25 to 200 micrograms/kg), and at each it was found to be completely effective in clearing blood microfilariae within five to 12 days. In most patients, microfilariae reappeared by three months; by six months the levels averaged 14% to 32% of pretreatment values in the four study groups, and all groups showed equivalent efficacy. Detailed monitoring identified some side effects in almost all patients: usually fever, headache, light-headedness, myalgia, sore throat, or cough that occurred most prominently 18 to 36 hours after treatment. These were most frequent and severe in patients with the greatest microfilaremia, but only when treated with the two higher doses of ivermectin (100 and 200 micrograms/kg). The low-dose (25 micrograms/kg) ivermectin group, despite equivalent efficacy in parasite killing, had clinical reaction scores that were minimal and that were not correlated with parasitemia. Since efficacy and side effects of ivermectin therapy compare favorably with those reported for treatment with the standard antifilarial drug diethylcarbamazine citrate, the major advantage of single-oral-dose administration makes ivermectin the best candidate to replace diethylcarbamazine as the treatment of choice for bancroftian filariasis.

Therapeutic compliance of patients on phenothiazines

The present study was designed to assess the therapeutic compliance of psychiatric patients who reported to be on regular medication particularly phenothiazines. Of the all cases subjected to the F.P.N, test, it was clearly negative in 21 (18.9 %) indicating, their non-adherence to the drug therapy. Despite their report of regular drug intake at the time of urine screening, five of these twenty one patients had reported at a later date discontinuity of therapy for some reason or the other. Curiously, on a long term drug therapy, the incidence of non-compliance is relatively less.