1 9 4 36 Ginseng Use in Medicine: Perspectives on CNS Disorders Radad Khaled Gille Gabriele Rausch Wolf-Dieter 1 11 2004 3 2 30 0 13 11 2017 25 12 2017 Ginseng, the root of Panax species, is a well-known folk medicine. It has been used as traditional herbal medicine in China, Korea and Japan for thousands of years and today is a popular and worldwide used natural medicine. The active ingredients of ginseng are ginsenosides which are also called ginseng saponins. Recently, there is increasing evidence in the literature on the pharmacological and physiological actions of ginseng. Ginseng had been used primarily as a tonic to invigorate week bodies and help the restoration of homeostasis. However current in vivo and in vitro studies have shown its beneficial effects in a wide range of pathological conditions such as cardiovascular diseases, cancer, immune deficiency and hepatotoxicity. Moreover, recent research has suggested that some of ginsengs active ingredients also exert beneficial actions on aging, CNS disorders and neurodegenerative diseases. In general, antioxidant, anti-inflammatory, anti-apoptotic and immunostimulant activities are mostly underlying the possible ginseng-mediated protective mechanisms. Next to animal studies, data from neural cell cultures contribute to the understanding of these mechanisms which involve decreasing nitric oxide (NO), scavenging of free radicals and counteracting excitotoxicity. In this review we focus on recently reported medicinal effects of ginseng and summarize the current knowledge of its effects on CNS disorders and neurodegenerative diseases.
35 Single-Agent Therapy for Low Risk Gestational Trophoblastic Neoplasia (LRGTN): A Preliminary Report on a Randomized Clinical Trial to Compare Pulse-Methotrexate versus Pulse-Dactinomycin Eftekhar Zahra Rahimi-Moghaddam Parvaneh Dehdar-Dargahi Farideh Yarandi Fariba 1 11 2004 3 2 41 0 13 11 2017 25 12 2017 The efficacy of single-agent chemotherapy for patients with low risk gestational trophoblastic neoplasia (LRGTN) with methotrexate or dactinomycin is well established, but efforts continue to reduce the toxicity, the patients time and cost of treatment. In a randomized clinical trial, we evaluated and compared the efficacy, toxicity and cost effectiveness of pulse-methotrexate versus pulse-dactinomycin as single-agent therapy in LRGTN. Forty low risk GTN patients were randomly assigned to receive pulse-methotrexate (30 mg/m2 weekly intramuscularly) (20 cases) or pulse-dactinomycin (1.25 mg/m2 every two weeks intramuscularly) (20 cases). Treatment continued if no major toxicity was encountered and beta human chorionic gonadotropin (-hCG) values were lower than 5mIU/m2 in three consecutive weeks. Seventy percent of methotrexate group and 90% of dactinomycin group responded to treatment (100% remission was achieved with no recurrence in one-year follow-up). The mean time to response was 43 days for methotrexate and 66 days for dactinomycin group (P-value = 0.001). Patients achieved remission after receiving an average of 8 courses of therapy in methotrexate versus 6 courses in dactinomycin group (P-value = 0.002). The average cost of treatment per course was about 7 US$ for methotrexate and 62 US$ for dactinomycin group (P-value < 0.001). There were no cases of major toxicity in methotrexate or dactinomycin groups. Overall, both methotrexate and dactinomycin were associated with good remission rate. Based on our results, LRGTN treatment with dactinomycin is somewhat more effective than that with methotrexate, but methotrexate is more cost-effective for both patients and the health system. As the effectiveness of both pulse-methotrexate and pulse-dactinomycin does not differ significantly, pulse-dactinomycin is recommended as first-line treatment. 34 Effect of Some Calcium Channel Blockers in Experimentally Induced Diabetic Nephropathy in Rats Yousef Wael Mohamed Darawish Morsey Mohamed Abdel Waheed Moshira Mohamed Ghanayeem Naglaa Mohamed Omar Adel Hussein 1 11 2004 3 2 45 0 13 11 2017 25 12 2017 Diabetic nephropathy (DNP) is considered a CRD (Chronic Renal Disease); it is a major cause of illness and premature death in people with DM. The present study was designed to illustrate the role of CCBs (amlodipine and diltiazem) in prevention and treatment of DNP in rats. Eighty male albino rats weighing (130-180gm) were used in this study. These animals were subdivided into five equal groups. Insulinopenic diabetes was induced by STZ, two weeks later, 30 minutes of complete ischemia was induced in the left kidney to induce diabetic nephropathy then treatment was started for 12 weeks. At the end of experiment urine samples and blood samples were taken for biochemical analysis and kidneys were taken for histopathological evaluation. Combination of renal ischemia with DM produced a significant increase in rat weight, rat kidney weight, BUN (Blood Urea Nitrogen) level, K/B (Kidney/Body weight) ratio, random blood glucose, 24 hrs urine proteins, and 24 hrs urine volumes and creatinine clearance. Treatment with diltiazem or amlodipine significantly lowered elevated SBP and elevated 24 hrs urine volumes. Furthermore, treatment with captopril produced a highly significant lowering of elevated SBP and elevated serum creatinine; and a significant reduction in elevated K/B ratio and proteinuria. Light microscopic examination of diabetic kidneys revealed glomerulopathy characterized by thickening of the glomerular basement membrane, mesangial matrix expansion, arteriolar hyalinosis and large proteinaceous deposits occluding some capillary loops and hyaline droplets within the glomeruli. Moreover, examination of kidneys of ischemic animals by light microscope revealed focal tubular necrosis at multiple points along the nephron, interstitial edema and accumulation of leucocytes within dilated vasa recta. 33 Efficacy of Tinospora cordifolia on Learning and Memory in Healthy Volunteers: A Double-Blind, Randomized, Placebo Controlled Study Bairy K Laxminarayana Rao Yeshwanth Kumar Das Shyamal Kumar K. Balachander 1 11 2004 3 2 57 0 13 11 2017 25 12 2017 Background. Tinospora cordifolia, an Indian medicinal plant, has been reported to have beneficial effects on disorders like peptic ulcer, hepatobiliary disorders, rheumatism, infectious diseases etc. It enhances cognition in normal rats and successfully overcomes cyclosporine induced memory deficit. Methods. Thirty healthy volunteers of age 18-30 years received Tinospora cordifolia (500 mg of pure aqueous extract) or a matching placebo for 21 days in a double blind, randomized and placebo controlled design. Learning and memory was assessed by subjecting the volunteers to a battery of psychological tests that aimed at studying visual memory, logical memory, verbal memory, attention span and concentration. Results. Tinospora cordifolia showed a significant (p < 0.05) increase in the test scores for verbal learning and memory (control -1.21.9, drug 6.92.5) and logical memory (control 5.16.1, drug 26.66.7). No significant untoward effects were reported during Tinospora cordifolia treatment. Conclusion. Tinospora cordifolia, 500 mg daily, enhances verbal learning and memory and logical memory (of immediate and short term type) compared to placebo in healthy volunteers. 32 Efficacy and Tolerability of Glucosamine - Chondroitin Sulphate - Methyl Sulfonyl Methane (MSM) in Osteoarthritis of Knee in Indian Patients Vidyasagar Sudha Mukhyaprana Prabhu Shashikiran U Sachidananda Adiga Rao Sharath Bairy K. Laxminarayana Adiga Shalini Jayaprakash B 1 11 2004 3 2 61 0 13 11 2017 25 12 2017 Background & Objective. Osteoarthritis is progressive degenerative disease resulting in significant affection of joints. Nonsteroidal anti-inflammatory drugs (NSAIDS) are widely used in this condition but are associated with significant side effects; hence the aim of this study was to evaluate the efficacy and tolerability of nutritional supplements such as Glucosamine, Chondroitin sulphate and methyl sulfonyl methane in osteoarthritis as an alternative approach for this condition. Patients & Methods. Thirty-seven patients from medicine and orthopedic out patient departments were assessed for severity of osteoarthritis based on visual analog scale, Lequesnes index, goniometry, and radiography and enrolled into the open label study. All patients received cartivit (Glucosamine, Chondroitin sulphate and MSM) two tablets thrice a day for twelve weeks and were reassessed for changes in above parameters every four weeks. The tolerability was also assessed during the monthly visits. Results. Out of 32 patients who completed study, there was significant improvement in pain and Lequesnes index at four, eight and twelve weeks (p < 0.05). There was gradual improvement in joint mobility over twelve weeks. There was no improvement in radiological changes in twelve weeks study period. Patients tolerated the study medication well and there was no abnormality observed in the various biochemical markers during the study. Conclusions. Glucosamine, chondroitin sulphate and methyl sulfonyl methane combination was useful in decreasing pain, improving functional ability and improving joint mobility and was well tolerated in patients with osteoarthritis. 31 A Case Report on Topiramate Induced Myopia Akbarian Mohammad A Mehrpour Massoud 1 11 2004 3 2 66 0 13 11 2017 25 12 2017 This is a case report of acute myopia following topiramate administration. There are several reports of this side effect recently and fortunately all of them were reversible. In our case we tried again topiramate with very low dose and increase it very slowly, the patient was followed and she tolerated it well and didnt find ocular problem anymore. So it could be suggested that starting with low dose topiramate may prevent recurrence of myopia.