Antinociceptive activity of the methanolic extract of Kaempferia galanga Linn. in experimental animals

Kaempferia galanga Linn. (Zingiberaceae) presents many chemical constituents of the volatile oil extracted from the rhizome. The rhizome of Kaempferia galanga is used by people in many regions for relieving toothache, abdominal pain, muscular swelling and rheumatism. In this study we investigated the antinociceptive activity in mice and rats using acetic acid-induced writhing, formalin, hot plate and tail-flick tests. The extract at test doses of 50, 100 and 200 mg/kg, p.o. clearly demonstrated antinociceptive activity in all tests. This activity was dose- and time-dependent. The extract administered at 200 mg/kg, p.o. had a stronger antinociceptive effect than aspirin (100 mg/kg, p.o.) but less than morphine (5 mg/kg, s.c.). Naloxone (2 mg/kg, i.p.) abolished the antinociceptive action of both morphine (5 mg/kg, s.c.) and the extract (200 mg/kg, p.o.) in a similar manner. In conclusion, the methanol extract of Kaempferia galanga markedly demonstrated the antinociceptive action in experimental animals. The antinociceptive mechanisms appear to be both peripherally and centrally mediated actions and the opioid receptors are probably involved. Therefore, our studies support the use in traditional medicine of Kaempferia galanga against pain caused by various disorders.     

Preventive and curative effects of curcumin on the development of gastric inflammatory diseases in rats

Preventive and curative effects of curcumin on experimental acute and chronic gastric ulcers were investigated to validate its clinical application on a remedy for peptic ulcer. Intraduodenal administration of curcumin, 5–20 mg/kg, inhibited gastric acid secretion in pylorus-ligated rats, and oral administration prevented ethanol-induced acute gastric mucosal lesions. Curcumin (20–80 mg/kg, p.o.) dose-dependently prevented both serotonin-induced gastric mucosal lesions and compound 48/80-induced gastric mucosal lesions in rats. Furthermore, oral administration of curcumin, 10–80 mg/kg, twice daily for 10 days, significantly accelerated the healing of acetic acid-induced chronic gastric ulcer and promoted mucosal regeneration in the ulcerated portion in a dose-related manner. Cimetidine prevented the formation of ethanol-induced gastric mucosal lesions, but not of serotonin-induced and compound 48/80-induced gastric mucosal lesions. Consecutive administration of cimetidine showed a marked acceleration in the healing of acetic acid-induced ulcer. Aminoguanidine, an inducible nitric oxide synthase (iNOS) inhibitor, showed anti-ulcerogenic effects similar to those oberved for curcumin. The present results indicate that curcumin exhibits gastric cytoprotection in the acute lesion models and ulcer healing promotion in the chronic ulcer model. The preventive and curative effects of curcumin might be due to an increase in the mucosal defensive mechanism through its antioxidant property and inhibition of NO or cytokine-mediated inflammation.     

Effects of curcumin on reflux esophagitis in rats

The preventive effect of curcumin, a compound isolated from the rhizome of Curcuma longa, on experimental reflux esophagitis in rats was investigated in order to validate its potential therapeutic use for gastroesophageal reflux disease. Curcumin (20 mg/kg, i.d.), the antioxidative agent dimethyl sulfoxide (DMSO) (1 ml/kg, i.p.) or the proton pump inhibitor lansoprazole (1 mg/kg, i.d.) inhibited the formation of acute acid reflux esophagitis by 52.5, 61.5 and 70.9% respectively. Curcumin alone was not effective in preventing chronic acid reflux esophagitis, but the combination of curcumin and DMSO reduced the mortality rate and the severity of the esophagitis ulcer index to the same extent (56.5%) as did the lansoprazole (53.9%). Intraduodenal administration of curcumin also markedly prevented the formation of acute mixed reflux esophagitis, together with reducing the incidence or the severity of neutrophil infiltration, when compared to a control group. In contrast, lansoprazole tended to increase the severity of all histopathological changes, when compared to either the control or the curcumin-treated group. Aminoguanidine, a specific inducible nitric oxide synthase inhibitor, had no preventive effect against both types of acute reflux esophagitis models, and increased the mortality in the chronic acid reflux esophagitis model. From these results, it is indicated that curcumin can effectively prevent acute reflux esophagitis formation. Although curcumin is less potent than lansoprazole in inhibiting acid reflux esophagitis, it is superior to lansoprazole in inhibiting mixed reflux esophagitis. The antiulcerogenic mechanisms are considered to be closely associated with its antioxidant nature and antiinflammatory property.     

Neurological complications in AIDS patients receiving HAART: a 2-year retrospective study

The positive role of highly active anti-retroviral therapy (HAART) in reducing opportunistic infections in acquired immunodeficiency syndrome (AIDS) patients is well known. However, case reports from around the world have demonstrated that some patients seem to suffer a paradoxical deterioration of health as their immune function improves with treatment. This phenomenon has been called immune restoration inflammatory syndrome (IRIS). In northern Thailand, GPO-vir (Stavudine-D4T + Lamivudine-3TC + Nevirapine-NVP) has been promoted for the treatment of AIDS patients since April 2002, in accordance with the Government Pharmaceutical Organization's guidelines. However, the incidence rates of IRIS affecting nervous system (NIRIS) and non-NIRIS in comparison with the previous incidence of AIDS-defining disease have not been reported. We conducted a retrospective study to review the incidence of NIRIS and non-NIRIS in AIDS patients treated with GPO-vir in Chiang Mai University Hospital, Thailand, between May 2002 and April 2004. We compare these incidence rates with the incidence rates of neurological complications in the pre-HAART era. Altogether 506 AIDS patients were treated with GPO-vir during the specified period. The overall incidence of NIRIS, including progressive multifocal leukoencephalopathy (PML), cerebral toxoplasmosis and cytomegalovirus (CMV) retinitis, was lower than the previous incidence of AIDS-defining disease in the pre-HAART era. However, the incidence of ischemic stroke, hemorrhagic stroke and primary central nervous system (CNS) lymphoma had increased.     

Anti-allergic and Antioxidative Activities of Some Compounds from Thai Medicinal Plants

Evaluation of the anti-allergic and antioxidative activities of compounds from Thai medicinal plants demonstrated that lawsone methyl ether significantly exhibited the inhibitory effect on degranulation in RBL-2H3 cells with an EC₅₀ of 26.71?µM, while quercetin, a standard control, had an EC₅₀ of 10.02?µM. Other compounds from Thai medicinal plants including lucidin-ω-methyl ether, bergenin, homorapanone, strictosidinic acid and barakol, had no effect on the degranulation assay. In a DPPH radical scavenging assay, strictosidinic acid and barakol were more potent than the positive control, BHT. The EC₅₀ values of strictosidinic acid and barakol were 27.68 and 39.62?µM, respectively. Other tested compounds, including lawsone methyl ether, bergenin, homorapanone and lucidin-ω-methyl ether, had weak antioxidative activities or no activity. In a nitrite assay, only lawsone methyl ether reduced nitrite production with an EC₅₀ of 10.27?µM in RAW 264.7 cells. In conclusion, lawsone methyl ether suppresses degranulation in RBL-2H3 cells and reduces nitrite production in RAW 264.7 cells whereas strictosidinic acid and barakol have an antiradical action against DPPH.     

Depression in pregnancy: drug safety and nursing management

Women who are already predisposed to depression are at increased risks during pregnancy because of endocrine changes; untreated depression in pregnant women might lead to adverse effects for both mothers and infants. This article examines outcomes associated with the use of antidepressants during pregnancy and identifies how nurses can help depressed pregnant women. It is recommended that pregnant women who have mild depression be treated with nonpharmacologic therapy, such as counseling, cognitive-behavioral therapy, or interpersonal psychotherapy. Current appropriate treatment for pregnant women with moderate and severe depression is antidepressant medication, although there is no consensus on the best antidepressants for use in pregnancy. Thus, the psychotropic drug must be chosen carefully to minimize negative effects on infants and mothers, for some studies have demonstrated deleterious effects on infants. Nurses in multiple settings who interact with pregnant women should be aware of the necessity of screening for depression. Nurses in antenatal care settings can refer appropriately screened women to mental health specialists; psychiatric nurse practitioners can identify suitable interventions based on potential risks and benefits to maternal and infant health.     

Educational needs of family caregivers of persons living with HIV/AIDS in Thailand.

As the AIDS epidemic continues to overwhelm the acute care hospital system in Thailand, an increasing number of family members are required to provide care for persons living with AIDS (PLWA) in their homes. In response to the increasing demand for home care, a qualitative study using focus group methodology was conducted to learn more about the need for education and support for family caregivers of PLWA in Thailand. Eighteen family caregivers and 18 nurses caring for PLWA participated in four focus group discussions. The major themes identified were fear, stigma, sorrow, empathy, hopelessness, and hope. In addition, participants voiced a need for education to improve the knowledge and skills related to care of PLWA. These findings will be used to guide the development of a training program for family caregivers.     

An exploration of the meaning of spirituality voiced by persons living with HIV disease and healthy adults

Spirituality has been documented in several studies as having a positive effect on chronic disease progression and as being efficacious in improving quality of life and well being. In many studies, researchers have used predetermined definitions of spirituality and have proscribed the variable by the selection of measures. This study examines the meaning of spirituality as voiced by participants in two ongoing intervention studies, a sample of healthy adults and a sample of persons living with HIV disease. The findings resulted in six themes for each sample. Exhaustive statements were written depicting the summary relationships of themes. The findings support spirituality as an essential human dimension.     

Analgesic and Antipyretic Activities of n-Butanol Alkaloids Extracted from the Stem Bark Hunteria Zeylanica and its Major Constituent,Strictosidinic Acid,in Mice

The pharmacological activities of the n -butanol alkaloids extracted from the stem bark of Hunteria zeylanica (Retz) Gardn. ex Thw. ( H. zeylanica ) and its major constituent, strictosidinic acid, on nociceptive response using writhing and hot plate tests, the antipyretic activity in yeast-induced fever, pentobarbital-induced sleep, and locomotor activity were examined in mice. Oral administration of H. zeylanica extract at 200 mg/kg significantly decreased the number of contortions and stretchings induced by acetic acid but not heat-induced pain. Strictosidinic acid (5–20 mg/kg, p.o.) also produced a similar effect but less pronounced than the extract. The antipyretic effect of strictosidinic acid (5–20 mg/kg, p.o.) was stronger than that of the extract (100–200 mg/kg, p.o.). The H. zeylanica extract dose-dependently (50–200 mg/kg, p.o.) prolonged the duration of pen-tobarbital-induced sleep but had no sign ificant effect on locomotor activity. No effect of strictosidinic acid was noted on both pentobarbital-induced sleep and locomotor activity. These results suggest that the H. zeylanica extract possesses peripheral analgesic and mild antipyretic effects and its major constituent, strictosidinic acid, exerts a similar analgesic effect with marked antipyretic activity.