Tag: Antibiotic resistance

Percutaneous Transhepatic Cholangiography (PTCA)

Post author By Mukul
Post date April 23, 2009
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Definition:

Percutaneous transhepatic cholangiography (PTHC or PTC) is a radiologic technique used to visualize the anatomy of the biliary tract. A contrast medium is injected into a bile duct in the liver, after which X-rays are taken. It allows access to the biliary tree in cases where endoscopic retrograde cholangiopancreatography (ERCP) has been unsuccessful. Initially reported in 1937, the procedure became popular after a 1952 report in the English-language literature.

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It is an x-ray test that can help show whether there is a blockage in the liver or the bile ducts that drain it. Since the liver and its drainage system do not normally show up on x-rays, the doctor doing the x-ray needs to inject a special dye directly into the drainage system of the liver. This dye, which is visible on x-rays, should then spread out to fill the whole drainage system. If it does not, that means there is a blockage. This type of blockage might result from a gallstone or a cancer in the liver.

It is predominatly now performed as a therapeutic technique. There are less invasive means of imaging the biliary tree including transabdominal ultrasound, MRCP, computed tomography and endoscopic ultrasound. If the biliary system is obstructed, PTC may be used to drain bile until a more permanent solution for the obstruction is performed (e.g. surgery). Additionally, self expanding metal stents can be placed across malignant biliary strictures to allow palliative drainage. Percutaneous placement of metal stents can be utilised when therapeutic ERCP has been unsuccessful, anatomy is altered precluding endoscopic access to the duodenum, or where there has been separation of the segmental biliary drainage of the liver, allowing more selective placement of metal stents. It is generally accepted that percutanous biliary procedures have higher complication rates than therapeutic ERCP. Complications encountered include infection, bleeding and bile leaks.
Why the test is performed?
Bile is a by-product of protein metabolism. It is created in the liver and excreted into the intestines via the bile ducts. If bile cannot be removed from the body, it collects in the blood and is seen as a yellow discoloration of the skin and eyes (jaundice).

Also, the pancreas creates digestive fluids which drain via a common bile duct into the intestine, and thus obstruction can prevent the drainage of the fluids and may cause pancreatitis (inflammation of the pancreas).

A PTCA test can help identify whether a blockage is causing the jaundice and pancreatitis.

How do you prepare for the test?
Tell your doctor if you have ever had an allergic reaction to lidocaine or the numbing medicine used at the dentist’s office. Also tell your doctor if you could be pregnant. If you have diabetes and take insulin, discuss this with your doctor before the test.

Most people need to have a blood test done some time before the procedure, to make sure they are not at high risk for bleeding complications. If you take aspirin, nonsteroidal anti-inflammatory drugs, or other medicines that affect blood clotting, talk with your doctor. It may be necessary to stop or adjust the dose of these medicines before your test.

You will be told not to eat anything on the morning of the test so that your stomach is empty. This is a safety measure in the unlikely case you have a complication, such as bleeding, that might require repair surgery.

What happens when the test is performed?
You lie on a table wearing a hospital gown. An IV (intravenous) line is inserted into a vein in case you need medicines or fluid during the procedure. An area over your right ribcage is cleaned with an antibacterial soap. Then the radiologist may take a picture of your abdomen with an overhead camera. Medicine is injected through a small needle to numb the skin and the tissue underneath the skin in the area where the dye is to be injected. You may feel some brief stinging from the numbing medicine.

A separate needle is then inserted between two of your ribs on your right side. A small amount of xray dye is injected, and some pictures are taken that are visible on a video screen. Your doctor adjusts the placement of the needle until it is clear that the dye is flowing easily through the ducts (drainage tubes) inside your liver.

Because taking the x-ray pictures sometimes requires a significant amount of time, the doctor replaces the needle with a softer plastic tube. First, the syringe holding the dye is detached from the top of the needle, leaving the needle in place. The doctor then gently pushes a thin wire through the needle and into the duct where the needle has been sitting. Next the needle is pulled out, sliding over the outside end of the wire. The wire is left with one end inside the liver to hold the position where the needle had been. A thin plastic tube similar to an IV line is slid along the wire, like a long bead on a string, until it is in the same place where the needle was. The wire is then pulled out, and the dye syringe is attached to the tube.

More dye is injected through the plastic tube, and pictures are taken with the video camera as the dye spreads inside the liver. If there is no blockage, the dye drains out of the liver through the bile ducts and begins to show up on the x-ray in the area of your small intestine. Once all of the needed pictures have been taken, the plastic tube is pulled out, and a small bandage is placed over your side. The whole test usually takes less than an hour.

Risk Factors:
It is possible to have serious bleeding from this test. In some cases, blood leaks to the outside surface of the liver and causes a buildup of blood there. In other cases, blood can leak directly into the liver’s drainage system, in which case it might start showing up in your intestine, causing a bloody bowel movement. It is less likely that you could develop an infection after the test. The only soreness you are likely to have is at the skin surface where the needle went in. This should last for only a day or two.

In rare cases, the dye used in the test can damage your kidneys. This kidney effect is almost always temporary, but some people have permanent damage.

As with all x-rays, there is a small exposure to radiation. In large amounts, exposure to radiation can cause cancers or (in pregnant women) birth defects. The amount of radiation from the video x-ray in this test is very small-too small to be likely to cause any harm. (The people performing the test on you will wear lead shields, since they would otherwise be exposed to this radiation over and over, which could be more of a danger.)

Must you do anything special after the test is over?
Call your doctor right away if you have pain in your right abdomen or shoulder, fever, dizziness, or a change in your stool color to black or red.

How long is it before the result of the test is known?
You may be told a few early results of your test as soon as the test is done. It takes a day or two for the radiologist to review the x-rays more thoroughly and to give your doctor a full report.

RESULTS:-

Normal Result:-The bile ducts are normal in size and appearance for the age of the patient.

Abnormal Results:-The results may show that the ducts are enlarged, which may indicate the ducts are blocked. The blockage may be caused by infection, scarring, or stones. It may also indicate cancer in the bile ducts, liver, pancreas, or region of the gallbladder.

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*Blocked bile ducts
*Cholangitis (infection in common bile duct)
Special considerations:-
A PTCA may be done if an endoscopic retrograde cholangiopancreatography ( ERCP) cannot be performed or has failed in the past.

An MRCP (magnetic resonance cholangiopancreatography) is a newer, non-invasive imaging method, based on MRI, which provides similar views of the bile ducts.

Resources:
https://www.health.harvard.edu/fhg/diagnostics/percutaneous-transhepatic-cholangiography.shtml
http://en.wikipedia.org/wiki/Percutaneous_transhepatic_cholangiography
http://www.healthline.com/adamcontent/percutaneous-transhepatic-cholangiogram

Tags Americas, Antibiotic resistance, Bile duct, Carbapenem resistant enterobacteriaceae, Cedars-Sinai Medical Center, Computed tomography, Conditions and Diseases, Disinfectant, Endoscopic retrograde cholangiopancreatography, Endoscopy, ERCP, Food and Drug Administration, Health, Los Angeles, Non-steroidal anti-inflammatory drug, Ronald Reagan UCLA Medical Center, Small intestine, University of California

Diagnonistic Test

Rapid Detection of Infectious Diseases.

Post author By Mukul
Post date April 16, 2009
No Comments on Rapid Detection of Infectious Diseases.

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Only a few minutes and a simple, ready-to-use diagnostic test kit are needed to determine an individual’s infectious disease status.
CLICK & SEE THE ICTURES
In about the middle of the 20th century, mass vaccination programs and the widespread availability of antibiotics significantly reduced the threat of infectious diseases in Canada and many other regions of the world. Indeed, a concerted worldwide effort led to eradication of the smallpox virus, the cause of the most serious infectious disease in the western world during the 17th and 18th centuries , and the incidence of other diseases, such as the common childhood ailments measles, mumps, and pertussis, have been reduced by similar vaccination programs . Despite these advances, however, infectious diseases remain the world’s leading cause of premature death, accounting for about 17 million deaths in 1995.

To further control communicable diseases, global efforts must overcome ongoing challenges provided by the evolution of infectious agents. Among the more significant evolutionary changes in the past 25 years are the increased prevalence of antibiotic resistance in infectious bacteria (e.g., methicillin resistant Staphylococcus aureus (MRSA) and vancomycin resistant enterococci (VRE)) and the emergence of about 30 new infectious agents (e.g., human immunodeficiency virus (HIV), hepatitis C virus (HCV), and the ebola virus) . Moreover, rapid evolutionary changes create new appearances for some infectious agents (e.g., the influenza virus and HIV), allowing them to circumvent the defensive mechanisms of our immune systems.

Another obstacle for the control of communicable diseases arises when the role of an infectious agent in a disease goes unnoticed. The significance of this point was demonstrated in the 1980s when the bacterium Helicobacter pylori was finally recognized as a causative factor of duodenal ulcers and other gastric diseases . As a result of the H. pylori discovery, many gastric diseases are now effectively treated with antibiotics, and it is possible that new therapeutic directions will be stimulated by a recent proposal, which implicates chronic infections as a cause of several well-Known diseases (e.g., atneroscierosis and Alzheimer’s Disease).

For infectious diseases, an unambiguous diagnosis obtained in a timely fashion is extremely important, not only from a personal viewpoint (i.e., the initiation of an appropriate treatment), but also from a public health perspective (i.e., the prevention of disease transmission from one individual to another).

To a large extent, evidence for the presence of an infectious agent, and thus the diagnosis of infectious disease status, is provided by the results of one or more diagnostic tests. In addition to providing an accurate result, an ideal rapid diagnostic test should be easy to perform while yielding a definite result within a reasonable length of time ([less than]30 min to be considered as a rapid test).

For these reasons, most rapid diagnostic tests for infectious diseases are based on the highly selective, noncovalent interactions between an antibody and an antigen. Antibodies are proteins produced by the immune system in response to the entry of a foreign entity, such as an infectious agent. Because antibodies specifically bind to a distinct site (or epitope) in a protein or another macromolecule (i.e., the antigen) associated with the infectious agent, the unique group of antibodies generated during each infection is an excellent diagnostic marker for disease. This immunoassay approach can be limited by the time required for antibody levels to increase to detectable levels after infection (e.g., antibodies for HIV are detectable on average 25 days post infection).

Immunoassays in various forms (e.g., enzyme immunoassays) are increasingly employed in clinical laboratories; however, the rapid test format is the most recent innovation in an industry undergoing substantial growth. In rapid tests, membrane immobilized antigens are used to capture the antibodies generated against the infectious agent. The specificity of a test towards a particular disease relies on the highly specific antigen-antibody interaction, and the appropriate choice of an antigen captures only the disease specific antibodies on the rapid test membrane. The appropriate antigen can be obtained from the infectious agent, produced by recombinant methods, or mimicked by synthetic peptides.

Antibodies captured by the membrane-immobilized antigen are detected using a colour reagent (e.g., protein A-colloidal gold or anti-human IgG antibodies conjugated to coloured particles), and a positive test typically is signified by the appearance of a coloured dot or line on the test membrane. If no disease antibodies are present in the sample, the colour reagent is not trapped on the membrane, and a negative result is obtained. A control dot or line often is included to verify that the colour reagent is functioning properly. While the rapid test format with visual interpretation provides only a qualitative result, a positive/negative result is sufficient in many diagnostic applications, including infectious disease diagnosis.

An immediate result provided by a rapid test is particularly advantageous when knowledge of a communicable disease is needed quickly (e.g., emergency surgery) or when a patient is apprehensive about the disease and might not make a second visit to a medical facility to receive the test result. The latter is a significant problem; about 30% of patients tested for HIV in publicly funded clinics in the United States during 1995 did not return , and a large cost is incurred by tracking them down to deliver the result of a laboratory test and to arrange a confirmatory test when a positive first result is obtained. The simplicity of the rapid test format allows the test to be used wherever an infectious disease has a high prevalence, or in remote clinical settings where patients must travel significant distances to get to the test centre.

The timeline from the initial idea to sales of an approved rapid diagnostic test is about five years. Over this period, research is undertaken to validate the concept; the optimum parameters are established for the immunoassay in the rapid test format, and in-house evaluation is conducted. The safety and effectiveness of the test is then established by independent clinical trials at several different locations before applications are submitted for regulatory approval by Health Canada and agencies in other countries, such as the Food and Drug Administration (FDA) in the United States. In April 1998, Health Canada granted its first approval for a rapid HIV test to MedMira Laboratories Inc.

MedMira is a publicly traded (CDNX: MIR) Canadian medical biotechnology company at the leading edge of rapid diagnostic test development. The company has expanded considerably since the early 1990s when it was established in Nova Scotia’s Annapolis Valley. At present, MedMira has over 45 employees and a corporate office in Toronto, ON. Separate locations for research and manufacturing are located in the Halifax Regional Municipality. In July 1999, MedMira Laboratories received International Organization of Standards ISO9001 registration designed around Health Canada’s ISO 13485 essentials for the manufacture of medical devices, and a system of product manufacturing compliant with the U.S. FDA current Good Manufacturing Practices (cGMP) was established and implemented at MedMira in April 1999.

In addition to the HIV test, which is able to detect HIV-1, HIV-2, and the rare group O variant of HIV-1, MedMira also has developed rapid tests for other infectious agents, including H. pylori, hepatitis B virus (HBV), HCV, and a HIV/HCV combination. The MedMira rapid tests meet the approval requirements in several countries and the approval process is underway in others. For example, the H. pylori test was granted U.S. FDA 510(k) clearance last year, and the U.S. FDA/PMA committee and the Chinese State Drug Administration (SDA) have accepted the MedMira HIV test for review. The MedMira test kits are marketed worldwide.

While the acute effects of infectious diseases are widely known, a connection between infectious agents and cancer has been established for HBV/HCV (liver cancer) , H. pylori (gastric cancer) , and human papillomaviruses (HPV) (cervical cancer) . Currently, rapid tests for infectious diseases identify certain underlying risk factors for cancer, but in the future, rapid test methodology will be available to detect markers associated with other forms of cancer.

Diagnostic tests are an integral part of modern health care. The availability of rapid diagnostic tests demonstrates that the complex interactions between molecules such as antigens and antibodies (and up-to-date science) can be utilized to provide a reliable diagnostic test in a simple format. Ongoing research is needed to keep rapid test methodology current with the evolution of infectious agents, and to expand the rapid test approach to the diagnosis of other diseases. Because of the simple format and reasonable cost, rapid test methodology holds the promise of bringing more efficient and effective diagnostic testing to both developed and undeveloped countries around the world.

Sources:http://www.allbusiness.com/north-america/canada/791219-1.html

Tags Antibiotic resistance, Antibody, Clinical trial, Food and Drug Administration, Health Canada, Helicobacter pylori, HIV, Immunoglobulin G, Infectious disease, MedMira Laboratories, Methicillin-resistant Staphylococcus aureus, United States, US Food and Drug Administration

News on Health & Science

Hot Chillies Can Help Mitigate Pain

Post author By Mukul
Post date February 26, 2009
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Capsaicin, the active agent in spicy hot chili peppers, often acts as an irritant, but it may also be used to reduce pain.

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Feng Qin, associate professor of physiology and biophysics at the University at Buffalo School of Medicine, and Jing Yao used capsaicin to unravel how pain-receptor systems can adapt to painful stimuli.

For example, adaptation happens when your eyes adjust from a dark movie theatre during a matinee to the bright sunlight outside. Whether pain receptors truly adapt or rescale their responses (versus simply desensitising) has been an open question.

Scientists had previously linked the analgesic or pain-relieving effects of capsaicin to a lipid called PIP2, found in cell membranes. When capsaicin is applied to the skin it induces a strong depletion of PIP2 in the cell membrane.

“The receptor acts like a gate to the neurons,” said Qin. “When stimulated it opens, letting outside calcium enter the cells until the receptor shuts down, a process called desensitisation.”

“The analgesic action of capsaicin is believed to involve this desensitization process. However, how the entry of calcium leads to the loss of sensitivity of the neurons was not clear,” he said, according to a Buffalo release.

Capsaicin creams are commonly sold over the counter as effective treatment for a variety of pain syndromes, from minor muscle or joint aches to those that are very difficult to treat, such as arthritis and neuropathic pain.

Sources:The Times Of India

Tags Analgesic, Antibiotic resistance, ATP-binding cassette transporter, Berkeley, Biomolecule, Bird, California, Cell biology, Cell membrane, Chili pepper, Conditions and Diseases, Docking and berthing of spacecraft, Health, Medical school, Molecular machine, Neuron, Neurotransmitter, Times Of India, University at Buffalo The State University of New York

Diagnonistic Test

Throat Culture

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Definition:
A throat infection with streptococcus bacteria (called strep throat) needs to be treated with an antibiotic.Throat swab culture is a laboratory test done to isolate and identify organisms that may cause infection in the throat. It is the traditional test used for identifying streptococcus bacteria on your throat surface. Throat cultures also can identify some other bacteria that can cause sore throat.

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Throat swab culture is a laboratory test done to isolate and identify organisms that may cause infection in the throat.The test is performed when a throat infection is suspected, particularly strep throat.

How do you prepare for the test?
No preparation is necessary.Only do not use antiseptic mouthwashes before the test.

What happens when the test is performed?
Tilt your head back with your mouth wide open.A sterile cotton swab is rubbed against the back of your throat to gather a sample of mucus from near the tonsils.Resist gagging and closing the mouth while the swab touches the back of the throat near the tonsils. This takes only a second or two and makes some people feel a brief gagging or choking sensation.

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In order to improve the chances of detecting bacteria, the swab may be used to scrape the back of the throat several times. The mucus sample is then placed on a culture plate that helps any bacteria present in the mucus grow, so they can be examined and identified.

How the Test Will Feel :
Your throat may be sore at the time the test is taken. You may experience a gagging sensation when the back of your throat is touched with the swab, but the test only lasts a few seconds.

What risks are there from the test?
There are no risks.This test is safe and well-tolerated. In very few patients, the sensation of gagging may lead to an urge to vomit or cough.

Normal Results:
The presence of the usual mouth and throat bacteria is a normal finding.

What Abnormal Results Mean :
An abnormal result means bacteria or other organism is present. This is usually a sign of infection.

Must you do anything special after the test is over?
Nothing.

How long is it before the result of the test is known?
Results from a strep culture are available in two or three days.

Resources:
https://www.health.harvard.edu/diagnostic-tests/throat-culture.htm
http://www.nlm.nih.gov/medlineplus/ency/article/003746.htm

Strep Throat Affects All Ages (articlesbase.com)
Rapid Strep Test (RADT) (findmeacure.com)
Thinking about sore throats (medrants.com)
MRSA Rising in Kids’ Ear, Nose, Throat Infections (momblognetwork.com)
Distinguishing Dangerous Strep Throat (abcnews.go.com)
Sore Throat Could be Deadly (articlesbase.com)
Man’s Strep Throat Leads to Leg Amputation (abcnews.go.com)
Suffering From Cold Sore Symptoms (articlesbase.com)

Tags Antibacterial, Antibiotic resistance, Bacterial, Conditions and Diseases, Drug resistance, Eardrum, Health, Infection, Infectious disease, Methicillin-resistant Staphylococcus aureus, Pathogenic bacteria, Pharyngitis, Scarlet fever, Staphylococcus, Streptococcal pharyngitis, Tonsil

Herbs & Plants

White Leadwort

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Botanical Name:Plumbago zeylanica
Family:Plumbaginaceae
Parts used: roots, leaves;
Common Names in English:Cape Leadwort, White Plumbago
Common Name: chitra or chitraka, Chitrak, Agnimatha, Chitawa,

Habitat :This herbal plant is found throughout India. It grows wild as a garden plant in East, North and Southern India.

Description:
A much-branched shrub with long and tuberous roots and a striate stem (Plate 48). The leaves are up to 8 cm long, simple, glabrous, alternate, ovate or oblong, with an entire or wavy margin, an acute apex and a short petiole. The flowers are white in terminal spikes, with a tubular calyx, a slender, glandular, hairy corolla tube, with five lobes and five stamens, a slender style and a stigma with five branches. The fruit is a membranous capsule enclosed within the persistent calyx. The dried roots occur as cylindrical pieces of varying length, less than 1.25 cm in width, reddish-brown in colour with a brittle, fairly thick, shrivelled, smooth or irregularly fissured bark. The roots have a short fracture, an acrid and biting taste and disagreeable odour.

click to see the pictures.>…...(01).……(1)……...(2)..…...(3)..….(4)…..

Uses: in Ayurveda, pacifies kapha dosha (pungent, light, dry, sharp), anticancer, antifertility, anti-inflammatory, antimicrobial, anti-oxidant, prevention of antibiotic resistance, immunomodulator, anti-coagulant, abortifacient, vesicant, rheumatism, diarrhea, diuretic, skin conditions; precautions: pregnancy.

Medicinal uses:-
in Ayurveda, pacifies kapha dosha (pungent, light, dry, sharp), anticancer, antifertility, anti-inflammatory, antimicrobial, anti-oxidant, prevention of antibiotic resistance, immunomodulator, anti-coagulant, abortifacient, vesicant, rheumatism, diarrhea, diuretic, skin conditions; precautions: pregnancy.

In Ayurveda Chitra is used in treatment of various diseases and disorders. The chitrak root contains an acrid crystalline principle called ‘Plumbagin’ that is a powerful irritant and has well marked antiseptic properties. In small doses, the drug is a sudorific;

large doses cause death from respiratory failure. It is suggested that the action is probably due to the direct effect of the drug on the muscles. Chitrak root is also said to increase the digestive power and promote appetite and used in cases of enlarged spleen. A paste made from root is applied to abscesses to open them. Ayurvedic doctors recommend the root of chitrak for dyspepsia, piles, anasarca, diarrhea, skin diseases etc. It is also useful in colic, inflammations, cough, bronchitis, helminthiasis, haemorrhoids, elephantiasis, chronic and intermittent fever, leprosy, leucaderma, ring-worm, scabies, hepatosplenomegaly, amenorrhoea, odontalgia, vitiated conditions of vata and kapha and anaemia. The herb is also used as part of many ayurvedic compound remedies for rubifacient applications.

Anticancer activity: Plumbagin has been reported as having anticancer activity against fibrosarcoma induced by methyl cholanthrene and P388 lymphocytic leukaemia, but not against L1210 lymphoid leukaemia in mice. It is thought to be an inhibitor of mitosis. It has also been evaluated against Dalton’s ascitic lymphoma, where an inhibition of tumour growth and a significant enhancement of mean survival time were observed for treated mice compared to the control group. Peritoneal cell counts were also enhanced. Plumbagintreated groups were able to reverse the changes in various haematological parameters which are a consequence of tumour inoculation. Studies have shown that plumbagin, when administered orally at a dose of 4 mg/kg body weight, caused tumour regression in rats with 3-methyl-4dimethyl aminoazobenzene (3MeDAB)-induced hepatoma. It reduced levels of glycolytic enzymes such as hexokinase, phosphoglucoisomerase and aldolase levels, which are increased in hepatoma-bearing rats, and increased levels of gluconeogenic enzymes such as glucose.6-phosphatase and fructose-I ,6-diphosphatase which are decreased in tumour hosts.

Antifertility activity: In rats, treatment during the first week of pregnancy abolished certain uterine proteins resulting in both preimplantationary loss and abortion of the foetus. Uterine endopeptidases (cathepsin D, remin and chymotrypsin) were studied after the root powder had induced these effects and cathepsin D and renin activities were found to be decreased whilst chymotrypsin activity was increased. The results indicated that cathepsin D and renin may playa role in maintenance of pregnancy and chymotrypsin may be involved in postabortive involution. Plumbagin, at a dose of I and 2 mg/IOO g body weight, prevented implantation and induced abortion in albino rats without any teratogenic effects, and produced a significant inhibitory effect on copper acetate-induced ovulation in rabbits.

Antiinflammatory activity: A phosphate buffered saline extract of the roots of P. zrylanica stabilised red blood cells subjected to both heat- and hypotonic-induced lyses,A biphasic response and a reduction in the enzymatic activities of alkaline and acid phosphatases were observed and adenosine triphosphate activity was stimulated in liver homogenates of formaldehyde-induced arthritic rats.

Antimicrobial activity: A chloroform extract from P. zeylanica showed significant activity against penicillin- and non-penicillin resistant strains of Neisseria gonorrhoeae. It also showed antibacterial activity against Bacillus mycoides, B. pumilus, B. subtilis, Salmonella typhi, Staphylococcus aureus and others. Eye drops containing 50 llg/ml of plumbagin demonstrated significant antibacterial, antiviral and antichlamydial effects in eye diseases with few side effects. Aqueous, hexane and alcoholic extracts of the plant were found to show interesting antibacterial activity. The alcoholic extract was the most active and showed no toxicity when assayed using fresh sheep erythrocytes.

Antibiotic resistance modification: Plumbagin has been studied for its effect on the development of antibiotic resistance using sensitive strains of Escherichia coli and Staphylococcus aureus. When the organisms were inoculated into the antibiotic (streptomycin/rifampicin) medium, some growth was observed due to development of resistance. However, it was completely prevented when plumbagin was added to the medium and this was attributed to prevention of antibiotic resistance.

Antioxidant activity: At a concentration of 1 mM, plumbagin prevented peroxidation in liver and heart homogenates. By a comparison with menadione (which has one hydroxyl group less) it was suggested that plumbagin may prevent NADPH and ascorbate-induced microsomal lipid peroxidation by forming hydroquinones. These may trap free radical species involved in catalysing lipid peroxidation.

Immunomodulatory activity: The effect of plumbagin was studied on peritoneal macro phages of BALB/c mice, evaluated by bactericidal activity, hydrogen peroxide production and superoxide anion release. The bactericidal activity in vivo of plumbagin-treated mouse macrophages was estimated using Staphylococcus aureus and in low doses plumbagin caused a constant increase in bactericidal activity. It was also seen to exert a similar response on oxygen radical release, showing a correlation between oxygen radical release and bactericidal activity. Plumbagin appeared to augment macrophage bactericidal activity at low concentrations by potentiating oxygen radical release, whereas at higher concentrations it had an inhibitory effect.

Hypolipidaemic activity: When administered to hyperlipidaemic rabbits, plumbagin reduced serum cholesterol and LDL cholesterol by 53-86% and 61-91 % respectively. It also lowered the cho/esteroV phospholipid ratio and elevated HDL cholesterol significantly. Furthermore, plumbagin treatment prevented the accumulation of cholesterol and triglycerides in the liver and aorta and caused regression of atheromatous plaques of the thoracic and abdominal aorta. The animals treated with plumbagin excreted more faecal cholesterol and phospholipids.

Uterine stimulant activity: The juice extracted from the root was found to have potent activity when tested on rat uterus in vitro, as well as on isolated human
myometrial strips. This ecbolic effect was not blocked by either atropine sulphate or pentolinium bitartrate.

Anticoagulant activity: Plumbagin significantly increased prothrombin time, GPT, total protein and alkaline phosphatase levels in liver tissue and decreased GPT levels in serum. The anti-vitamin K activity was thought to be associated with the hydroxyl group attached to the naphthoquinone ring ofthe compound.

Digestive effects: The roots of Plumbago zeylanica were found to stimulate the proliferation of coliform bacteria in mice and act as an intestinal flora normaliser. This supports claims that the plant is a digestive stimulant.

Safety profile
The LDso of plumbagin is approximately 10 mg/kg body weight (oral and IP) in mice and a 50% alcoholic extract of the root or whole plant has an LD50 of 500 mg/kg body weight when given IP.26 In view of the documented abortifacient activity, it should be avoided at all stages of pregnancy.

Disclaimer:The information presented herein is intended for educational purposes only. Individual results may vary, and before using any supplements, it is always advisable to consult with your own health care provider.

Resources:
http://medical-dictionary.thefreedictionary.com/white+leadwort
http://www.india-shopping.net/india-ayurveda-products/Chitrak%20_WhiteLeadwort.htm
http://www.divineremedies.com/plumbago_zeylanica.htm
http://zipcodezoo.com/Plants/P/Plumbago_auriculata_Alba/