ART ASSOCIATION OF AUSTRALIA AND NEW ZEALAND 2011 ANNUAL CONFERENCE 7-9 December 2011 Victoria University of Wellington Wellington, New Zealand CONFERENCE CONVENORSDavid Maskill, Victoria University of WellingtonSarah Caylor, Victoria University of Wellington CONFERENCE COMMITTEEDavid Maskill, Victoria University of Wellington (Chair)Christina Barton, Victoria University of WellingtonGeoffrey Batchen, Victoria University of WellingtonRoger Blackley, Victoria University of WellingtonPeter Brunt, Victoria University of WellingtonHeather Galbraith, Massey UniversityRaymond Spiteri, Victoria University of Wellington
Irjims.inEVALUATION OF ANTIOXIDANT ACTIVITY OF DADIM (PUNICA
GRANATUM LINN.) IN ESSENTIAL HYPERTENTION.
Dr. Shelke Rajshree D.1*, Dr. Ramteke Ashok D2, Dr.Pravin Patil 3, Dr. Dinesh Gavand4
1. Assistant Professor, Department of Dravyaguna, Ayurved Mahavidyalaya, Sion, Mumbai-22, India. Contact no: 9819835440, Email ID: 2. Professor & HOD, Department of Dravyaguna, Ayurved Mahavidyalaya, Sion, Mumbai-22, India. Contact no: 9892904151, Email ID: 2. Assistant Professor, Department of Samhita, Ayurved Mahavidyalaya, Sion, Mumbai- 22, India. Contact no.09765590061 Email ID: [email protected] 4. Gavand Dinesh, MD (Scholar), Department of Rasashastra, D.Y. Patil Ayurved college, Nerul Contact no: 9930650441, Email ID: [email protected] Correspondence Address: 202,Shree Ganesh Society, Ugantak Colony, Sukapur,
Panvel-Nere Road, New Panvel-410206
Dadim (Punica granatum Linn.) is natural source of antioxidants like vitamin C, punicalgin and gallic acid. Out of which vitamin C and punicalgin have major antioxidant effects. Besides this ancient Ayurvedic texts including Caraka samhita, Sushruta samhita and various nighantus have described Dadim as Hridya. With this background study was commenced. Total 30 patients were included in the study and divided into 2 groups of 15 patients. Group A patients were given Dadim swarasa with oral antihypertensive agents and Group B patients were given only oral antihypertensive agent i.e. Amlodipine 5 mg OD. Dadim swarasa was given in a dose of 200 ml, once daily, empty stomach in the morning for 60 days. Subjective criteria‟s evaluated were headache, breathlessness, palpitation, giddiness, insomnia, restlessness and chest pain. Objective criteria‟s were blood pressure, lipid profile and estimation of MDA (Malondialdehyde) and GSH (Glutathione peroxidase) level in blood to evaluate antioxidant action. At end of study it was noted that significant no of patients who were taking Dadim swarasa have decreased level of total cholesterol and LDL along with decrease in oxidative stress. Reduction of blood pressure is seen in 73.33% patients in group
A and 66.66% in group B. Reduction of blood pressure in both groups was found to
insignificant at 5% level of significance by using paired „t‟ test.
Keywords: Antioxidant, Dadima, Hridya, Hypertention, Punica granatum Linn, MDA
(Malondialdehyde), GSH (Glutathione peroxidase).
"Ayurveda" has much to offer to the modern world. "Ayurveda" has recently been rediscovered in the pursuit of holistic healing and natural health. If we want our science to reach the global platform, we first have to make people understand the deeper meaning in the „one liners‟. Hypertension being important and perhaps the common disease which target heart . Worldwide statistics reveals around 1 billion individuals have hypertension, contributing to 7.1 million deaths per year. A high salt intake, heavy consumption of alcohol, lack of exercise, impaired intrauterine growth and stress are important factors causing Hypertension . When healthy cells are attacked by these free radicals, they produce oxidative stress  which is responsible for many diseases. Oxidative stress occurs when the production of Reactive oxygen species (free radicals) exceeds available antioxidant systems. Long standing hypertension gives rise to many disorders and complications, atherosclerosis being most common among them. Atherosclerosis is the process of cholesterol accumulation, scarring and calcification (hardening) of the coronary arteries, which leads to plaque rupture and heart attack or narrowing of the arteries It also affects major organs like heart, brain, kidney due to increased oxidative stress  Dadim ( Punica granatum Linn.) has been described as „Hridya'in Ayurvedika texts [6,7,8,9,10] Dadim has madhura, kashaya and amla rasa, madhura vipaka, anushna veerya and snigdha guna Dadim contains vitamin C and flavonoids like Punicalgin which act as antioxidant[12,13]Antioxidants are body guards for the heart vessels which prevent them from clogging. So to prove „Hridya' karma and antioxidant action of Dadim , it has been used in essential hypertension. METHODS AND MATERIALS
Selection of cases: There was random selection of patient from O.P.D. and I.P.D. of Sheth R.V. Ayurvedic hospital, Sion, Mumbai-22. Study was carried out as per Ethical Clearance Number – AMS/1723/08-09, 15/12/08. Type of study: This is comparative open type of experimental study. Study Centre: OPD and IPD of Sheth R.V.Ayurvedic Hospital, Sion, Mumbai-22 Total no of cases: 30 Patients were divided into 2 groups as follows Group A (Experimental group): OAHA + Dadima swarasa Group B (Control group): OAHA* Duration :60 days Drug source: Dadim swarasa excluding seeds Formulation: Swarasa Dosage: 200 ml once a day early morning with water Kaal: Abhakta ( early in the morning empty stomach) Follow-Up: Fortnightly (Every 15 days) * (OAHA= Oral Anti-Hypertensive Agent =Amlodipine 5 mg OD) Statistical Analysis:
Subjective: Wilcoxon sign rank test
Objective: Paired t test
1. Patients diagnosed with essential Hypertension 2. Systolic blood pressure <160 mm Hg and >=140 mm Hg. Diastolic blood pressure <100 mm Hg and >= 90 mm H 3. Age: 40 to 70 years. 4. Sex: Both 5. Informed consent signed Exclusion criteria
1. Age less than 40 years and more than 70 years
2. Systolic blood pressure >=160 mm Hg and <140 mm Hg.
Diastolic blood pressure >=100 mm Hg and < 90 mm Hg
3. Patients having secondary hypertension
4. Patients with major systemic illness as hepatic or renal failure.
5. Patients on O.C pills, anabolic steroids, corticosteroids
6. Pregnant women
Assessment of Efficacy:
5. Insomnia 6.Restlessness 7.Chest pain
1. Blood Pressure
2. MDA & GSH enzyme study for antioxidant activity
Gradation of the symptoms is as follows
Absent Occasional Absent After exertion moderate At rest physical activity Absent After exertion moderate At rest physical activity Absent 2-2 times in a Occasionally Absent Disturbed sleep Totally disturbed Sleeplessness along with few sleep hrs. sound sleep Absent After exertion moderate At rest physical activity Absent After exertion moderate At rest physical activity OBSERVATION AND RESULTS
Table 1: Chart Showing % Improvement In Symptoms
Table 2: Blood pressure analysis
Table 3: MDA analysis
Table 4: GSH analysis
Table 5: Statistical analysis of MDA
Before treatment values of MDA After treatment values of MDA Value for t: 7.23 (Group A) Value for t: 0.89 (Group B) Table 6: Statistical analysis of GSH
Before treatment values of MDA After treatment values of MDA Value for t: 3.38 (Group A) Value for t: 1.50 (Group B) Wilcoxon sign rank test was applied to subjective criteria, it was significant at 5% level of significance for Palpitation, Giddiness and Restlessness in group A and was insignificant for all the symptoms in group B. Blood pressure readings were found to be statistically insignificant at 5% level of significance in both groups. Reduction in MDA was found to be significant at 1% level of significance in Group A while found to be insignificant in Group B. Increase in GSH level was found to be significant at 1% level of significance in Group A while found to be insignificant in Group B. It was noted that significant number of patients who were taking Dadima swarasa have decreased level of total cholesterol and LDL along with decrease in oxidative stress. DISCUSSION
Dadim is a rich source of Vit. C and punicalgin which interact quickly with ROS (Reactive oxygen species) i.e. free radical. It scavenges Free radicals. It ultimately results in termination of the free Radical chain reaction. It reduces lipid Peroxidation. It retains fluidity of lipid membrane and reduces destruction of epithelial cells of blood vessels. Thus it reduces oxidative stress in Essential Hypertension. Dadim with its madhura rasa and snigdha guna increases the „Avalambaka kapha'which is necessary for proper strength or poshana of the heart and its muscles. Heart is kaphasthana according to Ayurveda. It also controls the ativriddhi of vata and pitta dosha. Amlarasa increases the Sadhaka pitta. Along with this amla rasa has dipana and pachana karma, it helps in decreasing „Agnimandya‟ and does pachana of apachita meda dhatu which is the main factor in samprapti of „Dhamanipratichaya'. Kashaya rasa with its rukshaguna does the lekhana of Dhamanisanchit meda. So basically combination of all these functions give strength to the heart and keep its contraction, relaxation actions regular thus helping action of heart. There were no adverse effects found with Dadim svarasa. Only 3 patients found to have slight increase in BSL values after 2 months of treatment. At the end of study it was noted that significant number of patients who were taking Dadim svaras have decreased level of total cholesterol and LDL along with decrease in oxidative stress. So, further research can be done to evaluate hypocholesteromic effect. CONCLUSION
1) There was considerable decrease in MDA levels and good increase in GSH levels in patients taking Dadima swarasa. Thus Dadima reduces oxidative stress by scavenging free radicals and terminating chain reaction suggesting Dadima as effective anti- oxidant. 2) It reduces or prevents damage to blood vessels, decreasing the chances of atherosclerosis which in turn helps in making the prognosis of Hypertensive patient better. 3) Dadim has also showed decrease levels of cholesterol, triglycerides, LDL as evident by statistical analysis. It is great pleasure for me to express my gratitude with profound respect to my guide Dr. Ashok Ramteke. Also grateful to Shree Dhootpapeshwar Ltd. Mumbai for Standardization & Phytochemical Analysis of Dadim samples and Anchrom Lab. Mulund, Mumbai for HPTLC of Dadim Sample. I express my thankfulness to Blatter Herbarium, Dept. of Botany of St. Xavier‟s College, Mumbai. Last but not least I am very thankful to my institute Sheth R.V. Ayurved Rugnalaya, Sion, Mumbai-22. REFERENCES
1. Chuchill livingstone, Davidson‟s Principles & Practice of medicine, Ageing & disease, 20 th edition, page no.551 2. Chuchill livingstone, Davidson‟s Principles & Practice of medicine, Ageing & disease, 20 th edition, page no.163 3. Saikat Sen, Raja Chakraborty et al., Free Radicals, Antioxidants, Diseases And Phytomedicines: Current Status And Future Prospect, Academia. Edu, Volume 3, Issue 1, July – August 2010; Article 021. atherosclerosis? 5. Chuchill livingstone, Davidson‟s Principles & Practice of medicine, Ageing & disease, 20 th edition, page no.609 6. Tripathi Bramhanand, Shadavirechaniya, Varanasi, Chaukhamba Publication, 4 th edition, page no.80 7. Prof. Sharma Priyavat, Sushrut Samhita, vol.1, Annapan vidhiradhyaya, Varanasi, Chaukhamba Surbharati Prakashan, Page no.141 8. Prof. Sharma P. V. Dravyaguna vidnyan-vol-1, Varanasi, Chaukhamba bharati Academy, 2001, page.no33 Amradi phala varga, Varanasi, Chaukhamba bharati Academy, 1998, page no.102. 10. Prof. Sharma P. V. Kaiyadev nighantu, Aushadhi varga-59, Varanasi, Chaukhamba Oriental, 1979, page.no.308 11. Vaishya Lal Shaligram, Shaligram Nighantu, Phala Varga, Mumbai, Shree Vyankateshwar Yantralayadhyaksha, 1953, page no.417 12. Dr. Paranjape Prakash, Indian Medicinal Plants, Chaukhamba Sanskrit Pratishthan, 2005, page no.64-65. 13. Afaq F., Saleem M., Krueger C.G., Reed J.D., Muktar H.- „Anthocyanin and hydrolysable tannin rich pomegranate fruit extract modulates MAPK and NF Kappa B pathways and inhibits skin tumorigenesis in CD-1 mice.‟Int. J. Cancer, Sep 2005, Jan 20;113(3):423-33. 14. Stitzinger M.,-„Lipids, inflammation and atherosclerosis‟, Doctoral thesis, Digital repository of Leiden university, Leiden / Amsterdam center for Drug Research,2007-02-01, handle-http://hdl.handle.net/1887/9729.
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