BackgroundDyslipidemia is one of the most frequently implicated risk factors for development of atherosclerosis. This study evaluated the efficacy of amla (Emblica officinalis) extract (composed of polyphenols, triterpenoids, oils etc. as found in the fresh wild amla fruit) in patients with dyslipidemia.MethodsA total of 98 dyslipidemic patients were enrolled and divided into amla and placebo groups. Amla extract (500 mg) or a matching placebo capsule was administered twice daily for 12 weeks to the respective group of patients. The patients were followed up for 12 weeks and efficacy of study medication was assessed by analyzing lipid profile. Other parameters evaluated were apolipoprotein B (Apo B), apolipoprotein A1 (Apo A1), Coenzyme Q10 (CoQ10), high-sensitive C-reactive protein (hsCRP), fasting blood sugar (FBS), homocysteine and thyroid stimulating hormone (TSH).ResultsIn 12 weeks, the major lipids such as total cholesterol (TC) (p = 0.0003), triglyceride (TG) (p = 0.0003), low density lipoprotein cholesterol (LDL-C) (p = 0.0064) and very low density lipoprotein cholesterol (VLDL-C) (p = 0.0001) were significantly lower in amla group as compared to placebo group. Additionally, a 39% reduction in atherogenic index of the plasma (AIP) (p = 0.0177) was also noted in amla group. The ratio of Apo B to Apo A1 was reduced more (p = 0.0866) in the amla group as compared to the placebo. There was no significant change in CoQ10 level of amla (p = 0.2942) or placebo groups (p = 0.6744). Although there was a general trend of FBS reduction, the numbers of participants who may be classified as pre-diabetes and diabetes groups (FBS > 100 mg/dl) in the amla group were only 8. These results show that the amla extract used in the study is potentially a hypoglycaemic as well. However, this needs reconfirmation in a larger study.ConclusionsThe Amla extract has shown significant potential in reducing TC and TG levels as well as lipid ratios, AIP and apoB/apo A-I in dyslipidemic persons and thus has scope to treat general as well as diabetic dyslipidemia. A single agent to reduce cholesterol as well as TG is rare. Cholesterol reduction is achieved without concomitant reduction of Co Q10, in contrast to what is observed with statins.Trial registrationRegistered with Clinical Trials Registry- India at www.ctri.nic.in (Registration number: CTRI/2015/04/005682) on 8 April 2015 (retrospectively registered).Electronic supplementary materialThe online version of this article (10.1186/s12906-019-2430-y) contains supplementary material, which is available to authorized users.

The virtual-to-physical address translation overhead, a major performance bottleneck for modern workloads, can be effectively alleviated with huge pages. However, since huge pages must be mapped contiguously, OSs have not been able to use them well because of the memory fragmentation problem despite hardware support for huge pages being available for nearly two decades.This paper presents a comprehensive study of the interaction of fragmentation with huge pages in the Linux kernel. We observe that when huge pages are used, problems such as high CPU utilization and latency spikes occur because of unnecessary work (e.g., useless page migration) performed by memory management related subsystems due to the poor handling of unmovable (i.e., kernel) pages. This behavior is even more harmful in virtualized systems where unnecessary work may be performed in both guest and host OSs.We present Illuminator, an efficient memory manager that provides various subsystems, such as the page allocator, the ability to track all unmovable pages. It allows subsystems to make informed decisions and eliminate unnecessary work which in turn leads to cost-effective huge page allocations. Illuminator reduces the cost of compaction (up to 99%), improves application performance (up to 2.3×) and reduces the maximum latency of MySQL database server (by 30×).

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