A Pilot Trial of Jawarish Amla as Adjuvant to Anti-Tubercular Treatment Drugs for Control of Adverse Reactions in DOTS Regime in Pulmonary TB Patients

Abstract

Background and objectivesOne of the greatest challenges of health care systems at the dawn of the 21st century is tuberculosis (TB). Drug resistant strains of TB are becoming a global public health risk. These strains commonly appear due to faulty therapies. Patients frequently stop treatment due to the toxicity of anti-tubercular treatment (ATT) drugs. Amla (Emblica officinalis) is a well-known Unani single drug. Jawarish amla is a Unani compound formulation which is commonly used to administer amla. This study tested the efficacy of Jawarish amla as an adjuvant to ATT drugs in reducing their side effects.Methodology:Half of forty eligible pulmonary tuberculosis patients were randomly assigned to Test (Group B) and the other half to Control (Group A). Six grams of Jawarish amla twice daily was administered to the test group, and the same dosage of placebo was administered to control group along with directly observed treatment, short course chemotherapy (DOTS) for 60 days. Fisher exact test and paired t-test were applied for efficacy evaluation. Grading of symptoms was done to assess the toxicity of ATT and outcome of the adjuvant.Results and discussion:Significant improvements were observed in almost all subjective and objective parameters. The exceptions were serum creatine and serum uric acid, which showed non-significant slight elevations within normal limits.Conclusion:Jawarish amla was ascertained to be safe and effective adjuvant of DOTS in combating the adverse effects of ATT drugs.

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“…Calculate the number of cells per ml, and the total number of cells, using the following formula 71 . Calculate percent viability by using the formula: Principle of MTT Assay: This Colorimetric assay is based on the capacity of Mitochondria succinate dehydrogenase enzymes in living cells to reduce the yellow water-soluble substrate 3(4, 5dimethyl thiazol-2-yl)-2, 5-diphenyl tetrazolium bromide (MTT) into an insoluble, colored formazan product which is measured spectrophotometrically 19,20 . Since the reduction of MTT can only occur in metabolically active cells, the level of activity is a measure of the viability of the cells.…”

Botanical drugs in Ayurveda and Traditional Chinese Medicine

“…Distinctly, the processing methods of Ayurvedic medicinal materials also include frying, soaking and steaming, which is similar to the TCM processing methods. An example of a medicinal material (Phyllanthus emblica, commonly known as Amla in India) used with different processing methods in different systems of Indian medicine is indicated in Table 5 (Srivasuki, 2012;Anonymous, 2007;Sherwani et al, 2012).…”

Quality evaluation and standardization of a traditional Unani formulation Jawarish-e-Amla Sada

“…Recently, immunomodulatory and anti-mycobacterial activities of JAS available in the market have been reported. [3,4] Literature survey revealed that the formulation composition of the marketed formulation varies significantly in terms of the number as well as the percent component of ingredients. In order to have uniform quality as well as batch to batch consistency, there is an urgent need to have some reference standards for quality control and standardization of this formulation.…”