Asian Pacific Journal of Tropical Medicine

677-685

Authors: Kumar Gaurav Singhal, Ghanshyam Das Gupta

Objective To investigate the antioxidant and hepatoprotective activity of methanolic flower extract of Nerium oleander against CCl4-induced hepatotoxicity in rats. Methods In vitro antioxidant activity of methanolic extract of flowers of Nerium oleander (MENO–F) was evaluated by various assays, including reducing power, lipid peroxidation, DPPH, ABTS, superoxide anion, hydroxyl radicals and metal chelation. The hepatoprotective and in vivo antioxidant activity of MENO-F were evaluated against CCl4–induced hepatic damage in rats. The MENO-F at dose of 100, 200 and 400 mg/kg were administered orally once daily for seven days. Serum enzymatic levels of serum glutamate oxaloacetate transaminase (AST), serum glutamate pyruvate transaminase (ALT), serum alkaline phosphatase (ALP) and total bilirubin were estimated along with estimation of superoxide dismutase (SOD) and malondialdehyde (MDA) levels in liver tissues. Further histopathological examination of the liver sections was carried out to support the induction of hepatotoxicity and hepatoprotective efficacy. Results The extract showed potent activities on reducing power, lipid peroxide, DPPH, ABTS, superoxide anion, hydroxyl radical and metal chelation. The substantially elevated serum enzymatic levels of AST, ALT, ALP and total bilirubin were found to be restored towards normalization significantly by the MENO-F in a dose dependent manner with maximum hepatoprotection at 400 mg/kg dose level. The histopathological observations supported the biochemical evidences of hepatoprotection. Elevated level of SOD and decreased level of MDA further strengthen the hepatoprotective observations. Conclusions The results of the present study strongly reveal that MENO-F has potent antioxidant activity and hepatoprotective activity against CCl4-induced hepatic damage in experimental animals.

692-697

Authors: Adedayo O Ademiluyi, Ganiyu Oboh

Objective To investigate the modulatory effect of fermented legume condiments diet on oxidative stress in streptozotocin (STZ) induced diabetic rats. Methods Adult male Wistar rats were randomly divided into six groups with six animals in each group. Diabetes was induced by intraperitoneal injection of STZ (35 mg/kg b.w.). After being confirmed diabetic, the rats were fed with fermented Bambara groundnut, Locust bean and Soybean diets for 14 days. The plasma was obtained after 14-day treatment and analyzed for hepatic damage marker enzymes (AST, ALT and ALP) and in vivo antioxidant indices. Results The diabetic untreated rats showed elevated (P<0.05) levels of AST, ALT, ALP and malondialdehyde with reduced activities of glutathione−S−transferase, catalase as well as plasma reduced glutathione, vitamin C and total protein content. However, treatment of diabetic rats with fermented legume condiments diets for 14 days significantly (P<0.05) reversed the above parameters towards normalcy, suggesting their modulation of oxidative stress, which may be due to their high phenolic content and antioxidant capacity. Conclusions The attenuation of oxidative stress and protection of hepatic tissue damage by the legume condiment diets in STZ induced diabetic rats compare favourably with that of metformin, a well known oral hypoglycemic drug.

703-708

Authors: Nabil Ben Salem Abid, Rouis Zyed, Mahjoub Aouni

Objective To study the recombination events among enterovirus strains and the development of specific primers for the detection of enteroviruses in environmental samples. Methods Nucleotide sequence analysis of enteroviruses deposited in the international database GenBank (www.ncbi.nlm.nih.gov/Genbank) was conducted to develop specific primers for the detection of these viruses. The specificity and sensitivity of the method were tested using coxackievirus B3 strain Nancy, environmental isolate of human hepatitis A virus and human rotavirus strain WA. Seventy sewage samples were analyzed. Results Enterovirus genome was detected in all positive samples. The genome of enterovirus was not detected in negative samples. The level of detection of these viruses was 102 TCID50/mL. Conclusions The development of new primers is an important issue for the detection of enteroviruses in the environment and the assessment of risk factors to human health.

713-717

Authors: OPG Nmorsi, BP Isaac C Nkot, J Che

Objective To investigate the relationship between white blood cells, lymphocytes, monocytes, and Interleukin(IL)-1 α, IL-6, IL-10 and IL-13 production in Cameroonians with Onchocerca volvulus (O. volvulus) infection. Methods A total of 357 individuals from five sites at Upper Sanga, Lekkie, Nyong, Kelle and Sanaga Maritime divisions and located along Sanaga valley of Sanaga River in South Cameroon were screened for the presence of O. volvulus using the skin snip. The levels of the interleukins (IL-) namely IL-1 α, IL-6, IL-10 and IL-13 were evaluated using enzyme linked immunoabsorbent assay techniques. Haematological parameters were evaluated using standard laboratory automated analyser. Results O. volvulus microfilariae were found in skin tissues of 85 (23.81%) volunteers. The mean interleukin (IL-) levels in the O. volvulus control and infected individuals were IL-1 α in (1.65±0.79 and 2.31±0.5) pg/mL; IL-6 in (278.36±55.34 and 201.74±34.56) pg/mL; IL-10 in (436.03±208.64 and 418.49±147.88) pg/mL and IL-13 in (8.98±7.28 and 38.06±11.92) pg/mL. There was a negative correlation between monocyte counts and IL-10 concentration in positive individuals. A negative correlation of IL-6 with white blood cell and lymphocyte counts was observed (P<0.05). The level of IL-13 was positively associated with microfilarial load (P<0.05). Conclusions We observed depressed IL-6 and raised IL-13 concentrations in the sera of individuals with onchocerciasis which implicate these interleukins in the immunological responses of the disease. Therefore, these IL-6 and IL-13 are associated with O. volvulus infection among Cameroonians.

722-726

Authors: Hassan Vatandoost, Ahmad Ali Hanafi-Bojd

Objective To investiagte insecticide resistance in target species for better insecticide resistance managemnet in malaria control programs. Methods The status of insecticide resistance to different imagicides in Anopheles stephensi (An. stephensi) including DDT 4%, lambdacyhalothrin 0.50%, deltamethrin 0.05%, permethrin 0.75%, cyfluthrin 0.15% and etofenprox 0.50% was performed according to WHO standard method. Results The mortality rate to lambdacyhalothrin, permethrin, cyfluthrin, deltamethrin, etofenprox and DDT was (88.0±3.2), (92.0±2.7), (52.0±5.0), (96.0±2.2), (90.0±3.0) and (41.0±5.7) percent, respectively at diagnostic dose for one hour exposure time followed by 24 h recovery period. Conclusions These results showed first indication of pyrethroid resistance in An. stephensi in a malarious area, from southern Iran. There is widespread, multiple resistances in the country in An. stephensi to organochlorine and some report of tolerance to organophosphate insecticides and recently to pyrethroids. However, results of this paper will provide a clue for monitoring and mapping of insecticide resistance in the main malaria vector for implementation of any vector control.

735-737

Authors: Mohammad Mirzaei, Majid Fooladi

Objective To survey the prevalence of canine gastrointestinal helminthes in dogs presented to the Veterinary faculty of the University of Kerman between May and November 2011. Methods A total of 70 fecal samples were evaluated by the fecal sedimentation method. Results The prevalence of gastrointestinal helminthes was 7.14%. The parasites most frequently detected were Toxocara canis (T. canis) (4.3%); Toxascaris leonina (T. leonina) (1.4%) and Teania spp. (1.4%). The age distribution of intestinal parasites in dogs showed that the dog less than 1 year old had a higher overall prevalence than those dogs over 12 months of age but there was not significant (P>0.05). Also there was no significant difference in the prevalence between male (7.7%) and female (6.5%) dogs (P>0.05). Conclusions It is thought that the reduction in the frequency of the dogs with those helminthes may be mainly a result of the improvement in breeding environment and the routine use of antihelmintics. The significance of zoonotic diseases caused by intestinal helminthes makes it necessary for us to know the infection status of domestic dogs and to take measures for further control. It is concluded that veterinarians have an important role in educating dog owners of these potential risks and means for preventing or minimizing zoonotic transmission.

743-748

Authors: Jun Zhang, Ran Wang, Yi-Lei Zhao, Xiao-Hui Sun, Hong-Xing Zhao, Lu Tan, De-Cai Chen, Xu Hai-Bin

Objective To compare the effect of zoledronic acid in treatment and prevention of osteoporosis with placebo. Methods Random control trials regarding zoledronic acid in treatment of osteoporosis were retrieved by selecting Medline, EMbase and Pubmed databases till April 2012. The RevMan software was used for all of the statistical analysis. Results A total of 9 trials were included in this meta-analysis. The pooled effect showed that zoledronic acid could increase the bone mineral density by 2.98 times compared with placebo, and reduce the rate of fracture in patients by 32%. The results should the zoledronic acid intervention had significantly less serious adverse events than controls, and the odds ratio was 0.81 (0.76–0.87). The longer term intervention, more than 12 months intervention, could gain a better prevention effect for osteoporosis (OR, 95% CI for BMD was 3.35, 2.77–3.92; for fracture was 0.67, 0.54–0.82). Conclusions This present study shows that zoledronic acid could be effective approach in the prevention of osteoporosis, and could increase the bone mineral density and reduce the risk of facture.

755-756

Authors: Kushal Naha, Suman Karanth, Sowjanya Dasari, Mukhyaprana Prabhu

Diffuse myositis with progression to rhabdomyolysis has been reported in association with wide range of viral infections. We report a case of polymyositis-like syndrome complicated by rhabdomyolysis secondary to brucellosis. This case report thus contributes yet another atypical presentation to a disease already infamous for its protean manifestations.

589-593

Authors: Nanay river basin; Invasion; Sialic acid; Plasmodium falciparum; Malaria

Objective To determine whether the requirements for sialic acid varies and whether several types of silaic acid independent receptors utilized for invasion mechanisms of fresh filed isolates collected around Nanay river basin, Iquitos. Methods The field isolates were cultured as described previously by Jensen and Trager and MR4 protocol with little modifications. The erythrocytes preparation and subsequent enzyme treatment was done as described previously by Sharma. with little modification. Invasion assay was performed as described previously by Sharma et al with little modification. Results The Nanay river basin isolates showed five types of invasion mechanisms or types of receptors-ligand interactions. Here we observed that an equal numbers of neuraminidase sensitive and resistant invasion receptor-ligand interaction profiles as the most common receptor-ligand invasion profiles. Neuraminidase resistance trypsin sensitive chymotrypsin sensitive (NMRTSCTS) invasion of receptor-ligand interaction profile was found in seven isolates, Five field isolates and one reference strain showed neuraminidase sensitive, trypsin sensitive and chymotrypsin resistant (NMSTSCTR) invasion of receptor-ligand interactions, six isolates including one reference strains dd2 showed neuraminidase sensitive, trypsin and chymotrypsin resistance (NMSTRCTR) indicating its dependence on sialic acids and independence of trypsin and chymotrypsin sensitive proteins. Four isolates showed neuraminidase sensitive, trypsin sensitive and chymotrypsin sensitive (NMSTSCTS) invasion of receptor-ligand interactions, seven isolates were neuraminidase resistant, trypsin sensitive and chymotrypsin resistance (NMRTSCTR) invasion of receptor-ligand interactions, indicating its dependence on trypsin sensitive proteins. Conclusions The Nanay river basin isolates showed five types of invasion mechanisms or types of receptors-ligand interactions. A full understanding of theses invasion mechanisms may allow the development of novel prophylactic and therapeutic strategies that block erythrocyte receptor-ligand invasion mechanisms.

598-604

Authors: Kaliyamoorthy Krishnappa, Shanmugam Dhanasekaran, Kuppusamy Elumalai

Objective To investigate the potentiality of mosquitocidal activity of Gliricidia sepium (G. sepium) (Jacq.) (Leguminosae). Methods Twenty five early third instar larvae of Anopheles stephensi (An. stephensi) were exposed to various concentrations (50-250 ppm) and the 24 h LC50 values of the G. sepium extract was determined by probit analysis. The ovicidal activity was determined against An. stephensi to various concentrations ranging from 25-100 ppm under laboratory conditions. The eggs hatchability was assessed 48 h post treatment. The pupicidal activity was determined against An. stephensi to various concentrations ranging from 25-100 ppm. Mortality of each pupa was recorded after 24 h of exposure to the extract. Results Results pertaining to the experiment clearly revealed that ethanol extract showed significant larvicidal, ovicidal and pupicidal activity against the An. stephensi. Larvicidal activity of ethanol extracts of G. sepium showed maximum mortality in 250 ppm concentration (96.0±2.4)%. Furthermore, the LC50 was found to be 121.79 and the LC90 value was recorded to be 231.98 ppm. Ovicidal activity of ethanol extract was assessed by assessing the egg hatchability. Highest concentration of both solvent extracts exhibited 100% ovicidal activity. Similarly, pupae exposed to different concentrations of ethanol extract were found dead with 58.10% adult emergence when it was treated with 25 ppm concentration. Similarly, 18.36 (n=30; 61.20%); 21.28(70.93) and 27.33(91.10) pupal mortality was recorded from the experimental pupae treated with 50, 75 and 100 ppm concentration of extracts. Three fractions have been tested for their larvicidal activity of which the Fraction 3 showed the LC50 and LC90 values of 23.23 and 40.39 ppm. With regard to the ovicidal effect fraction 3 showed highest ovicidal activities than the other two fractions. Furthermore, there were no hatchability was recorded above 50 ppm (100% egg mortality) in the experimental group. Statistically significant pupicidal activity was recorded from 75 ppm concentration. Conclusions From the results it can be concluded the crude extract of G. sepium is an excellent potential for controlling An. stephensi mosquito. It is apparent that, fraction 3 possess a novel and active principle which could be responsible for those biological activities.

610-615

Authors: B.P. Pimple, P.V. Kadam, M.J. Patil

Objective To study the comparative gastroprotective effect of Luffa acutangula methanolic extract (LAM) and aqueous extract (LAW) on type II diabetes rats. Methods Streptozotocin (65 mg/kg, i.p.) along with nicotinamide (120 mg/kg, i.p.) was used to induce non insulin dependent diabetes mellitus (NIDDM) in rats. A daily oral dose of aspirin (200 mg/kg, i.p.) was administered for initial seven days to induce gastric ulcerations in the diabetic rats. LAM and LAW were administered orally in the doses of 100, 200 and 400 mg/kg once daily for 21 days. Glibenclamide and ranitidine were used as standards for comparing the antidiabetic and antiulcer effect respectively. Results LAM significantly (P<0.01) increased mucosal glycoprotein and antioxidant enzyme level in gastric mucosa of diabetic rats than LAW (P <0.05). LAM was efficient in reversing the delayed healing of gastric ulcer in diabetic rats close to the normal level. LAM exhibited better ulcer healing effect than glibenclamide and LAW, because of its both antihyperglycemic and mucosal defensive actions. Conclusions Thus, LAM is proved to be a better alternative for treating gastric ulcers co-occurring with diabetes.

623-629

Authors: Talib Hussain, Hefazat H Siddiqui, Sheeba Fareed, M Vijayakumar, Chandana V Rao

Objective To investigation the chemopreventive potential of Fumaria indica (F. indica) extract (FIE) on N-nitrosodiethylamine and CCl4-induced hepatocarcinogenesis in Wistar rats. Methods The experimental animals were divided into six groups (n=6). Hepatocellular carcinoma was induced by single intraperitoneal injection of N-nitrosodiethylamine (NDEA) in normal saline at a dose of 200 mg/kg body weight followed by weekly subcutaneous injections of CCl4(3 mL/kg/week) for 6 weeks, as the promoter of carcinogenic effect. After administration of the carcinogen, 200 and 400 mg/kg of FIE were administered orally once a day throughout the study. At the end of 20 weeks, the body weight, liver weight and relative liver weight were measured. The percentage of nodule incidence and liver cancer markers such as aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP), γ-glutamyl transferase (γ-GT), total bilirubin level (TBL), α-feto protein (AFP) and carcinoembryonic antigen were estimated along with histopathological investigation in experimental groups of rats. Results Obtained results demonstrated that the cotreatment with FIE significantly prevented the decrease of the body weight and also increased in relative liver weight caused by NDEA. The treatment with FIE significantly reduced the nodule incidence and nodule multiplicity in the rats after NDEA administration. The levels of liver cancer markers such as AST, ALT, ALP, γ-glutamyl transferase, TBL, AFP and carcinoembryonic antigen were substantially increased by NDEA treatment. However, FIE treatment significantly reduced the liver injury and restored the entire liver cancer markers. Histological observations of liver tissues too correlated with the biochemical observations. Conclusions These finding powerfully supports that F. indica exert chemopreventive effect by suppressing the tumor burden and restoring the activities of hepatic cancer marker enzymes on NDEA and CCl4-induced hepatocarcinogenesis in Wistar rats.

634-637

Authors: Amilcar Arenal, Leonardo Martín, Nestor M Castillo, Dainier de la Torre, Ubaldo Torres, Reinaldo González

Objective To evaluate, in hyperglycemic tilapia [Oreochromis niloticus (O. niloticus)], the effect of this aqueous extract on blood glucose levels. Methods The hyperglycemia in O. niloticus was induced by adding glucose to fish pond water. An aqueous extract of Ocimum tenuiflorum (O. tenuiflorum) was prepared by boiling fresh leaves and the doses of 0, 40, 80, 200 and 400 mg per liter of pond water were tested. Results The blood sugar concentration for tilapia with hyperglycemic induced was an average of 50% higher than the control group. The blood glucose levels in tilapia after the induction of hyperglycemia were higher than the control group for 90 min after the treatment. The treatment with the aqueous extract of O. tenuiflorum dropped the serum glucose level of hyperglycemic tilapia until it was similar to that of the control group and was dose dependent. Conclusions The results indicated that O. tenuiflorum was endowed with anti-hyperglycemic activity. To our knowledge, this is the first report on the use of fish as a diabetes model to test natural extracts from plants.

645-650

Authors: Wei Jie, Qi-Yi He, Bo-Tao Luo, Shao-Jiang Zheng, Yue-Qiong Kong, Han-Guo Jiang, Ru-Jia Li, Jun-Li Guo, Zhi-Hua Shen

Objective To explore the role of proto-oncogene Pim-1 in the proliferation and migration of nasopharyngeal carcinoma (NPC) cells. Methods Pim-1 expressions in NPC cell lines CNE1, CNE1-GL, CNE-2Z and C666-1 were examined by RT-PCR, western blotting and immunoflucesence, respectively. After CNE1, CNE1-GL and C666-1 cells were treated with different concentrations of Pim-1 special inhibitor, quercetagetin, the cell viability, colony formation rate and migration ability were analyzed. Results Pim-1 expression was negative in well-differentiated CNE1 cells, whereas expressed weakly positive in poor-differentiated CNE-2Z cells and strongly positive in undifferentiated C666-1 cells. Interestingly, CNE1-GL cells that derived from CNE1 transfected with an Epstein Barr virus latent membrane protein-1 over-expression plasmid displayed stronger expression of Pim-1. Treatment of CNE1-GL and C666-1 cells with quercetagetin significantly decreased the cell viability, colony formation rate and migration ability but not the CNE1 cells. Conclusions These findings suggest that Pim-1 overexpression contributes to NPC proliferation and migration, and targeting Pim-1 may be a potential treatment for anti-Pim-1-expressed NPCs.

656-660

Authors: Wen-Hui Wu, Yuan-Yuan Niu, Chang-Ran Zhang, Long-Bin Xiao, Hui-Shao Ye, De-Mao Pan, Mian Zeng

Objective To explore the easily applicable indicators of practical value to evaluate the prognosis of acute respiratory distress syndrome (ARDS). Methods Blood and biochemical tests and blood-gas analyses were performed upon entry into the ICUs, 12 h, 24 h, 48 h and 72 h after that in 72 ARDS patients (who were admitted to the ICUs of our hospital from January 2000 to December 2009). Then APACHE Π scores were achieved by combining relevant physiological parameters and laboratory results. Results There was a statistical difference between the death group and survival group at different time points upon entering the ICUs in terms of APACHE Π score, alveolar-arterial oxygen difference and arterial blood lactate clearance rate. PaO2/FiO2 values were recorded to be statistically different between the death group and survival group 24 h, 48 h and 72 h, respectively after entry into the ICUs. In addition, registered linear regression existed between APACHE Π score, alveolar-arterial oxygen difference or PaO2/FiO2 value and time. APACHE Π score 24 h and 72 h after entering ICUs predicted mortality with an area under the ROC curve (AUC) standing respectively at 0.919 and 0.955. Arterial blood lactate clearance rate 12 h, 24 h, 48 h and 72 h after entering ICUs predicted mortality with an area under the ROC curve (AUC) at 0.918, 0.918, 0.909 and 0.991, respectively. Conclusions APACHE Π score applied in combination with arterial blood lactate clearance rate is of clinical significance in assessing the prognosis of ARDS patients.

665-666

Authors: Jaydeep Sarkar, Biku Naik, Atul Gawande, Atul Goel

Most common cause of thalamic bleed is hypertension; other causes are arteriovenous malformation, aneurysm, bleeding diathesis, drugs, amyloid angiopathy, tumor etc. We present a case of Plasmodium vivax (P. vivax) malaria with unusual site of bleeding i.e. left thalamus of brain. To the best of our knowledge, this is the first reported case of thalamic bleed caused by vivax malaria in absence of severe thrombocytopenia/disseminated intravascular coagulation (DIC).

505-510

Authors: Benjamin Jelle Visser

Dracunculiasis (Guinea worm disease) is a preventable waterborne parasitic disease that affects the poorest people living in remote rural areas in sub-Saharan African countries, who do not have access to safe drinking water. The Guinea Worm Eradication Program, a 25-year old campaign to rid the world of Guinea Worm disease has now reached its final stage accelerating to zero cases in all endemic countries. During the 19th and 20th centuries, dracunculiasis was common in much of Southern Asia and the African continent. The overall number of cases has been reduced tremendously by ≥99%, from the 3.32 million cases estimated to have occurred in 1986 in Africa to only 1 797 cases reported in 2010 reported in only five countries (Sudan, Mali, Ethiopia, Chad and Ghana) and Asia free of the disease. This achievement is unique in its kind – the only previously eradicated disease is smallpox, a viral infection for which vaccination was possible – and it has been achieved through primary community-based prevention and health education programs. Most efforts need to be taken in two countries, South Sudan (comprising 94% or 1 698 out of 1 797 of the cases reported world-wide in 2010) and Mali because of frequent movements of nomads in a vast area inside and outside Mali's borders. All factors favourable to dracunculiasis eradication are available including adequate financial resources, community and political support and high levels of advocacy. Thus there is no reason that this disabling parasitic disease cannot be eradicated soon before surprises arise such as new civil conflicts in currently endemic countries.

514-517

Authors: Koroush Azizi, Aboozar Soltani, Hamzeh Alipour

To investigate on patients leishmanial infections in Jask County. Methods Impression smears were prepared from patients in 2008, all, were chequed for leishmanial infection by microscopy and molecular assays. Whole DNA was extracted using Proteinase K and Phenol/Chloroform/Isoamyl alcohol method. The variable segment on minicircles of kinetoplast DNA was amplified via a Nested-PCR technique using species-specific primers (LIN R4-LIN 17 -Lin 19). Results A total of 40 smears were prepared from 20 patients, from which, eight samples (40%) were positive for leishman body by microscopic method, while, 18 samples (90%) were positive, molecularly. The parasite was identified as Leishmania major (L. major). Conclusion Zoonotic or Rural cutaneous leishmaniasis is endemic in Jask County whose pathogen is L. major. Molecular assays using specific primers are very accurate and more sensitive and specific than microscopy which is time consuming and needs master microscopists.

523-528

Authors: Vijay Kumar Bansal, Rajesh Kumar Goel

Objective To systematically evaluate antiulcer potential of Acacia nilotica in different ulcer models in rats. Methods Different extracts [ethanolic, 50% hydroethanolic (50:50), 70% hydroethanolic (70:30) and aqueous] of young seedless pods were examined in pylorus ligation induced gastric ulcers in rats. Various parameters like, volume of gastric acid secretion, pH, free acidity, total acidity, ulcer index, mucin content and antioxidant studies were determined and were compared between extract treated, standard and vehicle control following ulcer induction. The most active extract was also evaluated in swimming stress induced and NSAID induced gastric ulceration. Results Among different extracts of young seedless pods only hydroethanolic extracts showed significant antiulcer activity in pyloric ligation induced ulceration. Even more the 70% hydroethanolic extract showed better protection as compared to 50% hydroethanolic extract. Further 70 % hydroethanolic extract also showed significant mucoprotection in swimming stress induced and nonsteroidal antiinflammatory drugs induced gastric ulceration. Conclusion The results of present study concluded that the hydroethanolic extract of young seedless pods of Acacia nilotica has antiulcer activity in pylorus ligation, swimming stress and NSAID induced rat ulcer models. The extract containing more amount of phenolic components show high antiulcer activity, indicating the phenolic component of the extract to be responsible for the activity of the extracts.

533-538

Authors: Abu Nasim Nizami, Md Atiar Rahman, Nazim Uddin Ahmed, Md Shahidul Islam

Objective To investigate the antilithiatic effect of the whole Leea macrophylla (L. macrophylla) Roxb (Leeaceae) ethanol extract in ethylene glycol-induced urolithiasis model of rats. Methods Forty two seven weeks old male wistar albino rats were randomly divided into two major groups namely: preventive (n=18) and therapeutic (n=24). Preventive group was further subdivided into 3 groups of 6 rats namely: preventive control (PC), preventive lithiatic control (PLC) and preventive lithiatic L. macrophylla (PLLM). Similarly, therapeutic group was also subdivided into 4 groups of 6 rats namely: therapeutic control (TC), therapeutic lithiatic control (TLC), therapeutic lithitatic L. macrophylla (TLLM) and therapeutic lithiatic cystone (TLCYS). The lithiasis was induced by 0.75% (v/v) ethylene glycol in the drinking water of all groups except the PC and TC groups. The urinary ionic parameters such as calcium, inorganic phosphate, oxalate, magnesium & creatinine and renal morphology were altered by ethylene glycol, which were partially recovered by 14 d preventive and almost fully recovered by 28 d therapeutic intervention trials with L. macrophylla extract (500 mg/kg BW daily). Results Significant difference on recovery was observed between preventive and therapeutic interventional trials. Anti-urolithiatic effect of cystone was significantly (P<0.001) higher than extracts. L. macrophylla extract was found nontoxic in the acute toxicity test. Conclusion The results of this study demonstrated very promising anti-urolithiatic effect of L. macrophylla extract with preventive and therapeutic treatments in this experimental condition.

547-551

Authors: Sachin Jain, Ankit Jain, Pritesh Paliwal, Shailendra Singh Solanki

Objective To investigate the antifertility effect of chronically administered Tabernaemontana divaricata (T. divaricata) leaf extract on male rats. Methods The effect of 50% ethanol extract of T. divaricata leaves on reproduction was studied on male rats. The study was divided into four groups of five animals each. The first groups (I) received vehicle alone to serve as control. The second, third and fourth groups (II, II and IV) of animals were administered the leaf extract daily at 50 mg/kg body weight, p.o.,100 mg/kg body weight, p.o., and 200 mg/kg body weight, p.o., respectively, for a period of 60 days. Results Significant decreases in the weight of testes, epididymis, seminal vesicle and ventral prostate were observed. A dose related reduction in the testicular sperm count, epididymal sperm count and motility, number of fertile male, ratio between delivered and inseminated females and numbers of pups were observed. The testis showed a clear correlation between the dose and severity of lesions of seminiferous epithelium. In general, the seminiferous tubules appear reduced in size with a frequently filled eosinophilic material. Spermatogenesis arrested at the secondary spermatocyte stage. Pachytene spermatocytes were undergoing degeneration. Disorganigation and sloughing of immature germ cell were visible. Leydinf cells were atrophied. No morphological changes were observed in Sertoli cells. Significant reduction in serum concentration of luteinizing hormone and testosterone were observed. No distinct change in serum FSH concentration was recorded. The final body weights of all groups were elevated markedly. No alterations were recorded in any hematologiocal parameters. Conclusion It is concluded that the 50% ethanol extract of T. divaricata leaf produced dose related effect on male reproduction without altering general body metabolism.

556-560

Authors: Patience O Osadebe, Chika C Abba, Matthias O Agbo

Objective To evaluate the antimotility activity of Eastern Nigerian mistletoe[Loranthus micranthus (L. micranthus) Linn] parasitic on six different host trees viz. Baphia nitida, Persia americana, Kola accuminata, Irvingia gabonensis, Citrus simensis and Pentacletra macrophylla (P. mycrophylla). Methods The antimotility of the methanol extracts and solvent fractions were evaluated in castor oil induced diarrheoa in rats. Results The methanol extracts (200 mg/kg, i.p.) inhibited defeacation significantly (P < 0.05) 4 h after administration (75.73% to 93.33%) more than that of atropine sulphate (2 mg/kg, i.p.) which inhibited defeacation by 80.0%. The methanol extract (200 mg/kg, i.p.) of L. micranthus parasitic on P. mycrophylla exhibited significant (P<0.05) inhibition in gastrointestinal transit (67.6%) more than that of atropine sulphate (2 mg/kg, i.p.) which inhibited gastrointestinal transit by 26.4%. The solvent fractions of L. micranthus parasitic on P. mycrophylla at dose levels of 150 mg/kg inhibited significantly the gastrointestinal transit of mice. Fraction F5 exhibited inhibitory activity which was comparable to loperamide (73.3%). Conclusion The methanol extract of L. micranthus parasitic on P. macrophylla exhibits higher antimotility activity that other extracts. The solvent fractions could serve as source of novel antimotility agents.

566-572

Authors: Singh Yashik, Mars Maurice

Objective To investigate the possibility of combining the interpretation of three gold standard interpretation algorithms using weighted heuristics in order to produce a single resistance measure. Methods The outputs of HIVdb, Rega, ANRS were combined to obtain a single resistance profile using the equally weighted voting algorithm, accuracy based weighing voting algorithm and the Bayesian based weighted voting algorithm techniques. Results The Bayesian based voting combination increased the accuracy of the resistance profile prediction compared to phenotype, from 58% to 69%. The equal weighted voting algorithm and the accuracy based algorithm both increased the prediction accuracy to 60%. Conclusion From the result obtained it is evident that combining the gold standard interpretation algorithms may increase the predictive ability of the individual interpretation algorithms.

577-581

Authors: Jian-Qiang Chen, Yin Guan, Gang Li, Xiao-Hua Li, Yue-Fu Zhan, Xiang-Yin Li, Liu Nie, Xiang-Jun Han

Objective To discuss the role of 3D-computed tomography angiography (3D-CTA) technology in reducing injuries of large meningioma surgery. Methods 3D-CTA preoperative examinations were done in 473 patients with large meningioma (simulated group). The images were analyzed by 3D post-processing workstation. By observing the major intracranial blood vessels, venous sinus, and the compression and invasion pattern in the nerve region, assessing risk level of the surgery, simulating the surgical procedures, the surgical removal plan, surgical routes and tumor blood-supplying artery embolisation plan were performed. Two hundred and fifty seven large meningioma patients who didn't underwent 3D-CTA preoperative examination served as control group. The incidence of postoperative complications, intraoperative blood transfusion and the operation time were compared between these two groups. Results Compared with the control group, the Simpson's grade I and II resection rate was 80.3% (380/473), similar with that of the control (81.3%, 209/257). The incidence of postoperative complications in 3D-CTA simulated group was 37.0% which was significantly lower than that (48.2%) of the control (P<0.01). The intraoperative blood supply for simulated group and the control was (523.4±208.1) mL and (592.0±263.3) mL, respectively, with significant difference between two groups (P<0.01). And the operation time [(314.8±106.3)] min was significantly lower in simulated group than that in the control [(358.4±147.9) min] (P<0.01). Conclusion Application of 3D-CTA imaging technology in risk level assessment before large-scaled meningioma resection could assist in the rational planning of tumor resectin, surgical routes, and is helpful in reducing injuries and complications and enhancing the prognosis of the patients.

261-264

Authors: Senaka Rajapakse, Chaturaka Rodrigo, Deepika Fernando

Scrub typhus is a zoonosis caused by the pathogen Orientia tsutsugamushi (O. tsutsugamushi). The disease has significant prevalence in eastern and Southeast Asia. Usually presenting as an acute febrile illness, the diagnosis is often missed because of similarities with other tropical febrile infections. Many unusual manifestations are present, and these are described in this review, together with an outline of current knowledge of pathophysiology. Awareness of these unusual clinical manifestations will help the clinician to arrive at an early diagnosis, resulting in early administration of appropriate antibiotics. Prognostic indicators for severe disease have not yet been clearly established.

270-276

Authors: D Bhagya, L Prema, T Rajamohan

To investigate whether tender coconut water (TCW) mitigates oxidative stress in fructose fed hypertensive rats. Methods: Male Sprague Dawley rats were fed with fructose rich diet and treated with TCW (4 mL/100 g of body weight) for 3 subsequent weeks. Systolic blood pressure was measured every three days using the indirect tail cuff method. At the end of the experimental period, plasma glucose and insulin, serum triglycerides and free fatty acids, lipid peroxidation markers (MDA, hydroperoxides and conjugated dienes) and the activities of antioxidant enzymes were analyzed in all the groups. Results: Treatment with TCW significantly lowered the systolic blood pressure and reduced serum triglycerides and free fatty acids. Plasma glucose and insulin levels and lipid peroxidation markers such as MDA, hydroperoxides and conjugated dienes were significantly reduced in fructose fed rats treated with TCW. Activities of antioxidant enzymes are up regulated significantly in TCW treated rats. Histopathological analysis of liver showed that TCW treatment reduced the lipid accumulation and inflammatory infiltration without any significant hepatocellular damage. Conclusions: The overall results suggest that, TCW treatment could prevent and reverse high blood pressure induced by high fructose diet probably by inhibition of lipid peroxidation, upregulation of antioxidant status and improved insulin sensitivity.

283-288

Authors: Ch V Rao, AKS Rawat, Anil P Singh, Arpita Singh, Neeraj Verma

To evaluate the hepatoprotective potential of ethanolic (50%) extract of Ziziphus oenoplia (L.) Mill (Z. oenoplia) root against isoniazid (INH) and rifampicin (RIF) induced liver damage in animal models. Methods: Five groups of six rats each were selected for the study. Ethanolic extract at a dose of 150 and 300 mg/kg as well as silymarin (100 mg/kg) were administered orally once daily for 21 d in INH + RIF treated groups. The serum levels of glutamic oxaloacetic transaminase (SGOT), glutamate pyruvate transaminase (SGPT), alkaline phosphatase (SALP), and bilirubin were estimated along with activities of superoxide dismutase, catalase, glutathione S-transferase, glutathione peroxidase, and hepatic melondialdehyde formation. Histopathological analysis was carried out to assess injury to the liver. Result: The considerably elevated serum enzymatic activities of glutamic oxaloacetic transaminase, glutamate pyruvate transaminase, alkaline phosphatase and bilirubin due to INH + RIF treatment were restored towards normal in a dose dependent manner after the treatment with ethanolic extract of Z. oenoplia roots. Meanwhile, the decreased activities of superoxide dismutase, catalase, glutathione S-transferase and glutathione peroxidase were also restored towards normal dose dependently. In addition, ethanolic extract also significantly prevented the elevation of hepatic melondialdehyde formation in the liver of INH + RIF intoxicated rats in a dose dependent manner. The biochemical observations were supplemented with histopathological examination of rat liver sections. Conclusions: The results of this study strongly indicate that ethanolic extract of Z. oenoplia has a potent hepatoprotective action against INH + RIF induced hepatic damage in rats.

294-298

Authors: Suthagar Pillai Piaru, Roziahanim Mahmud, Amin Malik Shah Abdul Majid, Zeyad Daoud Mahmoud Nassar

Toinvestigate the anti-angiogenic activity and antioxidant properties of Myristica fragrans (M. fragrans) (nutmeg) and Morinda citrifolia (M. citrifolia)(mengkudu) oils. Methods: The nutmeg and megkudu essential oils were obtained by steam distillation. The antioxidant activities of both essential oils were determined by beta-carotene/linoleic acid bleaching assay and reducing power while the anti-angiogenic activity was investigated using rat aortic ring assay using various concentrations. Results: The results showed that nutmeg oil has higher antioxidant activity than mengkudu oil. The nutmeg oil effectively inhibited the oxidation of linoleic acid with (88.68依0.1)% while the inhibition percentage of oxidation of linoleic acid of the mengkudu oil is (69.44依0.4)%. The nutmeg oil and mengkudu oil showed reducing power with an EC50 value of 181.4 毺g/mL and 3 043.0 毺g/mL, respectively. The antiangiogenic activity of nutmeg oil showed significant antiangiogenic activity with IC50 of 77.64 毺g/mL comparing to mengkudu oil which exhibits IC50 of 109.30 毺g/mL. Conclusion: Bioactive compound(s) will be isolated from the nutmeg essential oil to be developed as antiangiogenic drugs.

306-309

Authors: Zhi-Hua Zhang, Jian-Hua Tang, Zhi-Lin Zhan, Xiu-Long Zhang, Hong-Hai Wu, Yan-Ning Hou

To investigate the cellular toxicity of isoniazid together with rifampicin and the metabolites of isoniazid on cultured QSG-7701 cells lines. Methods: Isoniazid, rifampicin, mixture of rifampicin and isoniazid, acetylhydrazine, hydrazine were added in cultural media of QSG-7701 cells and cultured for 48 hours. The survival rate of cells was determined by MTT method. The cultural media and cells were collected and the activity of lactate dehydrogenase was detected by chromatometry. Results: Compared with control group, the survival rate decreased significantly and the lactate dehydrogenase released from cell increased significantly in cells treated with isoniazid , rifampicin, acetylhydrazine, hydrazine. Hydrazine, the metabolite of isoniazid produced significant damage on hepatocytes in low concentration. Conclusions: Rifampicin together with rifampicin and metabolites of isoniazid produce cellular toxic effects and hydrazine may be the most toxiferous metabolite.

315-317

Authors: Amiya Kumar Hati, Indranil Bhattacharjee, Hiranmoy Mukherjee, Bhaswati Bandyopadhayay, Deban Bandyopadhyay, Rajyasree De, Goutam Chandra

To establish the nature and extent of dual dengue and malaria infections in an endemic area through a longitudinal study. Methods: A prospective study was conducted from August 2005 to December 2010 to document the nature and extent of concurrent dengue and malaria infections in an area in central Kolkata, endemic both for dengue and malaria. Results: Of 2 971 suspected cases of dengue fever, in 605 (20.36%) persons dengue infection was detected, of whom 46 (7.60%, 46/605) patients (40 and 6 suffered from secondary and primary dengue fever respectively) were simultaneously suffering from malaria (28 and 18 were infected with Plasmodium vivax (P.vivax) and Plasmodium falciparum (P. falciparum) respectively, such dual infections of dengue and malaria were detected in all the years of the study period, except 2007, indicating intense transmission of both dengue and malaria in the study area, and the phenomenon was not an isolated one, the rate of concomitant infections ranged from 25% in 2009 to 4.9% in 2005. Out of total population surveyed, 1.54% (46/2 971) had concurrent dengue and malaria infection. Conclusions: These findings added a new dimension in diagnosis, treatment, epidemiology and control of dengue and malaria. The possible risk of concurrent dengue and malaria infections should always be kept in mind in endemic areas for early diagnosis employing modern technology and prompt and effective treatment to avoid serious complications.

323-325

Authors: Min Guo, Tao Liu, Jun-Cheng Guo, Xiang-Ling Jiang, Feng Chen, Yun-Suo Gao

To evaluate serum IL-2, IL-4, IL-6, IL-8, IL-10 and TNF-毩 levels in posttraumatic stress disorder (PTSD) patients. Methods: We utilized ELISA technology to examine cytokines such as IL-2, IL-4, IL-6, IL-8, IL-10 and TNF-毩 in serum from 50 well-characterized individuals with a primary DSM-桇 PTSD diagnosis, and 50 age- and gender-matched healthy controls. We conservatively employed a Mann-Whitney U testing. Results: Individuals with primary PTSD had significantly elevated peripheral cytokine levels for all 6 different cytokines compared to age- and gender-matched healthy controls (all P<0.01). Conclusions: These findings suggest that a generalized inflammatory state may be present in individuals with PTSD.

329-330

Authors: Bijayini Behera, TLVD Prasad Babu, A Kamalesh, Gangadhar Reddy

Melioidosis, a disease of public health importance in Southeast Asia and Northern Australia, of late has shown an increasing trend in India, particularly Southern India. We describe a case of a 39-year-old diabetic patient with left elbow septic arthritis, multiple liver, splenic abscesses, pneumonia, pleural effusion, followed by sepsis syndrome. Blood cultures and culture of the joint aspirate yielded pure growth of Burkholderia pseudomallei (B. pesudomallei), sensitive to carbapenem, co-trimoxazole and resistant to ceftazidime. The patient was successfully treated with imipenem- cilastin.He was discharged on co-trimoxazole to complete the 24 weeks course and follow-up has continued to date. The patient continues to remain asymptomatic. The case re-emphasizes the need to monitor the trend of B. pseudomallei in India, particularly the development of ceftazidime resistance, which incidentally is the drug of choice.

333-334

Authors: M Shahid

Notwithstanding the end of 2009 H1N1 pandemic, the threat for its revisit still persists and WHO has warned to remain vigilant. During that time the situation was more panicky than fatal. In this article, a suggestion to minimize the panic is provided by the usage of colour-coded masks and is proposed hereby as a “population segregation” approach in case of the revisit of H1N1 or similar threatening respiratory viral infections.

175-179

Authors: Karuppusamy Arunachalam, Thangaraj Parimelazhagan

To investigate the antidiabetic effect of aqueous extract of Merremia tridentata (M. tridentata) root (MTRAE) in normal, glucose-loaded hyperglycemic and streptozotocin (STZ)-induced diabetic rats. Methods: Oral administration of MTRAE at the doses of 50, 100 and 150 mg/kg was studied in normal, glucose-loaded and STZ-diabetic rats. The three doses caused significant reduction in blood glucose levels in all the models. Results: The effect was more pronounced in 100 and 150 mg/kg than 50 mg/kg. MTRAE also showed significant increase in serum insulin, body weight and glycogen content in liver and skeletal muscle of STZ-induced diabetic rats while there was significant reduction in the levels of serum triglyceride and total cholesterol. MTRAE also showed significant antilipidperoxidative effect in the pancreas of STZ-induced diabetic rats. The antidiabetic effect of M. tridentata was compared with glibenclamide, a well known hypoglycemic drug. Conclusions: The results indicate that aqueous extract of M. tridentata root possesses significant antidiabetic activity.

187-191

Authors: Ritesh Jain, Sanmati Kumar Jain

To elucidate the effect of ethanolic extract of Buchanania lanzan Spreng. (B. lanan)bark against cyclophosphamide induced genotoxicity and oxidative stress in mice. Methods: The prevalence of micronuclei in bone marrow, the extent of lipid peroxidation, reduced glutathione and the status of the antioxidant enzymes, superoxide dismutase and catalase in liver of mice were used as intermediate biomarkers for chemoprotection. Lipid peroxidation and associated compromised antioxidant defenses in cyclophosphamide treated mice were observed in the liver. Results: Pre-treatment with B. lanzan 250, 500 and 1 000 mg/ kg, p.o., daily for 7 days significantly reduced the chromosomal damage and lipid peroxidation with concomitant changes in antioxidants and detoxification systems. Conclusions: These results point out the presence of chemopreventive phytoconstituents in the crude extract offering protection against cyclophosphamide induced genotoxicity and oxidative stress in mice.

197-201

Authors: Ashish K Das, Papiya Bigoniya, Neelesh K Verma, AC Rana

The study was aimed at evaluating the antiulcer activity of ethanolic extract of Achyranthes aspera (EEAA) leaf. Methods: The anti-ulcer assays were performed on pylorus ligation and chronic ethanol induced ulcer model. The effects of the EEAA on gastric content volume, pH, free acidity, total acidity and ulcer index were evaluated. Results: The percentage of ulcer protection (59.55% and 35.58%) was significantly (P < 0.001) higher in the groups treated with the high dose of EEAA (600 mg/kg), it also reduced the volume of gastric juice and total acidity whereas, gastric pH was increased significantly. Conclusions: The results of this study show significant gastroprotective activity of EEAA may be due to presence of phyto-constituents like flavanoids, saponins and tannins.

210-213

Authors: Poovendran Ponnusamy, Vidhya Natarajan, Murugan Sevanan

To detect in vitro biofilm formation of uropathogenic Escherichia coli (E. coli) (UPEC) strains isolated from urine specimens and also to determine their antimicrobial susceptibility pattern using 13 commonly used antibiotics. Methods: The present study comprised of 166 urine specimens collected from tertiary care hospitals in and around Coimbatore, South India. All the specimens were subjected to gram staining, bacterial culture and the E. coli strains were screened for biofilm formation using Tube Method (TM), Congo Red Agar (CRA) and Tissue Culture Plate method (TCP) respectively. Subsequently, the antimicrobial susceptibility test was performed by Kirby Bauer-disk diffusion method for the biofilm and non-biofilm producing E. coli strains. Results: Of the 100 (60.2 %) E. coli strains, 72 strains displayed a biofilm positive phenotype under the optimized conditions in the Tube Method and the strains were classified as highly positive (17, 23.6%), moderate positive (19, 26.3 %) and weakly positive (36, 50.0 %), similarly under the optimized conditions on Congo Red agar medium, biofilm positive phenotype strains were classified as highly positive (23, 23 %), moderate positive (37, 37 %) and weakly positive (40, 40%). While in TCP method, the biofilm positive phenotype strains were also classified as highly positive (6, 6 %), moderate positive (80, 80 %) and weakly positive (14, 14 %), it didn’t not correlate well with the tube method for detecting biofilm formation in E. coli. The rates of antibiotic resistance of biofilm producing E. coli were found to be 100 % for chloramphenicol and amoxyclav (amoxicillin and clavulanic acid), 86% for gentamicin and cefotaxime, 84% for ceftazidime, 83% for cotrimoxazole and piperacillin/tazobactam, 75% for tetracycline and 70% for amikacin. Conclusions: This study reveals the prevalence and antimicrobial susceptibility pattern of biofilm and non-biofilm producing uropathogenic E. coli strains.

220-224

Authors: Shyamapada Mandal, Manisha Deb Mandal, Nishith Kumar Pal

To evaluate the antibacterial activity of Ocimum sanctum (O. sanctum) leaf extract, alone, and in combination with chloramphenicol (C) and trimethoprim (Tm) against Salmonella enterica serovar Typhi (S. typhi). Methods: The antibacterial activity of ethanolic extract of tulsi, O. sanctum, leaf (TLE; 500 毺g) for 23 S. typhi isolates was determined following agar diffusion. The C (30 毺g) and Tm (5 毺g) activity alone and in combination with TLE (250 毺g) was determined by disk diffusion. The zone diameter of inhibition (ZDI) for the agents was recorded, and growth inhibitory indices (GIIs) were calculated. Results: The S. typhi isolates (n=23), which were resistant to both C (ZDI 6 mm) and Tm (ZDI 6 mm), had TLE (500 毺g) ZDIs 16-24 mm. The ZDIs of C and Tm were increased up to 15-21 mm and 17-23 mm, respectively, when TLE (250 毺g) was added to the C and Tm discs. The GIIs ranged 0.789-1.235 and 0.894-1.352, due to combined activity against S. typhi isolates, of C and TLE and Tm and TLE, respectively. Conclusions: The data suggest that TLE, in combination with C and Tm, had synergistic activity for S. typhi isolates, and hence O. sanctum is potential in combating S. typhi drug resistance, as well promising in the development of non-antibiotic drug for S. typhi infection.

231-233

Authors: Ze-You Li, Yong Wang, Wen-Tao Shen, Peng Zhou

To determine the content of benzyl glucosinolate (BG) in the pulp and the seed and investigate the anti-cancer activity of its hydrolysis product in Carica papaya L. Methods: Determination of BG was performed on an Hypersil BDS C18 column at the wavelength of 214 nm with 0.1% trifluoroacetic acid (TFA) aqueous solution (A) and 0.1%TFA acetonitrile (B) as the mobile phase. In vitro activity test was adopted with cultured human lung cancer H69 cell in vitro to investigate the inhibition rate of cell proliferation of benzyl isothiocyanate (BITC) against H69 cell. Results: The pulp has more BG before the maturation of papaya and it nearly disappeared after papaya matured, while the seed contains BG at every stage. Activity test demonstrated that the a higher concentration of BITC would have better inhibition rate of cell proliferation on H69 cell, and the IC50 was 6.5 毺mol/L. Conclusions: BG also can be produced in the pulp of papaya and it will be stored in the seed after the fruit has been matured. The hydrolysis product of BG has certain cancer-prevention anti-cancer activities for human.

243-248

Authors: Pan Wei, Ming Liu, Yan Chen, De-Cai Chen

To clarify the effect of soy isoflavones on prevention of osteoporosis, and the effective dosage of soy isoflavones and its duration. Methods: Random control trials that investigated the association of soy isoflavones and osteoporosis were included in the meta-analysis by researching MEDLINE, EMBASE and the Chinese Biomedical Database up to October 2011. The RevMan software was used for all of the statistical analysis. Results: The present meta-analysis found that soy isoflavones significantly increased the bone mineral density by 54% and decreased the bone resorption marker urinary deoxypyridinoline (DPD) by 23% compared to baseline in women. Using random effects model, the effect of isoflavones on bone mineral density (BMD) regarding menopausal status and isoflavone dose revealed higher weighted mean difference changes were found in postmenopausal women and isoflavone dose above 75 mg/d. Subgroup analysis of trials with menopausal status, supplement type, isoflavone dose and intervention duration that used soy isoflavone extracts resulted in significant different overall effect of DPD using by random effects model. Sensitivity analysis indicated that the effect of soy isoflavones on BMD and DPD was robust. Conclusions: The present meta-analysis reveals that soy isoflavone supplements significantly increase bone mineral density and decrease the bone resorption marker urinary DPD. It shows no significant effect on bone formation markers serum bone alkaline phosphatase. The significant effect of soy isoflavones on BMD and urinary DPD is relative to menopausal status, supplement type, isoflavone dose and intervention duration.