THE EFFICACY OF TSAANG GUBAT (Ehretia microphylla Lam) DECOCTION AS AN ANTI- DIARRHEAL AGENT VERSUS...

THE EFFICACY OF TSAANG GUBAT (Ehretia microphylla Lam) DECOCTION AS AN ANTI-DIARRHEAL AGENT VERSUS ATROPINE SULFATE

GROUP 2A

BUDAO, Cherry Pinky M.BAŇAREZ, Karla Kristel A.BAQUIRAN, Jessica Aevan U.BASMAYOR, Edwin Marlon C.BASTE, Charisse Liz P.BAUTISTA, Jose Antonio L.BEESLA, Sundeep Kaur B.BELMONTE, Carlo AlphonsoBONDOC, Hidelisa E.BORROMEO, Christian Leo P.BRION, Marco Alberto C.BUENSALIDA, Rainier John BULAONG, Marie Veronica G.BUMANGLAG, Niña M.BURGO, Terence Aaron L.BUŇAG, Mark Chester Victor T.CACDAC, Maybelle ChrisCAMACLANG, Marie Len A.CANADALLA, Kristine Joyce L.CAOILI, Sylvia Nica J.CASTILLO, Maria Carmella P.CHAN, Jose Carlos A.CHAVEZ, Frances Joy T.

INTRODUCTION

ABSTRACT

Diarrhea

↑ stool mass, ↑ stool frequency, ↑ stool fluidity

> 200 gm/da severe: > 14 L/da w/o fluid resuscitation: death

increase in stool features

acute: > 2 wks persistent: 2-4 wks chronic: > 4 wks

Agents / Factors:

Escherichia coli Campylobacter jejuni Shigella spp. Aeromonas spp.

side effects from medications i.e. antibiotics, bronchodilators, antacids, laxatives

assoc DO: lactose intolerance, IBS

PATHOGENESIS

Other Assoc'ns

ingestion of poisonous substances e.g. organophosphate insecticides

amanita and other mushrooms arsenic cpds preformed environmental toxins

PATHOGENESIS

APPROACH TO DIARRHEA

fluid and electrolyte replacement

oral rehydration solutions : replace lost fluids

antibiotics : elimination of any causative agent

elimination of dietary lactose : suppressing the underlying mechanism

mild opiate i.e. Loperamide® : cases of mild to moderate diarrhea

LOCAL HERBAL MEDICATIONS

primary health care

increasing cost

found to be effective in tx of common ailments attested by the NSDB

advocated by the DOH

“Tsaang Gubat”

Ehretia microphylla Lam. tx: diarrhea, stomachache

BACKGROUND OF THE STUDY

to determine the efficacy of “Tsaang Gubat” as an alternative anti-diarrheal drug

tested along with Atropine Sulfate and Normal Saline Solution

“Tsaang Gubat” as effective as Atropine, as a very good alt drug for diarrheal cases in poverty-stricken communities due to lack of funds for purchasing expensive anti-diarrheal drugs

STATEMENT OF THE PROBLEM Philippines is the second largest contributor to diarrhea

morbidity in the world, next to China.

DOH and UNICEF:

over 70,000 Filipino children die span of 7 years

WHO:

fourth leading cause of death among children ≤ 4 y.o.

third leading cause of death among Filipino children Philippines ranks second among 13 countries with most

number of diarrhea cases

OBJECTIVE

to determine the effectiveness of Tsaang Gubat, one of the 10 herbal medicines launched by the DOH as an anti-diarrheal medication, compared to the standard drug, Atropine

1) By using the test drug Tsaang Gubat, was the distance travelled by the charcoal meal shortened?

2) Is Tsaang Gubat for treatment of diarrhea?

3) Is Tsaang Gubat as effective as the standard drug, Atropine, for the treatment of diarrhea?

SIGNIFICANCE OF THE STUDY

trend of utilizing medicinal plants from treating common ailments (e.g. colds) to extreme cases (e.g. cancer)

more scientific tests conducted to verify the efficacy

commonly advocated by our forefathers and our neighborhood albularios

government introduced several programs aimed at promoting and further developing this to bolster the health care sector

SIGNIFICANCE OF THE STUDY

Tsaang Gubat

one of the herbal medicines listed in “Sampung Halamang Gamot” program in the early 1990's

shrub commonly found in the Philippines endorsed as anti-spasmodic for abdominal pains and

for other GI DO (diarrhea, dysentery) listed in the BFAD as medicinal plant

SCOPE AND LIMITATION limited to the effects of the medicinal plant in decreasing

intestinal motility = beneficial of diarrhea or LBM

no other forms of treatment for diarrhea or LBM have been included

Normal Saline Solution has no known effect on GI motility

Atropine is a known muscarinic (cholinergic) blocker = inhibits GI motility

SCOPE AND LIMITATION (con't)

starved mice of the same sex and about the same weight as subjects = prevent bias d/t diff in sex and wt

starvation so as not to affect drug absorption and prevent any obstruction in the GIT for the charcoal sol'n

SCHEMATIC DIAGRAM

METHODOLOGY

% distance travelled as indicator of anti-diarrheal activity

parameter measured is the length of the small intestine travelled by the charcoal

METHODOLOGY Male and female albino mice obtained from UERM

day prior to the expt, mice were placed in wire meshed cages, given standard pellet diet and water

experimentation carried out accdg to the IAEC guidelines

mice were weighed and labeled for proper ID

divided into three groups:

Positive Control (Atropine Sulfate) Negative Control (Normal Saline Solution) Test Drug (“Tsaang Gubat”)

METHODOLOGY (con't) 9 mice in total; 3 mice per group

Negative control: Normal Saline Solution via gavage 0.5 mL/kg orally

Positive control: Atropine Sulfate via gavage 10mg/kg

Test drug: Ehretia microphylla Lam. (Tsaang Gubat”) extract via gavage 10g/kg orally

METHODOLOGY (con't)

Charcoal sol'n

10 gm charcoal mixed with 100 mL castor oil 20 mL of charcoal-castol oil suspension then mixed

with 10 mL coconut oil suspension stirred constantly to obtain uniform

suspension

METHOLODOGY (con't)

2 kg dried leaves of “Tsaang Gubat” chopped into small pieces, consequently boiled in 1L of distilled water for 8 hrs

boiled after filtering using filter paper, collected in a beaker

repeated twice until dark-brown extract was obtained

refrigerated for 1 hr prior to the expt

METHODOLOGY

ANIMATION OF METHODOLOGY

COLLECTION OF DATA

20 mins after, mice were sacrificed

intestines were excised (from pylorum to cecum)

distance travelled by activated charcoal measured and recorded corresponding to the different doses administered

total length was also measured

Percentage Distance = Activated charcoal___ X 100

Total length of intestine

ANALYSIS OF DATA

weight of the rat

dose of drug administered

length of intestine

charcoal distance

length of the small intestine travelled by the charcoal

percent of distance travelled

= Length travelled by activated charcoal x 100

total length of intestine

RESULTS AND DISCUSSION

RESULTS AND DISCUSSION

Group Statistics

18 23.2267 23.85315 5.62224

18 46.6561 22.05226 5.19777

DRUGSatropin

NSS

DISTRAN Mean Std. Deviation

Std. ErrorMean

Table 1.0. Mean and Standard Deviation of the Percentage of DistanceTravelled by Charcoal with administration of Atropine and NormalSaline Solution

Distance Travelled by Charcoal

Independent Samples Test

.249 .621 -3.060 34 .004 -23.4294 7.65679 -38.98991 -7.86898

-3.060 33.793 .004 -23.4294 7.65679 -38.99343 -7.86546

Equal variancesassumed

Equal variancesnot assumed

DISTRAF Sig.

Levene's Test forEquality of Variances

t df Sig. (2-tailed)Mean

DifferenceStd. ErrorDifference Lower Upper

95% ConfidenceInterval of the

Difference

t-test for Equality of Means

RESULTS AND DISCUSSION

Table 2.0. T-test Values for the Individual Samples in the Positive ControlGroup and the Negative Control Group

RESULTS AND DISCUSSIONTable 3.0. Mean and Standard Deviation of the Percentage of Distance

Travelled by Charcoal with administration of Tsaang Gubat andNormal Saline Solution

Group Statistics

18 31.3539 15.68023 3.69587

18 46.6561 22.05226 5.19777

DRUGStsaang

NSS

DISTRAN Mean Std. Deviation

Std. ErrorMean

Distance Travelled by Charcoal

Independent Samples Test

1.313 .260 -2.399 34 .022 -15.3022 6.37779 -28.26345 -2.34099

-2.399 30.690 .023 -15.3022 6.37779 -28.31513 -2.28931

Equal variancesassumed

Equal variancesnot assumed

DISTRAF Sig.

Levene's Test forEquality of Variances

t df Sig. (2-tailed)Mean

DifferenceStd. ErrorDifference Lower Upper

95% ConfidenceInterval of the

Difference

t-test for Equality of Means

Group Statistics

18 31.3539 15.68023 3.69587

18 23.2267 23.85315 5.62224

DRUGStsaang

atropin

DISTRAN Mean Std. Deviation

Std. ErrorMean

Distance Travelled by Charcoal

Independent Samples Test

3.028 .091 1.208 34 .235 8.1272 6.72823 -5.54618 21.80062

1.208 29.381 .237 8.1272 6.72823 -5.62581 21.88025

Equal variancesassumed

Equal variancesnot assumed

DISTRAF Sig.

Levene's Test forEquality of Variances

t df Sig. (2-tailed)Mean

DifferenceStd. ErrorDifference Lower Upper

95% ConfidenceInterval of the

Difference

t-test for Equality of Means

RESULTS AND DISCUSSION

Mouse 1: 10 cm distance (27% of the total intestinal length of 36 cm)

Mouse 2: 12 cm distance (30% of the total intestinal length of 40 cm)

Mouse 3: 18 cm distance (50% of the total intestinal length of 36 cm)

RESULTS AND DISCUSSION

Treatment Dose % Distance TraveledAtropine Sulfate 10 mg/kg 27.7Norrmal Saline Solution 0.5 mL/kg 30Tsaang Gubat 10 g/kg 50

CONCLUSION

Negative Ctrl Grp (NSS)

isotonic solution; same conc as body cells; N physiologic conditions in the intestine

ACTUAL: shorter % distance travelled in the intestine THEORETICAL: longer % distance travelled in the

intestine

Atropine Sulfate

antimuscarinic / anticholinergic agent competitive antagonist of Ach on the muscarinic

receptor ↓ GI motility & secretion ACTUAL: longer % distance travelled in the intestines THEORETICAL: shorter % distance travelled in the

intestine

RECOMMENDATIONS

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