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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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