Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Dr Bhanu K Bhakhri

"The Journal of Clinical and Diagnostic Research (JCDR) has been in operation since almost a decade. It has contributed a huge number of peer reviewed articles, across a spectrum of medical disciplines, to the medical literature.
Its wide based indexing and open access publications attracts many authors as well as readers
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Faculty, Pediatric Medicine
Super Speciality Paediatric Hospital and Post Graduate Teaching Institute, Noida
On Sep 2018




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Department of Dematolgy,
Believers Church Medical College,
Thiruvalla, Kerala
On Sep 2018




Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."



Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018




Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."



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Professor and Head
Department of Pathology
Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018




Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
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I wish JCDR a great success and I hope that journal will soar higher with the passing time."



Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
Lucknow
On Sep 2018




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Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata




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Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
Muzaffarnagar.
On Aug 2018




Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".



Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
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Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".



Dr. Mamta Gupta
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018




Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.


Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."



Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011

Important Notice

Experimental Research
Year : 2010 | Month : October | Volume : 4 | Issue : 5 | Page : 3298 - 3303

Evaluation Of The Antidiarrhoeal Activity Of The Leaves Of Ixora Coccinea Linn. In Rats

YASMEEN M*, PRABHU B**, AGASHIKAR N V***

*M.D. Pharmacology, Professor, ** M.Sc. Pharmacology, Lecturer, *** M.D. Pharmacology, Retired Professor

Correspondence Address :
*M.D. Pharmacology, Professor, ** M.Sc. Pharmacology, Lecturer, *** M.D. Pharmacology, Retired Professor

Abstract

Purpose:Ixora coccinea Linn (Rubiaceae), a small shrub which is cultivated throughout India, has been reported to possess a number of medicinal properties. The purpose of the present study was to evaluate the antidiarrhoeal activity of the aqueous extract of the leaves of Ixora coccinea linn which is used traditionally as folk medicine by using a castor oil induced diarrhoea model.
Methods: The aqueous extract of the leaves of Ixora coccinea were studied against a castor oil induced diarrhoea model in rats. The gastrointestinal transit rate was expressed as the percentage of the longest distance which was traversed by the charcoal, divided by the total length of the small intestine. The weight and the volume of the intestinal content induced by castor oil were studied by the enteropooling method. Loperamide was used as a positive control.
Result: The plant-extract showed significant (P<0.001) inhibitor activity against castor oil induced diarrhoea and castor oil induced enteropooling in rats at the dose of 400 mg/kg. There was significant reduction in gastrointestinal motility by the charcoal meal test in rats.
Conclusion: The results obtained by this study substantiate the antidiarrhoeal effects of the aqueous extract and its use by the traditional practitioners in the treatment of diarrhoea.

Keywords

Antidiarrhoeal activity, Ixora coccinea linn. Traditional medicine, castor oil induced diarrhoea, Enteropooling method, small intestinal transit.

Introduction
Millions of people in developing countries use herbal medicines because they are locally available and are prescribed by traditional practitioners of medicines who are a part of their community. Diarrhoea is a common and a potentially serious illness of early childhood. It is one of the major determining factors leading to malnutrition as the principal cause of death, if left untreated without proper medication, especially in developing countries.

Diarrhoea is defined by the WHO as having 3 or more loose or liquid stools per day, or as having more stools than is normal for that person. According to the World Health Report, diarrhoea is the cause of 3.3% of all deaths. The worldwide distribution of diarrhoea accounts for more than 5-8 million deaths each year in children less than 5 years. The use of traditional medicine to combat the consequences of diarrhoea has been emphasized by the WHO in its diarrhoea control programme (CDD) (1)(2)(3)(4)(5)(6).The approach towards evaluating medicinal plants has been based on the chemical extraction of plants which are then tested on various experimental models. Morphine, quinine, emitine, digitalis glycosides, ergot alkaloids and vinca alkaloids which are in wide use today, were originally obtained from plants. Several studies have shown the beneficial effects of traditional medicines in diarrhoea.(7)(8)(9)(10).

Ixora Coccinea Linn. is a small shrub which is cultivated throughout India.(Flame of Woods in English, Rangan in Hindi and Bengali, Kisukare in Kannada.) Its roots and flowers are used for dysentery, dysmenorrhea, leucorrhoea, haemoptysis and catarrhal bronchitis. The leaves are used for diarrhoea. Its roots are also used for hiccups, nausea and loss of appetite and externally for the treatment of sores, eczema and chronic ulcers. Its roots contain an aromatic acrid oil, tannin and fatty acids. Its leaves yield flavonol, kaemferol, quercetin, proanthrocyanidines, phenolic acids and ferulic acids. Its flowers yield cyanidins, flavonol and cooling materials which are related to quercitin.(11)(12)(13)(14)(15). Its roots are ground into pulp, mixed with water and are used as tincture is used for diarrhoea and dysentery [11-15]. However, there is limited scientific evidence to verify these claims.

Hence, the present study was undertaken to evaluate the possible antidiarrhoeal activity of the leaf extract of Ixora Coccinea Linn which is used commonly in Indian traditional medicine, by using various validated models and to find out if the folk medicinal use has a scientifically justified basis.

Material and Methods

Plant material
The leaves which were used for the study were collected from the Belgaum District of Karnataka in the month of November-December. The plant was authenticated by Prof: A. P. Kore, Dept of Botony, R.L.S. College, Belgaum. The voucher specimen of the plant has been deposited at the college for further reference.

After collecting the leaves, they were dried under shade for a period of four weeks. After drying, they were finely powdered. Cold extracts of the leaves were prepared according to the method described by Rawlins (16). The powder was dissolved in water in the ratio of 1:3 (250mg of powder in 750ml of distilled water (17) and this mixture was shaken three to four times a day, for a period of seven days. After filtration, the filtrate was concentrated and dried under reduced pressure. The extract was brown in colour, in a semisolid form and the yield was 18.6% (w/w). The extract was stored in desiccators until use.

Animals used
Albino Wistar rats of either sex, weighing 150-200gm, were used. They were housed in standard polypropylene cages under room temperature (24 ± 2˚C) and were exposed to 12:12 h light and dark cycles. The rats were fed with a standard diet (Gold Mogr Lipton India Ltd.) and water ad libitum. The study protocol was approved by the Institutional animal ethical committee (reg.no.627/02/a CPCSEA) of Ethical committee IAEC- Jawaharlal Nehru Medical College, Belgaum.

Phytochemical screening
The freshly prepared extract was subjected to a standard phytochemical screening test for various constituents (Trease and Evans, 1993) (18).The extract was screened for alkaloids, glycosoids, tannins, saponins, sterols and flavanoids.

Castor oil induced diarrhoea
This was studied by the method described by Niemegeers et al (19). The animals were kept in fasting for 24hrs before the test, with free access to water. The rats were divided into five groups of six animals each. Diarrhoea was induced by administering 1ml of castor oil orally. Group I was taken as the control (2ml/kg, i p saline), Group II which received loperamide (5mg/kg), served as the standard and Groups III, IV and V received the extract (100, 200 and 400mg/kg i p) 1hr before castor oil administration. The consistency of the faecal matter and a number of both wet and dry diarrhoeal droppings were counted every hour for a period of 4hrs.

Castor oil induced enteropooling
Intra luminal fluid accumulation was determined by the method of Robert et al (1976) (20), and Dicarlo et al (1994) (21). The rats were divided into five groups of six animals each and they were kept in fasting overnight, but were allowed free access to water. Group I was treated as the control (2ml/kg i p saline) and Group II which received loperamide (5mg/kg ip) was treated as the standard. Groups III, IV and V received the extract (100, 200, and 400mg/kg ip). Then, 1hr later, 2ml of castor oil was administered orally to the above groups for induction of diarrhoea. Two hours later, the rats were sacrificed, their small intestines were ligated at both the pyloric sphincter and the ileocaecal junction and they were dissected. Their small intestines were weighed. Then intestinal contents were collected by milking into a graduated tube and thus, the volume was measured. The intestines were reweighed and the difference between the full and the empty intestines was calculated.

Small intestinal transit
The method described by Jansen and Jageneau was used (22). The rats were kept in fasting for 18 hrs and were divided into six groups of six animals each. Group I received 2ml/kg of normal saline orally. Group II received 2ml of castor oil orally with 2ml/kg of normal saline intraperitoneally. Group III received loperamide (5mg/kg, ip) and Groups IV, V, and VI received 100, 200 and 400 mg/kg of the plant extract intraperitoneally, 1hr before the administration of castor oil. 1ml of marker (10% charcoal suspension in 5% gum acacia) was administered orally, 1hr after the castor oil treatment. The rats were sacrificed after 1hr and the distance travelled by the charcoal meal from the pylorus to the caecum was measured and was expressed as the percentage of the whole length of the intestine.

Statistical analysis
The experimental results were represented as mean± SE (standard error of mean). Student’s t- test was used for the evaluation of the data and P values < 0.05 were considered as significant.

Results

Castor oil induced diarrhoea
Diarrhoea was apparent in all the animals of control group, thirty minutes after the administration of castor oil, for the next 4hrs. This was largely eliminated by the intraperitoneal injection of 5 mg /kg (48.12%) loperamide.

(Table/Fig 1) The effect of the extract was not as potent as loperamide in the dose of 100 mg/kg, but in the doses 200 mg/kg and 400 mg/kg, the extract produced a significant dose dependent reduction in the number of defection over four hours (P<0.001).
(Table/Fig 1):Effect of aqueous extract of leaves of Ixora coccinea on castor oil induced diarrhoea in rats

Extract was administrated i.p , 1 hour before castor oil administration. Values are expressed as mean ± SEM from the experiments. * P <0.01, ** P <0.001 when compared with castor oil + saline treated group.

Castor oil induced enteropooling
Castor oil caused the accumulation of water and electrolytes in the intestinal loop. The treatment with the extract (100,200 and 400 mg/kg) produced a significant and dose dependent reduction in the intestinal weight and volume (Table/Fig 2). Significant results (P values < 0.001) were observed with doses of 200 and 400 mg/ kg.

(Table/Fig 2):Effect of aqueous extract of leaves of Ixora coccinea on castor oil induced enteropooling in rats.

Extract was administrated i.p , 1 hour before castor oil administration. Values are expressed as mean ± SEM from the experiments. * P <0.01, ** P <0.001 when compared with castor oil + saline treated group

Small intestinal transit
The aqueous extract of Ixora coccinea decreased the propulsion of the charcoal meal through the gastrointestinal tract significantly as compared to the control group. Loperamide (5mg/kg) produced a marked decrease in the propulsive movement and the intestinal length travelled by charcoal. (100,200 and 400 mg/kg) produced a significant and dose dependent reduction in the intestinal weight and volume (Table/Fig 3).

Table 3:Effect of extract of of leaves of Ixora coccinea on Castor oil induced small intestinal transit in rats.

Extract was administrated i.p , 1 hour before castor oil administration. Values are expressed as mean ± SEM from the experiments. * P <0.01, ** P <0.001 when compared with castor oil + saline treated group.

Discussion

The results of this study suggest that the aqueous extract of the leaves of Ixora coccinea in graded doses of 100, 200 and 400 mg /kg of body weight, reduced diarrhoea by inhibiting intestinal motility, intestinal fluid accumulation and by significantly reducing the frequency of defaecation. This signifies the use of the aqueous extract of Ixora coccinea as folk medicine.

Castor oil is known to produce changes in the intestinal mucosal permeability to electrolytes and water, thus leading to diarrhoea (23),(24). The antidiarrhoeal activity of this extract may be due to one of these mechanisms.

a) The extract may increase the reabsorption of NaCl and water by decreasing the intestinal motility by the charcoal meal. b) The presence of tannins in the extract may make the intestinal mucosa more resistant and may reduce the secretion (25),(26). Tannic acid and tannins are water soluble polyphenols that are present in many plants (27). c) The liberation of recinoleic acid by castor oil results in the irritation and the inflammation of the intestinal mucosa, thus leading to the release of prostaglandins (28),(29). The extract may reduce prostaglandin secretion. d) Flavoniods and alkaloids are known to inhibit the release of autocoids and prostaglandin, thereby inhibiting the secretion induced by castor oil (30),(31). The phytochemical analysis of the aqueous extract of Ixora coccinea showed the presence of flavonoids, alkaloids and tannins. The antidiarrhoeal and antidysentric properties of medicinal plants were found to be due to the presence of tannins, alkaloids, saponins, flavonoids, sterols and reducing sugars (32). Sesquiterpenes, diterpenes, terpenes, flovonoids and terpenoid derivatives are known to inhibit the release of autocoids and prostaglandis, thereby inhibiting the motility and the secretion induced by castor oil (33),(34).Loperamide, a synthetic opiate analogue, regulates the gastrointestinal tract by inhibiting the propulsive motor activity, predominantly in the jejunum and this effect is partially inhibited by an opiate antagonist. Loperamide is also reported to reduce the colonic rate of flow and to consequently increase colonic water absorption, but it does not have an effect on colonic motility (35).

This study has intentionally been undertaken by using a crude aqueous extract, as it is our belief that the different biological activities assayed herein, may not be due to a single constituent. This has also been highlighted by Mayer Manga et al (36), who have stated that the crude extracts contain several compounds acting on different mechanisms. In addition, the interplay of the constituents in the crude extract may result in better activity due to synergism or may lead to a decrease in toxicity and it is possible that pure compounds may not necessarily behave in the same manner as the natural extracts (37),(38)

To conclude, the present study supports the claims made by traditional medical practitioners about the use of the aqueous extract of Ixora coccinea Linn. in the treatment of diarrhoea. The active constituent which is responsible for the antidiarrhoeal activity remains to be identified and further studies are required to understand the mechanism of action of the antidiarrhoeal activity of Ixora coccinea Linn.

Conclusion

The results of this study suggest that the aqueous extract of the leaves of Ixora coccinea in graded doses of 100, 200 and 400 mg /kg of body weight, reduced diarrhoea by inhibiting intestinal motility, intestinal fluid accumulation and by significantly reducing the frequency of defaecation. This signifies the use of the aqueous extract of Ixora coccinea as folk medicine.

Castor oil is known to produce changes in the intestinal mucosal permeability to electrolytes and water, thus leading to diarrhoea (23),(24). The antidiarrhoeal activity of this extract may be due to one of these mechanisms.

a) The extract may increase the reabsorption of NaCl and water by decreasing the intestinal motility by the charcoal meal. b) The presence of tannins in the extract may make the intestinal mucosa more resistant and may reduce the secretion (25),(26). Tannic acid and tannins are water soluble polyphenols that are present in many plants (27). c) The liberation of recinoleic acid by castor oil results in the irritation and the inflammation of the intestinal mucosa, thus leading to the release of prostaglandins (28),(29). The extract may reduce prostaglandin secretion. d) Flavoniods and alkaloids are known to inhibit the release of autocoids and prostaglandin, thereby inhibiting the secretion induced by castor oil (30),(31). The phytochemical analysis of the aqueous extract of Ixora coccinea showed the presence of flavonoids, alkaloids and tannins. The antidiarrhoeal and antidysentric properties of medicinal plants were found to be due to the presence of tannins, alkaloids, saponins, flavonoids, sterols and reducing sugars (32). Sesquiterpenes, diterpenes, terpenes, flovonoids and terpenoid derivatives are known to inhibit the release of autocoids and prostaglandis, thereby inhibiting the motility and the secretion induced by castor oil (33),(34).Loperamide, a synthetic opiate analogue, regulates the gastrointestinal tract by inhibiting the propulsive motor activity, predominantly in the jejunum and this effect is partially inhibited by an opiate antagonist. Loperamide is also reported to reduce the colonic rate of flow and to consequently increase colonic water absorption, but it does not have an effect on colonic motility (35).

This study has intentionally been undertaken by using a crude aqueous extract, as it is our belief that the different biological activities assayed herein, may not be due to a single constituent. This has also been highlighted by Mayer Manga et al (36), who have stated that the crude extracts contain several compounds acting on different mechanisms. In addition, the interplay of the constituents in the crude extract may result in better activity due to synergism or may lead to a decrease in toxicity and it is possible that pure compounds may not necessarily behave in the same manner as the natural extracts (37),(38)

To conclude, the present study supports the claims made by traditional medical practitioners about the use of the aqueous extract of Ixora coccinea Linn. in the treatment of diarrhoea. The active constituent which is responsible for the antidiarrhoeal activity remains to be identified and further studies are required to understand the mechanism of action of the antidiarrhoeal activity of Ixora coccinea Linn.

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