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Malaria constitutes one of the biggest health problems in tropical and sub-tropical zones such as Africa, South America, Asia and Southeast Asia including Thailand. It is estimated that 250 million peoples are infected by malaria with about 1 million deaths annually. This disease is caused by protozoa parasite in genus Plasmodium, especially P. falciparum and P. vivax which are major cause of death.
For causes of death by malaria including cerebral malaria, hemolysis and severe anemia, metabolic acidosis, multiple organ failure such as liver and renal, and hypoglycemic shock have been reported. Malaria associated liver and renal damage occur between 2-5% of hospitalized patients with a mortality that can reach up to 45%. The pathogenesis for liver and renal damage induced by malaria is multifactorial and not well characterized, but several hypothesis suggest involvement of cytoadherence of parasitized erythrocytes, proinflammatory response, and damage due to oxidative stress. Moreover, the consumption of hemoglobin by malaria parasites in blood stage of infection gives rise of amounts of free heme that have the ability to induce oxidative stress. In addition, malaria associated hypoglycemia has been reported during malaria infection, and involvement of oxidative stress has also been described. This has prompted research towards the discovery of new drugs with protective effects on organ damage and anti-hypoglycemia. In this respect, plant extracts are potential targets for research and development of the alternative drugs.
In the present study, Andrographis paniculata (Acanthaceae) was selected for evaluation of its activities. The pharmacological properties of A. paniculata leaf extract are well documented and several in vitro and in vivo studies describe its antioxidant, anti-inflammation, anti-cold, anti-hepatotoxicity, anti-nephrotoxicity, antimalarial, antimicrobials, and anti-cancer activities.
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