Journal of Health and Medical Sciences
Published: 06 April 2020
Emblica Officinalis (Amloki) – Could Be the Remedy for Side Effects of Iron Supplementation in Pregnancy
Tahmina Akter,Qazi Shamima Akhter, Saima Haque Lisa, Mst. Ariza Sultana, Tamanna Binte Habib, Farhana Sultana, Sharmin Nahar, Sayeda Tasnim Kamal, Farhana Rahman, Sharmin Khan
Dhaka Medical College and Hospital (Bangladesh), Parkview Medical College and Hospital (Bangladesh), National Institute of Neurosciences and Hospital (Bangladesh), Dhaka Community Medical College (Bangladesh), Moinamoti Medical College (Bangladesh)
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Keywords: Iron Deficiency Anaemia, Pregnancy, Amloki, Constipation, Acidity
Background: Iron deficiency anemia (IDA) is the most common nutritional disorder in pregnancy in developing countries. Different iron preparations are supplemented to treat IDA in pregnancy, which can lead to different side effects like nausea, vomiting, decreased appetite, constipation or diarrohea, hyperacidity. Emblica officinalis is a well known traditional fruit to reduce these side effects. Aim: To determine the side effects of iron supplementation and beneficial role of amloki in pregnancy to reduce these side effects.Methods and materials: This interventional study was done in the Department of Physiology, Dhaka Medical College, Dhaka from July 2016 to June 2017. From the Outpatient Department of Obstetrics and Gynaecology, Dhaka Medical College and Hospital, 46 pregnant women were selected purposively on the basis of inclusion and exclusion criteria. Anaemic pregnant women supplemented with oral iron and amloki were considered as study groups (Group A) and pregnant women supplemented with only iron for 45 days were considered as control group (Group B). A previously formed structured questionnaire was used to evaluate the subjective complaints. Chi-square test was performed to compare between the groups. The test of significance was calculated & p value < 0.05 was accepted as level of significance. Results: Significant improvement in different subjective parameters nausea, vomiting, decreased appetite, constipation, hyperacidity (p<0.001), were seen in iron and amloki supplemented group. Conclusions: It can be concluded that, amloki supplementation along with iron can reduce the side effects of iron and improve the subjective complains of the iron deficient anemic pregnant women.
- Acharya J, Punchard NA, Taylor JA, Thompson RP, Pearson TC. Red cell lipid peroxidation and antioxidant enzymes in iron deficiency. Eur J Haematol 1991; 47(4): 287-91.
- Binkoski AE, Kris-Etherton PM, Beard JL. Iron Supplementation Does Not Affect the Susceptibility of LDL to Oxidative Modification in Women with Low Iron Status. J Nutr 2004; 134: 99–103.
- Brunner HI, Johnson AL, Barron AC, Passo MH, Griffin TA, Graham TB, Lovell DJ: Gastrointestinal symptoms and their association with healthrelated quality of life of children with juvenile rheumatoid arthritis: validation of a gastrointestinal symptom questionnaire. J Clin Rheumatol 2005; 11:194–204
- Chen Q, Le GW, Shi YH, Zhang SM, Jin X. Effect of iron supplementation on intestinal function and oxidative stress in piglets with induced colitis. J Animal Feed Sciences 2007; 16: 205–13
- de Jesus NZT, Falcao HS, Gomes IF, Leite TJAL, Lima GRM et al. Tanin, peptic ulcers and related mechanisms. Int. J. Mol. Sci. 2012, 13: 3203-3228. Doi: 10.3390/ijms 13033203
- Dostal A, Chassard C, Hilty FM, Zimmermann MB, Jaeggi T, Rossi S, Lacroix C:Iron depletion and repletion with ferrous sulfate or electrolytic iron modifies the composition and metabolic activity of the gut microbiota in rats. J Nutr 2012; 142:271–277.
- Erichsen K, Ulvik RJ, Grimstad T, Berstad A, Berge RK, Hausken T: Effects of ferrous sulphate and non-ionic iron-polymaltose complex on markers of oxidative tissue damage in patients with inflammatory bowel disease.Aliment Pharmacol Ther 2005; 22:831–838.
- Evans P, Halliwell B: Micronutrients: oxidant/antioxidant status. Br J Nutr2001; 85(Suppl 2):S67–S74.
- Ferreira ALA, Machado PEA, Matsubara LS. Lipid peroxidation, antioxidant enzymes and glutathione levels in human erythrocytes exposed to colloidal iron hydroxide in vitro. Braz J Med Biol Res 1999; 32(6): 689-94
- Festin M, Nausea and vomiting in early pregnancy.Clinical Evidence 2009; 06:1405. Doi: https://www.researchgate.net/publication/24438790
- Foster JM, van der Molen T, Caeser M, Hannaford P: The use of questionnaires for measuring patient-reported side effects of drugs: its importance and methodological challenges. Pharmacoepidemiol Drug Saf 2008; 17:278–
- Gambling L, Andersen HS, Czopek A, Wojciak R, Krejpcio Z, McArdle HJ. Effect of timing of iron supplementation on maternal and neonatal pregnant rats. J Physiol 2004; 561 (15): 195-203.
- Garshasbi A, Ghazanfari T, Zayeri F, Kamali M, Maternal serum levels of interleukin-6 and β-hCG in women with hyperemesis gravidarum in the first trimester of pregnancy. Journal of Basic and Clinical Pathophysiology 2017; 5(1): 13-18
- Hutchinson C, Al-Ashgar W, Liu DY, Hider RC, Powell JJ, Geissler CA: Oral ferrous sulphate leads to a marked increase in pro-oxidant nontransferrin- bound iron. Eur J Clin Invest 2004; 34:782–784.
- Idoate Gastearena MA, Gil AG, Azqueta A, Coronel MP, Gimeno M: A comparative study on the gastroduodenal tolerance of different antianaemic preparations. Hum Exp Toxicol 2003; 22:137–141.
- Isler M, Delibas N, Guclu M, Gultekin F, Sutcu R, Bahceci M, et al. Superoxide dismutase and glutathione peroxidase in erythrocytes of patient with iron deficiency anemia: effects of different treatment modalities. Croat Med J 2002; 43(1):16-19.
- Jansson LT, Perkkiö MV, Willis WT, Refino CJ, Dallman PR. Red cell superoxide dismutase is increased in iron deficiency anemia. Acta Haematol 1985; 74(4): 218-21
- Jeong JJ, Choi MG, Cho YS, Lee SG, Oh JH, Park JM, Cho YK, Lee IS, Kim SW, Han SW, Choi KY, Chung IS: Chronic gastrointestinal symptoms and quality of life in the Korean population. World J Gastroenterol 2008; 14:6388–6394.
- Khot BM, Patil AJ, Kakad AC. Comparative clinical study of dhatri lauha and navayasa lauha in garbhini panduroga with reference to anemia in pregnancy. Int Org Sci Res J Dental Med Sci 2013; 11(1): 28-33.
- Klemn RDW, Sommerfelt AE, Boyo A, Barba C, Kotecha P, Steffen M, Franklin N. 2011. Are we making progress on reducing anemia in women? [Internet] Washington: United States Agency for International Development; [Cited 2017 Jan o9] Available from: http://www.a2zproject.org/pdf/ReducingAnemia_low_res_06212011.pdf
- Layeeq S, Thakar AB. Clinical efficacy of amloki rasayana in the management of pandu (iron deficiency anemia). Ayu 2015; 36(3): 290-297.
- Lund EK, Wharf SG, Fairweather-Tait SJ, Johnson IT. Oral ferrous sulfate supplements increase the free radicalgenerating capacity of feces from healthy volunteers. Am J Clin Nutr 2003; 78(3): 498.
- Lutsey PL, Dawe D, Villate E, Valencia S, Lopez O: Iron supplementation among pregnant women in Bicol, Philippines. Public Health Nutr 2008; 11:76–82.
- Muthuraman A, Sood S, Singla SM. The anti-inflammatory potential of phenolic compounds from Emblica officinalis L. in rat. Inflammopharmacol 2011; 19:327. DOI: 10.1007/s10787-010-0041-9
- Nirali JB, Shankar MB. An observational clinical study of navayasa lauha tablets w.s.r to Iron Deficiency Anemia. Int J Ayu Pharm Chem 2015; 3(3): 283-291.
- Olivares M, Araya M, Pizarro F, Letelier A. Erythrocyte Cu- Zn superoxide dismutase activity is decreased in irondeficiency anemia. Biological Trace Element Research 2006; 112(3): 193-203.
- Quan C, Talley NJ, Cross S, Jones M, Hammer J, Giles N, Horowitz M:
- Development and validation of the diabetes bowel symptom questionn