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Publication history issue online: 28 jul 2006 accepted: april 1999 home list of issues table of contents article abstract journal of obstetric, gynecologic, & neonatal nursing volume 28 issue 5 page 545-553, september 1999 to cite this article: mary ellen rousseau rn, cnm, ms 1999 ; selected hormonal agents in gynecology journal of obstetric, gynecologic, & neonatal nursing 28 5 ; , 545– 55 doi: 1 1111 j 52-690 199 tb0202 x prev article next article welcome to blackwell synergy - the source of highly cited peer-reviewed society journals from blackwell publishing you are attempting to access the pdf of this article. 38. Anuradha CV et al. Taurine attenuates hypertension and improves insulin sensitivity in the fructose fed rat, and animal model of insulin resistance. Can J Physiol Pharm 77: 749-54, 1999. Nakaya Y et al. Taurine improves insulin sensitivity in the Otsuka Long-Evans fatty rat, a model of spontaneous type 2 diabetes. J Clin Nutr 71: 54-8, 2000. Kulakowski EC et al. Hypoglycemic properties of taurine: not mediated by enhanced insulin release. Biochem Pharm 33: 2835-8, 1994 Elizarova EP et al. First human ; experiments in taurine administration for diabetes mellitus: effects on erythrocyte membranes. Adv in Exp Med & Biol 403: 583-8, 1996. Hayes KC et al. Taurine modulates platelet aggregation in cats and humans. J Clin Nutr 49: 1211-6, 1989 Pop-Busui R et al. Depletion of taurine in experimental diabetic neuropathy; implications for nerve metabolic, vascular and functional deficits. Exp Neurol 168: 259-72, 2001. Obrosova IG et al. Taurine counteracts oxidative stress and nerve growth factor deficit in early experimental diabetic neuropathy. Exp Neurol 172: 211-19, 2001. Packer et al. Review: alpha lipoic acid as a biological antioxidant. Free Rad Biol Med 19: 227-50, 1995 Marangon K et al. Comparison of the effect of alpha-lipoic acid and alpha-tocopherol supplementation on measures of oxidative stress Free Rad Biol Med 27: 1114-21, 1999. Xu DP et al. Alpha lipoic acid dependent regeneration of ascorbic acid from dehydroascrobic acid in rat liver mitrochondria. J Bioenerg & Biomem 28: 77-85, 1996. Yaworsky K et al. Engagement of the insulin-sensitive pathway in the stimulation of glucose transport by alpha-lipoic acid in 3T3-L1 adipocytes. Diabetologia 43: 294-303, 2000 Estrada DE et al. Stimulation of glucose uptake by the natural coenzyme alpha lipoic acid. Diabetes 45: 1798-804, 1996. Zeigler D et al. Treatment of symptomatic diabetic polyneuropathy with the antioxidant alphalipoic acid : A 7 month multicenter randomized controlled trial. Diabetes Care 22: 1296-1301, 1999. Ziegler D et al. Treatment of symptomatic diabetic peripheral neuropathy with the antioxidant alpha-lipioc acid ALADIN Study ; . Diabetologia 38: 1425-33, 1995. Jacob S, Ruus P, Hermann R, et al. Oral administration of RAC-alpha-lipoic acid modulates insulin sensitivity in patients with type-2 diabetes mellitus: a placebo-controlled pilot trial. Free Rad Biol Med 27: 309-14, 1999 Konrad T et al. Alph-alipoic acid treatment decreases serum lactate and pyruvate concentrations and improves glucose effectiveness in lean and obese patients with type 2 diabetes. Diabetes Care 22: 280-7, 1999. American Diabetes Association, Diabetes Creates Serious Cardiovascular Risk, In The News, 2002-06-17 and cordarone.
Ropathy were randomly assigned to 100, 600, or 1, 200 mg d of parenteral alphha-lipoic acid or placebo.25 At 3 weeks, of the 260 patients that completed the study, those receiving the 600 and 1, 200 mg d doses of alpha-lipoic acid had statistically significant improvements in pain, paresthesias, and numbness compared with placebo. Improvements at the 1, 200 mg d dose were greater, but this group also reported more adverse effects eg, gastrointestinal upset and headache ; . Glycohemoglobin levels were similar among treatment groups at 3 weeks, indicating that alpha-lipoic acid did not affect glucose control. The ALADIN II study examined the effects of oral alpha-lipoic acid, 600 or 1, 200 mg d, in 65 patients with type 1 and type 2 diabetes and symptomatic polyneuropathy.26 At 2 years, both doses of alpha-lipoic acid showed a statistically significant increase in nerve conduction velocity compared with placebo. Severity of symptoms was not improved, however, based on the Neuropathy Disability Score. The Neuropathy Disability Score measures ankle reflexes, vibration, pinprick, and temperature sensation at the great toe and was developed to screen large populations of patients in epidemiologic studies.29 As a result, the sample size in the ALADIN II study might have been too small to detect significant changes in the Neuropathy Disability Score. Glycohemoglobin levels were similar between groups at the study endpoint. ALADIN III examined the effects of short-term treatment with parenteral alpha-lipoic acid followed by extended treatment with oral alpha-lipoic acid.27 In this multicenter trial, 503 patients with type 2 diabetes and symptomatic peripheral neuropathy were placed in one of three treatment groups: 1 ; 600 mg d parenteral alpha-lipoic acid for 3 weeks, then 1, 800 mg d of oral alpha-lipoic acid for 6 months; 2 ; 600 mg d parenteral alphalipoic acid for 3 weeks, then an indistinguishable oral placebo for 6 months; or 3 ; parenteral placebo for 3 weeks, then oral placebo for 3 months. Neuropathic deficits were significantly reduced in patients receiving parenteral alpha-lipoic acid at 3 weeks. After 6 months of treatment with oral alphalipoic acid, a decrease in neuropathy impairment scores was observed; however, this difference was not significant. At the study endpoint, no significant differences were detected in glycohemoglobin levels or adverse side effects between the treatment groups.

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Of the above : 1. 3, 90, ; Equity Shares of Rs.2 - each were allotted as fully paid bonus shares by capitalisation of Share Premium General reserve. 2. 82, 50, 000 82, 50, 000 ; Equity Shares of Rs.2 - each were allotted to erstwhile shareholders of Gujarat Glass Limited on amalgamation. 3. 88, 67, ; Equity Shares of Rs.2 - each were allotted to erstwhile shareholders of Boehringer Mannheim India Limited on amalgamation. 4. 51, 97, ; Equity Shares of Rs.2 - each were allotted to erstwhile shareholders of Sumitra Pharmaceuticals and Chemicals Limited as per the scheme of arrangement. 5. 3, 75, ; Equity Shares of Rs.2 - each were allotted to erstwhile shareholders of Piramal Healthcare Limited PHL ; as per scheme of arrangement. 6. The erstwhile Piramal Healthcare Limited shareholders held 9, 62, 180 warrants with a right to convert into 75 Equity Shares of the company for every two warrants held on payment of Rs. 10 - in Cash per Equity Share. Out of this 9, 52, 644 ; warrants were converted into 3, 57, 24, ; shares resulting in the Issued and Subscribed Capital increasing by Rs.71.4 Million Rs. 71.4 Million ; . The remaining 9, 536 warrants were cancelled. 7. 1, 57, 000 1, 57, 50, 000 ; Equity Shares of Rs. 2 - each were allotted to the erstwhile Shareholders of Rhone-Poulenc India Limited on its merger with the Company and endep.

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Of opioids. Opioid hyperalgesia may be more important than previously realised. In certain situations with careful consideration some patients benefit by reduction of opioid dose or even detoxification. This may reduce or abolish chronic pain, or give a clearer anatomical focus, with greater variability of pain intensity, and with improved therapeutic response to both pharmacological and non-pharmacological interventions and chlorthalidone and alpha-lipoic, for example, alpha lipoic product. Isolated by biochemists in 1951, alpha-lipoic acid plays a fundamental role in nearly all types of living cells and may be considered essential for life itself. In humans and other mammals, alpha-lipoic acid serves as a component of several key enzyme complexes, including pyruvate dehydrogenase and alpha-ketoglutarate dehydrogenase. These enzymes are required in the "Krebs cycle, " which breaks down carbohydrate molecules and converts them to energy. * Alpha-liloic acid, sometimes referred to as thioctic acid, is found in many foods and is found in spinach, red meat, potato, broccoli, liver, and tomato. It is also synthesized within the body. Alpha-kipoic acid was long considered a growth factor for plants. Beginning in the 1950s, it was used medicinally in Europe to maintain the integrity of liver and nerve cells. It wasn't until the late 1980s that alpha-lipoic acid was recognized as an antioxidant with several unique properties. This discovery accelerated research, human trials, and scientific publications on alpha-lipoic acid and heralded its rapidly growing acceptance among consumers and the medical community. In Germany where alpha-lipoic acid is prescribed, it has a long history of use helping people in certain populations maintain normal nerve function. At high * doses, alpha-lipoic acid helps maintain normal blood sugar balance in certain populations, and it also helps protect the liver and other tissues.
Oxidation during the process of normal metabolism causes extensive damage to DNA, proteins and lipids, which is thought to be a cause of ageing and degenerative disease. The body has numerous natural antioxidant defences, such as ascorbate vitamin C ; and tocopherol vitamin E ; , and these help to limit the levels of reactive oxidants and the damage they cause. Enzymes also involved in this include superoxide dismutase and glutathione peroxidase.2 These antioxidants can have a beneficial effect in many disease states, such as cancer, cardiovascular disease, immune system deficiencies, cataracts and brain dysfunction.3 Alpna-lipoic acid has been suggested as a possible candidate to be used specifically as an antioxidant, and has undergone several studies to demonstrate its use as a source of redox supplementation.4 It also appears to improve the recycling of other antioxidants, such as vitamin E, vitamin C, co-enzyme Q and glutathione.5 The possible beneficial actions of alphalipoic acid in a range of disease states has been investigated, including HIV, 3, 6 neurodegenerative diseases, 3 Alzheimer's disease, 7 depression, 8 diabetes9 and radiation injury.3 and tenoretic. Bluck, L. J., Izzard, A. P., and Bates, C. J. 1996 ; Measurement of ascorbic acid kinetics in man using stable isotopes and gas chromatography mass spectrometry. J. Mass Spectr. 31, 741748 42. Tsao, C. S., and Young, M. 1989 ; Effect of exogenous ascorbic acid intake on biosynthesis of ascorbic acid in mice. Life Sci. 45, 15531557 43. Sato, P., Nishikimi, M., and Udenfriend, S. 1976 ; Is L-gulonolactone-oxidase the only enzyme missing in animals subject to scurvy? Biochem. Biophys. Res. Comm. 71, 293299 44. Nishikimi, M. 1979 ; L-Gulono-gamma-lactone oxidase rat and goat liver ; . Meth. Enzymol. 62, 2430 45. Haramaki, N., Assadnazari, H., Zimmer, G., Schepkin, V., and Packer, L. 1995 ; The influence of vitamin E and dihydrolipoic acid on cardiac energy and glutathione status under hypoxiareoxygenation. Biochem. Mol. Biol. Int. 37, 591597 46. Sen, C. K., Roy, S., Han, D., and Packer, L. 1997 ; Regulation of cellular thiols in human lymphocytes by alpha-lipoic acid: a flow cytometric analysis. Free Radical Biol. Med. 22, 12411257 47. Han, D., Handelman, G., Marcocci, L., Sen, C. K., Roy, S., Kobuchi, H., Tritschler, H. J., Flohe, L., and Packer, L. 1997 ; Lipoic acid increases de novo synthesis of cellular glutathione by improving cystine utilization. Biofactors 6, 321338 48. Miquel, J. 1992 ; An update on the mitochondrial-DNA mutation hypothesis of cell aging. Mutat Res. 275, 209216 Received for publication March 3, 1998. Revised for publication April 16, 1998.

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