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Pathological profile
Treatment with PR lead to a remarkable recovery in the pathological profile of the patients. More than 92% patients showed a complete recovery from the discharge of Giardia-cysts in the stool. Frequency of stool was also resumed to 1-2 per day. Marked improvement was noticed as far as the presence of mucus, pus cells and RBC in stool was concerned. This may be due to the anti-inflammatory activity associated with PR.
Haematological profile
Statistically significant (51.6%) decrease in ESR and sharp (100%) in basophil counts were recorded following PR treatment of the giardiasis patients. A low order of increase was noticed in lymphocytes (9.8%) hemoglobin (9.95%) total RBC counts (9.67%) and PCV (8.9%). The overall profile showed a remarkable improvement of haematological status of the patients on PR treatment. However, as reported by Naik et al. haematological profile may not be used for diagnosis of the infection.
Immune  status
Majority of the patients showed a marked depression of immune status on giardiasis as evident form the values of leucocyte migration inhibition (LMI). This is well supported from the reports that 80% of the immuno-deficient persons with intestinal malabsorption suffer from giardiasi. A discrete role of Giardia in causing symptoms and lesions in the individuals with immuno-deficien-cy is well documented.
Possibly the giardiasis-patients possess certain immunosuppressive factor(s) in the serum. This is experimentally augumented from the values of migration index of mouse-peritoneal macrophages, where 23 out of 25 sera samples reduced the migration index to 15-2,0%.
PR treatment resulted into a marked recovery of symptoms in giardiasis-patients. Even the patients suffering from chronic giardiasis, and also those not responding to conventional anti-giardial drug therapy showed an encouraging response with PR treatment.
Anti-giardial activity of Pippalli Rasayana
No significant anti-activity was observed in vitro upto the highest dose of 1000 //g/ml of PR. Marked anti-giardial activity of the drug was, however, observed in vivo. Table 5 shows the data on the recovery of mice experimentally infected with G. lamblia and treated at different doses of PR. At the lowest dose of 11 2 mg/kg body weight the drug gave only 2.26% recovery as compared to untreated control animals, however, the values were statistically insignificant. The recovery increased with the increase in PR dose and 98% recovery was observed at the dose level of 900 mg/kg body weight. At all the dose levels above the lowest dose the recovery was highly significant (p< 0.001).
Immuno-modulatory-activity of PR
The data on immuno-modulatory effect of PR on mice using MMI, phagocytic activity, HA titre and PFC has been recorded in Table 6. As evident from the data, no significant change in HA titre or PFC was found in mice treated with PR. The MMI and phagocytic activity was, however, significantly enhanced in the treated animals. Though the maximum increase of about 2.6 fold in. MMI was observed at the dose level of 225 mg/kg, the increase was more than two fold at all the other dose levels. The phagocytic activity was enhanced by about 20% or more at the four dose levels. The maximum activity 36.4% of this parameter was also observed at 225 mg/kg dose. The increase in the phagocytic activity was significant at all the dose levels studied (p< 0.001 at dose levels of 112.5, 225 and 900 mg/kg and 0.01 at 450 mg/kg).
PR is used in traditional system of medicine for the treatment of bowel disorders. The Rasayana Therapy is believed to eradicate the disease by rejuvenation of the host and increasing the ‘Bala’ or immunity i.e., innate resistance against foreign invasions.
The observations of the present study not only provide scientific basis for the use of PR against bowel disorders but also unequivocally prove its efficacy in the treatment of giardial infection in experimentally infected mice. The recovery being 98% at the dose level of 900 mg/kg. Failure to obtain efficacy of PR in vitro suggests that the drug has no direct killing effect on the parasite.
Although the exact mechanism of action of PR in vivo is yet to be elucidated, one of the mechanisms could be through modulation of immune response of the host against the infective parasite. Eventhough the antibody response to SRBC was not affected, PR induced significant activation of macrophages as evidenced by enhancement of MMI and phagocytic activity. MMI has been regarded as a parameter for macrophage activation and has been shown to be correlated with cell mediated immune response. The macrophages not only form the first line of defense against foreign invasions, but also play important role in the elimination or clearance of the infective organisms. The present study, hence, also provides bearing to the concept that the Rasayana act by enhancing the Bala or Immunity of the host.
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