title: Piper sarmentosum enhances fracture healing in ovariectomized osteoporotic rats: a radiological study.
abstract: BACKGROUND
  Osteoporotic fractures are common during osteoporotic states. Piper sarmentosum extract is known to possess antioxidant and anti-inflammatory properties.
  
  
  OBJECTIVE
  To observe the radiological changes in fracture calluses following administration of a Piper sarmentosum extract during an estrogen-deficient state.
  
  
  METHODS
  A total of 24 female Sprague-Dawley rats (200-250 g) were randomly divided into 4 groups: (i) the sham-operated group; (ii) the ovariectomized-control group; (iii) the ovariectomized + estrogen-replacement therapy (ovariectomized-control + estrogen replacement therapy) group, which was supplemented with estrogen (100 μg/kg/day); and (iv) the ovariectomized + Piper sarmentosum (ovariectomized + Piper sarmentosum) group, which was supplemented with a water-based Piper sarmentosum extract (125 mg/kg). Six weeks after an ovariectomy, the right femora were fractured at the mid-diaphysis, and a K-wire was inserted. Each group of rats received their respective treatment for 6 weeks. Following sacrifice, the right femora were subjected to radiological assessment.
  
  
  RESULTS
  The mean axial callus volume was significantly higher in the ovariectomized-control group (68.2 ± 11.74 mm³) than in the sham-operated, estrogen-replacement-therapy and Piper sarmentosum groups (20.4 ± 4.05, 22.4 ± 4.14 and 17.5 ± 3.68 mm³, respectively). The median callus scores for the sham-operated, estrogen-replacement-therapy and Piper sarmentosum groups had median (range, minimum - maximum value) as 1.0 (0 - 2), 1.0 (1 - 2) and 1.0 (1 - 2), respectively, which were significantly lower than the ovariectomized-control group score of 2.0 (2 - 3). The median fracture scores for the sham-operated, estrogen-replacement-therapy and Piper sarmentosum groups were 3.0 (3 - 4), 3.0 (2 - 3) and 3.0 (2 - 3), respectively, which were significantly higher than the ovariectomized-control group score of 2.0 (1 - 2) (p<0.05).
  
  
  CONCLUSIONS
  The Piper sarmentosum extract improved fracture healing, as assessed by the reduced callus volumes and reduced callus scores. This extract is beneficial for fractures in osteoporotic states.
authors.affiliation: Department of Anatomy, Faculty of Medicine, University Kebangsaan Malaysia Medical Centre, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Malaysia.
authors.forename: Mohamed Abdalla
authors.initials: MA
authors.lastname: Estai
authors.forename: Farihah Haji
authors.initials: FH
authors.lastname: Suhaimi
authors.forename: Srijit
authors.initials: S
authors.lastname: Das
authors.forename: Fazalina Mohd
authors.initials: FM
authors.lastname: Fadzilah
authors.forename: Sharifah Majedah Idrus
authors.initials: SM
authors.lastname: Alhabshi
authors.forename: Ahmad Nazrun
authors.initials: AN
authors.lastname: Shuid
authors.forename: Ima-Nirwana
authors.initials: IN
authors.lastname: Soelaiman
mesh_terms: D000818:Animals; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D000975:Antioxidants / Q000627:therapeutic use*; D002146:Bony Callus / Q000000981:diagnostic imaging / Q000187:drug effects; D004967:Estrogens / Q000172:deficiency; D005260:Female; D017102:Fracture Healing / Q000187:drug effects* / Q000502:physiology; D058866:Osteoporotic Fractures / Q000000981:diagnostic imaging / Q000188:drug therapy*; D010052:Ovariectomy; D031701:Piper / Q000737:chemistry*; D010936:Plant Extracts / Q000627:therapeutic use*; D011859:Radiography; D011897:Random Allocation; D051381:Rats; D017207:Rats, Sprague-Dawley
chemical_list: D000893:Anti-Inflammatory Agents; D000975:Antioxidants; D004967:Estrogens; D010936:Plant Extracts