Different types of fractures

Fracture Management

•Anatomical realignment of bone Fragment (Anatomical reduction)

•Screws & Plates

•Immobilization to maintain alignment

•Casts, Braces & External fixators (Traction)

•Restoration of normal function

•Rehab aids

Challenges of Fracture Healing

•Time taken for healing •

•Proper & stable callus formation •

•Ensuring sufficient biomechanical strength

•Original shape

•Functionality

Current pharmacological agents available, only help in hastening the fracture healing process but have lesser role in restoration of the biomechanical strength & the quality of the newly formed bone which is the most critical component & left unaddressed Bone microarchitecture is one of the most important factors which is responsible for biomechanical strength & bone quality

sachets 2gm

first time in powder form sachets

• HEE from Dalbergia Sissoo extract 450mg,

• Cissus Quadrangularis 500mg,

• Vitamin K2-7 50mcg,

• Vitamin D3 1000 IU

The generic name Dalbergia honours the Swedish brothers Nils and Carl Dalberg, who lived in the 18th century The plant is native to India, it is the state tree of Punjab (India) Commonly known as Indian Rosewood The timber from the tree is called Shisham timber

Heartwood ethanolic extract (HEE)is obtained from the extract of the leaves of D.sisso

HEE improves biomechanical parameters in the Reparative phase of fracture healing process

HEE promotes fracture healing, formation of new bone at the drill-hole site and stimulated osteogenic genes at callus region.

HEE exhibits better micro-architectural parameters at various anatomical positions, better bone biomechanical strength and more osteoprogenitor cells in the bone marrow

HEE accelerates fracture healing and post-menopausal osteoporosis*

*Biomed Pharmacother. 2016 Oct;83:942-957. doi: 10.1016/j.biopha.2016.08.010. Epub 2016 Aug 11.

CONCLUSION OF A STUDY* : HEE was found to promote fracture healing and exhibited osteoprotective effect by possibly stimulation of osteoblast function

*J Pharm Pharmacol. 2017 Oct;69(10):1381-1397. doi: 10.1111/jphp.12764. Epub 2017 Jun 30

Cissus quadrangularis is a fleshy cactus like climber

•Commonly known as “Bone setter” •Used in traditional medicinal system & found to posses bone fracture healing properties

•MOA: •Phytogenic anabolic steroid acts on estrogenic receptors of the bone & stimulates osteoblastogenesis

introducing

Mechanism of Action

decreased expression of bone resorption markers like TRAP and RANK and caused an increase in osteogenic markers like RUNX2, BMP2 and OPG/RANKL ratio

induced no uterine estrogenicity and significantly lowered the osteocalcin amount in serum

Dosage :

How much & how long should one take SISSOCIS? For a broken bone to heal It requires minimum 3 -6 months of time to completely restore the original strength & functionality SISSOCIS should be Rx not less than 2 months

Indications

•All types of fractures

•Post-op Fractures

•Trauma induced fractures

•Internal & External fixators

•Osteoporotic fractures

Adverse effects: •No adverse events have been reported

Side effects : These products have reported sometimes with side effects such as headache, intestinal gas, dry mouth, diarrhoea & insomnia. Gastrointestinal issues like flatulence & diarrhoea. •SISSOCIS is safe when used appropriately in adults short term (for upto 6-12 weeks)

Drug Interactions : •We currently have no information on drug interactions or contraindications for SISSOCIS. •There is need to take precaution with diabetic drugs, as Cissus Quadrangularis may lower blood sugar.

Special precautions & Warnings : •Pregnancy & Breast feeding : Not enough is known about the use of Cissus Quadrangularis & Dalbergia sissoo during pregnancy & breast feeding. •Stay on safe side & avoid use

  The Marvel Innovative – HEE/D.SISSO

HEE/D.SISSO – extract from Dalbergia sissoo, every fracture patient can expect stronger bones again

HEE/D.SISSO’s ability to act as a dual acting compound stimulates osteoblast proliferation, survival and differentiation, simultaneously inhibits osteoclast formation and their differentiation in bone, suggesting positive skeletal effect

HEE/D.SISSO increases the levels of bone formation markers (ALP) and decreases the levels of bone resorption markers (RANK & TRAP)

HEE/D.SISSO is a proven compound that enhances the trabecular microarchitecture where by: ·

• It increases the Trabecular number

• It increases the Trabecular thickness

• It increases the bone volume %

• It decreases the Trabecular separation Therefore,

  HEE/D.SISSO-The novel compound enables fracture healing along with use of fixators.

REFEENCES : 

Ethanolic extract of Dalbergia sissoo promotes rapid regeneration of cortical bone in drill-hole defect model of rat.Khedgikar V, Kushwaha P, Ahmad N, Gautam J, Kumar P, Maurya R, Trivedi R.Biomed Pharmacother. 2017 Feb;86:16-22. doi: 10.1016/j.biopha.2016.11.140. Epub 2016 Dec 6.PMID: 27936389

Fast and long acting neoflavonoids dalbergin isolated from Dalbergia sissoo heartwood is osteoprotective in ovariectomized model of osteoporosis: Osteoprotective effect of Dalbergin.Choudhary D, Kushwaha P, Gautam J, Kumar P, Verma A, Kumar A, Maurya SW, Siddiqui IR, Mishra PR, Maurya R, Trivedi R.Biomed Pharmacother. 2016 Oct;83:942-957. doi: 10.1016/j.biopha.2016.08.010. Epub 2016 Aug 11.PMID: 27522257A

standardized phytopreparation from an Indian medicinal plant (Dalbergia sissoo) has antiresorptive and bone-forming effects on a postmenopausal osteoporosis model of rat.Khedgikar V, Gautam J, Kushwaha P, Kumar A, Nagar GK, Dixit P, Chillara R, Voruganti S, Singh SP, Uddin W, Jain GK, Singh D, Maurya R, Chattopadhyay N, Trivedi R.Menopause. 2012 Dec;19(12):1336-46. doi: 10.1097/gme.0b013e318256b6ae.PMID: 22850441

Biomechanical Characteristics of Osteoporotic Fracture Healing in Ovariectomized Rats: A Systematic Review.Chen L, Yang L, Yao M, Cui XJ, Xue CC, Wang YJ, Shu B.PLoS One. 2016 Apr 7;11(4):e0153120. doi: 10.1371/journal.pone.0153120. eCollection 2016.PMID: 27055104