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Chapter I

Background of the Study

Gout is one of the most painful forms of arthritis (Bethesda, 2014) and is the most common

inflammatory arthritis. Gout is a complex disorder occurring when uric acid levels in the blood

become excessive, medically termed as hyperuremic. Hyperuricemia, usually defined as a

serum urate (SU) level >7 mg/dL, may be present in up to 18% of some populations.

The Philippine Rheumatology Association (PRA) expressed concern over the growing

number of Filipinos suffering from gout which though may not be fatal, but could gravely affect

a persons quality of life. Notably, there are now some 1.6 million Filipinos with gout and such

figure is expected to perceptibly increase in the coming years due to the unhealthy lifestyle of the

growing population (Crisostomo, 2015).

In 2012, Doctors Lounge stated that the first lines of treatment for gout are pain relievers.

Once the diagnosis has been confirmed, the drugs of choice are colchicine, non-steroidal anti-

inflammatory drugs (NSAIDs), or intra-articular glucocorticoids. The mainstay of this approach,

however, is the drug Allopurinol, a xanthine oxidase inhibitor, which directly reduces the

production of uric acid and increases urinary excretion of uric acid.

Bermuda grass (Cynodon dactylon), a rapid growing perennial grass that has creeping runner

or stolons. Studies have shown that Bermuda grass possesses anti-inflammatory effect. A study

was conducted on evaluating the protective effect of Cynodon dactylon (20mg/kg,PO) against

rats with adjuvant-induced arthritis. Results have showed significant attenuation in the

inflammatory response, oxidative stress and amelioration to the arthritic changes to near normal

conditions. It was found out that the presence of alkaloid, flavonoids and glycosides contribute to
the anti-arthritic properties of Cynodon dactylon (Bhangale et.al, 2011). Among these

phytochemicals, the flavonoids present an essential role because it naturally inhibits xanthine

oxidase which leads to the reduction of uric acid synthesis. In addition, flavonoids possess an

inhibiting property on enzymes that are involved in the production of several mediators of

inflammation such as tumor necrosis factor- and C reactive proteins levels in the body. Hence,

findings clearly indicate that Cynodon dactylon extract has a promising protective role against

arthritis.

Thus, the study wants to determine the acute toxicity dose of Cynodon dactylon leaf

extract in mice and effective dose (ED50) in lowering serum uric acid-level in pyrazinamide-

induced hyperuricemia in rabbits.