ANTIMICROBIAL ACTIVITY AND EFFECT OF CINNAMON POWDER ON BLOOD GLUCOSE AND SERUM LIPID LEVELS OF MALE DIABETIC SUBJECTS Sivapriya T*, Sheila John*, Priya R Iyer # *Department of Home Science, # Department of Biotechnology, Women s Christian College, Chennai-600006, TamilNadu, India. Corresponding author.email:sivaamanick@gmail.com. ABSTRACT Cinnamon Zeylanicum is used in India as an herbal remedy for diabetes due to their traditional acceptability and availability. The present study was planned to investigate the antimicrobial activity and the effect of cinnamon powder on blood glucose and serum lipid levels of type 2 male diabetic subjects. A total of 24 type 2 male diabetic subjects were randomly assigned into experimental and control group. Experimental group subjects consumed 1 gm. of cinnamon powder capsule daily for a period of 45 days.antimicrobial activity of cinnamon powder was evaluated against pathogens causing urinary tract infection among diabetes patients before and after supplementation and the antimicrobial activity of cinnamon powder was compared against standard antibiotics. The results revealed that the cinnamon supplemented group of diabetic subjects showed a dramatic decrease in blood glucose (1% significant) and lipid levels (5% significant). Urine culture examination indicated E. coli as the most predominant pathogen causing urinary tract infection with ratio 43.9%. The zone of inhibition of cinnamon extract was 18 mm and minimum inhibitory concentration was 0.4521 mcg.cinnamomum Zeylanicum exhibited antidiabetic, hypolipedimic and antimicrobial property. Key words: Cinnamon, Diabetes Mellitus, Blood glucose, Serum lipids, Zone of inhibition, Minimum inhibitory concentration. Introduction India,experiencing rapid socioeconomic progress and urbanization, carries a considerable share of the global diabetes burden. Studies in different parts of India have demonstrated an escalating
prevalence of diabetes not only in urban populations, but also in rural populations as a result of the urbanization of lifestyle parameters. The prevalence of prediabetes is also high. Because of the considerable disparity in the availability and affordability of diabetes care, as well as low awareness of the disease, the glycemic outcome in treated patients is far from ideal. Lower age at onset and a lack of good glycemic control are likely to increase the occurrence of vascular complications. (1) The long-term complications of diabetes occurring during the most productive years of lives create a devastating burden of morbidity and mortality, which poses an economic and social burden both at the individual and at the national level. Prevention seems to be the need of the hour to tackle this epidemic. (2) The horizon of therapeutic management of type 2 diabetes mellitus is possibly shrinking at a faster pace than it is expanding. Many new drugs introduced in the last decade face an uncertain future due to safety issues, not withstanding their proven clinical effectiveness. With the advent of thiazolidinediones (also called glitazones ), the management of type 2 diabetes mellitus took a giant leap forward as this is the only class of drugs, other than biguanides, to address the main pathophysiological defect in type 2.However, right from the beginning, this class of drugs was mired in controversy because of their side effect profile due to which most drugs in this class have gone off the therapeutic armamentarium at some stage or the other. (3) Spices have been used to preserve food, enhance the flavour and as remedies for a long list of ailments. Today the pendulum is swinging back and researchers are confirming what herbalists have known all along that the spice rack can be potent as a medicinal chest. Herbs and spices are excellent antioxidants, which work to neutralize the attacks made by free radicals against the body. (4) Among spices, Cinnamon (Cinnamomum zeylanicum) has promising antidiabetic,antihyperlipidemic and antimicrobial properties.water-soluble polyphenol polymers from cinnamon, procyanidin oligomers of the catechins and/or epicatechins may function as antioxidants, potentiate insulin action, and may be beneficial in the control of diabetes and total cholesterol. (5) Antimicrobial property is attributed to the terpenoids and phenylpropanoids present in cinnamon. (6) One gram of daily adjunct cinnamon in addition to usual care leads to dramatic improvements in blood sugar, cholesterol, LDL-cholesterol and triglycerides. Intake of cinnamon, at these levels, is very safe and has no side effects. (5,7,8) The anticipated surge in the world wide incidence of type 2 diabetes is not inevitable. India has long passed the stage of a diabetes epidemic. The problem has now reached, in scientific language, "pandemic" proportions. Cinnamon and its products are more convenient for the treatment of Type
2 diabetes due to their easy availability, low cost, minimum side effects and greater acceptance amongst the users. This study about cinnamon supplementation will give diabetic care providers and diabetic patients an easily accessible, safe and cheap alternative to help treat type 2 diabetes.with these backgrounds, the study on Antimicrobial activity and effect of cinnamon powder on blood glucose and serum lipid levels of male diabetic subjects was undertaken with the following objectives. 1. To supplement, study and compare the effect of cinnamon powder on the urine culture, blood glucose, serum lipid profile of the selected type 2 diabetic subjects for a period of 45 days between the experimental (n= =12) and control group (n=12). 2. To compare the antimicrobial activity of cinnamon against standard antibiotics by determining the zone of inhibition (ZOI) and minimum inhibitory concentration (MIC). Materials and methods The study was carried out in accordance with the guidelines of the Independent Institutional Ethics Committee. The experimental design used in the study is before and after design with control group. Selection criteria included male diabetic subjects (40-60 yrs) willing to participate in the study, subjects who are only on hypoglycemic drugs, not under any other medication and not on insulin therapy.subjects with kidney, liver and cardiac diseaseswere excluded from study. Cinnamon will not induce any gastric disturbance as it acts as a digestive aid and relieves gas and bloating. The study was conducted in threee phases. Phase 1: Cinnamon powder capsule was developed using Cinnamon Zeylanicum bark. Cinnamon Zeylanicum bark was certified as true cinnamon bark by The Astoria Research and Analyticals, Chennai, India. About 0.5 gram of powder was used to make a capsule. Capsules were packed in plastic bags and enclosed in an air tight bottle to ensure the cinnamon aroma was present in the capsules. Phase 2:The study was carried out in a diabetic clinic in Thanjavur city in Tamilnadu state, India. Screening was done to identify fifty type 2 diabetes mellitus subjects between ages 40 and 60 years. From the fifty subjects, twenty four subjects were selected and were randomly assigned to experimental (n=12) and control groups (n=12). An interview schedulee was used to elicit information regarding demographic profile, physical activity pattern, family history of non-
communicable diseases and meal pattern. All the patients were allowed to take their routine diabetic diet, have regular physical activity and diabetic medicine. Phase 3 (Experimental procedure): On the first day of supplementation, blood parameters were analysed on 8-hour fasting and post-prandial state for subjects in experimental and control groups. 5 ml of venous blood was drawn from the subjects and analysed for blood glucose level (fasting and post-prandial) and total lipid profile. Urine samples were collected to test for urinary infection. Urine culture was examined for the presence of Escherichia coli, Proteus vulgaris, and Candida albicans to determine the antimicrobial activity of cinnamon. The antimicrobial activity of cinnamon was quantitatively assessed against standard antibiotics like erythromycin and tetracycline by determining the zone of inhibition (ZOI) and minimum inhibitory concentration (MIC) by disc diffusion method. Based on researches conducted by Javed et al., 2012, Zimmet, 2009, Anderson et al., 2004 the supplementation dosage was determined as 1 gm. The experimental group (n=12) was supplemented with sixty capsules of 0.5g of Cinnamon powder, 2 capsuless per day for 30 days. Patients were instructed to take one capsule after breakfast and one after lunch. Once the patients finished the 60 capsules, they were given the second package of tablets. Compliance was monitored by using a compliance monitoring sheet in which the patient had to mark the intake of capsule daily as well as by telephone enquiries. Blood parameters and urine was analysed on 46 th day (end of the supplement) in both experiment and control groups to elicit the impact of supplementation of Cinnamon powder. All data as mean ± standard deviation (SD) were presented. Paired sample t test and independent sample t test were used for dataa analysis. Statistically significant level for all tests P<0.05 was considered. Results and discussion The results pertaining to the study on antimicrobial activity and the effect of supplementation of cinnamon powdered capsules on type 2 diabetes subjects are discussed under the following headings: Effect of supplementation on the biochemical profile of the type 2 diabetes subjects
Oxidative stress has been described as key factor in obesity related diseasess such as diabetes and atherosclerosis. Reducing oxidative stress by increasing antioxidant dietary intakes could be a possible method of reducing the incidence of the pathologies. In the dietary antioxidant group, polyphenol from cinnamon could be of special interest in people with impaired fasting glucose since it acts as insulin sensitizers as well as antioxidants. (9) Fasting blood glucose The mean fasting blood glucose of the subjects in the experimental group before the supplementation was 107.3 ± 10.3.(Table 1) After the supplementationn the fasting glucose decreased to 100.7 ± 6.2. This decrease in blood glucose level was significant at 5%level. In case of the control group, the mean fasting blood glucose levels before and after was 128.1 ± 13.3 and 134.5 ± 17.8 respectively. Postprandial blood glucose The mean postprandial blood glucose levels of the subjects in the experimental group before the supplementation was 174.3 ± 37.6 (Table 1). After the supplementation of the cinnamon capsule, the postprandial glucose levels decreased to 147.4 ± 13.2. This decrease in blood glucose level was significant at 5% level. In case of the control group, the mean postprandial blood glucose levels before and after was 176.1 ± 17.5 and 185.5 ± 46.0 respectively. Total serum cholesterol profile Cinnamate, a phenolic compound found in cinnamon bark lowers cholestero levels by inhibiting hepatic 5-hydroxy-3-methylglutaryl-coenzyme Areductase activity. (10) The mean serum cholesterol levels of the subjects in the experimental group before the supplementation was 202.5 ± 17.8. (Table 2) After supplementation the mean serum cholesterol levels decreased to 191.1 ± 19.1.The decrease in cholesterol level was significant at 1% level.in case of control group, the mean serum cholesterol levels before and after supplementation was 211.2 ± 11.4and 208.3 ± 10.9 respectively. Serum triglyceride The serum triglyceride levels of the subjects in the experimental group before and after supplementation was 210.1 ± 59.5 and 180.3 ± 35.4 respectively. (Table 2) The reduction in the triglyceride level of the experimental group was too much after supplementation. The decrease in serum triglyceride was statistically significant at 5% level. In case of the control group the
triglyceride levels were 230.7 respectively. Panacea Journal of Health Sciences ± 22.1 and 223.8 ±11.8 before and after supplementation Low density lipoproteins The low density lipoprotein levels of the subjects in the experimental group were 120.9 ± 14.4 and 114.6 ± 20.3 before and after supplementation respectively (Table 2). There was a reduction in the level of the low density lipoproteins after supplementation of cinnamon. The reduction of low density lipoproteins level was however not significant.the subjects in the control group did not consume cinnamon and the level of low density lipoproteins before and after supplementation remained the same and was 107.4 ±14.5 and 107.4 ±14.5 respectively. High density lipoprotein The level of high density lipoprotein in the experimental group before and after supplementation remained almost same and was 40.5 ± 4.4 and 40.1 ± 4.0 respectively (Table 2). The level of high density lipoprotein did not rise significantly after supplementation. In case of control group, the levels of high density lipoprotein were 55.7 ± 7.4 and 56.9 ± 8.5 respectively. Very low density lipoproteins The mean values of very low density lipoproteins for the experimental group before and after supplementation were 42 ± 11.8 and 36.1 ± 7.1 respectively (Table 2). The levels have dropped considerably after supplementation. The reduction was significant at 5% level. In case of control group the mean values of very low density lipoproteins before and after supplementation were 46.0 ± 4.3 and 44.5 ± 4.3. Total cholesterol/hdl Ratio The mean values of Total cholesterol/hdl ratio for the subjects in the experimental group before supplementation was 5.0 ± 0.6 were and it reduced to 4.0 ± 0.7 after supplementation (Table 2). The decrease was however not statistically significant. In case of control group the mean values were 3.8 ± 0.4 before supplementation and after supplementation it came to 3.7 ± 0..6. Comparison of biochemical profiles between the experimental and control groups after supplementation Our study indicates that supplementation of 1 gm. of cinnamon powder has a supporting role in controlling the blood fasting glucose and post prandial levels. We found significant reduction in
fasting blood glucose, statistically significant at 1% level. (Table 3)When the postprandial blood glucose results between the experimental and control group were compared statistically the results were significant at 5% level. Cinnamon acts as a synergistic agonist with insulin in Vivo to decrease blood glucose levels. (11) The results of our study clearly indicate the positive role of cinnamon in lowering the serum lipid profile and thus corroborating the results of Balasasirekha(2011) (12), Kumar (13) et al., (2010). With regard to total cholesterol levels the statistically proved results were significant at 5% level. (Table 4) When the mean triglyceride levels were compared between experimental and control subjects, the results showed significant results at 1% level and clearly declares the hypolipedimic action of cinnamon. High density lipoproteins did not improve significantly after the supplementation but the results were statistically significant at 1% level. Comparison of VLDL cholestero level between the two groups revealed a statistically significant result at 1% level. (Table 4) TC/HDL ratio called the risk factor was significant at 1% between the experimental and control group indicating the beneficial effect of cinnamon over serum lipid profiles. Among the experimental group, a positive trend in the control of lipid profile was evident with 1 gm. cinnamon supplementation and longer periods of dietary supplementation of cinnamon could help to maintain the lipid levels. Being a potential antidiabetic, antihyperlipidemidic and antimicrobial agent, active agents of cinnamon can be used to prepare nutraceuticals that will keep infections as well as non- communicable diseases at bay. Anti-microbial activity of cinnamon powder Urine culture analysis Patients with diabetes are more prone to heart attacks, stroke, and peripheral vascular disease, as well as damage to the eyes, nerves, and kidney. There is another common complication of diabetes that gets less attention and affects thousands of patients every year, is the urinary tract infection. Diabetes has a number of long-term effects on the genitourinary system. Because of the frequency and severity of urinary tract infection in diabetic patients, prompt diagnosiss and early therapy is warranted. Bacteriuria is more common in diabetic men than in non-diabetic men because of a combination of host and local risk factors.
The most common cause of urinary tract infection is gram negative bacteria that belong to the family Enterobacteriaceae. Members of these families include Escherichia coli, Klebsiell Enterobacter and Proteus Sp. Escherichia coli are one of the most common bacteria capable of causing urinary tract infection in humans. (14) The frequency of the presence of Escherichia coli in urine samples varies in studies from 40 percent 75 percent. Purpose of our present study was to identify and isolate Escherichia coli, Proteus vulgaris, and Candida albicans from the urine culture of study sample and test for anti-microbial activity of cinnamon powder. But the urine culture analysis of our study samples revealed the presence of Escherichia coli,pseudomonas aeruginosa, Klebsiella Enterobacter species. Hence the antimicrobial activity of cinnamon was determined using Escherichia coli, which was found to be present in majority of the urine samples It can be interpreted from the table 5 that before the supplementation of cinnamon capsules, 41.6 percent in experimental group and 58.3 percent in control group had Escherichia coli in their urine culture analysis. An important characteristic of cinnamon and its components is their hydrophobicity, which enable them to partition the lipids of the bacterial cell membrane and mitochondria, disturbing the cell structures and rendering them more permeable. Extensive leakage from bacterial cells or the exit of critical molecules and ions will lead to death. Gram-positive bacteria weree more resistant to the essential oils than gram-negative bacteria. (15) In the present study supplementation of cinnamon capsule did not have any significant effect on these gram negative organisms as observed from the urine culture examination after the supplementation period of 45 days. It seems that the variability in the resistance of these organisms to the inhibitory action of cinnamon may be due to the difference between strains of the same species. (16) The dosage of cinnamon powder capsule 1 gm. /day for 45 days is not sufficient to inhibit the activity of the gram negative organisms as the anti-microbial activity of cinnamon is well proved by the zone of inhibition test. Another probability for the vainness of cinnamonn capsule to inhibit the gram negative stain is the mutation of Escherichia coli after the supplementation of cinnamon to survive the unfavourable condition.
Further research can be carried out by increasing the dosage of cinnamon capsule per day to prove the anti-microbial activity of cinnamon in the urine culture of diabetic subjects. Additional in vivo studies and clinical trials would be needed to justify and further evaluate the potential of cinnamon as an antibacterial agent. Zone of inhibition and minimum inhibitory concentration of cinnamon compared against standard antibiotics The spread of drug resistant pathogens is one of the most serious threats to successful treatment of microbial diseases. Down the ages extracts of spices have evoked interest as sources of natural products. They have been screened for their potential use as alternative remedies for the treatment of many infectious diseases. Cinnamon extracts have been shown to possess antibacterial, antifungal, antiviral, insecticidal, germicidal and antioxidant property. (17) The antibacterial activity of cinnamon may be due to its antimicrobial compound, cinnamaldehyde, thymol, carvacol, carvone, eugenol which is considered to bind to proteins and prevent the action of amino acid decarboxylase. (18) Theefficacy of essential oil of cinnamon in inhibiting different human bacterial pathogens was determined by many researchers and has reported varying results depending upon the micro-organism tested in their trials. The results of the present study were in close agreement with Babu et al, (2011) (19) who found that cinnamon extract inhibits the growth of Escherichia coli. Friedman et al (2002) (20) reported the strong inhibitory effect of cinnamon extract on Escherichia coli. From the laboratory analysis, the extract of cinnamon was found to be a most effective antibacterial agent against Escherichia coli isolated from urine of the diabetic subjects. The sensitivity of the cinnamon extract was classified (Table 6) by the diameter of the inhibition zone as per the procedure of Ponce et al (2003) (21) and Moreira et al (2005). (22 Cinnamon is high in antioxidan and antimicrobial activity by the mechanism of decreasing the DNA binding activity and by inhibiting transpeptidation enzyme involved in cross linking of polysaccharide chain of bacterial cell wall and also by activating cyclic enzym From the above table 7, it is construed that cinnamon possesses antimicrobial activity. The results obtained in this study indicated that the bacterial pathogen tested against the extract of cinnamon was found to be highly sensitive to its action. The results obtained from this study were comparable 2) mes. (23)
with the results of Babu et al., 2011. (19) Cinnamon extract had an inhibition zone (IZD) of about 18 mm, followed by tetracycline which had an inhibition zone of 36mm whereas erythromycin had an inhibition zone of 17 mm. The minimum inhibitory concentration (MIC) value of cinnamon extract was found to be 0.4521 mcg whereas the MIC of erythromycin and tetracycline were found to be 10 mcg and 30 mcg respectively. Although cinnamon powder has a zone of inhibition of 18 mm less than tetracycline, its minimumm inhibitory concentration is 0.452 mcg which is higher than tetracycline. Hence cinnamon powder proves to be a promising antibacterial agent. The present investigation with previous studies provides support to the antibacterial activity of the cinnamon. It can be concluded that the antimicrobial activity of the cinnamon extract would be helpful in treating various kinds of infectious diseases. Crude extracts of cinnamon and their mechanism of interaction with different active fractions of the plants needs to explore. The bioactive compounds from cinnamon can be used as antibacterial after further studies. (24) Conclusion In conclusion, one gram of cinnamon powder consumed daily in addition to usual care reduced serum glucose, triglyceride, total cholesterol, and LDL-cholesterol levels in people with type 2 diabetes. Because cinnamon would not contribute to caloric intake, those who have type 2 diabetes or those who have elevated glucose, triglyceride, LDL-cholesterol, or total cholesterol levels may benefit from the regular inclusion of cinnamon in their daily diet. In addition, cinnamon may be beneficial for the remainder of the population to prevent and control elevated glucose and blood lipid levels. Cinnamon extract was found to be the most effective with the lowest minimum inhibitory concentration and in future its bioactive components can used to prepare an antibiotic that is as effective as an antibiotic with minimal side effects to those who consume. List of tables Table 1 Comparison of mean blood glucose levels before and after supplementation. Blood values Fasting blood glucose (mg/dl) Study group Before Test Mean±SD Experimental 107.3± 10.3 Control 128.1± 13.3 After Test Mean±SD 100.7± 6.2 134.5 ± 17.8 Test of significance t value 2.177* 1.373 NS
Glucosepost prandial (mg/dl) Experimental 174.3± 37.6 Control 176.9± 17.5 Panacea Journal of Health Sciences 147.4± 2.202* 13.2 185.5± 46.0 0.478 NS * Significant at 5% ** Significant at 1% NS Not Significant Table 2 Mean total Serum cholesterol profile before and after supplementation. Blood Study group Before values Test Mean±SD Total cholesterol (mg/dl) Experimental Control 202.5± 17.8 211.2± 11.4 Triglycerides (mg/dl) Experimental 210.1± 59.5 Control 230.7± 22.1 LDL (mg/dl) Experimental 120.9± 14.4 Control 107.1 ± 14.5 HDL (mg/dl) Experimental 40.5± 4.4 Control 55.7 ± 7.4 VLDL (mg/dl) Experimental 42.0 ± 11.8 Control 46.8 ± 4.3 TC/HDL Experimental 5.0 ± 0.6 Control 3.8 ± 0.5 * Significant at 5% ** Significant at 1% AfterTest Mean±SD Test of significance t value 191.1± 19.1 3.212** 208.3± 10.9 1.198 NS 180.3 ± 35.4 2.057* 223.8 ± 11.8 4.046** 114.6± 20.3 1.315 NS 107.4 ± 14.5 0.886 NS 40.1± 4.0 0.296 NS 56.9 ± 8.5 1.017 NS 36.1 ± 7.1 1.996* 44.5 ± 4.3 3.978** 4.8 ± 0.885NS 0.7 3.7 ± 0.6 0.932 NS NS Not Significant Table 3 Comparison of mean after supplementation Blood values blood glucose between the experimental and control groups Mean Difference Test of significance
Experimental Control t value Fasting blood glucose(mg/dl) Glucose-post prandial(mg/dl) 100.7 ± 6.2 147.4 ± 13.2 128.1 ± 13.3 185.5 ± 46.0 7.244** 2.390* * Significant at 5% level ** Significant at 1% level NS Not Significant Table 4 Comparison of mean serum lipid profile between the experimental and control groups after supplementation Blood values Total cholesterol(mg/dl) Triglycerides(mg/dl) LDL(mg/dl) HDL(mg/dl) VLDL(mg/dl) TC/HDL * Significant at 5% ** Experimental Mean Difference Control 191.1± 19.1 208.3 ± 10.9 180.3 ± 35.4 223.0 ± 21.8 114.6 ± 20.3 107.4 ± 14.5 40.1 ± 4.0 56.9 ± 8.5 36.1 ± 7.1 44.5 ± 4.3 4.8 ± 0.7 3.7 ± 0.6 Significant at 1% NS Not Significant Test of significance t value 2.251* 3.434** 0.897 NS 5.345** 3.298** 3.096** Table 5 Pathogens identified in urine culture analysis before and after supplementation of cinnamon powder Microorganism Escherichia coli Pseudomonas aeruginosa Klebsiella pneumonia No growth of organism Study group Before test N=12 After test N=12 N % N % Experimental 5 41.6 5 41.6 Control 7 58.3 7 58.3 Experimental 3 25.0 3 25.0 Control 1 8.3 1 8.3 Experimental 1 8.3 1 8.3 Control 0 0 0 0 Experimental 3 25.0 3 25.0 Control 4 33.3 4 33.3 Table 6 Sensitivity of the cinnamon extract Sensitivity Diameter of Zone of inhibition (mm) Non sensitive (-) Less than 8 mm
Sensitive(+) 9-14 mm Very sensitive (+ ++) 15-19 mm Extremely sensitive (+++) Larger than 20 mm Table 7 Comparison of bacterial Inhibition (Escherichia coli.) between antibiotics and cinnamon powder Petri dish Antimicrobial agent Plate 1 Plate 2 Plate 3 Cinnamon powder Erythromycin stearate Tetracycline Hydrochloride Width of Zone of 18 inhibition( (mm) Sensitivity + + 17 36 + + + + + Minimum inhibitory concentration.4521 mcg 10 mcg 30 mcg Bibliography 1. Ramachandran A, and Snehalatha C. (2009) Current scenario of diabetes in India. Journal of Diabetes 1, 18-28. 2. Mohan V, Madan Z, Jha R et al. (2004), Diabetes social and economic perspectives in the new millennium,int. j. diab. dev. countries 24, 29-36. 3. Mohan V, Bedi S, Unnikrishnan R et al. (2012) Pioglitazone Where do we stand in India? VOL. 60 4. Zak V.2006.The magic teaspoon,penguingroup,usa. 5. Anderson RA, Broadhurst CL, Polansky MMet al. (2004) Isolation and characterization of polyphenol type-a polymers from cinnamon with insulin-like biological activity. JAgric Food Chem. 14, 65-70. 6. Helander IM, Alakomi HL, Latva K et al. (1998) Characterisation of the action of selected essential oil components on gram negative bacteria. J. Agril.food chemistry 46:3590-3595. 7. Javed F, Rahman K, Muhammed A et al. (2012) Lipid lowering effect of cinnamomumzeylanicum in hyperlipidemic rats. Pak J of pharm sci141-7 8. Khan A, Safdar M, Khattak KN et al. (2003) Cinnamon improves glucose and lipids of people with type 2 diabetes. Diabetes care 26, 3215-3218.
9. Roussel M, Hininger I, Benaraba R et al. (2009) Antioxidant effects of people with impaired fasting glucose. Journal Am collnutr 28,16-21. 10. Kannappan S, Jayaraman T, Rajasekar P et al. (2006) Cinnamon bark extract improves glucose metabolism and lipid profile in the fructose-fed rat. Singapore Med. J 47, 858-863. 11. Verspohl J, Bauher K, Neddarman E. (2005) Antidiabetic effect of cinnamon in Vivo and in vitro. Phytother. Res19, 203-206. 12. Balasasirekha R and Lakshmi U. (2011) Effect of cinnamon and garlic on hyperlipidemics. International Journal of Nutrition and Metabolism 3, 77-89 13. Kumar D, Subramaniam B, Mitra A et al. (2010) Antidiabetic and hypolipidaemic effects of few common plants extract in Type 2 diabetic patients. Int J Diabetes &Metab18,59-65 14. Jiffri OA, Zahira, SayedA antibacterial activity of some plants extracts. International Journal of Microbiological Research 2, 01-07. 15. Matan N, Rimkeeree H, Mawson AJ et al. (2006) Antimicrobial activity of cinnamon and clove oils under modified atmosphere conditions. Int J Food Microbiol 107,180-185. 16. Sivropoulou A, Papanikalaou E, Kokkini A.(1996) Antimicrobial and cytotoxic activities of essential oils. J Agrl.food.chem 44, 1202-1205. 17. SeenivasanPrabu S, Manickkam J and Savarimuthu I.(2006)Antibacterial activity of some plant essential oils.bmc Complementary and Alternative Medicine6,39. 18. Wendakon CN and Sakaguchi M. (2004) Inhibition of amino acid activity of enterobacteraerogenes by active components in spices. J food protection 58, 280-283. 19. Babu JA, Rupa S, Indumathi R et al. (2011) Study on the antimicrobial activity and minimum inhibitory concentration of essential oils of spices, Veterinary World 4,311-316. 20. Friedman M, Henika PR and Mandrell RE. (2002) Bactericidal activities of plant essential oils against E.coli. J food protection 65, 1545-1560. 21. Ponce AG, Fritz R, Delvallee CR.(2003) Antimicrobial activity of essential oils on the native microflora of organic swiss chard. J.Agrl food chemistry 36,679-684. 22. Moreira R, Alejandra G, Carlos E.(2005) Effect of clove oil and tea tree oils on Eschericia coli. J. food processing and preservation 31, 379-391. 23. Ranjan S, Nandita D, and Ramalingam C. (2012) Comparative study of antibacterial activity of garlic and cinnamon at different temperature and its application on preservation of fish.adv. Appl. Sci. Res. 495-501. Panacea Journal of Health Sciences a cinnamon extract in et al. (2011) Urinary tract infection with Esherichia coliand
24. Saraf A, Mohit M and Sharma K. (2011) Antibacterial activity of commercial and wild Cinnamon species. Journal of Phytology3, 102-106.