1 Fracture healing is a complex process, involving a series of cascade of events. The stages of tissue differentiation during fracture healing resemble that of fetal skeletal development.2 Osteoporosis is a major worldwide health problem, which leads to an increase in risk of fractures.3 Postmenopausal estrogen deficiency results in an increased Inhibitors,research,lifescience,medical bone remodelling and uncoupling between resorption by http://www.selleckchem.com/products/Y-27632.html osteoclasts and formation by osteoblasts which results in bone loss.4 Influence of osteoporosis on fracture healing is still not well understood. Earlier studies on animals showed that osteoporosis delayed fracture healing process.5 According to earlier

research reports, majority of the therapeutic agents Inhibitors,research,lifescience,medical used to treat osteoporosis, act to inhibit bone resorption rather than to induce bone formation.6 The main drugs used for treatment of osteoporotic fractures include: bisphosphonates, estrogen, selective estrogen receptor modulators and vitamin D.7 Estrogen replacement therapy (ERT) had beneficial effects on osteoporotic

fracture healing. However, long-term unopposed estrogen therapy has been proved to be strongly associated with estrogen dependent cancer such as endometrial carcinoma.8 Considering the high costs incurred, side effects observed and the risk of malignancy following long-term use of these agents, it is needed that Inhibitors,research,lifescience,medical natural products with less side effects be tried in addition to conventional treatment. Piper sarmentosum (P.s) belongs to the family of Piperaceae. It is widely distributed in South East Asia and is usually used Inhibitors,research,lifescience,medical as flavoring agent in food.9 In Malaysia, plant P.s is known as Daun Kadok, and its extract has been used for the treatment of toothache, fungal infection of the skin and cough.10 It has been reported that extracts of different

parts of P.s plant possess antioxidant, antimicrobial, anti-inflammatory and anticarcinogenic properties.11 Methanolic extract of P.s is rich in phenolic compounds such as naringenin. Naringenin belongs to the flavonoid Inhibitors,research,lifescience,medical groups, which exhibit high free radical-scavenging activity.12 Cilengitide Flavonoids rutin was reported to prevent ovariectomy-induced bone loss in rats.13 Isoflavones and soy food have been reported to prevent bone loss induced by menopause in women.14 Parhami concluded that the estrogen deficiency lead to an increase in the level of reactive oxygen selleck Vorinostat species (ROS). Reactive oxygen species induce the release of the cytokines, which is involved in osteoclastogenesis.15 Earlier studies showed that estrogen deficiency induced oxidative stress by increasing the level of ROS and hydrogen peroxide (H2O2), which induced osteoclasts activity.16 Hence, ROS may increase bone resorption and influence fracture healing. Water, methanol and hexane extracts of P.