A Scientifically developed and clinically Proven NATURAL MEDICINE- FLEXICART has cleared its Clinical Trail. The trial is Registered on WHO PORTAL for INTERNATIONAL CLINICAL TRIAL REGISTRATION (ICTRP) # CTRI/2012/09/002965 and published in international journals It is supposedly a superior alternate to Glucosamine/Chondroitin and similar combination supplements. The slideshow portrays Scientific parameters on which the product was evaluated in patients with arthritis. Highlight: Complete withdrawal of NSAID ( Chemical based pain killers) with time dependent progress of Treatment regime of this research product. The product can potentially become a better and affordable alternate to Glucosamine & Chondroitin and at the same time be more environment friendly. The Standardized ingredients of FLEXICART are 100% natural , do not contain any animal content ( Source of Glucosamine/Chondroitin: Fish/Pork/Crabs/Beef ) and devoid of harmful toxic metals as well.

1. ARTHRITIS & JOINT PAIN
New Treatment Option: Supported by Natural
Synergy
Scientifically Developed * Clinically Tested

2. INFLAMMATION OF JOINTS
Nearly 1 in 2 people may develop
symptomatic knee OA by age 85 years &
Two in three people who are obese may
develop symptomatic knee OA in their
lifetime.
1 in 4 people may develop painful hip
arthritis in their lifetime.

3. Effects of glucosamine, chondroitin, or placebo in patients with
osteoarthritis of hip or knee: network meta-analysis: Year2010
Results: Compared with placebo, glucosamine, chondroitin, and their
combination do not reduce joint pain or have an impact on narrowing of joint
space.
Effect of glucosamine on pain-related disability in patients with chronic
low back pain and degenerative lumbar osteoarthritis: a randomized
controlled trial: Year 2010
Results: Among patients with chronic LBP and degenerative lumbar OA,
6-month treatment with oral glucosamine compared with placebo did not result
in reduced pain-related disability after the 6-month intervention and after 1-year
follow-up.

4. Arthritis & Rheumatology
Effect of Oral Glucosamine on Joint Structure
in Individuals With Chronic Knee Pain: A
Randomized, Placebo-Controlled Clinical
Trial
Volume 66, Issue 4, pages 930–939, April 2014
Conclusion
The results of this short-term study provide no evidence of structural benefits
(i.e., improvements in MRI morphologic features or urinary
CTX-II excretion) from glucosamine supplementation in individuals with chronic
knee pain.

5. Glucosamine & Chondroitin
…Last 15 years

6. Phyto Chemistry
Phyto Research
Tulip Lab Proudly Introduces…
…A unique blend of Natural Scientific Synergy

7. In Patients with Osteo Arthritis
Flexicart offers:
59.85% reduction in mean joint pain score
assessed on VAS at end of Six months.
Statistically significant reduction in mean pain
score assessed on VAS at end of 30 days.
Complete Withdrawal of NSAIDs:
100% Patients stabilised on Flexicart monotherapy
at the end of 4 months therapy.

8. Increase in Joint Mobility :A significant reduction
(73.3%) in mean WOMAC stiffness score at the
end of 6 months.
Excellent Tolerability Profile.
At the end of 6 Months of treatment :
-50% of Subjects had good improvement
(75-95% remission of symptoms of OA).
-50% of Subjects had satisfactory improvement
(50-74% remission of symptoms of OA).
In Patients with Osteo Arthritis
Flexicart offers:

9. - Literature Review.
- Standardised Herbal Extracts.
- Acute Oral Toxicity Trial.
- Repeated dose toxicity study.
- International Clinical Trial Registration.
- Human Clinical Trial.
- Clinical Outcomes & Statistical Analysis.
- Publication in International Journals.
- Stability Studies & Validation of Commercial Batches.
* Scientifically Developed* Clinically Tested* Validated Internationally

10. The resinous part of Boswellia serrata possesses
monoterpenes, diterpenes, triterpenes, tetracyclic
triterpenic acids and four major pentacyclic triterpenic acids
i.e. β-boswellic acid, acetyl-β-boswellic acid, 11-keto-β-
boswellic acid and acetyl-11-keto-β-boswellic acid,
responsible for inhibition of pro-inflammatory enzymes.
Out of these four boswellic acids, acetyl-11-
keto-β-boswellic acid is the most potent
inhibitor of 5-lipoxygenase, an enzyme
responsible for inflammation.
Key Ingredients: Mechanism of Action
Boswellia serrata

11. Key Ingredients: Mechanism of Action
Inhibition of MAP kinases by Commiphora mukul
leads to down regulation of TNF-α, IL-1β and IL-2
- Inhibit platelet aggregation and
increase fibrinolysis.
- Possess antioxidant properties.
- Effects on high-sensitivity C-reactive
protein shows Anti-inflammatory
properties.
Commiphora mukul

12. Key Ingredients: Mechanism of Action
Withania Somnifera has profound effects on
the hematopoietic system, acting as an
immunoregulator and a chemoprotective agent
- Increases production of inducible nitric
oxide synthase, an enzyme generated in
response to inflammatory mediators.
- Potent Antioxidant.
Withania Somnifera

13. Key Ingredients: Mechanism of Action
- Works against Denaturation of
protein.
- Potent Cox – 2 Inhibitor
Vitex negundo Reduces Inflammation and provides
analgesia by Suppressing Prostagalandin synthesis,
Anti histamine and membrane stabilizing effects.you
Vitex negundo

14. R. communis has flavonoids which depict
anti-inflammatory and anti-arthritic action from
R.Communis prevents GAG release from
osteoarthritic cartilage and also prevented
chondrocytes and cartilage surface degradation.
Proven chondroprotective effect
Ricinus communis
Key Ingredients: Mechanism of Action

15. Key Ingredients: Mechanism of Action
Nyctanthes arbortristis exhibits control of
Oedema, Reduction of Aspartate Aminotransferase
(SGOT),Reduction of Alanine Aminotransferase
(SGPT) and diminishing Quantity of Alkaline
Phosphatase (ALP)
Nyctanthes arbortristis
Reduction of Oedema & Free
Radical Scavenging effect

16. Key Ingredients: Mechanism of Action
- Analgesic and anti-inflammatory
- It also reduces the intake of rescue
medicine.
The anti-inflammatory
action of Zingiber officinale is due to
inhibition of COX-1, COX-2 and LOX(Lipoxygenase).
Zingiber officinale

19. Inclusion criteria:
Males and Females, age group 40-70 years .
Symptoms of osteoarthritis in one or both knee joints for a minimum of six
months and maximum for five years.
History of knee pain due to osteoarthritis requiring the use of NSAIDs,
Acetaminophen, or another analgesic agent on a regular basis ( > three days
per week) for at least six months before the screening visit.
OA confirmed by radiographs and diagnosed according to ACR diagnostic
Criteria for the osteoarthritis of the knee(s) .
Subjects may take tab Paracetamol for breakthrough pain.
Subjects not having knee joint deformity.
Subjects with pain VAS > 40 mm on weight bearing activities .
An Open Label, Prospective Clinical Study to Evaluate The Efficacy
and Safety of TLPL/AY/03/2008 in Patients suffering from
Osteoarthritis of the Knee(s)

20. An Open Label, Prospective Clinical Study to Evaluate The Efficacy
and Safety of TLPL/AY/03/2008 in Patients suffering from
Osteoarthritis of the Knee(s)
Changes in the mean knee joint pain assessed on visual
analogue scale ( VAS)
At the end of the treatment, the mean knee joint pain score reduced
significantly from baseline to 20.83+/-08.35 (59.85%)
Excellent Pain
control

21. Changes in the mean WOMAC combined score
At baseline visit, the mean WOMAC combined score
was 35.38 +/- 11.21, which was reduced significantly to
13.56 +/- 06.89 (61.67%) at end of the study.
Powerful Analgesic
effect

22. The mean WOMAC stiffness sub-scores reduced significantly
from baseline value 02.81 +/- 01.72 to 00.75 +/- 00.77 (73.3%)
at the end of the study.
Changes in the mean WOMAC Stiffness sub-score
Reduced Stiffness
enhances flexibility

23. Changes in the mean WOMAC difficulty sub-score
At baseline visit , the mean WOMAC difficulty sub-score
was 24.00 +/- 08.3, which was reduced significantly from baseline
value to 09.69 +/- 04.78 (59.6%) at the end of the study
Improved
Productivity

24. Changes in the mean time (seconds) taken to walk 50 feet
distance
At baseline visit, the mean time taken by the patients to walk
50 feet was 16.31 +/- 01.70 s.
The mean time to walk 50 feet was reduced significantly
from baseline value to 12.19 +/- 02.04 (25.26%) s at the end of
the study
Enhanced Mobility

25. Flexicart Assures:
• Complete withdrawal of NSAID with time dependent treatment regime.
• High Safety Profile.
• High level of patient compliance.

26. Histological Evaluation of RCLE (200mg/kg & 400
mg /kg)On CFA induced arthritic rats

27. Radiological analysis: Radiographic examination of CFA induced
hind paws of the arthritic rats on
day 28 did not revealed narrowing of the joint spaces, and subsequent
bone and cartilage destruction in
the knee joint in case of control group. Control group showed marked
soft tissue swelling due to
inflammation along with joint space narrowing (Fig 1). RCLE 400mg/kg
treated rats (Fig 3) showed
normal architecture of joint where as RCLE 200mg/kg treated rats
showed normal architecture of joint
with mild soft tissue swelling (Fig 2).

28. Radiographic Evaluation of RCLE (200mg/kg &
400 mg /kg)On CFA induced arthritic rats

29. Radiological analysis: Radiographic examination of CFA induced
hind paws of the arthritic rats on
day 28 did not revealed narrowing of the joint spaces, and subsequent
bone and cartilage destruction in
the knee joint in case of control group. Control group showed marked
soft tissue swelling due to
inflammation along with joint space narrowing (Fig 1). RCLE 400mg/kg
treated rats (Fig 3) showed
normal architecture of joint where as RCLE 200mg/kg treated rats
showed normal architecture of joint
with mild soft tissue swelling (Fig 2).

30. Conclusion: Ethanolic extract of Ricinus Communis leaf
possesses acute inflammatory and prophylactic
and therapeutic anti arthritic activity; these effects are dose
dependent. Anti-inflammatory and anti
arthritic effect might be speculated due to phytochemicals
present such as flavonoids and saponin.
Standardized Extract of Ricinus communis
is a Major component of FLEXICART
However additional long term studies will be needed to justify
Chondroprotective action and extent of such protection
of Flexicart with existing composition
Evidence cannot be Overruled !!!

31. Arthritis & Rheumatology
Effect of Oral Glucosamine on Joint Structure
in Individuals With Chronic Knee Pain: A
Randomized, Placebo-Controlled Clinical
Trial
Volume 66, Issue 4, pages 930–939, April 2014
Conclusion
The results of this short-term study provide no evidence of structural benefits
(i.e., improvements in MRI morphologic features or urinary
CTX-II excretion) from glucosamine supplementation in individuals with chronic
knee pain.
Can the evidence be Overruled ?

32. Enhanced MobilityImproved ProductivityReduced Stiffness
enhances flexibility
Powerful Analgesic
effect
 Complete withdrawal of NSAID’s observed with regular
treatment regimen.
 Excellent Tolerability Profile.
 Excellent Safety Profile.
O R I G I N A L R E S E A R C H A R T I C L E
An open label, prospective, clinical study on a polyherbal formulation
in osteoarthritis of knee
Sanjay U. Nipanikar, Manjit Saluja1, Vinod V. Kuber, Kalyan P. Kadbhane, Arvind Chopra1, Namdev R. Khade1
Department of Medical Services, R and D Center, Tulip Lab Pvt. Ltd., Ranjangaon, Shirur, Pune, 1Center for Rheumatic Diseases (CRD),
Hermes Elegance, Pune, India

33. For Business Queries & Product Details, Connect with:
VISHAL CHANDRA – General Manager, International Business. TULIP LAB PVT. LTD.
vishal@tlplindia.com Mobile/Viber +91-9167770803 Skype:vishalukraine

34. Tired from Glucosamine/ Chondroitin combinations ?
Flexicart is a new option for Arthritis management
* Scientifically Developed* Clinically Tested* Validated Internationally
For Business Queries & Product Details, Connect with:
VISHAL CHANDRA – General Manager, International Business.
E-mail:vishal@tlplindia.com Mobile/Viber +91-9167770803
Skype:vishalukraine TULIP LAB PVT. LTD.