Traditional complementary and alternative medicine (TCAM) for diabetic foot ulcer management: A systematic review

Diabetic Foot Ulcers (DFUs) are a devastating micro-vascular complication of diabetes with an increased prevalence and incidence and high rate of morbidity and mortality. Since antibiotics are frequently used to treat DFU, managing the condition has proven to be extremely challenging and may eventually lead to the development of antibiotic resistance. Scientists from around the world are working to develop an alternative solution to the problem of drug resistance by exploring complementary and alternative medicines that may be obtained from natural sources. Hence, the review aims to comprehensively report the information on the natural treatments and therapy used to manage DFU. All of the information described in the current study was gathered from electronic scientific resources, including Google Scholar, PubMed, Scopus, Science Direct, and Springer Link. Findings from the current review revealed the pre-clinical and clinical utility of 18 medicinal plants, 1 isolated compound, 7 polyherbal formulations including herbal creams, a few micronutrients including vitamins and minerals, insect products such as propolis, honey and, Maggot debridement therapy for the treatment and management of DFU. Natural therapies possess better efficacy, low cost, and shorter duration of treatment when compared with the conventional treatments; hence, all information made available about them is crucial to alter the direction of treatment. Furthermore, the data presented in this review are up to date on the potential efficacy of natural complementary medicines for alleviating DFU problems in in vitro and in vivo tests, as well as clinical studies.

Ultrasound-Assisted Extraction of Verbascoside from Clerodendrum glandulosum Leaves for Analysis of Antioxidant and Antidiabetic Activities

Verbascoside (VER) is a phenylethanoid glycoside compound found in Clerodendrum species and is an important part of traditional medicine. It is found in the leaves of Clerodendrum glandulosum, which is taken as a soup or vegetable and also utilized in traditional medicine by the people of Northeast India, especially against hypertension and diabetes. In the present study, VER was extracted from C. glandulosum leaves using ultrasound-assisted extraction through the solvent extraction method (ethanol-water, ethanol, and water). The ethanol extract had the highest phenolic and flavonoid contents, viz., 110.55 mg GAE/g and 87.60 mg QE/g, respectively. HPLC and LC-MS were used to identify the active phenolic compound, and VER was found to be the main component present in the extraction with a molecular weight of 624.59 g/mol. NMR (¹H, 2D-COSY) analysis showed the presence of hydroxytyrosol, caffeic acid, glucose, and rhamnose in the VER backbone. Further, different antioxidant activities and antidiabetic and antihyperlipidemia enzyme markers' inhibition against VER-enriched ethanol extract were evaluated. The results showed that ultrasound extraction of polyphenols using ethanol from C. glandulosum could be a promising technique for the extraction of bioactive compounds.

Acute toxicity study of onion peel-derived gold nano-bioconjugate

The acute anti-inflammatory activity of onion peel-derived gold nano-bioconjugate was already established earlier. The current study was aimed to investigate the acute oral toxicity of onion peel-derived gold nano-bioconjugate (GNBC) for safe therapeutic utilization in vivo. The acute toxicity study was carried out in female mice for 15 days and showed no mortality and any abnormal complications. The lethal dose (LD50) was evaluated and found to be higher than 2000 mg/kg. After 15 days, animals were euthanized and hematological, and biochemical analyses were performed. In all hematological and biochemical assays, treated animals did not show significant toxicity when compared to the control group. The body weight, behavior, and histopathological studies showed that GNBC is nontoxic. Thereby, the results suggest that onion peel-derived gold nano-bioconjugate GNBC can be utilized for therapeutic applications in vivo.

Nanotheranostics: application of nanosensors in diabetes management

Objectives

The objective of the present study is to discuss the use of nanomaterials like nanosensors for diagnosing Diabetes and highlight their applications in the treatment of Diabetes.

Methods

Diabetes mellitus (D.M.) is a group of metabolic diseases characterized by hyperglycemia. Orally administered antidiabetic drugs like glibenclamide, glipalamide, and metformin can partially lower blood sugar levels, but long-term use causes kidney and liver damage. Recent breakthroughs in nanotheranostics have emerged as a powerful tool for diabetes treatment and diagnosis.

Results

Nanotheranostics is a rapidly developing area that can revolutionize diabetes diagnosis and treatment by combining therapy and imaging in a single probe, allowing for pancreas-specific drug and insulin delivery. Nanotheranostic in Diabetes research has facilitated the development of improved glucose monitoring and insulin administration modalities, which promise to improve the quality of life for people with Diabetes drastically. Further, nanomaterials like nanocarriers and unique functional nanomaterials used as nano theranostics tools for treating Diabetes will also be highlighted.

Conclusion

The nanosensors discussed in this review article will encourage researchers to develop innovative nanomaterials with novel functionalities and properties for diabetes detection and treatment.

Chemical composite of indigenous whole grain scented joha rice varietal prevents type 2 diabetes in rats through ameliorating insulin sensitization by the IRS-1/AKT/PI3K signalling cascade

Preventive measures to lower the prevalence of type-2 diabetes development using dietary phytochemicals are most realistic. A phytochemical composite derived from whole grain scented joha rice (PCKJ), which is indigenous to the North-eastern Region, India, was investigated to understand its preventive efficacy in rats in which type 2 diabetes was induced using a high-fat high-fructose (HFHF) diet and a low dose of streptozotocin, and the findings were correlated with those in L6-myotubes. Studies on cultured L6 myotubes revealed that treatment with PCKJ facilitated glucose uptake and GLUT-4 translocation to the plasma membrane, as evidenced by confocal microscopy and/or cell fractionation studies. Furthermore, the FFA-induced L6 myotubes were identified as having elevated levels of PI3K, p-AKT (Ser473) and GLUT-4, which returned to the basal level upon exposure to PCKJ. The administration of PCKJ (100 mg per kg body weight, oral gavage, 24 weeks) to rats significantly reduced their blood glucose levels along with common lipid and liver biomarkers (LDL, triglycerides, cholesterol, ALT, and AST) compared to the control group. Moreover, immunoblotting analysis showed that upon PCKJ treatment, PI3K, p-AKT and GLUT-4 levels are upregulated in the skeletal tissue of HFHF-fed rats, similar to the in vitro model. The alteration in the levels of inflammatory cytokines IL-6, IL-10 and IFN-γ in diabetic rats returned to normal levels upon exposure to PCKJ. Histological analysis of vital tissues further strengthens the findings of the preventive value of PCKJ against the development of insulin resistance. In conclusion, this study showed the prophylactic effect of PCKJ as a potent chemical composite, which can be used to develop functional foods (nutraceuticals) for ameliorating type-2 diabetes by improving insulin sensitization and thereby glucose metabolism.

Green Synthesis of Titanium Dioxide Nanoparticles Using Ocimum sanctum Leaf Extract: In Vitro Characterization and Its Healing Efficacy in Diabetic Wounds

Diabetes mellitus is one of the most prevalent metabolic disorders characterized by hyperglycemia due to impaired glucose metabolism. Overproduction of free radicals due to chronic hyperglycemia may cause oxidative stress, which delays wound healing in diabetic conditions. For people with diabetes, this impeded wound healing is one of the predominant reasons for mortality and morbidity. The study aimed to develop an Ocimum sanctum leaf extract-mediated green synthesis of titanium dioxide (TiO₂) nanoparticles (NPs) and further incorporate them into 2% chitosan (CS) gel for diabetic wound healing. UV-visible spectrum analysis recorded the sharp peak at 235 and 320 nm, and this was the preliminary sign for the biosynthesis of TiO₂ NPs. The FTIR analysis was used to perform a qualitative validation of the biosynthesized TiO₂ nanoparticles. XRD analysis indicated the crystallinity of TiO₂ NPs in anatase form. Microscopic investigation revealed that TiO₂ NPs were spherical and polygonal in shape, with sizes ranging from 75 to 123 nm. The EDX analysis of green synthesized NPs showed the presence of TiO₂ NPs, demonstrating the peak of titanium ion and oxygen. The hydrodynamic diameter and polydispersity index (PDI) of the TiO₂ NPs were found to be 130.3 nm and 0.237, respectively. The developed TiO₂ NPs containing CS gel exhibited the desired thixotropic properties with pseudoplastic behavior. In vivo wound healing studies and histopathological investigations of healed wounds demonstrated the excellent wound-healing efficacy of TiO₂ NPs containing CS gel in diabetic rats.

A Review on the Ethnomedicinal Plants to Cure Various Skin Diseases among the Tribal Communities in Mizoram, India: Based on the Theory of Traditional Remedy

Background:

Since primitive times, plants have been extensively utilized in conventional remedies for primary health care. It is observed that medicinal plants have a variety of bioactive components, and they have become an alternative choice for synthetic medications to treat various diseases.

Objective:

Major objective of this review article is to collect all information about the folk medicinal plants utilized by various tribal communities of Mizoram (India) as a folk remedy to cure various skin diseases.

Methods:

An extensive literature survey was carried out through different books and electronic search engines to understand the cause of skin disease and their traditional herbal remedy.

Results:

The present investigations reveal that the tribal communities of Mizoram use 93 plant species belonging to 50 different families have been identified for their ethnomedicinal indication to treat various skin diseases. The roots, rhizomes, stems, leaves, barks, bulbs, flowers, and even the whole plant are applied as folk remedies to cure various skin infections in the form of crushed juice, paste, and decoction.

Conclusion:

The information will help the researcher find unexplored medicinal plants to develop a new therapeutic approach to develop new chemical entities, which are safe, effective and inexpensive for isolation and identification of novel bioactive compounds.

Ethnobotanical Review of Medicinal Plants Used Against Diarrhea and Dysentery in Northeast India (Assam)

Background:

Since primitive times, plants have been extensively utilized in conventional remedies for primary health care. It is observed that medicinal plants have various bioactive components. It becomes an alternative choice for synthetic medications to treat diarrhea and dysentery, which are the primary waterborne diseases with high mortality rates that bring substantial health threats to global populations.

Objective:

The present review aims to look over the ethnobotanical knowledge for the treatment of diarrhea and dysentery and folklore practices by the people prevailing in Assam.

Methods:

In this perspective, an extensive literature survey was carried out to understand the mechanism, control, and treatment of diarrhea and dysentery in different online academic databases and books. An advanced search was carried out in 'PubMed' and 'Google Scholar' using the term "Phytoconstituents" and "antidiarrheal" along with "Phytoconstituents" and "anti-amoebic".

Results:

Data retrieved from databases were analyzed and interpreted to conclude that in Assam, diarrhea and dysentery are the primary leading causes of mortality among children under five years. It is mainly due to the unhygienic livelihood, unavailability of safe drinking water, unhealthy food, seasonal rainfall, flood, and open defecation. The present investigations reveal that the people of Assam use 39 plant species belonging to 36 families to cure diarrhea and dysentery.

Conclusion:

The present study established the effective use of medicinal plants by various communities in Assam to treat diarrhea and dysentery. Furthermore, it can be used to develop a new therapeutic approach to create new chemical entities (NCE) in drug discovery, which are safe, fruitful, and inexpensive.

Progress in Drug and Formulation Development for the Chemoprevention of Oral Squamous Cell Carcinoma: A Review

BACKGROUND

Cancer is a life-threatening global problem with high incidence rates. Prioritizing the prevention of cancer, chemopreventive agents have drawn much attention from the researchers.

OBJECTIVE

This review focuses on the discussion of the progress in the development of chemopreventive agents and formulations related to the prevention of oral cancer.

METHODS

In this perspective, an extensive literature survey was carried out to understand the mechanism, control and chemoprevention of oral cancer. Different patented agents and formulations have also exhibited cancer preventive efficacy in experimental studies. This review summarizes the etiology of oral cancer and developments in prevention strategies.

RESULTS

The growth of oral cancer is a multistep activity necessitating the accumulation of genetic as well as epigenetic alterations in key regulatory genes. Many risk factors are associated with oral cancer. Genomic technique for sequencing all tumor specimens has been made available to help detect mutations. The recent development of molecular pathway and genetic tools has made the process of diagnosis easier, better forecast and efficient therapeutic management. Different chemical agents have been studied for their efficacy to prevent oral cancer and some of them have shown promising results.

CONCLUSION

Use of chemopreventive agents, either synthetic or natural origin, to prevent carcinogenesis is a worthy concept in the management of cancers. Preventive measures are helpful in controlling the occurrence or severity of the disease. The demonstrated results of preventive agents have opened an arena for the development of promising chemopreventive agents in the management of oral squamous cell carcinoma.

Development and Analysis of Speech Recognition Systems for Assamese Language Using HTK

Language analysis is very important for the native speaker to connect with the digital world. Assamese is a relatively unexplored language. In this report, we analyze different aspects of speech-to-text processing, starting from building a speech corpus, defining syllable rules, and finally developing a speech search engine of Assamese. We have collected about 20 hours of speech in three (viz., read, extempore, and conversation) modes and transcribed it. We also discuss some issues and challenges faced during development of the corpus. We have developed an automatic syllabification model with 11 rules for the Assamese language and found an accuracy of more than 95% in our result. We found 12 different syllable patterns where 5 are found most frequent. The maximum length of a syllable found is four letters. With the help of Hidden Markov Model Toolkit (HTK) 3.5, we used deep learning based neural network for our speech recognition model, where we obtained 78.05% accuracy for automatic transcription of Assamese speech.

New vaccine adoption: qualitative study of national decision-making processes in seven low- and middle-income countries

As more new and improved vaccines become available, decisions on which to adopt into routine programmes become more frequent and complex. This qualitative study aimed to explore processes of national decision-making around new vaccine adoption and to understand the factors affecting these decisions. Ninety-five key informant interviews were conducted in seven low- and middle-income countries: Bangladesh, Cameroon, Ethiopia, Guatemala, Kenya, Mali and South Africa. Framework analysis was used to explore issues both within and between countries. The underlying driver for adoption decisions in GAVI-eligible countries was the desire to seize GAVI windows of opportunity for funding. By contrast, in South Africa and Guatemala, non-GAVI-eligible countries, the decision-making process was more rooted in internal and political dynamics. Decisions to adopt new vaccines are, by nature, political. The main drivers influencing decisions were the availability of funding, political prioritization of vaccination or the vaccine-preventable disease and the burden of disease. Other factors, such as financial sustainability and feasibility of introduction, were not as influential. Although GAVI procedures have established more formality in decision-making, they did not always result in consideration of all relevant factors. As familiarity with GAVI procedures increased, questioning by decision-makers about whether a country should apply for funding appeared to have diminished. This is one of the first studies to empirically investigate national processes of new vaccine adoption decision-making using rigorous methods. Our findings show that previous decision-making frameworks (developed to guide or study national decision-making) bore little resemblance to real-life decisions, which were dominated by domestic politics. Understanding the realities of vaccine policy decision-making is critical for developing strategies to encourage improved evidence-informed decision-making about new vaccine adoptions. The potential for international initiatives to encourage evidence-informed decision-making should be realised, not assumed.

Vermicomposting potentiality of Perionyx excavatus for recycling of waste biomass of Java citronella--an aromatic oil yielding plant

Laboratory investigation on vermicomposting efficacy of Perionyx excavatus for recycling of distillation waste biomass of java citronella (Cymbopogon winterianus Jowitt) was carried out in two seasonal trials i.e. summer and winter periods. The experiment was conducted in earthen pots using a mixture of citronella waste material and cowdung in the proportion of 5:1. A control treatment without earthworms was setup for comparison of the results. The vermicompost had shown 5.8 folds reduction in C/N ratio and 5.6 folds enhancement in ash content. The nutrient contents (N, P, K, Ca and Mg) in the vermicompost had increase in the range of 1.2 - 4.1 fold than the initial level. The FT-IR spectra of the vermicompost confirmed increase in nitrogen rich compounds and decrease in aliphatic/aromatic compounds as compared to the initial level of the biowaste materials. The vermicomposting process is influenced by seasonal variation and summer was more productive than winter.

Impact of measles elimination activities on immunization services and health systems: findings from six countries

BACKGROUND

One of the key concerns in determining the appropriateness of establishing a measles eradication goal is its potential impact on routine immunization services and the overall health system. The objective of this study was to evaluate the impact of accelerated measles elimination activities (AMEAs) on immunization services and health systems in 6 countries: Bangladesh, Brazil, Cameroon, Ethiopia, Tajikistan, and Vietnam.

METHODS

Primary data were collected from key informant interviews and staff profiling surveys. Secondary data were collected from policy documents, studies, and reports. Data analysis used qualitative approaches.

RESULTS

This study found that the impact of AMEAs varied, with positive and negative implications in specific immunization and health system functions. On balance, the impacts on immunization services were largely positive in Bangladesh, Brazil, Tajikistan, and Vietnam, while negative impacts were more significant in Cameroon and Ethiopia.

CONCLUSIONS

We conclude that while weaker health systems may not be able to benefit sufficiently from AMEAs, in more developed health systems, disruptions to health service delivery are unlikely to occur. Opportunities to strengthen the routine immunization service and health system should be actively sought to address system bottlenecks in order to incur benefits to eradication program itself as well as other health priorities.

Radiation-induced incidence of thymic lymphoma in mice and its prevention by antioxidants

Previous reports from our laboratory have shown that in Swiss female mice exposed to an acute dose (3 Gy) of whole body irradiation (WBI), induced thymic lymphoma (TL) resulted after three to four weeks of exposure. The present study was aimed to further evaluate dependency on gender and effect of age of mice at the time of irradiation on TL incidence. A significant decrease in body weight gain was observed in female mice exposed to WBI, which was found to be correlated with the increase in weight and size of thymus, compared to their respective controls. An increase in TL incidence was observed with the increased postirradiation time, which was 47, 80, and 93% after 90, 120, and 150 days of WBI, respectively, in female mice. In irradiated female mice, the TL incidence was significantly higher and the growth of tumor in terms of weight and size was more aggressive than in males of the same age. Moreover, mice with higher age groups at the time of irradiation showed substantial decrease in TL incidence and its aggressiveness; and these effects were more conspicuous in males than in females. In mice irradiated at the age group of three to four weeks, the TL incidence was 83 and 72% in female and male, respectively, which was decreased to 74% in female and 14% in male in the age group of 12-13 weeks. It was further observed that the postirradiation feeding of animals with antioxidants resulted in a significant decrease in TL incidence, and the prevention in TL incidence was more in animals fed with curcumin (55%) than with ascorbic acid and eugenol (20%). These results have provided significant new findings on the phenomenon of radiation-induced TL incidence related to gender and age at the time of irradiation and its prevention by postirradiation antioxidant feeding to mice.