Efficacy and safety of Link Natural Sudarshana, an Ayurvedic herbal preparation in COVID-19 patients: A phase II multicenter double-blind randomized placebo-controlled trial

ETHNOPHARMACOLOGICAL RELEVANCE

In vitro and in vivo studies have shown anti-viral and immunomodulatory actions in components of many traditional medicines. Various constituents of traditional medicines have been found to be effective against coronavirus disease (COVID-19) in several clinical trials and in-silico studies. Sudarshana cúrna, a polyherbal Ayurvedic medicine, has been used over thousands of years for a variety of infectious fevers.

AIMS OF THE STUDY

This study aimed to evaluate the efficacy and safety of Link Natural Sudarshana (LNS) tablets, in patients with COVID 19 disease. LNS is a polyherbal preparation comprising 49 medicinal plants included in the Sudarshana cúrna.

MATERIALS AND METHODS

A randomized parallel-group double-blind placebo-controlled multi-center phase II clinical trial was conducted in patients with mild to moderate COVID-19 disease. They were randomly allocated to intervention and control groups. The intervention group received LNS tablets whereas the control group received placebo tablets for 10 days or until the patient was discharged from the hospital. All patients received standard symptomatic treatment. The primary outcome, a reduction in mean log viral load was assessed at day 5 of treatment. The secondary outcomes, clinical progression and safety, were assessed by, monitoring changes in symptoms daily on a Likert scale ranging from 1 to 4 and laboratory tests respectively.

RESULTS

A total of 171 patients (treatment group 83, control group 88) completed the trial. There were no significant differences between the baseline status of the two groups except that body mass index was significantly higher in the placebo group. The mean log viral load reduction at day 5 was higher in the treatment group (2.20 ± 1.67) compared to the placebo group (1.93 ± 1.80), with a mean difference of -0.278. This difference was not statistically significant at the 5% significant level. Reduction of mean cumulative symptom score, which included 16 symptoms graded according to severity, was higher in the treatment group compared to the placebo group. This difference was not statistically significant. None of the study participants developed hypoxia. Among the 7 lymphopenia patients in the placebo group, 3 continued to have lymphopenia at day 10, whereas 9 lymphopenia patients in the treatment group, reverted to normal counts. C reactive proteins (CRP) showed a greater reduction in the treatment group. None reported adverse effects. No significant changes occurred in hematological and biochemical parameters that assessed safety.

CONCLUSIONS

LNS is safe to use in COVID-19 patients and accelerated the decline in viral load, relieved symptoms, reduced CRP levels and reversed lymphopenia earlier, when compared to the placebo.

Green synthesis of silver nanoparticles employing hamdard joshanda extract: putative antimicrobial potential against gram positive and gram negative bacteria

The bio-mediated synthesis of nanoparticles offers a sustainable and eco-friendly approach. In the present study, silver nanoparticles (AgNPs) were synthesized using Joshanda extract, a commercially available herbal formulation derived from a traditional medicinal plant, as a reducing and stabilizing agent. The as-synthesized AgNPs were characterized using UV-Vis spectroscopy, dynamic light scattering (DLS), X-ray Diffraction (XRD) study, and Fourier-transform infrared (FTIR) analysis. UV-Vis spectroscopy exhibited a prominent absorption peak at 430 nm, confirming the formation of AgNPs. DLS analysis revealed the size distribution of the nanoparticles, ranging from 80 to 100 nm, and zeta potential measurements indicated a surface charge of - 14.4 mV. The XRD analysis provide evidence for the presence of a face-centered cubic structure within the silver nanoparticles. FTIR analysis further elucidated the interaction of bioactive compounds from the Joshanda extract with the AgNPs' surface. Strong peaks at 765-829 cm-1 indicated C-Cl stretching vibrations of alkyl halides, while the stretching of alkenes C=C was observed at 1641 cm-1. Moreover, the presence of alcohols and phenol (OH) groups was identified at 3448 cm-1, suggesting their involvement in nanoparticle stabilization. The antimicrobial potential of the synthesized AgNPs was evaluated against both gram-negative Pseudomonas aeruginosa and gram-positive Streptococcus mutans using zone of inhibition assays. The AgNPs exhibited remarkable inhibitory effects against both types of bacteria. Additionally, AgNPs-treated groups demonstrated a significant increase in reactive oxygen species (ROS) levels, indicating potential of as-synthesized AgNPs in disruption of the target microbial membranes. Furthermore, the as-synthesized AgNPs exhibited notable anti-biofilm properties by effectively hindering the development of mature biofilms. This study highlights the efficient green synthesis of AgNPs using Joshanda extract and also provides insights into their physico-chemical properties of as-synthesized nanoparticles. The demonstrated antimicrobial activity against both gram-negative and gram-positive bacteria, along with biofilm inhibition potential, underscores the promising applications of the as-synthesized AgNPs in the field of biomedical and environmental sciences. The study bridges traditional knowledge with contemporary nanotechnology, offering a novel avenue for the development of eco-friendly antimicrobial agents.

Use of red grape pomace and Aloe vera gel as nutraceuticals to ameliorate stocking density-induced stress in commercial male broilers

The combined effect of Aloe vera gel (AVG) administered through drinking water and dietary red grape pomace powder (RGP) on growth performance, physiological traits, welfare indicators, and meat quality in densely stocked broilers was evaluated. A total of 750, two-week-old male Ross 308 broilers (317.7 ± 10.12 g live weight) were randomly assigned to 25 cages, with each cage as an experimental unit. The broilers were stocked at a density of 30 birds per cage with a floor space of 1.32 m2. Dietary treatments were a standard grower or finisher diet (CON); CON containing 30 g RGP /kg diet plus either 1 (GPA1), 2 (GPA2), 3 (GPA3), or 4% (GPA4) AVG in drinking water. Treatment GPA1 promoted higher (P < 0.05) overall weight gain and overall feed conversion ratio (FCR) than CON. Positive quadratic effects (P < 0.05) were noted for mean corpuscular hemoglobin, basophils, 24-hour breast meat yellowness, chroma, and hue angle. The GPA2 group had the lowest (P < 0.05) gait score while the CON group had the highest score. Concurrent supplementation with a 30 g RGP /kg diet plus 1% AVG in drinking water enhanced weight gain, FCR, and finisher weight of densely stocked broilers. However, AVG doses beyond 1% did not enhance performance and physiological traits in densely stocked broilers.

Aloe vera gel confers therapeutic effect by reducing pyroptosis in ethanol-induced gastric ulcer rat model: Role of NLRP3/GSDMD signaling pathway

BACKGROUND

Gastric ulcer (GU) is a common gastrointestinal tract illness. Aloe vera has anti-inflammatory, antioxidant, and healing characteristics. This research sought to explore the therapeutic impact of Aloe vera gel on ethanol-provoked GU in rats and to elucidate the underlying mechanisms involved.

METHODS

An ethanol-induced GU rat model was constructed using forty male Wistar rats distributed at random into four groups: control, ulcer, pantoprazole, and Aloe vera. Gross evaluation of the stomach, ulcer index (UI), inhibition index, and gastric pH estimation were analyzed. Gastric malondialdehyde (MDA) and reduced glutathione (GSH) were determined using the spectrophotometric method, and serum gastrin level was measured by an enzyme-linked immunosorbent assay. Gastric nucleotide-binding domain, leucine-rich repeat, and pyrin domain PYD containing protein 3 (NLRP3) and gasdermin D (GSDMD) mRNA expression levels were estimated by quantitative real-time PCR. Finally, the histopathological examination of the glandular part of stomach tissue was done.

RESULTS

The ulcer group revealed a significant increase in MDA, gastrin, NLRP3, and GSDMD and a decrease in gastric pH and GSH compared to the control group. Gross investigations of the ulcer group revealed a hemorrhagic lesion in the stomach and an increase in UI. Also, histopathological results for this group showed severe epithelial loss, haemorrhage, inflammatory cell infiltration, and blood vessel congestion. However, Aloe vera treatment improved the gross, biochemical, molecular, and histopathological alterations induced by ethanol when compared to the ulcer group.

CONCLUSIONS

Aloe vera exerted antiulcer activities through modulation of oxidant/antioxidant status, anti-secretory properties, and mitigation of pyroptosis.

Ethnobotanical study of medicinal plants used by the Yi people in Mile, Yunnan, China

BACKGROUND

The Yi people are a sociolinguistic group living in Mile City, which is their typical settlement in southeastern Yunnan, China. Over the long history of using medicinal plants, the Yi people have accumulated and developed a wealth of traditional medicinal knowledge, which has played a vital role in their health care. However, only a few studies have been performed to systematically document the medicinal plants commonly used by the Yi people. This study provides fundamental data for the development and application of ethnomedicine as well as supports the conservation of the traditional medical knowledge of the Yi people.

METHODS

This study was conducted from May 2020 to August 2022 and involved five townships in Mile. Information regarding medicinal plants was obtained through semistructured interviews, key informant interviews, and participatory observation. The collected voucher specimens were identified using the botanical taxonomy method and deposited in the herbarium. Ethnobotanical data were analyzed using informant consensus factor, relative frequency of citation, and fidelity level.

RESULTS

In total, 114 informants distributed in five townships of Mile were interviewed. The Yi people used 267 medicinal plant species belonging to 232 genera and 104 families to treat various diseases. Asteraceae, Lamiaceae, and Fabaceae were the most commonly used plant families by the Yi people. In addition, herbs were most commonly used by the Yi people. Whole plants and roots were the preferred medicinal parts. Decoctions were the most common method of herbal medicine preparation. There are 49 different recorded diseases treated by Yi medicinal plants, and among them, respiratory diseases, rheumatism, traumatic injury, fractures, and digestive system diseases have the largest number of species used. A quantitative analysis demonstrated that plants such as Zingiber officinale, Lycopodium japonicum, Aconitum carmichaelii, Panax notoginseng, Cyathula officinalis, and Leonurus japonicus played crucial roles in disease prevention and treatment.

CONCLUSION

Traditional knowledge of medicinal plants is closely associated with the social culture of the local Yi people. The medicinal plants used for health care in the study area were diverse. Local healers were skilled at using medicinal plants to treat various diseases. Their treatment methods were convenient and unique, exhibiting distinctive regional characteristics. However, the inheritance of their traditional medicinal knowledge and protection of wild medicinal plant resources are facing serious challenges, including the decreasing number of local healers, aging of healers, lack of successors, and excessive harvesting of medicinal plant resources. This ethnobotanical survey provides a useful reference for the sustainable utilization and protection of medicinal plant resources in Mile and the inheritance of traditional medicinal knowledge of the Yi people.

Comparison of aloe vera gel dressing with conventional dressing on pressure ulcer pain reduction: a clinical trial

BACKGROUND

Aloe Vera has a strong analgesic and anti-inflammatory effect, and its use effectively controls pain. This study aimed to determine the effect of Aloe Vera gel versus saline on pain relief of pressure ulcers.

METHODS

This study is a double-blind, randomized clinical trial conducted in Valiasr Hospital in Arak, Markazi Province, in the center of Iran from May 2020 to April 2022. Using the available sampling method, 95 patients with pressure ulcers were assessed for eligibility, 64 patients were selected, 33 patients were placed in the experimental and 34 patients in control. For the experimental group, the ulcers were first cleaned with normal saline to remove the slough and then the already prepared Aloe Vera gel was evenly applied. For control groups, the ulcers were first washed with normal saline to remove off the slough and then covered with a sterile cotton gage, and the wound was tightly bandaged with a cotton roll to keep the "daily dressing" in place. A visual pain scale was used to assess the patient's pain level. Data analysis was done using SPSS 17. Descriptive statistics, ANOVA, and greenhouse tests were used. The significance level was 0.05.

RESULTS

The results showed that the average pain score in both groups had a downward trend; that is, both dressings effectively reduced pressure ulcer pain (P < 0.001). The greenhouse test results showed that the difference between the two groups was significant (P < 0.001).

CONCLUSION

The results showed the effect of Aloe Vera gel in reducing pressure ulcer pain. Dressing with Aloe Vera gel is preferable to reducing pain during dressing changes in patients with pressure ulcers.

TRIAL REGISTRATION

Iranian Registry of Clinical Trials IRCT20180715040478N2, 2021-08-17.

Ethnobotanical study of traditional medicinal plants used by the local people in Habru District, North Wollo Zone, Ethiopia

BACKGROUND

Ethiopia is a country located in the Horn of Africa, which combines richness in plant resources and cultures of human plant use. The people of Habru District of North Wollo Zone (Amhara Region, Ethiopia) have a long history of use of plant resources for various purposes including in traditional herbal remedy preparation and use. However, the district has not been adequately studied for its ethnobotanical resources and the associated knowledge. This study focused on human medicinal plants and their traditional uses in Habru District. The objective of the study was to document and analyze the plant species used by the local communities to treat human ailments along with the associated traditional knowledge and practices.

METHODOLOGY

The study was carried out in Habru District from June 2021 to December 2022. Ethnobotanical data were collected using semi-structured interviews, guided field walks, 13 focus group discussions (one at the district level and 12 at the kebele/subdistrict level) and market surveys. A total of 388 informants (250 males and 138 females) were selected from all 13 kebeles within Habru District using systematic random sampling, and 42 key informants were purposively selected. Descriptive statistics, preference ranking, direct matrix ranking, informant consensus factor and fidelity level were applied for data analysis.

RESULTS

The results provide insights into the medicinal plant diversity within Habru District, where 134 plant species in 110 genera and 54 families were documented, including 2 endemics, highlighting the district's significance in biodiversity conservation and healthcare delivery. Disease prevalence analysis showed that gastrointestinal and parasitic ailments (ICF = 0.85), febrile diseases (ICF = 0.84), and culture-related conditions exhibit high informant consensus factors. Remedy preparation involves various plant parts, predominantly leaves (47.3%), followed by roots (22.1%), fruits (7.0%), and seeds (5.8%). Freshly harvested plant parts were frequently used (58.2%), while 24.7% involved both dried and fresh parts. Oral application (47.3%) and topical use (31.8%) are the major routes of remedy administration. The marketability of medicinal plants was evident, with 16.4% of the species reported as marketable, including Terminalia brownii Fresen. Myrtus communis L., Ruta chalepensis L., Olea europaea L. subsp. cuspidata (Wall. & G.Don) Cif., Allium sativum L. and Capsicum annuum L. Multipurpose plants such as Solanum somalense Franchet. (91.3% FL), Ocimum lamiifolium Hochst. ex. Benth. (88.9% FL), and Verbascum sinaiticum Benth. (85.7% FL) exhibited notable healing potentials.

CONCLUSION

The current study underscores the intricate relationship between the local community and medicinal plants, emphasizing the importance of biodiversity conservation and health care and acknowledging the dynamic interplay between cultural heritage and ecosystem health. The results contribute to the development of sustainable conservation strategies, healthcare practices and the preservation of traditional knowledge, and highlight the interdependence of human societies and their natural environments. Community-based conservation initiatives with active participation of local communities are desirable for the conservation and sustainable use of medicinal plant species and their habitats. Raising public awareness about the sustainable harvesting and utilization of marketed medicinal plants (e.g., Terminalia brownii Fresen.) that are under threat is also important to ensure their availability for future generations and contribution to socioeconomic development.

Could Natural Products Help in the Control of Obesity? Current Insights and Future Perspectives

Obesity is a global issue faced by many individuals worldwide. However, no drug has a pronounced effect with few side effects. Green tea, a well-known natural product, shows preventive effects against obesity by decreasing lipogenesis and increasing fat oxidation and antioxidant capacity. In contrast, other natural products are known to contribute to obesity. Relevant articles published on the therapeutic effect of natural products on obesity were retrieved from PubMed, Web of Science, and Scopus. The search was conducted by entering keywords such as "obesity", "natural product", and "clinical trial". The natural products were classified as single compounds, foods, teas, fruits, herbal medicines-single extract, herbal medicines-decoction, and herbal medicines-external preparation. Then, the mechanisms of these medicines were organized into lipid metabolism, anti-inflammation, antioxidation, appetite loss, and thermogenesis. This review aimed to assess the efficacy and mechanisms of effective natural products in managing obesity. Several clinical studies reported that natural products showed antiobesity effects, including Coffea arabica (coffee), Camellia sinensis (green tea), Caulerpa racemosa (green algae), Allium sativum (garlic), combined Ephedra intermedia Schrenk, Thea sinensis L., and Atractylodes lancea DC extract (known as Gambisan), Ephedra sinica Stapf, Angelica Gigantis Radix, Atractylodis Rhizoma Alba, Coicis semen, Cinnamomi cortex, Paeoniae radix alba, and Glycyrrhiza uralensis (known as Euiiyin-tang formula). Further studies are expected to refine the pharmacological effects of natural products for clinical use.

Ephedrine and pseudoephedrine in Ephedra saxatilis on the vertical altitude gradient changed in southern Tibet Plateau, China

Ephedra is one of the world's most important plants, used in medicine, plants and ecology. Most Ephedra grows in plain areas and is stable. But the plateau environment is special, with the change of altitude, the variety difference of plateau Ephedra saxatilis is very obvious. E. saxatilis metabolism on the Tibetan Plateau is not only affected by altitude, but also environmental conditions such as climate conditions and different soil components. However, the change mechanism of E. saxatilis alkaloids in special ecological environment is still unclear. Therefore, we analyzed the metabolic and altitude of E. saxatilis species in the Tibetan Plateau. Through the functional analysis of Kyoto Metabolism and Metabolomic Encyclopedia (KEGG), we can determine that the number of E. saxatilis metabolites decreases with the increase of altitude, and there are differences in metabolism among the three mountains. This was confirmed by univariate analysis of the top five metabolic pathways. Based on the analysis of soil and metabolomics, it was found that soil water content was also a factor affecting E. saxatilis metabolism. According to the difference of vertical height gradient, ephedrine and pseudephedrine showed the same change in vertical altitude under different mountains. Ephedrine increased as the altitude gradient increased, and pseudoephedrine decreased as the altitude gradient decreased. Our results provide valuable information for further study of metabolic mechanism and efficacy stability. It provides useful reference for the research of E. saxatilis planting in special area.

Staining ability of herbal tea preparations on a nano-filled composite restorative material - an in-vitro study

Background: Discoloration of tooth-colored restorations due to various factors is one of the principal causes behind the failure of aesthetics. There has been an surge in the consumption of herbal beverages in recent times and the dietary factors play a potential role in the discoloration tooth-coloured restorations. This study was done to juxtapose the staining ability of green tea (GT), moringa tea (MT), and hibiscus tea (HT) on a nano-filled composite restorative material. Methods: The study was conducted in-vitro on composite samples prepared using moulds. 112 discs were prepared from Filtek TM Z350XT composite using a brass mould lined with mylar strips. Samples were divided into GT, MT, HT, and artificial saliva (AS) groups and immersed in freshly prepared beverages for 15 minutes each day for 45 days. Digital reflectance spectrophotometer was utilized to record color at baseline, 30, and 45 days. Repeated-measures ANOVA with a post-hoc Bonferroni test was used to compare groups within each group. ANOVA with a post-hoc Games Howell test was used to compare mean differences in ΔE among the groups. Results: Maximum discoloration was observed in the GT, followed by HT and MT, with the least being in the AS group at the end of 30 and 45 days (P<0.001 and P<0.001) respectively. Conclusions: The universal nano-filled composite material showed clinically detectable discoloration when exposed to Green Tea, Hibiscus Tea, and Moringa Tea which increased with time. Herbal beverages have the potential to cause discoloration of the composite resin which is often the choice of material for anterior aesthetic restorations.

Ephedrae herba: A comprehensive review of its traditional uses, phytochemistry, pharmacology, and toxicology

ETHNOPHARMACOLOGICAL RELEVANCE

Ephedrae herba (called Mahuang in China) is the dried herbaceous stem of Ephedra sinica Stapf, Ephedra intermedia Schrenk et C. A. Mey., and Ephedra equisetina Bge. Ephedrae herba has a long history of use as an herb, and it was originally recorded in Sheng Nong's herbal classic. Ephedrae herba has also been widely used as both medicine and food. In the clinic, Ephedrae herba is commonly used for treating colds, bronchial asthma, nasal congestion, and other diseases.

AIM OF REVIEW

This review aims to provide a systematic summary on the traditional use, chemical constituents, pharmacological effects, clinical applications, quality control, toxicology, and pharmacokinetics of Ephedrae herba to provide a theoretical basis for further reasonable development of Ephedrae herba in clinical practice and creation of new drugs.

MATERIALS AND METHODS

Information on Ephedrae herba was gathered from various sources, including the scientific databases including CNKI, PubMed, SciFinder and ScienceDirect, classical books on traditional Chinese herbal medicine, Ph.D. and M.Sc. dissertations; Baidu Scholar; and from different professional websites.

RESULTS

Ephedrae herba is distributed in regions of China and other areas. Ephedra and its compound preparations can be used for colds, bronchial asthma, nasal congestion and other diseases. Approximately 281 chemical constituents have been isolated from Ephedrae herba, including alkaloids, flavonoids, tannins, polysaccharides, volatile oils, organic acids, and other compounds. Among these constituents, alkaloids and volatile oils are the most abundant and represent the major bioactive constituents. Ephedrae herba possesses multiple pharmacological activities, including diuretic effect, anti-allergic effect, blood pressure regulatory, anti-inflammatory effect, anti-oxidation effect and anti-viral effects. Ephedrine hydrochloride and pseudoephedrine hydrochloride are generally selected as indicators for the quantitative determination of Ephedrae herba. The maximum dosage of Ephedrae herba should not exceed 10 g. If overused, adverse reactions such as palpitations, sweating, irritability and insomnia will occur.

CONCLUSIONS

Ephedrae herba is an ancient herbal medicine with a broad spectrum of pharmacological activities that has been used for thousands of years in China. It is one of the most commonly used herbal components of the TCM formulas. Hydrochloride and pseudoephedrine are the major bioactive constituents. However, there is a need to further understand the mechanisms of active components of Ephedrae herba. Future studies should perform an in-depth analyses of the pharmacokinetics and mechanisms of toxicity of Ephedrae herba. Quality standards should be developed to correspond to the various application methods to ensure the efficacy of drugs in actual treatment.

Dual control system for comprehensive evaluation of quality consistency of herbal preparations

This study was undertaken to establish an integrated quality control method based on the fingerprint of different testing instruments and a four-dimensional antioxidant activity profile. Firstly, the comprehensive ratio quantitative fingerprint method was used to rapidly calculate the similarity of GC fingerprint, UV-vis quantized fingerprint, HPLC fingerprint and ATR-FT-IR quantized fingerprint. In addition, a comprehensive evaluation strategy was proposed using the variation coefficient weighting algorithm, incorporating four complementary inputs, to achieve highly accurate analysis. At the same time, multi-markers assay by monolinear method was used for the first time for the quantitative analysis of multiple components. Based on this, the fingerprint-efficacy relationship was investigated, and substances that might be biologically active and the wavelength range of their distribution were predicted using the online-HPLC-DPPH-FIA method in conjunction with a PLS model built from individual and combined data matrices. The results showed that all 20 batches of samples were within 1-3 grades, with good quality consistency. According to index E, the samples' overall antioxidant capacity was also highly correlated with the year of production. The four-dimensional antioxidant activity profile also led to the conclusion that variations in antioxidant characteristics were caused by differences in the concentration and volatility of particular bioactive chemicals. Finally, mid-level data fusion produced better classification results than a single technique, further demonstrating the synergistic effects that may occur when the four types of data were combined. This study demonstrated that the combination of GC, UV-vis, ATR-FT-IR and HPLC can be used for the consistency control of herbal preparations and can elucidate the potential in predicting the antioxidant capacity of herbal preparations.

6-Week Supplementation with Tribulus terrestris L. to Trained Male CrossFit® Athletes on Muscle, Inflammation, and Antioxidant Biomarkers: A Randomized, Single-Blind, Placebo-Controlled Trial

Tribulus terrestris L. (TT) ingredients have anti-inflammatory and antioxidant activities, but their effects on exercise-induced muscle damage (EIMD) in trained athletes are uncertain. The purpose of this single-blind placebo-controlled trial, in accordance with CONSORT guidelines, was to examine the effect of 6 weeks of TT supplementation on muscle metabolism, inflammation biomarkers, and oxidant status. Thirty trained male CrossFit® athletes were randomly assigned to be supplemented with 770 mg/day of TT (intervention group (IG)) or receive a placebo daily (control group (CG)) for 6 weeks. Muscle damage enzymes, inflammation biomarkers, and Total Antioxidant Status (TAS) were assessed at baseline (T1), 21 days after baseline (T2), and after 42 days (T3). Grace, a Workout of the Day, was measured in T1 and T3. Statistical significance (p < 0.05) was found between IG and CG in Lactate Dehydrogenase (LDH), C-reactive protein (CRP), and TAS levels at the end of the follow-up. Furthermore, TAS levels were significantly (p < 0.05) lower at T2 and T3 relative to baseline in the IG, also LDH and CRP increased significantly (p < 0.05) at T2 and T3 relative to baseline in the CG. No significant (p > 0.05) decreases in muscle damage or inflammation biomarkers were observed, although a slight downward trend was observed after 6 weeks for supplemented athletes. TT supplementation could attenuate the CrossFit® training program-induced oxidative stress, muscle damage, and inflammation which could be due to the natural antioxidant and anti-inflammatory properties of TT.

Beyond the Psychoactive Effects of Ayahuasca: Cultural and Pharmacological Relevance of Its Emetic and Purging Properties

The herbal preparation ayahuasca has been an important part of ritual and healing practices, deployed to access invisible worlds in several indigenous groups in the Amazon basin and among mestizo populations of South America. The preparation is usually known to be composed of two main plants, Banisteriopsis caapi and Psychotria viridis, which produce both hallucinogenic and potent purging and emetic effects; currently, these are considered its major pharmacological activities. In recent decades, the psychoactive and visionary effect of ayahuasca has been highly sought after by the shamanic tourism community, which led to the popularization of ayahuasca use globally and to a cultural distancing from its traditional cosmological meanings, including that of purging and emesis. Further, the field of ethnobotany and ethnopharmacology has also produced relatively limited data linking the phytochemical diversity of ayahuasca with the different degrees of its purging and emetic versus psychoactive effects. Similarly, scientific interest has also principally addressed the psychological and mental health effects of ayahuasca, overlooking the cultural and pharmacological importance of the purging and emetic activity. The aim of this review is therefore to shed light on the understudied purging and emetic effect of ayahuasca herbal preparation. It firstly focuses on reviewing the cultural relevance of emesis and purging in the context of Amazonian traditions. Secondly, on the basis of the main known phytochemicals described in the ayahuasca formula, a comprehensive pharmacological evaluation of their emetic and purging properties is presented.

Quality and nutritional value of cookies enriched with plant-based protein preparations

BACKGROUND

The objective of the study was to determine the effect of addition of plant-based protein preparations in cookie recipes on the quality and nutritional value of the obtained products. Wheat flour was replaced by 10%, 20% or 30% of pea, hemp seed, pumpkin and sunflower seed preparations. Baked cookies were analysed for chemical composition, amino acid profile, colour and texture as well as organoleptic attributes and overall acceptability.

RESULTS

The addition of plant protein preparations improved the nutritional value of cookies by supplementing them with threonine and part of lysine. Replacing at least 20% of wheat flour with pea protein allowed the production of cookies with a well-balanced amino acid profile. The use of pea and sunflower proteins improved the appearance of the obtained products (consumer notes from 7.4 to 8.0) in comparison to the control sample (note 7.2). The physical properties of cookies were changed while organoleptic properties worsened. Cookies with the most desirable sensory values were obtained using the pea protein preparation. Acceptable cookies were also obtained with pumpkin and sunflower seed protein preparations, if the proportion of additive did not exceed 20% in relation to the amount of wheat flour.

CONCLUSION

The use of protein preparations from pumpkin and sunflower as well as from hemp seeds allows the production of cookies with acceptable sensory characteristics that could diversify the range of cookie products. In the case of oilseed preparations, the amount of additive is limited primarily by the colour and taste of the finished products. © 2022 Society of Chemical Industry.

Role of Shankhpushpi (Convolvulus pluricaulis) in Neurological Disorders: An Umbrella Review Covering Evidence from Ethnopharmacology to Clinical Studies

C. pluricaulis Choisy (C. pluricaulis), a perennial herb aka C. microphyllus Sieb. and C. Prostratus Forsk. is being used as a traditional folk medicine for a variety of ailments. In this article, we collected information about C. pluricaulis through electronic search using PubMed, SciFinder, Google Scholar, and Web of Science as well as network pharmacology is done. This comprehensive review sheds light on the plant profile, phytochemistry, neuropharmacological, and toxicological data of C. pluricaulis. The crude herb and its metabolites have exhibited a wide range of in vitro and in vivo neuropharmacological effects, including memory enhancement, anxiolytic, tranquilizing, anti-depressant, anti-stress, neurodegenerative, anti-inflammatory, anti-oxidant, analgesic, sedative, anti-convulsant, and Alzheimer's disease-reversing effects. Network pharmacology results indicate that compounds from C. pluricaulis interact with various proteins, neuro synapses, signaling pathways, and serotonergic synapse which plays a crucial role in neurotransmission, Alzheimer's disease, long-term depression, addictions to alcohol, cognitive disorders, psychological conditions, and increasing serotonin concentration in synapses.

Safety assessment of natural products in Malaysia: current practices, challenges, and new strategies

The belief that natural products are inherently safe is a primary reason for consumers to choose traditional medicines and herbal supplements for health maintenance and disease prevention. Unfortunately, some natural products on the market have been found to contain toxic compounds, such as heavy metals and microbes, as well as banned ingredients such as aristolochic acids. It shows that the existing regulatory system is inadequate and highlights the importance of thorough safety evaluations. In Malaysia, the National Pharmaceutical Regulatory Agency is responsible for the regulatory control of medicinal products and cosmetics, including natural products. For registration purpose, the safety of natural products is primarily determined through the review of documents, including monographs, research articles and scientific reports. One of the main factors hampering safety evaluations of natural products is the lack of toxicological data from animal studies. However, international regulatory agencies such as the European Food Safety Authority and the United States Food and Drug Administration are beginning to accept data obtained using alternative strategies such as non-animal predictive toxicological tools. Our paper discusses the use of state-of-the-art techniques, including chemometrics, in silico modelling and omics technologies and their applications to the safety assessments of natural products.

[Qualitative and quantitative analyses of Tripterygium hypoglaucum in Yinning Tablets, a compound traditional Chinese herbal preparation]

OBJECTIVE

To conduct qualitative and quantitative analyses of Tripterygium hypoglaucum in Yinning Tablets, a compound preparation of traditional Chinese herbal medicine.

METHODS

Thin-layer chromatography (TLC) was used for qualitative analysis of Tripterygium hypoglaucum in Yining Tablets and the analytical protocols were optimized. High-performance liquid chromatography (HPLC) was used to quantitatively analyze the content of triptolide (the main active ingredient of Tripterygium hypoglaucum) in Yinning Tablets.

RESULTS

The results of TLC analysis showed that the test sample of Yinning Tablets and the positive control samples both produced clear, well separated spots without obvious interference in the blank samples. Assessment of the influences of the thin-layer plates from different manufacturers, temperature and humidity on the test results demonstrated good durability of the test. HPLC analysis of triptolide showed a good linear relationship within the concentration range of 1-100 μg/mL (regression equation: A=22.219C-19.165, r=0.9999); the contents of triptolide in 3 batches of Yinning tablets were 0.34, 0.34, and 0.28 μg per tablet, all within the range of 0.28-0.34 μg per tablet. It was finally determined that each Yinning tablet should not contain more than 0.6 μg of triptolide.

CONCLUSION

TLC and HPLC are simple, accurate, durable and specific for qualitative and quantitative analyses of Tripterygium hypoglaucum in Yinning Tablets.

Partially purified non-polar phytocomponents from Aloe barbadensis Mill. gel restores metabolic and reproductive comorbidities in letrozole-induced polycystic ovary syndrome rodent model- an "in-vivo" study

ETHNOPHARMACOLOGICAL RELEVANCE

In India, Kumaryasava, a popular Aloe barbadensis Mill. gel preparation has therapeutic value in treatment of female reproductive disorders like menstrual disturbances and menopausal problems. Despite their widespread use, only a limited number of studies have probed into the scientific evidence for their varied bioactivities. In this regard, studies have demonstrated that Aloe vera gel has the potential to modulate steroidogenic activity in letrozole induced polycystic ovary syndrome (PCOS) rat. However, isolation and identification of the bioactive molecule/s from Aloe vera gel and studying their molecular targets will underpin the treatment regime for PCOS.

MATERIAL AND METHODS

The Partially Purified Non-Polar Phytocomponents (PPNPP)- LP1 and LP3 were isolated from the petroleum ether extract of Aloe vera gel by column chromatography. Based upon the GC-MS analysis, LP1 and LP3 comprised of n-Hexadecanoic acid and Campesterol acetate with an abundance of 97.07%, and 96.07% respectively. For evaluation of their bioactivities, eighty 3-4 months female Balb/c mice were classified as 10 groups with 8 animals in each group. Groups were control (C), PCOS (0.5 mg/kg/day Letrozole orally for 21days), PCOS treated orally for 60 days with Aloe vera gel (AVG) (10 mg/kg/day) (PCOS + AVG), PCOS treated orally for 60 days with petroleum ether extract (PE) of Aloe vera gel (25 μg/kg/day) (PCOS + PE), PCOS treated orally for 60 days with LP1 (0.5 μg/kg/day) (PCOS + LP1), PCOS treated orally for 60 days with commercially available pure compound-n-Hexadecanoic acid (HA) (0.5 μg/kg/day) (PCOS + HA), PCOS treated orally for 60 days with LP3 (0.01 μg/kg/day) (PCOS + LP3), PCOS treated orally for 60 days with commercially available pure compound- Campesterol acetate (CA) (0.01 μg/kg/day) (PCOS + CA), PCOS treated orally for 60 days with Metformin (100 mg/kg/day) (PCOS + Metformin) and PCOS treated orally for 60 days with DMSO (Vehicle) (PCOS + DMSO). Body weight, Oral glucose tolerance test, lipid profile, fasting glucose, insulin, estrus cycle, hormonal profile, gene expression of gonadotropin receptors (Fshr and Lhr), steroid receptors (Ar, Esr1, Esr2 and Pgr) and steroidogenic markers (Star, Hsd3b1, Cyp19a1 and Amh) were analysed in the ovaries. Polycystic ovarian morphology was assessed through histopathological changes of ovary. Toxicity markers- SGOT, SGPT and creatinine were also measured at the end of the study.

RESULTS

Mice treated with letrozole demonstrated significant increase in body weight, glucose intolerance, fasting insulin levels, HOMA-IR, triglycerides levels as well as testosterone levels, and a significant decline in the progesterone levels as compared to the control animals. PCOS animals also exhibited arrested estrus cyclicity, disrupted ovarian histopathology with the presence of multiple peripheral cysts and abnormal gene expression of gonadotropin receptor, steroid receptor and steroid markers. Oral administration of AVG, PE extract of AVG, LP3 and metformin greatly alleviated these complications in PCOS animals.

CONCLUSION

The above findings indicate the effectiveness of LP3, isolated from Aloe vera gel against letrozole induced PCOS in mice and may be used in the treatment of PCOS as an alternative to metformin.

Estrogens and phytoestrogens in body functions

Estrogens are the hormones of reproduction in women as well as of many other important functions in the male and female body. They undergo significant changes in the different phases of life, e.g. during puberty, pregnancy or at menopause/andropause. Phytoestrogens are natural non-steroidal phenolic plant compounds that can mimic the activity of estrogens and their beneficial effects in women and in men. This narrative review summarizes the literature on the physiological role of estrogens and the several potential health benefits of phytoestrogens, with particular attention given to the possible role of phytoestrogens in aging.

Treating Chronic Wounds Using Photoactive Metabolites: Data Mining the Chinese Pharmacopoeia for Potential Lead Species

Efficient wound treatment that addresses associated infections and inflammation remains one of the big unmet needs, especially in low- and middle-income countries. One strategy for securing better healthcare can be using medicinal plants if sufficient evidence on their safety and therapeutic benefits can be ascertained. A unique novel opportunity could be photo-enhanced wound treatment with a combination of light-sensitive plant preparations and local exposure to daylight. Data mining strategies using existing resources offer an excellent basis for developing such an approach with many potential plant candidates. In the present analysis, we researched the 535 botanical drugs included in the Chinese pharmacopeia and identified 183 medicinal plant species, 82 for treating open wounds caused by trauma and 101 for inflammatory skin conditions. After further screening for reports on the presence of known photoactive compounds, we determined a core group of 10 scientifically lesser-known botanical species that may potentially be developed into more widely used topical preparations for photodynamic treatment of infected wounds. Our predictive approach may contribute to developing a more evidence-based use of herbal medicines.

Glucomannan from Aloe vera Gel Promotes Intestinal Stem Cell-Mediated Epithelial Regeneration via the Wnt/β-Catenin Pathway

Intestinal stem cells (ISCs) are essential to maintain intestinal epithelial regeneration and barrier function. Our previous work showed that glucomannan from Aloe vera gel (AGP) alleviated epithelial damage, but the mechanism was still elusive. Herein, RNA-sequencing analysis showed that proliferation and differentiation of intestinal epithelial cells as well as the canonical Wnt pathway were involved in this process. Further experiments exhibited that AGP promoted nuclear translocation of β-catenin and expression of transcription factor 7, increased the number of Lgr5⁺ ISCs, and differentiated epithelial cells in mice colon. Intriguingly, AGP reversed the inhibition of IEC-6 cells proliferation induced by an inhibitor of the canonical Wnt pathway. Hence, this study implied that AGP promoted proliferation and differentiation of colon stem cells via Wnt/β-catenin signaling, which subsequently facilitated the regeneration of epithelial cells and alleviated colitis in mice. It may provide new insights into the role of polysaccharides in regulating intestinal homeostasis and relieving intestinal injury.

Chocolate consumption and all-cause and cause-specific mortality in a US population: a post hoc analysis of the PLCO cancer screening trial

Few studies with mixed results have examined the association between chocolate consumption and mortality. We aimed to examine this association in a US population. A population-based cohort of 91891 participants aged 55 to 74 years was identified. Chocolate consumption was assessed via a food frequency questionnaire. Cox regression was used to estimate risk estimates. After an average follow-up of 13.5 years, 19586 all-cause deaths were documented. Compared with no regular chocolate consumption, the maximally adjusted hazard ratios of all-cause mortality were 0.89 [95% confidence interval (CI) 0.84-0.94], 0.84 (95% CI 0.79-0.90), 0.86 (95% CI 0.81-0.93), and 0.87 (95% CI 0.82-0.93) for >0-0.5 servings/week, >0.5-1 serving/week, >1-2 servings/week, and >2 servings/week, respectively (Ptrend = 0.009). A somewhat stronger inverse association was observed for mortality from cardiovascular disease and Alzheimer's disease. A nonlinear dose-response pattern was found for all-cause and cardiovascular mortality (all Pnonlinearity < 0.01), with the lowest risk observed at chocolate consumption of 0.7 servings/week and 0.6 servings/week, respectively. The favorable associations with all-cause and cardiovascular mortality were found to be more pronounced in never smokers than in current or former smokers (all Pinteraction < 0.05). In conclusion, chocolate consumption confers reduced risks of mortality from all causes, cardiovascular disease, and Alzheimer's disease in this US population.

Exposure to sublethal concentrations of the glyphosate-based herbicide Faena® increases sensitivity in the progeny of the American cladoceran Daphnia exilis (Herrick, 1895)

The use of herbicides has increased over the last decades. Glyphosate is the most widely used herbicide commercialized in more than 750 formulations. While information about glyphosate's toxicity on different non-target aquatic organisms has been vastly documented, we know little about the transgenerational effects in aquatic biota. This study determined the cross-generation effects produced by the glyphosate-based herbicide Faena® on the American cladoceran Daphnia exilis. Measured endpoints were survival, reproductive responses, metabolic biomarkers, and the size of neonates. D. exilis was exposed to glyphosate concentrations of 2.09, 2.49, and 3.15 (mg L-1) (as content in Faena®) during 21 days starting from neonates, at 25°C, 16:8 photoperiod, fed with 8 × 105 cells mL-1 of Pseudokirchneriella subcapitata. The LC50 was 4.22 mg L-1. Survival, accumulated progeny, and the number of clutches in the parental generation (P1) were significantly higher than those observed in the first generation (F1). Exposure to the herbicide completely inhibited reproduction in the F1. The size of the neonates varied among treatments and broods in P1; nevertheless, neonate size (body and total lengths, as well as body width) was significantly affected in F1. Toxic effects on the survival and reproduction of D. exilis were significantly increased in the F1 exposed to Faena®. Results warn about the augmented effect on progeny where parents were exposed to this herbicide. Multigenerational adverse effects could be expected in freshwater zooplankton exposed to Faena®. The frequently claimed low toxicity of glyphosate must be revised to control the indiscriminate use of this herbicide.

Protective effects of aloe vera gel (aloe baberdensis Miller) on aluminum chloride-induced reproductive toxicity in male Wistar rats

OBJECTIVE

This study aims at investigating the protective effects of aloe vera gel on aluminum chloride-induced testicular toxicity of adult Wistar rats.

METHODS

Twenty male Wistar rats were randomly divided into four groups (A, B, C, and D) with five animals per group. Group A serves as the control group and received distilled water (1ml/Kg). Group B received distilled water (1ml/Kg) with 100mg/kg b.wt of aluminum chloride daily. Group C received 100mg/kg b.wt of aluminum chloride with 600mg/kg b.wt of Aloe vera gel daily. Group D received 100mg/kg b.wt of aluminum chloride with 5mg/kg b.wt of vitamin C daily. The animals were fed on standard laboratory animal diet and water ad libitum. Administration was via oral cannula for four weeks. The rats were slaughtered using cervical dislocation. The testes were harvested for seminal, biochemical and histological analysis.

RESULTS

The results demonstrate that the administration of aloe vera gel (AVG) is capable of preventing testicular toxicity due to aluminum chloride. Aluminum chloride caused a significant change in the testes and seminal parameters of group B when compared to the control animals. The level of Nitric oxide (NO) increased and the level of Superoxide dismutase (SOD) decreased significantly in rats treated with aluminum chloride.

CONCLUSIONS

The administration of aloe vera gel showed a preventive response in aluminum-induced testicular toxicity of rats as evidenced by histological and biochemical analysis.

Challenges in the quality of herbal medicinal products with a specific focus on contaminants

BACKGROUND

The complex regulatory framework for the quality of herbal medicinal products, in particular with regard to potential contaminants, consists of legal provisions including Pharmacopoeia requirements, relating to limits as well as in most cases to methods for determination.

OBJECTIVE

This review intends to provide an overview on the legal requirements for testing potential contaminants in herbal drugs used for the production of herbal medicinal products.

METHODOLOGY

The following issues are described and discussed: For the assessment of pesticide residues, Chapter 2.8.13 of the European Pharmacopoeia and Regulation (EC) 396/2005 applies, for heavy metals the general Pharmacopoeia monograph as well as the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) Q3D guideline on elemental impurities. The Pharmacopoeia also includes limits and acceptance criteria for microbiological purity and aflatoxins, respectively. Polycyclic aromatic hydrocarbons are mentioned in Regulation (EC) 1881/2006 for food as well as in a Reflection Paper on herbal medicinal products. For several years, a potential contamination with pyrrolizidine alkaloids was discussed which led to measures being imposed on industry and health authorities.

RESULTS

Various examples demonstrate that the evaluation of data from daily analytical practice is extremely useful to gain an overview on the occurrence of residues and/or contaminants in herbal drugs and herbal preparations. Such evaluations might assist manufacturers in their individual risk assessment and the definition of their testing strategies and contribute to guarantee the quality and safety of the marketed products.

CONCLUSION

Annual data evaluations demonstrate that a remarkable decrease of the pyrrolizidine alkaloid content burden in herbal drugs and extracts used for the production of herbal medicinal products has been achieved over the past few years. However, it has also become clear that this issue cannot be completely solved in the near future.

Clinical Evaluation of the Effects of Topical Indocyanine-green Mediated Photosensitiser vs Aloe Vera Gel as Adjunct Therapy to Scaling and Root Planing in Chronic Periodontitis Patients

PURPOSE

To clinically evaluate and compare the efficacy of indocyanine green mediated photodynamic therapy (PDT) and aloe vera (AV) gel when used as adjunct therapy to scaling and root planing (SRP) for treatment of chronic periodontitis.

MATERIALS AND METHODS

One hundred fifty patients were randomly assigned to three treatment groups: group 1 (SRP), group 2 (SRP+PDT) and group 3 (SRP+AV). Four clinical parameters - plaque index (PI), bleeding on probing (BoP), periodontal (PD) pocket depth and clinical attachment level (CAL) - were evaluated at baseline and 3 and 6 months post treatment. Additionally, the amount of three inflammatory - cytokines IL-6, IL-8 and TNF-α - in gingival crevicular fluid (GCF) was identified using an enzyme-linked immune-sorbent assay (ELISA).

RESULT

Statistically significant improvement was observed for all clinical parameters in group 3 at follow-up in comparison to groups 1 and 2. Individuals treated with adjunct PDT showed statistically significant reduction in moderate (4-5 mm) and deep (≥6 mm) PD pockets at the 3-month follow-up. Group-2 and -3 patients displayed statistically significant reductions in cytokines IL-6, IL-8 and TNF-α at the 3-month follow-up in comparison to group 1 patients. This reduction in cytokines was maintained at the 6-month follow-up.

CONCLUSION

Adjunct treatment regimens PDT and AV gel statistically significantly contributed to decreasing inflammation in periodontal tissue. AV /gel showed potential to decrease BoP, whereas PDT can facilitate increasing the clinical attachment level.

Medicinal ethnobotany of wild plants: a cross-cultural comparison around Georgia-Turkey border, the Western Lesser Caucasus

BACKGROUND

The Mountains of the Western Lesser Caucasus with its rich plant diversity, multicultural and multilingual nature host diverse ethnobotanical knowledge related to medicinal plants. However, cross-cultural medicinal ethnobotany and patterns of plant knowledge have not yet been investigated in the region. Doing so could highlight the salient medicinal plant species and show the variations between communities. This study aimed to determine and discuss the similarities and differences of medicinal ethnobotany among people living in highland pastures on both sides of the Georgia-Turkey border.

METHODS

During the 2017 and 2018 summer transhumance period, 119 participants (74 in Turkey, 45 in Georgia) were interviewed with semi-structured questions. The data was structured in use-reports (URs) following the ICPC classification. Cultural Importance (CI) Index, informant consensus factor (FIC), shared/separate species-use combinations, as well as literature data were used for comparing medicinal ethnobotany of the communities.

RESULTS

One thousand five hundred six UR for 152 native wild plant species were documented. More than half of the species are in common on both sides of the border. Out of 817 species-use combinations, only 9% of the use incidences are shared between communities across the border. Around 66% of these reports had not been previously mentioned specifically in the compared literature. Only 33 species have similar use reports in both countries, most important of which are Plantago major, Urtica dioica, Picea orientalis, Anthemis spp., Sambucus ebulus, Achillea millefolium, Helichrysum rubicundum, Mentha longifolia, Pinus sylvestris var. hamata, Hypericum perforatum, Tussilago farfara, Helichrysum plicatum, Rumex crispus, Berberis vulgaris, and Origanum vulgare. More than half of species reported in each country were found to have more than one part of the plant valued for medicinal use. The most common way of using plants medicinally in both countries is drinking the water infusion of aerial parts with flowers. Based on CI index value, two-thirds of the salient 15 genera in both countries have use reports in at least seven medicinal use categories. While the most cited category with highest FIC is digestive in Georgia, it is skin category in Turkey. Patterns of medicinal plant knowledge among studied communities appear to be connected with more than one cultural factor, in particular ethnolinguistic diversity, cultural background, and access to multilingual written folk and scientific literature, or probably a combination of various factors.

CONCLUSION

Considering the regions' floral similarity, common historical-cultural contact, and similar livelihood strategies of the communities, shared ethnomedicinal knowledge across the Georgia-Turkey border is quite low. Even though the impacts of accessing multilingual folk and scientific literature are likely to be significant, the factors that shape the medicinal plant knowledge patterns of the communities are shown to be variable among species, needing further research into intracultural diversity and socio-economical conditions, as well as the political history across the border.

Evaluation of the effect of carrot seed (Daucus Carota) in women of fertile age with hypoactive sexual desire disorder: A randomized double-blind clinical trial

BACKGROUND

Hypoactive Sexual Desire Disorder (HSDD) is a common sexual problem of women which has negative impacts on their health and quality of life. Given the side effects of pharmacologic interventions, it would be beneficial to patients trying to find new options based on herbal medicine.

OBJECTIVES

To evaluate efficacy of carrot seed on sexual dysfunction of women with HSDD compared with placebo.

METHODS

In this randomized double-blind clinical trial, 68 participants randomly assigned to the intervention group which took 500 mg carrot seed three times a day for 12 weeks versus placebo. Participants in two groups filled Female Sexual Function Index (FSFI) questionnaire at baseline, week six and 12. Repeated measure analysis of variance (ANOVA) test was used for statistical analysis.

RESULTS

Thirty women in carrot seed group and thirty women in placebo group completed 12 weeks of the study. In general, carrot seed compared to placebo improved the total score of FSFI 7.329 ± 0.830 (p < 0.001), desire 4.1±0.7 (p < 0.001), lubrication 4.7±0.4 (p = 0.019), arousal 4.1±0.08 (p < 0.001), satisfaction 4.8±1.1 (p < 0.001), orgasm 3.9±0.9 (p < 0.001) and pain 5.4±1(p < 0.001). No adverse event was reported in this study.

CONCLUSIONS

Women with HSDD may benefit from six weeks' treatment with carrot seed for improvement of sexual dysfunction. Further large clinical studies are warranted to confirm efficacy of this herbal drug.

Advanced drug delivery systems can assist in targeting coronavirus disease (COVID-19): A hypothesis

The highly contagious coronavirus, which had already affected more than 2 million people in 210 countries, triggered a colossal economic crisis consequently resulting from measures adopted by various goverments to limit transmission. This has placed the lives of many people infected worldwide at great risk. Currently there are no established or validated treatments for COVID-19, that is approved worldwide. Nanocarriers may offer a wide range of applications that could be developed into risk-free approaches for successful therapeutic strategies that may lead to immunisation against the severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) which is the primary causative organism that had led to the current COVID-19 pandemic. We address existing as well as emerging therapeutic and prophylactic approaches that may enable us to effectively combat this pandemic, and also may help to identify the key areas where nano-scientists can step in.

Ethnobotanical survey of the medicinal flora of Harighal, Azad Jammu & Kashmir, Pakistan

BACKGROUND

The present study is the first quantitative ethnobotanical evaluation of Harighal, an inaccessible and unexplored area of District Bagh Azad Jammu & Kashmir (AJK). The exploration, quantification, and comparison of ethnobotanical knowledge among different rural communities of the study area were mainly focused during field survey.

METHODOLOGY

In total, 79 informants (49 men and 34 women) were selected randomly to collect data using a semi-structured questionnaire. Various quantitative indices, including use value, relative frequency of citation, relative importance, fidelity level, and informant consent factor, were employed to evaluate the gathered information. Furthermore, primary data were also compared with twenty-two papers published from adjoining areas.

RESULT

A total of 150 medicinal plants belonging to 98 genera and 60 families were documented. Asteraceae, Fabaceae, and Rosaceae were the dominant families having 15 species each. Of these, 76 species were indigenous, 74 exotic, 136 were collected in the wild, 10 cultivated, and 4 both wild-collected and cultivated. Herbaceous taxa were the most used life form, and leaves were the most exploited plant part. Decoctions were the most preferred method used in preparation of herbal recipes. Three species viz. Mentha longifolia, Berberis lycium, and Galium aparine had the highest use value (1.05), relative frequency of citation (0.81), and relative importance value (96), respectively. The highest informant consensus factor (ICF) was reported for digestive disorders. Mentha longifolia, Punica granatum, Zanthoxylum alatum, and Olea ferruginea had 100% fidelity values. The Jaccard index revealed that uses of plants were more similar in two neighboring areas, i.e., Pearl Valley and Toli Peer.

CONCLUSION

Local inhabitants still prioritize herbal medicines as an effective way to treat a wide variety of ailments. Elders and health practitioners of the study area are well aware of indigenous knowledge about medicinal plants, but young people are not much interested in herbal practices. Thus, valuable knowledge about the use of plants is on the verge of decline.

Ayurveda and COVID-19: Where psychoneuroimmunology and the meaning response meet

The COVID-19 pandemic has led to high levels of psychological distress in the general public, including symptoms of anxiety and depression. Such distress is associated with alterations in immune function, including an elevated risk of viral respiratory tract infections. In this light, the possible effects of Ayurveda, a traditional system of medicine promoted by the Indian government as an "immune booster", are examined from the point of view of psychoneuroimmune mechanisms as well as the "meaning response" described by Moerman. It was found that many of the measures advocated in their guidelines could positively influence immunity either by direct effects on symptoms of depression or anxiety, or through their symbolic significance. Therefore, it is possible that such traditional practices could be beneficial both in terms of psychological quality of life, and in terms of moderating the risk of infection.

Bioplastic (poly-3-hydroxybutyrate) production by the marine bacterium Pseudodonghicola xiamenensis through date syrup valorization and structural assessment of the biopolymer

Biobased degradable plastics have received significant attention owing to their potential application as a green alternative to synthetic plastics. A dye-based procedure was used to screen poly-3-hydroxybutyrate (PHB)-producing marine bacteria isolated from the Red Sea, Saudi Arabia. Among the 56 bacterial isolates, Pseudodonghicola xiamenensis, identified using 16S rRNA gene analyses, accumulated the highest amount of PHB. The highest PHB production by P. xiamenensis was achieved after 96 h of incubation at pH 7.5 and 35 °C in the presence of 4% NaCl, and peptone was the preferred nitrogen source. The use of date syrup at 4% (w/v) resulted in a PHB concentration of 15.54 g/L and a PHB yield of 38.85% of the date syrup, with a productivity rate of 0.162 g/L/h, which could substantially improve the production cost. Structural assessment of the bioplastic by Fourier transform infrared spectroscopy and nuclear magnetic resonance spectroscopy revealed the presence of methyl, hydroxyl, methine, methylene, and ester carbonyl groups in the extracted polymer. The derivative products of butanoic acid estimated by gas chromatography-mass spectrometry [butanoic acid, 2-amino-4-(methylseleno), hexanoic acid, 4-methyl-, methyl ester, and hexanedioic acid, monomethyl ester] confirmed the structure of PHB. The present results are the first report on the production of a bioplastic by P. xiamenensis, suggesting that Red Sea habitats are a potential biological reservoir for novel bioplastic-producing bacteria.

Factors associated with mortality in children under five years old hospitalized for Severe Acute Malnutrition in Limpopo province, South Africa, 2014-2018: A cross-sectional analytic study

Background

In South Africa, 30.9% of children under five years with Severe Acute Malnutrition (SAM) died in 2018. We aimed to identify factors associated with mortality among children under five years hospitalized with SAM in Limpopo province, South Africa.

Methods

We conducted a cross-sectional study including children under five years admitted with SAM from 2014 to 2018 in public hospitals of Limpopo province. We extracted socio-demographic and clinical data from hospital records. We used logistic regression to identify factors associated with mortality.

Findings

We included 956 children, 50.2% (480/956) male and 49.8% (476/956) female. The median age was 13 months (inter quartile range: 9–19 months). The overall SAM mortality over the study period was 25.9% (248/956). The most common complications were diarrhea, 63.8% (610/956), and lower respiratory tract infections (LRTIs), 42.4% (405/956). Factors associated with mortality included herbal medication use (adjusted Odds Ratio (aOR): 2.2, 95% Confidence Interval (CI): 1.4–3.5, p = 0.001), poor appetite (aOR: 2.7, 95% CI: 1.4–5.2, p = 0.003), Mid-upper circumference (MUAC) <11.5 cm (aOR: 3.0, 95% CI: 1.9–4.7, p<0.001), lower respiratory tract infections (LRTIs) (aOR: 1.6, 95% CI: 1.2–2.0, p<0.001), anemia (aOR: 2.5, 95% CI: 1.1–5.3, p = 0.021), hypoglycemia (aOR: 12.4, 95% CI: 7.1–21.8, p<0.001) and human immunodeficiency virus (HIV) infection (aOR: 2.3, 95% CI: 1.6–3.3, p<0.001).

Interpretation

Herbal medication use, poor appetite, LRTIs, anemia, hypoglycemia, and HIV infection were associated with mortality among children with SAM. These factors should guide management of children with SAM.

Botanical acaricides and repellents in tick control: current status and future directions

Ticks are obligate blood-sucking ectoparasites and notorious as vectors of a great diversity of, in many instances, zoonotic pathogens which can cause considerable damage to animal and human health. The most commonly used approach for the control of ticks is the application of synthetic acaricides. However, the negative impacts of synthetic acaricides on the treated animals and the environment, in addition to its documented role in the development of resistance has led to the search for safer and more environmentally friendly alternative methods without compromising efficacy. An emerging promising approach for the control of ticks which has attracted much attention in recent years is the use of botanicals. Indeed, botanicals have been widely reported to show diverse effects and great potential as tick repellent and control. Although several excellent reviews have previously focused on this topic, studies on the exploration and application of botanicals to control ticks have expanded rapidly. Herein, we provide an update on the current understanding and status of botanical acaricides and repellents in tick control using recently published articles between 2017 and 2019. We also discuss the challenges and future directions in the application of botanicals in tick control, with a view of providing important clues for designing new integrated tick control methods.

[Modern pharmacotherapy of uncomplicated infections of the lower urinary tract: the position of antibacterial and herbal preparations]

Lower urinary tract infections (UTIs) are one of the most common types of infections in women. The existing high risk of recurrent forms, including relapses and reinfection, suggests the paramount importance of the pharmacotherapy strategy chosen by the doctor for the primary episode of lower urinary tract infection, especially acute cystitis, determining the degree of rehabilitation. Current data on the resistance of the main pathogens of UTI to many broad-spectrum antibacterial drugs, on the one hand, and the risk of subsequent resistance formation with the use of reserve antibiotics, such as fluoroquinolones, cephalosporins of 3-4 generation, on the other hand, make the search for optimal antibiotic therapy an urgent task for clinical pharmacologists, urologists and therapists. The article presents an analysis of current data on the prevalence and resistance of major pathogens and provides an review of international and Russian clinical recommendations for the management of patients with lower UTIs, especially acute cystitis, including an analysis of the positions of antibacterial and herbal drugs.

Quantitative ethnopharmacological documentation and molecular confirmation of medicinal plants used by the Manobo tribe of Agusan del Sur, Philippines

BACKGROUND

The Philippines is renowned as one of the species-rich countries and culturally megadiverse in ethnicity around the globe. However, ethnopharmacological studies in the Philippines are still limited especially in the most numerous ethnic tribal populations in the southern part of the archipelago. This present study aims to document the traditional practices, medicinal plant use, and knowledge; to determine the relative importance, consensus, and the extent of all medicinal plants used; and to integrate molecular confirmation of uncertain species used by the Agusan Manobo in Mindanao, Philippines.

METHODS

Quantitative ethnopharmacological data were obtained using semi-structured interviews, group discussions, field observations, and guided field walks with a total of 335 key informants comprising of tribal chieftains, traditional healers, community elders, and Manobo members of the community with their medicinal plant knowledge. The use-report (UR), use categories (UC), use value (UV), cultural importance value (CIV), and use diversity (UD) were quantified and correlated. Other indices using fidelity level (FL), informant consensus factors (ICF), and Jaccard's similarity index (JI) were also calculated. The key informants' medicinal plant use knowledge and practices were statistically analyzed using descriptive and inferential statistics.

RESULTS

This study enumerated the ethnopharmacological use of 122 medicinal plant species, distributed among 108 genera and belonging to 51 families classified in 16 use categories. Integrative molecular approach confirmed 24 species with confusing species identity using multiple universal markers (ITS, matK, psbA-trnH, and trnL-F). There was strong agreement among the key informants regarding ethnopharmacological uses of plants, with ICF values ranging from 0.97 to 0.99, with the highest number of species (88) being used for the treatment of abnormal signs and symptoms (ASS). Seven species were reported with maximum fidelity level (100%) in seven use categories. The correlations of the five variables (UR, UC, UV, CIV, and UD) were significant (r_s ≥ 0.69, p < 0.001), some being stronger than others. The degree of similarity of the three studied localities had JI ranged from 0.38 to 0.42, indicating species likeness among the tribal communities. Statistically, the medicinal plant knowledge among respondents was significantly different (p < 0.001) when grouped according to education, gender, social position, occupation, civil status, and age but not (p = 0.379) when grouped according to location. This study recorded the first quantitative ethnopharmacological documentation coupled with molecular confirmation of medicinal plants in Mindanao, Philippines, of which one medicinal plant species has never been studied pharmacologically to date.

CONCLUSION

Documenting such traditional knowledge of medicinal plants and practices is highly essential for future management and conservation strategies of these plant genetic resources. This ethnopharmacological study will serve as a future reference not only for more systematic ethnopharmacological documentation but also for further pharmacological studies and drug discovery to improve public healthcare worldwide.

Researching New Therapeutic Approaches for Abdominal Visceral Pain Treatment: Preclinical Effects of an Assembled System of Molecules of Vegetal Origin

Abdominal pain is a frequent symptom of irritable bowel syndrome (IBS) and inflammatory bowel diseases (IBDs). Although the knowledge of these pathologies is progressing, new therapeutic strategies continue to be investigated. In the present study, the effect of a system of molecules of natural origin (a medical device according to EU Directive 93/42/EC, engineered starting from Boswellia serrata resins, Aloe vera polysaccharides and Matricaria chamomilla and Melissa officinalis polyphenols) was evaluated against the intestinal damage and visceral pain development in DNBS-induced colitis model in rats. The system (250 and 500 mg kg⁻¹) was orally administered once daily, starting three days before the injection of 2,4-dinitrobenzenesulfonic acid (DNBS) and for 14 days thereafter. The viscero-motor response (VMR) to colon-rectal balloon distension (CRD) was used as measure of visceral sensitivity. The product significantly reduced the VMR of DNBS-treated animals. Its effect on pain threshold was better than dexamethasone and mesalazine, and not lower than amitriptyline and otilonium bromide. At microscopic and macroscopic level, the tested system was more effective in protecting the intestinal mucosa than dexamethasone and mesalazine, promoting the healing of tissue lesions. Therefore, we suggest that the described system of molecules of natural origin may represent a therapeutic option to manage painful bowel diseases.

Microalgae with Immunomodulatory Activities

Microalgae are photosynthetic microorganisms adapted to live in very different environments and showing an enormous biochemical and genetic diversity, thus representing an excellent source of new natural products with possible applications in several biotechnological sectors. Microalgae-derived compounds have shown several properties, such as anticancer, antimicrobial, anti-inflammatory, and immunomodulatory. In the last decade, compounds stimulating the immune system, both innate immune response and adaptive immune response, have been used to prevent and fight various pathologies, including cancer (cancer immunotherapy). In this review we report the microalgae that have been shown to possess immunomodulatory properties, the cells and the cellular mediators involved in the mechanisms of action and the experimental models used to test immunostimulatory activities. We also report information on fractions or pure compounds from microalgae identified as having immunostimulatory activity. Given the increasing interest in microalgae as new eco-friendly source of bioactive compounds, we also discuss their possible role as source of new classes of promising drugs to treat human pathologies.

Medico-Religious Plants Employed in Mauritius: A Survey Among Hindu Priests

Mauritius is renowned for its rich floral and cultural diversity. The aim of this study was to identify and document medicinal plants exclusively employed in rituals and to promote wellness among the Hindu community. In addition, it also highlights poorly documented plants with respect to their safety, efficacy, and herb-drug interaction inducing potential. The informant group included Hindu priests (n = 14) solely, while the relative frequency of citation (RFC) and use value (UV) were utilised to analyse the data. A total of 33 plants were reported in this survey. Sixteen plants were reported by informants to have both medicinal and religious values, while the highest RFC and UV index was obtained by Ocimum tenuiflorum L. (RFC = 0.79; UV = 0.71). Nonetheless, despite known and utilised commonly for years by humanity, various plant species mentioned in this study have been poorly evaluated in randomised clinical trials and for any risks of herb-drug interactions. Hence, there are concerns surrounding the safe use of these plant species particularly among patients suffering from chronic diseases.

Preparation, characteristics, and antioxidant activities of carboxymethylated polysaccharides from blackcurrant fruits

In the present study, the native polysaccharide (RNP) extracted from blackcurrant fruits was carboxymethylated. Physicochemical characteristics and antioxidant activities in vitro of RNP and three carboxymethylated polysaccharides (CRNPs) were determined. GC analysis proved that RNP and CRNPs were composed of the same six monosaccharides (galacturonic acid, rhamnose, arabinose, mannose, glucose and galactose), but the molar ratios of monosaccharides were different. HPLC demonstrated that the molecular weights of CRNPs were improved. The assays of the antioxidant properties indicated that CRNPs possessed stronger scavenging activities on radicals (hydroxyl and superoxide radicals) and better anti-lipid peroxidation activities, as well as better protection effects on erythrocyte hemolyses in vitro compared with RNP. The activities of CRNPs were significantly enhanced with the increase of the degree of substitution (DS). These results proved that the carboxymethylation could effectively increase the antioxidant activities of the polysaccharide.

A Sustainable Wholesome Foodstuff; Health Effects and Potential Dietotherapy Applications of Yacon

A sustainable food supply is an ever-growing public and planetary health concern influenced by food culture, food practices, and dietary patterns. Globally, the consumption of plant foods that offer physiological and biochemical benefits is increasing. In recent years, products made from yacon (Smallanthus sonchifolius) tubers and leaves, e.g., in the form of syrup, powder, and herbal tea, have steadily emerged with scientific evidence to validate their possible health claims. Yacon was introduced to New Zealand in 1966, and its products can now be produced on a commercial scale. This paper reviews literature published mainly in the last 10 years concerning the health-related properties of yacon as a wholesome foodstuff and its bioactive components, e.g., fructooligosaccharides. Literature was sourced from Web of Science, PubMed, EBSCO Health, and Google Scholar up to June 2019. The potential markets for yacon in the field of food technology and new dietotherapy applications are discussed. Furthermore, the unique features of New Zealand-produced yacon syrup are introduced as a case study. The paper explores the scientific foundation in response to the growing public interest in why and how to use yacon.

Ethnobotanical research in Cava de' Tirreni area, Southern Italy

BACKGROUND

To best of our knowledge, this is the first quantitative ethnobotanical study with the aim of documenting the local knowledge and practices of using plants for curing diseases in the Cava de' Tirreni area, Salerno Province, Campania Region, Italy. The present ethnobotanical field study, carried out during 2016-2017, documents the local uses of 119 plant species for medicinal, food and domestic purposes.

METHODS

Ethnobotanical data were documented from 70 informants: field data were collected and information on the uses of plants was gathered through semi-structured and structured interviews with persons who still retain traditional ethnobotanical knowledge. Documented data were evaluated using the quantitative ethnobotanical index of use value (UV).

RESULTS

Overall, the informants native of the area were interviewed and 277 use-reports have been recorded. The scientific names, local names, plant part used, preparation and administration processes are reported and compared with practices in other Southern Italian regions. In total, 101 species are documented as medicinal, 36 as food or food aromatizer, 29 for domestic and handicraft uses, 10 in veterinary medicine. More or less 64% of all species have more uses and over half of the food plants (23 species) are also used for medicinal purposes.

CONCLUSIONS

The comparison of the documented species and their uses with ethnobotanical literature of other Italian regions reveals that the traditional plant knowledge in this area shows strong similarities with adjacent Southern Italian areas. Some of the recorded species and administration processes however seem to be unique for the zone.

Regulatory Aspects of Traditional Indian Medicines (TIM) in India and in International Purview

Background: Regulatory affairs play a crucial role in the pharmaceutical industry and are incorporated in all stages of drug development. Objective: Approval criteria practices were developed as a resolution of the government's desire to create policies to protect public health by controlling the safety and efficacy of merchandise in areas including pharmaceuticals, complementary color medicines, veterinary medicines, medical devices, and even food products and cosmetics. Method: Herbal health products are in practices in all parts of the world under either their legal system's or expert council's or agencies' guides. They include botanicals, health supplements, health foods, complimentary medicines, traditional medicines or following pathies like Ayurveda, Yoga, Unani, Siddha, and Homeopathy. The requisite parameters for registration or recognition of products by various major global regulatory agencies were reviewed, and compiled under purview. Results: In India, licensing these products is under the act provisions and the rules known as the Drugs and Cosmetics Act, whereas globally regulatory provisions follow the guidelines of developed countries like the U.S. Food and Drug Administration, European Medicines Agency, the Therapeutic Goods Act, or the World Health Organization's regulations for herbal products. Conclusions: The present communication highlights the provisions of regulatory and/or licensing requirements related to corporates, product composition, specifications, quality parameters, manufacturing methodology, stability, safety, preclinical studies, clinical studies, etc. for herbal products and the respective guidelines at one site. Highlights: Ultimately, all regulatory agencies across the world highlight majorly the safety and thereafter the efficacy for any products under the category.

DEVELOPMENT OF THE POWDER FORMULAS FOR ACNE TREATMENT

Given the large enough area of the spread of acne disease, research is needed on the development of the new versions of preparations. Cosmetics and cosmeceuticals of daily use are easy to consume as preventive remedies during mild form of the disease at an early stage. These remedies include powders, which women tend to use every day, and men, if necessary, but quite often. Powder should fit the skin, not be crumbled during the air disturbance and be kept on the face for a relatively long time, have hygroscopicity, that is, they should absorb the sweat and fat. When developing formula of similar powder, we used the available literature data on remedies using for the treatment of acne. There have been studied some technological and rheological properties of powders, such the bulk specific gravity, bulk density and natural angle of slope. Given that all parameters depend on the dispersion and a specific surface of powder, the shape of the particles and their size distributions, we used the particles of all ingredients with a size of 3 to 20 µm. The obtained powder samples are easily applied to the skin, keeping on it for at least 4-5 hours. When applied to the oily skin, there are not observed swelling of starch and coating of pores, as well as the formation of a colloidal structure of bentonite clay. For the first time, a new formula is proposed for acne treating powders containing both plant and mineral components, determining both the structural features of powder and those features that are involved in certain processes that help to increase the pharmacological effect.

[THE STUDY OF PHYSICAL - CHEMICAL AND TECHNOLOGICAL PROPERTIES OF EPIMEDIUM STRELOLIST'S DRY EXTRACT TO CREATE A SOLID DOSAGE FORM FOR THE TREATMENT OF ERECTILE DYSFUNCTION]

One of the most famous aphrodisiac plants and remedy for recoveryerectile dysfunction is Estrellita Epimedium (Epimedium sagittatum). On this basis, development of the new dosage form (capsules with dry extract of Epimedium strelolist) is one of the promising directions in phytotherapy of erectile dysfunction in men. The main task in development of a new dosage form is the study of the physical-chemical and technological active pharmaceutical substance's (API) characteristics, such as crystal form, solubility, flowability, angle of repose, tap density, water. In this study, the dry extract of Epimedium strelolist is an API. Research of above characteristics will determine the choice of excipients and technology of dosage form.

A systematic literature review and classification of knowledge discovery in traditional medicine

INTRODUCTION AND OBJECTIVE

Despite the importance of machine learning methods application in traditional medicine there is a no systematic literature review and a classification for this field. This is the first comprehensive literature review of the application of data mining methods in traditional medicine.

METHOD

We reviewed 5 database between 2000 to 2017 based on the Kitchenham systematic review methodology. 502 articles were identified and reviewed for their relevance to application of machine learning methods in traditional medicine, 42 selected papers were classified and categorized on four dimension; 1) application domain of data mining techniques in traditional medicine; 2) the data mining methods most frequently used in traditional medicine; 3) main strength and limitation of data mining techniques in traditional medicine; 4) the performance evaluation methods in data mining methods in traditional medicine.

RESULT

The result obtained showed that main application domain of data mining techniques in traditional medicine was related to syndrome differentiation. Bayesian Networks (BNs), Artificial Neural Networks (ANNs) and Support Vector Machines (SVMs) were recognized as being the methods most frequently applied in traditional medicine. Furthermore, each data mining techniques has its own strength and limitations when applied in traditional medicine. Single scaler methods were frequently used for performance evaluation of data mining methods.

CONCLUSION

Machine learning methods have become an important research field in traditional medicine. Our research provides information about this methods by examining the related articles.

Evidence of Some Natural Products with Antigenotoxic Effects. Part 2: Plants, Vegetables, and Natural Resin

Cancer is one of the leading causes of death worldwide. The agents capable of causing damage to genetic material are known as genotoxins and, according to their mode of action, are classified into mutagens, carcinogens, or teratogens. Genotoxins are also involved in the pathogenesis of several chronic degenerative diseases, including hepatic, neurodegenerative, and cardiovascular disorders; diabetes; arthritis; cancer; chronic inflammation; and ageing. In recent decades, researchers have found novel bioactive phytocompounds able to counteract the effects of physical and chemical mutagens. Several studies have shown the antigenotoxic potential of different fruits and plants (Part 1). In this review (Part 2), we present a research overview conducted on some plants and vegetables (spirulina, broccoli, chamomile, cocoa, ginger, laurel, marigold, roselle, and rosemary), which are frequently consumed by humans. In addition, an analysis of some phytochemicals extracted from those vegetables and the analysis of a resin (propolis),whose antigenotoxic power has been demonstrated in various tests, including the Ames assay, sister chromatid exchange, chromosomal aberrations, micronucleus, and comet assay, was also performed.