Therapeutic potential of Lawsonia inermis Linn: a comprehensive overview

Lawsonia inermis Linn, commonly known as henna, is a member of the Lythraceae family and has been found to contain a variety of compounds with both industrial and medicinal applications in its stem, bark, roots, flowers, and seeds. This report provides a comprehensive review of the bioactive components, pharmacological activities, pharmacokinetics, and pharmacological side effects of Lawsonia inermis. Relevant materials were gathered from Google Scholar, PubMed, Scopus, and Web of Science and reviewed for important properties and updates about the plant. Lawsonia inermis contains a variety of bioactive compounds, including flavonoids, coumarins, triterpenoids, steroids, xanthones, polyphenols, fatty acids, alkaloids, quinones, tannins, leucocyandin, epicatechin, catechin, and quercetin. The plant is been traditionally used to treat numerous conditions, including ulcers, bronchitis, lumbago, hemicrania, leukoderma, scabies, boils, ophthalmic disorders, hair loss, and jaundice. It has also been found to possess a range of pharmacological activities, including antioxidant, anti-inflammatory, analgesic, antiparasitic, hepatoprotective, antifungal, antitumor, wound healing, and hypoglycemic effects. The potential of Lawsonia inermis for various biological applications is promising, and further studies are needed to fully explore its therapeutic benefits for various diseases of public health. Concern advances in drug development could enable the characterization of various bioactive constituents and facilitate their development and application for the benefit of humanity.

The therapeutic value of Myrtus communis L.: an updated review

Myrtus communis L. (Family: Myrtaceae) is naturally found in the western part of Asia, Southern Europe, and North Africa. It has been reportedly applied in pharmaceutical industry, traditional medicine, cosmetics, spices, and food. Pubmed, Google scholar, Web of Science, and Scopus were utilized to seek out relevant content concerning the therapeutic potential of M. communis. Subsequently, we conducted a review to identity noteworthy updates pertaining to M. communis. Myrtle berries, leaves, seeds, and essential oils are natural sources of several nutrients and bioactive compounds with marked health effects. The chemical analysis showed that M. communis contained oils, alkaloids, flavonoids, phenolics, coumarins, saponosides, tannins, quinines, and anthraquinones. A pharmacological investigation revealed that M. communis possessed anti-inflammatory, analgesic, antimicrobial, antiparasitic, antioxidant, antidiabetic, anticancer, antimutagenic, immunomodulatory, dermatological, cardiovascular, central nervous system, and gastrointestinal protective effects, among numerous other biological effects. This current review focused on the biochemical, pharmacological, therapeutic effects, and various biological activities of different parts of M. communis. It signifies that M. communis is a therapeutic plant with numerous applications in medicine and could be used as a drug isolate based on its safety and effectiveness.

Treatment of drug-resistant tuberculosis in children and young adolescents in Brazil

Introduction

Drug-resistant tuberculosis (DR-TB) is a global threat and a challenge for public health authorities worldwide. In children, the diagnosis is even more challenging and DR-TB is poorly described in the literature, as are its treatment outcomes. In this study, we aimed to describe the treatment of drug-resistant TB in children and young adolescents in Brazil.

Methods

A descriptive epidemiological study of treatment for DR-TB in children under 15 years of age in Brazil between 2013 and 2020. The primary data source was the Information System for Special Tuberculosis Treatments (SITE-TB). Categorical variables were analyzed using relative frequencies (%) and continuous variables by measures of central tendency to characterize the profile of the cases, namely: sociodemographic, clinical characteristics, procedures, tests performed and treatment success. In order to verify the distribution of cases, a spatial analysis was carried out based on the municipality where the cases resided.

Results

Between 2013 and 2020, 19,757 tuberculosis (TB) cases occurred in children aged <15 years in Brazil, and 46 cases of treatment for DR-TB were reported during the same period (annual average of 6 cases). Of these, 73.9% were aged 10-14, 65.2% were male, 4.3% were HIV+ and 43.3% were underweight (BMI<18.5) at the start of treatment. 17.4% had previous contact with TB, 69.6% had primary resistance, 47.8% multidrug resistance. The median duration of treatment was 15 months. DOT and standardized treatment regimen were performed in 52.2% of cases. Bacilloscopy was performed for 97.8% (57.8% positive); culture for 89.1% (75.6% positive), rapid molecular test for 73.9% with proven resistance to rifampicin in 55.8%. Susceptibility testing revealed resistance mainly to isoniazid (87.8%) and rifampicin (60.6%). 73.9% of cases were successfully treated and one death was reported. Cases were treated in 26 Brazilian municipalities, with the majority in Rio de Janeiro (15) and São Paulo (4).

Conclusion

DR-TB treatment was recorded in <1% of general TB cases in children and young adolescents, suggesting underreporting of drug-resistant cases in the country. Despite the low number of registered cases, the data reflect the situation of DR-TB in this population and describe important aspects of the problem, as the child needs comprehensive, individualized care, with support from different professionals. We recommend a strengthening of the country's referral services for the care of children with DR-TB so that surveillance and health care services can work together to identify and follow up cases.

Health condition, income loss, food insecurity and other social inequities among migrants and refugees during the COVID-19 pandemic in Brazil

BACKGROUND

Brazil is the destination of many international migrants and refugees and, given the circumstances of their entry into the country, many face difficulties due to the absence of targeted policies. Thus, the objective of this study was to survey the social impact of COVID-19 on international migrants and refugees regarding income loss, food insecurity and other social inequities, and to identify explanatory factors on these aspects.

METHODS

This is a cross-sectional, analytical study. We used a validated instrument applied by trained interviewers. Descriptive analysis and binary logistic regression were performed to identify factors associated with income loss and food insecurity.

RESULTS

A total of 360 individuals from sub-Saharan African and South American countries participated in the study. Individuals who were white, black/brown, yellow, had an occupation/employment, and earned less than one minimum wage were more likely to lose income. Those who reported no income, received less than one minimum wage, and were diagnosed with COVID-19 were more likely to be food insecure.

CONCLUSIONS

The study advances knowledge by identifying factors associated with income loss, food insecurity, and individuals' difficulty in accessing health services and social support measures in Brazil.

Geo-spatial high-risk clusters of Tuberculosis in the global general population: a systematic review

INTRODUCTION

The objective of this systematic review is to identify tuberculosis (TB) high-risk among the general population globally. The review was conducted using the following steps: elaboration of the research question, search for relevant publications, selection of studies found, data extraction, analysis, and evidence synthesis.

METHODS

The studies included were those published in English, from original research, presented findings relevant to tuberculosis high-risk across the globe, published between 2017 and 2023, and were based on geospatial analysis of TB. Two reviewers independently selected the articles and were blinded to each other`s comments. The resultant disagreement was resolved by a third blinded reviewer. For bibliographic search, controlled and free vocabularies that address the question to be investigated were used. The searches were carried out on PubMed, LILACS, EMBASE, Scopus, and Web of Science. and Google Scholar.

RESULTS

A total of 79 published articles with a 40-year study period between 1982 and 2022 were evaluated. Based on the 79 studies, more than 40% of all countries that have carried out geospatial analysis of TB were from Asia, followed by South America with 23%, Africa had about 15%, and others with 2% and 1%. Various maps were used in the various studies and the most used is the thematic map (32%), rate map (26%), map of temporal tendency (20%), and others like the kernel density map (6%). The characteristics of the high-risk and the factors that affect the hotspot's location are evident through studies related to poor socioeconomic conditions constituting (39%), followed by high population density (17%), climate-related clustering (15%), high-risk spread to neighbouring cities (13%), unstable and non-random cluster (11%).

CONCLUSION

There exist specific high-risk for TB which are areas that are related to low socioeconomic conditions and spectacular weather conditions, these areas when well-known will be easy targets for intervention by policymakers. We recommend that more studies making use of spatial, temporal, and spatiotemporal analysis be carried out to point out territories and populations that are vulnerable to TB.

Factors associated with status and self-perceived mental health changes in the face of the COVID-19 pandemic in Brazil

The SARS-CoV-2-triggered Public Health Emergency of International Importance has significantly contributed to emotional and mental health issues. The aim of this study was to identify factors associated with self-perceived mental health changes while facing the COVID-19 pandemic in Brazil. This was a cross-sectional, descriptive, and analytical study that collected data via a web survey using a validated instrument. The study included individuals over 18 years old residing in the 26 federal units and the Federal District from August 2020 to November 2022. The sample was recruited using the snowball technique. Two logistic regression analyses were conducted to identify factors associated with the outcomes of interest. The first analysis considered individuals who rated their mental health condition as poor as the dependent variable, while the second analysis considered individuals who reported changes in their mental health during the pandemic as the dependent variable. The study found that individuals with complete college education and those using tranquilizers or antidepressants were more likely to perceive their mental health as poor (1.97 and 2.04 times higher likelihood, respectively). Increased consumption of ultra-processed foods during the pandemic was associated with a 2.49 higher likelihood of reporting mental health changes. Participants also reported more difficulty sleeping. The negative self-perception of mental health varied across Brazil's regions and changed over time, with different patterns observed before and after the vaccination period. In 2022, most regions of Brazil classified their mental health as "poor." The study highlights the impact of the COVID-19 pandemic on mental health, with increased prevalence of mental disorders and emotional problems among the population. The results highlight the presence of mental disorders and increased reporting of emotional problems among the population due to the impact of the COVID-19 pandemic.

A distributional regression approach to modeling the impact of structural and intermediary social determinants on communities burdened by tuberculosis in Eastern Amazonia - Brazil

BACKGROUND

Tuberculosis (TB) is a disease that is influenced by social determinants of health. However, the specific structural and intermediary determinants of TB in Eastern Amazonia remain unclear. Despite being rich in natural resources, the region faces significant challenges related to poverty, inequality, and neglected diseases. The objective of this study was to use mathematical modeling to evaluate the influence of structural and intermediary determinants of health on TB in Eastern Amazonia, Brazil.

METHODS

This cross-sectional included all TB cases diagnosed and registered in the Notifiable Diseases Information System (SINAN) from 2001 to 2017. Data on social determinants were collected at the census tract level. The generalized additive model for location, scale, and shape (GAMLSS) framework was employed to identify the effect of social determinants on communities with a high TB prevalence. The Double Poisson distribution (DPO) was chosen, and inclusion of quadratic effects was tested.

RESULTS

A total of 1730 individuals were diagnosed with TB and reported in SINAN during the analyzed period. The majority were female (59.3%), aged 31 to 59 years (47.6%), identified as blacks (67.9%), and had incomplete elementary education (46.6%). The prevalence of alcoholism was 8.6% and mental illness was 0.7%. GAMLSS analyses demonstrated that the risk of community incidence of TB is associated with the proportion of the population lacking basic sanitation, as well as with the age groups of 16-31 years and > 61 years.

CONCLUSIONS

The study highlights the strategic utility of GAMLSS in identifying high-risk areas for TB. Models should encompass a broader range of social determinants to inform policies aimed at reducing inequality and achieving the goals of the End TB strategy.

Morus alba: a comprehensive phytochemical and pharmacological review

Morus alba is a fast-growing shrub or medium-sized tree with a straight, cylindrical trunk. Medicinally, whole plants, leaves, fruits, branches, and roots have been employed. Google Scholar, PubMed, Scopus, and Web of Science were used to search for relevant material on the phytochemical components and pharmacologic and mechanism of action of the Morus alba. This was reviewed to assess important updates about Morus alba. The fruits of Morus alba have traditionally been used as an analgesic, anthelmintic, antibacterial, anti-rheumatic, diuretic, hypotensive, hypoglycemia, purgative, restorative, sedative tonic, and blood stimulant. Various plant parts were used as a cooling, sedating, diuretic, tonic, and astringent agent to treat nerve disorders. The plant contained tannins, steroids, phytosterols, sitosterol, glycosides, alkaloids, carbohydrates, proteins, and amino acids, as well as saponins, triterpenes, phenolics, flavonoids, benzofuran derivatives, anthocyanins, anthraquinones, glycosides, vitamins, and minerals. Previous pharmacological research identified antimicrobial, anti-inflammatory, immunological, analgesic, antipyretic, antioxidant, anti-cancer, antidiabetic, gastrointestinal, respiratory, cardiovascular, hypolipidemic, anti-obesity, dermatological, neurological, muscular, and protecting effects. This study looked at Morus alba's traditional uses, chemical components, and pharmacological effects.

A review of the bioactive components and pharmacological properties of Lavandula species

Lavandula species is a flowering plant that is common in Europe and across the Mediterranean. Lavender has many health benefits for humans. In addition to its use in herbal medicine, it is widely used in the fields of cosmetics, perfumes, foods, and aromatherapy. Google Scholar, PubMed, Scopus, and Web of Science were used to search for relevant material on the phytochemical ingredients, the pharmacologic effects of the ingredients, and the mechanism of action of the Lavandula species identified. These materials were reviewed in order to have access to important updates about the Lavandula species. Lavender as referred to in English contains essential oils, anthocyanins, phytosterols, sugars, minerals, coumaric acid, glycolic acid, valeric acid, ursolic acid, herniarins, coumarins, and tannins. It has been used to treat colic and chest ailments, worrisome headaches, and biliousness, and in cleaning wounds. It has antifungal, antibacterial, neurologic, antimicrobial, anti-parasitic, anti-diabetic, and analgesic effects among others. Lavandula species has prospects for various biological applications, especially with its dermatological application. Advances in drug development would enable characterization of various bioactive constituents; thus, its development and application can have a more positive impact on humanity. Here, we highlighted updated information on the history, distribution, traditional uses, phytochemical components, pharmacology, and various biological activities of Lavandula species.

Commiphora myrrh: a phytochemical and pharmacological update

Medicinal plants have a long track record of use in history, and one of them is Commiphora myrrh which is commonly found in the southern part of Arabia, the northeastern part of Africa, in Somalia, and Kenya. Relevant literatures were accessed via Google Scholar, PubMed, Scopus, and Web of Science to give updated information on the phytochemical constituents and pharmacological action of Commiphora myrrh. It has been used traditionally for treating wounds, mouth ulcers, aches, fractures, stomach disorders, microbial infections, and inflammatory diseases. It is used as an antiseptic, astringent, anthelmintic, carminative, emmenagogue, and as an expectorant. Phytochemical studies have shown that it contains terpenoids (monoterpenoids, sesquiterpenoids, and volatile/essential oil), diterpenoids, triterpenoids, and steroids. Its essential oil has applications in cosmetics, aromatherapy, and perfumery. Research has shown that it exerts various biological activities such as anti-inflammatory, antioxidant, anti-microbial, neuroprotective, anti-diabetic, anti-cancer, analgesic, anti-parasitic, and recently, it was found to work against respiratory infections like COVID-19. With the advancement in drug development, hopefully, its rich phytochemical components can be explored for drug development as an insecticide due to its great anti-parasitic activity. Also, its interactions with drugs can be fully elucidated.This review highlights an updated information on the history, distribution, traditional uses, phytochemical components, pharmacology, and various biological activities of Commiphora myrrh. Graphical summary of the phytochemical and pharmacological update of Commiphora myrrh.

The phytochemical profiling, pharmacological activities, and safety of malva sylvestris: a review

Malva sylvestris is a plant commonly found in Europe, Asia, and Africa. The leaves and flowers of this plant have been used for centuries in traditional medicine to treat various ailments such as cough, cold, diarrhoea, and constipation. Google Scholar, PubMed, Scopus, and Web of Science were used to search for relevant material on the phytochemical profiling and pharmacologic activities of Malva sylvestris. The techniques used in phytochemical profiling and the pharmacologic activity of each compound were extracted from the included studies, including in vitro, in vivo, and clinical studies. The phytochemical analysis of Malva sylvestris revealed that the leaves and flowers are the most commonly used parts of the plant and contain various bioactive compounds such as flavonoids, mucilages, terpenoids, phenol derivatives, coumarins, sterols, tannins, saponins, and alkaloids. These phytochemicals are responsible for the many pharmacological activities of Malva sylvestris, such as anti-inflammatory, antimicrobial, hepatoprotective, laxative, antiproliferative and antioxidant properties. This review has presented an overview of the antinociceptive and anti-inflammatory activities and the cytotoxic effects of Malva sylvestris on different types of cancer cells. It has also summarised the work on developing copper oxide nanoparticles using Malva sylvestris leaf extract and its potential use in food and medicine. This review aims to highlight the traditional uses, phytochemistry, pharmacological activities, and safety of Malva sylvestris.

Spatial Distribution and Temporal Trend of Childhood Tuberculosis in Brazil

Tuberculosis (TB) in children presents specificities in its diagnosis, which makes it prone to underreporting: therefore, the disease in this group is still a serious public health problem in several countries. We aimed to analyze the spatial distribution and temporal trend of childhood TB in Brazil. An ecological study with time series, spatial analysis, and description of cases in Brazil between 2010-2021 was conducted. A total of 1,054,263 TB cases were reported in the period, with 30,001 (2.8%) in children. The yearly average was 2,500 cases, with a trend toward an increase in the incidence rate in 2018 and 2019 and a decline in 2020. Children under 5 years old represented 38.2% of cases, 5.2% were indigenous, and 424 children (1.4%) died. Sputum culture was performed for 18.4% of pulmonary TB. The incidence rates were higher in municipalities in the north and midwest regions, with high occurrence locations (hot spots), especially on borders with other countries. There was a reduction in childhood TB in 2020, possibly related to the COVID-19 pandemic. Strategies are needed for the identification and monitoring of childhood TB, with reinforcement of professional training for assistance and control, especially in the most vulnerable locations and groups.

Level of Trust of the Population in the Unified Health System in the Midst of the COVID-19 Crisis in Brazil

OBJECTIVE

to assess the level of trust in health services during the COVID-19 pandemic in Brazil.

METHODS

A cross-sectional study, carried out between 2020 and 2021, among Brazilians over 18. Nonprobabilistic sampling was used. Descriptive and inferential statistics were applied, using the local bivariate Moran's technique to verify the existence of spatial dependence between the incidence and mortality of COVID-19 and trust in health services. Furthermore, multinomial regression was also used to analyze the factors associated with the confidence level, with the calculation of the odds ratio and with a confidence interval of 95%.

RESULTS

A total of 50.6% reported trust in hospital services, while 41.4% did not trust primary health care services. With the application of the local bivariate Moran, both for the incidence and mortality of COVID-19, the trust in tertiary care and primary care services showed a statistically significant spatial association predominant in the Midwest (high-low) and North (low-high) regions of Brazil. The level of trust was associated with education, religion, region of the country and income.

CONCLUSIONS

The level of trust in hospital services, more than primary health care services, may be related to the population's culture of prioritizing the search for hospital care at the detriment of health promotion and disease prevention.

Acquired and Transmitted Multidrug-Resistant Tuberculosis among the Incarcerated Population and Its Determinants in the State of Paraná-Brazil

(1) Background: Tuberculosis remains a public health problem in the world. The study analyzed the factors associated with drug-resistant tuberculosis in the prison population of the state of Paraná. (2) Methods: Ecological study of drug-resistant tuberculosis cases registered in the Paraná Information System, Brazil (2008 to 2018). We performed descriptive statistics of quantitative parameters calculated with absolute frequencies. Additionally, we used binary regression logistics, where the odds ratio with its respective confidence interval was calculated. (3) Results: Of the 653 cases registered as cases of tuberculosis in the incarcerated population, 98 were drug-resistant tuberculosis. We observed that educational level of up to 8 to 11 years of schooling, negative bacterial culture (test outcome) and no tobacco use were factors associated with the non-development of drug-resistant tuberculosis, while clinically confirmed pulmonary TB and positive sputum smear microscopy in the fourth month of follow-up showed an association for the development of drug resistance. (4) Conclusions: The study showed that clinically confirmed pulmonary TB and a positive sputum smear microscopy in the fourth month of follow-up were associated with drug-resistant tuberculosis.

Trend and Spatial Distribution of Drug-Resistant Tuberculosis in Liberty-Deprived Populations in the State of Paraná, Brazil

(1) Background: Tuberculosis remains a public health problem in the world. This study evaluated the temporal trends, distribution, and spatial associations of drug-resistant tuberculosis in liberty-deprived populations in the state of Paraná, Brazil. (2) Methods: An ecological study was developed using all cases of drug-resistant tuberculosis in penal establishments reported by the Brazilian Notifiable Diseases Information System between 2008 and 2018. For the time trend, the Prais–Winsten method was used. To verify the spatial association, the Getis–Ord Gi* technique was used. (3) Results: During the study period, 653 cases of tuberculosis were reported in the studied population, of which 98 (15%) were drug-resistant. Prais–Winsten autoregression identified an increasing trend, with APC = 15.08% (95% CI: 0.02–0.09) from 2008 to 2018; when analyzed from 2012 to 2018, the trend increased even more, with APC = 23.31% (95% CI: 0.01–0.16). Hotspots were also noted in the north, east, and west macro-regions of the state. (4) Conclusions: The presence of drug-resistant tuberculosis, as well as an increasing trend of these cases, was evidenced in all regions of the state among liberty-deprived populations,. The spatial analysis revealed priority areas for drug-resistant tuberculosis in penal establishments.

Possible mechanistic insights into iron homeostasis role of the action of 4-aminoquinolines (chloroquine/hydroxychloroquine) on COVID-19 (SARS-CoV-2) infection

OBJECTIVE

With the recent direction in drug repurposing, many approved drugs have been evaluated to assess their effect on the coronavirus or SARS-CoV-2 infection (COVID-19). Driving this path, chloroquine (CQ) has been used in the treatment of malaria and hydroxychloroquine (HCQ) in immunomodulatory and anti-thrombotic action, playing a leading role in initial management of the viral infection.

MATERIALS AND METHODS

Literature search was done using Google Scholar, PubMed and Scopus database using keywords "chloroquine" "SARS-CoV-2" "COVID-19" "mechanism of action" and articles of interest were selected providing evidence of the possible role of CQ in viral infection.

RESULTS

In a bid to understand how and if CQ and HCQ would exert their anti-viral property, mechanistic exegesis was done to review various proposed mechanisms of action. This revealed the inhibition of viral attachment and entry, inhibition of enveloped glycoprotein, inhibition of the development and proliferation of new viral particles as the way they perform their action. There is an interplay between iron metabolism and homeostasis with COVID-19 infection and viral reproduction.

CONCLUSIONS

This study aims to show the functional role of CQ and HCQ, as well as to provide possible mechanistic insight on the role of iron on viral infection, iron starvation and its downstream cellular pathways involving hepcidin and proinflammatory cytokines. The overall aim of providing possible mode of action of CQ and HCQ in the management of COVID-19 infection is exhibited via its anti-viral, anti-inflammatory and anti-thrombotic activities.

Functional foods’ bioactive components and their chemoprevention mechanism in cervical, breast, and liver cancers: A systematic review

The invasiveness and low survivability on the part of patients associated with cancer continues to raise global concern. Different approaches have been used in the treatment and restoration of normalcy in cancer patients. However, most of the therapeutic strategies employed are challenged with high cost, low efficacy, high toxicity, and multiple side effects. In recent times, emergent studies have provided evidence that functional foods and their bioactive components serve roles as potential agents in the prevention and treatment of cancers. Moreover, global interest has focused on how this chemoprevention potential of functional foods can be explored as plant-based medicines for drug development. Although, the literature is replete with the mechanism of chemoprevention elicited by individual components of functional foods, there are limited reports on their overall anti-cancer mechanisms. Therefore, this systematic review aims to unify the anti-cancer mechanisms of functional foods in cervical, breast, and liver cancers which were selected due to their high incidence and mortality globally. We reviewed articles from NCBI/PUBMED from 2010 until February 2020. Three different search words used include “Functional food and cervical cancer”; “Functional foods and breast cancer”; “Functional foods and hepatocarcinoma”. Consequently, 434 scientific papers resulted from the three search words. However, after applying the inclusion/exclusion criteria, 37 articles were selected: 14 on cervical cancer, 10 on breast cancer, and 13 on hepatocellular carcinoma. We subsequently emphasize the anti-cancer mechanisms of various functional foods in the studies selected and these include induction of apoptosis, cell cycle arrest, disruption of microtubular network, downregulation of anti-apoptotic Bcl-2 family expression, induction of autophagy, modulation of signaling cascades, ROS generation, and suppression of specific genes. Therefore, functional foods possess effective chemoprevention mechanisms which can be explored in drug development. Keywords: Cervical cancer, Breast cancer, Liver cancer, Cancer prevention, Functional foods, Bioactive compounds