Impact assessment of integrated-pathy on cancer-related fatigue in cancer patients: an observational study

BACKGROUND

Integrated-pathy aims to integrate modern medicine with traditional systems via applying the holistic approach of Ayurveda, Yoga, and natural medicine. This is important for addressing the challenges surrounding the delivery of long-term palliative care for chronic ailments including cancer. The prime intent of this study was to substantiate the underlying hypothesis behind the differential and integrative approach having a positive impact on Quality of Life of cancer patients.

STUDY DESIGN

Cross-sectional Observational study.

METHODS

A standardized questionnaire was developed and used, after obtaining written informed consent from patients to assess the impact of Integrated-pathy on patients (n = 103) diagnosed with cancer receiving care at Patanjali Yoggram. The research was carried out over 8 months. All participants received a uniform treatment protocol as prescribed by Patanjali. For the sample size determination and validation, α and 1-β was calculated and for the significance of the pre- and post-treatment QoL ratings, Shapiro wilk test and other descriptive statistics techniques were explored.

RESULTS

A total of 103 patients seeking cancer special-healthcare were interviewed, out of which 39 (37.86%) remained finally based on the inclusion/exclusion criteria with age (25-65 years), types of cancers (Carcinoma and Sarcoma), chemotherapy/radiotherapy received or not, before opting Integrated-pathy. Follow-ups revealed a significant increase in the QoL (17.91%) after receiving the integrated therapy over a course of at least 1 month. Further, a significant reduction in cancer-related pain followed by an increase in QoL index was reported in the patients. Shapiro-wilk test revealed significant pairing (p < 0.001) with validation of the model using test.

CONCLUSIONS

To bolster evidence-based backing for Integrated-pathy, there is a need for clearly delineated clinical indicators that are measurable and trackable over time. Clinical investigators are encouraged to incorporate Integrated-pathy into their proposed interventions and conduct analogous studies to yield sustained advantages in the long run.

Investigating Ayurvedic Strategies: An In-Depth Examination of Managing Diabetes across Different Types

In light of the escalating global concern surrounding diabetes mellitus, contemporary medical practices predominantly hinge on pharmaceutical interventions, accompanied by inherent side effects and enduring limitations. This investigation accentuates a discernible research void regarding the amalgamation of Ayurvedic principles an age-old traditional medical system with prevalent approaches to diabetes management. Despite Ayurveda's promising potential in furnishing a comprehensive and personalized strategy for diabetes treatment, the imperative for further research and collaboration between Ayurvedic practitioners and contemporary healthcare professionals becomes evident. Existing scholarly works underscore the potential advantages of Ayurveda in delivering holistic diabetes care, encompassing not only glycemic control but also fostering overall well-being. Nevertheless, a closer examination reveals specific limitations, challenges, and gaps in current research, necessitating targeted efforts to enable a more exhaustive exploration of Ayurvedic interventions within diabetes management. This comprehensive review scrutinizes Ayurvedic recommendations pertaining to dietary practices, lifestyle adjustments, and herbal therapeutics, shedding light on their plausible efficacy. It serves as a clarion call for heightened research endeavors, aiming to bridge existing gaps and carve a pathway toward an integrated, patientcentric paradigm in diabetes care. In summary, as diabetes prevalence continues to rise globally, the study underscores the limitations of current pharmaceutical-centric approaches and highlights the need for extensive research and collaboration to unlock the full potential of Ayurvedic principles in providing a more holistic and personalized framework for diabetes management. The review navigates through Ayurvedic recommendations, emphasizing the urgency for intensified research efforts to fill existing gaps and pave the way for a seamlessly integrated, patient-focused approach to diabetes care.

Traditional uses, hepatoprotective potential, and phytopharmacology of Tinospora cordifolia: a narrative review

OBJECTIVES

Despite significant advancements in modern medicine, effective hepatoprotective medication with minimal side effects is still lacking. In this context. Tinospora cordifolia, an Indian Ayurvedic liana, has attracted much attention.

KEY FINDINGS

Traditionally, T. cordifolia has been found to be effective in the treatment of jaundice; according to the literature, T. cordifolia is a hepatoprotective agent, and the CCl4 model is the most frequently used to evaluate its potential. Its hepatoprotective effects might be attributed to alkaloids (berberine, palmatine, and jatrorrhizine) and sinapic acid. Berberine decreases inflammation by inhibiting the proinflammatory cascade triggered by TNF-α and reduces nitrosative stress by inhibiting iNOS. T. cordifolia also exhibits anticancer, anti-inflammatory, antimicrobial, antioxidant, and other activities; it is safe at concentrations up to 2000 mg/kg. Its biological action can be attributed to polyphenols, alkaloids, steroids, terpenoids, and glycosides. T. cordifolia has also been found to be an active ingredient in several polyherbal formulations used to treat chemical-mediated hepatotoxicity.

CONCLUSION

T. cordifolia's hepatoprotective effects are mediated by the inhibition of lipid peroxidation, the management of oxidative stress, and other factors. T. cordifolia can be used to manage liver disorders and as a hepatoprotective supplement in the food industry. The bioprospecting of its alkaloids can lead to the development of novel formulations against hepatic ailments.

A critical review on the recent trends of photocatalytic, antibacterial, antioxidant and nanohybrid applications of anatase and rutile TiO2 nanoparticles

Titanium dioxide nanoparticles (TiO2 NPs) have become a focal point of research due to their widespread daily use and diverse synthesis methods, including physical, chemical, and environmentally sustainable approaches. These nanoparticles possess unique attributes such as size, shape, and surface functionality, making them particularly intriguing for applications in the biomedical field. The continuous exploration of TiO2 NPs is driven by the quest to enhance their multifunctionality, aiming to create next-generation products with superior performance. Recent research efforts have specifically focused on understanding the anatase and rutile phases of TiO2 NPs and evaluating their potential in various domains, including photocatalytic processes, antibacterial properties, antioxidant effects, and nanohybrid applications. The hypothesis guiding this research is that by exploring different synthesis methods, particularly chemical and environmentally friendly approaches, and incorporating doping and co-doping techniques, the properties of TiO2 NPs can be significantly improved for diverse applications. The study employs a comprehensive approach, investigating the effects of nanoparticle size, shape, dose, and exposure time on performance. The synthesis methods considered encompass both conventional chemical processes and environmentally friendly alternatives, with a focus on how doping and co-doping can enhance the properties of TiO2 NPs. The research unveils valuable insights into the distinct phases of TiO2 NPs and their potential across various applications. It sheds light on the improved properties achieved through doping and co-doping, showcasing advancements in photocatalytic processes, antibacterial efficacy, antioxidant capabilities, and nanohybrid applications. The study concludes by emphasizing regulatory aspects and offering suggestions for product enhancement. It provides recommendations for the reliable application of TiO2 NPs, addressing a comprehensive spectrum of critical aspects in TiO2 NP research and application. Overall, this research contributes to the evolving landscape of TiO2 NP utilization, offering valuable insights for the development of innovative and high-performance products.

Unraveling the therapeutic potential of Senna singueana phytochemicals to attenuate pancreatic cancer using protein-protein interactions, molecular docking, and MD simulation

Pancreatic cancer (PC) presents challenges due to limited treatment options and patients seek complementary therapies alongside conventional treatments to improve well-being. This study uses computational drug discovery approaches to find potential phytochemicals from S. singueana for PC treatment. Among the 38 phytochemicals screened from S. singueana, specific inhibitors against PC were selected. Protein-protein interaction (PPI) network analysis highlighted key targets with high degrees, including PTEN (8) and PTK2 (7) genes, along with their respective proteins 5BZX and 3BZ3, which were employed for molecular docking studies. 1-methylchrysene and 3-methyl-1,8,9-anthracenetriol showed strong binding affinities of - 9.2 and - 8.1 Kcal/mol, respectively. Molecular dynamics simulations lasting 300 ns assessed structural stability and interaction energy of compound-target dockings: 1-methylchrysene-PTEN and 3-methyl-1,8,9-anthracenetriol-PTK2. In molecular dynamics simulations, the 3-methyl-1,8,9-anthracenetriol-PTK2 complex showed lower RMSD, RMSF, radius of gyration, solvent-accessible surface area, and more hydrogen bonds than the 1-methylchrysene-PTEN complex. The 3-methyl-1,8,9-anthracenetriol-PTK2 complex exhibited significantly stronger binding with a binding free energy (ΔG) of - 21.92 kcal/mol compared to the less favourable ΔG of - 10.65 kcal/mol for the 1-methylchrysene-PTEN complex. The consistent and stable binding interaction observed in the 3-methyl-1,8,9-anthracenetriol-PTK2 complex highlights its potential as a potent inhibitor of Focal Adhesion Kinase 1. Consequently, it emerges as a promising lead compound for the development of pancreatic cancer therapeutics. Conversely, the fluctuations observed in the 1-methylchrysene-PTEN complex indicate a less stable binding interaction. This indicates the potential of 3-methyl-1,8,9-anthracenetriol as a primary candidate for pancreatic cancer treatment. These findings improve our grasp of S. singueana's multi-target effects and its promise in addressing pancreatic cancer. Nevertheless, additional in-vivo and in-vitro studies are required to validate their effectiveness and therapeutic potential.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40203-023-00179-9.

Sepsis-mediated renal dysfunction: Pathophysiology, biomarkers and role of phytoconstituents in its management

Sepsis has evolved as an enormous health issue amongst critically ill patients. It is a major risk factor that results in multiple organ failure and shock. Acute kidney injury (AKI) is one of the most frequent complications underlying sepsis, which portends a heavy burden of mortality and morbidity. Thus, the present review is aimed to provide an insight into the recent progression in the molecular mechanisms targeting dysregulated immune response and cellular dysfunction involved in the development of sepsis-associated AKI, accentuating the phytoconstituents as eligible candidates for attenuating the onset and progression of sepsis-associated AKI. The pathogenesis of sepsis-mediated AKI entails a complicated mechanism and is likely to involve a distinct constellation of hemodynamic, inflammatory, and immune mechanisms. Novel biomarkers like neutrophil gelatinase-associated lipocalin, soluble triggering receptor expressed on myeloid cells 1, procalcitonin, alpha-1-microglobulin, and presepsin can help in a more sensitive diagnosis of sepsis-associated AKI. Many bioactive compounds like curcumin, resveratrol, baicalin, quercetin, and polydatin are reported to play an important role in the prevention and management of sepsis-associated AKI by decreasing serum creatinine, blood urea nitrogen, cystatin C, lipid peroxidation, oxidative stress, IL-1β, TNF-α, NF-κB, and increasing the activity of antioxidant enzymes and level of PPARγ. The plant bioactive compounds could be developed into a drug-developing candidate in managing sepsis-mediated acute kidney injury after detailed follow-up studies. Lastly, the gut-kidney axis may be a more promising therapeutic target against the onset of septic AKI, but a deeper understanding of the molecular pathways is still required.

Incredible Combination of Lifestyle Modification and Herbal Remedies for Polycystic Ovarian Syndrome Management

A relatively frequent endocrine-metabolic illness called polycystic ovarian syndrome (PCOS) is characterized by polycystic ovaries, persistent anovulation, and hyperandrogenism, which cause symptoms such as irregular menstruation, infertility, and hirsutism. PCOS is linked to obesity, insulin resistance, and increased amounts of androgens, or male hormones. The sedentary lifestyle, dietary fluctuations, inactivity, and stress are other contributing variables. According to estimates from India in 2021, around 22.5% of women, or one in five Indian women, suffer from PCOS. Evidence-based medical care for PCOS places a strong focus on a multidisciplinary approach, as standard pharmacological treatment frequently targets a single symptom, may be contraindicated, has adverse effects, and is ineffective in certain circumstances. However, long-term treatments have drawbacks and are likely to be ineffective, making complementary and alternative therapies a worthwhile choice. Yoga science is a thorough treatment plan for a healthy body and mind that may eradicate PCOS's primary causes, stress and obesity. Some common herbal remedies, including Foeniculum vulgare, Tinospora cordifolia, Asparagus racemosus, Ocimum tenuiflorum, Areca catechu, and Lepidium meyenii, have been highly regarded sources that have the benefits of lowering PCOS as well as having hypoglycemic and antiobesity effects. In light of existing literature, women with PCOS experienced symptomatic relief, improvement in hormonal balance, and the quality of life by utilizing yoga practices as well as herbal remedies. In conclusion, combining lifestyle modifications with herbal remedies can be used in the management of PCOS as a holistic approach. Therefore, this review opens a new window for researchers all across the world to validate such findings.

Alzheimer's Disease: A Role of Biomarkers in Early Diagnosis and Evidences from African Ethnomedicinal Knowledge

Alzheimer's disease (AD) is a neurological ailment that primarily affects the elderly and necessitates an efficient treatment regimen backed up by extensive care. Despite advancement in the in vivo imaging techniques focussing on early diagnosis of reliable biomarkers using novel MRI and PET scans, AD remains largely unexplained and effective preventative and treatment strategies are still lacking. Consequently, research groups are constantly attempting to improve its early detection, using both invasive and non-invasive techniques with established core markers like Aβ and Tau (t-tau and p-tau) proteins. Unfortunately, African American and other black races are facing an increasing burden of closely associated risk factors, and only a few attempts have been made to find effective complementary and alternative therapies for AD cure and management. A greater epidemiology and natural product research are required to deal with the concurrent rise of dementia among quickly ageing African population, which so far have largely been ignored in addition to a disparity in the AD risk factors. We have tried to bring attention to the issue by reviewing up on this predisposition while generating a perspective on how race may affect AD risk and expression. This article also puts emphasis on finding new research leads from African phytodiversity while presenting several of the important species along with their biological agents found helpful in dementia related symptoms.

Unveiling Role of MicroRNAs in Metastasizing Triple Negative Breast Cancer: From Therapeutics to Delivery

Triple negative breast cancers are malignant, heterogeneous tumors with high histological grades, increased reoccurrence, and cancer-related death rates. TNBC metastasis to the brain, lungs, liver, and lymph nodes is a complex process regulated by epithelial to mesenchymal transition, intravasation, extravasation, stem cell niche, and migration. Aberrant expression of miRNAs, also known as a transcriptional regulators of genes, may function as oncogenes or tumor suppressors. In this review, we systematically elucidated the biogenesis and tumor suppressor role of miRNA in targeting distant metastasis of TNBC cells and the above-mentioned underlying mechanisms involved in complicating the disease. Apart from their therapeutic implications, the emerging roles of miRNAs as prognostic markers have also been discussed. To overcome delivery bottlenecks, RNA nanoparticles, nano-diamonds, exosomes, and mesoporous silica nanoparticle-mediated delivery of miRNAs have been contemplated. Altogether, the present review article uncovers the potential role of miRNA in antagonizing distant metastasis of TNBC cells, and highlights their clinical significance as prognostic markers and possible drug delivery strategies to enhance the likely outcome of miRNA-based therapy against the disease.

A systematic review on traditional, ayurvedic, and herbal approaches to treat solar erythema

Solar erythema is a kind of radiation burn that strikes living tissue, such as skin, that arises from overexposure to UV radiation often from the sun. Ordinary symptoms of solar erythema include reddish skin, specifically warm to touch, overall tiredness, hurting, and mild whirl. Sunscreen contains SPF value, which measures how much ultraviolet radiation is needed to cause sunburn on sunscreen-applied skin, which is proportional to the quantity of solar energy needed to cause sunburn on unprotected skin. Between 30 and 50 SPF value is sufficient to protect from sunburn, especially for the people who are more sensitive to sunburn. Sunscreen also protects from sun damage including dark spots and discoloration and helps to keep skin smooth, spotless, and more even. Chemical-based sunscreen is widely used because it effectively protects the skin from sun damage, but it clogs pores and can be problematic for sensitive skin as it can cause itching or stinging of the skin and pus in the hair follicles. On the other hand, herbal sunscreen absorbs light preferentially over the range of 280-320 mm without causing any harm to the skin and eyes. Ayurveda rejuvenates dull skin by regaining the skin's natural glow and radiance. This review concludes the damaging and harmful effects of UV rays, along with various traditional, ayurvedic, and herbal approaches to treat solar erythema naturally.

Tumor Suppressive Role of MicroRNAs in Triple Negative Breast Cancer

Triple-negative breast cancers are highly aggressive, a heterogeneous form of breast cancer with a high re-occurrence rate that further lacks an efficient treatment strategy and prognostic marker. The tumor microenvironment of the disease comprises cancer-associated fibroblasts, cancer stem cells, immunological molecules, epithelial-mesenchymal transition, and a metastatic microenvironment that contributes to disease progression and metastasis to distant sites. Emerging evidence indicated that miRNA clusters would be of clinical utility as they exert an oncogenic or tumor suppressor role in TNBC. The present review article aims to highlight the therapeutic significance of miRNA in targeting the above-mentioned signaling cascades and modulating the intracellular crosstalk in the tumor microenvironment of TNBC. Prognostic implications of miRNAs to depict disease-free survival, distant metastasis-free survival, relapse-free survival, and overall survival outcome were also unveiled.

Molecular Insights of Plant Phytochemicals Against Diabetic Neuropathy

Diabetes and its associated complications including diabetic neuropathy have become a menacing headache for health workers and scientists all over the world. The number of diabetic individuals has been growing exponentially every day while the entire medical fraternity feels crippled and unable to handle such an enormous and anarchical scenario. The disease also demonstrates itself in the patients in numerous ways ranging from a little discomfort to death. Diabetic neuropathy has a poor prognosis since it might go unnoticed for years after the onset of diabetes. The etiology of the disease has been linked to oxidative stress caused by increased free radical production. Hyperglycemia causes multiple metabolic pathways to be activated, as well as significant oxidative stress, which becomes the major cause of cell death, culminating in Diabetic Neuropathy. So, it is the need of the hour to find out permanent treatment for this life-threatening disease. The primary goal of this study is to emphasize the potential importance of numerous processes and pathways in the development of diabetic neuropathy as well as the possible role of plant metabolites to control the disease at a molecular level. A possible mechanism was also summarized in the study about scavenging the reactive oxygen species by a flavonoid component. The study also covered the in vivo data of various plants and some of the flavonoid compounds actively studied against Diabetic Neuropathy by inhibiting or reducing the contributing factors such as proinflammatory cytokines, ROS, RNS inhibition, and upregulating the various cellular antioxidants such as GSH, SOD, and CAT.

Effect of Music Tempo on Pattern Reversal Visual Evoked Potential in Young Adults-Multisensory Stochastic Resonance: A Pilot Study

Stochastic resonance (SR) is a phenomenon in which an intermediate level of noise enhances the response of a weak input signal. This phenomenon is experimentally used for rehabilitation and treatment of visuomotor disorders associated with low amplitude and higher latency P100 VEPs. We presupposed that shortly it will be possible to develop and design new devices that enable multisensory SR in the audio-visual modality for human sensorimotor enhancement and rehabilitation purposes. This study was newer in which the auditory noise was used in the form of song of different tempos and their amplitude and latency of P100 PRVEP (pattern reversal visual evoked potential) was compared. Whether the different tempos song may affects the PRVEP. This study was conducted on 57 healthy volunteers in AIIMS Bhopal. The subjects were placed in front of a computer displaying a checkerboard 8x8 size. Electrodes were pasted on their scalp. The average latencies and amplitudes of the PRVEP were recorded at resting, then with the stimulus of acoustic noise in the form of low and high tempo song. The PRVEP were recorded for each event. We found that low- and high-tempo songs do not affect the latency component of PRVEP, while it significantly affects amplitude. Music therapy can help with vision rehabilitation, especially in patients with low amplitude PRVEP. A more significant number of samples for further study in this field in multisensory SR with visual evoked potentials (VEP) are necessary. We can also conclude that a sound-free environment is essential during VEP recording.

Phytochemical and Pharmacological Profile of Desmodium styracifolium (Osbeck) Merr: Updated Review

Abstract:

Desmodium styracifolium (Osbeck) Merr. is an important traditional medicinal herb documented in the indigenous medicinal systems and used in many folk medicines to treat various ailments. D. styracifolium belongs to the legume family Fabaceae (Leguminosae) and is preferably abundantly found worldwide. The plant possesses various phytochemical and pharmacological activities. Plant’s phytochemical accouter confers significant therapeutic properties and has been used traditionally for treating ailments like pyrexia, stranguria, renal calculi, dysuria, and oliguria. Here, we provide a comprehensive review of scientific findings of D. styracifolium phytoconstituents and their related anti-hypertensive, anti-oxidant, anti-urolithic and hepatoprotective activities in non-clinical in-vitro and in-vivo studies. More than 50 chemical compounds have been reported from D. styracifolium, including flavonoids, terpenoids, glycosides, phenols, and phytosterols. This paper presents a comprehensive analysis of the chemical constituents, pharmacological activities, and ethnomedicinal uses of D. styracifolium, providing scientific evidence for ethnomedicinal claims and opening perspectives for future research.

A Comprehensive Account of the Rust Genus Skierka (Skierkaceae)

The rust genus Skierka belonging to the phylum Basidiomycota was described in 1900 by Raciborski with Skierka canarii as the type species. The published literature on this rust genus reveals its ambiguity in taxonomic placement. It was challenging to taxonomically delineate and precisely identify each species within this genus due to the species sharing some common characteristics. The latest studies based on morphology taxonomy and molecular characteristics, however, have solved this puzzle now and placed this genus in its new family Skierkaceae. To understand all about the genus Skierka, this compilation was carried out to unveil the general characteristics, history, diversity, distribution, ecology, morphology and molecular taxonomy of different species of Skierka. After exploring 14 species of Skierka, it was observed that this genus is distributed in seven plant families in 19 countries all over the world. The genus appears to be well-represented in Asian and South American counties. This rust has not been reported from any European countries to date. The morpho-taxonomy of all species is well studied, but molecular analyses are still required. Only two species of the genus namely S. robusta and S. diploglottidis were identified based molecular analyses. Therefore, further studies should be focused on epitypifying the taxa that are too old and updating their taxonomy based on molecular, biochemical, and physiological aspects along with morphological characteristics. Multiple analytical methods should be considered when dealing with multi-locus datasets. This will increase our understanding of the diversity, distribution, and identification of these rust fungi.

Suicide Trends during the COVID-19 pandemic and the International COVID-19 Suicide Prevention Research Collaboration

Introduction

There was and still is much speculation about the COVID-19 pandemic impact on suicide rates. We aimed to assess the effect of the COVID-19 pandemic on suicide rates around the world.

Methods

We sourced real-time suicide data from countries or countries areas through a systematic internet search (official websites of Ministries of health, police agencies, and government-run statistics agencies or equivalents), recourse to our networks (e.g. ICSPRC) and the published literature (a living systematic review). We used an interrupted time-series analysis to model the trend in monthly suicides before COVID-19 in each country or country area, comparing the expected number of suicides derived from the model with the observed number of suicides in the early months of the pandemic (from April 1 to July 31, 2020, in the primary analysis). We have now updated this work to cover the first 15 months of the pandemic and stratified analyses by age and sex and method. We will present findings from the new updated data (35 countries) at the conference.

Results

Initially we sourced data from 21 countries (16 high-income and five upper-middle-income countries). Rate ratios (RRs) and 95% CIs based on the observed versus expected numbers of suicides showed no evidence of a significant increase in risk of suicide since the pandemic began in any country or area. There was statistical evidence of a decrease in suicide compared with the expected number in 12 countries or areas.

Conclusions

This was the first study to examine suicides occurring in the context of the COVID-19 pandemic in multiple countries. Early on high-income and upper-middle-income countries, suicide numbers remained largely unchanged or declined compared with the expected levels based on the pre-pandemic period. We need to remain vigilant and be poised to respond as the longer-term mental health and economic effects of the pandemic unfold. We will present updated findings with more recent data.

Subjective and Objective Assessment of Effect of Allergic Rhinitis on Voice in Indian Patients

To perform a subjective and objective assessment of vocal complaints in patients of allergic rhinitis (AR) using voice handicap index and video-stroboscopy respectively and find the association of their parameters with severity of the disease. Cross-sectional-observational study design. Outpatient department of Otorhinolaryngology of a tertiary centre. Seventy-five adult patients diagnosed with AR and classified according to 'Allergic Rhinitis and its Impact on Asthma' guidelines were compared with same number of normal subjects as controls, with the same age and sex, to ensure uniformity. Both the groups were asked to fill a self-answered questionnaire called Voice Handicap Index (VHI) and underwent laryngeal examination with Video-Stroboscopy (VS). The mean VHI score of the AR group (29.45 ± 32.11) was significantly higher (p < 0.05) than that of controls (12.07 ± 16.62). VS parameters including amplitude, supraglottic activity, vocal edge and phase closure also showed significant difference between cases and controls (p < 0.05). VHI scores increased, but the VS findings did not change significantly with the severity of the disease. AR patients show subjective and objective derangements of voice quality. VHI scores show increase, while VS parameters do not change with the severity of AR.

Phytoantioxidant Functionalized Nanoparticles: A Green Approach to Combat Nanoparticle-Induced Oxidative Stress

Nanotechnology is gaining significant attention, with numerous biomedical applications. Silver in wound dressings, copper oxide and silver in antibacterial preparations, and zinc oxide nanoparticles as a food and cosmetic ingredient are common examples. However, adverse effects of nanoparticles in humans and the environment from extended exposure at varied concentrations have yet to be established. One of the drawbacks of employing nanoparticles is their tendency to cause oxidative stress, a significant public health concern with life-threatening consequences. Cardiovascular, renal, and respiratory problems and diabetes are among the oxidative stress-related disorders. In this context, phytoantioxidant functionalized nanoparticles could be a novel and effective alternative. In addition to performing their intended function, they can protect against oxidative damage. This review was designed by searching through various websites, books, and articles found in PubMed, Science Direct, and Google Scholar. To begin with, oxidative stress, its related diseases, and the mechanistic basis of oxidative damage caused by nanoparticles are discussed. One of the main mechanisms of action of nanoparticles was unearthed to be oxidative stress, which limits their use in humans. Secondly, the role of phytoantioxidant functionalized nanoparticles in oxidative damage prevention is critically discussed. The parameters for the characterization of nanoparticles were also discussed. The majority of silver, gold, iron, zinc oxide, and copper nanoparticles produced utilizing various plant extracts were active free radical scavengers. This potential is linked to several surface fabricated phytoconstituents, such as flavonoids and phenols. These phytoantioxidant functionalized nanoparticles could be a better alternative to nanoparticles prepared by other existing approaches.

Nanotechnology Interventions in the Management of COVID-19: Prevention, Diagnosis and Virus-Like Particle Vaccines

SARS-CoV-2 claimed numerous lives and put nations on high alert. The lack of antiviral medications and the small number of approved vaccines, as well as the recurrence of adverse effects, necessitates the development of novel treatment ways to combat COVID-19. In this context, using databases such as PubMed, Google Scholar, and Science Direct, we gathered information about nanotechnology's involvement in the prevention, diagnosis and virus-like particle vaccine development. This review revealed that various nanomaterials like gold, polymeric, graphene and poly amino ester with carboxyl group coated magnetic nanoparticles have been explored for the fast detection of SARS-CoV-2. Personal protective equipment fabricated with nanoparticles, such as gloves, masks, clothes, surfactants, and Ag, TiO2 based disinfectants played an essential role in halting COVID-19 transmission. Nanoparticles are used not only in vaccine delivery, such as lipid nanoparticles mediated transport of mRNA-based Pfizer and Moderna vaccines, but also in the development of vaccine as the virus-like particles elicit an immune response. There are now 18 virus-like particle vaccines in pre-clinical development, with one of them, developed by Novavax, reported being in phase 3 trials. Due to the probability of upcoming COVID-19 waves, and the rise of new diseases, the future relevance of virus-like particles is imperative. Furthermore, psychosocial variables linked to vaccine reluctance constitute a critical problem that must be addressed immediately to avert pandemic.

Unveiling Novel Therapeutic Drug Targets and Prognostic Markers of Triple Negative Breast Cancer

Triple negative breast cancer represents multiple genomic and transcriptomic heterogeneities. Genetic and epigenetic changes emerging in TNBC help it in acquiring resistance against immunological response. Distant metastasis, lack of clinically targeted therapies and prognostic markers make it the most aggressive form of breast cancer. In this review, we showed that driver alterations in targeted genes AR, ERR, TIL, TAM, miRNA, mTOR and immunosuppressive cytokines are predominantly involved in complicating TNBC by inducing cell proliferation, invasion and metastasis, and by inhibiting apoptosis. The role of node status, cathepsin-D, Ki-67 index, CD3+TIL, BRCA1 promoter methylation value and p53 as an efficient prognostic factor have also been studied to predict the disease free and overall survival rate in TNBC patients. The present review article is an attempt to gain an insight with a new vision on the etiology of TNBC, its treatment strategies and prognostic marker to identify the outcome of standard therapies and to re-design future treatment strategies to provide maximum benefit to patients.

Anti-Cancer and Anti-Inflammatory Potential of Furanocoumarins from Ammi majus L

Secondary metabolites have potential benefits to human being. They are used in the food, agricultural and pharmaceutical industries. The secondary metabolite of furanocoumarins from different plant sources is essential in various skin-related ailments. Biologically, these chemicals are isolated from different plants in the Apiaceae, Fabaceae, Rutaceae and Moraceae families. Ammi Majus L. is one of the most common plants in the family of Apiaceae with a large quantity of derivatives. The furanocoumarin derivatives defend the plant by fighting external enemies by systemic acquired resistance (SAR). Via suppressing or retarding microbial growth in infected parts, these derivatives, along with SAR, help to alleviate inflammation in the human body. Latest evidence of these compounds has been established in the treatment of cancer, but the mechanism that needs to be elaborated is not yet understood. Recent studies have shown that furanocoumarin derivatives bind to DNA base pairs and block DNA replication. This may be a potential pathway that helps to regulate the growth of cancerous cells. This article reflects on the pharmaceutical data of furanocoumarins and their different mechanisms in these cases.

Computational Evidences of Phytochemical Mediated Disruption of PLpro Driven Replication of SARS-CoV-2: A Therapeutic Approach against COVID-19

BACKGROUND

COVID-19 caused by SARS-CoV-2 has been declared as a global pandemic by WHO. Comprehensive analysis of this unprecedented outbreak may help to fight against the disease and may play a pivotal role in decreasing the mortality rate linked with it. Papain-like protease (PLpro), a multifunctional polyprotein, facilitates the replication of SARS-CoV-2 and evades it from the host immunological response by antagonizing cytokines, interferons and may be considered as a potential drug target to combat the current pandemic.

METHODS

Natural moieties obtained from medicinal plants were analysed for their potency to target PLpro of SARS-CoV-2 by molecular docking study and were compared with synthetic analogs named as remdesivir, chloroquine and favipiravir. The stability of complexes of top hits was analysed by MD Simulation, and interaction energy was calculated. Furthermore, average RMSD values were computed and deepsite ligand-binding pockets were predicted using Play Molecule. Drug-like-abilities of these moieties were determined using ADMET and bond distance between the ligand and active site was assessed to predict the strength of the interaction.

RESULTS

Nimbocinol (-7.6 Kcal/mol) and sage (-7.3 Kcal/mol) exhibited maximum BA against PLpro SARS-CoV-2 as evident from molecular docking study, which was found to be even better than remdesivir (-6.1 Kcal/mol), chloroquine (-5.3 Kcal/mol) and favipiravir (-5.7 Kcal/mol). Both nimbocinol- PLpro and sage-PLpro SARS-CoV-2 complex exhibited stable conformation during MD Simulation of 101ns at 310 K, and potential, kinetic and electrostatic interaction energies were computed, which was observed to be concordant with results of molecular docking study. RMSD average values were found to be 0.496 ± 0.015 Å and 0.598 ± 0.023 Å for nimbocinol and sage, respectively, thus revealing that both the deviation and fluctuations during MD Simulation were observed to be least. Deepsite prediction disclosed that both compounds occupied cryptic pockets in receptor and non-bond distance analysis revealed the formation of hydrogen bonds during ligand-receptor interaction. ADMET exploration further validated the drug-like properties of these compounds.

CONCLUSION

Present study revealed that active constituents of Azadirachta indica and Salvia officinalis can be potentially used to target SARS-CoV-2 by hindering its replication process.

Computational insights of phytochemical-driven disruption of RNA-dependent RNA polymerase-mediated replication of coronavirus: a strategic treatment plan against coronavirus disease 2019

The current pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has raised global health concerns. RNA-dependent RNA polymerase (RdRp) is the prime component of viral replication/proliferation machinery and is considered to be a potential drug target against SARS-CoV-2. The present study investigated the anti-RdRp activity of phytochemicals against SARS-CoV-2 infection. Virtual ligand screening was carried out to determine the potent compounds against RdRp. Molecular docking and an MD Simulation study were employed to evaluate the spatial affinity of selected phytochemicals for the active sites of RdRp. Structural stability of target compounds was determined using root mean square deviation computational analysis and drug-like abilities were investigated using ADMET. Bond distances between ligand and receptor were marked to predict the strength of interaction. Aloe, azadirachtin, columbin, cirsilineol, nimbiol, nimbocinol and sage exhibited the highest binding affinities and interacted with active sites of RdRp, surpassing the ability of chloroquine, lamivudine, favipiravir and remdesivir to target the same. All the natural metabolites exhibited stable conformation during MD Simulation of 101 ns at 310 K. Kinetic, potential and electrostatic energy were observed to be least in the case of natural metabolites in comparison with synthetic analogues. Deviations and fluctuations were observed to be structurally least in target phytochemicals. Physiochemical and biological properties of these compounds further validated their drug-like properties. Non-bonded distance was found to be short enough to form hydrogen bonding or hydrophobic interactions, which revealed that these target compounds can strongly bind with RdRp. The study found potential phytochemicals to disrupt the replication domain of SARS-CoV-2 by hindering RdRp. We therefore anticipate that the current findings could be considered as valuable for the development of an efficient preventive/therapeutic expedient against COVID-19.

Potential Role of miRNA in Metastatic Cascade of Triple-Negative Breast Cancer

Triple-negative breast cancer presents an aggressive form of breast cancer subtype, which further lacks efficient treatment strategies and prognostic markers. Genomic heterogeneity in TNBC has led to the relapse of tumor and cancer stem cells with a higher likelihood of distal metastasis. Several studies supported the notion that miRNAs may act as oncogene or tumor suppressors in TNBC. miRNAs may function as a global regulator of TNBC by targeting post-transcriptional regulation of several genes involved in influencing metastatic events, but the exact mechanism involved in inducing the effect is yet to be elucidated. In this review, we summarized miRNA expression, which can functionally suppress metastatic cascade in TNBC by targeting epithelial to mesenchymal transition, metastatic colonization, cancer stem cells, invasion, migration and metastasis. miRNAs may appear as a metastatic biomarker to predict distal reoccurrence of TNBC in lungs, brain and lymph nodes. miRNA can act as a prognostic marker in metastatic TNBC, thereby predicting overall survival, disease-free survival and distant metastasis-free survival in affected patients. The present review article is an attempt to gain an insight into the repertoire of miRNA that may emerge out as an effective treatment strategy, novel biomarker of distal reoccurrence and prognostic marker in metastatic TNBC.

Unveiling Role of MicroRNAs as Treatment Strategy and Prognostic Markers in Triple Negative Breast Cancer

Triple negative breast cancer is the highly aggressive form of breast cancer with high reoccurrence rate and is short of effective treatment strategy. The prognostic markers of it are also not well understood. miRNAs are the global regulators of various cancers on the virtue of its ability to post transcriptional regulation of genes involved in various pathways involved in complicating TNBC. In this review we studied the expression of miRNAs at different stages of TNBC and the role of miRNAs as a tumor suppressor to inhibit cell proliferation, angiogenesis, invasion and metastasis and to induce apoptosis and thereby proposing these miRNAs as an effective treatment strategy against TNBC. miRNA also acts as chemosenstizer in enhancing chemosensitivity of conventional drugs against resistant TNBC cells. The present review emphasizes the importance of miRNAs as prognostic markers to determine the overall survival, disease free survival and distant metastasis free survival rate in TNBC patients. We speculate that miRNA can present themselves as an effective treatment strategy and prognostic marker against TNBC.

Elemental formula associated hypophosphataemic rickets

OBJECTIVES

Hypophosphataemic rickets (HR) is usually secondary to renal phosphate wasting but may occur secondary to reduced intake or absorption of phosphate. We describe a series of cases of HR associated with the use of Neocate^®, an amino-acid based formula (AAF).

METHODS

A retrospective review of cases with HR associated with AAF use presenting to centres across the United Kingdom.

RESULTS

10 cases were identified, over a 9 month period, all associated with Neocate^® use. The age at presentation was 5 months to 3 years. The majority (8/10) were born prematurely. Gastro oesophageal reflux disease (6/10) was the most frequent indication for AAF use. Radiologically apparent rickets was observed after a median of 8 months (range 3-15 months) of exclusive Neocate^® feed. The majority (7/10) were diagnosed on the basis of incidental findings on radiographs: rickets (6/10) or fracture with osteopenia (5/10). All patients had typical biochemical features of HR with low serum phosphate, high alkaline phosphatase, normal serum calcium and 25 hydroxyvitamin D. However, in all cases the tubular reabsorption of phosphate (TRP) was ≥96%. Phosphate supplementation resulted in normalisation of serum phosphate within 1-16 weeks, and levels remained normal only after Neocate^® cessation. In patients with sufficient follow up duration (4/10), normalisation of phosphate and radiological healing of rickets was noted after 6 months (range: 6-8 months) following discontinuation of Neocate^®.

CONCLUSION

The presence of a normal TRP and resolution of hypophosphataemia and rickets following discontinuation of Neocate^® indicates this is a reversible cause likely mediated by poor phosphate absorption. Close biochemical surveillance is recommended for children on Neocate^®, especially in those with gastrointestinal co-morbidities, with consideration of a change in feed or phosphate supplementation in affected children.

The effect of increased chewing strokes on the DeMeester score

Saliva is known to be protective for esophageal mucosa. Increased chewing strokes result in a quantitative and qualitative enhancement of saliva. Reduction in the amount of saliva produced results in an increased incidence of gastroesophageal reflux disease (GERD), which can be objectively measured by the DeMeester score. The impact of increased chewing strokes on the DeMeester score remains largely unknown, thus this study aimed to find out their impact on the value of the DeMeester score and its individual components.The effect of increased chewing strokes on the DeMeester score was investigated in 12 subjects (5 male and 7 female) who were diagnosed with GERD. All subjects underwent a 48-hour pH monitoring using the Bravo® pH capsule. All the patients chewed their food 20 times more on Day 2 as compared to Day 1. The data were analyzed for change in the DeMeester score and its individual components in 2 days.In patients with GERD (DeMeester score > 14.72 on Day 1), the number of long refluxes (>5 minutes) on Day 2 (mean = 3.2, SD = 2.3) was significantly lower than on Day 1 (mean = 6.4, SD = 2.7); Z = -2.032, p = 0.04. Though, the DeMeester score and its other individual parameters decreased on Day 2, they were not statistically significant.In patients with GERD, increased chewing strokes lead to a decrease in the number of long reflux episodes. Though there is a decrease in the DeMeester score and its other individual components, larger randomized controlled studies are required to reach statistical significance.

Utilizing PBPK Modeling to Evaluate the Potential of a Significant Drug-Drug Interaction Between Clopidogrel and Dasabuvir: A Scientific Perspective

Dasabuvir, a component of VIEKIRA PAK, is a substrate of CYP2C8 enzymes. Prescribing information for VIEKIRA PAK contraindicates gemfibrozil, a strong CYP2C8 inhibitor, because coadministration significantly increases dasabuvir exposures, which may increase the risk of QT prolongation. Clopidogrel may increase dasabuvir exposures primarily due to CYP2C8 inhibition by clopidogrel-acyl-β-D-glucuronide. This commentary outlines the US Food and Drug Administration (FDA) interdisciplinary review team's scientific perspective to address the potential for a significant drug-drug interaction (DDI) between clopidogrel and VIEKIRA PAK.

Invasive floating macrophytes reduce greenhouse gas emissions from a small tropical lake

Floating macrophytes, including water hyacinth (Eichhornia crassipes), are dominant invasive organisms in tropical aquatic systems, and they may play an important role in modifying the gas exchange between water and the atmosphere. However, these systems are underrepresented in global datasets of greenhouse gas (GHG) emissions. This study investigated the carbon (C) turnover and GHG emissions from a small (0.6 km²) water-harvesting lake in South India and analysed the effect of floating macrophytes on these emissions. We measured carbon dioxide (CO₂) and methane (CH₄) emissions with gas chambers in the field as well as water C mineralization rates and physicochemical variables in both the open water and in water within stands of water hyacinths. The CO₂ and CH₄ emissions from areas covered by water hyacinths were reduced by 57% compared with that of open water. However, the C mineralization rates were not significantly different in the water between the two areas. We conclude that the increased invasion of water hyacinths and other floating macrophytes has the potential to change GHG emissions, a process that might be relevant in regional C budgets.

Association of CYP2C19, CYP3A5 and GPIIb/IIIa gene polymorphisms with Aspirin and Clopidogrel Resistance in a cohort of Indian patients with Coronary Artery Disease

INTRODUCTION

Dual antiplatelet therapy with clopidogrel and aspirin is the current standard of care in the management of patients with coronary artery disease (CAD) and acute coronary syndrome (ACS). The variability in response to these antiplatelet agents may be due to the underlying genetic diversity. This study was designed to determine the resistance to aspirin and clopidogrel in Indian patients and to look for correlation, if any, with selected polymorphisms.

METHODS

Platelet function testing by light transmission aggregometry was performed on 72 patients with CAD/ACS who were stable on dual antiplatelet therapy (clopidogrel 75 mg OD and aspirin 150 mg OD) along with 72 controls. Aspirin resistance was considered as mean platelet aggregation ≥ 70% with 10 μm ADP and ≥ 20% with 0.75 mm arachidonic acid. Clopidogrel resistance was defined as <10% decrease from the baseline in platelet aggregation in response to ADP 10 μm and semi-response as <30% decrease from the baseline. Polymorphisms CYP2C19*2, *3, CYP3A5*3 and PLA1/A2 were genotyped.

RESULTS

We found 51.4% patients with inadequate response to clopidogrel (1.4% resistant and 50% semi-responders) and 5.5% patients semi-responders to aspirin, none being completely resistant. The genotype and allele frequencies of CYP2C19*2 and PLA1/A2 gene polymorphisms were significantly different between clopidogrel semi-responders and responders. Carriers of CYP2C19*2 and CYP3A5*3 showed diminished inhibition of platelet aggregation. No significant correlation was found between coronary events, type of coronary intervention with clopidogrel nonresponsiveness.

CONCLUSION

Unlike aspirin, a high proportion of partial responders to clopidogrel were identified. In an interim analysis on 72 Indian patients, a significant association was found between CYP2C19*2 and PLA1/A2 in clopidogrel semi-responders.

Establishing RHD zygosity in India: a step into the future of foetal and neonatal haemolytic disease prevention

BACKGROUND

Determination of RHD zygosity is important for the prevention of haemolytic disease of foetus and neonate. There is no data from India regarding the prevalence of RHD genotypes.

OBJECTIVES

We conducted this study to investigate RHD zygosity in phenotypically RhD positive (RhD+) Indians. We have also investigated the utility and concordance of two different genotyping techniques.

METHODS

Hundred serologically RhD+ Indians were genotyped at the RHD gene using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and polymerase chain reaction-sequence-specific primer (PCR-SSP) techniques.

RESULTS

Of the 100 RhD+ individuals, 26 (25%) were D heterozygous by both methods and 74 (71·2%) were D homozygous. There was no discordance in the results from the two techniques.

CONCLUSION

At least 25% of RhD+ Indians are heterozygous at the RHD gene. Both the genotyping techniques were equally robust and their complete concordance indicates RHD deletion as the main mechanism underlying RhD negativity in Indians.

Vitiligo at Injection Site of PEG-IFN-α 2a in Two Patients with Chronic Hepatitis C: Case Report and Literature Review

A 72-year-old female and a 57-year-old male with chronic hepatitis C were treated with a combination therapy of pegylated interferon (PEG-IFN)-α 2a (180 μg s.c. once a week) and ribavirin (1,000 mg orally daily). This resulted in the destruction of melanocytes at the injection site in both patients. In the male patient, the depigmentation progressed to the surrounding skin area. The dermatologist concurred with vitiligo as the diagnosis in both patients. Injection and surrounding site vitiligo associated with PEG-IFN-α 2b treatment for hepatitis C was noticed in previous case studies. For the first time, the case reports below highlight the same immunological adverse event secondary to PEG IFN-α 2a/ribavirin combination therapy and explain, in part, the complex interaction between host immune response and viral genotype. In addition, we systematically review drug-induced vitiligo and autoimmune diseases associated with the depigmentation disorder.

Indigenous knowledge of medicinal plants used by Saperas community of Khetawas, Jhajjar District, Haryana, India

BACKGROUND

Plants have traditionally been used as a source of medicine in India by indigenous people of different ethnic groups inhabiting various terrains for the control of various ailments afflicting human and their domestic animals. The indigenous community of snake charmers belongs to the 'Nath' community in India have played important role of healers in treating snake bite victims. Snake charmers also sell herbal remedies for common ailments. In the present paper an attempt has been made to document on ethno botanical survey and traditional medicines used by snake charmers of village Khetawas located in district Jhajjar of Haryana, India as the little work has been made in the past to document the knowledge from this community.

METHODS

Ethno botanical data and traditional uses of plants information was obtained by semi structured oral interviews from experienced rural folk, traditional herbal medicine practitioners of the 'Nath' community. A total of 42 selected inhabitants were interviewed, 41 were male and only one woman. The age of the healers was between 25 years and 75 years. The plant specimens were identified according to different references concerning the medicinal plants of Haryana and adjoining areas and further confirmation from Forest Research Institute, Dehradun.

RESULTS

The present study revealed that the people of the snake charmer community used 57 medicinal plants species that belonged to 51 genera and 35 families for the treatment of various diseases. The study has brought to light that the main diseases treated by this community was snakebite in which 19 different types of medicinal plants belongs to 13 families were used. Significantly higher number of medicinal plants was claimed by men as compared to women. The highest numbers of medicinal plants for traditional uses utilized by this community were belonging to family Fabaceae.

CONCLUSION

This community carries a vast knowledge of medicinal plants but as snake charming is banned in India as part of efforts to protect India's steadily depleting wildlife, this knowledge is also rapidly disappearing in this community. Such type of ethno botanical studies will help in systematic documentation of ethno botanical knowledge and availing to the scientific world plant therapies used as antivenin by the Saperas community.

Cassia occidentalis L.: a review on its ethnobotany, phytochemical and pharmacological profile

Cassia occidentalis L. is an annual or perennial Ayurvedic plant which is used in several traditional medicines to cure various diseases. This weed has been known to possess antibacterial, antifungal, antidiabetic, anti-inflammatory, anticancerous, antimutagenic and hepatoprotective activity. A wide range of chemical compounds including achrosin, aloe-emodin, emodin, anthraquinones, anthrones, apigenin, aurantiobtusin, campesterol, cassiollin, chryso-obtusin, chrysophanic acid, chrysarobin, chrysophanol, chrysoeriol etc. have been isolated from this plant. The presented review summarizes the information concerning the botany, ethnopharmacologyquery, phytochemistry, biological activity and toxicity of the C.occidentalis plant.