Volume 19, Issue 2

Childhood needs diverse nutritional requirements. Poor appetite, lifestyle changes, and poor digestion affects child immunity and make them prone to diseases. Kaumarabhritya , a branch of Ayurveda which deals in child and adolescent health care, has a unique concept of Swarna Prashana (SP) to promote generalized immunity and intellect. SP is commonly recommended to children between 0 and 12 years of age and given as a general health promoter to improve intellect, digestion, strength, immunity, longevity, and complexion. Multiple benefits of SP are mentioned in different Samhitas which needs to be explored on scientific background. Authors have highlighted content variabilities, plausible mechanisms, research tasks and potentials, lacunae, and future prospects about SP. This manuscript is a spotlight on current social, clinical, marketing, and scientific information of Swarna Prashana. SP can be a cost-effective, safe, infrastructure compatible, and prevention-centric approach to improve children’s overall health status and has the potential to serve as a positive health care program for children.

Objectives Various aspects of aging in Ayurveda literature has been explored and correlated it with modern biological understanding. Content The concept of longevity is better understood upon the baseline understanding of Aging ie. Jara. Manda Jara or Ajara is synonymous with longevity. Vriddhavastha/Jirnavastha/Jara (old age) is the period after 60 or 70 years of age. This stage of life becomes very crucial as degenerative changes occur in the body. Deterioration occurs to Dhatus, Indriya (perception power), Bala (strength), Virya (potency), Utsaha (enthusiasm), Paurusha (masculinity), Parakrama (valour), Grahana (reception), Dharana (retention), Smarana (memory), Vachana (speech). Brihatrayis and Laghutrayis were reviewed to analyze the various aspects of Ayu and Jara and correlated with research papers establishing the concept of aging in terms of evidence-based technological advancements. Databases like PubMed, Scopus were searched using keywords like Jara , Ayu Lakshana , Aging, Old age, Senescence, biomarkers, DNA, blood biochemistry, proteomics, genomics, microbiota, microbiome, androgen, estrogen, lipolysis, peripheral blood monocytes, collagen, cognitive function; with the help of Boolean operators. Summary Various aspects of Jara in Ayurveda have been analyzed by taking ample references from evidence-based technological advancements related to the physiology of aging. The indicators of biological aging based on recent researches like genomic irregularities, mitochondrial dysfunction, cellular senescence, altered protein expression, immunological markers, oxidative stress, pathological microbiota profile, telomere shortening in peripheral blood monocytes, lipolysis, and many other factors have been put forward for basic evidence in relation with Jara Lakshana . Outlook Understanding the physiology of aging will give the insight to manage the elderly. So, the need of the hour is to develop strategies or to conduct more researches which prevent senile disorders and thus increase the health span for the future generation.

Asaroon is the rhizome of Asarum europaeum L. and is commonly used in Unani medicines for its various pharmacological actions. It is an evergreen plant with glossy foliage. It belongs to the family of Aristolochiaceae and is native to Europe and the United State of America. Some species of Asaroon have been found in the Eastern Himalayan region. Asaroon has actions like Muharrik-i-A‘sab (nervine stimulant), Mudirr-i-Bawl (diuretics), Mudirr-i-Hayd (emmenagogue), Musakkin-i-Alam (analgesic), Mufattit-i-sudad (remove obstructions) and Muqawwī-i-Jigar (hepatotonic), etc. It is used in the management of Hummā (fevers) , Waja 'al-Mafasil (polyarthritis), Sara (epilepsy), Falij (paralysis), Ihtibās al-Tamth (amenorrhea) and Niqris (gout), etc. as per the Unani system of medicine (USM). It is used as a single herb as well as with a combination of other drugs to manage many diseases. The A. europaeum L. contains volatile oils and flavonoids along with other secondary metabolites. In the Indian market, Valeriana wallichii DC has been sold as Tagar but in some cases, it is sold as Asaroon. It is a clear case of adulteration by replacement of costly foreign drugs with a similar-looking indigenous drug. In this manuscript, we have discussed the Ethno-pharmacology of the A. europaeum L. with special reference to USM and basic differences with V. wallichii DC to show that both drugs are different and their actions and uses are also different from each other.

Objectives The aim of this review is to summarise and appraise the findings of various studies on Trikatu. Content COVID-19 or SARS-CoV-2 disease a pandemic principally contaminating the respiratory tract and bringing about Severe Acute Respiratory Syndrome is liable for significant mortality around the world. Far-fetched, there is no exact treatment accessible till today. Consequently, it is critical to discover the alternative methodology which can decrease the weight of illness. Trikatu powder recommended by authorities for the management of mild cases of COVID-19 is a conventional  ayurvedic  formulation containing three spices;  Zingiber officinale, Piper nigrum, and Piper longum . A comprehensive search of the articles published since inception to 01/08/2020 on Trikatu was carried out. Major electronic medical databases such as Pub Med/MEDLINE and Cochrane Database of Systematic Reviews were used for the literature search. Summary A total of 21 records were identified by electronic searches between since inception to 01/08/2020 of which 13 records were included for review. The reviewed articles highlight Trikatu as a safe, anti-inflammatory, and immune-modulatory property by suppression of the production of pro-inflammatory cytokines TNF-a, IL-1b, IL-6, IL-17, alteration in levels of circulating immune complexes, anti-dyslipidaemia agent by reduced triglycerides and LDL cholesterol and increased HDL cholesterol, enhancing bio-availability of co-drug by reducing the elimination half-life (t1/2β) and zero time intercept of the elimination phase. Outlook The findings of this review seem to show Trikatu as a potential anti-inflammatory, anti-dyslipidaemia, and immune-modulatory ayurvedic formulation can be used for combating flu like illnesses and also in the management of COVID-19 as an adjuvant. However, rigorous double blind randomized controlled trials with larger sample size are warranted for better validation in such clinical conditions. Highlights – COVID-19 has affected the lives of millions worldwide and unfortunately no precise treatment available till today. – Trikatu an ayurvedic formulation suggested by various authorities in India. – Trikatu found to be a potential anti-inflammatory; anti-dyslipidaemia and immune-modulatory drug can be used for combating flu like illnesses.

Objectives The neem ( Azadirachta indica ) have been used in herbal medicine for the treatment of multiple diseases, particularly cancer. The mechanism of anti-cancer properties of neem are far from clear. However, it is well accepted that anti-cancer effects of neem is mediated via its hepatic anti-oxidant activity. In the present review, we are going to classify in vitro and in vivo studies about anti-cancer activity of neem via its hepatic anti-oxidant activity. We also summarize its active ingredients and some therapeutic and toxic dosage forms. Methods A systematic search in the literature was performed in PubMed, Scopus, Embase, Cochrane Library, Web of Science, as well as Google Scholar pre-print database using all available MeSH terms for neem, A. indica , anti-cancer, anti-tumor, carcinogen, liver, antioxidant activity, neem ingredients, and glutathione. Electronic database searches combined and duplicates were removed. Results The neem plant have been used in herbal medicine for the treatment of various diseases, particularly cancer. The mechanisms of anti-cancer effects of neem are far from clear. Cancerous cells growth can induce imbalance the oxidant and anti-oxidant activity in various organs particularly in the liver. Therefore, it seems that neem have anti-cancer effects via restore of the antioxidant disturbances close to the control ones in the liver. Additionally, administration of neem extract can induce oncostatic potential via several mechanism including; suppression of the NF-κβ pathway, increased expression of tumor suppressor (such as p53 and pTEN), decreased expression of oncogenes (such as c-Myc), and increased apoptosis in cancerous cells. The median lethal dose (LD50) value for extracts of neem was higher than 2,500 mg/kg. Conclusions It is suggested that neem plays pivotal role in the prevention and treatment of cancer via its hepatic antioxidant activity. Indeed, application of neem extract can decreased tumor growth via restore of the antioxidant disturbances close to the control ones in the liver.

Objectives The aim of this literature review is to describe the role of acupuncture for myofascial pain syndrome in interventional pain management. Content Myofascial pain syndrome (MPS) can be found at all ages. Approximately 30.0–93.0% of patients with musculoskeletal pain have MPS. Unsuccessful treatment can lead to dysfunction, disability, and a cost burden. We conducted a search of studies published in Google Scholar and PubMed databases from 2016 to 2021. Summary Acupuncture, combined with other therapies, is effective in reducing pain and improving physical function. Acupuncture can enhance endogenous opioids such as endorphins to relieve pain and enhance the healing process. Outlook Acupuncture could be considered as one of nonpharmacological options in Interventional Pain Management for MPS. Interventions with acupuncture are safe and have minimal side effects when performed by a trained and competent practitioner.

Objectives A bio-guided selection and identification of the most active compounds obtained from Algerian Pistacia atlantica desf. Subsp. atlantica. Methods An antioxidant activity guided fractionation was performed on buds’ extract using extensive chromatographic and spectroscopic techniques. The antioxidant potentials of isolated compounds and other unpurified fractions were evaluated against DPPH radicals using TLC plates and test tubes. Results The results showed that all isolated compounds and fractions exhibited eminent DPPH scavenging potential. Two coumarins (7-ethoxycoumarin and 7-hydroxy-5-methoxycoumarin) and two flavonoids (3′,5,7-trihydroxy-4′-methoxyflavanone and 5,6,7,4′-tetrahydroxyflavonol-3-O-rutinoside) were isolated for the first times from the titled subspecies. Conclusions These results confirm that the species of P. atlantica is far from being exhausted of active compounds, especially polyphenols.

Objectives Garcinia mangostana (GM) pericarp extract recognizes for relieving skin disorders. It becomes a household fruit juice due to its high concentration of antioxidant compounds, including phenolic and α -mangostin. The purpose of this study was to optimize the conditions of Ultrasonic-Microwave Assisted Extraction (UMAE) of GM pericarp. Methods GM pericarp was extracted by UMAE and conventional decoction extraction. UMAE was created in nine different individuals and combined ultrasonic and microwave power. The amount of phenolic compound, “caffeic acid, ferulic acid”, α -mangostin, and total phenolic content (TPC) were compared. The optimized parameters were particle size of grounded raw material, microwave power, and ultrasonic power during water extraction. Results The optimized UMAE conditions combined 200 W microwave power and 200 W ultrasonic power to extract raw material grounded to 22.6 μm diameter particles (p≤0.05). The synergistic effect of ultrasonic and microwave-assisted extraction significantly (p≤0.05) impacted on the TPC, the yield of caffeic acid, ferulic acid, and α -mangostin. Conclusions Overall, the synergistic effect of ultrasonic and microwave extraction resulted in a significantly higher amount of bioactive compounds when compared to conventional decoction extraction (p≤0.001). These results demonstrated the advantages of UMAE for preparing GM pericarp extract for the food, cosmetic and pharmaceutical industries.

Objectives In alternative medicine, plants pay a major role. Some plants are known for their poisonous nature but still have some importance in the herbal drug industry for their medicinal value. Strychnos nux-vomica is one such plant. Its nuts are called as poison nut due to the presence of alkaloids. Both the nut and its minerals are having medicinal properties and hence the present study was indented to understand the nature of primary metabolites and multi elemental composition. Methods The nuts of S. nux-vomica were procured, authenticated, powdered and subjected to proximate analysis parameters, visualization of thin layer chromatographic separation (TLC) and finger print profiling through high performance thin layer chromatographic (HPTLC); surface morphology by scanning electron microscopy, energy dispersive X-ray analysis, X-ray fluorescence spectrometry, X-ray photoelectron spectrometry, powder X-ray diffractometry and inductively coupled plasma optical emission spectrometry. Results In HPTLC, 7 spots each under 254 nm, 366 nm, derivatization with vanillin sulphuric acid (VSR) reagent appeared and 2 spots with Dragendorff’s reagent. In HPTLC, 12 peaks at 254 nm, 9 peaks at 366 nm, 7 peaks at 520 nm after derivatization with VSR reagent detected. Elements such as potassium, calcium, magnesium, chlorine, aluminium, iron, manganese, sodium, nickel, phosphorus, copper, zinc, sulphur and silicon were identified. PXRD revealed that the presence of potassium chloride, calcite and dolomite as major elemental composition. Conclusions The presence of all the above elements has vital roles on human physiology. Potassium, calcium, chlorine, aluminium, nickel, phosphorus, sulphur and silicon are reported for the first time in this study.

Objectives Cynometra travancorica , endemic to Western Ghats of India is pharmacologically similar to Saraca asoca and occasionally used as substitute in a well-known Ayurvedic uterine tonic Asokarishta . S. asoca possess various biological properties, but there are no reports on C. travancorica. The present study evaluated the pharmacological properties of C. travancorica and its efficacy in attenuating the sodium fluoride (NaF) induced oxidative stress in mice. Methods Antioxidant potential of methanolic extract of C . travancorica (CTE) stem bark was evaluated using DPPH, superoxide radical scavenging and total antioxidant assays. The effect of CTE on mitigating NaF deteriorated redox status in the liver tissue of mice was evaluated. Functional groups in CTE were analyzed by FTIR analysis. Results CTE effectively scavenged the free radicals in in vitro condition. CTE could augment catalase (46.6%), superoxide dismutase (53.8%) activities and GSH level (48.1%) against NaF induced decline in the liver tissue of mice. The peroxidation of lipids was found to be decreased by 44.9% and tissue damage abated as inferred by histopathology. FTIR analysis revealed the presence of biologically active functional groups in CTE. Conclusions The study revealed the ameliorative effect of C . travancorica against NaF induced deleterious effect in experimental animals by its potent antioxidant potential.

Objectives Diabetes is a chronic disease caused by high blood sugar greatly affected by diet. The chemical medicines applied to treat diabetes usually have side effects. This study aimed to investigate the effect of saffron petals, damask rose petals, and saffron-damask rose petal herbal teas on weight loss, fasting blood sugar, lipid profile, and the inflammatory factors of diabetic rats. Methods In this study, 40 male Sprague Dawley rats with an average age of four weeks received a high-calorie, high-fat, high-sugar diet for nine weeks. The rats were then randomly assigned to five groups, including normal, control, saffron petal, damask rose petal, and saffron plus damask rose petal groups. For nine weeks, 3 mL of the herbal tea was administered to the intervention groups daily through oral gavage. The levels of FBS, lipid profile, Insulin-like growth factor 1 (IGF-1), the high-sensitivity C-reactive protein (hs-CRP), hemoglobin A1c (HbA1C), and glucose tolerance test (GTT) were measured following the intervention. Results Saffron petals reduced weight gain, Triglyceride (TG), and HbA1c and increased hs-CRP and IGF-1 (all p < 0.05). The damask rose petal reduced weight gain, FBS, hs-CRP, and HbA1c and increased the IGF-1 (all p < 0.05). Saffron plus damask-rose petals reduced the weight gain, TG, hs-CRP and HbA1c, and increase IGF-1 factor (all p < 0.05) compared to the control group. No significant effect was found on visceral fat, LDL-C, and HDL-C. Compared with the normal group, saffron petals and damask rose petals increased the FBS, HDL, and LDL levels. Damask rose and the combination of saffron petals and damask rose decreased IGF-1 compared with the normal group (all p < 0.05). Conclusions Saffron and damask rose petals could have beneficial effects on improving the status of biochemical markers. The simultaneous use of saffron and damask rose may counteract the adverse effects of saffron on inflammatory indices.

Objectives Acute lung injury (ALI) is a life-threatening pulmonary dysfunction associated with severe inflammation. There are still no effective pharmacological therapies for the treatment of ALI. In this concern, several anti-inflammatory agents could be used as add-on therapy to inhibit inflammation. Achillea wilhelmsii (AW) C. Koch is a well-known medicinal plant in the Iranian ethnomedical practices with anti-inflammatory activity. This study was aimed to evaluate the efficacy of ethanolic extract of AW on lipopolysaccharide (LPS)-induced ALI in mice. Methods The ALI model was established via the intra-tracheal (i.t.) administration of LPS (2 mg/kg) to male BALB/c mice. The ALI mice were divided into four groups (n=8 each) which intra-peritoneally (i.p.) treated with repeated doses of saline (model), dexamethasone (2 mg/kg), and AW (150–300 mg/kg) 1, 11 and 23 h post LPS administration. Twenty-four hours after the LPS challenge, bronchoalveolar lavage fluid (BALF) and lung tissue were evaluated for inflammatory cell influx, level of tumor necrosis factor-α (TNF-α) and histopathological changes. Results The AW (150–300 mg/kg) treated mice showed lower inflammatory cells infiltration in BALF and TNF-α level when compared to the model group. In addition, LPS induced several pathological alterations such as edema, alveolar hemorrhage and inflammatory cell infiltration into the interstitium and alveolar spaces. Treatment with AW significantly reduced LPS-induced pathological injury. Conclusions Taken together, the data here indicated that AW may be considered as a promising add-on therapy for ALI.

Objectives Oral mucositis is a debilitating oncology treatment side effect, with honey identified as a viable management option due to established wound-healing abilities. However, effects of saliva on properties attributed to honey’s wound-healing abilities is unknown. Therefore, this study aimed to identify interactions between saliva, and antioxidant characteristics and pH of honey. Methods Saliva was collected from 15 healthy participants (Females n=9; mean age=34.1 ± 11.2 years). Centrifuged salivary supernatant, whole saliva, and water were independently used to dilute commercial Australian honeys (n=42). Antioxidant characteristics (DPPH and FRAP) and pH of diluted honeys were analysed, and differences between dilution conditions were determined. Results Honey and saliva dilutions increased antioxidant characteristics compared to water, and addition of honey to saliva reduced pH compared with saliva alone. There were significant differences between dilutions for FRAP and pH, and water and salivary conditions for DPPH (p<0.001). No difference was observed between salivary conditions for DPPH (p=0.931), suggesting smaller cells remaining in the supernatant possess antioxidant abilities. However, differences observed for FRAP suggest precipitable molecules, including epithelial and food debris, could provide additional antioxidant power. Conclusions The addition of saliva to honey may support properties attributed to honey’s wound-healing abilities and should be considered in the context of oral mucositis management.

Objectives The prevalence of obesity was increasing globally, with nearly half a billion of the world’s population now considered to be overweight or obese. The immature poken ( Citrus reticulata ) was a good source of flavonoids and phenolic acids, which may exert an anti-obesity effect. However, the current efficacy in clinical trials was still unclear. Thus, the object of this study was to explore whether immature poken had an anti-obesity effect in the clinical trial. Methods In this study, we identified nine major compounds from immature poken extract (IPE), and most compounds significantly decreased the lipid accumulation in adipocytes. In addition, 20 subjects with body mass index (BMI) ≥ 24 or body fat > 30 were recruited and randomly allocated to placebo and experimental (IPE) groups for 6 week intervention and 2 week follow-up. Results In comparison with the baseline results (week 0), the body weight, body fat, and waist circumference at week 6 in the IPE group were significantly decreased by 1.49 kg, 0.33%, 2.1 cm. Moreover, in blood biochemical analysis, total cholesterol (TC), triglyceride (TG), fasting blood sugar (FBS), and insulin levels at week 6 in IPE group were also decreased by 3.6, 4.6, 2.1 (mg/dL), and 2.9 (μU/mL), respectively. Conclusions The finding showed that immature poken had important roles in fat metabolism by suppressing adipogenesis, and immature poken may provide new weight loss strategies for obese people.

Objectives To investigate effect of beta adrenergic blockade on intestinal lactate production and glycogen concentration in dogs infused with hexoses. Methods Experiments were carried out on 35 fasted male anaesthetized dogs weighing between 9 and 16 kg. The animals were divided into 7 (5 dogs per group) groups. Group I dogs served as control and infused with normal saline, groups II-IV were intravenously infused with glucose (1.1 mg/kg/min), fructose (1.1 mg/kg/min) and galactose (1.1 mg/kg/min) respectively while groups V-VII animals were pretreated with propranolol (0.5 mg/kg) and were infused with glucose, fructose or galactose respectively. A vein draining the proximal segment of the jejunum was cannulated along with right and left femoral arteries and veins. Glucose uptake was calculated as the product of jejunal blood flow and the difference between arterial and venous glucose levels (A-V glucose), part of the jejunum tissue was homogenized for estimation of glycogen concentration, and plasma lactate was assayed using lactate colorimetric kit. Results The result showed significant increase in venous lactate production in response to glucose (78.30 ± 4.57 mg/dL), fructose (60.72 ± 1.82 mg/dL) and galactose (71.70 ± 1.30 mg/dL) when compared with the control group (51.75 ± 1.32 mg/dL) at (p<0.05) with no significant difference in animals pretreated with propranolol. There was no significant difference in glycogen concentration (p>0.05) in animals infused with hexoses only compared with propanolol pretreated group. Conclusions Results suggests that one of the possible fates of the enormous amount of glucose taken up by the intestine is conversion to lactate and not glycogen and β-adrenergic receptor does not affect it.

Objectives Teucrium polium (TP) has been traditionally used for treatment of the diabetes mellitus, kidney and liver diseases, and inflammations but some studies have reported the hepatotoxicity effects of this plant. Therefore, this study was conducted to investigate the effect of TP aqueous extract on the liver of the diabetic rats. Methods Adult male Wistar rats were randomly divided into five groups: (Control) Normal rats that were gavaged with normal saline (1 mL), (TP100) Normal rats (Non-diabetic) that were gavaged with TP (100 mg/kg), (DM) diabetic model rats, which became diabetic by intraperitoneal injection of streptozotocin (50 mg/kg), (DTP100) diabetic rats that were gavaged with TP (100 mg/kg), and (DTP200) diabetic rats that were gavaged with TP (200 mg/kg). The effects of the aqueous extract on the blood glucose, body weight, the activities of enzyme markers of liver damage (Aspartate Aminotransferase (AST) and Alanine Aminotransferase (ALT)) were investigated in the serum of the control and treated groups. At the end of study liver histopathology and the total antioxidant activity (TAA) test were evaluated. Finally, obtained data were analyzed by the SPSS software (version 16). Results Results showed that the AST and ALT levels were significantly increased in the diabetic rats (p<0.001). A comparison of 100 mg/kg and 200 mg/kg doses of TP administration in diabetic rats also showed a significant difference (p=0.01), indicating a better performance of 100 mg/kg dose. No significant difference was found between the control group and rats treated by the TP (TP100) (p=0.382). Also, triglyceride (TG) and cholesterol levels were significantly decreased in the treated groups compared to the diabetic untreated group. Conclusions Findings of the study revealed no hepatotoxicity, and the hepatoprotective effects of the TP were proved in the present study.

Objectives This animal study aimed to demonstrate the synergistic effect of high-intensity interval training (HIIT) and alcoholic extract of nettle on serum chemerin and beta cells function in type 2 diabetic male rats. Methods Thirty-two STZ-induced diabetic male Wistar rats were randomly divided into four groups including the control group, the supplemented group with 200 mg/day of nettle, the training group with five sessions per week of HIIT, and the group with combined nettle and HITT intervention. Body weight, lipid profile, beta cells function, and chemerin level were assessed after eight weeks of the intervention. Results The values of chemerin significantly decreased in combined HIIT and nettle intervention group compared to the control group (p=0.001). The levels of glucose and insulin decreased significantly in nettle group, exercise group, and combined HIIT and nettle group (p=0.001). Conclusions The present study found that intense interval exercise with the consumption of alcoholic extract of nettle can affect the performance of beta cells, glucose, and insulin. Future human studies are warranted.

Objectives Many diabetes-related complications are caused by oxidative stress. In the current study, the protective effect of Cinnamomum cassia against diabetes-induced liver and kidney oxidative stress was evaluated. Methods The male Wistar rats (n=48) were randomly divided into six groups including; control group received 500 µL normal saline orally for 42 days. Diabetes groups received intraperitoneally (i.p.) streptozotocin (STZ) as single-dose (60 mg/kg, i.p.). Cinnamon extract (100, 200, 400 mg/kg) and metformin (300 mg/kg) were orally administered to diabetic rats for 42 days. After the experiment period, the animals were anesthetized and the liver and kidney tissues were quickly removed and restored for oxidative stress evaluation. The levels of malondialdehyde (MDA), total thiol content, glutathione (GSH), nitric oxide (NO) metabolites, as well as, superoxide dismutase (SOD) and catalase (CAT) activities were measured in kidney and liver tissue. Results The level of MDA, SOD, and CAT activities increased significantly, while the total thiol content, and NO production were significantly reduced in diabetic animals compared to the control group (from p<0.05 to p<0.001). Treatment with cinnamon extract significantly decreased the MDA level, as well as, SOD and CAT activities in the liver and kidney of diabetic rats (from p<0.05 to p<0.001). In the liver and kidney of cinnamon treated groups, GSH and total thiol contents and NO production were significantly higher than diabetic group (from p<0.05 to p<0.001). Conclusions Cinnamon extract due to its potent antioxidant property could be effective in decrease of diabetes-induced oxidative stress that plays a major role in renal and hepatic complications.

Objectives The current study evaluates the protective role of aqueous extract of Sterculia tragacantha leaf (AESTL) on pancreatic gene expressions (insulin, PCNA, PDX-1, KI-67 and GLP-1R) and oxidative stress parameters in streptozotocin-induced diabetic rats. Methods Diabetes mellitus was induced into the experimental Wistar animals via intraperitoneal (IP) injection of streptozotocin (35 mg/kg body weight) and 5% glucose water was given to the rats for 24 h after induction. The animals were categorized into five groups of 10 rats each as follows normal control, diabetic control, diabetic rats administered AESTL (150 and 300 mg/kg body weight) and diabetic rats administered metformin (200 mg/kg) orally for two weeks. Thereafter, the animals were euthanized, blood sample collected, pancreas harvested and some pancreatic gene expressions (such as insulin, PCNA, PDX-1, KI-67, and GLP-1R)s as well as oxidative stress parameters were analyzed. Results The results revealed that AESTL significantly (p<0.05) reduced fasting blood glucose level, food and water intake, and lipid peroxidation in diabetic rats. Diabetic rats administered different doses of AESTL showed a substantial upsurge in body weight, antioxidant enzyme activities, and pancreatic gene expressions (insulin, PCNA, PDX-1, KI-67, and GLP-1R). Conclusions It can therefore be concluded that AESTL has the ability to protect the pancreas during diabetes mellitus conditions.

Objectives To assess the ameliorative activity of polyphenolic-rich extracts of Basella rubra leaves on β-cell dysfunction in type-II diabetes (T2DM). Methods Total phenolic and flavonoid contents; α-amylase and α-glucosidase inhibitory actions and qualitative analysis of the bioactive compounds of the polyphenolic-rich extract of B. rubra leaves were investigated using gas chromatography-mass spectroscopy (GC-MS). Diabetes mellitus (DM) was induced by single intraperitoneal injection of streptozotocin (60 mg/kg body weight) and the rats were orally given bound phenolic (BPE) and free phenolic extracts (FPE) of B. rubra (B.R) leaves at 200 and 400 mg/kg b.w once daily for 14 days. Biochemical analyses were executed for evaluation of serum insulin, serum lipid profile concentrations, liver enzymes activities. Results The extracts demonstrated antioxidant potentials and enzymes inhibitory activities in dose dependent manner; and several bioactive compounds as revealed by GC-MS. BPE and FPE considerably (p<0.05) reduced hyperglycemia, improved serum insulin levels, ameliorated the concentration of serum lipid profiles and improved liver antioxidant activities. Additionally, BPE and FPE expressively decreased alanine aminotransferases (ALT), aspartate aminotransferases (AST), gamma-glutamyl transferase (GGT) activities along with levels of bilirubin and urea when compare to diabetic control rats. Conclusions Data acquired exhibited the ability of BPE and FPE to improve pancreatic beta-cell in streptozotocin-induced rats.

Objectives Inflammation, insulin resistance, hyperinsulinemia and cell damage are the major patho-physiological reasons behind type 2 diabetes (T2DM), which is one of the most prevalent non communicable metabolic disorders in the world. Oral hypoglycemic drugs and insulin shots are usually exercised to treat the diabetic patients but it produces many side effects. Thereby paving the way for natural hypoglycemic agents; a Himalayan herb and alternative nutritional therapy; low glycaemic indexed pumpkin seed, are used in combination for a better management of the disease. The aim of the study was to explore the combined efficacy of Gymnadenia orchidis Lindl root Salep and low-glycemic indexed-pumpkin seeds in better management of T2DM and associated complications. Methods Balb/c mice were randomly allocated to six different groups (n=5). Streptozotocin along with high-fat-diet was used to induce T2DM. The experimental animals were supplemented with low-glycemic food or root Salep (200 mg/kg body weight) or combination of both according to their groups for 21 days, post which various biochemical tests were performed. Results T2DM augmented the IL-6, IFN-γ, TNF-α, BAX, Insulin levels, and HOMA-IR with concurrent reduction of IL-4, QUICKI, Bcl-2, estradiol and progesterone levels. FACS revealed augmented cellular damage in T2DM mice. Interestingly, root Salep and pumpkin seeds normalized those parameters in T2DM animals suggesting significant (p<0.001) improvement of immunity of the diseased animals and ameliorated associated complications. Conclusions Root Salep and pumpkin seed display synergism among binomial set of herbal agents which may be safely used for T2DM management.

Objectives Madhumeha Kusumakar Rasa (MKR) is an Ayurved formulation having a strong pharmacological base for diabetes management. This study aimed to validate MKR's efficacy in dexamethasone-induced insulin resistance (IR). Methods Albino Wistar rats were divided into four groups. Group 1 served as the normal control, Group 2 received dexamethasone 1.5 mg/kg (i.p.), Group 3 received dexamethasone and metformin 200 mg/kg (p.o.), and Group 4 received dexamethasone and MKR 236 mg/kg (p.o.). Animals were evaluated for serum glucose levels and glucose tolerance, serum insulin, Homeostatic model assessment of insulin resistance (HOMA-IR), Homeostatic model assessment of insulin sensitivity (HOMA-IS), fasting glucose to insulin ratio (FGIR), and lipid parameters. Pancreas, liver, and kidneys were evaluated for reduced Glutathione (GSH) and Malondialdehyde (MDA) levels. These tissues were also evaluated for histopathological changes. Results MKR showed significant improvement in serum glucose and glucose tolerance, serum insulin and HOMA-IR, HOMA-IS, and FGIR. It also showed a significant improvement in lipid parameters as compared to the dexamethasone-treated group. It prevented depletion of GSH levels and elevation in MDA levels. These effects were supported by histopathological analysis. Conclusions MKR treatment significantly attenuated dexamethasone-induced IR. This study validates the mechanism of the anti-diabetic potential of MKR.

Objectives This study aimed to investigate the effect of the n-butanol fraction of the methanol leaf extract of Artemisia campestris (BFAC), growing wild in the arid zone of Tunisia, on induced obesity in male Wistar rats. Methods The total phenolic content and antioxidant capacity of the BFAC were estimated. The main phenolic composition of the BFAC was determined using the high-performance chromatography system coupled with a diode array detector technics. Five groups of rats received either a standard diet (SD group), a high-fat diet (HFD group), or an HFD supplemented with oral administration of BFAC for eight weeks. Results The BFAC showed higher phenolic content and antioxidant potential than the total leaf methanol extract. Chlorogenic acid, rutin, and dicaffeoylquinic acids were identified in the BFAC. HFD increased body and relative liver weights, as well as serum and hepatic levels of triglycerides and total cholesterol, compared to SD. HFD generated significant oxidative stress in the liver by increasing lipid peroxidation and reducing glutathione-S-transferase, catalase, and glutathione peroxidase activities, compared to SD. These HFD-altered parameters were restored to normal values by oral treatment with the BFAC. Conclusions These findings give first evidence about the antiobesity efficacy of A. campestris . Such a study would enhance existing information and promote the use of this species.

Objectives Increasing hypertension incidence in Sub-Sahara Africa and the current cost of management of the metabolic disorder has necessitated research on medicinal plants employed in African Traditional Medicine for hypertension. Thus, this study evaluated antihypertensive effect of Annona muricata leaves or Curcuma longa rhizomes in experimentally-induced hypertensive male Wistar rats (n=70) which were unilaterally nephrectomized and daily loaded with 1% salt. Cardiovascular and haematological changes, as well as urinalysis were determined. Methods Rats were uninephrectomized and NaCl (1%) included in drinking water for 42 days. Extract-treated hypertensive rats were compared to normotensive, untreated hypertensive and hypertensive rats treated with lisinopril (5 mg/70 kg) or hydrochlorothiazide (12.5 mg/70 kg). A. muricata extract or C. longa extract were administered at 100, 200 or 400 mg/kg. Blood pressure (systolic, diastolic and mean arterial) and electrocardiogram was measured on day 41. Twenty-four-hour urine samples were collected from day 42. Blood samples were collected on day 43 for haematology (PCV, red cell indices, WBC and its differentials, and platelets). Results A. muricata or C. longa extracts caused a decline in elevated blood pressure of hypertensive rats. Heart rate and QT segment reduction coupled with prolonged QRS duration were reversed in extract-treated rats, with significant increases in hemogram parameters indicating increased blood viscosity. Also, leukocyturia, proteinuria and ketonuria with increased urine alkalinity, urobilinogen and specific gravity which are classical indicators of poor prognostic outcomes in hypertension were reversed in extract-treated rats. Conclusions In conclusion, A. muricata and C. longa have cardioprotective effect with reversal of derangements in haemogram and urinalysis associated with hypertension.

Objectives This study aimed to describe the development and implementation of a separated pathway to check and treat patients with a suspected/confirmed coronavirus disease 2019 (COVID-19) in the emergency department (ED) at King Abdullah bin Abdulaziz University Hospital in Riyadh. Methods We conducted a retrospective, descriptive longitudinal study from March to July 2020 by analyzing data of all confirmed cases of COVID-19 among ED visitors and healthcare workers in King Abdullah bin Abdulaziz University Hospital. Results During the study period, a total of 1,182 swab samples were collected for testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), of which 285 (24.1%) tested positive. Of the 285 cases of confirmed SARS-CoV-2 infection, 18 were healthcare workers and 267 were patients. As a result of using the respiratory pathway for COVID-19 patients, the hospital managed to limit transmission of SARS-CoV-2 not only between patients but also between patients and healthcare workers, while also containing the pandemic. There were no cases of nosocomial SARS-CoV-2 infection recorded among the patients who visited the ED or the flu clinic. All confirmed cases were community acquired and patients were cared for under constrained measures. Conclusions Implementing infection control measures and restricting those with respiratory symptoms to the ED pathway prevented nosocomial spread of SARS-CoV-2 infection in the ED.

Objectives Evaluate the association between overweight/obesity with serum gonadotropin and androgen levels in Egyptian pubertal girls. Methods A case-control study carried out in “Obesity Clinic” of “Diabetes, Endocrine and Metabolism Pediatric Unit (DEMPU)”, Pediatric Hospital, Cairo University. It included 40 overweight and obese girls and 40 age-matching normal weight (control) ones, aged 12–18 years. Anthropometric assessment (weight, height and hip and waist circumferences) was done, and waist/hip and BMI were calculated. Laboratory investigations: lipid profile, serum gonadotropin (LH, FSH), androgen (free and total testosterone), estradiol, insulin, and FBG were quantified, while insulin resistance (IR) was calculated. Results Hypogonadotropins (FSH and LH) and hyperandrogenaemia (total and free testosterone) were significantly prominent among obese girls. Correlation between gonadotropin, androgen and all of the studied variables, for the three studied groups (obese, overweight and control) revealed constant relations. Gonadotropin and androgens showed opposing correlations. Gonadotropin had significant negative correlations with the anthropometric parameters of obesity (BMI, waist, and W/H ratio), insulin, insulin resistance and lipid profile (triglycerides, total cholesterol and LDL), whereas androgens had significant positive ones. In addition, gonadotropin showed significant positive correlations with estradiol and HDL, while androgens showed significant negative ones. Conclusions Overweight/obesity had no effect on the correlations between gonadotropin and androgen on one side, with the anthropometric measurements and laboratory investigations on the other one. Alterations in androgen levels occur at earlier ages than gonadotropin, among both overweight and obese girls.

Objectives Type 2 diabetes mellitus (T2DM) represents a serious public health problem. Environmental toxins, other than infectious agents or exposures can stimulate immune responses which are associated with the occurrence of T2DM. Diabetic nephropathy (DN) is a serious complication of diabetes that leads to changes in the structure and function of the kidneys. The study aimed to detect diagnostic biomarkers for (DN), at an early stage, to prevent disease progression in these patients and improve their outcomes. Methods This study was performed on 102 T2DM patients and 80 normal controls. Blood glucose, HbA 1c , serum homocysteine (Hcy) and urinary periostin were assessed. Patients were divided into: controlled (n=46) (HbA 1c <6.5%) and uncontrolled diabetics (n=56) (HbA 1c >6.5%). Results The study results revealed a significant rise in blood glucose and HbA 1c as well as serum Hcy levels in diabetic groups compared to controls. Also, urinary periostin exhibited significant elevation in diabetic groups. Serum glucose, HbA 1c and serum Hcy revealed a highly significant difference between diabetic subgroups and control groups, while urinary periostin demonstrated a non-significant difference. Only, urinary periostin showed a significant increase in uncontrolled diabetics. Conclusions The highest levels of serum Hcy and urinary periostin were recorded only in the uncontrolled diabetics. Urinary periostin was demonstrated as a more preferable biomarker being a non-invasive sample for predicting renal insult in diabetic subjects. This biomarker could be performed regularly for early detection of DN. Also, it could be added to the periodic medical examinations of workers occupationally exposed to workplace pollutants inducing diabetes.

Objectives Increased incidence of multiple sclerosis (MS) calls for supporting complementary therapies in this field. Persian Medicine (PM) specialists present various assumptions to help patients through Mizaj (temperament) modification, but its confirmation requires scientific evidence. This study aimed at identifying the Mizaj of MS patients, and comparing it with their Mizaj before the onset of the disease, and with that of healthy people. Methods Forty-two MS and fifty-four healthy subjects participated in the study as case and control groups. General and brain Mizaj in patients were identified by five PM specialists before and after the onset of the disease. Mojahedi Mizaj Questionnaire (MMQ) was completed by the two groups. The validity of MMQ was assessed using Mizaj diagnosis by PM specialists as the gold standard. t-test, McNemar-Bowker, Wilcoxon, and Chi-square ( χ 2 ) tests were used to compare the Mizaj of patients before and after the onset of the disease, and between the two groups (p<0.05). Results The sensitivity and specificity of MMQ for Hotness (75, 81%) and Coldness (75, 65%) were acceptable. There were no significant differences between patients and healthy subjects in terms of general Mizaj. But general and brain Mizaj of patients after developing MS inclined to coldness and dryness, although merely inclination of general Mizaj to coldness was significant (p=0.03). Conclusions According to our results, the Mizaj of MS patients has an inclination toward coldness and dryness; Also, MMQ can be used as a validated scale for identifying the Mizaj of MS patients in future studies.

Objectives Sheetali pranayama , a cooling pranayama is best known for its calming and relaxing nature, widely used for many conditions like depression, anxiety and hypertension. The aim of the study was to evaluate the immediate effect of the practice of Sheetali pranayama on heart rate and blood pressure parameters in healthy volunteers. Methods Apparently, 60 healthy volunteers were involved, from both sexes. They were split into pranayama (n=30) and control (n=30) groups at random. Sheetali pranayama was performed for 5 min (5 cycles) in the pranayama group and normal breathing (12–16 breaths/min) was permitted in the control group. Heart rate (HR) and blood pressure (BP) were recorded with RMS polyrite in the supine position after 5 min of rest. Results The HR in the pranayama group significantly decreased (p=0.04). Systolic (SBP) and diastolic blood (DBP) pressure, pulse pressure (PP) and mean arterial pressure (MAP) decreased significantly (p<0.05) relative to control after pranayama practice. Pre-Post inter-group results has also shown that the pranayama group has substantially decreased HR and BP indices. Conclusions Present study shows that the practice of Sheetlai pranayama creates a relaxed state, and parasympathetic activity overrides sympathetic activity in this state. It indicates that in healthy volunteers, pranayama strengthens the resting cardiovascular parameters.

Objectives Steam bath is extensively used around the world. However, its physiological influence is not understood in detail. Objective of the current study is to examine the effects of 12 sessions of steam bath on spirometric parameters among healthy participants. Methods Forty healthy adult volunteers of both sex (14 male and 26 female) aged 26.38 ± 8 years participated in the study. A steam bath session (10–15 min) was given once a week for 12 weeks. The spirometric parameters [forced expiratory volume in the 1st second (FEV1, L), forced vital capacity (FVC, L), FEV1/FVC ratio (absolute value), maximal mid-expiratory flow (MMEF, L/s) and peak expiratory flow (PEF, L/s)] were measured by Helios 401 spirometer. Results Compared to baseline, post-intervention spirometric parameters showed significant (p<0.05) improvement in the FVC (82.40 ± 11.24 to 96.91 ± 18.76), FEV1 (86.13 ± 14.39 to 91.17 ± 12.48), FEV1/FVC ratio (86.96 ± 3.64 to 93.75 ± 4.80), MMEF 25–75% (86.96 ± 3.64 to 94.16 ± 11.57), peak expiratory flow rate (79.82 ± 14.90 to 92.18 ± 18.96). Conclusions Taking steam bath improves the spirometric parameters of healthy adult participants. However, future randomized controlled trials with on a large scale have to done to validate our findings.

Objectives Nausea and vomiting have psychological negative effects on some pregnant women during gestation. Different strategies have been used for the treatment of nausea and vomiting during pregnancy, such as acupressure and psychological interventions. This study was conducted to evaluate the effects of psychological counseling and acupressure based on couple therapy procedures on vomiting and nausea in pregnant women in Iran. Methods Two hundred and eight women were divided into four groups (n=52): 1) they did not any intervention (control group), 2) they received the psychological intervention, 3) they received acupressure intervention, and 4) they received a combination of psychological + acupressure interventions. To investigate the effects of interventions on nausea and vomiting, the Rhodes index of nausea, vomiting and retching were used. The counseling period has lasted for 4 weeks. The pressure intervention on the site was conducted in clockwise form for 1 min and anticlockwise form for another 1 min. Results Groups did not have a significant difference for abortion and income (p>0.05). The effects of counseling, and acupressure interventions on severity and period of vomiting and nausea were not significant (p>0.05), but the intervention based on counseling and acupressure decreased severity of vomiting and nausea (p<0.05). Conclusions The intervention based on counseling and acupressure could not reduce nausea and vomiting during the gestation, but the intervention based on a combination of both decreased nausea and vomiting. It can be suggested to apply an intervention based on a combination of counseling and acupressure in short-time period for decreasing nausea and vomiting in women during pregnancy.

Objectives Hypertension (HTN) is considered as chronic medical condition. Because of the increased complications associated with the conventional medicine, the effects of naturopathic modalities were emphasized to prevent and minimize those adverse effects. This study was done to assess the immediate effect of neutral spinal compress on heart rate variability and blood pressure and thereby to substantiate the clinical understanding of its effect in hypertensive individuals. Methods Hundred hypertensive individuals were recruited for the study. Subjects were assessed for blood pressure (BP) and Heart Rate Variability (HRV) before and immediately after the intervention of 20 min. Results Result shows significant reduction in mean heart rate (HR) (p<0.001), low frequency (LF) (p<0.001), low frequency/high frequency (LF/HF) (p<0.001), systolic blood pressure (SBP) (p<0.001) and diastolic blood pressure (DBP) (p<0.001) and significant increase in mean R-R interval (Mean RR) (p<0.001) and high frequency (HF) (p<0.001) components of Heart Rate Variability after neutral spinal compress intervention. Conclusions The results of the study reported that full neutral spinal compress reduces the sympathetic tone and shifts the Sympatho-vagal balance in favor of parasympathetic dominance and hence it can be concluded that neutral spinal compress can be effectively used in the management of hypertension. Trial registration Clinical Trial Registry- India (CTRI); CTRI Reg. No- CTRI/2020/01/022639.

Objectives To investigate the effect of whole-body vibration (WBV) in the recovery phase after resistance exercise (RE) bout on heart rate variability (HRV) and blood pressure (BP) in a hypertensive population. Methods Twenty hypertensive males and females were randomly allocated into group A (RE bout), and group B (RE bout with WBV). Pre-test and post-test measure of HRV, systolic blood pressure, and diastolic blood pressure were taken before and after RE and placebo WBV in one group and in another group of RE with WBV in the recovery phase. Results There were no significant differences in both RE bout group and RE bout with WBV on HRV parameters but on BP it has shown significant improvement in both groups with a p value of SBP and DBP as 0.001 and 0.03 respectively but comparatively RE with WBV in recovery has greater improvement. Conclusions Our data demonstrated that RE bout using WBV has no improvement on HRV but it has significantly improved BP in hypertensive population.

Objectives Current modalities for treating polycystic ovary syndrome (PCOS) are not curative and using them for a long period is associated with adverse effects. According to Persian Medicine recommendations, wet cupping on calf muscles can induce menstrual bleeding. In the present study, the effect of wet-cupping (traditional bleeding from capillary vessels) was assessed on menstrual cycles (as primary outcome), hirsutism, and laboratory manifestation of PCOS. Methods A quasi-experimental study was conducted from 2016/5/21 until 2017/5/20 on 66 PCOS women within the age range of 20–40 years and a menstrual interval of at least 60 days during the last year. Participants’ calf muscles were cupped on day 26 of their last menstruation cycle following the Persian Medicine recommendations. They were followed for 12 weeks and a menstruation history and physical examination was done twice (4 and 12 weeks after wet cupping). Insulin Resistance (IR) and Free Androgen Index (FAI) were evaluated at baseline and end of the study. Results Wet-cupping on calf muscles significantly improved menstrual cycles’ frequency 0.37(95% CI: 0.13, 0.51), p-value=0.001 and hirsutism after 4 and 12 weeks of intervention were −1.9 (95% CI: −2.5, −0.5), p-value<0.001 and −1.4(95% CI: −2.1, −0.8), p-value<0.001, respectively. While it was not significant in changing the IR and FAI. About 33% of participants suffered from mild temporary discomforts (which were resolved within a few minutes of rest) and 9% reported mild long-term side effects. Conclusions It is considered that wet-cupping on calf muscles can be propounded as an optional treatment of PCOS for those not willing to use chemical medication.

Objectives The purpose of this study was to investigate the role that the NSS-2 BRIDGE ® device, an auricular field nerve stimulator, may play in reducing opioid requirement and pain in kidney donor surgery. It was not a randomized study. Electrophysiologic studies have demonstrated that the stimulation of the cranial nerves produced by the NSS-2 BRIDGE ® device modulates the ascending/descending spinal pain pathways, especially at the level of the limbic system. Methods The design compared the effects of the NSS-2 BRIDGE ® device (NSS 2-BRIDGE ® device group; n=10) to a control group (n=10). In both groups, the surgery was performed using the same standard enhanced recovery after surgery protocol based on the use of a multimodal analgesic approach. For the active treatment group, the NSS-2 BRIDGE ® device was placed in the post anesthesia care unit. The primary endpoint was opioid requirement (oral morphine equivalent, OME in mg) at 24 h post-surgery. Secondary endpoints included pain (0–10), at 24 and 48 h, time to discharge from the recovery room, incidence of post-operative nausea and vomiting at 24 h, time to oral intake, time to ambulation, and time to discharge from the hospital. Data was analyzed using unpaired t-test and presented as mean ± standard deviation. Results Compared to control, the use of the NSS-2 BRIDGE ® was associated with a 75.4% reduction in OME (33.6 vs. 8.3 mg; p=0.03) and 41.5% reduction in pain (5 vs. 3.28; p=0.06) at 24 h and a 73.3% difference in pain at 48 h (1.6 ± 1.6 vs. 6.0 ± 2.8; p=0.0004). There was no difference in non-opioid analgesics administration between groups. Conclusions The tolerability of NSS-2 BRIDGE ® device was reported by most to be excellent. This study suggests that the NSS-2 BRIDGE ® device may represent a complementary approach for controlling postoperative opioid consumption and pain in patients undergoing kidney donation.

Objectives Amenorrhoea in women of reproductive age may be an indication of an undiagnosed and chronic condition. The concept of temperament is a fundamental component of health preservation and diagnosis of various disease conditions including amenorrhoea in Unani medicine. Dystemperament is the commonest cause of various diseases. Therefore, general body temperament and uterine dystemperament in amenorrhoea was determined. Methods A prospective, single-centre, cross-sectional observational study from June to November 2019 was conducted in 80 patients of reproductive age with amenorrhoea ≥60 days. Validated questionnaire for the assessment of women’s general body temperament and clinical features of uterine dystemperament was used. The data were analysed by appropriate statistical analysis. Results The age of patients with amenorrhoea ranged from 14 to 50 years. The most prevalent general body temperament was cold (57.5%) and wet (60%). Cold and wet general temperament was more common at the age of 21–30 years (30 and 36.25%), 60–90 days of amenorrhoea (33.75 and 32.5%) and body mass index (BMI) ≥25 kg/m 2 (47.5 and 50%). The most prevalent uterine dystemperament was cold and dry (95%). A significant correlation between general temperament with age, amenorrhoea and BMI >23 kg/m 2 was noted. Moreover, the cold temperament of the body had a significant correlation with cold uterine temperament (r=0.864, p<0.001). Conclusions This study corroborated the claim of Unani scholars that cold and wet general and uterine temperament is more common in amenorrhoea and obesity. However, amenorrhoea can also occur in normal and other temperaments.

Objectives A mixture of Z and E communic acid is isolated for the first time from the cones of Juniperus phoenicea. Its biological activity was studied. Methods The plant material was extracted in a Soxhlet apparatus with n -hexane, the resulting extract was subjected to column chromatography (CC) on silica gel. The structure elucidation of the constituents of the isolated fraction was identified by comparison of its spectroscopic properties 1 H and 13 C NMR data with those reported in the literature. The antimicrobial assay of hexanic extract and isolated compounds was carried out by the disc diffusion and micro-dilution methods. Results A mixture of two diterpene acids isomers was isolated, with a high yield (68%). Their chemical structures were confirmed after comparing their spectral data with published reports. These natural products exhibited a significant antibacterial and antifungal activity against the tested strains. Indeed, for Bacillus cereus , Staphylococcus aureus , and Pseudomonas aeruginosa , the inhibition zone diameters (36–37 mm) was better than penicillin, novobiocin, and amoxicillin. For Candida albican s activity, it show that the mixture possess an activity similar to that of Metrazol. Against Escherichia coli , the inhibitory activity was found less than Amoxicillin. This is the first report of isolation of communic acid from J. phoenicea . Conclusions These results showed that the cones of J. phoenicea were an important source of communic acid, and its hexanic extract had the greatest potential antibacterial activity against both Gram-negative and Gram-positive bacteria and C. albicans .

Objectives Plaque psoriasis is very embarrassing condition of skin as it produces itchy rashes and scaly lesions which may not respond well to the treatment. It can be correlated with Kitibhakushta which is one among the 18 types of Kushta (skin diseases). Several corticosteroids for skin applications are used now a day’s which gives only temporary relief. Case presentation A 36 years old moderate built male patient complains of blackish skin rashes with itching, pain and scaling all over the body for three months. Based on the symptoms, Dosha (Biological humors) involved were assessed as Kapha (binding factors) and Vata (vital force of life) and suggestive of Kitibhakushta. Diagnosis of the Plaque psoriasis was further confirmed by biopsy. Classical Kushta treatment was adopted here. As Poorvakarma (pre-operative procedures), Rukshana (Dehydrating therapy) was done and then Snehapana (intake of medicated ghee) was administered. Then classical Vamana (emetic therapy) and Virechana (purgative therapy) were performed. This took almost one month. After Samsarjana (special diet) patient was administered Manibhadragula as Shodhana Rasayana for a period of one month. At the end of Manibhadragula intake, remarkable changes were observed in all the symptoms. There were significant changes seen in PASI, DLQI and photographs taken before and after treatment. Conclusions Here the special mode of administration of Manibhadragula as mentioned in Ashtanga Hridaya helps for Shodhana and the Shodhana itself has Rasayana action. Drugs also have Rasayana property. This made the authors to propose a new concept called Shodhana Rasayana. Classical treatment by considering the condition of Roga (disease) and Rogi (patient) helps for management of Kushta.

Objectives Patients presenting with functional neurological symptoms like non-epileptic seizures and weakness have an underlying psychological component and tend to persist for a prolonged time, despite repeated evaluations and interventions. Ayurveda, with its holistic approach to health and disease, can provide better management for such disorders, in the form of customized treatment protocols and unique methods of psychotherapy. Case presentation The patient presented with drooping of both eyelids, initially diagnosed as ocular myasthenia, and later found to have psychogenic pseudo-myasthenic ptosis. She was evaluated based on ayurvedic parameters and managed successfully with ayurvedic treatment modalities of sodhana (dosha elimination), samana (pacifying), and a novel psychotherapy technique of Smriti meditation. Conclusions A holistic approach to the patient, as expounded by Ayurveda, is vital in evaluating and managing functional neurological complaints. Smriti meditation, in combination with selected ayurvedic medicines, is effective in managing psychosomatic manifestations as demonstrated in the present case.

Objectives The tongue is an organ with multiple functions, from sucking to phonation, from swallowing to postural control and equilibrium. An incorrect position or mechanics of the tongue can causes sucking problems in the newborn or atypical swallowing in the adult, with repercussions on the position of the head and neck, up to influencing upright posture and other problems. Tongue dysfunctions are quite frequent (10–15%) in the population. For the manual therapist, this frequency indicates one to two subjects every 30 patients. Exercises have been proposed to improve the tone and strength of the swallowing muscles but the results are not so clear in the literature. The aim of this study is to describe and provide a tongue muscle normalization technique that helps the manual therapist in the treatment of problems related to it. Methods The literature has been investigated through pubmed, Google scholar of the last 10 years, the keywords used and combined with the Boolean operators AND and OR, are: “tongue, tongue habits, tongue diseases, taste disorder, neck pain, posture, postural balance, atypical swallowing, muscle stretching exercise, tissue expansion, soft tissue therapy, osteopathic manipulative treatment”. Results and Conclusions The technique is possible to be executed even in a sitting position, in the case the patient is unable to assume a supine position, the subject should provides immediate feedback that allows the therapist to understand if the technique has been correctly executed. The simplicity of execution and application of the technique makes it a possible and immediate therapeutic tool in the clinical setting.

In 2020 COVID-19 made a major burden on health care system. The capacity of the healthcare system particularly emergency departments, ICU, hospital beds are insufficient to manage the increasing number of patients in cities and rural areas too. The primary health care centers and rural hospitals need preparedness for such disasters conditions. Novel and future oriented solutions are needed to effectively address the unprecedented pressure on the healthcare systems created by the COVID-19 pandemic. Considering the lacunae in healthcare system at primary level, various challenges encountered during pandemic has been identified and training session in consortia with simulation based training program for the training of the doctors, nurses, attendants and other related healthcare staff of Primary Health Center and Rural Hospitals intending to prepare them for future challenges in ventilatory care of COVID-19 has been carried out. After these training session certain conclusions and recommendations were drawn which could be able our health care system to be prepared for more critical situations and we can take our primary health care system at new horizon.