Volume 22, Issue 1

Health care workers have faced a significant challenge because of the rise in cancer incidence around the world during the past 10 years. Among various forms of malignancy skin cancer is most common, so there is need for the creation of an efficient and safe skin cancer treatment that may offer targeted and site-specific tumor penetration, and reduce unintended systemic toxicity. Nanocarriers have thus been employed to get around the issues with traditional anti-cancer drug delivery methods. Invasomes are lipid-based nanovesicles having small amounts of terpenes and ethanol or a mixture of terpenes and penetrate the skin more effectively. Compared to other lipid nanocarriers, invasomes penetrate the skin at a substantially faster rate. Invasomes possess a number of advantages, including improved drug effectiveness, higher compliance, patient convenience, advanced design, multifunctionality, enhanced targeting capabilities, non-invasive delivery methods, potential for combination therapies, and ability to overcome biological barriers,. These attributes position invasomes as a promising and innovative platform for the future of cancer treatment. The current review provides insights into invasomes, with a fresh organizational scheme and incorporates the most recent cancer research, including their composition, historical development and methods of preparation, the penetration mechanism involving effect of various formulation variables and analysis of anticancer mechanism and the application of invasomes.

Introduction People with dementia and their family carers may benefit from non-pharmacological interventions, including mind-body (MB-) practices, which can improve physical and mental health by inducing relaxation. This systematic review provides an overview of availability and effects of MB-practices. Content The authors performed a systematic search in PubMed, Embase, Emcare, Web of Science, Cochrane Library, PsycINFO, China National Knowledge Infrastructure and Academic Search Premier on February 1, 2024. Research papers on MB-practices for people with dementia and/or their family carers in English, Chinese, Japanese, German, French and Dutch were included if a full text was available. Selection of included articles, data extraction and methodological quality assessments were conducted by two researchers. Summary Of the 130 included studies, 100 (77 %) were of high quality. Traditional Chinese Medicine (TCM) and touch interventions for people with dementia, and meditations for family carers resulted in improvements in respectively cognition and neuropsychiatric symptoms, and mental health. Lack of evidence for other MB-practices is related to small numbers of studies, fragmented use of outcome measures and mixed findings. Outlook MB-practices showed promising results. We recommend implementation and further research of TCM- and touch interventions for people with dementia as well as meditations for family carers. We suggest a cross-over of the promising results of one group to be studied in the other group.

Medicinal plants have been utilized for centuries as a source of healing compounds, which consist of thousands of known bioactive molecules with therapeutic potentials. This article aims to explore and emphasize the significance of medicinal plants and bioactive compounds in the development of topical pharmaceutical formulations. The journey from the extraction of phytochemicals to the development of topical pharmaceutical formulations is described with the aid of scientific evidence selected from PubMed, Google Scholar, ScienceDirect, and Web of Science. Articles published in English during 2018–2023 period were considered and selected randomly. The review discusses the extraction process of medicinal plants, solvent selection, and green synthesis of metal nanoparticles. Subsequently, various biological activities of plant extracts are elaborated especially focusing on antimicrobial, antioxidant, anti-inflammatory, and sun protection activities, along with the corresponding in vitro assays commonly employed for the evaluation. The article presents the process of compound isolation through bioactivity-guided fractionation and also the toxicity evaluation of isolated fractions. Finally, the formulation of medicinal plant extracts into topical pharmaceuticals is addressed, emphasizing the stability evaluation procedures necessary for ensuring product quality and efficacy.

Objectives Drug-induced hepatotoxicity, particularly from ethanol and acetaminophen (APAP), is a pressing global health challenge. This damage arises from oxidative stress and inflammation, manifesting as elevated liver enzymes and structural liver alterations. Resveratrol and silymarin, recognized for their antioxidant and anti-inflammatory properties, offer potential hepatoprotective benefits. Methods This study investigated the hepatoprotective efficacy of resveratrol and silymarin, alone and in combination, in a rat model of ethanol- and APAP-induced liver injury. Thirty Wistar rats were divided into five groups: control, ethanol-APAP, ethanol-APAP-resveratrol, ethanol-APAP-silymarin, and ethanol-APAP-resveratrol-silymarin. Treatments were administered orally for 10 days. Serum ALT and AST levels were assessed, and liver tissues underwent histological evaluation. Results Ethanol and APAP administration significantly elevated ALT and AST levels, alongside severe liver structural disruptions. Treatment with resveratrol or silymarin alone normalized enzyme levels and improved liver histology. Notably, the combined resveratrol-silymarin treatment exhibited greater reductions in ALT and AST levels and superior restoration of liver architecture compared to either treatment alone, indicating a synergistic hepatoprotective effect. Conclusions Resveratrol and silymarin effectively counteract ethanol- and APAP-induced hepatotoxicity by mitigating oxidative stress and inflammation. Their combined use demonstrates a synergistic benefit, as evidenced by enhanced biochemical and histological improvements. These findings support the potential therapeutic role of these natural agents in managing drug-induced liver injury.

Background Excessive fluoride exposure leads to increased oxidative stress and lipid peroxidation, causing harmful effects on the metabolic organs in the human body. Betanin, a pigment obtained from beetroot, is seen to have powerful anti-inflammatory and antioxidant. The study was conducted to determine the role of betanin in fluoride induced hepato-renal toxicity in Wistar rats. Methods Twenty four rats were divided into four groups. Group Ⅰ (control) rats received 1 mL distilled water; group Ⅱ rats were administered 10 mg/kg of sodium fluoride (NaF); group Ⅲ received 10 mg/kg NaF and 50 mg/kg (low dose) betanin; group Ⅳ received 10 mg/kg NaF and 200 mg/kg (high dose) betanin. Animals were dosed orally for 90 days. Various markers of liver and kidney function as well as oxidative stress were measured. Liver and kidney samples were examined for histopathology. Results Animals in group Ⅱ had significantly increased levels of serum aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, creatinine, and blood urea nitrogen compared to the NaF + betanin treated animals (group Ⅲ & Ⅳ). Malondialdehyde, nitric oxide levels were significantly lower in rats treated with NaF + betanin (low and high dose). Histologically, in group II rats, signs of interstitial nephritis were seen in the kidneys while liver sections showed clear indication of features of fatty liver and inflammatory cell infiltration. Treatment with betanin alleviated the severity of histopathological changes induced by NaF. Conclusions Betanin significantly ameliorated NaF-induced oxidative stress and inflammation, therefore, has potential to be used as protective agent against fluoride induced hepato-renal toxicity.

Objectives Garcinia indica (commonly known as kokum) has been employed in Ayurvedic and Siddha medicine since ancient times. Every part of the plant has its own set of advantages and applications. Therefore, the present evaluates the phytochemical composition and biological activity spectrum of the ethanolic fruit extract of G. indica. Methods Ethanolic extract of fruits of G. indica (GIFEE) underwent TPC and TFC quantification, with bioactive components characterized via GC-MS and HPLC. The disc diffusion method was used for assessing the antibacterial activity against Staphylococcus aureus ( S. aureus ) and Escherichia coli ( E. coli ). GIFEE was employed to assess the cytotoxic impact on MDA-MB-231 cells through the utilisation of the MTT. The administered dosage of the extract ranged from 10-45 μg/mL. Results TPC and TFC of GIFEE were determined to be 255.09 ± 4.7 mg GAE/g and 184.83 ± 3.2 mg QE/g dry mass of the extract, respectively. Furthermore, GIFEE demonstrated antibacterial activity against S. aureus and a strong DPPH radical scavenging activity (IC 50 =51.46 μg/mL). GIFEE induced strong anticancer activity (IC 50 =20 μg/mL) against the human breast cancer cell line MDA-MB-231, while had no discernible impact on normal human HEK-293 cells. Conclusions By virtue of a high phenolic and flavonoid content and possessing potent anticancer activity profile in vitro , GIFEE appears to be a promising candidate for future and further testing in vitro and in vivo as an effective ‘adjunct’/complementary medicine in cancer chemotherapy regimens.

Objectives Terminalia schimperiana  Hochst, belonging to the  Combretaceae  family, is known for its ethnomedicinal values, particularly in treating various diseases in Africa. This study aimed to investigate the antibacterial, antioxidant, and cytotoxic properties of T. schimperiana stem bark extracts, with a specific focus on assessing their bioactive potential and identifying active compounds via TLC bioautography. Methods The in vitro antimicrobial activity was assessed using the agar well diffusion method against selected clinical strains. Antioxidant activity was evaluated using several methods including free radical scavenging, ferrous ion chelation assays and total phenolic content analysis. The cytotoxicity of the extracts was assessed using MTT assay towards Raw 264.7 and Vero cell lines. Results All extracts demonstrated significant antibacterial activity against the bacteria tested, with inhibition zones (IZ) ranging from 6.50 ± 0.71 to 15.50 ± 0.71 mm and minimum inhibitory concentrations (MIC) ranging from 1.95 to 1,250 μg/mL. The hydroethanolic extract exhibited strongest antioxidant activities with EC 50 values of 188.50; 245.30, and 281.50 μg/mL for DPPH; ABTS, ferrous ion chelation assays respectively, and a high content of phenolic compounds (101.67 ± 2.97 µgEFA/mg DW). Importantly, no cytotoxic effects were observed on Raw 264.7 and Vero cell lines. HPTLC analysis identified alkaloids and phenolic compounds in both aqueous and hydroethanolic extracts. Conclusions These findings indicate T. schimperiana provides a wealth of bio-compounds that can be utilised in the pharmaceutical industry as antibacterial and antioxidant agents to combat antibiotic resistance.

Objectives This study investigated the potential ameliorative effects of Albizia ferruginea leaves on letrozole-induced polycystic ovarian syndrome (PCOS) in Wistar rats. Methods PCOS was induced in 25 female Wistar rats by administering letrozole (1 mg/kg), followed by treatment with 100 and 250 mg/kg body weight A. ferruginea leaf methanolic extract, as well as 1 mg/kg body weight of clomiphene citrate as standard. Results An acute toxicity study revealed a toxic dosage of 2,000 mg/kg for the plant extract. The A. ferruginea extract exhibited potent hydroxyl radical scavenging ability. Treatment with A. ferruginea leaf extract improved the irregular estrus cycle and hormonal imbalance. Additionally, the extract administration led to decreased testosterone and increased estradiol levels when compared to the untreated PCOS rat. Furthermore, methanol extract normalizes the levels of insulin receptor substrate (IRS), type 2 17-HSD (HsD17β2), P53, 11a-hydroxylase/17,20-desmolase (CYP11a), and fat mass and obesity-associated (FTO), genes in the cervix of PCOS rats. Conclusions Overall, A. ferruginea demonstrated beneficial properties on polycystic ovary circumstances in rats, presenting its potential as a promising treatment for PCOS.

Objectives Vernonia amygdalina Del. leaves are used in traditional Southeast Asia and Africa medicinal practices. Metformin is used for diabetes management. This study investigated the effect of a single dose of aqueous leaf extract of V. amygdalina on metformin pharmacokinetics in diabetic rats. Methods Diabetic rats were randomly assigned to four groups, with six rats in each group. Group 1 was administered distilled water. Group 2 was administered V. amygdalina aqueous leaf extract alone. Group 3 was administered metformin alone. Group 4 was co-administered V. amygdalina extract plus metformin. Blood was collected at predetermined intervals, and plasma metformin levels were measured with liquid chromatography. The area under the curve (AUC 0-t ), maximum plasma concentration (C max ), time to reach C max (T max ), half-life (t 1/2 ), and clearance (CL), were calculated based on noncompartment analysis. The effect of the extract on CYP2C9, CYP3A4, and UGT activities was determined using a Fluorometric Screening Kit. Results The combined treatment altered the pharmacokinetic parameters of metformin. The T max increased from 90±0.18 min to 180±0.13 min and the C max, increased from 0.91±0.32 μg/mL to 2.153±0.28 μg/mL. Additionally, the AUC (0-t) increased from 118.25±1.37 μg min mL −1 to 301.006±1.96 μg min mL −1 and the t 1/2 increased from 34.69±0.61 min to 101.321±0.55 min. However, the CL rate was decreased. The extract inhibited CYP3A4 and CYP2C9 enzyme activities. Conclusions The alteration of pharmacokinetic parameters by the extract suggests potential herb-drug interactions.

Objectives The aim of this study was to evaluate and compare the antibacterial efficacy of licorice gel and tetracycline gel against Aggregatibacter actinomycetemcomitans , Porphyromonas gingivalis and Prevotella intermedia . Methods An indigenously prepared 50 μL licorice and tetracycline gel was subjected to antibacterial sensitivity test (thrice) against Aa, Pg, Pi by agar well diffusion method using Brain Heart Infusion media. Colonies of Aa, Pg, Pi were transferred into broth and incubated at 37 °C for 24 h and diameter of inhibition zone was measured. Results The drug release profile of licorice gel at six regular intervals was higher when compared to tetracycline. MIC of licorice gel (50 μg/mL) against Aa (14 mg), Pg (7 mg), Pi (7 mg) respectively. The diameter of inhibition zone of licorice gel was significant against Aa when compared to tetracycline gel. However, tetracycline gel exhibited significant diameter of inhibition zone against Pg and Pi when compared to licorice gel. There was a statistical significance difference between licorice and tetracycline gel against Aa (p=0.043*), Pg (p=0.037*), Pi (p=0.046*) while assessing antibacterial sensitivity test. Conclusions Licorice gel has anti-inflammatory and anti-microbial properties which can act against periodontal pathogens and can be considered in treating periodontal disease at low concentrations. Therefore, it can be used as an adjunctive local drug delivery agent to non-surgical periodontal therapy (NSPT) in treating periodontal disease.

Objectives Breast cancer is among the most heterogeneous and aggressive diseases and a foremost cause of death in women globally. Hypoxic activation of HIF-1α in breast cancers triggers the transcription of a battery of genes encoding proteins that facilitate tumor growth and metastasis and is correlated with a poor prognosis. Based on the reported cytotoxic and anti-cancer properties of Moringa oleifera ( Mo ), this study explores the inhibitory effect of bioactive compounds from M. oleifera and breast cancer target proteins HIF-1α, VEGF, and GLUT-1 in silico . Methods The X-ray crystallographic structures of HIF-1α, VEGF, and GLUT1 were sourced from the Protein Data Bank (PDB) and docked with 70 3D PubChem structures of bioactive compounds of M. oleifera using AutoDock Vina, and binding modes were analyzed using Discovery Studio. Five compounds with the highest binding energies were selected and further drug-likeness, oral bioavailability, ADME, and toxicity profiles were analyzed using SwissADME, ADMETSaR, and ADMETlab 3.0 web server. Results Out of the screened 70 bioactive compounds, the top five compounds with the best binding energies were identified namely Apigenin, Ellagic Acid, Isorhamnetin, Luteolin, and Myricetin with each receptor. Molecular docking results indicated that the ligands interact strongly with the target HIF-1α, VEGF, and GLUT-1 receptors through hydrogen bonds and hydrophobic interactions. These compounds showed favorable drug-like and pharmacokinetic properties, possessed no substantial toxicity, and were fairly bioavailable. Conclusions Results suggested that the compounds possess strong potential in developing putative lead compounds targeting HIF-1α that are safe natural plant-based drugs against breast cancer.

Objectives Natural flora historically has played a substantial part in drug development since they serve as active ingredients in medications and templates for the synthesis of novel pharmaceuticals. Emilia sonchifolia is a conventionally utilised therapeutic flora in Indian pharmacopoeia. Therefore, the current study is intended to separate, structurally describe and analyse the anti-pancreatic cancer potential of isolated natural bio-constituents from E. sonchifolia (L.) DC. Methods n-Hexane extract using chromatographic techniques and structurally characterize them using spectroscopic techniques. Further, in silico molecular docking method was employed to investigate the bioactivity of the isolated compound against Aurora 2 Kinase (pancreatic cancer target protein). Results A mixture of stigmasterol with straight-chain monounsaturated alcohol (C 49 H 86 O) was isolated and identified from the aerial parts of E. sonchifolia using chromatographic techniques. The docking results showed that the isolated natural compound of stigmasterol with straight-chain monounsaturated alcohol has good docking results compared with Food and Drug Administration-permitted medicine. Conclusions Based on the outcomes, it can be concluded that the stigmasterol with straight-chain monounsaturated alcohol may act as a novel inhibitor for Aurora 2 Kinase. In the future, it may lead to the development of drugs targeting Aurora 2 Kinase for the effective treatment of pancreatic cancer.

Background and Objectives Cardiovascular diseases (CVDs), including acute coronary syndrome (ACS), represent a major global health challenge. Arrhythmias such as ventricular tachycardia (VT), ventricular fibrillation (VF), atrial fibrillation (AF), premature ventricular contractions (PVCs), and premature atrial contractions (PACs) frequently complicate ACS, needing effective management strategies. Omega-3 fatty acids have shown potency in preventing sudden cardiac death by modulating arrhythmias, but their acute effects in ACS patients remain controversial. This study aimed to evaluate the impact of Omega-3 supplementation on reducing common arrhythmias among ACS patients. Methods A randomized clinical trial involving 74 ACS patients was conducted. Participants were randomly assigned to receive either 1 gr of Omega-3 daily or placebo (olive oil capsules) for five days. Arrhythmia frequencies (AF, PVCs, PACs, VT, VF) were monitored using daily ECGs, and statistical analyses were performed using SPSS software (version 24). Results Over the five days, patients receiving Omega-3 showed significant reductions in the occurrence of AF (26.66–11.66 %, p=0.015), PACs (21.66–3.33 %, p=0.043), and PVCs (36.66–3.33 %, p=0.021) compared to the control group. The frequency of VT and VF cases was low, with only one VT case in the Omega-3 group, which resolved without intervention after the second day. Conclusions This study highlights the potential of Omega-3 fatty acids as adjunct therapy for arrhythmia management post-ACS, particularly in reducing AF, PACs, and PVCs. However, the minimal effects on VF and VT and the lack of thorough statistical analysis for these arrhythmias warrant further investigation.

Objectives Nonsteroidal anti-inflammatory drugs (NSAIDs) are used for pain and inflammation relief. Our study aimed to explore the ulcerogenic effect of long-term diclofenac and celecoxib administration on male albino stomachs, focusing on the possible gastroprotective effect of royal jelly (RJ) administration. Methods Five equal groups of 50 male albino rats. The drug dosages were: diclofenac potassium (10 mg/kg/day), celecoxib (50 mg/kg/day), and RJ (300 mg/kg/day), for 4 weeks. Group 1 received no medication. Group 2 received oral diclofenac potassium. Group 3 received oral RJ plus diclofenac potassium. Group 4 received celecoxib orally. Group 4 received oral RJ plus celecoxib. When the experiment was over, rats were euthanized, blood samples were gathered, and stomachs were dissected out. Stomachs were examined for ulcer counts. Serum levels of MDA and SOD were determined. Gastric mucosa contents of MDA, SOD, PGE2, MPO, apoptotic (Bax), and anti-apoptotic (Bcl-2) genes were measured. Gastric tissue was also analyzed histopathologically. Results Long-term administration of diclofenac and celecoxib, in such dose and duration, caused each of the aforementioned parameters to significantly deteriorate, with significant improvement with RJ co-administration. Diclofenac developed severe gastric ulcers in group 2, and RJ co-administration significantly reduced the gastric mucosa damage in group 3. Celecoxib developed no gastric ulcer in both groups 4 and 5. Conclusions Long-term use of diclofenac in male albino rats caused severe gastric ulcers with significant gastroprotective effects of RJ. Celecoxib provides preferable GI tolerability; thus, it should be prescribed for patients at increased risk of gastrointestinal bleeding requiring NSAIDs.

Objectives Myofascial pain characterized by myofascial trigger point (MTrP) is a common cause of musculoskeletal pain and the main cause of neck and shoulder pain in the working population. Thread embedding acupuncture (TEA) is a new modality that can provide long-term stimulation to prolong the same therapeutic effect as conventional acupuncture. This study aimed to determine the effect of TEA therapy on pain score, neck disability index (NDI), and pressure pain threshold (PPT) for myofascial pain in the upper trapezius muscle. Methods The research design in this study was a double-blind, randomized clinical trial. This study with 44 research subjects was divided into TEA group (n=22) and sham TEA group (n=22). Both groups will receive TEA therapy once using CARA brand monofilament polydioxanone thread 29Gx50 mm or sham TEA (thread removed) at one trigger point in the upper trapezius muscle which will be followed-up on 3 days, 1 week, 4 weeks, and 8 weeks post-therapy. Results Both groups experienced significantly reduced pain intensity and disability, also increased PPT at 3 days, 1 week, 4 weeks, and 8 weeks post-therapy (p<0.001). TEA therapy had better effectiveness in improving pain intensity at 4 weeks (p=0.007) and 8 weeks post-therapy (p=0.004), NDI scores at 8 weeks post-therapy (p=0.004), and PPT at 4 weeks (p=0.04) and 8 weeks post-therapy (p=0.002) compared to sham TEA. Conclusions TEA reduced pain intensity and disability, and increased PPT for patients with myofascial pain in the upper trapezius muscle.

Objectives This study aims to investigate the molecular mechanisms of the combination of stellasterin, quercetin, and kaempferol – components of the phytopreparation ginseng (trade name Panax) – in the treatment of tissue hypoxia occurring in patients with viral and bacterial pneumoni. Methods An analytical single-center method of network pharmacology was utilized, involving 110 individuals divided into two subgroups: placebo and Panax phytopreparation. The therapy course lasted 2 months, after which physical (forced vital capacity, respiratory volume, oxygen saturation) and laboratory (total ATPase, Na+/K+-ATPase, glucose, leukocytes) parameters were evaluated. Results The administration of kaempferol, stellasterin, and quercetin increased the activity of total ATPase compared to baseline measurements in pneumonia patients with respiratory insufficiency, as well as compared to the placebo group. Thus, phytopreparations capable of controlling or limiting inflammatory reactions in various types of pneumonia and accompanying hypoxia represent promising adjunctive therapy. Conclusions Given the increasing incidence of viral and bacterial pneumonia, there is a growing need to develop new treatment strategies for patients and improve hypoxia outcomes.