Volume 22, Issue 4

Mangosteen ( Garcinia mangostana L.) has garnered attention for its diverse health benefits, including antibacterial, antioxidant, anti-proliferative, anti-carcinogenic, and anti-inflammatory properties. These therapeutic effects play a central role in the pathophysiology of many conditions. Periodontal disease, a chronic inflammatory disorder of the tooth-supporting structures, is primarily caused by biofilm-forming bacteria. This systematic review focuses on the effectiveness of mangosteen in local drug delivery (LDD) for the management of periodontitis. An electronic search was conducted across multiple databases, including PubMed, LILACS, Web of Science, and Scopus. Cohen’s Kappa coefficient was used to evaluate inter-rater agreement, and the risk of bias was assessed. A random-effects model and heterogeneity were examined using I 2 statistics, while funnel plots were used to detect publication bias. Clinical outcomes, including periodontal pocket depth (PPD) and clinical attachment level (CAL), were extracted from RCTs comparing mangosteen LDD to placebo or conventional therapies. The analysis revealed a significant reduction in PPD (effect size = −1.08, 95 % CI: −1.40, −0.77) and CAL (effect size = −0.96, 95 % CI: −1.80, −0.13) in the mangosteen-treated group. These findings suggest that mangosteen gel as an LDD can offer substantial clinical benefits by reducing PPD and CAL, thereby improving overall periodontal health.

Catechin is a group of bioactive flavonoids found in various plant sources such as tea, cocoa, and fruits. Recent studies have suggested that catechins has significant potential in preventing and treating cancer. Catechin exhibits a variety of biological activities that may contribute to its anticancer effects, including antioxidant, anti-inflammatory, and pro-apoptotic properties. Studies have demonstrated that catechin can inhibit cancer cell proliferation, induce cell cycle arrest, and promote apoptosis across multiple cancer types, including skin, breast, lung, liver, prostate, and colon cancers. Furthermore, catechin has shown the ability to inhibit angiogenesis, a critical process for tumor growth and metastasis, by restricting new blood vessel formation. Catechin’s impact on cancer extends beyond its direct effects on cancer cells. It modulates various signaling pathways involved in cancer progression, such as those associated with cell survival, inflammation, and metastasis. Despite these promising findings, additional research is needed to clarify the precise mechanisms of catechin’s anticancer action, optimal dosing strategies, and long-term safety in cancer prevention and treatment. This review will explore the current research landscape on tea polyphenols, particularly catechin, and their potential role in cancer prevention and therapy.

Oral squamous cell carcinoma (OSCC) remains a significant global health concern due to its high mortality rate, late-stage diagnosis, and limited treatment options. Conventional therapies such as surgery, radiotherapy, and chemotherapy often face limitations including drug resistance, recurrence, and systemic toxicity, prompting the need for alternative strategies. This narrative review synthesizes recent preclinical evidence on the use of natural phytochemicals including alkaloids, flavonoids, tannins, saponins, and terpenoids for OSCC treatment. These compounds demonstrate anticancer effects through apoptosis induction, oxidative stress modulation, immunoregulation, and metastasis inhibition. In vitro and in vivo studies highlight their cytotoxicity, tumor-suppressive properties, and pharmacokinetic profiles. Additionally, nanotechnology-based delivery systems have shown potential in overcoming bioavailability barriers and enhancing therapeutic efficacy. However, most findings are preclinical, and challenges such as poor pharmacokinetics, off-target effects, and limited clinical trial data must be addressed. This review emphasizes the translational promise of phytochemicals and calls for further clinical validation to integrate these agents into OSCC management.

India’s rural and tribal communities face persistent disparities in healthcare access and outcomes. While the biomedical model dominates the public health landscape, there is a growing recognition of the need for culturally responsive, preventive, and holistic approaches to health. This article proposes a synergistic integration of the Ottawa Charter for Health Promotion with Naturopathy , a core discipline under India’s AYUSH framework. Drawing upon both global frameworks and Indigenous wisdom of healing with plants and herbs for medicinal and nutritional purposes, the article argues for an integrated community health promotion strategy that leverages the cultural legitimacy, ecological appropriateness, and preventive strengths of Naturopathy to fulfil the Ottawa Charter’s vision. Evidence from public health interventions and AYUSH initiatives in India underscores the feasibility and relevance of this approach, particularly in tribal and rural regions.

Objectives Medicinal leeches have long been recognized for the bioactive compounds present in their saliva. These compounds have been of interest due to their potential therapeutic properties. This research aimed to explore the impact of both medicinal leech application and the application of medicinal leech saliva extract on wound healing in a rat model with a dorsal random flap in vivo. Methods In this in vivo study, a dorsal random skin flap model was created in female Wistar albino rats. Rats were randomly assigned to three groups: control (flap only), medicinal leech therapy (MLT), and leech saliva extract (LSE) injection. Histological, immunohistochemical (VEGF), and ELISA-based biochemical analyses were performed to assess wound healing parameters on postoperative day 7. Results The flap necrosis area (%) in Group II and Group III was significantly lower than the control group (p<0.05). Vascular Endothelial Growth Factor (VEGF) (+) cell (%), neovascularisation, epithelial regeneration, and granulation tissue thickness in Group II and Group III were significantly higher than the control group (p<0.05). Also, inflammatory cells in group III were substantially lower than in the control group (p<0.05). Conclusions To our knowledge, this study is the first in the literature to examine the effect of medicinal leech extract injection in the flap model. These findings emphasize the potential therapeutic benefits of medicinal leeches and their saliva extract in promoting efficient wound healing, with implications for future clinical applications.

Objectives Malaria and type 2 diabetes mellitus (T2DM) often coexist in sub-Saharan Africa, worsening disease burden and complicating treatment. This study evaluated the protective effects of Alstonia boonei stem bark aqueous extract on Plasmodium berghei -infected diabetic mice. Methods Male mice were divided into five groups: normal control, untreated infected/diabetic, chloroquine–metformin treated, and extract-treated groups (40 and 80 mg/kg body weight). Fasting blood glucose, parasitemia, α-amylase, α-glucosidase, antioxidant enzymes, inflammatory markers, and hematological indices were assessed following treatment. Results Untreated infected/diabetic mice exhibited significant hyperglycemia, elevated parasitemia, oxidative stress, anemia, and dysregulated inflammatory responses compared with controls. Administration of A. boonei extract produced a dose-dependent reduction in fasting blood glucose and parasitemia, alongside inhibition of α-amylase and α-glucosidase. The extract enhanced antioxidant status (SOD, catalase, GSH), restored red blood cell count, hemoglobin, and packed cell volume, reduced C-reactive protein levels, and elevated interleukin-10. These effects were more pronounced at 80 mg/kg and comparable to the standard drug group. Conclusions A. boonei stem bark aqueous extract demonstrated antihyperglycemic, antiplasmodial, antioxidant, and anti-inflammatory effects in malaria–diabetes comorbidity. The findings support its potential as a natural therapeutic agent for managing malaria and diabetes co-occurrence.

Objectives This study aims to assess the nutritional composition, antioxidant, antidiabetic, and toxicity properties of an herbal formulation (BF 2). Methods The proximate analysis of the BF 2 formulation was evaluated. The methanol extract of the BF 2 herbal formulation’s potential to reduce ferric ions and function as an iron chelator was evaluated. Oxidative pancreatic injury, induced by FeSO 4, was also treated with different concentrations of the BF 2 herbal formulation using Wistar rats’ pancreas via ex vivo method. The inhibitory effect of the methanol extract on α-amylase and α-glucosidase enzymes was measured using metformin as a standard. The effect of BF 2 formulation at 25 and 50 mg/kg was evaluated in male rabbits. Results The proximate analysis result of the BF 2 formulation estimated the contents of crude fat and crude protein to be 1.85 % and 26.25 %, respectively. Atomic absorption spectroscopy of the BF 2 formulation revealed the presence of magnesium (11.625 ppm) and sodium (4.879 ppm). BF 2 formulation had a better NO and DPPH radicals scavenging ability compared to the standard (Quercetin). The methanol extract showed a dose-dependent inhibitory activity on α-amylase and α-glucosidase enzymes. 25 mg/kg of BF 2 formulation resulted in a significant (p<0.05) increase in serum testosterone level and a decrease in FSH levels. 25 and 50 mg/kg b.w. of BF 2 formulation reduced serum ALT and AST in rabbits. Furthermore, BF 2 formulation exerted α-glucosidase and α-amylase inhibitory potential, coupled with its significant antioxidant activity; a more thorough examination of BF 2’s toxicity profile is necessary in rabbits. Conclusions BF 2 formulation exerted α-glucosidase and α-amylase inhibitory potential, coupled with its significant antioxidant activity. Therefore, further studies should be conducted on the BF 2 herbal formulation to evaluate its efficacy in higher animals.

Objectives Dengue virus (DENV), a single-stranded RNA virus from the Flaviviridae family, causes viral hemorrhagic fever and poses a global health threat due to limited diagnostics, treatments, and vaccines. The conserved NS5 protein, crucial for DENV replication, is a promising antiviral target. Antibody-dependent enhancement (ADE) complicates immunity, as serotype-specific antibodies may worsen infection. Moringa oleifera , rich in antiviral phytochemicals, shows potential as a DENV inhibitor by targeting proteomic, transcriptomic, and metabolomic pathways. Methods This study employed molecular docking with 3D PubChem structures of bioactive compounds of M . oleifera to evaluate the binding affinity with DENV-2 NS5 proteins (PDB ID: 6KR2) using AutoDock Vina, and binding modes were analyzed using Discovery Studio. Further drug-likeness, oral bioavailability, ADME, and toxicity profiles were analyzed using SwissADME, ADMETSaR, and ADMETlab 3.0 web server. Complexes were subjected to molecular dynamics simulation (MDS) analysis using Desmond Schrodinger v2019. Results Among the screened compounds, rhamnopyranosyl vincosamide (−9.0 kcal/mol), luteoxanthin (−8.6 kcal/mol), and luteolin (−8.3 kcal/mol) exhibited the most stable interactions and were further analyzed through molecular dynamics (MD) simulations. The results revealed that these phytochemicals interact with NS5 active-site residues, demonstrating significant inhibitory potential. Conclusions The study suggests that M . oleifera phytochemicals hold promise as DENV-2 NS5 inhibitors with minimal toxicity and favorable pharmacokinetic properties. These findings provide a strong foundation for further clinical investigations, potentially contributing to developing novel anti-dengue therapeutics.

Objectives This study aimed to evaluate the impact of oral licorice supplementation on cardiotoxic biomarkers and histological changes in cardiac tissue in rats, given the widespread use of licorice ( Glycyrrhiza glabra ) for its anti-inflammatory, antioxidant, and antimicrobial properties and the concerns about its cardiotoxic effects at higher doses or with short-term repeated use. Methods Twenty-four female Sprague-Dawley rats were divided into four groups (n=6 per group). Groups received either distilled water or licorice extract at 50, 100, and 200 mg/kg/day for 14 days. Cardiac tissue was analyzed via H&E staining, and blood samples were assessed for Troponin-T and Pro-BNP levels. Results No significant changes were observed in Troponin-T and Pro-BNP levels across all groups (p>0.05). Histological analysis revealed mild changes in the cardiac tissues of rats treated with licorice, indicating subtle histomorphological alterations. Conclusions Licorice supplementation at doses of 50, 100, and 200 mg/kg/day did not significantly impact the levels of cardiotoxic biomarkers but mild histomorphological changes were observed in the cardiac tissues of rats. These findings suggest that while licorice is generally safe at these doses, its long-term use at high doses should be approached with caution.

Objectives Milk products are good vehicles for probiotics due to their physical-chemical characteristics, improving probiotic survival in food and in the gastrointestinal tract. Lactobacillus acidophilus La-05 is known to modulate gut microbiota, and probiotics have been reported to influence mineral absorption by improving the gut microbiota profile, highlighting the gut-bone axis. This intervention could be relevant in nephrology due to the high prevalence of renal osteodystrophy in chronic kidney disease (CKD). Given the potential role of gut microbiota in bone metabolism, this is the first study to evaluate the effects of consuming Minas Frescal cheese enriched with L. acidophilus La-05 on bone parameters in nephrectomized Wistar rats. Methods Rats were divided into Sham and CKD groups receiving conventional or probiotic-enriched Minas cheese (20 g/day) for 6 weeks. Bone mineral density (BMD) of the femur and tibia was measured using dual-energy X-ray absorptiometry, and femoral biomechanical properties (maximum force, breaking strength, flexural modulus) were assessed using a three-point bending test. Results CKD significantly reduced tibial (0.08 ± 0.01 vs. 0.11 ± 0.01 g/cm 3 , p=0.0147) and femoral (0.14 ± 0.01 vs. 0.16 ± 0.01 g/cm 3 , p=0.0217) BMD in rats, and probiotic supplementation did not mitigate this loss. Probiotic intervention was associated with a significant decrease in femur length in CKD rats (3.74 ± 0.14 vs. 3.92 ± 0.10 mm, p=0.0221). Conclusions Short-term probiotic supplementation in a cheese matrix did not improve BMD or femoral biomechanics, suggesting a limited effect on CKD-related bone loss.

Objectives In Indonesia, several unregistered traditional Chinese medicines (UTCM) are still used to treat gastritis in pregnancy. On the other hand, the safety of medications during pregnancy remains unresolved. This study aims to investigate the teratogenic effect of UTCM containing Atractylodis lancea radix, Glycyrrhizae glabra radix, Rheum officinale rhizome , and Angelica dahurica radix on fetal morphology. Methods A total of 80 pregnant mice were divided into four groups including the negative control (N), given vehicle, as well as treatment groups D1, D2, and D3 given a dose of 35.2 mg/kg BW, 70.5 mg/kg BW and 105.65 mg/kg BW daily respectively. The drugs were administered between the 6th and 15th days of organogenesis. On the 18th day of pregnancy, a laparotomy was conducted. The teratogenic effects were determined by measuring maternal and fetal body weight, the number of fetuses, and skeletal abnormalities in mouse fetuses, visualised with Alizarin solution. All data were analysed using ANOVA. Results The results showed that in all treatment groups, there was a substantial difference in maternal body weight, fetal number, and fetal body weight (p<0.05). There were open eyelids and clubfoot abnormalities observed in all groups, while 27 fetuses with haemorrhages were found in D3. All treatment groups had sternal, sacral, caudal, phalanges and metacarpal abnormalities. Conclusions UTCM administration showed fetal development effects at the early stage of pregnancy in mice. The dose (D3) 105.65 mg/kg BW affected maternal weight gain and fetal skeletal ossification. UTCM administration D1 (35.2 mg/kg BW), D2 0.5 mg/kg BW), and D3 (105.65 mg/kg BW) had no maternal toxicity and fetal teratogenesis.

Objectives Non-alcoholic steatohepatitis (NASH) is a multifactorial chronic liver disease with limited treatment options. Murraya koenigii has reported hepato-protective effects against NASH in humans, but the bioactive compounds and mechanisms remain unknown. In this study, we explored the bioactive compounds of M. koenigii and their potential mechanisms for combating NASH using network pharmacology and molecular docking approach. Methods Using online platforms such as IMPPAT, GeneCards, KEGG, and DisGeNET, we identified the phytochemicals, target proteins, and genes associated with NASH. Through Venn diagram analysis, we determined 31 common targets between the bioactive compounds and NASH-related genes. Gene ontology (GO) and KEGG pathway enrichment analyses further revealed the key targets and underlying mechanisms. Molecular docking validated the binding interactions between the identified phytochemicals and core target proteins. Results Nine key targets (NFKB, HSP90, TLR4, ESR1, STAT3, MTOR, HIF1A, PI3KA, and PKCD) were identified that interacts with 16 selected phytochemicals. Molecular docking studies indicated phytochemicals, Osthole and Spathulenol to be the promising binders to the core targets especially NF-kB and STAT3. The results represented the muti-target, multi-compound and multi-pathway mechanisms of M. koenigii against NASH. Conclusions This study provides the evidence for further research into the mechanisms of M. koenigii bioactive compounds as complementary therapies for NASH. Our study also identifies the novel drug candidates based on M. koenigii active compounds.

Objectives Indiscriminate and widespread use of antibiotics has caused resistance among infectious bacteria. Citronellol (Cit) is a monoterpene that is defined as an essential oil and is found in lemon, rosemary, oranges, and aromatic plants. This experimental study investigated the effects of Cit on the complications caused by E. coli septicemia in liver tissue in rats. Methods A total of male Wistar rats with an approximate weight of 220 ± 20 were randomly divided into 7 groups of 30 including 1. Control group, 2. Sham group, 3. Received Cit at a dose of 100 mg/kg by intraperitoneal injection, 4. Received Cit at a dose of 200 mg/kg, 5. the E. coli group was administrated enteropathogenic E. coli bacteria O111 with a dose of 1 × 10 9 Colony-forming unit (CFU), 6. the first treatment group received E. coli and Cit at a dose of 100 mg/kg and 7. the second treatment group received E. coli and Cit at a dose of 200 mg/kg. Results Our findings showed that E. coli can cause a significant increase in alanine transaminase (ALT) and alkaline phosphatase (ALP) indices, while in the treatment groups, these indices were significantly reduced. In addition, E. coli septicemia caused oxidative stress in the liver tissue by increasing malondialdehyde (MDA) levels and reducing Superoxide dismutase (SOD) enzymes, which both were significantly regulated in the treatment groups. Conclusions Our results suggested the positive effects of Cit on the septicemia caused by E. coli in the liver tissue by upregulating the antioxidant balance and protective characteristics.

Objectives To assess the effects of daily spilanthol (SA3X) supplementation over three months on muscle metrics and hormonal profiles in healthy males. Methods A total of 546 participants were randomized into SA3X or placebo groups, with or without structured exercise. Muscle size (mid-arm, chest, thigh circumference) and strength (bench-press, squatting) were measured pre- and post-intervention. Serum testosterone (total and free), estradiol, and SHBG levels were assessed. Results Among the participants in the exercise groups, those given SA3X had significant increases than those given placebo in terms of muscle size – mid-arm muscle circumference (10.54 vs. 7.21 cm; p<0.05), chest circumference (15.23 vs. 10.82; p<0.05) and thigh circumference (change in quadriceps area, 12.84 vs. 9.01 cm; p<0.05) and significant increases in strength in the bench-press (85.01 vs. 65.09 kg, p<0.05) and squatting exercises (155.04 vs. 95.06 kg, p<0.05). The participants assigned to the SA3X-no-exercise group had significant increases in muscle size than those assigned to the placebo-no-exercise group (p<0.05). A significant increase was also observed in total and free testosterone levels in SA3X group as compared to placebo (p<0.05). No significant increase was seen in estradiol levels. No significant adverse effects were observed among the participants. Conclusions SA3X supplementation significantly enhanced muscle size, strength, and testosterone levels in exercising participants compared to placebo, with additional benefits observed even without exercise.

Objectives The use of complementary and alternative medicine (CAM) is increasing worldwide, specifically among gout patients, due to the perceived safety, low cost, and accessibility, but data on the usage remain limited. Therefore, this study aimed to assess the prevalence of CAM use, the predictors associated with CAM use, the impact on medication adherence, and the potential herb-drug interactions among gout patients. Methods This cross-sectional study was conducted from June to November 2024 across all 47 community health centers in Makassar City, Indonesia. The entire respondents were patients aged 18 years and older diagnosed with gout. Eligible respondents were recruited through direct questionnaire distribution, collecting data on socio-demographics, CAM and conventional medicine use, CAM perceptions, and medication adherence, while potential herb–drug interactions were assessed using the UpToDate database. Results Among the 430 respondents, 52.8 % reported using CAM, with herbal medicine being the most frequently used option. CAM use was significantly associated with prior experience (p<0.001) and influence from family or friends (p<0.001). A significant association was also found between CAM use and medication adherence (p<0.001), with a higher proportion of non-CAM users exhibiting high adherence (76.8 vs. 7.9 %) and a higher proportion of CAM users demonstrating poor adherence (8.4 vs. 0.5 %). Four potential herb–drug interactions were identified, namely ginger-aspirin (n=2), ginger-glibenclamide (n=1), honey-warfarin (n=1), and garlic-aspirin (n=1), suggesting a need for clinical monitoring. Conclusions The frequent use of CAM among gout patients highlights the crucial role of healthcare practitioners in educating patients about safety, efficacy, and potential interactions. It also underscores the need for strategies to address medication non-adherence associated with CAM use and to monitor herb–drug interactions in clinical settings.

Objectives The objective of this study was to evaluate whether PBM application at the nerve root emergence region could mitigate the deleterious effects of peripheral inflammation on the knee joint in Wistar rats. Methods Eighteen Wistar rats were divided into three groups: Control (intra-articular saline injection only), Arthritis (experimental arthritis model without treatment), and PBM + Arthritis (arthritis model treated with PBM – 660 nm, 20 J/cm 2 ). Treatment began 24 h after intra-articular arthritis induction and continued for three consecutive days. Animals in the arthritis groups were sensitized with two injections of Mycobacterium butyricum (CFA), while the control group received saline solution. The nociceptive threshold was assessed using a digital analgesimeter, and joint edema was measured with a caliper. After euthanasia, the right knee joints were collected, sectioned at 7 μm, and stained with hematoxylin and eosin. Histomorphometric and histomorphological analyses of the synovial membrane and articular cartilage of the femur and tibia were performed. Results A reduction in nociceptive threshold and an increase in joint diameter were observed in the injured and treated groups. However, the PBM + Arthritis group showed pro-repair morphological characteristics in the joint tissue. Conclusions PBM treatment applied distant from the injured knee promoted improvements in joint morphology; however, it did not significantly affect edema or nociception.

Objectives Traditional, Alternative, and Complementary Medicine (T&CM) encompasses a variety of health practices that differ from the conventional medical system, including the use of medicinal herbs and complementary therapies. In Peru, these practices, particularly the use of therapeutic plants, are legally protected and commonly used for treating certain conditions. However, the lack of inclusion of T&CM in medical education puts these practices at risk of disappearing. To analyze the inclusion of T&CM courses in the curricula of medical schools in Peru to identify gaps and opportunities for improving medical education and ensuring comprehensive training for future healthcare professionals. Methods A cross-sectional study was conducted by reviewing the curricula of 47 Peruvian medical schools. Data on the presence, structure, and content of T&CM courses were extracted and analyzed descriptively. Results In 2024, 15 out of 47 Peruvian universities offering Human Medicine programs (31.9 %) included T&CM courses. Among them, 73 % were public institutions, and 53 % were located in coastal regions. The most common topics were Traditional Chinese Medicine (93.3 %), Traditional Peruvian Medicine (87 %), phytotherapy (93 %), and acupuncture (80 %). Course structure varied: 60 % of courses were elective, while 40 % were mandatory. Most universities (93 %) allocated 2–3 academic credits, and 80 % incorporated practical training, though structured field visits were rare (6.7 %). Additionally, 53 % of universities included research activities. The lack of standardized curricular guidelines led to variability in course content and depth across institutions. Conclusions Few universities in Peru teach T&CM, highlighting a need to enhance medical education. Increasing T&CM topics in curricula and addressing information access disparities are crucial.