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Aim: The aim of this research work is the formulation, development and evaluation of Self-Micro Emulsifying Drug Delivery System (SMEDDS). Background: Zileuton, a drug that is poorly soluble in water, was formulated with Tween 20 in a 1:1 ratio as a surfactant. F1 formulation of SMEDDS was selected from the optimum concentration of oils, surfactant, and co-surfactants from psuedoternary diagrams. Materials and Methods: Enaltec Lab in Mumbai, India, provided Zileuton as a gift sample. Raj Chemicals in India provided the eucalyptus oil. Merk Private Ltd., INDIA provided a gift sample of Tween 20. N.R. Traders, INDIA, provided polyethylene glycol 300 (PEG 300). Result: For the optimized formulations, the mean globule size of SMEDDS was found to be below 107 nm, and the zeta potential was negative. The formulations were subjected to various accelerated physical stability tests and self-emulsification evaluations. For investigating drug-excipient interactions, FTIR analysis was carried out. Zileuton in SMEDDS dissolved rapidly and completely in the phosphate buffer pH 7.4 which was used as the dissolution medium, according to the in vitro dissolution data. Conclusion: From the droplet size analysis and zeta potential values confirm the reduction in particle size to nano range which definitely improves the solubility and the dissolution rate. [ABSTRACT FROM AUTHOR]

The present study aimed to elucidate and describe the basic pharmacokinetics of dapagliflozin after a single dose oral administration of a 10 mg immediate release tablet developed by Sun Pharmaceutical Industries Limited, India. Ten competing models were created in order to analyze the experimental data obtained from the 71 subjects who were enrolled and finalized two bioequivalence clinical trials, under fasting and fed state. The studies took place at the Clinical Pharmacology and Pharmacokinetics Department of Terapia S.A. Considering the Akaike index value for a rational model discrimination, model number 8 (M8) was found to be the best that fits the experimental data. The representative pharmacokinetic model involves zero order absorption kinetics with a lag time of approximately 0.3 hours, first order systemic metabolism and elimination and two-compartmental distribution. Furthermore, by using M8, the most important pharmacokinetic parameters of dapagliflozin were determined. All calculations were performed by Phoenix WinNonlin® version 6.3 (Certara, USA). [ABSTRACT FROM AUTHOR]

The present study compared pharmacokinetic (PK) profile and single-dose tolerability of 2 marketed brands of lamivudine (3TC) 150-mg tablets, Lamivir (Cipla, Mumbai, India) and Epivir (GSK, Basingstoke, UK). The randomized, 2-treatment study was conducted in 24 fasting, healthy, Indian male subjects. Each subject received Epivir and Lamivir formulation separated by 7 days of drug-free washout period. Plasma concentrations of 3TC were used to estimate PK parameters such as maximum observed plasma concentration (Cmax) and area under plasma concentration-time curve (AUCinfinity). Geometric mean ratios (relative to Epivir) and resultant 90% CI of 3TC for Cmax and AUCinfinity were 1.00 (0.89-1.12) and 1.01 (0.94-1.07), respectively. As 90% CIs were entirely within 0.80-1.25 for log-transformed data, the 2 formulations were considered bioequivalent in the extent (AUCinfinity) and rate of absorption (Cmax and time to Cmax [tmax]). The means of primary PK parameters of 3TC, Cmax, and AUCinfinity in Indian subjects were comparable to those previously reported in the literature. Both formulations exhibited similar tolerability under fasting conditions.

The current study aimed to establish and describe the basic pharmacokinetics of a single dose of gliclazide 60 mg modified release formulation manufactured by Ranbaxy Laboratories Limited, now Sun Pharmaceutical Industries Limited, India. Ten mathematical models were created for analyzing the experimental data resulted from two bioequivalence studies conducted at Clinical Pharmacology and Pharmacokinetics Department of Terapia S.A. Model discrimination was done using the Akaike index value and it was observed that model number 10 (M10) is the model that best describes the gliclazide disposition. This model has two compartments (peripheral and central), mixed order absorption process (1st and zero order kinetics) with a lag time of around 3 hrs and 1st order kinetics of elimination. Applying this model in Phoenix software version 6.3 (Pharsight Corp., Mountain view, CA, USA) the main pharmacokinetic parameters of gliclazide were also computed. [ABSTRACT FROM AUTHOR]

The effect of administration of different doses of Pterocarpus santalinus L. bark extracts in normal and diabetic rats, on blood glucose levels was evaluated in this study. Among the three fractions (aqueous, ethanol and hexane), ethanolic fraction at the dose of 0.25 g/kg body weight showed maximum antihyperglycemic activity. The same dose did not cause any hypoglycemic activity in normal rats. The results were compared with the diabetic rats treated with glibenclamide and the antihyperglycemic activity of ethanolic extract of PS bark at the dose of 0.25 g/kg b.w. was found to be more effective than that of glibenclamide.

The widespread occurrence of Type 2 Diabetes Mellitus (T2DM) is a significant public health issue in India. Diabetes severely impedes the wound healing process. Delayed wound healing in diabetes is caused by a decrease in nitric oxide generation, the presence of Advanced Glycation End products (AGEs), and impaired epithelial cell motility. In this case, a 38-year-old diabetic male presented seeking Ayurvedic treatment for a wound on his right lower limb, which resulted from a prick injury sustained 10 days earlier. He also had varicose veins in both legs and had been living with diabetes for five years. His medical history included slow wound healing. The condition was diagnosed as "Dushtvrana" associated with "Prameha" and was treated with Ayurvedic medicines in addition to oral hypoglycaemics. The Ayurvedic treatment included Panchavalkala Kwatha Vranadhavan, followed by the local application of Yashtimadhu Ghrita every third day, along with the oral administration of Nishadhatri Yoga (5 g) twice daily. Additionally, he was prescribed a daily evening dose of 500 mg metformin tablets for 25 days. There was no pain or inflammation observed, and the wound fully healed. This case demonstrates the effectiveness of Ayurvedic treatment-Panchavalkala Kwatha Vranadhavan, Yashtimadhu Ghrita for local application, and oral Nishadhatri Yoga-as an adjunct to the oral hypoglycaemic drug metformin in treating diabetic wounds. [ABSTRACT FROM AUTHOR]

Objective Our objective was to study the radiation exposure rate as function of time in the administration of radioiodine iodine-131 (I-131) for the treatment of thyrotoxicosis or Graves' disease and remnant ablation on an outpatient basis at the Department of Nuclear Medicine, and also, to study the impact of revised discharge criteria for radioiodine therapy enforced by the Atomic Energy Regulatory Board (AERB) of India. Materials and Methods This study included patients who underwent low-dose radioiodine therapy using I-131. Patients were classified into two different groups, that is, group A and group B. Group A included patients receiving low dose I-131 for the treatment of thyrotoxicosis, whereas group B included patients receiving I-131 therapy for the ablation of residual thyroid tissue after total thyroidectomy. The radiation exposure rate was measured using a radiation detector in milli roentgen per hour (mR/h) at 5 cm distance of stomach and neck levels and with the patient standing at the distance of 1 m after oral administration of I-131 at 0, 1, and 2 hours. Results A total of 134 (17 males and 117 females) patients were included in the study. Group A comprised 102 (14 male and 88 females) patients and group B of 32 (3 males and 29 females) patients. At the neck level, the average exposure rate in group A versus group B after 0, 1, and 2 hours was observed to be 6.9 versus 22.27 mR/h, 33.67 versus 43.39 mR/h, and 41.75 versus 48.90 mR/h, respectively. At the stomach level, the exposure rate was 23.65 versus 71.32 mR/h, 13.27 versus 48.45 mR/h, and 9.91 versus 39.43 mR/h after 0, 1, and 2 hours, respectively. At a distance of 1 m, the exposure rate was 1.31 versus 2.99 mR/h, 1.05 versus 2.58 mR/h, and 0.92 versus 2.21 mR/h, respectively. Conclusion Exposure rate measured for patients treated with up to 1,110 MBq (30 mCi) of I-131 was under permissible limits as per revised discharged limits, that is, 50 µSv/h (5 mR/h) prescribed by AERB, India. The patients undergoing radioiodine therapy I-131 (up to 1,110 MBq/30 mCi) can be discharged safely 2 hours postadministration following good work practice along with providing proper radiation safety instructions to patients. [ABSTRACT FROM AUTHOR]

Background: Prediabetes is an alarming condition to control and prevent from developing diabetes mellitus which occurs due to the change in lifestyle and food habits. Timely untreated prediabetes turn into type-2 diabetes mellitus within a year and systemic complications such as retinopathy, nephropathy, and neuropathy could occur and in later stage multi system damage could take place. Aims: The ai of this study is to evaluate the efficacy of Vamana Karma (therapeutic emesis) with Ikshuvaku Yoga and followed by oral administration of Darvyadi Kwatha (herbal decoction) in the management of prediabetes. Materials and methods: After approval of IEC and registration under clinical trial registry of India, 20 patients suffering from prediabetes were registered in the trial. Diagnosis criteria were hemoglobin A1c (HBA1c), fasting blood sugar (FBS) and postprandial blood sugar (PPBS), and assessment criteria includes HBA1c, FBS, PPBS, along with improvement in Agnibala (strength of digestion and metabolism), Dehabala (physical strength) and Satvabala (mental strength), relief sign and symptom of prediabetes (Prameha), and improvement in quality of life (SF-36 Score). Classical Vamana Karma followed by oral administration of Darvyadi Kwatha was done. Total duration of treatment was 45 days and last follow-up was done on the 120th day. Student's t– test was used for the analysis of parametric data. Results: After the treatment were observed that there is improvement in subjective as well as in objective parameters. Statistically highly significant result was observed in HBA1c (BT [day 0] Mean score 6.25 and AT [day 120] 5.63 [P < 0.001]), FBS (BT [day 0] mean score 120.05 and AT [day 120] 93.31 [P < 0.001]) and PPBS (BT [day 0] mean score 165.26 and AT [day 120] 112.84 [P < 0.001]), sign and symptoms of Prameha, Dehabala, Agnibala, Satvabala, and quality of life (SF-36 Score). Conclusion: The present clinical study concludes that therapeutic emesis (bio purification) followed by Darvyadi Kwatha as internal medicine shows significant result in treating prediabetes (Prameha) safely and effectively also control and prevent developing diabetes mellitus. None of the patient converted to diabetes mellitus on the day 120. [ABSTRACT FROM AUTHOR]

Introduction: The Bruguiera cylindrica L. is a mangrove plant that is typically found in coastal areas of Asia, including India. It has been known for its medicinal properties, which have been utilized for generations. For example, in Thailand, it has been used to treat wounds and diarrhoea, while in India, it has been effective in addressing diabetes, ulcers, and other health issues. This particular study sought to investigate the potential of B. cylindrica bark extract in reducing the symptoms of diabetes in rats. Methods: In this study, we examined the potential of B. cylindrica bark extract as an inhibitor of α-amylase and α-glucosidase enzymes in vitro. We also evaluated the effects of the extract and Metformin on rats fed high-fat diets and measured their lipid profiles and biochemical parameters. Furthermore, we conducted a network pharmacology analysis to identify proteins and pathways involved in the amelioration of diabetes. Results: Through metabolite profiling, we identified 58 compounds in B. cylindrica hydroalcoholic extract. These compounds include alkaloids, phenolics, flavonoids, and fatty acids. The extract was found to have a dose-dependent inhibition activity against α-amylase and α-glucosidase, with IC50 values similar to acarbose. In rats, oral administration of 200–400 mg/kg of B. cylindrica led to reduced blood glucose levels and normalized serum biochemical parameters. Conclusions: Bruguiera cylindrica bark may reduce blood sugar levels in rats with diabetes. The study found metabolites that interact with protein targets associated with different types of diabetes. Graphical Abstract [ABSTRACT FROM AUTHOR]

The aim of the current study was to investigate whether food intake alters the kinetics of dapaglliflozin, a modern anti-diabetic agent, after single-dose oral administration of a new 10 mg immediate release tablet. The evaluated formulation was developed and manufactured by Sun Pharmaceutical Industries Limited, India, and the studies were performed in healthy Caucasian subjects. The data obtained during the fasting and fed bioequivalence studies were analyzed to observe the influence of food on the bioavailability and disposition of the evaluated formulation. Although differences were observed between studies concerning some of the main parameters that describe dapagliflozin's disposition (maximum plasma concentration - Cmax, and the time to reach it -Tmax), they were proved bioequivalent. The 90% confidence intervals for the evaluated parameters were within the accepted range of 80.00-125.00% for bioequivalence conclusion, therefore the treatments are bioequivalent (dapagliflozin with/without food) and interchangeable. Hence, dapagliflozin can be administered regardless of food intake in diabetic patients. [ABSTRACT FROM AUTHOR]

Ayurvedic medicines are widely employed globally for prophylaxis and treatment of a variety of diseases. Coronil is a tri-herbal medicine, constituted with the traditional herbs, Tinospora cordifolia, Withania somnifera and Ocimum sanctum, with known immunomodulatory activities. Based on its proven in-vitro activity and in-vivo efficacy, Coronil has been approved as a 'Supporting Measure for COVID-19' by the Ministry of AYUSH, Government of India. The current study was aimed to assess the non-clinical safety of Coronil in a 28-day repeated dose toxicity study along with a 14-day recovery period in Sprague Dawley rats. This toxicity study was conducted in accordance with OECD test guideline 407, under GLP-compliance. Specific-Pathogen-Free animals of either sex, housed in Individually-Ventilated-Cages were particularly used in the study. The tested Coronil dose levels were 0, 100, 300 and 1000 mg/kg/day, orally administered to 5 males and 5 female rats per test group. In the current study, no mortality was observed in any group and in addition, Coronil did not elicit any finding of toxicological relevance with respect to clinical signs, ocular effects, hematology, urinalysis and clinical chemistry parameters, as well as macro- or microscopical changes in any organs, when compared to the control group. Accordingly, the No-Observed-Adverse-Effect-Level (NOAEL) of Coronil was ascertained to be 1000 mg/kg/day, subsequent to its 28-day oral administration to male and female rats. The acceptable safety profile of Coronil paves the way further toxicity assessments in rodents for a longer duration as well as in higher animals, and towards its clinical investigation. [ABSTRACT FROM AUTHOR]

Background: The plant Kingiodendron pinnatum (DC.) Harms, belonging to the family Fabaceae is endemic to the Western Ghats of India and is commonly used for various ailments, especially by the tribes. K. pinnatum is occasionally used as a substitute for Saraca asoca in Asokarishta, a well-known uterine tonic in Ayurveda. Recent studies revealed a pharmacological similarity between the plants. S. asoca is reported to have anti-cancer properties, but there are no reports on K. pinnatum except for antioxidant and antimicrobial activities. Therefore, the study is aimed to investigate the anticancer potential of the plant. Methods: Cytotoxicity of methanolic bark extract of the plant was analysed on different cancer cell lines by 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT) assay. Dalton's lymphoma ascites (DLA) cell-induced solid and Ehrlich ascites carcinoma (EAC) cell-induced ascites tumour models in mice were used to study the antitumor potential. Phytochemical screening of the extract was also performed. Results: The extract was found cytotoxic to DLA, EAC, HCT15, MDA-MB-231, T47D and PC3 with inhibitory concentration (IC50) values of 50.09, 74.74, 67.02, 119.22, 149.04 and 194.5 μg/mL, respectively. In the solid tumour model, a significant (P < 0.001) reduction in tumour weight of 0.7 ± 0.15 g was observed in 500 mg/kg b.wt. extract treated group compared to the control group (3.6 ± 0.24 g) by oral administration for 30 days. In the ascites tumour model, a high survival rate of 28.2 ± 8.72 days (P < 0.01) was found by the extract treatment compared to the control animals. Phytochemicals like alkaloids, flavonoids, phenols, phytosterols, saponins, tannins, steroids and terpenoids were detected in the extract. Conclusion: Results obtained by the cytotoxic and anti-tumour studies revealed the anticancer potential of K. pinnatum. The plant exhibits more cytotoxicity towards cancer cell lines of the reproductive system such as the breast and prostate. [ABSTRACT FROM AUTHOR]

Background: Arq-e-Keora is a liquid formulation of the Unani system of medicine and used since long for the management of weakness of heart, palpitations, etc. Objective: The study was carried out to generate a scientific data for its metabolite profiling, stability testing, pharmacokinetics, and pattern recognition analysis of Arq-e-Keora. Method: Arq-e-Keora has been prepared as water distillate of male wpadix of Pandanus odoratissimus L.f. TLC profiling of Arq-e-Keora was performed using hexane and acetone (7:3, v/v) as a solvent system. The metabolic profiling of volatile compounds was carried out using GC-MS. Pharmacokinetic analysis was performed through GC-MS to evaluate how quickly it absorbs and distributes in plasma. The pattern recognition analysis was performed in order to recognize the pattern and fate of metabolites in rat plasma up to 24h after single oral administration of Arq-e-Keora. Results: TLC and GC-MS analysis resulted in profiling of 11 and 21 metabolites, respectively. GC-MS analysis revealed that phenethyl alcohol, alpha-terpinolene, beta terpinene, alpha terpinene, beta fenchyl alcohol, hexadecanoic acid, and octadecanoic acid are the major metabolites found in Arq-e-Keora. The stability analysis showed that most of the compounds are stable at refrigerator temperature during their consumption. Pharmacokinetics data of phenethyl alcohol showed its absorption was rapid, with Tmax occurring within 1h after oral administration of Arq-e-Keora. In vivo pattern recognition analysis suggests that some metabolite expression was altered after its oral administration. Conclusions: As a result, our model could be used for quality, stability, and pharmacokinetic evaluation of various Unani formulations mentioned in Unani Pharmacopoeia of India. [ABSTRACT FROM AUTHOR]

Background: Urinary tract infections (UTIs) are infectious disorders that afflict both men and women. Drug-resistant bacteria are becoming more common in UTI patients. India has the world's highest rate of extended-spectrum -lactamase (ESBL)-producing microbes. Oral administration is required since it is the preferred dose form and route for patients released from the hospital. Clinicians in India frequently prescribe an alternate to intravenous carbapenems. Faropenem is an antibiotic that is taken orally and belongs to the "penems" class of - lactam antibiotics. Faropenem is increasingly popular among Indian urologists because to its broad range antibacterial action and lesser risk of resistance; nonetheless, real-world evidence is limited. Faropenem possesses wide antibacterial action against aerobic gram-positive, gramnegative, and anaerobic bacteria, as well as resistance to TEM, SHV, and CTX-M-type ESBLs. Faropenem is licenced in India for the treatment of infections of the respiratory tract, urinary tract, skin, soft tissue, and gynaecology. It is frequently used to treat invasive ESBL-producing Enterobacteriaceae infections, despite the fact that its effectiveness in these circumstances has not been shown clinically. Faropenem has little practical clinical experiences at the urologists level. Aim and Objective: To collect practical data from Indian urologists on the usage of faropenem in the treatment of UTIs. Materials and Methods: After asking a series of eight questions with multiple-choice and open-ended answers, Indian urologists responded on the use of Faropenem in the therapy of complex urinary tract infection Results: The responses of 220 Urologists were analysed. The incidence of complicated urinary tract infections was 12%(10-15%) in the majority of urology clinics, whereas some reported it to be approximately 18% (15-25%). Faropenem 300 mg demonstrated better compliance among the patients. The majority of urologists (70%) thought Faropenem was a successful pharmacotherapy for the treatment of UTIs, including complex urinary tract infection as a step-down therapy (70%). The majority of participants (76%) considered Faropenem to be beneficial in their practise (out of 220 replies), and 8% had used Faropenem as an option in complex urinary tract infection. The majority of people (70%) thought it was safe to use in complicated urinary tract infections. Conclusion: Faropenem is used to treat urinary tract infections because of its efficacy, capacity to produce reduced resistance, and safety profile. From a public health standpoint, prudent use of faropenem in the community is critical to preserving its broad spectrum of action for patients who truly require it. [ABSTRACT FROM AUTHOR]

Background: Hypertension is a major public health problem in India, affecting a significant proportion of the population. Drug utilization research is important for assessing the rationality of drug treatment and for identifying areas for improvement. This study examined the drug utilization pattern of antihypertensive drugs in hypertensive patients at an Outpatient Department (OPD) in Udaipur, Rajasthan, India, based on JNC-8 classification. Materials and Methods: The observational cross-sectional study included 300 hypertension patients aged above 25 attending the hypertension clinic. Exclusions were made for inpatients, age < 25, uncertain diagnosis, pregnant/lactating mothers, and patients subsequently admitted after OPD visits. Results: The majority of affected patients were above 60 years old, with most having hypertension for 2-5 years, often accompanied by Type II Diabetes Mellitus. Oral administration was the primary drug delivery route. On average, patients received 1.93 antihypertensive drugs per encounter (range: 1 to 4), with an average of 5.82 drugs per encounter (range: 1 to 12). Losartan (72%) and amlodipine (46%) were the most prescribed drugs, with Angiotensin Receptor Blockers (ARBs) being the most prescribed drug class (79.3%), followed by Calcium Channel Blockers (CCBs) at 46.6%. The most common therapy was a two-drug combination (44.6%), followed by single-drug therapy (33%). Approximately 26.3% of prescriptions indicated potential drug interactions. Conclusions: This study provides valuable baseline data on the prescribing pattern of antihypertensive drugs. Rational prescribing practices are being followed, with the majority of patients being prescribed a combination of two or three antihypertensive drugs. However, there is a need to educate patients about the risks associated with uncontrolled high blood pressure and the benefits of lifestyle changes. [ABSTRACT FROM AUTHOR]

Rising antimicrobial resistance (AMR) is causing therapeutic failures with antibiotics. Inappropriate use is a contributing factor. One such antibiotic on the radar is faropenem, a broad spectrum antibiotic approved in 2005 in India. Recently, faropenem sodium suspension was approved for use in children. There is a potential danger of overuse due to the convenience of oral administration. Other carbapenems such as meropenem are used parenterally. Overuse of faropenem may promote cross-resistance with other carbapenems making them ineffective. [ABSTRACT FROM AUTHOR]

Apremilast, an oral phosphodiesterase-4 inhibitor, is approved for use in the management of psoriasis and psoriatic arthritis. Although its efficacy and safety have been well established in clinical studies, in real-world settings, different practice scenarios have been reported. This review paper serves to evaluate clinical real-world scenarios and aspects of treatment for which the information in the literature was considered to be lacking or controversial. Following a literature review, a panel of five dermatologists with expertise in psoriasis considered five scenarios; namely, the positioning of apremilast in psoriasis, its use in difficult-to-treat areas, special conditions and populations, safety, dose titration and dose in maintenance therapy. These were then assessed with psoriasis experts in India using a web-based questionnaire. A total of 28 questions were discussed regarding these scenarios. According to the responses, apremilast is effective in stable mild to moderate psoriasis as monotherapy and in severe psoriasis in combination. Also, a positive response was received with regard to its effectiveness in difficult locations such as the scalp, palms and soles. To reduce adverse effects, prolonged titration therapy over 4 weeks is required and lower doses can be prescribed to maintain remission. Apremilast therapy should be continued for a minimum of 8 weeks once initiated to achieve the desired results, and the total duration of therapy should be about 24 weeks for better efficacy. It is also effective in many other cases, such as obese patients, patients with hepatitis B or C and HIV, or patients on polypharmacy. It was also reported that apremilast requires less prescreening and monitoring than other conventional and biologic systemic therapies. Overall, apremilast is an attractive option for the individualized treatment of psoriasis owing to its favorable safety profile, its ease of oral administration without the need for screening or ongoing laboratory monitoring, and its positive impact on symptoms and lesions in difficult-to-treat areas. [ABSTRACT FROM AUTHOR]

The retrospective cohort study aimed to evaluate the clinical outcomes of Ayurveda treatment exposure as an add-on to conventional care in early stage COVID-19 patients admitted at Samaras COVID care center, Ahmedabad, India. Conventional care included Vitamin-c, Azithromycin, and Paracetamol. Ayurveda formulations used as add-on were Dashamula and Pathyadi decoctions along with Trikatu powder, Sanshamani tablet, AYUSH-64 tablet AND Yastimadhu Ghana tablet for oral administration. Considering Add-on Ayurveda medicines as exposure of interest, patients who received Add-on Ayurveda medicines at least for 7 days were included in the exposed group while those who received only conventional care in unexposed group. Data was collected through record review and telephonic interviews. The outcomes of interest were the development of symptoms, duration of symptomatic phase in those progressing to symptomatic stage and mortality. Total 762 participants were included-[541 (71%) in the exposed group and 221 (29%) in the unexposed. Progression to symptomatic phase did not differ significantly between groups [27.6% in exposed, 24.6% in unexposed, adjusted RR 0.85; 95% CI 0.6-1.2]. The total duration of symptomatic phase among those progressing to the symptomatic stage was significantly decreased in the exposed group (x¯ = 3.66 ± 1.55 days in exposed (n = 133); x¯ = 5.34 ± 3.35 days in unexposed (n = 61), p < 0.001). No mortality was observed in either of the groups. Ayurveda Treatment as adjunctive to conventional care reduced the duration of symptomatic phase in early stage COVID-19 as compared to standalone conventional care. Add-on Ayurveda treatment has promising potential for management of early stage COVID-19. [ABSTRACT FROM AUTHOR]

Arthritis is a medical condition that affects the joints and causes inflammation, pain, and stiffness. There are different types of arthritis, and it can affect people of all ages, even infants and the elderly. Recent studies have found that individuals with diabetes, heart disease, and obesity are more likely to experience arthritis symptoms. According to the World Health Organization, over 21% of people worldwide suffer from musculoskeletal problems. Roughly 42.19 million individuals in India, constituting around 0.31% of the populace, have been documented as having Rheumatic Arthritis (RA). Compared to other common diseases like diabetes, cancer, and AIDS, arthritis is more prevalent in the general population. Unfortunately, there is no specific cure for arthritis, and treatment plans usually involve non-pharmacological methods, surgeries, and medications that target specific symptoms. Plant-based remedies have also been shown to be effective in managing inflammation and related complications. In addition to therapies, maintaining a healthy diet, exercise, and weight management are essential for managing arthritis. This review discusses the causes, prevalence, diagnostic methods, current and prospective future treatments, and potential medicinal plants that may act as anti-inflammatory or anti-rheumatic agents. However, more research is necessary to identify the underlying mechanisms and active molecules that could improve arthritis treatment., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

OBJECTIVE: Acute lower respiratory infections are an important cause of morbidity and mortality in developing countries. Recent randomized trials of zinc supplementation for the prevention of acute lower respiratory tract infections have revealed discrepant findings. The main aim of this study was to evaluate the prevalence of zinc deficiency and the effect of zinc supplementation on respiratory infections. MATERIAL AND METHODS: A single center, prospective open-label interventional single-arm pre-post study of the effect of oral zinc supplementation in zinc deficient children aged 6 months to 5 years was done. A total of 465 healthy children of age 6 months to 5 years were enrolled in the study for estimation of the prevalence of zinc deficiency. Children having zinc deficiency were recruited to study the efficacy and safety of oral administration of 20 mg zinc for two weeks during a 6-month follow-up period. RESULTS: There were statistically significant differences between the zinc deficient and non-deficient groups according to modified Kuppuswamy categorization of family status and exclusive breast feeding. There was significant difference in the mid arm circumference between the zinc deficient and non-deficient groups (p<0.001). There was significant difference (p<0.001) in the number of episodes of acute upper respiratory infections (AURI), mean duration of AURI, and acute lower respiratory infections (ALRI) between the two groups. There was no significant difference in the ALRI episodes between the two groups. After zinc supplementation in zinc deficient children, there was significant decrease in the number of episodes and mean duration of AURI (p<0.001) and ALRI (p<0.001) within six months after supplementation as compared with the preceding six months before supplementation. CONCLUSION: This study reveals that a short course of zinc supplementation may reduce the burden of AURI/ALRI among the zinc deficient children, but larger studies are needed. [ABSTRACT FROM AUTHOR]

Background and Objective: Remogliflozin etabonate is an orally available prodrug of remogliflozin, an inhibitor of renal sodium glucose co-transporter-2 (SGLT2) with antihyperglycemic activity. The present study was conducted to characterize the pharmacokinetic and safety profile of remogliflozin etabonate under fasting and fed conditions at single oral doses of 100 and 250 mg in healthy Asian Indian adults.Methods: Sixty-five healthy, adult Asian Indian male subjects were enrolled in an open-label, two-stage, single-period pharmacokinetic study. Remogliflozin was given under fasting and/or fed conditions as a single oral dose of 100 or 250 mg. The plasma concentrations of remogliflozin etabonate, remogliflozin, and the metabolite GSK279782 were quantified by validated liquid chromatography-tandem mass spectrometry (LC-MS/MS) method. Pharmacokinetic parameters were determined from the plasma concentration-time profile by non-compartmental analysis. Safety was assessed through monitoring of adverse events. Descriptive statistics were calculated and reported for all parameters.Results: The plasma concentration profiles showed rapid absorption of the prodrug remogliflozin etabonate and rapid conversion to the active moiety, remogliflozin, which is then further metabolized to another active metabolite, GSK279782. The geometric mean maximum concentration (Cmax) and area under the plasma concentration-time curve (AUC) were comparable for all three analytes between the fasted and fed state. The fed/fasted ratio for Cmax ranged from 0.77 to 1.44 at the 100 mg dose, and from 0.80 to 1.12 at the 250 mg dose. The fed/fasted ratio for AUC was 1.22 and 1.35 at 100 and 250 mg, respectively. An early time to Cmax (tmax) was observed for all three analytes while being administered in the fasted state. Both the Cmax and AUClast of all the three analytes increased in a dose-proportional manner under the fasted and fed states. The terminal half-life for remogliflozin ranged from 1.53 to 2.07 h. All three analytes had comparable terminal half-lives irrespective of dose levels or dietary conditions.Conclusions: Following single oral administration at 100 and 250 mg, remogliflozin etabonate showed favorable, linear pharmacokinetics. There were no clinically relevant food effects on the pharmacokinetics at both the 100 and 250 mg dose levels. Remogliflozin etabonate was well-tolerated without any safety concerns or hypoglycemic events.Clinical Trial Registration: Clinical Trial Registry-India identifier number CTRI/2017/10/010043. [ABSTRACT FROM AUTHOR]

In India, both pulmonary and Extrapulmonary Tuberculosis (TB) are prevalent. Central Nervous System TB (CNS-TB) is rare, with spinal intramedullary TB (SIMT) presenting as Longitudinally Extensive Transverse Myelitis (LETM) being even rarer. Diagnosing LETM often involves considering alternative aetiologies, frequently overlooking TB, particularly in patients without primary pulmonary TB. A 31-year-old male presented with high-grade fever, weight loss, and right hypochondriac pain. Initial investigations revealed pancytopenia and hepatosplenomegaly. Bone marrow biopsy showed granulomas and Acid-Fast Bacilli (AFB), but there was no evidence of Mycobacterium tuberculosis on the Cartridge-based Nucleic Acid Amplification Test (CBNAAT), leading to a presumptive diagnosis of disseminated TB. The patient was started on Antitubercular Therapy (ATT) but was non compliant with his medication, resulting in worsening symptoms, including paraparesis and urinary bladder involvement. Further investigations revealed LETM and ring-enhancing lesions in the brain. Despite negative CSF CBNAAT tests, empirical ATT with corticosteroids was resumed, and Mycobacterium tuberculosis was later confirmed via Lowenstein-Jensen (LJ) culture of the bone marrow. This case underscores the diagnostic challenges of disseminated TB with LETM, highlighting the importance of a high clinical suspicion and thorough evaluation, especially in endemic regions. [ABSTRACT FROM AUTHOR]

Purpose: Snakebites represent a pressing global public health concern, with India shouldering a disproportionate burden and often dubbed the "snakebite capital." Traditional and spiritual healing methods prevail in India, yet their efficacy and potential adverse health consequences warrant investigation. This study seeks to elucidate the perspectives of healthcare providers and caretakers regarding snakebite treatment practices, with a specific emphasis on traditional healing modalities. Methods: An exploratory study was conducted among ten healthcare providers–five traditional and five modern treatment providers, two snake trappers/catchers and 120 snakebite victims or their caretakers across three districts of Odisha, India. Data were collected through in-depth interviews and analysed using content analysis. Results: The analysis revealed five main categories: various snakebite treatment practices, care-seeking pathways of victims, perspectives of patients and caretakers on treatment, traditional healers' views on modern treatment, and allopathic doctors' views on traditional treatment. Treatment practices observed included allopathic treatment, cold treatment, spiritual healing practices at temples, brass plate treatment, mantra enchanting, herbal treatment, and self-medication. Reasons for treatment delay included strong community beliefs in traditional healing, lack of control over irrational treatment by traditional healers, suboptimal care at primary and secondary healthcare facilities, and poor community literacy on snakebites. Conclusions: The study emphasizes the need for improved snakebite preparedness strategies, community literacy, active involvement in prevention programs, and strong political commitment to control irrational treatment practices. [ABSTRACT FROM AUTHOR]

Context: Xanthone derivatives have been reported to possess a wide range of biological properties. In effort to search new effective antihypertensive compounds, we have synthesizednovel xanthone derivatives (xanthonoxypropanolamines) and got patent for these compounds (The Patent Office, Government of India, S. No.: 011–016308, Patent No.: 250538). Objective: In the present work, we attempted to establish the antihypertensive activity, toxicity and molecular docking study forthese newly synthesized compounds (1a, 1b and 2). Materials and method: The preliminary antihypertensive screening was performed by administering synthesized compounds and standard drugs intraperitonially and orally into wistar rats. The change in systolic, diastolic and the mean blood pressure before and after the treatment of the drugs was measured on a Digital LE-S100 Blood Pressure Meter by Tail-cuff method non-invasively. Toxicity studies were carried out after oral administration of synthesized compounds to rats at doses of 25, 50, and 100mg/kg. The serum samples were tested for different toxicity parameters such as liver function test, kidney function test etc. The docking simulations of all the compounds were performed using Maestro, version 9.4 implemented from Schrodinger software suite. Results and discussion: The result showed that the compound 1a, 1b and 2 have greater antihypertensive activity with almost equal or less toxicity profile in comparison to standard drug Propranolol and Atenolol. The docking score for the compound 1b was found -9.1 while for compound 1a and 2 were found -8.7 and -8.6 respectively. Conclusion: These novel compounds i.e. 1a, 1b, and 2 have greater antihypertensive activity in comparison to standard drugs Propranolol and Atenolol. All these compounds do not have any toxicity. [ABSTRACT FROM AUTHOR]

The in vivo acute and sub-acute toxicity of the hydroalcoholic leaf extract of Madhuca longifolia (HAEML) were evaluated as per the OECD guidelines. In the acute toxicity study, Albino Wistar rats were administered orally with 2000 mg kg−1 b.w. of HAEML and the animal behavior, adverse effect and mortality were observed for 14 d. Sub- acute toxicity study was conducted by oral administration of the extracts at daily doses of 200 and 400 mg kg−1 b.w. for 28 d. At the end of the treatment period the rats were sacrificed for hematological, biochemical and histopathological studies. No toxic signs or mortality were observed during the experimental period. Hence, the LD50 of the HAEML extracts was determined to be greater than 2000 mg kg−1 b.w. In repeated dose sub-acute toxicity study, the results did not reveal any treatment-related abnormalities in terms of body weight, relative organ weight and biochemical parameters. However, there was a notable difference in hematological profile and antioxidant enzymes. No gross morphological alteration was observed in histopathological studies. [ABSTRACT FROM AUTHOR]

Background: Dillenia pentagyna Roxb. (Dilleniaceae) is an endangered medicinal plant, commonly known as "agai" and distributed randomly in the Terai belt of North East states of India. D. Pentagyna extract has been studied for therapeutic possessions. Objective: The proximate parameters and high-performance thin layer chromatography (HPTLC) analysis in the same plant of D. pentagyna of four-time harvest stage during the maturation of fruits were studied and also the antihypoglycemic activity of hydroalcoholic extract of D. pentagyna fruit. Materials and Methods: The proximate compositions were determined by measuring the amount of water removed from the food AOAC method and the chemical fingerprinting was carried out by HPTLC method. An acute oral toxicity study was carried out in healthy male Wister rats (110 g). The dose was finally made to 200 and 400 mg/kg body weight for oral administration after the LD50 estimation. Results: The most phenolic concentration was continuously decrease with during the maturation of fruits. After 21 days of treatment, level of blood glucose, as well as albumin, protein, creatinine, urea, and uric acid were significantly decreased when compared with the diabetic control. Hydroalcoholic (80% alcohol to 20% DW) extracts will be subjected to further extensive studies to isolate and identify their active constituents which are useful for against antidiabetic. Conclusion: D. pentagyna fruit could act as a source of functional compounds for the control of diabetes mellitus. [ABSTRACT FROM AUTHOR]

The antioxidant and antidiabetic activity of methanol leaves extract (CPMLE) and ethyl acetate fraction (CPEALF) of lemon hill (Citrus pseudolimon) was examined on key enzymes (α-glucosidase and α-amylase) in type-2 diabetes. In-vivo antidiabetic activity was evaluated in streptozotocin (STZ)-induced diabetic rats against CPMLE and CPEALF. Methanolic extract of the plant was effective against 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging (IC50 = 313.20 µg mL−1), reducing power (IC50 = 366.69 µg mL−1), and H2O2 scavenging (IC50 = 498.26 µg mL−1) and phosphomolybdate radical scavenging activity (IC50 = 508.02 µg mL−1). Ethyl acetate fraction demonstrated DPPH radical scavenging (IC50 = 259.33 µg mL−1), reducing power (IC50 = 268.91 µg mL−1), and H2O2 scavenging (IC50 = 476.39 µg mL−1) and phosphomolybdate radical scavenging activity (IC50 = 278.60 µg mL−1). C. pseudolimon methanol extract had inhibitory activity against α-glucosidase (IC50 = 350.09 µg mL−1) and α-amylase (IC50 = 291.17 µg mL−1) enzymes. Oral administration of CPMLE and CPEALF reduced elevated fasting blood glucose, lipid levels, and oxidative stress along with Hb1AC level. [ABSTRACT FROM AUTHOR]

Background: Acacia farnesiana is a medicinal plant that grows throughout tropical parts of Indian subcontinent, particularly in sandy soils of river beds in Northern India. The objective of the present study was to evaluate the anti-hyperglycemic activity of the extracts using glucose tolerance test. Isolation of an active fraction (AF) from the active extract (water extract) using alcohol precipitation and to get insight to the mechanism of action of the AF of A. farnesiana. Materials and Methods: Glucose uptake by isolated rat diaphragm of the AF was performed. Further the effect of release of Insulin from isolated and cultured pancreatic β-cell was determined. Besides, effect of oral administration of the AF was compared with that of intraperitonial administration. The effect of AF on serum glucose levels in orally glucose loaded rats was compared with that of intraperitoneal glucose loaded rats. Results: The water extract significantly lowered the blood glucose level. When precipitated with alcohol, the activity was found in the soluble fraction. Glucose uptake in the isolated rat hemidiaphragm, was increased by the AF at 40 μg/ml concentration, the AF did not significantly influence insulin release from cultured islets. The AF was found to be effective in orally glucose loaded in contrast to intraperitonial route. Conclusion: Our findings suggest that this plant is promising for further studies leading to the development of valuable medicine for diabetes. [ABSTRACT FROM AUTHOR]

Schima wallichii (D.C.) Korth is traditionally used in Manipur, India for treatment of diabetes and hypertension. However, there is no data reported regarding safety profile of this medicinal plant upon repeated per oral administration over a period of time. In the current study phytochemical profile, toxicological profile and total phenolic and flavonoid compound content of Schima wallichii leaves extract were evaluated. Gas chromatography coupled to mass spectrometry was performed for chemical profiling by using Gas Chromatography-Mass Spectrometry/Mass Spectrometry (GC-MS/MS), Shimadzu, TQ8040 system. A 28 days sub-acute toxicity study was carried out using albino Wistar rats by administering 3 different doses (200, 400 and 800 mg/kg body weight per oral) of methanol leaves extract. Changes in body weights were recorded weekly. Serum biochemical parameters were estimated as well as blood-cell count was done to check the effect of extract on haematopoietic system. Histopathology of vital organs viz. kidney, heart, brain, liver was performed to find any pathological indications. Since, liver is main the site for xenobiotic metabolism, estimation of the level of glutathione, catalase and lipid peroxidation were done. Further, total phenolic and flavonoid compound content estimation was performed for the leaves extract. GC-MS revealed 14 major compounds with area percentage >1% of which quinic acid, n-Hexadecanoic acid, 9,12,15-Octadecatrienoic acid, (Z,Z,Z)-, Octatriacontyl trifluoroacetate, are three major compounds. No mortality was observed after the treatment with extract. Blood-cell count and biochemical parameters didn't show significant deviation as compared to control group. Histopathology study of vital organs viz. (liver, kidney, heart and brain) showed normal cellular construction comparing to control group. There was no sign of membrane lipid peroxidation, depletion of catalase level and glutathione level in liver. The result demonstrates that NOAEL (no-observed-adverse-effect levels) in the sub-acute toxicity was above 800 mg/kg. The leaves extract showed significant total phenol and flavonoid content. The present study revealed that Schima wallichii possessed important bioactive compounds with therapeutic values. The plant was safe for consumption after repeated high doses administration in rats and possesses significant amount of total phenol and flavonoid content. [Display omitted] • GC-MS of methanolic extract showed presence of 14 major compounds with area percentage >1%. 2-Pyrrolidinone, 1-methyl-, 1,2,3-Benzenetriol, 3-Hexenedioic acid, d-Glucitol, 2,5-anhydro-1-O-octyl, Heptanoic acid, alpha.-L-Galactopyranoside, methyl 6-deoxy-, n-Decanoic acid, 3-Octanethiol, thiolacetate, Butanoic acid, octyl ester, Carbonic acid, 2-ethylhexyl nonyl ester, Quinic acid, n-Hexadecanoic acid, 9,12,15-Octadecatrienoic acid, (Z,Z,Z)-, Octatriacontyl trifluoroacetate are the major compounds identified through GC-MS. • Presence of significant total phenolic and flavonoid content attributed to the therapeutic values of Schima wallichii leaves. • Even high dose of 800 mg/kg b.w., Schima wallichii methanolic leaves extract was found to be non-toxic and safe systematically upon repeated administration. • NOAEL (no-observed-adverse-effect levels was above 800 mg/kg b.w. • Schima wallichii methanolic leaves extract is hepatoprotective and renoprotective. [ABSTRACT FROM AUTHOR]

Background: Equisetum diffusum D. Don commonly known as 'Himalayan horsetail', has been traditionally used in the treatment of back pain, bone fracture and dislocation, and arthritis by various tribal communities of India. Our previous study confirmed the anti-inflammatory efficacy of the plant through in silico, in vitro, and in vivo model studies. Therefore, the current research is focused on safety dose evaluation for the first-time of the whole-plant methanol extract (EDME) of E. diffusum through appropriate in silico, in vitro, and in vivo approaches. Method: The whole plant, along with its rhizomes, was collected, and the methanol extract was prepared. The in silico ADMET study was performed to predict the pharmacokinetics profile and toxicity of all the identified phyto-compounds of EDME previously screened by GC–MS study. In vitro cytotoxicity study of EDME was performed using two cell lines: kidney (HEK293) and liver (Huh7) cell lines. The in vivo toxicity study of EDME was validated by the acute toxicity (OECD 423, 2002) and sub-acute toxicity assays (OECD 407, 2008) in the Wistar Albino rat model. Results: The in silico ADMET study of all 47 bioactives predicted good pharmacokinetic and low toxicity profiles. In vitro cytotoxicity showed higher IC50 values of EDME viz., 672 ± 15.7 μg/mL and 1698 ± 6.54 μg/mL for both kidney (HEK293) and liver (Huh7) cell lines, respectively, which were considered as low-toxic. Based on acute oral toxicity, the LD50 value of the extract was considered "non-toxic" up to a feeding range of 2000 mg/kg of body weight. The regular consumption of the extract for an extended period (28 days) was also qualified as safe based on the body and organ weight, hematological, biochemical, and histoarchitecture results in the sub-acute toxicity assay. Conclusion: The detailed in silico, in vitro, in vivo (acute and sub-acute oral toxicity) studies gave us a new insight to the safety dose evaluation of Equisetum diffusum, which may serve as a reliable documentation for undertaking the experimental validation of the ethnobotanical uses of the plant which would help in the field of drug development for the treatment of inflammation related complications. [ABSTRACT FROM AUTHOR]

Balanites aegyptiaca Delile (BA) is an enduring xerophytic woody and spinous flowering tree and is commonly known as desert date or Ingudi (Hingot). It belongs to the family Zygophyllaceae, which is specific to be drought areas of Nigeria, Africa, South Asia and India (Rajasthan). In Ayurveda, this traditional medicinal plant is reported for the management of jaundice, syphilis, yellow fever, metabolic disorders, liver, and spleen problems. The main aim of the review is to compile its medicinal uses and further advancements to showcase the promises inherited in various parts of the plant for the benefit of mankind. As per the literature survey, various researchers have focused on the detailed investigation of BA including the phytopharmacological evidence, chemical constituents, nano-formulations, commercialized products, and clinical trials. Several remarkable scaffolds and isolated compounds like diosgenin, yamogenin, balanitin1/2, balanitin 3, bal4/5, bal6/7, rutin-3-glycosides, 3,7-diglycosides, (3, 12, 14, 16)–(12-hydroxycholest-5-ene-3,16-diyl-bis)-D-glucopyranoside and balanitoside have been identified. Additionally, this traditional plant has been scientifically proven by in vitro and in vivo. Based on the complete review of this plant, most of the compounds have been isolated from the fruit and kernel part. Additionally, based on the literature, a histogram was developed for pharmacological activity in which antidiabetic study was found to be more compared to other pharmacological activity. As a spinous desert dates, this plant needs to be explored more to bring out newer phytochemicals in the management of various diseases. [ABSTRACT FROM AUTHOR]

Lung cancer (LC) ranks second most prevalent cancer in females after breast cancer and second in males after prostate cancer. Based on the GLOBOCAN 2020 report, India represented 5.9% of LC cases and 8.1% of deaths caused by the disease. Several clinical studies have shown that LC occurs because of biological and morphological abnormalities and the involvement of altered level of antioxidants, cytokines, and apoptotic markers. In the present study, we explored the antiproliferative activity of indeno[1,2-d]thiazolo[3,2-a]pyrimidine analogues against LC using in-vitro, in-silico, and in-vivo models. In-vitro screening against A549 cells revealed compounds 9B (8-methoxy-5-(3,4,5-trimethoxyphenyl)-5,6-dihydroindeno[1,2-d]thiazolo[3,2-a]pyrimidine) and 12B (5-(4-chlorophenyl)-5,6-dihydroindeno[1,2-d]thiazolo[3,2-a]pyrimidine) as potential pyrimidine analogues against LC. Compounds 9B and 12B were docked with different molecular targets IL-6, Cyt-C, Caspase9, and Caspase3 using AutoDock Vina 4.1 to evaluate the binding affinity. Subsequently, in-vivo studies were conducted in albino Wistar rats through ethyl-carbamate (EC)- induced LC. 9B and 12B imparted significant effects on physiological (weight variation), and biochemical (anti-oxidant [TBAR's, SOD, ProC, and GSH), lipid (TC, TG, LDL, VLDL, and HDL)], and cytokine (IL-2, IL-6, IL-10, and IL-1β) markers in EC-induced LC in albino Wistar rats. Morphological examination (SEM and H&E) and western blotting (IL-6, STAT3, Cyt-C, BAX, Bcl-2, Caspase3, and caspase9) showed that compounds 9B and 12B had antiproliferative effects. Accordingly, from the in-vitro, in-silico, and in-vivo experimental findings, we concluded that 9B and 12B have significant antiproliferative potential and are potential candidates for further evaluation to meet the requirements of investigation of new drug application. [ABSTRACT FROM AUTHOR]

Background: Phellinus fastuosus is a wood-eating medicinal fungus from Western Ghats of India. Therefore, we investigated hypoglycemic and hepatoprotective effects of P. fastuosus aqueous extract on streptozotocin-induced diabetic and carbon tetrachloride (CCl4) induced hepatotoxicity in rats, respectively. Result: As compared to the diabetic control group, a 400 mg/kg dose had significant hypoglycemic effects, including a reduction in blood glucose (24.44%) and gain in body weight. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) activity reduced by 31.81% and 32.84%, respectively, were also noted, along with decreases in triglycerides (24.32%) and cholesterol (25.89%) levels. The albumin, bilirubin and creatinine levels were also significantly reduced after administration of P. fastuosus extract in diabetic rats. Administration of P. fastuosus extract showed a substantial decrease in the activity of ALT, AST, alkaline phosphatase (ALP), catalase (CAT) and superoxide dismutase (SOD) in addition a decrease in the level of lipid peroxidation (LPO) as compared to CCl4-intoxicated rats. The cumulative effect of CCl4 increased the erythrocyte membrane peroxidation, whereas P. fastuosus extract reduced the cholesterol and increased phospholipid, thus preventing the alteration of membrane fluidity as compared to CCl4-intoxicated rats. FTIR and HR-LC-MS-based metabolic profiling revealed the presence of various functional groups and bioactive metabolites. Conclusion: The extract showed the hypoglycemic and hepatoprotective effects due to the presence of various bioactive metabolites. Exploration of therapeutic potential of P. fastuosus using bioassay-guided fractionation is needed. [ABSTRACT FROM AUTHOR]

Introduction: Excision of intra-axial tumours with maximal resection and minimal deficits is one of the intricate procedures in neurosurgery. Fluorescence-guided Surgery (FGS) helps in better identification of tumour tissue and allows Maximal Safe Resection (MSR) of high-grade brain tumours. Sodium fluorescein dye, when injected intravenously, gets concentrated in High-grade Glioma (HGG) tissue due to a disrupted Blood-Brain Barrier (BBB), thus aiding in MSR, Extent Of Resection (EOR), and Gross Total Resection (GTR). Aim: To assess the effectiveness of intraoperative use of sodium fluorescein in achieving MSR and GTR. Materials and Methods: This was a cross-sectional study conducted on 30 patients with HGG who underwent surgery between January 2021 and May 2023 at SDM College of Medical Sciences, Dharwad, Karnataka, India. Two groups of 15 patients each were divided into those operated with the use of Fluorescein Sodium (FS) and those without FS. FS was administered at a dose of 5 mg/kg at the time of craniotomy. The primary endpoint was the number of patients with Histopathological Examination (HPE)-confirmed HGGs showing no contrast-enhancing tumour in the immediate postoperative Magnetic Resonance Imaging (MRI). Secondary endpoints included residual tumours on postoperative MRI, Focal Neurological Deficits (FND), and FS-related toxicity. The association between FS status and recurrence at different treatment time points was assessed using the Pearson Chisquare test. Recurrence rates were compared in each FS group using the Cochran Q test. Statistical significance was set at a 5% level (p-value<0.05). Results: Homogeneous or heterogeneous yellow-green fluorescence was observed on the tumour tissue in all 15 patients (100%). Of the 15 patients where FS was used, two showed lesion recurrences at six months, and 13 showed recurrences at 12 months. Among the 15 patients where FS was not used, 11 showed recurrences at six months, and four showed recurrences at 12 months. This indicates that MSR, GTR, and EOR can be improved using FS intraoperatively during tumour resection. Conclusion: Based on the results, fluorescein dye with a 560 nm yellow filter under a highly illuminated microscope can help achieve better tumour resection with minimal injury to surrounding eloquent areas. It can be utilised as an ideal adjunct for tumour resection rather than with a microscope alone. [ABSTRACT FROM AUTHOR]

Introduction: Type 2 Diabetes Mellitus (T2DM) is characterised by hyperglycaemia, insulin secretion defects, or resistance. Most T2DM drugs help to improve glycaemic status, but the response varies among individuals. The modern lifestyle with unhealthy eating habits leads to gut dysbiosis. Altered gut microbiota can disrupt the host's metabolic and signaling pathways, intestinal barrier integrity, and function. Probiotics could restore a healthy microbiota in the intestine, thus improving glycaemic status. Need of the study: Probiotics may assist in re-establishing a healthy microbiota composition in the intestine. Limited studies have evaluated the supplementation of probiotics for effectively managing T2DM. Aim: To investigate the effects of probiotics on biomarker levels in type 2 diabetic male Wistar rats. Materials and Methods: This interventional case-control study will be conducted at the Centre for Toxicology and Developmental Research (CEFTE) at Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India. The study will involve 46 male Wistar rats divided into five groups. Diabetes will be induced by feeding the animals a High-Fat Diet (HFD) and administering a low dose of Streptozotocin (STZ) injection. Groups 1 and 2 will be on basal and HFDs, serving as negative and positive controls, respectively. Groups 3, 4 and 5 will be the intervention groups. The study duration will be four weeks and three days for diabetes induction and six weeks for intervention. Blood samples will be collected periodically to assess biomarkers, and at the end of the study, internal organs will be harvested for histopathological examination. Institutional Ethics Committee (IEC) approval has been obtained. Categorical variables will be analysed using Chi-square or Fisher's exact test, while continuous variables will be analysed using repeated measures Analysis of Variance (ANOVA). A p-value of =0.05 will be considered statistically significant, and statistical analysis will be performed using Statistical Package for Social Sciences (SPSS) version 16.0. [ABSTRACT FROM AUTHOR]

Anticarcinogenic activity ofmeso-zeaxanthin (MZ), a xanthophyll carotenoid with profound antioxidant activity, was evaluated against 3-methylcholanthrene (3-MC)-induced sarcoma in mice. Oral administration of MZ at different doses significantly increased tumor latency period. In 3-MC control group, animals started developing sarcoma on 6th week. However animals treated with 3-MC and MZ (50 and 250 mg/kg b.wt) started developing sarcoma only on 15th and 18th week, respectively. Survival of tumor-bearing mice was significantly increased by MZ treatment. Animals in 3-MC control group started dying due to tumor burden from 8th week. All animals treated with MZ (50 and 250 mg/kg b.wt) along with 3-MC were found to be alive even after 16 and 20 wk, respectively. Oral administration of MZ inhibited different CYP450 isoenzymes like CYP1A1 (PROD), CYP1A2 (MROD), and CYP2B1/2 (EROD), which are involved in carcinogen metabolism in a dose-dependent manner. Moreover, levels of phase II enzymes like UDP-glucuronyl transferase and glutathione-S-transferase, which are involved in detoxification of carcinogens, were significantly increased by MZ treatment. Results indicated that mode of action of MZ may be through inhibition of carcinogen activation coupled with enhancement of detoxification process. MZ may also inhibit promotion phases of carcinogenesis by its antioxidant activity. [ABSTRACT FROM PUBLISHER]

Context: Polyalthia longifolia (Sonn.) Thw. var. pendula (Annonaceae), a tall evergreen tree, is cultivated all over India. The plant is used in traditional systems of medicine for the treatment of fever, skin diseases, and hypertension. Objective: The present study evaluated the acute oral toxicity of Polyalthia longifolia var. pendula leaf extract in Wistar albino rats. Material and methods: The parameters evaluated daily after oral drug administration of the extract (540, 1080, 2160 and 3240 mg/kg body weight) were mortality, signs of toxicity, feed and water consumption and body weight changes up to 14 days. The effect of different doses of the extract on organ weight, biochemical and hematological parameters were evaluated on the 15th day. Results and conclusion: Methanol extract of Polyalthia longifolia leaf up to the dose level 3240 mg/kg body weight did not produce any toxic effects or deaths; the extract was well tolerated by the rats. It did not alter body weight, feed and water consumption. The organ weight, biochemical and hematological analysis did not show any dose- dependant changes in any of the parameters examined in animals of both sexes. The acute oral administration of the methanol extract of Polyalthia longifolia leaf was not toxic and safe in a single dose. [ABSTRACT FROM AUTHOR]

Pterospermum acerifolium (L.) Willd is one of the most popular medicinal plants in Eastern regions of India, commonly known as Muchkunda. Traditionally the leaves of the plant have been used as Hemostatic and for its wound healing properties, but to date there is no documented evidence corroborating its safety. This study thus aimed to determine the toxicity profile of the methanolic extract of Pterospermum acerifolium (L) Willd (MEPA) by determining its effects after acute and sub-chronic oral administration in female and male rats (Wistar albino). In adult rats, single oral administrations of the MEPA (4-20 g/kg body weight) did not show any mortality upto 20g/kg b.w. p.o. However there were signs of toxicity, namely anorexia and hypoactivity above 12 mg/kg b.w. (p.o.), which was the no-observed-adverse-effect level (NOAEL). In rats, daily single oral doses of MEPA (100 mg/kg b.w., 1g/kg b.w. and 2 g/kg b.w.) were well tolerated behaviorally after 28 days of dosing and induced no significant changes in body and organs weights. However, haematological and biochemical parameters showed significant increases in ALT, AST, cholesterol and creatinine levels suggesting disturbances of liver and kidney functions. Histopathological findings also provided conclusive evidence towards hepatotoxic and nephrotoxic potential of the extract at high dose levels. The extract was tolerated well at low dose levels (100 mg/kg b.w. p.o.) after 28 day repeated administration of the extract. Overall, the findings of this study indicate that MEPA is non-toxic and has, at low dose, a low toxicity potential in acute and chronic oral administrations, respectively. However, at high oral doses, repeated administration (28 days) MEPA has significant hepatotoxic and nephrotoxic potential. [ABSTRACT FROM AUTHOR]

Albizia amara is used as a medicinal herb by the tribes of forest regions of Western Ghats. It is used for headaches, backaches, stomach pain, piles and simple ulcers. The anti ulcer activity of various extracts of Albizia amara was investigated on ethanol, pylorus ligated and indomethacin induced pylorus ligated ulcer models in mice and rats. The common parameter determined was ulcer index. In the pyloric ligation model and indomethacin induced pyloric ligated models oral administration of both extracts such as petroleum ether and methanol, standard drug ranitidine and control group to separate groups of Wister rats of either sex was performed. Total acidity, volume of gastric juice, pH, percentage protection and ulcer index were assessed. In the case of the 90% ethanol-induced ulceration model in mice, there was a decrease in ulcer score and percentage protection in test groups of petroleum ether (46.72%), methanol (68%) and standard drug ranitidine (85.44%) when compared to the negative control. There was a decrease in gastric secretion and ulcer index among the treated groups i .e. petroleum ether (73.91%), methanol (80.72%) and in standard drug (91.59%) when compared to the negative control in pyloric ligated ulcers. In indomethacin induced pyloric ligated ulcer model in rats there was a reduction in ulcerative score in animals receiving petroleum ether (63.2%), methanolic (62.07%) and standard drug (80.02%) when compared to the negative control. The extract (250 mg/kg) showed significant (P < 0.01) reduction in gastric volume, free acidity and ulcer index as compared to control in all models. [ABSTRACT FROM AUTHOR]

Myrica nagi Hook (syn. Myrica esculenta Buch. & Ham) (Myricaceae) is commonly known as box berry. The bark of Myrica nagi is used in the treatment of mental illness by different ethnic groups of the rural region of Orissa (India). In the present work, the anxiolytic and antidepressant effects of an ethanol extract of M. nagi were analyzed at three different dosages (100, 200, and 400 mg/kg, p.o.) by elevated plus-maze, light/dark exploration test, tail suspension test, and the forced swimming model. Oral administration of the ethanol extract (100, 200, and 400 mg/kg, p.o.) of M. nagi showed significant (p < 0.01) and dose-dependent anxiolytic activity by increasing time spent in the open arms of the elevated plus-maze and in the lit box indicating an anxiolytic effect. Nevertheless this treatment was unable to exhibit an effect identical to antidepressants in the tail suspension and forced swimming tests. Altogether, these results suggest an anxiolytic effect of the ethanol extract of M. nagi. [ABSTRACT FROM AUTHOR]

Mizoram has a diverse range of ethnic and cultural groups, including the Lushai, Mara, Lai, Bawm, Hmar, Chakma, and Bru. Through practice and experience in their protracted battles with disease and the harsh natural environment, they have amassed rich folk medicine knowledge. The preservation of indigenous knowledge, identification of bioactive compounds, and the eventual discovery of novel medicinal plant species all depend on the documentation of the traditional uses of medicinal plants. Therefore, the present study was designed to document the ethnomedicinal knowledge related to the usage of medicinal plants in Mizoram, India. An ethnobotanical study of medicinal plants was carried out in 17 villages of 5 districts in Mizoram between September 2022 and January 2023. A total of 128 informants (77 males and 51 females) were interviewed. Information was gathered through field observations, group discussions, and semistructured interviews. The data were presented using descriptive statistics. To assess the importance of medicinal plant species, quantitative indices such as the informant consensus factor (ICF), fidelity level (FL), use value (UV), and cultural index (CI) was used. In our ethnobotanical investigation, 102 medicinal plant species from 95 genera and 58 families were recorded and documented. The majority of them (90 species) were obtained from wild habitats. The majority of the documented species were trees (48), followed by herbs (23 species) and shrubs (21 species). The most common method of preparation was decoction (67 species). Diabetes had the highest ICF value (0.81), followed by cancer, liver problems, and hypertension (0.8). The fidelity level (FL) of indigenous communities in the study area was evaluated to determine the dependability and consistency of herbal drug use. Indigenous knowledge and the variety of medicinal plant species that are used are of great values. The therapeutic applications of documented plants provide fundamental information for additional studies centered on pharmacological investigations and the preservation of the most significant species. [ABSTRACT FROM AUTHOR]

We present updated, evidence-based clinical practice guidelines from the Indian Society of Pediatric Nephrology (ISPN) for the management of urinary tract infection (UTI) and primary vesicoureteric reflux (VUR) in children. These guidelines conform to international standards; Institute of Medicine and AGREE checklists were used to ensure transparency, rigor, and thoroughness in the guideline development. In view of the robust methodology, these guidelines are applicable globally for the management of UTI and VUR. Seventeen recommendations and 18 clinical practice points have been formulated. Some of the key recommendations and practice points are as follows. Urine culture with > 104 colony forming units/mL is considered significant for the diagnosis of UTI in an infant if the clinical suspicion is strong. Urine leukocyte esterase and nitrite can be used as an alternative screening test to urine microscopy in a child with suspected UTI. Acute pyelonephritis can be treated with oral antibiotics in a non-toxic infant for 7–10 days. An acute-phase DMSA scan is not recommended in the evaluation of UTI. Micturating cystourethrography (MCU) is indicated in children with recurrent UTI, abnormal kidney ultrasound, and in patients below 2 years of age with non-E. coli UTI. Dimercaptosuccinic acid scan (DMSA scan) is indicated only in children with recurrent UTI and high-grade (3–5) VUR. Antibiotic prophylaxis is not indicated in children with a normal urinary tract after UTI. Prophylaxis is recommended to prevent UTI in children with bladder bowel dysfunction (BBD) and those with high-grade VUR. In children with VUR, prophylaxis should be stopped if the child is toilet trained, free of BBD, and has not had a UTI in the last 1 year. Surgical intervention in high-grade VUR can be considered for parental preference over antibiotic prophylaxis or in children developing recurrent breakthrough febrile UTIs on antibiotic prophylaxis. [ABSTRACT FROM AUTHOR]

Modernization, a stressful lifestyle, attachment to a Western diet, and the use of preserved and processed foods lead to a loss of homeostasis of intestinal microbial diversity. The use of refined flour and refined sugar, which lack of micro biota-accessible carbohydrates (MAC), means dietary fiber high salt consumption, and saturated fats in fried and packaged foods cause gut microbiota dysbiosis. Microbial dysbiosis caused by high fat, salt, and lack of fiber causes several metabolic diseases, including asthma. The objective of the study is to develop a hypothetic model that "Ancient Indian diet" which is inspired by thousands of years of Indian science, including Yoga, Ayurveda, and Naturopathy may maintain the diversity of the gut microbiota and may inhibits the asthmatic symptoms by enhancing the growth of antiasthmatic bacteria. A keyword search utilizing the phrases "western diet, beneficial microbiota, asthma, gut microbial dysbiosis, Ancient Indian diet" was conducted electronically search through the SCOPUS,Science Direct, PubMed, Web of Science, and PsycINFO databases. Search criteria are divided into two arms the first one includes different full-text research papers including how Indian diet altered gut microbial composition. The second one, we included the full text including how presence of certain gut microbiota can prevents the asthmatic attack. To And publications that met the eligibility requirements, the first and third authors separately reviewed each publication's title and abstract using the previously described inclusion criteria. We have included 124 research articles, which is published between 1989 to 2024. A plant-based ancient Indian diet increases the diversity of Bacteroidetes, Actinobacteria, Prevotella, Bifidobacterium, Lactobacillus, Ruminococcus, Roseburia, Lactobacillus, Lachnospira, Akkermansia and shows inhibitory effects against Clostridium, E. coli, Staphylococcus, Haemophilus, Moraxella and Neisseria.The ancient Indian diet a low-fat lacto-vegetarian diet maintains gut microbiota homeostasis, and suppresses the growth of pathogenic asthmatic bacteria and promotes the growth of beneficial asthmatic bacteria. [ABSTRACT FROM AUTHOR]

There is a long history of starvation, including reports dated back to antiquity. Despite exceptional scientific developments, starvation still exists today. The medical aspects of starvation were well established in the twentieth century, particularly following studies related to the 1943–1944 Bengal famine in India and starved prisoners of war and survivors of World War 2. The refeeding of the starved victims provided disappointing results. Nevertheless, those studies eventually led to the development of a new branch of research in medicine and to the definition of what is now known as refeeding syndrome. This paper briefly reviews the history and groundwork that led to today's understanding of starvation and refeeding, with a particular emphasis on the observations from studies on starved Holocaust survivors and prisoners of war after World War 2. The relevance of these studies for modern times is briefly discussed. [ABSTRACT FROM AUTHOR]

With newer anti-obesity medications (AOMs) being introduced at a rapid pace, it is prudent to make a concise and updated clinical practice document that may help busy clinicians in daily clinical practice. A group of metabolic physicians, diabetologists, endocrinologists, and bariatric surgeons assembled during the Integrated Diabetes and Endocrine Academy 2023 Congress (IDEACON, July 2023, Kolkata, India) to compile an update of pharmacotherapeutic options for managing people with obesity in India. After an extensive review of the literature by experts in different domains, this update provides all available information on the management of obesity, with a special emphasis on both currently available and soon-to-be-available AOMs, in people with obesity. Several newer AOMs have been shown to reduce body weight significantly, thus poised to make a paradigm shift in the management of obesity. While the tolerability and key adverse events associated with these AOMs appear to be acceptable in randomized controlled trials, pharmacovigilance is vital in real-world settings, given the absence of sufficiently long-term studies. The easy availability and affordability of these drugs is another area of concern, especially in developing countries like India. [ABSTRACT FROM AUTHOR]

The article examines the efficacy of aromatherapy in managing cancer-related fatigue through a systematic review and meta-analysis. It also discusses the databases searched for relevant studies, the assessment of methodological quality using the Cochrane Risk of Bias tool, and the planned meta-analysis using a random effect model.

Introduction: Melasma is a common acquired pigmentation disorder over the sun exposed areas found commonly in our country. Oral tranexamic acid and glutathione have been shown to have significant efficacy when given along with topical modified Kligman regimen. Aims: To compare the efficacy of oral tranexamic acid versus oral glutathione given in combination with modified Kligman regimen in the management of melasma. Settings and Design: An open label randomized controlled trial was conducted in the skin OPD of a tertiary level hospital in Northern India. Materials and Methods: The study group consisting of 96 patients was categorized into two groups; group A received oral tranexamic acid 250 mg twice daily in combination with a modified Kligman regimen and group B received oral Glutathione 500 mg once daily with a modified Kligman regimen. mMASI score was used to make the assessment. mMASI scores were measured at baseline, 4th, 8th, and 12th week. Intragroup and intergroup comparison was done using analysis of variance (ANOVA) and Chi‑square test statistical methods. Results: Ninety patients completed the study. Both the groups showed a significant fall in the mMASI score; group A showed a statistically significant fall in the score vis a vis the group B. Conclusion: Oral tranexamic acid with a modified topical Kligman regimen has a slight edge over oral glutathione given with topical modified Kligman’s regimen in the treatment of melasma. [ABSTRACT FROM AUTHOR]

SARS-CoV-2 virus, the causative agent of COVID-19, has produced the largest pandemic in the 21st century, becoming a very serious health problem worldwide. To prevent COVID-19 disease and infection, a large number of vaccines have been developed and approved in record time, including new vaccines based on mRNA encapsulated in lipid nanoparticles. While mRNA-based vaccines have proven to be safe and effective, they are more expensive to produce compared to conventional vaccines. A special type of mRNA vaccine is based on self-amplifying RNA (saRNA) derived from the genome of RNA viruses, mainly alphaviruses. These saRNAs encode a viral replicase in addition to the antigen, usually the SARS-CoV-2 spike protein. The replicase can amplify the saRNA in transfected cells, potentially reducing the amount of RNA needed for vaccination and promoting interferon I responses that can enhance adaptive immunity. Preclinical studies with saRNA-based COVID-19 vaccines in diverse animal models have demonstrated the induction of robust protective immune responses, similar to conventional mRNA but at lower doses. Initial clinical trials have confirmed the safety and immunogenicity of saRNA-based vaccines in individuals that had previously received authorized COVID-19 vaccines. These findings have led to the recent approval of two of these vaccines by the national drug agencies of India and Japan, underscoring the promising potential of this technology. [ABSTRACT FROM AUTHOR]

Background: The root bark of Zizyphus nummularia (Rhamnaceae) is traditionally used as an anti-inflammatory agent. The current study aimed to explore the anti-inflammatory activity (in vivo) of a crude ethanolic extract (EE) and the pure identified octadecahydro-picene-2,3,14,15-tetranone (IC) in the root bark of Z nummularia. IC was further subjected to suitable in vitro and in silico studies to find out the mechanistic pharmacology. Methods: EE (100 and 200 mg/kg, p.o.) and (IC) (400 and 600 µg/kg, p.o.) were subjected to in vivo anti-inflammatory assays to evaluate the anti-inflammatory activity and predict the probable mechanism(s) of action. Suitable acute (carrageenan-induced paw edema, arachidonic acid-induced ear edema, xylene-induced ear edema) and chronic (cotton pellet granuloma) models were employed to investigate in vivo the anti-inflammatory activity. Based on in vivo observation, IC was further subjected to in vitro assays to estimate the inhibition of nitric oxide (NO), prostaglandin-E2 (PGE-2) and tumor necrosis factor-α (TNF-α) production in PBS stimulated RAW 264.7 cells. Based on the observation of in vitro studies, finally, ADME prediction and molecular docking studies of IC were performed for better understanding of interaction of IC with TNF-α. Results: Oral administration of EE (100 and 200 mg/kg) exhibited significant inhibition of carrageenan (p < 0.05) and arachidonic acid (p < 0.05) induced oedema, and the reduced the granuloma tissue formation (p<0.05) in experimental mice. IC (400 and 600 µg/kg, p.o.) exhibited significant (p<0.01) inhibition of carrageenan, xylene and arachidonic acid-induced edema, and reduced the granuloma tissue formation. In in vitro assays, IC caused a concentration-dependent inhibition of LPS stimulated NO (up to ~67.4 % at 50 µM) and TNF-α (~84.5 % at 50 µM) production. However, the PGE-2 inhibition did not follow dose dependent pattern. Based on in vitro observations, the molecular docking has been performed on the basis of interaction with TNF-α. In in silico studies, it was observed that IC showed hydrogen bonding with GLN 47 amino acid residue of TNF-α protein. Conclusions: IC possibly produces anti-inflammatory activity through inhibition of TNF-α and NO production. [ABSTRACT FROM AUTHOR]