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Background • Cervical spondylosis is the most common cervical spine disorder which is clinically manifested by axial neck pain, stiffness, and limited movement and sometimes it is accompanied by tingling and radicular symptoms in the upper extremities. Pain is the most frequent complaint for which patients, suffering from cervical spondylosis, consult physicians. In conventional medicine, pain and other symptoms of cervical spondylosis are controlled by systemic and local use of non-steroidal anti-inflammatory drugs (NSAIDs), however long-term use of such medicines produces adverse effects like dyspepsia, gastritis, gastroduodenal ulcer and bleeding. Methods • We searched articles for neck pain, cervical spondylosis, cupping therapy, Hijāma, etc. from various databases, including PubMed, Google Scholar, and MEDLINE. We also searched for these topics in the books of Unani medicine available in HMS Central Library, Jamia Hamdard, New Delhi, India. Results • This review elucidated that in Unani medicine several non-pharmacological regimens known as Ilāj bi’l Tadbīr (Regimenal therapies) are advised in the management of painful musculoskeletal disorders. Ḥijāma (cupping therapy) stands out among all these regimens and in most of the classical Unani literature, Ḥijāma is suggested as one of the best regimens for the management of pain in Waja‘ al-Mafāsil including Waja‘ al-‘Unuq (cervical spondylosis). Conclusion • On going through the classical texts of Unani medicine and published research papers, it may be concluded that Ḥijāma is a safe and effective nonpharmacological treatment for the management of pain due to cervical spondylosis. [ABSTRACT FROM AUTHOR]

Objective: Melasma is a chronic, acquired, symmetrical hyper melanosis of skin, characterized by irregular light to dark brown patches on sun-exposed areas, with a significant effect on psychological health; melasma is termed as Kalf in Unani medicine. Conventional treatments have transitory results and often carry adverse effects like skin irritation, scarring, etc. This study was planned to evaluate the safety and efficacy of a Unani pharmacopoeial formulation Tila-e-Kalf, comprising of lentil (Lens culinaris), bitter almond (Prunus amygdalus), and fig (Ficus carica), and to compare its efficacy with standard drug hydroquinone in patients of melasma. Materials and Methods: This was an 8-week open-label, standard controlled, randomized clinical study conducted on patients of epidermal melasma. The test group received Tila-e-Kalf while the control group received hydroquinone 4% cream for local application once daily. Efficacy was assessed by MASI (Melasma Area Severity Index), DLQI (Dermatology Life Quality Index), and PGA (Physician Global Assessment) and colored photographs. Results: Mean MASI score decreased from10.65±0.85 to 7.07±0.74 in the test group (p<0.0001) and from 11.28±1.24 to 7.76±0.9 (p<0.0001) the in control group. Similar improvement was noticed in other parameters also. A large number of patients in the control group reported mild burning, itching, dryness, and skin rashes, while only one patient in the test group reported mild itching. Conclusion: Tila-e-Kalf as a topical depigmenting agent was found equally effective with better tolerability and safety as compared to hydroquinone. [ABSTRACT FROM AUTHOR]

Background: The Unani formulation Majun Brahmi (MB), a combination of herbs, is used in India as a brain tonic and memory enhancer. Aluminium deposition in the brain is associated with the development of neurodegenerative diseases. Aims and Objectives: The present study was designed to observe that the effects of MB have been evaluated on aluminium trichloride or aluminium chloride (AlCl3)-induced cognitive impairment in an experimental rat model. Materials and Methods: Twenty male Wistar albino rats were divided into four groups of five rats each. AlCl3 was administered orally for 30 days to induce cognitive impairment. Group I received saline, Group II-AlCl3 (100 mg/kg b.wt), Group III-MB (1027.77 mg/kg b.wt), and Group IV-AlCl3 + MB (100 mg/kg b.wt+1027.77 mg/kg b. wt). At the end of the experiment, rats were subjected to behavioral and biochemical assessments. Results: Animals treated with AlCl3 showed a significant increase in time to reach the platform in the Morris water maze test (MWM), prolonged transfer latency (TL) in the elevated plus maze, and decreased step-down latency in the passive avoidance test, as compared to controls (P<0.01). Cotreatment with MB resulted in a reduced time to reach the platform in MWM, increased step-down latencies, and decreased TL. AlCl3 induction significantly increased malondialdehyde and decreased superoxide dismutase, glutathione reductase, glutathione, total antioxidant capacity, and catalase levels. Concomitant administration of MB significantly attenuated the effects AlCl3 on lipid peroxidation and restored the reduced antioxidant parameters. Conclusion: The study provides strong evidence for the potential use of MB in the treatment of neurodegenerative disorders like Alzheimer's disease. [ABSTRACT FROM AUTHOR]

Background: Type 2 diabetes mellitus is a progressive polygenic disorder requiring a multi-targeted therapeutic approach. A polyherbal formula (PHF) comprised of four traditional herbs known for their anti-diabetic, anti-oxidant, and hepatoprotective activities were used in this study. Objectives: The purpose of this research was to find out the plausible mechanisms underlying the synergistic effects of PHF in an experimental setting of diabetes mellitus. Materials and Methods: PHF was evaluated for the presence of residual toxins, acute oral toxicity, and its effects on carbohydrate digestive enzymes. PHF (100, 200, and 300 mg/kg/p. o., respectively) was used to treat streptozotocin-induced diabetic rats for 12 weeks followed by glycemic, histopathological, biochemical, and ultrastructural changes measurement. mRNA levels of AMPK, insulin receptor substrate (IRS), phosphoinositide-3-phosphate kinase (PI3K), Akt, and glucose transporter 2 (GLUT2) were measured using real-time polymerase chain reaction. Results: In PHF, the residual toxins were absent. PHF inhibited the α-amylase (IC50 152.2 ± 9.3 μg/mL), and α-glucosidase (IC50 103.0 ± 0.81 μg/mL) activities in-vitro. Further, up to a dose of 2000 mg/kg, PHF showed no signs of mortality. PHF treatment significantly maintained the glycemic state, antioxidant status, lipid profile, hepatic-architecture, and ultrastructural alterations in diabetic rats. Similarly, diabetic rats showed detrimental effects on the mRNA level of AMPK and IRS-PI3K-Akt-GLUT2 signaling which were attenuated by PHF treatment. Immunohistochemical analysis also revealed an improvement in p-Akt expression after PHF treatment. Conclusion: In streptozotocin-induced diabetic rats, PHF improves glucose and lipid metabolism by attenuating hyperglycemia, hyperinsulinemia, dyslipidemia, insulin resistance, oxidative stress, inflammation, and deterioration of hepatic architecture possibly through AMPK mediated improvement in hepatic IRS-PI3K-Akt-GLUT2 signaling pathway. [ABSTRACT FROM AUTHOR]

Background: Majun Brahmi (MB) and Itrifal Muqawwi Dimagh (IMD) are polyherbal Unani formulations traditionally used for the treatment of mild cognitive impairment and memory enhancement. Although they are widely used, there is no particular scientific evidence regarding the toxicity of these medicines. Objective: The present study was undertaken to evaluate the safety of MB and IMD polyherbal Unani formulation. Materials and Methods: Wistar albino rats of both genders were treated with three doses of each drug – MB and IMD, i.e., 513.88, 1027.77, and 2055.54 mg/kg body weight (bwt) orally for 14 days for acute and 90 days for subchronic oral toxicity studies. At the end of the study, bwt gain, hematology, clinical biochemistry, and histopathological examination were performed. Although no significant changes in biochemical parameters occurred at the highest dose, mild damage to the liver, kidney, and spleen was observed. Results: At the lowest dose and at the dose of 1027.77 mg/kg bwt (therapeutic effective dose [TED]) of both the drugs, no abnormalities were observed in the biochemical and hematological parameters as well as histopathological findings. Conclusion: None of the rats exhibited apparent toxicity or mortality. The results of the present study provide evidence that both the formulations are not toxic at the TED dose and hence are clinically safe. [ABSTRACT FROM AUTHOR]

Cardiovascular complications associated with diabetes mellitus remains a leading cause of morbidity and mortality across the world. Diabetic cardiomyopathy is a descriptive pathology that in absence of co-morbidities such as hypertension, dyslipidemia initially characterized by cardiac stiffness, myocardial fibrosis, ventricular hypertrophy, and remodeling. These abnormalities further contribute to diastolic dysfunctions followed by systolic dysfunctions and eventually results in clinical heart failure (HF). The clinical outcomes associated with HF are considerably worse in patients with diabetes. The complexity of the pathogenesis and clinical features of diabetic cardiomyopathy raises serious questions in developing a therapeutic strategy to manage cardio-metabolic abnormalities. Despite extensive research in the past decade the compelling approaches to manage and treat diabetic cardiomyopathy are limited. AMP-Activated Protein Kinase (AMPK), a serine-threonine kinase, often referred to as cellular "metabolic master switch". During the development and progression of diabetic cardiomyopathy, a plethora of evidence demonstrate the beneficial role of AMPK on cardio-metabolic abnormalities including altered substrate utilization, impaired cardiac insulin metabolic signaling, mitochondrial dysfunction and oxidative stress, myocardial inflammation, increased accumulation of advanced glycation end-products, impaired cardiac calcium handling, maladaptive activation of the renin-angiotensin-aldosterone system, endoplasmic reticulum stress, myocardial fibrosis, ventricular hypertrophy, cardiac apoptosis, and impaired autophagy. Therefore, in this review, we have summarized the findings from pre-clinical and clinical studies and provided a collective overview of the pathophysiological mechanism and the regulatory role of AMPK on cardio-metabolic abnormalities during the development of diabetic cardiomyopathy. [ABSTRACT FROM AUTHOR]