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REVIEW ARTICLES
Scenario of dengue infection & its control in Pakistan: An up—date and way forward
Muhammad Zubair Yousaf, Adeena Siddique, Usman Ali Ashfaq, Muhammad Ali
January 2018, 11(1):15-23
DOI:10.4103/1995-7645.223529  
Dengue fever is one of the major health problems in tropical and subtropical areas throughout the world. The causative agent of dengue fever is the dengue virus which is an enveloped single stranded RNA virus belongs to the family Flaviviridae and has five distinct serotypes (DENV-1, DENV-2, DENV-3, DENV-4 and DENV-5). Dengue virus is transmitted to human via bite of Aedes aegypti and Aedes albopictus mosquitoes. The clinical symptoms of dengue fever ranging from mild to severe fonn as dengue hemorrhagic fever and dengue shock syndrome. Pakistan is dengue endemic since 1994 but from 2006, Pakistan faced the worst condition regarding dengue in which thousands of people affected by the disease and hundreds of people lost their lives. DENV-2, DENV-3 and DENV-1 are the prevalent serotypes in Pakistan. Common diagnostic techniques are being used in Pakistan such as enzyme-linked immunosorbent assay, polymerase chain reaction and rapid diagnostic tests, while differential diagnosis, limitations of diagnostic methods and poor health care system are the real challenges in dengue diagnosis. Favorable climatic conditions, unplanned urbanization, travelling etc., are major factors responsible for dengue epidemics in Pakistan. This presentation provides update about dengue circumstances in Pakistan and also describes the way how to improve dengue situation in Pakistan.
  12,386 973 6
ORIGINAL ARTICLES
Effects of some common additives on the antimicrobial activities of alcohol-based hand sanitizers
Nzekwe Ifeanyi Thaddeus, Egbuna Chukwuemeka Francis, Okpara Ogonna Jane, Agubata Chukwuma Obumneme, Esimone Charles Okechukwu
March 2018, 11(3):222-226
DOI:10.4103/1995-7645.228437  
Objective: To study the effects of some common additives on the antimicrobial activities of alcohol-based hand sanitizers. Methods: The antibacterial activities of varying aqueous concentrations of ethanol and isopropyl alcohol were tested by the agar well diffusion method. The influences of different concentrations of glycerin was similarly tested. Finally, isopropyl alcohol and benzalkonium chloride were combined in different ratios within the safe use concentrations of each, and the effects of these combinations were compared with values obtained for the two agents used alone. Statistical methods, such as student t test and one-way ANOVA were used when appropriate to evaluate the differences in activity. Results: The activities of the alcohols showed marked concentration dependence, and both showed peak activity at 85%–95% concentration range. Over the concentration range of 60%–100%, isopropyl alcohol inhibited more bacterial and fungal organisms than ethanol, though the inhibition zone diameters it produced were not statistically different from those of ethanol for organisms which were sensitive to both of them. Addition of glycerin reduced the antimicrobial activities of the isopropyl alcohol, as shown by reduction in the inhibition zone diameters produced in vitro, which may be due to reduced drug diffusion with increase in viscosity. Addition of benzalkonium to isopropyl alcohol systems improved the activity of the alcohol, but the overall activity of the combination was not superior to that seen in the use of benzalkonium alone. Conclusion: Alcohol-based hand sanitizers should not be used outside the concentration range of 85%–95% and isopropyl alcohol inhibits more bacterial and fungal organisms than ethanol for most concentrations. Inclusion of benzalkonium improves the antimicrobial spectrum and activity of isopropyl alcohol, and the combination may justifiably be used to achieve both immediate and long lasting effect. Glycerin may adversely affect the antimicrobial activities of isopropyl alcohol-based hand sanitizers and should be used with caution.
  10,743 771 1
REVIEW ARTICLES
Therapeutic role of Ricinus communis L. and its bioactive compounds in disease prevention and treatment
Waseem Mohammed Abdul, Nahid H Hajrah, Jamal S.M. Sabir, Saleh M Al-Garni, Meshaal J Sabir, Saleh A Kabli, Kulvinder Singh Saini, Roop Singh Bora
March 2018, 11(3):177-185
DOI:10.4103/1995-7645.228431  
Ricinus communis L. (R. communis), commonly known as castor oil plant, is used as a traditional natural remedy or folkloric herb for the control and treatment of a wide range of diseases around the globe. Various studies have revealed the presence of diverse phytochemicals such as alkaloids, flavonoids, terpenes, saponins, phenolic compounds such as kaempferol, gallic acid, ricin, rutin, lupeol, ricinoleic acid, pinene, thujone and gentisic acid. These phytochemicals have been responsible for pharmacological and therapeutic effects, including anticancer, antimicrobial, insecticidal, antioxidant, anti-diabetic, antinociceptive, anti-inflammatory, bone regenerative, analgesic, and anticonvulsant activity. R. communis harbours phytochemicals which have been shown to target peroxisome proliferator activated receptor (PPAR), nuclear factor NF- κ -B, cytochrome p450, P38 mitogen-activated protein kinases kinase (p38 MAPK), tumor protein P53, B-cell lymphoma-extra-large (Bcl-xL) and vascular endothelial growth factor receptor-2 (VEGFR-2). Considering its wide variety of phytochemicals, its pharmacological activity and the subsequent clinical trials, R. communis could be a good candidate for discovering novel complementary drugs. Further experimental and advanced clinical studies are required to explore the pharmaceutical, beneficial therapeutic and safety prospects of R. communis with its phytochemicals as a herbal and complementary medicine for combating various diseases and disorders.
  9,798 1,252 3
ORIGINAL ARTICLES
Retinal displacement after closure of idiopathic macular hole
Zhong-Cui Sun, Min Wang, Jia-Wen Fan, Ge-Zhi Xu
February 2018, 11(2):155-161
DOI:10.4103/1995-7645.225025  
Objective: To study the foveal displacement during the closure of idiopathic macular holes (MHs). Methods: Thirty-seven idiopathic MH patients treated by pars plana vitrectomy and internal limiting membrane peeling were studied prospectively. Locations of MH center and foveal pit were measured by optic coherence tomography. Retinal displacement was observed using confocal scanning laser ophthalmoscopy. Results: A total of 40 eyes were included in this study and MHs were closed in 37 eyes (92.5%). The confocal scanning laser ophthalmoscopy showed that all of the retinal capillaries in the superior, inferior, nasal and temporal sides of the MHs moved toward the optic nerve head (ONH). The optic coherence tomography results showed that the mean nasal displacements of foveal pits were (102.9±61.2), (109.6±53.1), and (137.0±52.0) μm at 3, 6 and 12 months, respectively. And the mean vertical displacements were (55.9±49.4), (61.4±57.8) and (67.8±54.3) μm, respectively. Post-operative foveal pits were located in the nasal side of the MH centers. The extension of retina and nasal to the MH were in opposite directions: the nasal hole margin moved toward the MH, but the retina located closer to the ONH moved toward the ONH. The fellow eyes of three patients developed into idiopathic MH during the follow-up period and operations were performed for all of the three patients. Conclusion: Our results showed that center of macula does not move when an idiopathic MH develops, but it moves toward ONH during closure of hole; thus, new fovea is in nasal side of original fovea.
  7,197 317 -
REVIEW
Herbal remedies, vaccines and drugs for dengue fever: Emerging prevention and treatment strategies
Rinku Rozera, Surajpal Verma, Ravi Kumar, Anzarul Haque, Anshul Attri
April 2019, 12(4):147-152
DOI:10.4103/1995-7645.257113  
Dengue fever is a disease that is caused by five dengue virus (DENV) serotypes. It is endemic in more than 128 countries. Millions of people are affected by this disease. But still, there is no specific treatment available till now to combat it. Some of the preventive measures using plant extracts showed certain promising ovicidal activity against Aedes aegypti. There are some vaccines as preventive measure and antiviral agents to cure the dengue fever, which are under clinical trials but their results have not been reported or approved yet. Dengvaxia is the only licensed vaccine to prevent dengue fever in some South American countries, but it is not approved by other regulatory authorities worldwide. Scientific research has been going on to find a permanent cure for dengue fever, but till now, no successful invention has been done. There are some general treatments for dengue patient by employing analgesics and fluid replacement; however, specific treatment is needed to overcome the lethal effect of dengue fever. Since this disease has affected millions of people and not much invention has been made in this field; therefore, advancement in dengue therapy is required for the safety and well-being of dengue patients. Herein we collectively describe the different chemotherapeutics agents, alternative methods like vaccines and antiviral agents to prevent and cure this lethal disease. Furthermore, the future perspective for the treatment of dengue is discussed in this review.
  6,381 728 -
REVIEW ARTICLE
Brucellosis: Pathophysiology and new promising treatments with medicinal plants and natural antioxidants
Mohsen Alizadeh, Ali Safarzadeh, Mahmoud Bahmani, Fatemeh Beyranvand, Mehdi Mohammadi, Kimia Azarbaijani, Mahmoud Rafieian-Kopaei, Saber Abbaszadeh
November 2018, 11(11):597-608
DOI:10.4103/1995-7645.246336  
Brucellosis is an old, infectious and common zoonosis whose causative agents are Gramnegative bacteria from the Brucella genus. Brucellosis is transmitted through direct contact with infected animals or using unpasteurized dairy products of goats, pigs, camels, sheep, buffalo and cows. Brucellosis is still the most common zoonosis in the world, with most of cases occurring in developing countries. Today, an approach to traditional medicine and medicinal plants, especially with regards to the repeated recommendations of the World Health Organization, is a necessity. One-third of chemical drugs are produced by using plants and there is a high potential to produce more drugs from plants. Medicinal plants are helpful in the management of various conditions, especially bacterial diseases. Although there is not enough scientific evidence regarding the clinical effectiveness of herbal drugs for the treatment of brucellosis, there is strong evidence on the antimicrobial effects of herbal drugs to prevent infection. Therefore, this article seeks to describe the antibacterial effects of some plant-derived essential oils or extracts, so that they can serve as promising choices to develop new anti-Brucella medications, as suitable alternatives to conventional antibiotics for brucellosis, as much as possible, taking into account the benefits of these herbal drugs.
  6,150 557 1
REVIEW ARTICLES
Biological, chemical and pharmacological aspects of Madhuca longifolia
Dhruv Jha, Papiya Mitra Mazumder
January 2018, 11(1):9-14
DOI:10.4103/1995-7645.223528  
Madhuca longifolia (M. longifolia) is also known as Mahua belonging to the family sapoteace family. M. longifolia is used in traditional and folklore system of medicine widely across India, Nepal, and Sri Lanka for its various pharmacological properties as in snake bites and in diabetes. Phytochemicals studies documented the different bioactive constituents, namely, glycosides, flavonoids, terpenes and saponins. The pharmacological studies proved that it possess wide range of biological activities such as antiulcer, antiinflammatory, antioxidant and antidiabetic activities. The toxicity studies reveal its non-toxic effect even at larger doses. Thus M. longifolia can be considered as a therapeutic agent for specific diseases. Scientific investigation on various isolated bioactive components and its efficacy on diseases proved the future usefulness of different species of Madhuca. This review summarizes the phytochemical, pharmacological, medicinal and non-medicinal uses of M. longifolia. Further exploration on M. longifolia for its therapeutic potential is however required for depth traditional knowledge.
  5,077 833 1
ORIGINAL ARTICLES
Plants used in traditional medicine for treatment of malaria by Tetun ethnic people in West Timor Indonesia
Maximus M Taek, Bambang EW Prajogo, Mangestuti Agil
November 2018, 11(11):630-637
DOI:10.4103/1995-7645.246339  
Objective: To document the medicinal plants used for the treatment of malaria by the Tetun ethnic people in West Timor–Indonesia. Methods: The ethnobotany and anthropology methods were used in the field surveys. Ninety four informants from 29 villages of 15 sub-districts in Belu and Malaka were interviewed since April to December 2017. Medicinal plants specimen were collected from the field and identified according to taxonomic methods. Results: Ninety six medicinal plants species belong to 41 families were found to be used by the Tetun ethnic people in their traditional medicine for the treatment of malaria. These plants have been used in various formulas for drinking, massage, bath, inhalation or cataplasm. Strychnos ligustrina, Calotropis gigantea, Cleome rutidosperma, Physalis angulata, Alstonia spectabilis, Carica papaya, Melia azedarach, Alstonia scholaris, Jatropha curcas, Garuga floribunda, and Tamarindus indica were the most cited plants. Conclusions: The documented plants are valuable sources for the future development of new drugs and strategies to support malaria eliminating programs that are culturally acceptable in these areas.
  4,814 484 2
REVIEW ARTICLE
A critical review on Nepal Dock (Rumex nepalensis): A tropical herb with immense medicinal importance
Samrin Shaikh, Varsha Shriram, Amrita Srivastav, Pranoti Barve, Vinay Kumar
July 2018, 11(7):405-414
DOI:10.4103/1995-7645.237184  
Rumex nepalensis Spreng. (Polygonaceae) commonly known as Nepal Dock has wide-spectrum therapeutic potencies and is extensively used for centuries in traditional medicine systems. The leaves of this plant are edible and a rich source of natural antioxidants. They act as a possible food supplement and are largely used in pharmaceutical industry. Extracts and metabolites from this plant exhibits pharmacological activities including anti-inflammatory, antioxidant, antibacterial, antifungal, antiviral, insecticidal, purgative, analgesic, antipyretic, anti-algal, central nervous system depressant, genotoxic, wound healing and skeletal muscle relaxant activity. Due to its remarkable biological activities, it has the potential to act as a rich source of drug against life threatening diseases. However, more studies are needed to scientifically validate the traditional uses of this plant, beside isolating and identifying their active principles and characterizing the mechanisms of action. We present herein a critical account of its botany, ecology, traditional uses, phytoconstituent profile and major pharmacological activities reported in recent years and therefore will provide a source of information on this plant for further studies.
  4,648 493 -
ORIGINAL ARTICLES
Knowledge and attitude toward COVID-19 among healthcare workers at District 2 Hospital, Ho Chi Minh City
Giao Huynh, Thi Ngoc Han Nguyen, Van Khanh Tran, Kim Ngan Vo, Van Tam Vo, Le An Pham
June 2020, 13(6):260-265
DOI:10.4103/1995-7645.280396  
Objective: To assess the knowledge and attitude toward coronavirus disease-2019 (COVID-19) among healthcare workers at District 2 Hospital in Ho Chi Minh City (HCMC). Methods: A cross-sectional study was performed between January 2020 and February 2020 at District 2 Hospital. A systematic random sampling strategy was carried out and the data was collected through a self-administered questionnaire of the knowledge and attitude of healthcare workers regarding COVID-19. Descriptive analysis was reported to describe the demographic, mean knowledge and attitude score of healthcare workers. Inferential statistics including t-test, ANOVA and Spearman’s correlation were used to evaluate the relationship between study variables. Results: A total of 327 eligible healthcare workers had a mean score of knowledge and attitude of 8.17±1.3 (range 4-10) and 1.86±0.43 (range 1-5), respectively. They showed good knowledge and a positive attitude. However, approximately two thirds of the participants knew the mode of transmission, the isolation period and treatment (67.0%, 65.8%, and 58.4%, respectively), and 82.3% and 79.8%, respectively, held positive attitude regarding the risk of personal and family members getting illness. There was a negative correlation between knowledge scores and attitude scores (r=-0.21, P<0.001). Additionally, healthcare workerspredominately used social media to inform themselves about COVID-19 (91.1%). Conclusions: The majority of healthcare workers had good knowledge and positive attitude toward COVID-19. However, the level of some knowledge and attitude lower than that expected for their position level towards the virus. Additional education interventions and campaigns are required for healthcare workers.
  4,097 693 -
REVIEW
Traditional medicines and their in-vitro proof against Staphylococcus aureus in Pakistan
Muhammad Adnan, Akash Tariq, Roqaia Bibi, Sakina Mussarat, Bibi Fatima, Nawab Ali, Hazir Rahman, Zabta Khan Shinwari
June 2018, 11(6):355-368
DOI:10.4103/1995-7645.234763  
Objective: To gather the fragmented literature on ethnobotany, phytochemistry and in-vitro activities of medicinal plants of Pakistan being used against common infections caused by Staphylococcus aureus (S. aureus). Methods: A large number of published and unpublished research studies related to the ethnomedicinal, phytochemical and anti-S. aureus activity of medicinal flora of Pakistan published from 1990-2018 were reviewed using online bibliographic databases such as PubMed, Web of Science, Science Direct, ResearchGate and libraries. Results: S. aureus can cause many human ailments including endocarditis, staphylococcal scalded skin syndrome, septic arthritis, respiratory problems with an estimated infection rate of 25%-35% across the globe. This review comprised of 86 medicinal plants. Data showed that people mostly used leaves (50%) for the preparation of traditional medicines. Correlation analysis on the reviewed data revealed that methanolic extract concentrations of medicinal plants was highly significantly positive correlated (r=0.8; P<0.01) with the S. aureus zone of inhibitions. S. aureus reportedly showed complete resistant to the commonly used antibiotic erythromycin. Isolated compounds like altheahexacosanyl lactone, cinnamaldehyde, niloticane, gobicusin A, asparacosin A, muzanzagenin, isoagatharesinol, friedelin, inophynone and eugenol were active against S. aureus. This study provided in-vitro proof for the flora of Pakistan used against different infections caused by S. aureus. Conclusions: Antibacterial agents from natural sources could be more effective against bacterial pathogens and will be helpful in minimizing the adverse effects of synthetic drugs, and hence provides a base for the pharmaceutical industries.
  3,928 756 -
ORIGINAL ARTICLES
Protective effect of Ocimum sanctum Linn. leaf extract on ethanol withdrawal syndrome in Wistar rats
Lalit Sharma, Aditi Sharma, GL Gupta, Gopal Singh Bisht
August 2018, 11(8):467-472
DOI:10.4103/1995-7645.240082  
Objective: To evaluate the effects of Oscimum sanctum L (O. sanctum), an important medicinal herb, on alcohol withdrawal syndrome in Wistar rats. Methods: Liquid diet with 7.2%, v/v ethanol was administered to the rats for 21 d. Control group animals received sucrose as an isocaloric liquid diet. After alcohol withdrawal, rats were examined at 6th and 24th hour for major withdrawal signs that included anxiety and hyper locomotor activity. Ethanol withdrawal anxiety was tested using elevated plus maze, light and dark model; the hyper locomotor activity using actophotometer. O. sanctum leaf extract (100, 200 and 300 mg/kg, oral) and diazepam (2 mg/kg, i.p) were administered to the treatment group animals 30 min before alcohol withdrawal estimation. Drug treatment was also given 30 min before the second observation at 24th hour. On the last day of the protocol, rats were sacrificed by cervical dislocation liver, kidney and brain were isolated and preserved in formalin for further histopathological examination. Results: Findings from the present study revealed that O. Sanctum leaf extract treatment at doses 100, 200 and 300 mg/kg, oral had a significant protective effect on signs and symptoms of ethanol withdrawal in alcohol-dependent rats. However, no remarkable pathological and microscopic alterations were observed in histopathological examination. Conclusions:O. sanctum seems to be an active drug for the treatment of alcohol abstinence syndrome.
  2,807 1,758 2
Phytochemical analysis and antioxidant profile of methanolic extract of seed, pulp and peel of Baccaurea ramiflora Lour.
Md Sahab Uddin, Md Sarwar Hossain, Abdullah Al Mamun, Devesh Tewari, Md Asaduzzaman, Md Siddiqul Islam, Mohamed M Abdel-Daim
July 2018, 11(7):443-450
DOI:10.4103/1995-7645.237189  
Objective: To analyze the phytochemical constituents responsible for the plausible antioxidant effect of methanolic extract of the seed, pulp and peel of Baccaurea ramiflora Lour. Methods: Fresh seed, pulp, and peel of Baccaurea ramiflora fruits were extracted with methanol (MEBRse, MEBRpu, MEBRpe) and evaluated by phytochemical analysis for their content of innumerable metabolites (primary and secondary) viz. carbohydrates, alkaloids, glycosides, tannins, phenols, terpenoids, flavonoids, proteins, and fixed oils. The antioxidant efficacy was assessed through different assay methods viz. 2,2-diphenyl-1-picrylhydrazyl (DPPH) free radical scavenging activity, total antioxidant capacity (TAC) and reducing power capacity (RPC). Estimation of total phenolic content (TPC), and total flavonoid content (TFC) was also done to confirm the presence of these phytochemicals. Results: It was revealed from the phytochemical analysis of MEBRse that alkaloids, glycosides, carbohydrates, phenols, and flavonoids were present, while that of MEBRpu showed the existence of carbohydrates, proteins, alkaloids, glycosides, phenols, saponins, flavonoids, and fixed oils. Presence of carbohydrates, alkaloids, phenols, tannins, flavonoids, and terpenoids were found in the MEBRpe. A significant antioxidant activity was revealed by the MEBRpu [EC50: (27.612 ± 1.375) μg/mL], compared to MEBRpe, and MEBRse in DPPH assay. The ranking order for RPC was MEBRpu > MEBRpe > MEBRse respectively. The EC50 value of TAC of the MEBRpu, MEBRpe, and MEBRse were (25.107 ± 0.744) μg/mL, (241.127 ± 7.463) μg/mL and (372.364 ± 11.030) μg/mL, respectively. Quantity of TPC and TFC were the highest in the MEBRpu (124.360 ± 2.078 mg GAE/g and 107.527 ±1.900 mg QRE/g extract) rather than MEBRpe and MEBRse extracts. Conclusions: This study suggests that MEBRpu has a significantly higher antioxidant property than MEBRpe and MEBRse. These extracts might be advantageous in prevention or decelerating the progress of different diseases related to oxidative-stress/damage. Moreover, detailed analysis of these extracts is required to identify the presence of promising compound(s) responsible for their antioxidant activity.
  3,847 680 -
REVIEW ARTICLE
Acute kidney injury in leptospirosis: Overview and perspectives
Geraldo Bezerra da Silva Junior, Nattachai Srisawat, Gabriela Studart Galdino, Ênio Simas Macedo, José Reginaldo Pinto, Geysa Maria Nogueira Farias, Renan Lima Alencar, Roberto da Justa Pires Neto, Elvino José Guardão Barros, Elizabeth De Francesco Daher
October 2018, 11(10):549-554
DOI:10.4103/1995-7645.244514  
Leptospirosis is a bacterial disease disseminated through the centuries in the whole world which causes symptoms that go from self-limited diseases to hemorrhagic manifestations and organ failure, including acute kidney injury (AKI), composing the severe disease known as the Weil's syndrome. Mortality rates varies according to the clinical presentation and usually increases when kidney injury is present, and is even higher in the setting of pulmonary hemorrhage. There are recent advances in the search for novel biomarkers of renal involvement and early detection of AKI in leptospirosis, as well as in its pathophysiology. We review in this article the clinical aspects of leptospirosis-associated AKI and the perspectives for future research.
  3,804 636 2
ORIGINAL ARTICLES
Modeling and predicting dengue fever cases in key regions of the Philippines using remote sensing data
Maria Ruth B. Pineda-Cortel, Benjie M Clemente, Pham Thi Thanh Nga
February 2019, 12(2):60-66
DOI:10.4103/1995-7645.250838  
Objective: To correlate climatic and environmental factors such as land surface temperature, rainfall, humidity and normalized difference vegetation index with the incidence of dengue to develop prediction models for the Philippines using remote-sensing data. Methods: Time-series analysis was performed using dengue cases in four regions of the Philippines and monthly climatic variables extracted from Global Satellite Mapping of Precipitation for rainfall, and MODIS for the land surface temperature and normalized difference vegetation index from 2008-2015. Consistent dataset during the period of study was utilized in Autoregressive Integrated Moving Average models to predict dengue incidence in the four regions being studied. Results: The best-fitting models were selected to characterize the relationship between dengue incidence and climate variables. The predicted cases of dengue for January to December 2015 period fitted well with the actual dengue cases of the same timeframe. It also showed significantly good linear regression with a square of correlation of 0.869 5 for the four regions combined. Conclusion: Climatic and environmental variables are positively associated with dengue incidence and suit best as predictor factors using Autoregressive Integrated Moving Average models. This finding could be a meaningful tool in developing an early warning model based on weather forecasts to deliver effective public health prevention and mitigation programs.
  3,723 695 2
REVIEW ARTICLES
Visceral leishmaniasis: An immunological viewpoint on asymptomatic infections and post kala azar dermal leishmaniasis
Neeraj Tiwari, Dhiraj Kishore, Surabhi Bajpai, Rakesh K Singh
February 2018, 11(2):98-108
DOI:10.4103/1995-7645.225016  
Elimination of visceral leishmaniasis is a priority programme in Indian subcontinent. The World Health Organization has set a new target to eliminate kala-azar by the year 2020 as previous target elimination year (2015) has passed. The elimination programme has successfully curbed the rate of infection in endemic regions; however, there are still few challenges in its route. The current drug control regime is extremely limited and comprises only two (amphotericin B and miltefosine) drugs, which are also susceptible for parasites resistance. Moreover, these drugs do not produce sterile cure, and cured patients may develop post kala-azar dermal leishmaniasis even after a decade of cure leaving behind a potent source of parasitic reservoirs for further disease transmission. A significant proportion of endemic population remain seropositive but aymptomatic for many years without any clinical symptom that serve as latent parasitic reservoirs. The lack of tools to identify live parasites in asymptomatic infections and there association in disease transmission, parameters of sterile cure along with post kala-azar dermal leishmaniasis progression remain a major threat in its elimination. In this review, we discuss the potential of host immune inhibitory mechanisms to identify immune correlates of protective immunity to understand the mystery of asymptomatic infections, sterile cure and post kala azar dermal leishmaniasis.
  3,819 425 -
ORIGINAL ARTICLES
Evaluation of antiparasitic, anticancer, antimicrobial and hypoglycemic properties of organic extracts from Panamanian mangrove plants
Dioxelis Lopez, Lilia Cherigo, Alejandro de Sedas, Carmenza Spadafora, Sergio Martinez-Luis
January 2018, 11(1):32-39
DOI:10.4103/1995-7645.223531  
Objective: To investigate 33 organic extracts of mangrove plants for: antiparasitic, anticancer, and antibacterial activities, as well as their ability to inhibit the activity of the α-glucosidase enzyme. Methods: Leaves from all different plant mangrove species located in five mangrove zones of the Pacific coast of Panama were collected according to standard procedures. Qualitative phytochemical analysis of the organic extracts was performed by thin layer chromatography. The antiparasitic activity against Plasmodium falciparum, Trypanosoma cruzi and Leishmania donovani, toxicity against Artemia salina, anticancer activity in MCF-7 cell line, and antibacterial activity against Staphylococcus aureus, Bacillus subtilis, Escherichia coli and Pseudomonas aeruginosa of all organic extract were investigated according protocols stablished in our institution. Finally, the ability to inhibit the enzymatic activity of α-glucosidase was evaluated by monitoring the hydrolysis of p-nitrophenyl α-D- glucopyranoside. Results: Thirty-three different samples belonging to nine different species of vascular plants with seeds of true mangroves were collected. Triterpenoids, phenolics, and tannins were the main groups of compounds found in the sampled mangroves. Saponins, quinones, and coumarins were found in less than 50% of the samples. Laguncularia racemosa showed moderate activity against Plasmodium falciparum. None of the extracts presented anticancer activity. Rhizophora mangle exhibited potent activity against Staphylococcus aureus and Bacillus subtilis [(90.41±7.33)% and (96.02±6.14)% of inhibition]; Avicennia germinans and Conocarpus erectus had activity against Escherichia coli [(71.17±6.15)% and (60.60±5.13)% of inhibition, respectively]. About 60% of the mangroves showed α-glucosidase inhibitory activity. In particular, extracts from Laguncularia racemosa, Pelliciera rhizophorae, Conocarpus erectus, Mora oleifera, and Tabebuia palustris species showed α-glucosidase inhibitory potential, with IC50 values of (29.45±0.29), (20.60±0.70), (730.06±3.74), (25.59±0.37), and (853.39±5.30) μg/mL, respectively. Conclusions: Panamanian mangroves are mainly a promising potential source of hypoglycemic compounds, specifically α-glucosidase inhibitors. These results highlight the therapeutic virtues of extracts from American mangrove plants.
  3,404 835 3
REVIEW ARTICLES
An updated systematic review of Zika virus-linked complications
Braira Wahid, Amjad Ali, Muhammad Waqar, Muhammad Idrees
January 2018, 11(1):1-8
DOI:10.4103/1995-7645.223527  
Objective: To determine the breadth of Zika virus (ZIKV)-associated brain anomalies in neonates and adults. Methods: Systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement using electronic databases ScienceDirect, Pubmed, Medline, Scopus, and Global Health Library. Only those research articles, case studies, case-control studies, case-cohort studies, cross-sectional studies, and organizational survey reports were included in the study that reported any fetal outcomes for pregnant women who had infected with ZIKV during the gestational period and ZIKV-related neurological complications in adults as well. Results: Out of total 72 retrieved articles, 50 met the inclusion criteria. We estimated a significant increase in incidence of neural abnormalities such as Guillain-Barre syndrome and microcephaly in the regions that are experiencing ZIKV outbreaks. Other neurological malformations found in ZIKV patients include hydrancephaly/hydrops fetalis, myasthenia gravis, meningoencephalitis and myelitis. Conclusion: Our systematic analysis provides the broad spectrum of neurological malformations in ZIKV infected patients and these data further support the causal link of ZIKV with neurological disorders.
  3,579 542 1
ORIGINAL ARTICLES
Inhibitory activities of extracts of Rumex dentatus, Commelina benghalensis, Ajuga bracteosa, Ziziphus mauritiana as well as their compounds of gallic acid and emodin against dengue virus
Riffat Batool, Ejaz Aziz, Tariq Mahmood, Benny KH Tan, Vincent TK Chow
April 2018, 11(4):265-271
DOI:10.4103/1995-7645.231466  
Objective: To investigate the inhibitory effects against dengue virus serotype 2 (DENV-2) by five different fractions (extracted by methanol, ethanol, benzene, chloroform and n-hexane) of Rumex dentatus, Commelina benghalensis, Ajuga bracteosa and Ziziphus mauritiana, as well as their constituents (gallic acid, emodin, and isovanillic acid). Methods: All the samples were tested for cytotoxicity on baby hamster kidney cells by MTT assay and for anti-DENV-2 activity by plaque reduction neutralization assay using two DENV-2 doses (45 and 90 plaque- forming units or PFU). Results: All the samples except isovanillic acid exhibited significant prophylactic effects against DENV-2 infectivity (without cytotoxicity) when administered to cells before infection, but were not effective when given 6 h post-infection. The methanol extract of Rumex dentatus demonstrated the highest antiviral efficacy by inhibiting DENV-2 replication, with IC50 of 0.154 μg/mL and 0.234 μg/mL, when added before infection with 45 and 90 PFU of virus, respectively. Gallic acid also exhibited significant antiviral effects by prophylactic treatment prior to virus adsorption on cells, with IC50 of 0.191 μg/mL and 0.522μg/ mL at 45 and 90 PFU of DENV-2 infection, respectively. Conclusions: The highly potent activities of the extracts and constituent compounds of these plants against DENV-2 infectivity highlight their potential as targets for further research to identify novel antiviral agents against dengue.
  3,528 553 -
REVIEW ARTICLE
Salacca zalacca: A short review of the palm botany, pharmacological uses and phytochemistry
Mohammed S. M. Saleh, Mohammad Jamshed Siddiqui, Ahmed Mediani, Nor Hadiani Ismail, Qamar Uddin Ahmed, Siti Zaiton Mat So'ad, Salima Saidi-Besbes
December 2018, 11(12):645-652
DOI:10.4103/1995-7645.248321  
Salacca zalacca (Gaertn.) Voss (family Arecaceae) is the snake fruit commonly known in Malay language as salak in Malaysia. This exotic fruit has diverse and potential pharmacological properties due to its high antioxidant content. It is often consumed due to its sweet taste. The abundant natural sugar and fibre along with minerals and vitamin makes it a nutritious fruit. Phytochemical investigation on this fruit has revealed the presence of flavonoids, phenolics, glycosides as well as some volatile and aromatic compounds, including gallic acid, quercetin, chlorogenic acid, epicatechin, proanthocyanidins, lycopene and β-carotene. Pharmacological studies on the fruit flesh and peel have shown some tremendous antioxidant, anti-inflammatory, anticancer and antidiabetic potential. This review provides the botanical information of Salacca zalacca as well as its scientific investigations involving the distinct pharmacological and phytochemical benefits. This could help in highlighting the lacking data and research gaps on this plant.
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ORIGINAL ARTICLES
Andrographolide inhibits chikungunya virus infection by up-regulating host innate immune pathways
Swati Gupta, Kamla Prasad Mishra, Paban Kumar Dash, Manmohan Parida, Lilly Ganju, Shashi Bala Singh
March 2018, 11(3):214-221
DOI:10.4103/1995-7645.228436  
Objective: To investigate the therapeutic efficacy of andrographolide, a plant derived compound, against chikungunya virus (CHIKV) infection. Methods: Using flow cytometry and immunoblotting assay, in vitro viral protein expression was studied in THP-1 cells line. In Balb/c mouse neonates, viral RNA copy number was determined by real time PCR. Results: The results showed reduced CHIKV protein expression on andrographolide treatment in CHIKV-infected human peripheral blood mononuclear cells, Vero cells and THP-1 cell line. In vivo, andrographolide treatment to CHIKV-infected neonates reduced viral RNA copy number. Further, andrographolide also increased cytotoxic T lymphocytes both in vitro and in vivo. Andrographolide also activated host innate immune pathways, viz., protein kinase R, phosphorylated eukaryotic initiation factor 2α , retinoic acid inducible gene-I and interferon regulatory factor 3/7, thereby increasing IFN- α secretion. CHIKV-induced nuclear factor κ light chain enhancer of activated B cells and tumor necrosis factor- α was also reduced on andrographolide treatment. Conclusion: Andrographolide inhibits CHIKV by suppressing viral protein expression and up-regulating host innate immunity and hence could be an effective therapeutic agent against CHIKV infection.
  3,695 250 -
REVIEW ARTICLES
Emerging and re-emerging human infectious diseases: A systematic review of the role of wild animals with a focus on public health impact
Marli C Cupertino, Michely B Resende, Nicholas AJ Mayer, Lorendane M Carvalho, Rodrigo Siqueira-Batista
March 2020, 13(3):99-106
DOI:10.4103/1995-7645.277535  
Infectious diseases continue to impose unpredictable burdens on global health and economies, a subject that requires constant research and updates. In this sense, the objective of the present article was to review studies on the role of wild animals as reservoirs and/or dispersers of etiological agents of human infectious diseases in order to compile data on the main wild animals and etiological agents involved in zoonotic outbreaks. A systematic review was carried out using PRISMA guidelines, using the PubMed, Scopus and SciELO platforms as data banks. The descriptors used were “zoonosis”, “human infectious diseases” and “wild animals”. The results show that wild animals (mainly bats, birds and primates) play an important role in the dissemination of etiological agents (mainly viruses, as a new coronavirus called 2019 Novel Coronavirus) in extensive geographic regions. Moreover, these wild animal organisms can act as the site for essential biotic synergy among several pathogenic microorganisms, promoting a higher rate of adaptation, mutation and even genetic recombination, with consequent stimulation of new strains and subtypes, inducing new infectious agents with unknown virulent potential. In conclusion, the monitoring of these diseases and adequate preparation for possible epidemics and pandemics are fundamental conditions for the mitigation of their future impact. The zoonotic threat of these etiological agents and the impact on public health can be enormous as shown by the ongoing epidemic of 2019 novel coronavirus (2019- nCoV) infections.
  3,034 755 4
ORIGINAL ARTICLES
Antimicrobial activity of kojic acid from endophytic fungus Colletotrichum gloeosporioides isolated from Sonneratia apetala, a mangrove plant of the Sundarbans
Tauhidur Rahman Nurunnabi, Shaymaa Al-Majmaie, Ismini Nakouti, Lutfun Nahar, S. M. Mahbubur Rahman, Md. Hossain Sohrab, Md. Morsaline Billah, Fyaz M. D. Ismail, George P Sharples, Satyajit D Sarker
May 2018, 11(5):350-354
DOI:10.4103/1995-7645.233183  
Objective: To isolate and evaluate the antimicrobial activity of the active principle(s) from the ethyl acetate (EtOAc) extract of endophytic fungus Colletotrichum gloeosporioides (C. gloeosporioides) isolated from Sonneratia apetala. Methods: Water agar technique was used to isolate the fungus, and both microscopic and molecular techniques were used for identification of the strain. Potato dextrose broth was used to grow the fungus in large-scale. Reversed-phase preparative HPLC analysis was performed to isolate the major active compound, kojic acid. The EtOAc extract and kojic acid were screened for their antimicrobial activity against two Gram-positive and two Gram-negative bacteria as well as a fungal strain using the resazurin 96-well microtitre plate antimicrobial assay. Results: The fungus C. gloeosporioides was isolated from the leaves of Sonneratia apetala. Initial identification of the fugal isolate was carried out using spore characteristics observed under the microscope. Subsequently, the ITS1-5.8S-ITS2 sequencing was employed for species-level identification of the fungus C. gloeosporioides. Five litres of liquid culture of the fungus produced approximately 610 mg of a mixture of secondary metabolites. Kojic acid (1) was isolated as the main secondary metabolite present in the fungal extract, and the structure was confirmed by 1D, 2D NMR and mass spectrometry. The EtOAc extract and compound 1 exhibited considerable antimicrobial activity against all tested microorganisms. Whilst the minimum inhibitory concentration (MIC) values from the EtOAc extract ranged between 2.4× 10-4 mg/mL and 2.5 mg/mL, those of kojic acid (1) were between 0.125 mg/mL and 1 mg/mL. The EtOAc extract and kojic acid (1) were most active against Pseudomonas aeruginosa (MIC = 2.4×10-4 mg/mL) and Micrococcus luteus (MIC = 0.125 mg/mL), respectively. Conclusions: The results revealed that the endophytic fungus C. gloeosporioides could be a good source of commercially important kojic acid, which exhibited antimicrobial properties.
  3,257 499 1
REVIEW ARTICLES
Exploring dynamic biomedical algorithm of Eurycoma longifolia Jack and its bioactive phytochemicals: A review of pharmacokinetic and pharmacodynamic implications and future prospects
Hnin Ei Thu, Zahid Hussain, Isa Naina Mohamed, Ahmad Nazrun Shuid
February 2018, 11(2):89-97
DOI:10.4103/1995-7645.225015  
Eurycoma longifolia Jack (E. longifolia) is a well-recognized traditional herbal medicine that offers a wide dynamic range of biomedical applications including anti-osteoporotic, anticancer, anti-proliferative, anti-malarial, antimicrobial, antioxidant, aphrodisiac, anti-inflammatory, anxiolytic, anti-diabetic, anti-rheumatism and anti-ulcer properties. This review aims to overview the pharmacokinetic and a pharmacodynamic algorithm of E. longifolia and its bioactive components. Analysis of pharmacokinetic profile revealed that E. longifolia exhibit higher bioavailability, high volume of distribution, slow elimination rate, and does not show inhibitory effects on cytochrome P450 isoenzymes. E. longifolia has been used, alone or in combination with other pharmacological agents, in the form of crude extracts, standard extracts, or decoctions of different plant parts (i.e., herbs, shrubs, stem, leaves, and roots) for the treatment of various ailments in animals and humans. Among various bioactive constituents, eurycomanone has been found to be the most remarkable, super-stable, versatile, and most potent phytochemical (isolated or extracted from root extracts) against various types of animals and human diseases. Based on its well-established pharmacokinetic and pharmacodynamic profiles, we suggested that E. longifolia can be a well-accepted complementary and alternative medicine for the treatment of different types of human ailments.
  3,178 565 4
REVIEW ARTICLE
Potential applications of lactic acid bacteria and bacteriocins in anti-mycobacterial therapy
Anbarasu Sivaraj, Revathy Sundar, Radhakrishnan Manikkam, Krupakar Parthasarathy, Uma Rani, Vanaja Kumar
August 2018, 11(8):453-459
DOI:10.4103/1995-7645.240080  
Tuberculosis (TB) is a communicable disease caused by Mycobacterium tuberculosis (M. tuberculosis). WHO estimated that 10.4 million new (incident) TB cases worldwide in year 2016. The increased prevalence of drug resistant strains and side effects associated with the current anti-tubercular drugs make the treatment options more complicated. Hence, there are necessities to identify new drug candidates to fight against various sub-populations of M. tuberculosis with less or no toxicity/side effects and shorter treatment duration. Bacteriocins produced by lactic acid bacteria (LAB) attract attention of researchers because of its “Generally recognized as safe” status. LAB and its bacteriocins possess an effective antimicrobial activity against various bacteria and fungi. Interestingly bacteriocins such as nisin and lacticin 3147 have shown antimycobacterial activity in vitro. As probiotics, LAB plays a vital role in promoting various health benefits including ability to modulate immune response against various infectious diseases. LAB and its metabolic products activate immune system and thereby limiting the M. tuberculosis pathogenesis. The protein and peptide engineering techniques paved the ways to obtain hybrid bacteriocin derivatives from the known peptide sequence of existing bacteriocin. In this review, we focus on the antimycobacterial property and immunomodulatory role of LAB and its metabolic products. Techniques for large scale synthesis of potential bacteriocin with multifunctional activity and enhanced stability are also discussed.
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