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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.
  6,403 170 -
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.
  4,050 721 1
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.
  3,323 416 3
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.
  1,609 1,566 -
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.
  2,173 462 1
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.
  1,742 573 2
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.
  1,868 347 -
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.
  1,582 543 -
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.
  1,856 264 -
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.
  1,659 314 1
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.
  1,681 290 -
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.
  1,671 299 -
ORIGINAL ARTICLES
Mayaro virus infection, the next epidemic wave after Zika? Evolutionary and structural analysis
Eleonora Cella, Marta Giovanetti, Teresa Milano, Marta Fogolari, Francesco Garilli, Ivailo Alexiev, Riccardo Bazzardi, Marco Salemi, Luiz Carlos Junior Alcantara, Silvia Angeletti, Stefano Pascarella, Massimo Ciccozzi
March 2018, 11(3):194-201
DOI:10.4103/1995-7645.228433  
Objective: To evaluate the evolution of the pathogen Mayaro virus, causing Mayaro fever (a mosquito-borne disease) and to perform selective pressure analysis and homology modelling. Methods: Nine different datasets were built, one for each protein (from protein C to non-structural protein 4) and the last one for the complete genome. Selective pressure and homology modelling analyses were applied. Results: Two main clades (A and B) were pointed in the maximum likelihood tree. The clade A included five Brazilian sequences sampled from 1955 to 2015. The Brazilian sequence sampled in 2014 significantly clustered with the Haitian sequence sampled in 2015. The clade B included the remaining 27 sequences sampled in the Central and Southern America from 1957 to 2013. Selective pressure analysis revealed several sites under episodic diversifying selection in envelope surface glycoprotein E1, non-structural protein 1 and non- structural protein 3 with a posterior probability P≤0.01. Homology modelling showed different sites modified by selective pressure and some protein-protein interaction sites at high interaction propensity. Conclusion: Maximum likelihood analysis confirmed the Mayaro virus previous circulation in Haiti and the successful spread to the Caribbean and USA. Selective pressure analysis revealed a strong presence of negatively selected sites, suggesting a probable purging of deleterious polymorphisms in functional genes. Homology model showed the position 31, under selective pressure, located in the edge of the ADP-ribose binding site predicting to possess a high potential of protein-protein interaction and suggesting the possible chance for a protective vaccine, thus preventing Mayaro virus urbanization as with Chikungunya virus.
  1,630 337 1
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.
  1,608 346 -
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.
  1,484 388 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.
  1,485 363 -
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.
  1,397 426 1
Preventive effects of cannabis on neurotoxic and hepatotoxic activities of malathion in rat
Omar M.E. Abdel-Salam, Amany A Sleem, Eman R Youness, Fatma A Morsy
April 2018, 11(4):272-279
DOI:10.4103/1995-7645.231467  
Objective: To investigate the effect of Cannabis sativa extract on the development of neuro- and hepato-toxicity caused by malathion injection in rats. Methods: The extract of Cannabis sativa was obtained from the plant resin by chloroform treatment. Δ-Tetrahydrocannabinol content of the extract (20%) was quantified using gas chromatography–mass spectrometry. The doses of cannabis extract were expressed as Δ -tetrahydrocannabinol content of 10 or 20 mg/kg. Malathion (150 mg/kg) was intraperitoneally administered followed after 30 min by the cannabis extract (10 or 20 mg/kg, subcutaneously). Rats were euthanized 4 h later. Malondialdehyde (MDA), reduced glutathione (GSH), nitric oxide and paraoxonase-1 (PON-1) activity were determined in brain and liver. Brain 5-lipoxygenase and butyrylcholinesterase (BChE) activity were measured as well. Histopathological examination of brain and liver tissue was also performed. Results: Compared to controls, malathion resulted in increased oxidative stress in brain and liver. MDA and nitric oxide concentrations were significantly increased (P<0.05) and GSH significantly decreased with respect to control levels (P<0.05). Malathion also significantly inhibited PON-1 and BChE activities but had no effect on brain 5-lipoxygenase. Brain MDA concentrations were not altered by cannabis treatment. Cannabis at 20 mg/kg, however, caused significant increase in nitric oxide and restored the GSH and PON-1 activity. Brain BChE activity significantly decreased by 26.1% (P<0.05) after treatment with 10 mg/kg cannabis. Cannabis showed no effect on brain 5-lipoxygenase. On the other hand, rats treated with cannabis exhibited significantly higher levels of liver MDA, nitric oxide and PON-1 activity compared with the malathion control group. Rats treated with only malathion exhibited spongiform changes, neuronal damage in the cerebral cortex and degeneration of some Purkinje cells in the cerebellum. There were also hepatic vacuolar degeneration and dilated and congested portal vein. These histopthological changes induced by malathion in brain and liver were reduced to great extent by cannabis administration at 20 mg/kg. Conclusions: Our data suggest that acute treatment with cannabis alleviates the malathion-induced brain and hepatic injury in rats possibly by maintaining the levels of GSH and PON-1 activity.
  1,463 298 -
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.
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REVIEWS
Zoonotic leishmaniasis and control in Ethiopia
Wossenseged Lemma
May 2018, 11(5):313-319
DOI:10.4103/1995-7645.233178  
Visceral leishmaniasis and cutaneous leishmaniasis are important public health problems in Ethiopian lowland and highland areas respectively. Failure of antimonial drugs to respond in some diffused cutaneous leishmaniasis and HIV/AIDS-leishmaniasis co-infected patients, side effects of these drugs, highly mutilating diagnostic procedures and high health care expense are among the problems associated with leishmaniasis. Control of leishmaniasis requires proper understanding of human parasites transmissions (anthroponotic or zoonotic or both). The aim of this review was to elaborate different ecologies of leishmaniasis based on evidences from previous researches and information from literatures obtained from different sources including PubMed to describe zoonotic leishmaniasis in Ethiopia with possible control methods. Although vectors of leishmaniasis in Ethiopia are not endophelic, night indoor visits of Phlebotomus vectors for possible blood meal on human have been indicated. Thus, application of indoor and domestic residual insecticides spraying, use of insecticide impregnated fine mashed bed net for visceral leishmaniasis, community based manipulation (destruction) and residual insecticide fogging of hyrax-sand fly habitats for cutaneous leishmaniasis are the visible vector and reservoir control methods that can be used for control of these diseases in Ethiopia. Use of repellants during night outdoor activities of people in the endemic areas requires further investigations.
  1,365 276 -
ORIGINAL ARTICLES
Antidiabetic effects of galactomannans from Adenanthera pavonina L. in streptozotocin-induced diabetic mice
Icaro Gusmão Pinto Vieira, Francisca Noélia Pereira Mendes, Sabrina César da Silva, Raquel Teixeira Terceiro Paim, Bruno Bezerra da Silva, Stephen Rathinaraj Benjamin, Eridan Orlando Pereira Tramontina Florean, Maria Izabel Florindo Guedes
February 2018, 11(2):116-122
DOI:10.4103/1995-7645.225018  
Objective: To evaluate the antidiabetic effect of galactomannans extracted from Adenanthera pavonina's L. seeds (GAP) in streptozotocin (STZ) induced diabetic mice. Methods: The preliminary galactomannan yield from Adenanthera pavonina L. plant and extraction products composition were evaluated. Various chemical characterization methods like thin layer chromatography, Fourier transform infrared spectroscopy, 1H and 13C nuclear magnetic resonance, and molecular weight by gel permeation chromatography have been employed to characterize the extracted galactomannan. The mice were divided in four groups: Normal control, diabetic control, GAP (1% and 2%) treated and standard drug treated groups. Diabetic mice received treatment daily for 30 d. Diabetes was induced by STZ at a single dose of 120 mg/kg. Body weight, water and food intake, fasting blood glucose, total cholesterol and triglycerides were measured. Histopathological analysis of pancreas and liver were performed to evaluate STZ-induced tissue injuries. Results: The isolated and extracted galactomannan from Adenanthera pavonina was confirmed by various chemical characterization methods. GAP exhibited a 1.46:1 mannose: galactose ratio, and high molar weight. Both GAP enriched food decreased glycaemia, total cholesterol and triacylglycerol. GAP didn't interfere on food intakes or body weight, although it increased water intake. Furthermore, the relative liver weight indicated toxic galactomannan effects on the histopathological changes of the pancreas in STZ induced diabetes. Conclusions: It is concluded that GAP is a natural product that contains potent galactomannan and is useful in preventing and treating diabetes.
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REVIEW ARTICLES
Dietary isoflavones, the modulator of breast carcinogenesis: Current landscape and future perspectives
Javed Iqbal, Banzeer Ahsan Abbasi, Ali Talha Khalil, Barkat Ali, Tariq Mahmood, Sobia Kanwal, Sayed Afzal Shah, Wajid Ali
March 2018, 11(3):186-193
DOI:10.4103/1995-7645.228432  
Breast cancer is a frightful disease and serious concern in women around the world causing significant health care burden in both developed and developing countries. Extensive research work has shown that breast cancer provides strong resistance to chemical agents, UV radiation, and hormonal treatments. It is generally accepted that cell genetics is not the only main reason for breast cancer and genetic risk factors, for example, mutations in BRCA1 and BRCA2 genes constitute 5%-10% of all breast cancer rates. Other related factors include age, gender, race, ethnicity, weight, reproductive factors, exo- and endogenous hormonal exposures, oral contraceptives use, ultraviolet radiation, diet, and night work (circadian disruption). Many studies have revealed that dietary isoflavones regulate breast cancer occurrence, recurrence and prognosis. Dietary isoflavones have long been part of Asian population diet and there is a significant increase as compared to dietary isoflavones intake among other populations. Dietary isoflavones are natural phytoestrogens having both estrogenic and anti-estrogenic potentials on breast cancer cells in culture, animal models and in experimental trials. This literature survey provides a comprehensive overview on the tumor preventive and tumor promoting potentials of dietary isoflavones on breast cancer. In addition, this paper provides a literature review of dietary isoflavones and their effects on up-regulation and down-regulation of different signaling pathways, genes and proteins. Finally, future perspectives of dietary isoflavones and breast cancer researchers are also critically discussed, which will provide a deeper insight regarding the inner molecular mechanisms of action.
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ORIGINAL ARTICLES
Antihyperglycemic effect of Passiflora glandulosa cav. fruit rinds flour in streptozotocin-induced diabetic mice
Erlāndia Alves Magalhaes Queiroz, Raquel Teixeira Terceiro Paim, Sandra Machado Lira, José Ytalo Gomes da Silva, Carla Laíne Silva Lima, Marcelo Oliveira Holanda, Stephen Rathinaraj Benjamin, Ícaro Gusmão Pinto Vieira, Maria Izabel Florindo Guedes
September 2018, 11(9):510-517
DOI:10.4103/1995-7645.242308  
Objective: To investigate the effect of administration of Passiflora glandulosa (P. glandulosa) fruit rinds flour on streptozotocin (STZ)-induced diabetic mice. Methods: The preliminary phytochemical screening and parameters such as centesimal composition and brine shrimp toxicity were evaluated. For in vivo study Swiss female mice were divided into four groups: NC-normal control; DC-diabetic control animals receiving saline; MET-diabetic animals receiving metformin (200 mg/kg); PFRF-diabetic animals receiving P. glandulosa fruit rinds flour (200 mg/kg). All of them were treated for 28 d. STZ was used in a single dose of 120 mg/kg to establish diabetic models. Body weight, water and food intake, fasting blood glucose were measured. Histopathological analysis of pancreas and liver were performed to evaluate STZ-induced tissue injuries. Results: Phytochemical screening showed the presence of flavanones and triterpenoids. The P. glandulosa fruit rinds flour was non-toxic by the brine shrimp test. The fruit rinds flour also reduced the loss of body weight and significantly decreased food intake in the diabetic mice. Additionally, a significant reduction in blood glucose was observed for 15 d and this was maintained on 21 d and 28 d when compared with diabetic mice. Furthermore, the P. glandulosa fruit rinds flour has a favourable effect on the histopathological changes of the pancreas in STZ induced diabetes. Conclusions: It is concluded that P. glandulosa fruit rinds flour is a natural product that contains potent antioxidant compounds and presents good prospects for the improvement of diabetic mellitus by reducing serum glucose levels.
  1,076 411 -
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.
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ORIGINAL ARTICLES
Economic burden and influencing factor analysis of outpatients with epilepsy: A cross-sectional study in Shanghai, Shanxi and Sichuan
Bing-Yu Wang, Yang-Mu Huang, Shi-Chuo Li, Yan Guo
January 2018, 11(1):82-88
DOI:10.4103/1995-7645.223591  
Objective: To better understand the economic burden of patients with epilepsy receiving outpatient services in China and to analyze potential factors influencing epileptic economic burden through a cross-sectional study. Methods: Using a self-designed questionnaire, we collected information retrospectively from 754 patients with epilepsy evaluated in neurology clinics in Shanghai Municipality, Shanxi Province and Sichuan Province. Descriptive analyses were used after cost variables were presented as logarithms, and multiple linear regressions were performed to explore influencing factors. Results: Fifty percent of the investigated patients experienced an epilepsy attack before the age of 15, and 51.3% had suffered from epilepsy for more than five years. In the past year, 87.9% of patients had visited different hospitals multiple times for evaluation (40.3%) and maintenance treatment (40.7%). The total economic burden of epilepsy was US$ 1 143.2. The average direct economic burden and indirect economic burden were US$ 939.0 and US$ 110.2, respectively. Multiple linear regressions showed that patients had to bear greater economic burden if they were hospitalized, using multiple antiepileptic drugs, experiencing illness for less than 5 years, in severe seizure index or active epilepsy with drug resistance, which was statistically significant. Totally only 14.3% of patients could get reimbursement in outpatient services. Conclusions: Patients with epilepsy must present to hospitals regularly for satisfactory prognosis, which results in economic burden. Patients bear greater economic burden, especially direct medical costs, if they are newly diagnosed, experience severe seizures, or undergo multiple drug treatments that require more frequent monitoring. However, current insurance policy for outpatient services do not help reduce economic burden of patients efficiently.
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