Appetite-inducing effect and safety evaluation of Habb-e-Hilteet in patients with Ḍu‘f al-Ishtihā (anorexia): An open prospective clinical trial

Objectives: Anorexia is one among the most prevalent conditions triggering malnutrition, drastic weight loss and serious health issues in people especially older adults. Habb-e-Hilteet is commonly prescribed Unani pharmacopoeial formulation for anorexia. However, no scientific data is available as to its safety and efficacy. The current study assessed the appetite-inducing effect and safety of Habb-e-Hilteet in Ḍu‘f al-Ishtihā (anorexia) patients. Methods: An open prospective clinical trial was carried out in 95 clinically diagnosed anorexia patients of either gender (19-65 yrs old). The study was approved by Institutional ethic committee and conducted in accordance with the GCP guidelines. Habb-e-Hilteet, 1 pill (500mg) was administered orally in patients twice daily for 14 days. The safety of the formulation was assessed by important pathological and biochemical indices and monitoring adverse events. The efficacy was assessed on the basis of improvement in the Simplified Nutritional Appetite Questionnaire (SNAQ) score. Results: Out of 95 patients recruited, 78 completed the trial and 17 patients lost to follow-up. The mean age of patients was 29.8 yrs, with the majority (59.0%) being female. Overall therapeutic response was found to be 96%. A significant (P<0.05) increase in the mean SNAQ score was observed after 7 and 14 days of treatment when compared to baseline. No significant difference before and after treatment was observed in pathological and biochemical indices. No adverse events were reported during the entire study period. Conclusion: The study results indicate that Habb-e-Hilteet could be a viable treatment option for anorexia with no safety concerns. Keywords: Ḍu‘f al-Ishtihā; Buṭlān al-Shahwa; Anorexia; Habb-e-Hilteet; Unani pharmacopoeal formulation

Zarawand Mudharaj (Aristolochia rotunda Linn.), an important medicinal plant used in Unani system of medicine: A review

Background: Zarawand Mudharaj (Aristolochia rotunda L.) belongs to family Aristolochiaceae. According to Unani scholars, it is a female plant of Aristolochia fontanesii Boiss. & Reut. (Syn. A. longa L.), usually found growing in Mediterranean regions, Central Asia and South Europe. Purpose of the review: The main aim of this review is to highlight various aspects of Zarawand Mudharaj such as temperament, botanical description, pharmacological properties, therapeutic uses etc, as mentioned in Unani literature that will ultimately guide researchers to design various studies for further exploration of this important medicinal plant. Materials and methods: The present review has been carried out through extensive literature survey of various classical Unani and botanical texts, and published papers available on different search engines. The botanical names and their synonyms were validated through ‘The Plant List’ (www.theplantlist.org). Results: In Unani medicine, the rhizome of Zarawand Mudharaj is used for the treatment of several ailments viz. stomach and liver diseases, jaundice, cough, septic wounds, splenomegaly, gout etc. Apart from its use as single drug, it has also been added in many compound preparations viz. Anqarooya-i-Kabir, Habb-i-Rewand, Majun Falasifa, Majun Dabeedul Ward etc. A study on physicochemical standardization of rhizome of Aristolochia rotunda L. has reported the presence of moisture content, total ash, acid insoluble ash, water soluble ash, sulphated ash, alcohol and water-soluble extractive values within normal limits. The same study has also revealed that the hydro-alcoholic extract of rhizome of Aristolochia rotunda L. possesses significant hepatoprotective activity against CCl4 induced liver toxicity in albino Wistar rats. Several toxicity reports have pointed out that aristolochic acid containing herbal drugs including Aristolochia rotunda L. cause renal impairment and other serious adverse reactions.  Conclusion: It is concluded that Aristolochia rotunda L. is widely used in Unani system of medicine. However, extensive studies on pharmacognosy, pharmacology, toxicology, phytochemistry and quality control of different parts of this potential medicinal plant have not been carried out so far. Therefore, such studies on modern scientific parameters may be conducted for further exploration so that the benefits may reach the masses. Keywords: Zarawand Mudharaj; Aristolochia rotunda L.; Unani medicine; Hepatoprotective; Aristolochic acid; Toxicit

Th1/Th2 profile in patients suffering with osteoarthritis and rheumatoid arthritis: An analytical observational study

Aims: To compare the cytokine (Th1/Th2) profile in serum as well as in synovial fluid of patients suffering with osteoarthritis (OA) and rheumatoid arthritis (RA). Settings and Design: Hospital-based analytical observational study. Materials and Methods: The present study comprised of 70 patients of arthritis, out of which, 40 patients were patients suffering from RA and 30 patients suffering from OA. Patients fulfilling the revised ARA Criteria for the Classification of Rheumatoid Arthritis are diagnosed as a case of RA and recruited for this study. Patients fulfilling the clinical and radiological features of osteoarthritis included in the study. Cytokine assay estimated using Western Blot (Immuno-blot transfer). Statistical Analysis Used: Analysis was performed using SPSS version 16.0 Statistical package for windows (SPSS, Chicago, IL). Results: Arthritis is commonly seen in females than males. Proinflammatory cytokines (IL-1, IL-2 and IFN-γ), anti-inflammatory cytokines (IL-4 and IL-10), regulatory cytokine (TGF-β) of blood as well as serum levels were raised in RA patients as compared with OA patients (P < 0.01). Tumor necrosis factor (TNF-α), an proinflammatory cytokine, levels were also raised significantly in OA. Conclusions: Our study shows that both Th1 and Th2 cells derived inflammatory markers as well as levels of IL-1 and TNF-α (both blood as well as synovial fluid) were significantly raised in RA as compared with OA patients. Thus, high levels of these substances have been found in inflammatory arthropathies, in particular in those characterized by a more aggressive and destructive outcome, such as RA

A cross-sectional study on the etiological causes of cervical lesions among patients without caries in Lahore, Pakistan

Background and Aim: Non-carious cervical lesions (NCCLs) are defined as any deterioration of the tooth tissue in terms of abrasion, composition, and erosion during normal and/or pathological function. The present study aimed to assess different etiological causes of cervical lesions among patients without caries in the population of Lahore, Pakistan. Materials and Methods: A cross-sectional analytical study was carried out on 62 patients aged 16-60 years in the Department of Dentistry of a Tertiary Care Hospital of Lahore, Pakistan from July 2022 to December 2022. Patients were categorized into two groups: Group-I (Non-carious dental lesions patients) and Group-II (without non-carious dental lesions patients). All the patients underwent clinical examinations and answered a questionnaire which included inquiries related to oral hygiene, personal impressions, eating habits, teeth appearance and functionality, and it also emphasized on the different etiologies of non-carious dental lesions.Results: Out of the total 62 patients, the study and the control groups consisted of 38 (61.3%) and 24 (38.7%) patients respectively. Age-wise distribution of the patients was as follows: 19 (30.6%) in 16-30 years, 12 (19.4%) in 31-45 years, and 31 (50%) in 46-60 years.&nbsp

Saqmunia (Convolvulus scammonia L.), an important drug used in Unani system of medicine: A review

Background: Saqmunia, a resin obtained from the root of Convolvulus scammonia L. is widely used in Unani system of medicine for the treatment of several body ailments. This important medicinal plant is belonging to Convolvulaceae family, and is commonly grown in Mediterranean regions. Purpose of the review: The core objective of this appraisal is to emphasize the different characteristics of Saqmunia (Convolvulus scammonia L.) viz. botanical description, pharmacological and therapeutic properties, folklore uses, temperament, dose, scientific studies, etc, as mentioned in Unani and botanical literature that will be helpful in the rationale use of this botanical drug. Materials and methods: This review was done after going through ample of literature survey of Unani and botanical texts, and published articles related to Saqmunia (Convolvulus scammonia L.). The botanical names of drugs mentioned in this review have been validated through ‘World Flora’ (http://www.worldfloraonline.org). Results: The Unani physicians prescribe Saqmunia for the treatment of skin diseases, chronic headache, bilious fever, conjunctivitis, jaundice, etc. This drug is also added in many compound Unani formulations such as Habb-i-Kotwali, Safoof-i-Suranjan, Habb-i-Banafsha, Ayarij-i-Kabir, Tiryaq-i-Zahab, Habb-i-Saqmunia, Majun-i-Anjeer, etc which are used for various therapeutic purposes. The phytochemical analysis of the root of Convolvulus scammonia L. has been reported that it contains 8% resin along with beta-methyl-esculetin, dihydroxy cinnamic acid, ipuranol, sucrose, reducing sugar, starch, etc. The resin yields glycosides mainly scamonin which is pharmacologically active. Some scientific reports showed that this important medicinal plant possesses certain potential pharmacological activities. The significant anticancer property of aqueous and alkaline extracts of Convolvulus scammonia L. has been identified in mice. Conclusion: Although, the resin of Convolvulus scammonia L. is extensively used in Unani medicine. But, sufficient studies regarding its pharmacognosy, phytochemistry, pharmacology and toxicology are still lacking. Hence, it is suggested that extensive studies by using modern scientific parameters may be carried out to explore the every aspect of this important botanical drug. Keywords: Saqmunia; Convolvulus scammonia L.; Unani medicine; Resi

Evaluation of Chronic Toxicity of Kushta Sammulfar (Calx of Arsenic Trioxide)

Sammulfar (arsenic trioxide) is a notorious poison and has extensively been studied for its toxicity. It is in use for various purposes for centuries and is used even today as a therapeutic agent in the form of kushta (calx) in traditional systems of medicine, particularly Unani medicine, but without apparent safety data. The present study, therefore, was conducted to produce data for prolong use of calx of arsenic trioxide. The calx (test drug) was prepared by the method described in National Formulary of Unani Medicine. The study was carried in healthy Wistar rats of either sex; weighing 150-250 g; 2-3 months of age, in a dose dependent manner, following the methods of Gupta et al. (2002), Ghosh (2008) and Klaassan (2008). The animals were divided into four groups of 10 animals each. Group I served as control, where as group II, III and IV were used for three dose levels of the test drug i.e. low (8.75 mg–1 kg), medium (17.50 mg–1 kg) and higher (26.25 mg–1 kg). Standard parameters usually applied for chronic toxicity studies were considered. The study revealed dose dependent toxicity. Usual signs of chronic toxicity were observed during the study. Low dose of Kushta Sammulfar (KSF) did not produce remarkable toxic effects. Mild to moderate toxicity was seen in KSF-II and KSF-III

Consequences of Sustainable Agricultural Productivity, Renewable Energy, and Environmental Decay: Recent Evidence from ASEAN Countries

Agriculture is critical for meeting the needs of the world&rsquo;s population, in terms of food production. As a result, it has become a significant contributor to economic growth. According to various studies, agricultural production is one of the most widely recognized sources of greenhouse gas (GHG) emissions globally. This study explores the causal link between aggregate energy consumption resources, trade liberalization, CO2 emissions, and modern agriculture in selected ASEAN nations from 2000 to 2020, through the use of panel FMOLS data from the United Nations Development Program (fully modified ordinary least square). According to scientific research, the value addition of agricultural commodities helps to reduce CO2 emissions in polluted countries such as the United States. In addition, it was revealed that the quantity of CO2 released per unit of energy spent was positively associated with the amount of energy consumed. The reduction of CO2 emissions is possible in nations where environmental pollution is reducing due to trade liberalization. Although fossil fuels have increased CO2 emissions, research has shown that adopting renewable energy can help mitigate environmental damage. Revenues and productivity in agriculture are increased due to climate-smart agricultural-favored institutions, while greenhouse gas emissions are reduced. As an example of renewable energy, new energy resources may contribute to the preservation of a clean and healthy environment. The use of renewable energy in agriculture reduces the dependency on fossil fuels, which is beneficial for farmers. Trade policy, on the other hand, may stimulate the movement of money and technology, in order to specialize in economies of scale and manufacturing. It is imperative that ASEAN countries examine policies that will improve living standards, while also protecting the environment. This includes measures that will stimulate agricultural sector production and create active marketplaces for international trad

Mortality and Clinical Outcomes among Patients with COVID-19 and Diabetes

Background Diabetes mellitus (DM) is a decisive risk factor for severe illness in coronavirus disease 2019 (COVID-19). India is home to a large number of people with DM, and many of them were infected with COVID-19. It is critical to understand the impact of DM on mortality and other clinical outcomes of COVID-19 infection from this region. Aims The primary objective of our study was to analyze the mortality rate in people with DM infected with COVID-19. The secondary objectives were to assess the effect of various comorbidities on mortality and study the impact of DM on other clinical outcomes. Methods This is a retrospective study of COVID-19 infected patients admitted to a tertiary care hospital in north India in the early phase of the pandemic. Results Of the 1211 cases admitted, 19 were excluded because of incomplete data, and 1192 cases were finally considered for analysis. DM constituted 26.8% of total patients. The overall mortality rate was 6.1%, and the rate was 10.7% in the presence of diabetes (p 2 at presentation, extensive involvement in CXR, and elevated ANC/ALC ratio were also significantly associated with mortality. Conclusions The presence of comorbidities such as DM, hypertension, CAD, CKD, and cancer strongly predict the risk of mortality in COVID-19 infection. Early triaging and aggressive therapy of patients with these comorbidities can optimize clinical outcomes