Alternative & Integrative Medicine

Background: The prevalence of diabetes is steadily increasing worldwide, and it is considered as one of the main threats to human health. In India, numerous reports describe the utilization of Unani medicine in the treatment of diabetes mellitus.
Objective: to systematically analyzed randomized clinical trials of Unani interventions in type-2 diabetes mellitus.
Materials and Methods: A comprehensive search of online databases, viz., Pub Med, Google Scholar etc. using keywords like ‘Unani Medicine’, ‘Diabetes mellitus’, ‘Clinical trial’, ‘Glycemic control’ or combination of these. In addition, journals and dissertations in the library of the National Institute of Unani Medicine, Bangalore, India was manually searched. Only four clinical trials met the criteria and were included in the review. The most common outcome measures encountered in these studies were fasting blood glucose level (FBS), postprandial blood glucose level (PPBS) and HbA1C. Trials on pre diabetes and those which primarily examined diabetic complications such as diabetic neuropathy or nephropathy were excluded.
Results: Significant reductions in FBS and PPBS were observed with the administration of combination of Gymnema Sylvester and Tinospora cardifolia. Highly significant effect on FBS (p<0.003) and moderately significant on PPBS (p<0.013) were observed with Spirulina. Significant effect on HbA1C (p<0.05) was observed with a polyherbal formulation containing Tinospora cardifolia, Bambusa bambos and Nelumbo nucifera. Similar effects were observed on FBS, PPBS and HbA1_C with administration of a combination of Eugenia jambolana and Withania coagulans. These studies enrolled 190 participants and treatment duration ranged from 6 to 12 weeks.

Conclusion: Although the results showed statistically significant effects with Unani interventions; however, due to limited number of trials, any definite conclusions regarding their efficacy cannot be ascertained. Hence, further studies with more number of participants and of sufficient length needed to determine a relevant clinical effect to validate the use of these interventions in routine clinical practice.

Background: The morphogenesis of Xenopus laevis is dependent on the thyroid system and the production of thyroxine. Numerous studies using the amphibian model have shown tadpoles to be responsive to ultra-high dilutions of Thyoxine. Ultra-high dilutions used in Homeopathy are not suitable to pharmacokinetic investigation due to their lack of detectable active ingredient and the lack of analytical methods with sufficient sensitivity; however, laboratory and clinical studies are providing experimental evidence contributing to the pharmacodynamics of high dilution remedies.

Method: The experiment consisted of four groups, labelled according to the dilution each group was administered, Control (no treatment), Thyroxine 6C, Thyroxine 30C and Thyroxine 200C. Each group consisted of 90 tadpoles divided into three tanks of 30 tadpoles each. The respective dilutions were administered to the water the tadpoles were housed in every eight hours from Day 32 until Day 58 of the experiment. Tail length was measured every three days from Day 32 to Day 48 and every day from Day 48 to Day 58.

Results: Thyroxine 6C was shown to have had a stimulatory effect while Thyroxine 30C had an inhibitory effect on the growth phase of the Xenopus laevis tadpole tail. Thyroxine 6C, 30C and 200C were shown to have had an inhibitory effect on the reduction phase of the Xenopus laevis tadpole tail.

Conclusion: Where the results were shown to have had a stimulatory effect on the growth phase of the Xenopus laevis tadpole tail, it was likely due to a physiological effect, mimicking the action of the naturally circulating thyroxine. The results that were shown to have had an inhibitory effect are in line with the “Law of Similars” and the fact that a homeopathic preparation of Thyroxine would have an opposing effect to that of naturally circulating thyroxine.

Dermatophytosis are skin infections caused by dermatophytes which can be pathogenic for humans and animals by infecting the stratum corneum, nails, claws or hair and which now affect more than 20%-25% of the world populations especially in the developing countries. Drug resistance and toxicity associated with long-term treatment with existing antifungal drugs necessitate the search for new drugs to treat dermatophytosis. The juice of Kigelia africana leaves has been used by the natives to treat dermatophytosis. The leaves were extracted with water, ethanol and petroleum ether. Phytochemical analyses of the extracts were carried out. Agar disc discussion method was used to determine the antifungal activities against clinical isolates of Microsporum audouinii, Epidermophyton floccosum, Trichophyton mentagrophytes and Malassezia furfur. Herbal creams formulated with 0.5, 1.0 and 2.0 g w/w of the extract were subjected to stability tests using standard methods. FTIR was used to determine if there were new functional groups formed during production of the herbal creams. Sensitivity and efficacy of the products were determined using animal model experiment.

The percentage yields of extracts are petroleum ether 6.3%, aqueous 6.5%, and ethanol 7.2%. Percentage ethanol phytochemical composition indicated that for Alkaloid (4.67%), saponins (2.48%), flavonoids (0.81%) and tannins (1.05%). The emulsion produced was an oil-in-water emulsion and had a white colour with pH of 7.02 spread of emulsion, rubbing-in effect and stability to centrifugation was very high. The antifungal results showed that the petroleum ether and aqueous extracts had 10 mm zones of inhibition, while ethanol extract had 15 mm at 10,000 μg/ml against Trichophyton mentagrophytes. Against Microsporum audouinii, the results are petroleum ether and aqueous extracts (10 mm) and ethanol extract (14 mm). Against Epidermophyton floccosum, the results are petroleum ether and aqueous extracts (10 mm) while ethanol was 13 mm. The zones of inhibition recorded by the extracts against Malassezia furfur are aqueous 4 mm, petroleum ether 12 mm and ethanol 15 mm respectively. The results for FTIR showed a spectrum of C-N stretch which peaks at 1019.00 cm-1 for Ka cream. Also, an O-H stretch peak was observed at 3254.00 cm-1. Temperature stability tests carried out indicated increasing stability in the order Ka.water cream E. floccosum (30.53 μm) < M. audouinii (31.37 μm) <M. furfur (36.22 μm) <T. mentagrophyte (37.01 μm).

The results showed that Kigelia africana ethanol extract can be used in herbal cream formulations for the management of dermatophytosis.