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Pharmacoeconomics: Open Access

ISSN: 2472-1042

Open Access

Article in Press

Volume 6, Issue 3 (2021)

    Editorial Note Pages: 1 - 1

    Pharmacoeconomic Aspects of Alzheimers Management

    Rubio Terres*

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    Volume 6, Issue 6 (2021)

      Commentary Pages: 1 - 2

      Parkinsons: Introduction and Cost Effective Treatment

      Rubio Terres

      Parkinson's sickness is brought about by a deficiency of nerve cells in a particular piece of the mind called the substantia nigra. Cells in the substantia nigra speak with other development control focuses in the cerebrum by emitting dopamine and different synapses. When substantia nigra cells pass on, they quit emitting dopamine, and the other development control focuses become unregulated [1]. This unsettling influence in the development control focuses of the mind cause the fundamental indications of Parkinson's infection. In many patients, what causes the deficiency of substantia nigra cells stays obscure. Ecological poisons that might cause Parkinsonism incorporate manganese, carbon monoxide, natural solvents certain pesticides. In any case, a great many people with Parkinson's infection have not been presented to these poisons. Various qualities have been displayed to cause Parkinson's sickness in about 10% of patients; however these quality irregularities don't happen in many people with Parkinson's illness. As of now, analysts presume that the reason for Parkinson's illness in many people mirrors a mix of hereditary variables and natural exposure(s)

      Commentary Pages: 1 - 2

      Treatment Methods for the Rheumatoid Arthritis: The Cost Effective Way

      Rubio Terres*

      The effectiveness of Rheumatoid Arthritis is complex and fundamentally incorporates numerous suspicions, there are all around created strategies and principles for directing such analyses. Such examinations commonly build a choice scientific model to assess results related with treatment choices furthermore, subsequently think about significant clinical methodologies, for example, non-biologic versus biologic DMARDs at different time focuses in the course of RA [1]. A suitable choice examination can be viewed as an express portrayal of run of the mill clinical dynamic that tends to the vulnerability in results through probabilistic reproductions and the vulnerability in proof through sufficient affectability investigations. Costeffectiveness proportions are determined by duplicating the worth connected to every individual result with the likelihood of a result [2]. Then, the subsequent anticipated weighted qualities for the branches are added to acquire the normal worth of a given clinical technique. These esteems are thought about in an expense effectiveness examination to assess the gradual cost effectiveness of one methodology versus another

      Editorial Pages: 1 - 1

      Pharmacoeconomic Aspects of the Alzheimers Management

      Rubio Terres*

      Although dementia has been described in ancient texts over many centuries our knowledge of its underlying causes is little more than a century old. Alzheimer published his now famous case study only 110 years ago, and our modern understanding of the disease that bears his name, and its neuropsychological consequences, really only began to accelerate in the 1980s [1]. Since then we have witnessed an explosion of basic and translational research into the causes, characterizations, and possible treatments for Alzheimer’s Disease (AD) and other dementias. We review this lineage of work beginning with Alzheimer’s own writings and drawings, then jump to the modern era beginning in the 1970s and early 1980s and provide a sampling of neuropsychological and other contextual work from each ensuing decade. During the 1980s our field began its foundational studies of profiling the neuropsychological deficits associated with AD and its differentiation from other dementias [2]. The 1990s continued these efforts and began to identify the specific cognitive mechanisms affected by various neuropathologic substrates. The 2000s ushered in a focus on the study of prodromal stages of neurodegenerative disease before the full-blown dementia syndrome. The current decade has seen the rise of imaging and other biomarkers to characterize preclinical disease before the development of significant cognitive decline. Finally, we suggest future directions and predictions for dementia-related research and potential therapeutic interventions

      Editorial Pages: 1 - 2

      Diabetes: Introduction and Cost-Viability of Examination

      Rubio Terres

      Diabetes is a persistent (durable) medical issue that influences how your body transforms food into energy. A large portion of the food you eat is separated into sugar (additionally called glucose) and delivered into your circulation system. When the level of glucose goes up, it flags your pancreas to produce insulin. Insulin behaves like a key to allow the blood to sugar into your body's cells for use as energy [1]. On the off chance that you have diabetes, your body either doesn't make sufficient insulin or can't utilize the insulin it makes just as it ought to. When there isn't sufficient insulin or cells quit reacting to insulin, a lot of glucose stays in your circulatory system. Over the long run, that can cause genuine medical conditions, like coronary illness, vision misfortune, and kidney infection.

      Editorial Pages: 1 - 2

      Pharmacoeconomic Aspects of the Rheumatoid Arthritis Management

      Snadeep Kumar*

      Rheumatoid joint inflammation is a drawn out immune system issue that basically influences joints. It ordinarily results in warm, enlarged, and excruciating joints. Pain and firmness regularly demolish following rest [1]. Most usually, the wrist and hands are included, with similar joints normally included on the two sides of the body. The infection may likewise influence different pieces of the body, including skin, eyes, lungs, heart, nerves and blood. This might bring about a low red platelet tally, irritation around the lungs, and aggravation around the heart. Fever and low energy may likewise be present. Often, indications come on progressively over weeks to months. While the reason for rheumatoid joint pain isn't clear, it is accepted to include a mix of hereditary and ecological factors. The hidden component includes the body's resistant framework assaulting the joints. Other infections that might introduce comparatively incorporate foundational lupus erythematosus, psoriatic joint inflammation, and fibromyalgia among others.

      Volume 5, Issue 1 (2015)

        Research Pages: 298 - 304

        ANTIHYPERLIPIDEMIC ACTIVITY OF CAMELLIA SINENSIS AND MACROTYLOMA UNIFLORUM ON HIGH FAT DIET INDUCED WISTAR ALBINO RATS

        Dhanalaxmi Mohan Raj*, K. Bhaskar Reddy

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        Hyperlipidemia is a disorder of lipid metabolism manifested by elevation of plasma concentrations of the various lipid and lipoprotein fractions, which is the key risk factor for cardiovascular disorders (CVD). Camellia sinensis and Macrotyloma uniflorum used as antihyperlipidemic drugs as per literature review. The aim of the present study was to evaluate the antihyperlipidaemic activity of polyherbal formulation of methanolic extract (Camellia sinensis and Macrotyloma uniflorum) in High fat diet (HFD) fed rats. Male Wistar albino rats were randomly assigned to five groups: Groups I normal control; Group II HFD control; Group III HFD+ standard drug (Atorvastatin10 mg/kg), Group IV HFD + Polyherbal methanolic extract (200 mg/kg) and Group V HFD + Polyherbal methanolic extract (400 mg/kg). The whole study lasted for 28 days. Administration of HFD caused a significant (p<0.05) rise in the serum total cholesterol (T.C), LDL-cholesterol, VLDL-cholesterol, triglycerides (T.G). Simultaneous administration of polyherbal methanolic extract of Camellia sinensis and Macrotyloma uniflorum significantly (p<0.05) prevented the rise in serum total cholesterol, LDL-cholesterol, VLDL-cholesterol, triglycerides. There was a significant decrease in body weight and increase in HDL-cholestrol was observed in polyherbal extract treated rats. Thus, the results indicate antihyperlipidaemic effect of Polyherbal formulation.

        Volume 6, Issue 5 (2021)

          Research Article Pages: 1 - 5

          Cost Comparison of Reusable and Single-Use Bronchoscopes in a Scottish Intensive Care Unit

          Rasmus Vinther Russell*, and MJG Dunn

          Background: Bronchoscopy procedures are conventionally associated with complex supporting processes, large capital investments and inevitable repairs. Cost-comparison analysis with the single-use bronchoscope Ambu® aScope™4 Broncho within a UK intensive care unit have never been done before. Materials and Methods: We conducted a cost-comparison analysis of reusable vs single-use bronchoscopes within the intensive care unit of the Royal Infirmary of Edinburgh via a micro-costing method. Results: At the current split between reusable and single-use bronchoscopes, the incremental cost of using single-use vs. reusable bronchoscopes was £111. In a binary setup with either reusable or single-use bronchoscopes, the incremental procedure cost was£90. Singleuse bronchoscopes were cost-minimising up to 75 annual procedures per reusable bronchoscope. When including a 0.72% and 2.8% risk of cross-infection the incremental cost of was £159 and £352. Conclusion: Single-use is cost-effective compared with reusable bronchoscopes within the ICU setting.

          Natural Products and Pharmacoeconomics-1 (2021)

            Special Issue Article Pages: 1 - 1

            Novel PPARα antagonists bearing Stilbene or Bioisosteres endowed with antiproliferative effects in cancer cell lines

            Alessandra Ammazzalorso

            Peroxisome Proliferator-Activated Receptors (PPARs) have been widely studied in the last decades, and they attracted the attention of scientists as promising therapeutic
            targets. Intensive efforts by researchers produced a wide panel of drugs targeting the three PPAR subtypes (PPARα PPARγ PPARδ) able to modulate important metabolic
            functions. PPAR activation is involved in several physiologic pathways, as lipid and glucose metabolism, insulin sensitivity, energy homeostasis, and cell differentiation.
            Fibrates and thiazolidinediones, respectively synthetic PPARα and PPARγ agonists, are currently used for the treatment of hyperlipidemia and hyperglycemia, in patients
            affected by type 2 diabetes and metabolic syndrome.
            In recent years, an increased expression of PPARα has been found in different tumors: it is well known that cancer cells present altered metabolic pathways, switching from
            the glycolysis to fatty acid oxidation metabolism. In this scenario, PPARα antagonists emerged as novel potential drugs in tumors overexpressing PPARα by interfering
            with cellular survival and metastasis formation.[2] In vitro anticancer effects were found for PPARα antagonists in chronic lymphocytic leukemia [3], renal cancer, colorectal
            and pancreatic cancer [4], paraganglioma [5].
            In this study we report on the synthesis of novel PPARα antagonists bearing stilbene or its bioisosteres, starting from the structure of a dual PPARα/γ agonist, previously
            synthesized in our laboratory. We explored the cytotoxicity of the novel compounds in different cancer cell lines (colorectal, pancreatic, renal, paraganglioma) expressing PPARα.

            Special Issue Article Pages: 2 - 2

            Thymoquinone attenuates phosphorylation of AKT to inhibit kidney cancer cell proliferation

            Ayed Dera *, Prasanna Rajagopalan

            Background: Nigella sativa is extensively used for medical remedies since ages in Middle East. Thymoquinone (Tq) is the major active constituent of this plant in which many reports confirmed the anticancer activities of the compound. However, the effect of Tq in kidney cancer cells and the pathway of action remains unproven. Herein we report anticancer properties of Tq in the kidney cancer cells. Methods: Cancer proliferation was assessed using A498 and Caki1 kidney cancer cells 000by MTT assay. Nuclear fragmentation was detected using Hoechst 333258 and Propedium iodide dual straining. Trans endothelial migration assay was used to study migration inhibitory effects of Tq. Flow cytometry was used to analyze apoptosis and cell cycle. Anti, pro apoptotic markers and Akt phosphorylation were measured by Western bolting procedure. Results: Tq demonstrated anti-proliferative effects in A498 cells with GI50 value of 40.07 μM and Caki-1 cells with GI50 of 51.04 μM. Tq exhibited nuclear fragmentation and inhibited trans-endothelial migration of A498 and Caki-1 cells in a dose dependent manner. Time dependent increase of Annexin V positive cells and sub G0/G1 cell population was observed in both cell lines after Tq treatment. Tq increased the pro apoptotic Bax protein and reduced anti-apoptotic Bcl-2 protein dose dependently in A498 and Caki-1 cells favoring apoptosis. Increasing concentration of Tq decreased the phosphorylation of Akt in both kidney cell types. Conclusion: Our observations suggest effective anticancer activity of Tq in kidney cancer cells which may be mediated by the Akt pathway.

            Special Issue Article Pages: 3 - 3

            Use of antioxidants from Brazilian Cerrado plants on veterinary medicine

            Melo, FR *, Cruz-Junior, CA, Fidelis, AAG

            Statement of the Problem: Several animal diseases involve an increase on reactive oxygen species (ROS) production, which could cause biological effects as aggravating of preexisting
            diseases or cell damage in infectious diseases. In addition, in vitro embryo production (IVP) induces excessive ROS production, which affects blastocyst quality. Therefore,
            the use of antioxidants represents an alternative to overcome oxidative stress damage both, in infectious diseases and in improving animal reproduction procedures. Brazil is a
            country of interest to ethnopharmacology, especially the ecological domain Cerrado, which represents a source of biological diversity. The purpose of this study is to evaluate crude
            extracts of plants from Cerrado used in traditional medicine, for the presence of phenolic compounds as well as its antioxidant activity, antibacterial and effect on apoptosis in IVP.
            Methodology & Theoretical Orientation: the crude extracts were obtained from several plants selected due to its traditional use. Leaves were dried, powdered and exhaustively
            extracted by maceration. The crude extracts were used do determinate in vitro phenolic compounds, antioxidant activity, antimicrobial activity, and apoptosis proportion on IVP.
            Findings: All plants studied showed expressive antioxidant activity, and the phenolic compounds amounts were different for each other. Those that showed majority
            antioxidant activity were used in antibacterial activity and in IVP tests. The crude extract of cagaita (Eugenia dysenterica Mart. DC.) showed antimicrobial activity against
            Staphylococcus intermedius, an important bacterium that causes infection in dogs and cats. The same extract also showed a significant reduction (p<0.05) in the proportion
            of apoptotic cells from embryos cultivated with 0.01 mg/mL.
            Conclusion & Significance: Antioxidative activity of natural products, especially those extracted from medicinal plants, is extremally important to provide scientific data for
            the treatment of infectious disease or in procedures of IVP. These extracts, normally, cause low side effects and can take advantage of complementary veterinary medicine

            Special Issue Article Pages: 4 - 4

            Revisting the use of Rubefacient in reducing the blood sugar level of people with type II diabetes via Clinical Aromatherapy

            Fai Chan

            acceptance among the medical professionals. The word “Rubefacient” stems from the use of the drug to“produce redness of the skin, e.g. by causing dilation of the
            capillaries and an increase in blood circulation. “ According to Wikipedia definition and there are some topical drugs that can achieve it. In fact , the TCM (Traditional Chinese
            Medicine) uses of the technique “Gua Sha” can achieve rubefacient effect too.
            The speech will discuss this technique combining with the use of essential oil massage in treating type II diabetes and how this integrative approach brings down the blood
            sugar levels to a significant extent that complement well with the conventional drugs in treating the diabetes. Actually, the author made use of this to help one diabetic person
            to reverse her diabetes and two of them to significant drops of blood sugar level and resolved the severe insomnia issue…
            Except for the mechanical technique of “Gua Sha” , essential oil blend that can create “rubefacient” effect is also employed… The formulation and its therapeutic applications
            will also be discussed. Last but not least, not each part of the whole body deserves the same attention. There will be discussion on which should go first as this will affect
            the result, specially when time is limited. This presentation not only tells you the facts or evidence but also points to the way that you can improve your formulation to better
            serve your customers.

            Special Issue Article Pages: 5 - 4

            Supercritical CO2 technologies: A GREEN alternative with applications in natural products (HEMP) isolation and characterization

            Gerard Rosse

            Supercritical fluid technologies for CO2 purification (SFC) and CO2 Extraction (SFE) are efficient and cost-effective to produce intact extracts and high purity ingredients relevant to
            Hemp, Flavors and Fragrances, Herbal Medicines, Spices, Decaffeination, Sterilization, Nutraceuticals & Aroma Therapy, Algae Extraction and Pharma industries. The seminar
            covers fundamentals and latest applications of SFC and SFE in analysis and purification of chiral/achiral small molecules, peptides and complex extracts relevant to the Pharma,
            Hemp and other Natural Products industries. CO2 extraction is a non-flammable, non-toxic process enabling isolation of volatile/non-volatile compounds and leaving no trace
            of toxic residual solvent. CO2 purification is a form of liquid chromatography that happens to use CO2 as a solvent to facilitating fast analysis and separation of complex mixtures.
            Both SFE and SFC use reclaimed carbon dioxide and automatically recycle it, contributing further to sustainability, high efficiency, low operating costs and increased profitability.

            Natural Products and Pharmacoeconomics-2 (2021)

              Special Issue Article Pages: 1 - 2

              Novel therapeutic anticancer property of Vernonia amygdalina Delile towards the treatment of prostate cancer

              Clement G. Yedjou *1, Alo A. Richard1, Paul B. Tchounwou2

              Prostate cancer is one of the common cancers in males and its incidence keeps increasing globally. Approximately 81% of prostate cancer is diagnosed during the early stage of the disease. The treatment options for prostate care include surgery, radiotherapy, and chemotherapy, but these treatments often have side effects that may result to poor quality of life such as impotence or decrease bowel function. Our central goal is to test the anticancer activity of Vernonia amygdalina Delile (an edible medicinal plant that is relatively inexpensive, nontoxic, and virtually without side effects) for the prevention of prostate cancer using human adenocarcinoma (PC-3) cells as a test model. To address our specific goal, PC-3 cells were treated with Vernonia amygdalina Delile (VAD). Cell viability and cell morphology was analyzed by acridine orange and propidium iodide (AO/PI) dye using the fluorescent microscope. DNA damage was evaluated by the comet assay. Cell cycle arrest and cell apoptosis was evaluated by Flow Cytometry assessment. Nucleosomal DNA fragmentation was detected by DNA ladder assay. Data obtained from the AO/PI dye assessment indicated that VAD significantly reduced the number of live cells in a dose-dependent manner, showing a gradual increase in the loss of viability in VAD-treated cells. Similar result was previously obtained by the MTT assay. We observed a significant increase in DNA damage in VAD-treated cells compared to the control group. Flow cytometry data showed that VAD induced cell cycle arrest at the G0/G1 checkpoint. Flow cytometry data also showed that VAD induced caspase-3 activation in treated cells compared to the control group. We observed the formation of the DNA ladder in gel electrophoresis by induction of apoptosis in PC-3 cells treated with VAD. These results suggest that inhibition of cancer cell growth, induction of DNA damage, cell cycle arrest at the G0/G1 checkpoint, and apoptosis through caspase-3 activation and nucleosomal DNA fragmentation are involved in the therapeutic efficacy of VAD as anticancer candidate towards the prevention and/or treatment of prostate cancer.

              Special Issue Article Pages: 3 - 3

              GC-MS analysis of Myrtus communis extract and its antibacterial activity against Gram-positive bacteria

              Mushtaq A. Mir *, Nasreena Bashir , Abdulkhaleg Alfaify , and Mohammed D. Y. Oteef

              Myrtus communis is a typical plant of Mediterranean area. The different parts of this plant such as berries, branches, and leaves have been used worldwide as a traditional/folk medicine for the treatment of various ailments and diseases. Ethanolic leaf extract of the plant was prepared and its effect on bacterial growth was investigated. The ethanolic extract showed strong inhibitory effect against Gram-positive and acid-fast bacteria with significant inhibition-zone size (9–25mm), MIC (4.87–78 μg/ml), as well as MBC (0.3–20 mg/ml). However, no effect was observed on the growth of Gram-negative bacteria. The growth inhibition was found to be associated with the damage of cell wall as the extract-treated cells were sensitive to cell wall-targeting antibiotics and displayed the cell wall damage-depicting morphological defects. GC-MS analysis confirmed the presence of novel compounds in addition to the most representative compounds of the essential oils/extracts of M. communis of other country origins. These results demonstrate that M. communis leaf extract could be the source of compounds to be used for the treatment of Gram-positive bacterial infections. This is the first report, which provides insights into the mechanism of action of the extract in inhibiting the growth of Gram-positive bacteria.

              Special Issue Article Pages: 4 - 4

              Bioactive component analysis of dices of pomegranate fruits in different genotypes

              Sibel Bayıl OÄ?uzkan *1,Elif Sine Düvenci 2,Halil Ibrahim UÄ?raÅ? 2

              Pomegranate fruit is a type of fruit belonging to the family of Lythraceae, consisting of shell, kernel, grains and dice. In this study, pomegranates of 3 different genotypes (local name : deve diÅ?i, hicaz and nuz ekÅ?isi) harvested (October-December), which are widely cultivated in the province of Gaziantep, OÄ?uzeli, were collected, and after identification, the dice sections were removed and dried in the shade. Total antioxidant and total oxidant levels, animicrobial activities, DNA protective activity and total flavanoid and total phenolic content were determined in 18 extracts in 3 different solvents (methanol, ethanol and DMSO) with solid-liquid extraction. Kirby-Bauer disc diffusion method was used to determine antimicrobial properties. According to the results obtained, 100% of Escherichia coli, Stenotrophomonas maltophilia, Staphylococcus aureus strains were resistant to all membrane extracts. While antioxidant levels of all membrane extracts were found highly and oxidant levels were found to be low. It was determined that the extracts have the potential to protect DNA against oxidative damage caused by UV and H2O2. Total phenolic determination by Folin-Ciocalteu method; Total flavonoid amount was measured by AlCl3 using colorimetric method. Compared to the solvent and extraction methods used, high results were obtained in both phenolic and flavonoid determinations in all extracts, although they differed slightly among themselves. While the pomegranate fruit is consumed as food, the dice and shell parts are discarded. According to our study results, it is thought that alternative new products that can be used in complementary medicine can be obtained from pomegranate membranes that have a rich bioactive composition.

              Special Issue Article Pages: 5 - 6

              Nanoliposomes of supercritical carbon dioxide extract of small cardamom seeds: A potent hypocholesterolemic agent

              Paramita Bhattacharjee *1, Kaninika Paul 1, NilendraChatterjee 2, Tapan KumarPal 3

              Oral administration of 1,8-cineole-rich supercritical carbon dioxide (SC-CO2) extract of small cardamom seeds in hypercholesterolemic Wistar albino rats resulted in restoring normal total cholesterol (TC) levels in the animals. These findings prompted us to encapsulate the aforesaid extract as nanoliposomes to enhance its shelf stabilitiy. Nanoliposome of the extractwas characterized and itsin vivo hypocholesterolemic efficacy was assessed in triton-X treated hypercholesterolemic rats. Atorvastatin served as the positive control in the in vivo study. PEGylated nanoliposomes of small cardamom seed extract (SN) were formulated using soya phosphatidylcholine and Tween 80 (composition standardized) using ultra-sonication (probe) technology. Entrapment efficiency of spherical SN (dp= 76.93 nm) was 84.20% possessing negative zeta potential value<30. The antioxidant potency and shelf stability of SN (T1/2 = 192 days at 4 ± 1 °C) were appreciably higher than that of the native extract and exhibited in vitro sustained release of the spiceutical from the same. The liposomes had thermal stabilities up to 250 °C and successful binding among their chemical constituents were confirmed by FT-IR and XRD spectra. Reduction in TC levels in rats co-administered with liposomes (550 mg/kg b.w.) and triton-X were comparable to that of atorvastatin-administered rats on day 35. Moreover, SN (550 mg/kg b.w.) exhibited inhibitory effects on HMG-CoA reductase activity in the animals. This study established nanoliposomes of small cardamom seed extract as natural alternative of statin in redressing hypercholesterolemia.

              Special Issue Article Pages: 7 - 8

              The Anti-inflammatory effects of the Jamaican species of Cymbopogon citratus (lemon grass) and Croton linearis (wild rosemary) plant extracts on carrageenan-induced inflammation

              A. Jacob *1, L.A.D Williams 2, Anthony Webly 1, Michael Heron 1, E.A Thomas 1

              Inflammation occurs in response to injury and if left untreated can lead to several diseases including arthritis. In Jamaican folklore practice plant extracts have been traditionally used to treat inflammatory conditions including rheumatoid arthritis and asthma. This is the first preliminary scientific investigation of the anti-inflammatory effects of extracts from the Jamaican species of Croton linearis (wild rosemary) and Cymbopogan citratus (lemon grass) leaves on carrageenan-induced rat paw edema. The methods used involved testing of plant extracts on inflammation induced by carrageenan lambda on the rat paw model. 0.1ml of 1% Carrageenan lambda in saline solution (0.9%) was injected into the plantar region of the right hind paw of all groups to induce inflammation. Hexane extract (50mg/kg) of Croton linearis screened by BSA assay represents a sample inhibiting denaturation greater than 0%. Findings show that Croton linearis extract and aspirin (NSAID) shows comparable efficacy in reducing rat paw oedema (p< 0.05)(n=18 Sprague Dawley rats). This extract might be blocking the COX enzymes, with emphasis on COX-2 actions inflammation. Lemon grass extract 400 mg/kg showed reduction in paw volume (p < 0.001), 200 mg/kg extract (p <0.01), saline group showed no significance compared to aceclofenac group (p<0.05), n=24. In concluding extracts of both Wild rosemary and lemon grass showed comparable efficacy to aspirin and aceclofenac in reducing the inflammatory response induced by carrageenan lambda. This data indicates that the extracts of Jamaican species of our samples contain components with anti-inflammatory potential. We are hoping to assess if the extracts are arresting inflammation at the early stage where there is release of histamine, 5-hydroxytrptamine and bradykinin or in in the late phase where prostaglandins are detectable (Prakash et al., 2011). Further work needs to be done to assess for toxicity and to purify the extracts to ensure safety.

              Traditional Medicine and Pharmacoeconomics (2021)

                Special Issue Article Pages: 1 - 1

                Biotransformation monitoring, protein-ligand interactions and In-cell NMR spectroscopy in natural products research

                I.P. Gerothanassis

                A critical overview of the following developments of NMR spectroscopy will be summarized:
                (a) rapid ‘in situ’ monitoring of enzymatic reaction products [1], and enriching the biological space of natural products, through real time biotransformation monitoring in the
                NMR tube. Investigation of interactions with the intrinsically disordered protein α-synuclein which is abundant in the human brain and a relevant target for neurodegenerative
                diseases [2].
                (b) The combined use of saturation transfer difference (STD), Tr-NOESY and INPHARMA (Interligand Noes for PHArmacophore MApping) NMR techniques for mapping
                interactions, specific binding sites and structure elucidation of lipids with non-labelled serum albumin and the anti-apoptotic protein Bcl-2 [3,4].
                (c) Application of in-cell NMR analytical methodology in the monitoring of the interaction of ligands with Bcl-2 inside living human cancer cells without requiring prior isotopic
                labeling of the target protein. STD and Tr-NOESY NMR were employed to evaluate the direct binding of the ligand to the nonlabelled Bcl-2 protein intracellularly [5], which
                was further validated in vitro. This approach has proved a very promising strategy for the real-time screening of the interaction profiling of drugs with their therapeutic targets
                in their native cellular environment in living eukaryotic cells, paving the way to the new field of intracellular rational drug design.

                Special Issue Article Pages: 2 - 2

                Ambrosin: a possible alternative for curcumin in alleviation of lipopolysaccharide induced memory impairment

                Mohammed N.A. Khalil * 1,2

                Despite its poor bioavailability, curcumin is a promising natural polyphenol targeting NF-κβ. NFκβ is a target for new therapeutics because it plays a pivotal role in the
                pathophysiology of Alzheimer disease (AD). In contrast, ambrsoin which is a potent NF-κβnhibitor, is scarcely studied in AD models. The current work aims to assess
                the efficacy of ambrosin as a possible remedy for AD. In silico studies showed that bioavailability and BBB permeability could be favorable for ambrosin over curcumin.
                Ambrosin was isolated and purified from extract of the traditional herb Ambrosia maritima. Memory impairment was induced in mice by single intraperitoneal injection of LPS
                (0.4 mg/kg). Treated groups received curcumin (100 mg/kg) or ambrosin at doses (5 or 10 mg/kg) for 7 days. Mice in treated groups showed a significant improvement in
                memory functions during Morris water maze and object recognition tests. Curcumin and ambrosin (10 mg/kg) inhibited the upsurge of NF-κβ65 transcript and protein levels.
                Consequently, downstream pro-inflammatory and nitrosative mediators were inhibited, namely, TNFα IL-1βCOX-2 and iNOS. BACE1 was inhibited, thereby reducing
                amyloid plaques (Aβ) deposition and eventually reducing inflammation and apoptosis of neurons as revealed by immunohistopathological examination. In conclusion,
                ambrosin can be repurposed as AD remedy after further pharmacokinetic/pharamacodynamic assessments. It could serve as an additional lead drug for AD therapeutics.

                Special Issue Article Pages: 3 - 3

                Food safety research at VSU in the US

                Chyer Kim1,* Rehab Almuqati2, Abeer Fatani2, Rahemi Alireza1, Paul Kaseloo2, Crystal Wynn3, Theresa Nartea4, Eunice Ndegwa1 and Laban Rutto1

                As farmers’ markets have increased in size, scope and complexity, so have the food-safety challenges and implications. Most products sold at farmers’ markets receive minimal
                to no treatment, which increase their potential microbial risks. The aim of this study was to assess the prevalence and characterization of foodborne pathogens on select fresh
                produce procured from farmers’ markets in Central Virginia. A total of 138 samples produced by 15 farms and sold at 9 registered farmers’ markets were obtained between March
                and November 2017. The highest level of coliforms was found in cilantro with 5.8 log MPN/g. Prevalence of Campylobacter, E. coli, and Listeria were observed. A total of 46
                bacterial isolates consisted of Campylobacter, E. coli, and Listeria were tested for their susceptibility to 12 antimicrobials. Ampicillin showed the highest frequency of resistance
                among Campylobacter (100%) and E. coli (47.8%) isolates while nalidixic acid showed the highest resistance in Listeria isolates (72.7%). At least 17% of each Campylobacter,
                E. coli, and Listeria isolates exhibited resistance to three or more categories of antimicrobials, meeting criteria for multidrug resistance (MDR). No isolates had matching pulsedfield
                gel electrophoresis (PFGE) profiles demonstrating that the isolated pathogens had a high degree of genomic diversity. This study demonstrated a potential health hazard
                arising from farmers’ market-acquired fresh produce and emphasizes the importance of good agricultural and handling practices to prevent foodborne illness. Continued
                research is needed to determine and intervene the cause(s) of the observed prevalence and to support the healthy development of food products sold at farmers’ markets.

                Special Issue Article Pages: 4 - 4

                Selected fungal natural products with antimicrobial properties

                Dorota Jakubczyk

                Natural products are an invaluable source of new drugs as they constitute more than two-thirds of clinically used antibiotics and 50% of anticancer drugs. Fungi
                produce many secondary metabolites which display high bioactivity. For example, toxic ergot alkaloids produced by filamentous fungi growing on rye poisoned
                thousands of people and livestock throughout the Middle Ages. However, their later medicinal applications, followed by the discovery of the first class of antibiotics,
                penicillins and other drugs of fungal origin, such as peptidic natural products, terpenoids or polyketides, have altered the historically negative reputation of fungal
                “toxins”. The development of new antimicrobial drugs is currently a major global challenge, mainly due to antimicrobial resistance phenomena. Therefore, the
                structures, biosynthesis and antimicrobial activity of selected fungal natural products will be presented.

                Special Issue Article Pages: 5 - 6

                Hijama practices and the perceived health benefits among the people of Al-Qassim Region, Saudi Arabia

                Khawla Al-luhaidan *, Prarthana M S

                Statement of the Problem: Hijama the traditional Arabic name for wet cupping therapy means “to return to the normal size”, is a form of alternative medicine that
                has been in practice for thousands of years and was adopted by many different cultures. Hijama being a bloodletting technique involves cupping, puncturing and
                cupping (CPC) method. Cups are applied through vacuum, skin is lacerated, the cups are repositioned and the blood is drawn so that the morbid substances are
                evacuated. Arabic medical literature has reported Hijama being effective in treating many diseases differing in etiology and pathogenesis. The purpose of this study
                is to determine the knowledge, attitude, practices and effectiveness of Hijama among the population practicing Hijama, in Qassim, Saudi Arabia.
                Methodology: 201 participants practicing Hijama were enrolled in the study. Data was collected using a self-administered online questionnaire in Arabic and
                analyzed using statistical software EpiInfo7.
                Findings: Most of the study participants were female 70%. 33.8% were in the age group of 21 to 30 years. About 39% of them have a bachelor’s degree. Hijama as
                modality of treatment was used for: back or shoulder or neck pain 46.7% (p=.014), headache and migraine 29.3%, joint pain 22.9% (p=.02), hypersomnia 16.4%.
                Hijama was performed by traditional healers in 14% of the participants and at Hijama centers in 64% of the participants. About 72% of the participants notice
                effectiveness. The effectiveness increased with increase in frequency of Hijama (p=.009). 7% of them had suffered complications.
                Conclusion and Significance: The study reveals Hijama as a simple, effective, economic alternative medicine to treat chronic aches and pains with minimal side effects
                and can be more beneficial when compared to the present use of non-steroidal anti-inflammatory drugs with relatively higher side-effects. Future research is needed to
                support its therapeutic benefits.

                Effect of Alternative Medicine and Pharmacoeconomics (2021)

                  Special Issue Article Pages: 1 - 1

                  Eficacy of fibromyalgia treatment using Bach Flower Therapy: Preliminary results

                  Jozélio Freire de Carvalho,1,2* Cassia Jesus Rocha,2 Natasha Lima Bastos de Queiroz2, Jordan Campos2

                  Statement of the problem: Fibromyalgia (FM) is a prevalent disease and often presents symptoms of anxiety and depression. Bach florals (BF) are widely used to treat such manifestations. No studies on the use of BF in FM were found.
                  Objective: To evaluate the effects of BF (Rescue) in FM patients.
                  Patients and methods: 6 patients and 6 healthy controls were included. They were evaluated at pre-intervention and after 60 days of BF using. Demographic data, anxiety and depression were evaluated by Beck inventories; sleep quality by the Pittsburgh scale and symptoms of dysbiosis by symptoms form.
                  Results: The median age was 60 years old (22-77) in patients and 41 (40-43) years old in controls. The disease duration was 3 years (4 months -10 years old). Caucasian race was 33% in the patient group and 66% in the controls. There was a statistically significant reduction between the Beck Anxiety Questionnaire before and after 60 days [16 (6-42) vs. 10 (2-27), p=0.05), Beck Depression Questionnaire before and after 60 days [16 (8-52) vs. 10 (6-35), p=0.02) and dysbiosis questionnaire before and after 60 days [18 (10-27) vs. 15 .5 (7-27), p=0.03). Regarding the sleep form, no significant differences were observed before and after BF.
                  Conclusion and significance: Treatment with Bach flower in patients with fibromyalgia seems promising, as it reduces tender points, symptoms of depression and anxiety, as well as improvement of symptoms of dysbiosis.

                  Special Issue Article Pages: 2 - 2

                  A single case study on Atopic Eczematous Dermatitis with special reference to Vicharchika

                  Anjana L.Siddapur

                  “Kushnaati vapuh iti kustah” that which disfigures or deforms a person’s physique is Kusta. One such common type of Kusta which is commonly encountered by Ayurveda physicians in day today practice is Vicharchika, which is characterized by Pidaka (vesicles), Srava (oozing), Shyava varna (discolouration) and Kandu (itching). Susruta samhita also gives a reference of ruksha Vicharchika which is also seen in clinical practice. Treatment in contemporary science restricts to the hindrance of the complaints but not from the route and condition is seen to reappear inspite of repeated management using antihistamines and topical steroid applications. A patient presented with clinical features vesicles, erythematous skin lesions and discharge with intense itching at the posterior part of lower limbs, forearms, front and back of chest, abdomen & inguinal region. He was treated with Virechana and Agada formulations, considering the history. Dooshivisha in the samprapti of that condition. Results were encouraging and remarkable.

                  Special Issue Article Pages: 3 - 4

                  Phenolic characterization and biological potential of Pterospartum tridentatum phenolic-rich extracts

                  Ana C. Gonçalves,1* Ana R. Nunes,1 Manuel Simões 2, Gilberto Alves 1, Luís R. Silva 1

                  For a long time, fruits, vegetables and natural plants have been a target of many studies and their consumption has been increasingly encouraged owing to their nutritional value and abundance of nutritional and bioactive compounds, known for their protective effects. Among plants, and although Pterospartum tridentatum, an endemic plant from the northwest of the Iberian Peninsula and Morocco, is largely used in culinary, their phytochemical profile and therapeutic effects remain little known. Therefore, we decided to determine the phenolic composition of infusions and hydroethanolic extracts of P. tridentatum by high-performance liquid chromatography method coupled to a diode array detector analysis. Furthermore, we also evaluated their biological potential, namely antioxidative and antiproliferative effects, and capacity to inhibit α-glucosidase activity. In total, 13 phenolics were found; genistein was the major one, comprising 36.8 and 20.2% of total phenolics in infusion and hydroethanolic extracts, respectively. Regarding the biological potential, the hydroethanolic extract was the most active against 2,2- diphenyl-1-picrylhydrazylâ? and in inhibiting α-glucosidase activity. On the other hand, the infusion proved to be a remarkable free radical scavenger against superoxide and nitric oxide free radical species, and in protecting human erythrocytes facing peroxyl radicals. Both extracts also showed cytotoxic selectivity for human epithelial colorectal adenocarcinoma (Caco-2) cells when compared to the NHDF normal cell line, inhibiting its growth in a dose-dependent manner. Furthermore, they also showed protective effects against oxidative stress induced by tert-butyl hydroperoxide on these cancer cells. Overall, the obtained data suggest that these extracts may be interesting to enrich nutraceutical, dietary and food supplements, and pharmaceutical drugs; however, more studies are needed to unravel ensure safe dosage of both extracts and to incite their use in new formulations, functional foods, pharmaceutical preparations and/or food additives.

                  Special Issue Article Pages: 5 - 5

                  Management of recurrent urethral stricture by Uttar Basti: A case study

                  Alok Kumar

                  Urethral stricture is the very common problem occurred in the patients after prolonged urinary tract infection, urethral injury or post-surgical intervention performed through per urethral. In Ayurvedic literature urethral stricture may be correlated as mutrotsanga mentioned in Sushruta Samhita. One of the prime literature in Ayurvedic surgery. Now day as the science advances with technology various surgeries like urethrolithotomy, Trans urethral removal of prostate (TURP), cystoscopy are performed with telescopic instruments like cystoscope. During these procedure the urethral lining of mucosa get injured and later on develop the scary fibrosis that lead the urethral stricture in the urethra. The most common way to overcome this problem is surgery i.e. urethroplasty. But the recurrence rate is good enough to think the alternative. In Ayurvedic literature uttarbasti is the procedure in which some medicinal preparation are introduced per urethral. In this particular case study we use the apamarga kshara tail oil for the uttarbasti procedure in the patient having history of recurrent urethral stricture. Patient also underwent urethroplasty twice. The results found in the case are encouraging enough. The study was completed in North eastern Institute of Ayurveda And Homoeopathy, Ayurveda hospital Shillong.

                  Special Issue Article Pages: 6 - 7

                  Polycystic Ovarian Syndrome: The mother of all lifestyle disorders in women - An Ayurvedic approach to its management

                  Monika Chauhan

                  PCOS is probably fastest growing health hazard amongst women of reproductive age. The prevalence of this disease in general population is about 5-10% world-wide. This familial disorder appears to be inherited as a complex genetic trait.The association of amenorrhoea with bilateral polycystic ovaries and obesity was first described by Stein & Leventhal. It is characterized by a combination of hyperandrogenism (clinical or biochemical), chronic anovulation and polycystic ovaries. This is frequently associated with insulin resistance and obesity. This condition is receiving so much attention due to its high prevalence and possible reproductive, metabolic, and cardiovascular consequences. It is the most common cause of hyperandrogenism, hirsutism, and anovulatory infertility in developed countries.As the aetiology is poorly understood, there is controversy about diagnostic criteria, clinical features of the syndrome. The management of PCOS is difficult and challenging task, faced by modern gynaecologists. So the holistic approach is demanded specially in Indian subcontinent because of high prevalence here (52%). This particular feminine disorder is not described word to word in Ayurveda. PCOS associated some features are closely related with some of Yonivyapada yet some features nearly bring into its relation with Aartvadushti. Word Aartava has been used extensively in Samhita in context of menstrual blood, ovum and ovarian hormones. Ayurveda, the age-old science of life, speaks of prevention and cure of PCOS through Aahar (Diet), Vihaar (Lifestyle Modification) and Aushadh (Medicine). Possible line of treatment is stipulated with Nidanaparivarjan, Samshodhana, Aaganeya Dravya, Savayonivardhana Dravya.

                  Complementary Medicine and Pharmacoeconomics (2021)

                    Special Issue Article Pages: 1 - 1

                    Evaluation of health care delivery, safety procedures, and canine welfare in an inpatient Animal-Assisted Therapy (AAT) program: A multicenter Failure Modes and Effects Analysis (FMEA)

                    Christian Tejeda*, Jeannette Meyer, Erin Rice, Kunal Wahi, Jennifer Dobkin, Dr. Megan Trieu, Dr. Daniel Karlin

                    Background: Growing evidence supports the use of animal-assisted therapy (AAT) as complementary therapy for various clinical conditions. In the academic literature, increasing evidence highlights utilization of AAT to address pain, anxiety, stress, depression, enhance mood, increase socialization, and increase energy levels. Currently, there is limited evidence-based practice research identifying and addressing areas of improvement within AAT programs. Our research aims to evaluate AAT at our institution using a Failure Modes and Effects Analysis (FMEA).
                    Methods: An FMEA is a tool for conducting a systematic analysis of a process in which potential risks may occur. For our study, we formed a multidisciplinary team and convened for 6 sessions to complete an FMEA table. Our research team reviewed, evaluated, and recorded failure modes pertaining to three process categories: health care delivery, safety procedures, and canine welfare. We devised improvements to prevent the identified failure modes.
                    Results: The process tree created consists of 8 subprocesses and 40 total steps or entries. The data analysis indicated 16 total failure modes, with RPNs ranging from 2 to 48 among which 4 failure modes fell within the “very high” risk category with RPNs greater than 40. The data analysis indicated that the two failure modes with the highest RPNs included failure to complete request list (RPN: 48) and canine contamination of injection site(s) (RPN: 48).
                    Discussion: For half of 16 failure modes, we found improving the program’s orientation and training process to be an appropriate preventative action. We will continue conducting evaluations of every failure mode at 3, 6, and 12-month time points. These results bear importance to a better understanding of the current challenges and improvement opportunities for inpatient AAT. One limitation of the study was the relatively small size of the research team which could have included more agents within the overall process.

                    Special Issue Article Pages: 2 - 2

                    Evaluation of Pistacia vera L. efficacy (Syrian traditional medicine) as adjuvant treatment for Cutaneous Leishmaniasis

                    Chadi Khatib

                    Our search has mainly focused on the use of the traditional dermal cream that consists of an extract of pistachio fruit peels and its tree gum as adjuvant treatment of Cutaneous Leishmaniasis. Pistacia vera L. is a plant of Syrian origin, and the oldest tree of this plant exists in Al-Qalamoun area in Rural Damascus in Syria. As the peels of Pistacia vera L. fruits and the gum of its tree are rich with the phenolic substances. Cutaneous Leishmaniasis is seen in more than 80 countries all over the world and the Mediterranean region is considered one of the most affected areas with this epidemic, knowing that Aleppo is historically considered the home for this disease and that's why, this disease is called "Aleppo Boil", the spread of this epidemic has markedly increased in the world. There is no vaccine for Leishmaniasis and the available chemical treatment, that includes several ant parasites such as the Pentium-equivalent antimony derivatives including antimoniate meglumene and sodium stibogluconate has several limitations including among others, its variable efficacy depending on the type of parasite and the potential resistance for it, its high toxicity for the liver and heart, the long treatment duration and its high cost. Due to the above-mentioned facts, the drugs co-treatments (chemical-chemical) is getting more consideration. Besides, the natural products have recently become an unlimited source for developing anti Leishmania drugs given that they provide better level of efficacy and safety along with lower levels of toxicity in addition to their lower cost. We have assessed the efficacy of the ethanolic extracts of Pistacia vera as anti-Leishmaniasis in both in vitro and clinical study through topical administration.
                    The in-vitro tests were conducted using the ethanolic extracts of Pistacia vera tree's gum and the L.tropica parasites viability. The results showed a good biological effect when treating the parasites with gradually increased concentrations of the ethanolic extracts during the 48 hours of incubation. The double- blinded clinical study was conducted on 102 patients at the Leishmania center in Aleppo. The clinical results and observations showed that the local complementary treatment with the extracts of both the skin peels of Pistacia vera L. fruits and the gum of Pistacia vera L. tree could support the chemical treatment with antimoniate meglumene (administered through local injection) in treating the Cutaneous Leishmaniasis. The above mentioned support is manifested with reducing the injured area and its hardness in addition to reducing the edema and the redness. Besides, the above mentioned extracts could significantly support the treatment of the secondary infection and its associated ulcer.

                    Special Issue Article Pages: 3 - 3

                    Rediscovering herbal contraceptives in Ayurveda - Windows of research via ethnopharmacological research

                    Charu Sharma *, Sujata Kadam, Meenakshi Pandey

                    In the time you read the title , there would have been 4 live-births around the globe. 210 million pregnancies occur worldwide each year, of which, 40% are un palnned. Current researches are centred around immunocontraceptives, molecular condoms but there is an immense quest for completely safe and used friendly contraceptive. Ethnopharmacological-Driven Drug Development becomes the need of the hour to establish noble solutions for global concerns. This review article is a methodology to analyze the pharmacological aspect of contraceptives along with evaluating the current scenario of researches in the drug development process of contraceptives. This article summarizes the results of various classical references and researches related to drug discoveries of contraceptives. This artcle deals with future leads to herbal contraceptives and presents an interdisciplinary model of research.

                    Special Issue Article Pages: 4 - 4

                    Holistic interventions in Ayurveda for a healthy progeny

                    Charu Sharma

                    Prenatal care is known as “garbhini paricharya” in Ayurveda. ‘Garbhini’ means pregnant woman and ‘paricharya’ means ideal protocol. It includes the ideal dietary and lifestyle protocol followed by a pregnant woman to attain optimum health of progeny and prevent any complications. The guidelines for prenatal care start even before conception. The couple planning to have a progeny shall follow purification procedures (panchakarma), proper diet and life style modifications as part of preconception care. The prenatal care begins from the very first day when the woman expects the conception (usually due to missed menstrual cycle). The conceived woman shall be treated with special care just like a pot filled with oil. As the slightest oscillation of such a pot causes spilling of the oil, similarly the slightest exertions or excitements to the pregnant woman can initiate adverse pregnancy outcomes.

                    Special Issue Article Pages: 5 - 5

                    Natural Anamorphosis Process

                    Alexandros Senarelis-Sinaris

                    With the deepest respect to the human imperfect, Natural Anamorphosis Process operates non-aggressively towards the cryptoalgorithm of any form of problem and the noisy, foggy, obfuscating dynamics of its potential complications. With the physio-logical tactic of its centrifugal approach, moves peripherally and in between (neutral behavior) the event horizons of the healthy bio-available and any pathology, disease, illness, syndrome, injury etc, which is basically the "abstract" area of the emerging stress before the true values-1 (biophotons-light-energy-electricity-3D holographic & elctromagnetic fields) inevitably become false values-0 (nihilism). With the introduction and the usage of valuable and complex information (informational medicine) of undoubtedly rigorous sciences such as mathematics, physics, biology and philosophy, NAP as a regulator/buffer aims for the least action path (Hamilltonian physics) and with the controlled repetition (enrgams) of its intentional systems & agents, intends to maintain and enhance the physio-logical mechanisms of homeostasis and, by extension, through the parasympathetic system (vagus nerve-interoception) the stored energy levels of healthy bioavailability, since they form the absolute natural intrinsic self repair mechanism of smoothness and existence (Navier-Stokes). NAP is an innocuous Salutogenic (health-stress-coping) neuro-based independent Naturopathic system with neutral behavior. Neuronal stimulation (e.g transdermal, transensory) is an emerging field in modern medicine. As neuronal networks were evolutionarily selected to achieve physiological homeostasis, it is not surprising that neuromodulation emerged as one of the first strategies used in medicine to reestablish homeostasis during illness. Scientific studies indicate that the design of novel non-invasive techniques for nerve stimulation can help control immune and organ functions. NAP is based purely on the logic behind the mathematical symmetric property of equality, by creating simple models of complex bio-logical neuro-behavioral organic algorithms (simplexity). So when therapy by definition aims to normalize a distorted biological condition, actually what it does is to try to bring biochemical regularity (normal functioning). Now if we see it from another perspective (Anamorphosis), by intensifying or enduring the normal bio-available functioning (eurythmia), essentially we are in a therapeutic sphere of influence via a simple reverse process thinking mechanism (logic).

                    Volume 6, Issue 1 (2021)

                      Research Article Pages: 1 - 3

                      When do Rayleigh and Weibull parametric models predict the same results? A short note

                      Martin Connock, Mubarak Patel, Daniel Gallacher and Aileen Clarke

                      Health Technology Appraisals (HTA) model survival data using a conventional set of six parametric distributions. Alternative and potentially useful distributions
                      exist and could also be exploited.
                      Rayleigh 2 parameter (R2P) and Weibull models are both defined with two parameters and exhibit monotonic hazard; the Rayleigh model is relatively unused in
                      HTA and should not be regarded as just a special case of the Weibull model.
                      Aim: To explore circumstances where the predictions from R2P and Weibull models may differ or coincide.
                      Method: Stata software was used to model sample survival data with R2P and Weibull models and to compare the predicted hazard and survival from each
                      parametric.
                      Results: R2P models generate different predictions to Weibull models except in the special case where the Weibull shape parameter equals or closely approaches
                      two and the Weibull hazard prediction is linearly increasing. When compared to Weibull models R2P models may generate a better fit to observed data according
                      to conventionally used indicators of goodness of fit.
                      Conclusion: Rayleigh modelling of survival warrants inclusion in the survival modelling undertaken in Health Technology Appraisals.

                      Medicinal Plants and Pharmacoeconomics (2021)

                        Special Issue Article Pages: 1 - 2

                        Application of biotechnology to added value in vegetable oils of the Amazon: a tool for the bioindustry!

                        André Luis Willerding

                        This work presents the potential areas which the use of enzymes can expand markets for forest products such as oils from plants of the Amazon. This will add value in this raw material served as inputs for the cosmetic, food and pharmaceutical industries. Enzymes can increase the processing power and catalysis of lipids through a green chemistry and these conversions can be incorporated into industrial systems. The enzymatic modification of oils containing a high percentage of unsaturated fatty acids is an alternative biotech process with excellent commercial prospects, since by traditional chemistry can generate oxidation products and polymers undesirable. Another application is the enrichment of vegetable oils with polyunsaturated fatty acids (PUFA - poly-unsaturated fatty acids) for the production of nutraceuticals foods. In another application line, biodiesel production can also occur by enzyme process, allowing the formation of biofuel. Among the oils studied Amazon, Brazil nuts, buriti, tucumã, passion fruit are considered as important as sources of fatty acids (Fig. 1). Together, the hydrolysis and transesterification enzymatic reactions are gaining ground as an alternative to physical and chemical processes (Fig. 2).

                        Special Issue Article Pages: 3 - 4

                        Sudarshan Kriya Yoga: A breath of hope during COVID-19 pandemic

                        Sameer Zope

                        Essential counter measures to fight a highly infectious rapidly spreading pandemic disease like COVID-19 include antiviral therapy,   immune-modulator therapy, and vaccination. Antiviral therapies are expensive and require mass production of drugs. Rampant uses of  immunosuppressant, immune-modulators are associated significant complications like lethal bacterial and fungal super infections.  Disease specific vaccines are moreover strain-specific, so the protection provided is also limited and specific. Globally the number of identified COVID- 19 cases has been steadily growing. Along with serious health problems, the disease has exerted a huge psychological impact on the public, hence worldwide there is an increased interest towards use of low-risk, cost-effective complementary alternative therapies, like Yoga and Ayurveda to tackle the infectious pandemic, COVID-19. Now substantial clinical evidence is available on the potential complementary role of various yogic practices in the management of diverse communicable and non-communicable diseases. Recently many studies have also highlighted importance of Sudarshan Kriya Yoga (SKY) practices in improvement of psychological, physical and social wellbeing among frontline COVID warriors, COVID patients and general population. A unique Multi-component Breath-Based Yogic Practice “Sudarshan Kriya Yoga” includes specific sequential breathing techniques. It alleviates routine stress, anxiety, depression, post-traumatic stress, and stress-related medical disorders through balancing of the Autonomic Nervous System (ANS), improvement in the systemic health parameters and the quality of life. It is capable of potentiating innate host immune defenses that are crucial to tackle a plethora of microbial infections. A non-governmental, non-profit organization, the Art of Living Foundation has provided solace to the global population at large through online Sudarshan Kriya Yoga workshop during this COVID-19 pandemic. Essential counter measures to fight a highly infectious rapidly spreading pandemic disease like COVID-19 include antiviral therapy,   immune-modulator therapy, and vaccination. Antiviral therapies are expensive and require mass production of drugs. Rampant uses of  immunosuppressant, immune-modulators are associated significant complications like lethal bacterial and fungal super infections.  Disease specific vaccines are moreover strain-specific, so the protection provided is also limited and specific. Globally the number of identified COVID- 19 cases has been steadily growing. Along with serious health problems, the disease has exerted a huge psychological impact on the public, hence worldwide there is an increased interest towards use of low-risk, cost-effective complementary alternative therapies, like Yoga and Ayurveda to tackle the infectious pandemic, COVID-19. Now substantial clinical evidence is available on the potential complementary role of various yogic practices in the management of diverse communicable and non-communicable diseases. Recently many studies have also highlighted importance of Sudarshan Kriya Yoga (SKY) practices in improvement of psychological, physical and social wellbeing among frontline COVID warriors, COVID patients and general population. A unique Multi-component Breath-Based Yogic Practice “Sudarshan Kriya Yoga” includes specific sequential breathing techniques. It alleviates routine stress, anxiety, depression, post-traumatic stress, and stress-related medical disorders through balancing of the Autonomic Nervous System (ANS), improvement in the systemic health parameters and the quality of life. It is capable of potentiating innate host immune defenses that are crucial to tackle a plethora of microbial infections. A non-governmental, non-profit organization, the Art of Living Foundation has provided solace to the global population at large through online Sudarshan Kriya Yoga workshop during this COVID-19 pandemic.

                        Special Issue Article Pages: 5 - 5

                        Secrets of Ayurveda for healthy life

                        Madhuri Singhal

                        Ayurveda is said to be an eternal science, it is a holistic system of medicine. The origins of Ayurveda stretch deep into antiquity. It is said to be “Anadi”(timeless) though it’s scripted existence is about 5000 years. In Ayurveda the immunity and wellness is associated with our entire lifestyle. Ayurveda’s primary focus is on preventing illness by proactively leading a healthy way of life. It seeks to balance and restore health through wholesome food, exercise, meditation, relaxation and cleansing (detoxification). Along with Ayurveda, Yoga is a practical wisdom rooted in the vedic literature. Ayurveda and Yoga are complimentary to each other. While Allopathy tends to focus on management of disease, Ayurveda provides wisdom to prevent disease, to eliminate its cause and to maintain health. Ayurveda is based upon the fact that there are five elements present every where, in nature and in all materials including human body. These are Air, Water, Fire, Earth and Space. Different combinations of these elements form “Tridosha”: Vata, Pitta and Kapha. Tridosha are present in every person from birth, which are responsible for “Prakruti” of any individual. The Dosha runs the entire physiology of the body. The imbalance between Tridosha causes “Vikruti”, which is the root cause of disease. Moderation in food, exercise, sleep, awareness about our feelings and emotions help us to enhance our immunity and keep our body healthy and mind stress free and calm.

                        Special Issue Article Pages: 6 - 6

                        Herbs useful in snakebite: Information from the ayurvedic classics

                        Dilip Kr. Goswami

                        Snakebite can be considered as the most fatal among all types of poisoning . In most of the conditions of snakebite the individual may breath his last either due to the effect of the poison or due to fear . Sometimes a person , after snakebite , dies due to combined effect of the envomated snake venom and fear . It is agreed by both the Ayurvedic scholars and the modern scientists that most of the snakebites are not poisonous . Most of the deaths in such bites occur due to fear . Considering the effect of snake venom and the cause of death due to snakebite, at the time of preparation of the treatment protocol more attention is paid on use of medicines having cardioprotective (hridya) action and also anti – poisonous property medicines by the Ayurvedic scholars even before thousands of years of Christ . Ayurvedic classics mention a good number of plants available around us for treatment of snakebite which are described to have potent anti poisonous effect . These plants are even said to have the potency to cure even the strongest snake venom . A detail scientific study on the drugs of plant origin advised to use for treatment of snakebite may gift the human society an invaluable way in management of snakebite .

                        Special Issue Article Pages: 7 - 8

                        Treatments used for malaria in young Ethiopian children: a retrospective study

                        Abyot Endale Gurmu

                        Background: In Ethiopia, medicinal plants have been used to treat different diseases, including malaria, for many centuries. People living in rural areas are especially noted for their use of medicinal plants as a major component of their health care. This study aimed to study treatment-seeking and prioritize plants/plant recipes as anti-malarials, in Dembia district, one of the malarious districts in Northwest Ethiopia. Methods: Parents of children aged under 5 years who had had a recent episode of fever were interviewed retrospectively about their child’s treatment and self-reported outcome. Treatments and subsequent clinical outcomes were analysed using Fisher’s exact test to elicit whether there were statistically significant correlations between them. Results and discussion: Of 447 children with malaria-like symptoms, only 30% took the recommended first-line treatment (ACT) (all of whom were cured), and 47% took chloroquine (85% cured). Ninety-nine (22.2%) had used medicinal plants as their first-choice treatment. Allium sativum (Liliaceae), Justicia schimperiana (Acanthaceae), Buddleja polystachya (Scrophulariaceae) and Phytolacca dodecandra (Phytolaccaceae) were the most frequently used. Justicia schimperiana was the one associated with the best clinical outcomes (69% self-reported cure rate). However, the difference in clinical outcomes between the plants was not statistically significant. Conclusion: In this study, only 30% of children took the recommended first-line treatment. 22% of children with presumed malaria were first treated with herbal medicines. The most commonly used herbal medicine was garlic, but J. schimperiana was associated with the highest reported cure rate of the plants. Further research is warranted to investigate its anti-malarial properties.

                        Special Issue Article Pages: 9 - 9

                        Evaluate the efficacy of Darvyadi lauha(A herbo mineral compound) in the management of hepatocellular jaundice(Kamala) and hepato-protective activity in paracetamol induced hepatotoxicity- A randomised controlled clinical

                        Arshathjyothi P S

                        Statement Introduction: Liver diseases cause significant mortality and morbidity not only in Indian population but also in world. Due to the changing lifestyle the liver is affected even in early adolescence itself, so an excellent Yakrut uthejaka dravyas (hepato-protective drugs) are need of the hour. It was observed in some cases that the liver injury even with herbal preparations. 2017 world journal of hepatology had published Ayurveda drug induced liver injury. The title of the study is to ‘Evaluate the efficacy of Darvyadi lauha in the management of hepatocellular jaundice (Kamala) and hepatoprotective activity in paracetamol induced hepatotoxicity- a randomised controlled clinical.Methodology;A combination of experimental and clinical study. In primary study efficacy of Darvyadi lauha as a hepatoprotective drug explored in the paracetamol induced Wistar rats.30 rats were classified under five groups. After assessment liver parameters, antioxidant potential and hepatocyte structures found significant changes in Darvyadi lauha treated group. Clinical study conducted in hepato- cellular jaundice patients Results; Darvyadi lauha at 400mg/kg body weight have shown promising results hepatoprotective activity against Paracetamol induced hepatic damage. The drug is having significant antioxidant potential. 400mg/kg body weight drug group almost resolved paracetamol induced hepatic damage

                        Special Issue Article Pages: 10 - 10

                        SEO For Doctors: The Challenges & Tactics to Address in 2020

                        Hayk Saakian

                        This sessions goal is to demonstrate successful & reproducible tactics that will increase search traffic, conversions, & improve your rankings in Google. Looking at our campaigns & experiments in 2019, we'll review examples of SEO tactics that have increased rankings, how much traffic improvement was seeing over 3, 6, and 12 month timelines. I will present the processes and documentation we used so that attendees can replicate and perform the work independently with their teams as they are able. This session will be targeted to those with mid-tier knowledge of SEO who want to increase results Learning Objectives: 1.It will deliver actionable information and assets that attendees can use to grow their online presence and earn more traffic 2.Attendees will be able to create high value content for any keyword target with specific recommendations on how to optimize the content and what related targets the page can be optimized to 3. And create a list of high value outreach targets that already connect to their competitors and related entities in their target market.

                        Acupuncture and Pharmacoeconomics (2021)

                          Special Issue Article Pages: 1 - 1

                          Evaluate the efficacy of Darvyadi lauha(A herbo mineral compound) in the management of hepatocellular jaundice(Kamala) and hepato-protective activity in paracetamol induced hepatotoxicity- A randomised controlled clinical??

                          Dr Arshathjyothi P S Dr.RamaKant Yadava

                          Statement Introduction: Liver diseases cause significant mortality and morbidity not only in Indian population but also in world. Due to the changing lifestyle the liver is affected even in early adolescence itself, so an excellent Yakrut uthejaka dravyas (hepato-protective drugs) are need of the hour. It was observed in some cases that the liver injury even with herbal preparations. 2017 world journal of hepatology had published Ayurveda drug induced liver injury. The title of the study is to ‘Evaluate the efficacy of Darvyadi lauha in the management of hepatocellular jaundice (Kamala) and hepatoprotective activity in paracetamol induced hepatotoxicity- a randomised controlled clinical.Methodology;A combination of experimental and clinical study. In primary study efficacy of Darvyadi lauha as a hepatoprotective drug explored in the paracetamol induced Wistar rats.30 rats were classified under five groups. After assessment liver parameters, antioxidant potential and hepatocyte structures found significant changes in Darvyadi lauha treated group. Clinical study conducted in hepato- cellular jaundice patients Results; Darvyadi lauha at 400mg/kg body weight have shown promising results hepatoprotective activity against Paracetamol induced hepatic damage. The drug is having significant antioxidant potential. 400mg/kg body weight drug group almost resolved paracetamol induced hepatic damage

                          Special Issue Article Pages: 2 - 2

                          Post traumatic stress disorder and the toxicology of cannabis sativa

                          Onunekwu O. Charles,

                          Many young men, women and even the elderly are addicted to Cannabis intake abuse despite its predictable toxicological consequences. In this paper we studied the toxic effects of oral administration of methanol extract of cannabis sativa seeds using total of forty male Wistar Rats. Animals randomized were into five groups (n=8rats) of approximately equal weight. Group 1 received 100mg/kg of the of the extract, group 2 received 200mg/kg of the extract, group 3 received 300mg/kg dosage of the extract, group 4 received 2ml of olive oil and group 5 received distilled water for 14 days. Result for AST was significantly

                          Special Issue Article Pages: 3 - 3

                          Pain management rehabilitation and medical acupuncture

                          Dr Imran Fazil

                          Aims Although acupuncture has been widely used to treat a variety of pain conditions, convincing scientific evidence for its efficacy is lacking. Earlier randomised controlled trials attempted to follow a double-blind, placebo-controlled model. This approach has encountered many problems, such as the virtual impossibility of blinding the acupuncturist and the uncertainties inherent in choosing control acupuncture points. The objective of this review is to assess whether acupuncture is an effective treatment for chronic pain. In addition, a number of key methodological issues that arise in the controlled evaluation of acupuncture will be discussed. Methods This review is based on the result of previous reviews, metaanalyses and consensus conference. The search was performed with MEDLINE (from 1966), EMBASE (from 1980) and Cochrane library (1999, volume 1). Only randomised trials of acupuncture (involved needling) for subjects with chronic pain published in English were included. Results Basic science research has demonstrated convincingly that, at least in the context of acute pain, acupuncture's effects are related to the release of a variety of natural opioids. Acupuncture has been shown to be effective for postoperative dental pain. There are reasonable studies showing relief of pain with acupuncture on diverse pain conditions such as menstrual cramps, tennis elbow, low back pain and fibromyalgia. This suggests that acupuncture may have a more general effect on pain. However, there are also studies that provide equivocal results because of design, sample size and other factors. The issue is further complicated by inherent difficulties in the use of appropriate controls, such as placebo and sham acupuncture groups. Conclusions As most of the studies were of poor methodological quality, there is a need for further high-quality randomised controlled trials. Future studies should also have larger sample sizes, use a valid acupuncture treatment, and have both short-term and long-term follow-up.

                          Special Issue Article Pages: 4 - 4

                          Alternative medical approaches to rare and intractable diseases Which one is legal: waiting for evidences or offering a potential treatment?

                          Dr. Mehdy Ghaeminia, MD, PhD, Lic Acupuncturist Dr. Sogand Zareisedehizadeh, MD, PhD, Lic Acupuncturist

                          Since the introduction of what we know as conventional medicine in 17th century, scientists and medical practitioners tried to focus on evidence-based medicine incrementally. Since that time, there has been objections towards traditional medicine due to lack of enough scientific data to support their efficacy or safety. Therefore, the traditional medical treatments were ignored by the conventional healthcare system for many years. However, many people continued to get help from traditional remedies mainly when they were disappointed from the conventional medicine. Additionally, conventional medicine faced growing challenges such as side effects and difficulties to control or treat some diseases. It convinced some practitioners to use traditional or other alternative methods beside the conventional approaches. Though, lack of scientific proof of efficacy and safety their position in the healthcare system remain as a significant challenge. Here, a survey is reported on the chief complaints of patients seeking help from alternative medicine and the reasons they are approaching this field of medicine in order to make a realistic overall picture of the practical position of alternative medicine in the actual healthcare system and discuss the role of alternative medical practitioners in the public education towards a better and healthier society through integrative medicine by merging the conventional and alternative medicine. Based on the survey, although most of patients refer to the alternative medical clinics for benign and cosmetic problems, the role of these therapeutic methods gets more prominent during the management of rare conditions and patients suffering from intractable diseases when they have unsuccessfully tried various diagnostic and therapeutic methods. Since these patients need more support to cover their medical expenses, it is important that the role of integrative and alternative medicine be well recognized by healthcare systems.

                          Special Issue Article Pages: 5 - 5

                          Nigerian Traditional Herbal remedies used in the management of Diabetes

                          Zainab Ujudud Shariff

                          This study critically assessed the Nigerian traditional remedies used in the management of diabetes scientifically formulated by Pharm. Zainab U. Shariff based on the constituents, actions and activities of the long used traditional remedies in Nigeria. The objectives of the study is to expose further research into these remedies for the possible discovery of a new drug in the management and treatment of diabetes while utilizing its benefits with the basic science as herbal and phyto-medicines for the benefit of diabetic patients. Another objective is to facilitate the use of traditional medicine in the official health care system by stating the potential and economic benefits of traditional medicine practice to future, utilize the knowledge passed down to generations by the traditional medicine practitioners into modern science thereby bringing the old knowledge into modern science and also to promote the protection of the intellectual property of traditional herbal medicine formulas. The findings of the study revealed that the expensive cost of diabetic orthodox drugs and long term side effects has led to the increase need for more affordable, accessible and safer treatment method, which led to the in-depth study of traditional remedies. The study of the traditional remedies captures the more in-depth benefits to diabetic patients such as insulin, anti-oxidants properties and tonicity of the body organs unlike the scientific method of only insulin effects. At the end of the presentation, it will be recommended various traditional herbal formulations for the prevention, management and treatment of diabetes and other chronic diseases.

                          Special Issue Article Pages: 6 - 6

                          Future Overview Of Complimentary And Alternative Medicine And Current GIT Disorders Management.

                          Dr Hameed Mohammed Rafeek.

                          Complimentary Medicine and Alternative Medicine is going to be a major health care center. Most of the therapeutic technique are today practicing by practitioner who are educated with complementary alternative medicine and integrated medicine even though medical doctors who are specialist practicing in complementary medicine. But today complementary therapies are intent to be used together with conventional treatment. While the term “Alternative” implies replacing the treatment you receive from the doctor with one or more approaches that fall outside mainstream medicine. In my clinical experience gastro intestinal problem or bowel syndrome (colitis) recommends that anyone considering CAM approaches should discuss them with their doctor and CAM as a complement to describe medication and not as alternative to a another doctor recommended treatment. I would like to say CAM may work in many ways, they may help to control symptom ease pain and enhance feeling of wellbeing quality of life and may boost the immune system. This point of view is a clinically example hyper acidity patient or hypo acidity ibs , when you give the treatment of alternative therapy food and lifestyle then example Aloe Vera juice can be taken bromoline ,flex seed, black seed , green megma powder, slippery elm , mint, ginger, garlic etc is very helpful to the patients, but according to the patients condition. Moreover, acid and alkaline water PH level should balance to the intestine flora , therefore we advice the patient to take more alkaline water so it helps to clean the flora with a healthy healing tissue. Not only that there are certain condition we should avoid spicy food and high contain of acidity food and hardening food should be avoided. The colon flora to balance they should take probiotic food or probiotic powder. Emotional factor can influence the acidity condition therefore to reduce the emotional thing rest , proper sleep , liquid contain food, cooling type of food plus moderate fibre green leaves fruits and vegetables also advisable. Note 1: high dose of the chemical drugs are concerned with medical doctors advise. Note 2: Detoxification and colon cleansing are accoding to the patient considered . Note 3: Drink more water 2-3 litres per day every patient necessary except serious clinical conditions not needed. According to my experience major dominance behind mind body medicine manipulative and body base practice ,energy medicine ,yoga and breathing exercise are more benefitted for these types of people. Avoiding fast food and spicy food and try to avoid fizzy drinks as well. Nutrition supplement is also helpful such as fish oil, fatty fish salmon , mackerel and sardine are good sources of fish oil. Nuts ,green vegetables provides anti inflammatory action. My point of view you can use color line and color foods could like carrots, orange, beetroot is helpful for intestinal disorder people. Also vitamin b12 patients add to the anaemic patients while they can add same time vitamin d to boost the immune system. Iron deficiency patients could use iron for supplementary purpose. My conclusion of CAM is that to combine with some area needed and some area needed for the medical advice.

                          Special Issue Article Pages: 7 - 7

                          Does fever increase or decrease blood circulation?

                          K. M. Yacob

                          This is the first time many people have heard such a question. When it comes to treating back pain, neck pain, and knee pain, it is often heard that the cause of the pain is reduced blood flow. A variety of heat-inducing devices are used to increase blood flow to the lower back, neck, and knee pains. Physiotherapy often provides more heat than fever. To this day, no one has heard that fever is caused by poor blood flow. As the disease progresses, blood flow decreases. Body tingling, body aches, and narrowing of the blood vessels under the skin are the signs, symptoms, and signals of decreased blood flow. Signs, symptoms, and signals of decreased blood flow show before the onset of fever. When the disease becomes a threat to life or organs blood circulation decreases, Temperature of fever will emerge to increase prevailing blood circulation. It is a well-known fact that as the disease progresses, blood flow decreases and this can lead to death. When there is a decrease in blood flow and its signs, symptoms, and signals, the immune system do actions to increase blood flow to save lives. It has been proven around the world that all types of heat increase blood flow. The heat of the fever increases the blood flow. Fever increases blood flow, which means more lymphocytes flow through lymphoid tissues. If the heat of the fever increases the blood flow, reducing the heat reduces the blood flow. It will increase inflammation and infection and finally, death will occur. According to physics, it is foolish that when fever temperature is reduced, shows the symptoms, signs, and signals of reduced blood flow, are ignored and then treated to reduce the heat again. The fever is heat energy. To date, modern science has not studied what actions were carried out heat on fever. The cause of all complications, including death, is the treatment of fever without knowing why it is hot. What kind of treatment should be given if you have symptoms of decreased blood flow? Treatment should be to increase blood flow. This is the basic principle of physics. Is there any benefit in reducing body heat during fever? There is no merit of any kind. Not only is it of no benefit, but it also causes death by inflammation and infection. The actual treatment for fever is to increase blood circulation. Two ways to increase blood circulation. 1. Never allow body temperature to lose 2. Apply heat from outside to the body. When the temperature produced by the body due to fever and heat which we applied to the body combines together, the blood circulation increases. Heat-reducing fever treatment with water and paracetamol should be banned as soon as possible.

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