Exploring Obstruction and Deobstruent Drugs in Unani Medicine: A Comprehensive Survey and Future Directions.

Background: Obstruction and its consequences have become a threat to human health globally. It includes thrombosis, embolism, and obstruction in the airway, bile duct, lymphatic channels, and intestines. Through extensive research, it was discovered that ancient Unani scholars discussed the concept of obstruction under the term "Suddah," which translates to "blocking the way". Objectives: This study aims to explore the predisposing factors and causes of obstruction and mode of action of various deobstruent (Mufattih-i-Sudad) drugs. Methods: The concept of obstruction formation and deobstruent drugs was explored in various Unani classical literature, published indexed journals, dissertations, authentic websites, and journals. Results: Based on observations from the literature, obstruction (Suddah) most commonly arises due to an excess of cold temperament (shadid burudat) and derangement of morbid matter (madda) in terms of quantity and quality. Specifically, excessive, viscous, and thick humor (kaseer, lesdar, and ghaleez khilt) can become occluded in various passages and cavities of the body. Further analysis revealed that deobstruent drugs exhibit a hot temperament (ha'rr), a bitter taste, and possess multiple properties such as being demulcent (latafat), resolvent (tahallul), detergent (jila), and disintegrator (taqti'). Conclusion: This study serves as a tool for screening deobstruent (Mufattih-i-Sudad) drugs which can be used in various forms of obstruction occurring in the lumen and cavities of the body. The deobstruent drugs with their reported activities validated the concept of deobstruent (Mufattih sudad) activity.

Evidence-Based Unani Pharmacotherapeutics for the Treatment of Non-Alcoholic Fatty Liver Disease: A Mechanistic Review.

Background: Non-alcoholic fatty liver disease (NAFLD) has emerged as a global health crisis, affecting a quarter of the world's population, and is anticipated to become a leading cause of liver transplantation and hepatocellular carcinoma by 2030. Conventional pharmacotherapy for NAFLD remains imperfect. In this context, Unani medicine offers a promising alternative for managing NAFLD. Objective: This review aims to compile information on Unani medications used for the treatment of NAFLD, aiming to provide evidence of their efficacy and delve into the mechanisms through which these Unani drugs exert their therapeutic effects in NAFLD. Methods: A comprehensive exploration of classical Unani literature was conducted, referencing well-established texts to extract pertinent information regarding NAFLD and its treatment in Unani Medicine. Electronic databases, including PubMed, Science Direct, and Google Scholar, were systematically searched to gather information on the efficacy of Unani drugs in the treatment of NAFLD. Results: Unani medicine offers a rich repository of single herbs and compound formulations. There is a description of about 32 single herbs and 18 compound formulations for the treatment of NAFLD. These drugs act due to their Musakhkhin (calorific), Mudirr (diuretics), Mufattih (deobstruent), Muqawwῑ-i-Jigar (hepatoprotective), and Muhallilat (anti-inflammatory) action. The bioactive components present in these drugs possess antioxidant, hypolipidemic, anti-inflammatory, hypoglycemic, and hepatoprotective activities. These actions of Unani drugs closely align with the multifaceted nature of NAFLD pathogenesis, and thus effective in the treatment of NAFLD. Conclusion: The findings led us to conclude that the use of Unani medicines can improve clinical outcomes in NAFLD, as demonstrated by various clinical and experimental trials. However, further clinical trials are essential to provide a safe and effective option for addressing this prevalent liver condition.

Therapeutic Evaluation of Unani Medicine, Including Single Drugs and Polyherbal Formulations with Special Reference to Neurodegenerative Disorders.

Ethnopharmacological relevance: Unani remedies are considered safe and can be utilized as a healthcare resource due to the adverse effects of conventional pharmaceuticals. For instance, Donepezil, used to treat alzhemier's disease exerts many adverse effects such as dizziness, vertigo, dryness of mouth. Similarly, Memantine used to slow the neurotoxicity involved in alzhemier's disease also exerts adverse effects like vomiting, tremors and sleep disturbance. Over sixty percent of drugs are derived from synthetic basis, highlighting the potential benefits of natural Unani treatments as a safer alternative. Neurodegenerative disorders are illnesses characterized by structural and functional deterioration due to abnormal protein aggregation, resulting in inflammation and oxidative stress in the central nervous system. In unani system of medicine all current brain ailments, including alzheimer's disease, parkinson's disease, mania, anxiety, melancholia and others are classified under the general category of neurodegenerative disorders Their pathogenic variables and soociated symptoms and therapeutic modalities are similar. This study focuses on evidence-based Unani herbs and polyherbal formulations for the treatment of various neurodegenerative disorders. It reveals that 43 ethnomedicinal plants can be employed to treat the symptoms of neurodegenerative disorders. The material was gathered from several sources that tabulated the specific details of individual herbs and polyherbal formulations and highlighted the importance of various phytoconstituents on neuroprotective action. The research provides in vivo and scientific evidence to support the use of ethnomedicine in treating neurodegenerative disorders. Aim of the study: This study aims to validate the efficacy of Unani medicines, traditionally used for neurodegenerative diorders through evidence-based research. Methods: To scan single and polyherbal formulations for neurodegenerative disorders, a literature review of traditional Unani medicine texts was conducted. To collect evidence on the efficacy of these indicated medications in the treatment of neurodegenerative disorders, electronic resources such as ScienceDirect, PubMed, Wiley Online Library, and Google Scholar were searched. The current study is a systematic review that applies inclusion and exclusion criteria rooted in the classical symptoms of neurological disorders. It evaluates the efficacy of individual herbs and polyherbal formulations recommended by Unani scholars for treatment perspectives. Results: The researchers have so far discovered 43 single drugs and 38 polyherbal formulations in Unani classical literature for treating various neurodegenerative disorders. These herbs have antioxidant, anti-Alzheimer's, anti-Parkinsonism, anti-convulsant, cognitive enhancer, anti-anxiety, neuroprotective, and anti-depressant properties, with clinical investigations proving their efficacy. The study exclusively focuses on systematic review, highlighting selected clinical studies to assess their quality and reliability of evidence. These are discussed in the introduction to provide context and understanding. Conclusions: After a thorough review of entire literature of Unani medicine, it is evident that has painstakingly focused more on physiopathology of diseases of Dimagh wa A'sab including their treatment protocols .These protocols include Istifragh (biopurification), Taskhin (producing warmth), Tajfiif (desiccation), Tafrih-i Taba' (exhilaration). Research into Unani medicine has shown promising results, particularly in the use of medicinal plants known for their neuroprotective properties. One of the key advantages of Unani herbs is their natural composition, which typically consists of bioactive compounds that exert neuroprotective effects without the harsh impact often associated with synthetic drugs. For instance, herbs like Brahmi(Bacopa monnieri), Waj Turki (Acorus calamus), Chilghoza(Pinus gerardiana Wall) and Asgand (Withania somnifera) and many other plants have been studied for their ability to enhance cognitive function, reduce oxidative stress, and support neuronal health. These herbs work through various mechanisms such as antioxidant activity, anti-inflammatory properties, and modulation of neurotransmitter levels, all of which contribute to their neuroprotective potential. Nevertheless some of the compound formulations presented, that, have not yet undergone clinical testing. As a result, the researchers are advised to validate those medicines that have not yet undergone clinical evaluation.

Unani Medicines for Glycemic Control in Type 2 Diabetes Mellitus: A Systematic Review.

Background: Diabetes, especially Type-2 diabetes mellitus (T2DM), poses a significant global health challenge. Complementary and alternative medicine, such as Unani Medicine, has gained popularity for managing T2DM. Objective: This systematic review aims to evaluate the efficacy and safety of Unani medications in T2DM management. Methods: A comprehensive literature search was conducted across multiple electronic databases to identify relevant clinical trials. Inclusion criteria focused on original research articles examining the efficacy and safety of Unani medications in patients with T2DM. Data extraction and quality assessment were performed using established criteria, and meta-analyses were conducted to assess the efficacy of Unani medications on glycemic control. Results: Five randomized controlled trials met the inclusion criteria. Meta-analyses revealed that Unani medications significantly reduced fasting blood glucose and postprandial blood glucose levels compared to control groups. However, the impact on HbA1c levels was not statistically significant. No adverse effects were reported. Conclusion: The findings of this review suggest that Unani medications hold promise in the management of T2DM, as evidenced by significant reductions in fasting and postprandial blood glucose levels. However, further investigation, particularly focusing on compounds like Qurs Gulnar, is essential to unravel their mechanisms and ascertain their long-term efficacy. Moreover, enhancing study quality would provide valuable insights into the role of Unani Medicine as a complementary or alternative therapy for T2DM. These efforts are critical for establishing Unani Medicine's place in the comprehensive management of T2DM.

Clinical Evaluation of a Topical Unani Polyherbal Formulation in the Management of Photodamaged Facial skin: An open-label Standard Controlled Trial.

Introduction: Ageing is a natural process of life. With increasing age, the skin suffers progressive morphological and physiological decrement. Hyperpigmentation, Wrinkles, and roughness of skin are some of the symptoms of aged skin. Exposure to sunlight, pollution, stress, nicotine, etc aggravates Skin aging. This study aimed to determine the efficacy and safety of polyherbal formulation and compare its efficacy with the standard drug tretinoin in subjects of moderate to advanced Photoaged facial skin. Ingredients of polyherbal formulation are Aarade baqla (Vicia faba), Jau (Hordeum vulgare), Nakhud (Cicer arietinum),Masoor (Lens esculenta), Tukhm e turb (Raphanus sativus), Khardal (Brassica nigra), Haldi (Curcuma longa), Kateera (Cochlospermum religiosum). Methods: This was a randomized open-label standard controlled study. 82 eligible subjects were allocated equally into test and control groups by computer-generated random numbers. In the test group, a paste of 15 gm polyherbal formulation in milk, and the control group, 0.025% Tretinoin 1 gram was used topically on the face once a day for two months. The response was assessed by theclinician using following different scales for different parameters. Assessment of Skin hyperpigmentation: It was assessed by the Skin Hyperpigmentation Index online calculator (SHI). It describes the ratio of two scores, namely the hyperpigmented skin of the affected area and normal sun-protected skin from the same patient. The image was recorded with a Digital microscope-Win7 from a hyperpigmented area and normal sun-protected area. Both the images were uploaded on https://shi.skinimageanalysis.com/ and calculated the mean value of hyperpigmentation. SHI ranges from 1 (no hyperpigmentation) to 4 (maximum hyperpigmentation) where scores between 1 and 2 showed as light hyperpigmentation, 2-3 as medium hyperpigmentation, and scores between 3 and 4 as severe hyperpigmentation. Assessment of Fine wrinkles: Fine wrinkles number was determined by digital photography. The photographs were taken through Canon EOS 1500D DSLR Camera with an 18-55 mm Lens. Three images were taken of each subject's face (right, left, and center full face) on Baseline and Day 15th, 30th, 45th, and 60th to assess visible changes/improvement in their fine wrinkles score. Assessment of Nasolabial Fold: Modified Fitzpatrick Wrinkle Scale (MFWS) was used to assess Nasolabial folds. The scale comprised four main classes of Nasolabial wrinkling: 0, 1, 2, and 3 representing absent, fine, moderate, and deep wrinkles, respectively, and three inter classes i.e., 0.5, 1.5, and 2.5 to estimate wrinkle depth. The definitions of the entire classes of the scale are as follows: Class 0 = No wrinkle. No visible wrinkle; continuous skin line; Class 0.5 = Very shallow yet visible wrinkle; Class 1= Fine wrinkle. Visible wrinkle and slight indentation; Class 1.5= Visible wrinkle and clear indentation. <1-mm wrinkle depth; Class 2= Moderate wrinkle. Visible wrinkle, 1- to 2-mm wrinkle depth; Class 2.5= Prominent and visible wrinkle. More than 2-mm and less than 3-mm wrinkle depth; Class 3=Deep wrinkle. Deep and furrow wrinkle; more than 3-mm wrinkle depth. Assessment of Forehead lines score: Forehead lines were assessed (number and depth) by a Validated Grading Scale for Forehead Lines. The Forehead Lines Grading Scale is a 5- point photonumeric rating scale that was developed to objectively quantify resting (static) and hyperkinetic (dynamic) forehead lines. The scale ratings are 0 for no wrinkles, 1 for no wrinkles present at rest but fine lines with facial expression, 2 for fine wrinkles present at rest and deep lines with facial expression, 3 for fine wrinkles present at rest and deeper lines with facial expression, and 4 for deeper wrinkles at rest and deeper furrows with facial expression. Assessment of lateral canthal lines: The number of lateral canthal lines was determined by a Validated Grading Scale for Crow's Feet. The Crow's Feet Grading Scale is a 5- point photonumeric rating scale developed to objectively quantify the severity of crow's feet. This scale was applied to two separate evaluations of crow's feet: at rest (static) and with expression (dynamic). The scale ratings are 0 for no wrinkles, 1 for very fine wrinkles, 2 for fine wrinkles, 3 for moderate wrinkles, and 4 for severe wrinkles. Assessment of Facial Skin Roughness: The Allergan Skin Roughness Scale was used for facial skin roughness assessment. The area of assessment for the Allergan Skin roughness Scale is the area between the nasolabial fold to the preauricular cheek and from the inferior orbital rim to the mandible. The Allergan Skin Roughness Scale assigns a grade from none (0) to extreme (4) that describes the severity of skin coarseness, crosshatching, and elastosis in the midface area. The scale grading are 0 (None) Smooth visual skin texture, 1 (Minimal) Slightly coarse and uneven visual skin texture, 2 (Moderate) Moderately coarse and uneven visual skin texture; may have early elastosis, 3 (Severe) Severely coarse visual skin texture, cross-hatched fine lines; may have some elastosis, and 4 (Extreme) Extremely coarse visual skin texture, cross Hatched deep creases; extreme elastosis. Assessment of Facial Dullness: Dullness was assessed on a clinical basis with an arbitrary scoring ranging from 0 to 9 where 0-3=mild, 3.5-6=moderate, and 6.5-9=severe facial skin dullness. Assessment of quality of life: Subjects' life quality was assessed by the Dermatology Life Quality Index questionnaire. It consists of 10 questions. Each question is scored on a four-point Likert scale: Very much = 3, A lot = 2, A little = 1, Not at all = 0, Not relevant = 0 and Question unanswered = 0. The DLQI is calculated by adding the score of each question, resulting in a maximum of 30 and a minimum of 0. Where, 0-1= no effect at all on patient's life, 2-5 = small effect on patient's life, 6-10 = moderate effect on patient's life, 11-20 = very large effect on patient's life, 21-30 = extremely large effect on patient's life. Results: Both groups showed a significant improvement in Fine Wrinkles, Forehead Lines, Crow's Feet, Roughness, Dullness, Nasolabial Fold, Hyperpigmentation, and Quality of Life parameters. (P < .001) A large number of subjects in the control group reported mild to moderate redness, itching, dryness, and blackening of the skin, while in the test group, absolutely no side effects were reported during treatment. Conclusion: The effects in both groups were substantial, but the polyherbal formulation is safe and effective for use in photoaged facial skin. It may be a more feasible easily accessible cheap and safe formulation to prevent skin aging and restore skin elasticity and make skin brighter. Further studies to evaluate the efficacy of formulation on objective parameters using standard instruments should be done for appropriate measurements of parameters.

A Systematic Review of COPD from the Perspectives of Greco-Arabic and Modern Medicine.

Context: The ongoing COVID-19 pandemic has heightened concerns about respiratory system disorders. In Unani Medicine's literature, chronic bronchitis, referred to as Iltihab al-Shu'ab Muzmin, is significant within the realm of respiratory disorders. Objective: The study intended to examine the perspectives of Greco-Arabic physicians, from Raban Tabari to Azam Khan, as well as that of Western physicians, exploring the definitions, signs, symptoms, pathophysiology, diagnosis, principles of treatment, and preventive measures for chronic bronchitis. Design: The research team performed a narrative review by reviewing important Unani classical textbooks and by searching scientific databases, including PubMed, ScienceDirect, and Google Scholar from their dates of inception until August 2023. The search used the keywords chronic bronchitis, Iltihab al-Shu'ab Muzmin, chronic obstructive pulmonary diseases, Unani, and Greco-Arabic. Setting: The study took place at the Regional Research Institute of Unani Medicine, Patna, India. Results: The alignment between the symptoms that Unani physicians categorize as Su'al (cough) and Iltihab al-Shu'ab Muzmin (chronic bronchitis) is evident. Conclusions: Unani philosophers have described risk factors, clinical features, pathology, and principles of management, showing farsightedness a thousand years ago. Contemporary Unani practitioners may obtain guidance from the work of the system's stalwarts.

Vector-control potential of Unani medicines: A review of classical Unani texts and contemporary scientific literature.

BACKGROUND OBJECTIVES: Vector-borne diseases pose substantial global health challenges, with a notable impact on India. Effective vector control strategies are crucial to mitigating these diseases as there are no effective vaccines available. Synthetic chemicals are widely used but concerns about safety and environmental impact have prompted exploration of alternative natural solutions. Unani medicine offers a potential source of natural products. This study aims to systematically review classical Unani texts and contemporary scientific literature to evaluate the vector control potential of Unani medicines. METHODS: A comprehensive review of classical Unani texts was carried out to compile data on herbal and mineral substances suggested in Unani medicine for control of insects. Furthermore, electronic databases like PubMed, Google Scholar, and Science Direct were explored for research studies evaluating the insect repellent, larvicidal, and insecticidal activities of the Unani medicines. Time restriction was not imposed to ensure comprehensive retrieval of pertinent and up-to-date information. RESULTS: From classical Unani texts, 29 drugs were identified for control of insects, primarily of plant origin from diverse botanical families. Recent scientific investigations have confirmed the insect-repellent, insecticidal, and larvicidal activities of 19 of these Unani medicines against various insect species, including mosquitoes. INTERPRETATION CONCLUSION: These findings underscore the potential of Unani medicines as a natural source for vector control. However, further research is essential to explore mechanism, delivery methods, and optimal concentrations for developing effective vector-control formulations.

Conceptual Understanding of Preventive Strategies for Metabolic Disorders in Unani Medicine: A Narrative Review.

Background: The global burden of metabolic disorders is increasing at an alarming rate. These disorders have a huge impact in terms of human suffering and economic implications. There is an urgent need for effective strategies, including the use of traditional systems of medicine, to reduce the burden of these diseases. Objective: The objective of this article is to compile information on preventive strategies for metabolic disorders found in Unani medicine. Methods: A literature survey of classical Unani texts was conducted to understand the conceptual framework in Unani medicine underlying preventive strategies for metabolic disorders. Electronic databases such as PubMed, ScienceDirect, and Google Scholar were searched to obtain the evidence needed to validate the Unani medicine viewpoint. Results: Unani scholars have described a set of clinical conditions caused by the insufficiency of the nutritive faculty. These conditions correlate in many ways with metabolic disorders. Cold dystemperament of the liver is considered to be the cause of insufficiency of nutritive faculty. Therefore, care and protection of the liver is considered as the main preventive approach for metabolic disorders in Unani medicine. Several epidemiological studies have also reported a strong relationship between non-alcoholic fatty liver disease and metabolic syndrome. Conclusion: The broad set of approaches (based on its theoretical foundations) used by Unani scholars to maintain the nutritive faculty in its optimal functional state seems to be an effective measure for the prevention of metabolic disorders.

Pharmacological Treatment of Upper Respiratory Tract Infections in Unani Medicine: An Evidence-Based Review.

Background: Upper respiratory tract infections (URTIs) are one of the most common illnesses in humans. Unani medications are widely used for this indication and are considered effective in alleviating the symptoms. Objective: This article aims to document the Unani medications used for URTIs under a single heading and to provide evidence of their efficacy. Methods: A literature survey of classic Unani texts was conducted to screen for single and compound Unani formulations for URTIs. Electronic databases such as PubMed, ScienceDirect, Wiley Online Library, and Google Scholar were searched to obtain evidence regarding the efficacy of these recommended drugs in URTI treatment. Results: In the Unani medicine literature, the authors found descriptions of 28 single herbs and 40 compound formulations for the treatment of URTIs. A search of electronic databases yielded 13 clinical studies confirming the efficacy of the recommended medications in URTI treatment. These trials demonstrated that the administration of Unani medications significantly accelerated clinical improvement in URTIs. Conclusions: The findings of the included studies led us to conclude that the use of Unani medicines significantly accelerates clinical improvement in URTIs, as demonstrated by various subjective and objective parameters. Hence, clinically validated Unani medications should be considered for the treatment of URTIs.

The Perspective of Unani Medicine in Understanding Hyperthyroidism.

Context: Hyperthyroidism, Kasrat-e-Ifraz-e-Darqiyya in Unani medicine, is a condition in which the thyroid gland produces an excessive amount of the thyroid hormone thyroxine. Its clinical features are excessive sweating, heat intolerance, increased bowel movements, a voracious appetite, insomnia, tremors, palpitations, and a rapid pulse. Objective: This review intended to investigate the observations in ancient Unani literature, Traditional Chinese Medicine (TCM), and Ayurveda that correspond to the clinical presentation of hyperthyroidism as well as to identify probable treatments in Unani medicine. Design: The research team performed a narrative review to evaluate the concept of hyperthyroidism using classical Unani Medicine books, such as Firdaus-Ul-Hikmat (Wisdom of Paradise), Al-Havi Fit Tib (Liber Continence), Kamil- Us- Sana (Liber Regius), Al-Qanoon (The Canon of Medicine), and Zakheera Khvarazm Shahi (The Treasure of Medicine) to assess the perception of hyperthyroidism. The team also searched internet sources, such as Pubmed, Medline, Scopus, Web of Science, Publons, and Google Scholar. using keywords such as Su-e-Mizaj Ha'ar Maddi, Ghair Tabayi Safra, Yang-Yin, Pitta, hyperthyroidism. The study was undertaken at National Institute of Unani medicine, Bengaluru, India. Results: In TCM, a dominant Yang Qi is considered as cause of hyperthyroidism; in Ayurveda, excessive Pitta production is considered as its cause, and in Unani Medicine it is due to an excess of abnormal bile (Ghair Tabayi Safra). Thus, the traditional systems all view the disease as a manifestation of excessive energy production. Conclusions: The clinical symptoms of the hot temperament of bile (Su-e-Mizaj Ha'ar Maddi) and hyperthyroidism are similar in the literature. The resemblance may help medical practitioners to recommend a better approach for preventing, treating, and reducing the condition's devastating complications using the treatment approach of Unani medicine. It approaches hyperthyroidism with recommendations for reducing excessive energy production, with the help of restoration of the imbalance in temperament (Mizaj).

Exploring Drug De-addiction Treatment in Unani Medicine.

Background: Drug addiction, or substance abuse disorder, has a long history. The use of a drug that causes dependence has been used in various religious and tribal initiation ceremonies. Currently, recreational use or peer modelling leads an individual to substance abuse. The magnitude of the problem of addiction increases multifold in the presence of stressors like broken families, joblessness, occupational stress, etc. Objectives: The de-addiction process is used to relieve an individual's craving for the drug. It is a painful process, as several effects of withdrawal compel a person to return to the drugs again and again. Our aim is to explore the available literature on the use of Unani medicine for de-addiction. Methodology: We surveyed various classical books from the available literature for drug de-addiction in Unani medicine. Indexed journals were also surveyed for the available related material using various keywords like "opium addiction" and "Unani medicine and de-addiction " and the information was filtered for this review. Results: We observed that there was an elaborate scheme for de-addiction in opium addiction and the process is so general that it could serve as a framework for the de-addiction process for other similar drugs. Conclusion: Unani medicine is significant in the literature as being among the the available de-addiction addiction processes and may furnish several leads for various herbal drugs that may be used for de-addiction in the future.

Analysis of Unani coded formulation on the hormonal parameters of patients with polycystic ovarian syndrome.

The effect of Unani coded polyherbal formulations (Picolin) containing: 1) Cinnamomum verum (Bark), 2) Glycyrrhiza glabra (Root), 3) Linum usitatissimum (Seed) and 4) Vitex agnus castus (Seed) on the hormonal levels of polycystic ovarian syndrome (PCOS) patients (n=73) was determined. A randomized controlled multi-center trial was conducted on three groups that received either: 1) Capsule Picolin (n=25, 500 mg, two capsules thrice a day) and 2) Hydroalcoholic extract, tablet Picolin-E (n=23, 250 mg thrice a day) or 3) Metformin (n=25, 500 mg, twice a day) that continued for 12 weeks. The effect of capsule Picolin before and after treatment on serum insulin (14.8±1.8 vs 10.7±1.7µIU/mL) and prolactin (17.7±0.9 vs 8.5±1.1ng/mL) levels were significant. Likewise, the tablet Picolin-E also demonstrated significant effect on serum insulin (16.7±1.7 vs 9.3±0.1µIU/mL) and prolactin (18.5±1 vs 10±1.5ng/mL) levels. On the contrary in metformin treated group these parameters, serum insulin (17.4±1.6 vs 16.4±1.4µIU/mL) and prolactin (21.7±2.8 vs 21±2.8ng/mL) were non-significant. The improvement in the menstrual flow in the PCOS patients after treatment with either capsule Picolin, tablet Picolin-E or metformin were improved by 84%, 61% and 54%, respectively. Unani formulation were comparatively more effective than metformin. The treatment effectiveness was capsule Picolin> tablet Picolin-E>metformin.

A non-inferiority randomized controlled clinical trial comparing Unani formulation & psoralen plus ultraviolet A sol in chronic plaque psoriasis.

BACKGROUND & OBJECTIVES: Though Unani medications have been used for centuries to treat psoriasis, there is paucity of published studies which have systematically evaluated their efficacy and safety. This study was conducted to establish non-inferiority of Unani medications (oral UNIM-401 and topical UNIM-403) vs psoralen plus ultraviolet A (PUVA) sol in treatment of moderate-severe chronic plaque psoriasis (CPP) in achieving psoriasis area severity index (PASI) 75 at 12 wk and to estimate proportion of patients who relapsed in follow up period of 12 weeks, after having achieved PASI 50. METHODS: In this randomized, controlled trial patients with CPP were block randomized to receive either Unani treatment (147 patients) or PUVA sol (140 patients) for 12 weeks. Percentage reduction in PASI was determined in each patient at 12 wk to calculate number of patients who achieved PASI 75 as also to estimate median of percentage reduction in PASI in each group. All patients who achieved PASI 50 at 12 weeks were followed up for another 12 wk to determine proportion of patients who relapsed. RESULTS: Of the 287 patients randomized, 84 of 147 in Unani group and 67 of 140 in PUVA sol group completed 12 weeks of treatment. On intention-to-treat (ITT) analysis, the response in patients on Unani medication was not inferior to those receiving PUVA sol, in attaining PASI 75 (16.3% in Unani group vs 15.7% in the PUVA sol group). Median of percentage reduction of PASI at 12 wk from baseline in Unani group (68.2%; -60, 100) and PUVA sol group (63%; -15.7, 100) was comparable. Proportion of patients who relapsed at 24 wk was comparable in both groups. However, frequency of clinical side effects was significantly higher (P =0.001) in PUVA sol group (16.4%) compared to Unani group (2%). INTERPRETATION & CONCLUSIONS: The findings of the present study indicated that oral UNIM-401 and topical UNIM-403 were effective and well tolerated therapeutic options in patients with moderate-severe CPP.

Clinical efficacy of Unani medicine Renax for treatment of Urolithiasis.

Stone formation occurs most commonly in acute and chronic renal failure. A kidney stone is a solid lump made up of crystals that separate from the urine and build up on the inner surfaces of the kidney. The current study was conducted to investigate the clinical efficacy of Unani medicine Renax in comparison with allopathic medicine (Spironolactone + Furosemide) to treat urolithiasis. The study was conducted in District Dera Ghazi Khan, South Punjab region. This was case control, randomized, double blind clinical study. All patients were examined by the Physician and given either herbal or allopathic medicine for Urolithiasis. The patients were divided "into two groups" a control group and test groups. A Total of 24 patients were completely cured out of 50 by use of Renax while a total of 9 patients was cured out of 50 with allopathic medicine (Spironolactone + Furosemide). This study validated the claim of traditional healer for use of Unani medicine in the treatment of urolithiasis.

Antimicrobial and wound healing potential of Marham-e-Aatshak (A Herb-o-Mineral formulation).

Marham-e-Aatshak (MA) is a Unani ointment, with wide use for treating chronic and infectious wounds since long time. This study was designed to screen the antimicrobial and wound healing potential of MA to validate the ethno-therapeutic claims. The agar diffusion method was used to study the antimicrobial action of MA as well as for all of its ingredients. Inhibition zone diameters were measured and MIC values were calculated. Wound healing activity was studied in models of both, excision and incision wounds. Wound contractibility was measured at different intervals in excision wound model; similarly tensile strength was measured in incision wound model. MA and its ingredients showed remarkable inhibitory activity against most of the organisms. In excision wound, a significantly enhanced wound contraction and significantly reduced epithelialization period was observed. In incision wound, significant increase in the mean breaking strength in the test group was observed. The results indicate that MA is capable of fighting against wound infections and able to potentiate the natural healing process.

Is folklore use of Euphorbia helioscopia devoid of toxic effects?

OBJECTIVE: To evaluate acute toxic effects of Euphorbia helioscopia in order to assure the safety and usefulness of herbal remedy. MATERIALS AND METHODS: The Organization for Economic Cooperation and Development (OECD) for chemical testing guidelines No. 425 for acute oral toxicity testing were followed in this study. Mice were divided into three groups (n = 5). Group I served as control. Groups II and III were administered methanol extract of E. helioscopia leaves and latex orally at dose of 2000 mg/kg, respectively. Then, all the animals were observed for two weeks. Blood sampling was done by cardiac puncture after 14 days from each group for biochemical analysis. Histopathology was performed to find out any microscopic lesion in vital organs. RESULTS AND DISCUSSION: LD50 was found greater than 2000 mg/kg. There was decrease in cholesterol, triglycerides, LDL and VLDL levels of latex and leaves with methanol extract-treated animals, with respect to control indicating plant's hypolipidemic effect. On macroscopic examination, no lesions were found on vital organs, such as liver, heart and kidney; and normal architecture was observed on microscopic examination. CONCLUSION: On the basis of results, it was concluded that methanol extract of E. helioscopia leaves and latex were devoid of toxic effects in acute toxicity study.

The Need to Develop a Regulatory Body for the Practice of Al-Hijama.

Al-Hijama is a traditional therapy which has been extensively used in the Middle East. It has an Islamic basis but is used in many cultures in the form of wet cupping. There has been a significant growth in its availability in most Western countries during the last decade. In none is it subject to statutory regulation and the training and quality of practitioners is variable. It has both a preventive and therapeutic element and so there are appropriate concerns about the potential for incorrect diagnoses and delays in other effective treatments. In the past, the apprenticeship model in which a trainee worked for some years with an experienced ijazah ensured such problems did not arise. However, there is now an urgent need to recognise the widespread practice of this therapy and ensure that it has the benefits of statutory regulation, be this through specific regulatory bodies or a negative licensing model.

Unani treatment and leech therapy saved the diabetic foot of a patient from amputation.

Every 30 seconds, a lower limb amputation is carried out due to diabetes throughout the world. The mortality rate due to diabetic foot gangrene is just next to that of cancer. As tissue death cannot be reversed, surgical removal of the affected tissue (debridement) or amputation of the limb is the only treatment option left when gangrene has advanced. The present case study illustrates an option to treat poorly healing diabetic wounds with Unani medicine (blood purifier and deobstruent) besides hirudotherapy. The study was performed on a 60-year-old woman suffering from diabetic foot (on the left) grade 5 and facing the prospect of imminent amputation. The patient was having severe pain (80 mm on a 100 mm visual analogue scale) in the gangrenous foot and foul-smelling with necrosed areas. Wound dressing was done with unripe papaya as it has a very good role in clearing necrotising area and hirudotherapy was also used in poorly healing wounds. The pain score decreased to 0-10 mm on a 100 mm visual analogue scale within 20 days and no further pain relieving medication was required. Over a time interval of nearly 3·5 months, necrotic areas disappeared and the wound was completely healed.

The effects of new polyherbal Unani formulation AJMAL06 on serum creatinine level in chronic renal failure.

This study was conducted to evaluate the efficacy of Unani Ajmal06, an herbal formulation for management of chronic renal failure (CRF). The therapeutic evaluations of three different formulations such as Itrifal Kashneezi, Jawarsih Zarooni Sada medicines were conducted on number 35 CRF patients clinically diagnosed cases of chronic kidney failure. It was found that herbal coded Ajmal06 was effective for the treatment of CRF in 70% of the patients treated. SPSS tests on sign and symptoms indicated the efficacy of Ajmal06 in lowering serum creatinine level in 70% of patients of chronic renal failure. In clinical response of BUN exhibited 75% of patients improved where as in case of fatigue (70%), edema (90%), leg pain (76%) improved these types of conditions with significant p value.

Clinical assessment of coded Unani formulation D-worm and mebandazole for the treatment of hook worm, roundworm and whip worm.

A case control, multicenter, prospective randomized two arm parallel group clinical trials was conducted on 190 patients. The main objective of this study is to provide comparative efficacy results of both trialed medicines. The comparison was done in between herbal medicine D-Worm and Mebandazole allopathic drug for the treatment of helminthiasis. All the rules of GCP (Good Clinical Practices) were followed including clinical history, clinical presentation, examination findings and stool tests. Stool D/R and Parasite antigen tests were performed before and after treatment. The comparison of symptoms were also done including the improvement in abdominal pain, worms in stool, anal itching, nausea and vomiting, loss of appetite, and fatigue etc. The data on clinical proforma was gathered and subjected to statistical analysis. Parasite specific antigen test and stool D/R is considered as gold standard test for the diagnosis and confirmation of helminthes infection. Different parameter i.e. age, sex, and other clinical sign and symptoms were studied and compared between two treatment groups (Control and Test groups) at baseline and end of therapeutic application. Consent of patient was taken at first before the start of examination. Majority of the patients (90%) included in this study group get cured after herbal treatment. The statistical analysis used for the assessment of the effect of the treatment also showed significant improvement after treatment.