DNA barcoding of herbal supplements on the US commercial market associated with the purported treatment of COVID-19.

INTRODUCTION: The COVID-19 pandemic was associated with an increased global use of traditional medicines, including Ayurvedic herbal preparations. Due to their growing demand, their processed nature, and the complexity of the global supply chain, there is an increased risk of adulteration in these products. OBJECTIVES: The objective of this study was to assess the use of DNA barcoding for species identification in herbal supplements on the US market associated with the Ayurvedic treatment of respiratory symptoms. METHODS: A total of 54 commercial products containing Ayurvedic herbs were tested with four DNA barcoding regions (i.e., rbcL, matK, ITS2, and mini-ITS2) using two composite samples per product. Nine categories of herbs were targeted: amla, ashwagandha, cinnamon, ginger, guduchi, tribulus, tulsi, turmeric, and vacha. RESULTS: At least one species was identified in 64.8% of products and the expected species was detected in 38.9% of products. Undeclared plant species, including other Ayurvedic herbs, rice, and pepper, were detected in 19 products, and fungal species were identified in 12 products. The presence of undeclared plant species may be a result of intentional substitution or contamination during harvest or processing, while fungal DNA was likely associated with the plant material or the growing environment. The greatest sequencing success (42.6-46.3%) was obtained with the matK and rbcL primers. CONCLUSION: The results of this study indicate that a combination of genetic loci should be used for DNA barcoding of herbal supplements. Due to the limitations of DNA barcoding in identification of these products, future research should incorporate chemical characterization techniques.

[What is the potential of ChatGPT for qualified patient information? : Attempt of a structured analysis on the basis of a survey regarding complementary and alternative medicine (CAM) in rheumatology]. / Welches Potential hat ChatGPT 3.5 für eine qualifizierte Patienteninformation? : Versuch einer systematischen Analyse anhand einer Befragung zu komplementärmedizinischen Verfahren in der Rheumatologie.

INTRODUCTION: The chatbot ChatGPT represents a milestone in the interaction between humans and large databases that are accessible via the internet. It facilitates the answering of complex questions by enabling a communication in everyday language. Therefore, it is a potential source of information for those who are affected by rheumatic diseases. The aim of our investigation was to find out whether ChatGPT (version 3.5) is capable of giving qualified answers regarding the application of specific methods of complementary and alternative medicine (CAM) in three rheumatic diseases: rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) and granulomatosis with polyangiitis (GPA). In addition, it was investigated how the answers of the chatbot were influenced by the wording of the question. METHODS: The questioning of ChatGPT was performed in three parts. Part A consisted of an open question regarding the best way of treatment of the respective disease. In part B, the questions were directed towards possible indications for the application of CAM in general in one of the three disorders. In part C, the chatbot was asked for specific recommendations regarding one of three CAM methods: homeopathy, ayurvedic medicine and herbal medicine. Questions in parts B and C were expressed in two modifications: firstly, it was asked whether the specific CAM was applicable at all in certain rheumatic diseases. The second question asked which procedure of the respective CAM method worked best in the specific disease. The validity of the answers was checked by using the ChatGPT reliability score, a Likert scale ranging from 1 (lowest validity) to 7 (highest validity). RESULTS: The answers to the open questions of part A had the highest validity. In parts B and C, ChatGPT suggested a variety of CAM applications that lacked scientific evidence. The validity of the answers depended on the wording of the questions. If the question suggested the inclination to apply a certain CAM, the answers often lacked the information of missing evidence and were graded with lower score values. CONCLUSION: The answers of ChatGPT (version 3.5) regarding the applicability of CAM in selected rheumatic diseases are not convincingly based on scientific evidence. In addition, the wording of the questions affects the validity of the information. Currently, an uncritical application of ChatGPT as an instrument for patient information cannot be recommended.

Labeling compliance and online claims for Ayurvedic herbal supplements on the U.S. market associated with the purported treatment of COVID-19.

During the COVID-19 pandemic, many consumers increased their use of supplements that claimed to support immune health, including Ayurvedic preparations. The goal of this study was to analyze labeling compliance and online claims for Ayurvedic herbal supplements associated with the purported treatment of COVID-19. The physical product labels for 51 herbal supplements labeled as ginger, tulsi/holy basil, amla, vacha/calamus root, guduchi/giloy, cinnamon, ashwagandha, tribulus, or turmeric were assessed for U.S. regulatory compliance. Disease claims, structure/function claims, and general well-being claims were also examined. The online listings for products purchased online (n = 42) were examined for claims and for the presence of the required legal disclaimer. Collectively, 61% of products had at least one instance of noncompliance on the physical label. The most common violations included missing/noncompliant disclaimer (33%), noncompliant "Supplement Facts" label (29%), noncompliant statement of identity (27%) and noncompliant domestic mailing address or phone number (25%). Structure/function claims occurred more frequently in the online product listings (average of 5 claims per product) compared to the physical labels (average of 2 claims per product). Disease claims were observed for 38% of online product listings and on 8% of physical labels. The use of disease claims on herbal supplements is a significant concern for public health because it may lead consumers to delay seeking professional treatment for life-threatening diseases. Overall, this study revealed a lack of labeling compliance among Ayurvedic herbal supplements and a need for greater scrutiny and monitoring of online product listings.

Evaluation of Na and K in anti-diabetic ayurvedic medicine using LIBS.

Diabetes mellitus, known as diabetes, is a challenging issue, and to control diabetes, a large population is lining toward ayurvedic medicine. In the present study, four brands of anti-diabetic ayurvedic medicines, along with a home remedy, are analyzed using the laser-induced breakdown spectroscopic (LIBS) technique. The study is carried out to know the elements responsible for glycemic potential. The laser-induced breakdown (LIB) spectra elucidate the presence of organic and inorganic elements like Al, Ba, C, Ca, Cu, Fe, H, K, Mg, N, Na, O, Si, Sr, Zn, and the molecular band of CN molecule in medicines. LIBS result also reveals Na and K's distinct concentration, which plays a vital role in diabetes management. The presence of the CN band and organic elements indicate the presence of organic molecular compositions in medicines. For confirmation of organic composition in the drugs, Fourier transform infrared spectroscopy (FT-IR) has been performed. Principal component analysis (PCA) on the LIBS data of the medicines has been used for instant discrimination based on their elemental/molecular compositions.

Optimizing Health - Integrative Medicine & Poor Performance.

Addressing poor performance issues in horses is a common yet challenging request to veterinarians. Often, there are limited field diagnostic or therapy choices. Growing lay popularity in integrative therapies, as well as increasing clinical incorporation, is creating more awareness of their clinical applications. Many modalities are showing increasing evidence of positive outcomes with minimal harm, but additional safety and efficacy evaluation is needed. Integrative modalities have unique ways of perceiving disease patterns that are different from more modern approaches, and these different perspectives can be used diagnostically and therapeutically either combined with more conventional approaches, or when those approaches fall short.

Hot and Cold Theory: A Personalized Medicine Approach.

The hot and cold theory is an important part of Traditional Medicines (TMs) which can be used in health care, disease prevention, diagnosis, and treatment purposes. However, little has been said about the material basis of the theory and how the hot and cold theory can be integrated with the conventional medicine. This article will summarize how the Hot and Cold Theory may help health care providers to personalize their treatment, as well as the material basis of the theory and its future prospects.

Promising traditional Indian medicinal plants for the management of novel Coronavirus disease: A systematic review.

Traditional Indian medical practices (Ayurveda, Siddha, Unani, and homeopathy) are a vast reservoir of knowledge about medicinal plants. The promising pharmacological properties of these plants have paved the way for developing therapy against novel Coronavirus (CoV) infection. The current review will summarize published works of literature on the effects of traditional Indian medicinal plants against acute respiratory infection (COVID-19, SARS, Influenza, and Respiratory syncytial virus infection) and registered clinical trials of traditional Indian herbal medicines in COVID-19. The current study aims to comprehensively evaluate the data of traditional Indian medicinal plants to warrant their use in COVID-19 management. PubMed, Embase, and Cochrane databases were searched along with different clinical trial databases. A total of 22 relevant traditional Indian medicinal plants (35 relevant studies) were included in the current study having potential antiviral properties against virus-induced respiratory illness along with promising immunomodulatory and thrombolytic properties. Further, 36 randomized and nonrandomized registered clinical trials were also included that were aimed at evaluating the efficacy of herbal plants or their formulations in COVID-19 management. The antiviral, immunomodulatory, and thrombolytic activities of the traditional Indian medicinal plants laid down a strong rationale for their use in developing therapies against SARS-CoV-2 infection. The study identified some important potential traditional Indian medicinal herbs such as Ocimum tenuiflorum, Tinospora cordifolia, Achyranthes bidentata, Cinnamomum cassia, Cydonia oblonga, Embelin ribes, Justicia adhatoda, Momordica charantia, Withania somnifera, Zingiber officinale, Camphor, and Kabusura kudineer, which could be used in therapeutic strategies against SARS-CoV-2 infection.

Withaferin A-A Promising Phytochemical Compound with Multiple Results in Dermatological Diseases.

Withaferin A (WFA) was identified as the most active phytocompound of the plant Withania somnifera (WS) and as having multiple therapeutic/ameliorating properties (anticancer, antiangiogenic, anti-invasive, anti-inflammatory, proapoptotic, etc.) in case of various diseases. In drug chemistry, WFA in silico approaches have identified favorite biological targets, stimulating and accelerating research to evaluate its pharmacological activity-numerous anticancer effects manifested in various organs (breast, pancreas, skin, colon, etc.), antivirals, anti-infective, etc., which are not yet sufficiently explored. This paper is a synthesis of the most relevant specialized papers in the field that are focused on the use of WFA in dermatological diseases, describing its mechanism of action while providing, at the same time, details about the results of its testing in in vitro/in vivo studies.

Ayurvedic plumbism.

Ayurveda is a traditional medicine native to India but is used in many parts of the world as an alternative or adjunct to standard medicine. Preparation can involve incorporation of heavy metals, including lead. We report the case of a 64-year-old man presenting with malaise, abdominal pain, anaemia and very high lead levels. He was found to be taking ayurvedic medicines to help his diabetic control. Analysis of the ayurvedic medications showed several with very high lead content. Following treatment with an oral chelating agent, the patient's symptoms and blood abnormalities resolved. This case highlights the need to be aware of potentially toxic alternative medications patients take and the efficacy of oral treatment choices in lead poisoning.

Perception and attitude of medical doctors in Dhaka, Bangladesh, with regard to Ayurvedic medicine.

The World Health Organization (WHO) Traditional Medicine Strategy (2014-2023) aimed to help member states promote the safe and effective use of traditional medicine. While economic conditions have markedly improved in Bangladesh, the country is experiencing significant public health problems. Because of limited medical resources, there is a strong incentive to enhance complementary and alternative medicine usage in Bangladesh. Therefore, this study aimed to confirm the perceptions and attitudes of medical doctors (MDs) in Dhaka, Bangladesh, with regard to Ayurvedic medicine (AM). A total number of 159 MDs in Dhaka were interviewed by face-to-face between February and June 2015. The study revealed that 62.0% of MDs had treated patients with AM and 55.3% believed that AM should be regarded as its own specialty, whereas 39.7% of MDs believed that AM should be part of the conventional medical curriculum and 32.7% thought that AM did not seem scientific. In terms of gender, 45.3% of male MDs agreed or strongly agreed that AM only had a placebo effect. On the other hand, 65.8% of female MDs disagreed or strongly disagreed it. In terms of age, 77.0% of MDs aged 36 or elder (elder MDs) believed they were more likely to recommend AM use and 80.3% of elder MDs believed that the government should encourage more initiatives to promote AM. To enhance AM use, scientifically robust information on the efficacy, safety and scientific basis of AM should be more effectively conveyed to male MDs.

Perceptions of Ayurvedic medicine by citizens in Dhaka, Bangladesh.

Bangladesh is now facing the public health problems of deficiency of iron and iodine, especially for women. The Ministry of Health and Family Welfare of Bangladesh has implemented strong countermeasures to enhance the health condition of the nation. On the other hand, based on the concept of the Declaration of Alma-Ata, complementary and alternative medicine should be used more vigorously to enhance public health in the world. The usage of complementary and alternative medicine such as ayurvedic medicine (AM) should be increased in Bangladesh. Therefore we conducted the study on perceptions of AM by citizens in Dhaka, Bangladesh in order to promote and enhance the effective usage of AM, including herbal medicines as medical resources, from December 2010 to January 2011. This study showed younger citizens (61.1%) did not get more benefit from AM than elder citizens (48.0%). On the other hand, younger citizens (76.8%) did not get more harm from AM than elder citizens (70.1%). We think that in terms of effectiveness of AM, the younger generation in Dhaka seems to be more skeptical to AM than the elder generation in Dhaka, even though the younger generation are more satisfied with AM than the elder generation. With viewpoint of enhancement of usage of AM in Dhaka, we think that scientifically sound information on AM should be collected rigorously and brought to the citizens vigorously to remove the skeptical feeling of AM from younger citizen in Dhaka. In terms of the effective utilization of limited medical resources, AM should be used appropriately in Bangladesh, Asia and the world.

A systematic review and meta-analysis focusing on the use of ayurvedic medicine in cerebral palsy.

Integrative practices have been incorporated into palliative care to provide holistic and multidimensional care for patients. This study aims to identify the scope of integrative practices, specifically whole medical systems, and demonstrate its safety and efficacy, specially in children with cerebral palsy. Key databases, including Embase, Cochrane, Medline/PubMed, Scopus, Google Scholar, Lilacs and Scielo were searched using specific terms. Only randomized and non-randomized clinical trials were included for meta-analysis purposes. Case-control, cohort, cross-sectional or retrospective observational studies were also included for the systematic review. Participants included children aged 0-18 years receiving palliative care for cerebral palsy and undergoing Ayurvedic Medicine practices. Descriptive analysis was conducted, including data such as year; author; design; sample size; intervention and comparison; outcomes and conclusion. Two interventional studies compared Ayurvedic practices with each other or with physiotherapy in children with cerebral palsy. The meta-analysis demonstrated an improvement in spasticity for children using Ayurvedic medicine. However, there were limitations in terms of heterogeneity in interventions, control groups, and assessed outcomes. Integrative practices, including Ayurvedic medicine have the potential to improve quality of life, manage disease symptoms and provide emotional support. However, more robust evidence is needed to support their widespread use. The use of Ayurvedic medicine showed evidence of improvement in spasticity for children with cerebral palsy. REGISTRATION NUMBER: Prospero CRD 42020198399.

Ayurvedic Medicine: A Traditional Medical System and Its Heavy Metal Poisoning.

Ayurveda is one of the oldest and most widely practiced traditional medical systems in the world. The ancient knowledge in this traditional medical system has yet to be fully explored. The interaction of rich knowledge from various traditional systems of medicine can open new pathways in the herbal drug discovery process. Apart from other hurdles in discovering plant-based medicines, the lack of knowledge of the differences and similarities between the theoretical doctrines of these systems is the greatest impediment to their convergence. Rasashastra is an Ayurvedic medicine section that deals with formulations that include minerals/metals, particularly Parad (mercury). According to the Ayurvedic Formulary of India, the most widely used heavy metals are mercury, arsenic, and lead. However, contemporary scientists are concerned about the use of heavy metals in Ayurvedic preparation. In this review article, we will discuss Ayurvedic medicine and the toxic effects of heavy metals.

Exploring the Promising Role of Guggulipid in Rheumatoid Arthritis Management: An In-depth Analysis.

BACKGROUND: Guggulipid, an oleo-gum resin extracted from the bark of Commiphora wightii of the Burseraceae family, holds a significant place in Ayurvedic medicine due to its historical use in treating various disorders, including inflammation, gout, rheumatism, obesity, and lipid metabolism imbalances. OBJECTIVE: This comprehensive review aims to elucidate the molecular targets of guggulipids and explore their cellular responses. Furthermore, it summarizes the findings from in-vitro, in-vivo, and clinical investigations related to arthritis and various inflammatory conditions. METHODS: A comprehensive survey encompassing in-vitro, in-vivo, and clinical studies has been conducted to explore the therapeutic capacity of guggulipid in the management of rheumatoid arthritis. Various molecular pathways, such as cyclooxygenase-2 (COX-2), vascular endothelial growth factor (VEGF), PI3-kinase/AKT, JAK/STAT, nitric oxide synthase (iNOS), and NFκB signaling pathways, have been targeted to assess the antiarthritic and anti-inflammatory effects of this compound. RESULTS: The research findings reveal that guggulipid demonstrates notable antiarthritic and anti-inflammatory effects by targeting key molecular pathways involved in inflammatory responses. These pathways include COX-2, VEGF, PI3-kinase/AKT, JAK/STAT, iNOS, and NFκB signaling pathways. in-vitro, in-vivo, and clinical studies collectively support the therapeutic potential of guggulipid in managing rheumatoid arthritis and related inflammatory conditions. CONCLUSION: This review provides a deeper understanding of the therapeutic mechanisms and potential of guggulipid in the management of rheumatoid arthritis. The collective evidence strongly supports the promising role of guggulipid as a therapeutic agent, encouraging further research and development in guggulipid-based treatments for these conditions.

Egyptian Dynasties to Biologics: A Historical Review of Nasal Polyposis.

The history of nasal polyposis originates even before Hippocrates described a nasal mass that he likened to a sea polyp. References to sinonasal disease and treatment can be found in ancient texts, such as the Ebers Papyrus and the Edwin Smith Papyrus of Ancient Egypt, as well as in the foundational texts of Ayurvedic medicine. Greek philosophers marked a significant shift away from the belief that illness was a result of divine intervention and embraced medical theory. Over the subsequent millennia, the understanding of nasal polyposis expanded, resulting in notable progress in surgical procedures and medical treatments. However, the complex pathophysiology of this condition remained enigmatic until breakthroughs in basic science and immunology. This historical journey takes us from the tomb of the first rhinologist in 2500 BC to the development of immune-modulating biologics.

Burning Mouth Syndrome in Association With Angular Cheilitis: A Case Report.

A burning sensation in the mouth without any obvious mucosal alterations is the hallmark of burning mouth syndrome, a chronic pain syndrome. BMS can worsen pain if it coexists with angular cheilitis, a condition characterized by inflammation around the corners of the mouth. Conventional therapies for angular cheilitis and burning mouth syndrome sometimes have unfavorable side effects and offer only little relief. When ozone is combined with oil, it accelerates tissue repair and oxygenation while destroying germs, fungi, and viruses. Triphala is a traditional treatment for oral health problems because of its anti-inflammatory, antioxidant, and antibacterial qualities. The effectiveness of alternative medicines, particularly ozonated oil, and triphala, a traditional herbal combination, in treating these diseases is examined in this case study. A 72-year-old woman reported a burning sensation in her mouth. The patient described the prolonged heat or burning sensation in the anterior two-thirds of her tongue. She was diagnosed with angular cheilitis and burning mouth syndrome. Conventional treatments, such as topical steroids and antifungal drugs, have not been effective. The patient was instructed to apply ozonated oil topically to the affected regions twice daily and to rinse their mouth with triphala. The patient reported full healing of the angular cheilitis lesions and considerable alleviation from burning feelings following two weeks of therapy. The patient noticed a significant decrease in the burning sensation in her mouth, characterized by a lack of discomfort, irritation, or pain. Throughout the treatment, no side effects were seen. According to this case study, ozonated oil and triphala may be useful in treating the symptoms of angular cheilitis and burning mouth syndrome, providing an alternative to traditional treatments.

Tryambak Mahadev Gogate (1913-1998): A Pioneer of Panchakarma Therapies of Ayurveda.

Tryambak Mahadev Gogate (1913-1998) was instrumental in the development of practical applications of Panchakarma therapies as well as in advancing Ayurvedic education and practice, which faced significant challenges during the colonial period in India. A gifted young individual, motivated by a desire to contribute to his nation, dedicated himself to the revitalization of Ayurveda. In pursuit of this goal, he engaged in self-experimentation, often at great personal risk. He meticulously documented his findings throughout these experiments, establishing techniques for administering Panchakarma therapies, refining Ayurvedic diagnostic methods, and contributing to the evolution of Ayurveda as a scientific discipline, all while making detailed observations that paralleled advancements in modern medical science.

A scoping review of Ayurvedic rasayana adaptogens in oncology.

INTRODUCTION: Rasayanas are Ayurvedic natural products that have adaptogenic effects. The extensive research on rasayanas in oncology is not currently well summarized. The aim of this review is to investigate the range and nature of the current body of research, identify gaps in knowledge, and to summarize the existing literature as it relates to Ayurvedic rasayanas and oncology. MATERIALS AND METHODS: A comprehensive literature search of fifteen Ayurvedic adaptogen rasayanas was conducted using three main concepts: Ayurvedic herbal terms, neoplasm terms, and oncological pathways. After screening was performed, key variables were extracted (tagged) including type of adaptogen, cancer type, type of study design, constituent type, and mechanisms of action (MOA). The results were synthesized and summarized using descriptive statistics and narrative summaries. RESULTS: Five hundred and eighty-four articles were reviewed and tagged. The two most tagged adaptogens were Glycyrrhiza glabra (Yashthimadhu/licorice) (n = 166 (28.4 %)) and Withania somnifera (Ashwagandha) (n = 151 (25.9 %)). The most frequently tagged cancer diagnostic categories were gastrointestinal (n = 175 (30 %)), and breast (n = 126 (21 %)). Most of the articles focused on in vitro studies (n = 470 (80.3 %)). Of the 12 MOA tags, the most frequently tagged was apoptosis (n = 298 (29.2 %)). CONCLUSION: A large body of pre-clinical literature exists on adaptogen rasayanas in oncology, indicating this field of research is still in its early phase. Comparatively few studies focused on the effects on the immune system. Given the growing interest in immuno-oncology therapeutics and the potential impact of adaptogen rasayanas on the immune system, future research may focus more in this area, along with work that is more directly linked to future clinical studies.