Corrigendum: Unravelling the therapeutic potential of botanicals against chronic obstructive pulmonary disease (COPD): molecular insights and future perspectives.

[This corrects the article DOI: 10.3389/fphar.2022.824132.].

Efficacy and safety of chinese herbal foot bath for hypertension: A systematic review and meta-analysis.

BACKGROUND: Hypertension is a prevalent condition with significant impacts on human health. Chinese herbal foot bath, a traditional Chinese medicine treatment, is believed to help manage hypertension. OBJECTIVE: This systematic review aims to assess the efficacy of combining Chinese herbal foot bath with conventional treatment for hypertension. METHODS: A thorough search across eight databases was conducted to identify relevant studies on Chinese herbal foot bath for hypertension. Randomized controlled trials examining the benefits and risks of using Chinese herbal foot bath combined with conventional treatment for hypertension were included. Blood pressure changes before and after the Chinese herbal foot bath were assessed, and outcomes were analyzed using Review Manager 5.3 software. The certainty of evidence was evaluated using the GRADE tool. RESULTS: Compared to conventional treatment, Chinese herbal foot bath combined with conventional treatment demonstrated greater effectiveness in reducing systolic blood pressure (MD 6.69, 95% CI: 5.86 to 7.53, p < 0.00001) and diastolic blood pressure (MD 5.83, 95% CI: 5.23 to 6.43, p < 0.00001), which reported fewer adverse effects.These studies commonly present issues such as inadequate randomization, lack of blinding, and absence of independent testing for the purity or potency of herbs. CONCLUSION: The meta-analysis suggests that Chinese herbal foot bath combined with conventional treatment may effectively manage hypertension, with few adverse effects. However, high-quality clinical trials are still needed to confirm these findings due to methodological weaknesses in randomization, blinding, long-term follow-up, and independent testing for the purity and potency of herbs.

Indigo naturalis (Qing dai) for inflammatory bowel disease: A systematic review and meta-analysis.

BACKGROUND: Indigo naturalis (Qing dai) is a traditional therapy reported to be useful in inflammatory bowel disease (IBD), especially for ulcerative colitis. We performed a systematic review of its efficacy and safety in IBD. METHODS: Electronic databases (Pubmed, Embase, and Scopus) were searched on 4th March 2023 to identify reports about the use of indigo naturalis in IBD. We extracted data with respect to clinical response, remission, endoscopic and histological responses, and adverse events with the use of indigo naturalis in IBD. Pooled clinical response rates and remission rates were calculated. The quality of studies was assessed using Joanna-Briggs tools. RESULTS: Nine studies reporting on 299 patients were included. The pooled clinical response rate was 0.796 (95 %CI, 0.7465-0.8379, I2=0), and the clinical remission rate in ulcerative colitis was 0.668 (0.488- 0.809, I2=85.2 %). The pooled relative risk of clinical response was higher in the indigo naturalis group as compared to placebo in the two randomized trials [3.82 (2.04; 7.14, I2=0)]. Except for one reversible pulmonary arterial hypertension case, most reported adverse effects were mild. The endoscopic and histological responses, when reported, suggested that indigo naturalis is effective for ulcerative colitis. The limitations of the systematic review included a small number of randomized studies, reports only from East Asia and a relatively small number of patients, especially for Crohn's disease. CONCLUSION: Indigo naturalis is effective in the treatment of ulcerative colitis. Future studies should evaluate the comparative efficacy with other drugs.

Pilot Intervention for Mindful Drinking and Eating for Patients on Hemodialysis with Fluid Restrictions: Lessons Learned.

Patients requiring hemodialysis would benefit from evidence-based strategies that improve adherence to fluid restrictions while concurrently improving quality of life (QOL). This pilot study examined the effect of a four-week mindful drinking and eating intervention on interdialytic weight gain and QOL in patients on hemodialysis. Using paired t tests, no significant differences from pre- to post-test were found in interdialytic weight gain, a measure of fluid restriction adherence, or QOL in either the intervention (n = 18) or wait list control (n = 19) group. However, there was positive qualitative feedback from participants in exit interviews, and there were other indications of feasibility (low drop out, engagement in at-home practice according to weekly checklists). Lessons learned from this pilot study about conducting research regarding fluid restrictions for patients on hemodialysis are presented.

Therapeutic potential of traditional Chinese medicine on heat stroke.

As global warming progresses, heat waves are becoming increasingly frequent and intense, meanwhile the incidence of heat stroke (HS) has increased sharply during the past decades. HS is typically associated with significant morbidity and mortality, and there is an urgent need for further research to solve this difficult issue. There currently exists difficulties regarding on-site emergency treatment methods and limited in-hospital treatment approaches, and better treatments are required as soon as possible. Theories and therapies from various traditional Chinese medicine (TCM) academic groups have been widely reported. Therefore, an exploration of prevention and protection methods should consider TCM experiences as an alternative. This article primarily reviews TCM herbal therapies and external therapies that have been described in various clinical reports and demonstrated in relevant studies. Herbal therapies, including herbal formulas, Chinese patent medicines (CPMs), single Chinese herbs, and associated extracts or monomers, are summarized based on the shared perspectives of the underlying mechanisms from TCM. In addition, external therapies including acupuncture, bloodletting, cupping, Gua sha and Tui na that have rarely been rarely mentioned and considered in most cases, are introduced and discussed to offer a unique perspective in the search for novel interventions for HS. In summary, TCM may provide abundant potential clinical benefits and research directions in the fight against HS.

Successful lumbal sympathetic block as an alternative therapy for improving Buerger's disease: A rare case report and literature review.

INTRODUCTION AND IMPORTANCE: Buerger's disease is an inflammation of blood vessels that is strongly related to smoking habits. Lumbal sympathetic block is one kind of lumbal sympathectomy intervention that is used to manage chronic pain, including Buerger's disease. In this case report, we present the case of a Buerger's disease patient treated with a lumbal sympathetic block procedure. CASE PRESENTATION: A 63-year-old male was referred to our emergency room with chronic pain and ulcers on his left foot. He had already undergone two debridement procedures at his previous hospital without any improvement. After a comprehensive assessment, our cardio-thoracic specialist chose to refer the patient to undergo the lumbal sympathetic block with the orthopaedic specialist. After two procedures, we found a reduction in pain (VAS 6-7 to 2-3), the skin looked more colored, and the patient's walking distance improved from 10 to 100 m without any complaints. We also found good wound healing of the ulcers in his left foot; they became smaller and dryer. CLINICAL DISCUSSION: Lumbal sympathetic block is thought to be able to reduce peripheral retention that causes the opening of an arteriovenous anastomose, thus increasing blood flow to skin tissue and leading to vasodilatation. It showed its capability to prevent Buerger's disease progression, reduce patient complaints, and heal the wound. CONCLUSION: Lumbal sympathetic block should be considered as an alternative therapy for Buerger's disease.

Do Medical Sciences Students Have the Proper Knowledge, Attitude, and Practice, Regarding the Complementary and Alternative Medicine in Iran?

Background: The increasing use of complementary and alternative medicine (CAM) has changed expectations of healthcare professionals concerning the knowledge, attitude, and practice of CAM. The present study aimed to investigate the knowledge, attitude, and practice of students of Arak University of Medical Sciences (Iran) in 2020 concerning CAM. Methods: The present descriptive cross-sectional study was conducted on 226 medical sciences students using targeted quota sampling. The data collection tool was a researcher-made questionnaire based on valid scientific articles and literature. The questionnaire was comprised of 92 items and assessed students' knowledge, attitude, and practice regarding CAM. Results: The study participants' mean CAM knowledge and attitude scores were 14.12±6.1 and 58.7±29.28, respectively. The primary information sources included mass media, the internet, and friends. Most participants (63.4%) were willing to use CAM methods. The most common CAM was herbal therapy (29.1%), and the most common reason for using, was gastrointestinal problems (39.2%). Conclusion: The participants indicated moderate knowledge and poor attitude regarding CAM. Thus, considering the extensive application of CAM methods among the participants and their insufficient knowledge and inappropriate attitude, that is recommended to include CAM methods be included besides the conventional medicine, in the academic curriculum of students of medical sciences.

Effects of Music on the Quality of Life of Family Caregivers of Terminal Cancer Patients: A Randomised Controlled Trial.

The aim of this study was to investigate the effects of listening to self-chosen music on the quality of life of family caregivers of cancer patients receiving palliative home care. A total of 82 family caregivers were assigned either to the intervention group (n = 41) or to the control group (n = 41) in this double-blind, multicentre, randomised controlled clinical trial. The recruitment period was between July 2020 and September 2021. The intervention group received individualised pre-recorded music in daily 30 min sessions for 7 consecutive days. The control group was given a recorded repetition of the basic therapeutic training education also in 30 min sessions for 7 consecutive days. The primary endpoint assessed was the caregivers' quality of life (Quality of Life Family Version and European Quality of Life visual analogue scale) before and after the intervention. The secondary endpoint was their perceived satisfaction with the intervention (Client Satisfaction Questionnaire). The music intervention was successful, producing a tangible improvement in the caregivers' quality of life (p < 0.01) and satisfaction with the care provided (p = 0.002). The intervention was not only effective but produced no adverse effects. This study encourages the use of self-chosen music as a complementary intervention in nursing care for family caregivers of palliative cancer patients.

Pharmacotherapy, alternative and adjunctive therapies for eating disorders: findings from a rapid review.

BACKGROUND: The current review broadly summarises the evidence base for pharmacotherapies and adjunctive and alternative therapies in the treatment of eating disorders and disordered eating. METHODS: This paper forms part of a Rapid Review series examining the evidence base in the field of eating disorders. This was conducted to inform the Australian National Eating Disorder Research and Translation Strategy 2021-2030. ScienceDirect, PubMed and Ovid/Medline were searched for included studies published between 2009 and 2021 in English. High-level evidence such as meta-analyses, large population studies and randomised control trials were prioritised, and grey literature excluded. Data from included studies relating to pharmacotherapy, and to adjunctive and alternative therapies in eating disorders, were synthesised and disseminated in the current review. RESULTS: A total of 121 studies were identified, relating to pharmacotherapy (n = 90), adjunctive therapies (n = 21) and alternative therapies (n = 22). Some of the identified studies involved combinations of the above (e.g. adjunctive pharmacotherapy). Evidence of efficacy of interventions across all three categories was very limited with few relevant high quality clinical trials. There was a particular scarcity of evidence around effective treatments for anorexia nervosa (AN). With treatment of bulimia nervosa (BN), fluoxetine has exhibited some efficacy leading to regulatory approval in some countries. With binge eating disorder (BED), recent evidence supports the use of lisdexamfetamine. Neurostimulation interventions show some emerging efficacy in the treatment of AN, BN and BED but some, such as deep brain stimulation can be highly invasive. CONCLUSION: Despite widespread use of medications, this Rapid Review has identified a lack of effective medications and adjunctive and alternative therapies in the treatment of EDs. An intensification of high-quality clinical trial activity and drug discovery innovation are required to better assist patients suffering from EDs.

Eating disorders have the highest mortality rates and treatment costs of all mental health conditions. This rapid review summarises the evidence around the use of medications and various alternative therapies in the treatment of eating disorders. The review highlights a lack of effective interventions for the treatment of anorexia nervosa with an urgent need to trial new treatments for this condition. Two medications show some efficacy in treating other eating disorders: the antidepressant drug fluoxetine for the treatment of bulimia nervosa, and the stimulant drug lisdexamfetamine for binge eating disorder. There is some positive evidence emerging from novel therapies that involve brain stimulation technologies. Overall, more high-quality research is needed to discover and develop new medications, and other alternative therapies, to better assist patients with eating disorders.

Efficacy and safety of acupuncture-point stimulation combined with opioids for the treatment of moderate to severe cancer pain: a network meta-analysis of randomized controlled trials.

Background: Pain is one of the most common and troublesome symptoms of cancer. Although potential positive effects of acupuncture-point stimulation (APS) on cancer pain have been observed, knowledge regarding the selection of the optimal APS remains unclear because of a lack of evidence from head-to-head randomized controlled trials (RCTs). Objective: This study aimed to carry out a network meta-analysis to compare the efficacy and safety of different APS combined with opioids in treating moderate to severe cancer pain and rank these methods for practical consideration. Methods: A comprehensive search of eight electronic databases was conducted to obtain RCTs involving different APS combined with opioids for moderate to severe cancer pain. Data were screened and extracted independently using predesigned forms. The quality of RCTs was appraised with the Cochrane Collaboration risk-of-bias tool. The primary outcome was the total pain relief rate. Secondary outcomes were the total incidence of adverse reactions, the incidence of nausea and vomiting, and the incidence of constipation. We applied a frequentist, fixed-effect network meta-analysis model to pool effect sizes across trials using rate ratios (RR) with their 95% confidence intervals (CI). Network meta-analysis was performed using Stata/SE 16.0. Results: We included 48 RCTs, which consisted of 4,026 patients, and investigated nine interventions. A network meta-analysis showed that a combination of APS and opioids was superior in relieving moderate to severe cancer pain and reducing the incidence of adverse reactions such as nausea, vomiting, and constipation compared to opioids alone. The ranking of total pain relief rates was as follows: fire needle (surface under the cumulative ranking curve (SUCRA) = 91.1%), body acupuncture (SUCRA = 85.0%), point embedding (SUCRA = 67.7%), auricular acupuncture (SUCRA = 53.8%), moxibustion (SUCRA = 41.9%), transcutaneous electrical acupoint stimulation (TEAS) (SUCRA = 39.0%), electroacupuncture (SUCRA = 37.4%), and wrist-ankle acupuncture (SUCRA = 34.1%). The ranking of total incidence of adverse reactions was as follows: auricular acupuncture (SUCRA = 23.3%), electroacupuncture (SUCRA = 25.1%), fire needle (SUCRA = 27.2%), point embedding (SUCRA = 42.6%), moxibustion (SUCRA = 48.2%), body acupuncture (SUCRA = 49.8%), wrist-ankle acupuncture (SUCRA = 57.8%), TEAS (SUCRA = 76.3%), and opioids alone (SUCRA = 99.7%). Conclusions: APS seemed to be effective in relieving cancer pain and reducing opioid-related adverse reactions. Fire needle combined with opioids may be a promising intervention to reduce moderate to severe cancer pain as well as reduce opioid-related adverse reactions. However, the evidence was not conclusive. More high-quality trials investigating the stability of evidence levels of different interventions on cancer pain must be conducted. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/#searchadvanced, identifier CRD42022362054.

Efficacy and safety of Danlou tablets in traditional Chinese medicine for coronary heart disease: a systematic review and meta-analysis.

Background: Danlou tablets exert auxiliary advantages in treating coronary heart disease (CHD), but a summary of evidence-based proof is lacking. This study aims to systematically evaluate Danlou tablets in treating CHD from two aspects, including efficacy and safety. Methods: By a thorough retrieval of the four English databases, namely, PubMed, The Cochrane Library, Embase, and Web of Science, and the four Chinese databases, namely, CNKI, Wanfang, VIP database, and China Biomedical Literature Service System, we found all randomized controlled trials (RCTs) related to Danlou tablets in treating CHD. The retrieval time was from the construction of the database to April 2022. We engaged two researchers to screen the studies, extract the required data, and assess the risk of bias. We then used RevMan5.3 and STATA.14 software to conduct a meta-analysis. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was used to evaluate the quality of outcome indicators. Results: Seventeen RCTs involving 1,588 patients were included. The meta-analysis results are displayed as follows: clinical treatment effect [risk ratio (RR) = 1.22, 95% confidence interval (CI): 1.16, 1.28, P < 0.00001], angina pectoris duration [MD = -0.2.15, 95% CI: -2.91, -1.04, P < 0.00001], angina pectoris frequency [standard mean difference (SMD) = -2.48, 95% CI: -3.42, -1.54, P < 0.00001], angina pectoris degree [SMD = -0.96, 95% CI: -1.39, -0.53, P < 0.0001], TC [MD = -0.71, 95% CI: -0.92, -0.51, P < 0.00001], TG [MD = -0.38, 95% CI: -0.53, -0.22, P < 0.00001], low-density lipoprotein cholesterol [MD = -0.64, 95% CI: -0.76, -0.51, P < 0.00001], high-density lipoprotein cholesterol [MD = 0.16, 95% CI: 0.11, 0.21, P < 0.00001], and adverse events [RR = 0.46, 95% CI: 0.24, 0.88, P = 0.02]. Conclusion: The current evidence suggests that the combination of Danlou tablets and Western medicine can enhance the efficacy of CHD and does not increase adverse events. However, because of the limited number and quality of the included studies, the results of our study should be treated with caution. Further large-scale RCTs are necessary to verify the benefits of this approach.

Iguratimod as an alternative therapy for systemic sclerosis and prevention of the occurrence of ischemic digital ulcer.

Objectives: This study aimed to assess the effectiveness of iguratimod (IGU) as an alternative treatment for systemic sclerosis (SSc), especially in the prevention of ischemic digital ulcers (DUs). Methods: We constructed two cohorts from the Renji SSc registry. In the first cohort, SSc patients receiving IGU were observed prospectively with effectiveness and safety. In the second cohort, we picked up all the DU patients with at least a 3-month follow-up to investigate the prevention of IGU on ischemic DU. Results: From 2017 to 2021, 182 SSc patients were enrolled in our SSc registry. A total of 23 patients received IGU. With a median follow-up of 61 weeks (IQR: 15-82 weeks), the drug persistence was 13/23. In total, 91.3% of the patients (21/23) became free of deterioration in the last visit with IGU. Of note, 10 patients withdrew from the study due to the following reasons: two patients withdrew due to deterioration, three due to incompliance, and five due to mild-to-moderate side effects. All the patients with side effects recovered fully after stopping IGU. Of note, 11 patients had ischemic DU, and 8 out of 11 (72.7%) patients had no new occurrence of DU during the follow-up. In the second cohort of 31 DU patients receiving a combination of vasoactive agents with a median follow-up of 47 weeks (IQR, 16-107 weeks), IGU treatment was protective of new DU occurrence (adjusted risk ratio = 0.25; 95% CI, 0.05-0.94; adjusted odds ratio = 0.07; and 95% CI, 0.01-0.49). Conclusion: Our study for the first time describes the potential of IGU possibly as an alternative treatment for SSc. To our surprise, this study provides a hint that IGU treatment can be used for the prevention of the occurrence of ischemic DU and merits further investigation.

Yoga Meets Intelligent Internet of Things: Recent Challenges and Future Directions.

The physical and mental health of people can be enhanced through yoga, an excellent form of exercise. As part of the breathing procedure, yoga involves stretching the body organs. The guidance and monitoring of yoga are crucial to ripe the full benefits of it, as wrong postures possess multiple antagonistic effects, including physical hazards and stroke. The detection and monitoring of the yoga postures are possible with the Intelligent Internet of Things (IIoT), which is the integration of intelligent approaches (machine learning) and the Internet of Things (IoT). Considering the increment in yoga practitioners in recent years, the integration of IIoT and yoga has led to the successful implementation of IIoT-based yoga training systems. This paper provides a comprehensive survey on integrating yoga with IIoT. The paper also discusses the multiple types of yoga and the procedure for the detection of yoga using IIoT. Additionally, this paper highlights various applications of yoga, safety measures, various challenges, and future directions. This survey provides the latest developments and findings on yoga and its integration with IIoT.

A systematic review and meta-analysis of randomized controlled trials of manipulative therapy for patients with chronic neck pain.

BACKGROUND: An increasing number of people suffer from chronic neck pain due to increased telecommuting. Manual therapy is considered a safe and less painful method and has been increasingly used to alleviate chronic neck pain. However, there is controversy about the effectiveness of manipulation therapy on chronic neck pain. Therefore, this systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to determine the effectiveness of manipulative therapy for chronic neck pain. METHODS: A search of the literature was conducted on seven databases (PubMed, Cochrane Center Register of Controlled Trials, Embase, Medline, CNKI, WanFang, and SinoMed) from the establishment of the databases to May 2022. This study included RCTs on chronic neck pain managed with manipulative therapy compared with sham, exercise, and other physical therapies. The retrieved records were independently reviewed by two researchers. Further, the methodological quality was evaluated using the PEDro scale. All statistical analyses were performed using RevMan V.5.3 software. The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) assessment was used to evaluate the quality of the study results. RESULTS: Seventeen RCTs, including 1190 participants, were included in this meta-analysis. Manipulative therapy showed better results regarding pain intensity and neck disability than the control group. Manipulative therapy was shown to relieve pain intensity (SMD = -0.83; 95% confidence interval [CI] = [-1.04 to -0.62]; p < 0.0001) and neck disability (MD = -3.65; 95% CI = [-5.67 to - 1.62]; p = 0.004). However, the studies had high heterogeneity, which could be explained by the type and control interventions. In addition, there were no significant differences in adverse events between the intervention and the control groups. CONCLUSIONS: Manipulative therapy reduces the degree of chronic neck pain and neck disabilities.

The Potential of Alternative Therapies and Vaccine Candidates against Helicobacter pylori.

Alternative therapies and vaccination are essential to combat the emergence of multidrug-resistant Helicobacter pylori and to prevent the development of gastroduodenal diseases. This review aimed to systematically review recent studies on alternative therapies, i.e., probiotics, nanoparticles, and natural products from plants, as well as recent progress in H. pylori vaccines at the preclinical stage. Articles published from January 2018 to August 2022 were systematically searched using PubMed, Scopus, Web of Science, and Medline. After the screening process, 45 articles were eligible for inclusion in this review. Probiotics (n = 9 studies) and natural products from plants (n = 28 studies) were observed to inhibit the growth of H. pylori, improve immune response, reduce inflammation, and reduce the pathogenic effects of H. pylori virulence factors. Natural products from plants also showed anti-biofilm activity against H. pylori. However, clinical trials of natural products from plants and probiotics are still lacking. A paucity of data assessing the nanoparticle activity of N-acylhomoserine lactonase-stabilized silver against H. pylori was observed. Nonetheless, one nanoparticle study showed anti-biofilm activity against H. pylori. Promising results of H. pylori vaccine candidates (n = 7) were observed at preclinical stage, including elicitation of a humoral and mucosal immune response. Furthermore, the application of new vaccine technology including multi-epitope and vector-based vaccines using bacteria was investigated at the preclinical stage. Taken together, probiotics, natural products from plants, and nanoparticles exhibited antibacterial activity against H. pylori. New vaccine technology shows promising results against H. pylori.

Senna singueana (Delile) lock: Ethnomedicinal uses and medicinal properties.

Senna singueana (Delile) Lock is a potential medicinal plant commonly used to mitigate various infectious and non-infectious diseases including malaria, typhoid, gonorrhoea, bilharzia, cancer, epilepsy and ulcer. The phytochemical profile of S. singueana indicates the presence of different phytoconstituents corresponding to the pharmacological properties. The pharmacological potentials such as antibacterial, antifungal, antioxidant, antimalarial and antidiabetics are possessed by S. singueana. This review comprehensively discusses the potential of S. singueana for the mitigation of medical conditions. The information is collected from various online databases such as Google scholar, ScienceDirect, Springer, Web of Science and PubMed. Among other information, ethnomedicinal uses, phytochemistry, pharmacology and mechanisms of action are extensively presented. A review concluded by highlighting the challenges and potential future outlooks.

Use of Complementary and Alternative Medicine in Children with Scabies.

INTRODUCTION: Scabies is a highly contagious infestation that is becoming increasingly resistant to treatment. The use of complementary and alternative medicine (CAM) has gradually increased for numerous diseases, and the aim of this study is to investigate the parental use of CAM in the treatment of scabies. METHODS: The study was planned as a cross-sectional study involving children who came to the departments of child health and diseases and dermatology departments for any reason and were diagnosed with scabies. Questionnaires were given to parents by physicians during face-to-face interviews, and responses were recorded. RESULTS: 75.9% of the 162 parents participating in the study were mothers, and 40% of the parents reported that their income was below expenses. The mean number of people living in the household was 4 (min 3-max 13), and the proportion of extended family was 34%. The mean duration of symptoms in patients with scabies was 4.8 ± 3.92 weeks (min. 1-max. 27), and scabies was diagnosed on average at the second visit to the doctor. CAM was used by 80.9% of parents for children with scabies. They most commonly used tea tree oil for itching and ice for the rash. Parents working in education and health care were less likely to use CAM (p < 0.001), while more than 90% of housewives used at least one CAM method on their children. Analysis showed that 61.7% of female users had benefited from CAM. Significant differences between parents who used CAM and those who did not were found in education (p = 0.003), monthly income (p = 0.023), number of children (p = 0.022), and living in large families (p = 0.001). The use of CAM was six times higher in parents in large families (OR: 6.143, 95% CI 0.776-21.252). CONCLUSIONS: With regard to the treatment of scabies, it is important to strengthen the education of health professionals at all levels, put the treatment of patients on a regular basis, explain the conditions that require special attention, and monitor patients closely. New treatment protocols must also be developed for refractory scabies, including alternative therapies.

Assessment of the phytochemical composition and antimicrobial properties of Tapinanthus bangwensis leaves hosted by the branches of Persea americana.

BACKGROUND: Medicinal plants represent a valuable source for new effective and safe antimicrobial drugs making them an alternative therapy. Existing antimicrobial agents are costly and mostly associated with possible side effects. The aim of the present study therefore, was to assess the antimicrobial property and phytochemical composition of hydroethanolic extract of Tapinanthus bangwensis leaves and its fractions. METHOD: T. bangwensis leaves (harvested from its host plant, Persea americana) was extracted by cold maceration with 70% ethanol and further fractionated with different organic solvents using the solvent partitioning method to obtain the crude extract, petroleum ether, chloroform, ethyl acetate and the resulting aqueous fractions. The phytochemical constituents of the extracts were screened and quantified. Also, the TLC of the extracts were analyzed to serve as a fingerprint. Using the agar diffusion and broth dilution methods, the antimicrobial properties of the extracts were assessed. RESULTS: The study showed that the hydroethanolic (70%) crude extract of T. bangwensis leaves and its fractions contain phenolic compounds, flavonoids, saponins, phytosterols and reducing sugars. The phytoconstituents were well extracted into the ethyl acetate fraction than the other fractions evidenced in the high levels (p < 0.0001) of saponins (66.47 ± 1.72% w/w), phenolic compounds (77.75 ± 1.06 mg/100 mg GAE) and flavonoids (44.34 ± 0.06 mg/100 mg QE) contents. From the antimicrobial studies, all the microorganisms tested exhibited varying degrees of susceptibility to the extracts with MIC values between 0.78 to 12.5 mg/mL. The crude extract of T. bangwensis leaves, its ethyl acetate and chloroform fractions also exhibited lethal antimicrobial activity with MLC between 6.25 to 50 mg/mL. CONCLUSION: The crude extract of T. bangwensis leaves and its fractions demonstrated antimicrobial properties against Escherichia coli, Staphylococcus aureus, Staphylococcus saprophyticus and Candida albicans, thereby representing a potential source of natural antimicrobial agent. Further study is required to identify and isolate antimicrobial compounds from the plant for the development of the natural bioactive antimicrobial agents.

ALSUntangled # 69: astaxanthin.

ALSUntangled reviews alternative and off-label treatments for people living with amyotrophic lateral sclerosis (PALS). Here we review astaxanthin which has plausible mechanisms for slowing ALS progression including antioxidant, anti-inflammatory, and anti-apoptotic effects. While there are no ALS-specific pre-clinical studies, one verified "ALS reversal" occurred in a person using a combination of alternative therapies which included astaxanthin. There have been no trials of astaxanthin in people living with ALS. Natural astaxanthin appears to be safe and inexpensive. Based on the above information, we support further pre-clinical and/or clinical trials of astaxanthin in disease models and PALS, respectively, to further elucidate efficacy.