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 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.

Evaluating the safety and efficacy of a polyherbal Unani formulation in dyslipidaemia-a prospective randomized controlled trial.

ETHNOPHARMACOLOGICAL RELEVANCE: Unani System of Medicine offers treatment for obesity and dyslipidaemia. Jawarish Falafili (JF) is a Unani polyherbal pharmacopoeial preparation. It has been used in the treatment of obesity for a long time. Dyslipidaemia is a recognised modifiable risk factor for hypertension, ischemic heart disease and stroke. Limitations of the current conventional therapy have provided scope for research of a potential drug in this medical condition. It was hypothesised that JF may ameliorate dyslipidaemia in human participants. AIM OF THE STUDY: The main objective of this study was to evaluate the safety and efficacy of the JF. MATERIALS AND METHODS: This was a prospective randomized, active-controlled, open-label and parallel-group study. We randomized 74 participants of dyslipidaemia into treatment (n = 38) and control (n = 36) groups. Of them, 30 participants in each group completed the trial. The participants of any sex aged between 30 and 60 years, with serum total cholesterol (TC) ≥200 mg/dl and/or serum triglycerides (TG) ≥150 mg/dl and/or low-density lipoprotein cholesterol (LDL-C) level ≥130 mg/dl and/or high-density lipoprotein cholesterol (HDL-C) level <40 mg/dl were enrolled in this study. The participants of the treatment group were treated with JF (10 gm/day) once and atorvastatin (20 mg/day) was given to the control group for 90 days once at night daily. RESULTS: We observed a significant reduction (treatment group versus control group) in mean serum TC by 22.89% versus 19.36%, TG by 29.90% versus 23.26% and LDL-C by 29.16% versus 27.92% from baseline (p < 0.05). But the change in mean serum HDL-C levels post-treatment was insignificant in both groups (p > 0.05). On intergroup comparison, the magnitude of the difference of mean TC, TG, LDL-C and HDL-C levels between the groups was not statistically significant (p > 0.00.05). CONCLUSIONS: This study concluded that JF and atorvastatin were equally effective in controlling dyslipidaemia. They were tolerated well by all participants and found safe during the course of treatment.

Efficacy of herbal anti-microbial soap in Tinea corporis: A randomized controlled study.

ETHNOPHARMACOLOGICAL RELEVANCE: Curcuma longa L., Azadirachta indica A Juss. Cassia tora L. has been used in Unani medicine for various skin ailments. Several researches have been conducted on these plants which have shown anti-microbial, anti-bacterial, anti-fungal, antiviral, anti-oxidant, wound healing, anti-inflammatory, and immune modulation activities. Skin diseases and the use of these drugs are mentioned in classical Unani literature like The Canon of medicine, Continens Liber, Hippocratic treatments, The Complete Book of the Medical Art etc. AIM: The aim of the study was to formulate anti-microbial soap and to evaluate its clinical efficacy of in the management of Tinea corporis. MATERIALS AND METHODS: The anti-microbial soap was prepared by hydroalcholic extracts of Curcuma longa L., Azadirachta indica A Juss. and Cassia tora L. The prepared soap was evaluated for various physicochemical parameters, microbiological evaluation, stability study, skin irritation, In-vitro anti-microbial activity, GCMS analysis, and a clinical trial was carried out to evaluate its efficacy. A Single Blind Randomized Placebo Controlled trail on 30 patients aged between 18 and 60 years of either gender was carried out. The participants were randomly allocated to receive either anti-microbial soap or Placebo soap for 4 weeks. Subjective parameters including erythema, pruritis and desquamation were assessed weekly while as objective parameter including Photograph of lesion, Total Symptom Score (TSS) and KOH mount was assessed at baseline and at the end of the trial. RESULTS: The improvement in subjective parameters was found significant in test group. Erythema, scaling, and desquamation was completely relieved by 70%, 80% and 25% patients respectively in test group while as none of the patients got complete relief in control group. There was statistically significant reduction in average TSS 8.65 ± 0.6708 to 3.05 ± 1.35 p < 0.001. KOH mount turned negative in 80% patients in test group while as only 20% turned negative in control group. CONCLUSION: It is concluded that Unani drugs can be utilized in better way by modifying into a convenient dosage form. Anti-microbial soap was formulated by adding minimal additives to achieve effectiveness, with cost effective benefits and less or no side effects. Anti-microbial soap was effective in management of management of Tinea corporis. Moreover further studies on large sample size are required to fine-tune these observations.

Historical account of endocrinal disorders in Unani medicine.

Hippocratic doctrine of four humors and qualities is implicated to be a pioneer of modern endocrinology because of the concept of dyscrasia. Imbalance in humors causes disease. Unani scholars were aware of endocrinological disorders like endocrinologic syndrome (i.e., association of amenorrhea and galactorrhoea in a non-pregnant woman), castration, contraceptives techniques, infertility, obesity, diabetes etc., and also their mode of remedy, albeit with a phenomenological approach. Their understanding of the symptoms and signs related to endocrinologic syndromes, which were explained in detail in the recent account of the endocrine system, is presented here with historical chronology. The survey was carried out from the literature of the Unani system of medicine, and the same was analyzed from the observations reported in various indexed journals and reputed books. The paper details the account of endocrinologic syndrome from the Greek era to the end of the medieval ages.

Traditional Indian medicine in China: The status quo of recognition, development and research.

ETHNOPHARMACOLOGICAL RELEVANCE: Traditional Indian medicine is one of the oldest medical systems and remains popular worldwide. Traditional medicine systems in China and India have historical origins pertaining to mutual learning, reference, and development from medical theory to the drugs used. The exchange of traditional medicine between China and India began in the Qin and Han Dynasties (221 BC-220 AD), prospered in the Tang Dynasty (618-907 AD), and declined after the Song Dynasty (960-1279 AD). It was also directly related to the rise and fall of Buddhism. The traditional medicines of the two countries are highly complementary because of differences in geographical climate and the modernisation process of traditional medicine. AIM: This review aimed to understand the spread and development of traditional Indian medicine in China to further promote exchange and cooperation between China and India in the field of traditional medicine. MATERIALS AND METHODS: We performed a systematic search of MEDLINE via PubMed, CNKI, Science Direct, Sci-Hub, and other databases using the terms 'traditional Indian medicine' or 'Indian medicine' or 'Ayurveda' or 'Yoga' or 'Unani', and limiting the search to articles published between 1958 and 2019. We analysed the sources, publication date, type, and topic of the retrieved articles/studies. RESULTS: Based on the results of research on traditional Indian medicine carried out by Chinese scholars, 518 academic papers and 60 classic works published in China and abroad were collected. The results showed the following. First, Chinese scholars have systematically investigated traditional Indian medicine including its composition, management, and education; the scale of medicinal and pharmaceutical plants; protective measures of intellectual property rights of traditional medicine; and international promotion of Yoga. Second, studies have examined the development status of traditional Indian medicine in China including the spread of Yoga in the country and the industrial scale of, education in, existing problems in, and clinical research on Yoga. In addition, Chinese scholars conducted research on and the translation of classic works and terms of Ayurveda, and studied the theory, treatment, and medicine thereof. Third, the historical exchange and trading status of traditional medicine between India and China have been discussed, including the exchange of traditional medicine between the two countries, effect of traditional Indian medicine on Chinese Buddhism, and minority medicine and trade in medicinal materials between the two countries. CONCLUSION: India attaches great importance to the management of, education in, and industry of traditional medicine, and has made various efforts to protect intellectual property rights. Indian Yoga is very popular in China, and Chinese scholars have conducted some clinical research thereon. However, regulatory systems and legislation for Yoga are lacking in China. At present, traditional Chinese medicine scholars have an enhanced understanding of the term Yoga and less knowledge of the terms Ayurveda, Siddha, Unani, and similar concepts. We suggest that Chinese scholars further study the classic works, basic theories, treatment of clinical diseases, medicinal materials, and prescriptions compounding traditional Indian medicine. The results of this study highlight directions for Chinese scholars to pursue in further studying traditional Indian medicine comprehensively, and will help promote exchange and cooperation between China and India in the field of traditional medicine.

Concept of 'Ihtiraq' in Unani Medicine - A correlation with oxidative stress, and future prospects.

ETHNOPHARMACOLOGICAL RELEVANCE: In recent years, oxidative stress (OS) and the generation of ROS have been recognized as a fundamental pathology contributing, at least partially, to a number of important diseases. However, the therapeutic application has been simplistically limited to using antioxidants with little correction of diseases, and many biomarkers of OS, although confirming and quantifying the magnitude of this pathology, are not suggestive of the underlying causes behind generation of a large amount of free radicals. Unfortunately, research has not noted the multi-implication parallel phenomenon of Ihtiraq (Combustion) in Unani Medicine, which possesses much richer etiopathological sub-typing and much more variegated selective and specific treatments (and prophylactics) corresponding to each sub-type of Ihtiraq; the identification of each sub-type's molecular counterparts can be used to develop not only sub-types of OS pathologies and corresponding selective treatments/prophylactics but also non-biomolecular factors. Eminent Unani physicians described a deteriorative phenomenon, which they termed as 'Ihtiraq' which stands for extreme metabolism or 'combustion' and is recognized as a fundamental pathology, contributing as a major factor to the development of chronic diseases. Further, Unani Medicine also possesses a pathophysiological phenomenon called 'Hararat Ghariba' (Unnatural Heat) whose diverse associations with Ihtiraq may be correlatable as upstream, parallel, or downstream associations of OS and consequent pathologies. AIM OF THE STUDY: The aim of the study is to: 1. Explore the correlation of the phenomenon and etiopathology of Ihtiraq and OS and the treatment and prevention of the pathologies arising from them. 2. Extrapolate Ihtiraq, its types, causes, prevention, and treatment to OS, hitherto existing as a fundamental and monolithic pathology of increased ROS, to hypothesize its molecular-level sub-typing, as well as to propose selective interventions in these molecular sub-types of OS in place of the existing use of only basic antioxidants such as Vitamin C. MATERIAL AND METHODS: This review is presented with a noteworthy insight into Unani concepts and a thorough study of classical Unani literature by Ibn Sina (10th century), Zakaria Razi (9th century), Ibn Rushd (12th century), Ibn al-Nafees (13th century), Majusi (10th century), and Jurjani (11th century), and comparative detailed study of modern concepts of OS from literature databases, as well as Google, recent researches, and review articles. RESULT: The study showed very close correspondences between the phenomenon, etiopathology, and treatment and prevention of Ihtiraq in Unani Medicine and OS in contemporary biomolecular medicine. It also revealed sub-types of Ihtiraq and corresponding selective Unani treatments and prophylactics including drugs and non-drug factors. CONCLUSION: After a comprehensive study and analysis of the most recent researches and classical theories, it can be stated that OS can be seen as a molecular level expression of Ihtiraq. Further, various components of Ihtiraq may be used to hypothesize molecular sub-types of OS and propose corresponding specific interventions.

Aatrilal (Ammi majus L.), an important drug of Unani system of medicine: A review.

ETHNOPHARMACOLOGICAL RELEVANCE: Ammi majus L. (Aatrilal) a member of the family Apiaceae, is native to Egypt and widely distributed in Europe, the Mediterranean, and West Asia. It has been used for the treatment of various dermatological disorders particularly vitiligo in the Unani system of Medicine for ages. In traditional medicine, fruits are used as an emmenagogue as well as a diuretic, blood purifier and to treat leprosy, urinary and digestive disorders. AIM OF THE REVIEW: This paper aims to highlight the medicinal properties of Aatrilal in view of its temperament and phytoconstituents; to signify its potential in the treatment of vitiligo and other ailments as mentioned in Unani system of medicine and also to explore its phytochemistry, pharmacological and clinical studies. MATERIALS AND METHODS: Aatrilal was explored in classical Unani literature for its temperament (mizaj), medicinal properties and therapeutic uses. Published works available on PubMed, Science Direct, and Google Scholar were referred to collect all the available information regarding its phytochemicals and pharmacological studies. All relevant articles up to 2020 were referred including 15 classical Unani books, 15 English books, 72 research, and 3 review papers. The plant's scientific names were validated using 'The Plant List' (www.theplantlist.org). Standard Unani Medical Terminology published by Central Council for Research in Unani Medicine in collaboration with the World Health Organization was used to describe the appropriate Unani terminologies. Glossary of Indian Medicinal Plants and different indexed journals were consulted for botanical and English names. RESULTS: Aatrilal has been used in traditional medicine for ages. Due to controversies in its identity, it was adulterated and substituted with many drugs. The real identity of Aatrilal is now established as the fruit of A. majus L. Despite having numerous pharmacological activities, it is considered the first-line drug for the treatment of vitiligo. It is a rich source of furanocoumarins (xanthotoxin, also known as 8-methoxypsoralen, bergapten, imperatorin, isopimpinellin) with other compounds viz. flavonoids, terpenoids, proteins, essential oil constituents, etc. It has been reported for anti-inflammatory, analgesic, antibacterial, antiviral, cytotoxic, and many other activities. Clinical trials have shown the therapeutic potential in vitiligo and other skin disorders. CONCLUSION: Based on the available literature, it can be concluded that Aatrilal is a drug that has been effectively used in Unani system of medicine for centuries to treat the cases of vitiligo and other dermatological disorders. It has been studied extensively for its phytopharmacological properties. Raw extracts of A. majus form the crux of the main research. Many potentially bioactive compounds are included in the essential oil, but to our knowledge, no detailed studies of its biological activity are yet available. Therefore, our suggestion is to focus future research on essential oil and its ingredients.

Recent Therapeutic Interventions of Fenugreek Seed: A Mechanistic Approach.

Fenugreek seeds have widespread relations with Ayurveda, Unani, and Arabic medicine. The seeds were useful for the treatment and prevention of different ailments. Fenugreek (Trigonella foenum-graecum) or methi is from the Leguminosae family and are primarily known for its anti-diabetic and hypocholesterolemic activities. The germinated fenugreek seeds were used in the treatment of E.coli infection in Germany and France. The important phytoconstituents responsible for such medicinal applications are saponins, polyunsaturated fatty acids, galactomannans, trigonelline, and 4-hydroxy isoleucine. Flavonoids, apigenin 6,8-di-C-glucoside, apigenin-6-C-glucosyl-8-C-galactoside, 6-Cgalactosyl- 8-C-arabinoside are the chief ingredients of fenugreek seeds; responsible for reducing blood glucose while given to diabetic rats, whereas important flavones are epigenin, luteolin and vitexin. The other major bioactive components in fenugreek seeds are polyphenols like rhaponticin and isovitexin. Fenugreek seeds contain phosphorus and are categorized into different classes such as inorganic phosphorus, phospholipids, phytates, phosphor-proteins, and nucleic acid. Germinated seeds profusely filled with amino acids with amino acids, proteins, ascorbic acid, sugars. Further, this review shares information about the recent therapeutic intervention not covered earlier; on in vivo and in vitro and some clinical applications against certain interesting ailments other than older applications. This review includes certain nano delivery systems of Fenugreek seeds and their medicinal application.

Hammam-i-Bukhari (Turkish bath): A promising regimenal mode of Unani treatment.

Hammam-i-Bukhari (Turkish bath) is one of the important regimens used for the prevention and cure of several bodily ailments in Unani system of medicine. This regimen is usually practiced in the Arab world. The classical Turkish bath is built in the form of cavernous structure with beautiful classy mosaics and fountains. This regimenal therapy advocates physical, psychological and cosmetic health by integral cleansing which has different corporal effects appearing in biological along with molecular level. This therapy reduces the viscosity of the khilt (humour), eliminates the khilt-i-radi (morbid matters) and also diverts the morbid matters to the surface of the body from deep seated organs. Unani physicians, sometimes advise to patients for massage and several other regimens with different medicated substances before hammam to enhance the physiological activity from where hammam eliminates by its unique actions which helps in establishing a state of humoural equilibrium thus promoting health. Due to its efficacy and necessity; this therapeutic module is gaining popularity and assuming greater prominence among patients who are referred by physicians. The present review will dwell at length various modalities of hammam with its beneficial effects so that wholesome wellness could be attained by practical indulgence.

Lithotriptic effect of Safuf Hajar-al Yahud in patients of Hasat-ul Kilya (Nephrolithiasis) - an open prospective clinical validation trial.

BACKGROUND: Hasat-ul Kilya (Nephrolithiasis) is one of the most common chronic conditions and has been known to the mankind since antiquity. The incidence is increasing globally with geographic, racial and gender variation in its occurrence. Medical management of Nephrolithiasis still poses a considerable challenge for modern medical practice. Unani drugs possessing lithotriptic activity are not only cost effective but also have least side effects. Safuf Hajar-al Yahud has been used since long for the treatment of Hasat-ul Kilya (Nephrolithiasis) but no documentary evidence based on scientific parameters as to its safety and efficacy are available. OBJECTIVE: To validate the safety and efficacy of Safuf Hajar-al Yahud in the treatment of Hasat-ul Kilya. METHODOLOGY: An open prospective clinical trial was carried out on 107 subjects of renal calculi of 3-7 mm diameter diagnosed by Ultrasonogram-KUB (USG-KUB). Subjects were evaluated by clinical history & examination, laboratory investigations followed by USG-KUB for confirmation. The safety was assessed by reporting of adverse events and by pathological and biochemical investigations. Assessment of efficacy was based on improvement observed in VAS score and expulsion/reduction of stone size as detected by USG-KUB. RESULTS: Substantial reduction (53%) in the size of calculi confirmed by USG-KUB and considerable lowering of VAS score (75%) were observed with the active intervention in majority of the cases. CONCLUSION: The trial has revealed that the Unani pharmacopoeal formulation Safuf Hajar-al Yahud was well tolerated and has the therapeutic potential in the reduction and expulsion of renal calculi.

Efficacy of Nardostachys jatamansi (D.Don) DC in essential hypertension: A randomized controlled study.

BACKGROUND: Nardostachys jatamansi (D.Don) DC, commonly known as muskroot and Indian spikenard, is a small, perennial, flowering, rhizomatous species of the Caprifoliaceae family. Nardostachys jatamansi (D.Don) DC (Sumbul-ut-teeb) has been used in Unani Medicine since antiquity. It is one of the important drugs mentioned by Ibn-e-Sina (Avicenna) in his treatise "Kitab al-Adwiya al- Qalbiya" for cardiac diseases. The drug has been shown to exhibit anxiolytic, sedative, antispasmodic, tranquillizing, and anti hypertensive activity. AIM: The aim of the present study was to examine the efficacy of Nardostachys jatamansi in reducing blood pressure in hypertensive patients. METHODS: The single blind randomized, placebo controlled study was conducted with 40 patients aged between 35-70 years. The participants were randomly allocated to receive either a total of 3 g of N. Jatamansi (1capsule 3 times a day) or placebo for 4 weeks. Patients using ≤ 2 antihypertensive drugs with stage 1 hypertension were included in the study. Systolic and diastolic Blood pressure was recorded at baseline and at every week for four weeks. MINICHAL score (for Quality of Life) was recorded at baseline and at the end of the trial. RESULTS: After the four weeks of treatment, there was a statistically significant reduction in average systolic blood pressure 144.20 ± 11.35 mmHg (CI, 138.89-149.51) to 134.30 ± 10.08 mmHg (CI, 129.58-139.02), p < 0.001) and diastolic blood pressure (94.9. ± 3.4 mmHg (CI 93.30-96.49) to 83.10 ± 5.29 mmHg (CI 80.62-85.57), p < 0.001) in the N. Jatamansi group whereas there was no significant difference in systolic blood pressure (143.40 ± 8.39 mmHg (CI, 139.47-147.33) to 142. ± 11.68 mmHg (CI, 136.53-147.47) p = 0.148) and diastolic blood pressure 95.10 ± 3.70 mmHg (CI, 93.37-96.83) to 94.80 ± 3.69 mmHg, (CI93.07-96.52) p = 0.186) in placebo group. A comparison between baseline and post treatment, MINICHAL score in N. Jatamansi group showed significant reduction 10.85 ± 1.27 (CI, 10.25-11.44) to 6.20 ± 1.77, (CI, 5.37-7.02) p < 0.001) whereas there was no significant difference in placebo group 11.05 ± 1.50 (CI, 10.34-11.75) to 10.85 ± 1.26, 95 % (CI, 10.25-11.44) p = 0.103). CONCLUSION: The present findings suggest that N. Jatamansi is effective in reducing both systolic and diastolic blood pressure in essential hypertension. Moreover studies on efficacy of different doses and treatment duration of test drug are required to finetune these observations.

Efficacy of Qurs-e-Gulnar in Ziabetus (type 2 Diabetes Mellitus): a single blind randomized controlled trial.

BACKGROUND AND OBJECTIVES: Diabetes is a serious threat to global health that respects neither socioeconomic status nor national boundaries. Globally, diabetes is among the top 10 causes of death. Unani system argued the effectiveness of several anti-hyperglycemic drugs, and all such drugs looked-for to be validated on scientifically. Hence a clinical trial was contemplated to evaluate the clinical efficacy of Qurs-e-Gulnar in the management of Diabetes Mellitus. METHODS: This study was conducted as single blind randomized control, on 40 patients of type 2 diabetes with the test (n=20) and control (n=20) groups for 45 days. Test group received Qurs-e-Gulnar at the dose of three Qurs twice a day, and control group received two capsules Diabeat® twice a day before meal. Subjective (at 0, 15th, 30th, and 45th) and objective parameters were assessed as pre-post treatment respectively. RESULTS: After treatment with test compound significant reduction was observed in all the subjective parameters viz. polyuria, polydipsia, polyphagia and tiredness in comparison of control group. The objective parameters FBS and PPBS was found to be significantly reduced (p<0.001) in both the groups where as HbA1c was found unchanged in test group but control drug showed highly significant reduction in HbA1c (p<0.001).The results were assessed statistically using two tailed Student's t-test, and Fischer exact test. CONCLUSION: On the basis of above observation it is concluded that the test compound Qurs-e-Gulnar has significant anti-diabetic effect which is evidentially observed both in subjective and objective parameters in test group in comparison of control group (CTRI/2017/07/009060).

Oxidative stress in Vitiligo patients and administration of Munzij and Mushil therapy, a poly herbal Unani formulation - hospital-based study.

Background Vitiligo, a skin disorder is viewed as a multifactorial process with major role of reactive oxygen species in concert to destroy or incapacitate melanocytes. In Unani system of medicine the treatment of Bars (Vitiligo) starts with removal of harmful materials from the body with Munzij and Mushil (MM), a poly herbal Unani formulation. Methods Herein, oxidative stress related parameters as MDA, SOD, GPx and CAT have been estimated in the 21 clinically diagnosed Vitiligo in-patients and subsequently these parameters were evaluated during and after administration of MM therapy and compared with 21 healthy subjects. Results There was significant difference in the parameters viz., SOD (p<0.001) and CAT (p<0.005) activity at the baseline with no statistical significant difference in MDA and GPx activity among Vitiligo subjects and controls. After MM therapy there was no statistical significant difference among the values of these parameters in Vitiligo subjects. Conclusions The results suggest that there is imbalance in the oxidant-antioxidant status of Vitiligo subjects and the MM therapy is not found to significantly change the levels of oxidative stress related parameters.

Understanding hypothyroidism in Unani medicine.

Hypothyroidism (Qillat-e-Ifraz-e-Darqiyya) is a condition where the thyroid gland is underactive and unable to produce enough thyroid hormone. The description of hypothyroidism as a disease is not directly found in Unani texts. However, the signs and symptom of hypothyroidism resemble the clinical manifestation associated with Su-e-Mizaj Barid Maddi (derangement in cold temperament), such as plethora (Imtila), excessive salivation (Kasrat-e-Luabe-e-Dahan), tiredness (Aa'yan), loss of appetite (Zoaf-e-Ishteha), excessive sleeping (Kasrat-e-Naum) and cold skin (Baroodat-e-Jildia). These signs and symptoms are the result of an excess in abnormal phlegm (Ghair Tabayi Balgham) in the body. This review article identifies the observations from Unani literature that describe derangement in cold temperament and relate them to the clinical presentation of primary hypothyroidism in conventional medicine. We also discuss management of these symptoms in Unani medicine.

Anti-Obesity Effect of Arq Zeera and Its Main Components Thymol and Cuminaldehyde in High Fat Diet Induced Obese Rats.

Arq zeera is a distillate product that prepared from four different herbs namely Trachyspermum ammi L., apiaceae, Zingiber officinale Roxb., zingiberaceae, Carum carvi L.,apiaceae and Cuminum cyminum L., apiaceae. The present study aims to determine the antiobesity effect of arq zeera and its main components thymol and cuminaldehyde in high fat diet induced obese rats and to explore its mechanism of action. In current study, orlistat was used as positive controls. Male Wistar rats were fed with HFD for 42 days to induce obesity. HFD-fed rats were administered with arq zeera, thymol, cumic aldehyde, thymol + cuminaldehyde and orlistat for 28 days. During the course of treatment, body weight and food intake frequently observed and after end of treatments, liver weight, visceral fat pad weight, plasma lipid proflie, alanine aminotransferase, aspartate aminotransferase, glucose, insulin, leptin levels and pancreatic lipase activity were studied on all treated obese rats. The histopathology of liver was also studied. After the treatments of arq zeera and its main components, body weight, food intake, liver weight, visceral fat pad weight and the level of lipid profile, alanine aminotransferase, aspartate aminotranferase, glucose, insulin, and leptin were found to be decreased and pancreatic lipase inhibition were increased. Arq zeera showed more potential antiobesity effect than orlistat. According to our present findings, arq zeera and its main components possessed potent antiobesity effect on high fat diet -induced obese rats and excreted anti-obesity effect partly via hypolipidemic, hypoglycemic, hypoinsulinemic, hypoleptinemic and pancreatic lipase inhibition action.

History of cupping (Hijama): a narrative review of literature.

Cupping (Hijama in Arabic) is an ancient, holistic method for the treatment of a variety of diseases. Though the exact origin of cupping therapy is a matter of controversy, its use has been documented in early Egyptian and Chinese medical practices. Diverse human civilizations have contributed to the historical development and continuation of cupping therapy. This narrative review describes the history of cupping, historical definitions, cupping instruments and uses of cupping therapy. Electronic searches of relevant databases (PubMed, Google Scholar and OvidSP) were conducted using keywords and Boolean operators. Manual searches and references of published articles and books were also conducted. A number of articles (N = 625) were retained for extensive review, and finally 83 articles were included in this paper. The historical descriptions of cupping therapy were found in ancient human civilizations of the Eastern and Western world. There were inconsistent data concerning the origin of cupping, definitions, instruments, procedures, definite advancements and research in Hijama over centuries. Cupping therapy fell out of favor in 17th and mid-18th centuries but recovered popularity in modern medicine. Currently, cupping therapy is used for health promotion, prophylaxis and treatment of a variety of diseases around the world. Cupping therapy with a good safety profile has a checkered history and is a well-recognized traditional method for managing medical conditions. Currently, the scope of cupping therapy is expanding, and a growing body of research is providing additional evidence-based data for the further advancement of cupping therapy in the treatment of a variety of diseases.