Exploring the Potential of Asl-us-Soos (Glycyrrhiza glabra L.) in the Treatment of Respiratory Diseases-An Ethnomedicinal and Pharmacological Review.

Background: Asl-us-Soos (Glycyrrhiza glabra L.) has been used as a therapeutic agent in the treatment of respiratory, digestive, and neurological disorders since ancient times in Unani Medicine. Its therapeutic uses have been documented in Unani pharmacopeia, classical textbooks, and manuscripts based on experience in clinical practices. Asl-us-Soos (AS) and its compound preparations are recommended in the treatment of respiratory diseases such as Dhat al-Janb (pleurisy), Dhat al-Ri'a (pneumonia), Jamod us Sadr (pulmonary apoplexy), Diq al-Nafas (asthma), Sil (thiasis), and Diq (pulmonary tuberculosis). Objectives: This review aimed to provide insight into ethno-medicinal uses, pharmacological activities, and phytochemical profile of AS. The review also highlights the prospects in the development of potential drug molecules for various respiratory ailments. Methods: This review is based on a search of authentic Unani classical literature and major databases such as Science Direct, Medline (via PubMed), Google Scholar, Scopus, and Web of Science. The studies published between January 2001 and February 2022 were included in this study. Results: This review found that AS had medicinal uses in various respiratory disorders. Its roots are used as single drug and compound formulations for the treatment of dry cough, bronchial asthma, bronchitis, and pneumonia. In addition, AS contains active phytoconstituents such as glycyrrhizin (glycyrrhizic acid), isoliquiritigenin, glabridin, and licochalcone A. They have been extensively studied using in vitro and in vivo models and were found to exhibit pharmacological effects in pulmonary tuberculosis, pulmonary carcinoma, emphysema, bronchial asthma, pneumonia, and upper respiratory tract infections. Moreover, glycyrrhizin has been found to possess therapeutic potential against COVID-19. Conclusion: This review concludes that AS is a potent anti-tumor, anti-inflammatory, anti-microbial, anti-oxidant, expectorant, and antitussive drug. This plant could be an important source for the development of new drug compounds for various respiratory diseases.

Parametric optimization of additive manufactured biocarrier submerged in sequencing batch reactor for domestic wastewater treatment.

The high nutrient concentration in domestic wastewater effluent can endanger the aquatic life via eutrophication. Thus, research have been carried out to prevent harm to aquatic life. In regard biofilm reactors have been successful by far with few limitations. Bio-carrier fabrication of desired shape is one of the limitations. Recently, the invention of additive manufacturing (AM) of object made it feasible to fabricate the desired shape. In this study additive manufactured bio‒carrier (AMB) was printed using AM technique, with high surface area to volume ratio as well as density higher than water. The submerged attach growth sequencing batch biofilm reactor (SAGSBBR) for organic and nutrient removal from domestic wastewater (DWW) was conducted to determine the optimum bio‒carrier filling ratio (FR) and cycle time (CT) by using response surface methodology (RSM) with CT ranging between 12 h and 24 h and FR ranging between 0 and 20%. The maximum chemical oxygen demand (COD), ammonia-nitrogen (NH4 +‒N), and total phosphorus (TP) removal was 96.8 mg/L, 93.32 mg/L, and 88.89 mg/L respectively, which was achieved in submerged attached growth sequential biofilm batch reactor with 10% FR (SAGSBBR‒10). The optimization study determined the optimal solution of CT and FR to be 17.07 h and 12.38% respectively, with desirability of 0.987. The predicted mean of responses for the optimal solution were 96.64%, 94.40% and 89.94% for COD removal, NH4 +‒N removal and TP removal, respectively. The rate of biomass attachment at the first stage in SAGSBBR‒10 and SAGSBBR‒20 was about 11.39 mg/carrier.d and 8.64 mg/carrier.d, whereas the highest accumulation achieved was 98.27 mg/carrier and 80.15 mg/carrier respectively. Thus, this study can assist us to achieve sustainable development goal (SDG) 6.

A randomized controlled clinical trial to evaluate safety and efficacy of a Unani formulation in the management of Kalaf (Melasma).

OBJECTIVES: Kalaf (Melasma) is an acquired facial hypermelanism. It has direct impact on patient's quality of life and leads to development of various personality disorders. Lack of effective treatment and recurrences have drawn the attention of researcher to find alternative treatment. This study aimed to evaluate safety and efficacy of a topical Unani formulation in the management of melasma. METHODS: We conducted a prospective randomized controlled clinical study on the participants diagnosed with melasma. The participants (n=72) randomized into test (n=36) and control (n=36) groups. Sixty participants (n=30 in each group) completed the duration of therapy. The participants of the test group were treated with a classical Unani formulation and control group with hydroquinone 4%. The primary end point was change in mean MASI score and secondary end point was improvement in quality of life after eight weeks of treatment. RESULTS: The Unani formulation reduced 40.5% mean MASI score (17.31 ± 9.58 to 10.28 ± 5.92) in comparison to 32% reduction in mean MASI score (20.58 ± 9.49 to 13.92 ± 7.38) in the control group after eight weeks of treatment. When comparing with baseline the difference in MASI score was found statistically significant in both groups (p<0.05). On intergroup comparison, the change in MASI score between both groups was not statistically significant (p>0.05). In addition, MQOL and DQLI also improved significantly in both groups. CONCLUSIONS: This study concluded that the Unani formulation and the control drug were equally effective and safer in the management of melasma.

Assessing the efficacy and safety of Unani pharmacopoeial formulations in dermatophytosis (quba) - a randomized controlled trial.

OBJECTIVES: The recent trends of rising unresponsive cases of dermatophytosis to conventional therapies pose a challenge in clinical practice. Unani medicine offers effective treatment for dermatophytosis. This study aimed to evaluate the efficacy and safety of the Unani herbo-mineral preparations Qurs-e-Asfar (QA) and Rogan-e-Narjeel (RN) in dermatophytosis. METHODS: This was a randomized, active-controlled and open-label clinical study. The participants diagnosed with dermatophytosis (n=78) randomized into treatment group (n=40) receiving oral QA (778 mg twice a day) and topical RN and control group (n=38) receiving oral Itraconazole (100 mg/day) and topical Terbinafine hydrochloride (1%) for 6 weeks. RESULTS: We found post-treatment improvement in itching by 86.3% vs. 78% (treatment vs. control group), erythema by 96.4% vs. 94.3%, scaling by 93% vs. 92.2% and peripheral raised margins by 82.3% vs. 81%. Furthermore, this study showed that the differences in the mean Total Signs and Symptoms Score (TSSS) and positive KOH mount were clinically and statistically significant (p<0.05) in both the groups. On comparing inter group, the differences in mean TSSS (p=0.07) and positive KOH mount (p=0.717) were found statistically insignificant. CONCLUSIONS: This study concludes that the formulations QA and RN were effective and safe in the treatment of dermatophytosis.

Evaluation of the efficacy and safety of Unani Formulations in Pityriasis Versicolor: A randomized controlled trial.

ETHNOPHARMACOLOGICAL RELEVANCE: Pityriasis Versicolor (PV) is a commonly encountered infection of the skin caused by Malassezia species. Despite effective conventional antifungal drugs, the prevention and treatment of PV remain a challenge. The Unani pharmacopoeial preparations Itrifal Hakim Ali (IHA) and Habb-e-Kalaf (HK) have been used in the treatment of PV for a long time. The Unani practitioners recommend these formulations for the successful treatment of PV in clinical practice. AIM OF THE STUDY: This study aimed to evaluate the efficacy and safety of Unani formulations IHA (oral) and HK (topical) in the treatment of PV. MATERIALS AND METHODS: A single centre, randomized, active-controlled, parallel-group and open-label clinical study was carried out in the outpatient departments of the National Research Institute of Unani Medicine for Skin Disorders, Hyderabad, India. The participants diagnosed with PV of any gender aged between 18 and 60 years were randomized into the test group (n = 37) to receive oral IHA (10g/day) and topical HK and the active control group (n = 35) to receive oral Itraconazole (100 mg/day) and local Terbinafine (1%) for the period of 6 weeks. Of them, 30 participants in each group completed the duration of the protocol therapy. The outcome of this study was based on a per-protocol analysis of the data. The efficacy of the interventions was measured by post-treatment change in subjective clinical symptoms/signs, mean TSSS, IGA score, direct microscopy of fungal elements and DLQI. The dermal safety was assessed by Berger/Bowman Scoring Scale and systemic safety was evaluated by Urinalysis, haematological and biochemical parameters. RESULTS: This study observed statistically and clinically significant post-treatment reduction in itching (test group vs. active control group; 73.4% vs. 89.1%), hypopigmentation (63.2% vs. 57.1%), hyperpigmentation (60% vs. 65.5%), and scaling (91.6% vs. 92.7%) (p < 0.001). The differences in mean TSSS (5.4 ± 0.63 vs. 5.60 ± 0.32), IGA score (2.07 ± 0.15 vs. 1.74 ± 0.08) and DLQI (9.6 ± 2.06 vs. 9.04 ± 2.7) were also found clinically and statistically significant (p < 0.001) in each group when compared baseline data to post-treatment. On inter-group comparison, the changes in mean TSSS and DLQI were not found statistically significant at p < 0.05. But, the change in the mean IGA score was significant (p = 0.03). Further, the mycological cure was observed in 100% and 76.7% of participants in the test group and the control group respectively. On comparing inter-group the effects of the interventions on direct microscopy were found statistically significant (p = 0.034). In addition, no significant change in urinalysis, biochemical and haematological parameters from baseline to post-treatment in each group was observed. CONCLUSION: This study concluded that the test drugs (IHA and HK) were safe and effective in the treatment of PV. The oral (IHA) and local (HK) Unani formulations were tolerated well by all the participants The efficacy and safety of the IHA and HK were comparable to the standard drugs (Itraconazole and Terbinafine).

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.