A comprehensive approach for detection of biotin deficiency from dried blood spot samples using liquid chromatography-mass spectrometry.

Aim: The aim of the present study is to develop a liquid chromatography-mass spectrometry method to measure two important biomarkers of biotin deficiency from dried blood spot samples for effective management of the disorder. Materials & methods: The method was developed on a liquid chromatography-mass spectrometry system using pentafluorophenyl column employing a mobile phase composition of methanol and water in the isocratic mode. A full validation of the method was performed as per relevant guidelines. Results & conclusion: Correlation between the results of dried blood spot and plasma method was evaluated to determine the interconvertibility of the method. The developed method was successfully applied for establishing the reference ranges for these biomarkers in the population of Udupi, a coastal district of South India.

Biotin deficiency can lead to many complications such as impaired growth, compromised immune function, depression, myalgia and may even lead to death. The disorder can be managed by supplementation of biotin. Early detection is crucial in managing biotin deficiency. In this paper we describe a comprehensive method for the early detection of biotin deficiency. The method employs the use of minimally invasive blood sampling such as dried blood spot that is suitable for vulnerable neonatal population.

Profile of Cardiovascular Autonomic Dysfunctions in Breast Cancer Patients.

Background Patients on breast cancer chemotherapy frequently present with signs and symptoms of autonomic dysfunction. Cardiac autonomic dysfunction (CAD) is a significant cause of morbidity and mortality, affecting the quality of life with progressive advancing disease. It is associated with the short survival of breast cancer patients. Therefore, thoroughly assessing cardiovascular autonomic functions is crucial to monitor these patients' disease prognosis and chemotherapy side effects. The present study evaluated baseline heart rate variability (HRV) and Ewing's battery of cardiac autonomic reactivity tests in breast cancer patients on chemotherapy to evaluate CAD. Methodology This is a case-control study. Autonomic reactivity tests were performed in the autonomic function laboratory, Department of Physiology, All India Institute of Medical Sciences, Raipur. HRV was recorded using a lead II electrocardiogram (ECG) in two groups, namely, controls (n = 25 healthy female volunteers) and cases (n = 25 histologically proven stage I-III breast cancer patients, age 30-65 years, received three cycles of chemotherapy). Results Patients on chemotherapy had significantly lower reactivity for the time domain (all parameters) and frequency domain (absolute total power) of HRV compared to age-matched healthy controls. Autonomic reactivity showed significant loss in the patient group. Conclusions The sympathetic and parasympathetic parameters showed a significant loss of autonomic functions in the patient group compared to the healthy controls. This may be because of the chemotherapeutic drugs taken by the patients or cancer as the disease per se. As autonomic dysfunction is highly prevalent in patients with cancer and is associated with multiple symptoms, it is essential to study it in the cancer population.

An Ecchordosis Physaliphora, a Rare Entity, Involving the Central Nervous System: A Systematic Review of the Literature.

Ecchordosis physaliphora (EP) is a benign notochordal remnant, which is often an incidental finding; however, it can rarely present with neurological symptoms. We performed a systematic review of the literature for cases of symptomatic EP published in PubMed, Web of Science and Embase from January 1982 to May 2023. This is the largest review to date and revealed 60 cases including ours. Headache (55%) and CSF rhinorrhea (32%) were the most frequent clinical manifestations. The majority of symptomatic EP lesions were located in the prepontine region (77%) and required surgical resection (75%). EP should be considered in patients with neurologic symptoms in the setting of prepontine or posterior sphenoid sinus lesions. While symptomatic patients often require surgical intervention, rare cases may respond to oral corticosteroids.

Treatment of H. pylori infection and gastric ulcer: Need for novel Pharmaceutical formulation.

Peptic ulcer disease (PUD) is one of the most prevalent gastro intestinal disorder which often leads to painful sores in the stomach lining and intestinal bleeding. Untreated Helicobacter pylori (H. pylori) infection is one of the major reasons for chronic PUD which, if left untreated, may also result in gastric cancer. Treatment of H. pylori is always a challenge to the treating doctor because of the poor bioavailability of the drug at the inner layers of gastric mucosa where the bacteria resides. This results in ineffective therapy and antibiotic resistance. Current treatment regimens available for gastric ulcer and H. pylori infection uses a combination of multiple antimicrobial agents, proton pump inhibitors (PPIs), H2-receptor antagonists, dual therapy, triple therapy, quadruple therapy and sequential therapy. This polypharmacy approach leads to patient noncompliance during long term therapy. Management of H. pylori induced gastric ulcer is a burning issue that necessitates alternative treatment options. Novel formulation strategies such as extended-release gastro retentive drug delivery systems (GRDDS) and nanoformulations have the potential to overcome the current bioavailability challenges. This review discusses the current status of H. pylori treatment, their limitations and the formulation strategies to overcome these shortcomings. Authors propose here an innovative strategy to improve the H. pylori eradication efficiency.

Anti-N-methyl D-aspartate Receptor Encephalitis in India: A Literature Review.

Anti N-methyl D-aspartate receptor encephalitis (NMDAR-E) though rare, is currently considered as the commonest antibody mediated encephalitis in the world. No review on perspectives of NMDAR-E from India is available. The aim of the study was to review all the cases of NMDAR-E reported from India until June 2021 in terms of clinical features, diagnosis, and treatment, and perform a comparison of adult and paediatric cases. A literature review of NMDAR-E case reports/case series published from India till June 2021 was done. Demography, clinical profile, triggers, electroencephalography (EEG), neuroimaging, treatment details and outcomes were analysed. Sixteen case series and 35 case reports with a total of 249 cases were analysed. 82% of cases were from paediatric age group. The female to male ratio was 3:1. Psychiatric deficits, movement disorders, seizures, and language abnormalities were the most common clinical features. MRI brain abnormalities were seen in 45% patients. Electroencephalographic abnormalities were seen in 85% of patients. Infective triggers (herpes simplex virus and various other agents) were reported in 11% of the cases. Pediatric patients as compared with adults had more encephalopathy, autonomic dysfunctions, and normal imaging whereas the latter had more cognitive dysfunctions and delta brush pattern in electroencephalography (p<0.005). Therefore, to conclude, this literature review suggests that overall, the clinical spectrum of Indian cases is like cases described from other parts of the world. However, most reported cases from India belonged to paediatric age group who had more encephalopathy, autonomic dysfunctions, and normal brain imaging compared to adults. A few novel infectious agents as triggers were described from India.

Etiological spectrum of isolated ileo-cecal ulcers in patients with gastrointestinal symptoms.

Background: Isolated ileo-cecal region (ICR) ulcers may represent underlying Crohn's disease (CD), intestinal tuberculosis (ITB), bacterial infections (including typhoid), amoebiasis, eosinophilic enteritis, drug-induced sequelae, or neoplasm. Overlapping morphological and microscopic characteristics of many of these diseases make it challenging to unequivocally confirm a diagnosis. Aims: The aim of the study was to investigate the etiology and clinical outcomes of isolated ileo-cecal ulcers discovered during an ileocolonoscopy in patients with gastrointestinal symptoms. Methods: Patients with isolated ileo-cecal ulcers and symptoms within the age range of 10 - 80 years were included in the study (N = 100). Patients not giving consent (assent in case of a minor), with a prior diagnosis of tuberculosis or inflammatory bowel disease, with incomplete colonoscopy and associated colonic lesions other than ICR were excluded from the study. Demographics, clinical information, and relevant biochemical and serological tests were recorded. During the colonoscopy, multiple biopsies were taken from the ileo-cecal ulcers for histopathological examination. Repeat ileocolonoscopy was performed as needed in consenting patients. Results: The mean age and mean duration of symptoms were 36.0 ± 15.6 years and 18.8 ± 21.6 months, respectively. The majority of the patients presented with abdominal pain (59%), followed by diarrhea (47%), weight loss (20%), gastrointestinal bleeding (15%), and fever (11%). A history of taking nonsteroidal anti-inflammatory drugs was present in only 5% of the patients. Mean hemoglobin, C-reactive protein, and albumin levels were 11.6 ± 2.8 g/dL, 6.9 ± 9.5 mg/L, and 3.7 ± 0.8 g/dL, respectively. Based on clinical, colonoscopic, and histopathological findings, initial treatment was symptomatic/antibiotics in 55%, anti-tubercular treatment in 21%, 5-aminosalicylic acid/steroids for CD in 13%, oral budesonide in 10% of patients, and one patient was referred for management of malignancy. Final diagnoses after 8 - 24 weeks of follow-up were non-specific ileitis/colitis (45%), CD (20%), ITB (18%), infective (7%), eosinophilic ileitis/colitis (6%), non-steroidal anti-inflammatory drug-induced (2%), and amoebic and malignant in 1% of patients each. Conclusions: The majority of patients with ileo-cecal ulcers have specific etiologies. Non-specific ulcers at the ICR can be managed symptomatically; however, close follow-up is necessary as sometimes the ulcers may harbor an underlying specific disease. Relevance for Patients: Isolated ileo-cecal ulcers are common findings during colonoscopy in both symptomatic and asymptomatic patients. The majority of these ulcers harbor underlying significant diseases that can cause morbidity and mortality if left undiagnosed and untreated. Reaching a specific diagnosis in such cases is not straightforward, and patients are often subjected to repeat examinations.

Jackfruit (Artocarpus heterophyllus Lam.) in health and disease: a critical review.

Artocarpus heterophyllus Lam. (Family Moraceae), is a tropical tree, native to India and common in Asia, Africa, and several regions in South America. The fruit is commonly known as jackfruit which is one of the largest edible fruits in the world. Jackfruits comprises a wide range of nutrients, including minerals, carbohydrates, volatile compounds, proteins, and vitamins. The fruit, bark, leaves, and roots are endowed with therapeutic attributes and are utilized in the many traditional medicinal systems for the management of various ailments. Fruit and seeds are commonly used to prepare various food items, including sauce, ice creams, jams, jellies, and marmalades. Due to unique texture, jackfruit is becoming a popular meat substitute. Based on preclinical studies, jackfruit exhibits antimicrobial, antioxidant, anti-melanin, antidiabetic, anti-inflammatory, immunomodulatory, antiviral, anthelmintic, wound-healing, and antineoplastic activities. Clinical studies reveal that the leaves possess antidiabetic action in healthy and insulin-independent diabetic individuals. Despite numerous health benefits, regrettably, jackfruit has not been properly utilized in a marketable scale in areas where it is produced. This review delivers an updated, comprehensive, and critical evaluation on the nutritional value, phytochemical profiling, pharmacological attributes and underlying mechanisms of action to explore the full potential of jackfruit in health and disease.

Idiopathic Hypertrophic Spinal Pachymeningitis.

Hypertrophic pachymeningitis (HP) is a rare presentation with duramater thickening and fibrosis which can result in cranial or spinal compressive disease. Most cases of spinal HP require surgical management. We present an uncommon case of idiopathic hypertrophic spinal pachymeningitis (IHSP) in a 40-year-old male who showed complete improvement to steroids without any further relapses. The patient presented with bilateral upper limb weakness with magnetic resonance imaging (MRI) spine showing diffuse dural thickening of the entire spine with cervical cord compression. He had an extensive workup for underlying etiology and worsening symptoms until he was diagnosed with IHSP. Later, he was started on high-dose steroids with good response and no relapse after 2 years. A descriptive analysis of IHSP cases since 2009 including ours showed that it usually occurs after 50s with female preponderance. Weakness and sensory loss are the most common complaints with 50% patients showing clinical signs of myelopathy like hyperreflexia, clonus, Babinski sign and sensory level. Cerebrospinal fluid (CSF) and inflammatory markers like erythrocytic sedimentation rate (ESR) and C-reactive protein (CRP) can be used to assess disease progression and prognosis. Surgical removal of HP followed by steroids is the best line of management while steroids alone can be tried in cases where clinical signs of myelopathy are absent.

Chlorogenic acid for cancer prevention and therapy: Current status on efficacy and mechanisms of action.

Chlorogenic acid (CA), also known as 5-O-caffeoylquinic acid, is a dietary phenolic acid produced by various plant species. CA, is the most ubiquitous compound among the phenolic acid group, is also present in tea and green coffee extracts. Its consumption reduces the risk of numerous diseases as validated by preclinical and clinical studies. CA possesses a wide range of pharmacological properties, such as hepatoprotective, antimicrobial, immunomodulatory, antioxidant, antidiabetic, and anticancer activities. It has been extensively used in the food, chemical, medicine, and health care industries. Available reports revealed that CA can exert anticancer activity by inhibiting the cell cycle, triggering apoptosis, and suppressing the proliferation of cancer cells. It upregulates the expression of nuclear factor of activated T cells 2 (NFATC2) and NFATC3 genes involved in immune pathway and downregulates B cell-specific moloney murine leukemia virus integration site 1 protein and SRY-box transcription factor 2 gene expression to facilitate tumor cell destruction. It promotes intracellular DNA impairment and topoisomerase I- and topoisomerase-II-DNA complex formation that perform a key function in apoptosis. In addition, CA has been documented to be an effective natural anticancer drug and was approved by the China Food and Drug Administration. Several previously published reports have provided fragmented summary of various anticancer activities of CA. Therefore, this review aims to deliver up-to-date and comprehensive assessment about the natural sources of CA, its bioavailability, metabolism, and anticancer property with an emphasis on the molecular mechanisms associated with several signaling pathways in tumor cells.

Role of baicalin as a potential therapeutic agent in hepatobiliary and gastrointestinal disorders: A review.

Baicalin is a natural bioactive compound derived from Scutellaria baicalensis, which is extensively used in traditional Chinese medicine. A literature survey demonstrated the broad spectrum of health benefits of baicalin such as antioxidant, anticancer, anti-inflammatory, antimicrobial, cardio-protective, hepatoprotective, renal protective, and neuroprotective properties. Baicalin is hydrolyzed to its metabolite baicalein by the action of gut microbiota, which is further reconverted to baicalin via phase 2 metabolism in the liver. Many studies have suggested that baicalin exhibits therapeutic potential against several types of hepatic disorders including hepatic fibrosis, xenobiotic-induced liver injury, fatty liver disease, viral hepatitis, cholestasis, ulcerative colitis, hepatocellular and colorectal cancer. During in vitro and in vivo examinations, it has been observed that baicalin showed a protective role against liver and gut-associated abnormalities by modifying several signaling pathways such as nuclear factor-kappa B, transforming growth factor beta 1/SMAD3, sirtuin 1, p38/mitogen-activated protein kinase/Janus kinase, and calcium/calmodulin-dependent protein kinase kinaseß/adenosine monophosphate-activated protein kinase/acetyl-coenzyme A carboxylase pathways. Furthermore, baicalin also regulates the expression of fibrotic genes such as smooth muscle actin, connective tissue growth factor, ß-catenin, and inflammatory cytokines such as interferon gamma, interleukin-6 (IL-6), tumor necrosis factor-alpha, and IL-1ß, and attenuates the production of apoptotic proteins such as caspase-3, caspase-9 and B-cell lymphoma 2. However, due to its low solubility and poor bioavailability, widespread therapeutic applications of baicalin still remain a challenge. This review summarized the hepatic and gastrointestinal protective attributes of baicalin with an emphasis on the molecular mechanisms that regulate the interaction of baicalin with the gut microbiota.

Comparative study of analgesia of ketorolac, tramadol, and flupirtine in the management of third molar surgery.

Introduction: The most commonly performed surgical procedure in most oral and maxillofacial surgery practices is the removal of third molars. Postoperative pain is considered a form of acute pain due to surgical trauma with an inflammatory reaction. Materials and Methods: One hundred and fifty patients were included in the study which were divided into GROUP-A, B, and C-50 patients each; those who underwent third molar removal under local anesthesia. Local anesthesia was obtained by inferior alveolar, lingual, long buccal, posterior superior alveolar, and greater palatal nerve block injections after first complain of pain, all patients were prescribed analgesics (Ketorolac-10 mg), (Tramadol-50 mg), (Flupirtine-100 mg), and antibiotics co-amoxiclav-625 mg) T. D. S in all the three groups A, B, C, respectively, for 5 days and the timing noted in the patients assessment sheet. The statistical analysis was done using SPSS Version 15.0 statistical analysis software. Results: The flupirtine group has early onset and also had minimum side effects. All the groups showed similar trend in change in pain score from 3 h. P. O to different time intervals. It was observed the pain score increased significantly till 6 h. Post operative a decreased trend was found at 24 h, 48 h, 78 h, after 6 h. and this change was found to be statistically significant for all three groups. Conclusion: Flupirtine had faster onset and comparable pain management profile as compared to tramadol, it also had minimum side effects, hence the use of flupirtine might be recommended for postoperative pain management in cases undergoing third molar surgery.

Compare the efficacy of recommended peripheral intravascular cannula insertion practices with a standard protocol: A randomized control trial.

Background: Millions of patients admitted globally in health care setups require insertion of peripheral intravascular catheter for intravenous drugs or fluid administration. However, if proper precautions are not followed during insertion, it results in significant morbidity. This study was designed to study the efficacy and safety of recommended Centre for Disease Control and Prevention (CDC) guidelines for peripheral intravascular catheter insertion practice and its comparison with a standard insertion protocol being followed and their outcome. Methods: Patients were randomized and catheter was inserted as recommended by CDC guideline (Group 1, n = 100) or followed standard defined steps during insertion (Group 2, n = 100). Results: Almost double the patients had occurrence of thrombophlebitis in Group 1 (p = 0.02). No difference observed between catheter needle size and infection rates (p = 0.3). Infection rate increased significantly if second attempt is taken for insertion. The time required to insert catheter following CDC recommended protocol is less than as by standard surgical complete asepsis cleaning protocol (86.03 vs 109.40 s) (p = 0.001). Study also observed that insertion at wrist joint leads to higher incidence of thrombophlebitis. During 0-24 h, 6% (12) insertions turned positive followed by a dip during 25-48 h, 2% (5) insertions. 80% (159) insertions did not develop thrombophlebitis at the end of 72 h. Conclusion: It is thus amply demonstrated that meticulous adherence to insertion procedure with asepsis plays an important role in decreasing intravascular catheter associated morbidity. Other parameters like needle gauge, sites of insertion, have little bearing. The time required in following standard aseptic technique is significantly more but keeping in view the benefit to the patient it is highly recommended.

Reliability of STOP-Bang questionnaire and pulse oximetry as predictors of OSA - a retrospective study.

OBJECTIVE: To verify the reliability of a STOP-Bang questionnaire and objective blood oxygen concentration (SpO2) estimation by pulse oximetry as an indicator of patients' vulnerability to OSA, by correlating data of these two tests with that of the "gold standard" all-night polysomnography. METHODS: STOP-Bang score and pulse oximetry value (SpO2) for each patient were tabulated against the total sleep AHI score (obtained from subsequent all-night polysomnography) and analyzed to evaluate the diagnostic accuracy of the STOP-Bang questionnaire and pulse oximetry. RESULTS: With sensitivity and specificity scores of 91.2% and 88.6%, respectively, positive predictive value 90.5%, negative predictive value 40.2%, the twin diagnostic test (STOP-Bang and pulse oximetry) was found to be highly congruent with the polysomnography (PSG), achieving a diagnostic accuracy of 85%. CONCLUSION: Dental chairside screening by STOP-Bang questionnaire and pulse oximetry would be a good option, especially where logistic and economic constraints impede all-night polysomnography.

Evaluation of metastatic neck nodes search for primary and subsequent management.

Background: Cancers in the head-and-neck region are the sixth most common cancers worldwide with an increasing incidence in developing countries. Methods: This study was carried out in the department of ENT and head-and-neck surgery in collaboration with the department of radiotherapy for a period of 1 year extending from May 01, 2014, to April 30, 2015. A total of 48 cases of metastatic secondary nodes were included in the study. Results: The male-to-female ratio in the present study was 4.33:1. Maximum number of patients were seen in the seventh decade. The youngest patient was a female 30 years old and the oldest was a male of 80 years. About 95.84% of primary tumors were squamous cell carcinomas and 40.47% of the patients of head-and-neck cancer with metastatic lymph nodes had well-differentiated squamous cell carcinomas. Majority of cases presented with N2 nodes, while N1 nodes were highest in cases of carcinomas larynx. Conclusions: Metastatic neck disease is a major problem in patients with head-and-neck cancer. The therapeutic goal includes not only known disease but also the elimination of possible subclinical disease. The judicious use of moderate doses of irradiation and modified surgical procedures should be used in specific clinical situations to significantly decrease neck recurrences while eliminating morbidity.

Correlation between duration of edentulism and severity of obstructive sleep apnea in elderly edentulous patients.

Objectives: To investigate the correlation between duration of edentulism and severity of obstructive sleep apnea in elderly edentulous patients. Material and Methods: 1,017 patients aged 55-65 years, with a history of edentulism of 12-60 months were screened. Detailed history of tooth loss and period of edentulism was recorded for the 414 patients who tested positive for OSA (obstructive sleep apnea). Complete dentures were prepared for each patient and they were trained to use the dentures as a mandibular advancement device (MAD) during sleep at night. Apnea-hypopnea index (AHI) data at pre-treatment, six months and one-year post-treatment time intervals was recorded. A correlation between the period of untreated edentulism and severity of OSA and improvement post-treatment was derived in this study. Results: Mean duration of edentulism was 12.14±2.57 months and mean AHI was 16.62±13.24. For every three month increase in the duration of edentulism (after initial 6 months of total tooth loss), there was a statistically significant increase in severity of OSA. Patients who are edentulous for more than 15 months are increasingly vulnerable to OSA. Discussion: Severity of OSA in afflicted long-term edentulous patients was in direct relation to the period of untreated edentulism and regressed likewise with concomitant denture wear and mandibular advancement during sleep at night. Early prosthetic rehabilitation of edentulous patients is imperative to obviate morbidity of OSA.

Optimized hybrid machine learning approach for smartphone based diabetic retinopathy detection.

Diabetic Retinopathy (DR) is defined as the Diabetes Mellitus difficulty that harms the blood vessels in the retina. It is also known as a silent disease and cause mild vision issues or no symptoms. In order to enhance the chances of effective treatment, yearly eye tests are vital for premature discovery. Hence, it uses fundus cameras for capturing retinal images, but due to its size and cost, it is a troublesome for extensive screening. Therefore, the smartphones are utilized for scheming low-power, small-sized, and reasonable retinal imaging schemes to activate automated DR detection and DR screening. In this article, the new DIY (do it yourself) smartphone enabled camera is used for smartphone based DR detection. Initially, the preprocessing like green channel transformation and CLAHE (Contrast Limited Adaptive Histogram Equalization) are performed. Further, the segmentation process starts with optic disc segmentation by WT (watershed transform) and abnormality segmentation (Exudates, microaneurysms, haemorrhages, and IRMA) by Triplet half band filter bank (THFB). Then the different features are extracted by Haralick and ADTCWT (Anisotropic Dual Tree Complex Wavelet Transform) methods. Using life choice-based optimizer (LCBO) algorithm, the optimal features are chosen from the mined features. Then the selected features are applied to the optimized hybrid ML (machine learning) classifier with the combination of NN and DCNN (Deep Convolutional Neural Network) in which the SSD (Social Ski-Driver) is utilized for the best weight values of hybrid classifier to categorize the severity level as mild DR, severe DR, normal, moderate DR, and Proliferative DR. The proposed work is simulated in python environment and to test the efficiency of the proposed scheme the datasets like APTOS-2019-Blindness-Detection, and EyePacs are used. The model has been evaluated using different performance metrics. The simulation results verified that the suggested scheme is provides well accuracy for each dataset than other current approaches.

Amalgamated Microneedle Array Bearing Ribociclib-Loaded Transfersomes Eradicates Breast Cancer via CD44 Targeting.

HR+/HER2- metastatic breast cancer (MBC) is one of the most common and life-threatening conditions diagnosed in women. The endocrine therapy using an orally active CDK4/6 inhibitor, ribociclib (RB), is the most intriguing approach for treating HR+/HER2- MBC. However, the repeated three to six cycles of multiple dosing and non-targeted distribution of RB led to severe neutropenia; hepatobiliary, gastrointestinal, and renal toxicities, and QT interval prolongation. Here, a novel organic solvent-free HA-PVA-PVP (hyaluronic acid-polyvinyl alcohol-polyvinyl pyrrolidone) composed of a microneedle (MN) array is formulated to deliver RB, integrated with amphiphilic conjugated polymer (HA-GMS)-anchored ultradeformable transfersomes. This unique MN array efficiently crafts microchannels in the skin, allowing HA-RB-Ts to internalize into the tumor cells through lymphatic and systemic absorption and interact with CD44 both spatially and temporally with an amplification of drug release time up to 6-folds. The pharmacokinetic and tissue distribution studies portray drug concentrations within the therapeutic window as long as 48 h, facilitating thrice-a-week frequency with the lower dose, and rule out severe toxicities, with a significant reduction in 8.3-fold RB concentration in vital organs that ultimately enhances the survival rate. Thus, the novel MN system pursues a unique embeddable feature and offers an effective, self-administrable, biodegradable, and chronic treatment option for patients requiring long-term cancer treatments.

Health-promoting and disease-mitigating potential of Verbascum thapsus L. (common mullein): A review.

Medicinal plants represent rich sources of traditional medicines and numerous currently used medicines are either directly or indirectly derived from plants. Verbascum thapsus L. (great mullein or common mullein), a medicinal herb indigenous to northern Africa, western and central Asia, and Europe, has been brought to the Americas and Australia. It has been used as a medicine for lung, skin and throat disorders and has a long history of therapeutic importance, particularly as an astringent and calming agent. Presently, the dried leaves, flowers, various plant extracts and flower oil are used in several formulations within Indian traditional medicine. An extract taken from the roots is useful in minimizing toothache, and it also relieves stiffness and seizures. V. thapsus contains a wide variety of phytoconstituents, such as flavonoids, iridoid, phenylethanoid and phenylpropanoid glycosides, saponins, as well as vitamin C and minerals. The most valuable constituents are coumarin and hesperidin, which possess healing properties. Emerging literature based on experimental studies on V. thapsus demonstrates various biological and pharmacological properties, including antiviral, antioxidant, analgesic, sedative, anti-inflammatory, hypnotic, antibacterial, antifungal, as well as anticancer activities. The present review provides an updated, comprehensive, and critical evaluation of various health-promoting and disease-mitigating properties of V. thapsus.