RESUMO
Introduction: Epilepsy is characterized by having two or more unprovoked seizures. Understanding the pathogenesis of epilepsy, requires deep investigation into the molecular mechanisms. This helps develop diagnostic techniques, treatments, and pharmacotherapy. It also enhances precision medicine and individualized treatment processes. This article reviews all the molecular mechanisms predisposing to epileptogenesis, presents the current diagnostic techniques and drug therapy, and suggests future perspectives in treating Epilepsy in a more comprehensive and holistic approach. Methodology: Four authors searched keywords concerning epilepsy at a molecular level, Epilepsy diagnostic techniques and technologies, and antiepileptic drug therapy and precision medicine. Separate search strategies were conducted for each concern and retrieved articles were reviewed for relevant results. Results: The traditional diagnostic techniques for Epilepsy and its pathogenesis are insufficient in highlighting dynamic brain changes. For this, emerging technologies including genetic sequencing and profiling, and functional neuroimaging techniques are prevailing. Concerning treatment, the current approach focuses on managing symptoms and stopping seizures using antiseizure medications. However, their usage is limited by developing resistance to such drugs. Some therapies show promise, although most antiseizure drugs do not prevent epilepsy. Discussion: Understanding epileptogenesis at a molecular and genetic level aids in developing new antiepileptic pharmacotherapy. The aim is to develop therapies that could prevent seizures or modify disease course, decreasing the severity and avoiding drug resistance. Gene therapy and precision medicine are promising but applications are limited due to the heterogeneity in studying the Epileptic brain, dynamically. The dynamic investigation of the epileptic brain with its comorbidities works hand-in-hand with precision medicine, in developing personalized treatment plans.
RESUMO
Globally, non-communicable diseases (NCDs) and communicable diseases (CDs) are on the rise, posing a significant public health threat. A holistic ayurvedic preparation called chyawanprash (CP) has shown positive outcomes in NCDs and CDs. Hence, we aimed to report the outcomes in a systematic manner. To determine the safety, efficacy, healthcare utilization, and quality of life of CP as an optional therapy for NCD and CD management. This systematic review will adhere to PRISMA-P and Cochrane guidelines for methodological considerations. It will evaluate CP efficacy in diverse populations, considering Ayurvedic and non-Ayurvedic comparators. The study design will encompass randomized controlled trials (RCTs) published from 2010 to 2023 in healthcare settings, controlled environments, and communities. We will also analyze primary outcomes related to immunity biomarkers, vital signs, and secondary outcomes such as quality of life. Data sources and search strategy will involve systematic searches in databases such as Cochrane, PubMed, Google Scholar, Web of Science, and Scopus using MeSH terms and Boolean operators. Screening and data extraction will follow a standardized form with four independent reviewers. Quality assessment will use the Cochrane risk of bias tool. The systematic review will provide an exhaustive summary of the effectiveness and safety of CP to address the growing burden of NCDs and CDs. Registration: CRD42023418994.