Antitussive Research Articles

Cough at the doctor’s office

Сough is a common symptom that requires medical attention. The range of diseases in which cough occurs is quite large. These are not only patients with bronchopulmonary pathology, cough can also occur in diseases of the gastrointestinal tract, cardiovascular system, diseases of the upper respiratory tract, taking medications and a number of other reasons. Cough has different developmental mechanisms and clinical characteristics. Treatment of cough should be primarily aimed at eliminating the cause of cough, the nosological form that triggered the development of this symptom. However, cough often requires a complex long-term diagnosis and personalized approach to therapy. Symptomatic treatment is often required before the cause of chronic cough is established and for patients with acute and subacute cough. When choosing symptomatic cough therapy, it is necessary to focus on a specific clinical situation and take a differentiated approach to the choice of medications. Combination medications are an effective symptomatic remedy in the treatment of cough, especially in situations where the patient has several symptoms at the same time (cough, viscous, difficult-to-separate sputum, bronchial obstruction). An example of such a combination are drugs that include bromhexine (mucolytic), guaifenesine (mucolytic/mucokinetic) and salbutamol (β2-adrenomimetic). The drugs have a synergistic effect, have an antitussive effect, improve mucociliary clearance, improve the rheological properties of bronchial secretions, reducing excessive bronchial tone, which leads to rapid cleansing of the bronchi from altered bronchial secretions and a decrease / cessation of coughing.

Benefit-Risk Profile of P2X3 Receptor Antagonists for Treatment of Chronic Cough: Dose-Response Model-Based Network Meta-Analysis

BackgroundRefractory or unexplained chronic cough disrupts quality of life and burdens healthcare systems around the world. The P2X3 receptor antagonist gefapixant is approved in many countries for its antitussive effects, but taste disturbances are a common adverse effect. Four newer, more selective P2X3 receptor antagonists have been developed to address this problem. Research QuestionHow does the benefit-risk profile vary across the five available P2X3 receptor antagonists? Study Design and MethodsA systematic review and network meta-analyses were conducted to evaluate the efficacy of P2X3 receptor antagonists, including gefapixant, sivopixant, eliapixant, camlipixant, and filapixant. Primary outcomes were a reduction rate in 24-hour cough frequency and incidence of taste disturbance. Dose-response curves, and median effective dose (ED50) were calculated. Effect size at ED50 was ranked according to SUCRA. The confidence was evaluated by CINeMA. ResultsSixteen randomized controlled trials involving 4,904 participants were analyzed. The gefapixant regimen demonstrated an ED50 of 90.7 mg/day for cough frequency reduction. Gefapixant showed the highest antitussive effectiveness at ED50 (reduction rate in 24-h cough frequency, median 28.1%; 95% Credible Interval 21.0 to 35.6%; ranked 1/5; moderate certainty) but the highest prevalence of taste disturbance (absolute risk difference per 100 patients, median 38; 95%CrI 27 to 51; ranked 5/5; high certainty) and the highest prevalence of discontinuation. Camlipixant had a well-balanced profile (reduction rate in 24-h cough frequency, median 14.7%; 95%CrI 5.4 to 26.0%; ranked 3/5; low certainty; and taste disturbance, absolute risk difference per 100 patients, median 2; 95%CrI 1 to 6; ranked 2/5; low certainty). Placebo had a mean of 33.1% reduction in 24-h cough frequency. InterpretationWhen used at safe doses, gefapixant had a favorable risk-benefit profile compared to the other four agents. Camlipixant showed initial promise, which may be further investigated by phase III trials currently underway. Clinical Trial RegistrationUMIN000050622

Temporary gains and permanent costs in methamphetamine precursor control

James Cunningham and co-authors did pioneering work in evaluating the impact of precursor control on methamphetamine markets and related harms. We discuss their studies, as well as others that followed, and review what is known of precursor control's short-run and long-run impacts. We interpret the evidence to suggest that precursor control was likely cost-effective initially. However, long-run supply adjustments by illicit meth producers weakened the controls' efficacy. Meanwhile, regulations on legal consumers of cold medications were permanent and unavoidable, which may have closed the gap on the positive net benefits that had accrued initially in the short run. Our review underscores the challenges policymakers face in achieving their goals when supply can adjust long-term, but non-participants in illegal markets cannot.

Enhancement of production of glycoalkaloids by elicitors along with characterization of gene expression of pathways in Solanum xanthocarpum

Solanum xanthocarpum fruits are used in the treatment of cough, fever, and heart disorders. It possesses antipyretic, hypotensive, antiasthmatic, aphrodisiac and antianaphylactic properties. In the present study, 24 elicitors (both biotic and abiotic) were used to enhance the production of glycoalkaloids in cell cultures of S. xanthocarpum. Four concentrations of elicitors were added into the MS culture medium. The maximum accumulation (5.56-fold higher than control) of demissidine was induced by sodium nitroprusside at 50 mM concentration whereas the highest growth of cell biomass (4.51-fold higher than control) stimulated by systemin at 30 mM concentration. A total of 17 genes of biosynthetic pathways of glycoalkaloids were characterized from the cells of S. xanthocarpum. The greater accumulation of demissidine was confirmed with the expression analysis of 11 key biosynthetic pathway enzymes e.g., acetoacetic-CoA thiolase, 3- hydroxy 3-methyl glutaryl synthase, β-hydroxy β-methylglutaryl CoA reductase, mevalonate kinase, farnesyl diphosphate synthase, squalene synthase, squalene epoxidase, squalene-2,3- epoxide cyclase, cycloartenol synthase, UDP-glucose: solanidine glucosyltransferase and UDP-rhamnose: solanidine rhamno-galactosyl transferase. The maximum expression levels of UDP-rhamnose: solanidine rhamno-galactosyl transferase gene was recorded in this study.

Antibacterial Activity of Sungkai Leaf Extract (Peronema canescens Jack) Against Streptococcus Pneumonia ATCC Bacteria. 49619 In Vitro

Pneumonia is an infectious disease of the respiratory tract that is transmitted through the air. Young leaves of the sungkai plant of the Verbenaceae tribe, traditionally often used as a cold medicine, worms (ringworms), prevent toothache by gargling, as a febrifuge. In addition, sungkai leaves are a traditional medicine to improve the immune system of patients with Covid-19. The purpose of this study was to determine the antibacterial activity of sungkai leaf extract in inhibiting the growth of Streptococcus pneumonia at bacteria.49619 The research methodology used was experimental. This research method starts with tool preparation, sampling, the extraction process, the photochemical process, and further extraction antibacterial activity testing is carried out by disk diffusion method using disc paper. The results of the study of the antibacterial activity of sungkai leaf extract have antibacterial activity in Streptococcus pneumonia atcc.49619 with a concentration of 25% categorized as medium, 50%, and 75% categorized as strong, while in Control + categorized as very strong. Based on the results of the conclusions showed that sungkai leaf extract has antibacterial activity.

A Semi-Mechanistic Population Pharmacokinetic Model of Noscapine in Healthy Subjects Considering Hepatic First-Pass Extraction and CYP2C9 Genotypes.

Noscapine is a commonly used cough suppressant, with ongoing research on its anti-inflammatory and anti-tumor properties. The drug has a pronounced pharmacokinetic variability. This evaluation aims to describe the pharmacokinetics of noscapine using a semi-mechanistic population pharmacokinetic model and to identify covariates that could explain inter-individual pharmacokinetic variability. Forty-eight healthy volunteers (30 men and 18 women, mean age 33 years) were enrolled in a randomized, two-period, two-stage, crossover bioequivalence study of noscapine in two different liquid formulations. Noscapine plasma concentrations following oral administration of noscapine 50 mg were evaluated by a non-compartmental analysis and by a population pharmacokinetic model separately. Compared to the reference formulation, the test formulation exhibited ratios (with 94.12% confidence intervals) of 0.784 (0.662-0.929) and 0.827 (0.762-0.925) for peak plasma concentrations and area under the plasma concentration-time curve, respectively. Significant differences in p values (<0.01) were both observed when comparing peak plasma concentrations and area under the plasma concentration-time curve between CYP2C9 genotype-predicted phenotypes. A three-compartmental model with zero-order absorption and first-order elimination process best described the plasma data. The introduction of a liver compartment was able to describe the profound first-pass effect of noscapine. Total body weight and the CYP2C9 genotype-predicted phenotype were both identified as significant covariates on apparent clearance, which was estimated as 958 ± 548 L/h for extensive metabolizers (CYP2C9*1/*1 and *1/*9), 531 ± 304 L/h for intermediate metabolizers with an activity score of 1.5 (CYP2C9*1/*2), and 343 ± 197 L/h for poor metabolizers and intermediate metabolizers with an activity score of 1.0 (CYP2C9*1/*3, *2/*3, and*3/*3). The current work is expected to facilitate the future pharmacokinetic/pharmacodynamic development of noscapine. This study was registered prior to starting at "Deutsches Register Klinischer Studien" under registration no. DRKS00017760.

Guaifenesin: The Ubiquitous Orphan.

Guaifenesin, a widely used ingredient in over-the-counter cough and cold medications, has been a subject of debate regarding its efficacy in treating respiratory conditions. Despite its historical use and US Food and Drug Administration approval, recent studies have questioned its claimed expectorant effect and its effectiveness in managing symptoms. This article examines the available evidence, highlighting the lack of significant benefits over placebo for upper respiratory disease. The rationale for clinical use is examined alongside the potential downside and alternatives to recommending guaifenesin as a treatment option.

#2358 Impact of COVID-19 on the clinical course of nephrotic syndrome in children: a single-center study

Abstract Background and Aims Children with nephrotic syndrome may experience disease relapse or aggravation triggered by various viral infections. Limited studies on the clinical implications of the coronavirus disease 2019 (COVID-19) pandemic in children with nephrotic syndrome have been published worldwide. Therefore, this study aimed to investigate the effects of COVID-19 on the clinical course of nephrotic syndrome in children. Method The medical records of pediatric patients with idiopathic nephrotic syndrome who visited our hospital between February and June 2022 were retrospectively analyzed. Patients aged &amp;lt;1 year and &amp;gt;19 years and those with inadequate medical records were excluded. Finally, total 59 patients (20 pediatric patients diagnosed with COVID-19 and 39 pediatric patients who did not have COVID-19) were included in the study. Results Twenty of the total 59 patients with nephrotic syndrome were diagnosed with COVID-19 during the study period. The mean age at the time of the diagnosis of nephrotic syndrome and COVID-19 in all 20 patients was 4.6 ± 3.5 and 8.9 ± 3.9 years, respectively. Three patients (15%) were diagnosed with nephrotic syndrome relapse during COVID-19 and the relapse rate was similar to them without COVID-19 (20.5%, 8/39 patients). At the time of the COVID-19 diagnosis, fever (85%) and cough (40%) were the most common symptoms. After the diagnosis of COVID-19, all patients showed improvement with symptomatic treatment, including antipyretic analgesics and cold medicine. None of the critical patients required hospitalization or oral antiviral medications. Conclusion Despite the use of immunosuppressants, the clinical manifestations of COVID-19 in children with nephrotic syndrome were not severe and are expected to be similar to that in the general population. The relapse rate of nephrotic syndrome in children with COVID-19 was also not different from them without COVID-19.

Chronic cough diagnosis, treatment, and referral practices among family physicians in the United States: a survey study

BackgroundCough is one of the most common presenting problems for patients in primary care and is largely managed in primary care clinical settings. Family physicians’ familiarity with chronic cough guidelines and the extent to which these guidelines translate into everyday practice have not been well described. The objective of this study was to characterize current diagnosis, treatment, and referral practices among family physicians and to identify potentially impactful strategies to optimize chronic cough management in primary care.MethodsWe conducted a cross-sectional survey of 5,000 family physicians to explore diagnosis, treatment, and referral practices related to chronic cough management in adults in primary care. Respondents completed the survey via paper or online. The outcome measures were self-reported numeric ratings and responses related to the survey elements.Results588 surveys were completed (11.8% response rate). About half (49.6%) of respondents defined chronic cough in a manner consistent with the American College of Chest Physicians (ACCP) chronic cough guidelines, with the rest differing in opinion primarily regarding duration of symptom presentation. Respondents reported trying to rule out most common causes of chronic cough themselves before referring (mean 3.41 on a 4-point scale where 4 is “describes me completely”) and indicated a desire for more resources to help them manage and treat chronic cough. Years in practice and rural/urban setting influenced diagnosis and referral practices.ConclusionsFamily physicians see chronic cough as a complicated condition that can be and is often diagnosed and treated entirely in a primary care setting. They also value the ability to refer in complex cases. Our results support that family physicians provide evidence-based management of chronic cough.

Homoeopathic treatment for chronic cough – a multicentric, prospective, exploratory trial

Context Cough is a major symptom of respiratory and some non-respiratory ailments for which patients usually seek primary medical care. Homoeopathy is frequently used for treatment of chronic cough. Objective This study aims to assess whether homoeopathy is useful for treating chronic cough resulting from Upper airway cough syndrome (UACS), Asthma and related syndromes, or Gastroesophageal reflux disease (GERD). Study Design A multi‑centre, exploratory, prospective trial. Study setting The study was conducted in the outpatient departments of 10 centres of CCRH, India from May 2018 – June 2020. Patients Patients of any gender, between 7-65 years of age, presenting with cough lasting &gt;8 weeks, were enrolled. Main Outcome Measure(s) Cough Severity Index (CSI) and EQ-5D-5L scales were used to analyse the outcomes. Results Out of 2397 patients screened only 706 cases, with minimum four follow ups were analysed, on modified Intention to Treat (mITT) basis. CSI and EQ-5D-5L scores were used to analyse the outcomes of the study. The mean of the CSI score at baseline was 19.09 whereas it reduced to 3.89 in the eighth follow-up with p value &lt;0.01. The mean of the EQ-5D-5L score at baseline was 50.59 which increased to 73.79 in the last follow-up, with p-value&lt;0.05. Phosphorus, Arsenic album, Pulsatilla, Sulphur, Lycopodium and Silica were found to be the most frequently prescribed medicines.

UNPREDICTABLE IDENTIFICATION OF A TITIN MUTATION IN A YOUNG PATIENT PRESENTING WITH INFLAMMATORY CARDIOMYOPATHY

Abstract Case Presentation A 23 years old patient, affected by type 1 diabetes, presented with fever, dyspnea and bilateral peripheral edemas. In the last week he received antibiotic treatment for a persistent dry cough and sore throat, and became symptomatic for exertional dyspnea from three days. His mother died at the age of 40 for sudden cardiac death. Blood pressure and oxygen saturation were normal: the ECG showed sinus tachycardia with symmetric negative T waves in all precordial leads. High sensitivity troponin T was 0.01 mcg/L (normal value &amp;lt; 0.014 mcg/L). All remaining blood tests were normal, except for CRP that was slightly elevated. His echocardiogram revealed left ventricular (LV) remodelling and dilation, severely reduced LV ejection fraction (LVEF 20%) with global hypokinesia, more pronounced at the level of the anterior wall, interventricular septum and apex and a dilated right ventricle (RV) with reduced systolic function. Cardiac magnetic resonance (CMR) confirmed severe biventricular disfunction (LVEF 19%; RVEF 23%) and showed a small area of subepicardial inferior junctional late gadolinium enhancement (LGE). The patient underwent an endomyocardial biopsy that showed a lymphocytic virus–negative myocarditis. Given his known type 1 diabetes, steroid treatment was not considered and anakinra was started. The patient was discharged after two weeks with a slight amelioration of the LV function (LVEF 27%), on optimal heart failure therapy and anakinra. At six months he was in NYHA class II and CMR showed slight reduction in LV dimensions and improvement of the LV and RV function (LVEF 39%; RVEF 45%), with no changes in the LGE pattern. A genetic test was performed and revealed two titin gene mutations, both categorized as likely pathogenic (TTN c.[11831T&amp;gt;A]; c.[72510_72517delGACAAATG]), responsible for a genetic form of dilated cardiomyopathy. Conclusion The present case suggests that in young patients presenting with clinical or histological diagnosis of myocarditis, genetic testing for cardiomyopathies should be considered especially in presence of a positive family history for sudden death or an incomplete recovery of the LV function at follow–up. Identification of a gene mutation in these patients allows a more tailored risk stratification of the index case and a proper management of the entire family.

Research progress of Chinese herbal medicines and classic prescriptions in the treatment of COPD based on the TCM theory and medicinal characteristics

Abstract Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease with a complex pathogenesis, which causes the lack of precise and personalized prevention, control, and treatment approaches in clinical practice. Traditional Chinese medicine (TCM) with multiple components acting on multiple targets plays a role in the prevention and treatment of COPD. After evaluating the treatment of cough, dyspnea, and lung distension based on syndrome differentiation in TCM, we summarized the commonly used TCM preparations for treating COPD. These preparations are mainly composed of medicines for clearing interior heat and releasing exterior, tonifying, activating blood and resolving stasis, resolving phlegm, relieving cough and breathlessness, and regulating Qi movement. Because all of them contain a variety of active ingredients such as flavonoids, terpenoids, and phenols, we analyzed the mechanisms of the classic prescriptions alone or in combination with other medicines or therapeutic methods. These mechanisms involve counteracting inflammation, oxidative stress, and fibrosis, inhibiting apoptosis, alleviating airway remodeling, and enhancing immunity. Meantime, we summarized the existing problems in the treatment of COPD by TCM. This review provides a scientific basis for the research and treatment of COPD in the future.

Qualitative and Quantitative Analysis of Chemical Components in Yinhua Pinggan Granule with High-Performance Liquid Chromatography Coupled with Q-Exactive Mass Spectrometry.

Yinhua Pinggan Granule (YPG) is an approved compounded traditional Chinese medicine (TCM) prescription for the treatment of cold, cough, viral pneumonia, and related diseases. Due to its complicated chemical composition, the material basis of YPG has not been systematically investigated. In this study, an analytical method based on high-performance liquid chromatography (HPLC) coupled with Q-Exactive mass spectrometry was established. Together with the help of a self-built compound database and Compound Discoverer software 3.1, the chemical components in YPG were tentatively identified. Subsequently, six main components in YPG were quantitatively characterized with a high-performance liquid chromatography-diode array detector (HPLC-DAD) method. As a result, 380 components were annotated, including 19 alkaloids, 8 organic acids, 36 phenolic acids, 27 other phenols, 114 flavonoids, 75 flavonoid glycoside, 72 terpenes, 11 anthraquinones, and 18 other compounds. Six main components, namely, chlorogenic acid, puerarin, 3'-methoxypuerarin, polydatin, glycyrrhizic acid, and emodin, were quantified simultaneously. The calibration curves of all six analytes showed good linearity (R2 > 0.9990) within the test ranges. The precision, repeatability, stability, and recovery values were all in acceptable ranges. In addition, the total phenol content and DPPH scavenging activity of YPG were also determined. The systematic elucidation of the chemical components in YPG in this study may provide clear chemical information for the quality control and pharmacological research of YPG and related TCM compounded prescriptions.

Therapeutic effect of ginkgetin on smoke-induced airway inflammation by down-regulating the c/EBPβ signaling pathway and CCL2 expression

Ethnopharmacological relevanceGinkgo biloba leaf and seed have been traditionally used in ancient China for the treatment of cough and asthma. However, there is limited literature available on the anti-COPD effects and mechanisms of Ginkgo biloba. Aims of the studyThe aim of this study was to comprehensively investigate the therapeutic potential of ginkgo extracts in COPD through a combination of in vivo and in vitro functional experiments. Transcriptomic analyses were also employed to uncover novel molecular mechanisms underlying the therapeutic effects of ginkgetin in COPD. Materials and methodsThe therapeutic efficacy of ginkgo extracts was assessed in a COPD model. The anti-inflammatory effects of ginkgetin and its underlying molecular mechanisms were examined in A549 cells treated with cigarette smoke extract (CSE). Additionally, transcriptomic analyses were conducted to identify novel molecular pathways influenced by ginkgetin. These findings were further validated using quantitative real-time polymerase chain reaction (qPCR) and Western blot techniques. ResultsThe ethyl acetate extract of Ginkgo biloba L. seeds and ginkgetin treatment significantly reduced cytokine production in COPD mice. Following drug administration, lung function improved in different groups. The transcriptome data strongly supports the inhibitory effect of ginkgetin on CSE-induced inflammation through the downregulation of the c/EBPβ signaling pathway and subsequent inhibition of CCL2 expression. ConclusionOur results demonstrate that ginkgetin, one of the biflavones found in Ginkgo biloba, exhibits inhibitory effects on smoke-induced airway inflammation. This effect is achieved through the downregulation of the c/EBPβ signaling pathway and the reduction of CCL2 expression.

A CROSS-SECTIONAL STUDY TO ASSESS SELF-MEDICATION FOR VARIOUS CONDITIONS AMONG MEDICAL, PARAMEDICAL, AND NON-MEDICAL STUDENTS

Objectives: The objectives of the study are to assess the knowledge about self-medication and factors influencing the use of self-medication among 2nd year medical, paramedical, and non-medical students. Methods: A cross-sectional, multicenter study was conducted among 520 students of medical, physiotherapy, nursing, and engineering courses. Students were given a pre-structured questionnaire in e form/physical forms. The responses were collected and analyzed using descriptive statistics. Results: It was found that 63% of students followed self-medication, among which 41% took medication from a chemist. Analgesic and antipyretic (31.8%) followed by cough and cold (23%) medication were the most common group for self-medication. Conclusion: Self-medication is seen more commonly in medical students, especially the hosteller group. The most common reason for self-medication is the easy availability of drugs and the absence of strict regulations.

Frequency of Self Medication Among Health Science Students in Foundation University Medical College, Islamabad, Pakistan

Objective: This study aimed to assess the level of knowledge and practices of self-medication among healthscience students. The research sought to identify factors influencing self-medication practices, includingdemographics, program of study, and access to medical facilities.Study Design: Descriptive cross-sectional study design.Place and Duration of Study: The study was carried out at Foundation University Medical College, Islamabad,Pakistan including the Departments of MBBS, BDS, Nursing, and DPT over six months, from February 2023 toJuly 2023.Methods: A descriptive cross-sectional study design was employed, involving students from a private universityin Islamabad, including those in MBBS, BDS, Nursing, and DPT programs. The study was conducted over sixmonths, from February to July 2023, using a non-probability convenience sampling technique. A validatedquestionnaire was utilized for data collection, pre-tested for clarity and relevance, and translated from Arabicto English. Data analysis was performed using SPSS version 23.0, involving descriptive and inferential statisticsto elucidate self-medication trends and associations.Results: Among the participants, 60.9% engaged in self-medication within the past six months. The most usedmedications were pain relievers (61.9%), antibiotics (39.1%), and cough syrups (35.8%). Motivations for selfmedication included perceiving the illness as non-serious (47%), saving time (46.4%), and relying on pastexperiences (36.4%). Access to personal knowledge (52.3%) and understanding the importance of prescribedmedicines (54.3%) were prevalent among the participants.Conclusion: The study concluded that a significant number of medical students practiced self-medication,primarily motivated by underestimating the severity of illnesses. Over-the-counter painkillers and antibiotics,despite requiring a physician's prescription, were the most commonly self-prescribed medications among thestudy population. How to cite this: Tahi Sk, Zaidi N, Shabbir M, Eman S, Batool A, Qureshi MH, Tariq MD. Frequency of Self Medication Among Health Science Students in Foundation University Medical College, Islamabad, Pakistan. Life and Science. 2024; 5(2): 222-227. doi: http://doi.org/10.37185/LnS.1.1.505

Paciente que consulta por tos

Cough is one of the most common reasons for outpatient medical consultation. Most of the time it is self-limiting so doctors tend not to give it much importance. However, cough can be caused by serious pathologies such as cancer, fibrosis and pulmonary tuberculosis. Furthermore, when the cough is intense or prolonged it can cause significant alterations in the quality of life of patients. In this article we will review the main guidelines for diagnosis and treatment of cough, how to suspect serious etiologies, when to define a treatment according to clinical information and when to request tests. Finally, we will discuss two clinical cases in order to illustrate some concepts.

Pectolinarigenin ameliorated airway inflammation and airway remodeling to exhibit antitussive effect.

Cough is a common symptom of several respiratory diseases. However, frequent coughing from acute to chronic often causes great pain to patients. It may turn into cough variant asthma, which seriously affects people's quality of life. For cough treatment, it is dominated by over-the-counter antitussive drugs, such as asmeton, but most currently available antitussive drugs have serious side effects. Thus, there is a great need for the development of new drugs with potent cough suppressant. BALB/c mice were used to construct mice model with cough to investigate the pharmacological effects of pectolinarigenin (PEC). Hematoxylin-eosin and Masson staining were used to assess lung injury and airway remodeling, and ELISA was used to assess the level of inflammatory factor release. In addition, inflammatory cell counts were measured to assess airway inflammation. Airway hyperresponsiveness assay was used to assess respiratory resistance in mice. Finally, we used Western blotting to explore the potential mechanisms of PEC. We found that PEC could alleviate lung tissue injury and reduce the release of inflammatory factors, inhibit of cough frequency and airway wall collagen deposition in mice model with cough. Meanwhile, PEC inhibited the Ras/ERK/c-Fos pathway to exhibit antitussive effect. Therefore, PEC may be a potential drug for cough suppression.

STUDY ON ANATOMICAL CHARATERIZATION OF MICROCOCCUS PANICULATA L

Micrococcus paniculata L., one of the important medicinal plants, commonly known as Cherikkotta, Kotta, Kottakka or Pottanga, of plant family Tiliaceae and are generally seen at the steep forested regions and also in scared grooves. The plant parts were utilized for the treatment of variety of diseases or conditions, including dysmenorrhea, paratyphoid, bone fractures, jaundice, kidney stones, dyspepsia, heat stroke, cold, fever, diarrhoea, hepatitis B, ingestion, and anthelmintic medication. It is widely distributed along the Western Ghats of India. Eventually, complete identification and authentication of plant material is needed to avoid confusion of species by non-taxonomist. Anatomical study supplement classical methods of identification. Specimen were examined by morphological and anatomical characteristics. Leaf and petiole anatomical profiling of this species Micrococcus paniculata occurring in of Kerala was investigated in this study. The study aims to search for the stable features marking out Micrococcus species. The species were distinguished based on the anatomical difference in the vascular bundles in midrib and petiole, palisade layer and type of stomata. The anatomical features of stem might be very useful for the identification of this plant species. Through this anatomical study, we concluded that this species has some unique features to its environmental habitat.

Menyikapi Preferensi Masyarakat Pondok Benda Pamulang Dalam Pemilihan Obat Flu Berdasarkan Iklan Dengan Bijak

Flu is an upper respiratory tract infection that is often treated with various flu medications on the market and promoted through various media, especially television. This research aims to understand people's preferences for flu medicine in Pondok Benda Pamulang, South Tangerang. Through group discussions and delivery of educational materials, this study found that price, quality, and brand trust factors influenced the choice of flu medication. The results show an increase in public knowledge about flu and its treatment. The attractiveness of flu medicine advertisements is important in influencing consumer behavior. The right use of endorsers and advertising frequency can increase the effectiveness of advertising in mass media. This study provides insight into the importance of education in forming wise health decisions and provides a better understanding of people's preferences for cold medicines.