Medicinal Importance Research Articles

Comprehensive Ethnomedicinal, Pharmacological and Phytochemical Report on <i>Basella alba</i> L. (Basellaceae)

From the primitive era to the current generation, natural extracts or products played the most conservative therapeutic and nutritional resources. Starting from the era of folklore or ancient, mother nature has protected us from various diseases by producing various natural products having strong medicinal implications like quinine, taxol, vinblastine, etc. Among the many available sources of natural products, pharma-herb being a new member has drawn considerable attention of the researcher in order to have a new pool of products having pronounced pharmaceutical activity. Now Basella alba is one of the brightest candidates belonging to pharma-herb because of its considerably enriched pharmacologically important product stocks like vitamin C, flavonoid compounds, carotenoids, saponins as well as a large number of different minerals and numerous amino acids. This plant is a perennial vine that is often cultivated as a food crop during the cooler months. It is also able to grow very fast and can resist temperatures that are quite high. Basella alba has been referred to by a number of different names throughout history, including Indian-, Malabar-, climber-, Ceylon-, and vine-spinach. Poi is the term that the majority of people in India use when referring to it. The various natural products isolated from B. alba have significant medicinal utilization because of its antimicrobial, anti-ulcer, wound healing, antiviral, anti- inflammatory depressant, androgenic potential, hepatoprotective, antidiabetic, antioxidant, anti-anxiety, diuretic and antiurolithiatic activities. This review will cover a detailed journey about Basella alba L. ranging from phytochemical to toxicological, morphological, pharmacological as well as medicinal importance.

Effective Ayurvedic Management of Steroid Resistant Nephrotic Syndrome - Case Study

Nephrotic syndrome presents with heavy proteinuria (3.5 g Proteins/ 1.73 m2 body surface area/24 hour), dyslipidaemia/ hypercholesterolemia, hypoalbuminema, edema and hypertension. If left untreated or undiagnosed, there is progressive damage to glomeruli causing renal failure. Heavy proteinuria is the most characteristic feature of this syndrome. Several studies have noted that higher the 24-h urine protein excretion, more rapid is the decline in GFR. It may be primary or secondary to other systemic diseases. Case study: This 2 year old male child developed Nephrotic syndrome and was placed on steroids, used to relapse when steroids are withdrawn, and subsequently developed steroid resistance. He was poorly managed by modern line of treatment for last 10 years. The case had developed Cushingoid features due to long term use of steroids. This case was successfully managed by Ayurvedic treatment principles of Deepan-Pachan, Vatalunoman and Mutral chikitsa. Steroids were withdrawn gradually and completely. There was no relapse. He was free of proteinuria. His Cushingoid features disappeared. Edema and Ascites also disappeared. This case study is the example of importance of alternative medicine in treating steroid dependent/resistant cases. When modern treatment has definite limitations to treat such cases, it is ray of hope to thousands of poor sufferers of Steroid resistant Nephrotic syndrome, finding them an effective alternative of Ayurvedic treatment. Keywords: Nephrotic syndrome, Steroid resistance, Ayurvedic management, Dridamula Basti Shotha

Determination of total phenolic and total flavonoid contents of Jasminum grandiflorum Lin

The current study was focused on the standardization & validation of hydroalcoholic extract of Jasminum grandiflorum (JG). Jasminum grandiflorum Linn. Belonging to family Oleaceae is a well-known medicinal plant. It is an Ayurveda (herbal) medicinal plant. This review is to give comprehensive information on the chemical constituents and medicinal importance of Jasminum grandiflorum. It is commonly known as Chameli in Hindi. The process such as which involved the morphological, microscopical, and physical evaluation. Quantitative determination of phenols and flavonoid in Jasminum grandiflorum hydroalcoholic extract was carried out using chromatographic methods.

Oscillometry in Lung Function Assessment: A Comprehensive Review of Current Insights and Challenges.

Oscillometry, a non-invasive technique for assessing lung function, has gained significant recognition and importance in modern pulmonary medicine. This comprehensive review thoroughly explores its principles, applications, advantages, limitations, recent innovations, and future directions. Oscillometry's primary strength lies in its ability to offer a holistic assessment of lung mechanics. Unlike traditional spirometry, oscillometry captures the natural airflow during quiet breathing, making it suitable for patients of all ages and those with severe respiratory conditions. It provides a comprehensive evaluation of airway resistance, reactance, and compliance, offering insights into lung function that were previously challenging to obtain. In clinical practice, oscillometry finds extensive application in diagnosing and managing respiratory diseases. It plays a pivotal role in asthma, chronic obstructive pulmonary disease (COPD), and interstitial lung diseases. By detecting subtle changes in lung function before symptoms manifest, oscillometry facilitates early interventions, improving disease management and patient outcomes. Oscillometry's non-invasive and patient-friendly nature is precious in pediatric care, where traditional spirometry may be challenging for young patients. It aids in diagnosing and monitoring pediatric respiratory disorders, ensuring that children receive the care they need from an early age. Despite its many advantages, oscillometry faces challenges, such as the need for standardized protocols and the complexity of data interpretation. However, ongoing efforts to establish global standards and provide education and training for healthcare professionals aim to address these issues. Looking ahead, oscillometry holds great promise in the field of personalized medicine. With its ability to tailor treatment plans based on individualized lung function data, healthcare providers can optimize therapy selection and dosing, ultimately improving patient care and quality of life. In conclusion, oscillometry is poised to play an increasingly pivotal role in modern pulmonary medicine. As standardization efforts continue and technology evolves, it is an indispensable tool in the clinician's arsenal for diagnosing, managing, and personalizing respiratory care, ultimately leading to improved patient outcomes and better respiratory health.

Diosgenin biosynthesis investigation in medicinal herb (Tribulus terrestris) by transcriptome analysis

Next-generation sequencing (NGS) has revolutionized the analysis of specific genes, pathways, and their regulation in various species. Tribulus terrestris L., an annual medicinal herb of Zygophyllaceae family, has gained significant attention due to its diverse medicinal properties, including anti-inflammatory, antimicrobial, and anti-cancer effects. Diosgenin, a steroidal saponin, is the major bioactive compound responsible for the medicinal importance of T. terrestris. However, there is a paucity of information regarding the genes involved in the diosgenin biosynthetic pathway in T. terrestris. To address this gap, this study aimed to identify candidate genes associated with diosgenin biosynthesis through whole transcriptome profiling. A total of ∼7.9 GB of data, comprising 482 million reads, was obtained and assembled into 148,871 unigenes. Subsequently, functional annotations were assigned to 50 % of the unigenes using sequence similarity searches against the NCBI non-redundant (NR), Uniprot, KEGG, Pfam, GO, and COG databases, primarily based on Gene Ontology and KEGG-KAAS pathways. The majority of unigenes associated with the biosynthesis of the steroidal diosgenin backbone exhibited up-regulation in the fruit, leaf, and root tissues, except the SQE gene in root. The differential expression of selected genes was further validated through quantitative real-time polymerase chain reaction (qRT-PCR). Additionally, the study identified 21,026 unigenes related to transcription factors and 15,551 unigenes containing simple sequence repeats (SSR). Notably, di-nucleotide SSR motifs exhibited a high repeat frequency. These findings greatly enhance our understanding of the diosgenin biosynthesis pathway and provide a basis for future research in molecular investigation and metabolic engineering, specifically for boosting diosgenin content.

The effects of vitamins C and E on the redox parameters of cytochrome P450 3A4

Abstract The research on the influence of antioxidant vitamins C and E on the catalytic activity of cytochrome P450 3A4 in electrochemical experiments is relevant, as they are widely used as additional biologically active substances in human diets and can affect biochemical processes in the body. Understanding these effects is of significant importance for pharmacology and medicine. The purpose of this study is to investigate how antioxidant vitamins C and E impact the catalytic activity of cytochrome P450 3A4 within the framework of electrochemical experiments. The voltammetry was performed in the presence of potassium phosphate buffer of neutral pH value (0.2 M) and 0.5 M erythromycin solution (Er). The ratio between the measures of current obtained in the presence of O2 and Er was 2.10 ± 0.09 (100 %, P < 0.05). With vitamin C and Er, it corresponded to 2.80 ± 0.12 (133 %, P < 0.05). The voltammograms of Cyt with Dic show a higher current stimulated by ascorbic acid. The effect of vitamin C on the H-dimethylation process of Er was investigated with a spectrophotometer (value 408 nm). The catalytic current of cytochrome P450 3A4 in the presence of diclofenac was stimulated by ascorbic acid, the effect of which on the N-demethylation of erythromycin was studied spectrophotometrically at 408 nm based on the formation of formaldehyde using the acetylacetone reagent. The obtained results suggest the potential impact of antioxidant vitamins not only on the stimulation of electrochemical reduction of cytochrome P450 3A4 but also on the clinical metabolism of substrates in patients. These findings provide valuable insights for further clinical investigations aimed at predicting the risk of drug interactions with antioxidants.

Expected benefits of administration of tannins extracted from Acacia seyal plants; a biochemical and traditional medicine overview

This study was focused on expected benefits of administration of tannins extracted from Acacia seyal pants. Tannins have been used throughout history for their pharmacological properties as part of plants and herbs in traditional medicine. Tannins are a heterogeneous group of polyphenols, secondary metabolites in plants synthesized in response to biotic and abiotic stress inducers. The phenolic rings and hydroxyl groups present in their chemical structures confer them antioxidant and protein-binding properties. Study results clearly showed the presence of tannins significantly (p≤0.05) in Acacia seyal plants, compared to control. There are many sources of tannins. Tannins, which are of great importance in traditional medicine can be extracted from numerous trees and small bushes rich in tannins.

Carboxymethyl cellulose coating maintains quality of harvested aonla fruit by regulating oxidative stress and ascorbate-glutathione cycle

Aonla is a well-known fruit of medicinal and dietary importance. Nevertheless, it has a short shelf life which is a major constraint in its utilization. In this work, 1% carboxymethyl cellulose (CMC) coating was applied on ‘Banarsi’ aonla and fruit were stored for 10 d at 20 ± 1 ºC. The results exhibited that CMC-coated fruit had lower physiological weight loss, disease incidence, relative electrolyte leakage, hydrogen peroxide (H2O2), malondialdehyde (MDA) and superoxide anion content. The coated aonla exhibited higher L* and lower b* and a* along with markedly lower chlorophyllase (Chl-Phy) and chlorophyll (Chl) degrading peroxidase (Chl-PD) which thereby resulted in higher total Chl content preservation. The CMC coated aonla fruit showed higher superoxide dismutase (SOD), ascorbate peroxidase (APX), peroxidase (POD) and catalase (CAT) along with higher ascorbate-glutathione (ASA-GSH) cycle related attributes. In addition, coated fruit exhibited higher total phenolic and total flavonoid contents along with higher phenylalanine ammonia-lyase (PAL) and reduced polyphenol oxidase (PPO) enzyme activities. On the other hand, juice pH, total soluble solids (TSS) and ripening index (RI) of coated fruit were considerably lower along with substantially higher titratable acidity (TA) content. Therefore, 1% CMC coating could be applied as an appropriate edible layer over aonla fruit to conserve their quality when stored at ambient conditions.

Bioactive Compounds of Jambu (Acmella oleracea (L.) R. K. Jansen) as Potential Components of Biodegradable Food Packing: A Review

The production of biodegradable food packaging with innovative characteristics is a current challenge that contributes to sustainable development and guarantees greater consumer safety. Thus, this review reports the general characteristics of jambu, highlighting the nutritional and medicinal importance, the rich composition of bioactive compounds and, mainly, the advances in the application of the plant as a multifunctional material for food packaging. The possibility of using jambu in active and “intelligent” films was identified. The addition of bioactive compounds to films can influence the physical, biochemical and sensory properties of foods, increasing the shelf life of packaged products, in addition to adding more economic value to the plant. According to the knowledge obtained by the authors of this review, information about the potential application of bioactive compounds from jambu in the development of films for biodegradable packaging will be presented for the first time in this review. Therefore, this study will provide researchers, food scientists and academics with a more comprehensive understanding of sustainable food packaging, with a focus on active and “intelligent” properties, contributing to the development of future research.

Sub-acute toxicity evaluation of aqueous leaf extract from Passiflora edulis Sims f. edulis (Gulupa) in Wistar rats

The genus Passiflora (Passifloraceae) comprises about 500 species. The Passiflora edulis stands out because of its economic and medicinal importance. It is widely planted in tropical and subtropical regions worldwide, especially in South America, the Caribbean, South Africa, and Asia. The aqueous extract of Passiflora edulis Sims f. edulis (Gulupa) leaves is used in traditional medicine for its soothing and tranquilizing effects on the central nervous system. Therefore, evaluating its safety for human use is a fundamental requirement to continue the development of new therapies within the framework of regulatory, preclinical, and clinical guidelines. Here, the sub-acute toxicity study was conducted following the Organization for Economic Cooperation and Development (OECD) guideline 407 for 28 days in Wistar albino rats. The study showed that 1000 mg/kg/day of the aqueous extract in 10 adult Wistar rats (five males and five females) was well tolerated. The hematological results are at normal levels. However, monocytopenia and eosinopenia were observed with a significant difference (P < 0,05) for both male and female rats treated with the aqueous extract of Passiflora edulis. The results show that liver and kidney function profiles were conserved. However, an increase in ALT is observed with significant differences between male and female rats treated with the extract compared to the controls. Study findings were limited to non-adverse histopathological results of a slightly increased incidence of focal periportal lymphocytic infiltrate in the liver and focal corticomedullary nephrocalcinosis in the kidney compared to control. Therefore, the aqueous extract of Passiflora edulis has a good safety profile in oral administration, was well tolerated, and did not cause any lethality or adverse effects in the sub-acute toxicity study in male and female rats. The NOAEL (no observed adverse effect level) for the 28-day subacute toxicity study was considered to be 1000 mg/kg.

Ethnobotanical Insights into Medicinal and Culinary Plant Use: The Dwindling Traditional Heritage of the Dard Ethnic Group in the Gurez Region of the Kashmir Valley, India.

This ethnobiological study addresses the complicated relationship between the Dard ethnic group and their natural environment in the Gurez region of the Kashmir Valley. The study documents their traditional knowledge of the use of plant species for medicinal and culinary purposes. A total of 87 plant species from 41 different families were cataloged, with the Asteraceae family (15 species) and the Lamiaceae family (12 species) being the most commonly used. These plants were found to be used to treat 20 different ailments, with menstrual cramps being the most common (12 species). The fidelity values for these plants ranged from 11.10 to 71.42, demonstrating their importance in traditional medicine. In addition, 17 plant species were found to be useful for gastronomic purposes, with Juglans regia being the most valuable (use value of 0.73). The study also evaluated the conservation status of these plants and found that seven of them are considered critically endangered, ten endangered, and four endangered according to the IUCN classification. This study offers insights into the Dard people's deep connection to their natural environment and has significant implications for policy formulation, cultural conservation, and sustainable use of endemic species, as well as potential applications in pharmaceutical research for therapeutic compounds.

The Accumulation of Volatile Compounds and the Change in the Morphology of the Leaf Wax Cover Accompanied the "Anti-Aging" Effect in Anethum graveolens L. Plants Sprayed with 6-Benzylaminopurine.

Essential oils (EOs) are of commercial importance for medicine, food, cosmetics, the perfume industry, and agriculture. In plants, EOs, like the wax cover, serve as protection against abiotic stresses, such as high temperatures and water deficiency. The use of spraying with exogenous hormones of aromatic plants affects the accumulation and composition of volatile compounds, as well as tolerance to abiotic stress. As a result of cytokinin treatment with 6-BAP (6-benzylaminopurine) (200 mg L-l) of Anetum graveolens L. "Uzory" and "Rusich" varieties, several responses to its action were revealed: a change in the division of leaf blades, inhibition of flowering, an increase in the content of EO and its main components α-phellandrene and p-cymene in leaves, and limonene in umbels and fruits. It was revealed that the increased accumulation of EO in dill leaves was longer with sufficient moisture. In contrast, under conditions of heat and water deficiency, the effect of 6-BAP treatment on accumulations of the EO in leaves was short-lived and did not appear on umbels and fruits. The study of the cytokinin effect on a fine structure of a wax cover on the adaxial side of leaves by scanning electron microscopy revealed a change in its elements (from amorphous layers with scales to thin tubules), which probably increased the sensitivity of leaves to water deficiency and, consequently, led to a decrease in the biosynthetic activity of leaf tissue. Thus, 6-BAP had an impact on the adaptive properties of dill plants, prolonging the "youth" of vegetative organs and the ability to EO biosynthesis under conditions of sufficient moisture.

Investigating the Effect of the Crosslinking Factor on the Properties of Hydrogel Materials Containing Tilia platyphyllos Hydrolate.

The use of natural ingredients in recent years has been of great importance in many industries and medicine. In biomedical applications, hydrogel materials also play a significant role. In view of this, the aim of this study was to synthesize and characterize hydrogel materials enriched with broadleaf linden hydrolate. An important aspect was to carry out a series of syntheses with varying types and amounts of crosslinking agents so as to test the possibility of synthesizing materials with controlled properties. The obtained hydrogels were subjected to detailed physicochemical analysis. The results of the tests confirmed the relationship between the selected properties and the type of crosslinking agent used. A crosslinking agent with a lower molar mass (575 g/mol) results in a material with a compact and strongly crosslinked structure, which is characterized by high surface roughness. The use of a crosslinking agent with a molecular weight of 700 g/mol resulted in a material with a looser-packed polymer network capable of absorbing larger amounts of liquids. The work also proved that regardless of the type of crosslinking agent used, the addition of linden hydrolate provides antioxidant properties, which is particularly important in view of the target biomedical application of such materials.

First record of Alternaria tenuissima causing Aloe barbadensis leaf blight and leaf spot disease in Beijing, China

In 2020, Alternaria leaf blight and spot disease was first observed on Aloe barbadensis in Beijing, China. Samples of diseased leaves of A. barbadensis showing blight and spot symptoms (dark brown necrotic, sunken, and emerged lesions) were collected and identified as Alternaria isolates. The fungal colony was olive green, while conidia were brown, obclavate and measured from 13.4 to 34.2 × 7.5–11.8 μm (length × width) on average. Genomic DNA extraction was performed by multi-locus sequence analysis and the pathogen was identified as Alternaria tenuissima. The pathogenicity test confirmed A. tenuissima's ability to infect A. barbadensis and cause typical leaf blight and spot symptoms, with subsequent re-isolation. This is the first report of leaf blight and leaf spot on A. barbadensis caused by A. tenuissima in Beijing, China. Due to the medicinal importance of A. barbadensis worldwide, studying A. tenuissima induced leaf blight and spot is imperative.

Ethnopharmacological Insights on Therapeutic Potential of Oleanolic Acid: A Review

Introduction: Plants have long been utilised as a supplement or alternative treatment for chronic conditions due to their therapeutic capabilities. Objectives: The objective of this study is to explore the ethnopharmacological aspects and therapeutic potential of naturally occurring oleanolic acid. Method: Information regarding oleanolic acid was collected from electronic databases, such as ScienceDirect, Web of Science, PubMed, Springer, Journal websites, Google Scholar, Taylor and Francis, Scopus and Wiley Online Library. Result: The article covered a wide range of immunomodulatory, antihypertensive, anticancer, antiinflammatory, antianxiety, antidepressant, antiischemic, antiviral, and other effects of triterpenoids. One such triterpenoid is oleanolic acid, which was reported to be present in a number of plants with a wide range of pharmacological potential. This article discussed the promising possibilities for alternative neurodegenerative disease treatment and management through oleanolic acid and its derivatives. Conclusion: The goal of this systematic review was to review the medicinal importance of oleanolic acid, extracted from a variety of plants used as a dietary source, such as apple, pomegranate, lemon, grapes, pears, olive, a highly powerful molecule with a wide range of biological actions, such as anti-microbial, anti-viral, anti-diabetic, hepatoprotective, antihypertensive, antiinflammatory, anticancer, anti-ischemic, antiviral, and cytotoxic properties.

Microbiological Composition of Fortified Foam-Mat Dried Yoghurt

Yoghurt is a nutritional food substance with high medicinal importance. However, it is highly perishable. This work investigated the influence of different ingredients such as ginger extract, moringa seed flour and lemon on the microbiological quality of fortified foam-mat dried yoghurt. The research was conducted in two stages based on the experimental design. The first stage comprises the production of yoghurt which involves the water, powdered milk, starter culture and flavour kept at constant. Followed by addition of ginger extract and moringa seed flour. The second stage involved foam-mat drying of yoghurt using electric oven at stipulated drying temperature for each run respectively. The mixture-process design matrix carried out stipulates twenty five experimental runs including the control experiment. Microbiological properties evaluated are limited to total bacteria and fungi count while the data collected were analyzed using Design Expert 7.0.0 software package. 3D surface response was also used to display the response predictions of the mixture-process factors.

Euphorbia royleana Boiss Derived Silver Nanoparticles and Their Applications as a Nanotherapeutic Agent to Control Microbial and Oxidative Stress-Originated Diseases.

Nanotechnology is one of the most advance and multidisciplinary fields. Recent advances in nanoscience and nanotechnology radically changed the way we diagnose, treat, and prevent various diseases in all aspects of human life. The use of plants and their extracts is one of the most valuable methods towards rapid and single-step protocol preparation for various nanoparticles, keeping intact "the green principles" over the conventional ones and proving their dominance for medicinal importance. A facile and eco-friendly technique for synthesizing silver nanoparticles has been developed by using the latex of Euphorbia royleana as a bio-reductant for reducing Ag+ ions in an aqueous solution. Various characterization techniques were employed to validate the morphology, structure, and size of nanoparticles via UV-Vis spectroscopy, XRD, SEM, and EDS. FTIR spectroscopy validates different functional groups associated with biomolecules stabilizing/capping the silver nanoparticles, while SEM and XRD revealed spherical nanocrystals with FCC geometry. The results revealed that latex extract-mediated silver nanoparticles (LER-AgNPs) exhibited promising antibacterial activity against both gram-positive and -negative bacterial strains (Bacillus pumilus, Staphylococcus aureus, E. coli, Pseudomonas aeruginosa, and Streptococcus viridians). Both latex of E. royleana and LER-AgNPs were found to be potent in scavenging DPPH free radicals with respective EC50s and EC70s as 0.267% and 0.518% and 0.287% and 0.686%. ROSs produced in the body damage tissue and cause inflammation in oxidative stress-originated diseases. H2O2 and OH* scavenging activity increased with increasing concentrations (20-100 μg/mL) of LER-AgNPs. Significant reestablishment of ALT, AST, ALP, and bilirubin serum levels was observed in mice intoxicated with acetaminophen (PCM), revealing promising hepatoprotective efficacy of LER-AgNPs in a dose-dependent manner.

Identification and diversity assessment of Ziziphus species using DNA barcoding

The genus Ziziphus, belonging to the family Rhamnaceae, is of great economic and medicinal importance worldwide due to the value of its fruits in household income and food security. However, many species within this genus are phenotypically identical, leading to imprecise identification and hindering their conservation, variation in the gene pool, and exploitation. To address this issue, we collected 26 individuals from different regions of Khyber Pakhtunkhwa, Pakistan and Shanxi province, China, to assess the efficiency of DNA barcoding regions in identifying Ziziphus species. We tested the ability of five DNA barcodes regions, namely ITS, matK, rbcL, trnH-psbA, and trnL-UAA, to distinguish between Ziziphus species as an alternative approach for species identification and the phylogenetic reconstruction. The results of the study, as the success rate of PCR amplification of matK, trnL-UAA, and ITS, provided the highest species resolution with 100 % accuracy, except for trnH-psbA (90.78 %). ITS and matK were identified as the most effective single barcode, with a species identification success rate of 87.4 %±0.98 % and 84.89 %±0.66 %. These results suggest that matK, trnL-UAA, and ITS are universal barcode regions for identification of all Ziziphus species identification and their discrimination power to differentiate. In contrast, the combination of trnL-UAA+ITS region displayed the highest species identification rate (92.1 %), the five barcodes region combination, and superior to any barcodes regions combination that included rbcL+trnH-psbA. Additionally, the study found high haplotypes and nucleotide diversity in Pakistani Ziziphus species, mainly in the ITS barcode, with values of 0.84 and 0.0086, respectively. In conclusion, the study establishes that the DNA fragments ITS, trnL-UAA, and matK are effective in identifying and distinguishing Ziziphus species. The approach can be considered as an accurate tool for identifying these species and will be used as a universal barcode's region for Ziziphus species. DNA barcoding is a useful approach and provides a reliable and effective means for Ziziphus discrimination, and in combination with morphology-based taxonomy will be a robust approach for tackling taxonomically complex species. Additionally, this study provides valuable insights into the genomic architecture of Ziziphus species, which has implications for their classification, conservation, and germplasm resource improvement. This research provides a novel approach to the problem of incorrectly identifying economically and medicinally important species, particularly those in the genus Ziziphus.

Development and evaluation of a point-of-care ocular ultrasound curriculum for medical students - a proof-of-concept study

BackgroundPoint-of-care Ocular Ultrasound (POCOUS) has gained importance in emergency medicine and intensive care in recent years. This work aimed to establish and evaluate a dedicated ultrasound education program for learning POCOUS-specific skills during medical studies at a university hospital.MethodsThe blended learning-based program (6 teaching units) based on recent scientific publications and recommendations was developed for students in the clinical part of their medical studies. Experts and trainers consisted of physicians from the Ear-Nose-Throat, radiology, ophthalmology and neurology specialties as well as university educational specialists. Lecture notes containing digital video links for preparation was produced as teaching material. In total, 33 students participated in the study. The education program, including the teaching materials, motivation and subjective gain in competency, was evaluated with the aid of a questionnaire (7-point Likert response format). Objective learning success was assessed on the basis of pre- and post-tests. These covered the skill areas: “anatomical basics”, “ultrasound basics”, “understanding of cross-sectional images”, “normal findings” and “pathology recognition”.ResultsIn the objective assessment of image interpretation, the participants improved significantly (p < 0.001) from pre- to post-test with a large effect size (Cohen’s d = 1.78, effect size r = 0.66). The evaluations revealed a high level of satisfaction with the course concept, teaching materials and the tutors. In addition, a high level of motivation was recorded in relation to continuing to study “ultrasound diagnostics” and “ophthalmologic diseases”. A significant (p < 0.01) positive gain was also achieved in terms of the subjective assessment of competency. This covers areas such as expertise, sonographic anatomy and performing a POCOUS examination as well as recognizing retinal detachment, globe perforation and increased optic nerve sheath diameter.ConclusionThe results of this feasibility study show that medical students accept and support a POCOUS-specific education program and are able to develop a higher objective and subjective level of competency. Future transfer to other sites and larger groups of participants seems feasible.

Phylogeny and species delimitations in the economically, medically, and ecologically important genus Samsoniella (Cordycipitaceae, Hypocreales).

Samsoniella is a ubiquitous genus of cosmopolitan arthropod-pathogenic fungi in the family Cordycipitaceae. The fungi have economic, medicinal, and ecological importance. Prior taxonomic studies of these fungi relied predominantly on phylogenetic inferences from five loci, namely, the nuclear ribosomal small and large subunits (nr SSU and nr LSU), the 3' portion of translation elongation factor 1 alpha (3P_TEF), and RNA polymerase II subunits 1 and 2 (RPB1 and RPB2). Despite many new species being described, not all of the recognized species inside this group formed well-supported clades. Thus, the search for new markers appropriate for molecular phylogenetic analysis of Samsoniella remains a challenging problem. In our study, we selected the internal transcribed spacer regions of the rDNA (ITS rDNA) and seven gene regions, namely, 3P_TEF, the 5' portion of translation elongation factor 1 alpha (5P_TEF), RPB1, RPB2, γ-actin (ACT), β-tubulin (TUB), and a gene encoding a minichromosome maintenance protein (MCM7), as candidate markers for species identification. Genetic divergence comparisons showed that the ITS, RPB2, ACT, and TUB sequences provided little valuable information with which to separate Samsoniella spp. In contrast, sequence data for 3P_TEF, 5P_TEF, RPB1, and MCM7 provided good resolution of Samsoniella species. The phylogenetic tree inferred from combined data (5P_TEF + 3P_TEF + RPB1 + MCM7) showed well-supported clades for Samsoniella and allowed for the delimitation of 26 species in this genus. The other two species (S.formicae and S.lepidopterorum) were not evaluated, as they had abundant missing data.