Rheumatic Pain Research Articles

Functional Properties and Quality Control of Cortex Dictamni: A Review

Abstract: In recent years, extensive research has been conducted on the functional properties of Cortex dictamni. Cortex dictamni has a huge potential to be an alternative medicine in the treatment of various diseases, such as inflammatory diseases, skin inflammation, tinea, eczema, scabies, rheumatic pain, and jaundice, and it receives greater attention due to its pharmacological effects. This review aims to find scientific evidence in order to support claims related to cortex dictamni. Subsequently, it is very important to gather studies related to the functional properties and toxicology of cortex dictamni from scientific research. We reviewed the existing literature related to the cortex dictamni. Multiple studies reported that cortex dictamni exhibits various functional properties, such as anti-inflammatory, antioxidant, anti-allergic, neuroprotective neuroprotection, hepatoprotective hepatoprotection, and anti-microbial. In conclusion, Cortex Dictamni is a commonly used medical herb in traditional Chinese medicines possessing various bioactivities. Quinoline alkaloids are regarded as one of the main active components in this herb. However, the safety aspects of this herbal medicine must be thoroughly evaluated to ensure its suitability for medicinal use.

A rapid weight loss caused by therapeutic cannabinoid use in an elderly individual: a case report

The proportion of older adults using medical cannabis is rising. Most of the cannabinoid research has focused on a healthy, younger population free from frailty and major comorbidity. In this case report, we describe an 82-year-old woman who was autonomous in basic and instrumental activities of daily living and who came to our geriatric department for marked weight loss over the past 2 months (about 10 kg) and anemia. After appropriate clinical and endoscopic checks, it was concluded that the weight loss was induced by the initiation of therapy with oral cannabis for the control of rheumatic pain.

Inula viscosa (L). Aiton leaves extract ameliorate arthritis by antioxidative and anti-inflammatory effects in formaldehyde-induced arthritis in mice

Ethnopharmacological relevanceInula viscosa (L.) Aiton is a traditional medicinal plant widely distributed and used in Mediterranean countries, its leaves are prepared by maceration to treat, rheumatic pain, inflammatory diseases, diabetes, anemia and cancer. Aim of the studyThe present study purpose to investigate the anti-inflammatory efficacy of I. viscosa leaves methanol extract (IVME) at three different doses on formaldehyde-induced arthritis in NMRI albinos mice. Materials and methodsMice were divided into six groups (n = 6) as follows: normal control, disease control, Diclofenac group (10 mg/kg, p.o. daily) and three groups, daily treated with 50, 100 and 200 mg/kg IVME (p.o.); Formaldehyde models were obtained by a sub-plantar administration of 20 μl of formaldehyde (3.75% v/v) into the right hind paws of NMRI albino mice on 1st and 3rd days of the 10 experimental days. Joint diameter was measured, arthritis severity was evaluated by inhibition of paw edema, histological changes, synovial hyperplasia and immune cells infiltration was evaluated by histological and immunohistochemical analyses of CD3+, CD20+ and CD68+. Post-mitochondrial supernatants (PMS) from liver tissues homogenates were collected for the assessment of enzymatic and non-enzymatic antioxidants: Catalase (CAT) & Myeloperoxidase (MPO) activities, glutathione (GSH) and an oxidative stress biomarker (nitric-oxide (NO)) level. ResultsAdministration of I. visocsa (at low dose: 50 mg/kg) significantly (∗∗∗p < 0.001) ameliorated the induced arthritis severity, reduced hyperplasia of synovial membrane, bone erosion and immune cells infiltration (∗p < 0.05), resulted by restoration of paw diameter. It also decreased levels of NO (∗∗∗p < 0.001) and MPO activity (∗∗∗p < 0.001), and significantly restored GSH levels (∗p < 0.05) and CAT activity (∗∗∗p < 0.001) in liver tissues. ConclusionThese findings suggest that I. viscosa leaves have an anti-arthritic property. Which is due to the combination of antioxidant activity regulating oxidative stress and anti-inflammatory effect by probably cytokines regulation.

Telephone-Based Acceptance and Commitment Therapy for Caregivers of Persons with Dementia: Results of a Randomized Controlled Trial

ABSTRACT Objectives Family caregivers of persons with dementia (PwD) experience high levels of distress. We used a randomized-controlled trial to investigate the effects of telephone-based acceptance and commitment therapy (tbACT) for family caregivers. Methods Caregivers were randomly allocated to an intervention group (tbACT, n = 41) or an untreated control group (CG, n = 40). The intervention consisted of eight weekly sessions of tbACT. Depression and anxiety (primary outcomes), physical symptoms, pre-death grief, care-related thoughts, acceptance (secondary outcomes), quality of life, coping and well-being (well-being/coping outcomes) were assessed pre- and post-assessment. A 6-month follow-up was conducted. Results Compared to CG participants, tbACT participants had at post-assessment significantly lower depressive symptoms; fewer physical symptoms (rheumatic pain); better physical health; more resource utilization (coping with daily hassles, social support); better coping with the care situation and better emotional well-being. During the six-month follow-up, tbACT participants showed less pre-death grief, fewer physical symptoms, and more utilization of resources related to coping with daily hassles. Conclusions tbACT is a feasible and promising psychotherapeutic intervention for family caregivers of PwD. Because of small sample size our results are preliminary. Clinical Implications Most of the effects of tbACT were not maintained 6 months after the intervention, suggesting that booster sessions may be helpful.

Antinociceptive and antineuropathic effects of Trifolium resupinatum L. on formalin-induced nociception and cervical spinal cord hemi-contusion: Underlying Mechanisms

Ethnopharmacological relevanceTrifolium resupinatum L. (Fabaceae), known as Persian clover, ethnomedicinally used in Persian folk medicine to treat peritoneal inflammation, rheumatism, and back pain. Aim of the studyTo investigate the antineuropathic and antinociceptive activities of Trifolium resupinatum leaves essential oil (TREO) in male Wistar rats, as well as to explore the potential mechanisms of action. Materials and methodsThe antinociceptive activity of TREO and its main constituents, quercetin (Qc) was assessed using the formalin-induced paw licking test. Moreover, the potential mechanisms of antinociception were evaluated through various competitive and non-competitive antagonisms. Additionally, the antineuropathic potential was investigated using the cervical spinal cord hemi-contusion (CCS) model, and the role of phosphorylated Stat-3 was analyzed using Western blotting. ResultsTREO exerted significant antinociceptive activity (P < 0.01) in both phases of the formalin-induced test; however, its effects were more pronounced in the second phase. Modulators of the NO-cGMP-K+ channel pathway significantly reversed the antinociceptive activity of TREO (P < 0.05). Additionally, antagonists of TRPV1 and TRPV2, as well as CB1 and GABAA receptors, significantly reversed the antinociceptive effects of TREO (P < 0.05). In another study, both TREO and Qc significantly attenuated hyperalgesia and mechanical allodynia (P < 0.01) when evaluated using the CCS-induced nociception model. Notably, TREO also reduced the expression levels of interleukin-1 beta, interleukin-2, and tumor necrosis factor alpha in CCS-induced rats (P < 0.05). ConclusionTREO and Qc exhibit both antinociceptive and anti-neuropathic activities. The antinociceptive effects are partially mediated through the NO-cGMP-K+ channel pathways, along with the activation of TRPV, GABA, and cannabinoid receptors. Furthermore, the anti-neuropathic activity of TREO may be partially regulated through the inhibition of cytokines.

Integrated Transcriptomics and Metabolomics Reveal Key Insights into Iridoid Biosynthesis in Gentiana crassicaulis Seeds during Germination.

Background:Gentiana crassicaulis Duthie ex Burk., a key species used in traditional Chinese medicine for treating rheumatic pain and stroke, contains iridoids as its primary active component. However, the biosynthetic mechanisms underlying iridoid production are not fully understood. Methods: This study focused on iridoid biosynthesis during the germination of G. crassicaulis seeds, integrating metabolomic and transcriptomic analyses to uncover the underlying pathways and key candidate genes. Results: 196,132 unigenes and 10 iridoid compounds were identified through RNA-seq and ultra performance liquid chromatography-quadrupole time of flight-mass spectrometer (UPLC-Q-TOF-MS), respectively. The intersection of results from Pearson correlation analysis and weighted gene co-expression network analysis (WGCNA) revealed a significant correlation between 26 genes and iridoid levels, suggesting their potential role in the iridoid metabolism. Notably, six highly expressed candidate genes (DL7H, SLS, CYP76, CYP72A2, CYP84A1, and 13-LOX3) and five iridoids (loganic acid, sweroside, swertiamarin, gentiopicroside, and 6'-O-β-D-glucosyl-gentiopicroside) responded to methyl jasmonate stimulation in G. crassicaulis seedlings. Conclusions: by combining the known functions of candidate gene families, It is hypothesized that the CYP716 and LOX families exert indirect influences on iridoid metabolism, while the CYP71, CYP81, CYP72, CYP76, CYP710 families, 2OG-FeII family, and the glucosyltransferase family are likely to play direct roles in the biosynthetic transformations of the five iridoids. This study provides a theoretical basis for further functional gene validation and metabolic engineering aimed at enhancing iridoid production. The insights gained could lead to improved iridoid production efficiency in medicinal plants, ultimately benefiting the quality and efficacy of medicinal materials.

Extract of Nanhaia speciosa J. Compton & Schrire alleviates LPS-induced acute lung injury via the NF-κB/Nrf2/AQPs pathway

Ethnopharmacological relevanceNanhaia speciosas J. Compton & Schrire (the name Nanhaia speciosas J. Compton & Schrire has been accepted by the World Checklist of Vascular Plants https://www.worldfloraonline.org/taxon/wfo-0001444004) is a traditional Zhuang medicine that have been widely used for centuries. It has been used in the treatment of lung inflammation, tuberculosis, rheumatic pain, lumbar muscle strain, and various other ailments, such as chronic hepatitis, menoxenia, leukorrhea, and injuries. In addition, N. speciosa has also been used to treat acute lung injury (ALI). Aim of the studyThe objective of this study was to conduct a comparative analysis of the effects of various constituents present in N. speciosas extract (NSE) on ALI and the related mechanisms while also elucidating the potential active monomeric components. Materials and methodsNSE was extracted using an AB-8 macroporous resin column, and five fractions (Fr. 0%, 25%, 50%, 75% and 95%) were obtained. The anti-inflammatory and antioxidant capacities of the five fractions were evaluated in an A549 cell-based in vitro model, with the aim of evaluating their potential therapeutic effects. The anti-inflammatory and antioxidant capacities of NSE were assessed in a murine model of ALI induced by intratracheal injection of LPS. We utilized an in vitro model to analyse the critical molecular mechanisms through which NSE ameliorates ALI. The chemical composition of the optimal fraction was analysed and confirmed using UHPLC/MS. ResultsDifferent fractions (especially Fr. 75%) significantly reduced inflammation and oxidative stress in A549 cells. Fr.75% abrogated LPS-induced pathological alterations and decreased the lung W/D ratio, total protein concentration in BALF, and the levels of the proinflammatory factors TNF-α, IL-6, and IL-1β. Moreover, Fr.75% reduced MPO and MDA concentrations and elevated SOD and GSH concentrations in pulmonary tissues. Additionally, it decreased the pulmonary tissue inflammation caused by LPS by downregulating the expression of p-NF-κB p65 and upregulating the expression of Nrf2, AQP1 and AQP5. Fr. 75% decreased p-NF-κB p65 protein levels; increased Keap1, Nrf2, HO-1, NQO1, AQP1 and AQP5 protein levels; and promoted the entry of Nrf2 into the nucleus. After UHPLC/MS analysis was conducted, the flavonoid Maackiain was determined to potentially play a pivotal role in this process. ConclusionFr.75% alleviates ALI by regulating the NF-κB/Nrf2/AQPs signalling pathway. The flavonoid Maackiain may also play an important role in this process. Overall, N. speciosas may be a potential therapeutic agent for the prevention and treatment of ALI.

Anxiolytic and Antidepressant Effects of Tribulus terrestris Ethanolic Extract in Scopolamine-Induced Amnesia in Zebrafish: Supported by Molecular Docking Investigation Targeting Monoamine Oxidase A.

Plants of the genus Tribulus have been used in folk medicine for wound healing, alleviating liver, stomach, and rheumatism pains, and as cognitive enhancers, sedatives, antiseptics, tonics, and stimulants. The present work aimed to evaluate whether Tribulus terrestris (Tt) administered for 15 days attenuated cognitive deficits and exhibited anxiolytic and antidepressant profiles in scopolamine-induced amnesia in zebrafish. Animals were randomly divided into six groups (eight animals per group): (1)-(3) Tt treatment groups (1, 3 and 6 mg/L), (4) control, (5) scopolamine (SCOP, 0.7 mg/kg), and (6) galantamine (Gal, 1 mg/L). Exposure to SCOP (100 µM) resulted in anxiety in zebrafish, as assessed by the novel tank diving test (NTT) and novel approach test (NAT). When zebrafish were given SCOP and simultaneously given Tt (1, 3, and 6 mg/L once daily for 10 days), the deficits were averted. Molecular interactions of chemical compounds from the Tt fractions with the monoamine oxidase A (MAO-A) were investigated via molecular docking experiments. Using behavioral experiments, we showed that administration of Tt induces significant anxiolytic-antidepressant-like effects in SCOP-treated zebrafish. Our result indicated that flavonoids of Tt, namely kaempferol, quercetin, luteolin, apigetrin, and epigallocatechin, could act as promising phytopharmaceuticals for improving anxiety-related disorders.

Opioid Prescription Practices and Risk Management among Physicians in Morocco

The opioid crisis represents a major public health challenge globally, notably in the United States where it has resulted in significant morbidity and mortality. In Morocco, the patterns of opioid prescription and the factors influencing these practices are not well documented. This study aims to explore the socio-demographic characteristics, professional backgrounds, and opioid prescription practices among physicians in Morocco. Utilizing a cross-sectional survey design, data were collected from 123 physicians across various regions. The findings indicate that specialist doctors, particularly those in urban public sectors, are more likely to prescribe opioids, with codeine, tramadol, and morphine being the most common. These opioids are primarily prescribed for cancer pain, rheumatic pain, and post-operative pain. The study underscores the necessity of targeted interventions to address gaps in opioid prescription practices and to enhance risk management strategies among physicians.

The Elusive Truth of Cannabinoids for Rheumatic Pain.

Medical cannabis (MC) has entered mainstream medicine by a unique route. Regulatory acceptance as a medical product in many jurisdictions has bypassed the traditional evidence-based pathway required for therapies. Easier access to MC, especially related to recreational legalization of cannabis, has led to widespread use by patients for symptom relief of a variety of medical conditions and often without medical oversight. Musculoskeletal pain remains the most common reason for MC use. This review examines real-world issues pertaining to MC and offers some guidance for clinical care of patients with rheumatic diseases being treated with MC. Controlled clinical studies of cannabis products in patients with rheumatic diseases have been small and tested a range of compounds, routes of administration, and clinical populations, limiting our ability to generate conclusions on MC's effectiveness in this population. Observational cohort studies and surveys suggest that use of MC and related products in patients with rheumatic diseases improves pain and associated symptoms but is commonly accompanied by mild to moderate side effects. Conflicting evidence contributes to practitioner and patient uncertainty regarding the use of MC for rheumatic disease-related pain. Despite promising preclinical and observational evidence that MC and cannabis-derived compounds are useful in the management of rheumatic disease-related pain, there remains limited high-quality clinical evidence to substantiate these findings. There are a significant number of clinical trials on this topic currently planned or underway, however, suggesting the next decade may yield more clarity. Nevertheless, given that many people with rheumatic diseases are using cannabis products, healthcare professionals must remain apprised of the evidence pertaining to cannabinoids, communicate such evidence to patients in a meaningful way that is free from personal bias and stigma, and maintain strong collaborative clinical care pertaining to MC.

Traditional Chinese Rehabilitation Exercise (TCRE) for Myofascial Pain: Current Evidence and Further Challenges.

Myofascial as a holistic structure emphasizes a holistic approach to intervention and treatment of fascial-related disorders such as neck pain (NP), low back pain (LBP), and knee pain. There are currently adverse effects of medication for diseases related to myofascial. Traditional Chinese rehabilitation exercise (TCRE) is a practical approach to traditional Chinese medicine and is a valuable option for intervening in myofascial-related pain. This article found some research evidence for Baduanjin, Wuqinxi, and Yijinjing in clinical studies of myofascial chain-related pain. The article summarizes the current evidence and finds that TCRE can enhance limb movement function through breathing and slow movements, increase joint movement and flexibility, and reduce joint pathology and stress-induced pain. As for future directions, focus on TCRE in improving the health of older adults and treating long-COVID syndrome, and integrate robotic and TCRE training to frame safe and effective exercise models. Relevant studies have already been registered in the Clinical Trials Registry, and some clinical study protocols have been published. TCRE can be an alternative nonpharmacological rehabilitation therapy to alleviate chronic rheumatic pain symptoms and augment public health management.

Advances in modern Balneology: new evidence-based indications from recent studies.

Balneotherapy (BT) is a therapeutic approach that utilizes various forms of water-based treatments to promote health and well-being. BT possesses a rich historical heritage and has garnered recognition from esteemed institutions such as the World Health Organization (WHO). Recent scientific research enables the identification of relevant diseases (obesity, metabolic diseases, sleep disorders, mental health conditions, Long-COVID-19, and cancer rehabilitation) that could potentially benefit from balneo-therapeutic treatments, thereby presenting new avenues of opportunity for SPA ("Salus per Aquam") medicine. These conditions exemplify the potential benefits of BT for ailments beyond the traditional scope of treatment associated with BT (most commonly osteoarthritis, fibromyalgia, rheumatic back pain, and chronic inflammatory respiratory or skin disorders). Overall, the current scientific evidence suggests that BT holds significant potential for enhancing both individual wellbeing and public health. However, further high-quality clinical trials are essential to corroborate these preliminary findings and to provide critical insights into the therapeutic benefits of BT, paving the way for its broader integration into healthcare practices and public health initiatives.

A Comprehensive Review of Traditional Medicinal Uses, Geographical Distribution, Botanical Characterization, Phytochemistry, and Pharmacology of Aralia continentalis Kitag.

Aralia continentalis Kitag. (A. continentalis) holds significant medicinal value among the Aralia genus. It has traditionally been employed in ethnomedicine to address a wide range of conditions, including wind-cold-dampness arthralgia; rheumatic pain in the waist and lower extremities; lumbar muscular strain; injuries resulting from falls, fractures, contusions, and strains; headache; toothache; and abscesses. Modern pharmacological research has validated its therapeutic potential, encompassing anti-inflammatory, analgesic, antioxidant, antimicrobial, insecticidal, hepatoprotective, anti-diabetic, and cytotoxic properties, among other pharmacological effects. To compile comprehensive knowledge on A. continentalis, a rigorous literature search was undertaken utilizing databases like SciFinder, PubMed, and Web of Science. This review seeks to delve into the plant's traditional applications, geographical distribution, botanical characteristics, phytochemistry, and pharmacology. The objective is to lay a foundation and propose novel research directions for exploring the plant's potential applications. Currently, one hundred and fifty-nine compounds have been isolated and identified from A. continentalis, encompassing diterpenoids, steroids, triterpenoids, volatile components, phenolics, vitamins, trace elements, and other compounds. Notably, diterpenoids, steroids, triterpenoids, volatile components, and phenolics have exhibited pronounced pharmacological effects, such as anti-inflammatory, analgesic, antioxidant, hepatoprotective, antidiabetic, and antimicrobial activities. However, despite the extensive research conducted, further studies are imperative to unravel new components and mechanisms of action, necessitating more in-depth investigations. This comprehensive exploration could pave the way for advancing and harnessing the potential of A. continentalis.

Effect of pruning intensity on biomass and essential oil yield in wild paramela (Adesmia boronioides Hook f.)

Adesmia boronioides Hook. f. (known as paramela), a member of the Fabaceae family, is native to Argentinean and Chilean Patagonia. Its leaves and young stems are used in the traditional health care system of these countries to treat rheumatic pains, colds, digestive disorders, and respiratory congestion. Paramela presents excellent organoleptic qualities and is attracting growing commercial interest. In recent years the gathering of plant material from natural populations for the extraction and export of essential oils has increased; however, no studies exist on harvest management for this species. In this study plants from a natural A. boronioides population underwent three different pruning treatments (light, medium and heavy) and their response in biomass production and the yield and quality of their essential oils was evaluated over four consecutive years. Of the different pruning intensities, the medium level generated the greatest amount of biomass for all years (p< 0.001) even though the increase seen in production up to the third harvest was followed by a marked decrease. By applying a medium pruning level for two consecutive years on the same plants, we achieved up to 112 % more biomass and 116 % higher essential oil yield compared to the initial pruning. Under the heavy pruning treatment 10 % of the plants died after the second consecutive pruning. Furthermore, we compared the yield and qualitative characteristics of essential oils (EO) over the first three years under the medium pruning level. We observed that EO yields increased after successive pruning, but the chemical compositions (GC-FID-MS) were not significantly affected in the years evaluated. These results provide valuable information for the design of sustainable harvesting protocols for A. boronioides and indicate ways to improve the yield in biomass and essential oils from wild populations.

Endemic Achillea species in Turkey; phytochemical contents and pharmacological activities

Asteraceae is the world's largest family of flowering plants, consisting of 23000 species distributed worldwide in 13 subfamilies, 44 tribes and more than 1600 genera. Achillea L. is one of the youngest evolutionary genera of the family Asteraceae with a worldwide widespread distribution of more than 100 species. Turkey is one of the main diversity centers of the genus Achillea. A total of 47 Achillea species are distributed and naturally growing in Turkey, 24 of which are endemic to Turkey with 51% endemism rate. Achillea species are used as tonic, anti-inflammatory, anti-spasmodic, diaphoretic, diuretic and emmenagogic agents and have traditionally been used to treat bleeding, pneumonia, skin disorders, rheumatic pains. Achillea species have several phytoconstituents such as essential oils, sesquiterpenes and phenolic compounds such as flavonoids and phenolic acids. Flavonoids and phenolic compounds are the most important effective metabolites of Achillea species. Phenolics and flavonoids have been reported to exert a wide range of pharmacological activities, including anti-cancer, anti-inflammatory, and antioxidant effects. In this review, endemic Achillea species were reviewed in terms of phytochemical content and pharmacological activities.

Effect of Infused Water Pineapple Cayenne (Ananas Comosus L Merr) on Reducing Uric Acid Levels in Patients With Gout Arthritis

The most common disease in old age and is considered a disease that is generally recognized by the public is gout. An increase in uric acid levels is indicated by rheumatic pain in the joints, pain, redness and swelling. Efforts to search and develop medicines to treat rising uric acid levels continue. One alternative that can reduce uric acid levels is to consume cayenne pineapple-infused water. To determine the effect of cayenne pineapple-infused water on uric acid levels in gout arthritis sufferers. Using a quasi-experimental design with a control group with a sample of 44 respondents. Data analysis used univariate and bivariate analysis. Based on the characteristics of the respondents, it was found that (52.2%) were aged 45-59, female (43.2%), had at least secondary school education (50.0%), worked as a labourer (43.2%) and acid levels. mean pre-intervention urate 8.08 mg/dL, post-intervention means 5.01 mg/dL pre-control mean 8.20 mg/dL, post-control mean 8.02 mg/dL, Mann Whitney test results Posttest uric acid in the intervention group had a mean value of 11.50 mg/dL, in the control group the mean value was 33.50 mg/dL. This study found that in the intervention group, the p-value was 0.000 &lt; 0.05. Shows that there is an effect of giving cayenne pineapple-infused water on uric acid levels in gouty arthritis sufferers.

Network pharmacology mechanism exploration of forsythia in analgesic treatment of rheumatic arthritis

Objective: This paper aims to investigate the genetic intersections and molecular biological mechanisms among the principal components of rheumatic arthritis, pain, and Forsythia utilizing bioinformatics and network pharmacology. The study seeks to ascertain the potential utility of Forsythia in the analgesic treatment of rheumatic arthritis, offering valuable insights for future research endeavors. Methods: Initially, the primary components of Fructus Forsythia were identified in the TCMSP database, and the corresponding genes linked to these active constituents were determined. Subsequently, relevant genes associated with "rheumatic arthritis" and "pain" were extracted from the GeneCards database. The intersection genes between Forsythia and rheumatic arthritis/pain were identified through microarray analysis, visualized using a Venn diagram. Further analyses included Gene Ontology (GO) enrichment, KEGG pathway exploration, construction of protein-protein interaction (PPI) networks, and prediction of hub genes. The hub gene was validated using the GEO database to enhance data reliability and draw conclusive findings. Results: The study identified 108 active components, 1402 genes related to rheumatic arthritis, and 14183 pain-related targets. Through intersection analysis, 37 potential targets of Forsythia for rheumatic arthritis pain management were revealed. The PPI network highlighted Fos, HIF1A, RELA, EGFR, PRKCA, IKBKB, NFKBIA, MAPK8, and VEGFA as key therapeutic targets. Validation using the GEO database confirmed Fos, HIF1A, RELA, and EGFR as crucial targets for treatment. Conclusions: Based on an in-depth analysis of hub gene functionalities, it was observed that the active ingredient forsythin exhibited strong binding activity with the potential target Fos. Additionally, KEGG pathway analysis indicated the involvement of key pathways such as the cancer signaling pathway and tumor necrosis factor signaling pathway in the pathogenesis of rheumatic arthritis. Considering the experimental results and existing literature on the efficacy of Forsythia in rheumatic arthritis treatment, it is concluded that Forsythia shows promise for analgesic therapy in rheumatic arthritis.

Prevalence of rheumatic musculoskeletal pain and disability in rural Nepal‐ a cross‐sectional community‐based study adopting WHO‐ILAR COPCORD stage I: Phases I and II protocol

AbstractBackgroundThe burden of musculoskeletal (MSK) pain and disabilities is high in health facilities but remains unknown in the community due to a lack of community‐level studies. The community‐oriented program for control of rheumatic diseases (COPCORD) is focused on determining MSK pain and disabilities through epidemiological surveys. This study adopted the COPCORD stage I protocol to determine the prevalence of rheumatic MSK pain and disability and its associated factors in the Pyuthan district of Nepal.MethodologyA cross‐sectional community‐based study using the quantitative method was conducted in Pyuthan municipality as per COPCORD stage I protocol. COPCORD stage I (phase I and phase II) questionnaires were used to collect data through the interview technique. Populations aged 18 years and above were included in the study. A multistage sampling technique was used, and the total sample size was 2145. The collected data from phase I and phase II were entered in Epidata version 3.1. Descriptive and analytical analysis was done in SPSS. The Chi‐square test was used to find the association between dependent and independent variables.FindingsThe overall prevalence (past and current MSK pain/swelling) was 26.81% (95% CI 24.9–28.7). Current MSK pain/swelling was found in 19.53% of the participants, and past MSK pain/swelling was found in 25.87%. Among self‐reported chronic diseases, joint pain was reported by the majority of the participants (17.86%). Age, sex, education, nature of work, current smoking, tobacco use, and alcohol use were found to be associated with past and current MSK pain/swelling.ConclusionsMore than one‐fourth of the participants had MSK pain/swelling. The prevalence of MSK pain/swelling was higher in elderly participants, females, illiterates, heavy workers, smokers, tobacco users, and alcohol users. Similar studies should be conducted in other regions of the country, and this study should also be expanded to COPCORD Stages II and III to identify the risk factors and to improve the management of MSK pain and disorders.

Lycopodium alkaloids from Huperzia serrata and their cholinesterase inhibitory activities

Huperzia serrata, belonging to the Lycopodiaceae family, has been traditionally utilized for the management of treating rheumatic numbness, arthritic pain, dysmenorrhea, and contusions. This plant is a rich source of lycopodium alkaloids, some of which have demonstrated notable cholinesterase inhibitory activity. The objective of this study was to identify lycopodium alkaloids with cholinesterase inhibitory properties from H. serrata. The structures of these alkaloids were elucidated by HRESIMS, NMR (including a 1H–15N HMBC experiment), ECD methods and single-crystal X-ray diffraction. The inhibitory activities against acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE) were assessed using a modified Ellman's method. Consequently, sixteen lycopodium alkaloids (1–16), including ten previously undescribed ones named huperradines A–G and huperradines I–K (1–7 and 9–11), along with one previously undescribed naturally occurring compound, huperradine H (8), were isolated from H. serrata. Among these, compounds 7 and 1 exhibited potent and moderate AChE inhibition, with IC50 values of 0.876 ± 0.039 μM and 13.125 ± 0.521 μM, respectively. Our results suggest that huperradine G (7) may be a promising lead compound for the development of new AChE inhibitors for Alzheimer's disease.

A Review on the Traditional Applications, Phytochemistry, and Pharmacology of the Genus Physochlaina G. Don.

Physochlaina is a genus of flowering plants belonging to the family Solanaceae and consists of 10 species distributed in various Asian countries. The species of the genus have been traditionally used to cure a variety of illnesses due to their highly valuable medicinal properties, including cancer, asthma, cough, weakness, stomachache, diarrhea, swelling, spasms, toothache, boils, ulcers, rheumatic pain, chronic bronchitis, gastric problems, abdominal pain, palpitation, and insomnia. The species have gained significant attention due to their remarkable ethnopharmacological and ethnomedicinal significance. The researchers have isolated so far 71 biologically active secondary metabolites from different Physochlaina species, which include flavonoids, alkaloids, coumarins, phenolic acids, iridoids, and sterols. These compounds exhibit diverse biological activities, such as antibacterial, anti-oxidant, anti-inflammatory, cytotoxic, and anticancer properties. The present review has been compiled with the intention of providing a comprehensive overview of the botany, distribution, traditional uses, phytochemical profile, and biological activities of the genus Physochlaina for future exploration of plant-based drugs and therapeutic approaches. The present review contributes to understanding the significant pharmacological potential of Physochlaina species and unraveling their chemical composition, highlighting their relevance in developing therapeutic agents. Till date, numerous pharmacological properties and isolated phytochemicals of Physochlaina species that support the species traditional and ethnobotanical history have been documented in a number of scientific publications. However, greater emphasis should be paid to in vivo investigations on various extracts and their phytoconstituents as well as mechanistic analysis to help drug developers better understand how to use Physochlaina species as significant therapeutic resources for herbal formulations using various techniques.