Antitussive Research Articles

Formulation and Evolution of Polyherbal Cough Syrup

Polyherbal formulation of multi components which produce synergistic effect cough is common respiratory system that can have a significant impact on the quality of life. Cough is chronic and acute disease. Polyherbal formulation have been used for to treat cough and other respiratory infection. In this we study, we prepared a polyherbal cough syrup using a various combination of Medicinal plant. plant which is used as Natural Ingredients, like Ginger: Zingiber and Liquorice: Turmeric: Curcuma longa (Zingiberaceae), Tulsi: Ocimum santum. (Labiatae) and Liquorice: Glycyrrhiza glabra (Leguminosae).

Overzealous over-the-counter cough syrup ingestion leading to serious manifestation in a child – A case report

ABSTRACT Cough is a protective reflex that allows clearance of secretions from upper respiratory tract. It is not a disease by itself but a symptom of underlying disease. In a majority of cases, it is self-limiting and requires only supportive care. But over-the-counter cough syrups are inadvertently used to relieve cough in Indian settings. We hereby report a case of a 6-year-old girl child who presented to pediatrics emergency services with complaints of loss of consciousness and abnormal body movement after ingestion of dextromethorphan and chlorpheniramine containing cough syrup. All investigations including cerebrospinal fluid examination, neuroimaging, and electroencephalogram revealed no significant abnormality. The child was admitted for 5 days and discharged after that in stable conditions.

Magnolol preserves the integrity of the intestinal epithelial barrier and mitigates intestinal injury through activation of PPAR γ in COPD rat

Ethnopharmacological relevanceMagnolia officinalis Rehder & E.H. Wilson is traditionally used in the treatment of gastrointestinal disorders, diarrhea, and cough. Its main active ingredient, magnolol, exhibits protective effects on the lungs and gastrointestinal tract, including the inhibition of inflammation in these organs. Aim of the studyThis work aims to explore the molecular mechanism by which magnolol suppressed Chronic obstructive pulmonary disease (COPD) intestinal damage by improving the intestinal epithelial barrier. Materials and methodsThe study focused on investigating the mitigation effect of magnolol on intestinal injury and epithelial barrier in a COPD rat. Caco-2 cells were induced with TNF-α or IL-1β to establish the barrier injury model in order to explore the direct protective effect of magnolol on the intestinal barrier and elucidate the molecular mechanism by which it activates peroxisome proliferators-activated receptors-γ (PPARγ). ResultsMagnolol significantly improves pulmonary function and tissue damage in COPD rats by inhibiting inflammation, protease imbalance, and oxidative stress. It also suppresses colon tissue damage and inflammation, and protects colon epithelial barrier function by suppressing the decline of tight junction proteins, reducing colon epithelial permeability. In Caco-2 cells, magnolol directly reduces monolayer permeability, increases TEER, and upregulates tight junction protein expression induced by TNF-α or IL-1β. Drug Affinity Responsive Target Stability (DARTS) and thermal shift assays show that magnolol effectively binds to SRC, activating PPARγ signaling in Caco-2 cells and colon tissues of COPD rats. Furthermore, magnolol enhances the binding of PPARγ and RXRα, promoting their activation and entry into the nucleus. The PPARγ inhibitor GW9662 can reverse the effects of magnolol on PPARγ activation and tight junction protein upregulation in IL-1β or TNF-α induced Caco-2 cells. ConclusionsThis work demonstrates that magnolol enhances lung and intestinal functions in COPD rats, and elucidates its mechanism of action in protecting the intestinal epithelial barrier by activating PPARγ.

The precision medicine strategy to treat COPD pulmonary traits in clinical practice: the role of N-acetyl cysteine.

Chronic obstructive pulmonary disease (COPD) is a progressive lung condition and a leading cause of physical decline and death. COPD prevalence is expected to increase steadily in the coming years, and as a result, the healthcare and social burden of this condition will intensify. In this scenario, a patient-centric approach, the treatable trait (TT) strategy, based on the identification of traits that are clinically relevant, identifiable, monitorable and treatable, has emerged. The TT strategy, which considers behavioral/risk factors, as well as pulmonary and extrapulmonary traits, has shown to be a promising strategy in COPD management. This work reviews the TT strategy in COPD, giving special attention to the most relevant pulmonary traits, such as frequent productive cough, chronic bronchitis, type 2 inflammation, neutrophilic inflammation, lung hyperinflation, bronchiectasis, exacerbations and non-reversible airflow limitation. N-acetylcysteine (NAC), a widely used mucolytic agent, might be a major player in this strategy. Indeed, through a thorough review of the literature, it has been possible to highlight that, besides being essential in the treatment of frequent productive cough, NAC could bring benefits in case of airflow limitations, airways inflammation, exacerbations and bronchiectasis. A clinical case in which the TT strategy was able to reduce symptoms and improve lung function and quality of life, minimizing unnecessary medication and side effects, is also presented. The identification of TTs and their proper treatment through personalized medicine remarkably ameliorates COPD management. Of note, the mucolytic, antioxidant, and anti-inflammatory activities of NAC might have beneficial effects on several TTs.

Essential Oils from the Leaves and Stem Barks of Pluchea Indica (L.) Less.: Chemical Analysis, Cytotoxicity, Anti-inflammation, Antimicrobial Activity, Molecular Docking, and ADMET Profiling.

Pluchea indica (L.) Less. is a medicinal plant native to Asia. Traditionally, it is known for numerous traditional uses, such as treatments for fever, cough, and digestive issues. The present investigation aims to determine the chemical compositions of essential oils from its fresh leaves and stem barks. By using hydro-distillation and the GC-FID/MS (gas chromatography-flame ionization detection/mass spectrometry) analysis, the studied samples were dominated by sesquiterpene hydrocarbons (76.8-82.2 %) and their oxygenated derivatives (8.4-19.0 %). β-Selinene (42.0-43.5 %) and silphinene (21.1-22.9 %) were the main compounds. Significantly, the stem bark essential oil strongly monitored the growth of four cancer cell lines K562, HeLa, HepG2, and MCF-7 with IC50 values of 2.89-7.34 μg/mL. Both studied samples showed strong anti-inflammatory activity against NO (nitric oxide) production with IC50 values of 21.81-23.18 μg/mL. The studied sample also exhibited antimicrobial activity at different levels. The molecular docking study revealed that β-selinene exhibited the strongest binding affinity for all four cancer-related protein targets: epidermal growth factor receptor (EGFR), human epidermal growth factor receptor 2 (HER2), Abelson tyrosine-protein kinase 1 (ABL1), and phosphatidylinositol 3-kinase (PI3 K-α). The ADMET profiles of the major compounds were also predicted to provide insights for further research considerations.

Formulation And Evaluation Of Herbal Cough Syrup Of Tulsi By Using Molasses Base

Syrup is generally useful and popular dosage form which is used for the treatment of cough and cold. We prepared the herbal cough syrup by adding Extraction of herbal drugs such as Tulsi, black pepper and Molasses as a base. The herbal cough syrup is formulated by using Extraction and decoction method. Adding the decoction of herbal drugs with base of Molasses is helpful to the formulation for thick and preserve the formulation. That was helpful to increase the shelf life of formulation of herbal syrup.

“The complexity of what to do” – clinical perspectives of tailored physiotherapy interventions in patients with respiratory symptoms in post-COVID condition

Purpose Knowledge gaps exist regarding the effects of interventions due to continuing respiratory symptoms in patients with post-COVID condition. The aim of the present study was to present the clinical outcomes of individualised treatments for patients with remaining respiratory symptoms due to post-COVID condition. Methods This prospective longitudinal study included a consecutive series of 57 patients with remaining respiratory post-COVID symptoms. Breathing pattern, thoracic pain/mobility, occurrence of cough, and respiratory muscle strength were assessed before and after the administration of individually tailored physiotherapy interventions. Results The median treatment duration was 3 months (range 1–36 months). Dysfunctional breathing pattern was the most common symptom (n = 55/57) at inclusion. After treatment, 95% of patients had a normalised or improved breathing pattern (p < 0.001). The treatments for pain, productive and unproductive cough, and respiratory muscle strength resulted in significantly improved symptoms (p < 0.01). With other targeted treatments, inspiratory muscle strength improved by 20 cmH2O and expiratory muscle strength by 11 cmH2O (both p < 0.001). Conclusions This study indicates positive outcomes of physiotherapy treatment based on the patient’s symptomatology and test results. Therefore, individualised physiotherapy treatment of post-COVID conditions may have an impact on recovery.

Pseudo-Hyperaldosteronism Arising from Licorice Cough Syrup Self-Ingestion: A Case Report

Background: Licorice (glycyrrhiza glabra) cough syrup intoxication is manifested with refractory hypokalemia, hypertension, and metabolic alkalosis. The transformation of glycyrrhiza glabra metabolic into glycyrrhetic acid after ingestion further inhibits the 11-β-hydroxysteroid dehydrogenase-2 enzyme, impeding the conversion of cortisol into cortisone. The accumulation of cortisol can also stimulate mineralocorticoid receptors, which leads to a pseudo-hyperaldosteronism-like effect. Case Presentation: We report a 60-year-old male patient with licorice intoxication due to the chronic consumption of licorice cough syrup. He exhibited a transient seizure lasting approximately one minute. Initially, hypokalemia (potassium level was 2.0 mmol/L), metabolic alkalosis, and QT interval prolongation with premature ventricular complexes were demonstrated on his electrocardiogram. Despite the administration of both intravenous and oral potassium supplements over two days, there was no significant improvement in hypokalemia. Spironolactone, an aldosterone receptor antagonist, was administered in addition to ongoing potassium supplementation from the 3rd day. This intervention led to a rapid normalization of hypokalemia in one day. The patient was ultimately discharged on the 6th day without any subsequent complications. Conclusions: The licorice-induced chronic intoxication, which led to pseudo-hyperaldosteronism and refractory hypokalemia, was successfully managed with aggressive potassium supplementation and spironolactone treatment.

Ethnopharmacological Insights into the Use of Chenopodium ambrosioides for Cough Treatment among Togolese Traditional Healers

Togo has an ethnobotanical potential with a great diversity of medicinal plants widely used to treat human diseases. Cough associated with respiratory diseases is one of the pathologies traditionally treated with medicinal plants in Togo. Chenopodium ambrosioides (L.) is a species used in the traditional treatment of cough in Togo. The aim of this study was to document the ethnopharmacological uses of Chenopodium ambrosioides in Togolese traditional medicine for treatment of cough. An ethnopharmacological survey was conducted using the semi-structured interview method among Traditional Medicine Practitioners (TMPs) from six health districts spread across four health regions. The ethnopharmacological and ethnobotanical data collected were analyzed using the User Value (UV) and Frequency of Citation (FC) of medicinal plants associated with the species. A total of 127 TMPs participated in this study and 96 (76%) of them were male and 31 (34%) were female. 73% of the informants claimed usually use Chenopodium ambrosioides in the cough treatment compared to 27% who claimed to not use it to treat cough. Chenopodium ambrosioides was used in combination with fifty-two (52) other botanical species in the treatment of cough and in the study area, Abrus precatorius Linn. (13.59%) followed by Ocimum gratissimum Linn. (11.58%), Zingiber officinale Rosc. Trans. Linn. (9.73%), Mangifera indica Linn. (6.21%), Eucalyptus citriodora Hooker (4.87%), Xylopia aethiopica (Dunal) A. Rich. (4.36%) and Eugenia caryophyllata Thunb. (4.19%) were the most popular plants used for cough treatment among the plants recorded. Sixteen (16) other pathologies including pulmonary infections are also treated by Chenopodium ambrosioides (L.). Abscesses, intestinal parasitic diseases, incurable wounds, stomach aches and headaches are the most pathologies commonly treated by this plant. The whole plant (72%) and leaves (22%) are the primary parts utilized for medicinal purposes. Decoction (77.50%) is the main preparation method, with oral (80.83%) and cutaneous (10.83%) routes being the most common modes of administration. The findings from this study provide a solid ethnopharmacological foundation for future pharmacological and toxicological investigations into Chenopodium ambrosioides (L.).

Comparative clinical trial of Langenlianqiao oral liquid and Lianhuaqingwen capsule in the treatment of mild cases of coronavirus disease 2019 (COVID-19)

ObjectiveTo evaluate the clinical efficacy of Langenlianqiao (LGLQ) oral liquid treatment and provide a reference basis for the clincal treatment of coronavirus disease 2019 (COVID-19).DesignAn experimental clinical study was conducted on three groups with confirmed diagnoses of COVID-19.SiteThis study was conducted at Changde Hospital.ParticipantsA total of 253 patients were enrolled in this study.MethodsThe patients were divided into the LGLQ treatment group (100 cases), the Lianhuaqingwen (LHQW) treatment group (100 cases) and the placebo control group (53 cases), according to the treatment each group received. The occurrence of major clinical symptoms, the duration of symptom disappearance, the number of days in hospitalisation and the duration of infection were compared among the three groups.ResultsCompared with the placebo control group (10.0 [1.2] d, 9.4 [1.3] d), the duration of infection and hospitalisation effectively decreased in the LGLQ group (6.8 [0.6] d, 7.4 [0.8] d) and the LHQW group (6.8 [1.0] d, 7.3 [1.0] d). Furthermore, the incidence of fatigue in the LGLQ group (4.0%) was lower compared to the LHQW group (14.0%) and the placebo control group (15.1%), but this difference was not statistically significant (P = 0.580 for LGLQ vs. LHQW, P = 0.246 for LGLQ vs. placebo). In the treatment of cough, the LGLQ group showed a significantly different effect compared to both the LHQW group (P = 0.014) and the placebo group (P = 0.016). Additionally, for dry cough specifically, LHQW was effective in reducing its incidence compared to the placebo control group (P < 0.05), while LGLQ showed no statistically significant difference from either LHQW (P = 0.39) or the placebo group (P = 0.14). However, neither the LGLQ group nor the LHQW group showed a reduction in the duration of symptom disappearance in patients with pre-existing symptoms (P > 0.05).ConclusionsCompared with the placebo control group, the LGLQ group showed an improvement in the clinical symptoms of COVID-19 and a decrease in the duration of hospitalisation and infection, which confirmed that the LGLQ treatment had the same antiviral effect as the LHQW treatment. This may provide in-depth insights for antiviral therapy research.

Efficacy of ensitrelvir for cough due to COVID-19 Omicron variant in medical healthcare workers.

We evaluated the efficacy of ensitrelvir for the treatment of cough due to coronavirus disease 2019 Omicron variant in medical healthcare workers. A total of 633 patients were registered in this study: 206 patients chose ensitrelvir and 427 patients chose symptomatic treatment. Difference in score changes using the Leicester Cough Questionnaire between groups was 3.17 on day 4, 3.24 on day 7, and 2.46 on day 14. The analysis demonstrated a significant difference at all time points.

8239 Recurrent Superior Laryngeal Nerve Glucocorticoid Injections: A Likely Cause Of Secondary Adrenal Insufficiency In An Otherwise Healthy Man

Abstract Disclosure: A. Lorin: None. M.C. Pranger: None. J. Park: None. C.A. Clutter: None. Background: Secondary adrenal insufficiency is well described in the literature with various offending agents implicated. Superior laryngeal nerve (SLN) glucocorticoid injections, however, have rarely been recorded as causal agents of secondary adrenal insufficiency. We present a case of a generally healthy man with secondary adrenal insufficiency after chronic administration ofsuperior laryngeal nerve glucocorticoid injections without other identifiable etiologies. Clinical Case: A 68-year-old man with no significant medical history presented to endocrinology clinic due to persistent nausea and severe fatigue. His initial labs were notable for morning cortisol of 1.66 mcg/dL (5-25) and an undetectable ACTH (&amp;lt;3.2 pg/mL, 10-60) suggestive of adrenal insufficiency. FSH/LH, testosterone, FT4, and IGF-1 were otherwise normal. On initial review of his medication history, the only glucocorticoid exposure appeared to be intranasal beclomethasone, with remote courses of oral prednisone. Further history revealed that the patient was receiving superior laryngeal nerve glucocorticoid injections for chronic cough every three weeks for over a year. The injection consisted of 1:1 mixture of 1 mL of triamcinolone acetonide 200 mg/5 mL and local anesthetic, which is equivalent to triamcinolone 40 mg or hydrocortisone 200 mg. Given the volume and chronicity of the glucocorticoid injections, the patient developed secondary adrenal insufficiency as above. Since the diagnosis, the patient discontinued SLN glucocorticoid injections and was placed on physiologic hydrocortisone replacement, with gradual recovery of his HPA axis. Conclusions: Sequelae of percutaneous glucocorticoid injection into the superior laryngeal nerve for treatment of chronic cough are not well documented in terms of their effects on the HPA axis. While an effective and increasingly common treatment for chronic cough, SLN glucocorticoid injection has the potential to cause suppression of the HPA axis and cause secondary adrenal insufficiency. Excess glucocorticoid appeared to solely inhibit ACTH production, as the other anterior pituitary hormones were not affected. Understanding consequences of glucocorticoid use in any formulation is important when considering such therapies, as these may alter normal HPA function with recurrent dosing. Recovery from a disrupted HPA axis may be achieved with the use of physiologic doses of hydrocortisone replacement in the case of secondary adrenal insufficiency. Presentation: 6/3/2024

8676 Hereditary Fructose Intolerance Unmasked: Report of a Pediatric Case Exploring Differential Diagnosis of Hypoglycemia and Genetic Insights

Abstract Disclosure: N. Solano: None. D. Baboun: None. A. Granados: None. A. Carrillo-Iregui: None. Introduction: Hereditary fructose intolerance (HFI) is an uncommon autosomal recessive metabolic disorder characterized by a deficiency of aldolase B, a crucial enzyme involved in fructose metabolism. This deficiency causes an accumulation of fructose-1-phosphate, which triggers a cascade of metabolic disturbances including hypoglycemia, lactic acidosis, and hepatic dysfunction. If left untreated, HFI can lead to severe complications, including liver failure and even death. Diagnosing HFI can be challenging due to its nonspecific clinical presentation and the absence of routine screening tests. Case presentation: A 4-year-old girl was referred from an outside hospital for hypoglycemia requiring intravenous dextrose infusion. The patient became lethargic 30 minutes after consuming a honey-based cough syrup. Upon presentation to the emergency department, her blood glucose level was 41 mg/dL. Her past medical history revealed an episode of lethargy and persistent vomiting at age 21 months, coinciding with an intussusception. A finger blood glucose test at the time was undetectable, and further evaluation revealed metabolic acidosis, elevated liver enzymes, and a normal ammonia level. Plasma amino acid, acylcarnitine, carnitine, urine acylglycine, carnitine, and urine organic acid levels were all within normal limits. Fatty acid oxidation and glycogen storage disease panels were also negative. On inquiry into her dietary habits, her parents recalled she would spit fruits out whenever tasting them, suggesting an innate aversion to fructose-rich foods. Initial comprehensive inpatient workup, including a critical sample, yielded no definitive results. She underwent a strict 24-hour inpatient fast and remained asymptomatic, with blood glucose levels above 65 mg/dL, ruling out hyperinsulinism. A broader next-generation sequencing (NGS) hypoglycemia panel was ordered, which identified a heterozygous pathogenic variant, c.178C&amp;gt;T (p.Arg60*) maternally inherited, and a likely pathogenic variant, c.379+1G&amp;gt;T (Splice donor) paternally inherited, in the aldolase B gene. Both confirmed the diagnosis of hereditary fructose intolerance (HFI). The family received comprehensive dietary and genetic counseling. Conclusion: HFI is an uncommon but potentially life-threatening inborn error of metabolism. Maintaining a high index of suspicion, considering a broad differential diagnosis, and obtaining a detailed dietary history, including fruit consumption, are crucial for identifying and managing HFI in infants and children with unexplained hypoglycemia. This case highlights the importance of early diagnosis and dietary intervention to prevent severe complications in patients with HFI. Additionally, it emphasizes the need for comprehensive dietary counseling and education for patients' families to ensure lifelong adherence to a fructose-restricted diet. Presentation: 6/2/2024

Evaluation of Efficacy and Safety of Different Doses of Eladis® in the Therapy of Cough Against Acute Respiratory Viral Infection

Aim. Justification of the optimal dosage regimen regarding the efficacy and safety of Eladis®, film-coated tablets, 10 mg (Valenta Pharm JSC, Russia) in comparison with placebo in patients with non-productive cough due to acute respiratory viral infection (ARVI). Material and methods. A double-blind placebo-controlled randomized multicenter study was conducted in which 141 patients with non-productive cough on the background of acute respiratory viral infection took part. The study participants were randomized into 4 groups. Patients from the first group took 1 tablet of Eladis® 2 times a day (daily dose of 20 mg); patients from the second group took 2 tablets of Eladis® 2 times a day (daily dose of 40 mg); patients from the third group took 4 tablets of Eladis® 2 times a day (daily dose of 80 mg). Patients in the fourth group received placebo tablets in quantities corresponding to the first three groups. For this purpose, 3 subgroups of 12 people were allocated within group 4. The duration of therapy was 7–14 days. The effectiveness of therapy was assessed based on monitoring the frequency of cough attacks, changes in values on the day and night cough scales, a digital rating scale (DRS), and the time to achieve clinical cure of cough and ARVI symptoms was also taken into account. The safety of the studied drug was assessed based on monitoring of vital signs, laboratory parameters, and electrocardiogram (ECG) data. The number and severity of adverse events (AEs) and serious adverse events (SAEs) were assessed. Results. Analysis of data on the primary endpoint (reduction of cough attack frequency by ;)50% by the 5th day relative to the 1st visit) showed the superiority of Eladis® over placebo at a daily dose of 80 mg (P=0.00003). At the same time, the proportion of patients who reached the primary endpoint by day 5 when receiving Eladis® at a dose of 80 mg per day was 71.43%, while in the combined placebo group it was 22.22%. Conclusion. Evaluation of various dosage regimens of Eladis® has shown that a daily dose of 80 mg is optimal for the treatment of non-productive cough in patients with ARVIs, as it provides the greatest effectiveness with a safety profile comparable to other studied doses.

Xiao-Er-Kang-Du capsules regulate autophagy against the influenza B virus (Victoria strain) through the mTOR/ULK1/Beclin1/VPS34 pathway

Ethnopharmacological relevanceXiao-er-kang-du (XEKD) capsule is a Chinese herbal formula used for treatment of upper respiratory tract infection caused by various viruses in pediatric patients in China. XEKD is used clinically for the treatment of influenza-like symptoms, including fever, chills, cough, stuffy and runny nose, headache, and sore throat, with remarkable efficacy. However, the pharmacologic mechanism of XEKD against influenza B virus (IBV) infection is unclear. Aim of the studyThe main purpose of the present work is to explore the curative effect as well as possible mechanisms of XEKD against influenza B virus (IBV) (Victoria strain). Materials and methodsBoth in vivo and in vitro experiments were performed to confirm the antiviral properties of XEKD. High-performance liquid chromatography was used to analyze the active components and assess the stability of XEKD. In addition, the mechanism of action of XEKD against IBV (Victoria) was investigated by western blot, immunofluorescence, and immunohistochemical analyses, in addition to confocal fluorescence microscopy. ResultsThe findings revealed that XEKD demonstrated antiviral effects against IBV infection in both in vivo and in vitro via the mTOR/ULK1/Beclin1/VPS34 pathway and promote cellular autophagy to mitigate IBV-induced lung tissue damage. The results of this work are expected to lead to a deeper understanding of the mechanism underlying the effect of the XEKD capsule against IBV infections. ConclusionsIBV infection was found to inhibit autophagy, which exacerbated inflammatory damage. XEKD regulates autophagy through the mTOR/ULK1/Beclin1/VPS34 pathway and exerts antiviral effects, thereby laying a foundation for further development of XEKD as a potential therapeutic against IBV infection.

Hypoglycemic and antihyperglycemic effects of Abelmoschus esculentus and Alchornea cordifolia in normal and alloxan-induced diabetic rats

BackgroundAbelmoschus esculentus and Alchornea cordifolia are commonly used in Traditional Chinese Medicine (TCM) to treat several diseases. Abelmoschus esculentus is used to treat infertility and menorrhagia, while Alchornea cordifolia is used for the treatment of venereal diseases, cough, and diarrhoea. However, very few studies assessed the antidiabetic effects of these plants. Therefore, this study aimed to investigate the hypoglycemic and antihyperglycemic effects of aqueous extract of A. esculentus fruits and A. cordifolia leaves. Material and MethodsFresh Abelmoschus esculentus fruits and the powder from the dried leaves of Alchornea cordifolia leaves were prepared by maceration in the aqueous phase (200g/100mL and 50g/100mL respectively) for 24 hours, then filtered and concentrated in an oven at 45°C. Diabete was induced to male Wistar rats by a single intraperitoneal injection of alloxan (150 mg/kg, b.w). Rats with a blood glucose level greater than or equal to 200 mg/dL were selected, divided into groups and were daily administered orally with either aqueous extracts of A. esculentus at 30 mg/kg (AEAE30) or A. cordifolia at 400 mg/kg (AEAC400) for 14 consecutive days. For comparison, acarbose (100 mg/kg), glibenclamide (5 mg/kg), and metformin (500 mg/kg) were administered orally as reference drugs. Moreover, insuline was also used as a positive control and administered intraperitoneally at a dose of 5 IU/kg. Then, blood glucose levels, oral glucose tolerance test, oral maltose tolerance club, body weight and hemoglobin were assessed. For evaluation of the aqueous extracts in the intestinal transit, imodium (2 mg/kg, p.o) and fructine (5 mg/kg, p.o) were used as a positive control to determine the spasmolytic and laxative activities, respectively. The histopathological study of the liver, kidney, pancreas, testis, epididymis, and seminal vesicle was also carried out using the hematoxyline & eosin (H&E) technique. ResultsAEAE30 and AEAC400 significantly reduced (P<0.001) fasting blood glucose (FBG) levels and significantly prevented (P<0.001) postprandial glycemia in AI-db rats following oral glucose tolerance test (OGTT) and oral maltose tolerance test (OMTT) in alloxan-induced diabetic rats (AI-db). In normoglycemic and insulin-resistant (IR) rats, AEAE30 significantly prevented the post-prandial blood glucose level during the OGTT (P<0.01) only in normoglycemic rats. At the end of treatment, AEAE30 significantly reduced the relative weight of the liver (P<0.01) and significantly increased (P<0.001) the relative weight of the testes and pancreas while AEAC400 significantly increased the relative weight of the testes compared to untreated AI-db rats. The histopathological study revealed a restoration of alloxan-induced tissue damage close to the normal control group in AI-db animals treated with plant extracts, as well as an increase in sperm density in the epididymis unlike in the untreated AI-db group. ConclusionThese findings suggested that AEAE and AEAC exhibited hypoglycemic and antihyperglycemic activities and could be therefore a useful source of antidiabetic agent.

Prunella vulgaris and Tussilago farfara demonstrate anti-inflammatory activity in rabbits and protect human adipose stem cells against thermal stress in vitro

Ethnopharmacological relevancePrunella vulgaris L.(PV) and Tussilago farfara (TF) are perennial herbs rich in flavonoids and phenolic compounds with immense medicinal value. PV extract (PV-E) possesses potent antipyretic, anti-inflammtory, antioxidant, antiseptic, anti-cancer and immune stimulatory properties and have been traditionally known for the treatment of wounds, ulcers and sores. TF extract (TF-E) has been known for antibacterial, antioxidant, anti-inflammatory, anti-viral, anti-diabetic, anti-cancer, anti-obesity and wound healing effects. Additionally, TF-E infusions have been used for asthma, cough, and bronchopneumonia treatments. Aim of the studyThe therapeutic efficacy of transplanted human adipose stem cells (hASCs) is abrogated under the deteriorating effects of heat stress offered by burn wounds. Earlier researches has documented antioxidant priming as an effective strategy to enhance stem cell performance. As both PV-E and TF-E are known for their potent antioxidant effects. The present study aims to examine the cryoprotective effects of PV-E and TF-E priming on hASCs against in-vitro heat-induced thermal stress. Moreover, we determined the anti-inflammatory potential of both PV-E and TF-E on rabbits. MethodsAntioxidant capacity of both PV-E and TF-E is examined via DPPH assay and anti-inflammatory activity is assessed in rabbits using carrageen-induced paw edema model of inflammation. Next, we investigate the efficacy of different doses (1.25-100μg/ml) of PV-E and TF-E on hASCs; MTT, LDH, calcein AM staining, and wound scratch assay were used to assess cell viability, cytotoxicity, proliferation ability and cell migration potential in the cells. Then, hASCs were pretreated for 24 h with optimum doses of PV-E and TF-E determined from MTT assay results and were subsequently exposed to in-vitro thermal injury (51 °C,10 min). The cytoprotective effects of both PV-E and TF-E priming under thermal stress were investigated via MTT, LDH, annexin-V staining and gene expression analysis. ResultsBoth PV-E and TF-E extracts demonstrated potent antioxidant and effective anti-inflammatory activities, with a clear reduction in inflammation. Study on hASCs exhibited improved cell viabilities, enhanced cell proliferation and migration abilities of both extracts. While heat stress data revealed that PV-E (2.5μg/ml) and TF-E (5μg/ml) pretreatment significantly ameliorated effects of thermal-injuries in hASCs as depicted by significantly enhanced cell viabilities, low LDH release profile, and lower annexin-V expression and regulated gene expression of the pretreated cells. ConclusionPV-E and TF-E priming effectively enabled hASCs to combat thermal injury by significantly promoting cell survival than untreated cells. Hence, these findings suggest that PV-E and TF-E priming could be used to attain improved cellular responses and enhanced therapeutic efficacy in burnt tissue.

From the first pilot initiatives in the early 1990s to the national OSIAP survey in the 2020s: More than 30 years of insight in medication diversion phenomenon in France

This article proposes to trace back the timeline of the monitoring of falsified medical prescriptions in France as part of the French Addictovigilance System's toolbox. It examines the genesis of the OSIAP survey (Suspect Prescriptions Indicator of Possible Abuse), which has been held at the national level since 2001 but was created in the early 1990s, and its development until the current situation with a continuously confirmed yearly increasing trend. Understanding the birth and development of OSIAP and some other Addictovigilance tools that continue to be useful after more than 30 years of existence requires to review key historical benchmarks including the principles and missions of the former French National Commission on Narcotic and Psychotropic Drugs. Even though the OSIAP survey is part of a specific toolbox developed and routinely explored by the Addictovigilance network in a multidimensional approach, it has also been the sole data source, which identified some problematic drug uses, such as the early detection of tropicamide eye drop misuse in France or the diversion of codeine cough syrups after July 2017. Nevertheless, findings obtained from this data source should be checked against other complementary sources. Close monitoring of falsified prescriptions should be maintained in France, and the recent evolutions are plaid for supporting this survey. It is still being determined whether the constant increase of false prescription forms recorded in the OSIAP survey results from an increase in the absolute number of falsified prescriptions or whether pharmacists have become more vigilant with time. Still, the acceleration of these falsifications is also in line with the deployment of teleconsultations and the democratisation of digital techniques such as copying prescriptions or generating false QR codes. The forging techniques will likely evolve again in the future, possibly by adapting to stricter requirements such as the implementation of dematerialised prescriptions.

Self-Medication of Medical Students at Erzincan Binali Yıldırım University in Turkey: A Cross-Sectional Study.

Responsible self-medication (SM) can save time, money, reduce the number of visits to the doctor, and alleviate pressure on health services. However, while there are clear benefits, SM also carries significant risks, such as increased drug side effects, inappropriate use of prescription drugs, drug interactions, misdiagnosis, drug dependence, masking of medical conditions, and antibiotic resistance. This study aimed to investigate the practices of medical students at a public university in Türkiye towards SM, as well as to determine the factors influencing such practices. The population of this cross-sectional study included first-, fourth-, and sixth-year medical students. As the goal was to reach the entire population (375 students), no sample selection was made. A total of 332 students (88.5%) participated in the study.The relevant literature was used for the basis of the questionnaire used in the study. In the statistical evaluation, percentages, means, standard deviations, medians, minimum, and maximum values were used to present the descriptive data, while factors influencing SM were analyzed using the chi-square test and bivariate and multivariate logistic regression analysis. The overall rate of SM among the participants was found to be 96.1%. No statistically significant difference was observed in SM rates based on the year of study (p>0.05). The rate of students using antibiotics without a prescription was 19.3%. Additionally, 82.5% of the students reported reading the package insert before using a drug. The most common symptoms leading to SM were headaches (83.1%) and the common cold (63.6%). The most frequently self-administered medications were analgesics (86.1%), common cold medicines (54.8%), and vitamins (34.0%). Furthermore, 79.3% of the participants indicated that they self-medicate because they perceive their condition as a simple illness, 64.6% because they had experienced a similar illness before, and 28.2% because they believed they had sufficient knowledge of medications.In multivariate regression analysis, keeping medicines at home/in the dormitory for later use and not having a chronic disease were found to be effective factors in students' practice of SM. It is important to plan educational interventions to promote the development of responsible SM behaviors. Starting these educational programs in the first year of medical school is thought to contribute significantly to the fostering of responsible SM practices.

Prescription patterns and symptom relief of antitussives and expectorants in patients with cough: a nationwide study in Korea.

Limited data are available on the prescription patterns and efficacy of antitussives and expectorants for patients with acute and chronic cough. This study examined the use and efficacy of these medications in a nationally representative sample of Korean patients. We examined 4,206,016 individuals from the National Health Insurance Service (NHIS)-National Health Information Database (NHID) between 2015 and 2017. Among them, a sample of 10% (n=420,602) was retrieved for the diagnosis of respiratory diseases using the International Classification of Diseases, 10th edition (ICD-10; J00-J99), or the prescription of antitussives and expectorants for cough (ICD-10; R05). The acute cough group included those who were prescribed medications within 4 weeks of initial diagnosis (prescription within 14 days), whereas the chronic cough group included patients who were prescribed medications within 16 weeks of initial diagnosis (prescription within 56 days). If the prescription was discontinued or not changed to an alternative drug after the initial prescription, these cases were considered to have achieved symptom relief. This study included 288,460 patients (971,065 cases) with acute cough and 5,888 patients (15,399 cases) with chronic cough. 'Expectorants, excluding combinations with cough suppressants' had the highest prescription rates in both groups (acute cough, 63.8%; chronic cough, 61.7%), and showed the highest symptom relief regardless of the number of medications prescribed (acute cough, 84.3%; chronic cough, 70.4%). 'Expectorants, excluding combinations with cough suppressants' were the most prescribed and effective medications for relieving cough symptoms in Korea patients. Further studies are needed to determine the optimal duration for using antitussives and expectorants in cough management.