The seeds and oil of Nigella sativa, commonly known as black cumin, have been in use for a very long time to cure various ailments. In a Hadith, one of the sayings of Prophet Muhammad about the black cumin was mentioned that states “hold on to use the black cumin, because it can heal every disease except the death.”[1] It has been mentioned as a curative black seed in the “Holy Bible” and is described as the Melanthion by Hippocrates and Dioscorides and as the Gith by Pliny.[2] Ibn Sina, a Persian physician, recommended its use to cure fever, wounds, skin diseases, fungus, parasites, and worms, as well as against bites and stings of poisonous animals. Thymoquinone (TQ), an active constituent of N. sativa seeds, has shown a wide range of pharmacological actions including antioxidant and antiinflammatory, antidiabetic, anticancer, antimicrobial, hepatic, and renal protective effects.[3] TQ has shown an anti-inflammatory activity by downregulating the expression of pro-inflammatory and proliferative mediators such as tumor necrosis factor-α (TNF-α), inducible nitric oxide, cyclooxygenases-2, 5-lipoxygenase, and cyclin D1. TQ also possesses an antiglycation activity and protects the enzymatic activity of superoxide dismutase (SOD) against glucose- or methylglyoxal-induced glycation.[4] Recently, TQ was shown to inhibit peroxynitrite-induced oxidative damage of histone-H2A protein.[5] TQ possesses a broad anticancer activity by altering p38 mitogen-activated protein kinase and peroxisome proliferatoractivated receptors-γ pathways[6] TQ also induces the inhibition of spindle formation in carcinoma cells through the induction of G2/M cell-cycle arrest. Moreover, TQ decreased the expression of antiapoptotic proteins including Bcl-2 and Bcl-xL, whereas increased the expression of proapoptotic protein Bax. It also increases the levels of Phosphatase and tensin homolog (PTEN) in doxorubicin-treated MCF-7 cells and inhibits their proliferation through the activation of p53. TQ also inhibits the growth of colon cancer cells by arresting at G1 phase of the cell cycle. TQ has been shown to possess the hepatic and renal protective effects against drug-induced toxicity by reducing the levels of aspartate transaminase, lactate dehydrogenase, alanine transaminase, blood urea, and creatinine.[7] TQ also demonstrated an ability to bind to free bilirubin and prevented the binding of bilirubin to erythrocytes that facilitated the increased detoxification and elimination of the toxic bilirubin.[7] Moreover, TQ showed immunomodulatory effects by downregulating the gentamicin-induced functional expression of cytokines including interleukin (IL)-6, IL-18, IL1β, and TNF-α.[8] TQ has shown nephroprotective role against lipopolysaccharide-induced renal fibrosis and corrected the parameters of SOD and catalase in Escherichia coli-induced pyelonephritis.[3] The protective effect of TQ is largely mediated through its antioxidant potential including the reactive oxygen species scavenging ability, the lipid peroxidation inhibition, the protection of hepatic antioxidant enzymes, the suppression of oxidative stress, and hepatic inflammation.[3] In recent years, the use of TQ was explored against a wide range of infectious diseases. TQ has been shown to prevent the biofilm formation in a number of bacteria including Staphylococcus aureus, Staphylococcus epidermidis, Enterococcus faecalis, and Pseudomonas aeruginosa.[9] Thus, TQ seems to be an important part of antimicrobial armory, particularly against the pathogens that use the biofilm formation as an important part of their virulence strategy. Interestingly, TQ inhibited the activity of the drug efflux pumps in P. aeruginosa, S. aureus, and Bacillus cereus.[9] TQ has shown activity against both the drug-susceptible and drug-resistant M. tuberculosis by specifically targeting the intracellular locations of the pathogens.[10] We showed that a liposomal formulation of TQ can effectively cure fluconazoleresistant Candida albicans.[11] In addition to above-mentioned actions, TQ also showed beneficial effects against respiratory disorders including asthma, emphysema, and pulmonary fibrosis. It ameliorated an allergic airway inflammation through the inhibition of Th-2 cytokines such as IL-4, IL-5, and IL-13.[12] TQ showed cardioprotective effect by reducing the hepatic steatosis in hyperlipidemic rabbits by virtue of its strong free radical scavenging and antioxidant activity. TQ, a principal bioactive compound of N. sativa seeds, is a hydrophobic molecule that shows poor solubility in an aqueous solution. A variety of TQ formulations have been developed to increase its bioavailability and pharmacological activity.[3] Majority of them showed superior therapeutic activity to free TQ. Recently, various TQ formulations have been investigated to treat multiple diseases including cancer, inflammatory and autoimmune disorders, and infections. We are still not able to use the full potential of TQ as a chemotherapeutic agent due to its reduced solubility in an aqueous milieu. To progress TQ from the bench to the bedside, major efforts should be made to prepare TQ formulations that can conquer the problem of poor solubility and bioavailability associated with the chemical nature of the drug. Thus, due to its multitargeting nature, TQ may be proved a very effective chemotherapeutic agent in the treatment of multiple diseases.  

Objective: Few studies have examined differences in ratings of perceived exertion (RPE) between overweight (OW) and non-OW (NW) youth. With lower voluntary participation in physical activity in OW children, it seems plausible that these youth may experience elevated RPE. Therefore, this study compared RPE during two separate steady-state cycling bouts OW (>95th body mass index [BMI] percentile) and NW (<90th BMI percentile) children. Methods: Participants completed one of two 20-min cycling trials; one performed at 70% age-predicted peak heart rate (HR) (70%) (OW n = 12 and NW n = 21) and a self-selected intensity (SS) (OW n = 6 and NW n = 13) with RPE overall, RPE legs (RPE-L), and RPE chest estimated at 5, 10, 15, and 20 min. Results: A repeated measures ANOVA revealed that OW individuals had significantly lower RPE-L values at 5, 15, and 20 min during the SS trial. No significant differences were identified during the 70% trial. Conclusions: OW youth do not perceive cycling at 70% age-predicted peak HR or at SS intensities more difficult than NW children. It may be that cycling could serve as an attractive mode to encourage physical activity in this population and perhaps increase self-efficacy of exercise in this population. Conclusions: OW youth do not perceive cycling at 70% age-predicted peak HR or at SS intensities more difficult than NW children. It may be that cycling could serve as an attractive mode to encourage physical activity in this population and perhaps increase self-efficacy of exercise in this population. Keywords: Body mass index, children, perception of effort, physical activity

Objectives: With the increase in the life expectancy of older adults, the scoring diagnosis of osteoporosis has been highly reported hence rising the incidence of fragility fractures due to decrease in bone mineral density (BMD), thereby significantly impacting the quality of life and health status of elderly population. The aim of this study is to identify the impact of different exercise regimes in improving the BMD among osteoporotic females. Methodology: A trial was conducted on 93 diagnosed postmenopausal osteoporotic females aged 50–75 years screened on the basis of physical activity readinessquestionnaire and YOU form randomly divided equally into three groups’, that is, aerobic, anaerobic, and osteoanabolic exercises using an envelope method. The intervention was given on the basis of American College of Sports Medicine (ACSM), frequency, intensity, time, and type protocol for the period of 12 weeks. The pre- and post-BMD was determined to find out the improvements on the t-value of the participants. The outcome measure was calculated using a peripheral dual X-ray absorptiometry scan (bone densitometer). Results: At 95% of confidence interval, the pre- and post-median difference observed within the osteoanabolic group was 0.4 followed by 0.3 and 0.1 in the aerobic and anaerobic groups, respectively. The level of significance was determined by applying the Friedman test revealing a statistically significant difference P < 0.001 between the groups. Further, post hoc analysis shows that osteoanabolic exercises were more significant in comparison with aerobic and anaerobic exercises. Conclusion: Structured physical exercises based on ACSM protocol show improvement among the osteoporotic females; however, the impact of osteoanabolic exercises significantly increased the BMD, thus reducing the t-value. However, larger scale studies in different clinical settings are recommended for more accurate results.

Objectives: The objective of this study was to determine the possible inflammatory responses in hypercholesterolemia patients receiving treatment using raw liquid extract of young cashew leaves in some herbal homes in Nigeria. Methods: Hypercholesterolemia patients (27: Aged 31–53 years; female - 10 and male - 17) 20 herbal homes in Saki-West, Saki-East, and ATISBO local governments constituting a Federal constituency in Nigeria, and non-hypercholesterolemia apparently healthy participants (50: Aged 20–64 years; female - 25 and male - 25) were recruited from the same federal constituency as test and control subjects, respectively. About 60 ml of this extract were given to the patients for an average of 14 days when there was a significant decrease in their plasma cholesterol. Plasma cholesterol was determined in the subjects using COBAS C111 auto chemistry analyzer; plasma tumor necrosis factor-alpha (TNF-α), interleukin (IL)-6, 8, and 29, intrahepatic chemokines such as fibrinogen and C-reactive protein (CRP), IL-6, CRP, hepatitis B surface antigen, antihepatitis C virus, and anti-human immunodeficiency virus were immunochemically determined by enzyme-linked immunosorbent assay, and identification of Plasmodium spp. was determined by microscopic examination of thick film-stained Giemsa stain. Results: There was a significant reduction in the plasma values of cholesterol, TNF-α, IL-6, and CRP with a significant increase in plasma aspartate transaminase (AST) and alanine transaminase (ALT). In the hypercholesterolemia patients who were supplemented with raw liquid extract of young cashew leaves compared with the control and their basal samples (P < 0.05). Discussion: Supplementation of raw liquid extract of young cashew leaves can cause a significant reduction in the plasma values of cholesterol TNF-α, IL-6, and CRP with an increase in plasma AST and ALT. In the hypercholesterolemia patients due to the phytochemicals in young cashew leaves.

Objectives: Parasitic infections such as toxoplasmosis, hydatidosis, and cysticercosis infect a large population worldwide. Toxoplasma gondii in the pancreas could damage the pancreatic cells. Hence, insulin secretion would be affected which leads to increased risk of diabetes. The present study was designed to investigate the cooccurrence of parasitic infections in patients with diabetes. Methods: A total of 256 confirmed parasitic serum samples were included in the study, of which 95 were positive for toxoplasmosis, 87 for hydatidosis, and 74 for cysticercosis infection. These samples were then analyzed for hyperglycemia. Results: In case of hydatidosis, the frequency of hyperglycemia was 14.94%, followed by cysticercosis (10.8%) and toxoplasmosis (8.42%). The frequency of insulin resistance was analyzed in these hyperglycemic samples. The coprevalence of diabetes was higher in case of hyperglycemic hydatidosis patient samples (11.49%), followed by cysticercosis (8.10%) while the coprevalence of diabetes was minimum (6.31%) in toxoplasmosis patients samples. Thus, the overall prevalence of diabetes with parasitic infections was 8.6%. Conclusion: The study suggested the coexistence of hyperglycemia in hydatidosis, cysticercosis, and toxoplasmosis infected samples. However, higher prevalence of high glucose level was detected among hydatidosis infected samples. Thus, suggested individuals infected with hydatidosis were more susceptible for diabetes in comparison to toxoplasmosis and cysticercosis.

Objectives: The objective of this research was to evaluate the effect of periodontitis on masticatory cycle efficiency and maximum molar bite force. Methods: Twenty-four individuals were divided into two groups: With periodontitis (Group I; mean age ± standard deviation (SD), 51.3 ± 2.8 years; n = 12) and without periodontitis (Group II; mean age ± SD, 48.9 ± 2.4 years; n = 12). Masticatory cycle efficiency was obtained from the value of the ensemble-averaged integrated linear envelope electromyographic signal of the masseter and temporalis muscles. Maximum bite force was recorded for the right and left molar regions. The data were tabulated and submitted to statistical analysis (P ≤ 0.05). Results: There was a significant difference between the groups for the left masseter muscle when chewing raisins (P = 0.04), peanuts (P = 0.02), and biocapsules (P = 0.01). Multiple regression analysis demonstrated the influence of dental mobility on masticatory cycle efficiency for peanuts (P = 0.03) and biocapsules (P = 0.01). The maximum bite force for the left molar region was significantly different between the groups (P = 0.02). Dental mobility was a variable that had a greater effect on masticatory cycle efficiency. The periodontitis group had a reduced bite force. Conclusion: The present study findings indicate that the loss of periodontal supporting structures had a negative impact on masticatory cycle efficiency and molar bite force. This finding suggested that dental mobility should be considered when determining clinical treatments aimed at improving masticatory efficiency and bite force in individuals with the periodontal disease.

Objectives: Previous research has shown that e-cigarette use is rising among young adults, but it is unknown whether the dual use of alcohol and marijuana is associated with e-cigarette use in a U.S.A. nationally representative sample. Methodology: Secondary analysis of the Population Assessment of Tobacco and Health 2013–2014 nationally representative sample of young adults (aged 18–24) was conducted to examine the relationships between dual ever and dual current use of alcohol and marijuana with e-cigarette use. Multiple logistic regression models were used to explore the associations between dual ever and dual current use alcohol and marijuana with two outcomes: Past 30 days and former experimental e-cigarette use. Covariates included sex, race/ethnicity, education level, household income, and the total number of tobacco products ever used. Results: Dual ever use of alcohol and marijuana was significantly associated with past 30 days use (adjusted odds ratio [AOR] = 2.20; 95% confidence interval [CI] = 1.67–2.91) and former experimental e-cigarette use (AOR = 2.82; 95% CI = 2.23–3.57). Exclusive ever marijuana use was also significantly associated with each outcome, while exclusive ever alcohol use was associated with former experimental e-cigarette use. Exclusive current marijuana use, exclusive current alcohol use, and dual current use of both substances were significantly associated with past 30-day e-cigarette use, but not former experimental e-cigarette use. Conclusions: These findings indicate that young adult dual users of marijuana and alcohol have increased odds of e-cigarette use. In addition, exclusive current and ever marijuana users had the highest odds e-cigarette use, higher than young adult dual users of alcohol and marijuana, indicating that marijuana users may be an important group to target with intervention programs.

Objective: The aim of this review was to identify the pooled effect of chlorhexidine cord application on prevention of neonatal sepsis in developing countries. Methods: We have conducted systemic review and meta-analysis. Articles were searched from electronic databases such as PubMed, EMBASE, CINHAL, Cochrane central register of controlled trials (CENTRAL), and other sources such as direct Google search, Google Scholar, and POPline. Only randomized controlled trial studies were considered for this review. The effect of chlorhexidine cord application on prevention of neonatal sepsis and mortality was assessed as compared to dry cord care. Results: Five studies from developing countries were included in the review with a total of 129,293 participants. Pooled result of meta-analysis showed that chlorhexidine cord application reduces neonatal sepsis by 32% as compared to dry cord care (relative risk [RR] 0.68, 95% confidence interval [CI] 0.57–0.81, random effect model, I2 =93%). It also indicated that chlorhexidine cord application reduces severe sepsis by 77% (RR 0.23, 95% CI 0.11–0.48, random effect model, I2 = 63%) and neonatal mortality reduction by 13 % as compared to dry cord care (RR 0.87, 95% CI 0.79–0.97, random effect model, I2 = 0%). Conclusions: Chlorhexidine cord application significantly reduces neonatal sepsis and mortality in developing countries. Therefore, we stress the importance of including chlorhexidine cord application into the essential newborn care in the setting with high burden of neonatal mortality. The review protocol was registered at PROSPERO with registration number CRD 42018089204.

Understanding the impact of evidence-based practice toward the rehabilitation of patients with knee osteoarthritis (PKOA) is possible with appropriate outcome measures. There is a definite need to summarize the available outcomes with reference to knee OA. This review summarizes the available outcome measures used in the diagnosis, prognosis, and rehabilitation of PKOA. Electronic searches of PubMed, Medline, CINAHL, PsycINFO, Google Scholar, and EBSCO were conducted using terms relating to outcome measures used in the diagnosis, prognosis, and rehabilitation of PKOA. Papers examining the relationship between psychosocial factors and pain and disability outcomes following physiotherapy were included. Two reviewers selected, appraised and extracted studies independently.The searched papers were classified under three classifications, radiological, arthroscopic, and functional knee OA outcome measures. 26 outcome measures used in the diagnosis, prognosis, and rehabilitation of PKOA were identified. Nine outcome measures were included under radiological, four under arthroscopic and remaining 13 under functional classification. Oxford knee score and WOMAC have excellent reliability and good validity among them. In developing countries, still, we use the scales validated and available from the developed countries. This will not reflect the actual treatment effect among PKOA. This review will assist in educating orthopedician, physiotherapist, academician, and researchers on the available in the diagnosis, prognosis, and rehabilitation of PKOA. This review highlight the need for patient-reported outcome measures from the developing countries to document actual treatment effect.

Anencephaly is one of the three major lethal fetal anomalies. Termination of pregnancy is offered for all prenatally diagnosed cases, but some parents choose to continue with pregnancy with full obstetric intervention. I describe the case of a woman who had two pregnancies with anencephalic stillbirths in the third trimester. There is a paucity of well-defined standards of care and management for pregnancies that are carried to the third trimester with this malformation. This case raises important practical questions: Management strategies of recurrent pregnancies with anencephaly, best supportive care during, and after birth and counseling the expectant parents.