The immunomodulatory effect of Withania somnifera (WS) extract was tested in healthy adults. In this randomized placebo-controlled double-blinded study, subjects were allocated either 60 mg WS extract or placebo. It consists of a blinded 30-day period and an open-label extension study of another 30 days with crossover of only placebo to test. After the 30-day blinded study period, the WS test group reported significant increase (p < 0.05) in Ig’s (IgA, IgM, IgG, IgG2, IgG3 and IgG4), Cytokines (IFN-γ, IL4), TBNK (CD45+, CD3+, CD4+, CD8+, CD19+, NK cells) whereas in the placebo group TBNK cells showed significant decrease (p < 0.05) and Ig’s and cytokines showed no change (p > 0.05). In the extension period on day 60, the subjects on placebo who were crossed over to the WS test group showed significant increase (p < 0.05) in Ig’s, cytokines and TBNK cells and the subjects who continued on the WS group showed a further significant improvement (p < 0.05) in Ig’s, cytokines and TBNK cells. There were no adverse events reported in the study. WS extract significantly improved the immune profile of healthy subjects by modulating the innate and adaptive immune systems. Boosting the immune system of people at risk of infection and during widespread infections can be targeted with WS extract.

Background: Urinary tract infections (UTIs) are some of the most commonly encountered infections in clinical practice that affects 150 million people each year worldwide. The emergence of resistance, adverse effects of antimicrobial agents, and other related issues have prompted the establishment of a research framework to explore alternative methods for managing UTIs. Cardamom exhibits unique botanical characteristics and biochemical compositions, contributing to their diverse culinary and medicinal applications. Techniques like gas chromatography-mass spectrometry analysis have identified 1,8-cineole and a-terpineol as main bioactive components in both black and green cardamom. Present study addresses urgent, unmet analytical and clinical care needs by exploring adoption of alternative therapies, specifically nutraceuticals viz, 1, 8-cineole and α-terpineol, major bioactive from cardamon for controlling and treating UTIs. Methods: Different concentrations of 1,8-cineole, α-terpineol and 1,8-cineole/α-terpineol (1:1) were used to determine the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) against multi-drug resistant (MDR) E. coli isolated from UTIs. Results: The mean MIC and MBC of 1,8-cineole, α-terpineol and 1,8-cineole/α-terpineol (1:1) for MDR E. coli strains were 7.73 µg/ml, 0.32 µg/ml and 0.32 µg/ml respectively. For non MDR E. coli strains the mean MIC and MBC of the 1, 8-cineole, α-terpineol and 1,8-cineole/α-terpineol (1:1) were 2.14 µg/ml, 0.2 µg/ml and the 0.2 µg/ml respectively. Conclusions: 1,8-cineole and α-terpineol exhibited good antimicrobial activity against urinary E. coli isolates tested, including MDR strains.

Introduction: Asleep deep brain stimulation (DBS) is limited by its reliance on interventional/intraoperative MRI in many cases. A frameless stereotaxy system can be used in combination with optical navigation for initial coarse alignment, followed by a navigational iCT scan to enable asleep DBS in standard operating rooms, aiming to improve accessibility and precision. Methods: This retrospective study analyzed 32 patients (33 procedures) undergoing DBS electrode placement using the SmartFrame OR™ system (ClearPoint Neuro Inc., San Diego, CA). Radial targeting error and operative duration were assessed. Surgical workflows combined O-arm imaging (Medtronic Inc, Minneapolis, MN) and StealthStation™ S8 neuronavigation (Medtronic Inc, Minneapolis, MN, USA). Targets included the ventral intermediate nucleus (VIM), subthalamic nucleus (STN), globus pallidus internus, hippocampus, and thalamic nuclei. Results: Median radial targeting error was 0.40 mm (range: 0–1.6 mm), with bilateral procedures showing marginally lower errors (0.35 mm vs. 0.50 mm unilateral). The VIM exhibited the highest precision (0.35 mm), while STN targeting had slightly higher error (0.53 mm). Median operative time was 189 min (140–275 min), with bilateral procedures requiring longer durations (190 vs. 155 min, p = 0.001). No major complications occurred, and no revisions were needed. Conclusion: The ClearPoint SmartFrame OR™ system achieved submillimeter accuracy and operational efficiency comparable to MRI-guided platforms while eliminating MRI dependency. Its integration with O-arm and Stealth Navigation enhances accessibility, reduces costs, and maintains safety, positioning it as a scalable solution for asleep DBS in standard neurosurgical settings.

Aim: Oral candidiasis is a fungal infection of the oral cavity caused by Candida albicans. Currently used antifungal drugs fail to treat oropharyngeal candidiasis. Herbal remedies are found to be safe and effective to treat bleeding gums, halitosis, mouth ulcers, and reduce tooth decay. Cardamom is known to possess antimicrobial, antioxidant, and immunomodulatory activity. In an in vitro study, we aim to evaluate the antifungal potential of cardamom-based Denteez ^TM mouthwash against opportunistic fungal infections in the oral cavity. Materials and Methods: Five Candida species were included in the study: namely C. albicans, C. tropicalis, C. krusei, C. parapsilosis, and C. glabrata. Additionally, 54 clinical isolates obtained from oral cavity of healthy individuals and patients suffering from oral candidiasis were randomly selected and included. Various antifungal agents tested included fluconazole, itraconazole, ketoconazole, miconazole, and amphotericin B. Minimum inhibitory concentration (MIC) and time-kill assay were performed as per standard guidelines. Results: The MIC obtained for fluconazole against different Candida species was 1.25 µg/ml. The MIC of azole drugs was in the range of 0.312–0.62 µg/ml. The MIC of Denteez ^TM mouthwash was determined as 1.25%. The clinical isolates of Candida showed major resistance to fluconazole (75.9%) and absolute susceptibility to amphotericin B. Denteez ^TM was found effective in inhibiting 98.2% of the clinical isolates. Denteez ^TM mouthwash showed time-dependent inhibition of all Candida species. Conclusion: The mouthwash has comparable efficacy to that of other routinely used antifungal agents. Denteez ^TM can be effectively used to deal with oral candidiasis and antifungal resistance.

Aim: To investigate anti-inflammatory, cytotoxic effects and viability of Recovereez- 51% 1,8-Cineol and 1,8-Cineol (natural), and to determine safety for both of the compounds and its use in new product range of nutraceuticals. Methodology: Cell line was divided into two groups; one was treated with Recovereez(R) and another one with 1,8-Cineol(C). The ELISA assay method was used to measure the COX, LOX, MPO, NO, and nitrate levels. Cellular viability was performed by observing cells under the inverted phase contrast microscope, followed by MTT assay. Results: R&C showed a reduction in levels of inflammatory markers such as IL-6, IL-1β, TNF-α, LOX, MPO, COX, iNOS, and nitrate levels. The inhibition as observed in the levels of COX and LOX enzymes were 65%±0.1 and 59%±0.3µg/ml, and 72%±0.3 and 67%±0.4µg/ml for R&C, respectively. iNOS production showed inhibition by 70%±0.3 and 65%±0.8µg/ml and NO production were reduced by 193 and 209.5µg/ml by R&C, respectively. Again, there was a decrease in the activity of MPO by 0.35 and 0.39U/ml for R&C, respectively. The results were significant with p<0.001 compared to the Diclofenac sodium. Cell viability of 60% was observed upon treating L929 cells with R&C. Conclusion: R&C exerted an anti-inflammatory effect on RAW 264.7 cells without exerting cytotoxicity in a dose-dependent manner. Therefore, Recovereez could be used as an alternative treatment or to prevent inflammatory diseases. Moreover, R&C are expected to treat different types of cancer. The findings could potentially lead to the discovery of safe and effective bioactive compounds that can prevent or cure the occurrence of cancerous cells. Keywords: dietary supplements, nutraceutical, COX, anti-inflammation, cancer

Fibrin-associated large B-cell lymphoma (FA-LBCL) is a rare disorder, but its role in transcatheter valve failure is unknown. This report describes the first documented case of FA-LBCL in a transcatheter aortic valve. A 62-year-old man with a prior transcatheter aortic valve replacement presented with symptomatic severe aortic stenosis. Histopathologic analysis of the explanted valve revealed FA-LBCL as the primary cause of valve failure. This case established a neoplastic process as a cause of structural valve degeneration (SVD) in transcatheter valves. It highlights that FA-LBCL should be included in the differential diagnosis of transcatheter aortic valve replacement failure, for which surgical explantation can be both diagnostic and curative. This is the first report that documents FA-LBCL causing SVD of a transcatheter bioprosthetic valve. FA-LBCL represents a cause of SVD in transcatheter bioprosthetic valves. This diagnosis should be considered in cases of premature valve failure.