The potential therapeutic effect of Carica papaya leaf juice has attracted wide interest from the public and scientists in relieving dengue related manifestations. Currently, there is a lack of evaluated evidence on its juice form. Therefore, this scoping review aims to critically appraise the available scientific evidence related to the efficacy of C. papaya leaf juice in dengue. A systematic search was performed using predetermined keywords on two electronic databases (PubMed and Google Scholar). Searched results were identified, screened and appraised to establish the association between C. papaya and alleviating dengue associated conditions. A total of 28 articles (ethnobotanical information: three, in vitro studies: three, ex vivo studies: one, in vivo study: 13, clinical studies: 10) were included for descriptive analysis, which covered study characteristics, juice preparation/formulations, study outcomes, and toxicity findings. Other than larvicidal activity, this review also reveals two medicinal potentials of C. papaya leaf juice on dengue infection, namely anti-thrombocytopenic and immunomodulatory effects. C. papaya leaf juice has the potential to be a new drug candidate against dengue disease safely and effectively.

The role of Carica papaya L. leaf juice in immune dysregulation caused by dengue virus infection remains unclear. This study aimed to investigate the immunomodulatory activities of the freeze-dried C. papaya leaf juice (FCPLJ) on AG129 mice infected with a clinical DENV-2 (DMOF015) isolate. The infected AG129 mice were orally treated with 500 and 1000 mg/kg/day of FCPLJ, for three days. Platelet, leukocyte, lymphocyte and neutrophil counts were microscopically determined. The level of plasma proinflammatory cytokines was measured by multiplex immunoassay. The levels of intracellular cytokines and viral RNA were determined by RT-qPCR technique. The results showed that the FCPLJ treatment increased the total white blood cell and neutrophil counts in the infected mice. The FCPLJ treatment decreased the level of GM-CSF, GRO-alpha, IL-1 beta, IL-6, MCP-1 and MIP-1 beta in the plasma of the infected mice. The intracellular IL-6 and viral RNA levels in the liver of infected mice were decreased by the FCPLJ treatment. In conclusion, this study supports the potential immunomodulatory role of the FCPLJ in a non-lethal, symptomatic dengue mouse model. Further studies on the action mechanism of the C. papaya leaf juice and its possible use as adjunctive dengue immunotherapy are warranted.

Apium graveolens is an indigenous plant in the family Apiaceae, or Umbelliferae, that contains many active compounds. It has been used traditionally to treat arthritic conditions, gout, and urinary infections. The authors conducted a scoping review to assess the quality of available evidence on the overall effects of celery when treating neurological disorders. A systematic search was performed using predetermined keywords in selected electronic databases. The 26 articles included upon screening consisted of 19 in vivo studies, 1 published clinical trial, 4 in vitro studies and 2 studies comprising both in vivo and in vitro methods. A. graveolens and its bioactive phytoconstituent, 3-n-butylphthalide (NBP), have demonstrated their effect on neurological disorders such as Alzheimer’s disease, Parkinson’s disease, stroke-related neurological complications, depression, diabetes-related neurological complications, and epilepsy. The safety findings were minimal, showing that NBP is safe for up to 18 weeks at 15 mg/kg in animal studies, while there were adverse effects (7%) reported when consuming NBP for 24 weeks at 600 mg daily in human trials. In conclusion, the safety of A. graveolens extract and NBP can be further investigated clinically on different neurological disorders based on their potential role in different targeted pathways.

Background: With rising obesity rates worldwide, clinical trials focused on identifying effective treatments are increasing. While guidelines exist for pharmaceutical drugs targeting obesity, there are none for herbal medicine clinical trials for anti-obesity. Both industries refer to the same guidelines for clinical trials. Objectives: This scoping review aimed to gather information from herbal medicine anti-obesity randomised controlled trials (RCTs), analyse the methodologies and assess their alignment with international guidelines. Eligibility criteria: This review included RCTs of participants of all ages with obesity utilising herbal medicine with any comparators and focusing on various outcome measures. Sources of evidence: Only published journal articles were included. Charting methods: Articles were extracted from MEDLINE, CENTRAL and EMBASE using predetermined keywords. Relevant data, such as the study characteristics, types of herbal interventions and controls, treatment durations, outcome measures and safety monitoring methods were recorded in a table format for comparative analysis. Results: We included 99 RCTs that showed participant sample sizes ranging from 8 to 182, ages 18 to 80 years and body mass indexes (BMIs) between 25 and 49.9 kg/m². Herbal interventions used single herbs ( n = 57) and mixtures ( n = 42), given for 14 days to 56 weeks. Studies implementing diet modifications include restricted calorie diets ( n = 35), food-portion controlled diets ( n = 7) and fixed calorie diets ( n = 7). Of the 28 studies implementing exercise, most were of moderate intensity ( n = 22). All studies collected BMI and weight as primary outcomes. Body fat composition was measured in over 50% of studies using a body analyser ( n = 57). Waist, hip and abdominal circumferences were infrequently measured. Radiological tools used include dual-energy X-ray absorptiometry ( n = 16), computed tomography scans ( n = 10) and ultrasound ( n = 2). Safety monitoring methods were reported in most studies ( n = 76). Conclusion: In conclusion, almost 50% of the studies adhered to international pharmaceutical clinical trial guidelines, addressing dietary, lifestyle, physical activity and cardiovascular risk factors. Nonetheless, more herbal anti-obesity studies need to consider the assessment of weight maintenance.

3-Monochloropropanediol esters (3-MCPDEs) and glycidyl esters (GEs) are food processing contaminants that raise significant food safety concerns due to their established potential for carcinogenicity. This study aimed to determine the occurrence of 3-MCPDEs and GEs in common Malaysian food items and to evaluate the associated health risks through dietary exposure assessment. A total of 251 samples, consisting of retail products and cooked/prepared meals, were analysed using GC-MS. The food consumption data were obtained from published national food surveys. Risk was characterised using health-based guidance values (HBGVs) and margin of exposure (MOE), lifetime cancer risk (LCR), and disability-adjusted life year (DALY) estimates. 3-MCPDE was detected in 94.8% of samples (range: ND to 7.77 mg/kg), while GE was found in 83.3% of samples (range: ND to 9.41 mg/kg). The highest levels were consistently observed in refined vegetable fats and oil products, specifically shortening (3-MCPDE: 3.53 [IQR 2.76–5.16] mg/kg; GE: 4.78 [IQR 3.52–6.14] mg/kg) and margarine (3-MCPDE: 2.50 [IQR 1.11–3.59] mg/kg; GE: 3.60 [IQR 1.18–5.26] mg/kg). Exposure assessment identified fried rice as the largest contributor to total daily intake (3-MCPDE: 3.16 μg/kg BW/day; GE: 1.36 μg/kg BW/day). Total exposure to 3-MCPDE exceeded the provisional maximum tolerable daily intake (PMTDI) established by JECFA by 39.5%, indicating a potential health concern. Low MOE estimates (<10,000) for 3-MCPDE and GE were determined for several food categories, including snacks, kuih-muih, and fried cooked dishes. Chronic GE exposure was estimated to cause up to 6.9 (for mean consumers) and 24.9 (for high consumers) cancer cases per year, with total the DALYs quantified at 124.2 years lost per 100,000 of the population. These data represent a worst-case scenario; however, risks could be minimised through continued surveillance, mitigation strategies by relevant authorities regarding food processing, and informed dietary choices.

Arboviral diseases represent an escalating global health threat, yet therapeutic development has been markedly slower than for other viral illnesses. Key barriers include the unpredictability and variability of arbovirus transmission, which complicate site selection, limit recruitment, and increase delays and the risk of inconclusive trials. Additional challenges include maintaining trial-ready sites, recruitment within the narrow therapeutic window, ensuring rapid diagnostics, and including high-risk groups. To address these barriers, we propose several innovative strategies based on a Clinical Experts meeting convened by the Dengue Alliance. These include pre-activated trial networks for rapid initiation during outbreaks; early-warning surveillance to guide geographic activation using real-time transmission signals; decentralized trial models to expand recruitment beyond major research centers; platform trial designs that allow treatment arms to be added or discontinued adaptively; and participant inclusion based on clinical syndrome supported by rapid diagnostics. Their successful adoption requires regulatory harmonization, ethical oversight, and emphasis on equity.