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Mashayekhi-Sardoo H, Sepahi S, Baradaran Rahimi V, Askari VR. Application of Nigella sativa as a functional food in diabetes and related complications: Insights on molecular, cellular, and metabolic effects. J Funct Foods 2024; 122:106518. [DOI: 10.1016/j.jff.2024.106518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2025] Open
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Akash SR, Tabassum A, Aditee LM, Rahman A, Hossain MI, Hannan MA, Uddin MJ. Pharmacological insight of rutin as a potential candidate against peptic ulcer. Biomed Pharmacother 2024; 177:116961. [PMID: 38901206 DOI: 10.1016/j.biopha.2024.116961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 06/11/2024] [Accepted: 06/15/2024] [Indexed: 06/22/2024] Open
Abstract
Peptic ulcer is a sore on the stomach lining that results from the erosion of the gastrointestinal tract mucosa due to various influencing factors. Of these, Helicobacter pylori infection and non-steroidal anti-inflammatory drugs (NSAIDs) stand out as the most prominent causes. This condition poses a significant global health concern due to its widespread impact on individuals worldwide. While various treatment strategies have been employed, including proton pump inhibitors and histamine-2 receptor antagonists, these have notable side effects and limitations. Thus, there is a pressing need for new treatments to address this global health issue. Rutin, a natural flavonoid, exhibits a range of biological activities, including anti-inflammatory, anticancer, and antioxidant properties. This review explores the potential anti-ulcer effect of rutin in experimental models and how rutin can be a better alternative for treating peptic ulcers. We used published literature from different online databases such as PubMed, Google Scholar, and Scopus. This work highlights the abundance of rutin in various natural sources and its potential as a promising option for peptic ulcer treatment. Notably, the anti-inflammatory properties of rutin, which involve inhibiting inflammatory mediators and the COX-2 enzyme, are emphasized. While acknowledging the potential of rutin, it is important to underscore the necessity for further research to fully delineate its therapeutic potential and clinical applicability in managing peptic ulcers and ultimately improving patient outcomes. This review on the anti-ulcer potential of rutin opened a new door for further study in the field of alternative medicine in peptic ulcer management.
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Affiliation(s)
- Sajidur Rahman Akash
- Department of Pharmacy, Bangladesh University, Dhaka 1207, Bangladesh; ABEx Bio-Research Center, East Azampur, Dhaka 1230, Bangladesh
| | - Afrida Tabassum
- Department of Genetic Engineering and Biotechnology, Jagannath University, Dhaka 1100, Bangladesh
| | - Lamisa Manha Aditee
- Department of Mathematics and Natural Sciences (MNS), BRAC University, Dhaka 1212, Bangladesh
| | - Abidur Rahman
- Sir Salimullah Medical College Mitford Hospital, Dhaka 1100, Bangladesh
| | - Md Imran Hossain
- Department of Pathobiological Sciences, Louisiana State University, Baton Rouge, LA 70803, USA
| | - Md Abdul Hannan
- Department of Biochemistry and Molecular Biology, Bangladesh Agricultural University, Mymensingh 2200, Bangladesh
| | - Md Jamal Uddin
- ABEx Bio-Research Center, East Azampur, Dhaka 1230, Bangladesh.
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Saleem M, Mazhar Fareed M, Salman Akbar Saani M, Shityakov S. Network pharmacology and multitarget analysis of Nigella sativa in the management of diabetes and obesity: a computational study. J Biomol Struct Dyn 2024; 42:4800-4816. [PMID: 37350443 DOI: 10.1080/07391102.2023.2222837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 06/02/2023] [Indexed: 06/24/2023]
Abstract
Obesity and diabetes are commonly associated with one another and represent a significant global health issue, with a recent surge in disease incidence. Nigella sativa, also known as black cumin, is believed to possess several health benefits, including anti-diabetic, anticancer, antioxidant, antimicrobial, and anti-obesity properties. In this study, we aimed to identify the active compounds derived from N. sativa, which can potentially inhibit key protein targets and signaling pathways associated with diabesity treatment. We employed an exhaustive in silico search, which led to the identification of 22 potential compounds. Out of these, only five hits were found to be non-toxic, including Arabic and ascorbic acids, dihydrocodeine, catechin, and kaempferol. Our analysis revealed that these hits were associated with genes such as AKT1, IL6, SRC, and EGFR. Finally, we conducted molecular docking and molecular dynamics simulations, which identified kaempferol as the best binder for AKT1 in comparison to the reference molecule. Overall, our in silico integrated pipeline provides a useful approach to identify non-toxic phytocompounds as promising drug candidates to treat diabetes and obesity.Communicated by Ramaswamy H. Sarma.
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Affiliation(s)
- Muntaha Saleem
- Department of Bioinformatics and Biotechnology, Government College University, Faisalabad, Pakistan
| | - Muhammad Mazhar Fareed
- Department of Computer Science, School of Science and Engineering, Università degli studi di Verona, Verona, Italy
- Department of Biotechnology, Applied Bioinformatics Group, Università degli studi di Verona, Verona, Italy
| | | | - Sergey Shityakov
- Laboratory of Chemoinformatics, Infochemistry Scientific Center, ITMO University, Saint-Petersburg, Russian Federation
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Alyami HH, Al-Hariri MT. Synergistic Effects of Nigella sativa and Exercise on Diabetic Profiles: A Systematic Review. Diabetes Ther 2023; 14:467-478. [PMID: 36645572 PMCID: PMC9841958 DOI: 10.1007/s13300-022-01362-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 12/23/2022] [Indexed: 01/17/2023] Open
Abstract
Individually, Nigella sativa (NS) and physical training interventions have been shown to be effective preventive and therapeutic strategies for diabetes mellitus. However, the effect of these in combination on bioindicators of diabetes has not yet been evaluated; there is little information available in the literature. A systematic review was therefore performed to assess any mutually potentiating impacts of NS and physical training interventions in diabetic subjects. A search was performed on this topic in the PubMed, CINAHL, Google Scholar and Web of Science databases for randomised, quasi-randomised or non-randomised controlled trials, studies with factorial or single-cohort pre-post designs, case series as well as case reports. The search terms encompassed various combinations of the following: "exercise", "training", "physical activity", "NS", "treadmill", "swimming", "Thymoquinone", "Nigellone", "caraway oil" and "black seeds". Two reviewers screened the abstracts of 202 identified publications according to predetermined inclusion criteria-i.e. papers published from 2009 onwards in the English language, studies on human or animal subjects, and the assessment of diabetic bioindicators following the combined administration of NS and exercise regimens in comparison with just one of these interventions or against controls. Despite the rich data available regarding the effect of both interventions separately, two human studies and two animal studies were ultimately included in the review. However, the benefit of combined administration of NS and exercise regimens on glycemic and lipidemic control was much more obvious compared to exercise alone. In conclusion, these findings suggested that combined administration of NS and exercise regimens could be used as an effective adjuvant for oral antidiabetic drugs in diabetes control.
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Affiliation(s)
- Hiedar H Alyami
- Department of Physiology, College of Medicine, Imam Abdulrahman Bin Faisal University, P.O. Box 2114, Dammam, 31541, Saudi Arabia.
| | - Mohammed T Al-Hariri
- Department of Physiology, College of Medicine, Imam Abdulrahman Bin Faisal University, P.O. Box 2114, Dammam, 31541, Saudi Arabia
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Mahomoodally MF, Aumeeruddy MZ, Legoabe LJ, Montesano D, Zengin G. Nigella sativa L. and Its Active Compound Thymoquinone in the Clinical Management of Diabetes: A Systematic Review. Int J Mol Sci 2022; 23:12111. [PMID: 36292966 PMCID: PMC9602931 DOI: 10.3390/ijms232012111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 10/05/2022] [Accepted: 10/07/2022] [Indexed: 11/16/2022] Open
Abstract
Despite existing conventional hypoglycemic drugs to manage diabetes, their non-availability and cost in low-income countries coupled with the associated side effects remain a major concern. Consequently, exploring for alternative treatments to manage diabetes has been a continuous priority. Nigella sativa L. (NS) (Family: Ranunculaceae) is regarded as a valuable traditional remedy in diabetes management and extensively studied for its biological properties. This systematic review provides a comprehensive and critical analysis of clinical studies on the efficacy, safety, and mechanism of action of NS and its compound thymoquinone (TQ) in diabetes management. The main scientific databases which were scrutinised were Scopus, PubMed, Google Scholar, and Web of Science. Data search was conducted from inception to January 2022. A total of 17 clinical studies were obtained; 16 studies on Nigella sativa L. and 1 study on its compound TQ. N. sativa was found to be highly potent in terms of its hypoglycemic activity when compared to placebo based on improvement in parameters including fasting blood glucose (FBG), postprandial blood glucose (PPBG), Hemoglobin A1C (HbA1c), homeostatic model assessment for insulin resistance (HOMA-IR), and homeostatic model assessment for assessment of beta-cell functionality (HOMA-β). The compound TQ in combination with a daily dose of metformin demonstrated a greater reduction in the levels of HbA1c and blood glucose compared to metformin alone. The bioavailability of TQ can be enhanced by using nanoparticulate drug delivery systems. Considering the findings of the clinical studies along with negligible adverse effects, NS has strong potential application in bioproduct development for the management of diabetes. Further investigations should explore the detailed mechanism of actions by which TQ exerts its therapeutic antidiabetic effects to provide more insights into its clinical use in the management of diabetes.
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Affiliation(s)
- Mohamad Fawzi Mahomoodally
- Institute of Research and Development, Duy Tan University, Da Nang 550000, Vietnam
- Faculty of Natural Sciences, Duy Tan University, Da Nang 550000, Vietnam
| | | | - Lesetja J. Legoabe
- Centre of Excellence for Pharmaceutical Sciences (Pharmacen), North-West University, Mmabatho 2735, South Africa
| | - Domenico Montesano
- Department of Pharmacy, University of Naples Federico II, Via D. Montesano 49, 80131 Naples, Italy
| | - Gokhan Zengin
- Department of Biology, Faculty of Science, Selcuk University, 42250 Konya, Turkey
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Saadati S, Naseri K, Asbaghi O, Abhari K, Zhang P, Li HB, Gan RY. Nigella sativa supplementation improves cardiometabolic indicators in population with prediabetes and type 2 diabetes mellitus: A systematic review and meta-analysis of randomized controlled trials. Front Nutr 2022; 9:977756. [PMID: 36034891 PMCID: PMC9403837 DOI: 10.3389/fnut.2022.977756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 07/25/2022] [Indexed: 11/13/2022] Open
Abstract
Objective Nigella sativa (N. sativa) from the family Ranunculaceae has medicinal properties. Previous studies have reported promising findings showing that N. sativa may benefit cardiometabolic health; however, current evidence on its cardiometabolic effects on those with prediabetes and type 2 diabetes mellitus (T2DM) is still unclear. Hence, we conducted a systematic review and meta-analysis to assess the efficacy of N. sativa on cardiometabolic parameters in population with prediabetes and T2DM. Methods PubMed/Medline, ISI Web of Science, Scopus, and Cochrane library were systematically searched up to June 20, 2022. Meta-analyses using random-effects models were used. Results Eleven randomized controlled trials (RCTs) were included in the meta-analysis. N. sativa intervention resulted in significant changes in fasting plasma glucose (FPG), hemoglobin A1c (HbA1c), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), c-reactive protein (CRP), and malondialdehyde (MDA), without overall changes in glucose levels after oral glucose tolerance test (OGTT), fasting insulin, homeostatic model assessment of insulin resistance (HOMA-IR), triglyceride, high-density lipoprotein cholesterol (HDL-C), and body mass index (BMI) when compared with the control group. In subgroup analyses, N. sativa supplementation enhanced serum levels of HDL-C in subjects with baseline HDL-C lower than 40 mg/dL. Furthermore, HOMA-IR and BMI values decreased in the N. sativa-supplemented group compared with the control group, when the length of follow-up was more than 8 weeks and the dose was more than 1 g/day for N. sativa supplementation, respectively. Conclusion Our findings indicate that N. sativa supplementation may effectively improve cardiometabolic profiles in individuals with prediabetes and T2DM.
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Affiliation(s)
- Saeede Saadati
- Department of Medicine, School of Clinical Sciences, Monash University, Melbourne, VIC, Australia
| | - Kaveh Naseri
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Omid Asbaghi
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Khadijeh Abhari
- Department of Food Science and Technology, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Pangzhen Zhang
- School of Agriculture and Food, Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Parkville, VIC, Australia
| | - Hua-Bin Li
- Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Ren-You Gan
- Research Center for Plants and Human Health, Institute of Urban Agriculture, National Agricultural Science and Technology Center, Chinese Academy of Agricultural Sciences, Chengdu, China
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Zhao J, Huang Y, Yu X. Effects of nutritional supplement and resistance training for sarcopenia in patients with inflammatory bowel disease: A randomized controlled trial. Medicine (Baltimore) 2022; 101:e30386. [PMID: 36042627 PMCID: PMC9410600 DOI: 10.1097/md.0000000000030386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Nutritional supplementation and resistance training are broadly recommended as part of the treatment of sarcopenia, but studies that have evaluated interventions in inflammatory bowel disease patients with sarcopenia are lacking. The aim of this study was to evaluate the effects of nutritional supplementation and resistance training for improving height-adjusted appendicular skeletal muscle mass (ASM/H2) and medical indices in patients with inflammatory bowel disease. METHODS This randomized, double-blind, placebo-controlled trial of forty-five participants was performed at Huadong Hospital Affiliated to Fudan University in Shanghai from September 2020 to June 2021. Eligible participants were randomly assigned to receive whey protein (10 g/d) or placebo (10 g/d) for 8 weeks while completing a resistance training program (3 times a week). Data such as ASM/H2 and other medical indices were collected at baseline and at 4 and 8 weeks of intervention. RESULTS Fifteen participants were allocated to the resistance training and whey protein (RT+WP) group, and thirteen participants were allocated to the resistance training and placebo (RT+placebo) group. The ASM/H2 significantly increased in the RT+WP group after 4 and 8 weeks of intervention, and the ASM/H2 of the RT+WP group was significantly higher than that of the RT+placebo group after 4 and 8 weeks of intervention (F = 1.092, P = .035). Both interventions significantly increased albumin (F = 7.214, P = .003). Hemoglobin and creatinine significantly increased in the RT+WP group (F = 3.592, P = .035; F = 3.922, P = .033, respectively). In addition, a significant group × time interaction was not observed for body mass index, 5-time chair stand test time, 3-metre walk speed, grip strength, waist circumference, hip circumference, or waist-to-hip ratio (P > .05). CONCLUSIONS Nutritional supplementation may be effective in improving sarcopenia, as well as many other physiological indicators during resistance training.
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Affiliation(s)
- Jiaxi Zhao
- Department of Gastroenterology, Huadong Hospital Affiliated to Fudan University, Shanghai, People’s Republic of China
| | - Yiqin Huang
- Department of Gastroenterology, Huadong Hospital Affiliated to Fudan University, Shanghai, People’s Republic of China
| | - Xiaofeng Yu
- Department of Gastroenterology, Huadong Hospital Affiliated to Fudan University, Shanghai, People’s Republic of China
- *Correspondence: Xiaofeng Yu, 221 Yan’an West Road, Jing’an District, Shanghai, People’s Republic of China (e-mail: )
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Chattopadhyay K, Wang H, Kaur J, Nalbant G, Almaqhawi A, Kundakci B, Panniyammakal J, Heinrich M, Lewis SA, Greenfield SM, Tandon N, Biswas TK, Kinra S, Leonardi-Bee J. Effectiveness and Safety of Ayurvedic Medicines in Type 2 Diabetes Mellitus Management: A Systematic Review and Meta-Analysis. Front Pharmacol 2022; 13:821810. [PMID: 35754481 PMCID: PMC9213670 DOI: 10.3389/fphar.2022.821810] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 04/07/2022] [Indexed: 11/21/2022] Open
Abstract
Introduction: Many Ayurvedic medicines have the potential for managing type 2 diabetes mellitus (T2DM), with previous systematic reviews demonstrating effectiveness and safety for specific Ayurvedic medicines. However, many of the reviews need updating and none provide a comprehensive summary of all the Ayurvedic medicines evaluated for managing T2DM. Objective: The objective of this systematic review was to evaluate and synthesize evidence on the effectiveness and safety of Ayurvedic medicines for managing T2DM. Inclusion criteria: Published and unpublished RCTs assessing the effectiveness and safety of Ayurvedic medicines for managing T2DM in adults. Methods: The JBI systematic review methodology was followed. A comprehensive search of sources (including 18 electronic databases) from inception to 16 January 2021 was made. No language restrictions were applied. Data synthesis was conducted using narrative synthesis and random effects meta-analyses, where appropriate. Pooled results are reported as mean differences (MD) with 95% confidence intervals (CI). Results: Out of 32,519 records identified from the searches, 219 articles were included in the systematic review representing 199 RCTs (21,191 participants) of 98 Ayurvedic medicines. Overall, in the studies reviewed the methodology was not adequately reported, resulting in poorer methodological quality scoring. Glycated hemoglobin (HbA1c) was reduced using Aegle marmelos (L.) Corrêa (MD -1.6%; 95% CI -3 to -0.3), Boswellia serrata Roxb. (-0.5; -0.7 to -0.4), Gynostemma pentaphyllum (Thunb.) Makino (-1; -1.5 to -0.6), Momordica charantia L. (-0.3; -0.4 to -0.1), Nigella sativa L. (-0.4; -0.6 to -0.1), Plantago ovata Forssk. (-0.9; -1.4 to -0.3), Tinospora cordifolia (Willd.) Hook.f. and Thomson (-0.5; -0.6 to -0.5), Trigonella foenum-graecum L. (-0.6; -0.9 to -0.4), and Urtica dioica L. (-1.3; -2.4 to -0.2) compared to control. Similarly, fasting blood glucose (FBG) was reduced by 4-56 mg/dl for a range of Ayurvedic medicines. Very few studies assessed health-related quality of life (HRQoL). Adverse events were not reported in many studies, and if reported, these were mostly none to mild and predominately related to the gastrointestinal tract. Conclusion: The current evidence suggests the benefit of a range of Ayurvedic medicines in improving glycemic control in T2DM patients. Given the limitations of the available evidence and to strengthen the evidence base, high-quality RCTs should be conducted and reported.
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Affiliation(s)
- Kaushik Chattopadhyay
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom
- The Nottingham Centre for Evidence-Based Healthcare: A JBI Centre of Excellence, Nottingham, United Kingdom
| | - Haiquan Wang
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Jaspreet Kaur
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Gamze Nalbant
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Abdullah Almaqhawi
- Department of Family and Community Medicine, College of Medicine, King Faisal University, Alahsa, Saudi Arabia
| | - Burak Kundakci
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Jeemon Panniyammakal
- Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India
| | - Michael Heinrich
- Centre for Pharmacognosy and Phytotherapy, School of Pharmacy, University College London, London, United Kingdom
| | - Sarah Anne Lewis
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | | | - Nikhil Tandon
- Department of Endocrinology, Metabolism and Diabetes, All India Institute of Medical Sciences, New Delhi, India
| | - Tuhin Kanti Biswas
- Department of Kayachikitsa, J B Roy State Ayurvedic Medical College and Hospital, Kolkata, India
| | - Sanjay Kinra
- Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Jo Leonardi-Bee
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom
- The Nottingham Centre for Evidence-Based Healthcare: A JBI Centre of Excellence, Nottingham, United Kingdom
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Maideen NMP. Antidiabetic Activity of Nigella Sativa (Black Seeds) and Its Active Constituent (Thymoquinone): A Review of Human and Experimental Animal Studies. Chonnam Med J 2021; 57:169-175. [PMID: 34621636 PMCID: PMC8485088 DOI: 10.4068/cmj.2021.57.3.169] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 07/26/2021] [Accepted: 07/27/2021] [Indexed: 01/23/2023] Open
Abstract
The use of herbal medicine to manage chronic conditions including diabetes has become a recent global trend. Diabetes mellitus (DM) is a group of metabolic disorders characterized by hyperglycemia. The present review is aimed to analyze the antidiabetic activity of N. sativa as many type 2 diabetic patients use it as a complementary therapy along with their modern allopathic medications or as an alternative therapy. The literature was reviewed in databases like Medline/PubMed Central/PubMed, Google Scholar, Science Direct, EBSCO, Scopus, Web of science, EMBASE, Directory of open access journals (DOAJ), and reference lists to identify relevant articles supporting the use of N. sativa in diabetes management. Numerous clinical and animal studies have demonstrated the antidiabetic efficacy of black seeds (N. sativa) and its major bioactive constituent thymoquinone. Based on these findings patients with diabetes may use N. sativa as an adjuvant therapy, which may help to reduce the dose and incidence of adverse effects of modern antidiabetic medicines.
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