Novel Herbal Topical Patch Containing Curcumin and Arnica montana for the Treatment of Osteoarthritis

Analgesic Potential Comparison Between Piperine-Combined Curcumin Patch and Non-Piperine Curcumin Patch: A Pragmatic Trial on Post-Cleft Lip/Palate Surgery Pediatric Patients

Purpose

Despite its well-acknowledged analgesic potential, curcumin's low bioavailability has been recognized. Piperine, a substance naturally contained in pepper, has been known for its effect on increasing curcumin bioavailability. To investigate the analgesic potential of curcumin and piperine addition to curcumin patch used as adjuvant therapy in the management of acute postoperative orofacial pain.

Patients and Methods

This pragmatic trial recruited 75 patients that underwent oromaxillofacial surgery at Unpad Dental Hospital, Bandung, Indonesia. Research participants were randomly assigned to three different groups: the first group that did not receive any intervention other than the post-operative standard treatment (POST), the second group that received POST and non-piperine curcumin patch, and the third group that received POST and piperine-combined curcumin patch. Participants' pain intensity was evaluated by using the face, leg, activity, cry, and consolability (FLACC) pain scale and salivary prostaglandin-E2 (PGE2) level for two-time points, which were eight hours apart. All data were gathered and analyzed to compare the within and between-group differences.

Results

Within groups comparison of the FLACC scores for two evaluation points showed significant differences for all groups (p < 0.01). For salivary PGE2 analysis, a comparison of the non-piperine group to the piperine group also showed significant results. Yet, when all three groups were compared, regardless of the differences, the results were not statistically significant.

Conclusion

Despite of the proven efficacy of curcumin patch, the addition of piperine to the curcumin patch in the current study did not provide any significant effects. Further investigation is of importance.

Effect of Ionic Liquid on Silver-Nanoparticle-Complexed Ganoderma applanatum and Its Topical Film Formulation

Imidazolium-based ionic liquids have been widely utilized as versatile solvents for metal nanoparticle preparation. Silver nanoparticles and Ganoderma applanatum have displayed potent antimicrobial activities. This work aimed to study the effect of 1-butyl-3-methylimidazolium bromide-based ionic liquid on the silver-nanoparticle-complexed G. applanatum and its topical film. The ratio and conditions for preparation were optimized by the design of the experiments. The optimal ratio was silver nanoparticles: G. applanatum extract: ionic liquid at 97:1:2, and the conditions were 80 °C for 1 h. The prediction was corrected with a low percentage error. The optimized formula was loaded into a topical film made of polyvinyl alcohol and Eudragit^®, and its properties were evaluated. The topical film was uniform, smooth, and compact and had other desired characteristics. The topical film was able to control the release of silver-nanoparticle-complexed G. applanatum from the matrix layer. Higuchi's model was used to fit the kinetic of the release. The skin permeability of the silver-nanoparticle-complexed G. applanatum was improved by about 1.7 times by the ionic liquid, which might increase solubility. The produced film is suitable for topical applications and may be utilized in the development of potential future therapeutic agents for the treatment of diseases.

The Efficacy of Curcumin Patch as an Adjuvant Therapeutic Agent in Managing Acute Orofacial Pain on the Post-Cleft Lip and Cleft Palate Surgery Patients: A Pragmatic Trial

OBJECTIVE

 Acute pain is one of the most common pains experienced by post-cleft lip or cleft surgery patients regardless of the administration of analgesic agents. This current study aimed to evaluate the efficacy of a curcumin patch as an adjuvant analgesic agent on the post-cleft lip and cleft palate surgery patients.

MATERIALS AND METHODS

 Fifty-five (33 male; 22 female) participants aged 36 months or less are recruited in this pragmatic trial and randomly assigned to a control group, where no curcumin patch was applied; or the experimental group, where the participants wore a curcumin patch with a dosage of 100mg. All participants (regardless of the group) received a standardized postsurgery analgesic agent immediately after the surgery was completed. A face, leg, activity, cry, and consolability (FLACC) scale was used to evaluate pain levels for three subsequent time points.

STATISTICAL ANALYSIS

 All data were then analyzed by using the Mann-Whitney U test to compare the mean differences between the two groups.

RESULTS

 The results of the current study revealed that there was no significant difference found between the control and the experimental group when mean pain scores were compared for the first evaluation time. Yet, there was a significant difference (p<0.01) between the two groups' mean pain scores on the second evaluation time.

CONCLUSION

 Curcumin patch was found to be effective when used as an adjuvant analgesic agent to reduce acute-orofacial postsurgery pain in cleft lip and cleft surgery patients.

Formulation Development and Pharmaceutical Evaluation of Lysiphyllum strychnifolium Topical Patches for Their Anti-inflammatory Potential

Topical drug delivery systems are interesting and popular dosage forms for formulation development. Thai herbs are used in alternative medicine to treat patients suffering from severe illnesses. They have significant economic and cultural value in Thailand. This work prepared Thai herbal topical patches of Lysiphyllum strychnifolium stem extracts using pectin and Eudragit^® NM 30D, and glycerin as a plasticizer. Astilbin was selected as a chemical marker in L. strychnifolium stem extracts. The L. strychnifolium stem extracts showed a statistically significant decrease in nitrate accumulation. The various properties of Thai herbal topical patches were not significantly different from blank patches. However, the trends of the properties depended on the amount of Eudragit^® NM 30D. All ingredients were homogeneously mixed in Thai herbal topical patches and showed a smooth and compact film. The astilbin content was found in a range of 52.72-63.36 μg/cm². The in vitro release of astilbin depended on the amount of Eudragit^® NM 30D. The kinetics of astilbin release were fitted to the Korsmeyer-Peppas model. The astilbin showed low permeation; thus, polyethylene glycol 400 was used as a permeation enhancer. Polyethylene glycol 400 could increase the permeation rates of astilbin and the cumulative amount of astilbin in pig skin. This would be suitable for preparing the Thai herbal topical patches and could be developed for pharmaceutical and herbal products.

External treatment of herbal medicine with tuina in congenital muscular torticollis: A protocol for systematic review and meta-analysis

BACKGROUND

This study is the protocol to evaluate the clinical evidence for external treatments using herbal medicine (ETHM) with tuina as a congenital muscular treatment (CMT) in pediatrics.

METHODS

Eleven databases will be searched until June 2022, without any language restrictions: four English databases (MEDLINE, Pubmed, EMBASE, and The Cochrane Central Register of Database of Controlled Trials), three Chinese databases (China National Knowledge Infrastructure, Chinese Scientific Journal Database, and Wan Fang Database), and four Korean electronic databases (Oriental Medicine Advanced Searching Integrated System, Korean Studies Information Service System, National Digital Science Links, and Research Information Sharing Service). This review will include randomized clinical trials (RCTs) of ETHM with tuina as an intervention versus the same tuina. All published RCTs for any ETHM for CMT will be included. Non-RCTs, RCT protocol, animal studies, case reports, reviews, and surveys will be excluded. The methodological quality assessment will be performed using the Cochrane risk of bias (ROBs). Review Manager version 5.4. will be used for the data synthesis and quantitative analysis.

RESULTS AND DISCUSSIONS

The systematic review and meta-analysis will provide evidence for ETHM as a treatment of CMT. The evidence can help clinicians and patients recognize more effective therapeutic and safe inventions.

INPLASY REGISTRATION NUMBER

INPLASY202210017.

Microstructure and mechanical properties of subchondral bone are negatively regulated by tramadol in osteoarthritis in mice

Objectives: In the treatment of osteoarthritis (OA), tramadol, a common weak opioid, has become popular due to its effectiveness in inhibition of pain. In the present study, we aimed to explore the effect of tramadol on subchondral bone, especially changes in the microstructure and mechanical properties.

Methods: A mouse model of OA was established in the present study by destabilization of the medial meniscus (DMM). A vehicle or drug was administered for 4 weeks. Specimens were harvested and analyzed radiologically and histologically using micro-computed tomography (micro-CT), scanning electron microscopy (SEM), atomic force microscopy (AFM) and histological staining to evaluate the knee joints of mice undergoing different forms of intervention.

Results: In the early stages of OA induced by DMM, the subchondral bone volume fraction in the OA group was significantly higher than in the sham+vehicle (sham+veh) group, while the volume in the treatment groups was lower than in the DMM+vehicle (DMM+veh) and sham+veh groups. In addition, the elastic moduli in the treatment groups clearly decreased compared with the DMM+veh and sham+veh groups. Observations of the subchondral bone surface by SEM indicated serious destruction, principally manifesting as a decrease in lacunae and more numerous and scattered cracks. Histological staining demonstrated that there was no difference in the degeneration of either the articular cartilage or synovial cells whether tramadol was used or not.

Conclusion: Although tramadol is effective in inhibiting pain in early OA, it negatively regulates the microstructure and mechanical properties of subchondral bone in joints.