National Institute of Siddha

INTRODUCTION:Photodynamic therapy (PDT) is increasingly recognized worldwide as a major therapeutic modality for the management of cancer and infectious diseases. The success of PDT largely depends on the design and performance of photosensitizers (PSs) capable of generating reactive oxygen species (ROS) upon light activation. However, traditional PSs face challenges such as poor solubility, limited tissue penetration, non-specific accumulation, and phototoxicity. The objective of this study is to provide an updated synthesis of advancements in this evolving field; therefore, a narrative review was conducted. METHODS:An extensive literature search was conducted using electronic databases including PubMed, Scopus, Web of Science, and Google Scholar up to March 2024. Keywords such as "photodynamic therapy", "photosensitizers", "nanoparticles", "ROS", and "theranostics" were used to identify relevant literature, with emphasis on original research articles, reviews, and clinical studies. RESULTS:This review highlights the evolution of photosensitizer systems, encompassing both natural and synthetic derivatives, and discusses how nanoparticle (NP)-based strategies such as up-conversion nanoparticles (UCNPs), lipid-based carriers, and polymeric systems have enhanced the therapeutic selectivity, ROS production, and tissue targeting of PDT. Particular attention is given to theranostic applications, combining imaging and therapy within a single platform. Furthermore, emerging clinical trials investigating PDT applications in cutaneous T-cell lymphoma, pancreatic cancer, systemic sclerosis, and head and neck cancers are summarized, illustrating the expanding translational potential of these technologies. DISCUSSION:These advances show a clear transition from a localized cytotoxic modality in PDT towards a precision nanomedicine modality. Using multifunctional nanocarriers in combination with optimized photosensitizers improves treatment efficacy and reduces off-target damage. Real-time monitoring of treatment and personalization is also made possible by the emergence of theranostic platforms. Collectively, current clinical studies indicate that PDT will be an increasingly flexible and translational approach across diverse disease settings. CONCLUSION:This review paper focuses on PDT with different classes of PSs, with a particular emphasis on nano-based applications at both therapeutic and diagnostic levels.

Background: Obstetric brachial plexus injury (OBPI) is a peripheral nerve injury occurring during childbirth, most commonly involving the upper trunk (C5–C6) and presenting as Erb's palsy. Although early physiotherapy is the standard management, persistent motor deficits may remain in some children. Case Presentation: Two children with right-sided Erb's palsy following forceps-assisted delivery presented with reduced shoulder abduction, elbow flexion, and sensory deficits over the lateral arm. Baseline muscle power ranged from Medical Research Council (MRC) grade 2/5 to 3/5. Intervention: Both children received integrative Siddha-based rehabilitation including Siddha regimen along with external therapies such as Varmam stimulation, Thokkanam, and Navarakizhi over a structured treatment period. Outcome: At 3-month follow-up, muscle strength improved to MRC grade 4/5 in affected muscle groups, with restoration of sensation and enhanced functional limb use. No adverse events were observed during treatment. Conclusion: These cases suggest that integrative Siddha-based rehabilitation may contribute to functional recovery in paediatric Erb's palsy. Larger controlled studies are warranted to establish efficacy.

Moolam (Grade I–III internal hemorrhoids) remains prone to recurrence after conventional treatment, highlighting the need for effective traditional therapies. Therefore, it is of interest to evaluate the Nilavagai Chooranam in 30 patients treated with 1.375 g twice daily for 48 days (CTRI/2024/04/066321). Clinical assessment showed a significant reduction in HSS scores from 8.43 ± 1.55 to 3.13 ± 1.38 (p < 0.001). All moderate and severe cases improved to mild severity and proctoscopy showed reduction in pile mass in all participants. Thus, data show the clinical evidence that Nilavagai Chooranam is associated with significant reductions in Hemorrhoid Symptom Severity (HSS) scores and pile mass in patients with Grade I–III internal hemorrhoids, supporting its potential as a Siddha therapeutic intervention warranting further evaluation in randomized controlled trials.

Introduction: Hepatocellular carcinoma (HCC) is the fourth leading cause of cancer-related deaths worldwide, with a five-year survival rate of only 19%. Although Sorafenib is the primary systemic therapy, its limited efficacy and complex interactions with signaling pathways highlight the need for multi-target drugs. Methods: This study evaluates the anti-cancer properties of selected phytochemicals against six key HCC target proteins, utilizing sorafenib tosylate as a positive control. Molecular docking was performed to evaluate binding affinities and interactions, and ADME/T predictions were generated to estimate drug-like properties. The topranking candidates were further evaluated using 100-ns molecular dynamics simulations to analyze conformational stability, protein-ligand interactions, and residue mobility. Results: Silymarin (SA) emerged as the most effective compound, demonstrating greater predicted inhibitory activity than Sorafenib. SA showed high binding affinity for target proteins 6HH1 (−9.9 kcal/mol) and 1CM8 (−9.6 kcal/mol). Molecular dynamics simulations also revealed increased stability of the SA-protein complexes, particularly for the 1CM8-SA complex, which maintained high conformational stability. The root-mean-square deviation (RMSD) value was found to be around 2.1 Å, and the root-mean-square fluctuation (RMSF) values were below 3 Å, indicating lower protein flexibility compared to both the native and sorafenib-bound complexes. Conclusion: These computational findings provide a strong theoretical basis for Silymarin’s efficacy as a highly potent, multi-targeted therapeutic agent against HCC. The improved stability and binding properties of Silymarin compared with Sorafenib provide a strong rationale for advancing this compound into preclinical and clinical studies.

INTRODUCTION:The Siddha formulation Gandhaga Rasayanam (GRM) is a classical polyherbo-mineral medicine containing purified sulphur and other herbal ingredients, including Schedule E(1) drugs. It is traditionally used to manage chronic ailments and dermatological conditions. Limited safety data have been documented for Siddha medicines; this report highlights a suspected adverse cutaneous reaction probably associated with GRM. CASE SUMMARY:A 36-year-old female treated for residual Padarthamarai (Tinea cruris) developed elevated plaque with ill-defined, diffuse borders over the neck and upper back on Day 3 of therapy with GRM in combination with other Siddha medicines. This lesion was inflamed, warm to the touch, and associated with pruritus, itching, and burning. The lesions subsided markedly upon GRM withdrawal and resolved completely after a short course of levocetirizine. The patient was advised to resume other internal medicines, excluding GRM, the most suspected drug, and no recurrence was observed. This implicates GRM as the probable cause of the adverse reaction. CONCLUSION:This case highlights the potential for adverse reactions even with traditionally regarded safe Ayush formulations and emphasizes the need for vigilant pharmacovigilance and systematic documentation of adverse events to ensure patient safety.