Andrographis paniculata is widely regarded as one of the most important medicinal plants due to its broad therapeutic value and global use in traditional medicine. Commonly known as Kalmegh, creat, or green chirayata, the plant has been an integral part of Ayurvedic, Siddha, Unani, and other traditional healing systems for centuries. It has traditionally been consumed to manage a variety of ailments, particularly those related to the liver, respiratory system, and immune health. Phytochemical investigations have revealed that Andrographis paniculata is rich in diverse bioactive constituents. Among these, andrographolide, neoandrographolide, and didehydroandrographolide are the most prominent diterpenoid lactones. Andrographolide, in particular, is recognized as the principal active compound and has been extensively studied for its wide pharmacological spectrum. Research indicates that andrographolide exhibits strong hepatoprotective, antioxidant, anti-inflammatory, immunomodulatory, antibacterial, antipyretic, anti-diabetic, and anti-cancer activities. These properties contribute to the plant’s reputation as a versatile therapeutic agent. In this review, we systematically searched and analyzed articles published in English from 2019 to 2025, using PubMed, ScienceDirect, Springer Link, and Google Scholar. Relevant search terms included “Andrographis paniculata”, pharmacology”, “clinical efficacy”, “safety”, etc. Given its chemical richness and diverse pharmacological actions, Andrographis paniculata continues to attract scientific attention. Numerous studies support its potential in managing chronic diseases, enhancing immune function, and mitigating oxidative stress. This review aims to provide a concise yet comprehensive overview of the plant’s therapeutic relevance, highlighting its major chemical constituents and summarizing key findings from pharmacological evaluations and clinical safety and efficacy reported in the scientific literature. By synthesizing existing knowledge, this review emphasises the significance of Andrographis paniculata as a promising natural resource in herbal medicine and modern pharmacotherapy.
Infertility is recognized as a major global health issue and has become one of the primary challenges in reproductive health; its prevalence and incidence are steadily increasing worldwide. Recent research has highlighted the critical role of epigenetic dysregulation as a direct factor affecting male infertility. The objective of this review is to investigate the relationship between epigenetic modifications (specifically 5-methylcytosine and 5-hydroxymethylcytosine) and essential male reproductive outcomes, including the spermatogenesis process, testicular function, and semen quality parameters. Furthermore, this study explores the influence of micronutrients such as vitamin B12, homocysteine metabolism, and antioxidant capacity on DNA methylation and genomic stability. Significantly, this review establishes a novel link between infertility and cellular hypoxia focusing on the modulation of hypoxia-inducible factor (HIF-1α and HIF-2α) as a potential therapeutic strategy. Additionally, this work introduces the overlooked association between HIF-2α and infertility, offering novel insights since current findings regarding HIF-2α in male infertility are remarkably limited. A literature search was conducted on PubMed, ScienceDirect, Springer Link, Oxford Academic and Nature databases for sources published in English from 2015 to 2025, using the following keywords: male infertility, DNA methylation, hypoxia, HIF-1α, and immunity. Our work investigates the interruption of inflammatory cytokines and immunological markers by linking them with molecular factors, micronutrients and hypoxia pathways. This approach provides an integrated foundation for advanced diagnostic and therapeutic strategies. Ultimately, understanding these molecular signatures provides ways to enhance reproductive outcomes and improve success rates of assisted reproductive techniques.
Background Post-stroke fatigue (PSF) is a multifactorial impairment characterized by persistent tiredness not relieved by rest, and affects nearly half of stroke survivors, leading to poor physical endurance which limits recovery and overall quality of life. Limited evidence suggests that combining cognitive and physical training might help in reducing fatigue. Brain endurance training (BET) involves both cognitive training and physical training, targeting PSF. The study aimed to evaluate the effect of BET on fatigue and physical endurance among stroke survivors. Methods A parallel group pilot randomized controlled trial was carried out in a private setting with 30 stroke survivors. Patients were randomized into two groups. Group A (n=15) received BET and group B (n=15) received conventional physiotherapy. Both groups underwent training for 65 minutes per day, thrice a week for eight weeks. Primary outcomes were Fatigue Severity Scale (FSS) and Six-Minute Walk Test (6MWT). Statistical analysis was performed using the chi-square test and independent t-test. Results At baseline, no significant differences were observed between groups for FSS and 6MWT (p>0.05). The BET group reported better reduction in fatigue (FSS: 5.39 ± 0.18 to 3.48 ± 0.16, p<0.001) and improvement in physical endurance (6MWT: 202.03 ± 4.35 to 273.35 ± 6.26, p<0.001) than the control group (FSS: 5.25 ± 0.10 to 4.19 ± 0.06) (6MWT: 200.53 ± 2.72 to 222.70 ± 3.64). Conclusion Brain endurance training is a feasible and safe approach for reducing fatigue and improving physical endurance among stroke survivors.
Background Dengue infection in children globally shows a significant increasing trend in incidence and remains a heavy public health burden. Dengue infection can progress rapidly to death, especially in children. The neutrophil-to-lymphocyte ratio (NLR) is an inflammatory biomarker that represents an immune response to the disease. This study investigated NLR as a risk factor of dengue infection severity in children. Methods A cross-sectional study was conducted involving 237 children, (110 girls and 127 boys) aged 1-18 years with dengue infection. Patients were categorized into dengue fever (DF) and dengue hemorrhagic fever (DHF) according to WHO 2011 criteria. Demographic characteristics, clinical manifestations, and hematological parameters, including hemoglobin (Hb), leukocyte count, thrombocyte count, hematocrit (HCT), and NLR, were extracted. Bivariate and multivariate logistic regression analysis were used to analyze the data. Results The study demonstrated that 59.9% of cases were classified as DF and 40.1% as DHF, with a mean age of 9.99 ± 4.84 years. The mean NLR was 0.99 ± 0.98 in DHF and 1.51 ± 1.38 in DF. Univariate regression analysis stated that NLR≥2 was associated with dengue severity. However, multivariate regression analysis stated that NLR was not a risk factor of dengue severity, adjusted from demographic characteristics and hematologic parameters. Hemoglobin and platelets are the independent factors of dengue severity. Conclusion Neutrophil-to-lymphocyte ratio is a simple biomarker but not a risk factor of dengue fever severity in children. There is evidence suggesting that the relationship between NLR and dengue fever severity is complex, with varying trends in different phases of the disease.
BACKGROUND Keloids are abnormal scars that present a therapeutic challenge. Various treatment modalities have been developed, including surgical excision. While cross-running intradermal sutures were previously created using absorbable polyglycolic acid, this study introduces a modification using a non-absorbable material. Therefore, this study aimed to evaluate the effect of the cross-running polypropylene intradermal suture (CR-PIS) technique compared to the simple interrupted suture technique on keloid repair. METHODS This was a randomized controlled trial with a post-test-only design involving 30 male and female keloid patients aged 20-50 years. Participants were randomized into the treatment group (n=15) and the control group (n=15). Wound assessment using the Vancouver Scar Scale (VSS), Manchester Scar Scale (MSS), and Patient and Observer Scar Assessment Scale (POSAS) was performed at 3, 6, and 9 months after surgery. Differences in VSS, MSS, and POSAS scores between the CR-PIS group and the simple knot group were analyzed using the Mann-Whitney U test. RESULTS Statistical analysis revealed a significant difference between the simple knot and CR-PIS groups (p<0.05). The median scores for each assessment (VSS, MSS, and POSAS) decreased significantly at 3, 6, and 9 months, with the control group's values being higher than those in the CR-PIS group (p<0.05). These results indicate that the control group developed moderate scars, whereas the treatment group exhibited good scars. CONCLUSIONS The CR-PIS is more effective than the simple knot technique in improving keloid scars, as shown by changes in wound appearance, morphological function, topography, and patient and evaluator assessments.
