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Table of Contents
REVIEW ARTICLE
Year : 2020  |  Volume : 8  |  Issue : 2  |  Page : 84-90

Epidemic containment measures in Unani medicine and their contemporary relevance


1 Department of Tahaffuzi wa Samaji Tib, National Institute of Unani Medicine, Bengaluru, Karnataka, India
2 Department of Kulliyat, National Institute of Unani Medicine, Bengaluru, Karnataka, India

Date of Submission01-Jun-2020
Date of Decision25-Jun-2020
Date of Acceptance02-Jul-2020
Date of Web Publication07-Sep-2020

Correspondence Address:
Dr. Malik Itrat
Department of Tahaffuzi wa Samaji Tib, National Institute of Unani Medicine, Kottigepalya, Magadi Main Road, Bengaluru, Karnataka.
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/JISM.JISM_53_20

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  Abstract 

Background and Objective: Nonavailability of clinically proven prophylaxis and specific drug against the coronavirus disease-2019 (COVID-19) turned the world’s attention toward finding ways to strengthen the host defense. Unani scholars fully understand and consider the host as a key determinant in disease dynamics and laid emphasis on host defense strengthening as an important disease prevention strategy. Hence, this article aimed to provide an overview of the epidemic containment measures described in Unani classical texts and their relevance in the current outbreak. Materials and Methods: A manual literature survey of classical Unani texts was conducted to collect the information on the measures suggested for epidemic containment. In addition, electronic databases such as PubMed, Google Scholar, and Science Direct were searched to identify researches conducted on Unani drugs listed in the article as well as to obtain recent information about COVID-19 outbreak. The keywords used were “Unani Medicine,” “Epidemic,” “Immunomodulator,” “Antiviral,” “Antimicrobial,” “Prevention,” and “COVID-19.”Results: The literature review shows that Unani scholars have given an elaborate description of the epidemic including its definition, etiological factors, susceptible host, clinical presentation of infected individuals, and the containment measures. Described measures can be broadly classified into cause-centric and host-centric depending on their application-at environment and individual level, respectively. Cause-centric measures are aimed to eliminate the causative agent present in the environment and host-centric measures are aimed to strengthen the host defense. Conclusion: Epidemic containment measures described in classical Unani treatises seem to be of much relevance in today’s context. These measures have been considered useful in reducing the risk of contracting the infection during epidemics. Hence, in our opinion, it is worth assessing them in the current outbreak.

Keywords: COVID-19, epidemic, host defense, immunomodulator, Unani medicine


How to cite this article:
Itrat M, Khan TN, Riaz Z, Zulkifle M. Epidemic containment measures in Unani medicine and their contemporary relevance. J Indian Sys Medicine 2020;8:84-90

How to cite this URL:
Itrat M, Khan TN, Riaz Z, Zulkifle M. Epidemic containment measures in Unani medicine and their contemporary relevance. J Indian Sys Medicine [serial online] 2020 [cited 2020 Oct 26];8:84-90. Available from: https://www.joinsysmed.com/text.asp?2020/8/2/84/294436




  Introduction Top


The ongoing pandemic of COVID-19 (coronavirus disease-2019) has challenged the health-care systems across the globe. The current epidemic came to world attention in December 2019 in Wuhan, China.[1] Initially, a provisional name was given to this virus as 2019-novel coronavirus (2019-nCoV).[2] Later on, due to nucleotide identity up to a large extent with SARS-CoV, this new virus is named as SARS-CoV-2 and the disease caused by it referred to as COVID-19.[3] The World Health Organization (WHO) declared this disease as pandemic on March 11, 2020.[4] Evidence indicates that disease is transmitted from human to human through droplets and direct contact.[5] It is reported that the virus may be found in aerosols for at least up to 3h; hence, the aerosol transmission is also possible in case of exposure to elevated aerosol concentrations in closed spaces.[6] The mean incubation period of this disease is 5 days, ranging from 1 to 14 days and the mean reproduction number (R0) is estimated to be ranged from 2.20 to 3.58.[5] The clinical picture in humans infected with SARS-CoV-2 has ranged from asymptomatic stage to severe signs and symptoms including death. The main symptoms include low-grade fever, fatigue, dry cough, myalgia, and dyspnea.[7]

Overall estimated mortality of COVID-19 for the infected population is 0.25%–3.0%, whereas it increases to >14% in old-age group, 8%–10% in associated comorbidities such as cardiovascular diseases, hypertension, and diabetes.[8] As of this writing, globally, the current number of cases is 97, 55, 196 along with 4,92,685 deaths.[9] In India, the total numbers of reported cases are 4, 90,401 among them 1,89,463 are active cases, with 15,301 deaths.[10] Real-time statistics on COVID-19 disease are available online on various government platforms.

Despite worldwide efforts to contain it, the pandemic is continuing due to lack of clinically proven prophylaxis and therapeutic strategy.[11] This turned the world’s attention toward strengthening the body’s defense force against disease-causing agents.[12] It provides an opportunity to revisit the wisdom of traditional systems of medicine for addressing the challenge of COVID-19 pandemic through improved immunity in combination with the proposed advisories by government authorities for hand hygiene, respiratory hygiene, physical distancing, and use of personal protective equipments. Consequently, it becomes logical to explore the literature of Unani systems of medicine for the understanding of the epidemic and the potential of this system in addressing this challenge. Hence, the authors have attempted to highlight the knowledge and practices of Unani medicine in the context of epidemic diseases that might be assessed as prophylactic measures in the present scenario.


  Materials and Methods Top


A manual literature survey of classical Unani texts was conducted to collect the information available on epidemics and the measures suggested for its containment. In addition, a comprehensive search of electronic databases, such as PubMed, Google Scholar, and Science Direct, was carried out to identify experimental and clinical studies conducted on drugs mentioned in literature as well as to obtain the recent information about COVID-19 outbreak. For electronic databases search, medical subject headings (MeSH) and other relevant terms to the topic were used as major constructs to build a search strategy. The MeSH or other relevant terms are related to Unani medicine, Epidemic, Prophylaxis, Prevention, and COVID-19 constructs. To combine these, Boolean operators “AND” and “OR” were used appropriately. The keywords used were “Unani Medicine,” “Epidemic,” “Disinfectant,” “Antiseptic,” “Immunomodulator,” “Antiviral,” “Antimicrobial,” “Prevention,” and “COVID-19.” Time restriction was not made to extract the most useful information.


  Observations Top


Epidemics in Unani texts are described either under the heading of wabā’ (epidemic) or hummā wabā’iyya (epidemic fever). Unani scholars have given a very elaborative description of epidemics including its definition, etiological factors, susceptible host, the clinical presentation of infected individuals, and the measures for its containment. Findings of the literature review are presented in [Tables 1]–[4]. [Table 1] provides brief information about the aim and applicability of the measures described in Unani texts for the containment of the epidemic. [Table 2] provides information about the measures applicable at the environment level. [Table 3] represents the preventive measures (includes pharmacological and nonpharmacological) applied at the individual level. Information about the pharmacological properties revealed from contemporary researches on Unani drugs listed in this article is given in [Table 4].
Table 1: Containment measures for epidemics

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Table 2: Measures applied at the environment level

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Table 3: Recommended pharmacological and nonpharmacological measures for prophylaxis during epidemics

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Table 4: Pharmacological properties of drugs listed in the article

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  Understanding of Epidemic Top


The putrefied change occurring in the air, water, soil, or environment, leading to putrefaction in humors of the body. This abnormal change affects a large part of the population at a particular time is known to be called as wabā’ (epidemic).[13],[14],[15],[16],[17],[18] Unani scholars considered certain climatic changes as the predisposing factors for the occurrence of an epidemic.[19],[20] In this regard, Hippocrates opined that warm and moist airs are conducive to “ufūnat (infection). Rāzῑ mentioned that bād Junūbῑ (southern wind) is associated with wabā” and is notoriously known to flare up infections. In his another book, he further specifies that the changes in air increase during those summers which are afflicted by rainfall and cloudy weather, wherein southern air blows or in areas where the southern air is trapped.[20] These claims have not been verified by any study, however, if these are true then this anticipation can help us to focus on the most likely threats. Accordingly, adequate arrangements and planning can be done to minimize the morbidity.

According to Unani Medicine, individuals of hārr-raṭb (hot and moist) temperament are at high risk and the individuals with bārid-yābis (cold and dry) temperament are at lower risk to acquire an infection during epidemic.[20] Likewise, individuals whose bodies are full of morbid matter are more susceptible to contract the infection, whereas the bodies devoid of morbid matter are at lesser risk to be affected.[21] Presence of morbid matter or the increase in the hararāt and ruṭūbat (heat and moisture) in the body or bodily tissues provides the conducive environment for the proliferation of ufūnat (infection) or in other words, we can say it reduces the disease resisting capacity of the body. Hence, the idea of prevention advocated by Unani scholars during an epidemic is mainly centred on employing all those regimens, which checks the humoral imbalance and keep the body in a nonsusceptible state.[22],[23],[24],[25],[26] Once the susceptibility for a disease no longer exists, either we don’t contract the disease or even if contracted, the episode will be less virulent, as the body is ready to counter any intrusion of disease-causing agents.

Unani scholars described the clinical picture of an infected person during epidemics. They mentioned that usually, the infected person presents with the symptoms of low-grade fever, fatigue, dry cough, increased thirst, increased respiratory rate, dyspnoea, and bad breath. Sometime, the patient may also present with the symptoms of nausea, loss of appetite, abdominal pain, diarrhea, and splenomegaly. Interestingly, it is also mentioned that higher mortality is seen among the individuals who have developed the symptom of bad breath; the presence of this symptom is an indication that the infection has reached to the heart.[14],[17] The clinical features of an infected person described in Unani texts are strikingly similar to the epidemics such as swine flu, SARS, and even COVID-19.

Epidemic containment measures mentioned by Unani scholars can be broadly divided into cause centric and host-centric measures and these are applicable at the environment and individual level, respectively [Table 1]. At environmental level measures are aimed to eliminate the pathogens present in the environment. At individual level suggested measures are aimed to strengthen the host defense.


  At Environment Level Top


Epidemic containment measures applicable at the environment level include the fumigation of medicinal herbs and the sprinkling of the medicinal herbs solution in residential places. Fumigation is done to purify the indoor air of residential places, whereas the objective behind the sprinkling of the solution is not mentioned; it may be as a surface disinfectant. A brief description of these measures is provided in [Table 2]. A large number of drugs such as Sandrūs (Trachylobium hornnemannianum), Kāfūr (Cinnamomum camphora), Qusṭ (Sausurea lappa), Kundur (Bowsellia serrata), ’Ūd (Aquilaria agallocha), Mushk (Musk), Murr (Commiphora myrrh), Lobān (Styrax benzoin), S‘ad kūfī (Cyperus rotundus), Idhkhar (Cymbopogon jwarancusa), Abhal (Juniperus communis), Waj (Acorus calamus), Tagar (Valeriana wallichii), Ās (Myrtus communis), and Safarjal (Cydonia oblonga) have been mentioned by Unani scholars for the purification of air [Table 2]. Sprinkling the mixture of sirka (vinegar) and hīng (Ferula asafoetida) or vinegar and water in residential places has also been recommended during epidemics. From the literature review of Unani classical text, and modern studies it is found that these drugs possess varied pharmacological properties. From Unani perspective, these drugs possess dāfi‘-i-ta‘affun (antiseptic) and māni‘-i-‘ufūnat (disinfectant) properties,[27],[28] whereas contemporary researches[29],[30],[31],[32],[33],[34] reported antibacterial, antifungal and antiseptic properties.


  At Individual Level Top


Communicable diseases are transmitted from the reservoir/source of infection to the susceptible host. One effective way of controlling the spread of infection is to strengthen the host defense.[35] A large number of immune individuals in the community will build up the herd immunity; which provides an immunological barrier to the spread of disease in the human herd. If herd immunity is sufficiently high, the occurrence of an epidemic is regarded as highly unlikely.[35]

From the review of Unani texts, it has been observed that Unani scholars were very well aware of the concept of the susceptible host. In this regard, Ibn Rushd (Averroes) says that disease does not occur in all individuals. Only those individuals affected from disease, who are susceptible to it. If this would not have been the case then not even a single individual in a population had escape disease during an epidemic.[15] It seems that this view formed the basis of the modern concept of the epidemiological triad, which propounds that “not everyone exposed to a diseased agent develops the disease, there are many other factors relating to the host and environment that are equally important to determine whether a disease will occur in an exposed person or not.”[35] Sīnā[14] and Rāzῑ[20] mentioned that the individuals, whose bodies are full of morbid matter, are more prone to be affected during epidemic and whose bodies are devoid of accumulated morbid matter seldom get affected. Sīnā[14] further specifies that infection chiefly affects akhlāṭ (humor) and due to the action of harārat gharība (abnormal temperature); it deforms their physiological functions in such a way that individuals become diseased. Rāzῑ[20] mentioned that temperamentally bārid (cold) and yābis (dry) individuals enjoy the advantage of remaining hale, when the danger of epidemic lurks around, provided that appropriate preventive measures are taken to retain their burūdat (coldness) and yubūsat (dryness). He also mentioned that tajfῑf (desiccation) is an excellent approach to take care of temperamentally hārr-raṭb (hot and moist) individuals, who often affected during epidemics.[13],[20]

Based on this perspective of the susceptible host, several measures have been recommended to strengthen the host defense and to reduce the susceptibility toward the disease. It includes both pharmacological and nonpharmacological interventions. Pharmacological measures include the use of prophylactic drugs, whereas nonpharmacological measures include diet and lifestyle recommendations. The description of these recommendations is presented in [Table 3].


  Discussion Top


It is interesting to note that the understanding of epidemic by Unani scholars described in classical Unani treatises centuries back is very much relevant to the contemporary era and their significance cannot be ignored.

Based on the review of Unani classics, and contemporary scientific studies, here we propose a Unani compound formulation made up of Sibr (Aloe barbadensis), Murr (Commiphora myrrh), and Zafran (Crocus sativus) to be assessed as prophylaxis against COVID-19. The rationale for suggesting the formulation is the long-term experiential knowledge of ancient Unani physicians; its use has been recommended by various Unani scholars as a prophylactic drug during epidemics.[13],[14],[15],[19],[20] This formulation is mentioned in Unani pharmacopoeia with the name of tiryāq-i-wabā’i.[36] Rāzῑ[13],[20] claimed that whoever has used this formulation during the epidemic remained healthy. Jālīnūs[36] opined that the persons who used tiryāq-i-wabā’i as a prophylactic drug in healthy condition did not affect from infectious diseases. Jurjani[23] mentioned in his book that the use of tiryāq during epidemics strengthens the heart, keeps the faculties strong, and prevents ufūnat (infections). According to Unani perspective, this formulation maintains the vitality of organs, protects them from untoward stimuli, and strengthens them to cope with the diverse physiological conditions.

Its efficacy has also revealed from various researches conducted on the formulation[37] or its ingredients. These researches showed that A. barbadensis, C. myrrh, and C. sativus possessed antioxidant, immunomodulator, antibacterial, and antiviral properties [Table 4].

It is reported in studies that SARS-CoV-2 affects immune homeostasis by altering the immune regulatory network and results in “cytokine storm,” characterized by increased IL-2, IL-7, granulocyte colony-stimulating factor, IFN-gamma and TNF-alpha. Cytokine storm damages tissues of the lungs, kidney, and heart leading to rapid multi-organ failure. T helper (Th) lymphocyte balance (Th1/Th2) is crucial in orchestrating the appropriate cytokine responses and is known to be useful in reducing disease aggravation and mortality rate.[38] Bani et al.[39] reported the Th2 upregulating activity of Crocus sativus and suggests its use in conditions where Th1/Th2 modulation is required. Findings of these researches suggest that the use of tiryāq-i-wabā’i (owing to its ingredients) may be helpful in the modulation of host Th-1/Th-2 immunity and inducing antiviral immunity. Hence, this formulation may be assessed as prophylactic drug in the current outbreak.[40-75]

Due to the lack of substantial evidence about the antiviral activity and the uncertainty about the airborne transmission of SARS-CoV-2, measures suggested at the environment level such as fumigation of herbs to purify the air and sprinkling the solution of herbs in residential places is not justifiable to suggest in containing the present outbreak of COVID-19.

Nevertheless, owing to the antimicrobial activities of these drugs, fumigation of herbs can be suggested for reducing the microbial load in the air by taking into consideration the health benefits. Likewise, the mixture of vinegar and asafoetida can be suggested to use as regular surface disinfectants due to their antibacterial and antifungal activity.


  Conclusion Top


Host-centric measures described in Unani literature have been considered useful in reducing the risk of contracting the infection during the epidemics, and thus these might be worth special consideration to assess as prophylactic measures in today’s context. The uncertainty about the airborne transmission of COVID-19 disease and the lack of substantial evidence of antiviral activity limits the application of cause-centric measures in the current outbreak.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Pneumonia of Unknown Cause––China. Available from: https://www.who.int/csr/don/05-january-2020-pneumonia-of-unkown-cause-china/en/. [Last accessed on 2020 Mar 25].  Back to cited text no. 1
    
2.
El Zowalaty ME, Järhult JD. From SARS to COVID-19: A previously unknown SARS- related coronavirus (SARS-CoV-2) of pandemic potential infecting humans––call for a one health approach. One Health 2020;9:100124.  Back to cited text no. 2
    
3.
Naming the Coronavirus Disease (COVID-19) and the Virus That Causes It. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/naming-the-coronavirus-disease-(covid-2019)-and-the-virus-that-causes-it. [Last accessed on 2020 Mar 28].  Back to cited text no. 3
    
4.
WHO Director-General’s Opening Remarks at the Media Briefing on COVID-19. Available from: https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-themedia -briefing-on-covid-19-11-march-2020. [Last accessed on2020 Mar 30].  Back to cited text no. 4
    
5.
He F, Deng Y, Li W. Coronavirus disease 2019: What we know? J Med Virol 2020;92:719-25.  Back to cited text no. 5
    
6.
Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y, et al. Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. N Engl J Med 2020;382:1199-207.  Back to cited text no. 6
    
7.
Lupia T, Scabini S, Mornese SP, Perri GD, Rosa FG, Corcione S. 2019 novel coronavirus (2019-nCoV) outbreak: A new challenge. J Glob Antimicrob Resist 2020;21:227.  Back to cited text no. 7
    
8.
Wu C, Chen X, Cai Y, Xia J, Zhou X, Xu S, et al. Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China. JAMA Intern Med2020;180:1-11.  Back to cited text no. 8
    
9.
Coronavirus Updates. Available from: https://www.worldometers.info/coronavirus/?utm_ campaign=home AdUOA?Si. [Last accessed on 2020 May 28].  Back to cited text no. 9
    
10.
COVID-19 India. Available from: https://www.mohfw.gov.in/. [Last accessed on 2020 May 28].  Back to cited text no. 10
    
11.
Tillu G, Chaturvedi S, Chopra A, Patwardhan B. Public health approach of Ayurveda and Yoga for COVID-19 prophylaxis. J Altern Complement Med 2020;26:360-4.  Back to cited text no. 11
    
12.
Rajkumar RP. Ayurveda and COVID-19: Where psychoneuro-immunology and the meaning response meet. Brain Behav Immun2020;87:8-9.  Back to cited text no. 12
    
13.
Rāzī Z. Kitāb al-Manṣurī. New Delhi, India: Central Council for Research in Unani Medicine;1991. p. 175-77.  Back to cited text no. 13
    
14.
Sīnā I. Al-Qānūn Fi’l Tibb. Vol. I. New Delhi, India: Idāra Kitābush Shifā‘;2010. p. 102-10, 1205-08.  Back to cited text no. 14
    
15.
Rushd I. Kitāb-al-Kulliyyāt. Lahore, Pakistan: Maktaba Daniyal;2017. p. 368-70.  Back to cited text no. 15
    
16.
Zuhr I. Kitāb al-Taysīr. New Delhi, India: Central council for Research in Unani Medicine;2000. p. 243-7.  Back to cited text no. 16
    
17.
Khan MA. Akseer-e-Azam. New Delhi, India: Idāra Kitābush Shifā‘;2011. p. 916-19 [Urdu].  Back to cited text no. 17
    
18.
Anonymous. Standard Unani Medical Terminology. New Delhi, India: Central council for Research in Unani Medicine;2012. p. 157.  Back to cited text no. 18
    
19.
Kabeeruddin M. Hummayāt-e-Qānūn. Part 2.New Delhi, India: Central council for Research in Unani Medicine;2009. p. 39-47.  Back to cited text no. 19
    
20.
Rāzī Z. Kitāb-al-Hawi. Vol.15. New Delhi, India: Central council for Research in Unani Medicine;2008. p. 151-5.  Back to cited text no. 20
    
21.
Majūsī IA. Kāmil al-Ṣanā‘a al-Ṭibbiyya. New Delhi, India: Idāra Kitābush Shifā‘;2010. p. 226-7.  Back to cited text no. 21
    
22.
Rāzī Z. Kitāb-al-Murshid. New Delhi, India: Taraqqī Urdu Beoro;2000. p. 34-7.  Back to cited text no. 22
    
23.
Jurjānī I. Dhakhīra Khawārizm Shāhī. Vol. 1. New Delhi, India: Idāra Kitābush Shifā‘;2010. p. 6-23.  Back to cited text no. 23
    
24.
Zuhr I. Kitāb-al-Aghdhiya. New Delhi, India: Central Council for Research in Unani Medicine;2009. p. 145-8.  Back to cited text no. 24
    
25.
Qamri MH. Minhaj-al-Ilaj (Ghana Muna). New Delhi, India: Central council for Research in Unani Medicine;2008. p. 584-9.  Back to cited text no. 25
    
26.
Baghdādī HI. Kitāb-al-Mukhtārāt Fi’l Ṭibb. Vol. I. New Delhi, India: Central Council for Research in Unani Medicine;2007. p. 237-8.  Back to cited text no. 26
    
27.
Ghani NH. Khazayenul Advia. New Delhi, India: Idāra Kitābush Shifā‘;2011. p. 171, 212, 193, 518, 811, 932, 955, 981, 999, 1069, 1187, 1229, 1244.  Back to cited text no. 27
    
28.
Khan MA. Muhit-i-Azam. Vol. 3 and 4. New Delhi, India: Central council for Research in Unani Medicine;2013.p. 27, 303, 463, 558, 621, 711, 820.  Back to cited text no. 28
    
29.
Okmen G, Turkcan O, Ceylan O, Gork G. The antimicrobial activity of Liquidambar orientalis mill. Against food pathogens and antioxidant capacity of leaf extracts. Afr J Tradit Complement Altern Med 2014;11:28-32.  Back to cited text no. 29
    
30.
Ismail SM, Aluru S, Sambasivarao KSR, Matcha B. Antimicrobial activity of frankincense of Boswellia serrata. Int J Curr Microbiol Appl Sci 2014; 3:1095-101.  Back to cited text no. 30
    
31.
Gautam H, Asrani RK. Phytochemical and pharmacological review of an ethnomedicinal plant: Saussurea lappa. Vet Res Int 2018;6:1-9.  Back to cited text no. 31
    
32.
Wang S, Yu Z, Wang C, Wu C, Guo P, Jianhe W. Chemical constituents and pharmacological activity of agarwood and Aquilaria plants. Molecules 2018;342:1-21.  Back to cited text no. 32
    
33.
Chen W, Vermaak I, Viljoen A. Camphor–a fumigant during the black death and a coveted fragrant wood in ancient Egypt and Babylon: A review. Molecules 2013;18:5434-54.  Back to cited text no. 33
    
34.
Boukhatem MN, Ferhat MA, Kameli A, Saidi F, Kebir HT. Lemon grass (Cymbopogon citratus) essential oil as a potent anti-inflammatory and antifungal drugs. Libyan J Med 2014;9:25431.  Back to cited text no. 34
    
35.
Park K. Textbook of Preventive and Social Medicine. 24th ed. Jabalpur, India: Banarsidas Bhanot Publications;2017. p. 107.  Back to cited text no. 35
    
36.
Kabeeruddin M. Bayaz-e-kabeer. Lahore, Pakistan: Siddiqui Publications;YNM (Year not Mentioned): 12, 36.  Back to cited text no. 36
    
37.
Zarnigar , Itrat M. Evaluation of a Unani polyherbal formulation (Tiryaqe wabai) as an immunostimulator in elderly persons. Anc Sci Life 2013;33:11922.  Back to cited text no. 37
    
38.
Zhou Y, Fu B, Zheng X, Wang D, Zhao C, Qi Y, et al. Pathogenic T cells and inflammatory monocytes incite inflammatory storm in severe COVID-19 patients. Natl Sci Rev2020;7:998-1002.  Back to cited text no. 38
    
39.
Bani S, Pandey A, Agnihotri KV, Pathania V, Singh B. Selective Th2 upregulation by crocus sativus: A neutraceutical spice. Evid Based Complement Alternat Med 2010;2011:639862.  Back to cited text no. 39
    
40.
Veer MN, Ghorpade AN. Formulation and evaluation of herbal cream for burn. Int J Pharm Res Sch2016;5:233-8.  Back to cited text no. 40
    
41.
Lee HJ, Hyun EA, Yoon WJ, Kim BH, Rhee MH, Kang HK, et al. In vitro anti-inflammatory and anti-oxidative effects of Cinnamomum camphora extracts. J Ethnopharmacol 2006;103:208-16.  Back to cited text no. 41
    
42.
Chang KM, Choi SI, Kim GH. Anti-oxidant activity of Saussurea lappa C.B. clarke roots. Prev Nutr Food Sci 2012;17:306-9.  Back to cited text no. 42
    
43.
Zahara K, Tabassum S, Sabir S, Arshad M, Qureshi R, Amjad MS, et al. A review of therapeutic potential of Saussurea lappa––An endangered plant from Himalaya. Asian Pac J Trop Med 2014;7S1:S60-9.  Back to cited text no. 43
    
44.
Goswami D, Mahapatra AD, Banerjee S, Kar A, Ojha D, Mukherjee PK, et al. Boswellia serrata oleo-gum-resin and β-boswellic acid inhibits HSV-1 infection in vitro through modulation of NF-кb and p38 MAP kinase signaling. Phytomedicine 2018;51:94-103.  Back to cited text no. 44
    
45.
von Rhein C, Weidner T, Henß L, Martin J, Weber C, Sliva K, et al. Curcumin and Boswellia serrata gum resin extract inhibit chikungunya and vesicular stomatitis virus infections in vitro. Antiviral Res 2016;125:51-7.  Back to cited text no. 45
    
46.
Lingbeck JM, O’Bryan CA, Martin EM, Adams JP, Crandall PG. Sweetgum: An ancient source of beneficial compounds with modern benefits. Pharmacogn Rev 2015;9:1-11.  Back to cited text no. 46
    
47.
Sağdıç O, Özkan G, Özcan M, Özçelik S. A Study on inhibitory effects of sığla tree (Liquidambar orientalis Mill. var. orientalis) storax against several bacteria. Phytother Res2005;19:549-551.  Back to cited text no. 47
    
48.
Canli K, Yetgin A, Akata I, Altuner EM. In vitro antimicrobial screening of Aquilaria agallocha roots. Afr J Tradit Complement Altern Med 2016;13:17881.  Back to cited text no. 48
    
49.
Mohammed S, Alhussaini AM, Alghonaim IM, Ibrahim EK. An evaluation of the antimicrobial activity of Commiphora myrrha Nees (Engl.) oleo-gum resins from Saudi Arabia. J Med Sci 2015;15:198-203.  Back to cited text no. 49
    
50.
Du J, Singh H, Yi TH. Antibacterial, anti-biofilm and anticancer potentials of green synthesized silver nanoparticles using benzoin gum (Styrax benzoin) extract. Bioprocess Biosyst Eng 2016;39:1923-31.  Back to cited text no. 50
    
51.
Daswani PG, Brijesh S, Tetali P, Birdi TJ. Studies on the activity of Cyperus rotundus linn. Tubers against infectious diarrhea. Indian J Pharmacol 2011;43:340-4.  Back to cited text no. 51
[PUBMED]  [Full text]  
52.
Kilani S, Ben Sghaier M, Limem I, Bouhlel I, Boubaker J, Bhouri W, et al. In vitro evaluation of antibacterial, antioxidant, cytotoxic and apoptotic activities of the tubers infusion and extracts of Cyperus rotundus. Bioresour Technol 2008;99:9004-8.  Back to cited text no. 52
    
53.
Fierascu I, Ungureanu C, Avramescu SM, Cimpeanu C, Georgescu MI, Fierascu RC, et al. Genoprotective, antioxidant, antifungal and anti-inflammatory evaluation of hydroalcoholic extract of wild-growing Juniperus communis L. (Cupressaceae) native to Romanian Southern sub-Carpathian hills. BMC Complement Altern Med 2018;18:3.  Back to cited text no. 53
    
54.
Devi SA, Ganjewala D. Antimicrobial activity of Acorus calamus (L.) rhizome and leaf extract. Acta Biol Szeged 2009;53:45-9.  Back to cited text no. 54
    
55.
Ghosh M. Antifungal properties of haem peroxidase from Acorus calamus. Ann Bot 2006;98:1145-53.  Back to cited text no. 55
    
56.
Khuda F, Iqbal Z, Zakiullah , Khan A, Nasir F. Antimicrobial and anti-inflammatory activities of leaf extract of Valeriana wallichii DC. Pak J Pharm Sci 2012;25:715-9.  Back to cited text no. 56
    
57.
Sisay M, Gashaw T. Ethnobotanical, ethnopharmacological, and phytochemical studies of Myrtus communis Linn: A popular herb in Unani system of medicine. J Evid Based Complementary Altern Med 2017;22:1035-43.  Back to cited text no. 57
    
58.
Al-Khazraji KS. Phytochemical screening and antibacterial activity of the crude extract of Cydonia oblonga seeds. Global Adv Res J Microbiol 2013;2:137-40.  Back to cited text no. 58
    
59.
Amalraj A, Gopi S. Biological activities and medicinal properties of Asafoetida: A review. J Tradit Complement Med 2017;7:347-59.  Back to cited text no. 59
    
60.
Cortesia C, Vilchèze C, Bernut A, Contreras W, Gómez K, de Waard J, et al. Acetic acid, the active component of vinegar, is an effective tuberculocidal disinfectant. mBio 2014;5:e00013-14.  Back to cited text no. 60
    
61.
Rutala WA, Barbee SL, Aguiar NC, Sobsey MD, Weber DJ. Antimicrobial activity of home disinfectants and natural products against potential human pathogens. Infect Control Hosp Epidemiol 2000;21:33-8.  Back to cited text no. 61
    
62.
Sun Z, Yu C, Wang W, Yu G, Zhang T, Zhang L, et al. Aloe polysaccharides inhibit influenza A virus infection: A promising natural anti-flu drug. Front Microbiol 2018;9:2338.  Back to cited text no. 62
    
63.
Rezazadeh F, Moshaverinia M, Motamedifar M, Alyaseri M. Assessment of anti HSV-1 activity of aloe vera gel extract: An in vitro study. J Dent (Shiraz) 2016;17:49-54.  Back to cited text no. 63
    
64.
Rahmani AH, Aldebasi YH, Srikar S, Khan AA, Aly SM. Aloe vera: Potential candidate in health management via modulation of biological activities. Pharmacogn Rev 2015;9:120-6.  Back to cited text no. 64
    
65.
Zeinali M, Zirak MR, Rezaee SA, Karimi G, Hosseinzadeh H. Immunoregulatory and anti-inflammatory properties of Crocus sativus (Saffron) and its main active constituents: A review. Iran J Basic Med Sci 2019;22:334-44.  Back to cited text no. 65
    
66.
Kianbakht S, Ghazavi A. Immunomodulatory effects of saffron: A randomized double-blind placebo-controlled clinical trial. Phytother Res 2011;25:1801-5.  Back to cited text no. 66
    
67.
Samarghandian S, Azimi-Nezhad M, Farkhondeh T. Immunomodulatory and antioxidant effects of saffron aqueous extract (Crocus sativus L.) On streptozotocin-induced diabetes in rats. Indian Heart J 2017;69:151-9.  Back to cited text no. 67
    
68.
Soleymani S, Zabihollahi R, Shahbazi S, Bolhassani A. Antiviral effects of saffron and its major ingredients. Curr Drug Deliv 2018;15:698-704.  Back to cited text no. 68
    
69.
Nasar-Abbas SM, Halkman AK. Antimicrobial effect of water extract of sumac (rhus coriaria L.) on the growth of some food borne bacteria including pathogens. Int J Food Microbiol 2004;97:63-9.  Back to cited text no. 69
    
70.
Vahid-Dastjerdi E, Sarmast Z, Abdolazimi Z, Mahboubi A, Amdjadi P, Kamalinejad M. Effect of rhus coriaria L. Water extract on five common oral bacteria and bacterial biofilm formation on orthodontic wire. Iran J Microbiol 2014;6:269-75.  Back to cited text no. 70
    
71.
Lim SH, Choi CI. Pharmacological properties of Morus nigra L. (Black Mulberry) as a promising nutraceutical resource. Nutrients 2019;11:E437.  Back to cited text no. 71
    
72.
Kim H, Chung MS. Antiviral activities of mulberry (Morus alba) juice and seed against influenza viruses. Evid Based Complement Alternat Med 2018;2018:2606583.  Back to cited text no. 72
    
73.
Dolatabadi S, Moghadam HN, Mahdavi-Ourtakand M. Evaluating the anti-biofilm and antibacterial effects of Juglans regia L. Extracts against clinical isolates of Pseudomonas aeruginosa. Microb Pathog 2018;118:285-9.  Back to cited text no. 73
    
74.
Alkhawajah MA. Studies on the antimicrobial activity of Juglans regia. Am J Chin Med 1997;25:175-80.  Back to cited text no. 74
    
75.
Boskabady MH, Shafei MN, Saberi Z, Amini S. Pharmacological effects of Rosa damascena. Iran J Basic Med Sci 2011;14:295-307.  Back to cited text no. 75
    



 
 
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