No abstract

Withania somnifera Dunal, also known as Indian ginseng, has been in use since ancient times in the management of diabetes mellitus (DM). This systematic review and meta-analysis evaluated the efficacy/effectiveness, safety and tolerability of W. somnifera in managing DM. Literature search (published/unpublished) was performed from inception to April 2019 in guidelines recommended databases. A total of 6 in-vitro, 13 pre-clinical and 5 clinical studies were included for systematic evaluation. W. somnifera treatment in DM significantly restored the altered levels of blood glucose (experimental data; mean difference, −196.27; 95% confidence interval [−220.96, −171.58]; p < .00001) glycosylated haemoglobin (HbA1c), insulin, lipid profile, serum and oxidative stress markers with no safety concerns. The results suggest the potential role of W. somnifera in managing DM. However, the available clinical data are not considerably enough to provide novel and sufficiently robust evidence for the use of W. somnifera in managing DM. To further strength the antidiabetic profile of W. somnifera, well-designed randomized-controlled trial(s) with alarger sample size and longer duration is warranted with evaluation of its effect primarily on blood glucose, HbA1c and insulin. Future research also needs to elucidate the molecular mechanism(s) of W. somnifera including its active principles in DM. K E Y W O R D Sdiabetes mellitus, Indian ginseng, meta-analysis, oxidative stress, systematic review

Eperisone, an analgesic and centrally acting muscle relaxant has been in use for the treatment of low back pain (LBP). The present systematic review evaluates the efficacy and safety of eperisone in patients with LBP. Cochrane Back and Neck (CBN) Group and Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were adopted to perform this systematic review. For risk of bias assessment CBN Group and Moga tools were used. Seven (5 randomized controlled trials [RCTs] and 2 uncontrolled studies) studies involving 801 participants were included. Eperisone intervention may be effective in acute LBP patients with less adverse effects (relative risk, 0.25; 95% confidence interval, 0.15-0.41; p<0.0001). Eperisone also improved paraspinal blood flow and was found to have efficacy similar to tizanidine in chronic LBP patients. The included studies in this review are of smaller sample size and short duration to support eperisone use in LBP. However, we recommend well-designed RCTs of high quality with larger sample size and longer follow-up to confirm the clinical benefits of eperisone in the treatment of acute or chronic LBP.