Curcumin Lozenges Show Promise in Managing Oral Lichen Planus, reveals study

In a new study, curcumin lozenges demonstrated comparable pain relief to triamcinolone acetonide 0.1% paste after one and two weeks, while also reducing lesion size, pain, and burning sensation. The findings, published in Cureus by Harakh Chand Baranwal, Neelam Mittal, and colleagues, suggest that curcumin may serve as a safe and effective therapy for oral lichen planus, offering an alternative to topical corticosteroids with minimal side effects. Oral lichen planus is a chronic inflammatory condition that can cause significant discomfort, and identifying treatments that provide relief while minimizing systemic or local adverse effects remains a key focus of clinical research.

The pilot clinical study assessed adult patients with erosive oral lichen planus who were treated with either curcumin lozenges or 0.1% triamcinolone acetonide paste over a two-week period. Both interventions were found to alleviate pain and reduce burning sensations, but curcumin additionally showed a favorable impact on lesion size and mucosal healing. These results highlight the anti-inflammatory and antioxidant properties of curcumin as the likely mechanisms behind its therapeutic effect. Moreover, curcumin’s natural profile and low side effect burden make it particularly appealing for long-term management of a chronic oral condition that often requires repeated interventions.

The authors conclude that curcumin lozenges could represent a viable alternative or adjunct to corticosteroid therapy in managing erosive oral lichen planus. Given the chronic nature of the disease and the potential side effects associated with long-term corticosteroid use, curcumin offers a promising option that is both effective and well-tolerated. Further large-scale studies are warranted to confirm these findings, optimize dosing, and explore long-term outcomes. This study supports the growing interest in natural and complementary therapies in oral medicine, emphasizing patient safety and quality of life alongside clinical efficacy.

Keywords: oral lichen planus, curcumin lozenges, triamcinolone acetonide, pain relief, lesion healing, anti-inflammatory therapy, pilot clinical study, Cureus, Harakh Chand Baranwal, Neelam Mittal

Reference: Baranwal HC, Mittal N, et al. Evaluation of Triamcinolone Acetonide and Curcumin Lozenges in Patients With Erosive Lichen Planus: A Pilot Clinical Study. Cureus. 2025. doi: 10.7759/cureus.364972
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Hanging Drop Sign in pelvis X-ray can be a useful tool to diagnose SNRA: study

Diagnosis of Seronegative Rheumatoid Arthritis (SNRA) is based on clinical, radiological, and MRI findings with set criteria. High specificity is provided by plain X-rays in the differential diagnosis of rheumatic disorders.

In the study by C Rex et al of pelvis X-rays, they found that ischiopubic ramus enthesopathy was more common than sacroiliitis and they have coined that enthesopathy finding as “hanging drop sign” because of its characteristic appearance.

A total of 152 proven (92 Females, 60 Males) SNRA cases (based on ACR*/EULAR**criteria and ASAS***criteria) were studied for enthesopathy features in their plain X-ray of pelvis. In addition to sacroiliitis, calcification/ ossification of attachment of pelvic muscle and ligaments was documented. Hanging drop enthesopathy was noted in ischiopubic ramus in most of the cases. A cadaveric study was done on 10 specimens just to understand the corresponding anatomical origin of this enthesopathy.

The key findings of the study were:

• Of the 152 pelvic radiographs studied, 110 revealed radiological evidence of SNRA.

• Among them, 64 patients had hanging drop sign (58.18%), 25 patients had sacroiliitis (22.72%), and 21 patients had other features like hip arthritis, calcifications around greater trochanter, iliac crest, and acetabular region.

• This hanging drop sign can be single (n = 52) or multiple (n = 12) and can be unilateral (n = 14) or bilateral (n = 50).

• The cadaveric study revealed that the hanging drop sign corresponds to the adductor part of adductor magnus muscle and gracilis muscle origin in the ischiopubic ramus.

“We conclude that the incidence of ischiopubic ramus enthesopathy presenting as “hanging drop sign” is higher than the incidence of sacroiliitis. Hanging drop sign can be considered as a reliable complementing sign to identify SNRA using standard diagnostic criteria. However, large volume and larger follow-ups are required to confirm the prevalence in various subtypes of axial spondyloarthropathies” the author commented.

Further reading:

“Hanging Drop Sign” in pelvis X-ray

C. Rex et al

Indian Journal of Orthopaedics (2025) 59:644–649

https://doi.org/10.1007/s43465-025-01360-2

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Inhaled Heparin Cuts Risk of Ventilation and Death in COVID-19 Patients: Study

A meta-trial of randomized clinical studies across six countries has found that inhaled heparin significantly reduced the need for intubation, overall mortality, and in-hospital death among hospitalized COVID-19 patients.

A widely available and affordable drug has been shown to be effective in treating seriously ill COVID-19 patients, according to a new international study led by researchers at the Australian National University (ANU) in collaboration with King’s College London.

The study analysed data from almost 500 patients hospitalised with COVID-19 across six countries. Patients who inhaled heparin were half as likely to require ventilation and had a significantly lower risk of dying compared with those receiving standard care.

Heparin, a drug traditionally injected to treat blood clots, was tested in this study in an inhaled form, targeting the lungs directly. As well as acting as an anticoagulant, heparin has anti-inflammatory and pan-antiviral properties. Earlier research results showed breathing and oxygen levels improved in COVID-19 patients after they inhaled a course of heparin.

The researchers believe the drug could also be useful in fighting other serious respiratory infections such as pneumonia.

Professor Clive Page, Emeritus Professor of Pharmacology at King’s who co-led the international study with ANU’s Professor van Haren, said: “Inhaled heparin is anti-viral, anti-inflammatory and anti-coagulant. There’s no other drug that has that unique combination. We know it’s only a matter of time until the next pandemic, and there are still COVID-19 patients who get very sick. This is a great weapon to have up our sleeve.”

While the findings highlight the potential of inhaled heparin, further development is required before the treatment can be routinely adopted. The researchers believe the drug could also be useful in fighting other serious respiratory infections such as pneumonia, which can be caused by a range of viruses and bacteria.

According to Professor van Haren, the drug would also be helpful for those with a compromised immune system, such as cancer patients, when they experience a respiratory infection.

Professor Frank van Haren, lead author, ANU and Director of the Intensive Care Unit at the St George Hospital in Sydney, said: “It doesn’t matter what kind of respiratory infection the patient is dealing with, the drug – when inhaled – will stop it from infecting the patient and from damaging the lungs. We’re aiming to conduct another trial in Europe to confirm its effectiveness in fighting other common respiratory infections such as influenza and RSV. And because it’s inexpensive, it’s much more accessible for those from low-income countries”

The researchers are now also developing an improved formulation of heparin, specifically designed to be given by inhalation.

Reference:

van Haren, Frank M.P. et al., Efficacy of inhaled nebulised unfractionated heparin to prevent intubation or death in hospitalised patients with COVID-19: an investigator-initiated international meta-trial of randomised clinical studies, EClinicalMedicine.

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High Sucralose Intake May Lower Effectiveness of Immune Checkpoint Inhibitors in Cancer Patients: Study

Research published in Cancer Discovery suggests that high consumption of the artificial sweetener sucralose may reduce the effectiveness of immune checkpoint inhibitors (ICIs) in cancer patients. The research revealed that sucralose disrupted the balance of the gut microbiota, inhibited T cell function and metabolism, and eventually dampened the efficacy of immune checkpoint inhibitors (ICIs), i.e., anti-PD-1 based treatments. The study was published by Kristin M. and fellow researchers.

The study probed the way diet affects gut microbiota and downstream immune responses in preclinical models of cancer and advanced cancer patients treated with ICI. Although the gut microbiota is known to influence cancer immunity, the particular effect of non-nutritive sweeteners was uncertain. In this research, direct evidence was given that sucralose intake altered microbial composition and decreased the pool of microbiota-accessible arginine, an amino acid necessary for T cell function.

Key Findings

  • 1 shared sweetener (sucralose) profoundly changed gut microbiota composition.

  • T cell metabolism and function were limited under sucralose treatment.

  • Anti-PD-1 immunotherapy efficacy was decreased in preclinical cancer models and patients with advanced cancer.

  • Arginine levels available to the microbiota decreased following sucralose consumption.

  • Amino acid supplementation or fecal microbiota transfer (FMT) from responder mice fully restored T cell function and immunotherapy results.

The researchers isolated the biological process underlying sucralose’s adverse effect. Sucralose changed microbial makeup within the gut, which then decreased the microbial pool of available arginine. Arginine is instrumental in T cell activation and metabolism. Without adequate arginine, T cells lost their functional abilities, restricting their capacity to develop effective immune responses against cancers. Restoring arginine levels—either by supplementation or microbiota transfer—restored normal T cell function and response to immunotherapy.

This research determined that sucralose intake destabilizes microbiota of the gut, decreases microbiota-accessible arginine, disrupts T cell metabolism, and eliminates response to anti-PD-1 immunotherapy. Notably, resupplementation of amino acids or microbiota transfer from responder subjects negated the adverse effects. These findings emphasize the necessity of dietary consideration in cancer therapy, as an ubiquitous artificial sweetener could perilously undermine lifesaving immunotherapies.

Reference:

Morder, K. M., Nguyen, M., Wilfahrt, D. N., Dahmani, Z. L., Burr, A. B., Xie, B., Morikone, M., Nieves-Rosado, H., Gunn, W. G., Hurd, D. E., Wang, H., Mullett, S. J., Bossong, K., Gelhaus, S. L., Rajasundaram, D., Kane, L. P., Delgoffe, G. M., Das, J., Davar, D., & Overacre-Delgoffe, A. E. (2025). Sucralose consumption ablates cancer immunotherapy response through microbiome disruption. Cancer Discovery. https://doi.org/10.1158/2159-8290.CD-25-0247

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After Cough Syrup Deaths, CDSCO Tightens Oversight on Drug Testing Compliance

New Delhi: In the wake of the tragic child deaths in Chhindwara, Madhya Pradesh, allegedly linked to contaminated cough syrups, the Central Drugs Standard Control Organisation (CDSCO) has issued a strong directive to all State and Union Territory Drug Controllers, calling for strict enforcement of the Drugs Rules, 1945, with specific emphasis on the mandatory testing of raw materials and finished pharmaceutical products.

In an official communication, the Drugs Controller General of India (DCGI), Dr Rajeev Singh Raghuvanshi, emphasized that manufacturers must test every batch of raw materials, including excipients and active pharmaceutical ingredients (APIs)—as well as the finished formulations before their release to the market.

The directive comes in the backdrop of inspection findings that exposed serious lapses by certain manufacturers, who failed to conduct the required batch-wise testing of raw materials and finished formulations, in violation of Rules 74(c) and 78(c)(ii) of the Drugs Rules, 1945.

It is noted that during the inspections carried out at the manufacturing facilities and in the investigations of the drugs declared as Not of Standard Quality, it was observed in the reports that the manufacturers are not carrying out testing of each batch of the excipients/inactive and active pharmaceutical ingredients for verification of compliance with the prescribed standards before using them in the manufacture of formulations and also in the finished products.

Also Read: UCPMP 2024: Govt Details Stricter Rules to Curb Gifts, Incentives from Pharma to Doctors

In addition to the above, the Drugs Controller General of India (DCGI) stated,

“It is to mention that as per the Drugs Rules, including rule 74 (c) and rule 78 (c) (ii), the licensee shall, either in his own laboratory or in any laboratory approved by the licensing authority test each batch or lot of the raw material used by him for the manufacture of his product and also each batch of the final product and shall maintain records or registers showing the particulars in respect of such tests as specified in Schedule U.”

Accordingly, the Drugs Controller General of India (DCGI) directed,

“All State and UT Drug Controllers be instructed to monitor compliance during inspections, issue sensitization circulars to manufacturers, and ensure that companies maintain robust vendor qualification systems. Manufacturers have also been told to procure raw materials only from approved and reliable suppliers.”

Also Read: Shut Non-Compliant Firms: Panel Demands Strict Action Against Counterfeit Drugs
To view the official notice, click on the link below:
https://medicaldialogues.in/pdf_upload/letter-to-sla-for-strict-compliance-303760.pdf

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Novel blood test for chronic fatigue achieves 96% accuracy

Scientists at the University of East Anglia and Oxford Biodynamics have developed a high accuracy blood test to diagnose chronic fatigue syndrome, also known as myalgic encephalomyelitis (ME/CFS).

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Study highlights risks of cesarean births to future pregnancies

Women who have cesarean births at an advanced stage of labor are about eight times more likely to develop scars in the womb which are known to increase the likelihood of premature births in future pregnancies, UCL researchers have found.

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Calorie labeling linked to 2% average reduction in energy content of menu items

Calorie labeling, which became law in April 2022 in England, is associated with only a small (2%) average reduction in the energy content of food that is available away from home, finds research published in the open access journal BMJ Public Health.

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Whole genome sequencing could match more breast cancer patients to tailored therapies and trials

Whole genome sequencing offered to breast cancer patients is likely to identify unique genetic features that could either guide immediate treatment or help match patients to clinical trials, say scientists at the University of Cambridge. Their research is published in The Lancet Oncology.

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Night shift workers undergo increased risk of kidney stone events: Study

A new study published in the journal of Mayo Clinic Proceedings showed that kidney stones are 15% to 22% more common in shift workers, with night shift workers having the highest risk.

A developing employment trend in contemporary culture, shift work interferes with circadian rhythms and modifies a number of physiological and behavioral processes. According to new research, these disturbances may raise the risk of kidney stones by causing metabolic and renal dysfunctions. This connection may be mediated by lifestyle characteristics that frequently accompany shift employment, like erratic sleep patterns, dehydration, nutritional imbalances, and decreased physical activity.

Developing focused preventative interventions requires an understanding of how these variables affect kidney stone etiology in shift workers. Using data from the UK Biobank, this study thoroughly examined the relationships between shift work, its kind, frequency, and length, as well as the mediating role that lifestyle plays in the relationship between shift work and kidney stone incidence.

This study included 226,459 UK Biobank individuals who were recruited between December 19, 2006, and October 1, 2010, and who were followed up with until May 1, 2023. The employment status of participants, including shift work, shift type, shift frequency, and years of shift work, were inquired about during the baseline study. Lifestyle factors included body mass index, hydration consumption, sleep duration, sedentary time, dietary features, physical activity, and smoking status. The relationship between shift employment and kidney stone occurrences was examined using Cox proportional hazards regression models, and the mediating effects of lifestyle choices were investigated using mediation analyses.

In 2893 patients, a kidney stone formed after a median follow-up of 13.7 years. Shift workers were more likely to experience kidney stone occurrences in the fully adjusted models (hazard ratio, 1.15; 95% CI, 1.04 to 1.26).

Younger individuals (less than 50 years old) and employees who never or infrequently performed hard manual labor showed stronger connections. Potential mediators were found to include body mass index, hydration consumption, smoking, sleep length, and sedentary time.

Overall, the risk of kidney stone occurrences was positively correlated with shift employment in this study, and the correlations were partially mediated by lifestyle choices. These results highlight the importance of encouraging healthy lifestyles among shift workers and imply that working shifts should be regarded as a risk factor for kidney stones.

Source:

He, M., Dou, X., Su, Y., Zhang, Z., Lin, H., & Yang, Y. (2025). Lifestyle factors in the association of shift work with kidney stone events. Mayo Clinic Proceedings. Mayo Clinic, 100(10), 1731–1744. https://doi.org/10.1016/j.mayocp.2025.03.032

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