Journal of Complementary and Alternative Medical Research

Anxiety Management through Yoga and Pranayama: A Critical Review of Mechanisms, Clinical Evidence and Implementation

Gajanan Shripad Kulkarni — 2026-07-13

Anxiety disorders represent one of the most prevalent categories of mental illness worldwide, and pharmacological and psychotherapeutic treatments, while effective, remain inaccessible or unacceptable to a substantial proportion of affected individuals. Yoga and pranayama, mind–body practices rooted in South Asian contemplative traditions, have attracted sustained scientific interest as adjunctive or standalone interventions for anxiety. This review synthesises physiological, neurobiological and clinical evidence on the anxiolytic potential of yoga-based postural practice and pranayama-based breath regulation. Mechanistic pathways considered include autonomic nervous system modulation, the vagal–gamma-aminobutyric acid theory, hypothalamic–pituitary–adrenal axis regulation, and the neural correlates proposed to underlie these effects. Clinical evidence is reviewed across generalised anxiety disorder, post-traumatic stress disorder, perinatal anxiety, occupational stress and sleep-related contexts, alongside comparative trials against cognitive behavioural therapy and mindfulness-based programmes. The available literature indicates that structured yoga and pranayama interventions produce measurable reductions in anxiety symptoms across diverse populations, with a favourable safety profile, though methodological heterogeneity, small sample sizes and inconsistent reporting of intervention components limit the strength of causal inference. In the most rigorously controlled head-to-head evidence, yoga has shown efficacy relative to inactive or educational controls but has not been established as equivalent to first-line cognitive behavioural therapy. Dose, breathing component and instructor qualification appear to moderate outcomes, though evidence for precise dose–response relationships remains preliminary. The review concludes with directions for methodologically rigorous future research, overall conclusions regarding clinical utility, and a candid appraisal of the limitations inherent to this body of work and to the present review itself.

Rasa Shastra: The Iatrochemistry of Ayurveda and Modern Pharmaceutical Science- A Critical Narrative Review

Amol Dhulgonda Patil — 2026-07-30

Rasa Shastra, the branch of Ayurveda concerned with the medicinal use of metals, minerals and processed mercury, occupies a contested position between an ancient iatrochemical tradition and contemporary pharmaceutical science. Its principal dosage forms, the incinerated herbo-mineral preparations known as bhasma and the mercurial kajjali and rasa products, are simultaneously described by practitioners as safe, potent and fast-acting, and by clinical toxicologists as recurrent sources of lead, mercury and arsenic poisoning. This review critically synthesises the evidence base connecting the classical iatrochemical operations of purification, incineration and trituration to modern understanding of particle formation, chemical speciation and toxicity. It examines the widely cited claim that bhasma constitutes an early form of nanomedicine, the argument that chemical form rather than elemental content determines toxicity, and the tension between mechanistic plausibility and demonstrated clinical benefit. The available evidence indicates that carefully controlled processing can convert reactive metals into poorly soluble sulphide or oxide phases of nanometric to submicron dimension, and that the most studied mercurial preparation, rasasindura, is a robust single-phase mercuric sulphide rather than free mercury. The evidence is far weaker, however, for the inference that structural stability guarantees clinical safety, and weakest of all for therapeutic efficacy, which rests largely on preclinical models and uncontrolled observation. Persistent problems include batch-to-batch variability, absence of enforced processing standards, reliance on animal and cell-line data of uneven quality, and a documented stream of poisoning cases traceable to inadequately processed or contaminated products. The field would benefit from mandatory speciation-based quality control, harmonised pharmacopoeial standards, transparent pharmacovigilance and adequately powered clinical trials that report chemical characterisation alongside outcomes. Until such evidence exists, confident claims of either uniform safety or established efficacy remain premature, and the reconciliation of Rasa Shastra with modern pharmaceutical science is best regarded as an open and empirically demanding question.

Effect of Moringa oleifera Leaf Extract on Breast Milk Immunoglobulin (IgA, IgG, and IgM) Levels across Lactation in Wistar Rats

Nsofor, Cordelia. Uchechukwu Theresa — 2026-07-18

Background: Breast milk immunoglobulins, particularly immunoglobulin A (IgA), immunoglobulin G (IgG), and immunoglobulin M (IgM), play essential roles in neonatal passive immunity. Although Moringa oleifera possesses recognised nutritional and immunomodulatory properties, its effects on breast milk immunoglobulin composition during lactation remain poorly understood.

Objective: The study aims to determine the effect of maternal Moringa oleifera leaf extract supplementation on breast milk IgA, IgG, and IgM concentrations during the colostrum, transitional, and mature stages of lactation in Wistar rats.

Methods: Forty-eight adult female Wistar rats were randomly allocated into five groups, while twenty-four fertile males were used exclusively for mating. The treatment groups received ethanolic Moringa oleifera leaf extract during different periods before mating and during pregnancy and/or lactation, whereas the control group received only standard rat chow and water. Breast milk samples were collected during the colostrum, transitional, and mature milk stages using a modified manual expression technique. Milk IgA, IgG, and IgM concentrations were quantified using the ProcartaPlex Rat Antibody Isotyping Panel. Data were analyzed using one-way ANOVA followed by Fisher's Least Significant Difference (LSD) post hoc test. Statistical significance was set at p < 0.05.

Results: Maternal Moringa oleifera supplementation significantly altered breast milk immunoglobulin composition. Significant differences among groups were observed for IgA and IgG during colostrum (IgA: F = 11.22, p < 0.001; IgG: F = 26.40, p < 0.001), transitional milk (IgA: F = 16.03, p < 0.001; IgG: F = 4.17, p = 0.030), and mature milk (IgA: F = 18.72, p < 0.001; IgG: F = 4.40, p = 0.010). Fishers post hoc analysis showed significantly lower IgA and significantly higher IgG concentrations in all treated groups compared with controls (p < 0.05). IgM concentrations did not differ significantly at any stage of lactation (colostrum: F = 0.85, p = 0.530; transitional milk: F = 1.21, p = 0.380; mature milk: F = 2.43, p = 0.090).

Conclusion: Maternal supplementation with Moringa oleifera leaf extract selectively modified breast milk immunoglobulin composition by decreasing IgA and increasing IgG concentrations throughout lactation without significantly affecting IgM. These findings indicate immunomodulatory effects of Moringa oleifera on mammary immune function; however, the potential implications for neonatal passive immunity require further mechanistic and translational investigation before clinical recommendations can be made.

Acute Toxicity and In-vivo Venom-Neutralizing Activity of the Aqueous Root Extract of E. divinorum against Bitis arietans Venom

Zacchaeus Rotich Kipkorir — 2026-07-18

Background: Snakebite envenoming remains an important public health concern, particularly in rural settings where access to conventional antivenom may be limited. Medicinal plants such as Euclea divinorum are traditionally used for snakebite management, but their safety and venom-neutralising efficacy require controlled experimental evaluation.

Aims: The study aims to assess the acute toxicity of Bitis arietans venom and the aqueous root extract of Euclea divinorum and to evaluate the extract's venom-neutralising activity in vivo in experimental mice.

Study Design: A controlled laboratory animal study evaluating the acute toxicity (LD₅₀) and venom-neutralising efficacy (ED₅₀) of an aqueous root extract of E. divinorum against B. arietans venom.

Place and Duration of Study: Department of Pharmacology and Toxicology, Faculty of Veterinary Medicine, University of Nairobi, from January to May 2024.

Methodology: To determine the median lethal dose (LD_₅₀) of B. arietans venom, lyophilised venom was administered intraperitoneally to male mice weighing 18–30 g at doses of 2.74, 4.11, 6.16, 9.24, 13.86, and 20.79 mg/kg. Mortality was recorded over 24 hours, and probit analysis was used to determine the LD_₅₀. To determine the LD_₅₀ of E. divinorum, powdered root extract reconstituted in phosphate-buffered saline (PBS) was administered at doses of 10, 100, and 1000 mg/kg. Mortality was recorded over 24 hours, and the LD_{₅₀ was} determined using Lorke’s method. The extract's neutralisation potential was evaluated by intraperitoneal administration of 2.5 × LD₅₀ venom combined with extract doses of 100, 200, and 300 mg/kg. The 24-hour mortality data were subjected to probit analysis to determine the median effective dose (ED_₅₀).

Results: The LD₅₀ values of B. arietans venom and the E. divinorum extract were 5.940 and 316 mg/kg, respectively. The ED₅₀ of the E. divinorum extract was 69.965 mg/kg.

Conclusion: The aqueous root extract of E. divinorum demonstrated in vivo venom-neutralising activity against B. arietans venom in mice.

Wound Healing Potential of the Leaf of Microdesmis puberula Hook.F. ex. Planch. (Pandaceae)

Imaobong Israel Etukudoh — 2026-07-30

Microdesmis puberula Hook. f. ex Planch. is used traditionally for the management of burns and wounds. This study evaluated the wound-healing potential of the methanol leaf extract and solvent fractions of M. puberula using an excision wound model in experimental animals. The dried leaves were extracted with methanol, and the crude extract was partitioned into n-hexane, dichloromethane, ethyl acetate and aqueous fractions. Ointment formulations of the crude extract and fractions were prepared and applied topically once daily to excision wounds. Wound contraction and epithelialisation period were assessed, while histopathological and histochemical examinations were used to evaluate tissue repair, re-epithelialisation, angiogenesis and reticulin fibre expression. The methanol extract formulations produced greater wound contraction than the untreated and ointment-base control groups. On day 20, the penicillin ointment group showed complete wound closure, while 5 % and 2 % crude extract ointments produced 94 % and 93 % wound contraction, respectively. Among the fractions, the dichloromethane fraction showed the highest activity, with 99.25 % wound contraction on day 20 and an epithelialisation period of 20.2 ± 0.02 days. Histological observations indicated improved granulation tissue formation, re-epithelialisation, angiogenesis and fibroblastic activity in treated groups compared with the negative controls. Histochemical staining further showed increased reticulin fibre expression in treated tissues. GC-MS analysis of the n-hexane fraction revealed several phytoconstituents, including phytol, squalene and vitamin E-related compounds. Stigmasterol was isolated from the dichloromethane fraction and characterised using spectroscopic methods. These findings support the wound-healing potential of M. puberula leaves under the experimental conditions used.