Senna fruit 12.4% / Ispaghula 54.2% granules

INTRODUCTION: Constipation is commonly treated with over-the-counter (OTC) products whose efficacy and safety remain unclear. We performed a systematic review of OTC therapies for chronic constipation and provide evidence-based recommendations. METHODS: We searched PubMed and Embase for randomized controlled trials of ≥4-week duration that evaluated OTC preparations between 2004 and 2020. Studies were scored using the US Preventive Services Task Force criteria (0-5 scale) including randomization, blinding, and withdrawals. The strengths of evidence were adjudicated within each therapeutic category, and recommendations were graded (A, B, C, D, and I) based on the level of evidence (level I, good; II, fair; or III, poor). RESULTS: Of 1,297 studies identified, 41 met the inclusion criteria. There was good evidence (grade A recommendation) for the use of the osmotic laxative polyethylene glycol (PEG) and the stimulant senna; moderate evidence (grade B) for psyllium, SupraFiber, magnesium salts, stimulants (bisacodyl and sodium picosulfate), fruit-based laxatives (kiwi, mango, prunes, and ficus), and yogurt with galacto-oligosaccharide/prunes/linseed oil; and insufficient evidence (grade I) for polydextrose, inulin, and fructo-oligosaccharide. Diarrhea, nausea, bloating, and abdominal pain were common adverse events, but no serious adverse events were reported. DISCUSSION: The spectrum of OTC products has increased and quality of evidence has improved, but methodological issues including variability in study design, primary outcome measures, trial duration, and small sample sizes remain. We found good evidence to recommend polyethylene glycol or senna as first-line laxatives and moderate evidence supporting fiber supplements, fruits, stimulant laxatives, and magnesium-based products. For others, further validation with more rigorously designed studies is warranted.

Abstract licence: CC BY-NC-ND

Senna alata is a medicinal herb of Leguminosae family. It is distributed in the tropical and humid regions. The plant is traditionally used in the treatment of typhoid, diabetes, malaria, asthma, ringworms, tinea infections, scabies, blotch, herpes, and eczema. The review is aimed at unveiling the ethnobotanical description and pharmacological activities of S. alata. Different parts of the plant are reported in folk medicine as therapeutic substances for remediation of diverse diseases and infections. The extracts and isolated compounds displayed pronounced pharmacological activities. Display of antibacterial, antioxidant, antifungal, dermatophytic, anticancer, hepatoprotective, antilipogenic, anticonvulsant, antidiabetic, antihyperlipidemic, antimalarial, anthelmintic, and antiviral activities could be due to the array of secondary metabolites such as tannins, alkaloids, flavonoids, terpenes, anthraquinone, saponins, phenolics, cannabinoid alkaloids, 1,8‐cineole, caryophyllene, limonene, α ‐selinene, β ‐caryophyllene, germacrene D, cinnamic acid, pyrazol‐5‐ol, methaqualone, isoquinoline, quinones, reducing sugars, steroids, and volatile oils present in different parts of the plant. The review divulges the ethnobotanical and pharmacological activities of the plant and also justifies the ethnomedical claims. The significant medicinal value of this plant necessitates a scientific adventure into the bioactive metabolites which constitute various extracts.

Abstract licence: CC BY

End-to-end autonomous driving demonstrates strong planning capabilities with large-scale data but still struggles in complex, rare scenarios due to limited commonsense. In contrast, Large Vision-Language Models (LVLMs) excel in scene understanding and reasoning. The path forward lies in merging the strengths of both approaches. Previous methods using LVLMs to predict trajectories or control signals yield suboptimal results, as LVLMs are not well-suited for precise numerical predictions. This paper presents Senna, an autonomous driving system combining an LVLM (Senna-VLM) with an end-to-end model (Senna-E2E). Senna decouples high-level planning from low-level trajectory prediction. Senna-VLM generates planning decisions in natural language, while Senna-E2E predicts precise trajectories. Senna-VLM utilizes a multi-image encoding approach and multi-view prompts for efficient scene understanding. Besides, we introduce planning-oriented QAs alongside a three-stage training strategy, which enhances Senna-VLM's planning performance while preserving commonsense. Extensive experiments on two datasets show that Senna achieves state-of-the-art planning performance. Notably, with pre-training on a large-scale dataset DriveX and fine-tuning on nuScenes, Senna significantly reduces average planning error by 27.12% and collision rate by 33.33% over model without pre-training. We believe Senna's cross-scenario generalization and transferability are essential for achieving fully autonomous driving. Code and models will be released at https://github.com/hustvl/Senna.

Abstract licence: CC BY-NC-SA

The use of phytochemicals is gaining interest for the treatment of metabolic syndromes over the synthetic formulation of drugs. Senna is evolving as one of the important plants which have been vastly studied for its beneficial effects. Various parts of Senna species including the root, stem, leaves, and flower are found rich in numerous phytochemicals. In vitro , in vivo , and clinical experiments established that extracts from Senna plants have diverse beneficial effects by acting as a strong antioxidant and antimicrobial agent. In this review, Senna genus is comprehensively discussed in terms of its botanical characteristics, traditional use, geographic presence, and phytochemical profile. The bioactive compound richness contributes to the biological activity of Senna plant extracts. The review emphasizes on the in vivo and in vitro antioxidant and anti‐infectious properties of the Senna plant. Preclinical studies confirmed the beneficial effects of the Senna plant extracts and its bioactive components in regard to the health‐promoting activities. The safety, side effects, and therapeutic limitations of the Senna plant are also discussed in this review. Additional research is necessary to utilize the phenolic compounds towards its use as an alternative to pharmacological treatments and even as an ingredient in functional foods.

Abstract licence: CC BY

Genus Senna belongs to the family of Fabaceae and comprises of about 250–300 accepted species extensively dispersed in tropical and subtropical regions. The Senna species is widely used in Africa, Asia, Europe and Latin America, some Senna species are well-known for their antimicrobial and anti-inflammatory activities with basis in traditional medicine to treat diabetes, microbial infections, malaria fever and other ailments. This review was extensively prepared by a comprehensive assessment of available literature via major scientific catalogues. The genus contains important metabolites such as alkaloids, anthraquinones, flavonoids, tannins, glycosides, steroids, terpenoids, saponins and volatile oils. The crude extracts and isolated metabolites from Senna displayed a wide range of in vitro and in vivo pharmacological activities such as antidiabetic, anti-gonorrhea, antimicrobial, antioxidant, antipyretic, antinociceptive, antidepressant and anti-inflammatory functions displayed by the genus Senna. The objective of this review is to critically explore the advances in the botanical, phytochemical, pharmacological and toxicological studies of the genus Senna, which will provide a useful bibliography for further investigations and applications in medicines. The review reveals that Senna species have been widely used for therapeutic purpose and substantial traditional evidence of their applications exist. Further studies should be tailored towards targeting active metabolites responsible for the pharmacological activities, structural elucidation and toxicological appraisals.

Abstract licence: CC BY

The dried leaves and pods of <italic>Cassia</italic> L., a member of the Caesalpinioideae subfamily of the Fabaceae family and the Cassiinae sub-tribe are called "senna drug". The drug is known by the names Senna, Indian Senna, Tinnevelly Senna, and <italic>Cassia Senna</italic> in the Indian, British, and American pharmacopeias. It appears to be native to North Africa. Sennoside A and B, anthraquinone glycosides responsible for the plant's laxative effects, are found in the leaves, pods, and seeds, which are the plant's most valuable parts. The plant grows as a perennial in the dry regions of Somalia, Ethiopia, Sudan, Egypt, Southern Arabia, and neighboring countries. Through the Medical School Salerno and the writings of Arab Physicians, it was first introduced into Europe in the twelfth century. <italic>Cassia accutifolia</italic>, or senna as it became known in English, is found in tropical North Africa's Northern Sudan, Egypt's Upper Nile, and some areas of Ethiopia. <italic>Senna alexandrina</italic> was born in Yemen, the Saudi province of Hadramgunl, and some areas of Sind (Pakistan). It is, however, common along the Gujarat coast, particularly in the Mundra coastal tract and Aigal near Bhuj in the Kutch area of India. The plant must have, at some stage, been transported from its native North Africa to India. It is believed that it was originally used in Tirunelvelle, an area of Tamil Nadu, sometime around the middle of the eleventh century. The plant has become a native in India throughout the years. It is grown in semi-arid regions of Gujarat, Rajasthan, and Tamil Nadu (Tinunevelle, Ramanathapuram, Madurai, Salem, and Tineichirapalli). <italic>Senna alexandrina</italic> is a tiny, obtuse-branched perennial shrub that grows to 60 to 75 cm. Large, compound, pinnate, 5−8 gugate, oval-lanceolate, plebrous, bluish-green to pale green, lamina 2.5−6 cm long, 7−8 mm broad, whole edge, acutely apical leaves. It typically blooms after 65 to 70 days. Bright yellow, axillary (or subterminal), many erect racemes with membranous bracts have bright yellow flowers. Legumes are flat, 15−17 mm wide, with compressed, obovate, and cuneate seeds. Compared to <italic>Cassia angustifolia</italic>, <italic>Cassia accutifolia</italic> has smaller, thinner-consistency leaves and pods. Some taxonomists combined these two species into a single taxon called <italic>Cassia senna</italic>. Senna is taken orally as a tea, pill formulation, or powder encapsulated to relieve intestinal constipation. Senna has been the subject of several reviews; however, we focus on the most recent facts to be updated rather than previous review papers. Senna's origin, botany and taxonomy, agriculture, genetic advancement, cytogenetics, mutation breeding, diseases and pests, pharmaceutical significance, microbiological activities, etc. were thoroughly reviewed. A brief review of available cytogenetics, genetic advancement, and agricultural technology was also addressed.

Abstract licence: CC BY