key: cord-0776992-0fk1dh1e authors: Ahmed Alghamdi, Huda title: A Need to Combat COVID-19; Herbal Disinfection Techniques, Formulations and Preparations of Human Health Friendly Hand Sanitizers date: 2021-04-09 journal: Saudi J Biol Sci DOI: 10.1016/j.sjbs.2021.03.077 sha: f405805fdcdf1587b1b05f6b1818ee6966dad6d0 doc_id: 776992 cord_uid: 0fk1dh1e Indigenous medicinal plants enriched with flavonoids, alkaloids, poly-phenolic compounds carry antiseptic, disinfectant and antimicrobial activities. During old era, plant extracts were used as strong antiseptics and disinfectants to get ride from microbes. We aimed to present the herbal formulations and preparations for human health hazards free hand sanitizers based on indigenous medicinal plants with reported effective results against infectious microbes along with least toxic impact on environment. Easily available plants formulations safe to human health and environment are presented with easy procedure for their preparations. Data have been collected from literature for dissemination to scientific community and common society. A recent report published on human health hazards linked with the frequent use of alcohol based hand sanitizers provoked the scientific community to prepare safe hand rubs. National Poison Data System, USA revealed 36.7% increase in alcoholic hand sanitizer exposure and toxicity in first three months of 2020 as compared to 2019. Adaptation of alternative preparations of hand sanitizers based on natural and plant resources are the possible solution to get ride off toxicity problem. There should be more detailed screenings of indigenous plants with enriched flavonoids contents for their antiseptic properties and to develop eco-friendly and effective hand sanitizers as compared to chemical formulations. 19 specifically, if an infected person with no symptom or mild indications came in interaction/contact with healthy person (Kratzel et al., 2020) . Till today, no medication has been found to treat this disease through, various researchers and pharmaceutical companies are putting their efforts to discover vaccine and medicines. In this situation protective measures and energetic life style with effectual immune system have been advocated by WHO to combat and stay insipid from this pandemic. Hand hygiene with alcoholic hand sanitizer or washing with soap has been reported effective to combat this pandemic (Rehman et al., 2021; Mahmood et al., 2020a) . Currently, people across the globe are using alcohol based hand sanitizers on massive scale to stop or reduce the spread of coronavirus. Most of the available hand rubs used as sanitizers composed up of isopropyl alcohols, H 2 O 2 and ethanol in different combinations. Misuse of these provisions may leads to the toxicity in human well beings and to environment (Mahmood et al., 2020a) . American Association of Poison Control Center (AAPCC) has testified a total of 11324 cases of alcoholic hand sanitizer's exposure in children below age of 12 Years during the early six months of 2020. AAPCC reported that aforesaid exposure was responsible for nausea and lethargy, confusion, respiratory arrests and even death in children (AAPCC, 2020) . Frequent use of hand sanitizers has also been reported for possible chance of other viral diseases and increased chance of anti-microbial resistance (Tachikawa, 2020; Morgan, 2020; Mahmood et al., 2020b) . A recent report has been published on human health hazards and environmental risks associated with the frequent use of alcohol based hand sanitizers (Mahmood et al., 2020a) . National Poison Data System, USA revealed 36.7% increase for alcoholic hand sanitizers exposure and toxicity in primary months of 2020 as compared to 2019 (Chang et al., 2020) . Adaptation of alternative preparations of hand sanitizers based on natural and plant resources can be the possible solution to get ride off toxicity problem. During COVID-19, reported medicinal plants with known anti-viral and disinfection properties can be used as alternatives of alcohol based hand rubs. Till date, numerous plants have been reported and published with broad-spectrum anti-viral properties (Mahmood et al., 2012) . As an example, quinine is a vital drug discovered from plant origin (from the barks of Cinchona tree) and characterized by long use history (Ganjhu,, et al., 2015; Mahmood et al., 2015; Mahmood et al., 2014) . Formulations and preparations of hand sanitizers by herbal plants have been proved effective against pathogens and results have also been compared and fond effective with alcoholic based formulations of hand sanitizers. These herbal formulations have been considered safe for human health as far as to environment (Kalaivani et al., 2018; Acharya et al., 2018; Yaun and Vasquez, 2017) . This article was aimed to present the formulation and preparations of human health hazards free hand sanitizers with reported effective results against infectious microbes along with zero toxic impact on environment. Psidium guajava L. belongs to family Myrtaceae. Phytochemicals extracted from the leave extract of guava showed a potential against bacterial pathogens activity (Guinto and Chua, 2013). Guava leaves have bio-active chemical constituents like flavonoids, saponins, tannins, triterpenoids and eugenol, where flavonoids and poly-phenolic compounds dominate over other (Mailoa et al., 2013) . Phenolic compounds are responsible to inhibit microbial growths, and leaves of guava process strong anti-microbial properties due to enrichment of phenolic compounds. 200 g of fresh guava leaves deliquesced with 95% ethyl alcohol. Mixture obtained after 72 hours was filtered and dried from alcohol by evaporation process. Solvent free mixture was mixed with distilled water to liquidity. This extract was used in the formulation of guava hand sanitizer gel by adding gelatin and glycerin in small proportion of alcohol (Yaun and Vasquez, 2017) . German Chamomile (Matricaria chamomilla), a member of Asteraceae family is enriched with blue oil and flavonoids. It has been reported that flowers extract of German chamomile is more effective to kill hand microbes, compared with the commercial hand sanitizer (Sing et al., 2011) . Extract from chamomile flowers contain 0.4 to 2% of essential oil with active antimicrobial properties; in addition, flower extract contain more than 120 chemical compounds identified as secondary metabolites, including 36 flavonoids and 28 terpenoids, α-bisabolol, cyclic ethers, chamazulene, flavonoids and umbelliferone etc. α-bisabolol and chamazulene exhibit antiseptic properties (Saad et al., 2011) . 200 g fresh flowers of Chamomile were homogenized and mixed in a mixer with ethanol (70%), followed by extensive maceration with alcohol (70%). Filtrate of this extract was evaporated through rotary evaporator and final residue (solvent free) was suspended in water (12.5 g in 40 ml distilled water) (Joshi et al., 2008 : Sing et al., 2011 . Aqueous extract can be mixed with glycerin to convert into hand rub. Investigators of this finding used above prepared extract to prepare antiseptic soap by mixing 4 ml of this extract in 3 g of sodium lauryl sulphate and solution was homogenized at room temperature and used for antimicrobial screening (Saad et al., 2011; Tilton and Howard, 1987) . Azadirachta indica L. is highly medicinal plant with all parts reported to be used for medicinal purposes e.g. antiviral, anticancer, immune-modulator, skin disorders, liver function improvements, blood detoxifier and anti-inflammation (Pai et al., 2004) . Ocimum sanctum is another important plant reported for anti-microbial properties. Citrus limon has been reported as enriched source of vitamin C along with antiviral, anti-diabetic, antimicrobial properties and high alkaloids, flavonoids contents (Harsha et al., 2016; Hammer et al., 1999) Fresh plant material was shade dried and grinded into powder form. 50 g of each plant material was soxhelt extracted with 400 ml of water (temperature 100°C) for 6 hours per plant sample. Plant extract was dried using rotary evaporator, then carbapol 940 plus EDTA (Ethylene diamine tetraacetic acid) was added to deionize the water. After uniform mixing of all plant material, glycerin was added with addition of 0.3% perfume and mixed thoroughly to achieve a uniform aqueous material. Hand sanitizer prepared by Azadirachta indica, Ocimum sanctum and Citrus limon showed great antimicrobial activities. Statistical analysis performed by investigators, reported that aforesaid herbal formulation exhibited broad spectrum antimicrobial activities. Investigations proved/reported that this hand rub was equally effective with alcoholic hand sanitizer (Acharya et al., 2018) . of Aloe barbadensis, 10% almond aqueous and 30% of menthol was added in above prepared mixture, where finally citric acid was used as preservative and make the final volume up to 100ml by using distilled water (Kalaivani et al., 2018). Herbal hand sanitizer was prepared by Coleus vettiveroides, Coriandrum sativum, Vetiveria zizanioides, Citrus limon and Melia azadirachta. Coleus vettiveroides has been reported as antibacterial, emollient and deodorant; Coriandrum sativum has broad spectrum anti-microbial properties; Citrus limon extract carry antimicrobial properties with ability to restore skin from oxidative damages; Vetiveria zizanioides extract has soothing, astringent and antimicrobial properties and Melia azadirachta contain a chemical constituents named nimbin, nimbinin and nimbidin with anti-viral properties (Herraiz et al., 2004; Mondal and Kolhapure, 2004) . Fresh plant material was extracted in ethyl alcohol (60% w/w) and dried through rotary evaporator to achieve solvent free extract. Plant extract and glycerin can be mixed with distilled water to prepare aqueous hand sanitizer (Mondal and Kolhapure, 2004) . Aloe vera, Hamamelis, Amorphophallus konjac, sweet orange essential oil, eucalyptus essential oil and tea tree essential oil are used for herbal hand sanitizer preparation. 51.40% of Aloe vera, 40% of Hamamelis (Witch hazel), 0.50% panthenol and 0.10% of dermofeel PA3 as chelator were blended together and stored in a beaker. Glycerine, Amorphophallus konjac (konjac gum) and xanthan gum (3.50%, 1.0% and 0.25%, respectively) were mixed separately in a second beaker. Add this new preparation in former preparation and keep stirring slowly and regularly with magnetic stirrer. In this mixture add another mixture of sweet orange essential oil, eucalyptus essential oil, tea tree essential oil, preservative and cocamidopropyl betaine (solubiliser) (0.20%, 0.15%, 0.10%, 0.80% and 2.0%, respectively), adjust the pH of whole formulation to 5 and store in proper container to use as hand sanitizer (Khanam and Afsar, 2013). Polyherbal hand sanitizers are mixture of low dose of alcohol (40%) and herbal extracts. Low concentration of alcohol is considered safe or less harmful for skin when used with herbal extracts. Ethanolic extracts of Zingiber officinale, Citrus limon and Andrographis paniculata were prepared and to get solvent free extract rotary evaporator was used. Carbapol-940, glycerine, polysorbate-20, perfume, alcohol, water and preservative (Ratio, 1:5:1:1:40:2:1, respectively) were mixed in 30% herbal extract (10% of each plant) (Grace et al., 2015) . Mixture prepared can be used as hand sanitizer. Cleaning along with disinfection is a finest practice to prevent COVID-19 and other viral respiratory illnesses in households and community settings (CDC, 2020) . To lessen the threat of disease spread in the community, it is recommended to prioritize better hygiene practices including washing and sanitizing hands frequently and thoroughly. Individually, people are observed to be using alcohol based hand sanitizer with 60-70% alcohol as suggested by CDC (2020), regularly upon meeting other individuals outside or on return back to home. It is reported that spraying of individual with substances such as alcohol, chlorine is responsible for the toxic influence on entities and lead towards eye and skin irritation, bronchospasm due to inhalation, and possibly gastrointestinal effects such as vomiting and nausea (Mahmood et al., 2020) . In starting six months of 2020, AAPCC stated 10824 hand sanitizer's (alcoholic) exposure cases in children under 12 years age and acknowledged that even a minor dose of alcohol may results alcohol poisoning in/among children which is liable for confusion, nausea and lethargy, and in extreme cases, respiratory seizure and death (Table 2) Though, National Poison Data System did not provided any evidence or linkage between chemical exposure and COVID-19 cleaning practices, there seems to be a strong temporal link with amplified usage of such products. Daily reports of call to poison center increased abruptly in early March 2020 (Figure 1 ). Among these chemical exposure 36.7% increase of calls reported alcoholic hand sanitizer exposure while inhalation was reported major route of exposure that increased 35.3% (Table 2) (Chang et al., 2020) . In current situation the adaptation of alternative preparations of hand sanitizers based on natural and plant resources can be the possible solution to get ride off toxicity problem. Historically, indigenous medicinal plants have been proved and provided the best source of anti-infectious agents. Plants based anti-microbial and antiviral constituents signify a broader source of antiseptics and disinfectants, and exhibit the effectiveness against infectious diseases with mitigating a number of side effects linked with synthetic antiseptic products. Plants with enriched flavonoids and polypeptides have been reported as broad spectrum antimicrobial and antiviral agents (Saad et al., 2011; Abbiw, 1990) . A list of medicinal plants with reported authenticated antiseptic and disinfectant properties is presented in Table 1 . During COVID-19 pandemic hand hygiene considered prime among preventive measures. WHO recommended alcoholic hand sanitizers have been reported to cause hazard to environment and human health. CDC has raised a serious concern on alcoholic hand sanitizers exposure and 36.7% Useful plants of Ghana-West African use of wild and cultivated plants. Intermediate Technology Publications and the Royal Botanic Gardens Kew Formulation, Evaluation and Antibacterial Efficiency of water-based herbal Hand Sanitizer Gel Center for Disease Control and Prevention (CDC), 2020. Cleaning and Disinfection for Households Cleaning and Disinfectant Chemical Exposures and Temporal Associations with COVID-19 -National Poison Data System Herbal plants and plant preparations as remedial approach for viral diseases Polyherbal hand sanitizer -formulation and evaluation Effectivity of guava leaves (Psidium guajava) as mouthwash for patients with aphthous ulcers Antimicrobial activity of essential oils and other plant extracts Tetrahydro-beta-carboline alkaloids occur in fruits and fruit juices. Activity as antioxidants and radical scavengers Clinical features of patients infected with 2019 novel coronavirus in Wuhan Human health risk assessment of heavy metals via consumption of contaminated vegetables collected from different irrigation sources in Lahore Tannin Extract of Guava Leaves (Psidium guajava). Variation with concentrated organic solvents Evaluation of Antimicrobial efficacy and safety of Pure Hands herbal hand sanitizer in hand hygiene and on inanimate objects Heavy use of hand sanitizer boosts antimicrobial resistance Evaluation of antiplaque activity of Azadirachta indica leaf extract gel-a 6-week clinical study Formulation and evaluation of herbal handwash from Matricaria chamomilla flowers extracts Chamomile (Matricaria Chamomilla L.): An overview Overreliance on hand sanitizers may increase risk of coronavirus infection. Kyodo News Antimicrobial susceptibility Testing WHO guidelines on hand hygiene in health care: first global patient safety challenge clean care is safer care. Geneva: the Organization Antibacterial activity of formulated Psidium guajava (guava) hand sanitizer gel on Staphylococcus aureus