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2.2.1. Praneem Polyherbal Broad-Spectrum Antimicrobial Formulation
 
In 1995, Talwar et al. developed a natural polyherbal preparation with contraceptive and broad spectrum antimicrobial properties that was shown through Phase 1 clinical trials on humans to be effective in treating patients with vaginal C. trachomatis infections [42]. This formulation contained three active natural materials: purified extract from seeds of Azadirachta indica (neem), quinine hydrochloride, and saponins extracted from the pericarp of Sapindus mukorossi. These ingredients were suspended in a water-washable cream base for topical delivery. In addition to antichlamydial activity, this formulation has also been shown to exhibit antibacterial and antifungal action on Gardnerella vaginalis and Candida albicans [42]. Toxicity studies on rodents, rabbits, monkeys, and humans, were performed and this formulation was declared to be safe, with a lack of side effects, such as skin irritation or sensitization [42]. The efficacy and safety of this product were further verified by human trials which were conducted with the same primary ingredients in India, Brazil, Egypt, and the Dominican Republic which all produced similar results [29,42]. With regards to vaginal C. trachomatis infections, during a study in Safdarjung Hospital, New Delhi, infected subjects were asked to topically apply 5 mL of the cream every night for 14 days. By the 8th day, swabs taken from the subjects indicated that C. trachomatis had been cleared from the cervicovaginal region of every subject studied [42]. This indicates the effective antichlamydial properties of this formulation and supports the premise that similar results may be achieved across a range of chlamydial serovars. However, although this preparation has been shown to exhibit a broad range of antimicrobial properties and be particularly effective in treating C. trachomatis, the specific antichlamydial activity of this formulation is unclear and would require further studies to elucidate.

In vitro antiviral activity of neem (Azardirachta indica L.) bark extract against herpes simplex virus type-1 infection
Herpes simplex virus type-1 (HSV-1) causes significant health problems from periodical skin and corneal lesions to encephalitis. We report here that an aqueous extract preparation from the barks of neem plant Azardirachta indica acts as a potent entry inhibitor against HSV-1 infection into natural target cells. The extract from neem bark (NBE) significantly blocked HSV-1 entry into cells at concentrations ranging from 50 to 100 μg/ml. The blocking activity of NBE was observed when the extract was pre-incubated with the virus but not with the target cells suggesting a direct anti-HSV-1 property of the neem bark. Further, virions treated with NBE failed to bind the cells which implicate a role of NBE as an attachment step blocker. Cells treated with NBE also inhibited HSV-1 glycoprotein mediated cell to cell fusion and polykaryocytes formation suggesting an additional role of NBE at the viral fusion step. These finding open a potential new avenue for the development of NBE as a novel anti-herpetic microbicide.

Evaluation of Contraceptive Properties of Neem Oil-A Prospective Study
 
Indigenous methods of conception have been used in India for immemorial times through age-old Ayurvedic system of medicine. The present study has attempted to explore the contraceptive effect of Neem seed oil as local application for reproductive female as family planning method apart from the conventional measures. In this study, total 246 women in the fertile age group were selected, among them only 4 women dropped out and remaining were followed up for a period of 12-36 cycles. No such serious adverse reaction and event was noticed during the study period. Nine cases had conceived due to drug failure and four cases had conceived due to drug omission. The general observation indicates that Neem seed oil may be used as an external barrier as cost effective herbal contraceptive for its spermicidal property and safe for regular use.

A Critical Review and Scientific Prospective on Contraceptive Therapeutics from Ayurveda and Allied Ancient Knowledge

Rajamartanda written in the 11th century is probably one of the earliest texts to mention a specific prescription for contraceptives. Compendia texts like Bhava Prakash, Yoga Ratnakara, Bhaishajya Ratnavali, Gadanigrah, and several others prescribe many herbal and herbo-mineral contraceptive preparations for local and oral use by men and women.

Some of the most prescribed practices and recipes for preventing conception are as follows. 

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• 1. Local Contraceptives for Females

  • Vaginal fumigation or application before coitus with (1) moistened Saindhava lavana (Rock salt)with Til (Sesame) oil. (Jugnu and Sharma, 2011), (2) wood of Neem (Azadirachta indica A. Juss. ) before coitus (Tripathi, 1969), and (3) powdered root of Dhattura (Datura metel L.) plucked on the 14th°day (dark night) of the lunar month[Indradev, 1998] or tying the waist with roots (Lakmipatishashtri, 1983).

1.2 Sexually transmitted diseases and Overview
While relatively few researchers have focused on neem efficacy in treating sexually transmitted diseases, the reports that have been completed are overwhelmingly positive. The most exciting study, focused on both the treatment and prevention of AIDS. Ten volunteers received 1000 grams of neem bark extract daily for 30 days, resulting in significantly increased CD4+ cell counts, body weight and hemoglobin counts. In fact, researchers report that all AIDS-related conditions were completely resolved during the treatment period and month-long follow-up with no adverse effects. Concurrent in vitro studies showed that neem bark extract prevented cytoadhesion of the HIV virus in 75% of protected cells, compared to 100% infection in unprotected cells.

A Review on Spermicidal Activities of Azadirachta indica

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1.4 Azadirachta indica:

The neem tree, A. indica is indigenous to the Indian subcontinent. Neem oil, extracted from the seeds of the neem tree, has been found to possess strong spermicidal activity. By the process of hydrodistillation, the volatile fraction of neem oil has been isolated and coded as NIM-76. A concentration of 25 mg/mL of the compound was found to achieve total spermicidal effect in 20 sec. Vaginal irritation study conducted in rabbits, by intravaginal application of 15 mg of NIM-76 in 2 mL of gelatin jelly for 10 days showed no irritation to the vaginal mucosa. The aqueous extract of old and tender neem leaves is a potent spermicide. The minimum effective concentration required to kill 1 million sperm in 20 sec was 2.91 mg and 2.75 mg for tender and old leaf extract, respectively (Khillare. and Shrivastav. 2003; Shah et al., 2008). Salannin (12), a limonoid bitter principle of the seed oil of A. indica, showed antiulcer, antibacterial and spermicidal activities [Ankita et al., 2010].

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