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Rational phytotherapy — A physician's guide to herbal medicine

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... Treatment of disease began long ago with the use of herbs[1]. Taraxacum officinale (L.) Weber ex F.H.Wigg. ...
... Taraxacum officinale has been used in folk medicine for its different medicinal properties[2]. In addition to its known health benefits[1,2], T. officinale whole plant decoction has been traditionally used in Jordan to enhance sperm parameters such as concentration and motility[13]. However, recent studies have proved that the whole plant or leaves aqueous extracts decrease male fertility instead of improving it[3,4]. ...
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Purpose: To investigate if T. officinale root aqueous extract has anti-spermatogenic activity similar to that of the whole plant which was shown previously to inhibit spermatogenesis. Methods: T. officinale aqueous extract was prepared by soaking 100 g of dried materials in 1 L distilled water for two days at 45°C. Fifty adult male rats were divided into five groups and treated for 60 days. Four groups were gavaged with the whole plant or root aqueous extract in low or high doses. The male rat rats were allowed to mate with female rats. The control group received distilled water. Sperm count, motility and morphology as well as chromatin integrity were evaluated. Results: Serum testosterone level, sperm parameters, pregnancy rate and average number of fetuses per pregnant females decreased significantly in the treated groups compared to control and in the root-receiving rats compared to the whole plant-receiving rats. Female rats which were mated with high dose root-receiving males did not deliver fetuses. Cross sections of seminiferous tubules of T. officinale-treated rats showed lesions and disorganized germinal epithelium. Late spermatogenesis maturation arrest (spermatid stage) was observed in all of the treated groups except the high dose root-receiving group which showed early maturation arrest (spermatocyte stage). In addition, the mRNA level of two spermatogonial stem cell markers responsible for self-renewal and proliferation of spermatogonia increased in high dose-receiving rats. Conclusion: T. officinale root aqueous extract has inhibitory effects on spermatogenesis. Further studies are required to identify specific ingredient(s) in T. officinale that may be useful as male contraceptive(s). © Pharmacotherapy Group, Faculty of Pharmacy, University of Benin, Benin City, 300001 Nigeria. All rights reserved.
... This statement was corroborated by Samojlik et al. [3], who additionally found that HMs are used in the modern day for health maintenance, the treatment or prevention of minor ailments and some chronic diseases, and they are often taken in addition to conventional medicine in the more serious and/or chronic conditions. However, complementary medicine, including herbal remedies, is certainly not a modern day phenomenon and has historically been used in the pharmacological treatment of disease [4], when it may have more commonly been known as traditional folk healing. Much of the population in developing countries still relies on traditional medicine practitioners and their collection of medicinal plants to meet all manner of healthcare needs. ...
Article
Background: Herbal medicines are commonly used in Saudi Arabia alongside conventional drug therapy. However, special attention must be paid when using such medicines and supplements with other drugs. Objective: This study was designed to evaluate the consumer awareness surrounding herbal remedies and the safety of herbal dietary supplements, as well as the sources of recommendation for their use and common beliefs regarding the combining herbals and drugs during therapy. Materials and methods: A self-administered questionnaire was used to capture data from 420 participants that purchased herbal medicines and/or herbal dietary supplements based on convenience sampling method from seven private pharmacies in Riyadh during 2013. The questionnaire included four parts: the socio-demographic characteristics of the consumer, the source of recommendation for the use of the purchased herbal products, the consumer’s attitude towards the safety of herbal remedies and herbal dietary supplements and their combination with conventional drugs, and assessment of the purchased herbal products. The data from each of the returned questionnaire were coded and entered into (SPSS) version 15.0 software which was used for statistical analysis. Response rate was 70%. The majority of participants were highly educated. Result: The study results show that 91.1% of the participants did not consult or take advice from a pharmacist or physician prior to purchasing herbal remedies for concurrent use alongside conventional medication. The study shows 8.8% used herbal medicines or herbal dietary supplements following advice from a physician or pharmacist, 66.2% of them on their friends or relatives, while 24.9% was based on the independent internet research, advertisements, etc. According to the study results, 81.2% believed that herbal medicines and herbal dietary supplements are harmless; however, 49.5% of participants acknowledged that combining herbal remedies and conventional drugs may be unsafe. Conclusion: This study demonstrates that public awareness regarding the use of herbal medicines and supplements, especially alongside other medication, is lacking. It is the responsibility of pharmacists and physicians to provide patients with comprehensive advice regarding the use of herbal medicines and herbal dietary supplements to ensure their safe use.
... The pharmacological treatment of disease began long ago with the use of herbs (Schulz et al., 2001). Herbal medicine is the use of plants, plant parts, their water or solvent extracts, essential oils, gums, resins, exudates or other forms of advanced products made from plant parts used therapeutically to provide proactive support of various physiological systems; or, in a more conventional medical sense, to treat, cure, or prevent a disease in animals or humans (Weiss and Fintelmann, 2000). ...
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Physiologically, it is known that thioacetamide (TAA) toxicity is generally associated with hepatic fibrosis induction, complicated metabolic disorders and health problems. The capability of extracts of olive and rosemary leaves to attenuate the severe physiological disturbances induced by thioacetmaide (TAA) intoxication in male rats has been evaluated. Healthy male Wistar rats were used in the present study and were divided randomly into eight groups. Rats of the first group were served as normal control. Rats of the second group were administrated with TAA. Rats of the third, fourth and fifth groups were exposed to TAA plus olive leaves extract, TAA plus rosemary leaves extract and TAA plus olive and rosemary leaves extracts respectively. The sixth, seventh and eighth groups were supplemented with olive leaves extract, rosemary leaves extract, and olive and rosemary leaves extracts respectively. After twelve weeks of experimental treatments, the levels of serum glucose, total protein, albumin and high density lipoprotein cholesterol were significantly decreased, while the levels of triglycerides, cholesterol, low density lipoprotein cholesterol, very low density lipoprotein cholesterol, creatine kinase and lactate dehydrogenase were statistically increased in rats exposed to TAA. Administration of the studied extracts inhibited the hematobiochemical parameters and improved the physiological disturbances induced by TAA intoxication. Additionally, the most improvements were noted in rats administrated with rosemary leaves extract followed by olive and rosemary leaves extracts and olive leaves extract. These results suggested that the effect of these extracts might be due to their antioxidant activities against TAA toxicity.
... Figure 6 shows that the maximum number of species were used for urinary disorders (11 species) followed by skin infections (8 species) and digestive disorders (7 species). These predominant disorders were also reported in the valley by the health department of Khyber Pakhtunkhwa province and Pakistan Demographic and Health survey (PDHS) [43]. The main reason for the use of medicinal plants by the inhabitants of the valley is the lack of basic health units, rich diversity of medicinal plants and the area is far away from the city. ...
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This paper represents the first ethnobotanical study in Chail valley of district Swat-Pakistan and provides significant information on medicinal plants use among the tribal people of the area. The aim of this study was to document the medicinal uses of local plants and to develop an ethnobotanical inventory of the species diversity. In present study, semi-structured interviews with 142 inhabitants (age range between 31-75 years) were conducted. Ethnobotanical data was analyzed using relative frequency of citation (RFC) to determine the well-known and most useful species in the area. Current research work reports total of 50 plant species belonging to 48 genera of 35 families from Chail valley. Origanum vulgare, Geranium wallichianum and Skimmia laureola have the highest values of relative frequency of citation (RFC) and are widely known by the inhabitants of the valley. The majority of the documented plants were herbs (58%) followed by shrubs (28%), trees (12%) and then climbers (2%). The part of the plant most frequently used was the leaves (33%) followed by roots (17%), fruits (14%), whole plant (12%), rhizomes (9%), stems (6%), barks (5%) and seeds (4%). Decoction was the most common preparation method use in herbal recipes. The most frequently treated diseases in the valley were urinary disorders, skin infections, digestive disorders, asthma, jaundice, angina, chronic dysentery and diarrhea. This study contributes an ethnobotanical inventory of medicinal plants with their frequency of citations together with the part used, disease treated and methods of application among the tribal communities of Chail valley. The present survey has documented from this valley considerable indigenous knowledge about the local medicinal plants for treating number of common diseases that is ready to be further investigated for biological, pharmacological and toxicological screening. This study also provides some socio-economic aspects which are associated to the local tribal communities.
... Many well-established medicines come from plants, for example, aspirin from willow bark and digoxin from foxglove [1]. Traditional herbal medicine is just one of the many different approaches to the use of plants as remedies [2]. Today, herbal remedies are a common therapy. ...
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Traditional herbal medicine is just one of the many different approaches using plants in the remedy of diseases. Carthamus tinctorius (CT) or safflower is a popular plant that is used for coloring and flavoring in food industries. The effect of CT on spermatogenesis and sperm parameters has been reported in traditional medicine but has not yet been confirmed scientifically. Therefore, this study was designed to determine the effects of CT on spermatogenesis and the male reproductive system in an animal model. Sixty male rats were divided into five groups. Four groups were injected with 5 mg/kg of busulfan as a model of partial infertility. Then, the experimental groups were treated with 10 mg/kg, 25 mg/kg, or 50 mg/kg of CT extract for 35 days. The control was treated with busulfan (infertile control) or distilled water only. After this period, the animals were sacrificed and blood samples were taken for hormonal assay. The semen was collected from the epididymis and the reproductive organs were assessed. Sperm count and motility were measured and smears were prepared for assessment of the other parameters. The results indicated that the percentage of sperm with good morphology, motility, and count increased significantly in the group treated with 10 mg/kg CT (p=0.002, p=0.03, and p=0.00001, respectively). The effects on hormonal changes and genital organ weights were also positive. It is probable that the CT extract affects spermatogenesis and as a result sperm quality. Further studies are needed.
... There is strong evidence that hypericin and pseudohypericin [Figure 5] contribute to the antidepressant action. Inhibition of monoamine oxidase is one mechanism by which some antidepressants operate to increase levels of neurotransmitters such as serotonin, norepinephrine, or dopamine.[46] This chemical appears to block synaptic re-uptake of serotonin, dopamine, and norepinephrine.[47] ...
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Cognitive dysfunction is a major health problem in the 21st century, and many neuropsychiatric disorders and neurodegenerative disorders, such as schizophrenia, depression, Alzheimer's Disease dementia, cerebrovascular impairment, seizure disorders, head injury and Parkinsonism, can be severly functionally debilitating in nature. In course of time, a number of neurotransmitters and signaling molecules have been identified which have been considered as therapeutic targets. Conventional as well newer molecules have been tried against these targets. Phytochemicals from medicinal plants play a vital role in maintaining the brain's chemical balance by influencing the function of receptors for the major inhibitory neurotransmitters. In traditional practice of medicine, several plants have been reported to treat cognitive disorders. In this review paper, we attempt to throw some light on the use of medicinal herbs to treat cognitive disorders. In this review, we briefly deal with some medicinal herbs focusing on their neuroprotective active phytochemical substances like fatty acids, phenols, alkaloids, flavonoids, saponins, terpenes etc. The resistance of neurons to various stressors by activating specific signal transduction pathways and transcription factors are also discussed. It was observed in the review that a number of herbal medicines used in Ayurvedic practices as well Chinese medicines contain multiple compounds and phytochemicals that may have a neuroprotective effect which may prove beneficial in different neuropsychiatric and neurodegenerative disorders. Though the presence of receptors or transporters for polyphenols or other phytochemicals of the herbal preparations, in brain tissues remains to be ascertained, compounds with multiple targets appear as a potential and promising class of therapeutics for the treatment of diseases with a multifactorial etiology.
... Herbal medicine appeals to consumers who believe that natural herbal products are preferable to synthetic pharmaceuticals (Kaptchuk et al., 1998). Usually herbal preparations are well thought-out more safe than pharmaceutical drugs although there are some potential adverse reactions from taking both together (Schultz et al., 1998). A relevant safety concern associated with the use of herbal medicines is the risk of interaction with prescription medications (Ernst et al., 2000). ...
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Many people have the mistaken notion that, being natural, all herbs and foods are safe; this is not so. Very often, herbs and food may interact with medications you normally take, result in serious reactions. During the latter part of this century the practice of herbalism has become mainstream throughout the world. This is due remove to the recognition of the value of traditional medical systems in the world. Herbal medicines are mixtures of more than one active ingredient. The multitude of pharmacologically active compounds obviously increases the likelihood of interactions taking place. Hence, the likelihood of herb-drug interactions is theoretically higher than drug-drug interactions because synthetic drugs usually contain single chemical entity. Case reports and clinical studies have highlighted the existence of a number of clinically important interactions, although cause-and-effect relationships have not always been established. Herbs and drugs may interact either pharmacokinetically or pharmacodynamically. The predominant mechanism for this interaction is the inhibition of cytochrome P-450 3A4 in the small intestine; result in a significant reduction of drug presystemic metabolism. An additional mechanism is the inhibition of Pglycoprotein, a transporter that carries drug from the enterocyte back to the gut lumen, result in a further increase in the fraction of drug absorbed. Some herbal products (e.g. St. John's wort) have been shown to lower the plasma concentration (and/or the pharmacological effect) of a number of conventional drugs including cyclosporine, indinavir, irinotecan, nevirapine, oral contraceptives and digoxin. The data available so far, concerning this interaction and its clinical implications are reviewed in this article. It is likely that more information regarding such interaction would crop up in the future, awareness of which is necessary for achieving optimal drug therapy.
... Achillea millefolium is a perennial herb that had been used for hundreds of years in folk medicine in several countries. Teas from the aerial parts are widely used to treat spasms (Yaeesh et al., 2006), pain, digestive complaints and other ailments (Schulz et al., 2001). Data from the literature report the presence of terpenoids, sesquiterpene lactones, essential oils (Agnihotri et al., 2005; Heinrich et al., 1998), flavonoid aglycones, flavonoids di-O-glycosides and di-C-glycosides, and two caffeic acid derivatives, 3,5-dicaffeoylquinic acid and chlorogenic acid (Si et al., 2006; Benedek et al., 2007; Innocenti et al., 2007) in A. millefolium. ...
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The hydroalcohol extracts of Achillea millefolium L. (AM) and Artemisia vulgaris L. (AV), both belonging to the Asteraceae family, were evaluated by the hot plate, writhing, formalin and intestinal transit tests in an attempt to confirm their folk use as analgesic, antiinflammatory and antispasmodic agents. AM 500 and 1000 mg/kg significantly inhibited abdominal contortions by 65% and 23%, respectively, whereas AV 500 and 1000 mg/kg inhibited them by 48% and 59%, respectively. None of the extracts produced differences in the intestinal transit in mice, nor in the response time in the hot plate or in the immediate or late responses in the formalin test. In HPLC/DAD analyses 'fingerprint', monitored at 360 and 270 nm, both hydroalcohol extracts showed the same flavonoid glycoside as a principal constituent, which was identified as rutin. A high content of caffeic acid derivatives were also found in both extracts. The main differences were observed at 240 nm: AM had a higher content of rutin, while in AV the hydroxybenzoic acid derivative was the major component.
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Discusses the regulation, quality, safety, and efficacy of herbal medical remedies. This paper also highlights individual herbs, such as ginkgo, hawthorn, saw palmetto, and St. John's wort. In conclusion, recommendations for clinicians are given regarding herbal remedies. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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The purpose of this study was to explore the effect of Lavandula angustifolia (lavender) inhalation on the symptoms of dysmenorrhea and the amount of menstrual bleeding in female students with primary dysmenorrhea. This study is an experimental clinical trial. The subjects were 96 female students residing in dormitory at Tehran University of Medical Sciences in 2011 and suffering from level two or three dysmenorrhea according to the verbal multi-dimensional scoring system. The inclusion criteria were as: being single, suffering from primary dysmenorrhea, having no genital organs disorder, having no systemic disease, having regular menstrual cycles, using no contraceptives, etc. The follow-up time was 4 menstrual cycles. The subjects were randomized into two groups: experimental (n=48) who inhaled lavender based on sesame oil, and placebo (n=48) who inhaled sesame oil only. The severity of dysmenorrhea symptoms was measured through a questionnaire, and the amount of menstrual bleeding was measured by sanitary towel usage. Ordinal logistic regression and generalized estimating equation (GEE) were used to analyze the data. The symptoms of dysmenorrhea were significantly lowered in the lavender group compared to the placebo group (p<0.001). The amount of menstrual bleeding in the lavender group was reduced in comparison to the placebo group but the difference was not statistically significant (p=0.25). No significant difference was observed for blood clot among the students (p=0.666). This study showed that lavender inhalation was effective in alleviating dysmenorrhea symptoms, suggesting that it could be applied by midwives in a safe manner because of no side effects, simplicity and cost-effectiveness for all patients.
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Oxidative stress is a normal phenomenon in the body. Under normal conditions, the physiologically important intracellular levels of reactive oxygen species (ROS) are maintained at low levels by various enzyme systems participating in the in vivo redox homeostasis. Therefore, oxidative stress can also be viewed as an imbalance between the prooxidants and antioxidants in the body. For the last two decades, oxidative stress has been one of the most burning topics among the biological researchers all over the world. Several reasons can be assigned to justify its importance: knowledge about reactive oxygen and nitrogen species production and metabolism; identification of biomarkers for oxidative damage; evidence relating manifestation of chronic and some acute health problems to oxidative stress; identification of various dietary antioxidants present in plant foods as bioactive molecules; and so on. This review discusses the importance of oxidative stress in the body growth and development as well as proteomic and genomic evidences of its relationship with disease development, incidence of malignancies and autoimmune disorders, increased susceptibility to bacterial, viral, and parasitic diseases, and an interplay with prooxidants and antioxidants for maintaining a sound health, which would be helpful in enhancing the knowledge of any biochemist, pathophysiologist, or medical personnel regarding this important issue.
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Abstract The widespread impact of cancer worldwide and noncurative treatment methods despite all developments drive patients towards investigating and using nonconventional treatment methods. Herbs, which have an important role in complementary and alternative medicine practices, may cause unfavorable results when used especially with chemotherapeutics in cancer patients due to the substances they contain and due to the properties of some, which still cannot be clarified. Further overshadowing the success of the treatments, patients do not talk about these issues with their doctors and physicians are unable to comprehend these properties of herbs. In this compilation we aimed to clarify the concepts of complementary and alternative medicine, to gather the properties of important and frequently used herbs, and to increase the awareness of physicians on this subject.
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The World Health Organization estimates that 80% of the world’s population relies on herbal medicine, with the use of herbs in the United States expanding significantly in the past decade. Alternative and herbal medicines—such as St. John’s wort, kava, ginkgo biloba, and valerian, among others—have become increasingly popular treatments for nervous and sleep disorders including stress, anxiety, dementia, and forgetfulness. This article reviews the use of ginkgo, kava, passionflower, and valerian in psychiatric practice, summarizing existing research on these major botanicals. Herbal remedies are compared with pharmaceuticals, and dosages, benefits, adverse effects, and drug–herb interactions are discussed for each herb.
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Safety and efficacy issues surrounding the use of the most popular herbs are discussed. The various herbs classified under the general heading "ginseng" are compared and contrasted. Echinacea is commonly used for treating colds and flu. St. John's Wort is among the best studied herbs in terms of efficacy in treating depression and drug interactions. Saw palmetto is used to treat benign prostatic hypertrophy with a minimum of side effects and drug interactions. Garlic has a wide range of uses, including hyperlipidemia, hypertension, and infections. Kava kava shows promise as an alternative for mild anxiety disorders. Valerian has been used with some success to treat insomnia. Ginkgo has gained acceptance for treating dementia, memory loss, and intermittent claudication. Goldenseal is a popular but probably ineffective antiseptic and agent for masking drug screens. Milk thistle may have a role in treating liver disease of various origins. Aloe is used as a laxative and to treat wounds. Black cohosh is a popular herb for treating the symptoms of menopause.
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This study has been done in order to identify plants that were used to make traditional Turkish salves between 2007 and 2008. During the step of identification of plants, the informants from different cities of Turkey were asked questions about the salves they have made and which plants and materials they have used. In this study, a total of 105 people from 21 provinces (N = 5 each province) were interviewed. Information was gathered through scientifically guided questionnaires, interviews, and general conversations, and fidelity level (FL) of species was determined. According to the results of the identification, 68 plants are being used to make Traditional Turkish Salves for medicinal purposes in Turkey. Among them, 61 plants are wild and 7 plants are cultivated plants. Most used families were Asteraceae, Apiaceae, Lamiaceae, Liliaceae, and Rosaceae. Urtica dioica (100%) has the highest FL and Lawsonia inermis (33%) has the lowest. The data provided from our informants and analyzed in the present article clearly show that folk knowledge on medicinal plants and plant uses is still alive in the studied region.
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The increase of atmospheric CO2 due to global change and/or horticultural practices promotes direct effects on plant growth and development. These responses may occur in natural ecosystems, but also can be used to increase the production of some plants and some secondary compounds. Present work tries to study the effects of atmospheric CO2 enrichment under greenhouse conditions on growth and in the concentration and composition of secondary metabolites of Taxus bacatta, Hypericum perforatum and Echinacea purpurea under Mediterranean environmental conditions. CO2 fertilization shows interesting perspectives to increase and improve horticultural techniques in order to increase plant medicinal productivity, in spite of clear differences among the species. In general this technique promotes important and significant increases in primary productivity and, in some cases, also in secondary compounds. This has a great horticultural relevance because the total productivity of this kind of products increase at crop level, directly because concentration is increased and /or indirectly because biomass is increased.
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We examined nonprescription weight-loss supplements marketed on the Internet for ingredients with potential arrhythmogenic and life-threatening cardiac adverse effects. We aimed to define the risks of life-threatening cardiac adverse effects that are associated with weight-loss supplements marketed on the Internet. We entered the key words "weight-loss supplements" and "diet pills" into three popular Internet search engines. The top four nonoverlapping hits from each search engine were purchased. After receipt, the products and their ingredient lists were inspected, and Medline and the Natural Medicines Comprehensive Database were searched for reports of significant associations between each ingredient and various key words for life-threatening cardiac adverse effects. All supplements had the list of ingredients on the label. We identified 60 different ingredients (7.25 +/- 4.66 per supplement; range 1-21). Eleven ingredients representing eight different substances (because multiple names were used for some substances) were each associated with two or more reports of life-threatening cardiac complications or death. Eight of the 12 products contained one or more such ingredients, but none of these eight products had warnings about life-threatening cardiac adverse effects on the Web pages, on the labels, or in the package inserts. One product contained ma huang (Chinese ephedra), even though the marketing of ephedra-containing products is banned in the United States. The Internet provides easy access to weight-loss supplements, several of which contain ingredients with potentially life-threatening adverse effects. There is a need for increased public education and awareness regarding such weight-loss products.
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To review the efficacy and safety of specific herbal medications that have been used traditionally to treat common conditions in women. Current literature, with emphasis on more rigorously controlled studies. Herbal medicines have long been used in traditional healing systems to treat conditions of particular interest to women, such as premenstrual syndrome (PMS) and menopausal symptoms. For a select number of phytomedicines, including evening primrose oil, black cohosh root extract, dong quai, and chaste tree berry, scientific investigation is elucidating the pharmacologically active constituents, mechanism of action, and clinical value. Based on the available evidence, evening primrose oil and chaste tree berry may be reasonable treatment alternatives for some patients with PMS. Dong quai may have some efficacy for PMS when used in traditional Chinese multiple-herb formulas. For relief of menopausal symptoms, black cohosh root extract and dong quai have good safety profiles, but only black cohosh has demonstrated efficacy for this indication. Safety data, especially during pregnancy and lactation, are still largely lacking for many herbal medications, and recommendations for usage and dosage vary. Pharmacists who wish to recommend herbal products for women's health conditions need to evaluate the scientific literature in order to form their own opinions about appropriate use and safety.
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To investigate the effect of garlic on total cholesterol level in persons with elevated levels by conducting a meta-analysis of randomized, double-blind, placebo-controlled trials. Systematic literature searches were conducted on the MEDLINE, EMBASE, BIOSIS, Cochrane Library, AMED, and CISCOM databases. Manufacturers of commercial garlic preparations and experts in the field were asked about published or unpublished trials. Selected trials were required to state that they were randomized, double-blind, and placebo-controlled; use garlic monopreparations; include persons with mean total cholesterol levels of at least 5.17 mmol/L (200 mg/dL); and report total cholesterol level as an end point. There were no language restrictions. Two reviewers, blinded to key identifiers of each paper, independently extracted data in a standardized manner and assessed methodologic quality by using the Jadad scale. Discrepancies were settled through discussion. In the 13 trials included in the meta-analysis, garlic reduced total cholesterol level from baseline significantly more than placebo (P < 0.01); the weighted mean difference was -0.41 mmol/L (95% CI, -0.66 to -0.15 mmol/L) (-15.7 mg/dL [CI, -25.6 to -5. 7 mg/dL]). Six diet-controlled trials with the highest scores for methodologic quality revealed a nonsignificant difference between garlic and placebo groups; the weighted mean difference was -0.11 mmol/L (CI, -0.30 to 0.08 mmol/L) (-4.3 mg/dL [CI, -11.7 to 3.1 mg/dL]). The available data suggest that garlic is superior to placebo in reducing total cholesterol levels. However, the size of the effect is modest, and the robustness of the effect is debatable. The use of garlic for hypercholesterolemia is therefore of questionable value.
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Analysis of the biochemical composition of Irvingia malayana was carried out. This Cambodian nut contains 7.5% water and 70% oil. Most of the fatty acids are saturated and include 42% C12:0 and 41.8% C14:0; the sterol composition is similar to that of other vegetable oils. This oil is less rich in alpha-tocopherol than in gamma-tocopherol. Analysis of the solid content of the oil with respect to the temperature by NMR shows a fast fall of solid content around its fusion range at 38-39 degrees C. The main differences in the properties of the indigenous Cambodia nut from other known oleaginous seeds are in its selenium content, fatty acid composition, fusion temperature profile, and content of antioxidants. These important characteristics can soon make possible its application in pharmacology, cosmetics, the margarine industry, etc.
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Whereas other components of the National Institutes of Health support the discovery and subsequent development of novel chemical entities into drugs, the National Center for Complementary and Alternative Medicine (NCCAM) studies complex natural products that are marketed as dietary supplements. This article contrasts the regulatory framework for dietary supplements and drugs, outlines the challenges of evaluating dietary supplements for safety and clinical effectiveness, and describes the evolving drug model for botanicals.
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To review and evaluate the literature relative to the use of herbal therapies in the treatment of benign prostatic hyperplasia. Literature was identified by MEDLINE, Embase, International Pharmaceutical Abstracts, and the International Bibliographic Information on Dietary Supplements searches and through cross-referencing of selected articles. All articles identified from the data sources were evaluated and all information deemed relevant was included in this review. A large percentage of men >50 years old begin to experience signs and symptoms of benign prostatic hyperplasia (BPH). Herbs hold promise in the treatment of BPH. Serenoa repens, Pygeum africanum, Urtica dioica radix, and Cucurbita peponis semen are some of the botanical therapies used in the treatment of BPH. There are many European studies examining efficacy, dose, and adverse effects of these plants in the treatment of BPH. However, numerous questions remain. These include issues concerning long-term beneficial and adverse effects of herbal therapy, prevention of complications, standardization of extracts, and concomitant use with "mainstream" medications. Based on the information available today, these botanical therapies can be used for treatment of a number of objective and subjective symptoms in patients with BPH, stages I and II.
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To determine what products health food store employees recommend for depression, to analyze the content of these products based on label claims, and to evaluate employee statements or recommendations for accuracy and safety. Twelve health food stores were selected for the study. One investigator approached an employee in each store and asked what they recommended for depression plus five additional questions regarding product use. Thirteen products containing St. John's wort were purchased and analyzed for hypericin and pseudohypericin content using high-performance liquid chromatography (HPLC). Total hypericin content was calculated by adding the values for hypericin and pseudohypericin. All 12 health food store employees recommended a St. John's wort supplement for treatment of depression. Furthermore, numerous comments made by employees regarding St. John's wort and the treatment of depression were unsafe and inaccurate. The HPLC analysis revealed that no product contained +/- 10% of the stated label claim for hypericin content, and two products contained 0% hypericin. The total hypericin content (hypericin plus pseudohypericin) of only two products was within +/- 10% of the label claim for hypericin. Health food store employees offer health care advice regarding treatment of depression with dietary supplements without proper scientific and medical training. Their comments could cause significant harm to customers. In addition, the inconsistencies of dietary supplement content continue to raise concern for individuals who use these agents as medical treatment.
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Four important categories of urologic herbs, their history, and modern scientific investigations regarding them are reviewed. Botanical diuretics are discussed with a focus on Solidago spp (goldenrod) herb, Levisticum officinale (lovage) root, Petroselinum crispus (parsley) fruit, and Urtica dioica (stinging nettle) herb. Urinary antiseptic and anti-adhesion herbs, particularly Arctostaphylos uva-ursi (uva-uri) leaf, Juniperus spp (juniper) leaf, and Vaccinium macrocarpon (cranberry) fruit are reviewed. The antinephrotoxic botanicals Rheum palmatum (Chinese rhubarb) root and Lespedeza capitata (round-head lespedeza) herb are surveyed, followed by herbs for symptoms of benign prostatic hyperplasia, most notably Serenoa repens (saw palmetto) fruit, Urtica dioica root, and Prunus africana (pygeum) bark.
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To assess the efficacy and safety of Melissa officinalis extract using a fixed dose (60 drops/day) in patients with mild to moderate Alzheimer's disease. A four month, parallel group, placebo controlled trial undertaken in three centres in Tehran, Iran. Patients with mild to moderate Alzheimer's disease aged between 65 and 80 years (n = 42; 18 women, 24 men) with a score of >or= 12 on the cognitive subscale of Alzheimer's disease assessment scale (ADAS-cog) and <or= 2 on the clinical dementia rating (CDR) were randomised to placebo or fixed dose of Melissa officinalis extract. The main efficacy measures were the change in the ADAS-cog and CDR-SB scores compared with baseline. Side effects were systematically recorded. At four months, Melissa officinalis extract produced a significantly better outcome on cognitive function than placebo (ADAS-cog: df = 1, F = 6.93, p = 0.01; CDR: df = 1, F = 16.87, p < 0.0001). There were no significant differences in the two groups in terms of observed side effects except agitation, which was more common in the placebo group (p = 0.03). Melissa officinalis extract is of value in the management of mild to moderate Alzheimer's disease and has a positive effect on agitation in such patients.
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It is important that the safety of herbal medicines is scientifically addressed Throughout history, plants have been used for medicinal purposes and, during the last three decades, we have witnessed a most remarkable revival of herbal medicine.1 Germany is the country with the largest per head consumption of herbal medicines. In 2002, the 100 best selling products achieved a total turnover of 420 million Euros.2 This high level of popularity means, among other things, that we ought to ensure that no harm is done. Even though the media frequently try to persuade us otherwise, not all herbal medicines are free of adverse effects (table 1).2–5 Phytopharmacovigilance—that is, the systematic research of the safety of herbal medicines—has therefore become an important topic. In this article, I will briefly outline some …
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A large proportion of patients use herbal remedies with a potential to interact with prescribed drugs. Such interactions can be dangerous, particularly if the therapeutic window of the prescribed drug is small, as with warfarin. Our aim was to estimate the prevalence of the use of herbal medicines by patients taking warfarin (co-ingestion). Postal questionnaire. General practices in the South West of England. Thirty-five general practices in Devon and Somerset identified 2600 patients taking warfarin and sent postal questionnaires to them. One thousand, three hundred and sixty usable responses were received (response rate = 54.2%). One or more of the specified herbal remedies thought to interact with warfarin were taken by 8.8% of all patients. Complementary or homeopathic treatments not specified in the survey questionnaire were taken by 14.3% of responders. Overall, 19.2% of responders were taking one or more such medicines. The use of herbal medicines had not been discussed with a conventional healthcare professional by 92.2% of patients. Twenty-eight point three per cent of responders thought that herbal medicines might or definitely could interfere with other drugs prescribed by their doctor, however, patients taking any non-prescribed medication were less likely to believe this (chi2 = 20, degrees of freedom = 1, P<0.001). A substantial proportion of patients taking warfarin in southwest England self-medicate with both herbal medicines that are thought to interact with warfarin and with others of unknown effect, usually without informing their healthcare team. Patients have a responsibility to mention such non-prescribed medication to their general practitioners, and general practitioners also have a responsibility to ask whether such co-ingestion is occurring.
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To provide evidence-based research information about 31 herbs and natural products that have shown potential in early research to decrease cancer growth or as adjuncts with cancer treatment. Names of herbs and natural products with potential to decrease cancer growth have been selected from listings in the Natural Medicines Comprehensive Database and Lawrence Review of Natural Products-Monograph System. Information about these herbs has been found in evidence-based studies cited in references. In preliminary studies, 31 herbs and natural products appear to have potential for cancer treatment. This preliminary evidence may be useful to healthcare professionals and patients with cancer. The information in this article is designed to provide quick access for healthcare professionals working in clinical oncology. Oncology nurses who have this information can become resources for patients and other healthcare professionals.
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For centuries the South Pacific islanders have consumed kava (Piper methysticum) as a ceremonial intoxicating beverage. More recently, caplets of kava extracts have been commercialized for their anxiolytic and antidepressant activities. Several cases of hepatotoxicity have been reported following consumption of the commercial preparation whereas no serious health effects had been documented for the traditional beverage. A detailed comparison of commercial kava extracts (prepared in acetone, ethanol or methanol) and traditional kava (aqueous) reveals significant differences in the ratio of the major kavalactones. To show that these variations could lead to differences in biological activity, the extracts were compared for their inhibition of the major drug metabolizing P450 enzymes. In all cases (CYP3A4, CYP1A2, CYP2C9, and CYP2C19), the inhibition was more pronounced for the commercial preparation. Our results suggest that the variations in health effects reported for the kava extracts may result from the different preparation protocols used.
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To provide evidence-based research information about 47 herbs and natural products that have the potential to protect against the development of cancer. Natural Medicines Comprehensive Database and Lawrence Review of Natural Products-Monograph System. Information about these herbs has been found in evidence-based studies cited in the references. Early research shows that some herbs and natural products appear to have the potential to prevent cancer growth. This preliminary evidence may be useful to healthcare professionals or patients who are concerned about cancer. Oncology nurses who receive this information can become resources for patients or other healthcare professionals.
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The growing popularity of botanical dietary supplements (BDS) has been accompanied by concerns regarding the quality of commercial products. Health care providers, in particular, have an interest in knowing about product quality, in view of the issues related to herb-drug interactions and potential side effects. This study assessed whether commercial formulations of saw palmetto, kava kava, echinacea, ginseng and St. John's wort had consistent labeling and whether quantities of marker compounds agreed with the amounts stated on the label. We purchased six bottles each of two lots of supplements from nine manufacturers and analyzed the contents using established commercial methodologies at an independent laboratory. Product labels were found to vary in the information provided, such as serving recommendations and information about the herb itself (species, part of the plant, marker compound, etc.) With regard to marker compound content, little variability was observed between different lots of the same brand, while the content did vary widely between brands (e.g. total phenolic compounds in Echinacea ranged from 3.9-15.3 mg per serving; total ginsenosides in ginseng ranged from 5.3-18.2 mg per serving). Further, the amounts recommended for daily use also differed between brands, increasing the potential range of a consumer's daily dose. Echinacea and ginseng were the most variable, while St. John's wort and saw palmetto were the least variable. This study highlights some of the key issues in the botanical supplement market, including the importance of standardized manufacturing practices and reliable labeling information. In addition, health care providers should keep themselves informed regarding product quality in order to be able to appropriately advise patients utilizing both conventional and herbal medicines.
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Herbal medicine has become a popular form of healthcare. Even though several differences exist between herbal and conventional pharmacological treatments, herbal medicine can be tested for efficacy using conventional trial methodology. Several specific herbal extracts have been demonstrated to be efficacious for specific conditions. Even though the public is often misled to believe that all natural treatments are inherently safe, herbal medicines do carry risks. Ultimately, we need to know which herbal remedies do more harm than good for which condition. Because of the current popularity of herbal medicine, research in this area should be intensified.
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Isolation and biological characterization of pure compounds was used to identify and characterize estrogenic activity and estrogen receptors (ER) preference in chemical components of Achillea millefolium. This medicinal plant is used in folk medicine as an emmenagogue. In vitro assay, based on recombinant MCF-7 cells, showed estrogenic activity in a crude extract of the aerial parts of A. millefolium. After fractionation of the crude extract with increasing polar solvents, estrogenic activity was found in the methanol/water fraction. Nine compounds were isolated and characterized by HR-MS spectra and 1D- and 2D-NMR techniques. In particular, dihydrodehydrodiconiferyl alcohol 9-O-beta-D-glucopyranoside - a glycosyl-neolignan - was isolated for the first time from the genus Achillea in addition to six flavone derivatives, apigenin, apigenin-7-O-beta-D-glucopyranoside, luteolin, luteolin-7-O-beta-D-glucopyranoside, luteolin-4'-O-beta-D-glucopyranoside, rutin, and two caffeic acid derivatives, 3,5-dicaffeoylquinic acid and chlorogenic acid. Apigenin and luteolin, the most important estrogenic compounds among those tested, were studied for their ability to activate alpha or beta estrogen receptors (ERalpha, ERbeta) using transiently transfected cells. Our results suggest that isolation and biological characterization of estrogenic compounds in traditionally used medicinal plants could be a first step in better assessing further (e.g. in vivo) tests of nutraceutical and pharmacological strategies based on phytoestrogens.
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The study was conducted around Debre Libanos monastery from October 2005 to June 2006. A total of 250 villagers, 13 monks and 3 nuns were interviewed using semistructured questionnaire on the knowledge and use of medicinal plants. The informant consensus factor (ICF) and the fidelity level (FL) of the species were determined. Eighty medicinal plant species were reported. The average medicinal plant reported by a female is 1.67+/-0.33 and a male is 5.77+/-0.71 with significant difference between them (alpha=0.05, p=0.023). The ICF values demonstrated that local people tend to agree more with each other in terms of the plants used to treat 'Mich' and headache (0.69) and intestinal illness and parasites (0.68) but a much more diverse group of plants are cited to treat problems related to rabies (0.14) and unidentified swelling and cancer (0.11). The FL values are also similar to ICF values. The knowledge of the villagers close to the monastery is found to be higher than those distant from the monastery and the correlation between Abichu and Telaye (r=0.970, alpha=0.05, p=0.001), and Zegamel and Doreni (r=0.745, alpha=0.05, p=0.027) is significant indicating the relationships between the number of plants reported by the informants and the distance from the monasteries to the villages. This study was not able to determine the knowledge difference between the villagers and the monastery dwellers because the monks and nuns were not willing to give information on the knowledge and use of medicinal plants. This may result in the long run in loss of local knowledge in the surrounding area and the country at large for preparation of pharmacologically effective remedies.
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Chemotherapy-induced leukopenia and neutropenia are common side effects during cancer treatment. Acupuncture has been reported as an adjunct therapy for this complication. The current study reviewed published randomized controlled trials of acupuncture's effect and explored the acupuncture parameters used in these trials. We searched biomedical databases in English and Chinese from 1979 to 2004. The study populations were cancer patients who were undergoing or had just completed chemotherapy or chemoradiotherapy, randomized to either acupuncture therapy or usual care. The methodologic quality of trials was assessed. From 33 reviewed articles, 682 patients from 11 eligible trials were included in analyses. All trials were published in non-PubMed journals from China. The methodologic quality of these trials was considerably poor. The median sample size of each comparison group was 45, and the median trial duration was 21 days. The frequency of acupuncture treatment was once a day, with a median of 16 sessions in each trial. In the seven trials in which white blood cell (WBC) counts were available, acupuncture use was associated with an increase in leukocytes in patients during chemotherapy or chemoradiotherapy, with a weighted mean difference of 1,221 WBC/muL on average (95% confidence interval 636-1,807; p < .0001). Acupuncture for chemotherapy-induced leukopenia is an intriguing clinical question. However, the inferior quality and publication bias present in these studies may lead to a false-positive estimation. Meta-analysis based on these published trials should be treated in an exploratory nature only.
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An ethnobotanical study was conducted from October 2005 to June 2006 to investigate the uses of medicinal plants by people in Zegie Peninsula, northwestern Ethiopia. Information was gathered from 200 people: 70 female and 130 males, using semistructured questionnaire. Of which, six were male local healers. The informants, except the healers, were selected randomly and no appointment was made prior to the visits. Informant consensus factor (ICF) for category of ailments and the fidelity level (FL) of the medicinal plants were determined. Sixty-seven medicinal plants used as a cure for 52 ailments were documented. They are distributed across 42 families and 64 genera. The most frequently utilized plant part was the underground part (root/rhizome/bulb) (42%). The largest number of remedies was used to treat gastrointestinal disorder and parasites infections (22.8%) followed by external injuries and parasites infections (22.1%). The administration routes are oral (51.4%), external (38.6%), nasal (7.9%), and ear (2.1%). The medicinal plants that were presumed to be effective in treating a certain category of disease, such as 'mich' and febrile diseases (0.80) had higher ICF values. This probably indicates a high incidence of these types of diseases in the region, possibly due to the poor socio-economic and sanitary conditions of this people. The medicinal plants that are widely used by the local people or used as a remedy for a specific ailment have higher FL values (Carissa spinarum, Clausena anisata, Acokanthera schimperi, Calpurnia aurea, Ficus thonningii, and Cyphostemma junceum) than those that are less popular or used to treat more than one type of ailments (Plumbago zeylanicum, Dorstenia barnimiana).
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Peppermint leaf and peppermint oil have a long history of use for digestive disorders. Recent evidence suggests that enteric-coated peppermint oil may be effective in relieving some of the symptoms of irritable bowel syndrome. A combination product including peppermint oil and caraway oil seems to be moderately effective in the treatment of non-ulcer dyspepsia. Topical application of peppermint oil may be effective in the treatment of tension headache. Because of its relaxing effects on smooth muscle, peppermint oil given via enema has been modestly effective for relief of colonic spasm in patients undergoing barium enemas. Peppermint oil is well tolerated at the commonly recommended dosage, but it may cause significant adverse effects at higher dosages.
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