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Effect of a traditional syrup from Citrus medica L. fruit juice on migraine headache: A randomized double blind placebo controlled clinical trial
... Some of the species and their phytochemicals are available as supplements in pharmacies or herbal shops. Also, some citrus plants and their related products are used in the preparation of a variety of herbal remedies in traditional medicine [27], but it is not clear how evidence-based these claims are. For example, lime juice is used for children with sickle cell anemia, but only one clinical trial has been reported about it [28], which is not enough for clinical decisionmaking or even to set up a meta-analysis. ...
... In a double-blind randomized controlled trial, ingestion of 15 mL of Citrus medica L. fruit juice syrup (citron syrup as a traditional Persian remedy), three times a day for four weeks, was found to be an effective treatment for migraine headaches by reducing the pain severity and duration of attacks with an impact comparable to propranolol [27]. In a case presented in an article on hypoglycemic headaches, drinking 100 cc. of orange juice daily at 4:00 a.m. ...
... Most citrus species accumulated, b,b-xanthophylls, which accounted for more than 90% of total carotenoids. z-carotene (20), antheraxanthin (21), lutein (22), lycopene (23), phytoene (24), phytofluene (25), b-carotene (26), b-cryptoxanthin (27), zeaxanthin (28), b-citraurin (29), and (all-E) violaxanthin (30) can be named as examples of citrus cocarotenoids [132e134] (Fig. 1). ...
s u m m a r y Fruits, flowers, leaves, essential oils, hydrosols, and juices of citrus spp. Are utilized to prepare various forms of food products. Along with their nutritional values, in the health industry, different parts of the plants of the citrus genus have been used as supplements or remedies to prevent or control diseases. This review focused on reported meta-analyses and clinical trials on the health benefits of citrus plants as functional foods. Also, chemical compounds of various citrus species were reviewed. The following information sources were used for data collection: Google Scholar, the Web of Science, Scopus, and PubMed. Various keywords, including "citrus AND chemical compounds," "citrus AND phytochemicals," "citrus species," "citrus AND meta-analysis," "nutritional and therapeutical values of citrus spp.," "clinical trials AND citrus," "clinical trials AND Rutaceae," "health benefits of citrus spp.," "citrus edible or non-edible applications," and scientific names of the citrus plants were utilized to collect data for the review. The scientific name and common name of all twenty-eight citrus species, along with any of the above keywords, were also searched in the mentioned databases. Scientific papers and data sources were sought to review and discuss the citrus plant's nutritional and therapeutic importance. Several meta-analyses and clinical trials have reported beneficial effects of citrus spices on a variety of cancer risks, cardiovascular risk factors, neurologic disorders, urinary tract conditions, and gastrointes-tinal tract conditions. They have shown anxiolytic, antimicrobial, and pain-alleviating effects. Some of them can be helpful in managing obesity and cardiovascular risk factors.
... Recently Haridas e al. [8] suggested that the herbal formulation of C. medica and Zingiber officinalis Rosco may have good potential for reducing the viral load of SARS-CoV-2 in the nasal passages Additionally, citron oil is widely used in Persian folk medicine for musculoskeleta gastrointestinal, and nervous ailments [9]. Furthermore, a juice-extract syrup also showed good activity against migraines [10]. Figure 3 represents the traditional uses in medicin of C. medica in different countries [11,12]. ...
... Flavonoids are a group of specialized metabolites with considerable health benefits, such as antiviral, antioxidant, antimicrobial, hypoglycaemic, and anti-inflammatory properties [10,23,24]. Malleshappa et al. [24] assessed the anti-inflammatory and nociceptive activity in ethanolic extract peels of some citrus fruits attributable to the high content of phenolic compounds. ...
... Clinical study > than placebo in reduction in headache-attack intensity juice Syrup [10] [38] trated juice from three cultivars, Diamante, Balady, and Corsican, with the following test data: 72.00 ± 0.82% for DPPH radical-scavenging activity and 309.08 ± 3.06 mg GAE/g for TPC [3]. Furthermore, the methanol-extract leaves showed antioxidant activity (EC 50 102.9 ...
Plant species are a reservoir of natural compounds that can potentially be used to treat different diseases. Citrus medica Linn. belonging to the Rutaceae family, has been used for centuries in medicine for its antioxidant, anti-inflammatory, antimicrobial, antiviral, and antihyperglycemic properties. These activities are ascribable not only to the presence of health-promoting macronutrients and micronutrients, such as carbohydrates, minerals, amino acids, and vitamins, but also to specialized metabolites, such as flavonoids (apigenin, hesperetin, hesperidin, naringin, naringenin, rutin, quercetin, and diosmin), coumarins (citropten, scoparone, and bergapten), terpenes (limonene, γ-terpinene, limonin, and nomilin), and phenolic acids (p-coumaric acid, trans-ferulic acid, and chlorogenic acid). In recent years, particular attention has been focused on the antioxidant, anti-inflammatory, antimicrobial activity, antidiabetic, anticancer, and neuroprotective activity of C. medica. However, although many studies have reported this species’ chemical and biological properties, the literature has never been analyzed via a systematic approach. For this reason, using PubMed and Scopus as databases, we performed a systematic review of C. medica’s chemical composition and biological properties to inspire new research approaches and increase its curative application.
... Some of the species and their phytochemicals are available as supplements in pharmacies or herbal shops. Also, some citrus plants and their related products are used in the preparation of a variety of herbal remedies in traditional medicine [27], but it is not clear how evidence-based these claims are. For example, lime juice is used for children with sickle cell anemia, but only one clinical trial has been reported about it [28], which is not enough for clinical decisionmaking or even to set up a meta-analysis. ...
... In a double-blind randomized controlled trial, ingestion of 15 mL of Citrus medica L. fruit juice syrup (citron syrup as a traditional Persian remedy), three times a day for four weeks, was found to be an effective treatment for migraine headaches by reducing the pain severity and duration of attacks with an impact comparable to propranolol [27]. In a case presented in an article on hypoglycemic headaches, drinking 100 cc. of orange juice daily at 4:00 a.m. ...
... Most citrus species accumulated, b,b-xanthophylls, which accounted for more than 90% of total carotenoids. z-carotene (20), antheraxanthin (21), lutein (22), lycopene (23), phytoene (24), phytofluene (25), b-carotene (26), b-cryptoxanthin (27), zeaxanthin (28), b-citraurin (29), and (all-E) violaxanthin (30) can be named as examples of citrus cocarotenoids [132e134] (Fig. 1). ...
Fruits, flowers, leaves, essential oils, hydrosols, and juices of citrus spp. Are utilized to prepare various
forms of food products. Along with their nutritional values, in the health industry, different parts of the
plants of the citrus genus have been used as supplements or remedies to prevent or control diseases. This
review focused on reported meta-analyses and clinical trials on the health benefits of citrus plants as
functional foods. Also, chemical compounds of various citrus species were reviewed. The following information
sources were used for data collection: Google Scholar, the Web of Science, Scopus, and
PubMed. Various keywords, including “citrus AND chemical compounds,” “citrus AND phytochemicals,”
“citrus species,” “citrus AND meta-analysis,” “nutritional and therapeutical values of citrus spp.," “clinical
trials AND citrus,” “clinical trials AND Rutaceae,” “health benefits of citrus spp.," “citrus edible or nonedible
applications,” and scientific names of the citrus plants were utilized to collect data for the review.
The scientific name and common name of all twenty-eight citrus species, along with any of the
above keywords, were also searched in the mentioned databases. Scientific papers and data sources were
sought to review and discuss the citrus plant's nutritional and therapeutic importance.
Several meta-analyses and clinical trials have reported beneficial effects of citrus spices on a variety of
cancer risks, cardiovascular risk factors, neurologic disorders, urinary tract conditions, and gastrointestinal
tract conditions. They have shown anxiolytic, antimicrobial, and pain-alleviating effects. Some of
them can be helpful in managing obesity and cardiovascular risk factors.
... Compared with the placebo, the citron syrup was associated with a significantly-reduced intensity and duration of migraine attacks, but not migraine frequency. Citron was comparable to propranolol in its prophylactic effects on migraine intensity and duration (Jafarpour et al., 2016). ...
... Paradoxically, there are investigations demonstrating that citrus fruits may be a trigger for migraine, however, no evidence for citron having this effect has been identified in the literature (Eagle, 2012;Millichap & Yee, 2003). In terms of the safety and tolerability of citron intake, it is generally welltolerated although in the study by Jafarpour et al. (2016) There has been one study examining the effects of the topical application of Damask rose oil on migraine. In a randomised, doubleblind, placebo-controlled, crossover study, 40 adults with episodic migraine applied 2 ml of either Damask rose oil or a placebo oil to their forehead and temporal area at the onset of a migraine attack. ...
... Results from Cochrane Collaboration's tool for assessing the risk of bias are detailed in Table 2. Overall, there is significant uncertainty about the quality of studies as essential details about study designs were not reported in many publications. Many studies were also likely underpowered due to the recruitment of small sample sizes (Borhani Haghighi et al., 2010;De Weerdt et al., 1996;Delavar Kasmaei et al., 2016;Ferro et al., 2012;Grossman & Schmidramsl, 2001;Jafarpour et al., 2016;Johnson et al., 1985;Niazi et al., 2017;Oelkers-Ax et al., 2008;Palevitch et al., 1997;Parohan et al., 2019). ...
Herbal treatments are often used as a treatment for migraine. Therefore, an evaluation of their safety and efficacy is important. Based on the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines, and Cochrane Collaboration's tool for assessing the risk of bias, a systematic literature review of randomised, controlled human trials assessing the effects of herbal treatments delivered as a single ingredient for the acute or prophylactic treatment of migraine were conducted. Studies were identified through electronic database searches on Medline (Pubmed), Cochrane Library, Scopus, and CINAHL. Nineteen studies were identified examining the effects on migraine of feverfew, butterbur, curcumin, menthol/peppermint oil, coriander, citron, Damask rose, chamomile, and lavender. Overall, findings on the efficacy of feverfew were mixed and there was positive, albeit limited evidence for butterbur. There were positive, preliminary findings on curcumin, citron, and coriander as a prophylactic treatment for migraine, and the use of menthol and chamomile as an acute treatment. However, the risk of bias was high for many studies. The results of this systematic review suggest that several herbal medicines, via their multifactorial physiological influences, present as potential options to enhance the treatment of migraine. However, further high‐quality research is essential to examine their efficacy and safety as a treatment for migraine.
... Nevertheless, previous reports showed that cyanidin and its glycosides (the main anthocyanin components of the red-pigment obtained from C. citrinus) could exhibit cytotoxic effects on different cell lines, such as human monocytic leukemia cells [40], glioblastoma cell lines [41], and prostate cancer cells [41,42]. Polyphenols such flavonoids and anthocyanins have shown a variety of biological activities in clinical trials [43]. Because of their antioxidant characteristics, anthocyanins have attracted special interest as cosmetic and therapeutic phytochemicals for the skin [44]. ...
Background and objectives: There is growing interest in introducing safe and bioactive natural red pigments to the pharmaceutical and cosmetic industries. This study was designed to determine the phytochemical content and potential cytotoxicity of red pigment from Callistemon citrinus (Curtis) Skeels (syn. Melaleuca citrina (Curtis) Dum.Cours.) flowers. Methods: The flowers' anthocyanin rich pigment was extracted with ethanol (70%, v/v) containing 0.5% formic acid. This extract was fractionated by a three-step process through a Sep-Pak C 18 cartridge with water, ethyl acetate, and methanol, respectively. The anthocyanin and coumarin content of the red pigment was identified based on a reverse phase high performance liquid chromatography-electrospray ionization mass spectrometry (HPLC/ESI-MS/MS). The MTT assay was used to assess the cytotoxicity of red pigment evaluated on normal human foreskin fibroblasts as well as two malignant cell lines: human breast cancer (MCF-7) and human fibrosarcoma cells (HT1080) at 24, 48 and 72 hours. Results: The anthocyanin compounds in the red pigment fraction were cyanidin (1), cyanidin 3,5-O-diglucoside (2), cyanidin 3-O-glucoside (3), and cyanidin 3-O-glucoside-8-ethyl-catechin (4). Flowers' pigment also contained two furanocoumarins, including 8-(but-2-en-2-yl)-8,9-dihydro-2H-furo[2,3-h] chromen-2-one (or 15-methyl angenomallin, (5)) and 9-methyl-7H-furo[3,2-g] chromen-7-one (or 8-methylpsoralen, (6)). According to the MTT assays, the highest cytotoxic effect was observed on human foreskin fibroblasts with an IC 50 values of <12.5 (µg/ mL, 24 h) and 85.2 (µg/ mL, 48 h). Conclusion: It might be assumed that application of the red pigment of C. citrinus in topical formulations and cosmetics should be done with caution due to the observed cytotoxicity on dermal fibroblasts.
... Other studies concur with our results on individual chronic conditions that higher intake of ASB would elevate the risks of type 2 diabetes, hypertension and asthma 34,38 whereas NJ were associated with reduced risk of chronic conditions such as type 2 diabetes, hypertension and migraine. [39][40][41] Another study using the UK Biobank study found a positive relationship between ASB intake and mortality but this relationship may be sensitive to residual confounding and reverse causation. 22 Additionally, the intake of NJ also showed a null association with mortality in their fully adjusted model. ...
Background
The burden of chronic conditions associated with sugary beverages is increasing but little is known about the role of different types of sugary beverages in the co-occurrence of multiple chronic conditions (‘multimorbidity’). To inform future sugar-reduction guidelines, we aimed to examine the associations of sugar-sweetened beverages (SSB), artificially sweetened beverages (ASB) and natural juices (NJ) with multimorbidity.
Methods
This prospective cohort study included 184 093 UK Biobank participants aged 40–69 years at baseline who completed at least one occasion of 24-h dietary recall between 2009 and 2012. Daily consumptions of SSB, ASB and NJ were assessed using 24-h dietary recall. Participants were followed from the first 24-h assessment until the onset of two or more new chronic conditions, or the end of follow-up (31 March 2017), whichever occurred first. Logistic regression models, Cox proportional hazard models and quasi-Poisson mixed effects models were used to estimate the association of beverages intakes with chronic conditions and multimorbidity.
Results
A total of 19 057 participants had multimorbidity at baseline and 19 968 participants developed at least two chronic conditions during follow-up. We observed dose–response relationships of SSB and ASB consumptions with the prevalence and incidence of multimorbidity. For example, the adjusted hazard ratios (HRs) and 95% CIs of the incidence of developing at least two chronic conditions ranged from 1.08 (1.01–1.14) for SSB intake of 1.1–2 units/day to 1.23 (1.14–1.32) for >2 units/day compared with 0 units/day. Also, the adjusted HRs (95% CIs) of ASB consumption ranged from 1.08 (1.03–1.13) for 0.1–1 unit/day to 1.28 (1.17–1.40) for >2 units/day compared with non-consumers. Conversely, moderate consumption of NJ was associated with a smaller risk of the prevalence and incidence of multimorbidity. Moreover, higher intakes of SSB and ASB were positively associated whereas moderate intake of NJ was inversely associated with increased number of new-onset chronic conditions during follow-up.
Conclusions
Higher SSB and ASB intakes were positively associated whereas moderate NJ intake was inversely associated with the higher risk of multimorbidity and increased number of chronic conditions. Current and intended policy options to decrease the burden of chronic conditions and multimorbidity need a formulation of SSB and ASB reduction strategies.
... Till now, more than 40 types of plant extracts are used for aromatherapy. Lavender oil, rose oil, and citrus species oils are the most commonly used (116)(117)(118). Around the world, Aromatherapy is used broadly by nurses as complementary and alternative medicines because it is applied easily and does not need any licensed experts, equipment, and patient involvement (119). ...
During the pre-operation period, surgical candidates experience situations that stimulate psychological anxiety leading to stress during and after surgery which is known as preoperative anxiety. This condition can cause psychological and physiological adverse effects on both children and adults. Due to the high prevalence and adverse effects of preoperative anxiety, different treatments have been evaluated including pharmacological and non-pharmacological approaches. As pharmacological treatments may cause adverse effects such as breathing problems, drowsiness, interfering with anesthetic drugs, and prolonged recovery, non-pharmacological interventions are becoming more popular. These methods include cognitive-behavioral therapy, music therapy, pre-op preparation video, aromatherapy, hypnosis, guided imagery relaxation therapy, and massage. In this study, the most popular non-pharmacological approaches to preoperative anxiety are reviewed focusing on more recent evidence provided by clinical studies. The reviewed clinical evidence on the mentioned methods shows the efficacy of non-pharmacological interventions for the treatment of preoperative anxiety, so they can be used in patients of different ages and types of disease and surgery.
... Migraine is the second most common type of headache disorder accounting for 12% of total headache incidents. It is predominant in women (15%) and affects only 6% of men [17,19,20]. It poses a high economic and psychosocial burden on the society due to its disabling nature, reduced quality of life and increased defection in work [21]. ...
Out of many disease conditions suffered by mankind since ancient ages, Migraine holds a significant position. It is derived from the word “hemi-crania” and is a type of primary headache. This disease is mentioned in the ancient scriptures dating back to the Mesopotamian era. It has been documented by Hippocrates (460–377 BC) in his treatise, further explored and explained on the basis of cause and location by Galen (131–201 AD). Later its etiopathogenesis clinical features and management was described by Al - Razi (850–923 AD), an eminent Unani physician. Migraine is a disease majorly affecting one side of the head and characterized by recurrent attacks of pulsating headache, mostly associated with nausea, vomiting, photophobia and phonophobia, with or without an aura. It is triggered by noise and light, based on the brightness, intensity, wavelengths or type of light that is being emitted. According to Unani physicians, the word Shaqeeqa is derived from Arabic word ‘Shiq’, meaning ‘a part’ or ‘a side’, hence the name Shaqeeqa . They describe it as a type of headache ( Suda) in which pain occurs only in one side of head, and the causative factors for it are the morbid matters and morbid vapours (Bukharat e Radiya) arising from morbid humours which are either excessive in amount, too hot or too cold. It often results due to abnormal substantial temperament (Su-e-Mizaj Maddi) giving two variants acute ( Shaqeeqa haar) and chronic ( Shaqeeqa barid) . The treatment mainly consists of elimination of morbid matter which is accumulated in the body, and strengthening the brain using brain tonics ( Muqawwiyat-e-Dimagh ).
... Curcumin is the most important curcuminoid found in turmeric root stalks and is one of the plant polyphenols [110]. It is estimated that the total amount of curcumin in turmeric root stalks is just around five-hundredths of a percent [111]. Curcumin's use in the treatment of headaches has recently gotten a lot of attention from scientists [112]. ...
Background
Migraine is a common neurological condition marked by frequent mild to extreme headaches that last 4 to 72 hours. A migraine headache may cause a pulsing or concentrated throbbing pain in one part of the brain. Nausea, vomiting, excessive sensitivity to light and sound, smell, feeling sick, vomiting, painful headache, and blurred vision are all symptoms of migraine disorder. Females are more affected by migraines in comparison to males.
Objective
The present review article summarizes preventive and therapeutic measures including allopathic and herbal remedies for the treatment of migraine.
Results
Review has highlighted the current aspects of migraine pathophysiology, covered an understanding of the complex workings of the migraine state. Therapeutic agents which could give an effective treatment have also been discussed.
Conclusion
It can be concluded that different migraines could be treated based on their type and severity.
... In biological studies and clinical trials, a range of active primary and secondary metabolites from various plant families have shown promising results (Hamedi et al., 2015Jafarpour et al., 2016;Pasdaran et al., 2016). Euphorbiaceae, generally known as the spurge family, is one of the main flowering plant families. ...
A new guaianolide sesquiterpene lactone with cytotoxic properties was isolated from Euphorbia microsphaera Boiss. To determine the highest active fraction and isolate bioactive compounds, a bioassay guided fractionation approach was used. The general toxicity properties of the plant's extracts and fractions (fr1-10) were assessed against Artemia salina, Oryzeaphilus mercator, and Tribolium castaneum. Cytotoxic activities were investigated against normal human foreskin fibroblasts and two malignant cell lines, including human breast cancer (MCF-7) and human fibrosarcoma cells (HT1080) using the MTT assay at different time points of 24, 48, and 72 hours. Single crystal X-ray diffraction (SC-XRD) and mass spectrometry data were used to determine the structure of the active guaianolide sesquiterpene lactone (3aR,4S,4aS,5R,7aS,9aS)-5-hydroxy-5,8-dimethyl-3-methylene-2-oxo-2,3,3a,4,4a,5,6,7,7a,9a decahydroazuleno [6,5-b] furan-4-yl acetate (named aryanin). Chloroformic fraction 7 (fr7, LC50 = 93.50 g/ml for general toxicity) had the highest toxicity result, with a mortality rate of more than 50% for both insect species after 12 hours at 15 mg/mL. The highest cytotoxicity of aryanin was observed on 24 hour treated MCF-7 with an IC50 of 13.81 μg/mL. After 24 h, the inhibition of MCF-7 cell proliferation was 92%-94% at concentrations of 25-50 μg/mL, respectively. On MCF-7, the IC50 was found to be 49.35 g/mL after 72 h. This compound had a considerable cytotoxicity (IC50≤12.5 μg/mL, 24 h) on human foreskin fibroblasts. In contrast to the MCF-7 cell line, the proliferation of human foreskin fibroblasts was increased after 72 h.
... Migraine is the second most common type of headache disorder accounting for 12% of total headache incidents. It is predominant in women (15%) and affects only 6% of men [17,19,20]. It poses a high economic and psychosocial burden on the society due to its disabling nature, reduced quality of life and increased defection in work [21]. ...
Out of many disease conditions suffered by mankind since ancient ages, Migraine holds a significant position. It is derived from the word “hemi-crania” and is a type of primary headache. This disease is mentioned in the ancient scriptures dating back to the Mesopotamian era. It has been documented by Hippocrates (460–377 BC) in his treatise, further explored and explained on the basis of cause and location by Galen (131–201 AD). Later its etiopathogenesis clinical features and management was described by Al - Razi (850–923 AD), an eminent Unani physician. Migraine is a disease majorly affecting one side of the head and characterized by recurrent attacks of pulsating headache, mostly associated with nausea, vomiting, photophobia and phonophobia, with or without an aura. It is triggered by noise and light, based on the brightness, intensity, wavelengths or type of light that is being emitted. According to Unani physicians, the word Shaqeeqa is derived from Arabic word ‘Shiq’, meaning ‘a part’ or ‘a side’, hence the name Shaqeeqa . They describe it as a type of headache ( Suda) in which pain occurs only in one side of head, and the causative factors for it are the morbid matters and morbid vapours (Bukharat e Radiya) arising from morbid humours which are either excessive in amount, too hot or too cold. It often results due to abnormal substantial temperament (Su-e-Mizaj Maddi) giving two variants acute ( Shaqeeqa haar) and chronic ( Shaqeeqa barid) . The treatment mainly consists of elimination of morbid matter which is accumulated in the body, and strengthening the brain using brain tonics ( Muqawwiyat-e-Dimagh ).
... Buddha's hand fruit has an insulin secretagogue effect in rats, and stated that it would be very beneficial to patients with type 2 diabetes (Peng et al. 2009). Buddha's hand fruit syrup as a traditional Persian remedy is effective for decreasing pain intensity and duration of attacks in migraine headache and the effectiveness is comparable to propranolol (Jafarpour et al. 2016). ...
Citrus medicaL.:Aurantium medicum (L.) M. Gómez; Citreum vulgare Torn. ex Mill.; Citrus x aurantium subvar. amilbed Engl.; Citrus x aurantium subvar. ckakotra Engl.; Citrus x limon (L.) Osbeck; Citrus x limon var. digitata Risso; Citrus x limonia (L.) Osbeck; Citrus x limonum Risso; Citrus alata (Tanaka) Tanaka; Citrus cedra Link; Citrus cedrata Raf.; Citrus fragrans Salisb.; Citrus limon (L.) Osbeck; Citrus medica fo. monstrosa Guillaumin; Citrus medica subsp. bajoum H. Perrier; Citrus medica var. alata Tanaka; Citrus medica var. digitata Risso; Citrus medica var. ethrog Engl.; Citrus medica var. limon L.; Citrus medica var. proper Hook. f.; Citrus medica var. sarcodactylis (Hoola van Nooten) Swingle; Citrus odorata Roussel; Citrus sacrodactulis Hoola van Nooten; Citrus tuberosa Mill; Sarcodactilis helicteroides Gaertn.
... [5][6][7] Migraine is the second most common cause of headache which affects near about 12% of the general population, with more prevalence in females, i.e., 15% and 6% in males. [8][9][10] It poses a high economic and psychosocial burden on the society due to its disabling nature, reduced quality of life, and increased defection in work. [11] It has not been possible to determine a unifying theory as a pathogenesis of migraine. ...
Backgrounds: Migraine is a form of primary headache, manifested by the recurrent attacks of pulsating headache, mostly associated with nausea, vomiting, photophobia, and phonophobia, with or without an aura. Its onset is unilateral with varying intensity, frequency, and duration. It is the second-most common cause of headache disorder affecting about 12% of general population with 15% females and 6% males. The World Health Organization listed migraine as the 19th disability cause worldwide. In the present scenario of high prevalence and limited treatment options, this study was conducted to assess the safety and efficacy of a unani formulation named Habb-e-Quqaya, as a nervine tonic, brain tonic, stomachic, purgative, and its action in evacuating viscid morbid matter from the body in the management of migraine without aura. Methods: Thirty patients with migraine without aura were selected and administered with Habb-e-Quqaya 3 tablets weighing 500 mg each twice daily for 45 days. Subjective and objective parameters were assessed for each patient every 15 days. Data were analyzed statistically using the Student's t-test and paired proportion test. Results: Highly significant improvement (P < 0.001) was observed in all subjective and objective parameters. Conclusion: It was thus concluded that Habb-e-Quqaya can be a potential treatment for Shaqeeqa (Migraine without aura) with high efficacy and safety and without any side effects or toxicity during or after the trial. Hence, this study validates the use of Habb-e-Quqaya in Shaqeeqa (migraine without aura).
... Migraine is a second most common cause of headache disorder which affects the near about 12% of general population, more prevalence in women about 15% and 6% of men. 17,19,20 It has high influence on our society due to its disabling nature, and it reduces quality of life and increases defection in work. 21 World Health Organization (WHO) listed migraine as the 19 th disability cause worldwide, and it is responsible for 1.4% of life lost due to disability in all years. ...
... Among behavioral factors, diet has an important role. There is evidence indicating that the intakes of dairy products, fruits, vegetables, and B-vitamins are associated with a lower incidence of primary headaches, while the intakes of red and processed meat, refined grains, and coffee contribute to an increased risk of these headaches [10][11][12][13][14][15][16][17] . Despite the evidence, little attention has been paid to other dietary behaviors such as breakfast consumption. ...
Objective
This study was conducted to examine the association between breakfast consumption pattern and primary headaches in a large population of university students.
Methods
This cross-sectional study was done on the MEPHASOUS dataset that contained the information of 83,677 university students, aged ≥18 years, from 28 provinces of Iran. Dietary intakes and breakfast consumption pattern were assessed using a validated self-administered dietary habits questionnaire. Primary headaches were determined according to the International Classification of Headache Disorders-3 (ICHD-3) criteria. Binary logistic regression in different adjusted models was used to assess the association between breakfast consumption and primary headaches.
Results
The mean age of participants was 21.50 ± 4.01. Primary headaches were prevalent among 9% of university students. A significant inverse association was seen between breakfast consumption and odds of primary headaches [odds ratio (OR): 0.57, 95% confidence interval (CI): 0.51-0.62]. This association remained significant even after taking potential confounders into account; such that students who consumed breakfast frequently had 26% lower odds of primary headaches compared with those who consumed it <1 day/week (OR: 0.74, 95% CI: 0.65-0.85). Moreover, such a significant inverse association was observed in female students (OR: 0.54, 95% CI: 0.49-0.61) as well as those with BMI < 25 kg/m² (OR: 0.68, 95% CI: 0.58-0.79). However, it became non-significant in male students and those with overweight or obesity.
Conclusion
We found that frequent breakfast consumption is associated with a decreased odds of primary headaches in female students and those with BMI < 25 kg/m². Further prospective studies are needed to confirm our findings.
... Buddha's hand fruit has an insulin secretagogue effect in rats, and stated that it would be very beneficial to patients with type 2 diabetes (Peng et al. 2009). Buddha's hand fruit syrup as a traditional Persian remedy is effective for decreasing pain intensity and duration of attacks in migraine headache and the effectiveness is comparable to propranolol (Jafarpour et al. 2016). ...
... As antioxidants obtained from natural sources help in combating various types of stresses one of which is migraine, which is considered a neurodegenerative disorder and helps in preventing the production of oxidative stress by suppressing the activation, spread, and oxidative chain reactions [234]. Clinical trials have also shown that the consumption of Citrus sp. is effective in reducing the risk of migraine attacks [235]. In 2006, Galli et al. [206] proposed an experiment on thirty male rats to study the effect of blueberries for 10 weeks. ...
Aging is a complicated biological process in which functional and structural alterations in a living organism take place over time. Reactive oxygen species is one of the main factors responsible for aging and is associated with several chronic pathologies. The relationship between aging and diet is quite interesting and has attained worldwide attention. Healthy food, in addition to dietary antioxidants, are required to delay the process of aging and improve the quality of life. Many healthy foods such as fruits are a good source of dietary nutrients and natural bioactive compounds which have antioxidant properties and are involved in preventing aging and other age-related disorders. Health benefits linked with healthy consumption of fruit have drawn increased interest. A significant number of studies have documented the advantages of fruit intake, as it suppresses free-radical development that further reduces the oxidative stress created in the body and protects against several types of diseases such as cancer, type 2 diabetes, inflammatory disorders, and other cardiovascular diseases that ultimately prevent aging. In addition, fruits have numerous other properties like anti-inflammatory, anti-cancerous, anti-diabetic, neuroprotective, and have health-promoting effects. Mechanisms of various bioactive compounds that aids in preventing various diseases and increases longevity are also described. This manuscript provides a summary of various bioactive components present in fruits along with their health-promoting and antiaging properties.
... The beneficial effects of a diet high in fruit and vegetables were also reported in the study of Ferrara et al. in which, adherence to a low-fat diet, containing a high amount of fruit and vegetables, significantly reduced the severity and frequency of migraine attacks [29]. In a randomized clinical trial, a traditional syrup from Citrus medica L. fruit juice had a therapeutic effect on migraine patients so that reduced headache intensity and the duration of migraine attacks [30]. Overall, based on our findings and current evidence, patients with primary headaches may benefit from high consumption of fruit and vegetables, particularly in the context of a healthy diet. ...
Background
Fruit and vegetable consumption may beneficially affect the odds of primary headaches due to their antioxidant contents. However, no study has examined the association between fruit and vegetable consumption and primary headaches among university students.AimTo assess the relation between fruit and vegetable intakes and primary headaches among Iranian university students.Methods
Overall, 83,214 university students with an age range of ≥ 18 years participated in the present study. Dietary intakes and also data on confounding variables were collected using validated questionnaires. Data on dietary intakes were collected using a validated dietary habits questionnaire. We used the International Classification of Headache Disorders-3 (ICHD-3) criteria to define primary headaches.ResultsFruit consumption was negatively associated with primary headaches; such that after controlling for potential confounders, greater intake of fruits was associated with 30% lower odds of primary headaches (OR: 0.70, 95% CI 0.58–0.84). Such an inverse association was also found for vegetable consumption. In the fully adjusted model, students in the top category of vegetable consumption were 16% less likely to have primary headaches compared with those in the bottom category (OR: 0.84, 95% CI 0.74–0.95). Subgroup analysis revealed that fruit consumption was inversely associated with primary headaches in females, unlike males, and vegetable consumption was inversely associated with these headaches in males, as opposed to females. Moreover, fruit and vegetable consumption was related to lower odds of primary headaches in normal-weight students.Conclusion
Fruit and vegetable intakes were associated with reduced odds of primary headaches.Level of evidenceLevel III, cross-sectional analytic studies.
... Among environmental factors, diet has an important role. There is evidence indicating that intakes of dairy products, fruits, vegetables, and B-vitamins are associated with a lower incidence of primary headaches, while intakes of red and processed meat, refined grains, and coffee contribute to increased risk of these headaches (9)(10)(11)(12)(13)(14)(15)(16). Previous studies have mainly focused on dietary intakes and little attention has been paid on dietary behaviors such as breakfast consumption. ...
Background
The prevalence of primary headaches has been increasing at an alarming rate, particularly in university students. Previous studies have shown that diet-related behaviors can affect neurological disorders. Therefore, this study was conducted to examine the association between breakfast consumption patterns and primary headaches in a large population of university students.
Methods
In total, 83,677 university students, aged ≥18 years, from 28 provinces of Iran were included in the current cross-sectional study. Dietary intakes and breakfast consumption patterns were assessed using a validated self-administered dietary habits questionnaire. Primary headaches were determined according to the International Classification of Headache Disorders-3 (ICHD-3) criteria.
Results
The mean age of participants was 21.50 ± 4.01. Primary headaches were prevalent among 9% of university students. A significant inverse association was seen between breakfast consumption and odds of primary headaches (OR: 0.57, 95% CI: 0.51-0.62). This association remained significant even after taking potential confounders into account; such that students who consumed breakfast frequently had 26% lower odds of primary headaches compared with those who consumed it rarely (OR: 0.74, 95% CI: 0.65-0.85). Moreover, such a significant inverse association was observed in female students (OR: 0.54, 95% CI: 0.49-0.61) as well as those with normal weight (OR: 0.68, 95% CI: 0.58-0.79). However, it became non-significant in male students and those with overweight or obesity.
Conclusions
We found that frequent breakfast consumption was inversely associated with the odds of primary headaches. Further prospective studies are needed to confirm our findings.
... Sirup ini biasanya tidak langsung dikonsumsi tapi merupakan bahan baku industri minuman sari buah. Sirup buah adalah jenis yang ketiga, yaitu sirup yang cita rasanya ditentukan oleh bahan dasarnya yaitu buah segar seperti jambu, markisa, nanas, mangga dan lain-lain (Satuhu, 2004;Jafarpour et al., 2016). ...
Buah jeruk merupakan salah satu buah yang berpotensi tinggi di Indonesia dengan hasil produksi menduduki peringkat ke-10 dunia. Varietas yang cukup banyak dibudidayakan yaitu jeruk manis baby java (Citrus sinensis). Jeruk diproduksi menjadi sirup dengan memperhatikan beberapa aspek, yaitu efektivitas proses terhadap penurunan kontaminasi mikroba dan masa simpan produk. Pengujian efektivitas proses dilakukan dengan mendeteksi kandungan mikroorganisme bahan setelah melewati tiap stasiun proses. Masa simpan produk diuji dengan metode Accelerated Shelf Life Time (ASLT) yang dioptimalkan dengan persamaan Arrhenius. Metode ini menggunakan faktor suhu penyimpanan sebagai penentu kecepatan reaksi kerusakan bahan. Adapun suhu penyimpanan yaitu 35 °C, 40 °C, dan 45 °C dengan parameter yang diamati yaitu total mikroba, kadar vitamin C, total padatan terlarut, dan pH. Hasil penelitian didapatkan bahwa proses produksi dapat secara signifikan menurunkan kandungan mikroba pada bahan dengan kandungan mikroba pada stasiun proses pertama dan akhir masing-masing sebesar 9.87x 102 CFU/ml dan 0 CFU/ml. Pendugaan masa simpan didapatkan pH memiliki energi aktivasi (EA) terendah sebesar 467.46 dengan pendugaan apabila sirup jeruk disimpan pada suhu 7 °C dapat bertahan hingga 42 hari.
... Citron oil has been used for osteoarthritis, sciatica and eczema, and its fruit for treatment of headache [37,60,61]. Recent pharmacological studies on various parts of citron fruit have exhibited asanti-helminthic [62], cytotoxic [63], antidiabetic, hypolipidemic, antifungal [64,65], antimutagenic [66] and antiulcer [67] effects. Citron contains organic acids, polyphenols, flavonoids, pectin, vitamin C, beta-carotene and dietary fibers [61,68,69]. ...
Background and objectives: The Jaundice recognized by increased bilirubin level of blood and yellow appearance in skin, sclera and mucous membrane. Natural products have been used for treatment of jaundice for long time and Persian Medicine can be a main source of natural drugs for this purpose. Methods: This study was done to find out Materia Medica used for jaundice based on Persian medicine (PM) texts including Canon, Al-Hawi fi al - Tibb, Tuhfat al - Mu’minin, Hedayat al - Motealemin fi al - Tibb, Zakhireye Kharazmshahi, Al - Abniah an Haqaeq al - Adwia, Makhzan ul - Adwia and Ikhtiyarat Badie. Results: One hundred eleven Materia Medica belonging to 51 families were identified as herbal remedies for treating jaundice. Apiaceae, Asteraceae, Cucurbitaceae, Fabaceae, Lamiaceae, Rosaceae and Zingiberaceae were the most dominant families. Conclusions: The results of this paper may be new sources for pharmacological studies and development of new herbal medicine for jaundice. It is concluded that Asparagus, Echium, Arnebia, Chicory, Citron and Purgative manna can be good candidate Materia Medica for future studies.
... Since inflammation is one of the several mechanisms hypothesized to be involved in migraine [36,37], these compounds might have some roles in the analgesic and hypnotic effects of the plant [33,35,38]. There are a few clinical trials on migraine in the field of ITM [28,39]; however, Gharabaghi conducted a study on the effect of Rosa damascena on elective C-section post-surgical pain and reported that the intensity of pain was lower in the Rosa group, which had a significant association with time [40]. Moreover, Hajhashemi indicated the anti-inflammatory and analgesic effects of Rosa damascena hydroalcoholic extract against inflammatory diseases in animal model. ...
Background and objectives: Migraine is the seventh most common cause of disability among all ailments according to the World Health Organization. Despite the availability of some medicines for prevention of migraine, their complications are a cause for concern. Traditional system of medicine and use of medicinal herbs can be beneficial in management of migraine. "Gol-e-ghand" is one of the most commonly prescribed products for the management of headaches in the Iranian traditional medicine. The present study was designed to evaluate the effect of "Ghol-e-ghand" on decreasing the frequency of migraine attacks. Methods: Nineteen migraine patients, who met the eligibility criteria, according to the International Headache Society diagnostic criteria were assigned to the intervention. The study was conducted as a before-after clinical trial and included two phases of drug administration. Propranolol was given during the first phase, while "Ghol-e-ghand" was administered along with propranolol in the second phase. The severity, duration, and frequency of headaches were measured before and after the intervention. Results: The analysis showed that "Ghol-e-ghand" decreased the frequency of migraine (20%, p=0.04), but it was not effective in decreasing the duration and severity of the attacks. Conclusion: "Ghol-e-ghand" can be suggested in migraine patients for reducing frequency of attacks.
... 77 A double-blind trial randomized 90 Iranian adults with migraine to citron syrup 15 mL, placebo syrup, or propranolol 20 mg t.i.d. with meals for one month. 78 Citron syrup did not reduce frequency of migraine compared to placebo, while propranolol did. However, it did significantly reduce intensity and duration of headaches compared to placebo, with no difference compared to propranolol. ...
Many herbs and herbal formulas are effective for migraine sufferers, both as acute treatment and for prevention, particularly when coupled with the identification and elimination of migraine triggers. The natural products discussed here include Zingiber officinale (ginger) for migraine treatment and Cannabis sativa (cannabis), intranasal Capsicum annuum (cayenne), and Lavandula stoechas (Spanish lavender) volatile oil for treatment and prevention. The many agents discussed for migraine prevention primarily include Petasites hybridus (butterbur) root, Curcuma longa (turmeric)1fish oil, Citrus medica (citron) fruit, Tanacetum parthenium (feverfew), Tanacetum parthenium (feverfew)1Salix alba (white willow), Ginkgo biloba (ginkgo), and Lippia alba (bushy matgrass), though the latter three have little published evidence of efficacy. The Chinese herbal formulas Zhèng Tiān Wán (Rectify Heaven Pill) and Wú Zhū Yú Tāng (Evodia Decoction, goshuyutō) have fairly strong evidence supporting their efficacy for migraine prophylaxis. Dosing and safety information are provided for all herbs discussed.
... The use of menthol and lavender against migraine attacks have also been investigated (Sasannejad et al., 2012;St Cyr et al., 2015). Citrus has been documented as an anti-migraine drug in an ethnopharmacological context (Jafarpour et al., 2016). ...
Motivation:
Ethnopharmacology, or the scientific validation of traditional medicine, is a respected starting point in drug discovery. Home remedies and traditional use of plants are still widespread, also in Western societies. Instead of perusing ancient pharmacopeias, we developed MedCrawler, which we used to analyze blog posts for mentions of home remedies and their applications. This method is free and accessible from the office computer.
Results:
We developed MedCrawler, a data mining tool for analyzing user-generated blog posts aiming to find modern 'traditional' medicine or home remedies. It searches user-generated blog posts and analyzes them for correlations between medically relevant terms. We also present examples and show that this method is capable of delivering both scientifically validated uses as well as not so well documented applications, which might serve as a starting point for follow-up research.
Availability:
Source code is available on GitHub at {{https://github.com/a-hel/medcrawler}} CONTACT: paivi.tammela@helsinki.fi SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.
Background:
Currently, only a few specific blood pressure-lowering medications are recommended for migraine prevention. Whether benefits extend to other classes or drugs is uncertain.
Methods:
Embase, MEDLINE, and the Cochrane Central Registry of Controlled Trials were searched for randomized control trials on the effect of blood pressure-lowering medications compared with placebo in participants with episodic migraine. Data were collected on four outcomes - monthly headache or migraine days, and monthly headache or migraine attacks, with a standardised mean difference calculated for overall. Random effect meta-analysis was performed.
Results:
In total, 50 trials (70% of which were crossover) were included, comprising 60 comparisons. Overall mean age was 39 years, and 79% were female. Monthly headache days were fewer in all classes compared to placebo, and this was statistically significant for all but one class: alpha-blockers -0.7 (95% CI: -1.2, -0.1), angiotensin-converting enzyme inhibitors -1.3 (95% CI: -2.9, 0.2), angiotensin II receptor blockers -0.9 (-1.6, -0.1), beta-blocker -0.4 (-0.8, -0.0) and calcium channel blockers -1.8 (-3.4, -0.2). Standardised mean difference was significantly reduced for all drug classes and was separately significant for numerous specific drugs: clonidine, candesartan, atenolol, bisoprolol, metoprolol, propranolol, timolol, nicardipine and verapamil.
Conclusion:
Among people with episodic migraine, a broader number of blood pressure-lowering medication classes and drugs reduce headache frequency than those currently included in treatment guidelines.Trial Registration: The study was registered at PROSPERO (CRD42017079176).
Citrus medica L. belongs to the Rutaceae family. It has a yellowish-orange round or oblong fruit of size varying from 8 cm to 12 cm in length and irregularly arranged branches with sharp spines. The plant is believed to be native to India and China, spread to the western countries by passing through Persia and is available in many different geographical areas. It is a very important plant with many culinary and medicinal uses. This chapter on C. medica focuses on nutritional and phytochemical composition and pharmacological activities, and other uses of the plant.
Citron (Citrus. medica L.) fruits are commonly utilized in the production of essential oil, therefore, the fruits residues turn out to be industrial byproducts. In the present study, a crude polysaccharide was extracted from citron fruit residues by hot water extraction and precipitation of ethanol (95%), after deproteinization, a major polysaccharide component (CMLP-2) was obtained by gradient ethanol precipitation (20%–80%). The physicochemical properties of CMLP-2 such as surface morphology, functional groups, and thermostability were examined by FT-IR spectroscopy, SEM, and thermogravimetric analysis. Moreover, the chemical structure of CMLP-2 was elucidated that CMLP-2 is an acidic pectic polysaccharide consisting of arabinose (Ara), galacturonic acid (GalA), and rhamnose (Rha) in a molar ratio of 4:2:1 with a molecular weight of 202.18 kDa. CMLP-2 is a novel pectic polysaccharide rich in rhamnogalacturonan I (RG-I). Moreover, rheological tests revealed that CMLP-2 solution is pseudoplastic and temperature resistant. The result could be a good basis for the utilization of Citrus medica L. fruits residues as plant-derived food additive.
Ethnopharmacological relevance
Carthamus tinctorius L. (Safflower) has been widely recommended to treat metabolic disorders in traditional herbal medicine in Persia, China, Korea, Japan, and other East-Asian countries. The anti-hypercholesterolemic and antioxidant effects of this plant have been well documented, but its protective effects against Metabolic Syndrome (MetS) have not been fully illustrated.
Aim of the study
The present study aimed to evaluate the effects of safflower oil on MetS risk factors.
Materials and methods
In this randomized, double-blind, placebo-controlled clinical trial, 67 patients with MetS were administered either divided 8 g safflower oil or placebo daily for 12 weeks. All patients were advised to follow their previous diets and physical activities.
Results
Safflower oil resulted in a significant reduction in waist circumference (-2.42 ± 3.24 vs. 0.97 ± 2.53, p<0.001), systolic blood pressure (-8.80 ± 9.77 vs. -2.26 ± 8.56, p = 0.021), diastolic blood pressure (-3.53 ± 7.52 vs. -0.70 ± 6.21, p = 0.041), fasting blood sugar (-5.03 ± 10.62 vs. 2.94 ± 7.57, p = 0.003), and insulin resistance (-0.59 ± 1.43 vs. 0.50 ± 1, p = 0.012), but an increase in adiponectin level (0.38 ± 0.99 vs. -0.09 ± 0.81, p = 0.042) in the treatment group in comparison to the placebo group. The results revealed a direct relationship between leptin level and Body Mass Index (BMI) in both groups (p<0.001). In addition, increase in BMI resulted in a non-significant decrease in adiponectin level in both groups. Moreover, no significant difference was observed between the two groups regarding lipid profiles, leptin serum level, serum creatinine concentration, and other outcomes.
Conclusion
Safflower oil without lifestyle modification improved abdominal obesity, blood pressure, and insulin resistance in patients with MetS.
Traditional Persian medicine (TPM) is a holistic approach to medicine, and treatment of various diseases originates from humoral medicine. The base of TPM is prevention from illness. Therefore several remedies have been recommended for staying healthy. Olive is a highly used medicinal plant in TPM. In this setting, olive and olive-derived products were prescribed for the treatment of several diseases, including neurological disorders, oral cavity problems, gastrointestinal diseases, cardiovascular diseases, respiratory system disorders, skin diseases, urinary system disorders, obstetrics, and gynecology conditions. Many recent studies support the traditional medicinal use of olives. In this chapter, the authors try to describe the medicinal use of olives in TPM and to allude to evidence-based studies on this subject in conventional medicine.
Ethnopharmacological relevance
Safflower (Carthamus tinctorius) has many applications in folk medicine. Its oil is used traditionally to treat obesity and other metabolic disorders. The anti-hypercholesterolemic and antioxidant effects of this plant have been well documented, but the anti-inflammatory effects and its role on fatty acid oxidation and homeostasis of trace elements are not fully understood.
Objective
The aim of this study was to evaluate the protective effects of different doses of oil and extract of safflower seed against fructose induced metabolic syndrome through evaluating of the homeostasis of trace elements, TNF-α, and fatty acids metabolism.
Methods
Eighty adult male Sprague-Dawley rats were randomly divided into ten groups and treated daily for 16 weeks. At the end of the study, plasma levels of liver enzymes, lipid profiles, blood glucose, insulin and TNF-α were measured. The levels of antioxidant enzymes and lipid peroxidation were also measured along with the expression of CD36, fatty acyl-CoA synthetase (FAS), and Carnitine palmitoyl transferase I (CPT-1) beta genes in the liver.
Results
The antioxidant enzymes activity significantly decreased and lipid peroxidation, lipid profiles, liver enzymes, and TNF-α significantly increased in fructose-induced metabolic syndrome compared to the control groups, as well as the level of some trace elements significantly changed (p < 0.05). Treatment with oil and safflower seed extract in a dose dependent manner could improve biochemical parameters in groups of metabolic syndrome treated with oil and extract compared to metabolic syndrome (p < 0.05). The results also showed that the expression of above mentioned genes significantly increased in groups of metabolic syndrome treated with oil and extract compared to control and metabolic syndrome groups (p < 0.05).
Conclusion
It can be concluded that safflower seed extract and its oil can improve fructose-induced metabolic syndrome through antioxidant and anti-inflammatory effects, adjustment of homeostasis of trace elements, and enhancing the beta-oxidation capacity of the liver by increasing the expression of CD36, FAS, and CPT-1beta genes.
Resumen
Introducción
El uso de nutracéuticos o suplementos dietarios/herbales para el tratamiento de la migraña en pacientes adultos es objeto de estudio reciente debido a que estos contribuirían al alivio del dolor de una manera eficaz, y con una tolerabilidad que las terapias farmacológicas convencionales actuales no siempre ofrecen. Existe un creciente interés en el uso de esto como tratamiento profiláctico en pacientes con migraña. El tratamiento nutracéutico consiste en la administración de vitaminas, suplementos y preparaciones a base de hierbas.
Objetivo
Efectuar una revisión bibliografía sobre el potencial uso del tratamiento nutracéutico en la práctica clínica en el abordaje de pacientes con migraña.
Métodos
En esta revisión se identificaron estudios observacionales, ensayos controlados aleatorios, revisiones sistemáticas y metaanálisis sobre la eficacia y la seguridad de los nutracéuticos para el manejo de la migraña en adultos, a través de una búsqueda bibliográfica en las plataformas virtuales de PubMed, Medline, LILACS, SciELO, Medscape y Cochrane, entre otras. Los artículos fueron revisados y verificados por su contenido relevante.
Conclusiones
Esta revisión proporciona un resumen actualizado de las pautas existentes para el uso de ciertos nutracéuticos y suplementos dietarios en el abordaje de la migraña. Se provee información sobre la eficacia y los efectos secundarios potenciales de estos. El tratamiento nutracéutico individualizado sería de utilidad para disminuir la frecuencia, la intensidad y el impacto de la cefalea en los pacientes con migraña.
Headaches, including primary headaches such as migraine and tension-type headache, are a common clinical problem. Complementary and integrative medicine (CIM), formerly known as complementary and alternative medicine (CAM), uses evidence informed modalities to assist in the health and healing of patients. CIM commonly includes the use of nutrition, movement practices, manual therapy, traditional Chinese medicine, and mind-body strategies. This review summarizes the literature on the use of CIM for primary headache and is based on five meta-analyses, seven systematic reviews, and 34 randomized controlled trials (RCTs). The overall quality of the evidence for CIM in headache management is generally low and occasionally moderate. Available evidence suggests that traditional Chinese medicine including acupuncture, massage, yoga, biofeedback, and meditation have a positive effect on migraine and tension headaches. Spinal manipulation, chiropractic care, some supplements and botanicals, diet alteration, and hydrotherapy may also be beneficial in migraine headache. CIM has not been studied or it is not effective for cluster headache. Further research is needed to determine the most effective role for CIM in patients with headache.
Citrus medica Linn. (Rutaceae) known as Gajanimbe is used as a folk medicine in the treatment of gastric ulcers. Present study was undertaken to study the
effect of aqueous extract of the fruits against water immersion restraint stress-induced ulcers in rats. The extract was subjected to phytochemical screening and
found to contain carbohydrates, proteins, amino acids and flavonoids. The rats were pretreated with the extract (250 mg kg-1 p.o.) and the antiulcer effect was
compared with that of omeprazole (10 mg kg-1 p.o.). The extract pretreatment showed a significant reduction in ulcer formation and gastric lesions.
Histopathological sections showed significant decrease in neutrophil infiltration in gastric mucosal tissues, mucosal ulceration, inflammatory mucosal changes
and submucosal edema with regenerated epithelial cells compared to untreated and omeprazole-treated rats. The results emphasize that, the fruits of C. medica
possesses significant antiulcer activity against stress-induced ulcers in rats and the antiulcer activity could be due to the presence of flavonoids as these
compounds have well documented antiulcer activity.
Citrus medica Linn., known as bijapura in Ayurvedic literature, is widely used in traditional system of medicine. Many pharmacological studies have been conducted to investigate the properties of Citrus medica L. in an attempt to authenticate its use as a multipurpose medicinal agent. The objective of this paper is to review the literature regarding Citrus medica Linn., a commonly used herb in Ayurvedic medicine. Specifically, the literature was reviewed for articles pertaining to chemical properties and therapeutic benefits. This review is in a narrative format and consists of all publications relevant to Citrus medica Linn. that were identified by the authors through a google scholar search and books from library of Dravyaguna department of IPGT &RA, regarding Indian medicinal plants. Result shows that Citrus medica Linn. possesses analgesic, hypoglycaemic, anticholinesterase, anticancer, antidiabetic, hypocholesterolemic, hypolipidemic, insulin Secretagogue, anthelmintic, antimicrobial antiulcer and estrogenic properties. The mechanisms of action for these properties are not fully understood. Preliminary studies have found various constituents of Citrus medica exhibiting a variety of therapeutic effects. These results are very encouraging and indicate this herb should be studied more extensively to confirm these results and reveal other potential therapeutic effects. Clinical trials using Citrus medica for a variety of conditions should also be conducted.
Currently cancer is considered as one of the main factors of mortality globally. Many chemicals
in our environment can cause genetic mutations and are potentially responsible for millions of cancer-related
deaths. Nowadays the scientists are looking for food materials which can potenthially prevent the cancer occurrence.
The purpose of this research is to examine antimutagenicity and anticancer effect of Citrus Medica
fruit juice.In present study human astrocytoma cancer cells were cultured in DMEM (Gibco),supplemented
with 10% fetal calf serum,peniciline-streptomycin,L-glutamine and incubated at 37 ºC for 2 days.In addition
cancer cell line were treated by half-ripe and ripe Citrus Medica fruit juice and cellular vital capacity was determined
by MTT. The Citrus Medica fruit juice was subsequenthy evaluated in terms of antimutagenicity
and anticancer properties by a standard reverse mutation assay (Ames Test). This was performed with histidine
auxotroph strain of Salmonella typhimurium (TA100) .Thus, it requires histidine from a foreign supply
to ensure its growth.The aforementioned strain gives rise to reverted colonies when expose to carcinogen substance
(Sodium Azide). During MTT, human astrocytoma cell line revealed to have a meaningful cell death
when compared with controls (P<0.01). In Ames Test the fruit juice prevented the reverted mutations and the
hindrance percent of half-ripe Citrus Medica was 71.7% and ripe Citrus Medica was 34.4% in
antimutagenicity test and this value in anticancer test was 83.3% and 50% in half-ripe Citrus Medica and ripe
Citrus Medica respectively.This is the first study that have revealed antimutagenicity and anticancer effect of
Citrus Medica fruit juice and the effects were higher in half-ripe Citrus Medica in comparison to the riprned
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We report an eco-friendly method for the synthesis of copper nanoparticles (CuNPs) using Citron juice (Citrus medica Linn.), which is nontoxic and cheap. The biogenic copper nanoparticles were characterized by UV-Vis spectrophotometer showing a typical resonance (SPR) at about 631 nm which is specific for CuNPs. Nanoparticles tracking analysis by NanoSight-LM20 showed the particles in the range of 10-60 nm with the concentration of 2.18 × 10(8) particles per ml. X-ray diffraction revealed the FCC nature of nanoparticles with an average size of 20 nm. The antimicrobial activity of CuNPs was determined by Kirby-Bauer disk diffusion method against some selected species of bacteria and plant pathogenic fungi. It was reported that the synthesized CuNPs demonstrated a significant inhibitory activity against Escherichia coli followed by Klebsiella pneumoniae, Pseudomonas aeruginosa, Propionibacterium acnes and Salmonella typhi. Among the plant pathogenic fungi tested, Fusarium culmorum was found to be most sensitive followed by F. oxysporum and F. graminearum. The novelty of this work is that for the first time citron juice was used for the synthesis of CuNPs.
Recent studies suggest that migraine may be associated with gastrointestinal (GI) disorders, including irritable bowel syndrome (IBS), inflammatory bowel syndrome, and celiac disease. Here, an overview of the associations between migraine and GI disorders is presented, as well as possible mechanistic links and clinical implications. People who regularly experience GI symptoms have a higher prevalence of headaches, with a stronger association with increasing headache frequency. Children with a mother with a history of migraine are more likely to have infantile colic. Children with migraine are more likely to have experienced infantile colic compared to controls. Several studies demonstrated significant associations between migraine and celiac disease, inflammatory bowel disease, and IBS. Possible underlying mechanisms of migraine and GI diseases could be increased gut permeability and inflammation. Therefore, it would be worthwhile to investigate these mechanisms further in migraine patients. These mechanisms also give a rationale to investigate the effects of the use of pre- and probiotics in migraine patients.
The use of herbal therapies is ancient and increasing worldwide. There is a growing body of evidence supporting the efficacy of various "complementary" and alternative medicine approaches in the management of headache disorders. Promising tools to treat migraine patients are herbal products. In particular constituents of Petasites hybridus, Tanacetum Parthenium and Ginkgo Biloba have shown antimigraine action in clinical studies. A miscellaneous of recreational drugs and other herbal remedies have been supposed to have a role in headache treatment but quality of clinical studies in this field is low and inconclusive. Further research is warranted in this area.
The objective of this article is to see whether the effect of candesartan for migraine prevention, shown in one previous study, could be confirmed in a new study, and if so, whether the effect was comparable to that of propranolol (non-inferiority analysis), and whether adverse events were different.
In a randomised, triple-blind, double cross-over study, 72 adult patients with episodic or chronic migraine went through three 12-week treatment periods on either candesartan 16 mg, propranolol slow-release 160 mg, or placebo. The main outcome measures were days with migraine headache per four weeks (primary outcome), days with headache, hours with headache, proportion of responders (>50% reduction of migraine days from baseline), and adverse events.
In the modified intention-to treat-analysis, candesartan and propranolol were both superior to placebo: 2.95 (95% confidence interval: 2.35-3.55%) and 2.91 (2.36-3.45%), versus 3.53 (2.98-4.08%) for migraine days per month ( P = 0.02 for both comparisons, Wilcoxon's paired signed rank test, blinded statistical analysis). Candesartan was non-inferior to propranolol (and vice versa). The proportion of responders was significantly higher on candesartan (43%) and propranolol (40%) than on placebo (23%) ( P = 0.025 and <0.050, respectively). There were more adverse events on candesartan ( N = 133%) and propranolol ( N = 143%) than on placebo ( N = 90%), and the adverse event profiles of the active substances differed somewhat.
It is confirmed that candesartan 16 mg is effective for migraine prevention, with an effect size similar to propranolol 160 mg, and with somewhat different adverse events.Trial registration: EUDRACT (2008-002312-7), ClinicalTrials.gov (NCT00884663).
Citrus medica L. commonly known as Otroj, is an important medicinal plant reputed for its nutritious and therapeutic uses. The present work was undertaken to investigate the protective effect of the ethanolic extract of otroj (EEOT) against isoproterenol (ISO)-induced cardiotoxicity in rats. In addition, the antioxidant activity and the phenolic and flavonoidal contents were determined. Rats were administered EETO (250 and 500 mg/kg) or vehicle orally for 15 days along with ISO (85 mg/kg, s.c.) on the 14th and 15th day. ISO induced cardiac dysfunction, increased lipid peroxidation and alteration of myocyte-injury specific marker enzymes. ISO also showed an increase in levels of plasma cholesterol, triglycerides (TG), LDL-C, and VLDL-C. Moreover, the histological investigations showed myocardial necrosis and inflammation. EETO treatment brought the above parameters towards normal level. Moreover, in vitro DPPH radical scavenging and β-carotene-linoleic acid tests of the EEOT exhibited a notable antioxidant activity in both assays used. In addition, histopathological examination reconfirmed the protective effects of EEOT. Thus, the present study reveals that C. medica alleviates myocardial damage in ISO-induced cardiac injury and demonstrates cardioprotective potential which could be attributed to its potent antioxidant and free radical scavenging activity.
The history of headache, as a common neurological complication, goes back to almost 9000 years ago. Many ancient civilizations present references to headaches and the coherent treatment strategies. Accordingly, several documents comprising headache complications embodying precise medical information stem from Traditional Persian Medicine (TPM) that can provide useful opportunities for more comprehensive treatment. We conducted a survey on headache through original important pharmacopeias and other important medical manuscripts of TPM which were written during 9(th) to 19(th) centuries and have derived all headache categories and herbal remedies. An extensive search of scientific data banks, such as Medline and Scopus, has also been exercised to find results relating to the anti-inflammatory, anti-nociceptive, and analgesic effects of denoted medicinal herbs. The concept of headache and treatments in TPM covers over 20 various types of headache and more than 160 different medicinal plants administered for oral, topical, and nasal application according to 1000 years of the subject documents. Nearly, 60% of remarked medicinal herbs have related anti-inflammatory or analgesic effects and some current headache types have similarities and conformities to those of traditional types. Beside historical approaches, there are many possible and available strategies that can lead to development of new and effective headache treatment from medicinal plants so that this study can provide beneficial information on clinical remedies based on centuries of experience in the field of headache which can stand as a new candidate for further investigations.
Estrogenic/anti-oestrogenic activities of petroleum ether extract of Citrus medica seeds was studied in albino rats. The extract at the dose level of 200 and 400 mg/kg body weight was administered for seven days to immature ovariectomised rats, along with or without 1 µg ethinyl estradiol. Suitable controls were maintained. The extract-treated rats exhibited estrogenic effects, which include increase in uterine weight and vaginal epithelial cell cornification. The micrometric measurements of the uterus and its components were increased and glands showed high secretory activity. When the above extract was tested in 30-day-old immature rats, they exhibited opening of vagina on the fifth day and cornification of vaginal epithelial cells, which is about 10 days earlier compared to controls, further supporting the estrogenic activity of the extract. Hence, these results strongly indicate the potent estrogenic nature of petroleum ether extract of Citrus medica seeds, which may be used as an antifertility agent. Phytochemical studies of the petroleum ether extract of Citrus medica seeds were also carried out to find the chemical nature of the extract.
Citrus medica Linn. (Rutaceae) known as Gajanimbe and is used as a folk medicine for the treatment of gastric ulcers. The present study was planned to evaluate the antiulcer activity of aqueous extract of the fruits against ethanol-induced ulcers in rats. The extract was subjected to phytochemical screening and found to contain carbohydrates, proteins, amino acids and flavonoids. The rats were pretreated with the extract at two doses (250 and 500 mg kgG p.o.) and the antiulcer effect was compared with that of ranitidine (20 mg kgG p.o.). 1 1 The extract of both doses showed a significant reduction in ulcer formation. Histopathological sections showed significant decrease in mucosal ulceration, inflammatory mucosal changes and submucosal edema compared to ethanol treated group and the ranitidine group. It is concluded that, the fruits of C. medica possesses significant antiulcer activity against ethanol-induced ulcers in rats and the antiulcer activity could be due to the presence of flavonoids as these compounds have well documented antiulcer activity.
To describe the prevalence, sociodemographic profile, and the burden of migraine in the United States in 1999 and to compare results with the original American Migraine Study, a 1989 population-based study employing identical methods.
A validated, self-administered questionnaire was mailed to a sample of 20 000 households in the United States. Each household member with severe headache was asked to respond to questions about symptoms, frequency, and severity of headaches and about headache-related disability. Diagnostic criteria for migraine were based on those of the International Headache Society. This report is restricted to individuals 12 years and older.
Of the 43 527 age-eligible individuals, 29 727 responded to the questionnaire for a 68.3% response rate. The prevalence of migraine was 18.2% among females and 6.5% among males. Approximately 23% of households contained at least one member suffering from migraine. Migraine prevalence was higher in whites than in blacks and was inversely related to household income. Prevalence increased from aged 12 years to about aged 40 years and declined thereafter in both sexes. Fifty-three percent of respondents reported that their severe headaches caused substantial impairment in activities or required bed rest. Approximately 31% missed at least 1 day of work or school in the previous 3 months because of migraine; 51% reported that work or school productivity was reduced by at least 50%.
Two methodologically identical national surveys in the United States conducted 10 years apart show that the prevalence and distribution of migraine have remained stable over the last decade. Migraine-associated disability remains substantial and pervasive. The number of migraineurs has increased from 23.6 million in 1989 to 27.9 million in 1999 commensurate with the growth of the population. Migraine is an important target for public health interventions because it is highly prevalent and disabling.
In order to develop a database for flavanones, the dominant flavonoid class in the genus citrus, the relevant scientific literature on flavonoids in grapefruit, lemons, and limes was searched, abstracted, documented, standardized by taxons and units (mg/100 g) and examined for quality. Values for eight flavanones (didymin, eriocitrin, hesperidin, naringin, narirutin, neoeriocitrin, neohesperidin, poncirin) are presented. Grapefruit had a total flavanone content (summed means) of 27 mg/100 g as aglycones and a distinct flavanone profile, dominated by naringin. White grapefruit varieties tended to be slightly but not significantly higher in total flavanones than pink and red varieties. For lemons, total flavanones (summed means) were 26 mg/100 g and for limes 17 mg/100 g. The flavanone profiles of both lemons and limes were dominated by hesperidin and eriocitrin.
SULT1A enzymes protect humans from catecholamines, but natural substances in many foods have been found to inhibit these enzymes in vitro. Given the hormonal roles of catecholamines, any in vivo SULT1A inhibition could have serious consequences. This paper uses a re-analysis of published data to confirm that SULT1A inhibitors have effect in vivo in at least some patients. Nineteen studies are cited that show ingestion of SULT1A inhibitors leading to catecholamine increases, blood pressure changes, migraine headaches, or atrial fibrillation. SULT1A inhibition does not create the catecholamines, but prevents normal catecholamine deactivation. Susceptible patients probably have lower-activity SULT1A alleles. The paper discusses new hypotheses that SULT1A inhibition can cause "holiday heart" arrhythmias and type 2 diabetes in susceptible patients. Subgroup analysis based on SULT1A alleles, and addition of a catecholamine source, should improve the consistency of results from tests of SULT1A inhibitors. SULT1A inhibition may be a key contributor to cheese-induced migraines (via annatto), false positives in metanephrine testing, and the cardiovascular impacts of recreational alcohols.
In a multicentric, open, preliminary trial, we evaluated the use of ginkgolide B, a herbal constituent extract from Ginkgo biloba tree leaves, in the prophylactic treatment of migraine with aura (MA). Fifty women suffering from migraine with typical aura, or migraine aura without headache, diagnosed according to International Headache Society criteria, entered a six-month study. They underwent a two month run-in period free of prophylactic drugs, followed by a four month treatment period (subdivided into two bimesters, TI and TII) with a combination of 60 mg ginkgo biloba terpenes phytosome, 11 mg coenzyme Q 10, and 8.7 mg vitamin B2 (Migrasoll), administered twice daily. A detailed diary reporting neurological symptoms, duration, and frequency of MA was compiled by patients throughout the trial. The number of MA significantly decreased during treatment (from 3.7 +/- 2.2 in the run-in period, to 2.0 +/- 1.9 during TI and to 1.2 +/- 1.6 during TII; Anova for repeated measures: P < 0.0001). There was also a statistically significant decrease in the average MA duration, which was 40.4 +/- 19.4 min during run-in, 28.2 +/- 19.9 during TI, and 17.6 +/- 20.6 during TII. Total disappearance of MA was observed in 11.1% patients during TI and in 42.2% of patients during T2. No serious adverse event was provoked by Migrasoll administration. Ginkgolide B is effective in reducing MA frequency and duration. The effect is clearly evident in the first bimester of treatment and is further enhanced during the second.
The present study assessed age- and sex-specific patterns of migraine prevalence in a US population of 40,892 men, women, and children who participated in the 2003 National Health Interview Survey. Gaussian mixture models characterised the relationship between migraine, age, and sex. Migraine prevalence was 8.6% (males), 17.5% (females), and 13.2% (overall) and showed a bimodal distribution in both sexes (peaking in the late teens and 20s and around 50 years of age). Rate of change in migraine prevalence for both sexes increased the fastest from age 3 years to the mid-20s. Beyond the age of 10 years, females had a higher prevalence of migraine than males. The prevalence ratio for females versus males was highest during the female reproductive/child-bearing years, consistent with a relationship between menstruation and migraine. After age 42 years, the prevalence ratio was approximately 2-fold higher in women.
The CONSORT statement is used worldwide to improve the reporting of randomised controlled trials. Kenneth Schulz and colleagues describe the latest version, CONSORT 2010, which updates the reporting guideline based on new methodological evidence and accumulating experience.
To encourage dissemination of the CONSORT 2010 Statement, this article is freely accessible on bmj.com and will also be published in the Lancet, Obstetrics and Gynecology, PLoS Medicine, Annals of Internal Medicine, Open Medicine, Journal of Clinical Epidemiology, BMC Medicine, and Trials.
Few trials have evaluated combination of two or more drugs in the preventive treatment of migraine. In this study three therapeutic regimens were compared: (a) propranolol, at a dose of 40 mg per day, (b) nortriptyline, at a dose of 20 mg per day, and (c) the combination of these two drugs in these dosages. The groups were matched according to age, gender, and frequency of migraine attacks prior to treatment. The period of treatment was two months and the frequency and intensity of headache attacks of the 30 days pre-treatment period were compared with the frequency of headaches in the treatment period. Fourteen patients in groups A and B and sixteen patients in group C have completed the study. Treatment with propranolol, alone or in combination, was shown to be effective. Treatment with nortriptyline alone was not effective. All three therapeutic regimens were safe and side effects were minimal. The frequency of discontinuation of the study was the same in the 3 groups but no patient left the study due to adverse reactions. The combined therapy proved to be as safe as the monotherapy. Further studies evaluating this and other possible combinations of drugs in higher doses and for longer periods, should more clearly elucidate the role of combined therapy in the treatment of migraine.
Migraine is a common and sometimes debilitating disorder. This review describes the epidemiology, pathophysiology, and preventive and symptomatic treatment of migraine, with special attention to drug therapy with the triptans.
Citrus medica L. popularly known as 'Bara nimbu' in India belongs to family Rutaceae. The objective of the present work was to evaluate the in-vitro anthelmintic potency of the ethanolic extract of Citrus medica peels using Indian earthworms (Pheretima posthumad). The various concentrations (25-100 mg/ml) of the ethanolic extract were tested in-vitro for anthelmintic potency by determination of time of paralysis and time of death of worm. Piperazine citrate (15mg/ml) used as standard. The result of present study indicates that the Citrus medica L. potentiate to paralyze earthworm and also caused its death after some time. The shortest time of paralysis and time of death was observed at higher dose (100 mg/ml) which was comparable with standard. Thus, the present study demonstrate that the Citrus medica L. as an potent anthelmintic has been confirm as the ethanolic extracts of peels displayed activity against the earthworm used in study.
The estrogenic activity of petroleum ether extract of Citrus medica L. leaves as well as the chemical constituents responsible for the biological activity was studied. The petroleum ether extract proved to retain high estrogenic activity in immature female rats. The extract was saponified and its components (saponifiable part 23% and the unsaponifiable matter 77%) were identified using GC/MS technique. The extract proved to be safe (LD50< 2g/kg.bw). Oral administration of petroleum ether extract of C. medica in ovariectomized immature female Wistar rats for 7 days in a dose of 400 mg/kg resulted in significant increase in the uterine weight (g) (1.7±0.11) when compared with ovariectomized control rats (1.3±0.07). GC/MS analysis of both saponifiable and unsaponifiable matters revealed the presence of thirty three components (28 hydrocarbons and 5 sterols) in the unsaponifiable fraction, the major hydrocarbon was n- Heneicosane (16.7%) while the major sterol was β-sitosterol (4.03%) and 15 components in the saponifiable matter it's major component was hexadecanoic acid (19.93%). As a conclusion petroleum ether extract of Citrus medica L. leaves possess a significant estrogenic activity.
Citrus medica L. popularly known as 'Bara nimbu' in India belongs to family Rutaceae. The objective of the present work was to evaluate the in-vitro anthelmintic potency of the petroleum ether extract of Citrus medica leaves using Indian earthworms (Pheretima posthumad). The various concentrations (20-80 mg/ml) of the petroleum ether extract were tested in-vitro for anthelmintic potency by determination of time of paralysis and time of death of worm. Piperazine citrate (15mg/ml) used as standard. The result of present study indicates that the Citrus medica L. potentiate to paralyze earthworm and also caused its death after some time. The shortest time of paralysis and time of death was observed at higher dose (80 mg/ml) of petroleum ether extract was found to 30.86 min. Thus, the present study demonstrate that the Citrus medica.L as an anthelmintic has been confirm as the petroleum ether extracts of leaves displayed activity against the earthworm used in study.
Background: Sweet substance-induced analgesia (SIA) has been widely investigated in rodents. The mechanism is thought to be involved in the central regulating systems in the anti-nociceptive process, taking advantage of sweet taste and not acting as a distraction. In human, this SIA is, however, limited in neonatal. The reasons underlying the reduced effects of SIA with growth have been less studied in adults. Consensus regarding SIA thus has not yet to be obtained in adults. Therefore, we aimed to determine the sweet stimulus of sucrose on responses of healthy adults to nociception using cold pressor testing. Methods: The present study was carried out a randomized control with crossover design. Using the cold pressor test (CPT), 13 adult male subjects immersed a hand in cold water to induce nociception. Subjects held either a 24% weight ⁄ volume sucrose solution or distilled water in their mouth before and during CPT. Analgesic effect and emotional state were quantitatively assessed as follows: pain threshold; pain tolerance; pain intensity; taste pleasantness; and the brief Japanese version of the Profile of Mood State (POMS). Results: With subjects held sucrose solution in the mouth, pain threshold was increased significantly (p<0.05) when compared with distilled water. In addition, the taste pleasantness rating was significantly higher with sucrose solution than that with distilled water (p<0.05). Conclusions: These data clearly indicate that the sweet stimulus of sucrose induces anti-nociception associated with taste pleasantness in adults, suggesting sweet substance-induced analgesia can be applied to young male adults.
To assess the effectiveness of OMT on chronic migraineurs using HIT-6 questionnaire, drug consumption, days of migraine, pain intensity and functional disability.
3-Armed randomized controlled trial setting: all patients admitted in the Department of Neurology of Ancona's United Hospitals, Italy, with a diagnosis of migraine and without chronic illness, were considered eligible for the study.
Patients were randomly divided into three groups: (1) OMT+medication therapy, (2) sham+medication therapy and (3) medication therapy only. Patients received 8 treatments in a study period of 6 months.
Changing from baseline HIT-6 score.
105 subjects were included. At the end of the study, ANOVA showed that OMT significantly reduced HIT-6 score (mean change scores OMT-conventional care: -8.74; 95% confidence interval (CI) -12.96 to -4.52; p<0.001 and OMT-sham: -6.62; 95% CI -10.85 to -2.41; p<0.001), drug consumption (OMT-sham: RR=0.22, 95% CI 0.11-0.40; OMT-control: RR=0.20, 95% CI 0.10-0.36), days of migraine (OMT-conventional care: M=-21.06; 95% CI -23.19 to -18.92; p<0.001 and OMT-sham: -17.43; 95% CI -19.57 to -15.29; p<0.001), pain intensity (OMT-sham: RR=0.42, 95% CI 0.24-0.69; OMT-control: RR=0.31, 95% CI 0.19-0.49) and functional disability (p<0.001).
These findings suggest that OMT may be considered a valid procedure for the management of migraineurs. The present trial was registered on www.ClinicalTrials.gov (identifier: NCT01851148).
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IntroductionGenetic polymorphismsEffects of age on drug metabolismEffects of diet on drug metabolismGender effectsSmokingEffects of ethanol on drug metabolismEffects of disease on drug metabolismSummary
Introduction: The objective of the present investigation was to evaluate the antidiabetic and hypolipidemic activity of petroleum ether extract of Citrus medica Linn. seeds in streptozotocin (STZ) induced diabetic model in rats. Methods: The study was carried out using albino rats of either sex weighing 150–200 gm. One group was selected as control group (buffer alone) and four groups of STZ induced diabetic rats (n = 5 in each group) were administered vehicle (1% tween 80), seed extract (200 and 400 mg/kg, p.o.) of C. medica Linn. and standard drug glibenclamide (5 mg/ kg) for 15 days after 10 days of single dose of STZ (60 mg/kg) intraperitoneal administration. Blood samples were collected by retro-orbital puncture and were analyzed for blood glucose, serum cholesterol, triglycerides, HDL, LDL and VLDL on days 0, 3, 10 and 25 by using diagnostic kit. Results: The petroleum ether extract of C. medica Linn. seeds (200 and 400 mg/kg, p.o.) induced significant reduction (p < 0.05) of fasting blood glucose, serum cholesterol, serum triglycerides, LDL and VLDL in dose dependent manner after 15 days of drug administration. Though 200 mg/kg/day seed extract for 15 days was not showing any change in HDL level, while 400 mg/kg/day dose significantly increased HDL level in diabetic rats. Conclusion: So it is concluded that C. medica Linn. seeds have significant antidiabetic, hypocholesterolemic and hypolipidemic activity.
Citric acid introduced into the stomach of mice at increasing concentrations of 0.1, 1 or 10 % (4.8 μM-0.48 mM; 95 μmol/kg-9.5 mmol/kg, 0.5 ml) caused dose-dependent inhibition of abdominal constrictions induced 1 h later by i. p. acetic acid injection by -51 % to -69.5 %. When administered at 10 % (0.48 mM, 0.5 ml) 15 min before nociceptive challenge, citric acid inhibited the nociceptive response by 96.8 %. Inhibition of the acetic acid-induced ab- dominal constrictions was also observed when lower doses of citric acid were introduced into the stomach (0.2 ml of 0.1-1 %; 38.1 μmol/kg-0.38 mmol/kg). The effect was evident as early as 5 min after administration of citric acid into the stomach and with the maximal effect being at 15-30 min after dosing. Lidocaine given orally 5 min prior to citric acid (1 %, 48 μM; 0.38 mmol/kg, 0.2 ml) prevented antinociception by citric acid, but lidocaine given 15 min before oral introduction of citric acid enhanced the citric acid-induced inhibition of the no- ciceptive response to acetic acid. The antinociceptive effect of orally administered citric acid (1 %, 48 μM; 0.38 mmol/kg, 0.2 ml) was increased by pre-treatment with propranolol (4 mg/kg, s. c.), yohimbine (4 mg/kg, s. c.), guanethidine (32 mg/kg, s. c.), but reduced after treatment with atropine (3 mg/kg, s. c.), which itself increased the nociceptive behavior. Simi- lar inhibition of the acetic acid-induced nociceptive behavior was also observed when sodium citrate (pH 7.21) or 0.1 N HCl (pH 3) or 1 % sucrose solution (0.2 ml) was intragastrically given. It is suggested that citric acid might act to stimulate sensory afferents and that trans- mission of nociceptive information centrally leads to the activation of descending antinocicep- tive mechanism to a noxious stimulus.
The efficacy of some nonpharmacologic therapies appears to approach that of most drugs used for the prevention of migraine and tension-type headaches. These therapies often carry a very low risk of serious side effects and frequently are much less expensive than pharmacologic therapies. Considering this combination of efficacy, minimal side effects, and cost savings, medications should generally not be prescribed alone but rather in combination with nonpharmacologic therapies.
In addition to the established nonpharmacologic therapies, such as biofeedback, relaxation training, butterbur, riboflavin, magnesium, and coenzyme Q10 (CoQ10) supplementation, recent data provide support for the use of aerobic exercise and acupuncture. Discovery of the high incidence of the C677T mutation of the methylenetetrahydrofolate reductase gene, MTHFR, and attendant elevation of homocysteine levels in patients with migraine with aura led to a trial of cyanocobalamin, folate, and pyridoxine in these patients. This trial showed that taking these three supplements resulted in a reduction of homocysteine levels and improvement of migraines.
Therapies proven (to various degrees) to be effective for migraine include aerobic exercise; biofeedback; other forms of relaxation training; cognitive therapies; acupuncture; and supplementation with magnesium, CoQ10, riboflavin, butterbur, feverfew, and cyanocobalamin with folate and pyridoxine.
Migraine remains underdiagnosed and undertreated despite advances in the understanding of its pathophysiology and management. This article focuses on acute and preventive treatment of migraine, including the mechanisms of action, dosing and side effects of medications, and strategies for the most effective care.
Best practice suggests that acute migraine treatment should be stratified based on the severity of the individual event, with a goal of returning the patient to full function within 2 hours of treatment. Migraine prevention strategies continue to be underused in the United States. More than 1 in 4 patients with migraines may be candidates for preventive therapy. To obtain the best results from preventive therapy, slow titration to an adequate dose for an adequate timeframe with good documentation of the results is recommended.
This article reviews several options for managing acute attacks, including information on expected efficacy, dosing, and adverse effects. Strategies for effective application of acute therapies are discussed. Prevention can be added to acute therapy depending on headache characteristics such as frequency, severity, disability, and the presence of comorbid conditions. The mechanisms of action of preventive medications and strategies for their most effective use are discussed.
This study evaluated the in vitro inhibition of carbohydrate-hydrolysing enzymes, the stimulation of insulin secretion, and the in vivo metabolic effects in mice of Citrus medica L. cv Diamante peel extract. The quantitative analysis of selected phytochemicals were determined to investigate their relationship with the biological activities. Citrus extract exhibited an inhibitory activity against both α-amylase and α-glucosidase with IC50 values of 258.7 and 263.2 μg/ml, respectively. Measurements of the effects of peel extract on the mouse insulinoma MIN6 β-cells indicated that it did exert direct stimulatory effects on the exocytotic release of insulin in a concentration-dependent manner. The supplementation of the C. medica cv Diamante was able to reduce plasma glucose (GLU) concentration and lowered the levels of plasma cholesterol (COL) and triglycerides (TG). The obtained results underline the potential health benefits as a result of consuming C. medica cv Diamante and suggest that it could be used as new potential source with functional properties for food or nutraceutical products.
The standard clinical advice for individuals who suffer from recurrent headaches is that the best way to prevent headaches is to avoid the triggers. This review challenges that advice from a number of perspectives, including: that the advice is given in a theoretical vacuum; it is associated with practical problems; and it is not evidence-based. The review considers cognate literatures on stress, negative affect, and chronic pain that advocate approach/confront strategies over avoidance strategies. It is suggested that advice to avoid triggers could result in maintenance of the capacity of the trigger to precipitate headaches or even a sensitization process whereby tolerance diminishes. As anxiety researchers have investigated extensively the issue of how stimuli acquire and lose their capacity to elicit fear, this literature is explored to draw inferences for headache triggers. The review concludes with suggestions concerning etiology of chronic headache and associated management implications, and directions for future research. It argues that the philosophy of ‘avoidance of triggers’ should be replaced with ‘coping with triggers,’ as the latter includes both avoidance and approach/confront strategies involving exposure to triggers.
This paper extended the evaluation of the depressant and antinociceptive activities of hesperidin in order to determine its effectiveness by the intraperitoneal and oral routes, its pharmacological interaction with diverse pathways of neurotransmission and the role of its aglycone, hesperetin. The capacity of hesperidin and hesperetin to bind to μ-opioid receptor and their actions on μ-opioid receptor co-expressed with GIRK1/GIRK2 channels (G protein-activated inwardly rectifying K+ channels) in Xenopus laevis oocytes were also determined. Hesperidin exhibited a depressant activity in the hole board and locomotor activity tests, antinociceptive activities in the abdominal writhing and hot plate tests and no motor incoordination in the inverted screen and rotarod assays, only by the intraperitoneal route. Hesperetin did not show any effects in vivo in mice in these models, but in vitro it displaced the [³H]DAMGO binding with low-affinity and inhibited inward currents through the expressed GIRK1/2 channels. Although hesperidin actions in vivo demonstrated to be mediated by an opioid mechanism of action, it failed to directly bind to and activate the μ-opioid receptor or produce any change on inward GIRK1/2 currents in vitro. However, it should be considered that hesperidin may be metabolized, possibly resulting in crucial changes in its biological activity.
Since the past decade consumption of certain foods has been reported to have a positive effect on health. The object of the study was to determine for the first time the chemical composition and the antioxidant, anti-inflammatory and hypoglycemic potential of Citrus medica L. cv Diamante flowers, leaves and fruits (endocarp and mesocarp) at two maturity stages. Flowers and leaves were characterized by the highest total phenols and flavonoids content. A declining trend was observed during maturity of fruits for both phenols and flavonoids. The antioxidant activity evaluated by the β-carotene bleaching test showed a strong activity for flowers and endocarp of mature fruits with IC50 values of 2.8 μg/mL and 3.5 μg/mL, respectively, after 30 min of incubation. Interestingly, the mature fruits endocarp (IC50 value of 426.0 μg/mL) could inhibit α-amylase with an IC50 value 2-fold higher than immature fruits. None of the tested extracts affected the proliferation of human skin fibroblasts 142BR. The obtained results suggest a potential use of C. medica L. cv Diamante as new valuable Citrus species with functional properties for food or nutraceutical product on the basis of high content of phytochemicals.
Migraine is characterized by multiple attacks of severe headaches often unilateral. The molecular mechanisms of migraine have not yet been clearly defined. Disorders of oxidant-antioxidant balance are observed in a number of acute and chronic diseases of the central nervous system. Oxidative stress is also believed to play a role in the pathogenesis of migraine. To the best of our knowledge, this is the first study investigating oxidant and antioxidant status of patients having migraine without aura (MWoA) and comparing them with those of age and sex matched healthy controls (CG).
We evaluated the Total Antioxidant Status (TAS) and Total Oxidant Status (TOS) of the plasma and Oxidative Stress Index (OSI) using a recently measurement method developed by Erel.
Seventy five patients (55 Female, 20 Male) having MWoA who are free of attacks and 65 healthy volunteers (41 Female, 24 Male) (CG) were enrolled in this research. Mean age of the patients with MWoA and the control group were calculated (30.94 +/- 10.37 vs 31.0 +/- 9.46 years respectively; p > 0.05). Serum TAS levels of patients with MWoA were significantly lower than those of healthy controls (0.72 +/- 0.008 vs. 0.80 +/- 0.179 micromol Trolox equivalent/L; p < 0.001). Conversely, serum TOS values were significantly higher in patients with MWoA than in CG (15.39 +/- 0.770 vs.13.01 +/- 0.471 pmol H2O2 equivalent/L; P < 0.001). The mean values of OSI were greater in patients than in controls (1.75 +/- 0.59 vs. 1.56 +/- 0.57, p < 0.023). Total SH levels were significantly higher in the control group (MWoA: 0.24 +/- 0.005; Controls: 0.28 +/- 0.005, p = 0.001). Furthermore, there was a negative correlation between the levels of Total SH and the duration of the headaches (r: -0.426, p < 0.001). Likewise; there was a positive correlation between OSI and the frequency of the headaches (r: 0.123, p < 0.002).
In this study, we demonstrated that the levels of total antioxidants were decreased and the levels of total oxidants and the oxidative stress index were increased in patients with MWoA. These findings may be an evidence of exposure to potent oxidative stress in MWoA patients. Further investigations are required to clarify the role of oxidative stress in the etiopathogenesis of MWoA.
Porphyra dentata, a red edible seaweed, has long been used worldwide in folk medicine for the treatment of inflammatory diseases such as hypersensitivity, lymphadenitis, bronchitis.
To clarify the anti-inflammatory role of Porphyra dentata crude extract and its identified phenolic compounds by investigating their effect on the nitric oxide (NO)/inducible nitric oxide synthase (iNOS) transcription pathway in macrophage RAW 264.7 cells.
Porphyra dentata crude extract was prepared with methanol. High performance liquid chromatography (HPLC) hyphenated to electrospray ionization mass spectrometry (ESI-MS) and UV detection were utilized to analyze the extract fingerprints. Nitrite measurement, iNOS promoter activity and nuclear factor-kappaB (NF-kappaB) enhancer activity were used to assess the anti-inflammatory effect in lipopolysaccharide (LPS) challenged mouse RAW 264.7 cell line.
Phenolic compounds (catechol, rutin and hesperidin) were identified in the crude extract of Porphyra dentata. The crude extract and the phenolic compounds inhibited the production of NO in LPS-stimulated RAW 264.7 cells. Catechol was a more potent suppressor of the up-regulation of iNOS promoter and NF-kappaB enhancer than rutin and yet, hesperidin alone failed to inhibit either activity.
Our results indicate that catechol and rutin, but not hesperidin, are primary bioactive phenolic compounds in the crude extract to suppress NO production in LPS-stimulated macrophages via NF-kappaB-dependent iNOS gene transcription. The data also explain the anti-inflammatory use and possible mechanism of Porphyra dentata in iNOS implicated diseases.
Finger citron [Citrus medica L. var. Sarcodactylis Hort, Rutaceae] (FC) fruits, widely cultivated in Japan, the southern provinces of China and Taiwan, are commonly used as functional vegetables and preserved as sweetmeats. Previously we identified the major compounds in essential oils (% in EO) of FC fruits to be d-limonene (51.24), gamma-terpenene (33.71), alpha-pinene (3.40), and beta-pinene (2.88). Documented evidence on its insulin secretion characteristics is still lacking. In parallel to compositional analysis, we performed in vivo the safety, hypoglycemic, and antidiabetic tests in Sprague-Dawley-SPF rats and Wistar DIO rats respectively. By kinetic analysis on the hypoglycemic patterns of the intraperitoneal glucose tolerance (IPGTT) and the insulin-glucose tolerance tests (IGTT), its insulin secretagogue effect was confirmed. In conclusion, FC fruits that concomitantly possess insulin secretagogue and slimming effects would be very beneficial to type 2 diabetes mellitus patients.
Migraine is the most common neurological disorder, and much has been learned about its mechanisms in recent years. However, the origin of painful impulses in the trigeminal nerve is still uncertain. Despite the attention paid recently to the role of central sensitisation in migraine pathophysiology, in our view, neuronal hyperexcitability depends on activation of peripheral nociceptors. Although the onset of a migraine attack might take place in deep-brain structures, some evidence indicates that the headache phase depends on nociceptive input from perivascular sensory nerve terminals. The input from arteries is probably more important than the input from veins. Several studies provide evidence for input from extracranial, dural, and pial arteries but, likewise, there is also evidence against all three of these locations. On balance, afferents are most probably excited in all three territories or the importance of individual territories varies from patient to patient. We suggest that migraine can be explained to patients as a disorder of the brain, and that the headache originates in the sensory fibres that convey pain signals from intracranial and extracranial blood vessels.
To assess the efficacy and safety of low-dose topiramate in migraine prophylaxis vs propranolol.
A randomized, double-blind, clinical trial including 62 patients with frequent migraine headaches (> or = 3 attacks per month) was performed for a period of 8 weeks. The patients were randomly divided into two treatment groups - treated by topiramate 50 mg/day and propranolol 80 mg/day, respectively. The patients were assessed at 0, 4, and 8 weeks of the study. Results - The topiramate group showed a reduction in the mean (+/-SD) of monthly migraine frequency from 6.07 (+/-1.89) to 1.83 (+/-1.39) episodes per month, headache intensity from 7.1 (+/-1.45) to 3.67 (+/-2.1) based on the Visual Analog Scale, and headache duration from 16.37 (+/-7.26) to 6.23 (+/-5.22) hours (P < 0.001). In the patients treated with propranolol, the mean (+/-SD) of monthly headache frequency declined from 5.83 (+/-1.98) to 2.2 (+/-1.67) per month, headache intensity lessened from 6.43 (+/-1.6) to 4.13 (+/-1.94) and headache duration decreased from 15.10 (+/-6.84) to 7.27 (+/-6.46) h (P < 0.001).
This study demonstrated that both low-dose topiramate and propranolol could significantly reduce migraine headache frequency, intensity, and duration. However, compared with propranolol, low-dose topiramate showed better results.
We present the first prevalence study of specific headache entities using the operational diagnostic criteria of the International Headache Society. One thousand 25-64 year old men and women, who lived in the western part of Copenhagen County were randomly drawn from the Danish National Central Person Registry. All subjects were invited to a general health examination focusing on headache and including: a self-administered questionnaire concerning sociodemographic variables, a structured headache interview and a general physical and neurological examination. The participation rate was 76%. Information about 79% of the non-participants showed a slightly differing headache prevalence which was not quantitatively important. The following results in participants are therefore representative of the total sample. The lifetime prevalences of headache (including anybody with any form of headache), migraine, and tension-type headache were 93, 8 and 69% in men; and 99, 25 and 88% in women. The point prevalence of headache was 11% in men and 22% in women. Prevalence of migraine in the previous year was 6% in men and 15% in women and the corresponding prevalences of tension-type headache were 63 and 86%. Differences according to sex were significant with a male: female ratio of 1:3 in migraine, and 4:5 in tension-type headache. The prevalence of tension-type headache decreased with increasing age, whereas migraine showed no correlation to age within the studied age interval. Headache disorders are extremely prevalent and represent a major health problem, which merits increased attention.
Hesperidin, a bioflavonoid, is an abundant and inexpensive by-product of Citrus cultivation. A deficiency of this substance in the diet has been linked with abnormal capillary leakiness as well as pain in the extremities causing aches, weakness and night leg cramps. No signs of toxicity have been observed with the normal intake of hesperidin or related compounds.
Both hesperidin and its aglycone hesperetin have been reported to possess a wide range of pharmacological properties. This paper reviews various aspects of hesperidin and its related compounds, including their occurrence, physical and chemical properties, analysis, pharmacokinetics, safety and toxicity and the marketed products available. A special emphasis has been laid on the pharmacological properties and medicinal uses of these compounds. Copyright
Migraine is a common episodic headache disorder. A comprehensive headache treatment plan includes acute attack treatment to relieve pain and impairment and long-term preventive therapy to reduce attack frequency, severity, and duration. Circumstances that might warrant preventive treatment include: (i) migraine that significantly interferes with the patient's daily routine despite acute treatment; (ii) failure, contraindication to, or troublesome side-effects from acute medications; (iii) overuse of acute medications; (iv) special circumstances, such as hemiplegic migraine; (v) very frequent headaches (more than two a week); or (vi) patient preference. Start the drug at a low dose. Give each treatment an adequate trial. Avoid interfering, overused, and contraindicated drugs. Re-evaluate therapy. Be sure that a woman of childbearing potential is aware of any potential risks. Involve patients in their care to maximize compliance. Consider co-morbidity. Choose a drug based on its proven efficacy, the patient's preferences and headache profile, the drug's side-effects, and the presence or absence of coexisting or co-morbid disease. Drugs that have documented high efficacy and mild to moderate adverse events (AEs) include beta-blockers, amitriptyline, and divalproex. Drugs that have lower documented efficacy and mild to moderate AEs include selective serotonin reuptake inhibitors (SSRIs), calcium channel antagonists, gabapentin, topiramate, riboflavin, and non-steroidal anti-inflammatory drugs.
Diet can play an important role in the precipitation of headaches in children and adolescents with migraine. The diet factor in pediatric migraine is frequently neglected in favor of preventive drug therapy. The list of foods, beverages, and additives that trigger migraine includes cheese, chocolate, citrus fruits, hot dogs, monosodium glutamate, aspartame, fatty foods, ice cream, caffeine withdrawal, and alcoholic drinks, especially red wine and beer. Underage drinking is a significant potential cause of recurrent headache in today's adolescent patients. Tyramine, phenylethylamine, histamine, nitrites, and sulfites are involved in the mechanism of food intolerance headache. Immunoglobulin E-mediated food allergy is an infrequent cause. Dietary triggers affect phases of the migraine process by influencing release of serotonin and norepinephrine, causing vasoconstriction or vasodilatation, or by direct stimulation of trigeminal ganglia, brainstem, and cortical neuronal pathways. Treatment begins with a headache and diet diary and the selective avoidance of foods presumed to trigger attacks. A universal migraine diet with simultaneous elimination of all potential food triggers is generally not advised in practice. A well-balanced diet is encouraged, with avoidance of fasting or skipped meals. Long-term prophylactic drug therapy is appropriate only after exclusion of headache-precipitating trigger factors, including dietary factors.