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Aloysia citriodora Palau (lemon verbena) for insomnia patients: A randomized, double-blind, placebo-controlled clinical trial of efficacy and safety: Aloysia citriodora for insomnia patients: A clinical trial
Abstract
Aloysia citriodora (A. citriodora) has a long history of traditional use for sedation and treatment of insomnia in different societies. This study was carried out to assess the efficacy of A. citriodora in patients with insomnia. One hundred patients were randomly divided into two groups of A. citriodora (total essential oil 1.66 mg/10 ml and total amount of flavonoid in terms of quercetin 3.22 mg/10 ml of the syrup) and placebo. They were advised to use 10 cc of the syrups; an hour before the bedtime for a period of 4 weeks. Participants were assessed using Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI) questionnaires at the baseline and then 2 and 4 weeks after the enrollment. Mean scores of global PSQI and its four components including sleep latency, habitual sleep efficiency, daytime dysfunction, and subjective sleep quality and also ISI score in the A. citriodora group improved significantly after 4 weeks of treatment when compared with the placebo group (p < 0.001, for all of them). Also, improvement of global score of PSQI and ISI was observed in the intervention group as compared with the placebo group, 2 weeks after the enrollment (p < 0.001). The results of this study showed that oral intake of A. citriodora can be suggested as a complementary treatment for patients with insomnia.
... Após leitura dos títulos e aplicação de critérios de elegibilidade, 59 artigos foram identificados para leitura completa, dos quais 43 artigos foram selecionados para compor este estudo. O fluxograma de seleção e aplicação dos critérios está apresentado na FIGURA 1. [24][25][26][27][28][29][30][31][32][33][34][35][36] , Escala de Avaliação de Ansiedade de Hamilton (HAM-A) [25,29,37] [38][39][40][41][42] , Inventário de Ansiedade de Beck (BAI) [37,43,44] e de Depressão de Beck [44] e Índice de qualidade do sono de Pittsburgh (PSQI) [43,[45][46][47][48][49][50][51][52] . ...
... Ansiedade Avaliação do nível de ansiedade por parâmetros fisiológicos [54] Escala Climatérica Verde (GCS, do inglês Green Climacteric Scale) [37,55] Escala Comportamental de Houpt [56] Escala de Ansiedade e Informação Pré-Operatória de Amsterdam (APAIS) [38] Escala de Ansiedade Odontológica Corah (DAS, do inglês Corah Dental Anxiety Scale) [57][58][59] Escala de Ansiedade, Depressão e Estresse-21 (DASS-21, do inglês Depression Anxiety Stress Scale-21) [49,60] Escala de Avaliação de Ansiedade de Hamilton (HAM-A, do inglês Hamilton Anxiety Rating Scale) [25,29,37] Escala de Avaliação do Comportamento de Frankl [56] Escala de Avaliação Numérica (NRS, inglês Numerical Rating Scale) [61] Escala Hospitalar de Ansiedade e Depressão (HADS, do inglês Hospital Anxiety and Depression Scale) [48,62] Escala Revisada de Ansiedade e Depressão Infantil (RCADS, do inglês Revised Child Anxiety and Depression Scale) [63] Escalas Analógicas Visuais (VAS, inglês Analogue Scale), Questionário de Saúde Geral-28 (GHQ-28, inglês General Health Questionnaire) para avaliação de sintomas psiquiátricos [64] Índice de Bem-estar Psicológico Geral (PGWBI, do inglês Psychological General Well-Being Index) [37] Inventário da Ansiedade Traço Estado de Spielberger (Idate ou Stai, do inglês Spielberger's State -Trait Anxiety Inventory) [38][39][40][41][42] Inventário de Ansiedade de Beck (BAI, do inglês Beck Anxiety Inventory) [37,43,44] Depressão Escala de Depressão de Hamilton (HAM-D, do inglês Hamilton Rating Scale for Depression) [24][25][26][27][28][29][30][31][32][33][34][35][36] Escala Revisada de Ansiedade e Depressão Infantil (RCADS, do inglês Revised Child Anxiety and Depression Scale) [63] Inventário de Depressão de Beck (BDI, do inglês Beck Depression Inventory) [44] Insônia Índice de qualidade do sono de Pittsburgh (PSQI, do inglês Pittsburgh Sleep Quality Index) [43,[45][46][47][48][49][50][51][52] Índice de Severidade de Insônia (ISI) [43,45,52] Dos 43 trabalhos incluídos no estudo, conforme constam no QUADRO 3, todos foram realizados em humanos, citando-se: estudo clínico randomizado controlado (1), estudos clínicos randomizados controlados por placebo (6), estudos clínicos randomizados abertos controlados ( Os estudos controlados (comparativos, duplo-cegos e randomizados) são considerados o padrão-ouro para a verificação da eficácia de medicamentos [65] . Para Faustino et al. [65] o melhor delineamento ocorre quando se compara a droga experimental com a droga-padrão e com o placebo, ou seja, compara a ação da substância-teste com o efeito conhecido e bem estabelecido de uma substância utilizada como controle ativo (droga-padrão), além de verificar (quantificar) uma parcela do efeito que, embora real, independe da ação específica da droga (efeito placebo). ...
... Ansiedade Avaliação do nível de ansiedade por parâmetros fisiológicos [54] Escala Climatérica Verde (GCS, do inglês Green Climacteric Scale) [37,55] Escala Comportamental de Houpt [56] Escala de Ansiedade e Informação Pré-Operatória de Amsterdam (APAIS) [38] Escala de Ansiedade Odontológica Corah (DAS, do inglês Corah Dental Anxiety Scale) [57][58][59] Escala de Ansiedade, Depressão e Estresse-21 (DASS-21, do inglês Depression Anxiety Stress Scale-21) [49,60] Escala de Avaliação de Ansiedade de Hamilton (HAM-A, do inglês Hamilton Anxiety Rating Scale) [25,29,37] Escala de Avaliação do Comportamento de Frankl [56] Escala de Avaliação Numérica (NRS, inglês Numerical Rating Scale) [61] Escala Hospitalar de Ansiedade e Depressão (HADS, do inglês Hospital Anxiety and Depression Scale) [48,62] Escala Revisada de Ansiedade e Depressão Infantil (RCADS, do inglês Revised Child Anxiety and Depression Scale) [63] Escalas Analógicas Visuais (VAS, inglês Analogue Scale), Questionário de Saúde Geral-28 (GHQ-28, inglês General Health Questionnaire) para avaliação de sintomas psiquiátricos [64] Índice de Bem-estar Psicológico Geral (PGWBI, do inglês Psychological General Well-Being Index) [37] Inventário da Ansiedade Traço Estado de Spielberger (Idate ou Stai, do inglês Spielberger's State -Trait Anxiety Inventory) [38][39][40][41][42] Inventário de Ansiedade de Beck (BAI, do inglês Beck Anxiety Inventory) [37,43,44] Depressão Escala de Depressão de Hamilton (HAM-D, do inglês Hamilton Rating Scale for Depression) [24][25][26][27][28][29][30][31][32][33][34][35][36] Escala Revisada de Ansiedade e Depressão Infantil (RCADS, do inglês Revised Child Anxiety and Depression Scale) [63] Inventário de Depressão de Beck (BDI, do inglês Beck Depression Inventory) [44] Insônia Índice de qualidade do sono de Pittsburgh (PSQI, do inglês Pittsburgh Sleep Quality Index) [43,[45][46][47][48][49][50][51][52] Índice de Severidade de Insônia (ISI) [43,45,52] Dos 43 trabalhos incluídos no estudo, conforme constam no QUADRO 3, todos foram realizados em humanos, citando-se: estudo clínico randomizado controlado (1), estudos clínicos randomizados controlados por placebo (6), estudos clínicos randomizados abertos controlados ( Os estudos controlados (comparativos, duplo-cegos e randomizados) são considerados o padrão-ouro para a verificação da eficácia de medicamentos [65] . Para Faustino et al. [65] o melhor delineamento ocorre quando se compara a droga experimental com a droga-padrão e com o placebo, ou seja, compara a ação da substância-teste com o efeito conhecido e bem estabelecido de uma substância utilizada como controle ativo (droga-padrão), além de verificar (quantificar) uma parcela do efeito que, embora real, independe da ação específica da droga (efeito placebo). ...
Sociobiodiversity can contribute to innovation in medicines from Brazilian plant diversity. This work sought to gather evidence from clinical studies on the effectiveness of using medicinal plants and herbal medicines in treating anxiety disorders and depression. Thus, an integrative review was carried out with a selection of plants from the work of Pio Corrêa (1926 - 1978) and through the PubMed, Lilacs and Cochrane databases. After applying the selection criteria, 43 articles were listed, and 12 plants were investigated. It was possible to demonstrate anxiolytic effects for saffron (Crocus sativus), cimicífuga (Actaea racemosa), dill (Anethum graveolens), orange (Citrus x aurantium), hops (Humulus lupulus), melissa (Melissa officinalis), passion fruit (Passiflora incarnata) and valeriana (Valeriana officinalis); antidepressants for saffron, curcuma (Curcuma longa), hops and melissa; sedatives for saffron, lettuce (Lactuca sativa), citron (Aloysia citriodora), hops, melissa, passion fruit and valeriana (Valeriana officinalis). Therefore, phytotherapy can help treat anxiety disorders and depression in mental health care, using plants from Brazilian sociobiodiversity. However, further investigations with clinical trials and investments in biotechnology are necessary to ensure the development of innovation in medicines of plant origin.
... Účinky na nervový systém V experimentech na zvířatech byl zjištěn anxiolytický, sedativní, antidepresivní, antikonvulzivní a neuroprotektivní účinek. Klinických studií, které by tyto účinky ověřily u lidí, je však zatím minimum (9,10,14,15,16). ...
... Studii dokončili všichni pacienti. Aloisie citronová se tak jeví jako účinný a bezpečný doplněk při léčbě nespavosti (14). ...
... Podávají se 2-3 šálky denně (9). Aloisie je obvykle dobře snášena, z nežádoucích účinků se může objevit neklid, průjem, třes, ospalost či svědění (14). Aloisii by neměli užívat pacienti trpící onemocněním ledvin a děti mladší 6 let. ...
Aloisies (Aloysia Paláu) are aromatic shrubs or semi-shrubs of the Verbenaceae family, native to South, Central and North America and widely
distributed in many parts of the world. Well-known is especially lemon verbena (Aloysia citrodora Paláu). Aloisies are widely used in traditional
medicine to treat indigestion, diarrhea, vomiting, rheumatism, asthma, bronchitis, cardiovascular diseases, epilepsy, infections, skin diseases, flu,
fever, malaria, but also to treat mental disorders, such as anxiety, depression or insomnia
... V experimentech na zvířatech byl zjištěn anxiolytický, sedativní, antidepresivní, antikonvulzivní a neuroprotektivní účinek. klinických studií, které by tyto účinky ověřily u lidí, je však zatím minimum (9,10,14,15,16). ...
... studii dokončili všichni pacienti. aloisie citronová se tak jeví jako účinný a bezpečný doplněk při léčbě nespavosti (14). ...
... Podávají se 2-3 šálky denně (9). Aloisie je obvykle dobře snášena, z nežádoucích účinků se může objevit neklid, průjem, třes, ospalost či svědění (14). Aloisii by neměli užívat pacienti trpící onemocněním ledvin Přehledné články a děti mladší 6 let. ...
Aloisies (Aloysia Paláu) are aromatic shrubs or semi-shrubs of the Verbenaceae family, native to South, Central and North America
and widely distributed in many parts of the world. Well-known is especially lemon verbena (Aloysia citrodora Paláu). Aloisies are widely
used in traditional medicine to treat indigestion, diarrhea, vomiting, rheumatism, asthma, bronchitis, cardiovascular diseases, epilepsy,
infections, skin diseases, flu, fever, malaria, but also to treat mental disorders, such as anxiety, depression or insomnia.
... This plant was initially cultivated in Central and South America and was transferred to Europe in the 17th century. [16][17][18] Moreover, it has received the approval of the American Food and Drug Administration. ...
... LV is a safe plant 19 and its ingredients have antioxidant, analgesic, antimicrobial, and anti-inflammatory properties. 16,[19][20][21][22][23][24] Likewise, the remarkable anxiolytic effect of LV has been reported by several studies. [25][26][27] But there have been no studies about the relationship between its anxiolytic effect and C/S. ...
Background
Aromatherapy is a noninvasive method used for alleviating anxiety. Lemon verbena (Aloysia citriodora Paláu, LV) has been frequently used in traditional medicine as an anxiolytic agent due to its pharmacological ingredients.
Objective
This randomized controlled trial aimed to assess the effects of inhaling essential oil of LV on the level of anxiety and subsequent hemodynamic changes before cesarean section.
Methods
The recent study was a randomized single‐blind trial. Participants (n = 84) were randomly divided into two groups: LV essential oil (group A) and placebo (group B). The intervention group underwent aromatherapy using three drops of LV essential oil at a distance of 10 cm for 30 min. The placebo group received aromatherapy in a similar fashion. The State‐Trait Anxiety Inventory of Spielberger questionnaire was administered before and 5 min after aroma inhalation. Vital signs were recorded before and after aromatherapy. Likewise, pain severity was assessed using the Numeric Rating Scale and vital signs were recorded. Data were analyzed using t‐test, χ², and the Kolmogrov–Smirnov test through SPSS21 software.
Results
Anxiety level was significantly attenuated in group A after aromatherapy. Heart rate, respiratory rate, and blood pressure decreased after inhalation; but no significant variation of pain scores was observed after inhalation in both groups.
Conclusion
We concluded that LV decreased preoperative anxiety in this recent study, therefore, aromatherapy with LV essential oil as a preemptive adjuvant to relieve anxiety before cesarean section is recommended by us; although more studies are required to endorse the results.
... Currently, various complementary and alternative medicine methods have been used for human diseases [14,15]. In line with this, therapeutic potency of many phytochemicals have been investigated to attenuating post-surgical adhesion band formation [15][16][17][18]. ...
... Currently, various complementary and alternative medicine methods have been used for human diseases [14,15]. In line with this, therapeutic potency of many phytochemicals have been investigated to attenuating post-surgical adhesion band formation [15][16][17][18]. Curcumin, also known as diferuloylmethane, is a polyphenol extract of turmeric (Curcuma longa L. rhizome) and has been used for centuries in traditional Chinese and Indian medicine [19]. ...
Background
Adhesion band formation is a common cause of morbidity for patients undergoing surgeries. Anti-inflammatory and anti-fibrotic properties of curcumin, a pharmacologically active component of Curcuma longa , have been investigated in several studies. The aim of this study is to explore the therapeutic potential of curcumin in attenuating post-operative adhesion band (PSAB) formation in both peritoneal and peritendinous surgeries in animal models.
Methods
Bio-mechanical, histological and quantitative evaluation of inflammation, and total fibrosis scores were graded and measured in the presence and absence of phytosomal curcumin.
Results
Results showed that phytosomal curcumin significantly decreased severity, length, density and tolerance of mobility of peritendinous adhesions as well as incidence and severity of abdominal fibrotic bands post-surgery. Curcumin may decrease inflammation by attenuating recruitment of inflammatory cells and regulating oxidant/anti-oxidant balance in post-operative tissue samples. Moreover, markedly lower fibrosis scores were obtained in the adhesive tissues of phytosomal curcumin-treated groups which correlated with a significant decrease in quantity, quality and grading of fibers, and collagen deposition in animal models.
Conclusion
These results suggest that protective effects of phytosomal curcumin against PSAB formation is partially mediated by decreasing inflammation and fibrosis at site of surgery. Further studies are needed to investigate the therapeutic potential of this molecule in preventing PSAB.
... Aloysia citriodora traditionally used as a sedative, anticonvulsant, diuretic, heart palpitation and dizziness reliever [23,24]. Some of the neuroprotective effects of Aloysia citriodora are related to the interaction with the benzodiazepine site of the GABA receptors [25]. ...
Over the years, medicinal plants have been considered promising treatments for managing various disorders. Numerous natural products contain prospective potential for the treatment of insomnia. This study aimed to determine the quantities of melatonin and GABA present in five plant extracts with hypnotic effects. Five plants were selected for investigation, including Valeriana officinalis, Passiflora incarnata, Aloysia citriodora, Withania somnifera, and Lavandula officinalis. The ethanolic extracts of these plants were prepared using the maceration method. For preliminary phytochemical evaluations, HPTLC fingerprinting was conducted on both the extracts and the standards, including melatonin and GABA. GABA content was determined using HPTLC in three out of the five plants. Furthermore, the HPLC method was used to confirm the presence of melatonin. The results of HPTLC fingerprinting revealed that the ethanolic extracts of Aloysia citriodora, Passiflora incarnata, and Withania somnifera contained GABA, which could be attributed to their reported hypnotic effects. Conversely, none of the five plants contained melatonin, indicating that the hypnotic effect was not related to this compound. In conclusion, this study described the HPTLC method for detecting and quantifying GABA in Withania somnifera and Aloysia citriodora for the first time. Notably, Withania somnifera exhibited the highest amount of GABA.
... Oxidative stress in the lungs was brought on by the increased production of hydrogen peroxide that was triggered by BLM. We found that GSPE significantly mitigated the oxidative stress after treatment (37). ...
Idiopathic Pulmonary Fibrosis (IPF) poses a significant challenge in the realm of respiratory diseases, characterized by progressive lung scarring and compromised breathing function. While conventional medical interventions provide some relief, the exploration of complementary therapies has gained traction, and herbal remedies stand out as a promising avenue. This abstract delves into the efficacy of numerous herbal remedies in the treatment of IPF, shedding light on their potential impact on disease progression and symptom management. Turmeric, derived from Curcuma longa, emerges as a golden healer due to its anti-inflammatory and antioxidant properties, with curcumin exhibiting promise in mitigating lung inflammation and fibrosis. Boswellia serrata, or Indian frankincense, demonstrates anti-inflammatory effects through boswellic acids, suggesting its potential role in suppressing pathways leading to fibrosis. Gingko biloba, renowned for enhancing blood circulation, may contribute to improved oxygenation in individuals with IPF, offering support for compromised lung function. Licorice root, with its anti-inflammatory and expectorant qualities, presents a potential ally in soothing inflammation associated with IPF. Green tea, rich in antioxidants like catechins, shows promise in protecting lung tissues from oxidative stress and inflammation. This abstract emphasizes the importance of caution in integrating herbal remedies, particularly licorice root, and encourages consultation with healthcare professionals to ensure safety, especially in individuals with pre-existing conditions like high blood pressure. In conclusion, the integration of herbal remedies into the treatment paradigm for IPF presents a holistic approach to addressing the complexities of this debilitating condition. As ongoing research explores the mechanisms and efficacy of these herbal interventions, the potential for natural remedies to play a crucial role in managing idiopathic pulmonary fibrosis continues to offer hope for improved patient outcomes.
... Among the pleomorphic properties of the plant, mostly attributed to the polyphenol verbascoside [20], a few clinical studies have examined the sedative effects of lemon verbena for improving sleep disorders and reducing anxiety symptoms. In a randomized, double-blind and placebo-controlled study, Afrasiabian et al. [35] reported the results of the administration of 10 cc of a syrup of A. citrodora (total essential oil content of the product 1.66 mg/10 mL and flavonoid quercetin 3.22 mg/10 mL) or placebo one hour before bedtime for 4 weeks in subjects with insomnia. All participants had a score > 5 of the PSQI questionnaire. ...
Seventy-one healthy subjects with sleep disturbances participated in a randomized, double-blind controlled trial in which dietary supplementation with an extract of Aloysia citrodora (lemon verbena) (n = 33) or placebo (n = 38) was administered for 90 days. There were between-group differences in favor of the experimental group in the visual analogue scale (VAS) for sleep quality (6.5 ± 1.6 vs. 5.5 ± 2.1, p = 0.021) as well as in the overall score (5.8 ± 2.4, p = 0.008) and scores for sleep latency (1.6 ± 1.0 vs. 1.9 ± 0.7, p = 0.027) and sleep efficiency (84.5 ± 12.8 vs. 79.8 ± 13.6, p = 0.023) in the Pittsburgh Sleep Quality Index (PSQI). Sleep-related variables (latency, efficiency, wakefulness after sleep onset, awakenings) assessed by actigraphy also showed better scores in the experimental group (p = 0.001). Plasma nocturnal melatonin levels also increased significantly in the experimental group (199.7 ± 135.3 vs. 174.7 ± 115.4 pg/mL, p = 0.048). Changes in anthropometric parameters and physical activity levels were not found. In summary, a dietary supplement of lemon verbena administered for 3 months was associated with a significant improvement in sleep quality as compared with placebo in a population of healthy subjects with sleep problems.
... As a consequence of this fact, the study of medicinal plants that have action on the stomach has high importance in the current society, considering the great need of substances that exhibit few side effects and greater efficacy (Afrasiabian et al. 2019). An alternative for the treatment with synthetic drugs would be derivatives of plant products, since they cost less and have reduced side effects, among them flavonoids, alkaloids and triterpenes that have exhibited an antiulcerous activity (Borrelli and Izzo 2000). ...
Phytol is a diterpene constituent of many essential oils, belonging to the group of unsaturated acyclic alcohols. Although phytol possesses antimycobacterial and anti-inflammatory effects, no reports of a gastrointestinal action are available from the literature. Due to the well-known shortcomings of classical anti-ulcer drugs (e.g. side effects or relapses), natural products may offer an attractive alternative. In this study, a potential gastroprotective activity of phytol was evaluated using acute and chronic ulcer models in rats. Phytol 12.5, 25 and 50 mg/kg, administered orally 1 h prior to induction of gastric lesions by absolute ethanol, inhibited the lesion area by 96, 90 and 95%, respectively. When lesions were induced by ischemia and reperfusion, phytol 12.5 and 25 mg/kg per os decreased the lesion areas by 89 and 46%, respectively. In the third acute ulcer model (lesions induced by ibuprofen), phytol 12.5 mg/kg reduced the lesion area by 55%. Phytol restored the decreased level of reduced glutathione, the increased levels of myeloperoxidase and malondialdehyde and the decreased levels of catalase and superoxide dismutase in rats with gastric ulcer induced by ethanol to levels obtained in vehicle group. Finally, in a chronic model in which gastric ulcer was induced by acetic acid directly instilled into the stomach, phytol administered orally over a time period of 7 days at 12.5, 25, 50 and 100 mg/kg reduced lesion areas by 84, 81, 83 and 68%. Our data suggest a gastroprotective and cicatrizing effect of phytol, possibly associated with its antioxidant effect.
... Main findings of this study were significant improvements in four components of the PSQI questionnaire (sleep latency, habitual sleep efficiency, daytime dysfunction, and subjective sleep quality) and also in the overall score of the Insomnia Severity Index (ISI) questionnaire, which indicated better sleep quality in the A. citriodora group. A benzodiazepine-like effect on the GABA receptor has been suggested as a plausible mechanism of action of A. citrodora in experimental studies [35,36]. ...
A single-center, randomized, double-blind, placebo-controlled clinical trial with two arms was conducted in 71 healthy subjects suffering from sleep disturbances, which were treated with a dietary supplement based on an extract of Aloysia citrodora (or Lippia citriodora, lemon verbena) (n = 33) for 90 days. Subjects in the placebo group (n = 38) received capsules of microcrystalline and maltodextrin with the same organoleptic properties. Between-group significant differences in favor of the experimental group were found in the visual analogue scale (VAS) score rating sleep quality; overall score, sleep latency and sleep efficiency of the Pittsburg Sleep Quality Index (PSQI); and sleep latency, sleep efficiency, wakefulness after sleep onset and duration of awakening assessed by actigraphy. Plasma nocturnal melatonin levels also increased significantly in the experimental group. Changes in anthropometric parameters and physical activity levels were not found. This study shows that the administration of a dietary supplement comprised lemon verbena administered for 3 months was associated with a significant improvement of sleep quality as compared with placebo in a population of healthy subjects with sleep problems. Improvements were also apparent at the mid-study visit after 45 days of supplementation.
... The aroma was consistently associated with these relaxing and calming mental effects, indicating a sustained impact over the past two weeks. Several studies on the safety of essential oils have recently been conducted [48,49]. In this study, there were no adverse events associated with the use of aroma seals because they did not adhere directly to the skin. ...
During the COVID-19 pandemic, face masks on patients and healthy people have been recommended to prevent airborne transmission of the virus. This increased the number of people who felt stressed while wearing masks. In this study, we investigated the stress-relieving effects of attaching aroma seals to masks. A double-blind, randomized controlled trial was conducted involving 62 university students. The participants were randomly assigned to two groups and instructed to apply a seal to their masks once a day throughout the study period. The primary measure used was the Depression, Anxiety, and Stress Scale-21 (DASS-21), while the secondary measures included the assessment of breathlessness associated with mask-wearing and the World Health Organization Five Well-Being Index (WHO-5). The intervention group, referred to as the aroma-seal use group, utilized aroma seals infused with orange-lime essential oil with the expectation of experiencing the healing effects of citrus. On the other hand, the non-intervention group, known as the placebo-seal use group, utilized identical seals without any aroma. Results indicated that the aroma-seal use group exhibited significant improvements in both the total DASS-21 scores and depression scores compared to their baseline values by the second week of the intervention. Furthermore, the aroma-seal use group demonstrated a reduced occurrence of breathlessness while wearing masks compared to the placebo-seal group. Additionally, when assessing the item "I have felt calm and relaxed" from the WHO-5 questionnaire, the aroma-seal use group displayed significantly higher scores than the placebo group. Therefore, using aroma seals containing orange–lime essential oil could be beneficial in relieving mental stress and reducing breathlessness while wearing a mask, thus improving mental health.
... For example, in a well-conducted parallel randomized double-blind placebo-controlled trial of 100 people using orally ingested lemon verbena, the authors concluded that this intervention can be a complementary therapy for improving sleep quality and reducing insomnia severity. 31 Another RCT with 60 participants evaluated an inhaled EO blend (lemon, eucalyptus, tea tree, and peppermint) over 4 weeks and found lowered perceived stress and depression as well as better sleep quality, but no influence on objective physiologic data such as stress indices or immune states. 32 In a 2020 randomized crossover placebocontrolled trial of 37 participants with diabetes reporting insomnia, inhaled lavender improved sleep quality and quantity, quality of life, and mood but not physiologic or metabolic measures, such as fasting glucose. ...
... This study was evaluated using the Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI) questionnaires. In the A. citriodora group, signifcant improvement was observed after 4 weeks of treatment (p < 0.001 for all), and it concluded that oral intake could be recommended as a complementary therapy in patients suffering from insomnia (Afrasiabian et al., 2019). A signifcant species in the history of medicine, Artemisia absinthium/wormwood from Asteraceae is formerly known as a medicinal herb in medieval Europe famous for its use against fatigue, but now it is known as an effective agent in the treatment of insomnia in traditional Asian and European medicine (Ahamad et al., 2019;Szopa et al., 2020). ...
... Furthermore, a recent clinically relevant survey indicated that quercetin can be used as complementary treatment for patients with insomnia (Afrasiabian et al., 2019). As the main compound of SZRD, quercetin was presumed to be the active substance that exerts a hypnotic effect. ...
... From long times ago, traditional medicinal plants are consumed globally for the management of different chronic diseases, including arthritis, in developing countries where other medical choices are mostly limited. [11][12][13][14] Along with their direct predictable effects on management of complications associated with knee OA's, plant remedies can also indirectly reduce the side effects associated with conventional therapies by reducing their minimal effective concentrations during concurrent therapy. 15 Ginger officially referred as Zingiber officinale Rosc. ...
What is known and objectives:
Present study evaluated the safety profile and efficacy of G-Rup® syrup (100 mg/ml ginger extract plus 150 mg/ml honey) in symptomatic treatment of knee osteoarthritis (OA).
Methods:
Patients diagnosed with knee OA were randomly assigned (1:1) to receive either of a 30 ml twice daily regimen of G-Rup® syrup or placebo over a 12-week period. Primary endpoints of the study comprised of an improvement in the joint's stiffness, physical functioning and pain score, assessed by WOMAC questionnaire and the visual analog scale (VAS). Secondary objectives comprised of safety and tolerability of the syrup by patients.
Results and discussion:
The 30 ml twice-daily regimen of G-Rup® syrup was safe and well tolerated by patients. Moreover, in whole studied time points, treatment with G-Rup® syrup could significantly Power the VAS score (p < 0.001) whereas improving WOMAC total score (p < 0.001) and pain (p < 0.001), physical functioning (p < 0.001), and stiffness sub-scores (p = 0.006) compared to the placebo receiving group.
What is new and conclusion:
Based on obtained results, the G-Rup® syrup, composed of a combination of honey and ginger, may be a proper supplementary choice, along with routine therapeutic regimens, for improvement of symptomatic treatment of OA.
... [6] At present, many studies on the substitution of traditional medicines for different disease groups have been completed. [7,8] Modern medicine should be closely integrated with traditional medicine and learn from each other's strengths. As complementary medicine, traditional medicine can be implemented through an "integrative approach," that is, individualized strategies are adopted according to the specific conditions of different patients. ...
Background:
At present, apart from lung transplantation, no drugs can effectively treat idiopathic pulmonary fibrosis (IPF). Therefore, it is imperative to explore new drugs to control or treat it. Traditional Chinese medicine (TCM) injections have been widely used in the field of IPF, but there is no comparison of their efficacy in the assisted improvement of IPF. Therefore, the purpose of this study is to network meta-analyze the efficacy and safety of 4 kinds of commonly used TCM injections assisted by conventional treatment to improve the disease.
Methods:
Used a computer to find the Randomized Controlled Trials (RCTs) from the 8 major databases (PubMed, EMbase, CENTRAL, MEDLINE, CBM, China National Knowledge Infrastructure, WanFang Database and VIP Chinese Science). Cochrane's risk assessment tool was used to evaluate the quality of the literature. The Grading of Recommendations Assessment, Development and Evaluation approach served to assess the certainty in the evidence of direct and indirect estimates. Revman5.3 (Review Manager (RevMan) Version 5.3. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2014.) and stata14.0 (Stata/SE 14.0 for Windows (64-bit). Revision Apr 22, 2015.Copyright 1985-2015 StataCorp LP). were used for Statistical analysis. Registration number: CRD42020220570.
Results:
After layer-by-layer screening, 20 RCTs were finally included, which include a total of 1363 patients and 4 kinds of RCT of TCM injection (12 studies on Danhong injection, 5 studies on Ligustrazine injection, 2 studies on Huangqi injection and 1 study on Dazhu hongjingtian injection). The results showed: Clinical effective rate: Danhong Injection (Odds ratio [OR] = 3.94, 95% CI [2.34, 6.64], moderate certainty of evidence), Huangqi injection (OR = 3.40, 95% CI [1.38, 8.41], moderate certainty of evidence) and Ligustrazine injection (OR = 2.74, 95% CI [1.62, 4.64], moderate certainty of evidence) combined with conventional treatment had better curative efficacy than that of the conventional treatment group. SUCRA Ranking: Danhong (80.5) > Huangqi (68.5) > Ligustrazine (52.9) > Dazhu hongjingtian (44.3) > Conventional treatment (3.8); Forced Expiratory Volume In 1s/Forced vital capacity%: SUCRA Ranking: Danhong (80.0) > Ligustrazine (62.9) > Conventional treatment (2.1); Carbon monoxide diffusing capacity%: SUCRA Ranking: Ligustrazine (89.9) > Dazhu hongjingtian (63.4) > Danhong (44.9) > Conventional treatment (1.8); Partial pressure of Oxygen: SUCRA Ranking: Dazhu Hongjingtian (87.1) > Danhong (78.8) > Ligustrazine (34.0) > Conventional treatment (0.0); Partial pressure of carbon dioxide: SUCRA Ranking: Danhong (99.3) > Ligustrazine (50.3) > Conventional treatment (0.4). No obvious adverse reactions were found in all studies.
Conclusion:
The four TCM injections combined with conventional treatment can effectively improve the clinical indicators of patients with IPF, and the improvement effect of Danhong injection was more obvious.
... Several studies refer to the chemical composition of common and lemon verbena; however, there are scarce literature reports about the constituents of aqueous preparations although they are attributed with important biological activities such as antigenotoxic effects and protection against genetic damage of lemon verbena infusion [44] or the neuroprotective [29,45] and hypnotic effects of the aqueous extract of verbena [46]. Moreover, some studies have reported the antioxidant properties of the species; however, they mostly refer to essential oils [34,47,48]. ...
The nutritional profiles of common and lemon verbena leaves were analyzed (proximate constituents, free sugars, organic acids, tocopherols, and fatty acids) and the leaves were prepared in hydromethanolic and aqueous (decoctions and infusions) extracts. The phenolic compound composition and antioxidant activity (2,2-Diphenyl-1-picrylhydrazyl (DPPH); 2,2′-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid (ABTS), ferric-reducing antioxidant power (FRAP); and cupric-reducing antioxidant capacity (CUPRAC) assays) of the extracts were characterized. The nutritional composition varied between the studied species, with lemon verbena showing higher amounts of protein, ash, and fat than common verbena, whereas the opposite trend was recorded for the dietary fiber content. The main free sugars detected in both species were fructose, glucose, and sucrose, which were present in higher amounts in the common verbena samples. Succinic acid was the most abundant organic acid in both species while high amounts of oxalic acid were detected in lemon verbena. The main fatty acids in both species were α-linolenic, palmitic, and linoleic acid. Regarding the phenolic compound content, the extracts of lemon verbena presented higher amounts of total phenolic compounds (TPCs), total flavonoids (TFs) and total phenolic acids (TPAs) than the common verbena extracts while the aqueous extracts (infusions and decoctions) were richer in TPCs, TFs, and TPAs than the hydromethanolic ones in both species. Nine phenolic compounds were identified and quantified, including seven phenolic acids and two flavonoids. The lemon verbena samples were characterized by higher antioxidant activity compared to the common verbena samples while the aqueous extracts showed higher antioxidant efficacy than the hydromethanolic ones. In conclusion, both species showed promising results in terms of the nutritional value, chemical composition, and antioxidant activities, which were positively correlated with the phenolic compound contents. Moreover, the extraction protocol may affect the chemical composition and bioactive properties of both species, with aqueous extracts showing better results than hydromethanolic ones.
... As new forms of treatment for sleep disorders, complementary and alternative medicine (CAM) is emerging [10]. Prior studies have demonstrated the efectiveness of lemon verbena [11] and auricular acupuncture [12] for treating insomnia. Auricular point acupressure may be promising nonpharmacological sleep intervention [13]. ...
Objectives:
The study aimed to evaluate the preliminary effect and efficacy of auricular point acupressure (APA) on the quality of sleep in women with breast cancer who were undergoing chemotherapy. Sample & Setting. We conducted a randomized controlled trial on 68 patients with breast cancer who reported poor sleep quality based on the Pittsburgh Sleep Quality Index (PSQI) scores (>7). Methods & Variables. Participants were randomly assigned to an APA treatment group or a control group. Patients in the APA group had magnetic pellets attached to selected auricular points and were instructed to apply pressure to these points 4×/day for three consecutive weeks. We objectively measured sleep quality using the Actiwatch Spectrum and the PSQI at the baseline and postintervention. Statistical analyses of changes in sleep data were performed using the t-test, a rank-sum test, and analyses of covariance.
Results:
In patients treated with APA, the PSQI total score and sleep onset latency had significantly decreased, while the total sleep time and sleep efficiency had significantly increased. Although the total PSQI score differed between groups at the baseline, ANCOVA results showed that the APA group had a significantly lower total PSQI score.
Conclusion:
APA could be an inexpensive and effective approach to improving sleep quality and reducing sleep disturbance in patients with breast cancer. Further research needs a larger sample size to verify our findings.
... For instance, Hashemi et al. [19] reported pomegranate seed powder to have beneficial effects on fasting blood glucose and HbA1c in patients with type 2 diabetes mellitus. Afrasiabian et al. [20] showed that lemon verbena can be suggested as a complementary treatment for patients with insomnia. Zhang et al. [21] demonstrated that acupuncture analgesia is effective in reducing pain. ...
Background:
Osteoarthritis (OA) is one of the most common joint degeneration ailments adversely affecting the elderly population by impairing their physical movements and quality of life. This study aimed to establish the efficacy of cabbage leaf application in alleviating pain-related distress and positively improving OA conditions.
Materials and methods:
Patients with moderate to severe (grades 3-4) OA by the Kellgren and Lawrence grading system with a poor to good Oxford Knee Score were selected for enrollment in this clinical trial. The participants were divided into three intervention groups: the cooling gel pad group for 20 minutes duration once a day (n = 20), the diclofenac gel group for 4 times a day (n = 20) as the control group (total n = 40), and the cabbage leaf group for 1-hour duration once a day (n = 20) as the experimental group (total n = 20). All trial participants were trained to record their Numerical Rating Scale (NRS) pain score and Oxford Knee Score and were advised to undergo weekly follow-ups and assessment of the outcome at 4 weeks. Data were analyzed by the paired t-test and analysis of variance (ANOVA).
Results:
The cabbage leaf group and cooling gel pad group showed a significant difference in both the Oxford Knee Score (p < 0.001 in both groups) and NRS score (p < 0.001 in both groups) before and after the intervention, by using the paired t-test. The three study procedures were found to be significantly different with respect to both the Oxford Knee Score (p=0.012) and NRS score (p < 0.001), by using ANOVA.
Conclusion:
This study clinically demonstrated that cabbage leaf application and cooling gel pad application showed similar improvements in reducing OA symptoms in terms of the overall NRS score and Oxford Knee Score. Their therapeutic effectiveness was better than that of diclofenac gel.
... Several investigators argued that modern and traditional medicines should not be separated, and traditional medicine should be used in an "integrative approach", which is a personalised strategy that considers the patient's specific conditions [36]. Integrative medicine aims to use all appropriate interventions from a wide range of science fields to restore health [37]. Hence, many experts believe that traditional medicine will eventually become the mainstream of modern medicine. ...
Idiopathic pulmonary fibrosis (IPF) is a progressive interstitial lung scarring condition with the histological characteristic of typical interstitial pneumonia. Injury to alveolar epithelial cells is a critical precursor in the pathogenesis of this disease. The prevalence of IPF is growing exponentially, with substantial morbidity and mortality rates increasing the burden on economic healthcare costs. A multidisciplinary approach for diagnosis is used to rule out the alternative causes of interstitial lung disease. Pirfenidone and nintedanib, two innovative antifibrotic medicines introduced in recent years, have provided therapeutic benefits to many IPF patients, and several IPF medications are in the early phases of clinical trials. However, available medications can cause unpleasant symptoms such as nausea and diarrhoea. More efforts have been made to uncover alternative treatments towards a more personalised patient-centred care and hence improve the outcomes in the IPF patients. Through a multi-level and multi-target treatment approach, herbal medicines, such as Traditional Chinese Medicine (TCM), have been identified as revolutionary medical treatment for IPF. Due to their natural properties, herbal medicines have shown to possess low adverse effects, stable therapeutic impact, and no obvious drug dependencies. Herbal medicines have also shown anti-inflammatory and anti-fibrotic effects, which make them a promising therapeutic target for IPF. A growing number of formulas, herbal components, and various forms of Chinese herbal medicine extracts are available for IPF patients in China. This review summarises the role of herbal medicines in the prevention and treatment of IPF.
... In recent years, there has been an increased interest in therapeutic herbal ingredients worldwide, due to reduced side effects and better availability, leading to the popularity of herbal toothpastes. With the increasing availability of herbal toothpaste brands on the market, the efficacy of these products on oral bacteria has been studied extensively in recent years [12][13][14][15][16][17][18]. ...
Background
The inclusion of herbal antibacterial agents in the composition of toothpastes is becoming increasingly popular, due to lower side effects. The present study intended to investigate the antibacterial efficacy of a herbal toothpaste containing Bamboo salt on cariogenic oral bacteria.
Methods
The present double-blinded parallel randomized controlled clinical trial was conducted on 60 dental students (age range: 18–30). Following the baseline saliva sampling, the participants were randomly assigned into the case and control groups, to use the Bamboo salt herbal toothpaste and conventional non-herbal toothpaste, respectively. They were instructed to brush their teeth twice a day using the Bass technique. Saliva sampling was repeated after four weeks. The salivary counts of Streptococcus mutans and Lactobacillus at baseline and 4-week follow-up were determined and presented as the logarithm of colony-forming units per milliliter (log CFU/mL).
Results
A significant decrease in salivary Streptococcus mutans and Lactobacillus was observed using both toothpastes (* P < 0.001). The difference between the antibacterial efficacy of two toothpaste types on Streptococcus mutans and Lactobacillus was not statistically significant ( P = 0.530, and P = 0.137, respectively).
Conclusion
Due to the comparable efficacy of the investigated herbal toothpaste with conventional toothpaste, it potentially qualifies as a complementary agent for self-care oral hygiene procedures.
Trial registration : This trial was registered in the “Iranian Registry of Clinical Trials” (IRCT20210414050964N1) on 21/06/2021.
... Simultaneously, however, the proportion of people relying on complementary and alternative medicine (CAM) or dietary supplements increased when facing stress [23]. ere are many different effective CAM options for the treatment of stress and other psychiatric disorders, ranging from music therapy to tai chi to phytotherapy [24][25][26][27], to mention some of the main ones. Herbal, homeopathic, and anthroposophic medicines are also very popular, as they are generally considered safe and are widely used in various indications [28][29][30][31][32][33]. ...
Introduction:
Stress is associated with a multitude of physical and psychological health impairments. To tackle these health disorders, over-the-counter (OTC) products like Neurodoron® are popular since they are considered safe and tolerable. Experience reports and first studies indicate that Neurodoron® is efficient in the treatment of stress-associated health symptoms. To confirm this, a non-interventional study (NIS) with pharmacies was conducted.
Methods:
The NIS was planned to enroll female and male patients who suffered from nervous exhaustion with symptoms caused by acute and/or chronic stress. The main outcome measures were characteristic stress symptoms, stress burden, and perceived stress. Further outcome measures included perceived efficacy and tolerability of the product as assessed by the patients and collection of adverse drug reactions (ADRs). A study duration of about 21 days with a recommended daily dose of 3-4 tablets was set.
Results:
279 patients were enrolled at 74 German pharmacies. The analyzed set (AS) included 272 patients (mean age 44.8 ± 14.4 years, 73.9% female). 175 patients of the AS completed the NIS. During the study, all stress symptoms declined significantly (total score 18.1 vs. 12.1 (of max. 39 points), p < 0.0001). Furthermore, a reduction of stress burden (relative difference in stress burden, VAS = -29.1%, p < 0.0001) was observed. For most patients, perceived stress was reduced at the study end (PSQ total score decreased in 70.9% of the patients). 75.9% of the study population rated the product efficacy as "good" or "very good" and 96.6% rated its tolerability as "good" or "very good." One uncritical ADR was reported. Discussion/Conclusion. This study adds information on the beneficial effects of Neurodoron® in self-medication. The results from this NIS showed a marked reduction in stress burden and perceived stress, along with an excellent safety profile of the medicinal product (MP) Neurodoron®. Further trials are required to confirm these results.
... The review of fourteen RCTs with 910 participants in Yan-Hua Lin's study shows that traditional Chinese medicines have significant effects on improving the Pittsburgh Sleep Quality Index [7]. In another study, Afrasiabian et al. show that the use of lemon verbena, an hour before bedtime for 4 weeks, could be improved significantly by the Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI) compared with the control group [8]. ...
Objective:
The study is aimed at determining the efficacy of spiritual content counselling on improving the sleep quality and insomnia severity of pregnant women.
Methods:
This randomized controlled trial was carried out on 40 pregnant women recruited at five health centres of Abhar, Iran, 2020. The eligible women were allocated into two intervention and control groups according to the randomized blocking method. Group counselling with spiritual content was carried out in eight sessions at 16 to 20 weeks of gestation. The control group only received routine care. Data were collected using the Pittsburgh Sleep Quality Index (PSQI) and the Insomnia Severity Index (ISI) questionnaires in three stages, before the intervention, at 28, and 36 weeks of gestation. Statistical analysis was performed using repeated measure ANOVA test, chi-square, and independent t-tests. P < 0.05 was considered significant statistical level.
Results:
In the counselling group, the mean (SD) of a total score of sleep quality before the intervention was 9.45 (2.30) which decreased to 5.40 (1.56) in 36 weeks of gestational age, while in the control group was increased from 9.26 (2.15) to 11.47 (1.54). After the intervention based on the repeated measure ANOVA test, the mean total score of the insomnia severity, sleep quality, and its components decreased statistically in the second and third trimesters compared to the first trimester in the intervention group compared to the control group (P = 0.001).
Conclusion:
The results showed that counselling with spiritual content could effectively ameliorate sleep quality and reduce insomnia severity in pregnant women. It seems that the approach is an acceptable basis to design intervention programs in this field that can be considered by midwives. Clinical Trial Registry and Registration Number. The study was registered at the Iranian Registry of Clinical Trials under the IRCT20150731023423N15.
... Few studies have clinically demonstrated that lemon verbena can improve sleep quality and stress. For example, a clinical study in patients with insomnia reported improved perceived sleep quality after 4 weeks of lemon verbena intake [31]. In another study, lemon verbena extract reduced the number of awakenings during the night, and less reported anxiety after 3 weeks of intake in amateur athletes [27]. ...
The current fast-moving, hectic lifestyle has increased the number of individuals worldwide with difficulties in managing stress, which in turn is also affecting their sleep quality. Therefore, the objective of the current study was to assess a natural plant-based dietary supplement comprised of lemon verbena (Lippia citriodora) extract, purified in phenylpropanoids, in alleviating stress and improving quality of sleep. A double-blind, placebo-controlled study was conducted for 8 weeks, followed by a 4-week washout period. Both validated questionnaires and functional tests were performed during the study, whereas questionnaires were used after the washout. As a result, the group taking the lemon verbena extract significantly reduced their perception of stress after 8 weeks, which was corroborated by a significant decrease in cortisol levels. After the washout period, the subjects reported to present even lower stress levels, due to the lasting effect of the ingredient. As for sleep quality, the subjects taking the supplement reported feeling better rested, with a stronger effect observed in women. Sleep tracking using a wearable device revealed that the supplement users improved their times in the deeper stages of sleep, specifically their percentage of time in deep sleep and REM. In conclusion, lemon verbena extract purified in phenylpropanoids is revealed as a natural solution to help individuals to improve their stress and sleep quality.
... Required consideration of risk assessment of post-COVID-19 complications and associated appropriate management [15] Arterial stiffness and admission systolic blood pressure < 120 mm Hg suggested as independent prognostic value for all-cause mortality in patients with COVID-19 requiring hospitalization Required consideration of specific conditions, e.g. arterial stiffness or blood pressure to predict individual COVID-19 prognosis [16] Prostate cancer Increased risk of SARS-CoV-2 infection; patients receiving androgen-deprivation therapy partially protected from infection The evaluation of overall health conditions (e.g., cancer) and cancer treatment in specific groups of cancer patients is essential for precise, individualised, and targeted COVID-19 therapy and protection against poor outcome [17] Protective role of androgen-deprivation therapy against SARS-CoV-2 infections seems to be lower in metastatic prostate cancer patients [203] Hypoxemia Association with in-hospital mortality [9,179,180] Sleep quality in COVID-19 healthcare givers [181] Periodontitis 43 post-scaling and root planing patients [182] Anti-inflammatory Periodontal health, anti-inflammatory effects [183,184] Active smoking or history of smoking 26 healthy smokers [187] Anti-inflammatory, improved immune responses, Immune responses, lung protective effects, modulation of inflammation [108,112,113,169] Chronic lung diseases (COPD) 15 COPD patients [188] Chronic inflammation (asthma) 9,709 individuals [189] Asthma in the elderly as risk factor; plant phenolics against asthma nd chronic inflammation Inflammation, allergies, immunity [13,190,191] Metabolic ill patients with obesity 28 individuals with metabolic syndrome [192] Inflammation in obese individuals Metabolic inflammation and oxidative stress (obesity), [43,193,194] Vascular function 19 essential untreated hypertensive patients [195] Cardiovascular functions, protection against cardiovascular damage Cardiovascular protection, inflammation, anti-thrombotic effects [136,151,152,196,197] Prostate cancer 73 prostate cancer patients [198][199][200] Modulation of cancer patients immune responses, protection against poor outcome Modulation of immunity, inflammation, prevention [19,113,201,202] In vitro (prostate cancer cell lines) ...
The risks related to the COVID-19 are multi-faceted including but by far not restricted to the following: direct health risks by poorly understood effects of COVID-19 infection, overloaded capacities of healthcare units, restricted and slowed down care of patients with non-communicable disorders such as cancer, neurologic and cardiovascular pathologies, among others; social risks-restricted and broken social contacts, isolation, professional disruption, explosion of aggression in the society, violence in the familial environment; mental risks-loneliness, helplessness, defenceless, depressions; and economic risks-slowed down industrial productivity, broken delivery chains, unemployment, bankrupted SMEs, inflation, decreased capacity of the state to perform socially important programs and to support socioeconomically weak subgroups in the population. Directly or indirectly, the above listed risks will get reflected in a healthcare occupation and workload which is a tremendous long-term challenge for the healthcare capacity and robustness. The article does not pretend to provide solutions for all kind of health risks. However, it aims to present the scientific evidence of great clinical utility for primary, secondary, and tertiary care to protect affected individuals in a cost-effective manner. To this end, due to pronounced antimicrobial, antioxidant, anti-inflammatory, and antiviral properties, naturally occurring plant substances are capable to protect affected individuals against COVID-19-associated life-* Dietrich Büsselberg threatening complications such as lung damage. Furthermore, they can be highly effective, if being applied to secondary and tertiary care of noncommunicable diseases under pandemic condition. Thus, the stratification of patients evaluating specific health conditions such as sleep quality, periodontitis, smoking, chronic inflammation and diseases, metabolic disorders and obesity, vascular dysfunction, and cancers would enable effective managemenet of COVID-19-associated complications in primary, secondary, and tertiary care in the context of predictive, preventive, and personalized medicine (3PM).
... Questionnaires were used at three intervals; at the baseline, 2 and 4 weeks after the enrollment. Data analysis showed that scores of global PSQI (measuring sleep latency, habitual sleep efficiency, daytime dysfunction, and subjective sleep quality) and ISI in the Aloysia citriodora group were higher after 2 and 4 weeks of treatment when compared with the placebo group [131]. ...
Limonene is a monoterpene confined to the family of Rutaceae, showing several biological properties such as antioxidant, anti-inflammatory, anticancer, antinociceptive and gastroprotective characteristics. Recently, there is notable interest in investigating the pharmacological effects of limonene in various chronic diseases due to its mitigating effect on oxidative stress and inflammation and regulating apoptotic cell death. There are several available studies demonstrating the neuroprotective role of limonene in neurodegenerative diseases, including Alzheimer’s disease, multiple sclerosis, epilepsy, anxiety, and stroke. The high abundance of limonene in nature, its safety profile, and various mechanisms of action make this monoterpene a favorable molecule to be developed as a nutraceutical for preventive purposes and as an alternative agent or adjuvant to modern therapeutic drugs in curbing the onset and progression of neurodegenerative diseases. This manuscript presents a comprehensive review of the available scientific literature discussing the pharmacological activities of limonene or plant products containing limonene which attribute to the protective and therapeutic ability in neurodegenerative disorders. This review has been compiled based on the existing published articles confined to limonene or limonene-containing natural products investigated for their neurotherapeutic or neuroprotective potential. All the articles available in English or the abstract in English were extracted from different databases that offer an access to diverse journals. These databases are PubMed, Scopus, Google Scholar, and Science Direct. Collectively, this review emphasizes the neuroprotective potential of limonene against neurodegenerative and other neuroinflammatory diseases. The available data are indicative of the nutritional use of products containing limonene and the pharmacological actions and mechanisms of limonene and may direct future preclinical and clinical studies for the development of limonene as an alternative or complementary phytomedicine. The pharmacophore can also provide a blueprint for further drug discovery using numerous drug discovery tools.
... The review of fourteen RCTs with 910 participants in Yan-Hua Lin's study shows that traditional Chinese medicines have significant effects on improving the Pittsburgh Sleep Quality Index [7]. In another study, Afrasiabian et al. show that the use of lemon verbena, an hour before bedtime for 4 weeks, could be improved significantly by the Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI) compared with the control group [8]. ...
Studies on the sexual consequences of female genital circumcision are controversial. In this article, we intend to compare the sexual function in women with or without experience of circumcision in the Kurdish region of Mahabad in Iran. In this case-control study 550 women completed the demographic and Female Sexual Function Index (FSFI) questionnaires. Female genital circumcision was associated with reduction of lubrication and sexual satisfaction as well as increasing dyspareunia compared to the uncircumcised women. However, there was no significant difference between two groups regarding to arousal, desire and orgasm of women.
... On the efficacy and value of traditional medicine as an alternative medicine, many scholars have conducted in-depth research in different fields such as immunology, biology, and chemistry [5]. In addition, many studies have been done on traditional medicine as a substitute for different disease groups [6,7]. us, some scholars put forward that modern medicine should not be separated from traditional medicine; ...
Objective:
To systematically review the efficacy and safety of Ligustrazine in the treatment of idiopathic pulmonary fibrosis (IPF).
Methods:
The electronic literature databases (PubMed, EMbase, CNKI, WanFang database, and VIP) were retrieved through a computer to find out the randomized controlled trials (RCT) of Ligustrazine in the treatment of IPF according to the inclusion/exclusion criteria screening test. Cochrane's bias risk table was also used to evaluate the quality of the study and to extract effective data. RevMan 5.3 was used for statistical analysis.
Results:
A total of 7 RCTs (a total of 366 patients, including 196 in experimental and 170 in control group). Compared with the control group, Ligustrazine could improve the clinical symptoms ([OR] = 2.20, 95% CI [1.40, 3.46], P=0.0006), lung function (VC % [MD] = 3.92, 95% CI [0.68, 7.17], P=0.02), (TLC% [MD] = 4.94, 95% CI [0.37, 9.52], P=0.03), the pulmonary diffusion function (DLCO % [MD] = 9.12, 95% CI [5.70, 12.55], P < 0.00001), and arterial blood gas analysis (PaO2 [MD] = 7.11, 95% CI [1.96, 12.25], P=0.007) (PaCO2 [MD] = -2.42, 95% CI [-4.36, -0.49], P=0.01) of IPF patients, respectively. However, FEV1/FVC % ([MD] = 9.37, 95% CI [-1.23, 19.97], P=0.08) and adverse reactions ([MD] = 0.35, 95% CI [0.02, 5.36], P=0.45) were not significantly improved.
Conclusion:
Ligustrazine has certain clinical efficacy in the treatment of IPF, but the safety of applying it and the adverse reactions need to be further analyzed and determined. It can be considered as a new alternative and complementary medicine to be promoted and recommended for use in medical units in various countries in the world and it solved the difficult problem of conventional drug treatment of IPF; therefore, more research strength can be put in the treatment of the pathological mechanism of IPF for further exploration. The study was registered under registration number CRD42020193626.
... Association of insomnia with chronic diseases, such as obesity, type 2 diabetes, cardiovascular disease, neurological issues including mood swings, increased mortality has been established as evidenced by available literature [5]. A survey suggests, more than 80% global population use plant extracts as medication for primary health care [6,7]. Ashwagandha found across India and south Asia, is a respected herb in traditional Indian Ayurveda, scientifically known as Withania somnifera (L.) Dunal. ...
Introduction
Insomnia is a prevalent sleep disorder that can profoundly impact a person’s physical health and mental wellbeing. Most of the currently available drugs for insomnia exert adverse effects. Hence, alternative herbal therapies could be effective in treating insomnia. Ashwagandha, a proven “Rasayana” from ancient Ayurveda is having the required potential to treat insomnia.
Objective
To determine the efficacy and safety of Ashwagandha root extract in patients with insomnia and anxiety.
Methods
This was a randomized, double-blind, placebo-controlled study conducted at Prakruti Hospital, Kalwa, Maharashtra, India. A total of 60 patients were randomly divided into two groups: test (n = 40) and placebo (n = 20) in a randomization ratio of 2:1. Test product was a capsule containing highest concentration full-spectrum Ashwagandha root extract 300 mg, and the placebo was an identical capsule containing starch. Both treatments were given twice daily with milk or water for 10 weeks. Sleep actigraphy (Respironics Philips) was used for assessment of sleep onset latency (SOL), total sleep time (TST), sleep efficiency (SE) and wake after sleep onset (WASO). Other assessments were total time in bed (sleep log), mental alertness on rising, sleep quality, Pittsburgh Sleep Quality Index (PSQI), and Hamilton Anxiety Rating Scale (HAM-A) scales.
Results
Two patients, one from each group, did not complete study and the per-protocol dataset (n = 58) included 29 and 19 patients from test and placebo, respectively. The baseline parameters were similar in the two groups at baseline. The sleep onset latency was improved in both test and placebo at five and 10 weeks. However, the SOL was significantly shorter (p, 0.019) after 10 weeks with test [29.00 (7.14)] compared to placebo [33.94 (7.65)]. Also, significant improvement in SE scores was observed with Ashwagandha which was 75.63 (2.70) for test at the baseline and increased to 83.48 (2.83) after 10 weeks, whereas for placebo the SE scores changed from 75.14 (3.73) at baseline to 79.68 (3.59) after 10 weeks. Similarly, significant improvement in sleep quality was observed with test compared to placebo (p, 0.002). Significant improvement was observed in all other sleep parameters, i.e., SOL, SE, PSQI and anxiety (HAM-A scores) with Ashwagandha root extract treatment for 10 weeks.
Conclusion
Ashwagandha root extract is a natural compound with sleep-inducing potential, well tolerated and improves sleep quality and sleep onset latency in patients with insomnia at a dose of 300 mg extract twice daily. It could be of potential use to improve sleep parameters in patients with insomnia and anxiety, but need further large-scale studies.
Introduction: : Zuojin pills(ZP) have been shown to be effective in the treatment of gastric ulcer (GU); however, the efficacy of Zuojin gastric floating bio-adhesive pellets(ZFP) in GU treatment is yet to be evaluated. Methods: : The pharmacokinetics(PK) and protective effects of ZFP against acetic acid-induced GU was examined using rat models. Mass spectrometry(MS) analysis was performed using a TSQ LC-MS system. A total of 50male Sprague-Dawley(SD) rats were randomly assigned to five groups: normal, acetic acid-induced, positive control (rabeprazole, 2 mg/kg/day), ZP (500 mg/kg/day), and ZFP (500 mg/kg/day) groups, to elucidate the anti-ulcerogenic effect of ZFP. Results: : ZFP prolonged the residence time of the drug (MRT, 10.88 ± 0.93 h; T1/2, 42.83 ± 2.56 h) in rats and promote the effective absorption of the drug with obvious sustained-release properties. Compared with the control group, ZFP treatment for 7 d significantly increased the weight of the rats, significantly reduced ulcer index, increased gastric tissue Superoxide dismutase(SOD) activity, reduced gastric tissue Malondialdehyde(MDA) content, and increased serum IgA, IgM, IgG, and Interleukin-2(IL-2) levels. Additionally, histopathological analysis showed that ZFP treatment reduced inflammatory cell infiltration to mainly the mucosal layer, anda small amount of fibrous scar proliferative repair was observed in the mucosal defect area and the underlying inflammatory granulation tissue. Conclusion: : These results indicated that ZFP prolonged the residence time of the drug in rats with sustained-release properties and had an obvious protective effect against acetic acid-induced GU in rats.
This study aims to evaluate the anti-caries effect of a mouthwash containing Lespedeza cuneata extract by confirming its effect on acid-producing capacity and bacteria causing dental caries in the oral cavity. For the same oral environments of 95 subjects who agreed to participate in this study, scaling was performed one week before the experiment. The final number of subjects included in the analysis was 82, excluding those who dropped out during the study period. A randomized placebo-controlled trial was conducted by dividing the subjects into the Lespedeza cuneata extract gargle group (n = 42) and the saline gargle group (n = 40). Participants in each group gargled once every day before going to bed for 5 days, and data were collected by measuring 3 times: before gargling (Baseline), immediately after gargling (Treatment), and 5 days after gargling (After 5 Days). Two trained dental hygienists confirmed the dental caries activity through the Cariview test under the guidance of a dentist. Microbiological analysis was performed to evaluate the changes in bacteria causing dental caries. By confirming the anti-caries effect in the oral environment according to the application of Lespedeza cuneata extract gargle, dental caries activity was found to be significantly lower from Treatment to After 5 Days (p < 0.05). Dental caries-causing bacteria in the upper and lower jaws were also significantly reduced (p < 0.05). These results confirm that Lespedeza cuneata extract is a natural substance with an anti-caries effect. Gargling with a mouthwash containing Lespedeza cuneata extract is useful in preventing dental caries and inhibiting its progression. The same mouthwash can also be used as an effective formulation for maintaining and promoting oral health.
Purpose:
Insomnia is the most common sleep disorder with high rate of prevalence, persistence, and leads to negative consequences. The mainstays of insomnia treatment have limitations due to either the side effects of hypnotics or limited accessibility to cognitive behavioral therapy. This study aims to compare the efficacy and safety of the traditional Chinese medicine (TCM) Zaoren Anshen capsule alone or as an adjunct treatment with different doses of the nonbenzodiazepine medication zolpidem tartrate in treating insomnia.
Method:
This randomized, double-blind, multicentre placebo control trial was conducted in 131 patients with chronic insomnia. The patients were randomly assigned to one of the following four regimen groups: Group ZA + Z5 : Zaoren Anshen capsule and 5 mg zolpidem tartrate (n = 32); Group Z5: 5 mg zolpidem tartrate and placebo capsule (n = 35); Group Z10 : 10 mg zolpidem tartrate and placebo capsule (n = 32); Group ZA : Zaoren Anshen capsule and placebo pill (n = 32). The drugs were administered for 4 weeks. All patients were evaluated by the Insomnia Severity Index (ISI) at 0, 2, 4, 5, and 6 weeks, and adverse events were recorded.
Result:
There are significant differences in the comparison between the four groups at each treatment stage (P < 0.05). Repeated measurement analysis of variance (ANOVA) of ISI scores in each treatment stage of the four groups exhibits significant differences in time effect, intergroup effect, and interaction effect (P < 0.05). After four weeks of drug administration, the treatment efficacy is similar in Groups ZA + Z5 and Z10 (93%) and in Groups Z5 and ZA (62% and 65%, respectively). Groups ZA + Z5 and Z10 present significantly lower ISI scores compared with Groups Z5 and ZA (P < 0.05), which indicates better treatment response of Groups ZA + Z5 and Z10. No significant difference was observed in the incidence of adverse events between the groups.
Conclusion:
Zaoren Anshen capsule can effectively treat insomnia disorder either alone or in combination with zolpidem tartrate. A preferred combination of TCM Zaoren Anshen capsule with zolpidem can provide a magnified therapeutic efficacy with fewer side effects than zolpidem-only management, clinical trial registration number: Chinese Clinical Trial Registry ChiCTR-IPR-1600969.
To compare the clinical efficacy of tamoxifen and Chinese patented medicine (Pingxiao capsules) in patients with gynecomastia and discuss the safety of the two treatments. We retrospectively analysed the clinical data of 388 male patients with gynecomastia who were treated in the Outpatient Clinic of our hospital between January 2010 and December 2020. There were 103 patients in the tamoxifen (TAM) group and 103 patients in the Chinese patented medicine group. There were 182 patients in the observation group (non‐medication group; age range, 11–75 years; average age, 33.1 years). The natural outcomes were compared between the observation and two medication groups under the same conditions. Disease progression was compared between the observation and two medication groups over the same treatment duration to confirm the efficacy of the medication treatments. Patients with clinical grade 2 gynecomastia accounted for the highest proportion of patients in the TAM group. The percentage of patients with clinical grade 2 gynecomastia was comparable in the Chinese patented medicine and observation groups. The percentage of patients with clinical grades 1 and 3 gynecomastia was the lowest in the TAM group and comparable among the three groups (p = 0.014). The TAM group had the largest number of patients achieving breast shrinkage, and therefore had the best efficacy (p = 0.000). Among the three groups, the surgery rate was the highest in the observation group (p = 0.000). Patients with the greatest glandular tissue thickness achieved better outcomes after medication treatment (p = 0.000). Patients with a higher clinical grade also had a higher surgery rate (p = 0.000). Some patients from the TAM and Chinese patented medicine groups had side effects. TAM results in better outcomes than Chinese patented medicine in gynecomastia patients. The surgery rate is the highest in the observation group. In addition, among some patients with a greater glandular tissue thickness, the higher the clinical grade is, the higher the surgery rate is. Both TAM and Chinese patented medicine cause some side effects and should be used with caution along with continuous follow‐up evaluation of patients receiving either treatment.
Objective
This study aimed to review the prevalence of complementary and alternative medicine (CAM) use and its different used types, characteristics of the studied cohorts, the reasoning for CAM use, and possible predictive factors for its use amongst ADHD patients.
Method
The Web of Science Core Collection, PubMed, and Scopus were searched from inception to 10 February 2022. All of the original papers published in English which report data on CAM use by patients with ADHD were included.
Results
Twelve original researches including 4,447 patients were included. The prevalence of CAM use varied from 7.5% to 67.6%. The most-reported CAM modalities were dietary modifications and natural products. Moreover, higher parental education should be considered as a predictive factor for CAM use.
Conclusion
CAM use by ADHD patients seems to be prevalent. Healthcare providers should be trained about the most commonly used CAM therapies and their possible adverse events.
Internal organs fibrosis (IOF) is the leading cause of morbidity and mortality in most chronic inflammatory diseases, which is responsible for 45% of deaths due to disease. However, there is a paucity of drugs used to treat IOF, making it urgent to find medicine with good efficacy, low toxic side effects and good prognosis. Essential oils (EOs) extracted from natural herbs with a wide range of pharmacological components, multiple therapeutic targets, low toxicity, and broad sources have unique advantages and great potential in the treatment of IOF. In this review, we summarized EOs and their monomeric components with anti-IOF, and found that they work mainly through inhibiting TGF-β-related signaling pathways, modulating inflammatory cytokines, suppressing NF-κB, and anti-oxidative stress. The prognostic improvement of natural EOs on IOF was further discussed, as well as the quality and safety issues in the current development of natural EOs. This review hopes to provide scientific basis and new ideas for the development and application of natural medicine EOs in anti-IOF.
In this study, a dimethyl methylphosphonate based potentiometric sensor was developed in order to detect nerve agents using molecular printed polymer technique. The most important advantages of this technique can be listed as being able to analyze quickly, precisely and at very low concentrations. The developed sensor has been validated for the adsorption of dimethyl methylphosphonate. Molecular printed polymer (MIP) was synthesized by emulsion polymerization. Dimethyl methylphosphonate was used as the molecule to be suppressed in polymerization. While preparing dimethyl methylphosphonate printed polymer, N-Ethylene glycol dimethacrylate (EDMA) was used as crosslinker. Measurements were made to evaluate the performance of the potentiometric sensor prepared using dimethyl methylphosphonate imprinted polymers. The data obtained as a result of the measurements revealed that a potentiometric sensor sensitive to dimethyl methylphosphonate was developed. The developed sensor showed high selectivity, large linear range (10-8 -10-3 mol L-1 ) and low detection limit (3.2x10-8 mol L-1 ) to dimethyl methylphosphonate
Insomnia is one of the most prevalent sleep disorders worldwide which significantly affects the quality of life. Pharmacological and non-pharmacological approaches have been applied in managing insomnia. The risk of tolerance and dependence on conventional medications and their other side effects leads the surveys to complementary and alternative medicine. This overview aimed to compile the clinical trials on herbal remedies in managing insomnia for facilitating future studies on medicinal plant in this issue. The keywords “Medicinal plant”, “Herbal medicine” in combination with “Hypnotic and sedative”, “Insomnia” or “Sleep” were searched through PubMed, Google Scholar, and Scopus electronic databases from 1st January 2000 to 31st August 2020. Then, all clinical trials focusing on the efficacy of medicinal plants on insomnia were collected. Based on the inclusion and exclusion criteria, 36 articles were selected, included 16 medicinal plants (23 studies) as a single herb and 13 polyherbal formulations. The most prevalent route of administration among these trials was oral. Matricaria chamomilla L., Valeriana officinalis L., Viola odorata L., and Passiflora incarnata L. were among the most prevalent effective herbal medicines on insomnia. Also, the modulation of the GABAergic system was the most common target of these medicinal plants. Herbal remedies can be introduced as safe and effective alternatives for conventional medications in managing insomnia. The popular herbal medicines, such as M. chamomilla, V. officinalis, V. odorata, are suitable for further therapeutic development. Other cited medicinal plants in this review can be more investigated in improvement of sleep.
Background:
Various neurocognitive and mental health-related conditions have been associated with the gut microbiome, implicating a microbiome-gut-brain axis (MGBA). The aim of this systematic review was to identify, categorize, and review clinical evidence supporting medicinal plants for the treatment of mental disorders and studies on their interactions with the gut microbiota.
Methods:
This review included medicinal plants for which clinical studies on depression, sleeping disorders, anxiety, or cognitive dysfunction as well as scientific evidence of interaction with the gut microbiome were available. The studies were reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.
Results:
Eighty-five studies met the inclusion criteria and covered thirty mental health-related medicinal plants with data on interaction with the gut microbiome.
Conclusion:
Only a few studies have been specifically designed to assess how herbal preparations affect MGBA-related targets or pathways. However, many studies provide hints of a possible interaction with the MGBA, such as an increased abundance of health-beneficial microorganisms, anti-inflammatory effects, or MGBA-related pathway effects by gut microbial metabolites. Data for Panax ginseng, Schisandra chinensis, and Salvia rosmarinus indicate that the interaction of their constituents with the gut microbiota could mediate mental health benefits. Studies specifically assessing the effects on MGBA-related pathways are still required for most medicinal plants.
Sleep disorders are one of the most prevalent psychiatric diseases. Insomnia is the most common sleep disorder amongst the general population. It is also one of the most frequent complaints in primary healthcare centers. Lavender is called “the broom of the brain” in different oriental traditional medicines. It is one of the most used plants for patients with sleep disorders. This study reviews what is currently known about the use of lavender for sleep disorders in patients with different diseases, from cancers and end‐stage renal disease to neurological‐psychiatric diseases (e.g., depression, dementia, and autism), respiratory, cardiac, and metabolic diseases. Additionally, its most used administration route is the inhalation of its essential oil (i.e., aromatherapy) alone or in combination by massage. Some limitations of the reviewed literature were discussed briefly. Overall, this critical review provides promising evidence of the lavender efficacy for sleep disorders in a wide variety of populations and diseases. However, further clinical studies with robust design and longer durations of intervention are necessary for more evidence‐based judgment on its effect on sleep problems and to investigate its mechanism of action.
The fire risk factor is one of the issues that should be taken into consideration when the zoning plans of
cities are being prepared and / or when they need to be renewed for various reasons, and which is often
not taken into account properly. Especially facilities and enterprises with high fire risk should be planned
in places with less human density and as far away from city centers as possible. In this way, fire risk
will be reduced in social living areas. It is possible that buildings can be built irregularly and contrary
to the zoning plans in time. Buildings with low fire risk such as residences, education and health facilities
and buildings with high fire risk such as industrial, fuel oil and storage facilities may come together
inappropriately according to the distances they should be between each other. Therefore; The fire risk
map of a city can be different over time.
Sleep disorders are common among the general population and can generate health problems such as insomnia and anxiety. In addition to standard drugs and psychological interventions, there are different complementary plant-based therapies used to treat insomnia and anxiety. This review aimed to find and examine the most recent research on the use of herbal medicines for treating anxiety and insomnia as compiled from clinical trials, as well as to assess the safety and efficacy of these medicines and to elucidate their possible mechanisms of action. The process entailed a search of PubMed, Scopus, and the Cochrane Library databases from 2010 to 2020. The search terms included “sleep disorder”, “insomnia”, “sedative”, “hypnotic”, “anxiety”, “anxiolytic”, and “clinical trial”, combined with the search terms “herbs” and “medicinal plants”, in addition to individual herbal medicines by both their common and scientific names. This updated review, which focuses mainly on clinical trials, includes research on 23 medicinal plants and their combinations. Essential oils and their associations have also been reviewed. The efficacy of medicinal plants depends on treatment duration, types of study subjects, administration route, and treatment method. More clinical trials with an adequate, standardized design are necessary, as are more preclinical studies to continue studying the mechanisms of action. As a result of our work, we can conclude that the 3 plants with the most potential are valerian, passionflower, and ashwagandha, with the combination of valerian with hops and passionflower giving the best results in the clinical tests.
Aloysia Paláu is an important herbal genus from the Verbenaceae family and possesses numerous remedial properties in the folk medicine of Asian, European, and, in particular, South American countries. Only a few reports have discussed some phytochemical characteristics associated with Aloysia species. Right the lack of an exhaustive report prompted us to organize this review article. Accordingly, besides the ethnobotanical knowledge of Aloysia species, their essential oil profiles, phytochemistry of the polar isolated fractions, and the relevant biological activities are discussed in detail.
Background
Use of plants and plant products in health care has shown exponential increase in past two decades.
Introduction
In-spite of the availability of well-established pharmacotherapy for epilepsy, a large no of population still explores alternative treatments due to refractory seizures, adverse effects of drugs, chronic treatment, inaccessibility of standard therapies in rural areas and the social stigma attached to the disease. Various studies on medicinal plants showed the protective effect of herbals in animal models of epilepsy.
Method
In the present review, a status analysis of the traditional use of various medicinal plants in epilepsy with a special focus on plats having anti-inflammatory potential is recorded.
Result and Conclusion
The shortcomings of research on medicinal plants which needs to be explored further in order to tackle the growing need of safer and effective drugs for epilepsy are discussed. Overall, there is a huge scope of herbal drugs in CNS disorders especially epilepsy, either as an adjunct by reducing the dose and thus side effects of standard anti-epileptic drugs or as standalone agent . Although, there is still an urgent need of well planned randomized controlled clinical trials to validate their efficacy and safety.
Objectives
Local anesthetic and antinociceptive activity of eugenol, as the main ingredient of clove, was determined in previous researches. This study aimed to assess the efficacy of its topical nanoemulsion gel vs. placebo in controlling pain caused by arteriovenous fistula (AVF) needling in patients undergoing hemodialysis (HD).
Design
In this double-blinded cross-over trial, the patients from Shariati Hospital, Fasa (Fars, Southern Iran) were randomly allocated to eugenol gel 4% (n = 34) and placebo gel (n = 34) groups from August to September 2017. For each patient, a tip of finger unit of gel was applied 2 cm around the insertion site of hemodialysis needles. After 10 minutes, AVF needling was done. AVF needling-related pain was assessed using visual analogue scale (VAS) immediately after the puncture. All patients were tested at three different states: 1- before using any intervention; 2- after using either the eugenol or placebo gel; and 3- after crossing over the groups. Wilcoxon signed-rank, and Friedman tests were used for data analysis.
Results
There was a significant difference between the mean of patients’ pain severity score in the three states (p = 0.001). It was reported as low as 3.29 ± 0.67 in patients who received eugenol nanoemulsion. Also, the highest pain severity score (5.03 ± 0.57) was reported at the no-intervention state.
Conclusions
It seems that topical application of eugenol nanoemulsion may significantly decrease AVF cannulation related pain intensity score in patients undergoing HD. However, further studies with larger sample size and longer intervention period should be done for better judgment on its efficiency and safety.
Chronic rhinosinusitis (CRS) is a common disease with evidence to show that its incidence and prevalence are increasing. Medicinal plants are commonly used to treat CRS. This systematic review aimed to assess the effectiveness and safety of herbal preparations for treatment of the patients with CRS. Cochran, Embase, ISI, PubMed, and Scopus databases were searched until August 1, 2016. Only randomized controlled trials were included. Four randomized controlled trials were included in this systematic review. Various medicinal plants were studied in each article. Inclusion and exclusion criteria, and outcome measures varied among different articles. The results of this trials showed that this special medicinal plants may be effective in the treatment of CRS. No serious reactions were reported during the administration of herbal remedies in the 4 studies. However, trials with a well-designed approach are needed to study the actual safety and efficacy of herbs in the treatment of CRS.
Dwarf elder (Sambucus ebulus L) is one of the best known medicinal herbs since ancient times. In view of its benefits as a widely applicable phytomedicine, it is still used in folk medicine of different parts of the world. In addition to its nutritional values, dwarf elder contains different phytochemicals among which flavonoids and lectins are responsible for most of its therapeutic effects. Dwarf elder has been used for different ailments including: joint pains, cold, wounds, and infections. Nevertheless, recent evidence has revealed its potentials for making attempts at treating cancer and metabolic disorders. This review aimed to provide a comprehensive description of dwarf elder regarding its traditional uses and modern findings which may contribute to the development of novel natural-based therapeutic agents.
Hemorrhoids is one of the most common gastrointestinal diseases. There are several therapeutic options associated with some complications. Therefore, researchers look for traditional medicines as a potential resource for introduction of new natural drugs. The current study reports an evidence-based review of herbal remedies for hemorrhoids in traditional Persian medicine. A comprehensive survey about hemorrhoids on the most important manuscripts of traditional Persian medicine was done. Then, scientific data banks were searched for possible related properties of each herb in the conventional medicine. We reported some historical aspects of traditional Persian medicine view on classification, examination, and predisposing factors of hemorrhoids. In addition, we have reported 105 medicinal plants belonging to 51 families. More than half of the reported herbs exhibited anti-inflammatory and analgesic effects. Although lack of human studies regarding the mentioned herbs is noted, positive results from experimental findings can be considered for new drug discovery supported by traditional and medieval experiences.
PurposePrimary insomnia is a persistent and recurrent disorder as well as a risk factor for depression. The aim of this study was to determine whether the zolpidem combined with paroxetine would be effective in the treatment of patients with primary insomnia. Methods
Ninety patients meeting DSM-IV criteria for primary insomnia were randomly assigned to 8 weeks of treatment with zolpidem combined with paroxetine (the combined treatment group, n = 45) or zolpidem combined with placebo (the control group, n = 45). Patients were assessed with the Pittsburgh Sleep Quality Index (PSQI), polysomnography (PSG), and the Treatment Emergent Symptom Scale (TESS). ResultsCompared with the control group, the combined treatment group was more significantly improved on wake time after sleep onset (WASO), total sleep time (TST), sleep efficiency (SE), and total PSQI scores, but not the sleep onset latency (SOL). Conclusions
Eight weeks of the zolpidem combined with paroxetine treatment to patients with primary insomnia is more effective than zolpidem treatment only in sleep maintenance and early morning awakenings.
Angelicae Gigantis Radix (AGR, Angelica gigas) has been used for a long time as a traditional folk medicine in Korea and oriental countries. Decursinol angelate (DCA) is structurally isomeric decursin, one of the major components of AGR. This study was performed to confirm whether DCA augments pentobarbital-induced sleeping behaviors via the activation of GABAA-ergic systems in animals. Oral administration of DCA (10, 25 and 50 mg/kg) markedly suppressed spontaneous locomotor activity. DCA also prolonged sleeping time, and decreased the sleep latency by pentobarbital (42 mg/kg), in a dose-dependent manner, similar to muscimol, both at the hypnotic (42 mg/kg) and sub-hypnotic (28 mg/kg) dosages. Especially, DCA increased the number of sleeping animals in the sub-hypnotic dosage. DCA (50 mg/kg, p.o.) itself modulated sleep architectures; DCA reduced the counts of sleep/wake cycles. At the same time, DCA increased total sleep time, but not non-rapid eye movement (NREM) and rapid eye movement (REM) sleep. In the molecular experiments. DCA (0.001, 0.01 and 0.1 µg/ml) increased intracellular Cl- influx level in hypothalamic primary cultured neuronal cells of rats. In addition, DCA increased the protein expression of glutamic acid decarboxylase (GAD65/67) and GABAA receptors subtypes. Taken together, these results suggest that DCA potentiates pentobarbital-induced sleeping behaviors through the activation of GABAA-ergic systems, and can be useful in the treatment of insomnia.
Background: Lemon verbena (Lippia citriodora) has a long history as a folk remedy for the common cold, asthma, colic, fever, diarrhea, indigestion, insomnia, and anxiety. The increasing use of Lippia citriodora and the lack of scientific data on its safety profile make necessary an evaluation of its toxicity. Objectives: The present study evaluated the acute, subacute, and cellular toxicity of the aqueous extract of L. citriodora leaves. Methods: The acute and subacute toxicity of the plant was evaluated with a single intraperitoneal (IP) injection of aqueous extract at the dosage range of 0, 1, 2, and 5 g/kg of body weight (acute model) in mice and rats and 21 days' administration at the dosage range of 0, 50, 100, and 200 mg/kg of body weight. For subacute toxicity, food intake, water intake, body weight, hematological and biochemical parameters, and histopathological changes were evaluated. In our in vitro study, the effect of different concentrations (0, 50, 100, and 200 μg/mL) in HepG2 cells was evaluated using MTT assay. Results: In the acute toxicity study, the calculated LD50 was 5g/kg of body weight. The subacute toxicity study did not show a significant change in any of the hematological, biochemical, or pathological findings compared to the control group, except for a reduction in triglyceride levels. The cytotoxicity assay also revealed that the viability in all groups was greater than the IC50 value. Conclusions: Results from the present study elucidated that treatment with the aqueous extract of L. citriodora leaves was well tolerated via daily IP injection at doses up to 200 mg/kg for a period of 21 days and did not produce any toxicity. The safety of L. citriodora aqueous extract was also confirmed by cell viability assay. © 2016, School of Pharmacy, Ahvaz Jundishapur University of Medical Sciences.
Objective:
Safety of Lippia citriodora, as a herbal remedy, in pregnancy has not yet been evaluated. This study aimed to identify the effect of L. citriodora aqueous extract on pregnancy outcome in mice.
Materials and methods:
Timed-pregnant mice received doses of 0.5 g/kg/day L. citriodora aqueous extract or the vehicle control during organogenesis, intraperitoneally. Maternal body weights were measured throughout the pregnancy. The litters were examined for external malformations and skeletal abnormalities. Fetuses were stained with Alizarin red S and Alcian blue.
Results:
There were no significant differences in mean maternal weight gain during pregnancy between groups. Also, no significant differences were observed in mean number of implantation, live and resorbed fetuses between control and treated groups. The prevalence of all types of deformity was low and similar to control group (%1.11).
Conclusion:
The results of this study show that moderate consumption of L. citriodora as an infusion or tea appears to be safe to be used during pregnancy and does not have toxic effects on development of mouse embryo.
Introduction Primary insomnia (PI) is commonly defined as a state of having disturbed daytime activities due to poor night-time sleep quality. Studies have demonstrated that it is a disorder of 24 h hyperarousal, expressed in terms of physiological, cognitive and cortical activation. Acupuncture is considered to be beneficial to restore the normal sleep–wake cycle. The aim of the trial is to assess the therapeutic effects of acupuncture on sleep quality and hyperarousal state in patients with PI.
Methods and analysis This study is a randomised, patient-assessor-blinded, sham controlled trial. –88 eligible patients with PI will be randomised in a ratio of 1:1 to the intervention group (real acupuncture) and control group (sham acupuncture, superficial insertion at irrelevant acupuncture points). Acupuncture intervention will be given to all participants three times a week for 4 weeks, followed up for 8 weeks.
The primary outcome measures are the Pittsburgh Sleep Quality Index (PSQI) and Hyperarousal scale (HAS). The secondary outcomes are Fatigue scale-14 (FS-14), polysomnography (PSG), heart rate variability (HRV) and Morning Salivary Cortisol Level (MSCL). Outcomes will be evaluated at baseline, post-treatment period and 8 weeks follow-up. All main analyses will be carried out on the basis of the intention-to-treat principle.
Ethics/dissemination This protocol has been approved by the Medical Ethical Committee of Beijing Traditional Chinese Medicine Hospital (Beijing TCM Hospital) on 5 January 2015. The permission number is 2014BL-056-02. The study will present data concerning the clinical effects of treating primary insomnia with acupuncture. The results will help to demonstrate if acupuncture is an effective therapy for improving sleep quality in association with a decreased hyperarousal level as a possible underlying mechanism. The findings from this study will be shared with the healthcare professionals, general public and relevant organisations through publication of manuscripts and conference presentations.
Trial registration number ISRCTN16079489; Pre-results.
Systematic reviews and meta-analyses represent the uppermost ladders in the hierarchy of evidence. Systematic reviews/meta-analyses suggest preliminary or satisfactory clinical evidence for agnus castus (Vitex agnus castus) for premenstrual complaints, flaxseed (Linum usitatissimum) for hypertension, feverfew (Tanacetum partenium) for migraine prevention, ginger (Zingiber officinalis) for pregnancy-induced nausea, ginseng (Panax ginseng) for improving fasting glucose levels as well as phytoestrogens and St John's wort (Hypericum perforatum) for the relief of some symptoms in menopause. However, firm conclusions of efficacy cannot be generally drawn. On the other hand, inconclusive evidence of efficacy or contradictory results have been reported for Aloe vera in the treatment of psoriasis, cranberry (Vaccinium macrocarpon) in cystitis prevention, ginkgo (Ginkgo biloba) for tinnitus and intermittent claudication, echinacea (Echinacea spp.) for the prevention of common cold and pomegranate (Punica granatum) for the prevention/treatment of cardiovascular diseases. A critical evaluation of the clinical data regarding the adverse effects has shown that herbal remedies are generally better tolerated than synthetic medications. Nevertheless, potentially serious adverse events, including herb-drug interactions, have been described. This suggests the need to be vigilant when using herbal remedies, particularly in specific conditions, such as during pregnancy and in the paediatric population. Copyright © 2016 John Wiley & Sons, Ltd.
Melissa officinalis L., a valuable medicinal plant in herbal medicine is native to the eastern Mediterranean Region and western Asia. The constituent of the essential oil of the plant in various climates is different, but citral (geranial and neral), citronellal, geraniol are main components. Many parameters influencing essential oil composition and yield, such as light intensity, nutrient, temperature, cultural practice genotype, plant part age, harvesting time. Lemon balm has been traditionally used for different medical purposes as tonic, antispasmodic, carminative, diaphoretic, surgical dressing for wounds, sedative-hypnotic strengthening the memory, and relief of stress induced headache, but in modern pharmacology is value in the management of mild to moderate Alzheimer's, against migraine and rheumatism, antitumel and antioxidant activities.
This work aimed to determine the efficacy of the essential oil of A. gratissima as anesthetic for silver catfish, and to perform the bio-guided fractionation of essential oil aiming to isolate compounds responsible for the noted effects. Fish were submitted to anesthesia bath with essential oil, its fractions and isolated compounds to determine time of anesthetic induction and recovery. Eugenol (50 mg L-1) was used as positive control. Essential oil of A. gratissima was effective as an anesthetic at concentrations of 300 to 900 mg L-1. Fish presented involuntary muscle contractions during induction and recovery. The bio-guided fractionation of essential oil furnished E-(-)-pinocamphone, (-)-caryophyllene oxide, (-)-guaiol and (+)-spathulenol. E-(-)-pinocamphone caused the same side effects observed for essential oil. (-)-Caryophyllene oxide, (-)-guaiol and (+)-spathulenol showed only sedative effects at proportional concentrations to those of the constituents in essential oil. (+)-Spathulenol (51.2 mg L-1) promoted deep anesthesia without side effects. A higher concentration of (+)-spathulenol, and lower or absent amounts of E-(-)-pinocamphone could contribute to increase the activity and safety of the essential oil of A. gratissima. (+)-Spathulenol showed potent sedative and anesthetic activities in silver catfish, and could be considered as a viable compound for the development of a new anesthetic.
Lemon Verbena (Aloysia triphylla L.) is a perennial aromatic and medicinal plant that belongs to the family Verbenaceae. It has long been introduced and maintained at Wondo Genet, Southern Ethiopia. Despite its long presence, various potential uses and existence of diverse ecologies, the plant has not evaluated for its performance in agronomic and chemical traits in different parts of Ethiopia. Thus, this activity was designed to contribute in addressing the existing technology gaps and thereby bringing the crop for cultivation in the country. Data plant height, number of branches/plant, number of leaves/plant, dry leaf weight/plant, fresh leaf weight/plant, aboveground biomass/plant, leaf to stem ratio, leaf yield/ha/year, essential oil (EO) content and EO yield/ha/year collected from three replications, four locations and three testing years were analyzed following the procedures of randomized complete block design. Growing location demonstrated a highly significant influence (P < 0.01) on the performance of all the parameters considered. The performance of lemon verbena was influenced significantly (P < 0.01) with testing year and interaction effects of location by year in all the studied parameters except for leaf to stem ratio. The respective average fresh leaf yield/ha/year, EO content and EO yield/ha/year varied from 1.78-6.73 t, 0.19-0.41% and 2.57-20.12 kg combined over the testing locations. Considering testing years, average annual fresh leaf yield/ha, EO content and EO yield/ha varied from 1.14-8.03 t, 0.19-0.49% and 4.13-15.99 kg, respectively. The leaf yield and essential oil yield was increased with increasing age from first to second year and it starts to decline then after.
Insomnia is the most common sleep disorder that reduces quality of life.
Due to side effects of hypnotic drug and the increasing demand for alternative medicine substitutes, violet oil (VO) was used in this study. VO is a known medication in Iranian traditional medicine that induces sleep in insomniac patients.
This study was conducted as an experimental pretest-posttest evaluation on VO efficacy in 50 patients with chronic insomnia in Iranian Traditional Medicine Clinic of Mashhad University of Medical Sciences, Mashhad, Iran. Treatment consisted of intranasal drop of VO, two drops containing 66 mg of VO in each nostril nightly before sleeping for one month. All patients were asked to complete an Insomnia Severity Index (ISI) questionnaire before the start of the trial and after one month of treatment.
Improvements in sleep and ISI scores were significantly greater in patients after a month receiving VO drop in comparison with before starting treatment (P < 0.05). A few patients reported some complications about VO consumption, most of which were mild and no serious adverse event was encountered.
VO can be presented as a safe, well-tolerated, and effective herbal preparation in patients with chronic insomnia.
The widespread use of CAM around the world requires health professionals including pharmacists to have the required knowledge to better advise their patients. This has lead to an increased need for the inclusion of CAM instruction into the mainstream undergraduate Pharmacy education. This study was designed to describe pharmacy students awareness, use, attitude and perceived need for CAM education at COMAHS-USL and at the same time, determine how these descriptive outcomes are influenced by the socio-demographic variables considered in this study.
A descriptive cross-sectional survey was conducted among undergraduate pharmacy students (n = 90) at the College of Medicine and Allied Health Sciences, University of Sierra Leone using a structured questionnaire. Chi square, fisher exact test, and general linear model univariate analysis were used to compare data between independent cohorts.
All 90 (100%) of the students were aware and have used (except Ayurveda) at least one of the listed CAM modalities. Herbal/Botanical/Supplements followed by Spirituality/Prayer were the most commonly known and used CAM modalities. Almost two thirds of students considered the CAM modalities they have used to be effective and not harmful. Overall, pharmacy students had a positive attitude towards CAM (Mean attitudinal score = 34.9 ± 4. 5 (range 19–43)) with fourth and fifth year students showing a significantly less positive attitude as compared to the first, second and third year (B = −3.203 p = 0.001, 95% confidence interval - 5.093 to −1.314). The media [53 (58.9%)] was the most frequent source of information about CAM. Nearly all students [89 (98.9%)] agreed that CAM knowledge is important to them as future pharmacist and that CAM should be included into the Pharmacy curriculum at COMAHS-USL [81 (90.0%)].
Pharmacy students in Sierra Leone are aware of and have used at least one of the CAM modalities and do show a positive attitude towards CAM. This was demonstrated by their overwhelming endorsement for CAM course to be part of the undergraduate pharmacy training at COMAHS-USL. This study among others will inform and guide the development and implementation of CAM instruction at COMAHS-USL.
Aloysia citriodora Palau, Verbenaceae ("cedrón") is widely used as infusion or decoction in South America to treat indigestion, tachycardia and anxiety. We previously demonstrated its antispasmodic effect on rat duodenum. Now, its aqueous extract (AEC) from 1 to 10 mg/kg was sedative in mice on the open-field, effect which was potentiated by diazepam and sensitive to flumazenil. In normotensive rats, 1 to 30 mg AEC/kg induced a transitory hypotension, insensitive to atropine and L-NAME. Regarding an effect on α-adrenergic receptors, AEC non-competitively blocked the phenylephrine contraction on vas deferens. In isolated rat hearts, AEC induced negative inotropism, as well as itexin, the main component. Then, the benzodiazepine-like sedation, negative inotropism and antispasmodic effect preclinically justify its popular use for abdominal cramps and as coadjuvant for anxiety and angor.
This study investigated the chemical composition of five different extracts of Aloysia triphylla and their activity against Aeromonas sp. The extracts were obtained from the dried leaves by pressurized CO2 extraction at 30, 50 and 70ºC, and 100, 150, and 200 bar, and analyzed by GC/FID and GC-MS. The antibacterial activity was assayed by the microdilution method. The tested microorganisms comprised seven Aeromonas isolates obtained from the kidney of infected silver catfish, Rhamdia quelen. The yield, chemical composition and antibacterial activity of the extracts were dependent on the extraction conditions. Mono and sesquiterpenoids were the major constituents of all the extracts and the highest extraction yield was obtained at 70oC and 200 bar. A. triphylla presented moderate antibacterial activity against Aeromonas sp.
Insomnia is a common sleep disorder which is prevalent in women and the elderly. Current insomnia drugs mainly target the γ-aminobutyric acid (GABA) receptor, melatonin receptor, histamine receptor, orexin, and serotonin receptor. GABAA receptor modulators are ordinarily used to manage insomnia, but they are known to affect sleep maintenance, including residual effects, tolerance, and dependence. In an effort to discover new drugs that relieve insomnia symptoms while avoiding side effects, numerous studies focusing on the neurotransmitter GABA and herbal medicines have been conducted. Traditional herbal medicines, such as Piper methysticum and the seed of Zizyphus jujuba Mill var. spinosa, have been widely reported to improve sleep and other mental disorders. These herbal medicines have been applied for many years in folk medicine, and extracts of these medicines have been used to study their pharmacological actions and mechanisms. Although effective and relatively safe, natural plant products have some side effects, such as hepatotoxicity and skin reactions effects of Piper methysticum. In addition, there are insufficient evidences to certify the safety of most traditional herbal medicine. In this review, we provide an overview of the current state of knowledge regarding a variety of natural plant products that are commonly used to treat insomnia to facilitate future studies.
Insomnia is a sleep disorder which affects 10-48% of general population. Different measures, such as pharmacotherapy and behavioral management, are applied for insomnia and associated complaints. In traditional medical systems, herbal medicines are considered beneficial. Therefore, the present paper compiles pharmacological and medical insights into the management of insomnia according to Traditional Persian Medicine. Herein, preserved medical and pharmaceutical manuscripts of Persian medicine from 10th to 18th century A.D. were investigated for information about concepts of insomnia treatment and herbal remedies. Additionally, for all herbal remedies, an extensive search of scientific databases, such as MEDLINE and Scopus, has been performed to find related works concerning hypnotic, sedative, and anxiolytic as well as narcoleptic effects. Insomnia (generally called Sahar in Persian manuscripts) is a well-known disorder. Herbal medical intervention was the major treatment prescribed by Iranian physicians. Totally, 36 medicinal herbs related to 25 plant families are derived from the searched literature. These remedies were applied orally, topically, and nasally. Based on scientific data, 50% of reported herbs have relevant pharmacological effects. Besides historical elucidation, this paper presents medical and pharmacological approaches that had been applied by Persian practitioners in order to deal with sleep complications. Considering the fruitful results of these findings, this essay should encourage researchers to conduct more investigations in this field in order to understand the mechanisms and effects of traditionally applied herbs still unknown to modern medicine. © 2014 S. Karger GmbH, Freiburg.
Lippia citriodora is an aromatic plant largely consumed in Morocco and in the world. It is well-known for its use in the food field, medicinal and aromatic. The production of this plant is for the local and for export. The therapeutic activity of L. citriodora or extracts mainly depends on the quality of finished products.
In this study, we aimed to evaluate the effect of irrigation with urban wastewater from Settat (Morocco) treated by lagoons on the composition of the essential oil, essential oil yield and physico-chemical composition infusion of L. citriodora.
The soil used for the implantation is characterized. Physico-chemical analyzes of well water and wastewater used for irrigation are analyzed
From the results obtained we found changes in the composition of the essential oil of a large number of constituents. After irrigation of L. citriodora by wastewater we observe changes in major compounds in the essential oil: a decrease neral (from 15.29% to 14.34%) and geranial (from 15.63% to 14.75%) and increased limonene (from 23.39% to 25.86%). We deduce that the wastewater has a beneficial effect in increasing the yield of essential oil.
The infusion of L. citriodora prepared by the fresh and dried leaves irrigated with wastewater contains a high concentration of NH4+, Ca2+, Mg2+of concentration from wastewater, and the concentration of NO2-N (mg / l) exceeds 100% of the concentration of waste water.
Lemon verbena (Aloysia triphylla) infusion, a widely consumed herbal tea, contains significant amounts of polyphenols such as flavone diglucuronides and phenylpropanoid glycosides (mainly verbascoside). We have recently shown that lemon verbena infusion offers beneficial effects against dextran sodium sulphate (DSS)-induced colonic inflammation in rats. The present study aimed to evaluate the bioavailability and intestinal absorption of polyphenols derived from lemon verbena infusion in both healthy and colitic rats. For this purpose, lemon verbena infusion was given to rats ad libitum for 14 d, and then 4 % DSS was added to the infusion for 7 d. Before and after DSS administration, 24 h urinary excretion of polyphenols was determined. Flavones were excreted in the urine as conjugated aglycones, and their excretion was not significantly altered by colonic inflammation. Only trace amounts of verbascoside were excreted in the urine, but various metabolites (hydroxycinnamic acids) were detected. The urinary excretion of hydroxycinnamic acids, particularly that of caffeic acid, increased after DSS administration (P< 0·05). Only flavone aglycones (luteolin and diosmetin) were excreted in the faeces in small proportions (3·2 % of ingested flavones). Intestinal absorption of lemon verbena polyphenols was examined using an in situ intestinal perfusion model. Intestinal absorption of verbascoside and flavone diglucuronides did not significantly differ between the healthy and colitic rats. Collectively, these results show that intestinal absorption and urinary excretion of lemon verbena flavone diglucuronides were not altered by colonic inflammation, but that urinary excretion of hydroxycinnamic acids derived from verbascoside was affected in a colitic situation.
As a spice and medicinal plant, Aloysia citriodora Palau (Family, Verbenaceae) is applied in nutritional and pharmacological purposes. According to the findings, many parameters relating to growth location and cultivation conditions, may affect on the secondary metabolites of the herb and result in different percentage of concerned constituents. Accordingly, present study was performed to compare the chemical composition profiles of essential oil and total flavonoid content of Aloysia citriodora Palau leaves under three different cultivation situations. To this, three cutting batch of herb were cultivated in garden, green house and hydroponic systems. Essential oil was then extracted by hydrodistillation and analyzed using Agilent technologies model 7890A gas chromatograph connected to a mass detector. Total flavonoid content was determined using Dowd method. Major essential oil constituents for the garden sample were Geranial (16.70%), Neral (13.46%) and Limonene (12.41%) followed by Caryophyllene oxide (9.30%), alpha-Curcumene (7.90%) and 1, 8-Cineole (5.49%). Main constituents were as Geranial (26.94%), Neral (21.46%) and alpha-Curcumene (9.15%) followed by trans-Caryophyllene (5.39%) for the green house sample and as Geranial (21.57%), Neral (18.25%), alpha-Curcumene (8.23%) followed by trans-Caryophyllene (6.20%) and Limonene (6.07%) for the hydroponic system. The total flavonoid content for garden, green house and hydroponic systems were determined as 7.01, 7.70 and 4.85 mg (QE)/g dry plant leaves. Despite some differences in volatile oil components of mentioned samples, findings of current work emphasizes that these cultivation conditions do not much create a significant difference in major essential oil ingredients. However results revealed the inappropriateness of hydroponic system versus other mentioned methods.
The Insomnia Severity Index (ISI) is a short subjective questionnaire which helps physicians in making decisions about patients suffering from insomnia. The present study was an attempt to test the reliability and validity of the Iranian version of the ISI and to measure the correlation between ISI items and polysomnography results in chronic insomnia patients.
Two groups responded to the Persian translation of four questionnaires; ISI, Pittsburg Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and General Health Questionnaire (GHQ). The first group consisted of 135 patients diagnosed with chronic insomnia, and the second group was comprised of 55 normal people. After completing the questionnaires, the insomniac patients underwent standard overnight polysomnography.
The internal consistency demonstrated by Cronbach's alpha coefficient was above 0.8 for both groups. The Intra-class correlation coefficient was above 0.7 after two weeks for both groups. The correlations between ISI, PSQI, ESS, and GHQ were high. In addition, close correlations were found between scores obtained from the ISI questionnaire items in insomniac patients with corresponding polysomnographic variables.
The Iranian version of the ISI is a reliable and valid instrument. It is a valuable short and first-line questionnaire for insomnia research and clinical work.
Pharmacovigilance is essential for developing reliable information on the safety of herbal medicines as used in Europe and the US. The existing systems were developed for synthetic medicines and require some modification to address the specific differences of medicinal herbs. Traditional medicine from many different cultures is used in Europe and the US which adds to the complexities and difficulties of even basic questions such as herb naming systems and chemical variability. Allied to this also is the perception that a 'natural' or herbal product must be safe simply because it is not synthetic which means that the safety element of monitoring for such medicines can be overlooked because of the tag associated with such products. Cooperation between orthodox physicians and traditional practitioners is needed to bring together the full case details. Independent scientific assistance on toxicological investigation, botanical verification can be invaluable for full evaluation of any case report. Systematic pharmacovigilance is essential to build up reliable information on the safety of herbal medicines for the development of appropriate guidelines for safe effective use.
Essential oils (EOs) have been reported to possess pharmacological properties, of which those related to the central nervous system have been especially attributed to mono- and sesquiterpenes. Baccharis uncinella DC. (Asteraceae) is used by the Laklaño Indians (Santa Catarina, Brazil) for sedative purposes. Interestingly, the species does not seem to be used medicinally elsewhere in Brazil.
This study was designed to compare the composition and sedative properties of B. uncinella EOs obtained closer (BU-SC) and farther (BU-PR) to the Laklaño Indian Reserve.
BU-SC and BU-PR obtained by hydrodistillation were analyzed by CG-MS. Mice treated with BU-SC and BU-PR (50 and 100 mg/kg) were evaluated regarding pentobarbital-induced sleeping time, body temperature, and locomotion. Results: BU-SC presents a higher monoterpene/sesquitherpene ratio (0.31); α-pinene (6.42%), limonene (7.21%), caryophyllene (26.13%), spathulenol (13.39%) and caryophyllene oxide (13.26%) were identified as major components. BU-PR presents a low monoterpene/sesquitepene ratio (0.004); spathulenol (32.93%), caryophyllene oxide (27.78%), viridiflorol (5.29%) and α-cadinol (2.42%) were identified as the main components. Both samples significantly (p < 0.05, ANOVA) decreased locomotion and body temperature, as well as increased sleeping time. The hypnotic activity was sensitive to the differences in monoterpene composition.
In comparison with a sample collected in Paraná State, B. uncinella EO collected closer to the Laklaño Indians possess a composition that better justifies the claimed sedative properties. The study confirms the value of traditional information to guide bioactivity assessment in medicinal plants, and gives notice to the ecological factors that can interfere with the conclusions of such assessments.
Benzodiazepines are among the most frequently prescribed drugs. Of all their side effects, hip fractures and possibility of developing dependence are usually studied.
The aim of this study was to determine how often do psychiatric outpatients suffer from adverse effects of benzodiazepines, and which adverse effects do they notice.
109 patients on two consecutive days were asked to fill in the questionnaire. Among them were 29 women and 80 men. Ten women (1/3) and 20 men (1/4) refused to participate in the study.
68% of women and 93% of men used benzodiazepines at least once in a lifetime; 40% of women used benzodiazepines in the last seven days, and 93% of men (32% of women and 44% of men used benzodiazepines every day for the last seven days). Unfortunately, 8% of men used more then one benzodiazepine daily. All of the women who used benzodiazepines had at least one adverse effect; and 91% of men had adverse effects. One third of women and one quarter of men stopped taking benzodiazepines due to adverse effects. The mean number of adverse effects was 4.8 both in men and women. Those who stopped taking benzodiazepines didn't have more adverse effects in comparison to those who continued to use them. More than half of the participants suffered from sleepiness, slowness and fatigue. One third of the participants said they noticed the change in sexual drive. More then 30% of women noticed dizziness and only 6% of men. None of the participants said to have jaundice after using benzodiazepines. The same adverse effects were present in those who stopped taking the drugs and in those who continued to use them.
The prevalence of benzodiazepine use is very high in psychiatric patients. Many of them notice adverse effects, but mainly continue to use the drug.
Background: Insomnia is a prevalent health complaint that is often difficult to evaluate reliably. There is an important need for brief and valid assessment tools to assist practitioners in the clinical evaluation of insomnia complaints.Objective: This paper reports on the clinical validation of the Insomnia Severity Index (ISI) as a brief screening measure of insomnia and as an outcome measure in treatment research. The psychometric properties (internal consistency, concurrent validity, factor structure) of the ISI were evaluated in two samples of insomnia patients.Methods: The first study examined the internal consistency and concurrent validity of the ISI in 145 patients evaluated for insomnia at a sleep disorders clinic. Data from the ISI were compared to those of a sleep diary measure. In the second study, the concurrent validity of the ISI was evaluated in a sample of 78 older patients who participated in a randomized-controlled trial of behavioral and pharmacological therapies for insomnia. Change scores on the ISI over time were compared with those obtained from sleep diaries and polysomnography. Comparisons were also made between ISI scores obtained from patients, significant others, and clinicians.Results: The results of Study 1 showed that the ISI has adequate internal consistency and is a reliable self-report measure to evaluate perceived sleep difficulties. The results from Study 2 also indicated that the ISI is a valid and sensitive measure to detect changes in perceived sleep difficulties with treatment. In addition, there is a close convergence between scores obtained from the ISI patient's version and those from the clinician's and significant other's versions.Conclusions: The present findings indicate that the ISI is a reliable and valid instrument to quantify perceived insomnia severity. The ISI is likely to be a clinically useful tool as a screening device or as an outcome measure in insomnia treatment research.
Definitions and epidemiology of insomnia Complaints of poor sleep are numerous and frequent in the general population. One of the most important is insomnia. As it is a subjective complaint, it can be difficult to define and diagnose. Various nosologies propose a common definition even if no consensus has yet been reached. Insomnia may be associated to or be the consequence of various psychiatric and somatic comorbidities. The purpose of this article is to present various definitions used to diagnose insomnia and provide updated knowledge about its prevalence, incidence, determinants and consequences.
Our aim is to assess the effect of cinnamon powder capsules on insulin resistance, anthropometric measurements, glucose and lipid profiles, and androgens of women with polycystic ovarian syndrome (PCOS). Out of 80 women that were diagnosed as PCOS by Rotterdam Criteria, 66 were enrolled in this randomized double-blind placebo-controlled clinical trial. All of the PCOS women were taking medroxy progesterone acetate 10 mg/day for the last 10 days of their menstrual cycles. The cases were randomly allocated to 2 groups. The women in the first group were treated by cinnamon powder capsules 1.5 g/day in 3 divided doses for 12 weeks and the second group by similar placebo capsules. Anthropometric measurements, fasting blood sugar, fasting insulin, blood glucose 2 hr after taking 75 g oral glucose, HbA1c, testosterone, dehydroepiandrosterone sulphate, homeostatic model assessment for insulin resistance, triglyceride, and cholesterol (low-density lipoprotein, high-density lipoprotein, and total) before and after the intervention were evaluated and compared as outcome measures. Fasting insulin (p = .024) and homeostatic model assessment for insulin resistance (p = .014) were reduced after 12 weeks in the cinnamon group compared with the placebo. There was also a significant decrease in low-density lipoprotein in cinnamon group (p = .004) as compared with baseline that caused significant difference with placebo (p = .049). However, changes in other outcome measurements did not lead to statistically significant difference with placebo. The present results suggest that complementary supplementation of cinnamon significantly reduced fasting insulin and insulin resistance in women with PCOS.
Introduction: Lemon herbena (Lippia citriodora) is a member of Verbenaceae family. This plant is endemic to South America and can growth in other areas, such as Iran. The aim of this study was to investigate and compare the chemical composition of the two production plants in the greenhouse and field of a lemon. Materials and Methods: Plants were cultivated in a Sarayan Ferdowsi area (south of Khorasan). Fourth kg of leaves was collected. Then, essential oil was extracted from fresh leaves using water and steam distillation. Finally, we treated PC12 cells with the essential oil that obtained from Lippia citriodora. The cell viability was evaluated by the MTT (3-[4, 5-dimethylthiazol2-yl]-2, 5-diphenyl tetrazolium bromide) assay. Results: Our results from GCMS (Gas chromatography–mass spectrometry) method showed that greenhouse and field samples contained 0.68% and 0.62% (w/w), respectively. In addition, the data showed that the essential oil decreased oxidative stress-induced PC12 cell death. Conclusion: The results suggest that Lippia citriodora could be a potential candidate for treatment of neurodegenerative diseases.