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Beasant L, Ingram J, Tonks R, Taylor CM. Provision of information by midwives for pregnant women in England on guidance on foods/drinks to avoid or limit. BMC Pregnancy Childbirth 2023; 23:152. [PMID: 36890490 PMCID: PMC9993745 DOI: 10.1186/s12884-023-05441-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 02/10/2023] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND The National Health Service (NHS) website gives guidance for pregnant women in England on foods/drinks to avoid or limit because of microbiological, toxicological or teratogenic hazards. These include, for example, some types of soft cheeses, fish/seafood and meat products. This website and midwives are trusted sources of information for pregnant women, but the ways in which midwives can be supported to provide clear and accurate information are unknown. AIMS The aims were to: (1) determine midwives' accuracy of recall of information and confidence in delivering the guidance to women; (2) identify barriers to provision; (3) identify the ways in which midwives provide this information to women. METHODS Registered Midwives practicing in England completed an online questionnaire. Questions included those on what information they provided and their confidence in delivering it, the ways they provided information on foods to avoid/limit, their recall of some of the guidance, and what resources they used. Ethics approval was given by the University of Bristol. RESULTS More than 10% of midwives (n = 122) were 'Not at all confident/Don't know' in providing advice about ten items, including game meat/gamebirds (42% and 43%, respectively), herbal teas (14%) and cured meats (12%). Only 32% correctly recalled overall advice on eating fish, and only 38% the advice on tinned tuna. The main barriers to provision were lack of time in appointments and lack of training. The most usual methods of disseminating information were verbal (79%) and signposting to websites (55%). CONCLUSION Midwives were often unconfident about their ability to provide accurate guidance, and recall on items tested was frequently mistaken. Delivery of guidance by midwives on foods to avoid or limit needs to be supported by appropriate training and access to resources, and sufficient time in appointments. Further research on barriers to the delivery and implementation of the NHS guidance is needed.
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Affiliation(s)
- Lucy Beasant
- Centre for Academic Child Health, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Jenny Ingram
- Centre for Academic Child Health, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Rachel Tonks
- School of Health and Social Wellbeing, University of the West of England, Bristol, UK
| | - Caroline M Taylor
- Centre for Academic Child Health, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.
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Nacka-Aleksić M, Pirković A, Vilotić A, Bojić-Trbojević Ž, Jovanović Krivokuća M, Giampieri F, Battino M, Dekanski D. The Role of Dietary Polyphenols in Pregnancy and Pregnancy-Related Disorders. Nutrients 2022; 14:nu14245246. [PMID: 36558404 PMCID: PMC9782043 DOI: 10.3390/nu14245246] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/06/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022] Open
Abstract
Polyphenols are a group of phytochemicals with extensive biological functions and health-promoting potential. These compounds are present in most foods of plant origin and their increased widespread availability through the intake of nutritional supplements, fortified foods, and beverages, has also led to increased exposure throughout gestation. In this narrative review, we focus on the role of polyphenols in both healthy and pathological pregnancy. General information related to their classification and function is followed by an overview of their known effects in early-pregnancy events, including the current insights into molecular mechanisms involved. Further, we provide an overview of their involvement in some of the most common pregnancy-associated pathological conditions, such as preeclampsia and gestational diabetes mellitus. Additionally, we also discuss the estimated possible risk of polyphenol consumption on pregnancy outcomes. The consumption of dietary polyphenols during pregnancy needs particular attention considering the possible effects of polyphenols on the mechanisms involved in maternal adaptation and fetal development. Further studies are strongly needed to unravel the in vivo effects of polyphenol metabolites during pregnancy, as well as their role on advanced maternal age, prenatal nutrition, and metabolic risk of the offspring.
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Affiliation(s)
- Mirjana Nacka-Aleksić
- Institute for the Application of Nuclear Energy, Department for Biology of Reproduction, University of Belgrade, Banatska 31b, 11080 Belgrade, Serbia
| | - Andrea Pirković
- Institute for the Application of Nuclear Energy, Department for Biology of Reproduction, University of Belgrade, Banatska 31b, 11080 Belgrade, Serbia
| | - Aleksandra Vilotić
- Institute for the Application of Nuclear Energy, Department for Biology of Reproduction, University of Belgrade, Banatska 31b, 11080 Belgrade, Serbia
| | - Žanka Bojić-Trbojević
- Institute for the Application of Nuclear Energy, Department for Biology of Reproduction, University of Belgrade, Banatska 31b, 11080 Belgrade, Serbia
| | - Milica Jovanović Krivokuća
- Institute for the Application of Nuclear Energy, Department for Biology of Reproduction, University of Belgrade, Banatska 31b, 11080 Belgrade, Serbia
| | - Francesca Giampieri
- Research Group on Food, Nutritional Biochemistry and Health, Universidad Europea del Atlántico, 39011 Santander, Spain
- Department of Biochemistry, Faculty of Sciences, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Maurizio Battino
- Research Group on Food, Nutritional Biochemistry and Health, Universidad Europea del Atlántico, 39011 Santander, Spain
- International Joint Research Laboratory of Intelligent Agriculture and Agri-Products Processing, Jiangsu University, Zhenjiang 212013, China
- Dipartimento di Scienze Cliniche Specialistiche, Facoltà di Medicina, Università Politecnica delle Marche, 60131 Ancona, Italy
| | - Dragana Dekanski
- Institute for the Application of Nuclear Energy, Department for Biology of Reproduction, University of Belgrade, Banatska 31b, 11080 Belgrade, Serbia
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Wake GE, Fitie GW. Magnitude and Determinant Factors of Herbal Medicine Utilization Among Mothers Attending Their Antenatal Care at Public Health Institutions in Debre Berhan Town, Ethiopia. Front Public Health 2022; 10:883053. [PMID: 35570953 PMCID: PMC9098925 DOI: 10.3389/fpubh.2022.883053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 03/29/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundWorld health organization defined herbal medicines as the practice of herbs, herbal materials, herbal preparations, and finished herbal products. Globally women are the primary utilizer of herbal medicine and even they consume it during their pregnancy period. The World health organization reported that the majority of the global population used traditional medicine. This study aimed to assess the magnitude and determinant factors of herbal medicine utilization among pregnant mothers attending their antenatal care at public health institutions in Debre Berhan town, Ethiopia.MethodologyInstitution-based cross-sectional study was conducted among pregnant mothers who attended their antenatal care at public health institutions in Debre Berhan town, Ethiopia from 12 February 2021 to 12 April 2021. A systematic random sampling method was used to get selected pregnant mothers. Epi data version 3.1 and SPSS version 25 were used for data entry and analysis, respectively. P-value ≤0.05 was used as a cut point of statistical significance in multivariable binary logistic regression.ResultsA total of 422 pregnant mothers were included with a 100% response rate and 277 (65.6%) of them used an herbal medicine during their current pregnancy. Educational level up to primary school [AOR 2.21, 95% CI: 1.17 – 4.18], monthly family income of <2,800 ETB [AOR 1.72, 95% CI: 1.01–2.92], and lack of awareness of the complication of herbal medicine utilization [AOR 10.3, 95% CI: 6.27–16.92] were determinant factors of herbal medicine utilization.ConclusionThe utilization of herbal medicine among pregnant mothers in this study is high and almost all of them did not disclose their utilization of herbal medicine to their healthcare providers. The ministry of health should integrate traditional medicine with conventional medicines. Midwives and obstetricians should openly discuss regarding benefits and complications of herbal medicine utilization for those pregnant mothers during their antenatal care counseling sessions as routine care.
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Alemu Anteneh T, Aklilu Solomon A, Tagele Tamiru A, Solomon Tibebu N, Nigatu Alemu H, Yibeltal Desalegn S, Getaneh Ayalew H, Abegaz MY, Ambachew Kebede A. Knowledge and Attitude of Women Towards Herbal Medicine Usage During Pregnancy and Associated Factors Among Mothers Who Gave Birth in the Last Twelve Months in Dega Damot District, Northwest Ethiopia. Drug Healthc Patient Saf 2022; 14:37-49. [PMID: 35369039 PMCID: PMC8974251 DOI: 10.2147/dhps.s355773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 03/24/2022] [Indexed: 11/28/2022] Open
Abstract
Background The use of herbal medicine is increasing globally, particularly in developing countries including Ethiopia, yet little is known regarding its effect and safety during pregnancy. Pregnant women prefer herbal medicine due to easy accessibility, traditional and cultural beliefs, and comparatively low cost. This study aimed to assess women’s knowledge and attitude towards the effects of herbal medicine usage during pregnancy and associated factors among women who gave birth in the last twelve months in Dega Damot district. Methods A community-based cross-sectional study was conducted from January 1st to February 30th, 2021. A total of 872 women were selected using a stratified cluster sampling technique. Data were collected by face-to-face interviews using a structured, pretested, and interviewer-administered questionnaire. Data were entered into EPI data version 4.6 and exported to SPSS version 25 for analysis. Multivariable logistic regression was done and a p-value of ≤ 0.05 was used to declare the level of significance. Results Women’s knowledge and positive attitude towards the effects of herbal medicine usage during pregnancy was 49.1% (95% CI: 46–52) and 57.3% (95% CI: 54–61), respectively. Access to media, had antenatal care visit, being urban dweller, history of herbal medicine usage, and a short distance to reach the nearby health facility were significantly associated with women’s knowledge about effects of herbal medicine usage. Besides, being primiparous and short traveling time to reach the nearby health facility was significantly associated with women’s attitude towards the effects of herbal medicine usage during pregnancy. Conclusion Women’s knowledge and positive attitude towards the effects of herbal medicine usage during pregnancy was low. It is important to design strategies to improve the accessibilities of maternal health services, and expand access to media will have a great role in improving women’s knowledge and attitude towards herbal medicine usage during pregnancy.
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Affiliation(s)
- Tazeb Alemu Anteneh
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Abayneh Aklilu Solomon
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Animut Tagele Tamiru
- Department of General Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Nebiyu Solomon Tibebu
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Haymanot Nigatu Alemu
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Selam Yibeltal Desalegn
- Department of midwifery, School of nursing and midwifery, College of Medicine and Health Sciences, Wollo university, Dessie, Ethiopia
| | - Hiwotie Getaneh Ayalew
- Department of midwifery, School of nursing and midwifery, College of Medicine and Health Sciences, Wollo university, Dessie, Ethiopia
| | - Marta Yimam Abegaz
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Azmeraw Ambachew Kebede
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Gad MZ, Azab SS, Khattab AR, Farag MA. Over a century since ephedrine discovery: an updated revisit to its pharmacological aspects, functionality and toxicity in comparison to its herbal extracts. Food Funct 2021; 12:9563-9582. [PMID: 34533553 DOI: 10.1039/d1fo02093e] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Ephedrine, a sympathomimetic amine that exhibits several adrenaline actions, is a plant alkaloid that is a common ingredient in several cold, asthma and narcolepsy treatment preparations, and in obesity management and sport medicine. Its principal action mechanism relies on its direct adrenergic actions as well as indirect role that involves the release of epinephrine and norepinephrine, thus increasing the activity of epinephrine and norepinephrine at the postsynaptic α and β receptors. Nevertheless, its serious side effects, including stroke, heart attack, drug abuse and interactions, have never been comprehensively reviewed. We conducted a systematic review of data on ephedrine, including its occurrence in functional foods, pharmacological aspects, metabolism, pharmaco/toxicokinetics and clinical features. Furthermore, a review of ephedrine natural structural analogues with regards to their differential adrenergic receptor binding affinities, food interaction, and their impact on the pharmacokinetics and effects relative to ephedrine are presented for the first time, and in comparison to its action when present in herbs.
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Affiliation(s)
- Mohamed Z Gad
- Department of Biochemistry, Faculty of Pharmacy & Biotechnology, The German University in Cairo, Egypt
| | - Samar S Azab
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt
| | - Amira R Khattab
- Pharmacognosy Department, College of Pharmacy, Arab Academy for Science, Technology and Maritime Transport, Alexandria 1029, Egypt
| | - Mohamed A Farag
- Pharmacognosy Department, College of Pharmacy, Cairo University, Kasr El Aini St, P.B. 11562, Cairo, Egypt. .,Chemistry Department, School of Sciences & Engineering, The American University in Cairo, New Cairo 11835, Egypt
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Adane F, Seyoum G, Alamneh YM, Abie W, Desta M, Sisay B. Herbal medicine use and predictors among pregnant women attending antenatal care in Ethiopia: a systematic review and meta-analysis. BMC Pregnancy Childbirth 2020; 20:157. [PMID: 32164603 PMCID: PMC7069203 DOI: 10.1186/s12884-020-2856-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 03/04/2020] [Indexed: 12/11/2022] Open
Abstract
Background The use of herbal medicine among pregnant women is increasing in many low- and high-income countries due to their cost-effectiveness in treatment and ease of access. Research findings across Ethiopia on the prevalence and predictors of herbal medicine use among pregnant women attending antenatal care are highly variable and inconsistent. Therefore, this systematic review and meta-analysis aims to estimate the overall prevalence of the use of herbal medicine and its predictors among pregnant women attending antenatal care in Ethiopia. Method We searched articles in Medline (PubMed), EMBASE, HINARI, Google Scholar, Science Direct, Cochrane Library, and other sources. The study included a total of eight studies that reported the prevalence and predictors of herbal medicine use among pregnant women from different regions of Ethiopia. Cochrane Q test statistics and I2 tests were used to assess heterogeneity. A random effect meta-analysis model was used to estimate the pooled prevalence. In addition, the association between risk factors and herbal medicine use in pregnant women attending antenatal care were examined. Results A total of eight studies were included in this review. The pooled prevalence of herbal medicine use among pregnant women attending antenatal care in Ethiopia was 47.77% (95% CI: 28.00–67.55). Subgroup analysis by geographic regions has showed that the highest prevalence (57.49%;95% CI: 53.14, 61.85) was observed in Oromia Region and the lowest prevalence was observed in Addis Ababa (31.39%; 95% CI: 2.83, 79.96). The herbal medicines commonly consumed by women during pregnancy were ginger: 41.11% (95% CI: 25.90, 56.32), damakasse: 34.63% (95% CI: 17.68, 51.58), garlic: 32.98% (95% CI: 22.21, 43.76), tenaadam: 19.59% (95% CI: 7.54, 31.63) and eucalyptus: 4.71% (95% CI: 1.1, 8.26). Mothers’ previous history of self-medication (95% CI: 1.91, 51.35), illness during pregnancy (95% CI: 1.56, 23.91), employment status (95% CI: 3.89, 10.89), educational status (95% CI: 1.52, 2.68), and place of residence (95% CI: 1.86, 3.23) were predictors of herbal medicine use by women during pregnancy. Conclusion In this study, about half of women attending antenatal care use herbal medicine and it is relatively high. The most commonly consumed herbal medicine during pregnancy was ginger followed by damakasse, garlic, tenaadam and eucalyptus. During pregnancy, it is not known that these most commonly consumed plant species have harmful fetal effects. However, many of the medicinal plant species are poorly studied, and it is not possible to rule out teratogenic effects. Teamwork between healthcare professionals and traditional practitioners to educate on the use of medicinal plants will encourage healthier pregnancies and better health for mothers and infants.
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Affiliation(s)
- Fentahun Adane
- Department of Anatomy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Girma Seyoum
- Department of Anatomy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Yoseph Merkeb Alamneh
- Department of Biomedical Sciences, School of Medicine, Debre Markos University, Debre Markos, Ethiopia
| | - Worku Abie
- Department of Biomedical Sciences, School of Medicine, Debre Markos University, Debre Markos, Ethiopia
| | - Melaku Desta
- Department of Midwifery, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Bihonegn Sisay
- Traditional and modern medicine research directorate, Ethiopia Public health institution, Addis Ababa, Ethiopia
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Akkaoui S, Ennibi OK. Use of traditional plants in management of halitosis in a Moroccan population. JOURNAL OF COMPLEMENTARY MEDICINE RESEARCH 2017; 6:267-273. [PMID: 28894624 PMCID: PMC5580951 DOI: 10.5455/jice.20170522103525] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 04/21/2017] [Indexed: 12/22/2022]
Abstract
Introduction: The use of medicinal plants was a very spread therapeutic way. At present, several studies are moving toward this ancestral option, seen the emergence of several bacterial resistance and for the large number of side effects of some synthetic drugs. Objective: The objective of this study was to collect and evaluate information on medicinal plants commonly used in five Moroccan cities: Rabat, Salé, Témara, Khémisset, and Tiflet for the management of halitosis. Methods: This is a cross-sectional survey; conducted among 171 herbalists. The tool of the study was a questionnaire filled by herbalists. SPSS in its version 13 was used for statistical calculations. Quantitative variables were expressed as a mean and standard deviation. Categorical variables were expressed as numbers and percentage. Results: Analysis of the results of this study identified 23 plants that are used the most. The herbal knowledge herbalists prescribed on the toxicity of plants and their side effects were appreciated. Conclusions: Preliminary results presented in this work allow knowing the plants used by this population. This data could be the basis for experimental and clinical studies to promote the use of natural agents in the treatment of bad breath.
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Affiliation(s)
- Sanae Akkaoui
- Center for Doctoral Studies in Life and Health Sciences (CEDOC SVS), Research Laboratory on Oral Biology and Biotechnology, Faculty of Medicine Dentistry, Mohammed V University, Rabat, Morocco
| | - Oum Keltoum Ennibi
- Department of Periodontology, Faculty of Medicine Dentistry, Research Laboratory on Oral Biology and Biotechnology, Mohammed V University in Rabat, Morocco
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Mekuria AB, Erku DA, Gebresillassie BM, Birru EM, Tizazu B, Ahmedin A. Prevalence and associated factors of herbal medicine use among pregnant women on antenatal care follow-up at University of Gondar referral and teaching hospital, Ethiopia: a cross-sectional study. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2017; 17:86. [PMID: 28143507 PMCID: PMC5286838 DOI: 10.1186/s12906-017-1608-4] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 01/27/2017] [Indexed: 01/22/2023]
Abstract
BACKGROUND Improving maternal and child health is one of the public health priorities in several African countries including Ethiopia. However, research on herbal medicine use during pregnancy is scarce in Ethiopia. The present study aimed at assessing the prevalence and correlates of herbal medicine use among pregnant women on antenatal care (ANC) follow-up at Gondar university referral hospital, Ethiopia METHODS: An institutional-based cross sectional study was conducted on 364 pregnant women attending ANC clinic from March to May 2016 at University of Gondar referral and teaching hospital, northwest Ethiopia. Data on socio-demography, pregnancy related information as well as herbal medicine use was collected through an interviewer-administered questionnaire. Descriptive statistics, univariate and multivariate logistic regression analysis were performed to determine prevalence and associated factors of herbal medicine use. RESULTS From 364 respondents, 48.6% used herbal medicine during current pregnancy. ginger (40.7%) and garlic (19%) were the two most commonly used herbs in pregnancy. Common cold (66%) and inflammation (31.6%) were the most common reasons for herbal use. Majority of herbal medicine users (89.8%) had not consulted their doctors about their herbal medicine use. Rural residency (Adjusted odds ratio (AOR): 3.15, Confidence interval (CI): 1.17-6.14), illiteracy (AOR: 4.05, CI: 2.47-6.62) and average monthly income less than 100 USD (AOR: 3.08CI: 1.221-7.77) were found to be strong predictors of herbal medicine use. CONCLUSIONS The use of herbal medicine during pregnancy is a common practice and associated with residency, level of education and average monthly income. From the stand point of high prevalence and low disclosure rate, the health care providers should often consult pregnant women regarding herbal medicine use.
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Nyeko R, Tumwesigye NM, Halage AA. Prevalence and factors associated with use of herbal medicines during pregnancy among women attending postnatal clinics in Gulu district, Northern Uganda. BMC Pregnancy Childbirth 2016; 16:296. [PMID: 27716105 PMCID: PMC5053208 DOI: 10.1186/s12884-016-1095-5] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 10/04/2016] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND According to World Health Organization (WHO) estimates, 80 % of the population living in rural areas in developing countries depends on traditional medicine for their health needs, including use during pregnancy. Despite the fact that knowledge of potential side effects of many herbal medicines in pregnancy is limited and that some herbal products may be teratogenic, data on the extent of use of herbal medicines by women during pregnancy in the study setting is largely unknown. We determined the prevalence and factors associated with herbal medicine use during pregnancy among women attending postnatal clinics in Gulu district, Northern Uganda. METHODS This was a descriptive cross-sectional study which involved 383 women attending postnatal care across four sites in Gulu district using quantitative and qualitative methods of data collection. A structured questionnaire was used to collect quantitative data while qualitative data were obtained using focus group discussions and key informant interviews. The selection of the study participants was by systematic sampling and the main outcome variable was the proportion of mothers who used herbal medicine. Quantitative data was coded and entered into a computerized database using Epidata 3.1. Analysis was done using Statistical Package for Social Scientists version 13, while thematic analysis was used for qualitative data. RESULTS The prevalence of herbal medicines use during the current pregnancy was 20 % (78/383), and was commonly used in the second 23 % (18/78) and third 21 % (16/78) trimesters. The factors significantly associated with use of herbal medicines during pregnancy were perception (OR 2.18, CI 1.02-4.66), and having ever used herbal medicines during previous pregnancy (OR 2.51, CI 1.21-5.19) and for other reasons (OR 3.87, CI 1.46-10.25). CONCLUSIONS The use of herbal medicines during pregnancy among women in Gulu district is common, which may be an indicator for poor access to conventional western healthcare. Perception that herbal medicines are effective and having ever used herbal medicines during previous pregnancy were associated with use of herbal medicines during current pregnancy. This therefore calls for community sensitization drives on the dangers of indiscriminate use of herbal medicine in pregnancy, as well as integration of trained traditional herbalists and all those community persons who influence the process in addressing the varied health needs of pregnant women.
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Affiliation(s)
- Richard Nyeko
- Department of Paediatrics and Child Health, St. Mary’s Hospital Lacor, P.O Box 180, Gulu District, Uganda
| | - Nazarius Mbona Tumwesigye
- Department of Epidemiology and Biostatistics, Makerere University School of Public Health, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda
| | - Abdullah Ali Halage
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda
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Kristanc L, Kreft S. European medicinal and edible plants associated with subacute and chronic toxicity part I: Plants with carcinogenic, teratogenic and endocrine-disrupting effects. Food Chem Toxicol 2016; 92:150-64. [PMID: 27090581 DOI: 10.1016/j.fct.2016.04.007] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Revised: 04/08/2016] [Accepted: 04/10/2016] [Indexed: 12/14/2022]
Abstract
In recent decades, the use of herbal medicines and food products has been widely embraced in many developed countries. These products are generally highly accepted by consumers who often believe that "natural" equals "safe". This is, however, an oversimplification because several botanicals have been found to contain toxic compounds in concentrations harmful to human health. Acutely toxic plants are in most cases already recognised as dangerous as a result of their traditional use, but plants with subacute and chronic toxicity are difficult or even impossible to detect by traditional use or by clinical research studies. In this review, we systematically address major issues including the carcinogenicity, teratogenicity and endocrine-disrupting effects associated with the use of herbal preparations with a strong focus on plant species that either grow natively or are cultivated in Europe. The basic information regarding the molecular mechanisms of the individual subtypes of plant-induced non-acute toxicity is given, which is followed by a discussion of the pathophysiological and clinical characteristics. We describe the genotoxic and carcinogenic effects of alkenylbenzenes, pyrrolizidine alkaloids and bracken fern ptaquiloside, the teratogenicity issues regarding anthraquinone glycosides and specific alkaloids, and discuss the human health concerns regarding the phytoestrogens and licorice consumption in detail.
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Affiliation(s)
- Luka Kristanc
- Institute of Biophysics, Faculty of Medicine, University of Ljubljana, Vrazov Trg 2, 1000 Ljubljana, Slovenia; Primary Healthcare of Gorenjska, ZD Kranj, Gosposvetska Ulica 10, 4000 Kranj, Slovenia.
| | - Samo Kreft
- Faculty of Pharmacy, University of Ljubljana, Tržaška Cesta 32, 1000 Ljubljana, Slovenia
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Anyanechi C, Saheeb B. Toothache and self-medication practices: a study of patients attending a niger delta tertiary hospital in Nigeria. Ann Med Health Sci Res 2014; 4:884-8. [PMID: 25506481 PMCID: PMC4250986 DOI: 10.4103/2141-9248.144896] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background: There is evidence that self-medication practices among dental patients with toothache are common, and despite the adverse clinical consequences, there is a paucity of literature on it, and only few programs are available for its control. Aim: The aim was to assess the self-medication practices among adult dental patients suffering from toothache. Subjects and Methods: An instrument adapted from modified form of 117-item self-report questionnaire based on world Health Organization guidelines for students’ substance use survey and open-ended questionnaire was administered to adult patients attending the Dental and Maxillofacial Surgery Clinic of this Health Institution for a period of 6 months. Results: The results show that 80.6% (287/356) subjects indulged in self-medication practices. Majority of the patients 42.9% (123/287) were in the 2-4th decades of life, whereas the male: female ratio was 1.3:1. The most commonly abused medications/substance was analgesics/non-steroidal anti-inflammatory drug (243/287; 24.5%), antibiotics (233/287; 23.5%), “touch and go” (187/287; 18.8%). The practice of self-medication cut across all social strata, P < 0.01 (significant) and only 3.8% (11/287) subjects admitted knowledge of the dosage and side-effects of the used medications/substances. The toothache not being serious initially (112/287; 22.5%) and time constraints to attend dental clinic (93/287; 18.7%) were the major reasons for self-medication. Conclusion: This study suggests that the practice of self-medication is common among adult dental patients with toothache in Nigeria. This should be reduced to the barest minimum by dental health education, upgrading of dental health facilities, and enforcement of drug control mechanisms.
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Affiliation(s)
- Ce Anyanechi
- Department of Dental Surgery, University of Calabar Teaching Hospital, Calabar, Nigeria
| | - Bd Saheeb
- Department of Oral and Maxillofacial Surgery, University of Benin Teaching Hospital, Benin-City, Nigeria
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Costa KCDS, Bezerra SB, Norte CM, Nunes LMN, Olinda TMD. Medicinal plants with teratogenic potential: current considerations. BRAZ J PHARM SCI 2012. [DOI: 10.1590/s1984-82502012000300009] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to present the implications of the use of herbs during pregnancy, pointing out those that should be avoided during this condition because of their abortifacient and/or teratogenic potential. We carried out searches in the databases ScienceDirect, Scielo and Google Scholar, adopting as criteria for inclusion: book chapters and/or complete articles (with abstract), available in English, Portuguese or Spanish, published from 1996 to in 2011. After a pre-selection of 83 articles, 49 bibliographies were used in the manufacturing end of the article, where 25 were from the Scielo database, 18 from ScienceDirect and 6 from Google Scholar. From the articles studied, we identified the four most commonly used plants as emmenagogue/abortifacient agents by patients of the Department of Prenatal SUS: senne, arruda, boldo and buchinha-do-norte or cabacinha. Thus, we conclude that people often adhere to the maxim "if it's natural, it does no harm" in their rational use of natural products, without the right guidance, believing that these products are safe to use. This usage is even more worrisome among the elderly, pregnant women and children. Regarding the safety of these products, some information and reliable data are scarce or contradictory.
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Bishop J, Northstone K, Green J, Thompson E. The use of Complementary and Alternative Medicine in pregnancy: Data from the Avon Longitudinal Study of Parents and Children (ALSPAC). Complement Ther Med 2011; 19:303-10. [DOI: 10.1016/j.ctim.2011.08.005] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2010] [Revised: 08/17/2011] [Accepted: 08/22/2011] [Indexed: 10/17/2022] Open
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Internet resources. J Perinat Neonatal Nurs 2011; 25:310-1. [PMID: 22071613 DOI: 10.1097/jpn.0b013e318234ac94] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Adams J, Sibbritt D, Lui CW. The use of complementary and alternative medicine during pregnancy: a longitudinal study of Australian women. Birth 2011; 38:200-6. [PMID: 21884228 DOI: 10.1111/j.1523-536x.2011.00480.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND The use of complementary and alternative medicine is increasingly prevalent in contemporary Western societies. The objective of this study was to explore trends and patterns in complementary and alternative medicine practitioner consultations and the use of complementary and alternative medicine consumption before, during, and after pregnancy and between pregnancies. METHODS Analysis focused on data from 13,961 women from the younger cohort of the Australian Longitudinal Study on Women's Health collected between 1996 and 2006. Chi-square tests were employed for the cross-sectional analysis of categorical variables and t tests for continuous variables. Generalized estimating equations were used to conduct multivariate longitudinal analysis. RESULTS Complementary and alternative medicine use among pregnant and nonpregnant women continued to increase over the 10-year period. Although pregnancy status was not predictive of the use of alternative treatments, pregnant women employed these therapies or modalities for the relief of pregnancy-related complaints and symptoms. Analysis also revealed that women used complementary and alternative treatments selectively during pregnancy. CONCLUSIONS This study highlights the need for further research that is sensitive to the consumption of specific complementary and alternative therapies or modalities and to the wider contexts within which women perceive risk associated with their use of complementary and alternative treatments.
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Affiliation(s)
- Jon Adams
- School of Population Health, University of Queensland, Brisbane, Australia
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Sibbritt D, Adams J, Lui CW. Health service utilisation by pregnant women over a seven-year period. Midwifery 2011; 27:474-6. [DOI: 10.1016/j.midw.2010.03.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2009] [Revised: 03/01/2010] [Accepted: 03/20/2010] [Indexed: 12/11/2022]
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Makaji E, Ho SHY, Holloway AC, Crankshaw DJ. Effects in Rats of Maternal Exposure to Raspberry Leaf and Its Constituents on the Activity of Cytochrome P450 Enzymes in the Offspring. Int J Toxicol 2010; 30:216-24. [DOI: 10.1177/1091581810388307] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The goal of our study was to determine whether maternal exposure to red raspberry leaf (RRL) and its constituents can permanently alter biotransformation of fluorogenic substrates by cytochrome P450 (CYP) in the livers of male and female offspring. Nulliparous female rats received vehicle, raspberry leaf, kaempferol, quercetin, or ellagic acid orally once breeding had been confirmed until parturition. Hepatic microsomes were prepared from animals at birth (postnatal day 1 [PND1]), weaning (PND21), PND65, and PND120 to determine the biotransformation of 8 fluorogenic substrates. The pattern of biotransformation of all but 2 of the substrates was gender specific. Maternal consumption of RRL increased biotransformation of 3 substrates by female offspring at PND120 resulting in a more masculine profile. Kaempferol and quercetin had a similar effect to RRL. These results suggest that maternal consumption of either RRL or some of its constituents leads to long-term alterations of CYP activity in female offspring.
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Affiliation(s)
- Emilija Makaji
- Department of Obstetrics & Gynecology, McMaster University, Hamilton, Ontario, Canada
| | - Shirley H. Y. Ho
- Department of Obstetrics & Gynecology, McMaster University, Hamilton, Ontario, Canada
- Honours Biology & Pharmacology Program McMaster University, Hamilton, Ontario, Canada
| | - Alison C. Holloway
- Department of Obstetrics & Gynecology, McMaster University, Hamilton, Ontario, Canada
| | - Denis J. Crankshaw
- Department of Obstetrics & Gynecology, McMaster University, Hamilton, Ontario, Canada
- Honours Biology & Pharmacology Program McMaster University, Hamilton, Ontario, Canada
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Jing Zheng, Pistilli MJ, Holloway AC, Crankshaw DJ. The effects of commercial preparations of red raspberry leaf on the contractility of the rat's uterus in vitro. Reprod Sci 2010; 17:494-501. [PMID: 20220111 DOI: 10.1177/1933719109359703] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
We investigated the direct effects of various commercially available preparations of red raspberry leaf (RRL) on the in vitro contractility of uteri collected from diethylstilbestrol (DES)-treated nonpregnant (NP) and late pregnant rats. In DES-treated NP rats, RRL tea and capsule caused weak contractions. Neither preparation affected the ability of oxytocin to initiate contractions; however, both partially inhibited preexisting oxytocin-driven contractions at the highest concentration tested. Red raspberry leaf ethanol extract had little effect on contractility. Pretreatment with tea did not alter the ability of oxytocin to initiate contractions. In pregnant animals red raspberry leaf tea had variable effects on preexisting oxytocin-induced contractions, sometimes augmenting oxytocin's effect and sometimes causing augmentation followed by inhibition. We conclude that the biological activity of RRL varies depending on the herbal preparation used and pregnancy status. These results do not support the hypothesis that RRL augments labor by a direct effect on uterine contractility.
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Affiliation(s)
- Jing Zheng
- Reproductive Biology Division, Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario, Canada
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Rayner JA, McLachlan HL, Forster DA, Cramer R. Australian women's use of complementary and alternative medicines to enhance fertility: exploring the experiences of women and practitioners. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2009; 9:52. [PMID: 20003533 PMCID: PMC2807849 DOI: 10.1186/1472-6882-9-52] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/15/2009] [Accepted: 12/15/2009] [Indexed: 12/26/2022]
Abstract
Background Studies exploring the use of complementary and alternative medicine (CAM) to enhance fertility are limited. While Australian trends indicate that women are using CAM during pregnancy, little is known about women's use of CAM for fertility enhancement. With the rising age of women at first birth, couples are increasingly seeking assisted reproductive technologies (ART) to achieve parenthood. It is likely that CAM use for fertility enhancement will also increase, however this is not known. This paper reports on an exploratory study of women's use of CAM for fertility enhancement. Methods Three focus groups were conducted in Melbourne, Australia in 2007; two with women who used CAM to enhance their fertility and one with CAM practitioners. Participants were recruited from five metropolitan Melbourne CAM practices that specialise in women's health. Women were asked to discuss their views and experiences of both CAM and ART, and practitioners were asked about their perceptions of why women consult them for fertility enhancement. Groups were digitally recorded (audio) and transcribed verbatim. The data were analysed thematically. Results Focus groups included eight CAM practitioners and seven women. Practitioners reported increasing numbers of women consulting them for fertility enhancement whilst also using ART. Women combined CAM with ART to maintain wellbeing and assist with fertility enhancement. Global themes emerging from the women's focus groups were: women being willing to 'try anything' to achieve a pregnancy; women's negative experiences of ART and a reluctance to inform their medical specialist of their CAM use; and conversely, women's experiences with CAM being affirming and empowering. Conclusions The women in our study used CAM to optimise their chances of achieving a pregnancy. Emerging themes suggest the positive relationships achieved with CAM practitioners are not always attained with orthodox medical providers. Women's views and experiences need to be considered in the provision of fertility services, and strategies developed to enhance communication between women, medical practitioners and CAM practitioners. Further research is needed to investigate the extent of CAM use for fertility enhancement in Australia, and to explore the efficacy and safety of CAM use to enhance fertility, in isolation or with ART.
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Johnson JR, Makaji E, Ho S, Boya Xiong, Crankshaw DJ, Holloway AC. Effect of Maternal Raspberry Leaf Consumption in Rats on Pregnancy Outcome and the Fertility of the Female Offspring. Reprod Sci 2009; 16:605-9. [DOI: 10.1177/1933719109332823] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Jill R. Johnson
- the Reproductive Biology Division, Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario, Canada, Department of Cell and Molecular Biology, Karolinska Institute, Stockholm, Sweden
| | - Emilija Makaji
- the Reproductive Biology Division, Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario, Canada
| | - Shirley Ho
- the Reproductive Biology Division, Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario, Canada
| | - Boya Xiong
- the Reproductive Biology Division, Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario, Canada
| | - Denis J. Crankshaw
- the Reproductive Biology Division, Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario, Canada
| | - Alison C. Holloway
- the Reproductive Biology Division, Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario, Canada,
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Abstract
AIM This paper presents an overview of current literature relating to over-the-counter and herbal preparations use, with a focus on pregnancy. BACKGROUND Internationally, there has been a shift towards self-medication through over-the-counter release of many prescription-category drugs and wider acceptance and use of herbal preparations. The general community perception that these preparations are safe may lead to inappropriate use, especially during pregnancy. METHOD A range of databases was searched to identify papers addressing 'over-the-counter preparations/medications', 'non-prescription medications', 'herbal preparations' and 'pregnancy', including Medline, Cumulative Index to Nursing, Allied Health Literature, Proquest and Sciencedirect. Midwifery, nursing and scientific papers published from 2000 onwards were included, along with a small number of scientific papers published from 1995 onwards, and some key textbooks to clarify the definitions. FINDINGS Pregnant women use a range of over-the-counter preparations, including analgesics, antihistamines, antacids and a variety of herbal preparations. However, in many cases, it is unclear whether their use is actually safe in the short- or long-term for mother or baby, owing to an inadequate evidence-base to support the use of these preparations during pregnancy. CONCLUSION While there is extensive literature on the use of over-the-counter preparations generally, less is available about their use in pregnancy. Further research is needed to explore the prevalence of use and effects of these preparations in pregnancy and neonatal outcomes, and to support midwives and nurses in harm minimization through the promotion of informed risk-avoidance behaviours.
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Affiliation(s)
- Lisa McKenna
- School of Nursing and Midwifery, Monash University, Peninsula Campus, Frankston, Victoria, Australia.
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Babu KM, McCormick MA, Bird SB. Pediatric Dietary Supplement Use—An Update. CLINICAL PEDIATRIC EMERGENCY MEDICINE 2005. [DOI: 10.1016/j.cpem.2005.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Elvin-Lewis M. Safety issues associated with herbal ingredients. ADVANCES IN FOOD AND NUTRITION RESEARCH 2005; 50:219-313. [PMID: 16263432 DOI: 10.1016/s1043-4526(05)50007-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Affiliation(s)
- Memory Elvin-Lewis
- Department of Biology, Washington University, St. Louis, Missouri 63130, USA
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Abstract
Complementary and alternative medicine (CAM) represent a group of diverse medical and health care systems, practices, and products that are not considered to be part of conventional medicine. Biofeedback, acupuncture, herbal medication, massage, bioelectromagnetic therapy, meditation, and music therapy are examples of CAM treatments. Some dentists in the United States have used some of these treatments and products in their practices. Complementary medicines include herbal remedies, homeopathic medicines, and essential oils. There has been an increase in the use of herbal medicines in the US over the last 15-20 years. There is a public belief that these medicines are safe because they are made from natural sources. However, some of these products have associated adverse effects including toxicity and drug interactions. The health history taken by the dentist should include questions regarding the taking of herbal and over-the-counter medications. The dentist needs to be informed regarding the herbal and over-the-counter products that may impact the delivery of safe and effective dental treatment. In addition, the use of CAM treatments in dentistry should be based on evidence of effectiveness and safety as demonstrated in randomized clinical trials.
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Current awareness in prenatal diagnosis. Prenat Diagn 2003. [DOI: 10.1002/pd.535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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