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Alharbi SF, Althbah AI, Mohammed AH, Alrasheed MA, Ismail M, Allemailem KS, Alnuqaydan AM, Baabdullah AM, Alkhalifah A. Microbial and heavy metal contamination in herbal medicine: a prospective study in the central region of Saudi Arabia. BMC Complement Med Ther 2024; 24:2. [PMID: 38166914 PMCID: PMC10759756 DOI: 10.1186/s12906-023-04307-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 12/11/2023] [Indexed: 01/05/2024] Open
Abstract
INTRODUCTION Herbal medicine is a medical system based on the utilization of plants or plant extracts for therapy. The continual increase in global consumption and the trade of herbal medicine has raised safety concerns in many regions. These concerns are mainly linked to microbial contamination, which could spread infections with multi-resistant bacteria in the community, and heavy metal contamination that may lead to cancers or internal organs' toxicity. METHODS This study was performed using an experimental design. A total of 47 samples, herbal medicine products sold in local stores in Qassim region, were used in the experiments. They were tested for bacterial contamination, alongside 32 samples for heavy metal analysis. Bacterial contamination was determined by the streak plate method and further processed to determine their antimicrobial susceptibility patterns using MicroScan WalkAway96 pulse; heavy metals were determined using a spectrometer instrument. RESULTS A total of 58 microorganisms were isolated. All samples were found to be contaminated with at least one organism except three samples. The majority of the isolated bacterial species were gram negative bacteria, such as Klebsiella spp., Pseudomonas spp. and E. coli., which could be of fecal origin and may lead to pneumonia, skin, or internal infections. Furthermore, most of the gram-positive bacteria were found to be multi-drug resistant. Moreover, for heavy metals, all samples had levels exceeding the regulatory limits. CONCLUSION This study demonstrated the presence of bacteria and heavy metals in samples of herbal medicines. Using these contaminated products may spread resistant infections, metal toxicities, or even cancers in the community.
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Affiliation(s)
- Sarah F Alharbi
- Department of Medical Laboratories, College of Applied Medical Sciences, Qassim University, 51452, Buraydah, Saudi Arabia
| | - Ameerah I Althbah
- Department of Medical Laboratories, College of Applied Medical Sciences, Qassim University, 51452, Buraydah, Saudi Arabia
| | - Amal H Mohammed
- Department of Medical Laboratories, College of Applied Medical Sciences, Qassim University, 51452, Buraydah, Saudi Arabia
| | - Mishaal A Alrasheed
- Department of Laboratory and Blood Bank, King Fahd Specialist Hospital, 52211, Buraydah, Kingdom of Saudi Arabia
| | - Mukhtar Ismail
- Department of Chemistry, College of Science and Arts, Qassim University, Al-Rass, Kingdom of Saudi Arabia
| | - Khaled S Allemailem
- Department of Medical Laboratories, College of Applied Medical Sciences, Qassim University, 51452, Buraydah, Saudi Arabia
| | - Abdullah M Alnuqaydan
- Department of Medical Biotechnology, College of Applied Medical Sciences, Qassim University, Buraydah, Saudi Arabia
| | | | - Azzam Alkhalifah
- Department of Medicine, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, Saudi Arabia.
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Metwally AS, Atallah IA, Almutairi IK, Alzand MS, Alqabli MS. The Prevalent Use of Complementary and Alternative Medicine Among Patients With Chronic Disease in the Al-Madinah Population of Saudi Arabia. Cureus 2023; 15:e51130. [PMID: 38149067 PMCID: PMC10751177 DOI: 10.7759/cureus.51130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/26/2023] [Indexed: 12/28/2023] Open
Abstract
BACKGROUND Global interest in complementary and alternative medicine (CAM) has recently risen, particularly in Saudi Arabia, and the use of CAM is gaining popularity as a healthcare option. OBJECTIVES This study aims to assess the prevalence of CAM use among patients with chronic diseases and identify the reasons for resorting to CAM in Al-Madinah, Saudi Arabia. METHODS A cross-sectional study was conducted in Al-Madinah City. Data for analysis were derived from 416 participants with chronic diseases. The data were collected using a valid, structured online questionnaire that was designed to extract socio-demographic data as well as data on the predominant use of herps, hijama (cupping), acupuncture, and other specific CAM applications. The collected data were analyzed using appropriate statistical methods. RESULTS Of the 416 participants, 164 (39.4%) were men, and 96.9% were Saudi citizens. Approximately one-third of the studied participants had diabetes (34.1%), while 29.3%, 25.2%, 15.1%, and 12.3% had hypertension, obesity, asthma, and gastrointestinal tract disease, respectively. The prevalence of herb and natural supplement use was 89.2%. The most commonly used herbs and natural supplements were ginger (55.5%), honey and its derivatives (53.4%), cinnamon (45.4%), and frankincense (33.4%). Of the studied participants, 36.1% and 6.5% reported undergoing cupping and acupuncture, respectively. No statistically significant differences were found between the use of herbs and acupuncture or any of the studied factors. Further, the use of acupuncture exhibited no significant differences. However, the use of cupping displayed statistically significant differences in age, sex, and income among the participants. CONCLUSION The prevalence of CAM use among patients with chronic diseases in Al-Madinah is high. It appears to play an essential role in health care, particularly in treating patients with chronic diseases in this population. Therefore, promoting research in the field of CAM is warranted.
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Affiliation(s)
- Ahmed S Metwally
- Family and Community Medicine, Taibah University, Medina, SAU
- Family and Community Medicine, Suez Canal University, Ismailia, EGY
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Yaghmour KA, Abu Sadi R, Badroun F, Alali R, Almubarak F, Alabbad Z, Alharthi N, Samkari JA, Gaddoury MA. Complementary and Alternative Medicine Use Among Patients With Diabetes Mellitus in Saudi Arabia: A Community-Based Cross-Sectional Study. Cureus 2023; 15:e45792. [PMID: 37745747 PMCID: PMC10517425 DOI: 10.7759/cureus.45792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2023] [Indexed: 09/26/2023] Open
Abstract
BACKGROUND Global studies have observed a disparity in the use of complementary and alternative medicine (CAM) among diabetic patients. OBJECTIVES To estimate the prevalence, types, and correlates of CAM use among patients with diabetes mellitus (DM) in Saudi Arabia. METHODOLOGY A cross-sectional study was conducted among 1290 Saudis with type 2 DM aged ≥18 years. An electronic questionnaire was distributed through social media to collect data about patient demographics and DM-related characteristics, including age at DM diagnosis, DM duration, family history of DM, DM complications, DM medicine, and chronic diseases. The use of CAM and its type, cost, and duration; sources of CAM-related information; reason for using CAM; usefulness and side effects; CAM use in the future; and doctor consultation before CAM use were also evaluated. Among CAM non-users, the reason for not using CAM and future considerations of CAM were assessed. RESULTS A total of 1290 patients were included (27.4%) aged 18-29 years; 726 (56.3%) were women; 554 (42.9%) had a bachelor's degree in education; and 457 (35.4%) were unemployed. The prevalence of CAM use was 528 (40.9%). The most commonly used types were bitter apple 503 (95.3%), cinnamon 341 (64.6%), and ginger 290 (55.1%). The most frequent sources of CAM-related information were friends, families, and neighbors 259 (49.2%), while the most frequent justifications for use were the need for another DM treatment and faith in its advantages. Only 106 (20.1%) of the patients who used CAM disclosed adverse effects; 373 (51.8%) said they would use it again, and 66.1% said they would recommend it to other patients. Only 145 (27.5%) consulted a doctor before using CAM. CAM was more commonly used by patients who were older, women, married, and taking hypoglycemic drugs; whose most recent HbA1c level was 7-10%; and who had dyslipidemia, chronic disease, and a family history of DM. CONCLUSION The prevalence of CAM use is high among the Saudi population. Analyzing CAM use is essential in clinical interactions with Saudis with DM. The managing healthcare professionals must educate patients with DM on how to use CAM more effectively and safely.
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Affiliation(s)
| | - Raneem Abu Sadi
- Medical Intern, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Ftoon Badroun
- Medical Intern, King Abdulaziz University, Jeddah, SAU
| | - Rezan Alali
- Medical Intern, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Fatimah Almubarak
- Medical Intern, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Zainab Alabbad
- Medical Intern, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Noura Alharthi
- Medical Intern, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Jamil A Samkari
- Family and Community Medicine, King Abdulaziz University Faculty of Medicine, Rabigh, Jeddah, SAU
| | - Mahmoud A Gaddoury
- Community Medicine, King Abdulaziz University, Faculty of Medicine, Jeddah, SAU
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Kumar S, Sharma SK, Mudgal SK, Gaur R, Agarwal R, Singh H, Kalra S. Comparative effectiveness of six herbs in the management of glycemic status of type 2 diabetes mellitus patients: A systematic review and network meta-analysis of randomized controlled trials. Diabetes Metab Syndr 2023; 17:102826. [PMID: 37451111 DOI: 10.1016/j.dsx.2023.102826] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 06/26/2023] [Accepted: 06/28/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND AND AIMS There are several herbal formulations for type 2 diabetes (T2D), but many of them have never been directly compared to establish the most effective methods. Therefore, the present systematic review and network meta-analysis aimed to compare and rank the effects of herbal formulations by combining direct and indirect evidence on the management of type 2 diabetes. METHODS From five electronic databases, relevant studies on the effectiveness of herbal formulations for glycemic status for people with type 2 diabetes were retrieved. Only randomized controlled trials that were published in English and looked at how herbal formulations affected adults' (>18-year-old) glycemic levels were included. A systematic review and network meta-analysis design with the random-effects model was used. RESULTS A total of 44 trials included 3130 participants on six herbs were included in the final analysis. Apple cider vinegar (ACV) (standardized mean difference (SMD) = -28.99), cinnamon (-9.73), curcumin (-13.15), and fenugreek (-19.64) significantly reduced fasting blood glucose (FBG) compared with placebo (all p < 0.05). Notably, only ACV (SMD = -2.10) and fenugreek seeds (0.84) were found significantly effective in reducing HbA1C. ACV was most effective herb to reduce FBG comparison with other herbs. CONCLUSIONS Several herbs could be considered as a valuable adjuvant therapy regarding glycemic control of type 2 diabetes patients. Health professionals should be encouraged to incorporate these herbs for the management of type 2 diabetes as part of their standard care.
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Affiliation(s)
- Subodh Kumar
- Department of Pharmacology, All India Institute of Medical Sciences, Deoghar, Jharkhand, India.
| | - Suresh K Sharma
- College of Nursing, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
| | - Shiv Kumar Mudgal
- College of Nursing, All India Institute of Medical Sciences, Deoghar, Jharkhand, India.
| | - Rakhi Gaur
- College of Nursing, All India Institute of Medical Sciences, Deoghar, Jharkhand, India.
| | - Rajat Agarwal
- Department of Cardiothoracic Surgery, All India Institute of Medical Sciences, Deoghar, Jharkhand, India.
| | - Harminder Singh
- Department of Pharmacology, All India Institute of Medical Sciences, Deoghar, Jharkhand, India.
| | - Sanjay Kalra
- Department of Endocrinology, Bharti Hospital and BRIDE, Karnal, Haryana, India.
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Muacevic A, Adler JR, AlMohaimeed YA, Aldhuwayhi MI, AlQahtani SW, Alghofaili SM, Bedaiwi BF, AlHajjaj AH. Habits, Traditions, and Beliefs Associated With the Use of Complementary and Alternative Medicine Among Diabetic Patients in Al-Qassim Region, Saudi Arabia. Cureus 2022; 14:e33157. [PMID: 36726934 PMCID: PMC9886406 DOI: 10.7759/cureus.33157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2022] [Indexed: 01/01/2023] Open
Abstract
Background Since diabetes mellitus (DM) affects every aspect of a person's being, more and more people are using complementary and alternative therapies such as ingesting ginger and cinnamon in addition to conventional medical care and lifestyle changes to manage their condition and enhance their well-being. Although this population uses complementary and alternative medicine (CAM) at a high rate, it is unclear what causes this use. Objective We aim to know the habits, traditions, and beliefs associated with the use of complementary and alternative medicine among type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) patients in the Al-Qassim region of Saudi Arabia. Methods This is an observational cross-sectional study conducted among diabetes patients in Al-Qassim, Saudi Arabia, in 2022. Participants were selected via a non-probability sampling technique. Patients were interviewed in the diabetic clinics using validated questionnaires. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) software (IBM SPSS Statistics, Armonk, NY, USA). Results A total of 444 validated responses were received in this study. The average age was 50 ± 16.9 years, and females represented the highest proportion (58.6%). Moreover, we found that most of the participants had type 2 diabetes (79.1%) and 93 (20.9%) had type 1 diabetes. Hypertension was the most reported chronic disease. Our results revealed that the prevalence of CAM usage was 29.1%. Regarding the sources of information on herbal medicines, we found that more than half of the respondents (57.4%) obtained information from friends, relatives, and neighbors. Ginger, vitamins and minerals, and cinnamon were the most frequently used herbals among our participants. Our results found that 38% of CAM users used herbal products on a regular basis. As regards the frequency of using herbal products, 29.5% of the respondents used herbal medicine weekly and 21.7% used it daily. In addition, we found that gender, marital status, and monthly income were significantly associated with the use of CAM (P value = 0.008, 0.011, and 0.011, respectively). The significantly higher CAM use was associated with females, married participants, and participants with a monthly income of 10,000-15,000 Saudi riyal (SAR). Conclusion According to our research, CAM use among diabetes patients in the Al-Qassim region was found to be relatively common. The prevalence of type 2 diabetes mellitus was higher (79.1%) in comparison to type 1 diabetes mellitus (20.9%). Also, the most commonly used herb was ginger (47.66%), followed by vitamins and minerals (44.53%), and cinnamon (42.19%). Patients with diabetes need to be informed of the significance of telling their doctors about their use of CAM.
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Muacevic A, Adler JR. The Prevalence and Pattern of Using Complementary and Alternative Medicine in Saudi Patients With Diabetes: A Cross-Sectional Study. Cureus 2022; 14:e30700. [PMID: 36457598 PMCID: PMC9704860 DOI: 10.7759/cureus.30700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2022] [Indexed: 01/25/2023] Open
Abstract
Background Diabetes mellitus is a common disease in Saudi Arabia. Patients with chronic diseases, such as diabetes, tend to use complementary and alternative medicine (CAM) either as an addition or alternative to their medical therapy. Many studies have evaluated the CAM herbal products used by patients with diabetes; however, there have been few and inconsistent studies on other types of CAM, and most studies on CAM have focused on their use in type 2 diabetes. Objective This study aimed to determine the prevalence and patterns of CAM use among patients with type 1 or type 2 diabetes in Riyadh, Kingdom of Saudi Arabia. Methods This cross-sectional study was conducted in an adult Saudi population at King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia. Data were collected from December 2019 to February 2020 using a data collection form and patient interviews. Results We included 332 patients, 43% of whom had type 1 diabetes; 26% of the patients had previously used one or more types of CAM. Approximately 53% of CAM users had glycated hemoglobin (HbA1c) level of ≥9%. Among CAM users, 51% mentioned that their blood sugar readings were improved with CAM treatments. Mind-body therapy was the most commonly used CAM (54%), followed by biologically based CAM, including herbs (46%). The most commonly used herbal supplements were black cumin (42%), followed by fenugreek (28%), myrrh (24%), frankincense (22%), cinnamon (15%), garlic (15%), and onion (15%). Older age and employment status were predictors of CAM use in Saudi patients with diabetes. The main sources of knowledge about CAM were from family and friends. Conclusions CAM use is common among Saudi Arabian patients with diabetes. Patients with diabetes who are aged >65 years and employment status were the main predictor of CAM use. Assessing CAM use is an important aspect of clinical encounters with Saudi patients, especially patients with type 1 diabetes.
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I Al-Suwaydani A, Alam MA, Raish M, A Bin Jardan Y, Ahad A, I Al-Jenoobi F. Effect of C. cyminum and L. sativum on Pharmacokinetics and Pharmacodynamics of Antidiabetic Drug Gliclazide. Curr Drug Metab 2022; 23:842-849. [PMID: 35747964 DOI: 10.2174/1389200223666220623155939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 03/30/2022] [Accepted: 04/12/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND Numerous herbs are reported to have anti-hyperglycemic activity and are frequently used in combination with prescription drugs to lower the blood glucose levels in diabetic patients, without proper knowledge about the possibility of herb-drug interaction. OBJECTIVES To investigate the effect of cumin and garden cress on pharmacokinetics (PK) and pharmacodynamics (PD) of gliclazide (GLZ) in nicotinamide-streptozotocin diabetic model. METHODS Diabetic animals of groups II-IV were treated with GLZ, cumin, 'cumin + GLZ', garden cress and 'garden cress + GLZ'. Herb's treatments were given for two weeks, and GLZ was administered in a single dose. Blood glucose levels (BGLs) were measured at pre-determined time points. Plasma samples of pharmacokinetic study were analyzed using UPLC-MS/MS. GLZ fragment at m/z 324.1>127 was monitored. RESULTS Cumin and garden cress have shown 15.3% and 15.9% reduction in mean BGL (1-24h) (p-value < 0.001), respectively. GLZ reduced mean BGL by 30.0%, which was significantly better than cumin and garden cress (pvalue <0.05). Concurrently administered "garden cress + GLZ" demonstrated the highest reduction in mean BGL (by 40.46%) and showed a prolonged effect. There was no significant advantage of simultaneously administered 'cumin + GLZ'. Cumin did not affect PK of GLZ. Garden cress has significantly enhanced AUC0-t (by 69.8%, pvalue 0.0013), but other PK parameters Cmax, Tmax, and Kel were close to the control group. CONCLUSION PK/PD-based herb-drug interaction was observed. Concurrently administered garden cress + GLZ showed improved antidiabetic effect and has enhanced GLZ bioavailability.
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Affiliation(s)
| | - Mohd A Alam
- Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed Raish
- Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Yousef A Bin Jardan
- Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Abdul Ahad
- Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Fahad I Al-Jenoobi
- Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
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Perception of Individuals with Diabetes about Efficacy and Safety of Complementary and Alternative Medicines (CAM) in the Jazan Region, Saudi Arabia. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:2104056. [PMID: 35571737 PMCID: PMC9098292 DOI: 10.1155/2022/2104056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 04/16/2022] [Accepted: 04/25/2022] [Indexed: 11/18/2022]
Abstract
Background CAM is widely accepted for the management of diabetes, and CAM users from many countries showed positive perception towards its use. However, little is known about the perception of individuals with diabetes in Saudi Arabia. Objectives This study was aimed to assess the perception of the individuals with diabetes of Jazan region in Saudi Arabia towards CAM. Methods An online, anonymous cross-sectional survey was designed and conducted between September 5 and December 31, 2021. Data were collected using 19-item self-report survey from the individuals with diabetes of the Jazan region. Results A total of 359 validated responses were received. Approximately, 34% of the participants reported using CAM with modern medicine to control diabetes. Most of the participants reported that CAM is affordable, accessible, acceptable, and effective. Of the study sample, 28% reported using herbal medicine to control diabetes. Significantly, higher percentages of CAM users reported media (42% vs 27%) and friends/family (31% vs 27%) as the primary sources of information about CAM as compared to non-CAM users. Individuals who used CAM for diabetes showed significantly more positive perception (β = 2.386; p=0.001) than those who did not use CAM in the adjusted analysis. Similarly, students had a significantly higher positive perception towards CAM (β = 4.121; p=0.013) compared to employed individuals. Conclusion A quarter of the sample of individuals with diabetes used herbal medicine to control diabetes. Individuals who ever used CAM for diabetes showed positive perception towards CAM. However, there is a need of healthcare workers to be involved in educating the individuals with diabetes and the general public in order to use CAM more effectively and safely.
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Shayakul C, Teeraboonchaikul R, Susomboon T, Kulabusaya B, Pudchakan P. Medication Adherence, Complementary Medicine Usage and Progression of Diabetic Chronic Kidney Disease in Thais. Patient Prefer Adherence 2022; 16:467-477. [PMID: 35221676 PMCID: PMC8880088 DOI: 10.2147/ppa.s350867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 01/27/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Non-adherence to medication is receiving more attention as a significant problem common to management of chronic diseases including diabetes and chronic kidney disease (CKD). This study was designed to assess the medication adherence and self-medication in a cohort of Thai patients with diabetic kidney disease, and its association with clinical outcomes. PATIENTS AND METHODS Non-dialysis patients with diabetic CKD visiting outpatient's clinics of Siriraj Hospital, the largest tertiary care in Thailand, were asked for participation. Self-administered questionnaire was given to assess medication adherence (the 6-item-medication-taking-behavior measure in Thai), complementary medicine usage, and personal information. Clinical, pharmaceutical, and relevant laboratory data (at current and the last visit of around 12 months) were abstracted from the medical records. RESULTS Of the 220 participants eligible (54.1% male, mean age 71.3), 50.9%, 24.1%, and 25% were classified as high-, medium-, and low-medication adherence, respectively. Overall, 24.1% reported self-usage of at least one type of herbal or complementary medicines. The most commonly identified items were cordyceps, cod liver oil, Nan Fui Chao, and turmeric (6 each), with unidentified Thai herbal mixture in 11. On multivariate analysis, late-stage CKD (stage IV-V) was the only independent predictor for low adherence (odds ratio (OR), 5.54; 95% confidence interval (CI), 2.82-10.88). Low adherence was associated with higher blood pressure, lower estimated glomerular filtrate rate (eGFR), and more eGFR decline with greater risk of being rapid CKD progressor (annual eGFR drop >5 mL/min/1.73 m2) [OR, 1.15; 95% CI, 1.06-1.25]. CONCLUSION Medication taking behavior was a frequently encountered problem in Thai diabetic CKD patients. Increased medication non-adherence was independently predicted by stages of increasing CKD severity, and it was associated with poorer hypertensive control and kidney outcome. Targeting interventions to improve medication adherence should be an important strategy to slow CKD progression among patients with diabetic CKD.
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Affiliation(s)
- Chairat Shayakul
- Renal Division, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Alamoudi A, Alrefaey Y, Asiri Y, Farrash E, Farahat F, Zaidi SF. Pattern and Factors Associated With the Utilization of Herbs As Medications Among Patients in a Tertiary Care Hospital in Western Saudi Arabia. Cureus 2021; 13:e19502. [PMID: 34917428 PMCID: PMC8668200 DOI: 10.7759/cureus.19502] [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] [Accepted: 11/01/2021] [Indexed: 11/18/2022] Open
Abstract
Background: Herbs are used worldwide as a treatment for plenty of diseases, and some herbs are used as the origin of modern medications. Although the therapeutic benefit was reported mostly from China, over time the world seemed to realize its importance. The use of herbs as medicine is also very common in the Arab region and Saudi Arabia. Objectives: This study was conducted to assess the pattern of use of herbs as medications in Saudi Arabia and factors associated with its use. Methods: A convenience sample of adult patients in a tertiary care hospital in Jeddah, western Saudi Arabia was used. A questionnaire consisted of two sections, i.e., demographic characteristics and the knowledge, attitudes, and practices on the use of herbs. The data collection was conducted during December 2019. Results: Three hundred and eighty patients were included, of which 53.3% were female. Almost half (49.7%) were college graduates. More than half of patients (55.6%) used herbs themselves, and (59%) reported members of the family used herbs for the past 12 months. Most patients (62.6%) use herbs without medical consultation. Patients used herbs following information received from family members (57.8%), social media (22.5%), doctors (8.1%), books (6.6%), or TV (5%). The most-reported herb was Anise followed by cumin and cinnamon. Conclusion: The use of herbs is common in Saudi Arabia. Herbs are mostly used for a variety of medical conditions following family members’ experience and social media recommendations. Detailed information on the type of herbs used, doses, and effects are worth further study with a focus on variation based on different regions.
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Affiliation(s)
- Ahmad Alamoudi
- Medicine, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Jeddah, SAU
| | - Yazeid Alrefaey
- Medicine, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Makkah, SAU
| | - Yazeed Asiri
- Medicine, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Jeddah, SAU
| | - Eyad Farrash
- Medicine, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Makkah, SAU
| | - Fayssal Farahat
- Medicine, King Saud Bin Abdulaziz University for Health Sciences College of Medicine, Jeddah, SAU.,Infection Prevention and Control, King Abdulaziz Medical City, Jeddah, SAU
| | - Syed Faisal Zaidi
- Pharmacology, School of Medicine, Batterjee Medical College for Sciences and Technology, Jeddah, SAU
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Abdelmola AO, Bahri A, Abuallut I, Refaei BA, Hakami WK, Abutaleb AK, Mahzari SM, Mashragi MA, Es'haq SA, Aldarbi KF. Prevalence, knowledge, and perception about the use of herbal medicines jazan - Saudi Arabia. J Family Med Prim Care 2021; 10:2386-2393. [PMID: 34322443 PMCID: PMC8284197 DOI: 10.4103/jfmpc.jfmpc_2475_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 02/28/2021] [Accepted: 03/12/2021] [Indexed: 11/29/2022] Open
Abstract
Aim: This study aimed to assess the prevalence, knowledge and perception of Jazan province residents about traditional herbal medication. Materials and Methods: A cross-sectional study was done on 440 Saudi residents using an electronically distributed questionnaire. The questionnaire included 39 items divided into 4 parts. Data collected were about demographic characters, knowledge and perception about HM, and HM usage among participants. Results: Most of the participants used HM for therapeutic purposes (80.9%) and (29.5%) believed that mixing herbs together led to more effective results. The participants agreed to a very high degree that inherited culture plays an important role in HM use, however (84.5%) of them never used herbs. The participants used herbs mostly for treatment of diabetes mellitus representing (37%) and hypertension (20.5%). Age, marital status, and the job of participants had a statistically significant effect on participants’ views about HM. While, gender, educational level, income, place of residence and chronic diseases had no statistically significant effect. Conclusion: The highest percentage of the participants used HM for therapeutic purposes. Increasing awareness of Saudi population about instructions and restrictions when using HM is greatly needed.
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Affiliation(s)
- Amani Osman Abdelmola
- Department of Family and Community Medicine, College of Medicine, Jazan University, Saudi Arabia
| | - Ahmed Bahri
- Department of Family and Community Medicine, College of Medicine, Jazan University, Saudi Arabia
| | - Ismail Abuallut
- Department of Family and Community Medicine, College of Medicine, Jazan University, Saudi Arabia
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Alazmi AS, Alhamad J. Attitudes and practices of complementary and alternative medicine among patients attending primary care center in Saudi Arabia: A prospective cross-sectional study. J Family Med Prim Care 2021; 9:5177-5182. [PMID: 33409184 PMCID: PMC7773103 DOI: 10.4103/jfmpc.jfmpc_871_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 06/14/2020] [Accepted: 08/31/2020] [Indexed: 11/04/2022] Open
Abstract
Introduction and objectives Estimated complementary and alternative medicine (CAM) usage in Saudi Arabia is 70%. The Saudi Food and Drug Authority, National Center for Complementary and Alternative Medicine (NCCAM) regulates the license-based practices of various CAM modalities including procedures, herbs, and devices. As an aid to help primary care physicians for understanding CAM practices among general population, this study aimed to explore the prevalence of CAM along with its most common modality, and to understand attitude and practices among patients attending primary care center in Riyadh (Saudi Arabia). Methods A prospective cross-sectional study was conducted among 403 literate patients aged more than 18 years, coming to the primary care center for regular check-up from 1st April 2019 to 1st April 2020 Saudi Arabia. Data was collected using self-administered questionnaire. Results Around 44.5% participants had practiced one method of alternative medicine in their life. Majority of participants who attended primary care centers belonged to the age group of 18-39 years (71.1%). The most common used method of alternative medicine was honey healing. More than half of the study participants had heard about the CAM from their family and friends. Nearly 45.7% had stated that the CAM cannot be used without consulting a medical professional. Nearly 3/4th population used it for treating up to 3 ailments. Conclusion Use of alternative medicine was found to be prevalent in Riyadh. Family and friends were recognized as gatekeepers for propagating information about CAM usage in the society. Primary healthcare physicians need to be trained on prevalent practices of CAM to understand the societal needs.
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Affiliation(s)
- Amal S Alazmi
- Family Medicine Center, Security Forces Hospital, Riyadh, Saudi Arabia
| | - Jamal Alhamad
- Family Medicine Center, Security Forces Hospital, Riyadh, Saudi Arabia
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Abdullah RI, Allah AA, Mubarak AS, Abdullah RI, Alzhrani SH, Alsufyani MH, Alharthi SJA, Althomali ROH. Prevalence and predictors of using complementary and alternative medicine among diabetic patients in Taif city, Saudi Arabia. J Family Med Prim Care 2020; 9:2092-2098. [PMID: 32670971 PMCID: PMC7346901 DOI: 10.4103/jfmpc.jfmpc_1222_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 12/30/2019] [Accepted: 02/12/2020] [Indexed: 12/14/2022] Open
Abstract
Background: Saudi Arabia has the second-highest rate of diabetes in the Middle East. Herbal treatment is the most used complementary and alternative therapy among Saudi diabetic patients. Little is known about the use of complementary and alternative medicine among diabetic patients who reside in Taif city. Method: This study evaluated the magnitude and correlates of complementary and alternative medicine (CAM) use among diabetic patients attending diabetic clinics and primary healthcare in two governmental hospitals, namely, Prince Mansour Military Hospital (PMMH) and National Gourd Hospital (NGH) in Taif city. Results: CAM prevalence was 33.7%, of whom 87.3% did not consult a doctor before use and 43.2% had more than one source of information while 62.7% used more than one CAM method. Around 49.2% reported that it is very useful, and 72.9% did not notice any side effect from its use. In addition, 47.5% would recommend CAM to other diabetic patients. All (100%) reported using bitter apple, 66.1% reported using cinnamon, 55.1% used ginger, 35.6% took fenugreek, and 21.2% reported using Garlic as an only CAM. Female gender, family history, diabetic complications, and longer duration of diabetes were associated with the increased use of CAM. Discussion and Conclusion: CAM use by diabetic patients in Taif is prevalent. Health education and the safe use of CAM is much needed. Appropriate efforts from the government to integrate CAM into conventional diabetes treatment should be considered.
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Affiliation(s)
- Rehab I Abdullah
- Department of Family Medicine, Al-Hada Armed Forces Hospital, Taif City, Saudi Arabia
| | - Ahmad Aman Allah
- Department of Family Medicine, Al-Hada Armed Forces Hospital, Taif City, Saudi Arabia
| | - Ali S Mubarak
- Department of Family Medicine, Al-Hada Armed Forces Hospital, Taif City, Saudi Arabia
| | - Rayan I Abdullah
- Department of Family Medicine, Al-Hada Armed Forces Hospital, Taif City, Saudi Arabia
| | - Sarah H Alzhrani
- Department of Family Medicine, Al-Hada Armed Forces Hospital, Taif City, Saudi Arabia
| | - Maram H Alsufyani
- Department of Family Medicine, Al-Hada Armed Forces Hospital, Taif City, Saudi Arabia
| | - Salman J A Alharthi
- Department of Family Medicine, Al-Hada Armed Forces Hospital, Taif City, Saudi Arabia
| | - Reham O H Althomali
- Department of Family Medicine, Al-Hada Armed Forces Hospital, Taif City, Saudi Arabia
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Alqathama A, Alluhiabi G, Baghdadi H, Aljahani L, Khan O, Jabal S, Makkawi S, Alhomoud F. Herbal medicine from the perspective of type II diabetic patients and physicians: what is the relationship? BMC Complement Med Ther 2020; 20:65. [PMID: 32111222 PMCID: PMC7076897 DOI: 10.1186/s12906-020-2854-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 02/12/2020] [Indexed: 12/24/2022] Open
Abstract
Background Diabetes mellitus (DM) is a major public health problem and one of the most challenging diseases worldwide. According to the World Health Organization (WHO), the Kingdom of Saudi Arabia (KSA) has the second highest rate of diabetes in the Middle East and seventh highest globally. Some diabetic patients may prefer to use alternative approaches such as herbal remedies to control their blood glucose level and this study aims to assess the prevalence of herbal usage and to evaluate users’ and doctors’ knowledge, attitudes and beliefs about herbal medicine as well as the patient/doctor relationship in this regard. Method A cross-sectional survey was conducted in several hospitals and medical centres in Makkah, KSA, between January and March 2019. Around 289 type II diabetic patients and 105 doctors were interviewed. Results We found that 68% of the participants were frequent consumers of herbal remedies, especially cinnamon, ginger and fenugreek. Patients’ knowledge of herbal usage was mainly gleaned from family and friends as well as social media, and we found that many (71.4%) did not bother to consult or inform their doctors about their choice to self-medicate with herbs. Patients had no concerns regarding the efficacy and safety of herbal usage use in diabetes, as around half of the participants believe that herbal medicine is effective (54%) and safe (46%) for treating symptoms of diabetes. Two-thirds of the doctors (66%) routinely ask patients whether they use herbs for their condition. Although 25% of the doctors took a positive view of herbal medicine in relation to diabetes, others expressed concerns with the rise in herb use and want to see more attention paid to safety aspects. Conclusion The study concludes that herbal remedies are commonly used by diabetic patients and that a gap exists in the relationship between patients and doctors concerning the disclosure of herbal remedy use and views on its safety.
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Affiliation(s)
- Aljawharah Alqathama
- Department of Pharmacognosy, Pharmacy College, Umm Al-Qura University, Makkah, 21955, Saudi Arabia.
| | - Ghadeer Alluhiabi
- Department of Pharmacognosy, Pharmacy College, Umm Al-Qura University, Makkah, 21955, Saudi Arabia
| | - Halah Baghdadi
- Department of Pharmacognosy, Pharmacy College, Umm Al-Qura University, Makkah, 21955, Saudi Arabia
| | - Lujain Aljahani
- Department of Pharmacognosy, Pharmacy College, Umm Al-Qura University, Makkah, 21955, Saudi Arabia
| | - Ola Khan
- Department of Pharmacognosy, Pharmacy College, Umm Al-Qura University, Makkah, 21955, Saudi Arabia
| | - Sara Jabal
- Department of Pharmacognosy, Pharmacy College, Umm Al-Qura University, Makkah, 21955, Saudi Arabia
| | - Shorooq Makkawi
- Department of Pharmacognosy, Pharmacy College, Umm Al-Qura University, Makkah, 21955, Saudi Arabia
| | - Farah Alhomoud
- Department of Clinical Pharmacy and Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Luketina-Sunjka M, Rancic N, Mihailovic N, Jakovljevic M. The Impact of the Socio-Demographic Characteristics of Complementary and Alternative Medicine Users in Serbia on OTC Drug Consumption. Front Public Health 2019; 7:303. [PMID: 31709216 PMCID: PMC6822287 DOI: 10.3389/fpubh.2019.00303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 10/04/2019] [Indexed: 12/11/2022] Open
Abstract
The Aim of this research is to analyze how the socio-demographic characteristics of users of Complementary and Alternative Medicine (CAM) in Serbia influence and impact their consumption of OTC drugs. Respondents and methods: The study employed the third edition of the National Health Survey of the Republic of Serbia, published in 2013, as a data source covering the Serbian population. The sample comprised of 550 interviewed individuals who had been applying a variety of CAM treatments over the previous 12 months. Their socio-demographic characteristics were used as independent variables impacting the consumption of OTC drugs over the previous 2-week period, representing the dependent variable. Results: Two thirds (65.3%) of the CAM users consumed OTC drugs at their own discretion, without recommendation by a physician or a relevant prescription. Users of OTC drugs were most often females whose ages ranged within the average interval of 49.16 ± 16.02, whose education level was to secondary school diploma, who were married and employed, lived in urban areas, mostly Belgrade, belonged to the middle-income group, and followed relevant headlines via public information channels (TV, the internet, radio, and print). Comparison of the results revealed, on the one hand, that 2/3 of respondents who had used and 1/3 of those who did not consume OTC drugs had undergone fecal occult blood tests over the past year (p < 0.05) and, on the other hand, that those respondents had been less frequently hospitalized in the previous year (p = 0.05). In addition, the same responders were found to access available health care services more frequently than did others (p < 0.05). Conclusion: Since, according to the statistics, it is highly likely that respondents who were CAM- and OTC drug-users would be less frequently hospitalized and not use medical leave, these results provide a strong indication that this phenomenon should be investigated in more depth. Moreover, the areas to be considered when defining strategies for determining patient treatments should also include the influence of socio-demographic factors on the patient's consciousness that would enable easier understanding of the proper usage of OTC drugs.
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Affiliation(s)
- Marina Luketina-Sunjka
- European Center for Peace and Development, University for Peace established by the United Nations, Belgrade, Serbia
| | - Nemanja Rancic
- Faculty of Medicine of the Military Medical Academy, Centre for Clinical Pharmacology, University of Defense, Belgrade, Serbia
| | - Natasa Mihailovic
- Department of Biostatistics and Informatics, Institute of Public Health Kragujevac, Kragujevac, Serbia
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Raja R, Kumar V, Khan MA, Sayeed KA, Hussain SZM, Rizwan A. Knowledge, Attitude, and Practices of Complementary and Alternative Medication Usage in Patients of Type II Diabetes Mellitus. Cureus 2019; 11:e5357. [PMID: 31608192 PMCID: PMC6783209 DOI: 10.7759/cureus.5357] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Introduction Complementary and alternative medicine (CAM) is becoming popular among individuals affected by chronic diseases, such as diabetes mellitus. We aimed to determine the knowledge, attitude, and practices of complementary and alternative medicine use among type 2 diabetes patients in Karachi, Pakistan. Methods An observational, prospective, cross-sectional study was conducted in the institute of diabetology in a tertiary care hospital in Pakistan from 1st March 2018 till 31st August 2018. All patients of type 2 diabetes mellitus attending the clinic for routine follow-up visits during the study period were interviewed. Their demographic characteristics, clinical data, and knowledge, attitude, practices towards use of CAM products were assessed. Data was managed using SPSS for Windows version 16.0 (SPSS Inc, Chicago, IL). Results CAM therapies were being used by 151 (57.8%) individuals. Herbs (n = 121; 80.1%), specific diets (n = 98; 64.9%), and cupping (n = 68; 45.0%) were the most readily utilized CAM practices. CAM practices were associated with diabetes-related complications [p < 0.000; Odds Ratio (OR) 2.57; Confidence Interval (CI) 1.53, 4.34], poor glycemic control (p < 0.000; OR 0.29; CI 0.17, 0.5), lack of trust in pharmaceutical products (p < 0.000; OR 5.08; CI 2.28, 11.32), poor patient-doctor relationship (p = 0.06; OR 1.47; CI 0.26, 8.17), CAM products being readily available and cheaper (p < 0.000; OR 6.1; CI 3.02, 12.32), and belief that CAM products have fewer side effects (p < 0.000; OR 12.32; CI 6.83, 22.22) and can help in diabetes control (p < 0.000; OR 35.76; CI 16.79, 76.15). Conclusion Use of complementary medicine products among Pakistani diabetic population is high. Herbs and specific diets were common modes of CAM practices. Use of CAM showed significant association with female gender, older age, unemployment, longer duration of diabetes, diabetes-related complications, and poor glycemic control.
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Affiliation(s)
- Ravi Raja
- Internal Medicine, New Medical Center, Al Ain, ARE
| | - Vikash Kumar
- Internal Medicine, Jinnah Sindh Medical University, Karachi, PAK
| | | | - Khalid A Sayeed
- Medicine, Liaquat College of Medicine and Dentistry, Darul Sehat Hospital, Karachi, PAK
| | | | - Amber Rizwan
- Family Medicine, Dr. Ruth Pfau Hospital, Karachi, PAK
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