Survey of Preoperative Patients' Use of Herbal Products and Other Selected Dietary Supplements

Purpose

This study was designed to determine the prevalence of herbal and selected dietary product use among preoperative patients.

Methods

A questionnaire listing 26 herbal/dietary supplements was given to 979 preoperative patients in the anesthesia assessment unit. Subjects were asked to indicate the amounts and durations of products taken. Demographic data and proposed surgical procedures were noted.

Results

One hundred and seventy surgical patients (17.4%) reported taking herbal or dietary supplements. Neurosurgical, gynecological, and orthopedic surgical patients reported the highest incidences of use at 21%, 21%, and 20%, respectively. Of patients taking these agents, 34.7% took only one product, 23.5% took two products, 11.2% took three products, and 10.6% took four or more products. The most commonly used herbals, in descending order of frequency, were ginkgo, garlic, ginseng, St. John's wort, and echinacea. Glucosamine, chondroitin, and chromium were the surveyed dietary supplements most widely used. More than 40 herbs were taken occasionally. The median age of users and nonusers was 62 years. Orthopedic patients took glucosamine and chondroitin most commonly, ophthalmic patients took ginkgo most commonly, and urology patients took saw palmetto most commonly.

Conclusion

The adverse effects of herbals and dietary products during surgical procedures and the interactions between these products and anesthetic drugs warrant further research. The use of herbal or dietary supplements may indicate alteration of patients' perioperative regimens.

Assessment of general public perceptions toward traditional medicines used for aphrodisiac purpose in state of Penang, Malaysia

The study aims to evaluate general public perceptions regarding the use of Traditional and Complementary Medicines (TCM) for aphrodisiac purposes. A questionnaire based, cross-sectional study was undertaken. Respondents were selected in the state of Penang, Malaysia. A total of 392 respondents were included in the study. Descriptive statistics were used for data analysis. Chi Square/Fischer Exact tests were used where appropriate. Out of 392 respondents, 150 (38.26%) reported using specific Traditional medicines for aphrodisiac purposes. Most respondents (46.94%) agreed that aphrodisiac medicines were easily available t. Moreover, 40.31% of the respondents reported that traditional aphrodisiac medicines were cheaper than modern (prescription) medicines. This study highlights limited public knowledge regarding the use of traditional aphrodisiac medicine. Healthcare professionals should be aware of informal TCM usage when prescribing allopathic medicines.

A proprietary extract from the echinacea plant (Echinacea purpurea) enhances systemic immune response during a common cold

In a previous paper, it was reported that Echinilin (Factors R & D Technologies, Burnaby, British Columbia, Canada) a formulation prepared from freshly harvested Echinacea purpurea plants and standardized on the basis of three known active components (alkamides, cichoric acid and polysaccharides) is effective for the treatment of a naturally acquired common cold. However, the mechanism by which this effect is achieved remains unknown. In the present study, Echinilin or placebo were administered to volunteers at the onset of their cold for a period of 7 days, with eight doses (5 mL/dose) on day 1 and three doses on subsequent days. Fasting blood samples were obtained before and during their colds. The decrease in total daily symptomatic score was more evident in the echinacea group than in the placebo group. These effects of echinacea were associated with a significant and sustained increase in the number of circulating total white blood cells, monocytes, neutrophils and NK cells. In the later part of the cold, the echinacea treatment suppressed the cold-related increase in superoxide production by the neutrophils. These results suggest that Echinilin, by enhancing the non-specific immune response and eliciting free radical scavenging properties, may have led to a faster resolution of the cold symptoms.

Efficacy of a standardized echinacea preparation (EchinilinTM) for the treatment of the common cold: a randomized, double-blind, placebo-controlled trial

BACKGROUND

Recently, echinacea has regained popularity as one of the treatments chosen most commonly by consumers with the expectation that it will reduce the severity and duration of the common cold. However, the results from a limited number of clinical trials for this application have thus far been inconclusive. This incongruity may be the result of investigators utilizing poorly standardized echinacea products, likely devoid of sufficient quantities of active constituents necessary to exert a definitive clinical effect. Therefore, a formulation containing alkamides, cichoric acid, and polysaccharides at concentrations of 0.25, 2.5, and 25 mg/mL, respectively, was prepared from freshly harvested Echinacea purpurea plants (commercially available as Echinilin, Natural Factors Nutritional Products, Inc., Vancouver, BC, Canada). The objective of this study was to test the efficacy of this highly standardized formulation in reducing the severity and duration of symptoms of a naturally acquired common cold.

METHODS

In a randomized, double-blind, placebo-controlled trial, 282 subjects aged 18-65 years with a history of two or more colds in the previous year, but otherwise in good health, were recruited. The subjects were randomized to receive either echinacea or placebo. They were instructed to start the echinacea or placebo at the onset of the first symptom related to a cold, consuming 10 doses the first day and four doses per day on subsequent days for 7 days. Severity of symptoms (10-point scale: 0, minimum; 9, maximum) and dosing were recorded daily. A nurse examined the subjects on the mornings of days 3 and 8 of their cold.

RESULTS

A total of 128 subjects contracted a common cold (59 echinacea, 69 placebo). The total daily symptom scores were found to be 23.1% lower in the echinacea group than in placebo in those who followed all elements of the study protocol (P<0.01). Throughout the treatment period, the response rate to treatments was greater in the echinacea group. A few adverse event profiles were observed in both groups.

CONCLUSIONS

Early intervention with a standardized formulation of echinacea resulted in reduced symptom severity in subjects with naturally acquired upper respiratory tract infection. Further studies with larger patient populations appear to be warranted.

Nutrition in gastroenterology and hepatology

Nutritional issues, sometimes obvious and sometimes not so obvious, confront the primary care practitioner on a daily basis. Understanding the multi-disciplinary nature of nutrition science and clinical nutrition and having a basic understanding of gastrointestinal tract digestive and absorptive physiology can only help sort out the many issues involved. The general practitioner needs a core understanding of the principles of nutrition assessment.

Personal and professional beliefs and practices regarding herbal medicine among the full time faculty of the newark-based schools of the university of medicine and dentistry of new jersey

Background: The use of alternative and herbal medicine is increasing among the general population in the United States. The use of herbal medicine by health care professionals has not been documented. Health care professionals tend to base personal and professional practices on scientific research and facts. This population interacts with the public and with health care students. Therefore, personal and professional practices will impact these audiences. Methods: A survey was distributed to all faculty members of the University of Medicine and Dentistry of New Jersey via interoffice mail. A total of 904 surveys were sent. Statistical analyses included descriptive analysis of personal and professional practice regarding herbal medicine and chi(2) analysis of the relationship between personal and professional practices regarding herbal medicine. Significance was set at alpha <.05. Results: The overall response rate was 51%. Approximately one-third (29.6%, n = 134) of the population reported personal use of herbal medicine, 22.1% (n = 42) of the population who provide patient care recommend herbal medicine, 9.4% (n = 36) of those involved in teaching include herbal medicine in coursework, and 1.1% of the population were involved in research on herbs. Respondents who use herbal medicine were more likely to recommend herbs to patients (p <.0001); likewise, users of herbal medicine were more likely to teach students about herbal medicine (p =.001). Conclusions: The results support the hypothesis that personal beliefs and practices do impact professional practices within the clinical and academic settings of the university.

Alternative medicine in maternity care

Primary care physicians are confronted daily with questions from their patients about alternative medicine. When maternity care patients seek information about such therapies, careful attention must be paid to issues of safety and efficacy for both the mother and her unborn child. This article clarifies the role of alternative medicine in maternity care by looking at the definitions and history of common alternative therapies, documenting the evidence for alternative therapies in prenatal, intrapartum, and postpartum care, and suggesting ways to incorporate alternative medicine into primary care practice.