[Use of medicinal plants in patients with symptoms of generalized anxiety]

BACKGROUND

Anxiety is one of the most common mental disorders. It has an impact on the decrease of productivity, the affectation of quality of life, and the increase in health care costs. The study of plant species with medicinal properties to treat anxiety has made significant progress, since they have been evaluated through in vitro, in vivo and clinical studies.

OBJECTIVE

To identify the use of medicinal plants among patients with symptoms of generalized anxiety disorder (GAD).

MATERIAL AND METHODS

A diagnostic questionnaire, including the Hamilton Anxiety Rating Scale, and another related with the use of medicinal plants, was applied. It was designed specifically for this study, and it was used in subjects and/or their companions, who visited an Instituto Mexicano del Seguro Social hospital.

RESULTS

The study had 985 subjects, 802 women, with a median age of 37.1 ± 15.17; anxiety symptoms were identified in 95.9% (940); according to the number of signs and symptoms, 53.1% (523) of subjects may have suffered a moderate or severe degree of anxiety. 23.09% (187) used medicinal plants to treat their symptoms. 39 plant species were identified as used by patients with GAD symptoms. Of these, 76.3% (29) had a history of ethnomedical use on mental disorders.

CONCLUSIONS

A high percentage of the population in Mexico presents symptoms of GAD. A significant number of patients use medicinal plants to treat the symptoms of anxiety, even when they do not know that their symptomatology is part of a mental disorder.

Effects of Copaiba oil in the healing process of urinary bladder in rats

Introduction

The appropriate closure of the urinary bladder is important to many urologic procedures to avoid the formation of fistulas and strictures by excessive fibrosis. This paper presents the alterations in the bladder healing process of rats after the topical use of Copaiba oil (Copaifera reticulata).

Material and Methods

Ten male Wistar rats were used and randomly divided into two groups: Control group (CG): injected 1ml/kg of saline solution on the suture line; and Copaiba group (CpG): 0.63ml/kg of copaiba oil applied to the suture line. Euthanasia was performed on the seventh day after surgery. The criteria observed were adherences formation, histopathological modifications and stereology for collagen.

Results

Both groups showed adhesions to the bladder, with no statistically significant difference (p=0.1481). The microscopic evaluation revealed a trend to more severe acute inflammation process on the CpG, but there was statistical difference only in the giant cells reaction (p=0.0472) and vascular proliferation (p=0.0472). The stereology showed no difference.

Conclusion

The copaiba oil modified the healing process, improving the quantity of giant cells and vascular proliferation, but not interfered in the collagen physiology.

Clinical Features of Drug-induced Liver Injury According to Etiology

Drug-induced liver injury (DILI) is an increasingly common cause of acute hepatitis. We examined clinical features and types of liver injury of 65 affected patients who underwent liver biopsy according DILI etiology. The major causes of DILI were the use of herbal medications (43.2%), prescribed medications (21.6%), and traditional therapeutic preparations and dietary supplements (35%). DILI from herbal medications, traditional therapeutic preparations, and dietary supplements was associated with higher elevations in aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels than was DILI from prescription medications. The types of liver injury based on the R ratio were hepatocellular (67.7%), mixed (10.8%), and cholestatic (21.5%). Herbal medications and traditional therapeutic preparations were more commonly associated with hepatocellular liver injury than were prescription medications (P = 0.002). Herbal medications and traditional therapeutic preparations induce more hepatocellular DILI and increased elevations in AST and ALT than prescribed medications.

The Effects of Different Media on Shoot Proliferation From the Shoot Tip of Aloe vera L

BACKGROUND

Aloe vera L. is an important pharmaceutical plant from which several medicinal and cosmetic compounds are extracted. Aloe is naturally propagated through offset, which is a slow and expensive labor cost method with low economical income.

OBJECTIVES

In this study, the effect of different media on shoot proliferation of the shoot tip of Aloe vera L. was investigated.

MATERIALS AND METHODS

In vitro techniques are some of the suggested methods for rapid propagation of Aloe. In this experiment, the shoot tips of mother plants were grown in a greenhouse. After surface sterilization of the explants, they were cultured on Murashige and Skoog (1962) (MS) medium containing different concentrations of kinetin and naphthaleneacetic acid (NAA). The experiment was carried out in the form of a randomized complete design with three replications.

RESULTS

The results showed that MS media containing 1.5 mg/L kinetin along with 0.15 or 0.3 mg/L NAA produced the highest percentage of proliferated shoots. In addition, the percentage of proliferated shoots in MS medium containing 2.0 or 2.5 mg/L benzylaminopurine (BAP) + 0.15 mg/L NAA was significantly higher than the other treatments.

CONCLUSIONS

Analysis of the interactive effects of NAA, kinetin and BAP on shoot proliferation showed that most of the proliferated shoots produced in MS medium containing 1.0 mg/L BAP + 1.0 mg/L kinetin + 0.15 mg/L NAA were significantly different from other treatments. Rooting quality was greater in MS media containing 1.0 mg/L IBA than a 1.0 mg/L NAA treatment.

In-vitro activity of saponins of bauhinia purpurea, madhuca longifolia, celastrus paniculatus and semecarpus anacardium on selected oral pathogens

OBJECTIVE

Dental caries, periodontitis and other mucosal diseases are caused by a complex community of microorganisms. This study aimed to investigate the antimicrobial properties of saponins of four important oil yielding medicinal plant extracts on selected oral pathogens that are involved in such diseases.

MATERIALS AND METHODS

Saponins were extracted from Bauhinia purpurea, Madhuca longifolia, Celastrus paniculatus and Semecarpus anacardium and purified. Antimicrobial properties of these saponins against Streptococcus mutans, Streptococcus mitis, Streptococcus salivarius, Staphylococcus aureus and Lactobacillus acidophilus were determined using well diffusion method. The minimum inhibitory concentration (MIC) was determined as the lowest concentration of saponins inhibiting bacterial growth after 14 h of incubation at 37°C. The bactericidal activity was evaluated using the viable cell count method.

RESULTS

The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of Madhuca longifolia saponin on Streptococcus mutans MTCC 890, Streptococcus mitis and Staphylococcus aureus was 18.3 ± 0.15/34.4 ± 0.24 μg/ml, 19.0 ± 0.05/32.2 ± 0.0 μg/ml and 21.2 ± 0.35/39.0 ± 0.30 μg/ml, respectively and Bauhinia purpurea saponin on Streptococcus mutans MTCC 890, Staphylococcus aureus and Lactobacillus acidophilus was 26.4 ± 0.20/43.0 ± 0.40 μg/ml, 29.0 ± 0.30/39.6 ± 0.12 μg/ml and 20.2 ± 0.05/36.8 ± 0.23 μg/ml, respectively.

CONCLUSION

The strong antimicrobial activity of Madhuca longifolia and Bauhinia purpurea may be due to the presence of complex triterpenoid saponins, oleanane type triterpenoid glycosides or atypical pentacyclic triterpenoid saponin. Hence, these extracted saponins may be used in food and oral products to prevent and control oral diseases.

Self-reported Use and Attitudes Regarding Herbal Medicine Safety During Pregnancy in Iran

BACKGROUND

Despite the vast use of herbal medicines in the world, little is known about their use in pregnancy and the attitudes of pregnant women regarding their safety during pregnancy.

OBJECTIVES

The aim of this study was to evaluate the use and attitudes of pregnant women toward herbal medicine use in pregnancy in Iran.

MATERIALS AND METHODS

A questionnaire was completed by 400 women selected by convenience sampling from postnatal and prenatal wards of two hospitals. Data were analyzed using the SPSS software version 13.5. Chi2 test was used to analyze the data.

RESULTS

The median age was 26.4 (± 5.2) years and the mean number of pregnancies was 1.9 (± 0.98). The use of herbal remedies during pregnancy was positive in 22.3% of patients. They took herbal medicines recommended by their physician (46.1%), through self-medication (44.9%), or with the advice of family members or friends (9%). Additionally, 39.8% believed that it was safe to use herbal remedies during pregnancy, 32.3% believed that it was harmful for both mother and fetus, and 22% did not know whether it was safe or not.

CONCLUSIONS

Herbal medicine use was not high among our subjects but was significantly affected by age. The level of education, place of living, and number of pregnancies significantly affected the attitudes of the subjects. Women with higher education mostly relied on their own information, whereas those with lower education relied on physician advice. Further educational programs are required to increase the information for this group of susceptible individuals.

Effect of Maytenus ilicifolia Mart.ex. Reiss on spermatogenesis

The effect of the ethanolic extract of Maytenus ilicifolia Mart.ex. Reiss leaves on spermatogenesis was studied in Swiss mice by evaluating morphological characteristics by light and electron microscopy. The extract was administered at a dose of 200 mg/kg/day intraperitoneally for 20 days, and at a dose of 800 mg/kg/day orally for 30 days. Structural analysis of the germ epithelium showed that treated animals were not noticeably different from control animals. The alterations included some exfoliated immature germ cells, occasional germ cell death (recognized as pyknotic nuclei) and a few vacuolized seminiferous tubules. Ultrastructurally, enlarged lipid droplets were found in Sertoli cells and swollen acrosomes occurred in early spermatids of animals treated with the higher dose. Sperm production indicated that the ethanolic extract of M. ilicifolia leaves did not contain substances sufficient to arrest spermatogenesis.

Women's use of complementary and alternative therapies in reproductive health care

Numerous studies have documented that health care consumers all over the world are spending money out of pocket for alternative therapies and that billions of dollars are spent in the United States alone. In this article, the use of complementary and alternative therapies by women health care consumers is discussed, particularly as this phenomenon relates to women's reproductive health in the United States. Women use conventional health care services more frequently than men; thus, it is not surprising that women account for approximately two thirds of health care appointments for complementary and alternative therapies. The traditional conceptual frameworks of herbal medicine, homeopathy, acupuncture, and acupressure are presented, and common clinical applications to women's reproductive care are discussed.

Prevalence and clinical correlates of unsuccessful use of drugs to induce menstruation

Despite its prohibition, illegal abortion is widely practiced in Brazil, with important adverse health consequences. This report aims to document the prevalence and correlates of the unsuccessful use of drugs to "induce menstrual flow" in a cohort of pregnant Brazilian women. In a cross-sectional study, 6,102 pregnant women between gestation weeks 21 and 28 were interviewed in prenatal clinics of the Brazilian National Health Care System from April 1991 to November 1995. When asked "In order to know if you were pregnant, did you take any medication to induce menstrual flow", 874 (14.4%) responded "yes." The most frequently used drugs were herbal teas (41%), estrogens and/or progestogens (30%), and misoprostol (16%). As demonstrated through logistic regression analysis, independent correlates of such use were unplanned pregnancy (odds ratio [OR] 4.3), low educational attainment (OR 3.3), absence of a husband or partner (OR 1.8), number of children (one or more) (OR 1.5), a history of a previous induced abortion (OR 1.4), and use of oral contraceptives at the time (OR 1.4). Misoprostol use occurred in 2.2% of pregnancies, and showed a very strong association with an unplanned pregnancy (OR 16.0), absence of a husband or partner (OR 3.5), and a history of a previous induced abortion (OR 2.2). It was not associated with a history of menstrual irregularity. In contradistinction, the use of medroxyprogesterone was strongly associated with previous menstrual irregularity (OR = 5.0). The use of drugs and teas, many of which are unknown in terms of fetal risk, in early pregnancy to induce menstrual flow is quite common in women in the Brazilian National Health System. Although the objective of such drug use appears to be varied, analysis of the clinical correlates of use suggest attempted abortion to be the principal aim.

Screening of anti-diarrhoeal profile of some plant extracts of a specific region of West Bengal, India

Ethanol extract of four different plants of the Khatra region of the Bankura district of West Bengal, India were evaluated for anti-diarrhoeal activity against different experimental models of diarrhoea in rats. The extracts of Ficus bengalensis Linn. (hanging roots), Eugenia jambolana Lam. (bark), Ficus racemosa Linn. (bark) and Leucas lavandulaefolia Rees (aerial parts) showed significant inhibitory activity against castor oil induced diarrhoea and PGE2 induced enteropooling in rats. These extracts also showed a significant reduction in gastrointestinal motility in charcoal meal tests in rats. The results obtained establish the efficacy of all these plant materials as anti-diarrhoeal agents.

Zinc acetate and lyophilized aloe barbadensis as vaginal contraceptive

Twenty samples of fresh ejaculate, donated by healthy volunteers ranging in age from 20-30 years, were obtained from the Center for Fertility & Cryobiology, University of Missouri, Columbia, Missouri. Average semen volume was 2.49 ml; average sperm motility was 71.32%; and average sperm density was 113.71 x 10(6) /ml. Testing for spermicidal effectiveness of a 1% concentration of zinc acetate, zinc sulfate, zinc chloride, and zinc gluconate proved that only zinc acetate was spermicidal. It appears this is due to the acetate in zinc acetate which may decrease oxygen utilization by sperm. Zinc acetate in vitro was antiviral while lyophilized aloe barbadensis was not. Lyophilized aloe barbadensis at concentrations of 7.5% and 10% proved to be spermicidal due to the multiple micro elements (boron, barium, calcium, chromium, copper, iron, potassium, magnesium, manganese, phosphorus, and zinc) which were toxic to the tail causing instant immobilization. The two compounds did not irritate or cause ulceration of rabbit vaginal epithelium. These results suggest the possibility of using zinc acetate and lyophilized aloe barbadensis as a new, effective and safe vaginal contraceptive.

Drug leads from the Kallawaya herbalists of Bolivia. 1. Background, rationale, protocol and anti-HIV activity

Aqueous, organic and alcoholic extracts of over 100 samples of 60 species of Kallawaya medicinal herbs representing 30 plant families were assayed to compare their toxicity and ability to protect MT-2 T-lymphoblastoid cells from the cytopathic effect of human immunodeficiency virus (HIV). The results are reported as a therapeutic index (TI) which was > 25 for eighteen species, including seven > 50 and one > 100. The anti-HIV activity resided primarily in the aqueous rather than in the organic extracts and was concentrated in plants used in ethnomedicine to treat lung and liver diseases.

Inhibitory effects of Egyptian folk medicines on human immunodeficiency virus (HIV) reverse transcriptase

Extracts of 41 medicinal plants used in Egyptian folk medicine were screened for their inhibitory effects on human immunodeficiency virus-1 reverse transcriptase. The extracts of fruits of Phyllanthus emblica, Quercus pedunculata, Rumex cyprius, Terminalia bellerica, Terminalia chebula and Terminalia horrida showed significant inhibitory activity with IC50 < or = 50 micrograms/ml. Through a bioassay guided-fractionation of the methanol extract of the fruit of P. emblica, putranjivain A (1) was isolated as a potent inhibitory substance with IC50 = 3.9 microM, together with 1,6-di-O-galloyl-beta-D-glucose (2), 1-O-galloyl-beta-D-glucose (3), kaempferol-3-O-beta-D-glucoside (4), quercetin-3-O-beta-D-glucoside (5) and digallic acid (6). The inhibitory mode of action by 1, 2 and 6 was non-competitive with respect to the substrate but competitive with respect to a template-primer. Furthermore, the stereochemistry of 1 was established in this paper by nuclear magnetic resonance spectroscopy.

Female sexuality, social reproduction, and the politics of medical intervention in Niger: Kel Ewey Tuareg perspectives

This essay explores connections between political institutions, forms of power, and women's health care concerns from a cultural anthropological perspective. I focus on the roles of different medical establishments among the Kel Ewey Tuareg of Niger--Western-European sponsored, central state, traditional herbalism and Islamic scholarship--in creating, maintaining, and disputing these constructs, through the invention and elaboration of disease categories and through the selective application of medical and reproductive models and technology to women. I also explore women's attempts to manage these forces, as they draw upon a cultural inventory that is alternately supportive and in conflict with their interests.

Post-coital contraceptive activity of crude extracts of Sri Lankan marine red algae

This study investigates the potential of marine red algae as a source for post-coital contraceptive agents using three varieties: Gracilaria corticata, Gelidiella acerosa and Jania sp. Methanol: methylene chloride (1:1) extracts of these red algae were made and were orally administered (500 or 1000 mg/kg/day) to female rats from day 1 to day 7 of pregnancy. The higher dose of Gracilaria corticata and both doses of Gelidiella acerosa extracts produced significant post-coital contraceptive activities without any marked side effects. Furthermore, the post-coital contraceptive activity of the latter extract was dose-dependent. On the other hand, extract made from Jania sp. had no significant post-coital contraceptive action. The post-coital contraceptive activity of Gracilaria corticata was due to enhanced pre-implantation loss and of Gelidiella acerosa was due to elevated post-implantation loss. These findings indicate that marine red algae is a useful source to be harvested for potential post-coital contraceptive drugs.

Exploration of the frontiers of tradomedical practices: basis for development of alternative medical healthcare services in developing countries

The study is a brief exploration of the functions and roles of the traditional healers in the total health care delivery system as a basis for tapping the salient features of this age old art: for the purpose of refining, and establishing it as an alternative medical health-care service. The investigation is considered relevant particularly in the developing countries where, in addition to the dearth of orthodox medical services, institutions and personnel, it is relatively cheaper, socio-culturally accessible and acceptable. Refining and developing some aspects of the traditional healers' services will serve the interest of the health consumers whose main concern is with service and not the source. Furthermore, it is hoped that the study will stimulate purposeful discussions on the need for an unbiased examination of the materials, methods and techniques of the traditional healers including, eventually, compiling a native pharmacopoeia. A more comprehensive account of the traditional healers contributions to the battle against diseases and maintenance of health and well being is envisaged.

Rapid coma resolution with artemether in Malawian children with cerebral malaria

Artemisinin compounds clear parasitaemia more rapidly than other drugs do in both mild and severe malaria, but no advantage in clinical efficacy has been shown. We have compared artemether treatment with standard quinine treatment in Malawian children with cerebral malaria. 65 unconscious children were randomly allocated to intravenous quinine (n = 37) or intramuscular artemether (n = 28) treatment. The two groups were well matched for various prognostic features. Median parasite clearance times were shorter in the artemether group (28 [interquartile range 18-34] vs 40 [36-44] h in the quinine group, p = 0.0002). Coma resolution times were also shorter with artemether than with quinine (8 [4-15] vs 14 [10-36] h, p = 0.01).

Maternity and medicinal plants in Vanuatu. I. The cycle of reproduction

Ethnobotanical data collection to select pharmacologically active species was carried out within a clearly defined therapeutic context: those plants used during the course of a woman's reproductive life. Extensive bibliographical and field data collection and cross-examination of the information thus gathered have provided us with a clearer picture of the effectiveness of these plant species. Various concepts, behaviours and practices relating to menstruation, pregnancy, birth and birth control were examined in detail from an ethnopharmacological point of view. A list of selected species of particular interest is proposed for further study.

Two proteins with ribosome-inactivating, cytotoxic and abortifacient activities from seeds of Luffa cylindrica roem (Cucurbitaceae)

Two immunologically distinct glycoproteins, with a molecular weight of 28,000 and 28,500 respectively, were isolated from seeds of Luffa cylindrica using a procedure that involved acetone precipitation, gel filtration on Sephadex G-75 and ion exchange chromatography on CM-Sepharose CL-6B. The proteins differed in the content of aspartic acid, threonine, proline and alanine but were otherwise similar in amino acid composition. The proteins were capable of inducing mid-term abortion in mice, inhibiting protein synthesis in a cell-free system and suppressing thymidine uptake by human choriocarcinoma cells.

Knowledge, attitudes, and practices and their policy implications in childhood diarrhoea in Uganda

A nationwide study of the knowledge, attitudes, and practices about childhood diarrhoea among health workers and mothers of children less than 5-years old was conducted in Uganda during 1987. We found that each child, on the average, has 6 episodes of diarrhoea in a year. While most parents (65%) continue with almost normal feeding practices during their children's diarrhoea, as is officially recommended, there are some foods that are traditionally withheld. The use of oral rehydration therapy in the form of a salt and sugar solution is very limited and needs to be promoted. Herbal treatment for diarrhoea is a widespread practice and needs to be studied further to ascertain its usefulness. Over 55% of mothers recognise poor hygiene as the most important cause of childhood diarrhoea. The general level of sanitation is not satisfactory and needs to be improved to achieve the widespread availability of safe water and adequate means of human waste disposal for all homes. The radio was found to be a potentially effective tool for health education, and the need to provide all health workers with continuing education about diarrhoea management was identified.

Sperm immobilizing effect of triterpene saponins from Acacia auriculiformis

A mixture of two partially triterpenoid saponins (Tg), isolated from Acacia auriculiformis was tested for sperm immobilizing activity by using in vitro system. The lowest concentration (ED) required for an obvious immobilization of human sperm by using a modified Sander-Cramer test was found to be 0.35 mg/ml in physiological saline. The ability of the compound as a sperm immobilizing agent was compared with that of Triton X-100 and found to be more potent. Cervical mucus penetration test was also performed and the ED successfully prevented sperm entry in human cervical mucus. Supra-vital staining with eosin-nigrosin indicated death of the treated sperm. Electron microscopic study of Tg-treated sperm showed plasma membrane disintegration and dissolution of acrosomal cap which is presumably the cause for the spermicidal effect of the saponins. No permanent lesion was observed after application of 1.25 mg/ml Tg solution in physiological saline to the eye of rabbits for ten consecutive days.

Traditional methods in management of diarrhoeal diseases in Uganda

A total of 292 traditional healers were interviewed in five districts of Uganda to discover how diarrhoeal diseases were treated by them. At least two healers were present in every village visited, and over 42% of their case-load was concerned with diarrhoeal treatment. The investigation showed that a great variety of herbs/plants are used by traditional healers in the treatment of diarrhoeal diseases. All those interviewed used water as the main vehicle for their herbal preparations, the amount prescribed daily ranging from 20 ml to over 100 ml for children (in the case of 54.5% of healers) and 100 ml to over 500 ml for adults (56.6%); 26.4% of healers considered fluid supplements as mandatory and 70.5% advised patients to take as much fluid as possible. Only 3.1% of healers either limited or did not advise fluid intake. These findings indicate that traditional healers could play an important role in interventions to control diarrhoeal diseases using modern oral rehydration therapy if they are assisted to improve their techniques.