Syzygium cumini (L.) Skeels: A review of its phytochemical constituents and traditional uses

Syzygium cumini (S. cumini) (L.) Skeels (jambolan) is one of the widely used medicinal plants in the treatment of various diseases in particular diabetes. The present review has been primed to describe the existing data on the information on botany, phytochemical constituents, traditional uses and pharmacological actions of S. cumini (L.) Skeels (jambolan). Electronic database search was conducted with the search terms of Eugenia jambolana, S. cumini, jambolan, common plum and java plum. The plant has been viewed as an antidiabetic plant since it became commercially available several decades ago. During last four decades, numerous folk medicine and scientific reports on the antidiabetic effects of this plant have been cited in the literature. The plant is rich in compounds containing anthocyanins, glucoside, ellagic acid, isoquercetin, kaemferol and myrecetin. The seeds are claimed to contain alkaloid, jambosine, and glycoside jambolin or antimellin, which halts the diastatic conversion of starch into sugar. The vast number of literatures found in the database revealed that the extracts of different parts of jambolan showed significant pharmacological actions. We suggest that there is a need for further investigation to isolate active principles which confer the pharmacological action. Hence identification of such active compounds is useful for producing safer drugs in the treatment of various ailments including diabetes.     

Clove (Syzygium aromaticum): a precious spice

Clove (Syzygium aromaticum) is one of the most valuable spices that has been used for centuries as food preservative and for many medicinal purposes. Clove is native of Indonesia but nowadays is cultured in several parts of the world including Brazil in the state of Bahia. This plant represents one of the richest source of phenolic compounds such as eugenol, eugenol acetate and gallic acid and posses great potential for pharmaceutical, cosmetic, food and agricultural applications. This review includes the main studies reporting the biological activities of clove and eugenol. The antioxidant and antimicrobial activity of clove is higher than many fruits, vegetables and other spices and should deserve special attention. A new application of clove as larvicidal agent is an interesting strategy to combat dengue which is a serious health problem in Brazil and other tropical countries. Pharmacokinetics and toxicological studies were also mentioned. The different studies reviewed in this work confirm the traditional use of clove as food preservative and medicinal plant standing out the importance of this plant for different applications.     

An update on Ayurvedic herb Convolvulus pluricaulis Choisy

Convolvulus pluricaulis Choisy (C. pluricaulis) is a perennial herb that seems like morning glory. All parts of the herb are known to possess therapeutic benefits. The plant is used locally in Indian and Chinese medicine to cure various diseases. It is used in Ayurvedic formulation for chronic cough, sleeplessness, epilepsy, hallucinations, anxiety etc. Based on the comprehensive review of plant profile, pharmacognosy, phytochemistry, pharmacological and toxicological data on the C. pluricaulis, there will be more opportunities for the future research and development on the herb C. pluricaulis. Information on the C. pluricaulis was collected via electronic search (using Pub Med, SciFinder, Google Scholar and Web of Science) and library search for articles published in peer-reviewed journals. Furthermore, information also was obtained from some local books on ethnopharmacology. This paper covers the literature, primarily pharmacological, from 1985 to the end of 2012. The C. pluricaulis is an important indigenous medicine, which has a long medicinal application for liver disease, epileptic disease, microbial disease, cytotoxic and viral diseases, central nervous system (CNS) disease in Ayurvedic medicine, traditional Chinese medicine and other indigenous medical systems. The isolated metabolites and crude extract have exhibited a wide of in vitro and in vivo pharmacological effect, including CNS depression, anxiolytic, tranquillizing, antidepressant, antistress, neurodegenerative, antiamnesic, antioxidant, hypolipidemic, immunomodulatory, analgesic, antifungal, antibacterial, antidiabetic, antiulcer, anticatatonic, and cardiovascular activity. A chemical study of this plant was then initiated, which led to the isolation of carbohydrats, proteins, alkaloids, fatty acids, steroids, coumarins, flavanoids, and glycosides as active chemicals that bring about its biological effects. A series of pharmacognostical studies of this plant show that it is a herb, its stem and leaves are hairy, more over it has two types of stomata, anisocytic and paracytic. A herb, C. pluricaulis has emerged as a good source of the traditional medicine for the treatment of liver disease, epileptic disease, microbial disease, cytotoxic and viral diseases, and CNS disease. Pharmacological results have validated the use of this species in traditional medicine. All the parts of the herb are known to possess therapeutic benefits. Expansion of research materials would provide more opportunities for the discovery of new bioactive principles from C. pluricaulis.     

Ethnobotanical,phytochemical and pharmacological review of Mimusops elengi Linn.

Mimusops elengi is Indian native plant and is used for a long time in the history of the medicine. Plant was well studied in majority of the world because of its high potential medicinal value. Traditionally all different part of this plant, namely leaf, root, fruit, seed, bark and flower are used to cure various kinds of disorders. Information compiled here will be useful to improve the present investigation of several health care research regarding the Mimusops elengi.     

Ethno botanical and Phytophrmacological potential of Abrus precatorius L.: A review

Medicinal plants are being widely used, either as a single drug or in combination in health care delivery system. Medicinal plants can be important source of previously unknown chemical substances with potential therapeutic effects. Abrus precatorius L. is commonly known as Gunja or Jequirity and abundantly found all throughout the plains of India, from Himalaya down to Southern India and Ceylon. This plant is having medicinal potential to cure various diseases. The roots, leaves and seeds of this plant are used for different medicinal purpose. It principally contains flavonoids, triterpene glycosides, abrin and alkaloids. The plant have been reported for neuromuscular effects, neuro-protective, abortifacient, antiepileptic, anti-viral, anti-malarial, antifertility, nephroprotective, immunomodulator, immunostimulatory properties, anti-inflammatory activity, antidiabetic effect, etc. As this is a potential medicinal plant, present review reveals chemical constituents of leaf, root and seeds of Abrus precatorius. The plant is considered as a valuable source of unique natural products for development of medicines against various diseases and also for the development of industrial products.     

A review on ethnobotany,phytochemistry and pharmacology of Fumaria indica (Fumitory)

Fumaria indica (Hausskn.) Pugsley (Fumariaceae), known as “Fumitory”, is an annual herb found as a common weed all over the plains of India and Pakistan. The whole plant is widely used in traditional and folkloric systems of medicine. In traditional systems of medicine, the plant is reputed for its anthelmintic, diuretic, diaphoretic, laxative, cholagogue, stomachic and sedative activities and is used to purify blood and in liver obstruction in ethnopharmacology. The whole plant is ascribed to possess medicinal virtues in Ayurvedic and Unani systems of medicine and is also used in preparation of important Ayurvedic medicinal preparations and polyherbal liver formulations. The review reveals that phytochemical constituents of wide range have been separated from the plants and it possesses important pharmacological activities like smooth muscle relaxant, spasmogenic and spasmolytic, analgesic, anti-inflammatory, neuropharmacological and antibacterial activities. The separation of hepatoprotective and antifungal constituents from this plant was also reported newly. This review highlights the traditional, ethnobotanical, phytochemical, pharmacological information available on Fumaria indica, which might be helpful for scientists and researchers to find out new chemical entities responsible for its claimed traditional uses.     

In vitro biological screening of the stem of Desmodium elegans

Objective

To explore the medicinal importance of the stem of Desmodium elegans, methanolic extract, and its different solvent fractions were evaluated for brine shrimp lethality, insecticidal and phytotoxicity, antifungal, and antibacterial activities.

Methods

The methanolic extract and its solvent fractions were tested for cytotoxic, phytotoxic, insecticidal, antifungal, and antibacterial effects using our previous published protocols.

Results

The methanolic, DCM, ethyl acetate and n-butanol fractions exhibited insecticidal effect against Callosobruchus analis and Rhyzopertha dominic. The methanolic extract, n-hexane, DCM ethyl acetate and n-butanol showed 75, 85, 85, 65 and 5% phytotoxicity at the tested concentration of 500 µg/mL respectively. The solvent fractions (DCM and ethyl acetate) were effective against F. solani (10% and 20% inhibition respectively). All the tested samples were devoid of cytotoxic and antibacterial effects.

Conclusion

It was concluded that this plant can be practiced for control of weeds and insects.     

Pharmacognostic studies of the leaves and stem of Careya arborea Roxb.

Objective

To study detailed pharmacognostic profile of leaves and stem of Careya arborea (C. arborea) Roxb. (Lecthyidaceae), an important medicinal plant in the Indian system of medicine.

Methods

Leaf and stem samples of C. arborea were studied by macroscopical, microscopical, physicochemical, phytochemical, fluorescence analysis of powder of the plant and other methods for standardization recommended by WHO.

Results

Macroscopically, the leaves are simple, broadly obovate in shape, acuminate apex with crenate, dentate margin, petioles (0.1–1.8 cm) long. Microscopically, the leaf showed the presence of median large size vascular bundle covered with fibrous bundle sheath, arrangement of xylem in cup shape and presence of cortical vascular bundle, patches of sclerenchyma, phloem fibers in groups and brown pigment containing cells in stem are some of the diagnostic features noted from anatomical study. Powder microscopy of leaf revealed the presence of parenchyma cells, xylem with pitted vessels and epidermis with anisocytic stomata. The investigations also included leaf surface data; quantitative leaf microscopy and fluorescence analysis. Physiochemical parameters such as loss on drying, swelling index, extractive values and ash values were also determined and results showed that total ash of the stem bark was about two times higher than leaf and water soluble extractive value of leaf and stem bark was two times higher than alcohol soluble extractive value. Preliminary phytochemical screening showed the presence of triterpenoids, saponins, tannins and flavonoids.

Conclusions

The results of the study can serve as a valuable source of information and provide suitable standards for identification of this plant material in future investigations and applications.     

Exploring a natural MDR reversal agent: potential of medicinal food supplement Nerium oleander leaf distillate

Objective

To investigate the molecular effects of Nerium oleander leaf distillate on paclitaxel and vincristine resistant (MCF-7/Pac and MCF-7/Vinc) cells and sensitive (MCF-7/S) cell lines.

Methods

Nerium oleander (N. oleander) leaf extract was obtained by hydrodistillation method. The toxicological effects of N. oleander distillate, previously suggested as medicinal food supplement, on drug resistant cells were evaluated by XTT tests. MDR modulation potential of the plant material was evaluated by flow cytometry and fluorescent microscopy. Paclitaxel and vincristine were applied to the sublines in combination with N. oleander distillate.

Results

Fractional inhibitory indices show that N. oleander distillate did not increase the antiproliferative effects of anticancer drugs. N. oleander treatment in to MCF-7/Pac and MCF-7/Vinc did not inhibit P-gp activity and MDR1 gene expression level.

Conclusions

As a result it may be suggested that although N. oleander distillate has some medicinal effects as food supplement it may not be suitable as an MDR modulator for drug resistant breast cancer cells.     

Barbaloin: A concise report of its pharmacological and analytical aspects

Barbaloin is C-glucoside of aloe emodin anthrone which is found in the plant name as Aloe vera is a perennial succulent (Liliaceal), also called the healing plant. Barbaloin have variety of pharmacological activity such as strong inhibitory effect on histamine release, anti-inflammatory, cathartic, antiviral, antimicrobial, anticancer, antioxidant activity and alternative for pharmaceutical or cosmetic applications. The peak amount of barbaloin was reached about 3 h after oral administration. Concentration of barbaloin in Aloe vera leaves was shown to depend on the leaf part, age, and position of the leaf. Young leaves contain more barbaloin compared to old one. Various researches have been done on barbaloin but still the relationship between the barbaloin and its overall effect has not been clarified. A more specific perceptive of the pharmacological activities of barbaloin is required to develop for pharmaceutical purpose. Many attempts have been made regarding its isolation, biological activity to examine their effects, and clarify their functional mechanism. This review gives a brief idea about its uses, ethnomedicinally and commercially important analytical techniques and their pharmacological activities.     

In vitro analysis on bactericidal screening and antioxidant potentiality of leaf and root extracts of Thottea siliquosa (Lam.) Ding Hou. An ethnobotanical plant

Objective

Natural products of plant origin are potential source of novel antimicrobial and antioxidative agents. Thottea siliquosa (Lam.) Ding Hou. (T. siliquosa). A medicinal herb used by local tribals for treating various ailments. The present study aims at the phytochemical screening, GC-MS analysis, in vitro antibacterial activity and antioxidant potentiality of root and leaf extracts of T. siliquosa.

Methods

Hot continuous Soxhlet extraction, GC-MS analysis, antibacterial analysis by disc diffusion, microdilution assay and antioxidant potentialities by hydroxyl radical and nitric oxide radical scavenging. The data was statistically analyzed.

Results

Phytochemical screening of the ethyl acetate and methanolic extract of leaf and root revealed the presence of phenols, alkaloids, tannins and saponin. The extract revealed a pool of phytochemicals by comparison with authentic standards from spectral library. Both the extracts has shown their broad spectrum of inhibition against the selected bacteria Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa and Klebsiella pneumonia compared with standard antibiotic drug streptomycin. The extracts showed antioxidant activity by scavenging of free radicals such as hydroxyl and nitric oxide. The IC₅₀ values of the ethyl acetate extracts leaf and root and standard in this assay were 167.5±0.67, 99.4±1.2, 192±2.5 µg/mL respectively. Similarly those methanolic extracts of leaf and root were 269.5±0.89 and 289.1±2.66 µg/mL respectively. Similarly, ethyl acetate and methanolic extracts also caused a moderate dose-dependent inhibition of nitric oxide with an IC₅₀ range 65.5±1.55 to 148 ±3.09 µg/mL. The inhibitory activities were found to be dose dependent.

Conclusion

The present study provides evidence that ethyl acetate and methanol extract of leaf and root of T. siliquosa are potential source of natural antioxidants and bactericidal nature. It is essential that research should continue to isolate and purify the bio active components of this natural plant and use in drug discovery and development.     

Pharmacognostic studies of insect gall of Quercus infectoria Olivier (Fagaceae)

Objective

To study the detailed pharmacognostic profile of galls of Quercus infectoria Olivier (Q. infectoria olivier) (Fagaceae), an important medicinal plant used in the Indian system of medicine.

Methods

Samples of galls of Q. infectoria were studied by macroscopical, microscopical, physiochemical, phytochemical, fluorescence analysis and othjer methods for standardization as recommended by WHO.

Results

Macroscopically, the crude drug is globose with horny appearances on external surface (1.4-2.3 cm in length and 1-1.5 cm in diameter), with greyish-brown to brownish-black in colour externally and dark brown buff colored. Surface is smooth with numerous horny protuberances giving rough touch, and with unpleasant odour. Microscopically, a wide zone of radially elongated parenchyma cells between upper and lower epidermis were found. The vascular strands were present at all places and radially elongated sclerides touched the lower epidermis. In physico-chemical studies, the moisture, total ash, acid insoluble ash, alcohol soluble, water soluble, petroleum ether, chloroform extractive value and tannin content were found to be 2.790, 5.020, 0.110, 38.780, 41.210, 0.402, 1.590 and 49.200 percentage respectively. Preliminary phytochemical screening showed the presence of phenols, flavonoids, steroids, triterpenes, tannins, saponins and alkaloids.

Conclusions

The results of the present study serve as a valuable source of information and provide suitable standards for identification of this medicinally important plant drug material for future investigations and applications.     

Synthesis of silver nanoparticles using leaves of Catharanthus roseus Linn. G. Don and their antiplasmodial activities

Objective

To develop a novel approach for the green synthesis of silver nanoparticles using aqueous leaves extracts of Catharanthus roseus (C. roseus) Linn. G. Don which has been proven active against malaria parasite Plasmodium falciparum (P. falciparum).

Methods

Characterizations were determined by using ultraviolet-visible (UV-Vis) spectrophotometry, scanning electron microscopy (SEM), energy dispersive X-ray and X-ray diffraction.

Results

SEM showed the formation of silver nanoparticles with an average size of 35–55 nm. X-ray diffraction analysis showed that the particles were crystalline in nature with face centred cubic structure of the bulk silver with the broad peaks at 32.4, 46.4 and 28.0.

Conclusions

It can be concluded that the leaves of C. roseus can be good source for synthesis of silver nanoparticle which shows antiplasmodial activity against P. falciparum. The important outcome of the study will be the development of value added products from medicinal plants C. roseus for biomedical and nanotechnology based industries.     

Analysis of phytochemical profile of Terminalia arjuna bark extract with antioxidative and antimicrobial properties

Objective

To investigate phytochemical screening, antimicrobial activity and qualitative thin layer chromatographic separation of flavonoid components, antioxidant activity and total flavonoid compound of Terminalia arjuna.

Methods

For phytochemical screening, some common and available standard tests were done. Antimicrobial bioassay was done through agar well diffusion method. Detection of antioxidant activity and flavonoid compounds were done through thin layer chromatography. Total antioxidant activity was measured by 2, 2-diphenyl-1-picrylhydrazyl (DPPH) in colorimetric method. Aluminum chloride colorimetric method was used for total flavonoid determination.

Results

Phytochemical screening showed the active compounds presence in high concentration, such as phytosterol, lactones, flavonoids, phenolic compounds and tannins and glycosides. The antimicrobial activity of extract showed that greater inhibition zone against Gram negative bacteria than Gram positive bacteria. This methanolic extract showed a promising antioxidant activity, as absorption of DPPH redicles decreased in DPPH free radical scavenging assay. Flavonoids components having antioxidant property present in the methanol extract at a level of 199.00 mg quercetin equivalent/g of dried methanol extract in colorimetric method.

Conclusions

The Terminalia arjuna bark extract revealed the presence of bio-active constituents which are known to exhibit medicinal as well as physiological activities.     

Evaluation of anti-resistant activity of Auklandia (Saussurea lappa) root against some human pathogens

Objective

The antimicrobial activity of the ethanol extract of the Auklandia (Saussurea lappa)root plant was investigated to verify its medicinal use in the treatment of microbial infections.

Methods

The antimicrobial activity of the ethanol extract was tested against clinical isolates of some multidrug-resistant bacteria using the agar well diffusion method. Commercial antibiotics were used as positive reference standards to determine the sensitivity of the clinical isolates.

Results

The extracts showed significant inhibitory activity against clinical isolates of methicillin resistant Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumonia, Extended Spectrum Beta-Lactemase, Acinetobacter baumannii. The minimum inhibitory concentration values obtained using the agar dilution test ranged from 2.0 µg/µL-12.0 µg/µL. In the contrary the water extract showed no activity at all against the tested isolates. Furthermore, the results obtained by examining anti-resistant activity of the plant ethanolic extract showed that at higher concentration of the plant extract (12 µg) all tested bacteria isolates were inhibited with variable inhibition zones similar to those obtained when we applied lower extract concentration using the well diffusion assay.

Conclusion

The results demonstrated that the crude ethanolic extract of the Auklandia (Saussurea lappa) root plant has a wide spectrum of activity suggesting that it may be useful in the treatment of infections caused by the above clinical isolates (human pathogens).     

Comparative micromorphological study of wild and micropropagated Dioscorea bulbifera Linn.

Objective

To study the leaf epidermis of wild and micropropagated Dioscorea bulbifera Linn. (D. bulbifera) in order to document useful diagnostic features that may be employed for correct crude drug identification and to clear any taxonomic uncertainties in the micropropagated medicinal plant.

Methods

Growth responses of micropropagated D. bulbifera were observed on Murashige Skoog medium supplemented with 6-benzylamino purine (1.0 mg/L)+α-naphthaleneacetic acid (0.2 mg/L)+cysteine (20 mg/L) using nodal segments as explants. Leaves of the wild and micropropagated plants were studied microscopically.

Results

More than 80% shoot regeneration and formation of 10%-30% whitish-brown callus were observed within 3 weeks. The highest root proliferation was obtained from Murashige Skoog medium of 6-benzylamino purine (0.05 mg/L) and α-naphthaleneacetic acid (0.01 mg/L) with mean root length of (27.00±1.25) mm and elongated single shoot of mean length (38.00±11.09) mm. Leaf epidermal features that revealed similarities between the wild and micropropagated plants included amphistomatic condition, presence of mucilage, glandular unicellular trichome with multicellular head, polygonal cells with smooth walls, stomata type and shape. Slight variations included thick cuticular wall with closed stomata in wild plant compared to thin walled opened stomata in the in vitro plant. Opening of stomata accounted for larger average stomata sizes of (7.68±0.38) µm and (6.14±0.46) µm on the adaxial and abaxial surfaces, respectively of the micropropagated plant compared to the wild.

Conclusions

The diagnostic features obtained in the study could serve as a basis for proper identification for quality control for standardization of the medicinal plant.     

Chemical composition and antioxidant activity of a Lebanese plant Euphorbia macroclada schyzoceras

Objective

To determine the chemical composition, total phenolic and total flavonoid contents of the crude extracts from leaves and stems of a Lebanese plant Euphorbia macroclada schyzoceras (E. macroclada), and to evaluate their antioxidant potential using DPPH, H₂O₂, and chelating of ferrous ions tests.

Methods

Quantification of the total phenolic and total flavonoid contents of the crude extracts from leaves and stems and the antioxidant activities were evaluated using spectrophotometric analyses. The chemical composition has been estimated using different techniques such as IR, LC/MS and NMR.

Results

Ethanolic extract from leaves of E. macroclada was better than aqueous extract and showed higher content in total phenolic and total flavonoid than found in the stems. On the other hand, using DPPH and H₂O₂ tests, this extract from leaves showed higher antioxidant capacity than aqueous extract. However, using the chelating of ferrous ions test, the antioxidant activity of the aqueous extract of both stems and leaves was stronger than that of ethanolic once. The chemical composition of the whole plant showed the presence of some aromatic compounds and fatty acids.

Conclusions

Both ethanolic and water extracts from both parts of this plant are effective and have good antioxidant power. So, this plant can be used in the prevention of a number of diseases related to oxidative stress.     

A recent review on phytochemical constituents and medicinal properties of kesum (Polygonum minus Huds.)

Medicinal plants and herbal preparations are gaining renowned interest in scientific communities nowadays due to their reliable pharmacological actions and affordability to common people which makes them effective in control of various diseases. Polygonum minus (Polygonaceae) locally known as kesum is an aromatic plant commonly used in Malay delicacies. The plant is having potential applications due to its high volatile oil constituents in perfumes and powerful antioxidant activity. It has been used traditionally to treat various ailments including dandruff. The research has been carried out by various researchers using different in vitro and in vivo models for biological evaluations to support these claims. This review paper may help upcoming research activities on Polygonum minus by giving up to date information on the phytochemical constituents and medicinal properties of kesum to a possible extent with relevant data.     

Isolation and identification of Salmonella from curry samples and its sensitivity to commercial antibiotics and aqueous extracts of Camelia sinensis (L.) and Trachyspermum ammi (L.)

Objective

To isolate Salmonella from curry samples and to evaluate the drug sensitivity of the food-borne Salmonella and its susceptibility to specific plant extracts.

Methods

Salmonella was isolated from the curry samples by standard microbiological methods and was confirmed by biochemical tests. The antibiotic susceptibility test was conducted by disc diffusion method using commercially available antibiotics such as ampicillin, tetracycline, chloramphenicol, kanamycin, and penicillin. In addition, the susceptibility of the food-borne Salmonella was also evaluated against the aqueous extracts of Camelia sinensis (L.) Theaceae (tea leaves) and the Trachyspermum ammi (L.) Apiaceae ( ajwain or omum seeds).

Results

Out of fifty curry samples, only seven samples were identified to have Salmonella contamination. The Salmonella isolates showed a significant drug resistance pattern except for kanamycin. The plant extracts showed a considerable antibacterial activity against the isolates, indicating the presence of antimicrobial principle which can be exploited after complete pharmacological investigations.

Conclusions

The present study demonstrates the occurrence of Salmonella in the curry samples, and shows significant drug resistance against most of the commercially available antibiotics, except kanamycin. Antimicrobial effect of the plant extracts against the food-bone Salmonella suggests that dietary including medicinal herbs would be one strategy to manage food borne pathogens.     

Chemical profiling of Elaeocarpus serratus L. by GC-MS

Objective

To determine the possible bioactive components of the ethanolic extract of leaves of Elaeocarpus serratus (E. serratus).

Methods

The present research was carried out by using GC-MS analysis, while mass spectra of the compounds found in the extract was matched with the National Institute of Standards and Technology and Wiley library.

Results

Thirty components from leaves of the above said plant were identified. The active principles with their retention time, molecular formula, molecular weight and concentration (%) in the ethanol extracts of leaf of E. serratus are obtained.

Conclusions

This is the first report of documentation of active constituents from leaves of E. serratus. The research reveals the potential of E. serratus leaves as a good source of bioactive compounds such as fatty acid esters, alcohols, hydrocarbons, aldehydes, alkenes, fatty acids and amides that justify the use of this plant for its various ailments by traditional practitioners.