Antibacterial activity of some African medicinal plants used traditionally against infectious diseases

Context: Plants are known to play a crucial role in African traditional medicine for the treatment of infection diseases.

Objectives: To investigate the claimed antimicrobial properties of plants traditionally used in African countries, providing scientific validation for their use.

Materials and methods: Eighty-three polar and non-polar extracts from 22 medicinal plants were screened for their antibacterial activity against Gram-positive (Staphylococcus aureus and Enterococcus faecalis) and Gram-negative bacteria (Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae) and Mycobacterium smegmatis using the broth microdilution method.

Results and Discussion: In vitro antibacterial activity against one or more tested bacteria was shown by 83% of the extracts. The highest activity was obtained with the methanol extracts of the aerial parts of Acacia karroo Hayne (Fabaceae) and Anacardium occidentale L. (Anacardiaceae) and the roots of Bridelia cathartica G. Bertol (Euphorbiaceae), against S. aureus (minimum inhibitory concentration (MIC)?=?7.5 µg/mL). The same MIC values were exhibited against E. faecalis by the methanol extract of A. occidentale, the dichloromethane and methanol extracts of B. cathartica and the ethyl acetate extract of Momordica balsamina l. (Curcubitaceae) leaves. Gram-negative bacteria were less sensitive; the growth of P. aeruginosa was significantly inhibited (MIC?=?31 µg/mL) by the n-hexane and methanol extracts of Gomphocarpus fruticosus (l.) Ait. (Asclepiadaceae) fruits and by the dichloromethane extract of Trichilia emetica Vahl (Meliaceae) seeds. Most of the active extracts were rich in fenols/flavonoids.

Conclusion: This study supports the use of most of the studied plants in traditional medicine, for the treatment of infectious diseases. Some of them are worthy of further investigation.     

Selection of chemical markers for the quality control of medicinal plants of the genus Cecropia

Context: Several Cecropia (Cecropiaceae) species are traditionally used in Latin America for the treatment of a variety of diseases including diabetes, arterial hypertension, asthma, bronchitis, anxiety, and inflammation. At present, a number of commercial products based on these plants have been introduced into the market with very little information on methods for guaranteeing their quality and safety.

Objective: This work proposes potential chemical markers for the quality control of the raw materials of Cecropia obtusifolia Bertol., Cecropia peltata L., Cecropia glaziovii Snethl., Cecropia pachystachya Trécul, and Cecropia hololeuca Miq.

Methods: The Herbal Chemical Marker Ranking System (Herb MaRS) developed by the National Institute of Complementary Medicine (NICM) at the University of Western Sydney was used for selecting chemical markers for the quality control of selected medicinal species of Cecropia. This review covers the period from 1982 to 2016.

Results: Chlorogenic acid, flavonoidal glycosides (orientin, isoorientin, vitexin, isovitexin, and rutin), catechin, epicatechin, procyanidins (B2, B5, and C1), steroids (β-sitosterol), and triterpenoids (α-amyrin, pomolic, tormentic and ursolic acids) were selected as chemical markers for the quality control of the leaves.

Conclusion: It is necessary to establish comprehensive standards for guaranteeing quality, safety and efficacy of herbal drugs. The selection of adequate chemical markers for quality control purposes requires a good knowledge about the chemical composition of medicinal plants and their associated biological properties. To the best of our knowledge this review article is the first to address the identification and quantitative determination of the chemical markers for the genus Cecropia.     

Ethnopharmacological use of plants by Sisala traditional healers in northwest Ghana

Context and objective: The Sisala traditional healers of northwest Ghana have a rich ethnomedical tradition. The purpose of this study was to collect and analyse data on medicinal plants commonly used by Sisala traditional healers.

Methods: A total of 30 traditional healers were interviewed using a mixture of open- and closed-ended questionnaires after obtaining prior-informed consent. Plant materials of each species of medicinal plant mentioned being used were collected and processed as voucher specimens following standard ethnobotanical methods.

Results: The majority (65%) of traditional healers were males, age ≥ 38, and their knowledge about medicinal plants was acquired orally largely from their parents (81.3%). A total of 35 species of plants were reported used to treat 24 diseases. Most (55%) of the plant materials were harvested from the bush and about half (54.8%) of the healers collected plant materials in the morning. Leaf (20%) and root (17.5%) plant materials were most commonly used in the preparation of 27 herbal remedies for treatments. The modes of administration of the herbal remedies were both through internal and external routes.

Conclusion: The results of this study show that Sisala traditional healers possess rich traditional knowledge about medicinal plants and new therapeutic use claims for 34 medicinal plants used in Ghana and widely within Africa are documented for the first time.     

Ethnopharmacological study of herbal remedies used for the management of thyroid disorders in Algeria

Traditional medicine is gaining an increasing importance in diseases management. Besides, thyroid disease is one of the common endocrine disorders spreading at high frequency worldwide. The present work is an ethnopharmacological study aiming to identify, document and analyze aromatic and medicinal plants used in Algerian traditional medicines for thyroid disorders management. Semi-structured interviews with 120 herbalists and traditional practitioners and rural dwellers were realized in eleven locations in Algeria throughout field studies achieved from June 2017 to July 2019. Results reveal the use of 63 medicinal plants belonging to 59 genera and 34 families. The most represented botanical families were Lamiaceae, Fabaceae, Apiaceae, Amaranthaceae and Asteraceae. However, the most cited plant species were Atriplex halimus L., Bunium incrassatum (Boiss.) Amo, Nigella sativa L., Aquilaria malaccensis Lam. and Saussurea costus (Falc.) Lipsch. These species are taken alone or in mixtures of two or more ingredients from different origins such as honey, olive oil, and goat milk. Our findings revealed new therapeutic uses of 60 medicinal plants that have not been previously reported for the treatment of thyroid in Algeria. This is the first study documenting the traditional uses based on herbal medicine for thyroid management in Algeria. Our findings are relevant in the search for novel drug discovery. Obviously, it is the time to increase effective scientific studies on mechanisms of action of these medicinal plants in order to validate their popular usages.     

Traditional medicines and their common uses in central region of Syria: Hama and Homs – an ethnomedicinal survey

ContextSince ancient times, traditional Arabic medicine (TAM) has been used to treat various diseases in Syria. They are cost-effective with fewer side effects and are more suitable for long-term use compared with chemically synthesized medicines. In addition, the scientific importance is manifested, as this survey proceeds, for the purposes of verifying and documenting these traditional medicines and their common uses.ObjectiveWe conducted ethnobotanical and ethnomedicine research on plants traditionally used to treat various diseases in central region of Syria.MethodsInformation was collected from 2019 to 2021 from the cities of Homs and Hama and their villages, which are two governorates located in central Syria, after interviews with traditional practitioners called Attarin, and many other people. Plant specimens were collected according to different references concerning medicinal plants of Syria, to document the traditional uses of plants at least two of the traditional healers and three other people were asked.ResultsIn this survey, we listed 76 medicinal plants belonging to 39 families in alphabetical order with the parts used and the method of preparation according to their therapeutic use, which are used to treat 106 ailments.ConclusionsMany of the uses of medicinal plants mentioned in this survey are still under study. There is no doubt that this study will provide new data that could contribute to further pharmacological discoveries by identifying the active ingredients and their mechanism of effect by doing additional pharmacological work to confirm the alleged biological activities of these plants.     

Risks and benefits of commonly used herbal medicines in Mexico

In Mexico, local empirical knowledge about medicinal properties of plants is the basis for their use as home remedies. It is generally accepted by many people in Mexico and elsewhere in the world that beneficial medicinal effects can be obtained by ingesting plant products. In this review, we focus on the potential pharmacologic bases for herbal plant efficacy, but we also raise concerns about the safety of these agents, which have not been fully assessed. Although numerous randomized clinical trials of herbal medicines have been published and systematic reviews and meta-analyses of these studies are available, generalizations about the efficacy and safety of herbal medicines are clearly not possible. Recent publications have also highlighted the unintended consequences of herbal product use, including morbidity and mortality. It has been found that many phytochemicals have pharmacokinetic or pharmacodynamic interactions with drugs. The present review is limited to some herbal medicines that are native or cultivated in Mexico and that have significant use. We discuss the cultural uses, phytochemistry, pharmacological, and toxicological properties of the following plant species: nopal (Opuntia ficus), peppermint (Mentha piperita), chaparral (Larrea divaricata), dandlion (Taraxacum officinale), mullein (Verbascum densiflorum), chamomile (Matricaria recutita), nettle or stinging nettle (Urtica dioica), passionflower (Passiflora incarnata), linden flower (Tilia europea), and aloe (Aloe vera). We conclude that our knowledge of the therapeutic benefits and risks of some herbal medicines used in Mexico is still limited and efforts to elucidate them should be intensified.     

Simultaneous determination of five anthraquinones in medicinal plants and pharmaceutical preparations by HPLC with fluorescence detection

A reversed-phase high-performance liquid chromatography (RP-HPLC) method with fluorescence detection for simultaneous determination of five anthraquinones in Rhubarb collected from nine different locations in China, Polygonum cuspidatum, Polygoni multiflori and three pharmaceutical preparations is proposed and validated. Chromatography was carried out at 25 °C on a Hypersil C18 column with the isocratic mobile phase of methanol–0.1% aqueous formic acid (85:15, v/v) at a flow rate of 1.0 ml/min. The excitation and emission wavelengths were set at 440 and 540 nm, respectively. A comprehensive validation of the method included tests of sensitivity, linearity, precision and accuracy. The linear regressions were acquired with r > 0.999. Satisfactory intra- and inter-day precisions were achieved with R.S.D.s less than 3.95% and the average recovery factors obtained were in the range of 93.2–103.8%.     

Ethno medicinal survey of plants used by the indigenes of Rivers State of Nigeria

Context: The medicinal plants used in the traditional medicine of Rivers State of Nigeria were surveyed.

Objective: The survey aims to identify and document the plants used amongst the indigenes of Rivers State.

Materials and methods: Semi-structured interviews were conducted during a field trip to gather information from traditional medical practitioners (TMPs) and community elders.

Results: Medicinal plant species (188) representing 169 genera and 82 families used in the ethno medicine of the people of Rivers State were recorded from 460 households. The most represented genera were Ipomoea and Citrus providing four species each. The most important species showed the highest Fidelity level (FL) value and these included Ageratum conyzoides L. (Asteraceae) (100%) and Tridax procumbens L. (Asteraceae) (100%). The most important categories of diseases were those that showed the highest Informant consensus factor (ICF) value of 0.99, such as dermal or digestive problems and fever/malaria. The most used plant part was leaves (42%), while decoction was the main method of drug preparation (36%).

Discussion and conclusion: The survey shows that more than half of the medicinal plants gathered in Rivers State are also used in other countries of the world for various ailments. The high values of ICF recorded indicate high degree of agreement among the informants, while the high FL values suggest the popular use of the plants. The survey provides a useful source of information for TMPs and medicinal plant researchers. These medicinal plants gathered may bring about drug discovery and may also be incorporated into the healthcare delivery system of the country.     

中医药治疗高血压病临床研究

目的：观察自拟中药方穴位敷贴和涌泉穴按压治疗原发性高血压病的降压效果及安全性。方法：选择2014年1月—2015年1月中心门诊高血压患者150例,分为干预组、对照组Ⅰ和对照组Ⅱ,每组50例。三组在不改变原降压药的基础上,干预组同时增加自拟中药方穴位敷贴加涌泉穴按压,对照组Ⅰ仅增加自拟中药方穴位敷贴,对照组Ⅱ仅增加涌泉穴按压。观察三组降压效果、中医临床症候和安全性,观察时间为1年。结果：三组治疗后血压较治疗前均有所改善,患者临床症状也都有不同程度减轻,干预组较对照组疗效更加显著。结论：自拟中药方穴位敷贴和涌泉穴按压治疗高血压病都具有确切的疗效,且二者联合应用效果更显著。以上三组在治疗过程中均未发生不良反应,安全性好。     

Survey of the use of complementary and alternative medicine among Korean diabetes mellitus patients

PURPOSE: This study was designed to measure the prevalence of complementary and alternative medicine (CAM) use among Korean diabetes mellitus (DM) patients. METHODS: A 23-question survey on DM was used and included questions on demographic information (7), clinical information (7) and the utilisation of CAM (9). RESULTS: Of 223 respondents, 145 (65%) had taken CAM products, while 78 (35%) had not. At the suggestion of family members and relatives, 43.5% of the respondents started taking CAM products. A total of 57.9% of the users felt that it was effective, 30.3% considered that it regulated the blood glucose level and 27.6% felt it was effective in achieving psychological relaxation. Of 93 CAM materials used by respondents, 63.7% were various types of plants, 21.6% were animal material and 14.7% were a mixture of both. The majority of DM patients (81.2%) were trying a new type of CAM, and one third of all patients were trying to start using a new type of CAM after consulting with their physicians. CONCLUSIONS: Doctors should recognise that complementary medicines are widely used by diabetic patients and should appreciate that these medicines can cause adverse effects. Doctors should therefore be prepared to question patients to determine what non-conventional medicines they are using.     

心血管疾病治疗中的中药注射剂处方点评与案例分析

目的：对心血管疾病治疗方案中的不合理中药注射剂处方进行点评与分析,为临床合理用药提供参考。方法：根据药品说明书和《中药注射剂临床使用基本原则》的要求,对5例典型的中药注射剂处方进行点评与解析。结果：在治疗心血管疾病过程中,中药注射剂不合理使用的问题主要集中在配伍禁忌、溶媒不适宜和适应证不适宜等方面。结论：药师应加强对中药注射剂的审核点评,同时采取积极有效的干预措施,以促使中药注射剂在治疗心血管疾病方面的应用更加安全、合理、有效。     

缬沙坦联合硝苯地平治疗高血压合并糖尿病的临床研究

目的观察缬沙坦联合硝苯地平治疗高血压合并糖尿病的临床治疗效果。方法选择2013年1月~2015年1月收治的84例高血压合并糖尿病患者作为研究对象,随机分为对照组和治疗组,每组各42例。两组患者治疗前7d停服所有对血压有影响的药物,均积极控制血糖,对照组予缬沙坦80mg/d,若2周后血压未下降者,缬沙坦增至160mg/d。观察组加用硝苯地平缓释片5mg/d,2次/d。疗程3个月。比较两组患者治疗后的临床疗效,两组患者治疗前后SBP、DBP水平。结果对照组治疗后的总有效率为76.2%,治疗组治疗后的总有效率为95.2%,两组疗效组间比较差异显著(P<0.05)。治疗组治疗后SBP、DBP分别显著低于对照组(t=2.349,2.581,P<0.05)。治疗组治疗后空腹血糖、餐后2h血糖分别显著低于对照组(t=2.723;2.782,P<0.05)。结论缬沙坦联合硝苯地平治疗高血压合并糖尿病临床效果确切,显著降低血压及血糖水平,值得临床推广和应用。     

Polypharmacy and combination therapy in the management of hypertension in elderly patients with co-morbid diabetes mellitus

The demographic shift towards an older population increases the public health burden. Two conditions, commonly occurring together, that contribute to this burden are hypertension and diabetes mellitus. Effective blood pressure (BP) control is particularly important in this patient population, with a recommended BP goal of <130/80?mmHg. Most of these patients will require treatment with a combination of antihypertensive agents to reach this goal. Polypharmacy can be defined as the use of two or more medications, and it is commonly seen in this patient population. The risks of polypharmacy and the potential for inappropriate therapy must be considered and balanced against the possible benefits of multiple drug therapies. An optimal approach to reducing the risks and maximizing the benefits of polypharmacy should include regular reviews of patients' medication lists, which can be changed to include, where appropriate, combination therapy and the use of single-pill combinations. Combination therapy can achieve greater BP reductions than monotherapy and can also enhance the safety and tolerability of pharmacotherapy. The safety and efficacy of numerous antihypertensive combinations in elderly patients have been demonstrated in a number of clinical trials. Single-pill formulations can simplify the medication regimen, and specific combinations can offer further benefits, such as enhanced reduction of macrovascular and microvascular complications, independent of BP reductions. Rational combination therapy can maximize BP control along with glycaemic control and help maximize the benefits of polypharmacy on outcomes in elderly patients with hypertension and co-morbid diabetes.     

A qualitative assessment of diabetes care access and disease management in Central America

BackgroundDiabetes is a growing concern in low-and middle-income countries. Medical missions play a role in increasing access to care and medicines, but often ignore non-communicable disease prevention and advanced management. Increased knowledge of local community needs and resources can lead to the development and implementation of pharmacist-supported interventions to improve diabetes management in rural areas.ObjectivesThe purpose of this study was to 1) understand the availability of monitoring for diabetes locally; and 2) describe knowledge and health beliefs regarding diabetes management for those with diabetes, and prevention among those at high risk of developing diabetes.MethodsThis qualitative evaluation used semi-structured interviews with key informants in a community in rural Honduras. Participants included those with diabetes, those at-risk for developing diabetes, and community leaders. Data was analyzed using thematic content analysis through an iterative process of coding and theme development.ResultsA total of 35 interviews were conducted with five resulting themes: 1) participants identified multiple barriers to diabetes management including access to monitoring, access to certain medications, and access to advanced levels of care; 2) participants acknowledge the relationship between lifestyle choices and diabetes control, but struggled with adherence to a healthy lifestyle; 3) participants identify that they have limited knowledge of diabetes pathophysiology, diabetes management, and strategies to prevent diabetes; 4) participants felt that opportunities existed within the community to support diabetes education and prevention, and 5) providers should integrate culture, societal norms, and religion in diabetes management.ConclusionThis research identifies challenges and resulting opportunities for managing diabetes in rural Honduras. Health care providers including pharmacy personnel should consider strategies to engage communities around self-care and diabetes education. Further, strategies are needed to enhance access to resources and essential medicines for diabetes management. These themes can guide clinicians in supporting communities to enhance diabetes care.     

中药及其制剂在中毒性疾病治疗中的应用进展

中毒性疾病是威胁人类健康的一类特殊疾病,由于社会的快速发展,生存环境的恶化,人类接触的有毒物质日益增多,发生中毒的概率与日俱增,所以中毒性疾病已是当前急诊医学、危重病医学、职业病学、毒理学、环境医学等共同研究的重要课题.近年来,随着急诊医学和危重病医学的迅速发展,中毒性疾病的救治水平有了很大的提高,其中我国传统中药及其制剂在救治中毒性疾病中发挥了重要的作用.     

Ethnopharmacological study of natural products used for traditional cancer therapy in Algeria

Traditional and complementary medicine constitutes an important, and often underestimated, source of healthcare for multiple diseases including cancer. However, little is known about the ethnomedical knowledge and practices in Northern Africa. The main objective of this study is to identify and analyze the variety of natural products used in Algerian ethnopharmacology for cancer therapy. For this purpose, semi-structured interviews with 225 traditional healers, herbalists and practitioners were realized in twelve locations in Algeria throughout field studies performed from June 2015 to July 2019. Interviews covered popular and vernacular names of the natural product, mode of use and administration, dose, period of treatment, toxicity and side effects among other data. The obtained results reveal the use of 113 medicinal plants (belonging to 53 families and 104 genera), 10 animal species and various products and by-products from different origins such as honey, olive oil, thorns, urine, milk, animal fat and the alkaline water of Zamzam. Basing on the frequency of citation (FC), use reports (UR) and use value (UV), the most used natural products for cancer treatment are honey (FC = 181, UR = 194, UV = 0.65), Nigella sativa L. (FC = 131, UR = 152, UV = 0.54), Aristolochia longa L. (FC = 118, UR = 144, UV = 0.51), Berberis vulgaris L. (FC = 111, UR = 142, UV = 0.51), Curcuma longa L. (FC = 107, UR = 121, UV = 0.43), Trigonella foenum-graecum L. (FC = 102; UR = 119, UV = 0.43), Citrus limon (L.) Obseck (FC = 97, UR = 120, UV = 0.43), Artemisia herba-alba Asso (FC = 92, UR = 115, UV = 0.41) and the holy water ‘Zamzam’ (FC = 110, UR = 110, UV = 0.43) respectively. Mixtures of two or more ingredients were frequently used. The use of Pelophylax saharicus skin’ was reported for the first time for the treatment of visible tumors and skin cancer. This is the first study documenting the traditional uses of various natural products for cancer treatment in Algeria. Our findings are relevant to document the traditional uses of numerous natural products and to provide background basis to search for novel compounds for cancer therapy.