Herbal Medicine Drugs Research Articles

Clinical management of children with tic disorder: insights from therapeutic visits in China-a real-world study.

This retrospective study aims to investigate the treatment of tic disorder (TD) in Dongfang Hospital affiliated with Beijing University of Chinese Medicine, explore its underlying mechanism, and provide valuable insights for future research and clinical management of TD. The electronic medical records of children with TD, from 2015 to 2021, were extracted from the information system of Dongfang Hospital affiliated with Beijing University of Chinese Medicine. The clinical characteristics of TD, utilization patterns of Chinese herbal medicine and synthetic drugs in prescriptions, as well as their pharmacological effects, were statistically described and categorized. In addition, association rules and network pharmacology were employed to identify core prescriptions (CPs) and elucidate their microscopic molecular mechanisms in treating TD. The age range of the children was from 6 to 11 years, with a higher proportion of male participants than female ones. The average duration of treatment was 6 weeks. Regimen Z for the treatment of TD can be summarized as follows: Chinese herbal medicine [Saposhnikoviae Radix (FangFeng), Puerariae Lobatae Radix (GeGen), Uncariae Ramulus cum Uncis (GouTeng), Acori Tatarinowii Rhizoma (ShiChangPu), Chuanxiong Rhizoma (ChuanXiong)] and vitamins [lysine, inosite, and vitamin B12 oral solution] form the basic treatment, combined with immunomodulators, antibiotics, electrolyte-balancing agents, and antiallergic agents. CPs primarily exerted their effects through the modulation of gene expression (transcription), the immune system, and signal transduction pathways, with interleukin-4 and interleukin-13 pathways being particularly crucial. Among the lysine synthetic drugs used, inosite and vitamin B12 oral solution were the most frequently prescribed. The regimen Z drug treatment holds significant importance in the field, as it exerts its therapeutic effects through a multitude of pathways and intricate interventions. Chinese herbal medicine primarily regulates immune system-related pathways, while synthetic drugs predominantly consist of vitamins.

A review on pharmacological studies of natural flavanone: pinobanksin.

Herbal medicinal drugs, or phytotherapy, have historically played a pivotal role in treating human ailments. In the contemporary medical landscape, there is a burgeoning interest in natural products owing to their diverse and health-beneficial components. Among these, bioactive phytochemicals represent a dynamic area of global research. This study focuses on pinobanksin, a potential polyphenolic component identified through meticulous scientific research and purified using advanced chromatographic techniques from various sources, including plants, propolis, and honey. Pinobanksin has emerged as a compelling subject of investigation, exhibiting a spectrum of pharmacological effects. Scientific studies have unveiled its prowess as an anti-oxidant, anti-bacterial, anti-inflammatory, anti-parasitic, anti-mutagenic, anti-proliferative, and anti-angiogenic agent. This literature review systematically synthesizes the existing body of research on pinobanksin, providing a comprehensive overview of its diverse pharmacological activities. In light of its multifaceted pharmacological profile, pinobanksin stands out as a promising scaffold for future drug discovery endeavors. This review not only consolidates the current understanding of pinobanksin's bioactivities but also underscores its potential as a valuable candidate for advancing therapeutic interventions.

A multi-center cross-sectional study of Chinese Herbal Medicine-Drug adverse reactions using active surveillance in Singapore’s Traditional Chinese Medicine clinics

BackgroundThis study aimed to investigate the rates and causality of patient-reported adverse events (AEs) associated with concomitant Chinese Herbal Medicine (CHM) and Western Medicine prescription drug (WMPD) consumption through active surveillance in Singapore’s Traditional Chinese Medicine (TCM) clinics.MethodsA cross-sectional study was conducted at five TCM clinics across Singapore from 8th May till 8th July 2023. Patients were screened to determine rates of CHM and WMPD consumption, and then interviewed if an AE was reported. An expert committee assessed the AE reports to determine causality. Along with descriptive statistics, odds ratios were calculated to determine AE occurrence likelihoods for patients who consumed both CHM and WMPD compared to CHM consumption alone.Results1028 patients were screened and 62.65% of them reported concurrent CHM-WMPD consumption. Patients who consumed CHM and WMPD were 3.65 times more likely to experience an AE as compared to CHM consumption alone. 18 AE reports were adjudicated, with most AEs deemed unlikely due to CHM consumption.ConclusionsA large proportion of patients consumed CHM and WMPD concurrently, thus increasing their risk of experiencing AEs compared to those consuming CHM only. Active surveillance is applicable for detecting AEs, collecting data for causality assessment, and analysis.

The Potential of Phytotherapy In Managing Dyspepsia: A Narrative Review

Dyspepsia, commonly known as indigestion, is delineated as suffering the manifestations of epigastric pain, nausea, burning, or after-meal fullness. The common therapy for dyspepsia, e.g., proton pump inhibitors or histamine-H2 receptor antagonists, has shown some adverse effects, thus, phytotherapy is currently becoming the drug of interest. Phytotherapy, additionally known as herbal medicine or botanical medicinal drug, includes the use of plant-derived compounds to prevent, alleviate, or therapy for diverse ailments. Most medications commonly used in Chinese traditional medicine or Asian folklore drugs contain mixtures of several plant extracts. Twelve clinical trials reported the effect and safety of phytotherapy on gastrointestinal disorders. Taken together, phytotherapy may be considered safe for the management of dyspepsia with close monitoring of the dose and duration of therapy.

Integrating in Silico and In Vitro Studies to Screen Anti-Staphylococcus aureus Activity From Vietnamese Ganoderma multiplicatum and Ganoderma sinense

Background: Staphylococcus aureus is a nosocomial pathogen responsible for many serious infectious diseases in humans. Finding the anti- S. aureus agents is a time-consuming and costly process. Recently, computational methods have provided a better understanding of the interactions between herbal medicine drug targets to help clinical practitioners rationally design herbal formulae. Methods: In this study, molecular docking simulation was applied to screen a list of natural secondary metabolites from Ganoderma sp. on the protein target S. aureus sortase A. Molecular dynamics models were used to assess the stability of protein–ligand complexes during the first 100 ns. To validate the computational results, 2 Ganoderma species, G. multiplicatum VNKKK1901 and G. sinense VNKKK1902, were tested for antibacterial activity against S. aureus using the disk diffusion method. Results: The results showed that, among the selected compounds, ganosinensin B and ganosinoside A generated the highest binding energy on S. aureus sortase A, and demonstrated strong and stable binding capacity to proteins. In addition, the extracts of G. sinense VNKKK1902 and G. multiplicatum VNKKK1901 were bactericidal, with minimum bactericidal concentration (MBC)/minimum inhibitory concentration (MIC) ratios of 2. Conclusion: Our findings provide the first scientific report on the antibacterial activity of Ganoderma sp., which contain 2 promising compounds, ganosinensin B and ganosinoside A, as potential hits for developing novel drugs capable of supporting treatment of S. aureus infection.

African care for congenital central nervous system disorders: Falling far short of global management standards?

African care for congenital central nervous system disorders: Falling far short of global management standards?

Standardization, evaluation and quantification of herbal drugs by various analytical methods

This review article encompasses the various evaluation parameters of standardization of different medicinal plants and its constituents. In today’s life, more and more people of the world are turning towards the use of natural or herbal products as these have very less or negligible side effects. As the use of herbal medicinal products is increasing day by day, the questions regarding their quality are also arising. This is due to lack of parameters for the standardization of these products. There is a need to set different parameters or methods that can help to standardize the herbal medicinal plant materials. Various methods like physical, chemical, biological is used for standardization and quality evaluation of herbal medicinal plants. These methods can act as a basic tool for the quality evaluation of herbal plant materials. Different parameters of standardization are the fundamental tool for evaluating and assuring the quality of the herbal plant material and its products. This review article includes the quantitative evaluation of more than 20 herbal drugs. The evaluation parameters such as TLC, HPLC, HPTLC, GC, LC-MS, UPLC, UHPLC, UPLC-MS, UHPLC-MS will help to maintain quality of different herbal medicinal drugs as well as its formulations. The set parameters can ultimately lead to the quality and efficacy of the herbal medicinal formulations. Analytical methods and standardization can ensure the quality and consistency of active ingredients in herbal medicinal formulations.

Integrative Management of Poorly Responsive Canine Spinal Pain and Paresis Using Acupuncture, Chinese Herbal Medicine and Conventional Drugs: A Case Series

This case series reports data on an integrative treatment (IVM) combining a Chinese herbal medicine (modified Da Huo Luo Dan), acupuncture, and conventional anti-inflammatory pharmaceuticals (CT) in relieving pain and restoring mobility in dogs with neck or back pain and paresis. A total of 11 dogs with acute neck or back pain (<30 days) unresponsive to CT therapy were evaluated for pain reduction and neurological improvement associated with IVM treatment. Two pain scores, Colorado State University (CSUPS) and Glasgow Composite (GCPS) along with a neurologic deficit score (NDGS), were assessed on Days 0, 7, 14, 21, and 28. The CSUPS (Mean±SD) on Day 0 was 3.27±0.61, which reduced to 1.59±1.07, 1.00±0.87, 0.80±0.75, and 0.50±0.67 on Days 7, 14, 21, 28, respectively, with all assessments statistically significant (p<0.01). For GCPS, Day 0 pain scores were 14.9±4.04, reduced to 9.09±5.19, 6.45±5.24, 4.90±5.02, and 3.50±4.09 on Days 7, 14, 21, 28, respectively (all statistically significant, p<0.01). The Day 0 NDGS was 1.86±0.78 which reduced to 1.46±0.82, 1.23±0.90, 0.97±0.94, and 1.03±1.00 on Day 7, 14, 21 and 28, respectively (all statistically significant with p<0.05). The IVM cases were compared to 15 concurrent CT cases (smaller, younger dogs with uncomplicated disease) and demonstrated more rapid pain relief and similar neurological improvement. The statistically significant clinical improvements observed for IVM cases suggest that integrating Chinese herbal medicine and acupuncture with CT can be effective in providing rapid pain relief and improved mobility in dogs that have failed to respond adequately to conventional therapy (NSAID/corticosteroid) only.

Integrative Management of Poorly Responsive Canine Spinal Pain and Paresis Using Acupuncture, Chinese Herbal Medicine and Conventional Drugs: A Case Series

This case series reports data on an integrative treatment (IVM) combining a Chinese herbal medicine (modified Da Huo Luo Dan), acupuncture, and conventional anti-inflammatory pharmaceuticals (CT) in relieving pain and restoring mobility in dogs with neck or back pain and paresis. A total of 11 dogs with acute neck or back pain (<30 days) unresponsive to CT therapy were evaluated for pain reduction and neurological improvement associated with IVM treatment. Two pain scores, Colorado State University (CSUPS) and Glasgow Composite (GCPS) along with a neurologic deficit score (NDGS), were assessed on Days 0, 7, 14, 21, and 28. The CSUPS (Mean±SD) on Day 0 was 3.27±0.61, which reduced to 1.59±1.07, 1.00±0.87, 0.80±0.75, and 0.50±0.67 on Days 7, 14, 21, 28, respectively, with all assessments statistically significant (p<0.01). For GCPS, Day 0 pain scores were 14.9±4.04, reduced to 9.09±5.19, 6.45±5.24, 4.90±5.02, and 3.50±4.09 on Days 7, 14, 21, 28, respectively (all statistically significant, p<0.01). The Day 0 NDGS was 1.86±0.78 which reduced to 1.46±0.82, 1.23±0.90, 0.97±0.94, and 1.03±1.00 on Day 7, 14, 21 and 28, respectively (all statistically significant with p<0.05). The IVM cases were compared to 15 concurrent CT cases (smaller, younger dogs with uncomplicated disease) and demonstrated more rapid pain relief and similar neurological improvement. The statistically significant clinical improvements observed for IVM cases suggest that integrating Chinese herbal medicine and acupuncture with CT can be effective in providing rapid pain relief and improved mobility in dogs that have failed to respond adequately to conventional therapy (NSAID/corticosteroid) only.

Application of differential scanning calorimetry to study the interpretation on herbal medicinal drugs: a review

Application of differential scanning calorimetry to study the interpretation on herbal medicinal drugs: a review

Phytochemical and Pharmacological Evaluation along with Antimicrobial Properties of Gynura Procumbens Leaves Extract

The accentuated growth inside the use of Gynura procumbens go away as suitable for eating leave and herbal medicinal drug to deal with sicknesses makes its miles essential to evaluate facts available on its antibacterial, antifungal, phytochemical screening and antioxidant activities. G. procumbens leaves methanol and ethyl acetate crude extract was prepared via the cold extraction approach. The methanolic G. procumbens extract became used to phytochemical assessments for plant secondary metabolites; carbohydrates, alkaloids, phenolic compounds, flavonoids, tannins, glycosides, steroids, proteins, acidic compounds and saponins using preferred processes techniques. Antibacterial activities of G. procumbens extracts was investigated by using agar well diffusion method and antifungal activities by using the disc-diffusion method. G. procumbens extracts antioxidant activity was assessed via DPPH assay to measure its free radical scavenging capability. Phytochemical screening revealed that presence of carbohydrate, alkaloids, flavonoids, glycosides, phenolic compounds and tannins but saponins, proteins, acidic compounds and steroids were not found. Antimicrobial investigation showed that only ethyl acetate extracts have the mild sensitivity to almost all the bacteria and fungi (except Escherichia coli), whereas methanol extracts did not demonstrate any antimicrobial property. The average zones of inhibition produced by ethyl acetate extracts were found to be 6-7 mm at a concentration of 400μg/disc. Antioxidant study showed that IC50 of ethyl acetate extract of G. procumbens leaves was 322.244 μg/ml whereas the IC50 of standard ascorbic acid was 41.683 μg/ml. From the present experiment it could be concluded that G. Procumbens is the source of alkaloids, flavonoids, tannins and it’s has also antimicrobial, antioxidant properties. These findings imply that G. Procumbens leaves extracts is a good medicinal supply or herbal properties that may have high therapeutic value.

Efficacy and Safety of Acupuncture Combined with Herbal Medicine in Treating Gouty Arthritis: Meta-Analysis of Randomized Controlled Trials

Background Gouty arthritis is a common metabolic disease caused by long-term purine metabolism and elevated serum uric acid. In recent years, the incidence of gouty arthritis has been increasing year by year. As an effective method for treating gouty arthritis, acupuncture combined with herbal medicine has been widely used in clinical practice. However, the evidence for the treatment needs to be evaluated through systematic review and meta-analysis. Methods. The Cochrane Library, PubMed, Web of Science, EMBASE, China CBM database, Clinical Trials, CNKI, China Wanfang database, and VIP information database were searched from the establishment of each database to March 2021. Randomized controlled trials (RCTs) were included in the study, and the therapeutic effects of acupuncture combined with herbal medicine versus conventional therapy, or acupuncture combined with herbal medicine versus anti-inflammatory drugs, or acupuncture combined with herbal medicine versus acupuncture/herbal medicine alone were compared in the subjects with gouty arthritis. Two authors screened all references, assessed the risk of bias, and independently extracted the data. The binary outcome was summarized using 95% confidence intervals (CIs) and risk ratios (RRs). The overall quality of the evidence was assessed with hierarchy, and meta-analysis was performed with a random-effects model. Results A total of 14 randomized controlled trials (1,065 participants, 540 treatment groups, and 525 control groups) with treatment courses of 5 to 21 days were included. Acupuncture combined with herbal medicine and acupuncture was compared in three trials, acupuncture combined with herbal medicine and conventional therapy was compared in 14 of them, and acupuncture combined with herbal medicine and anti-inflammatory drugs was compared in 8 of them. The clinical efficacy (clinical symptoms, serological tests, and visual analogue scale (VAS) results) was significantly improved in the acupuncture combined with herbal medicine treatment group (P=0.0005, 95% CI 0.03 to 0.13; 687 participants; 8 trials), and the efficacy in reducing uric acid was also better (P < 0.00001; 95% CI −102.89, −68.37; 100 participants; 2 trials; evidence with moderate quality). The effect of acupuncture combined with herbal medicine was better than that of acupuncture alone (RR 1.22, 95%CI 1.06 to 1.41; 139 participants; 3 trials), the effect of acupuncture combined with herbal medicine was better than that of herbal medicine alone (RR 1.31 95%CI 1.08 to 1.57, 100 participants, 2 trials, evidence with moderate quality), and the effect of acupuncture combined with herbal medicine was better than that of colchicine (P = 0.02, RR 1.14 95%CI 1.02 to 1.27, 2 trials, evidence with moderate quality). The incidence of adverse events was considerably different between the two groups, and the acupuncture combined with herbal medicine group was significantly superior to the control group in terms of adverse events (P < 0.00001; 95% CI (0.08 to 0.32)). Conclusions The efficacy of acupuncture combined with herbal medicine was better than conventional drug therapy in treating gouty arthritis. The study results must be interpreted with caution due to the high or unclear risk of bias of the trials included in the study. PROSPERO registration number: CRD42020202544. INPLASY registration number: 202090006.

Development of a nursing assessment form for patients with diabetes mellitus in a hospital: A research and development study.

People with Diabetes Mellitus (DM) tend to seek herbal medicine or complementary drugs in their treatments. But, unfortunately, the existing nursing assessment forms have not prepared the format for the use of complementary medicine. This study aimed to develop a nursing assessment form in patients with DM based on the Chronic Care Model (CCM) approach. This study employed a Research and Development study design, which consists of ten stages. The nursing assessment form was developed based on CCM theory and integrated complementary medicines into the assessment form. A content validity test was done by four experts and calculated using Aiken's V formula. Face validity among 12 nurses through Focus Group Discussions (FGDs) was also employed to test the quality of the nursing assessment form based on three aspects: functionality, efficiency, and usability. In addition, nine nurses were included for pilot testing of the form. Data were analyzed using descriptive analysis. The nursing assessment form demonstrated a good content validity, with Aiken's V value of 0.94. The form was categorized based on four components of CCM: self-management support, decision support, social activities, and clinical information. Additionally, all nurses could fill the form properly. The nursing assessment form is valid. It can be used for nurses to assess patients with DM based on the CCM with an additional component to evaluate the use of complementary medicine.

Analysis of Metformin and Five Gliptins in Counterfeit Herbal Products: Designs of Experiment Screening and Optimization.

Drug counterfeiting is a rising problem due to difficulties with identifying counterfeit drugs and the lack of regulations and legislation in developing countries. This study aims to develop a robust and economic reversed phase high performance liquid chromatography (LC) method for simultaneously determining metformin HCl, vildagliptin, saxagliptin, alogliptin benzoate, sitagliptin phosphate monohydrate, and linagliptin to target counterfeiting. Plackett-Burman (PB) and Box-Behnken (BB) designs were used to screen and optimize the mobile phase composition. Chromatographic separation was carried out on an Inertsil® ODS-3 C18 column with isocratic elution mode and the mobile phase was a mixture of acetonitrile-methanol-ammonium formate buffer, pH 3.5 (25:10:65, v/v/v). This method was applied to analyze synthetic drugs in three traditional Chinese and Indian herbal medicines. To identify the adulterants, thin-layer chromatography (TLC), nuclear magnetic resonance (NMR), and mass spectrometry (MS) were used on counterfeit herbal medicines. The developed method is sensitive, simple, rapid, economical, accurate, and highly robust. Student's t-test and variance ratio (F-test at P < 0.05) were used to compare the results statistically with the reference methods. The study found that the analyzed herbal medicines were adulterated with metformin and the quantification of anti-diabetic counterfeits was therefore applied. This study determined counterfeited anti-diabetic drugs in Indian and Chinese traditional herbal medicines(THMs). Design-of-experiment, PB, and BB designs were used. Method validation was also performed in accordance with the International Conference on Harmonization guidelines.

The use of herbal medicines and conventional drugs by individuals with cerebral palsy and the risk of interactions

IntroductionThe use of herbal medicine has been increasing in many parts of the world, despite safety issues. Cerebral palsy (CP) is traditionally considered a group of disorders, which include cognitive, communicative and epilepsy symptoms. Individuals with CP use conventional drugs in addition to herbal medicines, with the expectation of alleviating side effects. However, improper use of herbs may lead to treatment failure or pharmacokinetic interactions. This research investigated herbal medicines and conventional drugs; used by individuals with CP. In addition, individual assessments for each participant of this study was used to gather information in order to improve quality of life. MethodsThis is a descriptive and qualitative study, in which twelve individuals with CP completed a questionnaire about their use of herbal medicine and conventional drugs. ResultsIndividuals with CP reported ten herbal medicines and twelve conventional drugs; pharmacokinetic interactions were described in detail. ConclusionFortunately, none of the participants reported clinical evidence related to the interaction, but it is not possible to conclude that the risks, in general, are over-estimated. Therefore, we recommend the implementation of a public education campaign with herb-drug interactions, involving health professionals and patients, in order to avoid future problems.

Efficacy of traditional herbal medicine for psychological sequelae in COVID-19 survivors: A protocol for systematic review and meta-analysis.

Introduction:This study is the protocol for a systematic review to evaluate the efficacy of herbal medicine on COVID-19 survivors with psychological sequelae. Currently, there are many COVID-19 survivors with psychological sequelae as COVID-19 has widely spread all over the world. However, there is no critically appraised evidence of the benefit of herbal medicine for COVID-19 survivors with psychological sequelae.Materials and Methods:We will search 11 electronic databases from inception to December, 2022: 4 English databases, MEDLINE, PubMed, Excerpta Medica database (EMBASE), and the Cochrane Central Register of Controlled Trials (CENTRAL); 3 Chinese databases, the Chinese National Knowledge Infrastructure, the Chinese Scientific Journal database, and the Wan Fang database; and 4 Korean databases, the Oriental Medical Advanced Searching Integrated System, the Korean Studies Information Service System, the National Digital Science Links, and the Research Information Sharing Service. We will include randomized controlled trials (RCTs), non-RCTs, and quasi-RCTs for all formations of TRADITIONAL herbal medicine versus conventional drug, placebo, and no treatment for COVID-19 survivors. We will only include the COVID-19 survivors with psychiatric symptoms lasting at least 1 month, regardless of their race, sex, and age.Discussion and conclusions:This systematic review will be published in a peer-reviewed journal. The findings will provide evidence and treatment directions for clinicians. This protocol does not need ethical approval because it will be based on published research.Prospero registration number:PROSPERO CRD42020210592

The Prevalence of Auto-Medication among Pregnant Women in a Conflict Affected, North West Region, Cameroon

Background: The excessive use of medicines and generally self-medication is considered as one of the major health and socio-economic problems in different countries. There is increasing evidence that self-medications among pregnant women are common in many developing countries. Despite the adverse impact on pregnancy, there are few programs available for their control. The Northwest region of Cameroon has been affected by socio-political crisis since 2016, which has slowed down economic activities and have grievous effects on the economy. It was therefore necessary to evaluate the prevalence of auto-medication amongst pregnant women. Aim: The aim of this study is to ascertain the knowledge, prevalence and practice of auto medication among pregnant women in Cameroon especially in the North West Region. Method: A community based cross-sectional study was conducted among 500 pregnant women, aged between 15 - 45 years in the Bamenda Health District between January to October 2019. A structured questionnaire based interview was used to collect data from each study subject. Then, data were categorized and analyzed using SPSS version 20 software. Results: The prevalence of auto-medication (allopathic and herbal medicines) in this study was 337 (67.4%) and was predominant during the first trimester 246 (72.86%) of pregnancy. 98 (29.09%) previous experience, 70 (20.77%) that they did not have money for consultation, 70 (20.77%) non-severity of ailments and 75 (22.25%) high cost of medication in hospital/pharmacy were the most common reason pregnant women auto medicate. 96 (28.48%) antiemetic, 72 (21.36%) analgesics and 58 (17.21%) antacids were the most frequent drugs used for auto-medication and the main symptoms for which pregnant women practice auto-medication were: 72 (21.36%) fever/headache, 63 (18.69%) constipation and 58 (17.21%) nausea/vomiting. 116 (34.42%) friends/family/neighbors were the main source of recommendation in auto medication. 96 (28.49%) of the self-medicating pregnant women, self-medicate with local herbs and 40 (41.66%) blood leaves (iron supplement) was the most used plant (herbs) in our study. Conclusion: We conclude that after 3 years of crisis in this region, the prevalence of auto-medication is increasing at a geometric rate and becoming a practical routine. Adequate counselling of reproductive age girls by healthcare professionals about the potential risks of self-medication with herbal medicine and allopathic drugs during pregnancy is strongly recommended.

Health policy versus kava (Piper methysticum): Anxiolytic efficacy may be instrumental in restoring the reputation of a major South Pacific crop

Ethnopharmacological relevanceKava (Piper methysticum G. Forst. f.) is by far the most important plant used in the islands of Melanesia, Polynesia and Micronesia for its relaxing effects. Kava drinking is a pillar of South Pacific societies and is also the foundation of their economies. Preparations of kava extract as herbal medicinal drugs were banned in Germany in 2002 and again in 2019, with dramatic consequences for the South Pacific economies. In 2002, the major regulatory argument for the ban of kava was safety issues. In 2019, the assessment report of the European Medicines Agency's Herbal Medicinal Product Committee (HMPC) justified a negative benefit-to-risk ratio by a supposed lack of efficacy of ethanolic extracts for an indication of which kava extract preparations never had an approval. In this HMPC report the efficacy in the approved indications ‘nervous anxiety, tension and restlessness’ was attributed to the extract branded as ‘WS 1490’, which was assumed to have been prepared with acetone as an extraction solvent. In addition to this change of indication and the attribution of efficacy to acetone kava extract alone, the German health authorities and the HMPC still refuse to discuss quality issues as a likely factor impacting drug safety. The first case reports of liver toxicity were observed with an acetone extract in a timely relationship with the introduction of ‘two-day kava’ instead of ‘noble kava’ as used in ethanolic kava extracts. Aim of the studyThe correlation between clinical benefits and the type of extract preparation was examined. MethodsIn order to identify the types of kava material and extracts used in clinical trials, the respective publications were compared with regulatory databases and protocols of a German regulatory advisory board. Results and conclusionsThe comparison reveals inconsistencies in the regulatory decisions. In all studies with WS 1490, the evidence points to the use of an ethanolic extract. The efficacy of kava extract for the approved indication was clearly demonstrated. The HMPC report and the recent renewed German regulatory ban of kava therefore require major revision, which should include the impact of the use of “two-day kava” on drug safety. Such a revision could contribute to restoring the reputation of “noble kava” on the international markets.

Healing indigestion: a phytotherapeutic review

Any abnormality in digesting food or lack of proper digestion is termed as indigestion. It refers to variety of gastrointestinal complaints, ranging from gas (belching or flatulence) to stomach upset. Common indigestion signs and symptoms are fullness, early satiety, nausea, vomiting, belching, bloating, ulcer, diarrhoea, dyspepsia and some other associated temporary discomforts or long lasting disorders. Treatment options are many which include change in food, drinks, lifestyle, synthetic medication, etc. But amongst all, the one by complementary and alternative medicines (CAMs), especially the time-tested phytotherapeutic traditional herbal remedies is gaining significance and reliance. Herbal medicinal plants and drugs therefrom are arguably the oldest forms of healthcare recognized to humanity and have been used by all cultures throughout history. Plants contain phytochemicals having specific as well as holistic biological functions, which may have a significant role in the treatment and prevention of various digestive disorders. The present review will address the indigestion issue as a common and universal discomfort to human being around the globe and also the magical healing options by some medicinal plants and herbals. With the remarkable surge of and reliance to the so-called CAM, it is imperative that the present and future researchers be aware of both the potential risks as well as the benefits of using herbal medicine in their cutting-edge exercise in the days ahead.

Phytotherapy for diabetes mellitus; A review of Middle Eastern and North African folk medicinal plants

Diabetes mellitus (DM) is considered as one of the most common metabolic disorders affecting huge number of people worldwide. Despite the availability of large numbers of drugs in the market to treat the disease, there is still a need for new sources to deal with the problem and avoid side effects. In the pursuit of discovering safer and more effective anti-diabetic drugs, herbal and folk medicine drugs from regions all over the world have captured researchers’ interest. Middle Eastern and North African medicinal plants contain a variety of pharmacologically active components that have shown to possess promising anti-diabetic potential. However, few data have been reported about medicinal plants from these regions in comparison to plants from other regions. Anti-diabetic medicinal plants from the MENA (the Middle East and North Africa) region, their role in controlling DM, and suggested mechanisms for the anti-diabetic activity of some medicinal plants are discussed in this review. Many of these plants have not been fully investigated and characterized, yet they have great potential for further development as anti-diabetic drugs.