Herbal Pill Research Articles

Efficacy and safety of Sri Lankan traditional medicine regimen for knee osteoarthritis: study protocol for an open-label, active comparator, randomized controlled trial

BackgroundKnee osteoarthritis (KOA) is the most common form of arthritis, causing disability and impaired quality of life especially in the elderly. Sri Lankan traditional medicine (STM) is widely used to treat OA, but no clinical trial evaluated on STM regimens for KOA to discuss their safety and efficacy in the treatment. The aim of this study is to compare the efficacy and safety of STM regimen for KOA in comparison to recommended conventional pain management therapy over a period of 8 weeks on relieving the condition.Study designThis is a clinical trial following a protocol-driven open-labeled randomized controlled study enrolling patients with KOA that will be conducted as a single-center trial in the National Ayurveda Teaching Hospital, Sri Lanka. Rasnadvigunabhagasaya herbal decoction (RDBD) and an herbal pill Yoaraja Guggulu were selected as the rescue medication for treating joint disorders. The two Ayurvedic dosage forms will be tested against the non-steroidal anti-inflammatory drugs tab paracetamol and tab ibuprofen as the rescue medication for their safety and efficacy. As test products for external application, oil with an herbal fomentation—Kumburuetaperumkayam Pottani (KAP)—and paste—Sandivadam Lepaya (SVL)—were selected. External applications will be tested against the diclofenac sodium gel and hot water fomentation. KOA patients will be allocated randomly into two arms, and the medications will be given orally for 60 days and externally for 30 days. The primary endpoint is the change in the score on the WOMAC after 08 weeks. WOMAC and KOOS will be recorded and compared between the two arms prior to visiting 1, at the end of 15 days and end of 30 days, and end of the 45 days and end of the second month and 3 months of follow-up. KOOS and WOMAC subscales, a pain disability index, a visual analog scale for pain and sleep quality, and a quality-of-life index are used as secondary outcome measurements.DiscussionThis clinical trial will be able to provide evidence-based scientific data on Sri Lankan traditional medicine regimens in the management of KOA. This trial is expected to develop capacity to scientifically evaluate various STM that are claimed to have efficacy in treatment of various disease conditions.Trial registrationISRCTN58050062.

Optimization of the formulation for manufacturing of Bokbunja (Rubus coreanus Miquel)-black mulberry (Morus alba) herbal pill by D-optimal mixture design approach

Optimization of the formulation for manufacturing of Bokbunja (Rubus coreanus Miquel)-black mulberry (Morus alba) herbal pill by D-optimal mixture design approach

Herbal weight loss pill overdose: sibutramine hidden in pepper pill.

Supposedly herbal weight loss pills are sold online and are widely used in the world. Some of these products are found to contain sibutramine by FDA and their sale is prohibited. We report a case of a female patient who presented to the emergency department after taking slimming pills. 17-year-old female patient presented to the emergency room with palpitations, dizziness, anxiety, and insomnia. She stated that she had taken 3 pills named La Jiao Shou Shen for slimming purposes during the day. Her vital signs revealed tachycardia. On her physical examination, she was restless, her oropharynx was dry, her pupils were mydriatic, and no other pathological findings were found. Sibutramine intoxication was suspected. She was given 5 mg IV diazepam for restlessness. After supportive therapy and observation in emergency department for 12 hours there were no complications and the patient was discharged home. Some herbal pills that are sold online for weight loss have sibutramine hidden as an active ingredient, and their sale is prohibited for this reason. For people who use herbal weight loss drugs, sibutramine excessive intake should be kept in mind at all times.

Serum Pharmacological Effect of Chinese Herbal Pill Yi Shen Juan Bi (YJB) on Cultured Macrophages and Synoviocytes

The patent herbal compound drug, Yi Shen Juan Bi (YJB), has been found to be effective for the treatment of rheumatoid arthritis (RA), and our previous studies revealed that it has potent anti rheumatic effects [1, 2, 3]. We have conducted further investigations into the anti arthritic activity of YJB using macrophage and synoviocytes cells in an ex-vivo serum pharmacology assay. For that purpose, we used mouse serum containing YJB and analyzed the macrophage derived cytokine tumor necrosis factor alpha (TNF-á) and interleukin-1 (IL-1) using ELISA kits, nitric oxide (NO) by Griess reaction and the proliferation of rats synoviocytes stimulated by TNF-á by MTT reduction assay in vitro. In addition, we analyzed the cytotoxicity concentrations of YJB by MTT reduction assay. This study confirmed the anti-rheumatic effects of YJB correlated with a significant decrease of TNF-á, IL-1 and NO production by macrophages and also with significant decrease in the proliferation of synoviocytes in vitro. A subsequent cytotoxicity assay also revealed no significant difference in cell viability. Our results suggest that YJB is a potential anti-rheumatic agent targeting the inflammatory and immunomodulatory response of macrophages and synoviocyte cells.

Hyperglycemia in poor controlled diabetes from crude tamarind herbal pill: a case study

Hyperglycemia is an important finding in the diabetic patient with poor glycemic control. There are several possible causes of hyperglycemic. Here, the author presents an interesting case study on a female diabetic patient presenting with hyperglycemic due to intake of crude tamarind herbal pill. General practitioner should realize that the use of alternative medicine can be a cause of unexplained hyperglycemic episode in diabetic patient.

Ex vivo and in vivo effect of Chinese herbal pill Yi Shen Juan Bi (YJB) on experimental arthritis

Chinese herbal pill Yi Shen Juan Bi (YJB), which is a compound herbal drug, has traditionally been used as an anti-rheumatic drug in Chinese local clinics. Thus, we investigated the therapeutic effect of the YJB in rheumatoid arthritis (RA), using Freund's complete induced adjuvant arthritis (AA) in rat model. For that purpose, macrophage derived cytokine tumor necrosis factor alpha (TNF-α) and interleukin-1 (IL-1) were measured in ex vivo by enzyme linked immunosorbent assay (ELISA). We also assayed the effect of YJB on peritoneal macrophage derived nitric oxide (NO) in ex vivo by Griess reaction. Prostaglandin E (PGE) in metapedes was assayed by ultraviolet spectrophotometer method. Further synovial Bax level was examined by Western blot analysis. YJB significantly decreased the production of peritoneal macrophages derived TNF-α, IL-1 and NO. YJB also significantly decreased prostaglandin E (PGE) and upregulated the Bax expression in AA rat's synovium. YJB is a potential anti-rheumatic agent targeting the inflammatory and immunomodulatory response of macrophages while down regulating the PGE and up-regulating the pro-apoptotic Bax expression. Such characteristics of YJB on AA may be advantageous to the treatment of clinical rheumatoid arthritis.