Herbal Usage Research Articles

Utilization of herbs with abortifacient potentials to prevent Malaria in pregnant women in Southwestern Nigeria: A random survey

Background: Little is known about the potential harmful effects of the plants used by pregnant women for treatment of malaria. This study determined the level of awareness about the potential harmful effects of 3 antimalarial plants (with potential abortifacient properties) used during pregnancy in Abeokuta, Nigeria.Methods: Structured questionnaire was used to obtain relevant information form 120 participants (43 pregnant and 77 women of reproductive age) from 3 major markets and 2 traditional birth homes (TBHs) in Abeokuta between 2019 and 2020. Data obtained were analyzed using descriptive statistics. Relationship between herb usage and pregnancy outcome(s) was determined using chi-square with probability value of p<0.05.Results: A high proportion of the participants (71.7%) preferred to use herb for malaria treatment during pregnancy. About 13.3 %, 3.3 % and 4.2 % of the respondents claimed to have experienced abortion, still birth and low birth weight (LBW) respectively. Though, abortion was significantly (p<0.005) associated with use of antimalarial herbs among the women, none of them linked it to the use of herb. A good proportion of the respondents (43%) were aware that one of the plants used against malaria has the potential of inducing abortion. However, they still preferred to use it in presumably safe quantity.Conclusion: The use of herbs with abortifacient properties in management of malaria is common among the respondents. There is need to enlighten the public on possible harmful effect of these plants on both mother and the unborn child to improve their health.Keywords: Traditional Birth Homes; Herbs; Pregnant women; Malaria; Abortion

ბიოლოგიურად აქტიური ნაერთებით გამდიდრებული არომატიზებული ღვინოების წარმოების პერსპექტივები

Within the experiment, for preparation of the aromatized wines, enriched with biologically active compounds, were used the endemic medicinal plants and fruits. In the control and trial samples, by application of high performance liquid chromatography, were determined the content of total phenols, resveratrol, quercetin, myricetin and micronutrients. Compared to the corresponding control samples – sweet fortified wine, Saperavi and Hawthorn Red Aromatized Wine contents 21%, and Rkatsiteli, Kiwi and Elecampane White Aromatized Wine, 18.25% more total phenols. Based on conducted analyses, the trial samples contain twice more antioxidants, than they are typically identified in wines: Saperavi, Blackberry, Plum and Leonurus Red Aromatized Wine is characterized with the rich content of resveratrol, while, Rkatsiteli, buckthorn and balm with - quercetin and myricetin. These compounds are widely used in pharmaceutical industry. The enrichment of wines with these antioxidant is achieved by the usage of plants and herbs. Besides, the selected materials influenced on micronutrients, their content is also significantly increased. The obtained results confirm, that the selected materials and worked out recipes are effective for the production of beverages that have a positive effect on the human health.

Health assessment of medicinal herbs, celery and parsley related to cadmium soil pollution-potentially toxic elements (PTEs) accumulation, tolerance capacity and antioxidative response.

Celery and parsley are recognized as medicinal herbs and nutraceutical vegetables due to their valuable pharmacological properties and numerous health benefits. However, in recent years, soil loadings with various PTEs have become a serious concern across the world, leading to plants pollution, which can consequently diminish their quality and safety for humanconsumption. Therefore, we attempted to quantify quality and safety of celery and parsley grown in Cd polluted soil. We examined the presence of PTEs: As, Cu, Fe, Mn, Ni, Cu and Cd in soil and selected herbs, as well as their physiological responses to different Cd exposures (control-without Cd addition, 3 and 6µg/g Cd of dry soil). Following elevation of Cd in plants, both species showed increasing trend of As, Pb and Cu in plants, which overcome safe limits, with exception for Cu. Further, celery showed strong phytoextraction ability (99.9µg/g Cd of dry weight) with high potential to tolerate Cd due to the efficient antioxidative machinery. Besides that herbs pollution was evident on the basis of target hazard quotients (HQ), hazard index (HI) and cancerogenic risk (CR), revealing that chronic consumption of contaminated herbs can consequently endanger human health. HI was greater than 1, while CR exceeded safe limits in treated plants, with exception for As. In the point of view of toxicology and food safety, growing of medicinal plants should be strictly regulated and distinguished based on the purpose of growing, and further herbs usage.

Effectiveness of Chinese herbal medicine and persian medicine against viral infections: A systematic review

The underlying aim of this study is to systematic discuss the effectiveness of Chinese and Persian herbal medicine through the analysis of the existing and available studies on the usage of such herbs, plant extracts and herbal formulations that are descended from these two traditional medicinal roots. Using the technique of a systematic literature review, the researcher extracted 64 articles, only 8 of which were reviews and all others were original clinical researches, from medical databases including Pub Med, NIH and other clinical and scientific reports. After putting effort in conducting a screening in accordance to the exclusion criteria, the researcher included 64 articles, all of which were from 2010 and onwards to conduct this analysis. The study can be concluded as suggesting that the herbal medicine is quite effective in helping to treat, prevent and cure viral infections and widespread viral diseases. However, there is need of much more research in this area and the future researchers need to make investigations into the area of combined impacts of herbal and traditional medicine.

Exploring the Knowledge on Herbal Medicine (HM) usage in Disease Management among People with Type 2 Diabetes Mellitus (T2DM) in Negeri Sembilan, Malaysia

It is estimated that diabetes affects approximately 415 million people worldwide and this is expected to increase to 642 million by 2040. There are several methods used in managing diabetes which include nutritional control, taking medications, insulin injection and/or consuming herbal medicine (HM). This study explored the knowledge of herbal medicine usage among people with Type 2 Diabetes Mellitus (T2DM) in regard to diabetes management. A qualitative study was conducted among 28 diabetic patients from government clinics in Negeri Sembilan. They were interviewed face-to-face and all information about their herbal medicine consumption were analysed thematically. Findings showed that the main source of information on herbal usage were from family members, friends and/or neighbours. This study discovered that knowledge on herbal medicine among T2DM patients was greatly influenced from such sources and it is also hereditary. In addressing herbal medicine safety issues, some patients were unaware of the proper channel while others chose to accept any arising consequences without informing the healthcare authorities. This study also revealed that most of the informants were aware on the types and ways of consuming herbal medicine. Besides, patients understood that diabetes can only be controlled and cannot be cured. However, knowledge on complementary intake with modern medicine should be enlightened. Therefore, it is suggested that the healthcare provider need to update their knowledge on herbal medicines and be able to give informative insights to their patients.

Effects of Herbal Medicine Use on Adherence to Conventional Anticancer Drugs

Background: Use of herbal medicines alongside conventional anticancer drugs is common among cancer patients. This may potentially cause reduced adherence to conventional anti-cancer drugs, unpredictable side effects and unknown drug-herb interactions. This in the long run could result in poor clinical outcomes.
 Aim: This study was conducted to investigate how use of herbal medicines affects adherence to conventional anti-cancer drugs, to determine the proportion of patients using both conventional and herbal anticancer medicines and to identify the common herbal medicines used alongside conventional anti-cancer drugs by patients at the Mbarara Regional Referral Hospital Oncology unit.
 Methods and Findings: A cross-sectional study was conducted in the oncology clinic of Mbarara Regional Referral Hospital found in Mbarara district, Uganda. Data was collected between 20th March and 20th April 2019 from 122 participants who met the inclusion criteria with subsequent consenting. Our primary outcome was adherence and secondary outcome was to investigate whether cancer patients use herbal medicines alongside conventional anti-cancer drugs.
 Our study had 122 patients most of them belonging to the Banyankole tribe, 75 (61.5%) being males. Of the 72 (59.02%) patients who used herbal medicine, 40 (55.56%) were males and 66.67% of the herbal users reported relief from herbal medicines. Aloe Vera was the most commonly used herb. Most of the patients 77 (63.1%) showed high adherence, this was greater in the non-herbal users than in the herbal users (COR=1.62) though this was not significant (p=0.399).
 Conclusion: It is most likely that majority of cancer patients use at least one herb during their course of life. The results did not show a significant relationship between herbal medicine use and adherence to conventional anti-cancer drugs. The high proportion of herbal medicine users calls for more research into the area to provide further information that can help optimize cancer treatment outcomes.

Prevalence of Traditional Herbs and Supplements Use Among Hypertensive Patients in Om Elamad Health Center

Background: In recent years, hypertension has developed into a global health concern as the number of deaths from it has been on the increase across the world. Health provision in Jordan like other developing nations is poor compared to countries like the United Kingdom (UK) and US. However, concurrent use of conventional medication and the supplements and traditional herbs can impact on the treatment of hypertension. In this regards, it was significant to conduct this study to find out the prevalence of supplements and traditional herbs usage among hypertensive patients in Jordan so as to understand the associated factors and create awareness on the magnitude so that appropriate advice can be given to patients and thus improve health of populations. Material and Methods: The study employed a cross-sectional study design in undertaking the research. A total of 208 hypertension patients aged 16 years and above were used as the sample. Purposive and convenient sampling was applied in the selection of the Om elamad health centre in Jordan because it has a population of the catchment Centre. Data analysis was carried out using various techniques SPSS version21and excel. Results: The key findings of the study were as follows: Hypertension was prevalent among the elderly, herbs had no effect on the blood pressure, conventional drugs were more potent in comparison to herbs and/or supplements. Combining antihypertensive drugs and herbs was found to be potent than taking antihypertensive drugs only(P-value=0.0050) in SBP, and (P-value=0.0001) in DPB. Influences on herbs use came from the patients' families/relatives as they were found to be the most knowledgeable sources of medicinal herbs. Conclusion: From the study, it was deduced that the use of herbal medicines and supplements as well as antihypertensive drugs was prevalent among hypertensive patients in Jordan. Over half of the patients involved in this study were taking herbs to treat their blood pressure diseases (51. 4 %). It was also deduced that a combined usage of herbal medicine and supplements with antihypertensive drugs was far more potent than using antihypertensive drugs only.

Awareness on nootropic herbs among dental students Herbal nootropic agents

Nootropics herb constitutes of compounds that enhance cognitive performance by increasing mental functions memory, creativity, motivation, and attention, eventually causing individuals to be many alerts and focused. These nootropic herbs tend to enhance brain performances. To assess the awareness on nootropic herbs among dental students. A cross-sectional study was done with a self-administered questionnaire with 10 questions circulated among 100 dental students. The questionnaire assessed the awareness on pharmacological properties, traditional uses, medicinal uses and memory-enhancing function of the nootropic herbs from ayurvedic pharmacopoeia. The responses were recorded and analysed. 17% were aware of nootropic herbs.5% were aware of their pharmacological properties.3% were aware of traditional uses. 3 % aware of medicinal uses. 12%were aware of memory-enhancing function. The awareness of nootropic herbs usage in clinical practice among dental students was found to be low in this study. Our findings emphasize the importance of incorporating several educational and training programs to dental students to sensitize them to look for alternative and herbal medicines in the treatment of diseases.

Toxicity assessment of sub-acute and sub-chronic oral administration and diuretic potential of aqueous extract of Hibiscus sabdariffa calyces

BackgroundFood and herbal usage of Hibiscus sabdariffa (HS) is attaining improved global relevance and acceptance without recourse to its potential toxic effects. This study investigated the safety profile of acute, sub-acute, sub-chronic administrations and diuretic potential of aqueous extract of Hibiscus sabdariffa calyces (AEHSC). MethodAcute oral toxicity, sub-acute and sub-chronic toxicity as well as diuretic studies were carried out on HS. A total of 20 Wistar rats were used for each toxicity study and assigned into four groups of five rats. The extract was administered as a single daily dose of 125, 250 and 500 mg/kg body weight (bwt) for 28 and 90 days respectively. To evaluate diuretic activity, 25 rats were divided into five groups of five rats and administered normal saline, hydrochlorothiazide 10 mg/kg, AEHSC 67.5, 125 and 250 mg/kg via the oral route. Urine sample was collected after 18 h, volume measured and concentration of electrolytes analyzed. The hematological and biochemical parameters were evaluated as well as the histopathology of kidney and liver. ResultsThe acute oral toxicity was found to be >2000 mg/kg. AEHSC did not alter concentration of WBC, MCV, MCHC, lymphocyte as well as total and direct bilirubin in the sub-acute study. However, AEHSC significantly (p < 0.05) increased total protein, albumin, globulin, Na+, Cl−, HCO3- and platelet levels, while levels of uric acid, creatinine, K+, RBC, Hb, total cholesterol, triglycerides, LDL-C, HDL-C and atherogenic index were decreased significantly (p < 0.05). In the sub-chronic study, AEHSC significantly (p < 0.05) increased the levels of globulin, urea, creatinine, MCH and atherogenic index. The concentrations of uric acid, WBC, platelets and HDL-C were significantly (p < 0.05) decreased. In both the sub-acute and sub-chronic studies, activities of ALP, ALT, AST, GGT and LDH in selected organs were altered without significant increase (P < 0.05) in activity of these enzymes in the serum. The AEHSC at all the doses showed remarkable diuretic activity during 18 h period comparable to hydrochlorothiazide. The extract also showed a non-dose-dependent increase in excretion of electrolytes. Histological analysis of sections of the liver and kidney for both sub-acute and sub-chronic studies showed normal histology comparable to the control group. ConclusionThis study revealed AEHSC has some toxic effects in rats on sub-chronic administration. In addition, the extracts produced a significant diuretic activity. Hence, prolonged oral consumption of the extract may not be recommended.

Prevalence, Awareness, Attitudes and Usefulness of Allopolyherbal Medications Among Type 2 Diabetics: A Community Based Cross-sectional Survey

Objectives: The prevalence of herbal medicines is drastically increasing among patients with chronic diseases like diabetes mellitus due to its difficulty in adhering to therapeutic regimens and lifestyle changes, without considering its consequences of concomitant uses. The aim of this study was to explore the prevalence, attitude, awareness and consequences of simultaneous use of herbal medicines with allopathic anti-diabetic drugs. Methods: A community based cross-sectional study was conducted among Type 2 diabetes using pre-structured questionnaire consisting socio-demographic details and herbal use characteristics. Patients with type 1 diabetes, gestational diabetes and those rely only on anti-diabetic herbal products were excluded. Descriptive statistics and multivariatelogistic regression were employed to analyze data. Results: A total of 470 patients responded, 340 tried herbal plants along with allopathic drugs. The herbal users were mostly females (54.89%) and from rural background (62.55 %) (P= 0.011). The herbal use was higher among 40 to 55 age group, having a duration of diabetes less than one year (P=0.001). About 34 herbal plants identified, Guava (17.6%) and Bitter-gourd (12.9%) were most commonly used and families, friends, neighbors (32.60%) were their herbal information providers. About 67% of patients reported satisfactory with herbal use but only 35% patients informed their doctors about the concomitant use. Among herbal users, 25% of patients reported hypoglycemia and a negligible patient reported about such occurrence. Conclusion: This study identified high prevalence of herbal use with modern treatment. Hence, patients as well as health providers must be educated about potential risks and benefits of herbal treatment.

Usage of Chinese Herbs in Cancer Patients in Southern China: A Survey.

To study the use of Chinese medicine (CM) in cancer patients in southern China. A total of 1,950 cancer patients finished questionnaires in four provinces in southern China. The survey included socio-demographic and clinical characteristics of participants, dosage forms, efficacy, and side effects. The study results showed that cancer patients with higher education (>12 years) were more likely to accept the treatment of Chinese herbs. There were 54.61% (1,065 cases) of patients chose Chinese herbs for the initial treatment and 14.46% (282 cases) chose Chinese herbs as monotherapy. Most patients (54.51%, 1,063 cases) continuously used CM for more than 6 months, and a few of them (212 cases) used CM for up to 3 years. All kinds of dosage forms of CM had been used, including CM decoction, CM patent prescription and CM injection. Concerning the efficacy in the view of patients, 40.31% (786 cases) believed that it would be effective to take Chinese herbs before they starting the anti-cancer treatment, and the percentage increased to 81.08% after 1-month CM treatment. The effect of Chinese herbs was mainly demonstrated by symptom relief and improvement of quality of life, and 8.31% (162 cases) of patients experienced control of tumor growth and decreased tumor markers. Furthermore, only 14.31% (279 cases) participants reported that they experienced side effects during CM treatment. This large scale investigation reflects the current situation of domestic CM usage objectively and comprehensively, which might provide new ways for cancer treatment.

Ethnobotanical Study of Medicinal Plants in Aziziye District (Erzurum, Turkey).

The present research was conducted to document the usage of medicinal plants, plant parts utilized, and methods of preparation by the people living in Aziziye district, situated in the western part of Erzurum. The medicinal plant species utilized by local public for remedial aims were collected and identified. The related knowledge about conventional herbal medicine was collected, herbarium materials were prepared, and they were deposited in the Herbarium of the Faculty of Science, Atatürk University. A total of 77 medical plants pertaining to 30 families were defined in this research. Amongst these, 62 species grew naturally and 15 species were cultivated. The most widespread medicinal plant families were Asteraceae (14), Rosaceae (7), Lamiaceae (5), and Apiaceae (5). The most widespread preparation was decoction. The ethnobotanical outcomes documented in this study provide practical evidence about the use of medicinal plants among the inhabitants of Aziziye District. Furthermore, the results revealed that the medicinal plants of the region are a major source of herbal drugs for primary healthcare utilized among the rural communities. This study can be utilized as baseline knowledge for further scientific research to improve new plant-based commercial drugs, and may transfer the traditional information as regards usage of medicinal herbs to new generation.

Neuromuscular manifestations of lead poisoning in opium and herbal users in Iran

Opium sale is prohibited in Iran, and sellers mix it with lead to increase the weight. Herein, we describe neuromuscular findings in nine patients who developed lead poisoning due to opium/drug consumption. The mean age of patients was 53±3.5 years and their mean blood lead level was 122.6±20.8μg/dL. Most of the patients had an acute/subacute course presenting as axonal or demyelinating sensorimotor polyneuropathy, motor neuron disease, and multiple mononeuropathies with favorable response to the chelation therapy. Lead poisoning should be considered in patients with a history of opium use and neuromuscular symptoms.

Herbal medicine from the perspective of type II diabetic patients and physicians: what is the relationship?

BackgroundDiabetes mellitus (DM) is a major public health problem and one of the most challenging diseases worldwide. According to the World Health Organization (WHO), the Kingdom of Saudi Arabia (KSA) has the second highest rate of diabetes in the Middle East and seventh highest globally. Some diabetic patients may prefer to use alternative approaches such as herbal remedies to control their blood glucose level and this study aims to assess the prevalence of herbal usage and to evaluate users’ and doctors’ knowledge, attitudes and beliefs about herbal medicine as well as the patient/doctor relationship in this regard.MethodA cross-sectional survey was conducted in several hospitals and medical centres in Makkah, KSA, between January and March 2019. Around 289 type II diabetic patients and 105 doctors were interviewed.ResultsWe found that 68% of the participants were frequent consumers of herbal remedies, especially cinnamon, ginger and fenugreek. Patients’ knowledge of herbal usage was mainly gleaned from family and friends as well as social media, and we found that many (71.4%) did not bother to consult or inform their doctors about their choice to self-medicate with herbs. Patients had no concerns regarding the efficacy and safety of herbal usage use in diabetes, as around half of the participants believe that herbal medicine is effective (54%) and safe (46%) for treating symptoms of diabetes. Two-thirds of the doctors (66%) routinely ask patients whether they use herbs for their condition. Although 25% of the doctors took a positive view of herbal medicine in relation to diabetes, others expressed concerns with the rise in herb use and want to see more attention paid to safety aspects.ConclusionThe study concludes that herbal remedies are commonly used by diabetic patients and that a gap exists in the relationship between patients and doctors concerning the disclosure of herbal remedy use and views on its safety.

In silico screening of Chinese herbal medicines with the potential to directly inhibit 2019 novel coronavirus

ObjectiveIn this study we execute a rational screen to identify Chinese medical herbs that are commonly used in treating viral respiratory infections and also contain compounds that might directly inhibit 2019 novel coronavirus (2019-nCoV), an ongoing novel coronavirus that causes pneumonia. MethodsThere were two main steps in the screening process. In the first step we conducted a literature search for natural compounds that had been biologically confirmed as against sever acute respiratory syndrome coronavirus or Middle East respiratory syndrome coronavirus. Resulting compounds were cross-checked for listing in the Traditional Chinese Medicine Systems Pharmacology Database. Compounds meeting both requirements were subjected to absorption, distribution, metabolism and excretion (ADME) evaluation to verify that oral administration would be effective. Next, a docking analysis was used to test whether the compound had the potential for direct 2019-nCoV protein interaction. In the second step we searched Chinese herbal databases to identify plants containing the selected compounds. Plants containing 2 or more of the compounds identified in our screen were then checked against the catalogue for classic herbal usage. Finally, network pharmacology analysis was used to predict the general in vivo effects of each selected herb. ResultsOf the natural compounds screened, 13 that exist in traditional Chinese medicines were also found to have potential anti-2019-nCoV activity. Further, 125 Chinese herbs were found to contain 2 or more of these 13 compounds. Of these 125 herbs, 26 are classically catalogued as treating viral respiratory infections. Network pharmacology analysis predicted that the general in vivo roles of these 26 herbal plants were related to regulating viral infection, immune/inflammation reactions and hypoxia response. ConclusionChinese herbal treatments classically used for treating viral respiratory infection might contain direct anti-2019-nCoV compounds.

Looking for immortality: Review of phytotherapy for stem cell senescence.

In this paper, we discussed natural agents with protective effects against stem cell senescence. Different complications have been observed due to stem cell senescence and the most important of them is “Aging”. Senescent cells have not normal function and their secretary inflammatory factors induce chronic inflammation in body which causes different pathologies. Stem cell senescence also has been investigated in different diseases or as drug adverse effects. We searched databases such as Embase, Pubmed and Web of Science with keywords “stem cell”, “progenitor cell”, “satellite”, “senescence” and excluded keywords “cancer”, “tumor”, “malignancy” and “carcinoma” without time limitation until May 2019. Among them we chose 52 articles that have investigated protective effects of natural agents (extracts or molecules) against cellular senescence in different kind of adult stem cells. Most of these studies were in endothelial progenitor cells, hematopoietic stem cells, mesenchymal stem cells, adipose-derived stem cells and few were about other kinds of stem cells. Most studied agents were resveratrol and ginseng which are also commercially available as supplement. Most protective molecular targets were telomerase and anti-oxidant enzymes to preserve genome integrity and reduce senescence-inducing signals. Due to the safe and long history of herbal usage in clinic, phytotherapy can be used for preventing stem cell senescence and their related complication. Resveratrol and ginseng can be the first choice for this aim due to their protective mechanisms in various kinds of stem cells and their long term clinical usage.

HERBS AS A SOURCE OF NATURAL PRESERVATIVES AGAINST RANCIDITY IN THE LOW-MOISTURE BAKERY PRODUCTS

In recent years, it is a global trend of avoiding the use of synthetic ingredients for the food products quality enhancement. In this case it is actual task to search for the alternative natural raw materials, which provide the stabilization the products quality during storage. Due to their chemical composition, physiological and functional-technological properties the usage of herbs is a perspective solution of this problem. The aim of the study was to evaluate the effectiveness of natural ingredients based on herbs (powder and extracts) on the rancidity retardation. The antioxidant effect of herb raw-materials (hop, chamomile, nettle) was studied for the low-moisture bakery products with high fat content. These products are the ideal type of “food on the go” with long term of storage, which characterized with increasing popularity among modern consumers. The study was conducted at the Odessa National Academy of Food Technologies labs. The peroxide value of samples was determined by iodometric method (ISO 3960:2017). The results revealed that addition of natural antioxidants to the bakery goods in comparison to products without additives reduced this indicator up to the 37…52 %&nbsp; for the samples with herbs. It has been determined that hop, chamomile and nettle incorporation have pronounced antiseptic properties also. The use of herbs in the low-moisture bakery products technology leads to the quality stabilization during their shelf life, improvement of nutritional value and it may be more attractive to consumers due to their natural origin.

Herbal Supplement Use and Herb-drug Interactions among Patients with Kidney Disease.

Objective:The prevalence of herb–drug interactions and herb's adverse effects may be serious in susceptible population such as patients with chronic kidney disease (CKD). In this study, we planned to determine the usage prevalence of herbal products and herb–drug interactions in CKD patients.Methods:A cross-sectional prospective study was conducted on CKD and posttransplant patients with a history of using herbal supplements in Isfahan, Iran. The patients were subjected to a validated checklist, containing demographic and clinical information. The knowledge of herbal use, side effects, and herb–drug interactions was assessed based on patients' responses. Data were reported as prevalence (percent) of the occurrence.Findings:The prevalence of herbal supplement usage among CKD patients was 18.6% in this study. The study included 400 patients (261 males and 139 females). The majority of the study population were in the age range of 50–70 years (61.5%). Hypertension (34.36%) was the most common cause of kidney failure, while diabetes mellitus (21.80%) took the second place. The most frequently used unformulated medicinal herb was Echium (Echium amoenum) (15.27%), and the most commonly used formulated herbal products were anticough and mucolytic based on Thymus vulgaris (24.27%). Eighteen patients (4.5%) used herbal mix with unknown entity and sources. In this study, ginseng has the most possible interactions with prescription drugs (18 interactions), while this interaction (with clopidogrel, warfarin, and heparin) was severe in six cases.Conclusion:The present study provided the information on possible herb–drug interactions in CKD patients on herbal usage. Since the issue of using herbal products may be arbitrarily in the majority of the patients, and considering the importance of adverse reactions or major interactions, health-care providers should play an active role to identify these cases and inform the patients regarding herbal product safety, adverse effects, and possible interactions.

Synergistic Inhibition of Acetylcholinesterase by Alkaloids Derived from Stephaniae Tetrandrae Radix, Coptidis Rhizoma and Phellodendri Chinensis Cortex.

Alkaloids having acetylcholinesterase (AChE) inhibitory activity are commonly found in traditional Chinese medicine (TCM); for example, berberine from Coptis chinensis, galantamine from Lycoris radiata, and huperzine A from Huperzia serrata. In practice of TCM, Stephaniae Tetrandrae Radix (STR) is often combined with Coptidis Rhizoma (CR) or Phellodendri Chinensis Cortex (PCC) as paired herbs during clinical application. Fangchinoline from STR and coptisine and/or berberine from CR and/or PCC are active alkaloids in inhibiting AChE. The traditional usage of paired herbs suggests the synergistic effect of fangchinoline–coptisine or fangchinoline–berberine pairing in AChE inhibition. HPLC was applied to identify the main components in herbal extracts of STR, CR, and PCC, and the AChE inhibition of their main components was determined by Ellman assay. The synergism of herb combination and active component combination was calculated by median-effect principle. Molecular docking was applied to investigate the underlying binding mechanisms of the active components with the AChE protein. It was found that fangchinoline showed AChE inhibitory potency; furthermore, fangchinoline–coptisine/berberine pairs (at ratios of 1:5, 1:2, 1:1, and 2:1) synergistically inhibited AChE; the combination index (CI) at different ratios was less than one when Fa = 0.5, suggesting synergistic inhibition of AChE. Furthermore, the molecular docking simulation supported this enzymatic inhibition. Therefore, fangchinoline–coptisine/berberine pairs, or their parental herbal mixtures, may potentially be developed as a possible therapeutic strategy for Alzheimer’s patients.

Herbal Drug use in Sickle Cell Disease Management; Trends and Perspectives in Sub-Saharan Africa - A Systematic Review.

Nigeria has the largest burden of Sickle Cell Disease (SCD) with estimated 100,000 new born affected annually. SCD is a Hemoglobin (Hb) disorder with the major form resulting from the substitution of a polar glutamate (Glu) by non-polar Valine (Val) in an invariant region of Hbβ chain-subunit. Species of Hb found in the sickle cell trait are HbA and HbS in a 60:40 proportion, in SCD only HbS, in the HbC disease only HbC, and in the SC disease it's HbS and HbC in a 50:50 equal proportion. This paper reviews herbal medicines usage in sub-Saharan Africa (sSA) to ameliorate the crisis associated with SCD. The model Hb tetramer suggests a higher membrane affinity of HbS and HbC, promoting dehydration of RBCs, with concomitant in vivo crystallization. Some drawbacks using these herbal drugs include; poor bioavailability and the lack of proper pharmacovigilance monitoring procedures arising from weak governance structure combined with under reporting of herbal usage to physicians were discussed. Probable epigenetic loci that could be targeted using phytomedicines for effective SCD management were also discussed. Using search engines, several databases including Google scholar, PubMed, Academic Resource Index were utilized as a source for relevant publications/ literature. The protein coordinates for the Hb tetramer were obtained from the Protein Data Bank (PDB). Manipulation of epigenetics to achieve better SCD management involves careful thinking. Herein, we discuss some epigenetic interactions that could be putatively tweaked with a view of enhancing soluble bioactive small molecular components with the potential to reactivate γ -globin genes, thereby boosting immune response in patient with SCD.