Use Of Conventional Medications Research Articles

Efficacy and safety of pembrolizumab as first-line treatment for advanced non-small cell lung cancer complicated with chronic obstructive pulmonary disease: protocol for a prospective, single-arm, single-center, phase II clinical trial.

The first-line standard treatment option for patients with NSCLC complicated with Chronic obstructive pulmonary disease (COPD) is still unclear and relies on the treatment option of NSCLC alone. To date, a limited number of retrospective studies have explored the efficacy and safety of immunotherapy in patients with NSCLC complicated with COPD. We therefore designed this study to further explore the efficacy and safety of first-line immunotherapy in patients with NSCLC complicated with COPD. This study was designed as a single-armed, single-center, prospective, phase II clinical study. It will include 30 advanced (stage IV) NSCLC combined with COPD primary treatment subjects. Each subject's diagnosis will be confirmed by clinical, radiographic, pathologic, and pulmonary function evaluation. A fixed dose of 200 mg pembrolizumab will be administered by intravenous infusion on day1 every 3 weeks (Q3W). The management of stable and acute exacerbations of COPD include home oxygen therapy, and the use of conventional medications are also administered. Imaging evaluation will be performed every 6 weeks for 6 months from the first pembrolizumab dose and approximately every 12 weeks thereafter until disease progression or early withdrawal. COPD status will be evaluated every 3 months by pulmonary function, GOLD grading, mMRC score, CAT score, ABCD grouping, and AECOPD severity. The primary outcome is Progression-free survival. The secondary outcome measures include objective response rate, overall survival, rate of acute exacerbations of COPD (times/year), lung function, mMRC score, CAT score, impact of treatment on patient's health-related quality of life, antibiotic use (including duration and classes), and adverse events associated with immune checkpoint inhibitors. Exploratory endpoint is to explore the association between COPD grade and the degree of immune cell (CD4+ T lymphocytes and CD8+ T lymphocytes) infiltration, as well as the association between COPD grade and the efficacy of immune checkpoint inhibitors. ClinicalTrials.gov, identifier NCT05578222.

Antihypertensive Medications Can Prevent Fostamatinib-Induced Blood Pressure Elevation

Fostamatinib is a tyrosine kinase inhibitor that has been shown in clinical trials to be effective against spleen tyrosine kinase in patients suffering from rheumatoid arthritis. Fostamatinib medication was linked in clinical trials to a slight increase in systemic arterial Blood Pressure (BP). This observation is consistent with other kinase inhibitors, particularly those that obstruct VEGFR2 signaling. In conscious rats, we examined the relationship between the elevation of blood pressure caused by fostamatinib and the plasma levels of the fostamatinib-active metabolite R940406. We discovered that there was a strong correlation between changes in R940406 plasma concentration and the time course of the blood pressure effect, suggesting a direct pharmacological relationship. The experiments yielded free plasma levels of R940406 up to 346 nmol/L, which is greater than the mean peak free plasma concentration of 49 nmol/L that has been recorded in clinical settings. We beyond the clinically noted mean peak free plasma concentration of 49 nmol/L, up to 346 nmol/L. We’ve shown that there are several effective ways to reduce the blood pressure elevation caused by fostamatinib dosing, including simple drug withdrawal or condoning with a variety of common antihypertensive medications like atenolol, captopril, and nifedipine. These results provide credence to prospective strategies for preserving patient safety during fostamatinib therapy. Additionally, we have shown—using nifedipine as an example drug—that this blood pressure control was not brought about by a decrease in R940406’s plasma exposure, indicating that potential pharmacological benefits of the investigational drug may be preserved while blood pressure control is managed with the use of conventional medications.

Self-medication practice among pregnant and postpartum women attending the regional hospital center of Souss Massa, Morocco: a cross-sectional study.

Background: Self-medication among pregnant women represents a serious risk to the mother's and child's health. It is a global concern that requires careful attention from professionals in healthcare. In Morocco, there is a lack of available data on self-medication and predicting variables among pregnant and postpartum women. The purpose of this study was to determine the incidence of self-medication and the factors that contributed to it among pregnant and postpartum women in the Sous Massa Regional Hospital. Methods: A cross-sectional study was conducted using a pretested questionnaire among 420 pregnant and postpartum women who were attending the regional hospital center of the Sous Massa region from April to December 2022. Statistical analysis was performed using Jamovi Software. The logistic regression analysis was used to determine the significance of the association between the outcome and independent variables. Results: The research enrolled 420 pregnant and postpartum women. During the current pregnancy, 24.8% of the women used self-medication. The leading common causes/symptoms that necessitate self-medication among pregnant and postpartum women were Anemia (84.8%), epigastralgia (16.8%), vomiting, pyrosis (15.2%), and urinary and vaginal infections The therapeutic families concerned with self-medication practice were Analgesics (41.4%), Antacids (20.3%), antimicrobials (13.5%), and Vitamin supplements (9%). According to the findings, the most frequent sources of information were pharmacists (45.6%), followed by physicians (44.3%). The primary reasons given by respondents for self-medication were the need for rapid release (51.7%), previous treatments with the same drugs (31.7%), and 20% reported difficulty of access to healthcare professionals. Out of 95.9% of the participants reported that they knew the dangers of self-medication and 96% of them were informed and received information about the dangers and contraindications of self-medication during pregnancy. This was significantly statistically associated with self-medication respectively with p-value = 0.031 and p-value = 0.005. Conclusion: The findings of the present study provide an initial awareness of the state of self-medication among pregnant and postpartum women attending the regional hospital centers. It is recommended that healthcare professionals increase their interventions to improve the consciousness of pregnant women; this might require implementing suitable strategies to regulate the commercialization, delivery, and use of conventional medications.

Prediction of Carcinogenic, Mutagenic, Hepatotoxic, and LD50 Toxicity of Herbs Euphorbia hirta and Camellia sinensis Leaf Compounds as In Silico Antihypertensive Agents

Hypertension is defined as an increase in systolic blood pressure above 140 mmHg and diastolic blood pressure above 90 mmHg. Treatment for hypertension is lifelong, and continuous use of conventional medications can lead to the accumulation of drugs, potentially cautilizing adverse effects on the body compared to traditional treatments. The herbal tea formulation of Euphorbia hirta herbs and Camellia sinensis leaves can lower blood pressure due to their high antioxidant activity, which is associated with hypertension-related diseases, including compounds like quercetin and myricetin. This research serves as an initial screening to assess safety and minimize side effects of the active compounds in E. hirta and C. sinensis, which are beneficial as antihypertensive agents, through in silico analysis. Toxicity predictions utilizing the ProTox II, pkCSM, and Vega-QSAR platforms, which have been verified to meet the acceptability criteria of Cooper statistics parameters, were conducted. The toxicity assessment parameters include carcinogenicity, mutagenicity, hepatotoxicity, and acute toxicity (LD50). The research results indicate that 9 compounds are carcinogenic and mutagenic, while 2 compounds are hepatotoxic. Based on the toxicity prediction assessment (LD50), it was found that quercetin and myricetin, with moderate toxicity, have LD50 values of 159 mg/kgBW

Evaluation of the Effect of Phytocomplex on Chondroprotective Biomarkers in an Experimental Model of Osteoarthritis in Rats

Osteoarthritis (OA) is most prevalent joint disease and major contributor to non-fatal burden in India, with prevalence rates of 22% - 39%. The use of conventional medication can be associated with insufficient clinical management and serious side effects. The present study aims to evaluate the anti-arthritic activity and chondrocytes protection and regeneration potential of Joint Support Product (JSP) in monosodium Iodoacetate induced Osteoarthritis rat model. Pain threshold, knee joint swelling, Blood inflammatory parameters like Tissue necrosis factor, Interlukin-6, Leukotriene B 4, C- reactive protein and arthritic biomarkers Matrix metalloproteinase-13 and Cartilage Oligomeric Matrix Protein, were estimated. Also Radiographic and histopathological evaluation were done to estimate the severity of OA. Treatment of JSP demonstrated significant increase in pain threshold by 68 % and decrease in knee joint swelling by 92 %. The inflammatory markers decreased significantly (p< .00001) after treatment with JSP. The Tissue necrosis factor decreased by 55 %, Interlukin-6 by 61%, Leukotriene B 4 by 57%, C- reactive protein by 69 % and arthritic biomarkers - Matrix metalloproteinase by 88% and Cartilage Oligomeric Matrix Protein by 37% as compared to disease control rats. Also the radiological evaluation and gross histopathology of rats showed improved chondrocytes structure. Thus JSP’s analgesic, anti-inflammatory, chondrocyte regeneration, and chondroprotective properties have therefore demonstrated an anti-arthritic impact.

Microdosing with psychedelics to self-medicate for ADHD symptoms in adults: A prospective naturalistic study

ADHD in adulthood is often overlooked, which negatively affects the individual’s well-being. First-line pharmacological interventions are effective in many ADHD patients, relieving symptoms rapidly. However, there seems to be a proportion of individuals who discontinue, or fail to respond to these treatments. For these individuals, alternative treatment options should be explored. A retrospective survey study reported that using classic psychedelics in low, repeated doses, so called microdosing (MD), was rated as being more effective than conventional treatments for ADHD. The current prospective study aimed to measure the effect of MD on ADHD symptoms, well-being and time perception. Adults with ADHD who had the intention to start MD on their own initiative to self-treat their symptoms were measured before MD and two- and four weeks later. It was expected that ADHD symptoms would decrease, well-being would increase, and performance on a time perception task would improve after MD. It was investigated if conventional medication use alongside MD and comorbidities alongside ADHD influenced the effect of MD. Sample sizes included N=233, N=66, and N=47, respectively. The results showed decreases and increases in ADHD symptoms and well-being, respectively. No improved performance on a time perception task was found. Conventional medication use and having comorbidities did not change the effect of MD on ADHD symptomatology and well-being after four weeks of MD. Placebo-controlled experimental studies are needed to explore further whether there is a beneficial effect of MD for ADHD, beyond the placebo-effect.

Is the Association between Herbal Use and Blood-Pressure Control Mediated by Medication Adherence? A Cross-Sectional Study in Primary Care.

Herbs have been used worldwide for many health conditions as an alternative treatment, including hypertension. Their use might affect the use of conventional medications, as well as blood-pressure control. This study aims to determine whether the potential associations between herb use and high blood pressure in hypertensive patients was mediated by medication adherence. A cross-sectional study was conducted using questionnaires and available medical databases at a primary care clinic of a tertiary hospital in Chiang Mai, Thailand. The data were collected from 450 patients with essential hypertension. Drug adherence was assessed by the Morisky Green Levine Medication Adherence Scale. The history of herbs used in the past three months was obtained. The goal of controlled blood pressure was defined in accordance with the Thai guidelines on the treatment of hypertension. Of the total 450 patients, 42% had high adherence. Nearly 18% reported herb use in the past three months. High medication adherence was strongly associated with blood-pressure control when adjusted for age, gender, education, the presence of comorbidities, and herb use (aOR 26.73; 95% CI 8.58–83.23; p < 0.001). The association between herb use and blood-pressure control did not achieve statistical significance (p = 0.143). However, the adjusted odds ratio of the association between herb use and blood-pressure control was diluted from 0.67 to 0.83 when adding the factor of medication adherence to the model. In conclusion, herb use was associated with poor medication adherence, which was in turn associated with poor blood-pressure control. Assessing this information contributes to appropriate exploration and counseling.

No pain, all gain? Interim analyses from a longitudinal, observational study examining the impact of medical cannabis treatment on chronic pain and related symptoms.

Previous studies have demonstrated improvements in pain following short-term medical cannabis (MC) use, suggesting long-term MC treatment may alleviate symptoms associated with chronic pain. The goal of this observational and longitudinal study was to examine patients using MC to treat chronic pain pre versus post MC treatment. These interim analyses included 37 patients with chronic pain evaluated prior to initiation of MC treatment and following 3 and 6 months of MC use; pain, clinical state, sleep, quality of life, and conventional medication use were assessed. Correlation analyses examined the relationship between changes in pain and other clinical measures, assessed the impact of cannabinoid exposure on pain and clinical ratings, and assessed whether baseline cannabis expectancies influenced outcome variables. Additionally, a pilot group of treatment-as-usual patients (n = 9) who did not use MC were examined at baseline and 3 months later. Relative to baseline, following 3 and 6 months of treatment, MC patients exhibited improvements in pain which were accompanied by improved sleep, mood, anxiety, and quality of life, and stable conventional medication use. Reduced pain was associated with improvements in aspects of mood and anxiety. The results generally suggest increased THC exposure was related to pain-related improvement, while increased CBD exposure was related to improved mood. Cannabis expectancies were not related to observed improvements. Pilot analyses revealed that treatment-as-usual patients do not demonstrate the same pattern of improvement. Findings highlight the potential efficacy of MC treatment for pain and underscore the unique impact of individual cannabinoids on specific aspects of pain and comorbid symptoms. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

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.

Factors Associated with Inflammatory Bowel Disease Flare During Pregnancy Among Women with Preconception Remission.

The factors associated with inflammatory bowel diseases (IBD) relapse throughout gestation in those with preconception remission remain unknown. We aimed to investigate disease and pregnancy course among IBD women with quiescent disease at conception. Women with IBD attending a multidisciplinary clinic for preconception, antenatal and postnatal treatment were prospectively recruited during 2011-2018. Overall, 298 women with IBD with quiescent disease at the time of conception constituted the study cohort. Of these, 112 (37.6%) women experienced disease flare during pregnancy. The risk of disease relapse was higher in those with ulcerative colitis (UC) as compared to those with Crohn's disease (CD) (48.1% vs. 31.8%, P = 0.005). The proportion of women with prior IBD-related gastrointestinal surgery was lower in those who experienced disease flare up (13.4% vs. 26.3%, P = 0.009). The use of biologic therapy at the time of conception was associated with lower rates of disease relapse (25.0% vs. 43.9%, P = 0.001). In multivariate analysis, use of conventional medications or no treatment (aOR [95% CI]: 2.0 (1.12, 3.57), P = 0.02) and lack of prior history of IBD-related surgery (aOR [95% CI]: 3.13 (1.37, 7.14), P = 0.007) were independently positively associated with disease relapse. Rates of hospitalization during pregnancy (21.4% vs. 2.2%, P < 0.001) and preterm delivery (22.3% vs. 9.1%, P = 0.002) were higher, and birthweight was lower (median 2987 vs. 3153 grams, P = 0.05) in those with disease flare as compared to those who maintained remission. Prior IBD-related surgery and biologic therapy were found as independent protective factors against relapse during pregnancy among women with quiescent disease at conception.

ANTIMICROBIAL MODULATOR OF INFLAMMATORY RESPONSE IN THIRD MOLAR SURGERY COMPARED WITH CONVENTIONAL MEDICATION

Surgeries performed in retained third molars occur in the contaminated field, bringing post-operative problems such as pain, bleeding, discomfort, swelling, infection, trismus, and inactive days. This study evaluated the differences between conventional medication and topical doxycycline in third molar surgery. Twenty-eight patients were selected requiring removal of four third molar. Half of the mouth was randomly selected to undergo surgery with the use of conventional medication (analgesic, anti-inflammatory and antimicrobial) and after 25-30 days, the other half of the mouth was subjected to surgery using doxycycline delivered through gel nanotubes. The results showed that in both treatments there was no clinical infection. The other evaluations were significantly lower in relation to pain, bleeding, edema, inactive days, trismus, and discomfort when compared with conventional therapy.

Estimating the Impact of Novel Digital Therapeutics in Type 2 Diabetes and Hypertension: Health Economic Analysis.

BackgroundBehavioral interventions can meaningfully improve cardiometabolic conditions. Digital therapeutics (DTxs) delivering these interventions may provide benefits comparable to pharmacologic therapies, displacing medications for some patients.ObjectiveOur objective was to estimate the economic impact of a digital behavioral intervention in type 2 diabetes mellitus (T2DM) and hypertension (HTN) and estimate the impact of clinical inertia on deprescribing medications.MethodsDecision analytic models estimated health resource savings and cost effectiveness from a US commercial payer perspective. A 3-year time horizon was most relevant to the intervention and payer. Effectiveness of the DTx in improving clinical outcomes was based on cohort studies and published literature. Health resource utilization (HRU), health state utilities, and costs were drawn from the literature with costs adjusted to 2018 dollars. Future costs and quality-adjusted life years (QALYs) were discounted at 3%. Sensitivity analyses assessed uncertainty.ResultsAverage HRU savings ranged from $97 to $145 per patient per month, with higher potential benefits in T2DM. Cost-effectiveness acceptability analyses using a willingness-to-pay of $50,000/QALY indicated that the intervention would be cost effective at total 3-year program costs of $6468 and $6620 for T2DM and HTN, respectively. Sensitivity analyses showed that reduced medication costs are a primary driver of potential HRU savings, and the results were robust within values tested. A resistance to deprescribe medications when a patient’s clinical outcomes improve can substantially reduce the estimated economic benefits. Our models rely on estimates of clinical effectiveness drawn from limited cohort studies with DTxs and cannot account for other disease management programs that may be implemented. Performance of DTxs in real-world settings is required to further validate their economic benefits.ConclusionsThe DTxs studied may provide substantial cost savings, in part by reducing the use of conventional medications. Clinical inertia may limit the full cost savings of DTxs.

Integrated Oncology in an Integrated Medicine Hospital in Pitigliano (Grosseto, Italy)

Background. Complementary medicines (CM: homeopathy and acupuncture/traditional Chinese medicine) have been introduced for cancer patients under treatment with chemotherapy and radiotherapy in the Pitigliano Hospital Centre of Integrated Medicine to minimize the side effects of these treatments, improving quality of life and adherence to conventional therapies. Methods. Two hundred and forty cancer patients were enrolled in an integrated care model offering a comprehensive protocol including homeopathy and acupuncture, provided in line with the stage of the disease as well as in consideration of any comorbidities in individual patients. The following parameters were collected at the beginning and after 1-2 months of the integrated therapies: SF-12 quality of life (QoL) questionnaire; Edmonton symptom assessment scale (ESAS); Questionnaire on the use of conventional medications. Results. There was a 92.4% reduction in symptoms (as monitored by ESAS) caused by the patient’s disease or by comorbidities. The SF-12 revealed reduced fatigue and increased wellness, as well as good adherence to the cancer treatments and a reduction in the use of conventional medications for side effects, good control of cancer symptoms and an improved QoL. Conclusions. This study suggests the use of complementary medicines to reduce therapy related symptoms in oncologic patients, without any adverse affectcs and to reduce the use of conventional drugs in this case .

The Grass Might Be Greener: Medical Marijuana Patients Exhibit Altered Brain Activity and Improved Executive Function after 3 Months of Treatment.

The vast majority of states have enacted full or partial medical marijuana (MMJ) programs, causing the number of patients seeking certification for MMJ use to increase dramatically in recent years. Despite increased use of MMJ across the nation, no studies thus far have examined the specific impact of MMJ on cognitive function and related brain activation. In the present study, MMJ patients seeking treatment for a variety of documented medical conditions were assessed prior to initiating MMJ treatment and after 3 months of treatment as part of a larger longitudinal study. In order to examine the effect of MMJ treatment on task-related brain activation, MMJ patients completed the Multi-Source Interference Test (MSIT) while undergoing functional magnetic resonance imaging (fMRI). We also collected data regarding conventional medication use, clinical state, and health-related measures at each visit. Following 3 months of treatment, MMJ patients demonstrated improved task performance accompanied by changes in brain activation patterns within the cingulate cortex and frontal regions. Interestingly, after MMJ treatment, brain activation patterns appeared more similar to those exhibited by healthy controls from previous studies than at pre-treatment, suggestive of a potential normalization of brain function relative to baseline. These findings suggest that MMJ use may result in different effects relative to recreational marijuana (MJ) use, as recreational consumers have been shown to exhibit decrements in task performance accompanied by altered brain activation. Moreover, patients in the current study also reported improvements in clinical state and health-related measures as well as notable decreases in prescription medication use, particularly opioids and benzodiapezines after 3 months of treatment. Further research is needed to clarify the specific neurobiologic impact, clinical efficacy, and unique effects of MMJ for a range of indications and how it compares to recreational MJ use.

THE UNEXPECTED CARDIOPROTECTION BY EPIGENETIC FOODS

Epigenetic changes affect the gene expression profile of cells without altering the DNA sequence in response to different environmental stimuli, such as the diet. Several dietary plant compounds have the epigenetic ability to prevent both the onset and the progression of different diseases, including cardiovascular diseases that are one of the most common in the world. Heart failure following perioperative myocardial infarction is a complex clinical syndrome without cure, also affecting high-risk patients undergoing non-cardiac surgery. It is characterized by serious decay of cardiac pump function as a result of ongoing remodelling of the myocardium. Despite the increasing use of conventional medications has reduced the mortality of patients with myocardial infarction, the outcome remains unpredictable so far. The past three decades have witnessed incessant research aimed at protecting the adult myocardium against ischemic injury, but the development of effective strategies to prevent the maladaptive tissue remodelling is still a desirable achievement. Recent findings reveal that the dietary intake of natural bioactive components with known antioxidant activity improves the intercellular communication and increases the tolerance of both cardiomyocytes and coronary endothelial cells against the ischemic microenvironment. The Epigenetic activation of rescue genes prevents the decay of function of the abovementioned cardiac cells. Consequently, this scenario would reduce the myocardial accumulation of collagen responsible for the tightening of the heart walls. Whereas the noninvasive delivery of cardioprotectant epigenetic compounds through diet is a promising approach, regulatory mechanisms need to be unravelled.

What do people with hypertension use to reduce blood pressure in addition to conventional medication – Is this related to adherence?

IntroductionPatients with chronic diseases may sometimes prefer to use alternative approaches to improve their health. Such approaches may be used solely or in combination with their conventional western medication. This survey in a primary care setting aimed to evaluate dietary substances used by patients with hypertension and to explore whether there was a relationship with adherence to conventional drug treatment. MethodsThe study group was composed of 465 patients who were registered with the Family Medicine Center in the city center in the period between April 2016 and June 2016. Socio-demographic characteristics of the patients and substances they used in addition to the drugs were recorded. ResultsThe dietary substances most commonly preferred were lemon, garlic, yoghourt, and combinations of these. Medication adherence among patients with hypertension was moderate to high with 72.25% of patients using their medications. Patients forgetting to take their antihypertensive medications were more likely to use these substances. ConclusionsPatients reported high adherence to their use of conventional medication. The most important problem was "forgetting" in low adherent patients and they mainly used lemon, garlic, and yoghourt at times of sudden blood pressure elevations. Physicians should inform the patients who struggle with hypertension about the risk of nonadherence which can result in serious morbidity and possibly mortality.

Attitudes and Perceptions among Dublin International Foundation College Students towards Taking Conventional Medications and Herbal Medicines

Background: The use of both conventional medications and herbal medicines has increased recently. Consequently, the chance of misusing medications has also increased, leading to unwanted complications and economic burdens. This study examined the attitudes and perceptions of international students at Dublin International Foundation College (DIFC) towards conventional medication and herbal medicine. Methods: A cross-sectional quantitative method was used to collect information from international students at DIFC. A total of 85 questionnaires were distributed to the students, and 54 completed questionnaires were received from them. Chi-square test was used to examine the possible relationships between students’ background, gender and region of origin and their attitudes and perceptions toward using conventional medications and herbal medicines. Results: Participants from different regions of origin showed significant differences in the responses to questions about informing their healthcare providers about their drug allergies. While most students did not usually mix herbal medicines with either conventional medications or other types of herbs, students aged between 21 and 25 were more likely to combine different types of medications compared to students from other age groups. No significant differences were observed in relation to students' educational backgrounds and gender. Conclusion: This study demonstrated the need of educating students from different regions and backgrounds about the use of conventional medications and herbal medicines. Information regarding the proper use of medications and the dangers of drug interactions should be included in the curricula of formal education and disseminated to the public using culturally sensitive strategies.

The use of indigenous medicine for the treatment of hypertension by a rural community in northern Maputaland, South Africa

Worldwide, the occurrence of hypertension is the highest in the African WHO Region where 46% of adults above the age of 24years suffer from hypertension. This study was undertaken to document the plants used by lay persons in a rural community for the treatment of hypertension, and to determine to what extent they use these plants concurrently with prescribed drugs for hypertension. A total of one hundred lay people with knowledge on antihypertension plants were interviewed using structured questionnaires. Information regarding vernacular plant names, plant parts used, preparation, and dosages was collected, as well as some health information with reference to hypertension. It was found that a total of 28 plant species were used singularly or in 17 different plant combinations in decoctions to treat hypertension. Twenty plant species have never been documented before for the treatment of hypertension. The species most used were: Momordica balsamina (by 44 interviewees), Aloe marlothii (32), Hypoxis hemerocallidea (17), Musa acuminata (10), Strychnos madagascariensis (10), and Senecio serratuloides (9). Thirty-one of the 50 people who had been diagnosed with hypertension were supplementing their prescribed hypertension drugs with medicinal plants. None of them had revealed to their healthcare practitioners that they were also using herbal medicines. Although none of the interviewees were aware of the possible consequences of drug interactions, they were mindful of some side effects caused by the medicinal plants they used for the treatment of hypertension. According to the majority of the interviewees, hypertension is caused by unhappiness and stress. Information from the community was cited as their main source of which plants to use to treat hypertension. It is clear from this survey that medicinal plant remedies play a vital role in the treatment of not just communicable diseases but also in the treatment of chronic ailments like hypertension by the lay persons in this deep rural area. The findings suggested that there is no awareness of the risks that may accompany the simultaneous use of conventional medication and medicinal plants. There is a definitive need to educate health practitioners and patients of the risks they are taking in using both prescribed hypertension drugs and medicinal plants.

Herbal medicine use among patients with chronic diseases.

Aim:Complementary and alternative medicine (CAM) is commonly used all over the world, and herbal medicines are the most preferred ways of CAM. The aim of this study was to determine the frequency of herbal medicine use among patients with chronic diseases.Methodology:A cross-sectional descriptive study was conducted from April 2014 to December 2014 among patients who had been diagnosed with diabetes mellitus (DM), hypertension (HT), and hyperlipidemia (HL) in Family Medicine Department of Dışkapı Yıldırım Beyazıt Training and Research Hospital, in Ankara. A questionnaire about herbal drug use was applied by face to face interview to the participants.Results:A total of 217 patients were included in this study. The mean age of the participants was 56.6 ± 9.7 years (55 male and 162 female). The rate of herbal medicine use was 29%. Herbal medicine use among female gender was significantly higher (P = 0.040). Conventional medication use was found to be lower among herbal medicine consumers. There was no relationship between herbal medicine use and type of chronic disease, living area, and occupation or education level. Most frequently used herbs were lemon (39.6%) and garlic (11.1%) for HT, cinnamon (12.7%) for DM, and walnut (6.3%) for HL.Conclusions:In this study, herbal medicine use was found to be higher among patients who had been diagnosed with chronic diseases. Therefore, physicians should be aware of herbal medicine usage of their patients and inform them about the effectivity and side effects of herbal medicines.

Vitamin and Supplement Use among Old Order Amish: Sex-Specific Prevalence and Associations with Use

BackgroundComplementary and alternative medicine (CAM) in the form of vitamin and supplement use is increasingly prevalent in the United States. The interplay between CAM use and use of conventional medications is not well studied. We examined this issue in Old Order Amish (OOA), a population lacking several factors known to influence supplement use, whose culture and barriers to conventional medications may result in high rates of supplement use. ObjectiveWe characterized the patterns of supplement use in OOA, including the extent to which CAM use aggregates in families, and assessed whether higher use of supplements is associated with lower medication use. DesignWe conducted a cross-sectional study of conventional medications and supplements in 2,372 adult Amish from the Lancaster County, PA, area. Data were collected through face-to-face interviews. Supplements were subcategorized as herbal vs vitamin/mineral supplements. ResultsSeventy-seven percent of all Amish adults reported current supplement use, whereas 22% reported medication use. Women used supplements more often and used more supplements than men, and familial aggregation of supplement use was stronger in family pairs involving women. Supplement use was associated with less medication use after controlling for age, sex, body mass index, and self-reported histories of hypertension, diabetes, and hyperlipidemia (adjusted odds ratio [OR] 0.96, 95% CI 0.92 to 1.00; P=0.047). This association was driven primarily by use of herbal supplements (adjusted OR 0.94, 95% CI 0.89 to 0.99; P=0.025) as vitamin/mineral supplements were not associated with different use of medication (adjusted OR 0.99, 95% CI 0.90 to 1.09; P=0.8). In analyses limited to cardiovascular medications and cardiovascular supplements in participants with hyperlipidemia, hypertension, or diabetes, supplement use was not associated with conventional medication use. ConclusionsOAA, particularly women, take dietary supplements much more frequently than they use conventional medications. Use of herbal supplements is associated with less use of conventional medications, whereas vitamin/mineral supplement use is not.