Use Of Traditional Medications Research Articles

Contact Dermatitis Following Use of Tropical Traditional Medicine

Traditional or herbal medications are generally perceived as safe since it is derived from natural or plant sources. A rise in number of adverse reactions are being reported with the use of traditional medications including localized cutaneous reactions. The diagnosis of contact dermatitis is often quite straight forward based on its appearance, pattern, site and distribution of the lesion which usually corresponds to the area of contact. We report the case of a 65-year-old woman who presented with redness, burning sensation and swelling of her hand after applying topical Chinese traditional medication. This report aims to outline simple measures to identify and manage contact dermatitis secondary to topical medication. The present case creates awareness that topical traditional medications are not as harmless as previously thought to be. Precautions regarding adverse reactions are required, as those with conventional medications.

Review of naloxone safety for opioid overdose: practical considerations for new technology and expanded public access.

Opioid overdose and mortality have increased at an alarming rate prompting new public health initiatives to reduce drug poisoning. One initiative is to expand access to the opioid antidote naloxone. Naloxone has a long history of safe and effective use by organized healthcare systems and providers in the treatment of opioid overdose by paramedics/emergency medicine technicians, emergency medicine physicians and anesthesiologists. The safety of naloxone in a prehospital setting administered by nonhealthcare professionals has not been formally established but will likely parallel medically supervised experiences. Naloxone dose and route of administration can produce variable intensity of potential adverse reactions and opioid withdrawal symptoms: intravenous administration and higher doses produce more adverse events and more severe withdrawal symptoms in those individuals who are opioid dependent. More serious adverse reactions after naloxone administration occur rarely and may be confounded by the effects of other co-intoxicants and the effects of prolonged hypoxia. One component of the new opioid harm reduction initiative is to expand naloxone access to high-risk individuals (addicts, abusers, or patients taking high-dose or extended-release opioids for pain) and their close family or household contacts. Patients or their close contacts receive a naloxone prescription to have the medication on their person or in the home for use during an emergency. Contacts are trained on overdose recognition, rescue breathing and administration of naloxone by intramuscular injection or nasal spraying of the injection prior to the arrival of emergency medical personnel. The safety profile of naloxone in traditional medical use must be considered in this new context of outpatient prescribing, dispensing and treatment of overdose prior to paramedic arrival. New naloxone delivery products are being developed for this prehospital application of naloxone in treatment of opioid overdose and prevention of opioid-induced mortality.

Unidentified drugs in traditional medications causing toxic epidermal necrolysis: a developing country experience

Drugs are by far the most common cause of toxic epidermal necrolysis (TEN), but unidentified drugs and chemicals present in herbal and traditional medications may also be responsible for this reaction, which manifests as widespread epidermal detachment of the skin and mucous membrane. In contexts in which a subject has used an herbal or traditional medication, it is very difficult to diagnose the condition, identify the offending agent, and prevent the disease from recurring. This prospective study was conducted at a tertiary burn center between July 2004 and October 2012. All patients were referred to this unit by the local department of medicine at least one week after the eruption of vesicles. On arrival, all patients demonstrated a severe form of disease with features of sepsis and electrolyte imbalance (SCORTEN scores of ≥4). All non-fatal cases were followed to observe long-term sequelae and recurrences. About 34% of patients had developed the condition after ingesting traditional herbal medications and were unable to identify the responsible drug by name. Nineteen (66%) of the 29 patients referred to the unit with TEN died within the first week after being transferred. Nine patients achieved complete recovery, and one developed corneal haziness and alopecia. One patient experienced recurrence within three months but recovered. Illiteracy and financial vulnerability were major factors in driving patients towards the use of traditional medications, which were often prepared and preserved improperly. Mortality and other complications could be reduced by the prompt recognition of the condition, immediate withdrawal of the culprit drug, and quick referral to proper care.

Factors associated with treatment gap in children and adolescents with epilepsy in a rural Nigerian community.

Background: The campaign against epilepsy is hampered by the difference between those with the active disorder and the number of them receiving appropriate treatment (treatment gap) in sub-Saharan Africa. Identifying the determinants of this gap is crucial to providing and achieving optimal care.Objective: To identify the determinants of epilepsy treatment gap (ETG) in children and adolescents (Subjects) with epilepsy in a rural community.Methods: Subjects were identified through a community house to house survey. Information obtained from Subjects and their care givers included: sociodemographic characteristics, type and frequency of epileptic seizures,current and past treatment options utilized, reasons for treatment options used, and treatment options utilized for other health complaints.Results: Twenty three Subjects (6.4/1000 of the child and adolescent population) were identified as having epilepsy. Their age range was 4-19 years (mean 14.3±4.7 years). Most were males (82.6%) and adolescents (78.3%). Seizures were mostly generalized (95.7%) and occurred most frequently daily. Current treatment modalities were use of traditional medication (100%) and prayers (34.8%).None was currently on orthodox medical therapy (ETG, 100%) but 5(21.7%) had utilized orthodox medical therapy in the past. The main determinants of the ETG were strong cultural belief, weakness in the health system to epilepsy treatment and low socioeconomic status. Fever was the commonest other health complaint and use of orthodox medical therapy was significantly (p˂ 0.05) the main (16, 69.6%) treatment option utilized.Conclusion: Cultural belief, weak health system and low socioeconomic status were determinants of an absolute ETG. It highlights the need to strengthen initiatives that enhance accessibility to standard epilepsy treatment.Key words: Epilepsy treatmentgap, determinants, children, adolescents, rural community

Patient refusal of glaucoma surgery and associated factors in lagos, Nigeria

Purpose:To determine the prevalence of patient refusal of glaucoma surgery (GSR) and the associated factors in Lagos, Nigeria.Materials and Methods:A multicenter cross-sectional survey was conducted in Lagos state, Nigeria. Twelve centres were invited to participate, but data collection was completed in 10. Newly diagnosed glaucoma patients were recruited and interviewed from these sites over a four week period on prior awareness of glaucoma, surgery refusal, and reason(s) for the refusal. Presenting visual acuity was recorded from the patient files. The odds ratio and 95% confidence intervals (CI) were calculated.Results:A total of 208 newly diagnosed glaucoma patients were recruited. Sixty–five (31.2%) patients refused surgery. Fear of surgery (31 (47.7%) patients), and fear of going blind (19 (29.2%) patients) were the most common reasons. The odds ratio of surgery refusal were marital status – not married versus married (2.0; 95% CI, 1.02–3.94), use of traditional medication – users versus non users (2.4; 95% CI, 1.1–5.2), perception of glaucoma causing blindness – no versus yes (3.7; 95% CI, 1.3–10.5), type of institution - government versus private (5.7; 95% CI, 1.3–25.1), and visual acuity in the better eye - normal vision versus visual impairment (2.3; 95% CI, 1.1–4.9). Age, gender, level of education, family history of glaucoma, and prior awareness of the diagnosis of glaucoma, were not significantly associated with surgery refusal. Perception of patients concerning glaucoma blindness was the strongest factor on multivariate analysis.Conclusion:GSR was relatively low in this study. Unmarried status, use of traditional medications, perception that glaucoma cannot cause blindness, government hospital patients, and good vision in the better eye were associated with GSR. These factors might help in the clinical setting in identifying appropriate individuals for targeted counseling, as well as the need for increased public awareness about glaucoma.

Prevalence of risk factors for chronic kidney disease among civil servants in Kano

Background: Data on the epidemiology of chronic kidney disease (CKD) from sub-Saharan Africa are still sparse. Preventive strategy through early detection and treatment has been advocated for CKD, especially in our environment where majority of patients present late and cannot afford the cost of renal replacement therapy which is not widely available. We investigated the prevalence of risk factors for CKD among the civil servants who volunteered after a public enlightenment campaign in Kano, northern Nigeria. Materials and Methods: We studied 225 apparently healthy civil servants who availed themselves of the opportunity to be screened for risk factors for CKD during the 2011 World Kidney Day activities. Relevant demographic and clinical data were obtained using a questionnaire. Weight, height, Body Mass Index (BMI), and blood pressure were measured. Spot urine samples were collected and tested for protein, sugar, and other parameters using a dipstick. Random blood sugar was measured with a glucometer. Results: The mean age of the study participants was 41.5 ± 9.68 years. Males constituted 83.6% of the respondents. Majority had a positive history of use of traditional medications, followed by the use of analgesic drugs, while very few (less than 5% each) admitted to alcohol ingestion or use of bleaching creams. While there was a significant family history of hypertension and diabetes, only about 3% had positive family history of kidney disease. Proteinuria was found to be present in 19.4%. Other risk factors found include hypertension (29.8%), obesity (11%), and diabetes mellitus (3.6%). Conclusion: Risk factors for CKD are common among civil servants in Kano. The most frequent CKD risk factors found among the study subjects were use of traditional medication, cigarette smoking, obesity, hypertension, and proteinuria.

Echinacea-induced cytosolic Ca2+ elevation in HEK293

BackgroundWith a traditional medical use for treatment of various ailments, herbal preparations of Echinacea are now popularly used to improve immune responses. One likely mode of action is that alkamides from Echinacea bind to cannabinoid type 2 (CB2) receptors and induce a transient increase in intracellular Ca2+. Here, we show that unidentified compounds from Echinacea purpurea induce cytosolic Ca2+ elevation in non-immune-related cells, which lack CB2 receptors and that the Ca2+ elevation is not influenced by alkamides.MethodsA non-immune human cell line, HEK293, was chosen to evaluate E. purpurea root extracts and constituents as potential regulators of intracellular Ca2+ levels. Changes in cytosolic Ca2+ levels were monitored and visualized by intracellular calcium imaging. U73122, a phospholipase C inhibitor, and 2-aminoethoxydiphenyl borate (2-APB), an antagonist of inositol-1,4,5-trisphosphate (IP3) receptor, were tested to determine the mechanism of this Ca2+ signaling pathway. E. purpurea root ethanol extracts were fractionated by preparative HPLC, screened for bioactivity on HEK293 cells and by GC-MS for potential constituent(s) responsible for this bioactivity.ResultsA rapid transient increase in cytosolic Ca2+ levels occurs when E. purpurea extracts are applied to HEK293 cells. These stimulatory effects are phospholipase C and IP3 receptor dependent. Echinacea-evoked responses could not be blocked by SR 144528, a specific CB2 receptor antagonist, indicating that CB2 is not involved. Ca2+ elevation is sustained after the Echinacea-induced Ca2+ release from intracellular Ca2+ stores; this longer-term effect is abolished by 2-APB, indicating a possible store operated calcium entry involvement. Of 28 HPLC fractions from E. purpurea root extracts, six induce cytosolic Ca2+ increase. Interestingly, GC-MS analysis of these fractions, as well as treatment of HEK293 cells with known individual and combined chemicals, indicates the components thought to be responsible for the major immunomodulatory bioactivity of Echinacea do not explain the observed Ca2+ response. Rather, lipophilic constituents of unknown structures are associated with this bioactivity.ConclusionsOur data indicate that as yet unidentified constituents from Echinacea stimulate an IP3 receptor and phospholipase C mediation of cytosolic Ca2+ levels in non-immune mammalian cells. This pathway is distinct from that induced in immune associated cells via the CB2 receptor.

Withdrawal from multiple sedative agent therapy in an infant: Is dexmedetomidine the cause or the cure?*

To report withdrawal symptoms experienced by an infant following the prolonged use of dexmedetomidine. Case report. Pediatric intensive care unit at a freestanding tertiary care children's hospital. One pediatric patient with respiratory failure following pertussis infection that required prolonged intubation and sedation. The patient required dexmedetomidine to maintain optimal sedation before ventilator weaning. Subsequent to receiving dexmedetomidine the patient developed withdrawal symptoms. In patients who fail to achieve adequate sedation with the use of traditional medications, dexmedetomidine is an adequate alternative. However, abrupt discontinuation of dexmedetomidine may result in withdrawal symptoms that may be avoided with a dexmedetomidine taper.

Caracterização físico-química do fármaco antichagásico benznidazol

Currently, benznidazole (BNZ) is a unique therapeutic alternative available in Brazil to treat Chagas disease. Despite its traditional medical use, little is known about the chemical nature of this drug. A detailed study of the physicochemical properties of BNZ was performed using multiple assays. Thermal, diffractometric, morphological and reological drug profiles were obtained. The partition coefficient and solubility results allowed this drug to be classified as a class IV drug according to the biopharmaceutical classification system. This information will be useful for the development of more effective BNZ formulations and for establishing the quality profile of BNZ.

In vitro susceptibility of Helicobacter pylori to extracts of Eucalyptus camaldulensis and Eucalyptus torelliana

The in vitro susceptibility of Helicobacter pylori to extracts of Eucalyptus camaldulensis Dehnh. and Eucalyptus torelliana F. Muell. (Myrtaceae), Nigerian medicinal plants, was investigated in six strains of H. pylori, namely, ATCC 4504, ATCC 47619, A2, TI8984, 019A, and A6. The susceptibility of these strains was determined using a standardized agar dilution method (National Committee for Clinical Laboratory Standards guidelines) with Mueller–Hinton agar, supplemented with defibrinated horse blood. The minimum inhibitory concentrations of the crude extracts against all the tested strains ranged from 12.5 to 400 μg/mL. Phytochemical screening of the plant extracts revealed the presence of tannins, saponins, and cardenolides. The anti-H. pylori activities demonstrated by these plants may be attributed to their chemical constituents, and explain their reported traditional uses, as well as their gastroprotective properties as demonstrated previously in experimental animals. The results of this work suggest that, in accordance with their traditional medical use in Nigeria, E. camaldalensis and E. torelliana have some therapeutic potential against H. pylori, and thus are of interest for the treatment of H. pylori infections.

Pectic polysaccharides from Biophytum petersianum Klotzsch, and their activation of macrophages and dendritic cells

The Malian medicinal plant Biophytum petersianum Klotzsch (Oxalidaceae) is used as a treatment against various types of illnesses related to the immune system, such as joint pains, inflammations, fever, malaria, and wounds. A pectic polysaccharide obtained from a hot water extract of the aerial parts of B. petersianum has previously been reported to consist of arabinogalactans types I and II (AG-I and AG-II), probably linked to a rhamnogalacturonan backbone. We describe here further structural characteristics of the main polysaccharide fraction (BP1002) and fractions obtained by enzymatic degradations using endo-alpha-d-(1-->4)-polygalacturonase (BP1002-I to IV). The results indicate that in addition to previously reported structures, rhamnogalacturan type II and xylogalacturonan areas appear to be present in the pectic polymer isolated from the plant. Atomic force microscopy confirmed the presence of branched structures, as well as a polydisperse nature. We further tested whether the BP1002 main fraction or the enzymatically degraded products could induce immunomodulating activity through stimulation of subsets of leukocytes. We found that macrophages and dendritic cells were activated by BP1002 fractions, while there was little response of T cells, B cells, and NK cells. The enzymatic treatment of the BP1002 main fraction gave important information on the structure-activity relations. It seems that the presence of rhamnogalacturonan type I is important for the bioactivity, as the bioactivity decreases with the decreased amounts of rhamnose, galactose, and arabinose. The demonstration of bioactivity by the plant extracts might indicate the mechanisms behind the traditional medical use of the plant.

Anti-inflammatory and anti-leukemic activities of the flower extracts from Thai medicinal plants

Based on the traditional medical use in Thailand, the flowers of six medicinal plants were investigated for anti-inflammatory and anti-leukemic activities. In the screening, the n-hexane, dichloromethane, methanol and water extracts were tested for anti-inflammatory activity by the inducible nitric oxide synthase assay (iNOS) [1] and for anti-leukemic activity by a growth inhibition assay against human CCRF-CEM leukemia cell line [2]. The results from the iNOS assay showed that the tested extracts were only weak inhibitors with inhibition rates of 0–53% at 10µg/ml. The n-hexane extracts of Mammea siamensis (Miq.) T. Anderson, Mesua ferrea Linn. and the dichloromethane extracts of Mesua ferrea Linn. and Michelia alba DC. exhibited very strong cytotoxic effect against human CCRF-CEM leukemia cells at 10µg/ml with inhibition values of 85–99%. Bioassay-guided fractionation of the active extracts is in progress.

A case-control study of risk factors for male infertility in Southern Nigeria

Aim: The purpose of this study was to evaluate the association between selected potential socio-demographic and behavioural risk factors and infertility in Nigeria males. Methods: The study consisted of cases and controls. The cases were 150 males with proven male infertility, while the controls were 150 fertile males with normal semen parameters. Both cases and controls were matched for age places of residence, and were similar in key socio-demographic variables. They were compared for sexual history, past medical and surgical history, past exposures and treatment of symptoms of sexuality transmitted diseases, past and current use of drugs and history of smoking and alcohol intakes. Results: The results showed infertile men to be significantly more likely than fertile men to report having experienced penile discharge, painful micturition and genital ulcers. Infertile men were less likely to seek treatment for these symptoms, and to seek treatment with informal sector providers rather than formal sector providers in private, district and referral hospitals. Multivariate analysis showed that male infertility was also significantly associated with bacteria in semen cultures, self-reporting of previous use of traditional medications and moderate to heavy alcohol intake. By contrast, infertility was not significantly associated with smoking and occupational types. Conclusion: We conclude that infertility is associated with various proxies of sexually transmitted infections (STIs) and poor healthcare-seeking behaviour concerning for STIs in Nigeria men. Efforts to address these problems will likely contribute to reducing the prevalence of male infertility in Nigeria. Tropical Journal of Obstetrics and Gynaecology Vol. 22(2) 2005: 136-143

A case-control study of risk factors for male infertility in Nigeria

To evaluate the association between selected potential socio-demographic and behavioral risk factors and infertility in Nigerian men. There were two groups in this study. One group consisted of 150 men with proven male infertility, and the other consisted of 150 fertile men with normal semen parameters. Both were matched for age, place of residence and key socio-demographic variables. They were compared for sexual history, past medical and surgical history, past exposures to sexually transmitted infections and treatment, past and current use of drugs as well as smoking and alcohol intake history. Infertile men were significantly more likely than fertile men to report having experienced penile discharge, painful micturition and genital ulcers, less likely to seek treatment for these symptoms and more likely to seek treatment with informal sector providers. Multivariate analysis showed that male infertility was significantly associated with bacteria in semen cultures, self-reporting of previous use of traditional medications and moderate to heavy alcohol intake, but not with smoking and occupational types. INFERTILITY is associated with various proxies of sexually transmitted infections (STIs) and poor healthcare-seeking behavior for STIs in Nigerian men.

Linalool modifies the nicotinic receptor–ion channel kinetics at the mouse neuromuscular junction

Linalool is a monoterpene compound reported to be a major component of essential oils in various aromatic species. Several linalool-producing species are used in traditional medical systems. Among these is Aeolanthus suaveolens G. Dom (Labiatae) which is used as an anticonvulsant in the Brazilian Amazon. Psychopharmacologicalin vivo evaluation of linalool showed that this compound has dose-dependent marked sedative effects at the central nervous system (CNS), including hypnotic, anticonvulsant and hypothermic properties. It has been suggested that these neurochemical effects might be ascribed to the local anaesthetic activity of linalool. The present study reports an inhibitory effect of linalool on the acetylcholine (ACh) release and on the channel open time in the mouse neuromuscular junction. These findings could provide a rational basis to confirm the traditional medical use of linalool-producing plant species. Indeed, our data demonstrate some interactions in the modulation of the ACh release at the mouse neuromuscular junction, which are well correlated with the suggested molecular mechanisms. Linalool induced a reduction of the ACh-evoked release. The possibility that this effect could be ascribed to some interaction with pre-synaptic function is noteworthy. Moreover, the inhibitory effect induced on the kinetics of the miniature end-plate current decay demonstrates a local anaesthetic action, either on the voltage or on the receptor-activated channels.

Reconsidering the DSM-IV Diagnoses of Alzheimer's Disease: Behavioral and Psychological Symptoms in Patients With Dementia

In traditional medical use, a categorical diagnosis conveys essential (although stereotypic) information about the signs and symptoms of a disease, its treatment, and its prognosis. Its utility derives from its generalizability. However, many of the shortcomings of categorical classification also reflect these same qualities. Diagnoses too often fail to capture important qualities of a disorder or do not sufficiently characterize a patient's particular symptoms. Recent editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM), which have emphasized highly specific entry criteria to establish psychiatric conditions in a more homogeneous fashion, have sometimes resulted in enhanced reliability at the cost of diminished validity. The variability of psychiatric disorders often defies attempts to create strictly defined clusters amenable to syndrome classifications.

An Ethnopharmacological Study from Kulu District, Himachal Pradesh, India: Traditional Knowledge Compared with Modern Biological Science

A synthesis of ethnopharmacological knowledge and western biological science has been attempted in this paper. Thirty-four species of plants used by local women in hamlets of Banjar taluka, Kulu district, Himachal Pradesh have been recorded. The knowledge of medicinal plants that local women have is important as they have a lifetime experience in using them through caring for themselves, their families and others around them. For the plants recorded, information from scientific literature has been included in order to explain or justify the traditional medical use.

An Ethnopharmacological Study from Kulu District, Himachal Pradesh, India: Traditional Knowledge Compared with Modern Biological Science

A synthesis of ethnopharmacological knowledge and western biological science has been attempted in this paper. Thirty-four species of plants used by local women in hamlets of Banjar taluka, Kulu district, Himachal Pradesh have been recorded. The knowledge of medicinal plants that local women have is important as they have a lifetime experience in using them through caring for themselves, their families and others around them. For the plants recorded, information from scientific literature has been included in order to explain or justify the traditional medical use.

Post natal maternal morbidity patterns in mothers delivering in Gweru City (Midlands province).

To determine morbid conditions suffered by mothers during the first six weeks post delivery and risk factors associated with them in Gweru district. A cross sectional survey. Gweru district hospital, Monomotapa, Mkoba 1 and Mkoba polyclinic. A consecutive sample of 201 mothers residing in Gweru district who delivered in these facilities during the month of June 1997. Morbid conditions, magnitude and the risk factors. During follow up checks on recruited mothers, turn up rates were 82% and 63% at two and six weeks respectively. Fifty eight percent (58%) of the mothers reported at least one morbid condition within the first 24 hours post delivery and pain was a dominant feature. At two weeks, 56% of those who turned up predominantly presented with sepsis in areas of the reproductive tract. The figure fell to 35% among mothers who turned up at six weeks and a mixture of pain and sepsis were the predominant complaints. Episiotomies caused a lot of pain post operatively and the risk of subsequent sepsis was high, (OR: 9; 95% CI: 1.16 < OR < 69.7; p = 0.020). Statistically significant associations were found between backache and multiparity (OR: 1.89; 95% CI: 1 < OR < 3.4; p = 0.040) and also between Caesarian section and some morbid conditions (OR: 4.14; p = 0.002; 95% CI 2.05 < OR < 10.91). The prevalence rate of HIV was 29.4%. HIV positivity was associated with marriage below the age of 19 years (OR: 2.4; 95% CI 1.21 < OR < 3.8; p = 0.024). There was no association between HIV serostatus and maternal morbidity. Use of traditional medication during pregnancy was reported by 42% of mothers, but it did not have any immediately observable intrapartum of post partum effects. Similarly the place of delivery was not associated with post natal maternal morbidity. The first two weeks post delivery were the most critical for the mother in terms of post natal maternal morbidity. Sepsis associated pain was the predominant condition. To improve the effectiveness of post natal care, a review within the first two weeks post delivery is an essential intervention, in addition to the routine six weeks check.

Effects of Linalool on glutamatergic system in the rat cerebral cortex.

Linalool is a monoterpene compound reported to be a major component of essential oils in various aromatic species. Several Linalool-producing species are used in traditional medical systems, including Aeolanthus suaveolens G. Dom (Labiatae) used as anticonvulsant in the Brazilian Amazon. Psychopharmacological in vivo evaluation of Linalool showed that this compound have dose-dependent marked sedative effects at the Central Nervous System, including hypnotic, anticonvulsant and hypothermic properties. The present study reports an inhibitory effect of Linalool on Glutamate binding in rat cortex. It is suggested that this neurochemical effect might be underlining Linalool psychopharmacological effects. These findings provide a rational basis for many of the traditional medical use of Linalool producing plant species.