Conceptual graph-based knowledge representation for supporting reasoning in African traditional medicine

Although African patients use both conventional or modern and traditional healthcare simultaneously, it has been proven that 80% of people rely on African traditional medicine (ATM). ATM includes medical activities stemming from practices, customs and traditions which were integral to the distinctive African cultures. It is based mainly on the oral transfer of knowledge, with the risk of losing critical knowledge. Moreover, practices differ according to the regions and the availability of medicinal plants. Therefore, it is necessary to compile tacit, disseminated and complex knowledge from various Tradi-Practitioners (TP) in order to determine interesting patterns for treating a given disease. Knowledge engineering methods for traditional medicine are useful to model suitably complex information needs, formalize knowledge of domain experts and highlight the effective practices for their integration to conventional medicine. The work described in this paper presents an approach which addresses two issues. First it aims at proposing a formal representation model of ATM knowledge and practices to facilitate their sharing and reusing. Then, it aims at providing a visual reasoning mechanism for selecting best available procedures and medicinal plants to treat diseases. The approach is based on the use of the Delphi method for capturing knowledge from various experts which necessitate reaching a consensus. Conceptual graph formalism is used to model ATM knowledge with visual reasoning capabilities and processes. The nested conceptual graphs are used to visually express the semantic meaning of Computational Tree Logic (CTL) constructs that are useful for formal specification of temporal properties of ATM domain knowledge. Our approach presents the advantage of mitigating knowledge loss with conceptual development assistance to improve the quality of ATM care (medical diagnosis and therapeutics), but also patient safety (drug monitoring)

A Computational Drug-Target Network for Yuanhu Zhitong Prescription

Yuanhu Zhitong prescription (YZP) is a typical and relatively simple traditional Chinese medicine (TCM), widely used in the clinical treatment of headache, gastralgia, and dysmenorrhea. However, the underlying molecular mechanism of action of YZP is not clear. In this study, based on the previous chemical and metabolite analysis, a complex approach including the prediction of the structure of metabolite, high-throughput in silico screening, and network reconstruction and analysis was developed to obtain a computational drug-target network for YZP. This was followed by a functional and pathway analysis by ClueGO to determine some of the pharmacologic activities. Further, two new pharmacologic actions, antidepressant and antianxiety, of YZP were validated by animal experiments using zebrafish and mice models. The forced swimming test and the tail suspension test demonstrated that YZP at the doses of 4 mg/kg and 8 mg/kg had better antidepressive activity when compared with the control group. The anxiolytic activity experiment showed that YZP at the doses of 100 mg/L, 150 mg/L, and 200 mg/L had significant decrease in diving compared to controls. These results not only shed light on the better understanding of the molecular mechanisms of YZP for curing diseases, but also provide some evidence for exploring the classic TCM formulas for new clinical application

Exploring the Ligand-Protein Networks in Traditional Chinese Medicine: Current Databases, Methods, and Applications

The traditional Chinese medicine (TCM), which has thousands of years of clinical application among China and other Asian countries, is the pioneer of the "multicomponent-multitarget" and network pharmacology. Although there is no doubt of the efficacy, it is difficult to elucidate convincing underlying mechanism of TCM due to its complex composition and unclear pharmacology. The use of ligand-protein networks has been gaining significant value in the history of drug discovery while its application in TCM is still in its early stage. This paper firstly surveys TCM databases for virtual screening that have been greatly expanded in size and data diversity in recent years. On that basis, different screening methods and strategies for identifying active ingredients and targets of TCM are outlined based on the amount of network information available, both on sides of ligand bioactivity and the protein structures. Furthermore, applications of successful in silico target identification attempts are discussed in detail along with experiments in exploring the ligand-protein networks of TCM. Finally, it will be concluded that the prospective application of ligand-protein networks can be used not only to predict protein targets of a small molecule, but also to explore the mode of action of TCM

Network Pharmacology: A New Approach for Chinese Herbal Medicine Research

The dominant paradigm of “one gene, one target, one disease” has influenced many aspects of drug discovery strategy. However, in recent years, it has been appreciated that many effective drugs act on multiple targets rather than a single one. As an integrated multidisciplinary concept, network pharmacology, which is based on system biology and polypharmacology, affords a novel network mode of “multiple targets, multiple effects, complex diseases” and replaces the “magic bullets” by “magic shotguns.” Chinese herbal medicine (CHM) has been recognized as one of the most important strategies in complementary and alternative medicine. Though CHM has been practiced for a very long time, its effectiveness and beneficial contribution to public health has not been fully recognized. Also, the knowledge on the mechanisms of CHM formulas is scarce. In the present review, the concept and significance of network pharmacology is briefly introduced. The application and potential role of network pharmacology in the CHM fields is also discussed, such as data collection, target prediction, network visualization, multicomponent interaction, and network toxicology. Furthermore, the developing tendency of network pharmacology is also summarized, and its role in CHM research is discussed

Plant-Based Ethnopharmacological Remedies for Hypertension in Suriname

Hypertension is the most important modifiable risk factor for cardiovascular, cerebrovascular, and renal diseases which are together among the most frequent causes of morbidity and mortality in the world. Despite the availability of a wide range of effective medicines, many individuals suffering from hypertension use plant-derived preparations for treating their disease. The choice for these alternatives is often associated with the closer relationship of such approaches to specific social, cultural, and religious perceptions about health and disease. However, in most cases, the scientific evidence for clinical efficacy of such medications is scant. The Republic of Suriname is a middle-income country in South America with a relatively high prevalence of hypertension and other cardiovascular diseases. This country harbors descendants of all continents, all of whom have preserved their cultural customs including their ethnopharmacological traditions. As a result, many Surinamese are inclined to treat their diseases including hypertension as they have done for centuries, that is, with plant-based preparations. This chapter has compiled the plants used for treating hypertension in Suriname; extensively evaluates 15 commonly used plants for potential efficacy on the basis of available phytochemical, mechanistic, preclinical, and clinical literature data; and closes with conclusions about their potential usefulness against the disease

Evaluation of herb-drug interactions in Nigeria with a focus on medicinal plants used in diabetes management

Studies have shown an increasing use of herbal medicines alongside conventional drugs by patients in their disease management especially for chronic diseases, with the attendant risks of herb-drug interactions. In order to forestall this, adequate information about the pharmacological and toxicological profile of herbal medicines and how these would in turn affect the bioavailability of the co-administered drug is required. To evaluate potential herb-drug interactions that could occur in diabetes management in Nigeria- (a) An assessment of available data on the pharmacological and toxicological effects of plants used in diabetes management was conducted as a means of mapping those with identified potential risks for herb-drug interactions; (b) A field work study was carried out in different localities in Nigeria to identify potential pharmacokinetic interactions based on the prescription drugs and herbal medicines co-administered by diabetic patients; and (c) Experimental analysis of plant samples collected during the field work was done to assess their effects on known cell detoxification mechanisms and pharmacokinetic parameters. The results of the research have confirmed the continued use of a wide range of medicinal plants in diabetes management, many of which have not been thoroughly investigated. In addition, 50% of diabetic patients visiting healthcare facilities in Nigeria routinely manage their diabetes or existing co-morbidities with herbal medicines alongside prescription drugs. Even more worrying is the frequent use of unlabeled herbal preparations which would constitute a huge challenge in the proper identification of herb-drug interactions when they occur. Based on previously available data and the experimental results of this research, a number of these herbal medicines have been identified as having overlapping interactions with prescription drugs. There is therefore a need for better regulation of herbal medicine use alongside pharmacovigilance monitoring in Nigeria in order to forestall the occurrence of clinically relevant untoward herb-drug interactions

Identifying Chinese Herbal Medicine Network for Endometriosis: Implications from a Population-Based Database in Taiwan

Background. Endometriosis is a common but bothersome gynecological disease, and Chinese herbal medicine (CHM) is used for treating endometriosis. The aim of this study is to explore CHM network and core treatments for endometriosis by analyzing nationwide CHM prescription database. Methods. From 1998 to 2013, the CHM prescriptions made primarily for endometriosis among women diagnosed with endometriosis (ICD-9-CM code: 671) by gynecologists during their reproductive age were collected. CHM network analysis was then carried out by using association rule mining and social network analysis. Results. A total of 12,986 CHM prescriptions made for endometriosis were analyzed. There were 556 kinds of CHM ever used, and, in average, each prescription was composed of 6.2 CHMs. Gui-Zhi-Fu-Ling-Wan (GZFLW) was used most frequently, followed by Cyperus rotundus (28.1% and 18.8% of all prescriptions, resp.). Additionally, the combination of Cyperus rotundus with GZFLW (8.0%) was the most frequently used combination of two CHMs. CHM network showed that GZFLW was the core CHM for endometriosis and graphically demonstrated the extensive coverage of TCM syndromes and pathogenesis of endometriosis. Conclusions. CHM network provides graphical demonstration and summary of commonly used CHMs for endometriosis, and further studies are warranted based on these findings

The use of complementary and alternative medicine by staff and students of UKZN residing in eThekwini Municipality.

Masters Degree. University of KwaZulu-Natal, Durban.Healthcare can systematically be separated into current (conventional, orthodox, Western or allopathic) and traditional (indigenous, reciprocal, elective or integrative). The former is plainly characterised, with minor provincial varieties in its fundamental way of thinking and clinical techniques. In present day treatment, improvement on medicinal products is accomplished through scientific research, which can include worldwide joint effort and responsibility. Such research is all around bolstered monetarily by industry, governments and altruistic associations. This is in sharp contrast to the circumstance with traditional complementary and alternative medicine. CAM is a class of medication that incorporates an assortment of treatment approaches that fall outside the domain of conventional prescription. An expanding measure of research is being done to build up the proof and viability of alternative medication. Even with limited proof of safety, CAM use remains popular worldwide. This study therefore seeked to find out CAM use between staff and students of UKZN Durban campuses. This was a campus-based quantitative cross-sectional survey involving adult individuals. Data on the demographic characteristics of the participants, the reasons for CAM use, monthly expenditure on CAM, personal beliefs on CAM use were collected. In total, 229 participants were included in the study, and among them, approximately 42% were aged 21–30 years. Additionally, 69% of the participants were women, over 73% were of Black ethnic group, over 58% reside in a suburbs setting. There was correlation between the reasons for CAM use namely to treat/manage a condition or promote health and gender, where it was statistically significant at p< 0.001 level. However, no statistical evidence could be shown that there was dependence between using CAM and race/ethnic group. Highest education attained and the reasons for using CAM practices and products showed a significant correlation (p<0.001). Some of the cultural and religious influences were statistically significant (p<0.05) influencers to our participants for their healthcare practices. In conclusion, the use of CAM was quite significant in the study population, and the most used therapy was exercise which was followed by vitamins and minerals. Larger numbers of participants in future will help solidify or negate these findings

Sources, blood concentrations, and approaches for reducing exposure to lead: A critical appraisal on lead poisoning

Lead, a non-essential metal, enters the body in various ways, making it a major public health issue. Painters and smelters report lead poisoning in children and staff. Mining and battery workers risk lead exposure. Traditional and cultural remedies may include dangerous quantities of lead, producing lead poisoning. These drugs must be properly understood and regulated to avoid toxicity. Lead poisoning symptoms vary by duration and severity. Lead first impairs cognition, development, and behaviour by damaging the neural system. Time degrades reproductive and haematological systems. Lead's quiet entry into the body makes it deadly. Acute lead nephropathy damages kidneys at 100mg/dL. Lead levels exceeding 150mg/dL may induce encephalopathy. Blood lead levels indicate lead poisoning severity. Lead levels over 10g/dL in children and 40g/dL in adults are hazardous. Lead toxicity affects various organs. Lead may induce hypertension and cardiovascular disease. It may also cause chronic kidney disease and renal failure. Lead exposure may impede fertility, cause miscarriages, and alter foetal development; hence the reproductive system is vulnerable. Symptoms and lead levels may be treated with different approaches. Lead chelation treatment is frequent. Other vitamins and medications may enhance organ function and treat lead poisoning. Lead poisoning prevention requires widespread awareness. Strict standards and education regarding lead-contaminated products and conventional remedies should reduce occupational lead exposure. Regular blood lead level monitoring, especially in youngsters and lead workers, may help detect and treat lead poisoning early. Lead poisoning has serious health consequences. Understanding lead exposure pathways, identifying symptoms, and preventing lead poisoning is essential to public health and organ system protection