Management of Post Menstrual Syndromes: From Traditional Knowledge to Evidence-Based Medicine

Plants were and are still widely used for a number of pathologies affecting women health, particularly post menstrual syndromes (PMS). PMS refers to a diverse set of clinical symptoms and nearly omnipresent in the woman of reproductive age and can impinge on women's interpersonal relationships, social behavior, work absenteeism, and work productivity [1]. In additionto conventional FDA approved drugs, a plethora of other selections are imperative to reflect on for women who prefer natural alternative and complementary therapies or for whom conventional remedies are contraindicated [2]. Indeed, prior to the introduction of modern therapy, a panoply of medicinal herbs such as Kacip Fatima, Vitex, Yam, Licorice, Alfalfa, Chamomile, Dong-Quai, Evening Primrose, Ginkgo, Water-Willowand Cohosh have been used predominantly to treat or relief PMS. Traditional Chinese medicine has been prescribing herbs and herbal formulas since time immemorial; for instance Angelica (Dang Gui) has been widely used by Chinese and Japanese women for centuries. It is well-known for regulating menstrual cycles, eliminating the discomfort of premenstrual syndromes, and relieving menstrual cramps. Medicinalplants thus tend to represent a safe alternative to current hormone or drug therapy used to manage PMS symptoms. Many of these herbals formulas were geared towards regulating hormonal cycle and some recently being reported to have estrogen and/or progesterone-like effects [3-5]. Other less popular herbs that have been used successfully to decreasenervous tension include passion-flower, valerian, oatgrass, lemon-balm and skull-cap [6]. One phytotherapeutic combination; dandelion root/leaf-Taraxum officinale, milk or blessed thistle- Cnicus benedictus, Vitex- Vitex agnus-castus, black or blue Cohosh- Cimcifuga racemosa and Caulophylum thalictroides, Dong-Quai - Angelica sinensis and wild-Yam - Dioscorea villosa, is prescribed by phytotherapists and/or traditional healers as a polyherbal tea (1 tsp. of the herbal formula, one parteach, in 1 cup of boiling water thrice daily) or in tincture (1/2 tsp. 3 to 4 times daily). However, Vitex also known as chaste tree berry, has attracted much consideration and comprehensively tested in randomized controlledtrials; [1, 7-8] and reported to exhibit dopaminic agonist, inhibiting prolactin and increasing estrogen secretions and its flavonoids ligands to benzodiazepine receptors- thereby depicting antidepressant andanxiolytic properties [1]. Chaste berry fruit extract has also been shown to correct prolactin levels in latent hyperprolactinaemia via dopamine receptors. Vitex formulation (Agnolyt®) has been reported to besuperior to pyridoxine in reducing premenstrual tension, whereas Femicur® (dried extract of Vitex) decreased and/or ceased mastalgia, associated toPMS; both tested in randomized controlled clinical trials [7, 8]. Nonetheless, many of the above-mentioned mono or poly-phytotherapeutic combinations are not recommended during pregnancy and possiblehormonal effects through breast milk (some via prolactin inhibition) [3]. Additionally, extensive and scientific-based clinical research into the use of herbal therapies for premenstrual disorders, specifically in adolescents is unfortunately sparse. To this effect, phytotherapies for PMS can be given due consideration provided they are prescribed by trained professionalsfollowing rigorous high-quality clinical testing and with optimal dosing standards but avoided concurrently with conventional medications. Additionally, it is believed that it is of uttermost importance for medicalpractitioners to be aware of such herbal therapies and any innate potential drug-herb interactions and/or side effects in an endeavor to offer alternatives to women

A QUANTITATIVE ETHNOBOTANICAL STUDY OF COMMON HERBAL REMEDIES USED AGAINST 13 HUMAN AILMENTS CATERGORIES IN MAURITIUS

Background and aim: Mauritius is a tropical multicultural island with a long-standing use of herbal remedies. The present ethnobotanical survey was geared towards documenting and preserving local knowledge pertaining to common medicinal plants (MP) used as therapeutic agents in Mauritius. Methods: Interviews were conducted among local people and herbalists (n=318). Also, 7 quantitative ethnobotanical parameters (variety of use (VU), relative frequency of citation (RFC), informant consensus factor (FIC), fidelity level (FL), index of agreement on remedies (IAR), relative importance (RI) and cultural importance index (CII)) were calculated for MP used. Results: A total of 87 plants belonging to 45 families were reported to be used in formulating herbal remedies among which 3 endemic plants have been documented. Mentha piperita was found to be the most used plant against gastrointestinal diseases with an RFC index of 0.55. Holy basil (Ocimum tenuiflorum) had the highest RI value (RI=2.00), being cited for 9 different ailments. Therapeutic properties of some herbal remedies reported correlated to some extent with those of previous studies while others have open potential perspectives for further research as their chemistry and pharmacology have not been published. Conclusion: From the information obtained, it can be suggested that the Mauritian population still relies heavily on MP for their primary health care. Nonetheless, further research is needed to investigate the possible active constituents that could be the basis of an evidence based investigation to discover new drugs

New Insights in Staging and Chemotherapy of African Trypanosomiasis and Possible Contribution of Medicinal Plants

Human African trypanosomiasis (HAT) is a fatal if untreated fly-borne neuroinflammatory disease caused by protozoa of the species Trypanosoma brucei (T.b.). The increasing trend of HAT cases has been reversed, but according to WHO experts, new epidemics of this disease could appear. In addition, HAT is still a considerable burden for life quality and economy in 36 sub-Saharan Africa countries with 15–20 million persons at risk. Following joined initiatives of WHO and private partners, the fight against HAT was re-engaged, resulting in considerable breakthrough. We present here what is known at this day about HAT etiology and pathogenesis and the new insights in the development of accurate tools and tests for disease staging and severity monitoring in the field. Also, we elaborate herein the promising progresses made in the development of less toxic and more efficient trypanocidal drugs including the potential of medicinal plants and related alternative drug therapies

The Therapeutic Potential of Medicinal Foods

Pharmaceutical and nutritional sciences have recently witnessed a bloom in the scientific literature geared towards the use of food plants for their diversified health benefits and potential clinical applications. Health professionals now recognize that a synergism of drug therapy and nutrition might confer optimum outcomes in the fight against diseases. The prophylactic benefits of food plants are being investigated for potential use as novel medicinal remedies due to the presence of pharmacologically active compounds. Although the availability of scientific data is rapidly growing, there is still a paucity of updated compilation of data and concerns about the rationale of these health-foods still persist in the literature. This paper attempts to congregate the nutritional value, phytochemical composition, traditional uses, in vitro and in vivo studies of 10 common medicinal food plants used against chronic noncommunicable and infectious diseases. Food plants included were based on the criteria that they are consumed as a common food in a typical diet as either fruit or vegetable for their nutritive value but have also other parts which are in common use in folk medicine. The potential challenges of incorporating these medicinal foods in the diet which offers prospective opportunities for future drug development are also discussed

Crude Aloe vera

Aloe vera gel (AVG) is traditionally used in the management of diabetes, obesity, and infectious diseases. The present study aimed to investigate the inhibitory potential of AVG against α-amylase, α-glucosidase, and pancreatic lipase activity in vitro. Enzyme kinetic studies using Michaelis-Menten (Km) and Lineweaver-Burk equations were used to establish the type of inhibition. The antioxidant capacity of AVG was evaluated for its ferric reducing power, 2-diphenyl-2-picrylhydrazyl hydrate scavenging ability, nitric oxide scavenging power, and xanthine oxidase inhibitory activity. The glucose entrapment ability, antimicrobial activity, and total phenolic, flavonoid, tannin, and anthocyanin content were also determined. AVG showed a significantly higher percentage inhibition (85.56±0.91) of pancreatic lipase compared to Orlistat. AVG was found to increase the Michaelis-Menten constant and decreased the maximal velocity (Vmax) of lipase, indicating mixed inhibition. AVG considerably inhibits glucose movement across dialysis tubes and was comparable to Arabic gum. AVG was ineffective against the tested microorganisms. Total phenolic and flavonoid contents were 66.06±1.14 (GAE)/mg and 60.95±0.97 (RE)/mg, respectively. AVG also showed interesting antioxidant properties. The biological activity observed in this study tends to validate some of the traditional claims of AVG as a functional food

Piper betle L. (betel quid) shows bacteriostatic, additive, and synergistic antimicrobial action when combined with conventional antibiotics

Piper betle L., commonly chewed as betel quid (paan), has been extensively acclaimed in a panoply of countries for both its nutritive and medicinal values. The present study was geared towards investigating the antibacterial activities of P. betle extracts and its antibiotic modulating activity. A decoction of P. betle (AQE) leaves as used traditionally, as well as ethanolic (EE), ethylacetate (EAE), acetone (ACE), and dichloromethane (DCME) extracts were evaluated using the broth microdilution assay against six bacterial ATCC strains. The minimum inhibitory concentration (MIC), bacteriostatic and bacteriocidal activities of the extracts were evaluated. Additionally, the ability of the extracts to modulate conventional antibiotics (synergistic, additive, indifference, antagonistic) was assessed using a modified Checkerboard method and the fractional inhibitory concentration index (ƩFIC) was calculated. The phytochemical profile of each extract was determined and the Pearson’s correlation coefficient was used to establish any association between the MIC, ƩFIC, and phytochemical content. All the five extracts inhibited at least one of the six bacterial strains tested with EAE and ACE exhibiting the most potent antibacterial activity. The lowest MIC (0.2500 μg/μl) recorded was against Staphylococcus aureus. Piper betle has been further shown to exhibit only bacteriostatic effect. Results from the Checkerboard indicated additive and synergistic effects of P. betle extracts especially in the 50% EAE-50% antibiotic and 50% ACE-50% antibiotic combinations. The greatest synergy was observed against Pseudomonas aeruginosa (ƩFIC 0.09) in the 70% ACE-30% Chloramphenicol combination. Synergy was also observed against S. aureus, Propionibacterium acnes, Staphylococcus epidermidis, and Streptococcus pyogenes. Phytochemical screening revealed that ACE and EAE contain the highest amount of phenols while DCME contains the highest amount of flavonoids. Statistical analysis showed that lower MICs occurred with increasing phenol content (R=−0.392, p ≤ 0.05) and increasing flavonoid content (R=−0.551, p ≤ 0.01). However, no correlation was established between ƩFIC and phytochemical content which could indicate a different mechanism of action employed by the combinations. Data amassed have provided insight into the antibacterial activity, antibiotic modulating activity, and the phytochemical profile of P. betle.http://www.elsevier.com/locate/sajb2017-07-31hb2016Plant Scienc

Plants’ bioactive secondary metabolites in the management of sepsis: Recent findings on their mechanism of action

Sepsis is a severe inflammatory response to systemic infection and is a threatening cause of death in intensive care units. In recent years, a number of studies have been conducted on the protective effect of natural products against sepsis-induced organ injury. However, a comprehensive review of these studies indicating the mechanisms of action of the bioactive compounds is still lacking. In this context, this review aimed to provide an updated analysis of the mechanism of action of plants’ secondary metabolites in the management of sepsis. Scopus, Science Direct, Google Scholar, and PubMed were searched from inception to July 2022. A variety of secondary metabolites were found to be effective in sepsis management including allicin, aloin, cepharanthine, chrysin, curcumin, cyanidin, gallic acid, gingerol, ginsenoside, glycyrrhizin, hesperidin, kaempferol, narciclasine, naringenin, naringin, piperine, quercetin, resveratrol, rosmarinic acid, shogaol, silymarin, sulforaphane, thymoquinone, umbelliferone, and zingerone. The protective effects exerted by these compounds can be ascribed to their antioxidant properties as well as induction of endogenous antioxidant mechanisms, and also via the downregulation of inflammatory response and reduction of biochemical and inflammatory markers of sepsis. These findings suggest that these secondary metabolites could be of potential therapeutic value in the management of sepsis, but human studies must be performed to provide strength to their potential clinical relevance in sepsis-related morbidity and mortality reduction

A study on the potential of ants to act as vectors of foodborne pathogens

Ants (Technomyrmex difficilis and Solenopsis geminata) are insects often found in domestic kitchens of Mauritius. Unfortunately, they harbour disease-causing organisms and can potentially transfer these pathogens to food. This study was carried out to (i) investigate the knowledge, perception and behaviors of consumers in relation to the problem of ant infestation of domestic kitchens; (ii) identify the pathogenic microorganisms carried by ants; and (iii) determine the potential for ants to transfer these pathogenic microorganisms to food. A survey based on a stratified sampling design was carried out with 100 consumers using a questionnaire. To identify the pathogenic microorganism(s) harbored by ants, bait traps were set up using sterile sugar as a non-toxic attractant. Captured ants were then subjected to microbiological analyses. Most respondents (72%) agreed that ants constitute a hygienic issue but they did not perceive ants as a serious threat to human health. However microbiological analyses of ants (n = 50) confirmed the presence of various pathogenic microorganisms as well as fecal contaminants. Ants were found to harbor yeasts and molds systematically (100%), coliforms frequently (52%), Bacillus spp. and Escherichia coli occasionally (26% and 18% respectively) and Salmonella and Listeria monocytogenes sporadically (8 and 6 % respectively). Ants were also found to transfer E. coli to food surfaces at a moderately high frequency of 70%. This study demonstrated that the majority of consumers acknowledged the problem of ant infestation as a sanitation-related problem rather than a food safety issue. Since ants have the ability to harbor and subsequently transfer pathogenic or toxigenic microorganisms, ants may act as disease vectors and contaminate food, water and food-contact surfaces of kitchens resulting in foodborne illnesses

Essential oil composition, antimicrobial potential, phytochemical profile and toxicity of essential oils and crude extracts of sweet basil prior and after flowering

Essential oils and crude extracts of sweet basil (Ocimum tenuiflorum - OT) which are mostly used to flavor and spice food were prepared and analyzed prior and after flowering by GC and subjected to in vitro antimicrobial and in vivo toxicity evaluation. The essential oil composition was found to vary considerably with respect to harvesting time (prior to flowering stage- eugenol- 17.7%, carvacrol-27.1% and methyl-eugenol- 52.1%; as compared to flowering (caryophyllene- 9.26% and methyl-eugenol and comparatively smaller percentages of carvacrol and eugenol). Phytochemical screening of the plant samples from either season showed that the whole plants constituted of alkaloids, flavones, saponins, terpenes, sterols, tannins and triterpenes. The essential oils and crude extracts of plant parts of OT (leaves, twigs and/or inflorescence) in both stages showed marked antimicrobial activity against S. aureus and MRSA and with no apparent toxicity in rats. The observed antimicrobial properties and non-toxic nature during both stages of flowering would tend to validate the medicinal properties of OT as a functional food