Potential benefits versus hazards of herbal therapy during pregnancy; a systematic review of available literature

Association between the use of herbal medicines during pregnancy and adverse fetal outcomes among mothers in eastern Ethiopia, 2023

Background

Nowadays, pregnant women around the world use herbal remedies extensively. Evidence illustrated that the association between the use of herbal medicines and unfavorable fetal outcomes is not well established. Furthermore, much of the existing research is conducted within medical facilities, which may result in excluding mothers who do not receive antenatal follow-up care. Therefore, this study aimed to explore the association between the use of herbal medicine and adverse fetal outcomes in eastern Ethiopia.

Methods

A community-based cross-sectional study was conducted among 882 randomly selected mothers from February 1, 2023 to November 1, 2023. Data were collected through face-to-face interviews using structured questionnaires adapted from previous literature. The dataset was analyzed using Stata version 18, and a modified Poisson regression model was applied. Adjusted prevalence ratios (APR) with 95 % confidence intervals were estimated.

Results

The prevalence of herbal medicines use among pregnant women in eastern Ethiopia was 43.2 % (95 % CI: 39.9, 46.5). The most commonly used herbal medicines were Ocimum lamiifolium 109 (29.1 %), pumpkin fruit 68 (18.2 %) and Rutachalepensis 61(16.3 %). Factors such as rural residency [APR = 1.27, 95%CI (1.01,1.59)], having obstetric complications in recent pregnancy [APR = 1.42, 95 % CI: (1.14,1.78)], and experiencing adverse fetal outcomes [APR = 1.59, 95%CI: (1.05,2.2)] were significantly associated with the use of herbal medicine.

Conclusions

More than two out of five mothers used herbal remedies during their recent pregnancy. The study identified a significant association between the use of herbal medicines and various sociodemographic and obstetric factors. Consequently, it is essential to establish the safety and effectiveness of herbal medications before their use during pregnancy. To address the diverse health needs of pregnant women and mitigate the risks associated with the indiscriminate use of herbal remedies, a collaborative strategy should be developed involving herbalists, communities with strong beliefs in herbal medicine, and healthcare professionals.

Cycasin derivative: a potential embryotoxic component of Atractylodes macrocephala rhizome for limb malformation

Objective

The rhizome of Atractylodes macrocephala Koidz. (Asteraceae), called Atractylodes macrocephala rhizome (AMR) and known by its traditional name Bai Zhu, is a prominent Chinese herbal medicine employed for preventing miscarriage. However, our previous study revealed that high dosages of AMR administered during pregnancy could cause embryotoxicity but the specific embryotoxic components and their underlying mechanisms remain unclear. This study aimed to screen and identify the potential embryotoxic components of AMR.

Methods

The AMR extracts and sub-fractions were analyzed by thin layer chromatography and subsequently screened by in vitro mouse limb bud micromass and mouse whole embryo culture bioassays. The embryotoxic fractions from AMR were further evaluated in vivo using a pregnant mouse model. The structures of the potential embryotoxic components were analyzed using matrix-assisted laser desorption/ionization tandem time-of-flight mass spectrometry (MALDI-TOF/TOF-MS).

Results

In vitro and in vivo bioassays revealed that AMR glycoside-enriched sub-fractions (AMR-A-IIa and AMR-A-IIb) exhibited potential embryotoxicity. These sub-fractions, when administered to pregnant animals, increased the incidence of stillbirth and congenital limb malformations. MS spectrometry analysis identified cycasin derivatives in both sub-fractions, suggesting their possible role in the observed limb malformations. However, further experiments are necessary to validate this hypothesis and to elucidate the underlying mechanisms.

Conclusions

Our study provides significant scientific evidence on the pharmacotoxicity of AMR, which is important for the safe clinical application of commonly used Chinese herbal medicines during pregnancy.

Complementary Approaches to Retinal Health Focusing on Diabetic Retinopathy

Diabetes mellitus affects carbohydrate homeostasis but also influences fat and protein metabolism. Due to ophthalmic complications, it is a leading cause of blindness worldwide. The molecular pathology reveals that nuclear factor kappa B (NFκB) has a central role in the progression of diabetic retinopathy, sharing this signaling pathway with another major retinal disorder, glaucoma. Therefore, new therapeutic approaches can be elaborated to decelerate the ever-emerging "epidemics" of diabetic retinopathy and glaucoma targeting this critical node. In our review, we emphasize the role of an improvement of lifestyle in its prevention as well as the use of phytomedicals associated with evidence-based protocols. A balanced personalized therapy requires an integrative approach to be more successful for prevention and early treatment.

Pharmacological Basis for Antispasmodic, Bronchodilator, and Antidiarrheal Potential of Dryopteris ramosa (Hope) C. via In Vitro, In Vivo, and In Silico Studies

Background:Dryopteris ramosa is used as an old treatment for several diseases. D. ramose fronds are eaten to treat gastrointestinal (GIT) issues and as an antibiotic. However, there is a dearth of literature justifying its traditional use. Aims and objectives: the current work used biological and molecular docking studies to support traditional usage and elucidate D. ramosa's multitarget mechanism. Materials and methods: Bioactive compounds were docked in silico. Force displacement transducers coupled with a power lab data gathering system examined the effects of compounds on rabbit jejunum, trachea, and aorta tissues. Albino mice and rats were used for in vivo studies. Results: Bioactive compounds interacted with inflammation, asthma, and diarrhea genes, according to in silico studies. D. ramosa crude extract (Dr.Cr) calmed impulsive contractions and K+ (80 mM)-provoked contractions in the jejunum and tracheal tissue dose-dependently, showing the presence of the Ca++ channel-blocking (CCB) effect, further verified by the rightward parallel shift of CRCs equivalent to verapamil. Polarity-based fractionation showed spasmolytic activity in Dr.DCM and muscarinic receptors mediated spasmogenic activity in the Dr.Aq fraction. Dr.Cr vasoconstricted the aortic preparation, which was totally blocked by an angiotensin II receptor antagonist. This suggests that Dr. Cr's contractile effect is mediated through angiotensin receptors. In rats and mice, it showed anti-inflammatory and antidiarrheal action. Conclusion: This study supports the traditional medicinal uses of D. ramosa against GIT disorders and may be an important therapeutic agent in the future.

Jaundice and its associated factors among neonates admitted to selected referral hospitals in southwest oromia, Ethiopia: Multi-center cross-sectional study

Background

Jaundice is a common clinical problem during the first month of birth throughout the world. Mainly, it is the leading cause of neonatal morbidity and mortality in developing countries.

Objectives

The aimed of this studied was to assess predictors of jaundice among neonates admitted to selected referral hospitals in southwest Oromia, Ethiopia, 2021.

Methods

An Institutional based cross-sectional study was implemented among 205 admitted neonates at selected referral hospitals in southwest Oromia, Ethiopia from October 05 to November 5, 2021. Jimma medical center (JMC), Wollega University referral hospital (WURH), and Ambo University Referral hospital (AURH) were selected by simple random sampling technique. A pretested structured interviewer-administered questionnaire and medical record review was used to collect data. Both binary and multivariable logistic regression analyses were performed to identify factors associated with neonatal jaundice. Logistic regression analyses were performed to identify factors associated with neonatal jaundice. Statistical Significance was declared at P-value less than 0.05 in the final model, and if the confidence interval does not include the null hypothesis value.

Results

The prevalence of neonatal jaundice was 20.5% (95%CI: 1.74-1.85). The mean age of neonates was 8.6 ± 7.8 days. Traditional medicine use during current pregnancy (AOR: 5.62, 95%CI: 1.07, 9.52), Rh incompatibility (AOR: 0.045, 95%CI: 0.01, 0.21), gestational age (AOR: 4.61, 95%CI: 1.05, 10.3), premature rupture of membrane (AOR: 3.76, 95%CI: 1.58, 8.93) and hypertension (mother) (AOR: 3.99, 95%CI: 1.13, 14.02) were factors significantly associated with neonatal jaundice.

Conclusion

Neonatal jaundice was relatively higher in the current study. Traditional medicine use, Rh incompatibility, premature ruptures of membrane, hypertension, and preterm gestational age were factors associated with neonatal jaundice.

The effect of crocin versus sertraline in treatment of mild to moderate postpartum depression: a double-blind, randomized clinical trial

Postpartum depression (PPD) is one of the most common conditions among women. This study aimed to investigate the effect of crocin compared to sertraline in women with mild to moderate PPD. This trial study was performed on women with PPD. Patients in two groups received crocin (15 mg) and sertraline (50 mg) daily for 3 months, respectively. Patients have assessed by Beck's Depression Inventory-II (BDI-II) and Beck's Anxiety Inventory (BAI) at 0-12 weeks. A total of 64 patients were examined. The mean of the BDI-II score in the crocin group decreased after 3 months from 20.75 to 4.93 (P = 0.0001). In the sertraline group, the mean score of BDI-II decreased after 3 months from 21.06 to 2.37 (P = 0.0001). The mean of the BAI score in the crocin group decreased significantly after 3 months from 13.75 to 4.06 (P = 0.0001) and in the sertraline group from 12.9 to 2.71 (P = 0.0001). No significant difference was observed between crocin and sertraline after the clinical trial (P = 0.5). No severe side effects were observed during the study in the two groups. The results of this study showed that crocin (15 mg daily) could be useful in treating PPD. Furthermore, this study showed that crocin, with far fewer side effects than chemical drugs, can be widely used in PPD, but due to the small sample size further studies are necessary to confirm such efficiency.

Evaluation of Genotoxic Effect and Antigenotoxic Potential against DNA Damage of the Aqueous and Ethanolic Leaf Extracts of Annona muricata Using an In Vivo Erythrocyte Rodent Micronucleus Assay

Annona muricata have been extensively used in traditional medicine to treat multiple diseases, including cancers. This study evaluated the genotoxic potential and antigenotoxic activities of A. muricata aqueous and ethanolic leaf extracts by employing an in vivo erythrocyte rodent micronucleus assay. Different doses (187.5, 375, and 750 mg/kg) of both extracts were administered orally for 5 days alone and combined with cyclophosphamide (CP, 60 mg/kg) to BALB/c mice. Also, it was administered orally to Wistar rats for 5 days through the final stage of gestation. No genotoxic or cytotoxic effects were observed in the two adult rodent models when A. muricata was administered orally nor in newborn rats transplacentally exposed to the extracts. Moreover, A. muricata aqueous and ethanolic leaf extracts demonstrated a protective effect against CP-induced DNA damage. Due to its lack of genotoxic effect and its capacity to decrease DNA damage, A. muricata is likely to open an interest field regarding its potential safe use in clinical applications.