Use of and attitudes towards herbal medicine during the COVID-19 pandemic: A cross-sectional study in Vietnam

Factors influencing the utilization, and perceived benefits of complementary and alternative medicine in the management of common childhood diseases among residents of Makun community, Sagamu, Ogun State Nigeria

PURPOSE

The utilization of Complementary and Alternative Medicine (CAM) has been on the rise, despite the expansion of conventional medicine across populations. The choice and utilization of CAM are informed by individuals' health-care-seeking behavior and the derived benefits. This study examined the factors responsible for the choice and utilization of CAM in the management of common childhood diseases among residents of Makun community, Sagamu, Ogun state Nigeria.

DESIGN AND METHODS

A descriptive cross-sectional design was adapted for this study, using an interview-administered questionnaire to elicit data on respondents' socio-demographic characteristics, knowledge, utilization, and factors influencing the utilization of CAM and perceived effects and satisfaction. Multi-stage sampling technique was used to select a total of 332 respondents comprising 129 males and 203 females. Data were analyzed with the Statistical Package for Social Sciences and presented using tables, percentages, and frequencies.

RESULT

The findings revealed the following as the most influencing factors for the choice and utilization of CAM: Effectiveness (75.9 %), affordability (82.9 %), accessibility (81.7 %), and tolerance for children (44.6 %). CAM therapies that are always utilized in the management of common childhood diseases include herbal medicine (36.7 %), natural supplements (21.4 %), dietary therapy (13.3 %), and chiropractic (10.2 %). Perceived benefits include satisfaction (71.1 %), effectiveness (45.8 %), safety (37.3 %), and minimal side effects (46.7 %).

CONCLUSION

The study concludes that despite the popularity of conventional or orthodox medicine in Nigeria, there is still a significant percentage of the population who actively utilize complementary and alternative medicine therapies in the management of common childhood diseases. CAM therapies are mostly used in communities as either primary or adjunct therapy, due to high perceived safety and effectiveness.

PRACTICE IMPLICATIONS

It is pertinent for Nurses to be aware of the knowledge of CAM and It is pertinent for Nurses to be aware of the growing popularity and utilization of Complementary and Alternative Medicine in managing common childhood diseases. Nurses need to develop solid strategies to ensure there is an open conversation regarding CAM use by clients towards improving the care of communities and mitigating the uncontrolled utilization of complementary and alternative medicine in the care of children.

A critical review on the active anti-viral metabolites of bioprospecting traditionally used plant species from semi-arid regions of the subcontinent

Plants are crucial medicinal resources, with 80 % of people relying on them for primary healthcare. The search for natural antiviral compounds is increasing, especially in semi-arid ecosystems where abiotic stress promotes the production of beneficial secondary metabolites. This review highlights semi-arid plants with the potential as functional foods to combat viral diseases and other illnesses. Literature was searched in databases like ScienceDirect to gather information on novel compounds from stress-tolerant semi-arid plant species. These compounds have potential uses in treating viral infections and other health issues such as diabetes and high blood pressure. The review screened 61 semi-arid plants known for their antiviral metabolites. Eight plants were identified with novel antiviral compounds. Key metabolites include agathisflavone, pectic arabinogalactan, azadirachtin, aloin, aloe-emodin, aloesaponarin I, allicin, terpenoids, chlorogenic acids, curcumin, chromones, β-sitosterol, lupeol, oleuropein, carissol, β-amyrin, and ∆-9-tetrahydrocannabinol. Stress-tolerant semi-arid plants are significant sources of metabolites for treating infectious diseases and boosting immune systems. Further research on these metabolites in animal models is needed to verify their efficacy for treating human diseases during endemic and pandemic outbreaks, such as COVID-19.

Safe use elements of finished herbal products: insights from consumers and practitioners in Malaysia

BACKGROUND

The use of finished herbal products (FHPs) among Malaysians today is expanding rapidly leading to a huge market of FHPs in the country. However, the mass production of FHPs in today's market is alarming due to safety-use issues that could lead to serious adverse effects. Nevertheless, demands are still high for FHPs as most consumers perceived it as safe to consume as it is made from natural substances as the active ingredients. This study aims to explore the safe use elements of FHPs identified by two stakeholders: consumers and practitioners in Malaysia and further compare these elements with the current regulations.

METHODS

As an exploratory study, its approach is to investigate at an in-depth level of understanding of safe use elements from the involved stakeholders: consumers and practitioners. We had a total of 4 focus group discussion sessions (1 FGD session with consumer and 3 FGD sessions with practitioners) as a method of collecting data from the participants. The FGDs were conducted in local native Malaysian and then being translated by researchers without changing their meanings. Thematic analysis was done which involves methodically reading through the verbatim transcripts and consequently segmenting and coding the text into categories that highlight what the participants have discussed.

RESULTS

From the result, we found that both practitioners and consumers agreed a safe FHP must be in compliance with the guidelines from the Ministry of Health Malaysia (MOH). There are other safe use elements highlighted including halal certification, trusted over-the-counter outlets, and published reports on the safety, efficacy, and quality.

CONCLUSIONS

In conclusion, both practitioners and consumers agreed that the most important safe-use element is compliance with MOH guidelines, but the depth of discussion regarding the safety elements among these stakeholders holds a very huge gap. Thus, initiatives must be planned to increase the knowledge and understanding about the MOH guidelines towards achieving a sustainable ecosystem in the safe use of FHPs.

Causal Model of Herb Use Behavior Among Working-age Adults in Thailand

OBJECTIVES

This study developed a causal relationship model of herb use from observational data and analyzed the direct and indirect effects of herb use on health according to the model.

METHODS

A cross-sectional study was conducted with 400 participants aged 26-59 years, selected through multistage random sampling. The instruments used for data collection included demographic information, herb use, health literacy (HL), perceived social support, societal values, and attitudes toward herb use. The conceptual model, hypothesized based on prior evidence, was tested using confirmatory factor analysis through structural equation modeling. Path coefficients were estimated using the maximum likelihood method.

RESULTS

The final model utilized empirical data, which showed that perceived social support had the most significant impact on herb use. This was followed by HL, positive attitudes toward herbal remedies, and societal values, with coefficients of 0.31, 0.18, and 0.16, respectively. When analyzing variables that indirectly affected herb use, it was clear that positive attitudes, perceived social support, and societal values significantly influenced herb use through HL, with influence coefficients of 0.08, 0.16, and 0.04, respectively. Together, these variables accounted for 68% of the variance in herb use.

CONCLUSIONS

The findings from this study can be utilized to develop and implement strategies that guide the use of herbal products, ultimately aiming to improve human health.

Yusoff Y. Set of data on consumers' perceived safety and efficacy towards natural health products to control or cure Covid-19 viruses in Malaysia

This study evaluated the level of knowledge of effects, knowledge of safe use, information complexity of natural health products and consumers' perceived safety and efficacy toward natural health products used to control or cure Covid-19 viruses in Malaysia. The validated questionnaires were used to survey randomly selected stakeholders in Malaysia, who were asked to participate voluntarily in an online survey from 1st September 2020 to 31st December 2020. 723 respondents of adults above 18 years old returned completed questionnaires. The survey used for data collection consisted of 5 questions on knowledge of effects, 4 questions on knowledge for safe-use, 9 questions on perception towards safety and efficacy and 4 questions on the information complexity of natural health products. Besides that, 8 questions are being asked on the demography of respondents at the very end of the survey. The Statistical Package for the Social Sciences (SPSS) version 26 was used to analyse the data. The mean score, correlation and regression values were the focus of this study. The findings provide various opportunities to investigate Malaysian consumers' perceptions which facilitates the development of regulation and strategic plans related to health, and encourage additional research by other researchers interested in the measures and data given.

In silico identification of compounds from Piper sarmentosum Roxb leaf fractionated extract inhibit interleukin-6 to prevent rheumatoid arthritis

Objective: Medicinal herbs with a phytonutrient background has been applied globally as major alternatives to ameliorate the continuous increase in rheumatoid arthritis cases worldwide. We herein aimed to critically examine the bioactive components of the medicinal herb Piper sarmentosum Roxb leaf fractionated extract for its potential to inhibit the influx of interleukin-6 (IL-6) in rheumatoid arthritis. Methods: The Schrödinger platform was employed as the main computational acumen for the screening of bioactive compounds identified and reference compounds subjected to molecular simulation (MDS) for analyzing the stability of docked complexes to assess fluctuations and conformational changes during protein-ligand interactions. Results: The values of the simulatory properties and principal component analysis (PCA) revealed the good stability of these phytochemicals in the active pocket of interleukin-6 (IL-6). Discussion: Our findings reveal new strategies in which these phytochemicals are potential inhibitory agents that can be modified and further evaluated to develop more effective agents for the management of rheumatoid arthritis, thereby providing a better understanding and useful model for the reproduction and/or discovery of new drugs for the management of rheumatoid arthritis and its complications.

Ethnomedicinal Importance of Patuletin in Medicine: Pharmacological Activities and Analytical Aspects

BACKGROUND

Plant-derived bioactive molecules have been a major source of therapeutic agents for human and veterinarian purposes. Different traditional medicine system across the globe had relied on natural resources to meet their demand of healthcare. Still in modern world, pharmaceutical industries look for phytochemicals to develop new drugs. The current review explores patuletin, a flavonoid for its diverse reported pharmacological activities along with its analytical techniques.

METHODS

Scientific data published on patuletin was collected from Scopus, Science Direct, Pubmed, Google, and Google Scholar. The collected data were analyzed and arranged as per specific pharmacological activities performed using in-vitro or in-vivo methods. Analytical methods of patuletin have been presented next to pharmacological activities Results: Available scientific literature indicates patuletin has anti-inflammatory, cytotoxic, genotoxic, hepatoprotective, antiproliferative, antiplatelet, antinociceptive, and antioxidant activity. In addition to these activities, its biological potential on breast cancer, rheumatoid arthritis, aldose reductase, and different types of microorganisms has been also presented in this work. Analytical data on patuletin signified the importance of patuletin for the standardization of herbal products and derived medicine.

CONCLUSION

It may be concluded that patuletin with its diverse biological activities and readily available analytical methods, holds the potential to be translated into a new drug entity.

Silk nanoparticles for the protection and delivery of guava leaf (Psidium guajava L.) extract for cosmetic industry, a new approach for an old herb

Guava (Psidium guajava L.) is a well-known plant containing high levels of natural antioxidants, the phenolic compounds, which have been employed in numerous cosmetic products. However, these molecules are unstable to oxidants, light, temperature, pH, water, and enzymatic activities. Therefore, to enhance their stability and preserve their antioxidant activity, this study investigated the silk fibroin nanoparticles (SFNs) ability to encapsulate, deliver, and heat-protect the phenolic compounds of the guava leaves ethanolic extract. Firstly, the guava ethanolic extract was produced by maceration, which possessed a total phenolic content of 312.6 mg GAE/g DPW and a high antioxidant activity (IC₅₀ = 5.397 ± 0.618 µg/mL). Then, the extract loaded SFNs were manufactured by desolvation method, and the particles demonstrated appropriate sizes of 200-700 nm with narrow size distribution, spherical shape, silk-II crystalline structure, high drug entrapment efficiency of > 70% (dependent on the fibroin content), and a two-phase sustained drug release for at least 210 min. Using the 2,2-diphenyl-1-picrylhydrazyl (DPPH) assay, the antioxidant activity of the guava extract was well-preserved in the extract loaded SFNs. Finally, after being treated with high temperature of 70 °C for 24 h, the guava extract almost loses all of its antioxidant property (5 times decrement), whereas the extract loaded SFNs could retain the extract activity. Conclusively, the SFNs proved much potential to deliver and heat-protect the guava extract phenolic compounds, and preserve their antioxidant activity. Confirmed by this case, SFNs could be further explored in protecting other natural compounds from environmental factors.

Usage of Natural Health Products (NHPs) for respiratory diseases: user characteristics and NHP-Consumption behavior during the Covid-19 pandemic in Germany

BACKGROUND

Respiratory diseases (RD) can challenge healthcare systems around the globe. Natural health products (NHPs) are popular complementary and alternative medicine options for health issues concerning non-fatal RD. Little is known about the characteristics of the users of RD-NHPs and about their NHP consumption behavior during the Covid-19 pandemic in Germany.

METHODS

A representative online survey was conducted in Germany in 2022. 1707 participants were classified based on having used NHPs for RD within the previous 12 months, having used NHPs but not for RD within the previous 12 months and not having used NHPs. Data were analyzed using descriptive and inferential statistical methods as well as a multinomial logistic regression model.

RESULTS

Users of RD-NHPs within the previous 12 months were more likely to be employed and to consult pharmacists more often for non-fatal health issues than individuals who did not take RD-NHPs. RD-NHP users were more likely to suffer from a Covid-19 infection and to have children living in the same household than other NHP users. Compared to non-NHP users, RD-NHP users were more likely to be female, highly educated and have stronger openness-to-change value orientations. Vaccination-related behavior was no indicator of RD-NHP usage. Most RD-NHP users took NHPs in self-medication. Few reported informing their practitioner about their self-medication. Drugstores were the most visited supply source for NHPs during the pandemic, followed by pharmacies. Common information sources regarding NHPs were the products themselves and pharmacists.

CONCLUSION

This study emphasized the important role of NHPs as a popular prevention and treatment option for RD. RD-NHPs were more likely used by individuals who were employed, who suffered from a RD and who consult pharmacists for non-fatal health issues. The importance of product information and pharmacies as information sources should be considered to make communication strategies about safe self-medication options with RD-NHPs more effective, which could help to reduce the burden of health facilities regarding non-fatal RD. To improve and develop future pandemic-control strategies, health professionals and policy makers should consider NHP usage behavior and provide critical information about chances and risks of self-medicated NHP consumption.

Attitudes toward herbal medicine for COVID-19 in healthcare workers: A cross-sectional observational study

The coronavirus disease 2019 (COVID-19) pandemic has adversely affected working life all over the world, and the employees with the highest risk of transmission have been those in the health sector. Since there are currently no effective treatments for COVID-19, there have been numerous attempts to find alternative treatments for both the spread of the infection and its treatment. These efforts have included the use of herbal extracts to boost immunity and reduce the likelihood of contracting the infection. This study explored the attitudes of healthcare workers toward the consumption of COVID-19 herbal medicine (HM) products. This is an online, cross-sectional observational study. In total, 1335 participants were reached. It was observed that 722 (54%) of them preferred herbal treatments during the pandemic period. The attitudes of HM toward 327 (45.3%) healthcare workers and 395 (54.7%) general population participants were examined. Both groups had high rates of use of HM as a COVID-19 preventive measure (68.8 percent and 67.1 percent, respectively). While its use was higher among healthcare workers during infection (OR: 2.00, 95% CI: 1.32-3.03), its use was higher in the non-healthcare group for post-COVID problems (OR: 0.51, 95% CI: 0.35-0.74). The opinion of healthcare professionals was that HM was more efficient (OR: 1.59, 95% CI: 1.19-21.15). All participants' main incentive to utilize HM was family advice (n = 194, 26.9%). A total of 90 (12.4%) participants reported side effects. Vomiting-nausea were the most typical adverse effects (38.9%). The herb most frequently utilized was ginger (54%). Healthcare workers use HM at rates that are the same as those of the general population. Both its use during infections and the idea that it is effective are more common among healthcare professionals than in the general population.

Herbal medicine use in Republic of Korea to alleviate side effects of COVID-19 vaccines: A cross-sectional study

OBJECTIVE

Coronavirus disease 2019 (COVID-19) has spread worldwide, and several virus variants have emerged. Vaccines are administered to help prevent the infection. In Republic of Korea, most people take herbal medicine. This study investigated the use of herbal medicine to counter the side effects of COVID-19 vaccines.

METHODS

This cross-sectional study was conducted using an online survey. Chi-square tests were used to determine differences in the use of herbal medication according to sociodemographic characteristics. Independent two-sample and paired t-tests were performed to examine the effect and satisfaction of herbal medicine use for countering the side effects of COVID-19 vaccines. One-way analysis of variance was used to determine vaccine-related differences.

RESULTS

A total of 233 and 181 participants received the first and second doses of COVID-19 vaccines, respectively. The majority of herbal medicine users were in their thirties, had a bachelor's degree, suffered from side effects of vaccination, and received Vaxzevria for their first COVID-19 vaccine dose and Comirnaty for their second dose. The herbal medicine group had a higher satisfaction level of post-vaccination side effects than the non-herbal medicine group (P < 0.0001). The numeric rating scale scores for vaccination side effects were lower among participants who took herbal medication to alleviate those symptoms (P < 0.0001). The most commonly used herbal formula was Shuanghetang.

CONCLUSION

A third of participants receiving COVID-19 vaccines used herbal medication to counter the side effects of vaccination. The use of herbal medicine was associated with age, education level, vaccine brand, and whether side effects of vaccination occurred. Herbal medication use was associated with greater satisfaction compared to vaccine recipients not using herbal medication.

Dietary supplements used by otolaryngology patients in Turkey during the COVID-19 pandemic: A cross-sectional survey

Introduction

This study investigated the characteristics of dietary supplement (DS) use of patients who attended the otolaryngology clinic at a university training and research hospital in Turkey during the pandemic, including patients who had experienced Coronavirus disease 2019 (COVID-19).

Methods

This cross-sectional study was conducted between March and September 2021. 277 literate patients aged ≥ 18 years who attended the otolaryngology clinic were enrolled. A questionnaire was used to collect sociodemographic data, as well as data on DS use during the pandemic. The questionnaire was administered in a face-to-face setting by a single researcher.

Results

Approximately half of the participants (50.18%) took DSs during the pandemic and 67.18% of those who experienced COVID-19 infection used DSs during their illness. The most commonly used supplements were vitamin C (43.16%) and D (33.09%), along with herbal supplements such as lemon (54.68%), garlic (46.76%), ginger (46.04%), and thyme (43.88%). In total, 85.23% of the patients primarily used DSs to enhance their immunity, while 32.95% used them to prevent cough, and 26.14% to improve breathing. The majority of the patients (85.23%) felt benefit from DSs. Typically, the patients obtained information about DSs from doctors (32.37%) or friends and relatives (29.49%), and most of them used the supplements without first consulting a doctor (63.64%).

Conclusion

DSs were commonly used by otolaryngology patients during the COVID-19 pandemic, particularly to enhance immunity. Although the majority of patients reportedly benefited from these products, most of them did not inform their physicians that they were using them and often obtained information from unofficial sources.

Complementary and Alternative Medicines in Northern Cyprus: Public Awareness, Patterns of Use, and Attitudes

Background: The utilization of herbal medicine (HM) as a component of complementary and alternative medicine (CAM) is increasing worldwide. Little is known about justifications for its use and the factors associated with it. This study gains insights into the use of herbal medicines in Northern Cyprus, concentrating on targets for its use, the role played by disease type, reasons for its use, and sources of information. Methods: A questionnaire was utilized to achieve the aim of the study. The questionnaire was distributed to a random sample comprised of people in two different regions in Northern Cyprus over a 12-week period from August to November 2020. A self-administered questionnaire was used for data collection. Moreover, qualitative research explored individuals’ decision making regarding CAM, which aimed to examine 20 patients as a context for beliefs, decision making, and dialogue about CAM. After audio-taping and verbatim transcription, the data were analyzed with qualitative content analysis. Results: The findings show that the majority of respondents learned about herbal products (HPs) and CAM from other patients, the Internet, friends, and family. The results indicate that almost half of the respondents were aware of how CAMs, especially herbal preparations, are used to treat common illnesses. Fennel, ginger, and echinacea were the most commonly used HMs, mainly for the treatment of the common cold. Furthermore, nearly 50% of the participants expressed the belief that HMs are safe, have fewer side effects than conventional medicines, and are also effective for treating minor health conditions. The prevalence was strongly associated with education level based on a Pearson Chi-square analysis. Conclusions: Although herbal medicines were mostly used to treat mild to moderate ailments and the participants were aware of their limitations, the combination of self-medication, inexperienced counseling, and lack of awareness of the risks of herbal medicines is potentially harmful. This is particularly important for elderly users, because although they seemed to be more aware of health-related issues, they generally used more medication than younger people. Given our finding that dissatisfaction with modern medicine is the most important reason for the preferred use of herbal medicines, government agencies, physicians, and pharmaceutical companies should be aware of this issue and should aim to create some level of awareness among users.

Attitudes and beliefs regarding the use of herbs and supplementary medications with COVID-19: A systematic review

BACKGROUND AND AIM

There is growing interest in using herbs and supplementary medications to treat and/or prevent COVID-19, evidenced by multiple reports exploring their effectiveness and safety. From a health psychology perspective, the desire to use herbs and supplementary medications to prevent and/or treat COVID-19 is a health behavior which is attributed to attitudes and beliefs. This systematic review critically appraised and synthesized the data from studies investigating these attitudes and beliefs.

METHODS

EMBASE, PubMed, ScienceDirect, Scopus, Cochrane (library), and WebOfScience were searched from inception to December 13, 2021 for studies investigating attitudes and beliefs on the use of herbs and supplementary medications to treat and/or prevent COVID-19.

RESULTS

A total of 17 articles were identified for inclusion. All except one were of cross-sectional design. Participants across most studies had a positive attitude towards using herbs and supplementary medications. They believed that herbs and supplementary medications were effective and were confident in their value in preventing and/or treating COVID-19 symptoms. The majority of included studies had significant flaws in study design and reporting, including inconsistent definitions of herbs and supplementary medications, a lack of theoretical models and conceptual frameworks underpinning the study of beliefs and attitudes, in addition to methodological issues of robustness affecting the validity and reliability of data.

CONCLUSION

The use of herbs and supplementary medicines to prevent and/or treat COVID-19 could well be driven by a positive attitude stemming from beliefs of effectiveness and safety. There is a need for well-designed studies on attitudes and beliefs that are driven by health behavior theories to permit generalizability of findings and establish more conclusive relationships between beliefs, attitudes and the decision to use herbs and supplementary medications to treat and/or prevent COVID-19.

The Effects of Medications and the Roles of Pharmacists on the Recovery of Patients with COVID-19 Infection: An Epidemiological Study from the United Arab Emirates

Patients infected with coronavirus have new experiences and hence new needs from the healthcare sector. Acknowledging patients' experiences can exhibit promising outcomes in coronavirus management. Pharmacists are considered a vital pillar in managing patients' experiences during their infection. A cross-sectional study was conducted to assess the experiences of COVID-19-infected individuals and the roles of pharmacists in the United Arab Emirates. The survey was face- and content-validated after being developed. Three sections were included in the survey (demographics, experiences of infected individuals, and the roles of pharmacists). Data were analyzed using the Statistical Package for the Social Sciences. The study participants (n = 509) had a mean age of 34.50 (SD = 11.93). The most reported symptoms among participants were fatigue (81.5%), fever (76.8%), headache (76.6%), dry cough (74.1%), muscle or joint pain (70.7%), and sore throat (68.6%). Vitamin C was the most used supplement (88.6%), followed by pain relievers (78.2%). Female gender was the only factor associated with symptom severity. About 79.0% agreed that the pharmacist played an important and effective role during their infection. The most reported symptom was fatigue, with females reporting more severe symptoms. The role of the pharmacist proved to be vital during this pandemic.

Controlled-Release Wedelia trilobata L. Flower Extract Loaded Fibroin Microparticles as Potential Anti-Aging Preparations for Cosmetic Trade Commercialization

Background

Wedelia trilobata L. (WT), a common herbal plant in Vietnam, is popularly used as a strong antioxidant in Vietnamese folk medicine. However, limited studies have reported the application of WT flower in cosmeceutical area.

Purpose

This study explored the potentials of WT loaded fibroin microparticles (FMPs-WT) as a novel anti-aging cosmeceutical product.

Methods

The WT flower was firstly extracted by maceration with methanol, ethanol 60%, and ethanol 96%, and its chemical compositions and total polyphenol content were investigated. Then, the FMPs-WT were developed by desolvation method and physicochemically characterized. Finally, the product antioxidant activities were in-vitro determined using DPPH assay.

Results

The optimal WT extract was the ethanol 60% extract, which contains polyphenols, alkaloids, flavonoids, saponins, glycosides, and organic acids; with a total polyphenol content of 46.47 ± 2.32 mg GAE/g plant powder. The FMPs-WT were successfully formulated, with a distinct silk-II polymorph; varied sizes of 0.592 to 9.820 µm, depending on the fibroin concentrations and the WT extraction solvent; high entrapment efficiencies of >65%; and sustained-release patterns of polyphenol in pH 7.4 for >6 h. Regarding the antioxidant activity, the pure WT flower extracts possessed high scavenging actions with IC₅₀ of 7.98 ± 0.40 µg/mL, comparable with the standard ascorbic acid (IC₅₀ = 4.23 ± 0.21 µg/mL). Moreover, the FMPs-WT could retain the extract antioxidant capacity, and exert the effects in a timely manner, corresponding to its release profile.

Conclusion

The FMPs-WT could be further investigated to become a potential anti-aging cosmeceutical product in the market.

Determination of Antioxidant, Cytotoxicity, and Acetylcholinesterase Inhibitory Activities of Alkaloids Isolated from Sophora flavescens Ait. Grown in Dak Nong, Vietnam

Traditional/herbal medicine has gained increasing interests recently, especially in Asian countries such as Vietnam, due to its diverse therapeutic actions. In the treasure of Vietnamese medicinal plants, one of the potential herbs is the roots of Sophora flavescens Ait. (SF, "Kho sam" in Vietnamese). However, limited information has been reported on the Vietnamese SF compositions and their respective alkaloids' anti-acetylcholinesterase action. Thus, this study investigated the extractions, isolations, identifications, and in-vitro antioxidant, cytotoxicity, and acetylcholinesterase inhibitory activities, of the SF root extracts and their purified alkaloid compounds. To this end, four pure compounds were successfully isolated, purity-tested by HPLC, and structurally identified by spectroscopic techniques of FTIR, MS, and NMR. These compounds, confirmed to be oxysophocarpine, oxymatrine, matrine, and sophoridine, were then determined their therapeutic actions. The SF extracts and the compounds did not possess significant antioxidant activity using the DPPH and MDA assays, and cytotoxicity action using the MTT assay on the MDA-MB-231 breast cancer cell line. On the other hand, the SF total extract yielded a moderate acetylcholinesterase inhibition effect, with an IC50 of 0.1077 ± 0.0023 mg/mL. In summary, the SF extract demonstrated potential effects as an anti-acetylcholinesterase agent and could be further researched to become a pharmaceutical product for diseases related to acetylcholine deficiency, such as dementia.

Antifungal Potential of Some Herb Decoctions and Essential Oils on Candida Species

(1) Background: Candidiasis is a fungal infectious disease caused by opportunistic Candida species. The incidence of candidiasis has improved, due to prolonged antibiotic therapy and an increased number of immunocompromised patients. The purpose of this study was to evaluate if decoctions and essential oil (EO) of neem (Azadirachta indica, Meliaceae family), coptidis (Coptis chinensis, Ranunculaceae family), magnolia (Magnolia officinalis, Magnoliaceae family), scutellaria (Scutellaria barbata, Lamiaceae family), and the EO of manuka (Leptospermum scoparium, Myrtaceae family), have antifungal activity in vitro against some clinically prevalent species of Candida. (2) Methods: The antifungal activity was studied by the determination of the minimum inhibitory concentration (MIC) and minimum lethal concentration (MLC) against five Candida strains. The effect in dimorphic transition of Candida albicans was also evaluated for the two plants with higher antimicrobial behavior. (3) Results: C. chinensis decoction and EO and L. scoparium EO exhibited antifungal activity in Candida spp. In addition to the fact that both C. chinensis decoction and EO proved strong antifungal activity, L. scoparium EO also displayed a relevant inhibitory effect on the dimorphic transition. (4) Conclusions: The results provided support for the potential use of C. chinensis and L. scoparium in the treatment of infections by Candida spp.

5-year inventory management of drug products using ABC-VEN analysis in the pharmacy store of a specialized public hospital in Vietnam

In developing economies, expenses of healthcare delivery have risen disproportionally to the monetary backing supplied by the federal government. However, issues relating to inventory control alongside regulating the pharmaceutical market have been recognized. We conducted a systematic categorization based on ABC and VEN analysis for available drugs at Can Tho Dermatological Hospital (CTDH) from 2016–2020, thereby making evidence-based recommendations for public authorities to attain rationality in monitoring the stock supply network. Results revealed that ratio of Category I with the highest cost and importance to the annual revenues was barely 88%. Meanwhile, fractions of Category II and III to the overall expenses were 5–10% and below 5%, respectively. Given scarce funds, it is crucial that Essential drugs be utilized effectively. Thanks to ABC-VEN integrated matrix, we uncovered medicines for which significant savings could be achieved. This method has proven to be a powerful tool in decision-making for importation and stockholding.

Medications and natural products used in Jordan for prevention or treatment of COVID-19 infection during the second wave of the pandemic: A cross-sectional online survey

Worldwide, during the COVID-19 pandemic in 2019, there was an increase in the tendency of misusing prescription drugs as well as self-medicating with over-the-counters. Additionally, an increase in the use of herbs and natural products was reported. A descriptive cross-sectional survey was conducted in Jordan from May 19th to July 29th, 2021, to assess the medications and natural products used in Jordan during the second wave of the pandemic. The survey was developed and validated, then distributed using Google Forms via social media platforms. Data was analyzed using Statistical Package for Social Sciences-24. The study participants (n = 386) had a mean age of 29.35 (SD = 11.90) years. Most of participants were females (72.8%), not married (64.5%), non-smoker (69.2%), have a Jordanian nationality (80.6%), hold a bachelor's degree (73.1%), and living in the middle of Jordan (74.1%). More than 70% of the participants used vitamin C, D and pain relievers. The most used natural products were citrus fruits (78.8%), honey (63.0%) and ginger (53.1%). The participants reported that family and friends (55.4%) played a major role in advising them to use medications and dietary supplements. Pharmacists ranked second (54.1%), followed by social media platforms (43.3%). Multiple logistic regression analysis highlighted that only the age significantly affected the participants' use of medications and natural products (P < 0.001). The results of this study warrant the need of conducting awareness campaigns guided by trained healthcare providers to educate people and minimize the risk of side effects that may arise from unsupervised use of medications and natural products.

Use of Traditional, Complementary and Integrative Medicine During the COVID-19 Pandemic: A Systematic Review and Meta-Analysis

Background

Traditional, Complementary and Integrative Medicine (TCIM) has been reported to use for symptom management of coronavirus disease 2019 (COVID-19). The objective of this review was to identify the overall usage prevalence of TCIM interventions for COVID-19.

Methods

Surveys on the general population and observational studies on the COVID-19 patient chart review were located in the search of PubMed, EMBASE and Cochrane Central Register of Controlled Trials databases in September 2021. Observational studies, such as cross-sectional studies, surveys, cohort studies and hospital-based patient case reviews, published in any language, reporting the usage of TCIM in the patients with COVID-19 or the general population during the COVID-19 pandemic were included in this review. Data screening and extraction were performed independently by two reviewers. The reporting quality of the included studies was assessed with the STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) statement. To conduct a meta-analysis of the usage prevalence of various TCIM interventions, the effect size of the proportion for each intervention was calculated with the inverse variance method. The main outcome was usage prevalence of TCIM interventions among patients with COVID-19 or the general population during the COVID-19 pandemic.

Results

A total of 62 studies were included in this review. The overall TCIM usage prevalence was estimated to be 0.64 (95% CI 0.54-0.73). The overall prevalence did not differ between the population-based survey (0.65, 95% CI 0.48-0.81) and the hospital-based patient case review (0.63, 95% CI 0.52-0.73). Statistical heterogeneity and comparatively low quality in reporting were observed, which should be cautiously considered when interpreting the results.

Conclusion

Various TCIM interventions were reported to be used with comparatively high frequency. Future international collaborative research might overcome the main limitation of this study, i.e., the heterogeneity of the included data.

Systematic Review Registration

https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=278452, identifier: CRD42021278452.

The effects of beliefs, knowledge, and attitude on herbal medicine use during the COVID-19 pandemic: A cross-sectional survey in Indonesia

Background: Herbal medicines are gaining a greater degree of popularity as complementary and alternative medicines during the COVID-19 pandemic. Nonetheless, there is a lack of data concerning the rationale for and factors influencing their use. Methods: A cross-sectional community-based online study involving 1,621 participants was conducted to explore the effects of magical health beliefs, holistic health beliefs, knowledge, and pro- complementary alternative medicine (CAM) attitudes on herbal medicine use in the Indonesian population. Results: Logistic regression findings showed that knowledge about herbal medicines was independently and positively associated with herbal medicine use to a greater extent than herbal medicine non-use (adjusted odds ratio; AOR = 1.20; 95% confidence interval; CI = 1.16 to 1.24). The participants who used herbal medicines had a greater magical health belief score than herbal medicine non-users, with AOR = 1.03 and 95% CI = 1.00 to 1.06. Moreover, holistic health beliefs and pro-CAM attitudes were also found to be independently associated with herbal medicine use. Conclusion: These findings alert nurses to assess the roles of magical health beliefs, holistic health belief, knowledge, and attitudes toward herbal medicine use.

The effects of beliefs, knowledge, and attitude on herbal medicine use during the COVID-19 pandemic: A cross-sectional survey in Indonesia

Background: Herbal medicines are gaining a greater degree of popularity as complementary and alternative medicines during the COVID-19 pandemic. Nonetheless, there is a lack of data concerning the rationale for and factors influencing their use. Methods: A cross-sectional community-based online study involving 1,621 participants was conducted to explore the effects of magical health beliefs, holistic health beliefs, knowledge, and pro- complementary alternative medicine (CAM) attitudes on herbal medicine use in the Indonesian population. Results: Logistic regression findings showed that knowledge about herbal medicines was independently and positively associated with herbal medicine use to a greater extent than herbal medicine non-use (adjusted odds ratio; AOR = 1.20; 95% confidence interval; CI = 1.16 to 1.24). The participants who used herbal medicines had a greater magical health belief score than herbal medicine non-users, with AOR = 1.03 and 95% CI = 1.00 to 1.06. Moreover, holistic health beliefs and pro-CAM attitudes were also found to be independently associated with herbal medicine use. Conclusion: These findings alert nurses to assess the roles of magical health beliefs, holistic health belief, knowledge, and attitudes toward herbal medicine use.

The effects of beliefs, knowledge, and attitude on herbal medicine use during the COVID-19 pandemic: A cross-sectional survey in Indonesia

Background: Herbal medicines are gaining a greater degree of popularity as complementary and alternative medicines during the COVID-19 pandemic. Nonetheless, there is a lack of data concerning the rationale for and factors influencing their use. Methods: A cross-sectional community-based online study involving 1,621 participants was conducted to explore the effects of magical health beliefs, holistic health beliefs, knowledge, and pro- complementary alternative medicine (CAM) attitudes on herbal medicine use in the Indonesian population. Results: Logistic regression findings showed that knowledge about herbal medicines was independently and positively associated with herbal medicine use to a greater extent than herbal medicine non-use (adjusted odds ratio; AOR = 1.20; 95% confidence interval; CI = 1.16 to 1.24). The participants who used herbal medicines had a greater magical health belief score than herbal medicine non-users, with AOR = 1.03 and 95% CI = 1.00 to 1.06. Moreover, holistic health beliefs and pro-CAM attitudes were also found to be independently associated with herbal medicine use. Conclusion: Magical health beliefs, holistic health belief, knowledge, and attitudes are key factor in determining the herbal medicine use. Our findings offer crucial implications for health policymakers to encourage the use of herbal medicine during the COVID-19 pandemic.

Leveraging knowledge of Asian herbal medicine and its active compounds as COVID-19 treatment and prevention

The outbreak of COVID-19 disease has led to a search for effective vaccines or drugs. However, insufficient vaccine supplies to meet global demand and no effective approved prescribed drugs for COVID-19 have led some people to consider the use of alternative or complementary medicines, such as traditional herbal medicine. Medicinal plants have various therapeutic properties that depend on the active compounds they contain. Obviously, herbal medicine has had an essential role in treatment and prevention during COVID-19 outbreak, especially in Asian cultures. Hence, we reviewed the uses of herbal medicine in Asian cultures and described the prominent families and species that are sources of antiviral agents against COVID-19 on the basis of case reports, community surveys, and guidelines available in the literature databases. Antiviral efficacy as determined in laboratory testing was assessed, and several promising active compounds with their molecular targets in cell models against SARS-CoV-2 viral infection will be discussed. Our review findings revealed the highly frequent use of Lamiaceae family members, Zingiber officinale, and Glycyrrhiza spp. as medicinal sources for treatment of COVID-19. In addition, several plant bioactive compounds derived from traditional herbal medicine, including andrographolide, panduratin A, baicalein, digoxin, and digitoxin, have shown potent SARS-CoV-2 antiviral activity as compared with some repurposed FDA-approved drugs. These commonly used plants and promising compounds are recommended for further exploration of their safety and efficacy against COVID-19.

Medicinal Importance, Pharmacological Activities, and Analytical Aspects of Strictinin: A Mini-Review

BACKGROUND

Plants and their derived products have been used in history as food and medicine. Plant materials are rich sources of fiber, minerals, vitamins, and bioactive phytochemicals, which are useful for human beings. Strictinin is an important phytoconstituent of green tea.

METHODS

Present work mainly focuses on the biological importance, therapeutic potential, and pharmacological activities of strictinin in medicine. Numerous scientific data have been collected from various literature databases such as Google Scholar, Science Direct, PubMed, and Scopus database in order to realize the health beneficial potential of strictinin. Pharmacological data has been collected and analyzed in the present work to find the effectiveness of strictinin against human disorders and complications. Analytical data of strictinin has been also collected and analyzed in the present work.

RESULTS

Scientific data analysis revealed the biological importance of strictinin in medicine. Scientific data analysis signified the therapeutic benefit of strictinin mainly due to its anticancer, antimicrobial, antibacterial, antiviral, and antioxidant activity. However, enzymatic activities, cytotoxicity, effectiveness on skin disorders, and osteogenic potential of strictinin have also been discussed. Analytical data revealed the importance of modern analytical techniques in medicine for the separation, identification, and isolation of strictinin.

CONCLUSION

Present work signified the biological importance and therapeutic benefits of strictinin in medicine and other allied health sectors.

[Literature review on pharmacovigilance of medicines derived from traditional pharmacopoeias. Part I: risks identification]

Globally, the use of drugs from traditional pharmacopoeias is a major subject. The confidence of the populations in these drugs is linked to their presumption of safety and also to the fact that geographically and financially they are more accessible than synthetic drugs. In view of the high exposure of the world population to traditional medicines, they are subject to pharmacovigilance guaranteeing their safety in use. Thus, this review aims to take stock of the risks identified by the national pharmacovigilance systems. It is based on research referenced in PubMed, Embase, ScienceDirect and GoogleScholar. These studies indicate that the use of traditional drugs can involve risks including adverse effects, interactions with synthetic drugs, adulteration and contamination. The spontaneous notification system was the basis for their identification. Strengthening this system and making populations aware of these risks constitute the key levers for traditional medicines pharmacovigilance progress.

Mixtures of Scutellaria baicalensis and Glycyrrhiza L. Extracts as Antibacterial and Antiviral Agents in Active Coatings

The aim of this study was to develop active packaging materials covered in active coatings (offering antibacterial and antiviral properties) that contain selected plant extracts. In addition, the synergistic effect of the active substances in these extracts was also analysed. The results of the study demonstrated that Scutellaria baicalensis and Glycyrrhiza L. extracts (two of six analysed plant extracts) were the most active agents against selected Gram-positive and Gram-negative bacterial strains. Additionally, the synergistic effect of S. baicalensis and Glycyrrhiza L. extracts was noted, meaning that the effect of these two plant extract mixtures on Bacillus subtilis, Staphylococcus aureus, Escherichia coli and Pseudomonas syringae growth was higher than the activity of individual pure extracts. Mixtures of the extracts were introduced into the coating carrier. A polyethylene (PE) foil was then coated with active layers containing mixtures of S. baicalensis and Glycyrrhiza L. extracts as antimicrobial agents. The results of this research showed that all of the active coatings had a bacteriolytic effect on B. subtilis and a bacteriostatic effect on S. aureus cells. The coatings were found to be inactive against E. coli and P. syringae cells. This means that the coatings could be used as internal coatings to preserve food products against Gram-positive bacteria that may be responsible for food spoilage. The results of this study also demonstrated that the coatings were highly active against phage phi 6 phage particles, used as SARS-CoV-2 surrogate. This means that the coatings could be used as external coatings to limit the spread of SARS-CoV-2 and pathogenic Gram-positive bacteria via human hands.

A Preliminary Report on Herbal Medicine Use Among Patients Hospitalized at Two-Large COVID-19 Treatment Centers in Uganda

INTRODUCTION

Herbal medication use among patients with COVID-19 imposes a significant risk of drug-herbal interactions and adverse events. This study aimed to assess the prevalence and factors associated with herbal medicine use among patients hospitalized with COVID-19 attending two large COVID-19 Treatment Units (CTU) in Uganda.

METHODS

A hospital-based descriptive cross-sectional study was conducted recruiting patients with COVID-19 hospitalized at the Mulago National Referral Hospital and Namboole Stadium CTUs. Chi-square or Fishers' exact test for categorical and Mann-Whitney U-test for numerical were used to determine the association between dependent and independent variables.

RESULTS

The study was terminated early because of significant reduction in the number of patients hospitalized with COVID-19 and the closure of Namboole CTU. Of the anticipated 422 participants, we recruited 108 (25.6%). Of this, 58 (53.7%) were female, with a median age of 38 (range: 20-75) years. Forty-nine (45.4%) had received at least one dose of the COVID-19 vaccine. Fifty-eight (57.3%) of the participants had ever used herbal medicine and the majority had used them in the past 12 months (71.9%, n = 41) either before the diagnosis of COVID-19 (85.4%, n = 35) or after (36.6%, n = 15). Being vaccinated for COVID-19 (adjusted odds ratio (aOR): 3.1, 95% confidence interval (CI): 1.4-6.8, p = 0.005) and having attained tertiary level of education (aOR: 6.2, 95% CI: 1.7-23.1, p = 0.006), as well as the accessibility to herbalists (aOR: 31.2, 95% CI: 3.7-263.2, p = 0.002) were significantly associated with herbal medication use. The majority of participants reported some improvement after using herbal medicine (80.7%, n = 46) and their doctors or nurses asked almost half of the participants about herbal medicine use (49.5%, n = 53).

CONCLUSION

The use of herbal medicines to treat or prevent COVID-19 among hospitalized patients is a widespread practice in Uganda amidst unpublished evidence of their safety and efficacy.

Previously published ethno-pharmacological reports reveal the potentiality of plants and plant-derived products used as traditional home remedies by Bangladeshi COVID-19 patients to combat SARS-CoV-2

Several plants have traditionally been used since antiquity to treat various gastroenteritis and respiratory symptoms similar to COVID-19 outcomes. The common symptoms of COVID-19 include fever or chills, cold, cough, flu, headache, diarrhoea, tiredness/fatigue, sore throat, loss of taste or smell, asthma, shortness of breath, or difficulty breathing, etc. This study aims to find out the plants and plant-derived products which are being used by the COVID-19 infected patients in Bangladesh and how those plants are being used for the management of COVID-19 symptoms. In this study, online and partially in-person survey interviews were carried out among Bangladeshi respondents. We selected Bangladeshi COVID-19 patients who were detected Coronavirus positive (+) by RT-PCR nucleic acid test and later recovered. Furthermore, identified plant species from the surveys were thoroughly investigated for safety and efficacy based on the previous ethnomedicinal usage reports. Based on the published data, they were also reviewed for their significant potentialities as antiviral, anti-inflammatory, and immunomodulatory agents. We explored comprehensive information about a total of 26 plant species, belonging to 23 genera and 17 different botanical families, used in COVID-19 treatment as home remedies by the respondents. Most of the plants and plant-derived products were collected directly from the local marketplace. According to our survey results, greatly top 5 cited plant species measured as per the highest RFC value are Camellia sinensis (1.0) > Allium sativum (0.984) > Azadirachta indica (0.966) > Zingiber officinale (0.966) > Syzygium aromaticum (0.943). Previously published ethnomedicinal usage reports, antiviral, anti-inflammatory, and immunomodulatory activity of the concerned plant species also support our results. Thus, the survey and review analysis simultaneously reveals that these reported plants and plant-derived products might be promising candidates for the treatment of COVID-19. Moreover, this study clarifies the reported plants for their safety during COVID-19 management and thereby supporting them to include in any future pre-clinical and clinical investigation for developing herbal COVID-19 therapeutics.

Fear of COVID-19 and the Media Influence on Herbal Medication Use in Uganda: A Cross-Sectional Study

BACKGROUND

The coronavirus disease-2019 (COVID-19) pandemic has created fear in people around the world. This has led to the widespread use of various herbal remedies in its prevention and treatment regardless of the paucity of scientific evidence about their safety and efficacy. This study assessed the fear of COVID-19 and the influence of media on the use of herbal medicine to prevent or treat COVID-19 in Uganda.

METHODS

In the first 2 weeks of July 2021, a descriptive online cross-sectional study was carried out anonymously in the general population in Uganda. A validated questionnaire was used to collect data on herbal medicine use and the influence of media. Fear of COVID-19 was rated using the Fear of COVID-19 Scale (FCV-19S).

RESULTS

We recruited 488 participants, 273 (55.9%) were female, with a median age of 25 (range: 18-73) years. Sixty-seven (57.8%) participants had a confirmed COVID-19 diagnosis. The mean FCV-19S score was 21.7 SD 5.9 with 53.3% reporting high levels of COVID-19 fear. About 57.4% of participants reported using herbal remedies either to prevent or treat COVID-19-like symptoms. Media was the main source of information, with more than 80% of the participants reporting seeing or accessing information about herbal medication use. Women (adjusted odds ratio (aOR): 1.74, 95% CI: 1.2-2.5, p=0.003) and people with a previously confirmed COVID-19 diagnosis (aOR: 3.1, 95% CI: 1.35-7.14, p=0.008) had a statistically significantly higher FCV-19S score. Being unemployed (aOR: 1.0, 95% CI: 1.1-2.3, p=0.008) and a female (aOR: 1.0, 95% CI: 1.1-2.3, p=0.012) were statistically significantly associated with herbal medicine use. Participants who used herbal remedies had a higher median FCV-19S score compared to non-users (23 versus 21, p<0.001).

CONCLUSION

The use of herbal medicines to treat or prevent COVID-19 is a widespread practice among the general population in Uganda amidst the high levels of fear of COVID-19.