The Use of Medicinal Plants for the Treatment of Toothache in Ethiopia

Ethnobotanical study of medicinal plants in Dibatie district, Metekel zone, Benishangul Gumuz Regional State, western Ethiopia

BACKGROUND

Herbal medicine has been used for the treatment of human and livestock ailments since ancient times. Numerous rural and urban communities in Ethiopia practice traditional medicine and transfer the knowledge verbally from generation to generation. Thus, this study was conducted to document the traditional medicinal plants and associated indigenous knowledge in Dibatie district, Metekel zone, Benishangul Gumuz Regional State, western Ethiopia.

METHODS

Three hundred seventy-four (374) informants from 11 kebeles (the smallest administrative units) were selected and participated in the data delivery. The ethnobotanical data collection was carried out using semi-structured interviews, preference ranking, direct matrix ranking, field observation, market surveys, and focus group discussions, including voucher specimen collections. The ethnobotanical data were analyzed using descriptive statistics (frequency and percentage), ranking, comparison, and quantitative ethnobotanical techniques such as informant consensus factor, fidelity level index, Jaccard's coefficient of similarity, and use value index.

RESULTS

A total of 170 plant species were recorded to treat 79 human and 29 livestock ailments. Fabaceae (with 20 species) and Asteraceae (with 18 species) were the most dominant medicinal plant families in the area. Most remedial plants were herbs (61 species, 35.88%), followed by shrubs (39 species, 22.94%). The majority (135 species, 79.41%) of medicinal plants were harvested from wild sources and mainly possessed multiple remedy parts (41.17%) that are usually prescribed in fresh form (60.13%). The most commonly reported human ailment was snake venom, while blackleg was mostly reported among livestock diseases. The herbal medicines were mostly administered orally (52.20%), followed by dermal (17.62%) application. Embelia schimperi Vatke, Glinus lotoides L., Haplosciadium abyssinicum Hochst., Mucuna melanocarpa Hochst. ex A. Rich., and Phragmanthera macrosolen (Steud. ex A. Rich.) M.G.Gilbert had the highest fidelity level values (100%) against the corresponding ailments.

CONCLUSION

The study area is rich in a diversity of potential medicinal plants and associated indigenous knowledge. Thus, appropriate conservation actions and careful utilization are essential to counteract the rise of anthropogenic threats and to ensure the continuity of plants with the related indigenous knowledge. Additionally, the medicinal plants should be validated through experimentation to integrate local knowledge with modern medications.

Self-medication for dental caries-associated toothache among dental outpatients attended at public health facilities in Dar es Salaam, Tanzania: A cross-sectional study

Background and aim

Self-medication is a common practice worldwide, and its prevalence ranges between 20% and 80% among patients suffering from dental pain. The socioeconomic status of an individual plays a key role in self-medication practice, especially sex and education level. This study aims to investigate the extent of self-medication practice for toothache due to dental caries among adults in Dar es Salaam, Tanzania.

Methods

This was an analytical cross-sectional study carried out over 6 months. It included adult patients presenting with toothache in public dental clinics. A questionnaire captured information on demography, self-medication practice, the substance used for self-medication, duration of self-medication, and reason for self-medication. Univariate analysis was carried out to assess factors associated with self-care remedies. The probability level of α < 0.05 was selected for statistical significance.

Results

A total of 420 participants took part in this survey with a majority (54.3%) being females. The ages of the participants ranged between 18 years and 79 years, with a mean age of 33.37 (SD = 12.64) years. Nearly all (98.5%) participants used some sort of self-prescribed remedies for managing toothache before attending a dental clinic for appropriate treatment. The sociodemographic status of the participants did not influence the practice of self-medication.

Conclusion

About 98% of patients suffering from toothache in Tanzania practice self-medication, and it cuts across all social strata of the adult dental population.

Patient or Public Contribution

Patients with toothache secondary to dental caries participated in the pilot study and were consulted on the suitability of the study tool.

Bioactive plant waste components targeting oral bacterial pathogens as a promising strategy for biofilm eradication

The significance of this study lies in its exploration of bioactive plant extracts as a promising avenue for combating oral bacterial pathogens, offering a novel strategy for biofilm eradication that could potentially revolutionize oral health treatments. Oral bacterial infections are common in diabetic patients; however, due to the development of resistance, treatment options are limited. Considering the excellent antimicrobial properties of phenolic compounds, we investigated them against isolated oral pathogens using in silico and in vitro models. We performed antibiogram studies and minimum inhibitory concentration (MIC), antibiofilm, and antiquorum sensing activities covering phenolic compounds. Bacterial strains were isolated from female diabetic patients and identified by using 16S rRNA sequencing as Pseudomonas aeruginosa, Bacillus chungangensis, Bacillus paramycoides, and Paenibacillus dendritiformis. Antibiogram studies confirmed that all strains were resistant to most tested antibiotics except imipenem and ciprofloxacin. Molecular docking analysis revealed the significant interaction of rutin, quercetin, gallic acid, and catechin with transcription regulator genes 1RO5, 4B2O, and 5OE3. All tested molecules followed drug-likeness rules except rutin. The MIC values of the tested compounds varied from 0.0625 to 0.5 mg/mL against clinical isolates. Significant antibiofilm activity was recorded in the case of catechin (73.5% ± 1.6% inhibition against B. paramycoides), cinnamic acid (80.9% ± 1.1% inhibition against P. aeruginosa), and vanillic acid and quercetin (65.5% ± 1.7% and 87.4% ± 1.4% inhibition, respectively, against B. chungangensis) at 0.25-0.125 mg/mL. None of the phenolic compounds presented antiquorum sensing activity. It was, therefore, concluded that polyphenolic compounds may have the potential to be used against oral bacterial biofilms, and further detailed mechanistic investigations should be performed.

Ethno-Dentistry of Medicinal Plants Used in North Waziristan, Pakistan

OBJECTIVE

This study aimed at recording therapeutic plant species used by inhabitants to treat dental disorders in the district of North Waziristan, Pakistan. The indigenous people of the studied area are dependent on medicinal plants for their basic health care needs including dental care.

METHODS

Ethnomedicinal data were collected using a semi-structured questionnaires, and in addition 130 local informants were interviewed. The collected data were evaluated using various quantitative indices, including use value (UV), relative frequency of citation (RFC), fidelity level (FL%), and Jaccard Index (JI).

RESULTS

A total of 69 plants belonging to 48 plant families used in dental disorders were identified. The Lamiaceae was the leading family that shared 7 species, followed by Solanaceae (4 spp).The dominant life form used was herbs (47.83%), folowed by leaves (43.90%) in preparing remedies for different dental disorders. Decoction was the most common mode of preparation (34.21%), followed by pastes (21.05%). The highest RFC (0.36) was reported for Bergenia ciliata, followed by Salvadora oleoides (0.35). The majority of the plants (36 spp) were utilised as herbal medicine to treat toothache, followed by 13 species for periodontal (gum) infections, 11 species used for teeth cleaning, and 9 species for halitosis (bad breath).

CONCLUSIONS

This study is the first-ever record of ethnomedicinal applications for the treatment of dental diseases from Pakistan. Some of the forgeoing hebal medications should be further evalauted for the development of pahrmaceutical bio-products for the treatment of dental disorders.

Medicinal Plants Used by Oromo Community in Kofale District, West-Arsi Zone, Oromia Regional State, Ethiopia

Purpose

The purpose of this study was to record the utilization of medicinal plants by the Oromo people in the Kofale District, Oromia Regional State, Ethiopia, to control human and animal health problems.

Methods

Data regarding the use of medicinal plants were collected using ethnobotanical methods from 84 traditional medicine practitioners and 304 general informants sampled employing purposive and systematic random sampling methods, respectively, in the Kofale District. Data were analyzed using different indices, including a preference ranking exercise, informant consensus factor (ICF), fidelity level (FL) and relative popularity level (RPL).

Results

In the district, 106 medicinal plants were claimed to be used for the treatment of 43 human and 18 livestock illnesses, of which 75 (71%) were used to manage human health problems, 23 (21.5%) were used to treat both human and livestock ailments and eight (7.5%) were utilized to treat manage livestock health problems. Most (76.4%) plants were harvested from the wild. Leaves were the most commonly used plant part (55.6%) in remedy preparations. Skin diseases scored the highest ICF value (0.97), followed by gastrointestinal disorders (ICF = 0.95), cancer (ICF = 0.93), and hemorrhoids (ICF = 0.91). Medicinal plants that record the highest fidelity level (FL) (100%) and rank order priority (ROP) (100%) values included Justicia schimperiana, Embelia schimperi, Ekebergia capensis and Datura stramonium, which have been used to treat liver disorders, tapeworm infections, babesiosis, and rabies, respectively. There were significant differences (p<0.05) in the mean numbers of medicinal plants claimed by different social groups: older, illiterate, and traditional medicine practitioners reported higher mean numbers of medicinal plants than younger, literate, and general informants, respectively.

Conclusion

This study indicated the richness of medicinal plant species in Kofale District. Medicinal plants with the highest FL and ROP values and those used to treat disease categories with the highest ICF values should be prioritized in future phytochemical and pharmacological investigations.

In vitro antimicrobial and antioxidant activities, essential oil composition, and in silico molecular modeling analysis of secondary metabolites from roots of Verbascum sinaiticum

Verbascum sinaiticum is locally used to treat wound, stomachache, viral infection, cancer, sunstroke fever, abdominal colic, diarrhea, hemorrhage, anthrax, and hepatitis. The objective of this study was to identify the compounds and to evaluate the antimicrobial and antioxidant activity of the extracts and isolated compounds from V. sinaiticum. The 1H-NMR, 13C-NMR, and DEPT-135 were used to elucidate the structures of isolated compounds. Essential oils were extracted by hydrodistillation method and their chemical analyses were performed by GC-MS. The broth microdilution method was used to evaluate the antimicrobial activity. The radical scavenging activity of the extracts and isolated compounds were evaluated using DPPH method. Silica gel column chromatographic separation of root extracts afforded seven known compounds: 3'-(4''-methoxy phenyl)-3'-oxo-propionyl hexadecanoate (1), harpagoside (2), pulverulentoside I (3), scrophuloside B4 (4), scropolioside A (5), scropolioside-D2 (6), and harpagide 6-O-β-glucoside (7), which are all reported from this species for the first time. The EO extracts from leaves and roots were the most susceptible to Streptococcus agalactiae, with a 2 mg/mL MIC. The EO from roots was effective against Candida albicans and Trichophyton mentagrophytes, with a MIC of 8 mg/mL. The MeOH and CH2Cl2/CH3OH (1:1) root extracts showed the maximum activity against S. epidermidis with MIC values of 0.25 mg/mL. The strongest antibacterial effects were demonstrated against Staphylococcus epidermidis, which exhibited a 0.0625 mg/mL MIC for compound 1. The strongest radical scavenging activity was exhibited by the methanol extract (IC50 = 3.4 μg/mL), and compounds 4, 6, 5, 3, 7, and 2 with IC50 values of 3.2, 3.38, 3.6, 3.8, 4.2, and 4.7 μg/mL, respectively, in comparison with ascorbic acid (IC50 = 1.3 μg/mL). The results of the molecular docking analysis of compounds revealed minimal binding energies range from -38.5 to -43.1 kJ/mol, -33.1 to -42.7 kJ/mol, -34.7 to -39.3.7 kJ/mol, -25.5 to -37.6 kJ/mol against human myeloperoxidase (PDB ID: 1DNU), murA enzyme (PDB ID: 1UAE), human topoisomerase IIβ (PDB ID: 4fm9), S. epidermidis FtsZ (PDB number: 4M8I) proteins, respectively. The docking results and the in vitro antibacterial activity are in good agreement. These findings show that the isolated compounds 2-7 can act as potential antioxidants and strong antibacterials against Staphylococcus aureus and S. epidermidis. As a result, V. sinaiticum root extracts have the potential to be effective in treating diseases caused by bacteria and free radicals, as long as further investigation has been suggested for the ultimate decision of this plant's potential candidate.

GC-MS analysis, molecular docking, and pharmacokinetic studies of Multidentia crassa extracts' compounds for analgesic and anti-inflammatory activities in dentistry

Plant extracts have been useful for oral health or dentistry. However, only a few evidence-based justifications exist. This study evaluated Multidentia crassa (Hiern) Bridson & Verdc, one of the oral health-used plants in Malawi. Gas chromatography-mass spectrometry (GC-MS) and Fourier transform infrared (FT-IR) identified the extracts' compounds. The pharmacokinetics of the identified compounds were studied using pkCSM and SwissADME, and molecular docking studies were used to identify potential drug candidates for oral health by predicting the binding affinity of the compounds to cyclooxygenases, interleukin-1 beta receptors, odontoblast cold sensor proteins, and purinergic receptor P2X3. FT-IR analysis showed characteristic peaks of phenols, carboxylic acids, alkenes, alkyl halides, amines, esters, ethers, aromatics, and lipids. GC-MS results showed the presence of 58 bioactive phytocompounds, some of which have various pharmacological activities relevant to oral health. Molecular docking further validated stigmastan-3,5-diene's potency for analgesic and anti-inflammatory purposes. Based on a literature review, this is the first report on the bioactive compounds of M. crassa extracts showing analgesic and anti-inflammatory effects. This study's results can lead to new herbal and conventional medicines. Therefore, we recommend in vivo and in vitro studies to elucidate the pharmacological effects of the plant extracts.

Integrated Microbiome and Metabolomics Analysis of the Effects of Dietary Supplementation with Corn-Steep-Liquor-Derived Candida utilis Feed on Black Pigs

In this experiment, glucose master liquor and corn steep liquor were used as carbon and nitrogen sources, and Candida utilis was used as a strain to ferment yeast feed. The OD value and number of yeast cells were used as response values to optimize the medium components of the yeast feed through a response surface methodology. The optimal medium components were a glucose master liquor concentration of 8.3%, a corn steep liquor concentration of 1.2%, and a KH2PO4 concentration of 0.14%. Under this condition of fermentation, the OD value was 0.670 and the number of yeast cells was 2.72 × 108/mL. Then, we fed Candida utilis feed to Dongliao black piglets, and the effects of the yeast feed on the piglets' growth performance, fecal microbiota, and plasma metabolic levels were investigated through 16S rDNA sequencing and metabolomics. In total, 120 black piglets with an average initial weight of 6.90 ± 1.28 kg were randomly divided into two groups. One group was fed the basic diet (the CON group), and the other was supplemented with 2.5% Candida utilis add to the basic diet (the 2.5% CU group). After a pre-feeding period, the formal experiments were performed for 21 days. The results showed that the addition of Candida utilis to the diet did not affect growth performance compared with the control group. Meanwhile, no significant differences were observed in the serum biochemical indices. However, piglets in the 2.5% CU group had a significantly altered fecal microbiota, with an increased abundance of Clostridium_sensu_stricto_1, Lactobacillus, and Muribaculaceae_unclassified. Regarding the plasma metabolome, the 12 differential metabolites detected were mainly enriched in the histidine, tryptophan, primary bile acid, and caffeine metabolic pathways. Regarding the integrated microbiome-metabolome analysis, differential metabolites correlated with fecal flora to variable degrees, but most of them were beneficial bacteria of Firmicutes. Collectively, dietary Candida utilis feed had no adverse effect on growth performance; however, it played an important role in regulating fecal flora and maintaining metabolic levels.

Ethnobotanical Study of Medicinal Plants Used against Human Diseases in Zuway Dugda District, Ethiopia

Introduction

In Ethiopia, traditional medicine has significantly contributed to the treatment of public health conditions. However, when contrasted with the ethnic diversity of Ethiopians, the number of medicinal plants that have been documented remains limited. As a result, the study aimed to record the medicinal plants used in the Zuway Dugda district communities. Methodology. An ethnobotanical study of medicinal plants used by local people of Zuway Dugda district was carried out from February 2020 to November 2020. Semistructured interviews, a market survey, field observations, and group discussions were used to gather pertinent data. One hundred informants (83 males and 17 females) provided data. 76 informants were chosen at random, while 24 key informants were chosen on the basis of recommendations from local elders. Data were analyzed using descriptive statistics, preference ranking, paired comparison, and direct matrix ranking.

Results

A total of 73 plant species, representing 62 genera and 40 families, were collected and identified. Asteraceae, Fabaceae, and Solanaceae had the most species, with each family having 6 (8.22%) species, followed by Euphorbiaceae, which had 4 (5.48%) species. The wild harvest of approximately 49 medicinal plants (or 67.12%) was used. 31 plant species, or 42.47% herbs, were found to be the most commonly used life forms. The most frequently used plant parts were reported to be the leaves, which accounted for 55 species (41.35%) and then the roots 25(18.80%). Headache, toothache, depression, febrile illness, and fever had the lowest ICF values (0.33), while snake bite-related issues had the highest ICF values (0.93). The results of the preference ranking indicated that locals prefer to treat wounds with Asparagus africanus Lam. The community used Cordia africana Lam. the most, according to direct matrix ranking.

Conclusions

It is essential to combine indigenous knowledge with scientific methods in order to extract the most benefit from medicinal plants. The results of the ICF and preference ranking could be used as a prelude to this. Since A. africanus was found to be the most effective wound-healing medicinal plant in the current study, further phytochemical and pharmacological research is recommended.

Herbal remedies used by traditional healers to treat haemorrhoids in Tabora region, Tanzania

CONTEXT

Haemorrhoids are one of the most common gastrointestinal disorders in humans. In Tanzania, particularly in the Tabora region, medicinal plants (MPs) are used by traditional healers (THs) to treat haemorrhoids, but no study has explicitly attempted to compile these treatments.

OBJECTIVE

This study documents MPs used by THs of the Tabora region in Tanzania to treat haemorrhoids.

MATERIALS AND METHODS

A semi-structured questionnaire was used to gather ethnobotanical data from 44 THs on MPs used to treat haemorrhoids, parts used, preparation methods and administration routes. The collected ethnobotanical data were analysed by computing percentage frequencies and relative frequency citations.

RESULTS

Twenty-six MPs belonging to 19 families and 25 genera, used to manage haemorrhoids, were documented. Fabaceae was the dominant family (four species), whereas shrubs constituted a high proportion (38.46%) of the MPs, and the root was the most (30.3%) utilized plant part. Decoction (38.5%) and topical application (53.8%) were the most preferred preparation and administration techniques. Most MP materials (76.9%) were sourced from the wild. Aloe vera (L.) Burm.f. (Asphodelaceae) (68%), followed by Allium sativum L. (Alliaceae) (66%) and Psidium guajava L. (Myrtaceae) (66%) were the most utilized MPs. Among the recorded MPs, 12 are reported for the first time for the treatment of haemorrhoids. The recorded MPs are believed to possess anti-inflammatory properties that aid in managing inflammation associated with bowel diseases, including haemorrhoids.

CONCLUSIONS

This study has documented valuable MPs used to manage haemorrhoids and provides a basis for further studies to discover efficient and affordable anti-haemorrhoid drugs.

Anti-Inflammatory and Analgesic Activity of Methanolic Root Extract of Verbascum sinaiticum Benth

INTRODUCTION

Pain in its various forms is undoubtedly the most common ailment known to human beings. Non-steroidal anti-inflammatory drugs (NSAIDs) and opioid analgesics are widely used to treat pain. However, long-term use of NSAIDs and opioids causes serious adverse effects on various organs. As a result, looking for drugs with better efficacy and lesser adverse effects appears crucial. For this purpose the obvious search begins from traditional medicines, particularly herbs. Therefore, this study investigated analgesic and anti- inflammatory activity of 80% methanol root extract of Verbasicum sinaiticum Benth (VS) in vivo.

METHODS

The dried and crushed plant material was macerated with 80% methanol sequentially and dried with lyophilizer. As per the acute toxicity study conducted elsewhere, 100 mg/kg, 200 mg/kg and 400 mg/kg doses of extract were used in the acetic acid induced writhing, hot plate test, as well as carrageenan and formalin induced anti-inflammatory models. As a positive control, aspirin 150 mg/kg was used for anti-nociceptive and anti-inflammatory model and morphine 10 mg/kg was used for central analgesic models.

RESULTS

VS200 and VS400 doses of the extract significantly (p< 0.05) reduced acetic acid induced writhing as compared with the control group. Similarly in hot plate test also, both VS200 and VS400 groups demonstrated significant (p< 0.05 at 30 min and p< 0.001 at 60 and 120 min) analgesic effect in comparison with the control and VS100 groups. Furthermore, in carrageenan and formalin induced anti-inflammatory test both VS200 and VS400 were shown to produce significant (p< 0.05) anti-inflammatory effect at the later hours and days.

CONCLUSION

The findings from this study suggest that 80% methanol root extract of V. sinaiticum possesses peripheral and central analgesic as well as anti-inflammatory activity, possibly emanating from the phytochemicals present in the hydroalcoholic crude extract.

There Is Not Only Cupressus sempervirens L.: A Review on the Phytochemistry and Bioactivities of the Other Cupressus L. Species

This review article reports for the first time phytochemistry, ethnobotanical uses and pharmacological activities of all Cupressus L. species other than Cupressus sempervirens L. Indeed, the literature survey showed how many other Cupressus species are rich of important phytochemical compounds, widely used in the ethnobotanical field for several purposes and endowed with interesting biological activities, even if they are somehow neglected by the scientific community. This review aims to continue the study of these other Cupressus species and promote more research on them.

A Review on Medicinal Plants Used in the Management of Respiratory Problems in Ethiopia over a Twenty-Year Period (2000–2021)

This review is aimed at assessing and compiling the different ethnomedicinal studies in different parts of Ethiopia used to treat respiratory diseases. The data were collected from different published research papers through searching the web sources such as PubMed, Science Direct, Google Scholar, and other related websites. The important search terminologies included ethnobotany, respiratory diseases, medicinal plants, and Ethiopia. For this, a total of 65 articles of recent publications (from 2000 to May 2021 years) that provided full information about the use of medicinal plant species to treat respiratory disorder diseases in Ethiopia were consulted. Based on this, a total of 96 medicinal plants belonging to 57 families were reviewed. The commonly recorded families used to manage respiratory problems were Asteraceae, Lamiaceae, Solanaceae, and Fabaceae. Herbs and shrubs were the dominant plant growth forms. Due to the easiest form of their preparation for treating respiratory disorders, leaves are the most cited plant parts followed by roots. Crushing and pounding are useful methods of remedy preparation to treat respiratory diseases. This review concluded that different medicinal plants have a significant contribution in combating serious respiratory problems in Ethiopia. Hence, the complied review of medicinal plants on the treatment of respiratory problems would play a great role in further pharmacological and phytochemical investigations in developing new drugs used for the treatment of respiratory problems and in the conservation of these important medicinal plants.

Medicinal Plants Used to Treat Human and Livestock Ailments in Basona Werana District, North Shewa Zone, Amhara Region, Ethiopia

This study was conducted on medicinal plants used for the treatment of human and livestock ailments in Basona Werana District, North Shewa Zone, Amhara Region. Data were collected through semi-structured interviews, field walk observation, preference, and direct matrix ranking with randomly and purposefully selected informants. A total of 80 respondents (46 men and 14 women) and 20 (16 men and 4 women) traditional healers participated in this study. A total of 76 plant species distributed in 75 genera and 45 families were collected and identified. Of the 76 medicinal plants collected from the study area, 85.5% were used to treat human ailments. The Lamiaceae came out as a leading family with 8 (10.5%) species followed by Asteraceae and 7 (9%) medicinal plant species each, while Solanaceae followed with 6 (7.8%) species. The majority of medicinal plants were collected from wild habitat and accounted for 56 plant species (73.6%). The result of growth form analysis showed that herbs constituted the highest proportion of medicinal plants represented by 33 species (43.4%), followed by shrubs with 30 species (39.4%) and trees with 10 species (13.1%). The medicinal plants were administered through oral, which accounts for 54 species (48.1%), followed by dermal with 38 species (33.9%) and nasal with 9 species (8%), respectively. Leaves were the most frequently used plant parts for the preparation of traditional herbal medicines in the study area. Crushing was the widely used preparation method (33.9%) followed by pounding (16%). Cucumis ficifolius A. Rich. was the most preferred plant used to treat stomachache. Phytochemical and pharmacological studies of this type of plant are recommended to get the most out of the plant.

Randomized, Triple-Blinded, Placebo-Controlled Trial of SA3X (Spilanthes acmella) for the Management of Erectile Dysfunction

Introduction Spilanthes acmella has been used as an aphrodisiac in India and other countries. However, studies concerning humans have been limited. This randomized controlled trial was carried out to evaluate the effect of SA3X capsules containing 500 mg of S. acmella on sexual function domain scores in sexually active men with symptoms of erectile dysfunction (ED) using the Men's Sexual Health Questionnaire (MSHQ). Materials and methods This triple-blind, placebo-controlled, parallel-group was conducted at two centres in Hyderabad and Secunderabad from May to December 2021. Patients were randomized 1:1 to SA3X therapy or placebo for one month along with an observational cohort. The change of MSHQ score and its subdomains from baseline to month 1 (primary endpoint) and one-month post-treatment (secondary outcome) was assessed using a mixed model repeated measures analysis. Additional secondary outcomes measured were the change in the International Index of Erectile Function (IIEF) and duration of penile erection. Safety was evaluated. Results The intention-to-treat population included 448 patients (152 - SA3X therapy; 146 - placebo; 150 - observational cohort). A significant increase was observed with SA3X therapy versus placebo on the total MSHQ score (17.24 vs 4.72; SE: 2.11, 1.98; P<0.001) along with the sub-domains at the end of one month of therapy. At one-month post-treatment, the increase in MSHQ score with SA3X therapy was significant (18.48 vs 3.78; SE 2.81, 1.39; P<0.001). The IIEF scores and duration of penile erection also increased significantly in the SA3X therapy group. Dysgeusia (3.94%) was the most common drug-related adverse effect. No serious adverse effects were noted. Conclusion SA3X was concluded to be safe and effective as a potential treatment for ED.

The Genetic Diversity of Enset (Ensete ventricosum) Landraces Used in Traditional Medicine Is Similar to the Diversity Found in Non-medicinal Landraces

Enset (Ensete ventricosum) is a multipurpose crop extensively cultivated in southern and southwestern Ethiopia for human food, animal feed, and fiber. It has immense contributions to the food security and rural livelihoods of 20 million people. Several distinct enset landraces are cultivated for their uses in traditional medicine. These landraces are vulnerable to various human-related activities and environmental constraints. The genetic diversity among the landraces is not verified to plan conservation strategy. Moreover, it is currently unknown whether medicinal landraces are genetically differentiated from other landraces. Here, we characterize the genetic diversity of medicinal enset landraces to support effective conservation and utilization of their diversity. We evaluated the genetic diversity of 51 enset landraces, of which 38 have reported medicinal value. A total of 38 alleles across the 15 simple sequence repeat (SSR) loci and a moderate level of genetic diversity (He = 0.47) were detected. Analysis of molecular variation (AMOVA) revealed that only 2.4% of the total genetic variation was contributed by variation among the medicinal and non-medicinal groups of landraces, with an FST of 0.024. A neighbor-joining tree showed four separate clusters with no correlation to the use-values of the landraces. Except for two, all "medicinal" landraces with distinct vernacular names were found to be genetically different, showing that vernacular names are a good indicator of genetic distinctiveness in these specific groups of landraces. The discriminant analysis of the principal components also confirmed the absence of distinct clustering between the two groups. We found that enset landraces were clustered irrespective of their use-value, showing no evidence for genetic differentiation between the enset grown for 'medicinal' uses and non-medicinal landraces. This suggests that enset medicinal properties may be restricted to a more limited number of genotypes, might have resulted from the interaction of genotype with the environment or management practice, or partly misreported. The study provides baseline information that promotes further investigations in exploiting the medicinal value of these specific landraces.

The Current and Potential Application of Medicinal Cannabis Products in Dentistry

Oral and dental diseases are a major global burden, the most common non-communicable diseases (NCDs), and may even affect an individual's general quality of life and health. The most prevalent dental and oral health conditions are tooth decay (otherwise referred to as dental caries/cavities), oral cancers, gingivitis, periodontitis, periodontal (gum) disease, Noma, oro-dental trauma, oral manifestations of HIV, sensitive teeth, cracked teeth, broken teeth, and congenital anomalies such as cleft lip and palate. Herbs have been utilized for hundreds of years in traditional Chinese, African and Indian medicine and even in some Western countries, for the treatment of oral and dental conditions including but not limited to dental caries, gingivitis and toothaches, dental pulpitis, halitosis (bad breath), mucositis, sore throat, oral wound infections, and periodontal abscesses. Herbs have also been used as plaque removers (chew sticks), antimicrobials, analgesics, anti-inflammatory agents, and antiseptics. Cannabis sativa L. in particular has been utilized in traditional Asian medicine for tooth-pain management, prevention of dental caries and reduction in gum inflammation. The distribution of cannabinoid (CB) receptors in the mouth suggest that the endocannabinoid system may be a target for the treatment of oral and dental diseases. Most recently, interest has been geared toward the use of Cannabidiol (CBD), one of several secondary metabolites produced by C. sativa L. CBD is a known anti-inflammatory, analgesic, anxiolytic, anti-microbial and anti-cancer agent, and as a result, may have therapeutic potential against conditions such burning mouth syndrome, dental anxiety, gingivitis, and possible oral cancer. Other major secondary metabolites of C. sativa L. such as terpenes and flavonoids also share anti-inflammatory, analgesic, anxiolytic and anti-microbial properties and may also have dental and oral applications. This review will investigate the potential of secondary metabolites of C. sativa L. in the treatment of dental and oral diseases.

Beneficial Role of Antioxidant Secondary Metabolites from Medicinal Plants in Maintaining Oral Health

Plant-derived phytochemicals have been touted as viable substitutes in a variety of diseases. All over the world, dentists have turned to natural remedies for dental cure due to the negative possessions of certain antibacterial mediators used in dentistry. Antimicrobial and other drugs are currently in use, but they show some side effects. Since ancient times, antioxidant EOs have been used for different ailments and have grown in popularity over time. Several in vitro, in vivo, and clinical trials have shown the safety and effectiveness of antioxidant essential oils (EOs) in oral health obtained from medicinal plants. The current review of literature provides a summary of secondary metabolites, more specifically EOs from 20 most commonly used medicinal plants and their applications in maintaining oral health. Dental caries and periodontal diseases are the most common and preventable global infectious diseases, with diseases of the oral cavity being considered major diseases affecting a person's health. Several clinical studies have shown a connection between oral diseases and oral microbiota. This review discusses the role of antioxidant secondary metabolites in inhibiting the growth of oral pathogens and reducing the formation of dental plaque, and as well as reducing the symptoms of oral diseases. This review article contributes a basic outline of essential oils and their healing actions.

Antibacterial Activities of Echinops kebericho Mesfin Tuber Extracts and Isolation of the Most Active Compound, Dehydrocostus Lactone

Echinops kebericho Mesfin is traditionally used for the treatment of various infectious diseases. This study investigated antibacterial activity of the essential oil (EO) and the different fractions of ethanol extract. The most active component was isolated and identified. Isolation and purification was accomplished using chromatographic techniques while identification was done by spectroscopic method. Minimum inhibitory concentration (MIC) was determined using the broth micro-dilution method. In bioactive-guided isolation, percent inhibition was determined using optical density (OD) measurement. The MICs of the essential oil ranged from 78.125 μg/ml to 625 μg/ml, and its activity was observed against methicillin-resistant Staphylococcus aureus (MRSA, NCTC 12493). Ethyl acetate fraction showed high activity against MRSA (NCTC 12493), MIC = 39.075 μg/ml followed by Enterococcus faecalis (ATCC 49532), MIC = 78.125 μg/ml and was least active against Klebsiella pneumoniae (ATCC 700603), MIC = 1,250 μg/ml. MIC of hexane fraction ranged from 156.2 µg/ml to Escherichia coli (ATCC 49532) to 1,250 μg/ml to E. coli (NCTC 11954). The MICs of chloroform fraction ranged from 312.5 to 2500 μg/ml; while butanol fraction could be considered pharmacologically inactive as its MIC value was 2,500 μg/ml for all and no activity against E. coli (NCTC 11954). Dehydrocostus lactone was successfully isolated and identified whose MIC was 19.53 μg/ml against MRSA. Dehydrocostus lactone isolated from E. kebericho M. showed noteworthy antibacterial activity which lends support to ethnopharmacological use of the plant. Further optimization should be done to improve its antibacterial activities and pharmacokinetic profile.