Open Access Short Research Article

Utilization of Herbal Medicines among Diabetic Patients Attending Kenyatta National Hospital Outpatient Clinic

Okoth Molly Elsa, Kimani Kuria, David Nyamu, Evans Mwangangi

Journal of Complementary and Alternative Medical Research, Page 1-18
DOI: 10.9734/JOCAMR/2017/33962

Background: World Health Organization has estimated that 70-90 % of Africa’s population still relies on herbal remedies in order to meet their healthcare needs. Although the role of herbal medicines in the management of diabetes is an emerging health issue, use of herb remedies is common among diabetics.

Objectives: To evaluate knowledge, perception and describe the pattern of utilization of herbal medicines among diabetic outpatients at Kenyatta National Hospital.

Methodology: The study was a tertiary hospital-based cross sectional study. Simple random sampling technique was used to select 251 adult diabetic outpatients who were interviewed. Data was captured into Microsoft Excel computer software and then exported to SPSS version 17.0 for analysis. Descriptive data was analyzed quantitatively and presented in form of charts and tables as appropriate. Statistical significance was determined using Pearson Chi Square at p<0.05. Where numbers of participants were too small, Fishers exact results were used.

Results: The prevalence of use of herbal remedies for managing diabetes mellitus was 7.2%. However, the total prevalence of use of herbs among the diabetic outpatients was 39.5% implying that 32.3% of the study participants used herbs for other medical conditions. The commonest herbs used were ginger and Aloe vera used by 50% of the herbal users. Almost half of the herb users did not regard it important to inform the doctor about their use of herbs. The reasons given for use of herbal medicines were varied; the commonest being that herbs could easily be accessed 13 (13.1%) of the herbal users.

There was no statistically significant relationship between socio-demographic characteristics and use of herbs (P>0.05).

Conclusion: About 40% of diabetic outpatients are in some form of herbal remedy.  In addition, 1 out of 5 of diabetic herbal users use them for managing diabetes; commonest herbs being Aloe vera and ginger. Therefore, healthcare workers and researchers should find ways of harmonizing the utilization of herbal and conventional medicines amongst diabetic patients.


Open Access Minireview Article

Tui Na (or Tuina) Massage: A Minireview of Pertinent Literature, 1970-2017

Abdullah Mohammed Al-Bedah, Gazzaffi Ibrahim Ali, Tamer Shaban Abushanab, Naseem Akhtar Qureshi

Journal of Complementary and Alternative Medical Research, Page 1-14
DOI: 10.9734/JOCAMR/2017/32941

Background: Tuina massage is a traditional method used effectively in the treatment of various ailments in China since ancient time, and currently it is used around the world.

Objective: This minireview aims to describe several aspects of Tuina massage an integral part of Traditional Chinese Medicine in order to fill up the knowledge gap concerning traditional practitioners in Saudi Arabia.

Methods: Electronic searches of databases using Boolean operators and keywords were conducted to retrieve data published in English and Chinese literature. Thousands of articles were identified and screened by two independent reviewers using exclusion and inclusion criteria, and 56 articles were finally included in this study.

Results: Tuina has a very rich history in Chinese culture since antiquity. With continuous advancements in research, training, regulation and clinical practice, Tuina massage became popular worldwide and now used either alone or in conjunction with other complementary and alternative medicine or conventional therapies in diverse diseases associated with pain and other symptoms with good outcome. Although Tuina has good safety profile with level of evidence (LOE) of I to III, well defined indications and contraindications, a variety of minor adverse effects together with some major complications including deaths have been reported in the literature. Besides continuous training of Tuina practitioners, Tuina massage practice needs regulatory measures and guidelines for avoiding complications and improving the clinical outcome of patients.

Conclusion: Evidently, Chinese Tuina massage supported by theory, mechanisms, procedure and included randomized clinical trials snapshots, systematic reviews and meta-analysis with LOE of I to III is reported to be effective in several conditions. Further, rigorous randomized controlled studies with active comparators including other traditional modality or conventional medications or placebo with intensified quality control measures are required to provide further robust evidence-based data to support its efficacy in chronic diseases associated with pain and disabilities.


Open Access Original Research Article

GC-MS Analysis of Methanolic Extracts of Leaf and Stem of Marsilea minuta (Linn.)

Govindaraj Sabithira, Rajangam Udayakumar

Journal of Complementary and Alternative Medical Research, Page 1-13
DOI: 10.9734/JOCAMR/2017/30871

Aims: To analyze the chemicals composition of methanolic extracts of leaf and stem of M. minuta collected from Uppur Village, Tamilnadu, India by GC-MS.

Study Design: Experimental study.

Methodology: The Methanolic extracts were prepared and concentrated at 40°C using hot air oven. The concentrated methanolic extracts were subjected to GC-MS analysis using the instrument Perkin Elmer Clarus 500.

Results: The methanolic extract of leaf of M. minuta showed the presence of 36 phyto compounds including n-Hexadecanoic acid (44.41%) (C16H32O2); (Z)6,(Z)9-Pentadecadien-1-ol (35.49%) (C15H28O); Phytol (5.10%) (C20H40O); 2-Cyclohexane-1-one,4-hydroxy-3,5,6-trimethyl-4  (3-oxo-1-butenyl)   (2.25%) (C13H18O3); 9,12,15-Octadecatrienoic acid (Z,Z,Z) (2.0%) (C18H30O2); 3,7,11,15-Tetramethyl-2-hexadecan-1-ol (1.99%) (C20H40O) and Benzofuran, 2,3-dihydro- (1.1%) (C8H8O). The methanolic extract of stem of M. minuta showed the presence of 27 bioactive compounds including 1,19-Eicosadiene (40.94%) (C20H38); n-Hexadecanoic acid (20.13%) (C16H32O2); 2(R)3(S)-1,2,3,4-Butanetetrol (16.31%) (C4H10O4); Glycerin (6.70%) (C3H8O3); Octadecanoic acid (4.24%) (C18H36O2); Benzofuran, 2,3-dihydro- (1.73%) (C8H8O); 3,7,11,15 – Tetramethyl-2 hexane decen-1-ol (1.55%) (C20H40O); n-Hexadecanoic acid methyl ester (1.15%) (C17H34O2) and 10- Octadecenoic acid methyl ester (1.42%) (C19H36O2).

Conclusion: The results of the present study concluded that the presence of various phytocompounds in leaf and stem of M. minuta. Therefore, plants are the rich sources of chemicals but largely unknown and unexplored. So, it is our hope that this study will encourage further research on isolation and purification of therapeutically important phytocompounds from M. minuta


Open Access Original Research Article

Medical Students’ Knowledge, Attitude and Practice towards Traditional and Complementary Medicine, Tanta City, Gharbiyah Governorate, Egypt

Ahmed Tawfik El-Olemy, Nashwa Mohammed Radwan, Walid Mostafa Dawoud, Hanaa A. Zayed, Ehab Abo Ali, Hala Elsabbagh, Dalal Salem Al-Dossari, Sara Osama Salem, Naseem Akhtar Qureshi

Journal of Complementary and Alternative Medical Research, Page 1-10
DOI: 10.9734/JOCAMR/2017/33484

Background: The use of traditional and complementary medicine (T&CM) is rising among public and patients around the world, and this epidemiological trend is attributed to multiple explanations including diverse cultural belief systems.

Objective: The aim of this study was to explore knowledge, attitude and practice (KAP) of medical students towards T&CM.

Methods: A cross-sectional study enrolled a random sample of 1160 medical students from Tanta city, Gharbiyah governorate, Egypt between February and March, 2016. Their responses were recorded on a self-designed and self-administered structured questionnaire.

Results: About 86.21% of students had some knowledge about T&CM. Media was the main source of knowledge (TV 31.2%, and internet 13.6%) but males (media, 63.2%) and females (multiple sources, 32.9%) differed significantly concerning source of knowledge (P<0.05).Of studied subjects, 66.6% used once some form of T&CM in lifetime but 62.2% of them used more than one modality. The most common modalities used in decreasing frequency were herbal medicine, Prophetic medicine, cupping (hijama), nutritional supplements, and honey and bee products. The reported reasons for using T&CM included being safe with less side effects (29.0%), religious and social beliefs (25.5%), failure of conventional medicine (15.9%) and less cost (13.1%). Most of the participants (80.3%) agreed that T&CM services should be available to patients. 90.0% of students expressed that T&CM needs to be regulated by concerned authorities. Furthermore, 86.6% of the participants suggested that the community including patients need health education about T&CM.

Conclusion: Overall, majority of participants showed good knowledge and favourable attitudes towards T&CM along with its good practice. Furthermore, T&CM needs regulatory measures along with its integration into conventional medicine. T&CM should be accessible to all patients, and all concerned people including medical students require mandatory health education and training to further improve their KAP.


Open Access Original Research Article

Evaluation of Antioxidant Potentiality of Methanolic and Aqueous Extracts of Pandanus foetidus R. Leaves

Nurunnahar ., Md. Uzzal Haque, Ronok Zahan, Md. Badrul Islam, Ashik Mosaddik

Journal of Complementary and Alternative Medical Research, Page 1-6
DOI: 10.9734/JOCAMR/2017/34109

Aim: Plants are the natural source of antioxidants take part a vital role in the treatment of many age-related diseases and improvement of public health. Therefore the present study was carried out to assess the antioxidant activity of the methanolic and aqueous extracts of Pandanus foetidus R. leaves.

Materials and Methods: Total phenolic and flavonoids content, total antioxidant activity and scavenging of 1,1-diphenyl-2-picrylhydrazyl (DPPH) radical were used to evaluate antioxidant efficacy of methanolic and aqueous extracts of Pandanus foetidus R. leaves.

Results: The total phenolic contents of the methanol and aqueous leaf extracts (CME & CAE) were found to be 39.75±4.56 mg of GAE/g and 45.75±5.69 mg of GAE/g, whereas total flavonoid content in CME and CAE was 295.27±6.29 and 323.25±8.12 mg/g of catechin, respectively. In DPPH, CAE and CME showed moderate antioxidant potentiality with the IC50 value of 90.40 µg/ml and 115.60 µg/ml respectively. The total antioxidant capacity was found to be higher in CME (200.4 ± 8.96 mg/g of ascorbic acid) than in CAE (180.21 ± 7.38 mg/g of ascorbic acid).

Conclusion: This study reveals that, both methanolic and aqueous extracts of Pandanus foetidus leaves could be a potential source of natural antioxidant which could be used to prevent diseases associated with free radical.