Analysis of floristic composition and species diversity of vascular plants native to the State of Palestine (West Bank and Gaza Strip).

This study aims at providing an updated checklist of the native vascular flora of the Palestinian West Bank and Gaza Strip (State of Palestine, SP), serving as a taxonomic and nomenclatural basis for botanical research and encouraging new floristic surveys and biosystematic studies. The study provides an up-to-date checklist of native vascular taxa of the SP and their distribution within the plant districts in the country. This is the very first annotated checklist for the native vascular plants of the SP which incorporates recent name changes, new distribution records, habitat, herbarium specimens catalouge, Red List criteria, wild edible plants, endemism and use in Traditional Palestinian Herbal Medicine. The quantitative analysis of the flora has shown that the SP hosts 1826 taxa, distributed in 686 genera and 108 families; five taxa are gymnosperms, nine taxa are Pteridophytes and 1812 taxa are angiosperms. The most represented families are Leguminosae (222 taxa, 12.2%), Asteraceae (197, 10.2%) and Poaceae (196, 10.7%), while the most represented genera are Trifolium (38, Leguminosae), Silene (32, Caryophyllaceae), Astragalus (27, Leguminosae), Medicago (26, Leguminosae), Allium (25, Amaryllidaceae) and Euphorbia (25, Euphorbiaceae). Annuals (52.4%), Hemicryptophytes (20.2%) and Chamaephytes (12.2%) are the most represented life-forms amongst the SP flora. The richest plant districts in the SP vascular plant taxa are Gaza Strip (GS) (1216 taxa), Jerusalem and Hebron Mountains (JHM) (1235) and Nablus Mountains (NM) (1126). Agglomerative hierarchical clustering (AHC) permitted the division of SP into two main regions, based on the existence of vascular plant taxa: Region 1 (western plant districts with 1128-1237 taxa) with higher water availability and temperate Mediterranean climate which permit the establishment of more than 65% of the total SP flora in these districts and Region 2 (eastern plant districts with 571-698 taxa), characterised by desert and semi-desert conditions, as well as the presence of alluvial and co-alluvial soils, which allow the survival of lower numbers of plant taxa. One hundred and sixty-five taxa of the SP flora are endemic and near-endemic. However, in comparison with some countries of the Mediterranean Basin, this number is below the average endemism concentration, along with other southern arid countries, such as Tunisia and Egypt. In total, there are 102 threatened plant taxa, belonging to 39 families and 83 genera representing 5.6% of the total plants in the SP. IUCN and the Conservation Measures Partnership (CMP) unified classification of direct threats for SP Red-Listed plants has shown a high extinction risk to the Palestinian threatened wild flora, with 76.5% of the threatened species being either critically endangered (CR) or endangered (EN); only 23.5% were vulnerable (VU). However, several taxa are threatened by numerous factors including small population size, human activities, for example, conversion of traditional to intensive agriculture accompanied by deep ploughing and the application of pesticides, urban development and construction, global climatic change, drying of marshes and wetlands, quarrying, fires and pollution. This checklist can help focus conservation efforts and provide a framework for research, protection and policy applications for the SP flora, especially for the endemic and threatened plants.

Isolation, identification, and antimycotic activity of plumbagin from Plumbago europaea L. roots, leaves and stems.

Plumbago europaea L. is a plant utilized in Palestinian ethnomedicine for the treatment of various dermatological diseases. The current investigation was designed to isolate plumbagin from P. europaea leaves, roots and for the first time from the stems. Moreover, it aimed to evaluate the antimycotic activity against three human fungal pathogens causing dermatophytosis, also against an animal fungal pathogen. The qualitative analysis of plumbagin from the leaves, stems, and roots was conducted using HPLC and spectrophotometer techniques, while the structure of plumbagin was established utilizing Proton and Carbon-13 Nuclear Magnetic Resonance (NMR) and Infrared (IR) techniques. The entire plant constituents were determined by GC-MS. Moreover, the antimycotic activity against Ascosphaera apis, Microsporum canis, Trichophyton rubrum, and Trichophyton mentagrophytes was assessed utilizing the poison food technique method. The percentage of plumbagin recorded in the leaves, stems, and roots was found to be 0.51±0.001%, 0.16±0.001%, and 1.65±0.015%, respectively. The GC-MS examination declared the presence of 59 molecules in the plant extract. The plant extract and pure plumbagin exhibited complete inhibition against all tested dermatophytes at 6.0mg/mL for the extracts and 0.2mg/mL for plumbagin. P. europaea root is the best source of plumbagin and the plant extract could represent a potential drug candidate for the treatment of dermatophytosis infections. Further studies required to design suitable dosage forms from the natural P. europaea root extracts or plumbagin alone, to be utilized for the treatment of dermatological and veterinary ailments.

Detection and Phylogenetic Analysis of Viruses Linked with Fig Mosaic Disease in Seventeen Fig Cultivars in Palestine.

Fig mosaic is a viral disease (FMD) that spreads in Palestinian common fig ( Ficus carica L.) orchards. Recognizing the economic value of fig plants and the harmful nature of FMD, the disease poses a significant threat to the economy of the fig production in Palestine. We applied the reverse transcription and amplification (RT-PCR) and PCR technique to leaf samples of 77 trees and 14 seedlings of 17 fig cultivars. The samples were collected from orchards in the main fig-growing provinces of the Palestinian West Bank, to assess the prevalence of viruses associated with FMD, and confirm a possible link of symptoms with viruses detected. Four viruses were detected: Fig mosaic virus (FMV), Fig badnavirus-1 (FBV-1), Fig leaf mottle-associated virus 2 (FLMaV-2), and Fig fleck-associated virus (FFkaV). FMV and FBV-1 were found in all tested fig plants (100%), while FLMaV-2 and FFkaV were detected in 61.5% and 33% of the fig samples, respectively. The high incidence of FBV-1 in the newly propagated symptomatic and symptomless seedlings from different cultivars may be an indication that FBV-1 is integrated into the genome of the fig in a cultivar nondiscriminatory manner. Very weak or no association was detected between FMD symptoms severity in the 17 Palestinian fig cultivars with the various viruses' combinations observed (i.e., number of the viruses infecting the plant). These results support the notion that FMD symptom severity expression is likely to be controlled by a combination of FMV infection, cultivars, and environmental factors, rather than the number of viruses infecting the plant.

Downy Lavender Oil: A Promising Source of Antimicrobial, Antiobesity, and Anti-Alzheimer's Disease Agents.

Lavandula pubescens Decne (LP) is one of the three Lavandula species growing wildly in the Dead Sea Valley, Palestine. The products derived from the plant, including the essential oil (EO), have been used in Traditional Arabic Palestinian Herbal Medicine (TAPHM) for centuries as therapeutic agents. The EO is traditionally believed to have sedative, anti-inflammatory, antiseptic, antidepressive, antiamnesia, and antiobesity properties. This study was therefore aimed to assess the in vitro bioactivities associated with the LP EO. The EO was separated by hydrodistillation from the aerial parts of LP plants and analyzed for its antioxidant, antimicrobial, anticholinesterase, and antilipase activities. GC-MS was used for phytochemical analysis. The chemical analysis of the EO composition revealed 25 constituents, of which carvacrol (65.27%) was the most abundant. EO exhibited strong antioxidant (IC50 0.16-0.18 µL/mL), antiacetylcholinesterase (IC50 0.9 µL/mL), antibutyrylcholinesterase (IC50 6.82 µL/mL), and antilipase (IC50 1.08 µL/mL) effects. The EO also demonstrated high antibacterial activity with the highest susceptibility observed for Staphylococcus aureus with 95.7% inhibition. The EO was shown to exhibit strong inhibitory activity against Candida albicans (MIC 0.47 µL/mL). The EO was also shown to possess strong antidermatophyte activity against Microsporum canis, Trichophyton rubrum, Trichophyton mentagrophytes, and Epidermophyton floccosum (EC50 0.05-0.06 µL/mL). The high antioxidant, enzyme inhibitory, and antimicrobial potentials of the EO can, therefore, be correlated with its high content of monoterpenes, especially carvacrol, as shown by its comparable bioactivities indicators results. This study provided new insights into the composition and bioactivities of LP EO. Our finding revealed evidence that LP EO makes a valuable natural source of bioactive molecules showing substantial potential as antioxidant, neuroprotective, antihyperlipidemic, and antimicrobial agents. This study demonstrates, for the first time, that LP EO might be useful for further investigation aiming at integrative CAM and clinical applications in the management of dermatophytosis, Alzheimer's disease, and obesity.

Biological Properties and Bioactive Components of Mentha spicata L. Essential Oil: Focus on Potential Benefits in the Treatment of Obesity, Alzheimer's Disease, Dermatophytosis, and Drug-Resistant Infections.

In the present study, the medicinal aromatic plant Mentha spicata has been investigated as a source of essential oil (EO) and pharmaceuticals. The quantity and composition of EO from M. spicata cultivated in Palestine were analyzed seasonally over a three-year period. A significantly higher EO content was produced in summer and fall months (2.54-2.79%). Chemical analysis of EO revealed 31 compounds with oxygenated monoterpenes (90%) as the most abundant components followed by sesquiterpene and monoterpene hydrocarbons (6 and 3%, respectively). M spicata can be characterized as a carvone chemotype (65%). EO and carvone have shown strong inhibitory activities against the principal enzymes associated with Alzheimer's disease (AD) and overweight diseases (cholinesterase and porcine pancreatic lipase) and also shown strong antidermatophytic activity against Microsporum canis, Trichophyton rubrum, T. mentagrophytes, and Epidermophyton floccosum. The pancreatic lipase inhibition and the synergism showed the potential activity of M. spicata EO and carvone and that their combinations with standard drugs can be useful for the treatment of obesity and overweight. The results also demonstrated that, in addition to their significant inhibitory activity against biofilm formation of methicillin-resistant Staphylococcus aureus (MRSA), M. spicata EO and carvone had a strong inhibitory effect on metabolic activity and biomass of the preformed biofilm. The current study supports the utilization of M. spicata EO as a traditional medicine and opens perceptions to find more potent substances in the EO for the management of obesity, AD, and dermatophytosis and for combating drug-resistant bacterial infections.

Characterizing Palestinian snake melon (Cucumis melo var. flexuosus) germplasm diversity and structure using SNP and DArTseq markers.

BACKGROUND: Crop landraces embody a source of beneficial genes potentially providing endurance to environmental stress and other agronomic qualities including yield. Our study included 88 snake melon accessions (Cucumis melo var. flexuosus) collected from 9 districts in the Palestinian West-Bank. These accessions represent four landraces of Palestinian snake melon: Green, and White Baladi, and Green, and White Sahouri. RESULTS: This is the first report on successful application of genotyping by sequencing in snake melon. Nine thousand seven hundred fifty single-nucleotide polymorphism (SNP) and 7400 DArTseq genetic markers were employed to evaluate genetic biodiversity and population structure of Palestinian snake melon germplasm collection. Clustering based on neighbor-joining-analysis, principle coordinate and Bayesian model implemented in Structure showed that patterns of genetic diversity of snake melon landraces depends on their geographical source and unraveled the presence of two major local landraces (Sahouri, and Baladi) with accessions from each group clustering together. A significant correlation was observed between both types of markers in Mantel correlation test. A significant association between genetic and geographic matrices (P < 0.0001) was also detected. AMOVA indicated that majority of variation (90%) was due to the difference within accessions. CONCLUSION: The Palestinian landraces seem to have unique genes that may allow the enhancement of the global snake melon gene pool and developments of the plant production worldwide. Our subsequent objective is to detect genotypes with promising qualities and to conduct association mapping studies concentrating on Fusarium-wilt resistance, yield, and environmental stresses.

Antiobesity and Antioxidant Potentials of Selected Palestinian Medicinal Plants.

We evaluated the antioxidant and porcine pancreatic lipase inhibition (PPLI) activities of 90 plants extracts. The antioxidant activity was measured using the free-radical scavenging capacity (DPPH) and reducing power (RP) assays. The pancreatic lipase inhibition assay was used to determine the PPLI activity of plant extracts. Among the 90 plant extracts examined, 41.0 % crude extracts showed antilipase activity of more than 50%. The most active plants by means of IC50 value were Camellia sinensis (0.5 mg/ml), Ceratonia siliqua (leaves) (0.8 mg/mL), Curcuma longa (0.8 mg/mL), Sarcopoterium spinosum (1.2 mg/mL), and Mentha spicata (1.2 mg/mL). The antioxidant activity of plant extracts using the DPPH and RP assays reveals comparable results. The most active antioxidant extracts using both assays were the leaves and fruit epicarp of Rhus coriaria, areal parts of Sarcopoterium spinosum, and leaves of Ceratonia siliqua. Our results suggest natural resources that possess strong antioxidant and pancreatic lipase inhibitory activities with potential applications in the treatment and prevention of obesity and overweight. The extracts of Camellia sinensis, Ceratonia siliqua, Curcuma longa, Sarcopoterium spinosum, and Mentha spicata were proved to have a great potential as antioxidants and antiobesity agents.

Effects of selected Palestinian plants on the in vitro exsheathment of the third stage larvae of gastrointestinal nematodes.

BACKGROUND: Gastrointestinal parasites are one of the main restrictions to small ruminant production. Their pathological importance is primarily related to the major production losses, in quantity or quality, induced by the direct action of worms. Control of these parasites is based exclusively on the frequent use of anthelmintic drugs. However, the resistance to anthelmintics in worm populations after commercialisation of chemical drugs is now widespread. Therefore, there is a need to find new natural resources to ensure sustainable and effective treatment and control of these parasites. The aim of this study was to evaluate the anthelmintic activity, as minimum inhibitory concentration (IC 50 mg/mL), of different plant extracts using larval exsheathment inhibition assay using a two-species but steady population of parasitic nematodes (ca. 20% Teladorsagia circumcinta and 80% Trichostrongylus colubriformis). RESULTS: The study showed that the ethanolic extracts of 22 out of the 48 plant extracts, obtained from 46 plant species, have an inhibitory effect >50% (at concentrations of 100 mg/mL) on the third stage larvae (L3) of the nematodes exhibited the strongest inhibition activity (94%) with IC 50 of 0.02 mg/mL, where other members of the Rhamnaceae family have shown to possess strong anthelmintic activity (70-89%). CONCLUSIONS: Plant extracts are potential rich resources of anthelmintics to combat helminthic diseases. Our results suggest that extracts from Rhamnus elaternus, Epilobium hirsutum, Leucaena leucocephala and Rhamnus palaestinus have promising anthelmintic activity, with potential applications in animal therapeutics and feed.

Complementary and alternative medicine use among cancer patients in Palestine with special reference to safety-related concerns.

ETHNOPHARMACOLOGICAL RELEVANCE: The use of CAM including herbal medicine as the most preferred CAM modality, among cancer patients who are taking prescription medications has shown to be highly prevalent worldwide as well as in several Middle Eastern countries, with a high percentage of the patients do not disclose their CAM use to treating physician. AIM OF THE STUDY: The current study aimed to evaluate the patterns of CAM use among two cohorts of cancer patients in Palestine over a three-year period, and to identify socio-demographic factors that are associated with CAM use. MATERIALS AND METHODS: Across-sectional survey of patients attending outpatient cancer clinics. The method was based on a semi-structured questionnaire. In order to identify safety-related concerns associated with the products listed, a literature search was conducted using different databases (PubMed, Micromedex, AltMedDex, and the Natural Medicine Comprehensive Database). RESULTS: In 472 cancer patients including 372 of the 2011 cohort; and 100 of the 2014 cohort, the overall prevalence of CAM use was 69.5%. CAM users were more likely to be ≤65 years old, village resident, being in the midst of chemotherapy, to have high interest spiritual quest, and to have no other chronic diseases. A significant number of CAM users reported using herbal preparations (98.3%, and 89.6% in the two study cohorts, respectively). In the current study, a total of 40 plant taxa belonging to 23 botanical families were reported by ≥3 cancer patients in the two cohort groups. The top most commonly used plant in the 2011 cohort group was Arum palaestinum (43.5%), while Ephedra foeminea emerged as the top most commonly utilized plant (from 0.0% in 2011 to 55.2% in the 2014 cohort), mainly due to a recent publicizing and portraying of the plant in the local media as an effective cancer herbal remedy. Safety-related concerns were associated with 33 (82.5%) herbs, including herb-drug interactions with altered pharmacokinetics (8, 20% herbs), direct toxic effects (16, 40% herbs), and increased in vitro response of cancer cells to chemotherapy (30, 75% herbs). CONCLUSIONS: CAM use, especially herbal medicine in cancer is highly prevalent in Palestine. This study has demonstrated the role of the media on the emergence of new CAM herbal therapies among cancer patients in Palestine, and discussed its potential implications on patients and for oncologists who are treating them. Some of the most widely used herbal medicines by cancer patients in the present work are known to interact with conventional anticancer drugs. Hence, the disclosure of the use of herbal remedies by patients to health professionals with sufficient training in CAM use is important for the later in order to assess whether there are any possible herbal drug interactions and/or harmful drug reactions.

Traditional Arabic Palestinian ethnoveterinary practices in animal health care: A field survey in the West Bank (Palestine).

BACKGROUND: In Palestine, medicinal plants have continued to play a vital role in fulfilling animal healthcare needs of rural communities. However, these valuable resources are being depleted mainly due to over-harvesting, inappropriate agricultural practices (e.g., over use of herbicides), agricultural expansion, and over-grazing. Therefore, immediate action is required to conserve these resources and document the associated knowledge. The purpose of this study was, thus, to document and analyze information associated with medicinal plants that are used in managing animal health problems in the West Bank, Palestine. MATERIALS AND METHODS: Ethnobotanical data were collected from Apr 2012 to Feb 2014 mainly using semi-structured interviews with informants sampled using purposive sampling technique and through field observations. RESULTS: The study revealed the use of 138 medicinal plant species in the West Bank for the treatment of several livestock diseases, of these 75 species representing 70 genera and 33 families were reported by 3 independent informants or above. Classification of the ethnoveterinary plant species cited by three informants or above used in a rank-order priority (ROP) based on their claimed relative healing potential has demonstrated that the following are the plants with the highest efficacy: Camellia sinenses, Teucrium capitatum, and Salvia fruticosa with ROPs of 97.1, 93.2, and 91.4, respectively, are used primarily to relieve gastric disorders. Gastrointestinal disorders is the disease group in the study area that scored the highest Informant consensus factor (ICF) value (0.90), followed by urinary, and reproductive disorders (0.89). CONCLUSION: Our study provided evidence that medicinal plants are still playing important role in the management of livestock diseases, and showed that ethnoveterinary plants used in animal health care in Palestine have been also recorded in human Traditional Arabic Palestinian Herbal Medicine (TAPHM), and demonstrated a strong link between human and veterinary medical practices. This survey has identified a number of important medicinal plants used by the Palestinian farmers of the West Bank area for the treatment of various animal ailments. It provides a baseline for future phytochemical and pharmacological investigations into the beneficial medicinal properties of such plants.

Plants used during pregnancy, childbirth, postpartum and infant healthcare in Palestine.

PURPOSE: This study aims to evaluate the prevalence and the factors related to the use of herbs by women during pregnancy, childbirth, postpartum and for infant healthcare. The study also aims to identify the herbs therapeutic uses and preparation. To date, no previous studies have investigated this prevalence in Palestine. METHODS: A cross-sectional survey of women of different child-bearing age group inhabiting different locations in Palestine was carried out by means of a semi-structured questionnaire. RESULTS: A total of 372 women were interviewed. Of the participants 72.3% reported using herbs at different pregnancy stages and for infant healthcare. The most common herbal products used in this study at different stages of pregnancy were Pimpinella anisum, Salvia fruticosa, Matricaria aurea, and Mentha spicata. CONCLUSION: This study revealed that there is an appreciable prevalence of herbal use among pregnant women at different pregnancy stages and for infant healthcare in Palestine.

Compared perspectives of Arab patients in Palestine and Israel on the role of complementary medicine in cancer care.

CONTEXT: Complementary medicine (CM) is extensively used by patients with cancer across the Middle East. OBJECTIVES: We aimed to compare the perspectives of two Arab populations residing in diverse socioeconomic-cultural settings in Palestine and Israel regarding the role of CM in supportive cancer care. METHODS: A 27-item questionnaire was constructed and administered to a convenience sample of Arab patients receiving cancer care in four oncology centers in northern Israel and Palestine. RESULTS: Each of the two groups had 324 respondents and was equally distributed by age and marital status. Compared with the Israeli-Arab group, Palestinian participants reported significantly higher CM use for cancer-related outcomes (63.5% vs. 39.6%, P < 0.001), which included more herbal use (97.6% vs. 87.9%, P = 0.001) and significantly lower use of dietary supplements, acupuncture, mind-body and manual therapies, and homeopathy. Most respondents in both groups stated that they would consult CM providers if CM was integrated in oncology departments. Related to this theoretical integrative scenario, Palestinian respondents expressed fewer expectations from their oncologists to actively participate in building their CM treatment plan. Treatment expectations in both groups focused on improving quality of life (QOL), whereas Palestinian respondents had fewer expectations for CM to improve fatigue, emotional concerns, sleep, and daily functioning. CONCLUSION: Arab patients with cancer from Palestine and Israel highly support CM integration within their oncology institutions aiming to improve QOL. Nevertheless, respondents differed in their perceived model of CM integration, its treatment objectives, and their oncologists' role in CM integration.

HPLC-DAD-ESI-MS/MS screening of bioactive components from Rhus coriaria L. (Sumac) fruits.

Rhus coriaria L. (sumac) is an important crop widely used in the Mediterranean basin as a food spice, and also in folk medicine, due to its health-promoting properties. Phytochemicals present in plant foods are in part responsible for these consequent health benefits. Nevertheless, detailed information on these bioactive compounds is still scarce. Therefore, the present work was aimed at investigating the phytochemical components of sumac fruit epicarp using HPLC-DAD-ESI-MS/MS in two different ionisation modes. The proposed method provided tentative identification of 211 phenolic and other phyto-constituents, most of which have not been described so far in R. coriaria fruits. More than 180 phytochemicals (tannins, (iso)flavonoids, terpenoids, etc.) are reported herein in sumac fruits for the first time. The obtained results highlight the importance of R. coriaria as a promising source of functional ingredients, and boost its potential use in the food and nutraceutical industries.

Frequent migration of introduced cucurbit-infecting begomoviruses among Middle Eastern countries.

BACKGROUND: In the early 2000s, two cucurbit-infecting begomoviruses were introduced into the eastern Mediterranean basin: the Old World Squash leaf curl virus (SLCV) and the New World Watermelon chlorotic stunt virus (WmCSV). These viruses have been emerging in parallel over the last decade in Egypt, Israel, Jordan, Lebanon and Palestine. METHODS: We explored this unique situation by assessing the diversity and biogeography of the DNA-A component of SLCV and WmCSV in these five countries. RESULTS: There was fairly low sequence variation in both begomovirus species (SLCV π = 0.0077; WmCSV π = 0.0066). Both viruses may have been introduced only once into the eastern Mediterranean basin, but once established, these viruses readily moved across country boundaries. SLCV has been introduced at least twice into each of all five countries based on the absence of monophyletic clades. Similarly, WmCSV has been introduced multiple times into Jordan, Israel and Palestine. CONCLUSIONS: We predict that uncontrolled movement of whiteflies among countries in this region will continue to cause SLCV and WmCSV migration, preventing strong genetic differentiation of these viruses among these countries.

Molecular characterization of watermelon chlorotic stunt virus (WmCSV) from Palestine.

The incidence of watermelon chlorotic stunt disease and molecular characterization of the Palestinian isolate of Watermelon chlorotic stunt virus (WmCSV-[PAL]) are described in this study. Symptomatic leaf samples obtained from watermelon Citrullus lanatus (Thunb.), and cucumber (Cucumis sativus L.) plants were tested for WmCSV-[PAL] infection by polymerase chain reaction (PCR) and Rolling Circle Amplification (RCA). Disease incidence ranged between 25%-98% in watermelon fields in the studied area, 77% of leaf samples collected from Jenin were found to be mixed infected with WmCSV-[PAL] and SLCV. The full-length DNA-A and DNA-B genomes of WmCSV-[PAL] were amplified and sequenced, and the sequences were deposited in the GenBank. Sequence analysis of virus genomes showed that DNA-A and DNA-B had 97.6%-99.42% and 93.16%-98.26% nucleotide identity with other virus isolates in the region, respectively. Sequence analysis also revealed that the Palestinian isolate of WmCSV shared the highest nucleotide identity with an isolate from Israel suggesting that the virus was introduced to Palestine from Israel.

In vitro antioxidant and antitumor activities of six selected plants used in the Traditional Arabic Palestinian herbal medicine.

CONTEXT: Despite several pharmacological applications of the medicinal plants in the Traditional Arabic Palestinian Herbal Medicine in Palestine (TAPHM), studies on their antioxidant properties are still scarce. OBJECTIVE: This work evaluates the antioxidant and antitumor activities of the ethanol extracts from different parts of six plants: [Arum palaestinum Boiss (Araceae), Urtica pilulifera L. (Urticaceae), Coridothymus capitatus (L.) Reichb (Lamiaceae), Majorana syriaca (L.) Rafin. (Lamiaceae), Teucrium creticum L. (Lamiaceae), and Teucrium capitatum L. (Lamiaceae)] used in the TAPHM. MATERIALS AND METHODS: The antioxidant activity was evaluated for the ethanol extracts by DPPH and ß-carotene-linoleic acid assays together with total contents of phenols and flavonoids. For the anti-carcinogenic evaluation, the extracts were tested for the ability to inhibit the proliferation of breast cancer cells (MCF-7) using the MTT reduction assay. RESULTS: Among the extracts, the U. pilulifera had the highest amount of total phenolics, possessing the second highest total flavonoids. It also showed a maximum cytotoxic activity (IC50 = 63 µg/ml), followed by C. capitatus, and A. palaestinum. Otherwise, the extract of T. creticum was demonstrated to be an efficient scavenger of O2 (IC50 = 83 µg/ml), followed by M. syriaca, C. capitatus, T. capitatum, A. palaestinum, and U. pilulifera. DISCUSSION AND CONCLUSION: The results suggest that the investigated plants have shown varied antioxidant capacities which were strongly correlated with their contents of phenolics. Accordingly, this study proposes that the therapeutic benefit of these plants can be, at least in part, attributed to its potential inhibition of oxidative processes.

Complementary and alternative medicine (CAM) use among hypertensive patients in Palestine.

PURPOSE: To explore the frequency of CAM use among hypertensive patients in Palestine, determine demographic characteristics that may increase the likelihood of CAM use and to find out how benefits were perceived by patients. METHODS: Across-sectional survey of patients attending outpatient hypertension clinics. The method was based on a semi-structured questionnaire. RESULTS: Of the 4575 hypertensive patients interviewed, 85.7% respondents used at least one type of CAM. Of the 3921 CAM users, 62.13% reported taking herbs. Most of these users were >50 years old, of low educational level, and had a family history of HTN, 62.9% claimed to have obtained the desired effect from taking these herbs; however, 68.1% did not disclose this fact to their health care providers, 83 plant taxa were reported by these patients, Allium sativum was the most commonly used herb. CONCLUSIONS: The use of CAM, particularly herbal therapies for hypertension treatment, is highly prevalent in Palestine.

Integrative oncology research in the Middle East: weaving traditional and complementary medicine in supportive care.

INTRODUCTION: Complementary and alternative medicine (CAM) has an important role in supportive cancer care in the Middle East and is often used in association with traditional medicine. This article provides a comprehensive review of published data on CAM research in supportive cancer care in the Middle East. METHODS AND RESULTS: A multi-disciplinary Middle-Eastern Research Group in Integrative Oncology (MERGIO) was established in six countries. Authors independently searched Medline database for articles in Arabic, Hebrew, French, and Turkish using oncology and CAM-related keywords. Articles were recorded according to the first author's affiliation with an academic or clinical institution in the Middle East. RESULTS: We identified 143 articles on CAM and cancer care that had been published in 12 Middle-Eastern countries. Eighty-five articles were directly related to cancer supportive care. The latter included studies on the prevalence of CAM use by patients with cancer, aspects related to of doctor-patient communication, ethics and regulation, psychosocial aspects of CAM, CAM safety and quality assurance, studies of CAM education for health care providers, and ethno-botanical studies and reviews. Twenty-eight articles referred to clinical research on supportive care, and the use of specific CAM modalities that included acupuncture, anthroposophic medicine, dietary and nutritional therapies herbal medicine, homeopathy, mind-body medicine, shiatsu, therapeutic touch, and yoga. CONCLUSIONS: CAM-related supportive care research is prevalent in the Middle East, a fact that may serve as a basis for future multinational-multidisciplinary research work in supportive care in oncology.

Complementary and alternative medicine use amongst Palestinian diabetic patients.

OBJECTIVES: To measure the frequency of herbal medicine use among patients with diabetes mellitus in Palestine; to determine demographic characteristics that may increase the likelihood of Complementary and Alternative Medicine (CAM) use and to find out how benefits, if any, were perceived by patients. METHOD: Cross-sectional survey of patients attending the outpatient diabetes departments at 7 Governmental Hospitals. The method was based on semi-structured questionnaires. RESULTS: A total of 1883 patients with diabetes were interviewed. Of the participants, 51.9% (n = 977) reported taking herbs primarily bought from Palestine (98%) and used in crude form mainly as decoctions (44.1%). The five most common herbal products used were: Trigonella berythea (Fabaceae) (n = 191, 19.6%), Rosmarinus officinalis (Lamiaceae) (n = 132, 13.5%), Olea europaea (Oleaceae) (n = 131, 13.4%), Teucrium capitatum (Lamiaceae) (n = 111, 11.4%), and Cinnamomum zeylanicum (Lauraceae) (n = 105, 10.8%). Most CAM users were above 40 years old 79.6% (n = 778), predominantly female (53.2%) and residents of refugee camps and rural areas (59.3, and 53.5, respectively). The recommendations of a family member or friend was the main factor prompting the use of CAM (40.2 and 37.1%). Most CAM users (71.7%) were satisfied with the perceived effects. Interestingly, 68% of patients recruited in the study did not disclose CAM use to their physicians or pharmacists. CONCLUSION: Use of herbal therapies in diabetes is highly prevalent in Palestine. More than 70% of those using CAM (977, 51.9%) reported positive benefits including a feeling of slowing down disease progression, symptom relief, disease resolution or a reduction in the side effects of allopathic medication. Use of CAM should be explored with patients before clinical decisions are made. There is a need for health education relating to herbal use in conjunction with conventional medicines in diabetes.

Herbal preparation use by patients suffering from cancer in Palestine.

UNLABELLED: This study sought to describe type, frequency, purpose and patterns of herbal medicine used by a sample of patients with cancer in Palestine. A cross-sectional survey of patients attending the outpatient cancer departments at the Governmental Hospitals was undertaken using semi-structured questionnaires. RESULTS: A total of 1260 patients with cancer were interviewed. Of the participants, 60.9% (n = 767) reported using herbs primarily bought from Palestine (92.3%) frequently employed in the form of decoctions (43%). The most common herbal product was Arum palaestinum (22.5%). Most Complementary and Alternative (CAM) users were more than 40 years of age, predominantly female, and living in rural areas of Palestine. Family member's recommendation was cited as the main factor prompting participants to use CAM (43.5%). CONCLUSION: This study revealed that there is an appreciable prevalence of herbal use among patients with cancer in Palestine.