A Panoramic Review on the Management of Rheumatoid Arthritis through Herbalism.

Arthritis is a chronic inflammatory condition that affects millions of individuals worldwide. The conventional treatment options for arthritis often come with limitations and potential side effects, leading to increased interest in herbal plants as alternative therapies. This article provides a comprehensive overview of the use of herbal plants in arthritis treatment, focusing on their traditional remedies, active components, mechanisms of action, and pharmaceutical approaches for enhancing their delivery. Various herbal plants, including turmeric, ginger, Boswellia, and willow bark, have shown anti-inflammatory and analgesic properties, making them valuable options for managing arthritis symptoms. The active components of these herbal plants, such as curcumin, gingerols, and boswellic acids, contribute to their therapeutic effects. To enhance the delivery of herbal medicines, pharmaceutical approaches like nanoparticle-based drug delivery systems, liposomes, polymeric nanoparticles, nanoemulsions, microneedles, and inhalation systems have been explored. These approaches aim to improve bioavailability, targeted delivery, and controlled release of herbal compounds. Safety considerations, including potential interactions with medications and the risk of allergic reactions, are also discussed. Future perspectives for this field involve conducting well-designed clinical studies, enhancing standardization and quality control measures, exploring novel drug delivery systems, and fostering collaborations between traditional medicine practitioners and healthcare professionals. Continued research and development in these areas will help unlock the full potential of herbal plants in arthritis treatment, offering personalized and effective care for affected individuals.

Phytotherapeutic Approaches in Canine Pediatrics.

Phytotherapy is a clinical modality that incorporates botanical remedies as part of the therapeutic approach. It is a very ancient branch of medicine that is currently undergoing a renaissance, evident in the numerous preparations available on the market. The majority of these formulations are for preventive and curative use in adult animals. Experimental experiences in the pediatric age group are particularly scarce within the existing literature. Since these products are readily accessible, dog owners often turn to them due to their ease of availability, a preference for self-medication, and the perception that herbs are safer, gentler, and less expensive than conventional medications, often leading them to bypass seeking the advice of experienced professionals. The purpose of this review is to illustrate, on the basis of the currently available bibliography, phytotherapeutic approaches in canine pediatrics, paying particular attention to the adverse effects resulting from the use of certain plants, even when used in conjunction with some synthetic drugs. Consequently, it becomes evident that further clinical and more relevant studies, specifically focusing on puppies, are needed to increase knowledge about the effects of herbal remedies.

Evidence-Based Opinions from Multidisciplinary Experts on Use of Naturopathic Herbal Remedies in Pain Management.

Background: Pharmacological approaches to acute and chronic pain management, including non-steroidal anti-inflammatory drugs (NSAIDs) and opioids, are respectively associated with adverse reactions (such as gastrointestinal, cardiovascular, and renal effects) that might limit their use in patients with comorbidities and controversy related to inappropriate use. Naturopathic remedies might offer patients alternative and integrative treatments with minimal side effects. Objective: To explore the regional variation in the acceptance and use of naturopathic remedies in pain management. Methods: Two expert panel discussions were held by GlaxoSmithKline Consumer Healthcare (now Haleon Pte. Ltd.) over 9 and 12 hours in 2020 and 2021, respectively, and attended by multidisciplinary experts in naturopathy, Ayurvedic medicine, community pharmacy, physiotherapy, clinical pharmacy, Western medicine, academics, and naturopathic pain relief. Experts shared and discussed their experiences of naturopathic treatments and relevant clinical evidence related to different types of pain (including joint and muscle pain, migraine, sleeplessness due to pain, and general pain) and examined barriers to providing support to patients. Results: Experts agreed on the potential for curcumin (2020, 71.4% [5/7]; 2021, 91.7% [11/12]) and fish oil (2020, 100% [7/7]) for management of osteoarthritic joint pain although these are not uniformly recommended in osteoarthritis treatment guidelines. In treatment of migraines, coenzyme Q10 and magnesium were favored by experts (2021, 90.9% [10/11] and 63.6% [7/11], respectively). Conclusion: The need was emphasized for more and higher quality clinical studies to support naturopathic remedies, which might not be reflected in the latest treatment guidelines. The expert panel also highlighted missed opportunities for physicians and pharmacists to recommend effective naturopathic treatments.

A comprehensive review of antimalarial medicinal plants used by Tanzanians.

CONTEXT: Tanzania has rich medicinal plant (MP) resources, and most rural inhabitants rely on traditional healing practices for their primary healthcare needs. However, available research evidence on antimalarial MPs is highly fragmented in the country. OBJECTIVE: This systematic review compiles ethnomedicinal research evidence on MPs used by Tanzanians as antimalarials. MATERIALS AND METHODS: A systematic web search was conducted using various electronic databases and grey materials to gather relevant information on antimalarial MPs utilized by Tanzanians. The review was per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The data were collected from 25 articles, and MS Excel software was used to analyse relevant ethnobotanical information using descriptive statistics. RESULTS: A total of 227 MPs belonging to 67 botanical families and 180 genera were identified. Fabaceae (15.9%) is the most frequently utilized family. The ethnobotanical recipes analysis indicated leaves (40%) and trees (44%) are the preferred MPs part and life form, respectively. Decoctions (67%) are the dominant preparation method of remedies. Of the recorded MPs, 25.9% have been scientifically investigated for antimalarial activities with positive results. However, 74.1% of MPs have no scientific records on antimalarial activities, but they could be potential sources of remedies. CONCLUSIONS: The study discloses a wealth of antimalarial MPs possessed by Tanzanians and suggests a need for research to authenticate the healing potential of antimalarial compounds from the unstudied MPs. Additionally, it indicates that some of the presented MPs are potential sources for developing safe, effective and affordable antimalarial drugs.

South African women's use of African traditional medicine during pregnancy: A scoping review.

In South Africa, about 72% of black South Africans are said to rely on traditional medicine. This contributes to a high prevalence of traditional medicine (TM) used by women during pregnancy, especially in rural areas. This paper explored literature knowledge on the use and reasons of using African traditional medicine in pregnant women who reside in South Africa. This was a scoping review search conducted in October 2021. The search was done with the aid of PubMed, Science Direct, JSTOR and EBSCOHost. This study included only studies on pregnant women's use of traditional African medicine, conducted in South Africa which were published between 2011 and 2021, written in English. Six studies were found to be relevant to the phenomenon. Lack of research and regular health education on the safety and efficacy of traditional medicine during pregnancy is a major cause of traditional medicine induced pregnancy-related complications in South Africa.

En Afrique du Sud, environ 72 % des Sud-Africains noirs auraient recours à la médecine traditionnelle. Cela contribue à une forte prévalence de la médecine traditionnelle (MT) utilisée par les femmes pendant la grossesse, en particulier dans les zones rurales. Cet article a exploré les connaissances documentaires sur l'utilisation et les raisons de l'utilisation de la médecine traditionnelle africaine chez les femmes enceintes résidant en Afrique du Sud. Il s'agit d'une recherche d'examen exploratoire menée en octobre 2021. La recherche a été effectuée avec l'aide de PubMed, Science Direct, JSTOR et EBSCOHost. Cette étude comprenait uniquement des études sur l'utilisation de la médecine traditionnelle africaine par les femmes enceintes, menées en Afrique du Sud et publiées entre 2011 et 2021, rédigées en anglais. Six études se sont révélées pertinentes pour le phénomène. Le manque de recherche et d'éducation sanitaire régulière sur la sécurité et l'efficacité de la médecine traditionnelle pendant la grossesse est une cause majeure des complications liées à la grossesse induites par la médecine traditionnelle en Afrique du Sud.

Review of Phytochemicals Present in Psidium guajava Plant and Its Mechanism of Action on Medicinal Activities.

For centuries, herbal remedies have been employed to address a variety of human ailments, and Psidium guajava Linn (Myrtaceae), commonly known as guava, stands out as a noteworthy medicinal plant with significant pharmacological potential. In India, particularly in rural areas where access to conventional medicines can be limited, the various parts of the Psidium guajava plant, including its leaves, bark, roots, and fruit, have been harnessed for their therapeutic properties to tackle various health issues. Psidium guajava Linn proves to be a valuable repository of essential nutrients along with bioactive compounds such as α-terpineol, ß-caryophyllene (trans-caryophyllene), rutin, α-humulene, oleanolic acid, flavonoids, and quercetin. These components exhibit diverse medicinal activities, encompassing anti-inflammatory, anti-cancer, anti-bronchitis, anti-proliferative, anti-tumor, anti-bacterial, and anti-diabetic effects. Every facet of the guava plant holds economic significance and is cultivated on a large scale. Taxonomically, Psidium guajava can be classified within the Plantae kingdom, Magnoliophyta division, Magnoliopsida class, Rosidae subclass, Myrtales order, Myrtaceae family, Myrtoideae subfamily, Myrteae tribe, Psidium genus, Guajava species. This adaptability of guava to various soils and environmental conditions facilitates relatively easy cultivation, yielding rapid fruit production. Its widespread cultivation across India is attributed to its manifold commercial applications. To comprehensively comprehend how this plant can effectively address the array of health challenges encountered by the Indian populace, this review delves into its multifaceted therapeutic properties, highlighting its significance in healthcare practices. Ongoing research endeavors by investigators continue to uncover novel medicinal attributes associated with Psidium guajava, enriching our understanding of its potential benefits.

The Use of Fibers, Herbal Medicines and Spices in Children with Irritable Bowel Syndrome: A Narrative Review.

The pathophysiology of irritable bowel syndrome in children involves multiple factors. Thus, treatment options are variable, targeting both diet and the child's and parents' behavior via pharmacological and psychological interventions or neuromodulation. Parents are increasingly interested in complementary and alternative therapies for children with irritable bowel syndrome, especially when other treatments have been tried without relieving the child's symptoms. This paper examines current evidence for the benefits and side effects of herbal remedies and spices in pediatric patients with IBS. The benefits of peppermint oil, STW5, psyllium fiber, Curcuma, ginger, and other herbal medicines are discussed based on findings in the current literature.

Cakes fortified with papaya seeds effectively protects against CCl4-induced immunotoxicity.

Maintaining a robust immune system and safeguarding the liver from toxins are crucial for overall health. The study aimed to investigate the immunostimulant effects of papaya seed-enriched cakes (CPS) in countering carbon tetrachloride (CCl4)-induced immunocytotoxicity in rats (n = 48). The rats were divided into six groups (8 each): a control group (Group 1), rats fed cakes containing 15% papaya seeds (Group 2 - CPS), rats exposed only to CCl4 (Group 3 - CCl4), rats injected with CCl4 and administered silymarin (Group 4 - CCl4 + S), rats receiving both CCl4 and cakes with papaya seeds (Group 5 - CCl4 + CPS), and rats receiving both CCl4 and silymarin with papaya seed-enriched cakes (Group 6 - CCl4 + CPS + S). HPLC analysis of papaya seeds revealed the presence of ten polyphenol compounds, with quercetin, apigenin, and catechin identified as major flavonoids, along with pyrogallol, ellagic, and gallic acid as predominant phenolic acids. These compounds displayed potent antioxidant activity, attributed to the seeds' high total phenolic and flavonoid content. The administration of CCl4 significantly affected hematological parameters, liver enzymes, hepatic oxidative stress, levels of TNF-α, IL-6, IgG, as well as IgM. However, rats fed with CPS exhibited mitigation of CCl4-induced toxic effects on hematological parameters and hepatotoxicity. CPS consumption enhanced the antioxidant system, improved inflammatory markers, and immune parameters, restoring them to normal levels. Histopathological analysis confirmed CPS's ability to reduce CCl4-induced hepatocellular necrosis. Immunohistochemical assessment further revealed reduced immunoreactivity against cleaved caspase-3 expression and increased COX2 immunoreactivity, indicating hepatocellular regeneration in CPS. The combination of CPS and silymarin demonstrated even more notable improvements, suggesting augmented protective impacts against CCl4-induced immunosuppression and hepatotoxicity. In conclusion, CPS exhibited antioxidant properties and effectively protected against CCl4-induced immunotoxicity and hepatotoxicity, with additional benefits observed when combined with silymarin. These findings emphasize the potential health advantages of incorporating papaya seeds into food products, promoting immune system health, and safeguarding against liver damage induced by hazardous agents like CCl4.

Women's wellness in the mountains: An exploration of medicinal plants among tibeto-burman groups in Thailand.

Ethnopharmacological relevance: This study offers valuable insight into the traditional healing practices of women's healthcare within four Tibeto-Burman groups. By focusing on women's wellness, the research sheds light on the often-neglected yet significant contributions made by women in the field of traditional medicine. Aims of the study: The study seeks to address the gap of studies on the ethnobotany of women healthcare of the Tibeto-Burman groups in Thailand and to analyst the factors that could affect the diversity of ethnobotanical knowledge. Materials and methods: The study compiled data from 15 group-informants residing in 12 different villages. The information gathering process involved a combination of free-listing, semi-structured interviews, group discussion, and the walk-to-the-wood method. To analyze the data, the researchers used various methods such as use-reports, Relative Frequency of Citation (RFC), Relative Importance Index (RI), and Cluster analysis. Results: This study identified 200 plant species used in traditional women's healthcare practices, with leaves being the most frequently used part. Drinking was the most common method for internal use, while bathing and steam were the most emphasized for external use. Blumea balsamifera and Buddleja asiatica had high RI and RFC. Cluster analysis revealed that group-informants were divided by ethnicity and geographical location. Conclusion: This study contributes to the understanding of traditional healthcare practices among Tibeto-Burman groups in Thailand, with a particular focus on women's wellness. The results provide insight into the ethnobotanical knowledge of these communities and highlight the important role played by women in traditional medicine. The study underscores the need for continued research in this field to preserve and utilize this valuable knowledge.

Gut microbiota and Autism Spectrum Disorder: From pathogenesis to potential therapeutic perspectives.

Autism is a complex neurodevelopmental disorder which disrupts communication, social and interactive skills followed by appearance of repetitive behavior. The underlying etiology remains incomprehensible but genetic and environmental factors play a key role. Accumulated evidence shows that alteration in level of gut microbes and their metabolites are not only linked to gastrointestinal problems but also to autism. So far the mix of microbes that is present in the gut affects human health in numerous ways through extensive bacterial-mammalian cometabolism and has a marked influence over health via gut-brain-microbial interactions. Healthy microbiota may even ease the symptoms of autism, as microbial balance influences brain development through the neuroendocrine, neuroimmune, and autonomic nervous systems. In this article, we focused on reviewing the correlation between gut microbiota and their metabolites on symptoms of autism by utilizing prebiotics, probiotics and herbal remedies to target gut microflora hence autism.

Spontaneous Reversal of Vitiligo, a Rare Phenomenon Reported in a Case in Saudi Arabia with an Insight into Metabolic Biochemical Derangements.

Background and Objectives: Vitiligo is a skin disorder characterized by hypopigmented macules occurring due to melanocyte destruction. An interplay of several biochemical mechanisms has been proposed to explain the etiopathogenesis of vitiligo, such as genetic, autoimmune responses, generation of inflammatory mediators, oxidative stress, and melanocyte detachment mechanisms. There is no cure for vitiligo; however, pharmacological treatment measures (cosmetic camouflage creams, steroids, psoralen and ultraviolet A (PUVA) therapy, narrowband UVB) are available, but they could have certain side effects. We reported an interesting case of vitiligo in Saudi Arabia that showed reversal of vitiligo, which is an extremely rare phenomenon, with the objective of probing the probable reasons for this reversal. To the best of our knowledge, there is no study on vitiligo that has reported spontaneous reversal of vitiligo in Saudi Arabia so far. Materials and Method: The patient presented to the Family Medicine clinic with a history of restoration of melanin pigment in his lesions after 3 years of the onset of vitiligo. Patients history was taken carefully along with clinical examination, carried out necessary biomedical lab investigations and compiled the data. The data at the time of pigment restoration were compared to the previous data when he developed the lesions. Result: The probable reasons for vitiligo reversal could be markedly decreased psychological stress, regular consumption of an antioxidant-rich herbal drink made of curcumin and honey, and dietary switchover to vegetarianism and an alcohol-free lifestyle. Conclusions: Curcumin-based herbal remedies could be an alternative option to treat vitiligo. These methods must be further explored through clinical trials as they are safer, easily available, and more affordable.

Immune System and Epidemics: The Role of African Indigenous Bioactive Substances.

With over 6 million coronavirus pandemic deaths, the African continent reported the lowest death rate despite having a high disease burden. The African community's resilience to the pandemic has been attributed to climate and weather conditions, herd immunity, repeated exposure to infectious organisms that help stimulate the immune system, and a disproportionately large youth population. In addition, functional foods, herbal remedies, and dietary supplements contain micronutrients and bioactive compounds that can help boost the immune system. This review identified significant traditional fermented foods and herbal remedies available within the African continent with the potential to boost the immune system in epidemics and pandemics. Methodology: Databases, such as PubMed, the Web of Science, and Scopus, were searched using relevant search terms to identify traditional African fermented foods and medicinal plants with immune-boosting or antiviral capabilities. Cereal-based fermented foods, meat-, and fish-based fermented foods, and dairy-based fermented foods containing antioxidants, immunomodulatory effects, probiotics, vitamins, and peptides were identified and discussed. In addition, nine herbal remedies and spices belonging to eight plant families have antioxidant, immunomodulatory, anti-inflammatory, neuroprotective, hepatoprotective, cardioprotective, and antiviral properties. Peptides, flavonoids, alkaloids, sterols, ascorbic acid, minerals, vitamins, and saponins are some of the bioactive compounds in the remedies. Bioactive compounds in food and plants significantly support the immune system and help increase resistance against infectious diseases. The variety of food and medicinal plants found on the African continent could play an essential role in providing community resilience against infectious diseases during epidemics and pandemics. The African continent should investigate nutritional, herbal, and environmental factors that support healthy living and longevity.

Green Manufacturing for Herbal Remedies with Advanced Pharmaceutical Technology.

Herbal remedies are in most cases still manufactured with traditional equipment installations and processes. Innovative chemical process engineering methods such as modeling and process intensification with green technology could contribute to the economic and ecologic future of those botanicals. The integration of modern unit operations such as water-based pressurized hot water extraction and inline measurement devices for process analytical technology approaches in traditional extraction processes is exemplified. The regulatory concept is based on the quality-by-design demand for autonomous feed-based recipe operation with the aid of digital twins within advanced process control. This may include real-time release testing to the automatic cleaning of validation issues. Digitalization and Industry 4.0 methods, including machine learning and artificial intelligence, are capable of keeping natural product extraction manufacturing and can contribute significantly to the future of human health.

Andaliman (Zanthoxylum acanthopodium DC.) fruit ethanolic extract exerts attenuative effect on hyperglycemia, sensory and motoric function's disorders in alloxan-induced diabetic mice.

Objective: Andaliman (Zanthoxylum acanthopodium) is a potent medicinal plant in Asia. This present study aimed to reveal the effectivity of Andaliman fruit extract in alleviating hyperglycemia, sensory and motoric balance disorders, histopathology of the cerebellum, and tissue oxidative stress in diabetic mice induced by alloxan. Materials and Methods: Diabetes induction was performed by intraperitoneally injecting alloxan monohydrate [200 mg/kg body weight (BW)]. Subsequently, the mice were treated daily with an ethanolic extract of Andaliman fruit (0, 150, 300, 450 mg/kg BW per oral) for 28 days, followed by measurements of blood glucose, paw sensitivity, motoric balance, histopathology of the cerebellum, and malondialdehyde (MDA) levels. Moreover, the phytochemical constituents of the extract were elucidated by liquid chromatography. Results: Higher doses of Andaliman fruit extract could significantly attenuate the elevation of random and fasting blood glucose (p < 0.05) and improve paw sensitivity responses (p < 0.05) and motoric balances (p < 0.05) in diabetic mice. Moreover, Andaliman fruit extract could significantly attenuate the degeneration of cerebellar Purkinje cells (p < 0.05) and suppress MDA levels in the blood (p < 0.05) while blunting the MDA in the brain tissue (p < 0.05). Phytochemical screening revealed 39 compounds in the Andaliman extract belonging to the groups of alkaloids (26 compounds), flavonoids (12 compounds), and terpenoids (1 compound). Conclusion: The ethanolic extract of Andaliman fruit is capable of ameliorating diabetic neuropathy, motor balance disorders, and Purkinje cell degeneration while also reducing oxidative stress in the peripheral system. Hence, Andaliman extract is a promising candidate for formulation as an herbal remedy against the detrimental outcomes of diabetes mellitus.

Ethnobotanical survey of medicinal wild plants in the Shouf Biosphere Reserve, Lebanon.

BACKGROUND: Medicinal plants and associated traditional knowledge play a vital role in supporting the livelihoods and resilience of indigenous communities. This ethnobotanical survey aims to identify medicinal plants used by the local communities of the Shouf Biosphere Reserve of Lebanon (SBR) and document the associated traditional knowledge. METHODOLOGY: Focus groups and personal interviews with 133 informants of community members of 22 villages of SBR were performed during 2019-2022. Informants were selected using purposive sampling techniques based on their knowledge of medicinal plants and experience in traditional herbal medicine. Interviews were conducted using a semi-structured questionnaire through field visits. RESULTS: Informants were equally represented by females and males and had different demographic characteristics, and the main source of knowledge was ancestral. A total of 184 medicinal plant species belonging to 57 families were documented. The predominant families were Asteraceae (31 spp.), Lamiaceae (14 spp.), and Rosaceae (14 spp.). Leaves (23%) were the plant part most used. Decoction (45%) was the predominant preparation method, while internal (oral) use (47%) was the most frequent administration mean. Berberis libanotica, Dittrichia viscosa, and Daucus carota achieved the highest scores of frequency of citation (FC), relative frequency of citation (RFC), use value (UV), and fidelity level (FL). Furthermore, diseases and ailments of gastrointestinal tract were the category most treated. CONCLUSIONS: Findings revealed a rich and diverse list of medicinal plants with associated traditional knowledge still actively used to treat a wide range of diseases. Future phytochemical and pharmacological studies are recommended to determine the efficacy and safety of plant species used. The management body of the SBR and all related authorities are invited to continue their conservation efforts to protect such rich biocultural heritage.

Farang (Psidium guajava L.) Dried Leaf Extracts: Phytochemical Profiles, Antioxidant, Anti-Diabetic, and Anti-Hemolytic Properties for Ruminant Health and Production.

Due to its advantageous antioxidant phytochemical components, Psidium guajava L. has become an indispensable plant in pharmaceutical formulations, playing a crucial role in safeguarding human health. On ruminant animals, however, there has been limited investigation. The purpose of this investigation was to assess the phytochemical profiles and biological potential of Farang (P. guajava L.) leaf extracts for ruminant health. Methanolic and hexanoic extracts from various agricultural areas were prepared over a five-month period. By means of HPLC-DAD, vitamin C (ascorbic acid), essential oil (eugenol), tannin (gallic acid), cinnamic acids (caffeic acid, syringic acid, p-coumaric acid, sinapic acid, and ferulic acid), and flavonoids (catechin, rutin, myricetin, quercetin, apigenin, and kaempferol) were detected and quantified. Solvent type, but not cultivation site or sampling time, explained the observed variation in phytochemical profile. Phytochemicals were found in lower concentrations in hexanoic extracts than in methanolic extracts. Catechin and sinapic acid were discovered to be the two most abundant phytochemicals in the methanolic extract of Farang leaf, followed by other phenolic compounds, essential oils, and water-soluble vitamins. Compared with the methanolic extract, the hexanoic extract of Farang leaves was less effective at scavenging oxidation in terms of 1,1-diphenyl-2-picrylhydrazyl (DPPH), nitric oxide, and superoxide, and α-glucosidase inhibitory activity. Hexanoic extract was found to be less protective against oxidative damage in ruminant erythrocytes than methanolic extract in terms of inhibiting hemoglobin oxidation, lipid peroxidation, and hemolysis. According to the findings of this study, the leaves of Farang (P. guajava L.) are a potential source of phytochemical compounds with wellness properties for ruminant production.

Ethnomedicinal plants used for treatment of snakebites in Tanzania - a systematic review.

CONTEXT: Snake envenomation is one of the neglected health problems in Tanzania. Since most people, especially in rural areas, suffer from its burden, their cases are not documented due to reliance on medicinal plants. Despite the pivotal role of medicinal plants in treating snakebites, there is a paucity of information. OBJECTIVE: This review documents medicinal plants used to treat snakebites in Tanzania. MATERIALS AND METHODS: A systematic search using electronic databases such as PubMed, Google Scholar, Scopus, Science Direct and grey literature was conducted to retrieve relevant information on medicinal plants used to treat snakebites in Tanzania. The review was conducted as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The obtained information from 19 published articles was organized and analysed based on citation frequency. RESULTS: A total of 109 plant species belonging to 49 families are used as snakebite antivenom in Tanzania. Fabaceae had the highest number of medicinal plants (19.3%). The dominant plant growth forms were trees (35%) and shrubs (33%). Roots were the most frequently used plant part (54%), followed by leaves (26%) and bark (11%). Annona senegalensis Pers. (Annonaceae), Dichrostachys cinerea (L.) (Fabaceae), Suregada zanzibariensis Baill. (Euphorbiaceae), Antidesma venosum E.Mey. ex Tul. (Phyllanthaceae), Cissampelos pareira L. (Menispermaceae) and Dalbergia melanoxylon Guill. & Perr. (Fabaceae) were the most cited medicinal plants. CONCLUSIONS: Tanzania has diverse plants used for snakebite treatment; a few have been analysed for their bioactive components. Further study of the phytochemicals may provide scientific information to develop snakebite drugs.

Natural Alternatives and the Common Cold and Influenza.

The use of complementary and integrative medicine has increased . It is estimated that one-third of the population of the United States uses some form of alternative medicine. Physicians should consider integrative medicine therapies . Alternative medical therapies for the common cold and influenza include herbal supplements, dietary supplements, diet, and other adjunct therapies. However, it is important to research and study these therapies. Therefore, communication with patients and other health care providers is important. This will ensure effective and positive patient care experiences. Further randomized clinical trials are necessary to further establish the role of various alternative options.

Prevalence and associated factors of complementary and integrative medicine use in patients afflicted with COVID-19.

BACKGROUND: Complementary and Integrative Medicine (CIM) is often taken up by individuals seeking relief from different diseases. This study investigates the prevalence and associated factors of CIM use in patients with COVID-19. METHODS: In this telephone-based, cross-sectional study, data on CIM usage were collected from COVID-19 patients from February till June 2020 in Fars province, Iran using a researcher-made checklist. Additionally, we asked about the patients' attitudes toward these treatments. RESULTS: Out of 453 patients diagnosed with COVID-19, 400 (88.30%) responded to our calls and agreed to participate in the study. Among them, 276 patients reported using CIM to treat COVID-19 [prevalence: 69% (95% CI: 64.2 to 73.5)]. The most frequently used herbal medicine among COVID-19 patients was ginger (n = 273, 98.9%), thyme (n = 263, 95.3%), and black cumin (n = 205, 74.3%). Most of these patients were recommended to use herbal medicine by their families and friends (n = 96, 34.8%). Univariable logistic regression revealed that age under 50 years old, residency in urban areas (including the capital of the province and small cities), employment, academic education, and being an outpatient were statistically significant factors resulting in CIM usage. Multivariable logistic regression revealed that CIM use among outpatients was 3.65 times more than among inpatients. In addition, patients under 50 years old used CIM 85% more than older patients. Ultimately, only 9 (3.3%) patients consulted with their doctors regarding these medications. No side effects due to CIM use were reported. CONCLUSION: Many patients with COVID-19 used CIM, but few consulted with their physicians in this regard. Therefore, physicians should ask their patients about CIM usage, and patients should also report their use of CIM therapies during their medical visits. Furthermore, age and hospitalization status affected CIM use among patients with COVID-19.