Ethnomedical uses and pharmacological activities of most prevalent species of genus Piper in Panama: A review.

ETHNOPHARMACOLOGICAL RELEVANCE: Piperaceae is the fifth largest family of plants in Panama. This review focuses on the ethnomedical uses of the most prevalent Panamanian species and biological activities of their extracts and/or constituents both in Panama and worldwide. Many species have a plethora of ethnomedical uses such as antibacterial, antifungal, anti-inflammatory, anticancer, antidiabetic, anti-Helicobacter pylori, antiulcer, antiprotozoal, estrogenic, insecticidal, local anesthetic, diuretic, and for women's health conditions. AIM OF THE REVIEW: The aim of this review is to compile all ethnomedical uses of most prevalent species of Piper in Panama, and their extracts or phytoconstituents worldwide, through a complete literature search, so that it may allow selection of potential unexplored Piper species for future research and development of phytotherapeuticals for important ailments. METHODOLOGY: This review conducted a thorough search in books and databases such as Google Scholar, PubMed, Sci-Finder, Scopus, ACS publications, Science Direct, and Reaxys (Elsevier), until October of 2017. The information provided in this review is based on peer-reviewed papers only in English. The key words used to search were: "Piper", "Piperaceae", "Panama", "Pharmacological activity", "Chemistry," "Toxicity," and "Clinical studies". Scientific names of the plants were validated through www.tropicos.org. Potential full-texts of eligible papers, irrespective of database, were identified. Study selection and data extraction were conducted by one author (AIS) and confirmed by others (MPG, ADA). The extracted data were summarized in tabular form and a narrative description was used to provide a summary of updated information. RESULTS: The ethnomedical uses of most prevalent 23 Panamanian species of Piper both in Panama as well in the world are provided. Of these species only Piper arboreum, Piper auritum, Piper cordulatum, Piper hispidum, Piper dariense, Piper multiplinervium and Piper umbellatum have ethnomedical uses in Panama. Some of the uses are by native Amerindians of Panama. These include ailments such as liver pains, common colds, skin infections, insecticidal, as a bath to alleviate colds, snakebites, different types of pains, skin ailments, wound healing, rheumatism, women's health, antipyretic, and anti-inflammatory. Other Panamanian species are widely used in many countries of the world. Of all the Piper species, P. aduncum has the most ethnomedical uses. Panamanian uses are different from the ones in other countries. A total of 61 compounds present in Piper species reported in this review have shown a variety of biological activities in vitro. These compounds belong to different chemical types, such as chromenes, amides, alkaloids, benzopyrans, benzoates, essential oils, pyrrolidines, flavokaines, chalcones, methylenedioxy propiophenones, cinnamates, monoterpenes, sesquiterpenes, phenols, among others. From this review it is evident that extracts and pure compounds isolated from Piper species have shown a wide array of mainly in vitro activity and some ethnomedical uses may be correlated with their activities reported. CONCLUSIONS: Plants of this genus have provided bioactive species, both from crude extracts and pure compounds thus substantiating their efficacy in traditional medicine. In vivo and toxicological studies are still limited, but the results of different activities of Piper reported point out the great potential of these species for obtaining bioactive principles that may be useful in treating diseases. However, a thorough investigation of Piper species relating to chemistry, in vivo pharmacological activities, with emphasis on their mechanism of action, safety and efficacy and toxicity is warranted.

Traditional use and perception of snakes by the Nahuas from Cuetzalan del Progreso, Puebla, Mexico.

BACKGROUND: Indigenous cultures are the result of their adaptation to the natural surroundings, in such a way that, amongst their main features is a set of knowledge, technologies and strategies for the appropriation of nature. In Cuetzalan del Progreso, Puebla, Mexico snakes represent 71.1% of the total local herpetofauna; and in addition to this, different groups of Nahuas have shown to have information of their use of various snake species in many ways. This study was conducted to investigate the traditional uses of snakes in this cultural group. METHODS: Formal and informal interviews were conducted with the inhabitants of the communities. During these interviews, 30 images of the different species of snakes present in the area were presented to the subjects, so that they would recognize them and reveal information about the knowledge they possess on them. A usage analysis was applied to each species considering the following categories: food purposes, medicinal, artisanal and magical-religious. Likewise, the frequency, the diversity and the value of use was estimated for these snakes. RESULTS: A total of 51 interviews were carried out. The individuals recognized 18 out of 30 images of snakes that were presented. The total of usage categories was five; we found that the magic-religious use was the most mentioned by 32 personas. Boa imperator and Antropoides nummifer were the species with the highest value of use. More than half of the interviewees mentioned killing snakes because they're poisonous and aggressive. In the magic-religious aspect the "Danza de los Negritos" is highlighted; this is a local festival, brought by Africans, and alludes to snakes. CONCLUSIONS: This study revealed that snakes are still very important for the culture in Cuetzalan del Progreso, finding that the magical-religious and the medicinal use stand out. On the other hand, the fear and misperception on the toxicity of snakes might represent a potential threat for their conservation. Therefore, it is necessary to carry out a long-term monitoring of the ethno-zoological activities, and develop a sustainable management plan compatible with the cultural characteristics of the natives of the region.

Conocimientos, actitudes y prácticas sobre la malaria en la población indígena guna de la comarca de Madungandí, Panamá, 2012 / Knowledge, attitudes and practices regarding malaria in the indigenous Guna population of the Madungandí region, Panamá, 2012

Introducción. Las encuestas sobre comportamientos, actitudes y prácticas permiten determinar el grado de conocimiento de la población sobre la malaria o paludismo, así como las actitudes y prácticas que contribuyen a su transmisión. Objetivo. Identificar los conocimientos, actitudes y prácticas que favorecen la transmisión de la malaria en la población indígena guna de Madungandí. Materiales y métodos. Se hizo un estudio transversal mediante una encuesta a los jefes de familia de una muestra de 40 % de las viviendas en tres comunidades con alta incidencia de malaria. La encuesta se hizo con encuestadores gunas e integrantes del equipo de investigación, y con la ayuda de un traductor. El análisis se hizo en Epi-Info 6.04. Resultados. El rango de edad de los encuestados fluctuaba entre los 20 y los 70 años. Todos los encuestados indicaron pertenecer a la etnia guna y hablar su lengua; 64 % eran del sexo masculino y 30 % eran analfabetas. La mitad de los encuestados (51 %) manifestó haber enfermado de malaria, por lo menos, una vez en los últimos ocho años y 89 % reconoció la enfermedad como un problema de salud. El 63 % manifestó que el médico tradicional "inadule" curaba la malaria, y 78 % practicaba la "fuma de la pipa" y la "quema del cacao" para prevenirla. Conclusión. Dado el limitado conocimiento sobre la malaria y su vector, así como la actitud de colaboración de la población guna, es necesario iniciar programas educativos y de participación comunitaria para mejorar las prácticas de prevención y control en las comunidades, y disminuir así la incidencia de la enfermedad en la comarca de Madungandí.

Introduction: Knowledge, attitudes and practices surveys allow to determine the degree of knowledge on the management of malaria in a given population, as well as the attitudes and practices that contribute or not to its transmission. Objective: To identify the knowledge, attitudes and practices that favor or not the transmission of malaria in the indigenous Guna population of Madungandí. Materials and methods: A cross-sectional study was conducted by applying a survey to the heads of the families in a sample of 40% of households in three communities with high malaria incidence. Local Guna residents and translators were part of the research team that applied the questionnaires. The statistical analysis was performed in Epi-Info 6.04. Results: The age range of those surveyed was between 20 and 70 years. All responders indicated that they belonged to and spoke the language of the Guna ethnic group, 64% were male and 30% were illiterate. Half (51%) of the responders declared they had suffered malaria at least once in the last eight years, and 89% accepted that malaria was a health problem. Sixty-three per cent responded that their traditional doctors, “inadule”, cured malaria and 7.0 % practiced the “pipe smoking” and “cocoa burn” rituals to prevent the disease. Conclusion: Considering the limited knowledge about malaria and its vector, as well as the willingness to collaborate shown by the Guna population, it is essential to initiate educational and participative programs to improve control and prevention activities in the communities aimed at achieving a reduction in malaria incidence in the Madungandí indigenous region.

[Is disease merely illness?: Biomedicine, "parallel" forms of care and power]. / Las enfermedades ¿son solo padecimientos?: biomedicina, formas de atención "paralelas" y proyectos de poder.

Following Giovanni Berlinguer's proposal that health/disease processes are one of the primary spies into the contradictions of a system, this article describes cases that occurred in central and peripheral capitalist contexts as well as in the so-called "real socialist" States that allow such a role to be seen. Secondly, we observe the processes and above all the interpretations developed in Latin America and especially Mexico regarding the role attributed to traditional medicine in the identity and sense of belonging of indigenous peoples, which emphasize the incompatibility of indigenous worldviews with biomedicine. To do so we analyze projects that were carried out under the notion of intercultural health, which in large part resulted in failure both in health and political terms. The almost entirely ideological content and perspective of these projects is highlighted, as is the scant relationship they hold with the reality of indigenous people. Lastly, the impact and role that the advance of these conceptualizations and health programs might have had in the disengagement experienced over the last nearly ten years in the ethnic movements of Latin America is considered.

[Knowledge, attitudes and practices regarding malaria in the indigenous Guna population of the Madungandí region, Panamá, 2012]. / Conocimientos, actitudes y prácticas sobre la malaria en la población indígena guna de la comarca de Madungandí, Panamá, 2012.

INTRODUCTION: Knowledge, attitudes and practices surveys allow to determine the degree of knowledge on the management of malaria in a given population, as well as the attitudes and practices that contribute or not to its transmission. OBJECTIVE: To identify the knowledge, attitudes and practices that favor or not the transmission of malaria in the indigenous Guna population of Madungandí. MATERIALS AND METHODS: A cross-sectional study was conducted by applying a survey to the heads of the families in a sample of 40% of households in three communities with high malaria incidence. Local Guna residents and translators were part of the research team that applied the questionnaires. The statistical analysis was performed in Epi-Info 6.04. RESULTS: The age range of those surveyed was between 20 and 70 years. All responders indicated that they belonged to and spoke the language of the Guna ethnic group, 64% were male and 30% were illiterate. Half (51%) of the responders declared they had suffered malaria at least once in the last eight years, and 89% accepted that malaria was a health problem. Sixty-three per cent responded that their traditional doctors, “inadule”, cured malaria and 7.0 % practiced the “pipe smoking” and “cocoa burn” rituals to prevent the disease. CONCLUSION: Considering the limited knowledge about malaria and its vector, as well as the willingness to collaborate shown by the Guna population, it is essential to initiate educational and participative programs to improve control and prevention activities in the communities aimed at achieving a reduction in malaria incidence in the Madungandí indigenous region.

Who's judging the quality of care? Indigenous Maya and the problem of "not being attended".

In developing countries, lack of trust in the quality of care provided is often cited as a major factor promoting reluctance to seek biomedical help for obstetric emergencies. This article draws on fieldwork among Mayan informants in Sololá, Guatemala, to explore poor perceptions of the quality of care received when seeking obstetric care in the hospital. Using data collected over two years, I set out to understand why interviewees repeatedly complain that hospital staff "do not attend to you." I maintain that the powerlessness of patients to influence the treatment they receive further reduces their trust in the quality of care delivered, ultimately negatively impacting the decision to seek obstetric care. Finally, I argue for the importance of recognizing the influence of the wider historical and social context in creating the dynamics of this interaction. The implications of this research in defining the quality of care and skilled attendance within the quest to make pregnancy safer are discussed.

An anthropological study about epilepsy in native tribes from Central and South America.

PURPOSE: Epilepsy was a well-recognized disease in pre-Columbian cultures. However, anthropological studies about epilepsy in native cultures living at the present time are scarce. The objective of this paper was to study native perception and myths about epilepsy, their magic-religious healing rites and ceremonies, and the natural treatments that archaic cultures used. METHODS: An anthropological fieldwork was performed in Central and South America with Tzeltal Maya (Chiapas, Mexico, 1995), Kamayurá (Matto Grosso, Brazil, 1999) and Uru-Chipaya people (Bolivian Andes, 2004). We collected information from shamans and medicine men about epilepsy beliefs and the use of traditional treatments. RESULTS: Epilepsy is called tub tub ikal by Tzeltal people. It is caused by an attack suffered by the animal spirit who accompanies the person, after a fight between the spirits who serve the forces of good and evil. People with chronic epilepsy are considered witches. Epilepsy is called teawarup by Kamayurá, and is caused by the revenge of the spirit (mama'e) of the armadillo killed by a huntsman. It is treated with two roots, tsimó and wewurú, kneaded and diluted in water. Epilepsy is called tukuri by the Chipaya people, and is originated by a witchcraft that enters into the nose and the head, as a wind. Tukuri is treated with a ritual animal sacrifice called willancha, and by taking several dried insect infusions and bird's blood. CONCLUSION: These American native cultures have developed a system of orally transmitted knowledge about epilepsy based on magic-religious traditions.

[Depression in Precolumbian Mesoamerican medicine]. / La depresion en la medicina mesoamericana precolombina.

AIM: To review the concept of depression and its treatment in the context of Precolumbian Mesoamerican medicine. DEVELOPMENT: The origins of Precolumbian Mesoamerican medicine (ticiotl) are imprecise, since the theoretical and disease-healing concepts of the times were doubtlessly influenced by magic and religious beliefs. However, the ticiotl was constructed on a 'theory' based on structured information integrated to the world philosophy, which included the social, religious and cultural behavior of the Aztec people. Health was considered a result of the balance between cold-hot polarity. Imbalance caused disease, which in turn produced a dynamic impairment of the body and its relation to the cosmos. Disease could be originated by multiple factors, e.g., by god-sent punishment, or caused by man's evil or by a destiny marked since birth. Depression, among other diseases, was identified in the ticiotl, and was attributed to alterations in the yollotl (heart). It was treated with plants such as quauhyayual, itzauhyatl and xoxocoatl, with animals such as hare, chicken and fish, and with some minerals. Also, recommendations were given to the individual on his life style in a magic-religious context. CONCLUSION: In Precolumbian Mesoamerican medicine, depression was identified, and therapeutic methods were developed which may be far from the modern medical concept, but at the time fulfilled the function of understanding and recovering the individual's health.

La depresión en la medicina mesoamericana precolombina / Depression in precolumbian mesoamerican medicine

Objetivo. Revisar el concepto de la depresión y su tratamiento en el contexto de la medicina mesoamericana precolombina (ticiotl). Desarrollo. Los orígenes de la ticiotl sin duda son imprecisos debido a que sus conceptos teóricos y curativos acerca de la enfermedad estuvieron influenciados por sus creencias mágicas y religiosas. No obstante, la ticiotl se fundamentó en una ‘teoría’ basada en información estructurada e integrada en la visión del mundo, que incluyó el comportamiento social, religioso y cultural del pueblo azteca. La salud se consideraba como el equilibrio de la polaridad frío-calor, mientras que su desequilibrio era la causa de la enfermedad, que provocaba la falla en la dinámica del cuerpo y su relación con el cosmos. La enfermedad tenía un origen multifactorial, podía ser causada por el castigo de los dioses, por la maldad de los hombres o por el destino marcado desde el nacimiento. La depresión, entre otras enfermedades, se identificó en la ticiotl y se atribuyó a alteraciones del yollotl (corazón). Su tratamiento se basó en el consumo de plantas como la quauhyayual, la iztauhyatl y el xoxocoatl, de animales como la liebre, el pollo y el pescado, así como de algunos minerales además de recomendaciones en el estilo de vida del individuo en un contexto mágico y religioso. Conclusión. En la medicina mesoamericana precolombina se identificó la depresión, para la cual desarrollaron métodos terapéuticos que, aun cuando distan de nuestro concepto médico moderno, en su momento cumplieron la función de entender y reestablecer la salud del individuo

Aim. To review the concept of depression and its treatment in the context of Precolumbian Mesoamerican medicine. Development. The origins of Precolumbian Mesoamerican medicine (ticiotl) are imprecise, since the theoretical and diseasehealing concepts of the times were doubtlessly influenced by magic and religious beliefs. However, the ticiotl was constructed on a ‘theory’ based on structured information integrated to the world philosophy, which included the social, religious and cultural behavior of the Aztec people. Health was considered a result of the balance between cold-hot polarity. Imbalance caused disease, which in turn produced a dynamic impairment of the body and its relation to the cosmos. Disease could be originated by multiple factors, e.g., by god-sent punishment, or caused by man’s evil or by a destiny marked since birth. Depression, among other diseases, was identified in the ticiotl, and was attributed to alterations in the yollotl (heart). It was treated with plants such as quauhyayual, itzauhyatl and xoxocoatl, with animals such as hare, chicken and fish, and with some minerals. Also, recommendations were given to the individual on his life style in a magic-religious context. Conclusion. In Precolumbian Mesoamerican medicine, depression was identified, and therapeutic methods were developed which may be far from the modern medical concept, but at the time fulfilled the function of understanding and recovering the individual’s health

Variations regarding susto causality among the Cakchiquel of Guatemala.

George Foster's model of 'personalistic' and 'naturalistic' disease theories is employed in the present analysis of fright-sickness among Cakchiquel villagers in highland Guatemala. Field data from Panajachel and San Antonio Aguas Calientes suggest that pronounced intrasocietal competition favors personalistic interpretation, with sorcery cited as the ultimate source, rather than naturalistic interpretation, which emphasizes chance or destiny. Village differences in subsistence echology and internal competition apparently underlie variations in both the social function and assumed etiology of fright-sickness.