Delayed diagnosis of pemphigus vulgaris in rural Nepal due to healthcare inaccessibility and harmful traditional practices: A case report.

Early intervention is imperative for potentially fatal dermatologic diseases such as pemphigus vulgaris. In rural Nepal, limited public awareness, home remedies, and delays in healthcare access lead to poor outcomes. Although biopsy confirms the diagnosis, experienced dermatologists can make an accurate clinical diagnosis when characteristic skin lesions are present.

Use of Traditional Remedies for Treatment of Diabetic Foot Ulcers: A Cross-Sectional Study at a Tertiary Center in Saudi Arabia.

Patients with diabetic foot ulcer (DFU) are prone to major complications including amputations. Traditional remedies (TR) have been used to treat DFU around the world. This study aims to identify the prevalence of TR among patients with DFU in our local cohort and its effect on DFU. 1408 patients were included in the analysis. Data were collected retrospectively from patients' medical records. DFU characteristics include grading ulcers using the Wagner scale (WG) and infections (cellulitis and osteomyelitis). Ulcer management (UM) includes medical treatment, self-medical treatment, traditional treatment, and medical-traditional treatment. The mean age of the cohort was 60 years (SD = 12.4). The mean duration of diabetes was 18.6 years (SD = 9.3) and the mean duration of open wounds was 206.9 days (SD = 545.6). The majority were males (71%) and had type 2 diabetes (96%, SD = .204). Forty-three percent of patients were treated with TR (29% were self-prescribed and 14% prescribed by a physician) while 48% had medical treatment and 10% were self-treated using medical treatment. More than two-thirds of the cohort had cellulitis and/or osteomyelitis at the time of presentation. The use of traditional treatment was significantly associated with higher WG (WG 4 OR = 1.936, 95% CI: 1.338-2.800; WG 5 OR = 2.937, 95% CI:1.614-5.346; P < 0.05). Moreover, osteomyelitis was associated with medical-traditional treatment (OR = 1.608, 95% CI: 1.006-2.572; P < 0.05) and increased wound depth (WG 3 OR = 1.969, 95% CI: 1.193-3.250; WG 4 OR = 1.874, 95% CI: 1.115-3.15; P < 0.05). There is high use of TR for the treatment of DFU in our cohort. High Wagner-grade of foot ulcers and the presence of osteomyelitis were highly associated with DFU. This study showed for the first time the use of traditional potions by medical physicians. Both physicians and patients need to be made aware of the detrimental effects of using traditional methods on DFU.

The impact of cultural healthcare practices on Children's health in the United Arab Emirates: a qualitative study of traditional remedies and implications.

Aim: This qualitative study investigates the impact of cultural practices on children's health in the United Arab Emirates (UAE) by examining the use of traditional remedies and home treatments by mothers. Methods: Twenty-five participants, all mothers who had employed traditional treatments or home remedies for their children during periods of illness, were included in the study. The participants represented a diverse range of educational backgrounds, from school diploma holders to university degree graduates, with ages spanning from 20 to 50 years. Hailing from different Arabic countries and cultural subgroups, the majority of participating mothers were from the UAE. Results: Through in-depth interviews, three major themes emerged from the participants' experiences. Firstly, a strong connection between culture, religion, and healthcare practices was evident. Many mothers opted for cultural remedies as their first line of defense against illnesses due to the practices' strong foundations in their cultural heritage. Herbal remedies, Quranic healing, and other traditional methods were perceived to be both effective and spiritually comforting, reinforcing participants' sense of cultural identity. Secondly, participants highlighted unintended consequences of relying solely on traditional treatments. Some instances were reported where the use of ineffective remedies resulted in delays in seeking appropriate medical care for their children, potentially compromising their health. Additionally, certain misconceptions regarding the safety and efficacy of traditional remedies were identified, emphasizing the need for evidence-based healthcare education. Conclusion: This qualitative study sheds light on the intricate interplay between culture, traditional remedies, and children's health in the UAE. The incorporation of diverse participants from various Arabic countries and cultural subgroups enriches the study's applicability to broader Arabic cultures. By recognizing the significance of cultural healthcare practices and striking a balance with evidence-based care, healthcare providers can create a more inclusive and effective healthcare environment for children in the UAE. Future research should explore diverse samples and develop targeted interventions to further advance cultural awareness and understanding in healthcare practices.

Efficacy of Two Moroccan Cistus Species Extracts against Acne Vulgaris: Phytochemical Profile, Antioxidant, Anti-Inflammatory and Antimicrobial Activities.

BACKGROUND: The genus Cistus L. (Cistaceae) includes several medicinal plants growing wild in the Moroccan area. Acne vulgaris (AV) is a chronic skin disorder treated with topical and systemic therapies that often lead to several side effects in addition to the development of antimicrobial resistance. Our study aimed to investigate the bioactivity of extracts of two Moroccan Cistus species, Cistus laurifolius L. and Cistus salviifolius L., in view of their use as potential coadjuvants in the treatment of mild acne vulgaris. METHODS: Targeted phytochemical profiles obtained by HPLC-DAD and HPLC-ESI/MS analyses and biological activities ascertained by several antioxidants in vitro chemical and cell-based assays of the leaf extracts. Moreover, antimicrobial activity against Gram-positive and Gram-negative bacteria, and Candida albicans was evaluated. RESULTS: Analyses revealed the presence of several polyphenols in the studied extracts, mainly flavonoids and tannins. Cistus laurifolius L. and Cistus salviifolius L. possessed good biological properties and all extracts showed antibacterial activity, particularly against Staphylococcus aureus, S. epidermidis, and Propionibacterium acnes, identified as the main acne-causing bacteria. CONCLUSION: The results suggest that examined extracts are promising agents worthy of further studies to develop coadjuvants/natural remedies for mild acne treatment.

Traditional remedies and other characteristics among human snakebite survivors in Baringo county, Kenya, 2010-2020: a case series.

BACKGROUND: Seeking traditional remedies following snakebites leads to avoidable deaths in rural settings in developing countries. METHODS: In this case series study, we identified and recruited 169 snakebite survivors in Baringo county, a hard-to-reach region in northwestern Kenya, who experienced snakebites from 2010 to 2020 using a snowballing technique. We explored associations between traditional and hospital care in managing snakebites and other characteristics. χ2 tests assessed these categorical differences. RESULTS: Fifty-four (33%) of the survivors used traditional remedies to manage snakebites. The majority (56%) were men and aged >18 y (72%); 59% had low education levels and income. They sourced water from rivers or lakes (93%) and used charcoal as an energy source (74%). These survivors (>67%) resided in households practicing free-range and stall-feeding animal husbandry systems and in houses with thatch roofing or an earthen floor structure. Also, >62% reported muscle tremors, fever and chills, while 80% visited health facilities for further treatment. CONCLUSION: Community sensitization covering the risks of non-effective remedies and escalation of training to traditional healers could improve the speed of referrals in hard-to-reach snakebite hotspots. Medical anthropology studies could explore the enablers of continued use of traditional remedies in snakebite management in rural communities.

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

CONTEXT: Haemorrhoids are one of the most common gastrointestinal disorders in humans. In Tanzania, particularly in the Tabora region, medicinal plants (MPs) are used by traditional healers (THs) to treat haemorrhoids, but no study has explicitly attempted to compile these treatments. OBJECTIVE: This study documents MPs used by THs of the Tabora region in Tanzania to treat haemorrhoids. MATERIALS AND METHODS: A semi-structured questionnaire was used to gather ethnobotanical data from 44 THs on MPs used to treat haemorrhoids, parts used, preparation methods and administration routes. The collected ethnobotanical data were analysed by computing percentage frequencies and relative frequency citations. RESULTS: Twenty-six MPs belonging to 19 families and 25 genera, used to manage haemorrhoids, were documented. Fabaceae was the dominant family (four species), whereas shrubs constituted a high proportion (38.46%) of the MPs, and the root was the most (30.3%) utilized plant part. Decoction (38.5%) and topical application (53.8%) were the most preferred preparation and administration techniques. Most MP materials (76.9%) were sourced from the wild. Aloe vera (L.) Burm.f. (Asphodelaceae) (68%), followed by Allium sativum L. (Alliaceae) (66%) and Psidium guajava L. (Myrtaceae) (66%) were the most utilized MPs. Among the recorded MPs, 12 are reported for the first time for the treatment of haemorrhoids. The recorded MPs are believed to possess anti-inflammatory properties that aid in managing inflammation associated with bowel diseases, including haemorrhoids. CONCLUSIONS: This study has documented valuable MPs used to manage haemorrhoids and provides a basis for further studies to discover efficient and affordable anti-haemorrhoid drugs.

A study of rural chicken farmers, diseases and remedies in the Eastern Cape province of South Africa.

The source of emerging diseases and antimicrobial resistance is of increasing interest to epidemiologists. This paper looks at village chickens as such a source. In addition, infectious diseases constitute a major challenge to the growth and profitability of the rural poultry sector in Sub-Saharan Africa. A serological survey was conducted to estimate the apparent seroprevalence of selected chicken diseases in the Eastern Cape Province of South Africa alongside a sociological survey of poultry farmers and the remedies most commonly used to prevent diseases in their flocks. Sera collected from village chickens (n = 1007) in the province were screened for specific antibodies against Newcastle disease (ND), avian influenza (AI), avian infectious bronchitis (IB) and Mycoplasma gallisepticum (MG). The overall seroprevalence of ND, AI, IB and MG in the province was found to be 69.2 % (95 % CI 51.9-86.5%); 1.8 % (95 % CI 0.2-3.4%); 78.5 % (95 % CI 74.9-82%) and 55.8 % (95 % CI 41.3-70.3%) respectively with clustering found at the District level. Cross hemagglutination inhibition (HI) tests indicated that the chickens were exposed to the ND vaccine. AI ELISA-positive samples were tested using HIs against the H5, H6 and H7-subtypes, but only H6-specific antibodies were detected. Avian influenza strains shared the common ancestor responsible for the 2002 chicken outbreak in KwaZulu-Natal Province. The majority of chicken farmers were females and pensioners (69 % and 66.1 % respectively) and had a primary school education (47.1 %). Traditional remedies were commonly used by farmers (47.15 %) and among the remedies, Aloe plant (Aloe ferox Mill.) or ikhala (Xhosa) was the most commonly used product (28.23 %) for preventing and reducing mortalities among village chickens. The findings stress the importance of village chickens as a substitute for social welfare and highlight the exposure of village chickens to important chicken pathogens. The economic impact of these pathogens on the development of this sub-sector needs further investigation. Village chickens are a potential source of virulent Newcastle disease virus (NDV) because of the lack of vaccination and biosecurity. They may serve as amplification hosts which increases the probability that virulent NDV could spill over into commercial poultry flocks due to large amounts of circulating virus. The zoonotic threat of circulating H6N2 viruses raise concern due to their mutation and reassortment among chickens and a potential movement of infected birds within the province. Finally, the use of antibiotics by untrained chicken farmers constitute another major concern as it could serve as a source of antimicrobial resistance (AMR).

Knowledge & awareness of burn first aid among health-care workers in Saudi Arabia: Are health-care workers in need for an effective educational program?

OBJECTIVE: The objective of this study was to assess the level of awareness and knowledge of first aid for burns among healthcare workers in Saudi Arabia. METHODS: We conducted a cross-sectional study between September 2 and December 5, 2019, via a self-administered online questionnaire among healthcare workers at a university hospital. The questionnaire comprised 24 questions divided into two sections pertaining to demographics and first aid for burns. This study was approved by the Research Ethics Committee. RESULTS: We included 1,438 respondents in this study. Females comprised 68.2% (982) of the respondents. A total of 513 respondents (35.7%) were medical students. The mean burn knowledge score of all respondents was 8.07 ± 2.03 out of 13. Interestingly, 940 individuals (65.4%) used traditional medications on the burn area. Knowledge regarding antibiotic use in burn injuries was poor-1,199 (82.3%) study participants agreed that antibiotics are beneficial in the case of burns, which is a wrong act. The mean knowledge score was significantly different across groups of different ages, sexes, nationalities, marital statuses, and job positions (P < 0.001). CONCLUSION: The level of awareness of first aid for burn patients among healthcare workers was insufficient, and the unnecessary use of traditional medicines and antibiotics in burn patients being high. Moreover, this study confirmed the need for an effective educational program among healthcare workers.

Do parents have knowledge of first aid management of burns in their children? A hospital based survey.

OBJECTIVE: To ascertain knowledge of first aid among parents of children suffering from burns. METHODS: The cross-sectional study was conducted at Mayo Hospital, Lahore, Pakistan, from July 2017 to January 2018, and comprised parents of patients in the paediatric burns unit. Questionnaires were filled by the duty doctor after interviewing parents, and data was collected regarding first aid, application of traditional remedies and demographic details. Optimal knowledge was defined as parent's knowledge of application of tap water on burns as first aid. SPSS 20 was used for data analysis . RESULTS: There were parents of 310 patients who had a mean total body surface area of burns of 25.11}13.80%. All (100%) accidents had occurred at home. All (100%) parents had removed their children from heat and electric source immediately after the accident, while 282(91%) stripped their children of their clothes. Only 41(13.2%) parents irrigated the burn area with tap water and 93(30%) applied traditional remedies. Further, 21(6.8%) parents had covered the burnt area with sterile dressing, while 25(8.1%) had covered the child to avoid hypothermia. One (0.3 2%) parent had attended a first aid course, while 13(4.2%) had knowledge of first aid because of previous history of a child having suffered from burns. Optimal knowledge wasstatistically associated with previous knowledge of first aid (p=0.0001), level of education of the parent (p=0.003) and monthly income (p=0.01). CONCLUSIONS: The knowledge of first aid among parents was found to be inadequate and there was an urgent need to introduce campaigns focussing on prevention and first aid to manage burns, especially among illiterate and poor classes.

Human disorders associated with inflammation and the evolving role of natural products to overcome.

Inflammation is a biological function which triggered after the mechanical tissue disruption or from the responses by the incidence of physical, chemical or biological negotiator in body. These responses are essential act provided by the immune system during infection and tissue injury to maintain normal tissue homeostasis. Inflammation is a quite complicated process at molecular level with the involvement of several proinflammatory expressions. Several health problems are associated with prolonged inflammation, which effects nearly all major to minor diseases. The molecular and epidemiological studies jagged that the inflammation is closely associated with several disorders with their specific targets. It would be great achievement for human health around the world to overcome on inflammation. Mostly used anti-inflammatory drugs are at high risk of side effects and also expensive. Hence, the plant-based formulations gained a wide acceptance by the public and medical experts to treat it. Due to extensive dispersal, chemical diversity and systematically established biological potentials of natural products have induced renewed awareness as a gifted source for medications. However, today's urgent need to search for cheaper, more potent and safe anti-inflammatory medications to overcome on current situation. The goal of this review to compile an update on inflammation, associated diseases, molecular targets, inflammatory mediators and role of natural products. The entire text concise the involvement of various cytokines in pathogenesis of various human disorders. This assignment discussed about 321 natural products with their promising anti-inflammatory potential discovered during January 2009 to December 2018 with 262 citations.

Traditional methods for managing illness in newborns and infants in an Arab society.

AIM: This study explored self-management practices in relation to traditional methods for managing illness in newborns and infants and the implications of these practices on infant health. BACKGROUND: Self-medication with folk remedies is believed to have short- and long-term impacts on well-being. Little is known about how mothers in Arab societies used their traditional beliefs and practices in self-managing their newborns' and infants' health. METHODS: Data were collected from five focus groups using open-ended questions with 37 mothers. Participants were selected using snowball sampling and were recruited from four different cities in Jordan between June 2016 and August 2016. ETHICAL APPROVAL: All identifying information regarding the study participants has been omitted, and this study was approved by the Academic Research Committee at the University of Jordan. FINDINGS: Mothers were more willing to try herbal remedies, traditional massage and certain foods to self-manage their infants' health. Folk remedies were not restricted to traditions handed down through generations, but included a representation of newly emerged trends towards 'safety' or 'nature'. CONCLUSIONS: While the use of folk remedies have been handed down generations as customs, today, virtual support groups and social media provide modern resources for folk remedies' promotion in care and self-management. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Nursing and health policymakers can use our findings for planning and developing strategies and health policies that increase public awareness about adverse health effects associated with herbal remedies. Such strategies are likely to be facilitated through partnerships between nursing and midwifery education institutions, antenatal clinics and social media in the region.

Prevention and treatment of malaria in pregnancy: what do pregnant women and health care workers in East India know and do about it?

BACKGROUND: Limited qualitative research has been performed in India to investigate views and behaviours of pregnant women regarding malaria despite the threat of malaria-related adverse maternal and neonatal outcomes. To address this gap, a comprehensive study on malaria prevention and treatment attitudes, knowledge and behaviour among pregnant women in India was conducted. METHODS: Pregnant women and healthcare workers (HCWs), encompassing clinic-based providers, traditional birth attendants, and auxiliary nurse-midwives were enrolled for in-depth interviews (IDIs) at 7 hospital sites and nearby communities in Jharkhand and Chhattisgarh States. Questions addressed health concerns and attitudes, knowledge and practices regarding malaria prevention and treatment; probing covered modern and traditional approaches. Data were analyzed using a thematic approach. RESULTS: A total of 83 pregnant women and 119 HCWs participated in 202 IDIs, 90 in Jharkhand and 112 in Chhattisgarh. A majority of Jharkhand respondents, but only one-fourth in Chhattisgarh, named malaria among top health issues for pregnant women. Just over half of pregnant women were willing to try new prevention methods (especially insecticide-treated bed nets), although cost-related barriers to such methods were stressed. Most respondents voiced concerns about malaria treatment during pregnancy, mainly citing potential harm to the baby. Most knew that mosquitoes transmitted malaria, but a substantial minority, including among HCWs, described incorrect transmission modes. Most knew a proven prevention method (usually bed nets or coils); a few knew other methods. A minority of pregnant women, but most HCWs, knew about malaria treatment, although some HCWs described unproven treatments. Most respondents described use of modern prevention methods in their communities, typically bed nets, although probing revealed irregular use. Half (especially in Jharkhand and particularly HCWs) described use of traditional prevention approaches such as burning leaves and rubbing oils on the body; traditional remedies for malaria treatment were common, and varied by site and population. CONCLUSIONS: Understanding of malaria varied as a concern for pregnant women, continued use of unproven malaria prevention and treatment strategies was evident in this population in India. These results highlight the need to educate both pregnant women and HCWs about effective malaria methods to protect pregnant women and their babies from malaria.

Is syndromic data from rural poultry farmers a viable poultry disease reporting tool and means of identifying likely farmer responses to poultry disease incursion?

Syndromic surveillance is a well described tool used in developed countries for alerting authorities to livestock disease incursions. However, little work has been done to evaluate whether this could be a viable tool in countries where disease reporting infrastructure and resources is poor. Consequently, a syndrome-based questionnaire study in Eastern Zambia was designed to gather data on previous encounters farmers had with poultry diseases, as well as control measures they use to mitigate them. Descriptive statistics and logistic regression were used to analyse the data. Farmers reported an overall annual disease incidence in rural poultry for eastern Zambia of 31% (90% CI 29-32%). Occurrence of poultry disease in the last 12 months was associated with use of middlemen to purchase poultry products (p = 0.05, OR = 7.87), poultry products sold or given away from the farm (p = 0.01, OR = 1.92), farmers experiencing a period with more trade of poultry and its products (p = 0.04, OR = 1.70), presence of wild birds near the farm or village (p = 0.00, OR = 2.47) and poultry diseases being reported from neighbouring farms or villages (p = 0.00, OR = 3.12). The study also tentatively identified three poultry diseases (Newcastle Disease, Gumboro Disease and Fowl Pox) from the thirty-four disease syndromes provided by farmers. Farmers reported an incidence of 27% for Newcastle Disease in 2014. When compared with the state veterinary services data which reported Newcastle Disease incidence at 9% in 2014, it seems syndromic data obtained from farmers may be more sensitive in identifying disease incursion. Thirty-six remedies and strategies farmers use to treat and control these diseases were revealed. The main control strategy for identified diseases was vaccination and the main treatment was unspecified herbs, which warrants further investigation and presents an opportunity for further research in ethno-veterinary medicine. More still, this study identified chilli, Aloe Vera, garlic onion, moringa, and ash as traditional remedies that are commonly being used in Eastern Zambia, and which are also used to treat poultry diseases in Zimbabwe and Botswana. Only fourteen remedies described are conventionally accepted by veterinarians as remedies and disease control measures for poultry diseases. This study shows that syndromic data obtained from farmers is a useful disease reporting tool and could be used as an effective means of alerting authorities to disease incursion. In addition, it shows that these data may give a more accurate estimate of incidence for certain diseases than current surveillance methods and could be useful in assessing significant risk factors associated with disease occurrence.

Alpha-glucosidase inhibitory activity of ethanol extract, fractions and purified compounds from the wood of Albizia myriophylla.

Albizia myriophylla Benth. is a medicinal herb which is used as a traditional remedy for various ailments including diabetes in Thailand. In our continued investigation of the biological activity of A. myriophylla, the ethanol extract, fractions and the isolated compounds from the wood of this plant were evaluated for in vitro α-glucosidase inhibition using spectrophotometric method. The plant ethanol extract and its different fractions possessed α-glucosidase inhibitory activity in a concentration-dependent manner. Dichloromethane fraction of the wood ethanol extract exhibited the highest percent inhibition against α-glucosidase (69.30%) among all fractions. Subsequent α-glucosidase inhibition assay proved that indenoic acid (1), 8-methoxy-7, 3',4'-trihydroxyflavone (2) and 3,4,7,3'-tetrahydroxyflavan (3) were partially rational for antidiabetic effect of this plant species. Among these compounds, 3 (IC50 98.59 µg/mL) exhibited potent inhibition of α-glucosidase, compared with a positive control acarbose (IC50 125 µg/mL). The inhibitory effect towards α-glucosidase of compounds 1-3 was reported herein for the first time.

"It's so hard taking pills when you don't know what they're for": a qualitative study of patients' medicine taking behaviours and conceptualisation of medicines in the context of rheumatoid arthritis.

BACKGROUND: Patients with chronic illnesses are often required to take lifelong medication to alleviate symptoms and prevent disease progression. Many patients find it difficult to adhere to prescribed medication for various reasons, some of which may link to the way they conceptualise medicines and understand their illness and treatment. This study explores the medicine taking behaviours of patients presenting with Rheumatoid Arthritis (RA), a chronic inflammatory autoimmune disease. We focused particularly on patients' conceptualisation and understanding of medicines within this disease context, against a backdrop of scarce healthcare resources. METHODS: We conducted semi-structured interviews with 18 female patients at a rheumatology clinic in South Africa, as well as a review of participants' medical records. We conducted a secondary analysis of the data using thematic analysis and framework analysis principles. RESULTS: Participants reported a range of medicine taking behaviours including self-medicating, adding complementary and alternative medicines (CAM) or traditional remedies, and sometimes acquiring prescribed medicines illegally. Participants provided insights into their understanding of what constitutes a medicine and what substances can be added to a prescribed regimen, which impacted on adherence. Importantly, the majority of participants demonstrated poor understanding of their illness, medications, regimens and dosage instructions. CONCLUSIONS: Medicine taking in the context of RA, within the studied demographic, is complex and appears strongly mediated by individual and contextual factors. Poor patient understanding, individual conceptualisation of medicines and medicine taking, and the availability of a range of additional medicines and remedies impact on adherence. Based on these findings, we make some suggestions for how healthcare providers can play a greater role in educating patients living with RA about medicines, CAM and traditional remedies, as well as medicine taking behaviours.

Current knowledge of burn injury first aid practices and applied traditional remedies: a nationwide survey.

BACKGROUND: Burn first aid awareness has been shown to reduce morbidity and mortality. We present a report on the knowledge and practices of the Saudi population with regard to burn first aid and the application of traditional remedies. METHODS: An internet-based survey was conducted to assess the public's knowledge on first aid practices and home remedies applied for burn injuries among Saudi adults. RESULTS: A total of 2758 individuals responded to the survey. There were 1178 (42.7 %) respondents who had previously received burn first aid information. One thousand five hundred fifty respondents had a history of burn exposure in which burn injury first aid was applied as follows: 1118 (72.1 %) removed clothing and accessories from the injured area; water was applied by 990 (63.9 %); among those who applied water, 877 (88.6 %) applied cold water; and only 57 (5.8 %) did so for more than 15 min. Wrapping the burn area was performed by 526 (33.9 %), and 985 (63.5 %) sought medical assistance. When it comes to traditional remedies, 2134 (77.4 %) knew of and/or implemented these remedies as first aid or to treat burns. Honey and toothpaste were the commonest among these remedies with 1491 (69.9 %) and 1147 (53.7 %), respectively. This was associated with female gender (r = 0.87, P < 0.001), younger age group (19-25 years) (r = 0.077, P < 0.001), from central region (r = 0.012, P < 0.001), and university graduate (r = 0.05, P = 0.002). Nearly half of those who knew of traditional remedies did not have previous knowledge of burn first aid. CONCLUSIONS: Proper burn first aid is a simple, cheap, and accessible means of managing burns initially. Although the majority of the respondents were university graduates (51.1 %), knowledge and implementation of burn first aid was very poor. Major healthcare agencies should review and promote a consistent guideline for burn first aid in an effort to tackle and minimize the effect of this grave injury.

Taste of medicinal plants: A potential tool in predicting ethnopharmacological activities?

ETHNOPHARMACOLOGICAL RELEVANCE: Taste (rasa) is traditionally valued in Ayurveda as an important ethnopharmacological category, and reported to correlate with certain therapeutic activities (karman). The present paper endeavors to provide for the first time a type of mapping of ayurvedic ethnopharmacological space by the integration of medicinal plant taste-activity relationship (TA) data, originating from several traditional sources. MATERIAL AND METHODS: The present TA database included 183 ayurvedic medicinal plants, with their traditional description of taste and ethnophamacological actions (EPA). 111 plants had a unique taste, and 72 plants a combination of several tastes, consisting of one principal taste, and other 2-4 secondary tastes. 121 ethnopharmacological actions were considered. Potential global or individual associations between rasa and karman were statistically analyzed. RESULTS: We found a statistically significant global correspondence between the predominant plant taste and the ethnopharmacological activities (Chi-square test, p<0.05), and the following individual associations (Fisher exact test, p<0.05, positive association if lnOR >0, negative association if lnOR <0): bitter- 11 positive associations (lnOR 0.940 to 3.544) and 8 negative associations (lnOR -0.997 to -3.101), sweet- 14 positive associations (lnOR 0.839 to 3.132) and 20 negative associations (lnOR -0.962 to -3.270), pungent- 23 positive associations (lnOR 0.835 to 4.126) and 11 negative associations (lnOR -1.255 to -3.147), astringent- 7 positive associations (lnOR 1.099 to 3.813) and 7 negative associations (lnOR -1.076 to -2.631), sour- 7 positive associations (lnOR 1.128 to 4.664) and 1 negative association (lnOR -2.244). Among the 109 statistically significant associations, 24 were not traditionally mentioned, and only 4 were in opposition with the traditional ayurvedic sources. DISCUSSIONS: The present study confirms the traditional relationship rasa-karman and demonstrates that statistical models can be used to predict EPAs of medicinal plants depending on their taste. Integration of the ayurvedic concept of taste into ethnopharmacological research might reveal new facets of plant therapeutic potentials and provide a framework for developing a probabilistic approach to drug discovery that can be exploited to increase bioprospecting research efficacy.

Antiplasmodial potential of traditional antimalarial phytotherapy remedies used by the Kwale community of the Kenyan Coast.

ETHNOPHARMACOLOGICAL RELEVANCE: In Kenya, 22 million people are at risk of malaria, 70% of them are in rural areas and most of these people use traditional plant based medicines to treat malaria. The aim of the study was to escalate documentation, from an earlier study of medicinal plants, traditionally used to treat malaria by the Digo community of Kwale County, taking cognizance of their pharmacological information by evaluating their antiplasmodial efficacies. MATERIALS AND METHODS: The study was carried out in Kwale County at Shimba Hills Game Reserve and adjoining part of Kinango. Traditional health practitioners (THP) were interviewed with a standard questionnaire to obtain information on medicinal plants traditionally used for management of malaria. Group interviews were also held among THPs and members of the community. The plant samples collected were tested for antiplasmodial activity against chloroquine sensitive (D6) and resistant (W2) Plasmodium falciparum using the ability of extracts, prepared from the plant species, to inhibit the incorporation of [G-3H] hypoxanthine into the malaria parasites. RESULTS: Fifty seven (57) species in forty eight (48) genera and thirty (30) families were documented and evaluated for in vitro antiplasmodial activity. Apocynaceae, Euphorbiaceae, and Rubiaceae families had each about 12% of the plant species reported as antimalarial remedy and represented the species that are most commonly used. Twelve species (21.1%) showed antiplasmodial efficacy of IC50<5µg/ml and these were Boscia salicifolia, Cissampelos mucronata, Clerodendrum myricoides, Commiphora schimperi, Flueggea virosa, Maytenus undata, Maytenus senegalensis, Maytenus putterlickioides, Vernonia amygdalina, Warburgia stuhlmannii, Zanthoxylum chalybeum and Tabernaemontana pachysiphon. CONCLUSIONS: These results seem to indicate that ethnopharmacological inquiry used in search for new herbal remedies as predictive and could form the basis of an ethnopharmacopoeia and search for new active principles. This is the first report on traditional use of T. pachysiphon for malaria and its antiplasmodial activity.

Dietary compliance, dietary supplementation and traditional remedy usage of type 2 diabetic patients with and without cardiovascular disease.

This analytical cross-sectional study examined the nutrient intakes, dietary compliance, dietary supplementation and traditional remedy usage in type 2 diabetes mellitus (T2DM) patients from selected tertiary hospitals in multi-racial Malaysia. We compared the different characteristics of T2DM patients with and without cardiovascular disease (CVD). Socio-demographic status, dietary intakes, dietary supplementation, traditional remedy use, medical history, anthropometric measurements and clinical characteristics were obtained from face-to-face interviews. A total of 313 patients who were treated for T2DM participated in this study, in which 36.1% of them had CVD. The mean age of study subjects was 55.7 ± 9.2 years; mean diabetes duration was 10.1 ± 8.1 years; 52.1% were females; and 47.0% were Malays. The mean total energy intake of the subjects was 1674 ± 694 kcal/day, and patients with CVD consumed higher total calories (p = 0.001). Likewise, the mean carbohydrate, protein and total fat intake of CVD patients were significantly higher than non-CVD patients (p < 0.05), while mean intakes of cholesterol, fibre, minerals and all vitamins were comparable between CVD and non-CVD patients. Regardless of CVD status, a notably high proportion of the subjects did not meet the recommendations of the Medical Nutrition Therapy Guidelines for Type 2 Diabetes for total energy, carbohydrate, protein, total fat, and fibre intakes. Meanwhile, 52.4% used at least one dietary supplement and 12.1% took single traditional remedy or in various combinations. Traditional remedies and supplement intake did not differ between CVD and non-CVD subjects. It is suggested that T2DM patients should be educated based on their personalized dietary intake, dietary supplementation and traditional remedy usage. The recommendations for T2DM patients shall be met to achieve the optimal metabolic goals and minimize the potential diabetic complications.