Ethnoveterinary medicinal plants and their utilization by indigenous and local communities of Dugda District, Central Rift Valley, Ethiopia.

BACKGROUND: Ethnoveterinary medicinal plants have been used by the people of Dugda District in the primary health care system to treat various livestock ailments for generations, particularly, in underserved rural areas. However, these ethnoveterinary practices and medicinal plants are dwindling without proper documentation, due to undergoing socio-cultural and environmental changes. Hence, this study aimed at inventory and analysis of ethnoveterinary medicinal plants and the associated indigenous and local knowledge used in the treatment of livestock health problems in Dugda District. METHODS: Data were collected from 378 local inhabitants through semi-structured interviews, 18 focus group discussions with 6 to 8 participants in each couple with participant field observations. Informant consensus factor (ICF), fidelity-level (FL) and relative importance value (RI) were used to evaluate the agreement of informants on ethnoveterinary practices, healing potential of medicinal plants and the most multipurpose species. Using standard taxonomic procedures, voucher specimens were collected, identified and deposited at the National Herbarium of Addis Ababa University. RESULTS: In total, 64 medicinal plants of ethnoveterinary uses, belonging to 33 families were reported to treat 37 livestock health problems. Anthrax, inappetence and diarrhoea were said to be the most prevalent veterinary health problems treated by traditional medicinal plants. Family Fabaceae was the most widely reported (7 spp.), followed by Apocynaceae, Cucurbitaceae and Solanaceae (5 spp. each). Herbs were the dominant life forms (21spp.), followed by shrubs (20 spp.). The most commonly sought plant parts were leaves (55.25%), followed by roots (23.44%). The principal method of preparation was pounding remedial parts (46.85%) and mixing with cold water. The main route of administration was via oral application (72.67%), drenching diseased livestock. Withania somnifera and Kedrostis foetidissima were the most cited medicinal plants with 53 and 43 use reports (URs), respectively. ICF showed that respiratory diseases scored the highest value (0.94), while most of the reported medicinal plants were gastrointestinal agents. RI value analysis revealed that Croton macrostachyus had highest diversity of uses, followed by K. foetidissima and W. somnifera. Ethnoveterinary uses of some medicinal plants such as Phytolacca dodecandra, Calpurnia aurea, Cyphostemma cyphopetalum and Verbascum sinaiticum as prophylaxis against rabies were a new input for ethnoveterinary database. CONCLUSION: The study revealed that the people of the Dugda District are endowed with rich ethnoveterinary knowledge and medicinal plants. However, ethnoveterinary knowledge associated with medicinal plant species significantly differ (P < 0.05) between general and key informants, young and matured age groups and informants' educational level. This infers the impact of mode of ethnoveterinary knowledge transfer, literacy, modern education and globalization on ethnoveterinary uses of medicinal plant species. And also most of the medicinal plants are found in wild habitats with nearly no conservation attention. Therefore, it is imperative to implement participatory conservation actions for medicinal plants in collaboration with traditional institutions (Gada system). The disparity of ethnoveterinary knowledge could be also minimized through awareness creation among local communities about the knowledge and its revitalization. Furthermore, medicinal plants, which are widely utilized and multipurpose, should be screened for their phytochemicals, pharmacological and toxicological activities to confirm ethnoveterinary uses and for future development of veterinary pharmaceuticals.

Polygonati Rhizoma: A review on the extraction, purification, structural characterization, biosynthesis of the main secondary metabolites and anti-aging effects.

ETHNOPHARMACOLOGICAL RELEVANCE: Polygonati Rhizome (PR) is a plant that is extensively widespread in the temperate zones of the Northern Hemisphere. It is a member of the Polygonatum family of Asparagaceae. PR exhibits diverse pharmacological effects and finds applications in ethnopharmacology, serving as a potent tonic for more than two millennia. PR's compounds endow it with various pharmacological properties, including anti-aging, antioxidant, anti-fatigue, anti-inflammatory, and sleep-enhancing effects, as well as therapeutic potential for osteoporosis and age-related diseases. AIM OF THE STUDY: This review seeks to offer a thorough overview of the processing, purification, extraction, structural characterization, and biosynthesis pathways of PR. Furthermore, it delves into the anti-aging mechanism of PR, using organ protection as an entry point. MATERIALS AND METHODS: Information on PR was obtained from scientific databases (Google Scholar, Web of Science, ScienceDirect, SciFinder, PubMed, CNKI) and books, doctoral theses, and master's dissertations. RESULTS: In this investigation, 49 polysaccharides were extracted from PR, and the impact of various processing, extraction, and purification techniques on the structure and activity of these polysaccharides was evaluated. Additionally, 163 saponins and 46 flavonoids were identified, and three key biosynthesis pathways of secondary metabolites were outlined. Notably, PR and Polygonat Rhizomai polysaccharides (PRP) exhibit remarkable protective effects against age-induced injuries to the brain, liver, kidney, intestine, heart, and vessels, thereby promoting longevity and ameliorating the aging process. CONCLUSIONS: PR, a culinary and therapeutic herb, is rich in active components and pharmacological activities. Based on this review, PR plays a meaningful role in lifespan extension and anti-aging, which can be attributed to PRP. Future research should delve deeper into the structural aspects of PRP that underlie its anti-aging effects and explore potential synergistic interactions with other compounds. Moreover, exploring the potential applications of PR in functional foods and pharmaceutical formulations is recommended to advance the development of industries and resources focused on healthy aging.

Ethnoveterinary medicinal plants and their utilization by the people of Soro District, Hadiya Zone, southern Ethiopia.

BACKGROUND: Ethnoveterinary studies are important to maintain the sustainability of livestock health and support people's livelihoods through the provision of food, maintaining livestock health, and other biological resources. This study was carried out in Soro District, southern Ethiopia, to identify, document and analyse plant species with ethnoveterinary uses along with the associated indigenous and local knowledge. MATERIALS AND METHODS: Informants were selected using purposive (key informants) and systematic random sampling (general informants) methods. Data on ethnoveterinary plants and their uses were collected through semi-structured interviews, guided field walks, 13 focus group discussions with five to seven members in each and participant observation. Informant consensus factor and fidelity level were computed to identify the most common livestock ailment categories and the best plant species with ethnoveterinary use, respectively. Preference ranking methods were used to identify the potentially effective ethnoveterinary medicinal plants for the most frequently reported livestock ailments. The use diversity of multipurpose plants with ethnoveterinary importance was analysed using the analytical methods of ethnobotany including priority ranking, comparisons and important indices. The T-test statistic was used to compare knowledge differences among different social groups. RESULTS: A total of 132 plant species in 120 genera and 61 families were reported by informants as having ethnoveterinary uses. The plants are said to be used by the local communities in various ways to treat 50 livestock health problems. Higher number of informants (23.77%) cited Momordica foetida for the treatment of 16 livestock ailments. The highest informant consensus value for this species is associated with its use for treating blackleg in cattle; Nicotiana tabacum was cited for the treatment of 15 livestock ailments mainly recommended for the Lumpy Skin Disease/Ailment of bovines; Croton macrostachyus for treatment of 13 livestock ailments including wooden tongue, FMD in bovines; and Gymnanthemum amygdalinum for nine ailments mainly diarrhoea of all livestock types. Achyranthes aspera is claimed to provide the most effective treatment for Aspiration pneumonia (severe coughing in bovines, sheep and goats) alone, while Croton macrostachyus, Ximenia americana, Allium sativum and Juniperus procera were indicated as potential plant species to treat Lumpy Skin Disease in bovines in the order given. The fidelity level analysis showed that Datura stramonium, Dodonaea viscosa subsp. angustifolia and Asparagus africanus were potential medicinal plant species to treat the respective ailments of rabies, Peste des petits ruminants (PPR) and evil eye/spirit. Multipurpose plant species including Prunus africanus, Combretum molle and Afrocarpus falcatus have been highly threatened as indicated by direct matrix ranking mainly due to collection of fuel wood, construction materials and making household utensils, and farm implements rather than for other uses. CONCLUSION: Soro District has rich and diversified livestock herbal medicinal resources, and indigenous knowledge of remedy preparations and applications is transmitted through generation lines. This resource faces anthropogenic threats with deforestation being the leading factor. Consequently, ethnoveterinary medicinal plants continue to decline before adequate and proper scientific documentation and testing are made. There is a dire need for planning and implementation of appropriate in situ and ex situ conservation strategies and to strive towards ensuring the survival and sustainable utilization of such important plant resources of Soro District. This must be supported by further documentation of the associated indigenous knowledge and pharmacological testing of the key promising species including Balanites aegyptiaca (novel species/NS to treat specific ailment), Brugmansia suaveolens (novel species/NS reported first to treat Livestock ailments/LsAs), Euclea divinorum (NS to treat specific ailments), Grevillea robusta (NS), Hagenia abyssinica (NS for the reported specific ailment), Pentanema confertiflorum (NS), Juniperus procera (NS), Maesa lanceolata (NS), Millettia ferruginea (NS for reported specific ailments), Schrebera alata/NS, Securidaca longepedunculata, Spiniluma oxyacantha/NS, Vepris nobilis (novel species reported first to treat LsAs), Zanthoxylum asiaticum /NS and Ximenia americana (NS for specific ailments). This ethnoveterinary study attempted to fill part of the gaps concerning the prevalent livestock health problems and the associated indigenous and local knowledge in the area.

Ethnobotanical study of medicinal plants used by the Yi people in Mile, Yunnan, China.

BACKGROUND: The Yi people are a sociolinguistic group living in Mile City, which is their typical settlement in southeastern Yunnan, China. Over the long history of using medicinal plants, the Yi people have accumulated and developed a wealth of traditional medicinal knowledge, which has played a vital role in their health care. However, only a few studies have been performed to systematically document the medicinal plants commonly used by the Yi people. This study provides fundamental data for the development and application of ethnomedicine as well as supports the conservation of the traditional medical knowledge of the Yi people. METHODS: This study was conducted from May 2020 to August 2022 and involved five townships in Mile. Information regarding medicinal plants was obtained through semistructured interviews, key informant interviews, and participatory observation. The collected voucher specimens were identified using the botanical taxonomy method and deposited in the herbarium. Ethnobotanical data were analyzed using informant consensus factor, relative frequency of citation, and fidelity level. RESULTS: In total, 114 informants distributed in five townships of Mile were interviewed. The Yi people used 267 medicinal plant species belonging to 232 genera and 104 families to treat various diseases. Asteraceae, Lamiaceae, and Fabaceae were the most commonly used plant families by the Yi people. In addition, herbs were most commonly used by the Yi people. Whole plants and roots were the preferred medicinal parts. Decoctions were the most common method of herbal medicine preparation. There are 49 different recorded diseases treated by Yi medicinal plants, and among them, respiratory diseases, rheumatism, traumatic injury, fractures, and digestive system diseases have the largest number of species used. A quantitative analysis demonstrated that plants such as Zingiber officinale, Lycopodium japonicum, Aconitum carmichaelii, Panax notoginseng, Cyathula officinalis, and Leonurus japonicus played crucial roles in disease prevention and treatment. CONCLUSION: Traditional knowledge of medicinal plants is closely associated with the social culture of the local Yi people. The medicinal plants used for health care in the study area were diverse. Local healers were skilled at using medicinal plants to treat various diseases. Their treatment methods were convenient and unique, exhibiting distinctive regional characteristics. However, the inheritance of their traditional medicinal knowledge and protection of wild medicinal plant resources are facing serious challenges, including the decreasing number of local healers, aging of healers, lack of successors, and excessive harvesting of medicinal plant resources. This ethnobotanical survey provides a useful reference for the sustainable utilization and protection of medicinal plant resources in Mile and the inheritance of traditional medicinal knowledge of the Yi people.

Ethnobotanical study of traditional medicinal plants used by the local Gamo people in Boreda Abaya District, Gamo Zone, southern Ethiopia.

BACKGROUND: Medicinal plants have been used for centuries and are still relied upon by over 80% of the Ethiopian population. The people of Gamo, southern Ethiopia, have a rich cultural and traditional lifestyle with a long history of using plant resources for various uses including traditional herbal medicine. However, their traditional knowledge of traditional medicinal plants in Boreda Abaya District has not been explored Ethnobotanically yet, despite preserving diverse indigenous traditional medicinal plants. Hence, the study aimed to document and analyze traditional medicinal plants and associated traditional knowledge and practices used by local people. MATERIALS AND METHODS: Quantitative ethnobotanical data were collected via semi-structured interviews, face-to-face conversations, group discussions, and guided field trips between September 2022 and February 2023. In total, 92 informants participated, of which 25 were key informants. Quantitative data indices (informant consensus factor-ICF-and use report-Ur) were computed by MS Excel spreadsheet software. Scientific names of medicinal plants were checked via World Flora Online. RESULTS: In the present study, we recorded 188 traditional medicinal plant species belonging to 163 genera and 73 plant families. Lamiaceae (16 species), Asteraceae (16 species), Fabaceae (11 species), and Euphorbiaceae (8 species) contributed highest number of species and were found to be predominant family in the area. Leaves and seeds were most frequently used plant parts, and pounding (46%) was the main method to prepare remedies. The sudden sickness disease category scored the highest consensus (ICF: 0.35), followed by blood and circulatory-related disease categories (ICF: 0.33). The highest number of plant taxa (61 species) used to treat dermal disease has a 71-use report score, while fewer plant taxa (21 species) were utilized to treat genitourinary system-related disease category, having 25 use reports. Ocimum lamiifolium (Ur:56) and Moringa stenopetala (Ur:51) are widely used species and received highest use report value. CONCLUSION: Gamo people possess extensive traditional knowledge of ethnomedicine. The region's vegetation hosts diverse medicinal species, but deforestation, agriculture, and droughts threaten them. Local conservation practices require scientific support, prioritizing species having higher use reports (Ur), and in-depth investigations of promising species for drug development are essential.

Targeting chemokine-receptor mediated molecular signaling by ethnopharmacological approaches.

ETHNOPHARMACOLOGICAL RELEVANCE: Infection and inflammation are critical to global human health status and the goal of current pharmacological interventions intends formulating medications/preventives as a measure to deal with this situation. Chemokines and their cognate receptors are major regulatory molecules in many of these ailments. Natural products have been a keen source to the drug development industry, every year contributing significantly to the growing list of FDA approved drugs. A multiverse of natural resource is employed as a part of curative regimen in folk/traditional/ethnomedicine which can be employed to discover, repurpose, and design potent medications for the diseases of clinical concern. AIM OF THE STUDY: This review aims to systematically document the ethnopharmacologically active agents targeting the infectious-inflammatory diseases through the chemokine-receptor nexus. MATERIALS AND METHODS: Articles related to chemokine/receptor modulating ethnopharmacological anti-inflammatory, anti-infectious natural sources, bioactive compounds, and formulations have been examined with special emphasis on women related diseases. The available literature has been thoroughly scrutinized for the application of traditional medicines in chemokine associated experimental methods, their regulatory outcomes, and pertinence to women's health wherever applicable. Moreover, the potential traditional regimens under clinical trials have been critically assessed. RESULTS: A systematic and comprehensive review on the chemokine-receptor targeting ethnopharmaceutics from the available literature has been provided. The article discusses the implication of traditional medicine in the chemokine system dynamics in diverse infectious-inflammatory disorders such as cardiovascular diseases, allergic diseases, inflammatory diseases, neuroinflammation, and cancer. On this note, critical evaluation of the available data surfaced multiple diseases prevalent in women such as osteoporosis, rheumatoid arthritis, breast cancer, cervical cancer and urinary tract infection. Currently there is no available literature highlighting chemokine-receptor targeting using traditional medicinal approach from women's health perspective. Moreover, despite being potent in vitro and in vivo setups there remains a gap in clinical translation of these formulations, which needs to be strategically and scientifically addressed to pave the way for their successful industrial translation. CONCLUSIONS: The review provides an optimistic global perspective towards the applicability of ethnopharmacology in chemokine-receptor regulated infectious and inflammatory diseases with special emphasis on ailments prevalent in women, consecutively addressing their current status of clinical translation and future directions.

An ethnoveterinary study on medicinal plants used by the Bai people in Yunlong County northwest Yunnan, China.

BACKGROUND: The Bai people in Yunlong County, northwest Yunnan, China, have used medicinal plants and traditional remedies for ethnoveterinary practices. The Bai have mastered ethnoveterinary therapeutic methods in livestock breeding since ancient times. The Bai's traditional ethnoveterinary knowledge is now facing extinction, and their unique ethnoveterinary practices have rarely been recorded. This study documented animal diseases, EMPs, and related traditional knowledge in Yunlong County, China. METHODS: Ethnobotanical fieldwork was conducted in six villages and townships of Yunlong County between 2021 and 2022. Data were obtained through semi-structured interviews, participatory observations, and keyperson interviews. A total of 68 informants were interviewed, and the informant consensus factor and use reports (URs) were used to evaluate the current ethnoveterinary practices among the local communities. Information on livestock diseases, medicinal plants, and traditional ethnoveterinary medicine knowledge were also obtained. RESULTS: A total of 90 plant species belong to 51 families, 84 genera were recorded as being used as EMPs by the Bai people, and Asteraceae plants are most frequently used. A total of 68 informants were interviewed, including 58 men (85.3%) and 10 women (14.7%). The most commonly used EMPs parts included the roots, whole plants, leaves, and stems, and the common livestock diseases identified in this field investigation included trauma and fracture, gastrointestinal disorders, respiratory disorders, parasitic diseases, miscellaneous, venomous snake bites, reproductive diseases, infectious diseases, skin disease, and urinary diseases. Most of the EMPs are herbs (77.78%). Courtyard is one of the habitats of medicinal plants in Yunlong County. CONCLUSION: Traditional knowledge of ethnoveterinary medicine is related to the local sociocultural characteristics of the Bai. Plants are used in cultural traditions, which, in turn, nourish the plant culture. Cultural diversity and biodiversity are interdependent. This traditional knowledge is at risk of disappearance because of the increasing extension of Western veterinary medicine, lifestyle changes, and mainstream cultural influences. Therefore, it is important to continue research on ethnoveterinary practices.

Preliminary exploration of herbal tea products based on traditional knowledge and hypotheses concerning herbal tea selection: a case study in Southwest Guizhou, China.

BACKGROUND: Herbal tea usually refers to "beverage plants that do not belong to the genus Camellia", and it holds a significant historical legacy as a traditional beverage among specific regions and ethnic groups. In light of this, our research aims to investigate and analyze the traditional knowledge pertaining to herbal tea plants used by local people in the Qianxinan Buyi and Miao Autonomous Prefecture, Guizhou Province. We also initiated preliminary efforts to create tea products from herbal tea leaves using various processing techniques. Additionally, we attempted to test hypotheses to elucidate how local people select herbal tea plants. METHODS: Data related to the use of herbal tea plants in this study were collected through semi-structured interviews and participatory observations in four villages in Qianxinan. Quantitative indicators, including the relative frequency of citation (RFC) and the relative importance (RI) value, were calculated, and the availability of plants was also evaluated. General linear model was performed to examine the relationship between the frequency of citation and resource availability, as well as the correlation between the relative frequency of citation and the relative importance, to test both the resource availability hypothesis and the versatility hypothesis. Centella asiatica tea was processed using techniques from green tea, black tea and white tea, with a preliminary sensory evaluation conducted. RESULTS: A total of 114 plant species were documented as being used for herbal teas by local residents, representing 60 families and 104 genera. Of these, 61% of herbal tea plants were found growing in the wild, and 11 species were exotic plants. The family with the highest number of species was Asteraceae (20 species). The study identified 33 major medicinal functions of herbal tea, with clearing heat-toxin and diuresis being the most common functions. General linear model revealed a strong correlation (correlation coefficient of 0.72, p < 0.001) between the frequency of citation and plant availability, as well as a significant correlation (correlation coefficient of 0.63, p < 0.001) between RFC and RI. Under different processing conditions, the characteristics of Centella asiatica tea exhibited variations and were found to be suitable for consumption. CONCLUSION: The consumption of herbal tea serves as a preventive measure against common ailments for local residents. The resource availability hypothesis, diversification hypothesis and the versatility hypothesis were shown to provide some insight into "how and why local communities select plants for use." Exotic herbal tea plants in the study area also possess valuable therapeutic properties. The processing and production of Centella asiatica herbal tea products hold promising prospects.

Ethnobotanical study on medicinal plants in Melit area (North Darfur), Western Sudan.

BACKGROUND: The documentation of ethnobotanical knowledge in Sudan is restricted to specific regions, and there is a far-reaching lack of written information on the traditional use of medicinal plants in other places like Darfur State, in western Sudan. The present study was designed to document the medicinal plants used in traditional medicine of Melit area in North Darfur State. METHOD: Ethnomedicinal information was collected from 135 local informants through semi-structured questionnaires. Data were analysed for use value (UV), informant consensus factor (ICF) and fidelity level. RESULTS: A total of 59 medicinal plants, belonging to 32 families and 55 genera, were recorded for their traditional uses in Melit area. Fabaceae were represented by highest number of species (13) followed by Asteraceae and Malvaceae (4 each) and Poaceae (3). Herbs comprise the main sources (50.8%) of traditional remedies. Fruits and stem bark (17.9% each) were the major plant parts used. Decoction (36.5%) is the most mode of preparation used. Geigeria alata was most commonly used species with UV of 2.37. The highest ICF values were recorded for swellings (ICF = 1.00) and respiratory system (ICF = 0.95) categories. Ten plants, namely Carica papaya, Corchorus trilocularis, Eragrostis cilianensis, Heliotropium sudanicum, Mollugo cerviana, Psiadia punctulate, Rhynchosia minima, Solanum coagulans, Solanum forskalii and Tephrosia purpurea, were cited for the first time as medicinal plants used in Sudan traditional medicine. Resins of Boswellia papyrifera, seeds of Nigella sativa, pods of Vachellia nilotica (syn. Acacia nilotica) and clove of Syzygium aromticum were used to make different preparations for the treatment of the corona virus. CONCLUSION: This is the first ethnobotanical survey conducted in this region which is always suffering from security issues, and results indicated that Melit area harbours high diversity of plants used traditionally to cure different health conditions. The present study aids in conserving such rich heritage, and it is recommended that the newly reported species worth further studying over their phytochemical and biological properties.

Effects and core patterns of Chinese herbal medicines on hematologic manifestations in systemic lupus erythematosus: A systematic review and meta-analysis.

OBJECTIVE: This systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to evaluate the effects of Chinese herbal medicines (CHMs) on hematologic manifestations in patients with systemic lupus erythematosus (SLE). DATA SOURCES: PubMed, Embase, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, and Airiti Library were searched for the period January 2000 to February 2022. STUDY SELECTION: RCTs involving CHMs in patients with SLE with available hematologic data. DATA EXTRACTION: The primary outcomes included white blood cell (WBC) count, hemoglobin level, and platelet count. The Cochrane risk of bias tool was used to assess the quality of the included RCTs. Sensitivity analysis of RCTs with abnormal hematologic data before intervention was performed to verify the robustness of the results. Subgroup analysis was also applied for results with high heterogenicity. Core patterns of used herbal drug pairs had also been analyzed and visualized. DATA SYNTHESIS: Fifteen RCTs involving 1183 participants were included. The effects of elevating WBC count (weighted mean difference [WMD]: 0.69; 95% confidence interval [CI]: 0.33-1.06; p <0.001), hemoglobin levels (WMD: 0.64; 95% CI: 0.31-0.97; p <0.001), and platelet count (WMD: 0.61; 95% CI: 0.48-0.74; p <0.001) in the CHM group were significantly greater than those in the control group. In total, 23 single herbs and 152 herbal drug pairs were identified for core patterns network analysis. CONCLUSIONS: We demonstrated significantly superior therapeutic effects achieved with CHMs and conventional therapy regarding leukopenia, anemia, and thrombocytopenia compared to that of conventional therapy alone in patients with SLE.

Cranberries for preventing urinary tract infections.

BACKGROUND: Cranberries contain proanthocyanidins (PACs), which inhibit the adherence of p-fimbriated Escherichia coli to the urothelial cells lining the bladder. Cranberry products have been used widely for several decades to prevent urinary tract infections (UTIs). This is the fifth update of a review first published in 1998 and updated in 2003, 2004, 2008, and 2012. OBJECTIVES: To assess the effectiveness of cranberry products in preventing UTIs in susceptible populations. SEARCH METHODS: We searched the Cochrane Kidney and Transplant Specialised Register up to 13 March 2023 through contact with the Information Specialist using search terms relevant to this review. Studies in the Register are identified through searches of CENTRAL, MEDLINE, and EMBASE, conference proceedings, the International Clinical Trials Registry Platform (ICTRP) Search Portal and ClinicalTrials.gov. SELECTION CRITERIA: All randomised controlled trials (RCTs) or quasi-RCTs of cranberry products compared with placebo, no specific treatment or other intervention (antibiotics, probiotics) for the prevention of UTIs were included. DATA COLLECTION AND ANALYSIS: At least two authors independently assessed and extracted data. Information was collected on methods, participants, interventions and outcomes (incidence of symptomatic UTIs, positive culture results, side effects, adherence to therapy). Risk ratios (RR) with 95% confidence intervals (CI) were calculated where appropriate. Study quality was assessed using the Cochrane risk of bias assessment tool. Confidence in the evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. MAIN RESULTS: For this update, 26 new studies were added, bringing the total number of included studies to 50 (8857 randomised participants). The risk of bias for sequence generation and allocation concealment was low for 29 and 28 studies, respectively. Thirty-six studies were at low risk of performance bias, and 23 studies were at low risk of detection bias. Twenty-seven, 41, and 17 studies were at low risk of attrition bias, reporting bias and other bias, respectively. Forty-five studies compared cranberry products with placebo, water or no specific treatment in six different groups of participants. Twenty-six of these 45 studies could be meta-analysed for the outcome of symptomatic, culture-verified UTIs. In moderate certainty evidence, cranberry products reduced the risk of UTIs (6211 participants: RR 0.70, 95% CI 0.58 to 0.84; I² = 69%). When studies were divided into groups according to the treatment indication, cranberry products probably reduced the risk of symptomatic, culture-verified UTIs in women with recurrent UTIs (8 studies, 1555 participants: RR 0.74, 95% CI 0.55 to 0.99; I² = 54%), in children (5 studies, 504 participants: RR 0.46, 95% CI 0.32 to 0.68; I² = 21%) and in people with a susceptibility to UTIs due to an intervention (6 studies, 1434 participants: RR 0.47, 95% CI 0.37 to 0.61; I² = 0%). However, there may be little or no benefit in elderly institutionalised men and women (3 studies, 1489 participants: RR 0.93, 95% CI 0.67 to 1.30; I² = 9%; moderate certainty evidence), pregnant women (3 studies, 765 participants: RR 1.06, 95% CI 0.75 to 1.50; I² = 3%; moderate certainty evidence), or adults with neuromuscular bladder dysfunction with incomplete bladder emptying (3 studies, 464 participants: RR 0.97, 95% CI 0.78 to 1.19; I² = 0%; low certainty evidence). Other comparisons were cranberry products with probiotics (three studies) or antibiotics (six studies), cranberry tablets with cranberry liquid (one study), and different doses of PACs (two studies). Compared to antibiotics, cranberry products may make little or no difference to the risk of symptomatic, culture-verified UTIs (2 studies, 385 participants: RR 1.03, 95% CI 0.80 to 1.33; I² = 0%) or the risk of clinical symptoms without culture (2 studies, 336 participants: RR 1.30, 95% CI 0.79 to 2.14; I² = 68%). Compared to probiotics, cranberry products may reduce the risk of symptomatic, culture-verified UTIs (3 studies, 215 participants: RR 0.39, 95% CI 0.27 to 0.56; I = 0%). It is unclear whether efficacy differs between cranberry juice and tablets or between different doses of PACs, as the certainty of the evidence was very low. The number of participants with gastrointestinal side effects probably does not differ between those taking cranberry products and those receiving a placebo or no specific treatment (10 studies, 2166 participants: RR 1.33, 95% CI 1.00 to 1.77; I² = 0%; moderate certainty evidence). There was no clear relationship between compliance with therapy and the risk for repeat UTIs. No difference in the risk for UTIs could be demonstrated between low, moderate and high doses of PACs. AUTHORS' CONCLUSIONS: This update adds a further 26 studies, taking the total number of studies to 50 with 8857 participants. These data support the use of cranberry products to reduce the risk of symptomatic, culture-verified UTIs in women with recurrent UTIs, in children, and in people susceptible to UTIs following interventions. The evidence currently available does not support its use in the elderly, patients with bladder emptying problems, or pregnant women.

An ethno-botanical study of medicinal plants used for the management of respiratory tract disorders in northern parts of Palestine.

BACKGROUND: The medicinal application of natural plant remedies is well established. These medicinal plants are still in use within the Palestinian community to treat several illnesses. This research is intended to study the use of natural plants to treat different types of respiratory tract disorders. METHOD: This ethno botanical study focused on the medicinal plants that are used to treat respiratory diseases in the northern part of Palestine; Nablus, Tulkarm, Qalqilia, and Jenin. A questionnaire was distributed to 120 respondents. The data obtained included names of the plants used, the parts used, the diseases for which the products were applied, as well as the method of preparation. To evaluate results, percentages (%), Fic (factor of informant consensus), and FL (fidelity-level) were calculated. RESULTS: A total of 120 participants were selected for the final analysis. The highest percentage of herbal use was reported for flu 85.8% (103 participants) followed by cough 83.3%, while the lowest percentage of users was for bronchitis with 54.1%. The study showed that 31 plant species of 19 families were used for respiratory disorders treatment. Six species were from the Lamiaceae family, three species from the Apiaceae family, two species from Amaryllidaceae, Fabaceae, Myrtaceae, Rutaceae and Zingiberaceae, and one plant species for each of the rest of families. Leaves and fruits were the most commonly used parts of plants. Decoction was the method of preparation and was taken as a hot drink. Chamomile, mint, sage, lemon, and ginger were in the recipes for the five respiratory diseases. CONCLUSION: In Palestine, patients with respiratory diseases rely heavily on the use of herbal remedies. Leaves and fruits were the most commonly used plat elements. Age and marriage were significantly associated with the use of botanical remedies. Whereas there was no significant association between the source of information about medicinal plants and the location where medicinal plants were purchased. It is vital to conduct comprehensive clinical investigations and pharmacological assessments of these herbal remedies, in order to identify their efficacy, safety, and toxicity levels.

Medicinal plants of the upper Aswa River catchment of northern Uganda - a cultural crossroads.

BACKGROUND: This paper presents a comparative inventory of medicinal plant taxa and their uses by smallholder farming communities of four cultures in the Aswa River catchment of northern Uganda, situated in the eastern Sudanian savanna parkland ecotype of sub-Saharan Africa. The purpose of the study was to document the ethnobotanical use of medicinal plants by the Lango, Acholi, Teso (Atesot) and Ethur (jo Abwor), in an historical moment before civil conflict and mass displacement of the respondent communities disrupted the inter-generational transmission of traditional technical knowledge within the study area. METHODS: Following community consultations in four districts of northern Uganda during 1999-2000, interviews were conducted with holders of specialist knowledge on plants used as medicine on basis of a plant specimen allocated a voucher number and identified by the national herbarium. Use reports reflecting specific medicinal applications were compiled in aggregate to obtain a Relative Importance Index ranking. The commonality of medicinal taxa cited between each cultural interface was assessed by the Jaccard Index of Similarity, and the similarity of specific medicinal usage by taxon using Rahman's Similarity Index. RESULTS: The data collected from 112 respondents comprise 280 medicinal use reports describing 263 applications for 62 medical conditions, citing 108 taxa from 44 botanical families of which Fabaceae comprised 20% of all use reports. No earlier mention could be found to corroborate 72 use reports (27% of the total), representing medicinal indications as yet undocumented, and potentially worthy of investigation. The RI values ranged between 15 and 94%, with 13 taxa having RI values above 50%. The JI ratios indicate the highest degree of similarity in the plant taxa used as medicine (21%) between the Lango and Teso cultures who share a common origin; however, Rahman's Similarity Index indicates the highest similarity of specific medicinal usage by taxon between the Lango and Acholi, who share a common language group through cultural assimilation over time. CONCLUSIONS: As a comparative study, the results imply that cultural exchange and assimilation may be a greater driver of inter-cultural similarity of ethnopharmacological use of a given taxon, as compared to shared historical origins.

Anti-cancer bioprospecting on medicinal plants from Indonesia: A review.

The Indonesian archipelago is home to the second largest biodiversity in the world and is inhabited by more than 300 ethnic groups with a total population of more than 270 million. The indigenous population still rely on traditional medicine practices, especially the use of plant-based remedies. Although modern science-based exploration on Indonesian medicinal plants started with the European settlement in the archipelago in the 16th century, it was not until the 1970's that the phytochemistry of Indonesian medicinal plants was recognized for its potency. The need for new cancer cures to increase the quality of human life has led to the bioprospecting of medicinal plants including those of Indonesian origin. Despite published reports on the anticancer potency of Indonesian medicinal plants, to date there has been no comprehensive review on this topic. In this manuscript, we review the phytochemical and pharmacological studies on medicinal plants from Indonesia related to cancer therapy. Established databases (GARUDA, SciFinder, and PubMed) were used to collate data from 1990 to 2022, resulting in the description of 134 medicinal plants and their phytochemical and pharmacological properties including examples containing potent agents against breast, leukaemia, cervix, lung, and colon cancer cell lines based on in vitro bioassays and in vivo evaluation. These findings provide valuable insights into the bioprospecting of Indonesian medicinal plant providing directions for future studies, including the development of new therapeutics, both as botanicals or by using conventional dosage.

Genus Gelsemium and its Endophytic Fungi - Comprehensive Review of their Traditional Uses, Phytochemistry, Pharmacology, and Toxicology.

BACKGROUND: The use of ethnic medicinal plants has revitalized wide popularity in Africa, Asia, and most of the world because of the energy consumption barriers increase of synthetic drugs. Gelsemium is a traditional genus of plants with famous cultural and medicinal significance in Southeast Asia and North America. Three species are reported from the genus Gelsemium, including Gelsemium elegans (Gardn. & Camp.) Benth., Gelsemium sempervirens (L.) J.St.-Hil., and Gelsemium rankinii Small. Among them, G. elegans is well known for its toxicity and is used as a traditional remedy for skin problems, neuralgia, fractures, and cancer. The first record of the toxic medicine G. elegans is the Chinese herbal medicine classically known as Shen-Nong Ben-Cao Jing. In the legend, the Shennong emperor was poisoned by G. elegans, hence, it is also wellknown as Duan Chang Cao in China. In addition, G. sempervirens tincture is also used in the treatment of inflammation of the spinalcolumn, and diminishes blood to the cerebrospinal centers. INTRODUCTION: This review aims to provide up-to-date information on Gelsemium and its endophytic fungi on their traditional uses, phytochemistry, pharmacology, and toxicology. Mechanism studies regarding the detoxification profile of Gelsemium are also reviewed. METHODS: For this updated review, the literature survey and search were performed on the scientific databases PubMed, ScienceDirect, Wiley, China CNKI, Web of Science, SciFinder, and Google Scholar using the relevant keywords. RESULTS: The plants of the genus Gelsemium are all reported as rich sources of monoterpene indole alkaloids. Previous phytochemical studies published more than 200 alkaloids from Gelsemium and its endophytic fungi, which have attracted considerable attention from pharmaceutists and phytochemists due to their diverse and complex structures. The bioactivities of Gelsemium phytoconstituents studied using various chemical methods are summarized and described herein. Considering the huge influence of Gelsemium regarding its traditional applications, the activities of isolated compounds were focused on the anti-tumor, anti-inflammatory, analgesic and antianxiety, immunostimulatory, and immunosuppressive properties, which provide evidence supporting the ethnopharmacological effectiveness of the genus Gelsemium. Unlike all previous reviews of genus Gelsemium, to the best of our knowledge, the recently reported natural products from its endophytic fungi are first time summarized in this review. CONCLUSION: It is clearly suggested from the literature information that the structures and biological activities of Gelsemium have a wide range of attraction from folk to the community of scholars. However, as a highly toxic genus, the work on the detoxification mechanism and toxicology of Gelsemium is urgently needed before entering clinical research. It is noteworthy that the discussion about the relationship between structural and biological activities are a valuable topic of expectation, while the structural modification for active or toxic components may shed light on toxicological breakthrough. Besides the compounds from the plants of genus Gelsemium, the recently reported natural products from its endophytic fungi may provide a supplement for its ethnomedicinal uses and ethnological validity.

Rheumatological patients' knowledge of, beliefs about, and practices in using phytotherapy: an exploratory study.

Phytotherapy has emerged as a new concept and has quickly and widely spread in recent years. Studies on phytopharmaceuticals in rheumatology practice are very limited. In this study, we aimed to examine the knowledge of, beliefs about, and practices of using phytotherapy in patients who use biologics due to rheumatological disease. In the first part of the questionnaire, there are 11 questions, including the demographic data of the person, and in the second part, there are 17 questions that aim to learn the level of knowledge about phytotherapy and the use of phytopharmaceuticals. The questionnaire was administered face-to-face to patients with rheumatology using biological therapy who gave consent to participate. A total of 100 patients who were followed up with biological therapy were included in the final analysis. Approximately half of participants (48%) received any phytopharmaceuticals during their biologic treatment. Camellia sinensis (green tea) and Tilia platyphyllos were the most preferred phytopharmaceuticals. Gender, age, smoking, duration of disease, and duration of biologic treatment were not found to be associated with the use of phytopharmaceuticals. Of the 100 participants, 69% had information about phytotherapy, and the primary sources of information about phytotherapy were television and social media. Rheumatological diseases cause chronic pain, multiple drug use, and a decrease in quality of life, so the search for alternative treatment methods is frequent in these patients. Studies with a high level of evidence are necessary for healthcare professionals to inform their patients about this topic.

Nanotechnology Formulations Designed with Herbal Extracts and Their Therapeutic Applications - A Review.

Because of the increasing demand for natural products, the development of nanoformulations containing natural active ingredients requires in-depth knowledge of the substances used, methods of obtaining, and stability profiles to ensure product quality, efficacy, and safety. Considering this, the bibliography of the last five years presented in databases (PubMed and Science Direct) was discussed in this work, discussing the study with medicinal plants to obtain active metabolites with therapeutic properties, as well as the different nano-systems responsible for carrying these molecules. Due to the wealth of biodiversity found in the world, many species are submitted to the extraction process for several purposes. However, identifying, classifying, and quantifying the constituents of herbal matrices are crucial steps to verify their therapeutic potential. In addition, knowing the techniques of production and elaboration of nanotechnology products allows the optimization of the incorporation of herbal extracts as an innovation target. For studies to be successful, it is necessary to exhaust experimental results that guarantee the efficacy, safety, and quality of natural nanosystems, with the objective of obtaining reliable answers in nanotechnology therapy.

The medicinal plant used in the Guangxi Fangcheng Golden Camellias national nature reserve, a coastal region in southern China.

BACKGROUNDS: Guangxi Fangcheng Golden Camellias national nature reserve, situated in Fangcheng City, Guangxi Province, China, is a coastal region renowned for its exceptional natural environment. Over time, the residents of this area have acquired extensive knowledge regarding medicinal plants, owing to their close association with the abundant flora. Our study aims to document the medicinal plants used by the local community near the Guangxi Fangcheng Golden Camellias national nature reserve. We seek to investigate the unique regional properties, cultural significance, and potential connections between medicinal plants used in surrounding villages and those sold in markets. METHODS: During 2019-2021, 96 informants, including 36 key informants, were interviewed in the study area. The snowball sampling method was used to select respondents from medicinal markets and villages. Local therapists were defaulted as key informants. A panel discussion was held on the protection and threat of medicinal plants and traditional knowledge. In this study, two quantitative indicators, relative frequency citation (RFC) and informant consensus factor (ICF), were used to analyze the traditional medicinal plants in the study area. RESULTS: According to the investigation, a total of 396 species of medicinal plants belonging to 295 genera and 116 families were recorded. From the perspective of Lifeform, herbs accounted for 38.9%, followed by shrubs. Most of the medicinal parts are whole plant (120 species, 25.59%), branches and leaves (116 species, 24.73%), and roots (101 species, 21.54%). Medicinal bath is the most commonly used therapeutic method. Among the 13 therapeutic targets recorded, rheumatic drugs accounted for the highest proportion, followed by muscular system diseases and skin-related diseases, which are closely related to local climate and livelihood. ICF shows that the use of local medicinal plants and related knowledge is very diverse, so local people have more options for treating diseases. Melicope pteleifolia, Clerodendrum cyrtophyllum, Lygodium flexuosum, Elephantopus scaber, Artemisia argyi, Plantago asiatica, Centella asiatica, Grangea maderaspatana, and Liquidambar formosana have high RFC, which are closely connected to local people's daily lives and are potentially vital to them. The wild vegetation, mostly around the nature reserve, is the primary source of medicinal materials sold in the urban medicinal market. Urban areas have fewer varieties of medicinal plants compared to villages near protected areas. However, there is consistency in their usage and application. CONCLUSION: The medicinal plants used in the villages near the Golden Camellia Nature Reserve are diverse, and the relevant traditional knowledge is relatively well preserved. The collection of medicinal materials by local people is sustainable. This study suggests that the local government should also protect relevant traditional knowledge in the decision-making process.

Concurrent use of herbal and prescribed medicine by patients in primary health care clinics, South Africa.

BACKGROUND: The use of herbal medicine (HM) as a self-management practice for treating various diseases has gained popularity worldwide. Consumers co-administer herbal products with conventional medicine without the knowledge of possible herb-drug interaction (HDI). AIM: This study aimed to assess patients' perception and use of HM and their knowledge of HDI. SETTING: Participants attending primary health care (PHC) clinics in three provinces (Gauteng, Mpumalanga and Free State), South Africa, were recruited. METHODS: Focus group discussions comprising a total of thirty (N = 30) participants were conducted using a semi-structured interview guide. Discussions were audio-recorded and then transcribed verbatim. Data were analysed using thematic content analysis. RESULTS: Reasons for using HM, sources of information on HM, co-administration of HM and prescribed medicine, disclosure of the use of HM, PHC nurses' attitudes and not having time to engage were frequently discussed. Respondents' lack of knowledge and perceptions about HDI and their dissatisfaction with prescribed medicine because of experienced side effects were also discussed. CONCLUSION: Because of the lack of discussions and non-disclosure about HM in PHC clinics, patients are at risk of experiencing HDIs. Primary health care providers should regularly enquire about HM use on every patient, to identify and prevent HDIs. The lack of knowledge about HDIs by patients further compromises the safety of HM.Contribution: The results highlighted the lack of knowledge of HDI by patients thus assisting the healthcare stakeholders in South Africa to implement measures to educate patients attending PHC clinics.

Patient' and social aspects related to complementary mistletoe therapy in patients with breast cancer: A systematic review commissioned by the German agency for Health Technology Assessment.

PURPOSE: To mitigate side effects of conventional cancer care and improve quality of life, many patients with breast cancer in German-speaking countries opt for mistletoe therapy in addition to standard treatment. To understand the value for users, we evaluated the domain "Patient and Social aspects" in a health technology assessment on complementary mistletoe therapy in patients with breast cancer. METHODS: A systematic review was conducted according to PRISMA guidelines. Fifteen electronic databases and the internet were searched. Qualitative studies were analyzed using qualitative content analysis; quantitative studies were systematically summarized in evidence tables. RESULTS: Seventeen studies out of 1203 screened publications with 4765 patients and 869 healthcare professionals were included in the review. The median proportion of patients using mistletoe therapy was 26.7% (range: 7.3-46.3%). Predictors for use were younger age and higher educational level. Main reasons for patients' use of mistletoe therapy were to leave nothing untried and to be actively involved in the treatment process. Reasons against use were related to a lack of knowledge or uncertainty regarding effectiveness and safety. Physicians mainly aimed to support the patient's physical condition as main reason for use and a lack of resources and knowledge as main reason against use. CONCLUSION: Mistletoe therapy was commonly used in the treatment of breast cancer despite a lack of scientific knowledge among patients and physicians. Transparent communication on motivation for use and its potential effect enables realistic expectations. Relatively small samples of mistletoe therapy users limit the representativeness and validity of our results.