Determination of the heavy metal contents of frequently used herbal products in Pakistan

Purpose: To determine the heavy metal content of selected local and international herbal medicines sold for the treatment of various diseases in Pakistan. Methods: The different dosage forms of herbal medicines assessed were crude forms of syrups, gel, capsule, powder and tonic. Wet digestion method was used to prepare the herbal samples using nitric acid, and then analyzed for arsenic (As), cadmium (Cd), lead (Pb) and mercury (Hg), using MHS-15 mercury/hydride system and flame atomic absorption spectrometry (FAAS). Results: The investigated results displayed the Arsenic level (0.00 ppm to 0.580 ppm); Cadmium (0.001 ppm to 0.006 ppm); Lead (0.00 ppm to 1.078 ppm) and Mercury (0.001 ppm to 0.012 ppm). All results were found below the permissible limit of acceptability intake of the World Health Organization (WHO) and American Herbal Products Association (AHPA). The pH of the samples were in the range of 1.52 to 6.99. Conclusion: The findings reveal that the investigated herbal products available in Pakistan are safe with reference to heavy metals, and considered non-toxic for human consumption.

Application Potential of Plant-Derived Medicines in Prevention and Treatment of Platinum-Induced Peripheral Neurotoxicity

As observed with other chemotherapeutic agents, the clinical application of platinum agents is a double-edged sword. Platinum-induced peripheral neuropathy (PIPN) is a common adverse event that negatively affects clinical outcomes and patients’ quality of life. Considering the unavailability of effective established agents for preventing or treating PIPN and the increasing population of cancer survivors, the identification and development of novel, effective interventions are the need of the hour. Plant-derived medicines, recognized as ideal agents, can not only help improve PIPN without affecting chemotherapy efficacy, but may also produce synergy. In this review, we present a brief summary of the mechanisms of platinum agents and PIPN and then focus on exploring the preventive or curative effects and underlying mechanisms of plant-derived medicines, which have been evaluated under platinum-induced neurotoxicity conditions. We identified 11 plant extracts as well as 17 plant secondary metabolites, and four polyherbal preparations. Their effects against PIPN are focused on oxidative stress and mitochondrial dysfunction, glial activation and inflammation response, and ion channel dysfunction. Also, ten clinical trials have assessed the effect of herbal products in patients with PIPN. The understanding of the molecular mechanism is still limited, the quality of clinical trials need to be further improved, and in terms of their efficacy, safety, and cost effectiveness studies have not provided sufficient evidence to establish a standard practice. But plant-derived medicines have been found to be invaluable sources for the development of natural agents with beneficial effects in the prevention and treatment of PIPN.

Herbal Medicines—Are They Effective and Safe during Pregnancy?

Since the teratogenicity of Thalidomide has been proven, herbal products are more commonly used in pregnancy to not only relieve morning sickness but also to fight infections. These products are frequently considered as natural and therefore harmless. However, herbs contain a number of active substances that, when used during pregnancy, can affect the development of the fetus. Often, pregnant women do not consult the usage of herbal medicines with a physician. The access to these products is easy and treatment of certain ailments with the use of herbs is common in many countries. The aim of the present literature review was to discuss available data regarding the efficacy and safety of cranberry, chamomile, Echinacea purpurea, garlic, ginger, Ginkgo biloba, and peppermint, which are used to counteract the most common ailments during pregnancy, i.e., infections and pregnancy-related ailments (e.g., nausea and vomiting, dizziness, and headache). Analysis of available data showed that ginger is one of the most extensively analyzed herbal remedies. The dose of ginger below 1000 mg per day may help to relief hypereremesis gravidarum, and such an amount of ginger did not increase frequency of adverse effects for either woman or developing fetus. Data regarding other herbs are most often heterogeneous and give conflicting results with no clear conclusions. However, all herbal products should be used with a special caution in pregnancy. Further high-quality human studies should be determined to confirm the safe doses of herbal products which could be used by pregnant or breast-feeding women.

Herbal Medicine for the Treatmentof Viral Infections: A Systemic Review

The term “Antiviral agents” has been defined in very wide terms as substances other than a virus or virus containing vaccine or specific antibody which can build either a protective or therapeutic effect to the direct measurable advantage of the virus infected host. Viruses are simple in form which are very tiny germs. They comprise of genetic material inside of a protein coating. Viruses cause amicable infectious diseases like common cold, flu and warts. They also cause severe diseases such as HIV/AIDS, Ebola, avian influenzas, dengue virus and COVID-19. Viral diseases are very complex and are easily spread. Herbs and herbal medicines were the foremost in treating infections from centuries over the world in every civilization. Modern science has narrowed the importance of herbal medicine in the past two centuries. But, the side effects and new varieties of diseases creating challenges to modern science. So, usage of herbal medicines is again attaining interests these days. Herbal products for different treatments have achieved a lot of popularity in the last couple of decades. Thus, discovering novel antiviral drugs is of extremely important and natural products are an excellent source for such discoveries. There are many herbs which are excellent sources for the antiviral properties to treat viral infections. This review provides the verified data on the herbal substances with antiviral activity, and some of the herbal marketed antiviral agents like CORONIL TABLETS from Patanjali and different companies had made an attempt to treat viral infections in this pandemic situation. Therefore, herbal plants proved to be a major resort for the treatment of diseases and sickness by traditional healers in many societies.

Use of Complementary and Alternative Medicine Among Patients With Epilepsy and Diabetes Mellitus, Focusing on the Outcome of Treatment

Introduction: Millions all over the world live with epilepsy, and they may require long-term drug treatment. The use and interest in complementary and alternative medicine (CAM) have grown over the previous years. Coadministration of herbal products with medicines may result in adverse drug reactions (ADRs) and/or unfavorable interactions. The aims of this study were to determine the prevalence of CAM use among patients with epilepsy, to compare the results to those of the patients with diabetes mellitus (DM), to reveal factors that may drive the use of CAM, and to measure outcomes and adherence. It was also our intent to have state-of-the-art information on CAM use in our region among patients with the two diseases above.Materials and Methods: We conducted a non-interventional study using a self-developed questionnaire. It was distributed among adult patients with either epilepsy or DM who also suffered from cardiovascular consequences. A database was compiled from the anonymous questionnaires filled in voluntarily by the patients. Basic statistics were used to analyze this database.Results: A total of 227 questionnaires were filled in by 127 patients (55.9%) with epilepsy and 100 patients (44.1%) with DM. Mean age was 54.54 ± 17.33 years. Of the patients, 50.2% were male. Average body weight was 80.3 ± 17.3 kg. Of the patients, 22 (9.7%) used CAM because they believed in CAM. Two of them reported ADRs. Among the patients with epilepsy, the ratio was only 7.9% compared to 12% among those with DM. While the number of CAM users was higher among younger patients with epilepsy, it was the elderly patients with DM who tended to use CAM.Conclusion: Attention should be paid to reliance on CAM during the follow-up. Our finding that health-conscious patients tend to use CAM more often (than the general population) may indicate it is necessary to discuss CAM usage sincerely. CAMs modulating cytochrome P450 (CYP) enzymes were the most common, leading to interactions with medication used and resulting in ADRs. This shows the importance of educating patients and treating team including clinical pharmacists in this field.

Discrimination of Adulterated Ginkgo Biloba Products Based on 2T2D Correlation Spectroscopy in UV-Vis Range

Ginkgo biloba is a popular medicinal plant widely used in numerous herbal products, including food supplements. Due to its popularity and growing economic value, G. biloba leaf extract has become the target of economically motivated adulterations. There are many reports about the poor quality of ginkgo products and their adulteration, mainly by adding flavonols, flavonol glycosides, or extracts from other plants. In this work, we developed an approach using two-trace two-dimensional correlation spectroscopy (2T2D COS) in UV-Vis range combined with multilinear principal component analysis (MPCA) to detect potential adulteration of twenty G. biloba food supplements. UV-Vis spectral data are obtained for 80% methanol and aqueous extracts in the range of 245–410 nm. Three series of two-dimensional correlation spectra were interpreted by visual inspection and using MPCA. The proposed relatively quick and straightforward approach successfully differentiated supplements adulterated with rutin or those lacking ginkgo leaf extract. Supporting information about adulteration was obtained from the difference between the DPPH radical scavenging capacity of both extracts and from chromatographic (HPLC-DAD) fingerprints of methanolic samples.

Formulation of Polyherbal Carbonated Beverage Based on Halalan Thoyyiban Principle

Herbal products usually have less palatability on their taste even though they are healthy and nutritious. Thus, this study aims to formulate polyherbal carbonated beverages, followed by the evaluation of sensory, physicochemical properties and their compliances with the halalan thoyyiban principle. Five formulations were prepared by varying the amount of water and polyherbal extracts that were designated using Design Expert 6.0.4 software. The most accepted formulation was formulation 1 (F1), containing 12.50% polyherbal extract and 87.50% water. F1 was characterised for its physicochemical properties, including carbon dioxide volume, pH, and total acidity, with 3.0 g/L, 4.5, and 1.7 %, respectively, and these findings have complied with the halalan thoyyiban principle. The antioxidant properties were evaluated by using 2,2-diphenyl-1-picrylhydrazyl (DPPH), ferric reducing antioxidant potential (FRAP), as well as total phenolic content (TPC), and it exhibited 1.25 mg GAE/mL,1.08 mM Fe (II) and 0.39 mg GAE/mL respectively. Eight Halal Control Point (HCP) were identified along with the production. Moreover, the beverage was found to have antioxidant properties and nutritional content (carbohydrate (0.3%) and energy content (2.0 kcal/100g)), which can give health benefits to the consumer and proven safe for consumption (LC50 =1066.60 μg/ mL). To conclude, the formulated polyherbal carbonated beverage is accepted by the consumer and complies with the halalan thoyyiban principle.

Nutraceuticals for Prevention of Chemotherapy-Induced Peripheral Neuropathy

A wide range of neurologic complications, including central neurotoxicity conditions and peripheral neurotoxicity, are associated with antineoplastic drug regimens. Chemotherapy-induced peripheral neuropathy (CIPN) is one of the most common and severe cancer treatment-related adverse effect, as well as the most diffuse type of neurotoxicity, because about one third of all patients who undergo chemotherapy may experience this side effect. CIPN can negatively impact the long-term quality of life of cancer survivors, and can lead to dose reduction of the chemotherapy agent, or possible cessation of treatment. Unfortunately, although several agents and protocols have been proposed, no prophylactic strategies have proven useful yet. Therefore, new alternative therapies have been considered for CIPN prevention. In this chapter, the authors analyze the potential applications of nutrients, dietary supplements and herbal products, such as single herbs, the Kampo medicine goshajinkigan and other herbal combinations, for CIPN prevention.

Herbal Products for Management of COVID- 19

COVID-19 is a human-infectious virus. The respiratory system is the primary target of the coronavirus, but it can also harm cardiac tissues and gastrointestinal organs. Many frequent circumstances, such as the medication's or medicine's purpose, the dosage/potency of the drug, and the patient's condition, can place patients in grave danger. Several cures have been reported using a variety of therapy methods. Among the various treatments, natural and synthetic medicines are the most commonly documented. Some herbal medicines, such as Tribulusterrestris, Withaniasomnifera, Curcuma longa, Ocimum sanctum, and Phyllanthusemblica, have powerful antiviral (AntiCOV-19) properties against novel coronavirus, heralding the start of a new era in herbal therapy.