Journal of Complementary and Integrative Medicine

Antidiarrhoeal Activity of Pterocarpus santalinoides L'H�rit ex DC Leaf Extract

Chukwuemeka S. Nworu — Wed, 24 Jun 2009 16:48:42 PDT

Diarrhoea is a leading cause of deaths in developing countries, especially in children, and contributes to one in five deaths of children all over the world. The burden and mortality due to diarrhoea diseases have encouraged the development and the patronage of herbal alternatives. In this study we investigated the methylene chloride-methanol leaf extract of Pterocarpus santalinoides (PSE), a plant believed to possess potent antidiarrhoeal properties in folk medical practice. The antidiarrhoeal and anti-enteropooling activity of PSE were investigated in castor oil induced diarrhoea in rats. The effect on gastrointestinal motility was studied by the charcoal meal transit in mice. Smooth muscle activity of the extract was investigated in isolated guinea pig ileum. P. santalinoides extract (100-500 �g/ml) caused a significant and dose-related inhibition of the frequency of diarrhoeic drops in rats (P< 0.05) and prolonged the time for diarrhoea induction. The extract also exhibited significant anti-enteropooling activity (P<0.05). The extract (500 mg/kg) inhibited propulsion of the charcoal meal through the gastrointestinal tract in mice, and this effect was comparable to that of atropine (2.5 mg/kg). In vitro, the contractile responses produce by histamine and acetylcholine were inhibited by PSE with IC50 of 59.93 and 57.01 �g/ml, respectively; but serotonin-evoked contraction was unaffected. The claimed benefits of P. santalinoides in traditional medical management of diarrhoea could be supported by the results of this investigation.

Is All Glucosamine Alike? Clarifying the Controversies for Product Selection and Clinical Research

Jamie G. Barnhill — Tue, 23 Jun 2009 12:42:18 PDT

In the United States, glucosamine is marketed as a dietary supplement therefore subject to less stringent manufacturing, labeling and marketing regulations than pharmaceuticals. The glucosamine product selected for the NIH-sponsored Glucosamine/chondroitin Arthritis Intervention Trial (GAIT) was required to satisfy Investigational New Drug (IND) application (and therefore pharmaceutical manufacturing requirements). This review describes the procedure that was developed by the authors to identify a high-quality glucosamine product for GAIT and to clarify confusing product information and nomenclature.Proprietary glucosamine products and bulk glucosamine powders of various salt forms were evaluated. Both the published literature and information provided by suppliers of bulk glucosamine powders were evaluated. No proprietary glucosamine product was selected due to manufacturing practices that did not meet the pharmaceutical standards mandated by GAIT; i.e., no practices that control and document the quality issues of product purity and content variability. At the time this study was initiated dietary supplements were not required to meet these standards. Other problems identified with proprietary products included the presence of other dietary supplements and/or trace elements and the inability of a manufacturer to provide the appropriate quality of product within the time constraints of the study. A bulk powder of glucosamine hydrochloride was identified and capsules were manufactured for the trial in compliance with pharmaceutical Good Manufacturing Practices.

A Review of Side Effects and Adverse Events of Non-Drug Medicine (Nonpharmaceutical Complementary and Alternative Medicine): Psychotherapy, Mind-Body Medicine and Clinical Holistic Medicine

S�ren Ventegodt — Tue, 12 May 2009 15:05:58 PDT

Background: Review of side effects of psychotherapy, bodywork (without high-energy manipulations), mind-body medicine, body-psychotherapy, sexology, clinical holistic medicine and complementary and alternative medicine (CAM). Method: We reviewed 857 records from a combined Medline/PubMed and PsycINFO search on “psychotherapy AND side effects" We also searched for “mind-body medicine," “bodywork," “body-psychotherapy," “clinical holistic medicine," “CAM," “sexology," “sexological examination," “physiotherapy," and specific side effects like “psychosis," “re-traumatization," “suicide," "hypomania," “depersonalisation," “derealization" and the drugs Lysergic acid diethylamide (LSD-25), “psilosybin," “mescaline," “Peyote" and MDMA (3,4-methylenedioxy-N-methamphetamine (MDMA) for searches. We looked for all case reports 1950-2009 and studies that included data on side effects and negative events. Results: Non-drug medicine did not have significant side effects (NNH (number needed to harm)> 18,000) and the only severe side effect was rare, brief reactive psychosis, a temporary illness with full recovery (NNH >65,000). Non-drug therapy did not significantly cause re-traumatization, implanted memories, or induction of suicide (NNH>100,000). The most intensive psychotherapy enhanced with psychotropic (hallucinogenic) drugs had serious, but rare side effects and only for the mentally ill, psychiatric patients: brief reactive psychosis (NNH=556), suicide attempts (NNH=833), and suicide (NNH=2,500). Conclusions: Non-drug (non-pharmaceutical) medicine seems to be safe even for seriously physically and mentally ill patients and, whenever efficient, therefore recommended as treatment of choice.

Using the Biopsychosocial Model to Understand the Health Benefits of Yoga

Subhadra Evans — Tue, 28 Apr 2009 18:58:43 PDT

Yoga is widely practiced as a means to promote physical, psychological and spiritual well-being. While a number of studies have documented the efficacy of yoga for functioning in healthy individuals and those experiencing illness or pain, biopsychosocial effects have not been detailed. We propose an analogue between the physical, psychological and spiritual effects of practice as espoused in yoga traditions, and the biopsychosocial model of health. To this end, we present a review and conceptual model of the potential biopsychosocial benefits of yoga, which may provide clues regarding the possible mechanisms of action of yoga upon well-being. Physical systems activated through yoga practice include musculoskeletal, cardiopulmonary, autonomic nervous system and endocrine functioning. Psychological benefits include enhanced coping, self-efficacy and positive mood. Spiritual mechanisms that can be understood within a Western medical model include acceptance and mindful awareness. We present empirical evidence that supports the involvement of these domains. However, additional well-conducted research is required to further establish the efficacy of yoga for health states, and to understand how posture, breath and meditative activity affect the body, mind and spirit.

The Effect of Tai Chi in Reducing Anxiety in an Ambulatory Population

Kimberly A. Hoffmann-Smith — Tue, 28 Apr 2009 18:53:20 PDT

Tai Chi is an ancient Chinese art that has been practiced for centuries. This mind-body exercise is a standard of medical care in many Asian countries. The Western world lags behind in the study of alternative medical treatments. This pilot study utilized Tai Chi to relieve anxiety in a population diagnosed with moderate-severe anxiety. This diagnosis was made by clinicians utilizing the well-respected Hamilton-Anxiety psychiatric rating scale. This non-pharmacologic method for reduction of anxiety was chosen because medications presently utilized for anxiety often cause untoward side effects. Subjects were recruited throughout the community. Patients completed a health questionnaire and were screened by a psychiatrist before and after participating in a 10-week program of Tai Chi classes lasting one hour twice weekly. The results of this study showed marked improvement in anxiety. The median beginning score for all participants on the Ham-A scale was 23 points. The median ending score after Tai Chi instruction was 12 points. The median overall difference in scores was 11 points. This pilot study demonstrated phenomenal reductions in the symptoms of anxiety. Patients also reported feeling more relaxed and peaceful. It is apparent that Tai Chi may be a clinically effective tool for reducing anxiety.

Methodological Issues Pertaining to the Evaluation of the Effectiveness of Energy-Based Therapies, Avenues for a Methodological Guide

Eric Forgues — Tue, 28 Apr 2009 18:49:55 PDT

The current interest in Complementary and Alternative Medicine (CAM) begs the question of their integration into the health care system, which will most likely require rigorous scientific evaluation in randomized controlled trials (RCT) before they are fully accepted and integrated. Although some meta-analyses demonstrate the potential of certain energy-based (EB) CAM therapies others highlight significant methodological weaknesses in the study design. It is not only important to verify the effectiveness of energy-based therapies (EBT), but also to do it with methods that are appropriate to the evaluation of this type of therapy. In fact, there are those who question the applicability of traditional research models to the evaluation of CAM therapies. It is with this in mind that we wish to suggest certain parameters that should be taken into account when planning a research for the evaluation of CAM therapies and meta-analyses.

In Vitro Evaluation of Antioxidant and Free Radical Scavenging Activities of Rhodiola imbricata

Vanita Gupta — Tue, 28 Apr 2009 16:35:49 PDT

The present study was undertaken to evaluate the in vitro antioxidant activities of aqueous extract of Rhodiola imbricata rhizome. The plant extract was evaluated for DPPH (1,1-diphenyl, 2-picryl hydrazyl) radical scavenging, superoxide anion radical scavenging, hydrogen peroxide scavenging, anti-lipid peroxidation assay, metal chelating activity, reducing power and total flavonoid content. Rhodiola imbricata aqueous extract (RIAE) exhibited more DPPH scavenging potential with IC50 value of 5.56 �g/ml as compared to standard butylated hydroxytoluene (BHT) (IC50 = 5.74 �g/ml). The extract also provided superoxide anion radicals' scavenging (IC50 = 4.68 vs 4.63 �g/ml) and anti-lipid per-oxidation activity (IC50 = 5.06 vs 4.91 �g/ml) and IC50 value was comparable to standard α-tocopherol. The RIAE showed a decrease in hydrogen peroxide generation with IC50 value of 3.25 �g/ml when compared with standard α-tocopherol (IC50 value=4.00 �g/ml). IC50 of the extract for chelating activity was 5.33 μg/ml which was lower than the positive standard quercetin (IC50 = 3.12 μg/ml) but higher than α-tocopherol (IC50 = 6.13 μg/ml). The reducing capability of extract increased in dose dependent manner. Flavonoid content of RIAE determined spectrophotometrically in terms of Quercetin equivalent was 66.7�g/mg. The results obtained in the present study indicated that aqueous extract of root of Rhodiola imbricata is a potent source of natural antioxidant.

Biphasic Modulation of Neutrophil Migration by Aqueous Extracts of Uncaria tomentosa in Murine Lung

Noelia Roque — Fri, 24 Apr 2009 09:47:43 PDT

In the history of medicine, the treatment of disease has been influenced by an intimate contact with nature. A mice model of lipopolysaccharide (LPS)-induced acute lung injury was used to evaluate the protective effects of long-term water-soluble administration ad libitum of Uncaria tomentosa extracts (20 gr/L; UTE) in lung inflammation. Swiss mice had LPS (1,67�g/ml) instilled intranasally 3hs before sacrificed, and were then pre-treated with UTE for 7, 15, 30 or 90 days or with a single dose of dexamethasone (2,5 mg/kg, DX). Inflammatory cell concentration was measured in the bronchoalveolar fluid (BALF) and histology was performed. No acute or chronic toxicity signs were observed in the clinical status. In addition, body weight, food consumption, organ weight, kidney, liver, and lung pathology were not found to be affected by the UTE treatments. UTE or DX significantly reduced the lung edema, exudation and lung injury histology for 7 and 90 day treatments. In addition, pre-treatment with UTE revealed a biphasic attenuated recruitment in BALF from neutrophils at 7 and 90 days induced by endotoxin exposure compared to the control (p<0.05). These data suggest that UTE initially induces a nonspecific response that is transient protection from PMNs migration into the lung mice.

Ameliorative Role of Vitamin E on Adverse Impact of Azadirachta indica in Reproductive Indices of Male Rats

Yinusa Raji — Thu, 16 Apr 2009 20:21:12 PDT

This study was undertaken to determine the role of vitamin E on reproductive activity of Azadirachta indica extract in rats. Forty adult male albino rats were divided into 5 equal groups. The control group received distilled water while the other groups were treated with Azadirachta indica (150mg/kg bwt) extract alone, vitamin E (100mg/kg bwt) alone, combined Azadirachta indica (150mg/kg bwt) and vitamin E (100mg/kg bwt), and combined Azadirachta indica (150 mg/kg bwt) and vitamin E (150 mg/kg bwt). Group administered Azadirachta indica alone showed significant (p<0.05) decrease in sperm count, viability and motility. Co-administration of A. indica with vitamin E caused an increase in values of these parameters. Serum testosterone concentration decreased significantly (p<0.05) in A. indica only treated group with concomitant increase in groups co-administered with vitamin E. Lipid peroxidation showed significant decrease (p<0.05) in all treated groups with group co-administered with vitamin E showing enhanced modulatory effect than group administered with Azadirachta indica extract alone. Superoxide dismutase (SOD) activity was also significantly (p<0.05) enhanced in all treated groups; the groups treated with vitamin E showed higher activity. The results suggest possible ameliorative effect of vitamin E on adverse impact of Azadirachta indica in reproductive activity of male rats.

Antibacterial Activity and Anticorrosive Efficiency of Aqueous Methanolic Extract of Artemisia pallens (Asteraceae) and Its Major Constituent

Adirajan Elango — Mon, 13 Apr 2009 16:49:39 PDT

An aqueous-methanolic [methanol:water (1:1)] extract of the whole plant of Artemisia pallens (Family: Asteraceae) has shown good antibacterial activity against Pseudomonas aeruginosa and Shigella flexneri at the concentration of 100 mg/mL. The activity-guided fractionation has led to isolation of compound 4-hydroxyphenyl-β-D-glucopyranoside (which is known as arbutin), as a major constituent and exhibited the same antibacterial activity at a concentration of 17 mg/mL. Both the crude extract and arbutin also showed 94% anticorrosive efficiency against mild steel in 1M HCl at concentration of 200 mg/L.