scholarly journals Antidoping Concept of Play Clean to Win Clean: Implication of Herbal Supplements uses for Athletes in Competitive Sports

2021 ◽  
pp. 39-58
Author(s):  
John Dobgima Fonmboh ◽  
Estella Achick Tembe Fokunang ◽  
Ngono Mballa Rose ◽  
Tama Wango ◽  
Richard Abah Ejoh ◽  
...  
Keyword(s):  
Critical Issue ◽  
Competitive Sports ◽  
Herbal Supplement ◽  
Herbal Supplements ◽  
Herbal Products ◽  
Middle Income ◽  
As Doping ◽  
Supplement Use ◽  
Resource Limited ◽  
Low Middle Income Countries

The popularity of doping in competitive sports is relevant for all those involved in sports, particularly for evaluating anti-doping policy measures. However, there is a gap of information that addresses this subject so far. As a consequence, the prevalence of doping in competitive sports in resource limited countries is unknown. Even though it is challenging to uncover the exact prevalence of herbal products with prohibited activity such as doping, various methods put in place by world antidoping agency (WADA) have now been adopted to uncover parts of this particular problem, and enables the circumvention to some extend the issues of honesty, definition problems and the limits of pharmacological evidence. It is evident that current doping control test results can show a distinct underestimation of true doping prevalence in low middle income countries (LMIC). Nowadays, doping is a critical issue at international levels of sporting competitions. Athletes’ use of herbal supplements has seen a significant increase in the past two decades. At the top of the list of popular herbs used in sports are echinacea and ginseng, whereas garlic, St. John’s wort, soybean, ephedra and others are also gaining popularity or have been historically prevalent. Despite the increasing popularity of herbal supplements, recent events have illustrated possible concerns regarding efficacy and safety of herbal supplements usage. Remarkable sports performances at the end of the 20th century raised suspicions about herbal supplement use by athletes, prompting the formation of WADA. With WADA creation it was not long when the deaths of two professional athletes raised concerns that the herbal supplement ephedra, may have contributed to their deaths. These events and others have prompted clinicians and scientists to reexamine and evaluate the role of herbal supplements in competitive sports. This review attempts to give an insight into the use of herbal supplement in doping within the concept of play clean to win clean. An attempt has been made to provide guidance on the efficacy and side effect of most used herbal supplements found in sporting activities, especially in international competitive sports.

Marked Transaminase Elevations and Worsening Glycemic Control Associated With Counterfeit Polyherbal Use in a Patient With Diabetes

2009 ◽  
Vol 22 (6) ◽  
pp. 600-605 ◽  
Author(s):  
Nickole N. Henyan ◽  
Daniel M. Riche ◽  
James J. Pitcock ◽  
Dayna C. Strickland
Keyword(s):  
Weight Loss ◽  
Health Care Providers ◽  
The United States ◽  
Morbidly Obese ◽  
Care Providers ◽  
Herbal Supplement ◽  
Herbal Supplements ◽  
Herbal Products ◽  
Supplement Use ◽  
Patient Reported

Dietary and herbal supplements, a US$20.3 billion entity, are used by more than half of the adult population in the United States. Since weight loss is beneficial in obese patients at high risk for cardiovascular disease, many obese Americans are ingesting herbal weight loss supplements under the assumption that they are inherently safe. We report the case of a 55-year-old morbidly obese Caucasian female with diabetes, who started multiple polyherbal supplements. Six months after starting several herbal products, the patient’s A1C increased from 7.8% to 9.4% and the AST/ALT were markedly elevated. After discontinuation, transaminases normalized in 28 days. On follow-up visit, the patient reported compliance with prescribed medications and denied use of herbal products. The patient’s A1C approached target goal. The potential for counterfeit herbal supplement production exists. Our patient’s products were analyzed for purity, and 0% Hoodia gordonii was found. A misconception of herbal products is that they are safe because they are natural. Unfortunately, many natural products can act in the same capacity as drugs, educing both benefit and harm. Health care providers, particularly pharmacists, should be aware of counterfeit herbal supplements and closely monitor for dangers of herbal supplement use.

Surveying Physicians' Attitudes about Herbal Supplements, Resources, and Pharmacy Consultations

2005 ◽  
Vol 21 (5) ◽  
pp. 247-253 ◽  
Author(s):  
Carla J Bouwmeester
Keyword(s):  
Web Sites ◽  
Perceived Barriers ◽  
Herbal Supplement ◽  
Educational Materials ◽  
Herbal Supplements ◽  
Electronic Survey ◽  
Supplement Use ◽  
Personal Bias ◽  
Comprehensive Health ◽  
Consultation Services

Objective: To investigate whether physicians discuss herbal supplement use with their patients and document this information in the medical record, to determine the perceived barriers to discussing herbal supplement use, and to assess all resources currently available to physicians in their office setting and additional resources needed to answer questions about herbal supplements. Methods: An electronic survey was conducted of physicians enrolled in a managed care electronic network as of November 2002; data were collected from December 2002 through March 2003. Results: Of the 203 physicians who responded to the survey, 18% always discussed herbal supplements with their patients, 57% sometimes carried on these discussions, 21% rarely did, and 4% never asked. These responses correlated roughly with how often herbal supplement use was documented in the medical chart (always 27%, sometimes 51%, rarely 20%, never 2%). The strongest barriers to discussing herbal supplements were lack of resources and lack of time. The largest number of physicians used Web sites or print resources for information on herbal supplements. The most preferred resources were Web sites, computer databases, and pharmacy consultations. Conclusions: Awareness of herbal supplement use is vital for the healthcare practitioner to deliver comprehensive health services. Physicians' attitudes regarding herbal supplements are influenced by the resources available and by personal bias. Pharmacists can play a pivotal role in providing consultation services, educational materials, and screening for drug–herb interactions.

scholarly journals Prevalence and Predictors of Herbal Medicine Use Among Adults in the United States

2017 ◽  
Vol 4 (3) ◽  
pp. 108-113 ◽  
Author(s):  
Mohamed Rashrash ◽  
Jon C Schommer ◽  
Lawrence M Brown
Keyword(s):  
Herbal Medicine ◽  
Herbal Medicines ◽  
Prescription Medications ◽  
Mail Order ◽  
Herbal Supplement ◽  
Medicine Use ◽  
Herbal Supplements ◽  
Factors Associated ◽  
Supplement Use ◽  
Mail Order Pharmacy

Objective: To describe the prevalence of herbal medicine use among US adults and to assess factors associated with and predictors of herbal use. Design: The data for herbal products use were collected from the 2015 National Consumer Survey on the Medication Experience and Pharmacists’ Roles. Chi-square test was used to analyz factors associated with herbal use, and predictors of herbal use were assessed with logistic regression analysis. Results: Factors associated with herbal supplement use include age older than 70, having a higher than high school education, using prescription medications or over-the-counter (OTC) medications, and using a mail-order pharmacy.” All Disease state associated significantly with herbal use. Approximately thirty-eight percent of those who used herbals used prescription medications and 42% of those who used herbals also used an OTC medication. The most frequent conditions associated with herbal supplement use were a stroke (48.7%), cancer (43.1%), and arthritis (43.0%). Among herbal product users, factors that predicted use included having higher than school education, using OTC medications, using mail-order pharmacy, stroke, obesity, arthritis, and breathing problems. Conclusions: More than one-third of respondents reported using herbal supplements. Older age and higher education were associated with a higher use of herbal supplements. People with chronic diseases are more likely to use herbal medicines than others. OTC drug users and patients with stroke are more likely to use herbal medicines than others.

scholarly journals LINC-10. SIOP PODC ADAPTED TREATMENT GUIDELINES FOR CRANIOPHARYNGIOMA IN LOW- AND MIDDLE-INCOME SETTINGS

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii379-iii380
Author(s):  
Nisreen amayiri ◽  
Ariane Spitaels ◽  
Mohamed Zaghloul ◽  
Anthony Figaji ◽  
Sergio Cavalheiro ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Pediatric Oncology ◽  
Treatment Guidelines ◽  
Treatment Options ◽  
Care Providers ◽  
Middle Income ◽  
Service Levels ◽  
Resource Limited ◽  
Low Middle Income Countries ◽  
Available Resources

Abstract Pediatric craniopharyngioma is a rare tumor with excellent survival but significant long-term morbidities due to the loco-regional tumor growth or secondary to its treatment. Visual impairment, panhypopituitarism, hypothalamic damage and behavioral changes are amongst the main challenges. This tumor should be managed under the care of a multidisciplinary team to determine the optimum treatment within the available resources. This is particularly important for low middle-income countries (LMICs) where resources are variable. We provide a risk-stratified management guideline for children diagnosed with craniopharyngioma in a resource limited setting based on the service levels describing the facilities and personnel required for management as previously specified by the Pediatric Oncology in Developing Countries (PODC) committee of The International Society of Pediatric Oncology (SIOP). A multi-disciplinary group of neurosurgeons, radiation and pediatric oncologists, radiologists, pediatric endocrinologists and an ophthalmologist with experience in managing children with craniopharyngioma in LMIC setting was formed and carried online meetings to form a consensus guideline. The clinical characteristics (including the visual and endocrine presentations), suggestive radiological features as well as potential treatment options including surgery, radiotherapy and intra-cystic therapies were discussed in depth and in relation to available resources. In addition, hormonal management, pre- and post-operative PICU care and expected future complications related to craniopharyngioma and to follow up these children were discussed and documented in the guideline. We believe this guideline is a useful reference for health care providers in LMIC.

scholarly journals Nucleic Acid–Based Rapid Detection of Tuberculosis and Rifampicin Resistance in a Resource-Limited Setting

2021 ◽  
Author(s):  
Michael Abel Alao
Keyword(s):  
Nucleic Acid ◽  
Urban Communities ◽  
Molecular Beacon ◽  
Paediatric Population ◽  
Early Morning ◽  
Global Village ◽  
Middle Income ◽  
Resource Limited ◽  
Low Middle Income Countries ◽  
Sensitivity Specificity

Abstract BackgroundThe GeneXpert MTB/RIF assay for the diagnosis of tuberculosis (TB) and its uptake has been limited in most developing countries. This may lead to under-diagnosis, ineffective treatment and high mortality. We determine the prevalence of Mycobacterium tuberculosis (MTB) and Rifampicin-resistant TB using a nucleic acid–based test and AFB-smear in a Nigerian population.MethodsWe analyzed a single early morning sputum and extrapulmonary specimen from suspected cases of TB. Smear microscopic and real-time PCR for the detection of MTB and mutation on the rpoB gene using a molecular beacon was performed. ResultsThe median age of the participants was 40 years (range: 6 weeks to 120 years). The incidence of MTB and RR-TB determined using GeneXpert were 620 (16.6%) and 59(1.6%), respectively. Acid-fast bacilli (AFB) smear identified AFB only in 2 out of 59(3.4%) cases with RR-TB. The agreement between the paired test of GeneXpert and AFB smear was poor (Kappa = 0.009, p = 0.01; McNemar’s p < 0.0001). AFB sensitivity, specificity positive and negative predictive value were 2.4%, 98.2%, 1.9 and 98.1 respectively. The distribution of the RR-TB are more prominent among new TB-AFB-negative cases, those residing in densely populated semi urban communities and migrants at border towns. Conclusion The GeneXpert test shows a high detection for MTB in the paediatric population but a lower RR-TB than the national average. There is a need for aggressive escalation of the nuclei acid based test in low middle-income-countries in order to achieve the end TB strategy in a global village.

Who and How Many People Are Taking Herbal Supplements? A Survey of 21923 Adults

2004 ◽  
Vol 74 (3) ◽  
pp. 183-186 ◽  
Author(s):  
Harrison ◽  
Holt ◽  
Pattison ◽  
Elton
Keyword(s):  
Adult Population ◽  
Well Being ◽  
Evidence Base ◽  
Postal Questionnaire ◽  
Individual Characteristics ◽  
Evening Primrose Oil ◽  
Herbal Supplement ◽  
Herbal Supplements ◽  
Evening Primrose ◽  
Supplement Use

Background: There is little information on the number and characteristics of adults taking herbal supplements and the relationship of this with other health and lifestyle factors. These were examined in the current study. Methods: Information on herbal supplement use and health and lifestyle characteristics was obtained by postal questionnaire, sent to a sample of the adult population in Northwest England. Results: In summer 2001, 70.5% (15,465/21,923) of questionnaires were returned. The mean age of responders was 49.8 years (SD 17.57) and 45.2% (6,986/15,465) were men. The percentage taking at least one herbal supplement was 12.8% (1,987/15,465). Users of herbal supplements were more likely to be younger, female, white, and to own their home. Herbal supplement use was not strongly associated with any health and lifestyle variables examined. Weak associations were found with physical activity, psychiatric caseness, and use of prescribed medications. The most common herbal supplement was evening primrose oil, taken by 7.7% (1,186/ 15,465) of respondents (12.7% of women and 1.1% of men). Conclusions: More than one in ten adults were taking herbal supplements, with evening primrose oil, the most common supplement, used mainly by women. Individual characteristics such as age, sex, ethnicity, and social class influenced the use of herbal supplements, but there was no evidence that this substituted for conventional medical care. The evidence base to support some popular herbal supplements is weak. Large well-designed trials are needed to quantify the value of herbal supplements to health and well-being.

scholarly journals An Observational Study of Paediatric Preoperative Transfusion Practice in a Resource-Limited Setting

2022 ◽  
Author(s):  
Somy Charuvila ◽  
Tasmiah Tahera Aziz ◽  
Sarah E. Davidson ◽  
Ummay Naznin ◽  
Shiuly Sinha ◽  
...  
Keyword(s):  
Observational Study ◽  
Management Strategies ◽  
Transfusion Practice ◽  
Major Surgery ◽  
Blood Testing ◽  
Optimal Care ◽  
Middle Income ◽  
Resource Limited ◽  
Low Middle Income Countries ◽  
Preoperative Anaemia

Abstract Background Paediatric anaemia is highly prevalent in low–middle-income countries and can negatively impact postoperative outcomes. Currently, there are no guidelines for the management of paediatric preoperative anaemia. To ensure optimal care in resource-limited settings: balancing the risks of anaemia and using resources such as blood transfusion, we first need to understand current practices. To address this, a joint UK–Bangladesh team conducted an observational study at a paediatric surgical centre in Bangladesh. Methods A total of 464 patients ≤16 years who underwent elective and emergency surgery were categorised into major (351/464), moderate (92/464) and minor (21/464) surgery groups according to anticipated blood loss. Preoperative anaemia testing and transfusion was assessed retrospectively through patient notes. Results Median age was 4 years and 73% were male. 32.5% (151/464) patients had preoperative blood testing for anaemia. 17.5% (81/464) children were transfused preoperatively. Of those children transfused, 40.7% (33/81) underwent transfusion solely based on visible signs of anaemia on clinical examination. Seventy-five percentage (36/48) of children who underwent transfusion after blood testing had haemoglobin ≥80 g/L. Major surgery category had the highest proportion of children who were transfused and tested for anaemia. Conclusion A liberal transfusion approach is evident here. Discussion with local clinicians revealed that this was due to limitations in obtaining timely blood results and reduction in laboratory costs incurred by families when clinical suspicion of anaemia was high. Further research is needed to analyse the potential of using bedside haemoglobin testers in conjunction with patient blood management strategies to limit blood transfusions and its associated risks.

Supplement use in patients with hepatocellular carcinoma.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e15037-e15037
Author(s):  
Valerie Lee ◽  
Abhishek Goyal ◽  
Christine Cho-Shing Hsu ◽  
Rosa D. Rodriguez ◽  
Abby B. Siegel
Keyword(s):  
Hepatocellular Carcinoma ◽  
Vitamin D ◽  
Overall Survival ◽  
Clinical Characteristics ◽  
The United States ◽  
Milk Thistle ◽  
Newly Diagnosed ◽  
Herbal Supplement ◽  
Herbal Supplements ◽  
Supplement Use

e15037 Background: Vitamin and herbal supplement use has been steadily rising in the United States. Few data are available evaluating this use in patients with hepatocellular carcinoma (HCC). We analyzed our prospective database of patients with HCC to determine predictors of supplement use and associations with survival. Methods: We prospectively enrolled 146 patients with newly-diagnosed HCC between 10/2008 and 11/2012. Upon enrollment, patients completed an epidemiologic questionnaire and provided detailed demographic and lifestyle data including diet, exercise, smoking and use of vitamins and herbal supplements. Clinical characteristics and overall survival were collected from medical records. We assessed if socioeconomic, lifestyle, or clinical characteristics predicted vitamin and herbal supplement use in HCC patients. We also evaluated if use was predictive of overall survival. Results: The median age was 62, and 79% were men. 60% had underlying HCV and 38% had HBV; 64% were Child-Pugh A and 19% were metastatic. 71% of our cohort used vitamins and 45% used herbal supplements. Most commonly used were antioxidants (including vitamins C, E, A and selenium) (51%), multivitamins (46%), vitamin D (25%), and milk thistle (23%). Vitamin D use was higher in women and those without HCV. Use of vitamin C was associated with being HBV positive (OR = 3.01, P = 0.01) while HCV patients were more likely to use milk thistle (OR = 2.80, P = 0.03). In a univariable model, use of milk thistle at baseline was associated with a trend toward worse overall survival (HR = 1.78, P = 0.09), despite not being associated with other poor prognostic signs like higher stage or AFP, or worse Child-Pugh score. Use of other vitamin or herbal supplements did not predict survival. Conclusions: The majority of patients with newly-diagnosed HCC have used some form of vitamin or herbal supplement, with almost a quarter having used milk thistle in their lifetime. In our analyses, use of milk thistle may be associated with worse survival. Though our cohort is small, this emphasizes the prevalence of supplement use in patients with HCC and the need to further evaluate the safety and efficacy of these alternative treatments in various patient populations.

The Impact of Covid 19 on Pregnant Women and Child Health

2020 ◽  
Vol 11 (SPL1) ◽  
pp. 1367-1373
Author(s):  
Nikhil Sanjay Mujbaile ◽  
Smita Damke
Keyword(s):  
Social Issues ◽  
Middle Income ◽  
Web Based ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
The Social ◽  
Social Separation ◽  
The Impact ◽  
And Child Health ◽  
General Wellbeing

The Covid illness (COVID-19) pandemic has spread rapidly all through the world and has had a drawn-out impact. The Pandemic has done incredible damage to society and made genuine mental injury to numerous individuals. Mental emergencies frequently cause youngsters to deliver sentiments of relinquishment, despondency, insufficiency, and fatigue and even raise the danger of self-destruction. Youngsters with psychological instabilities are particularly powerless during the isolate and colonial removing period. Convenient and proper assurances are expected to forestall the event of mental and social issues. The rising advanced applications and wellbeing administrations, for example, telehealth, web-based media, versatile wellbeing, and far off intuitive online instruction can connect the social separation and backing mental and conduct wellbeing for youngsters. Because of the mental advancement qualities of youngsters, this investigation additionally outlines intercessions on the mental effect of the COVID-19 Pandemic. Further difficulties in Low Middle-Income Countries incorporate the failure to actualize successful general wellbeing estimates, for example, social separating, hand cleanliness, definitive distinguishing proof of contaminated individuals with self-disconnection and widespread utilization of covers The aberrant impacts of the Pandemic on youngster wellbeing are of extensive concern, including expanding neediness levels, upset tutoring, absence of admittance to the class taking care of plans, decreased admittance to wellbeing offices and breaks in inoculation and other kid wellbeing programs. Kept tutoring is critical for kids in Low Middle-Income Countries. Arrangement of safe situations is mainly testing in packed asset obliged schools. 

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