MEDICINAL PLANTS AND PHYTOCHEMICALS IN PREVENTION AND MANAGEMENT OF LIFE STYLE DISORDERS: PHARMACOLOGICAL STUDIES AND CHALLENGES

The prevalence of lifestyle disorders such as hypertension, diabetes mellitus (DM), dyslipidemia, and overweight/obesity is rising rapidly. Recently the popularity of herbal supplements among patients with lifestyle disorders has been increasing. Consumption of a plant-based diet consisted of appropriate phytochemicals has been accepted as a reliable means for the prevention and management of several disorders. Phytochemicals play a crucial role in disease prevention, especially when lifestyle changes alone are not found effective. Various human and animal trials have established the pharmacological action of phytonutrients present in herbal plants. Several bioactive compounds such as polyphenols, flavonoids, alkaloids, and stilbenes. are present in plants such as garlic, Aloe vera, turmeric, tulsi, and drumstick. that have shown a significant beneficial effect on DM, metabolic syndrome, lipid disorders, etc. This review focuses on the therapeutic effect of some of the high potential herbal plants and their phytochemicals in the management of lifestyle disorders and the challenges with the use of herbal medicines.

Implications of Cannabidiol in Pharmacogenomic-Based Drug Interactions with CYP2C19 Substrates

This is a patient case exploring the importance of evaluating herbal and dietary supplements and how they may impact drug-drug and drug-gene implications based on pharmacogenomics test results. Even though herbal supplements are considered natural by many patients, which is often the reason for starting them, herbal supplements may still be metabolized by the same pathways as other medications, potentially contributing to drug-drug, drug-herb, and drug-gene interactions, and therefore, potentially impacting a patient’s response to medications.

Screening for consistency and contamination within and between bottles of 29 herbal supplements

In the United States the marketing of dietary supplements, of which the majority are herbal supplements, is currently a multibillion-dollar industry involving use from over half of the adult population. Due to their frequency of use and the lack of regulation of herbal supplements by the Food and Drug Administration (FDA) it is important for the health and safety of consumers to know about consistency of supplements and any possible contamination by harmful products, such as heavy metals or microorganisms. The purpose of the study was to determine consistency and contamination within and between bottles of common herbal supplements. Duplicate bottles of 29 herbal supplements were tested for consistency for antioxidant activity, phenolic concentration and flavonoid concentration under methanolic and water extraction. The supplements were also analyzed for the presence of metals and fungal contaminants. For all of the supplements tested there was high variability around the mean in antioxidant activity, phenolic concentrations and flavonoid concentrations, with coefficients of variation (CV) ranging from 0–120. Zinc was found in almost 90% of the supplements, nickel in about half of the supplements and lead in none of the supplements. Approximately 60% of the supplements contained fungal isolates. Although the majority of the fungi that were found in the supplements are generally not hazardous to human health, many of them could be problematic to sensitive groups, such as immunocompromised individuals. The data, which demonstrates contamination and a lack of consistency, in conjunction with previous studies on supplement contamination, strengthen the case that the FDA should regulate over-the-counter herbal supplements the same way that they regulate food and drugs. Until such time it is crucial that consumers are informed that many of the supplements that they take may lack the standardization that would reduce the chance of contamination and lead to consistency from one pill to the next.

Adulteration of Weight Loss Supplements by the Illegal Addition of Synthetic Pharmaceuticals

Weight loss supplements that have illegal additives of pharmaceutical drugs or analogues have additional health risks, and customers may not be aware of what they are taking. This research is an essential investigation and quantification of illegally added pharmaceuticals or prescription medications, specifically fluoxetine, phenolphthalein, and sibutramine, in herbal weight loss supplements offered for sale in the United Arab Emirates (UAE). In this case, 137 weight loss supplements were collected and analyzed in this study. Reversed-phase high-performance liquid chromatography with UV absorption detection coupled to tandem mass spectrometry (RP-HPLC-MS/MS) analyses were used to determine the presence of the pharmaceutical chemicals. Among the weight loss supplements, 15.3% (95% CI: 9.2–21.4) contained undeclared sibutramine, 13.9% (95% CI: 8.01–19.7) contained undeclared phenolphthalein, and 5.1% (95% CI: 1.4–8.8) contained undeclared fluoxetine. Amongst all weight loss supplements, 17.5% (95% CI: 11.07–24) contained significant concentrations of either sibutramine, phenolphthalein, or fluoxetine. Whilst weight loss herbal supplements offered for sale in the UAE have relatively low percentages of undeclared pharmaceuticals, many people take several different supplements daily and may encounter quite high levels of combined exposure to toxic compounds.

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

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.

Intravenous Thrombolysis for a Stroke Mimic Patient

The authors present the case of a young woman on phentermine and herbal supplements who presented as an acute stroke alert with right-sided facial droop and numbness. She was treated acutely with intravenous tissue plasminogen activator (tPA). However, the workup did not reveal any evidence of cerebrovascular disease or cerebral infarct. The authors discuss plausible stroke mimics and the safety of administering tPA to such patients.

Utilization of herbal supplements on feed on growth and survival rate of catfish (Clarias sp.)

The feed is one of the most important factors in the growth and survival of fish. One of the efforts made to increase the growth and survival of fish is the provision of herbal supplements in fish feed. The research aim is to provide information about the utilization of herbal supplements on the growth and survival of catfish (Clarias sp). This research has been carried out from July to August 2020 at Bandar Agung Lahat Village, South Sumatera. Catfish rearing containers use two waring units placed in concrete ponds with two treatment that P0: control (without herbal supplements) and P1: utilization of herbal supplements and. The data taken includes absolute growth and absolute length, survival, feed efficiency, and water quality. The utilization of herbal supplements has a good effect on fish growth, feed efficiency, and survival rate. Maintenance of P0 (control) resulted in an absolute weight of 9.79 grams, an absolute length of 6.3 cm, the survival of 85.15%, feed efficiency of 107.89% while maintenance of P1 with the utilization of herbal supplements resulted in an absolute weight of 14.17 grams, an absolute length 7.8 cm, survival 98.57%, feed efficiency 161.170%.