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Pancytopenia is a health condition in which there is a reduction in the amount of leucocytes, erythrocytes and thrombocytes. If more than one of the blood cells is low then the condition is called as bicytopenia. The pancytopenic condition is observed in treatment of diseased conditions like thalassemia and hepatitis C. Iatrogenically pancytopenia is caused by some antibiotics and anti-HCV drugs. Medical conditions like aplastic anaemia, lymphoma, copper deficiency, and so forth can also cause pancytopenia. Pancytopenia can in turn decrease the immunity of the person and thereby can be fatal. Current therapies for pancytopenia include bone marrow stimulant drugs, blood transfusion and bone marrow transplant. The current therapies are very excruciating and have long-term side-effects. Therefore, treating these condition using herbal drugs is very important. Herbs like wheatgrass, papaya leaves and garlic are effective in treating single lineage cytopenias. The present review is focused on the potential effects of natural herbs for the treatment of pancytopenia.

Background Evidence-based practice (EBP) has been the focus of increasing attention in the teaching and delivery of both complementary and conventional healthcare. Western herbal medicine (WHM) is a system of complementary healthcare rooted in tradition. How WHM practitioners perceive, are prepared for, and use EBP, has to date been largely ignored. We therefore examined the use, opinion, skills, and training in EBP, and barriers and facilitators of EBP uptake, among herbal practitioners in the United States (US). Methods The study utilized a cross-sectional, descriptive survey design. A sample of US clinical herbalists was invited to complete a validated online questionnaire, the Evidence-Based practice Attitude and utilization SurvEy (EBASE). Results Seventy-four US herbal practitioners completed the survey (response rate=35 %). Participants demonstrated a generally positive attitude toward EBP (median attitude subscore 31 [possible range=8–40]), a moderate to high level of self-assessed skill in EBP (median skill subscore 46 [13–65]) and a moderate level of EBP uptake (median use subscore 12 [0–24]). Apart from a lack of clinical evidence in herbal medicine, there were few perceived barriers to EBP uptake among herbal practitioners. Access to the Internet, online databases and full-text journal articles were considered most useful in facilitating the uptake of EBP in WHM practice. Conclusions Respondents’ attitudes, skill level, and uptake of EBP were generally consistent with other complementary and alternative medicine providers. Educational initiatives, including those focused on the appraisal and application of evidence, may help to optimize the use of EBP among WHM practitioners.

Evaluating conventional medicine (CM) and complementary and alternative medicine (CAM) with respect to integration opportunities (such as patient referrals and professional knowledge sharing) and possible geographic implications is novel. This research utilizes nearest neighbour and local spatial autocorrelation statistical analyses and surveys directed towards Doctors of Naturopathic Medicine (NDs) and their patients to better understand the geographic patterns of NDs and potential integration qualities. While the statistical tests reveal that the offices of NDs and Doctors of Medicine (MDs) display clustered patterns in intermediately-sized census metropolitan areas in Ontario and that the majority of NDs are near MDs, proximity is not manifesting in discernible integration tendencies between NDs and MDs. The NDs polled were strongly in favour of greater integration with the CM sector (as were their patients) to: achieve better patient health outcomes and to gain efficiencies within the health care system. Yet, both surveys also indicate that the barriers to integration are substantial and, generally speaking, centre on the perception that many MDs lack respect for, and/or knowledge about, naturopathic approaches. It is speculated that as students in conventional medical schools are increasingly exposed to CAM approaches, perhaps more MDs in the future will be receptive to greater integration with CAM. Should this occur, then it is also possible that geographic proximity may be a catalyst for deeper CAM-CM integration; as it has been for CAM–CAM relationships.

Background Neuropathic pain (NP) is a common condition accompanied by nerve injury. To date, there is no definite treatment approved for this disorder. In addition, many drugs that are used for NP cause adverse reactions. Luteolin is a naturally occurring flavonoid with diverse pharmacological properties such as anti-inflammatory, antioxidant and anticancer. We sought to investigate luteolin effects on chronic, acute and neuropathic pain as well as its potential to increase morphine anti-nociceptive effects in mice. Methods Albino mice (20–25 g) were randomly divided into 14 groups (n=7) including morphine 1 mg/kg body weight +luteolin (5 mg/kg body weight), morphine (9 mg/kg body weight, i.p.), luteolin (2.5, 5 and 10 mg/kg body weight), imipramine 40 mg/kg body weight and normal saline (NS) (0.9 %) as vehicle and subjected to hot plate test. Formalin test was done in the following groups: NS, diclofenac sodium (10 mg/kg body weight, i.p.), morphine (9 mg/kg body weight, i.p.) and luteolin (2.5, 5 and 10 mg/kg body weight). Results Administration of luteolin single dose (5 and 10 mg/kg body weight) significantly reduced neuropathic pain (p<0.05$\rm{p}<0.05$) in comparison to negative control. Anti-nociceptive effects of luteolin were comparable to imipramine as the standard positive control (p<0.001$\rm{p}<0.001$). Co-administration of luteolin and morphine potentiated morphine 1 mg/kg body weight painkilling effects (p<0.001$\rm{p}<0.001$). Conclusions Our results showed that luteolin alone reduces neuropathic pain. Furthermore, when co-administered with morphine 1 mg/kg body weight, luteolin potentiates morphine effects. Therefore, luteolin-morphine co-administration might be a valuable alternative for the conventional treatment.

Background The objective of the study was to evaluate the antinociceptive, antipyretic and anti-inflammatory activities of ethanolic extract, methanolic extract and n -hexane and chloroform-soluble fractions of methanolic extract of Eria javanica leaves in animal model (rat and mice). Methods The anti-nociceptive potentials of the extracts were studied using the acetic acid-induced writhing test in mice and the antipyretic activity was investigated using yeast-induced pyrexia in rats. Anti-inflammatory activity test was done on rats at a dose by using carrageenan-induced paw edema test. Results In acetic acid-induced writhing inhibition study in Swiss albino mice, the crude methanolic extract at 200 mg/kg and 400 mg/kg doses and the n -hexane soluble fraction of crude methanolic extract at 400 mg/kg showed statistically significant activity with 53.21 % (p<0.001), 50.36 % (p<0.001) and 67.86 % (p<0.001) inhibition respectively compared to control. The crude ethanolic extract showed statistically significant antipyretic activity from 1 hours and onwards after administration at doses of 200 mg/kg body weight (p<0.005 at 1st hour and p<0.001 at 2nd, 3rd and 4th hour respectively) and 400 mg/kg body weight (p<0.05 at 1st hour and p<0.001 at 2nd, 3rd and 4th hour respectively). The crude methanolic extract showed statistically significant antipyretic activity from 2 hours and onwards at 400 mg/kg body weight (p<0.05 at 2nd hour and p<0.001 at 3rd and 4th hour respectively) and 200 mg/kg body weight dose showed statistically significant antipyretic activity from 3 hours and onward(p<0.001) in Brewer’s yeast-induced pyrexia test in albino Wister rats. In carrageenan-induced rat’s paw edema test, crude methanolic extract showed statistically significant anti-inflammatory activity from 2nd hour and onwards. The chloroform-soluble fraction of methanolic extract also showed significant activity from 1st hour onwards. Conclusions This study thereby indicates that leaves of E. javanica possess peripheral analgesic, antipyretic and anti-inflammatory activities and therefore a suitable candidate for further study.

Background Phenylhydrazine (PHE) in experimental animal models has been widely reported to cause haemolytic anaemia, via the induction of oxidative stress and thus causing deleterious cardiovascular complications. Hence, this study was designed to evaluate the possible modulatory role of melatonin (MLT) or vitamin C when co-administered with PHE. Methods Anaemia was established with PHE administration. MLT or vitamin C was co-administered with PHE. Haematological parameters, markers of oxidative stress, enzymic and non-enzymic antioxidants, blood pressure and electrocardiograms were assessed. Results PHE administration led to a significant (p<0.05) increase in malondialdehyde (MDA), and hydrogen peroxide (H 2 O 2 ) generated in cardiac, renal and red blood cell (RBC) lysates. PHE also significantly reduced the activity of glutathione peroxidase (GPx), superoxide dismutase (SOD) and reduced glutathione (GSH) contents, respectively. The RBC counts, haemoglobin (Hb) concentration and packed cell volume (PCV) were also significantly reduced following the administration of PHE. Furthermore, the systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial blood pressure (MABP) increased significantly in rats administered PHE alone. Similarly, PHE administration led to a significant drop in heart rate but prolonged QRS, QT and QTc interval. Pathology of the heart and kidney was also observed in PHE treated group. However, treatment with MLT and vitamin C improved enzymic and non-enzymic antioxidant system together with the restoration of SBP, DBP and MABP to near normal. The architectural anarchy observed in the heart and kidney of PHE administered rats was reversed to some extent. Conclusions Hence, MLT and vitamin C could be employed as therapeutic targets in various cardiovascular diseases and its complications.

Background Phenolic compounds from Citrus are known to be a topic of many studies due to their biological properties including antioxidant activity. Methods Methanolic and aqueous extracts were isolated from Citrus leaves of different species ( C. clementina , C. limon , C. hamlin , C. navel , C. aurantifolia , C. aurantium and C. grandis ) harvested in Algeria. Results The results showed that aqueous extracts of all species are rich in total phenolic compounds and flavonoids (from 68.23 to 125.28 mg GAE/g DM) and (from 11.99 to 46.25 mg QE/g DM) respectively. The methanolic and aqueous extracts were examined for in vitro antioxidant properties using various antioxidant assays. For aqueous extracts, C. limon showed an important DPPH radical scavenging activity (IC 50 35.35 µg/mL), and C. clementina exerted the highest ABTS radical scavenging activity (1,174.43 µM ET/g DM) and a significant ferric reducing potential (30.60 mg BHAE/g DM). For methanolic extracts, C. clementina showed the highest antioxidant activity for all the realized assays (IC 50 41.85 µg/mL, 378.63 µM ET/g DM and 13.85 mg BHAE/g DM) for DPPH, ABTS radicals scavenging activities and ferric reducing potential respectively. Antiperoxidase and antipolyphenol oxidase activities of these samples were also evaluated. Conclusions In this investigation, the assessment of antiperoxidase activity proved that the leaves extracts of different species were able to inhibit peroxidase activity. However, this inhibition varied with the species and the source of these enzymes. On the other hand, the aqueous extracts of different species showed moderate inhibition of polyphenol oxidase, while no effect on these enzymes was obtained with methanolic extracts.

Background Berberis vulgaris L. (BV), commonly known as “ Aghriss ” in Moroccan pharmacopoeia, is used to cure liver disorders and other diseases. The present study aimed to investigate the protective effect of BV aqueous extract against lead-induced toxicity in mice liver. Methods Sixty IOPS mice were divided into six groups and were treated as follows: group 1 (normal control) received double distilled water; group 2 (toxic control) received lead acetate (5 mg/kg body weight/day) in double distilled water for 40 days; groups 3–6 received BV aqueous extract at doses of 25, 50, 100 and 150 mg/kg body weight , respectively, once daily for 30 days from 11 day after beginning of lead acetate exposure to the end of the experiment. Results Toxic control group showed a significant alteration of serum alanine-aminotransferase (ALT), aspartate-aminotransferase (AST), total cholesterol (TC), total bilirubin (TB), catalase (CAT), superoxide dismutase (SOD), glutathione peroxidase (GPx) and reduced glutathione (GSH). Histological assessment of lead-intoxicated mice liver revealed alterations in hepatocytes and focal necrosis. BV treatment significantly prevented lead accumulation, increased ALT, AST, TC, and TB, inhibited lipid peroxidation and protein carbonyls(PCO) formation. Additionally, BV extract normalized the antioxidant enzymes (CAT, SOD and GPx), GSH and architecture of liver tissues. Conclusions BV aqueous extract exerts significant hepatoprotective effects against lead-induced oxidative stress and liver dysfunction. The BV effect may be mediated through the enhancement of antioxidant status, lead-chelating abilities and free radicals quenching.

Background The present study focused on the antioxidant, phenolic profile and free radical scavenging-mediated protective effect of leaves extracts of Syzygium guineense var. macrocarpum against ferric nitriloacetate-induced stress in the liver, heart, kidney and brain tissues of Wistar rats homogenates. Methods Spectrophotometric standardized methods were used to determine the free radical scavenging potential, antioxidant and protective properties of plant extracts on rat homogenates. Results All the extracts showed a concentration-dependent free radical quenching potential, and the ability to protect all the tested organs by inhibiting the lipid peroxidation and potentiating or restoring the activity of enzymatic and non enzymatic markers. The polyphenolic profile revealed the presence of at least one simple phenolic acid (gallic, caffeic, para-coumaric acid) although the majority (6 out of 14) of the compounds used as standard are present in the aqueous and aqueous–ethanol extracts. Conclusions Ethanolic extract of leaves of S. guineense var macrocarpum (SGETOH) exhibited the highest phenol content and appeared as the best extract taking into consideration the antioxidant and organo-protective activities tested.

Background Although a certain level of competitive anxiety may increase performance, many athletes with anxiety experience uncontrolled negative feelings and cognition that in turn can have overwhelming effects on their performance. Methods We aimed to assess the effect of acupuncture on competitive anxiety of the adolescent football players prior to the competition using psychological and physiological markers. A total of 30 athletes were randomly and equally allocated to either acupuncture or sham control group. Results The results of t-test on posttest scores showed that acupuncture had a significant effect on cognitive anxiety (p=0.001) and somatic anxiety (p<0.001) but not self-confidence (p>0.05). Furthermore, the results showed that acupuncture significantly decreased the skin conductance in acupuncture group compared to sham group (p=0.006) (p<0.001). Conclusions In conclusion, the results suggested that acupuncture has the capacity to decrease cognitive and somatic anxiety prior to competition in adolescent athletes while this was accompanied by significant physiological changes.

Background There is very little evidence relating to the association of herbal medicine with diarrhea and the development of acute kidney injury (AKI). This study reports a case of diarrhea-induced AKI, possibly related to an individual ingesting copious amounts of homemade mixed fruit and herb puree. Case presentation A 45-year-old Thai man with diabetes had diarrhea for 2 days, as a result of taking high amounts of a puree made up of eight mixed fruits and herbs over a 3-day period. He developed dehydration and stage 2 AKI, with a doubling of his serum creatinine. He had been receiving enalapril, as a prescribed medication, over one year. After he stopped taking both the puree and enalapril, and received fluid replacement therapy, within a week his serum creatinine had gradually decreased. The combination of puree, enalapril and AKI may also have induced hyperkalemia in this patient. Furthermore, the patient developed hyperphosphatemia due to his worsening kidney function, exacerbated by regularly taking some dietary supplements containing high levels of phosphate. His serum levels of potassium and phosphate returned to normal within a week, once the patient stopped both the puree and all dietary supplements, and had begun receiving treatment for hyperkalemia. Results The mixed fruit and herb puree taken by this man may have led to his diarrhea due to its effect; particularly if the patient was taking a high concentration of such a drink. Both the puree and enalapril are likely to attenuate the progression of kidney function. The causal relationship between the puree and AKI was probable (5 scores) assessed by the modified Naranjo algorithm. This is the first case report, as far as the authors are aware, relating the drinking of a mixed fruit and herbal puree to diarrhea and AKI in a patient with diabetes. Conclusions This case can alert health care providers to the possibility that herbal medicine could induce diarrhea and develop acute kidney injury.