Volume 15, Issue 1 -

Cancer is a major public health problem in the world. The use of the medicinal plants in cancer prevention and management is frequent in Africa, especially in Tunisia, and it is transmitted from generation to generation within cultures. Many previous studies showed that a wide range of Tunisian medicinal plants exerted cytotoxic and anticancer activity. A comprehensive review was conducted to collect information from scientific journal articles, including indigenous knowledge researches, about Tunisian medicinal plants used for the prevention and management of cancer. The aim of this review article is to provide the reader with information concerning the importance of Tunisian medicinal plants in the prevention and management of cancer and to open the door for the health professionals and scientists working in the field of pharmacology and therapeutics to produce new drug formulations to treat different types of cancer.

Background : Various epidemiological studies showed that herbal remedies containing polyphenols may protect against various diseases such as cancers, vascular diseases and inflammatory pathologies. Currently, such groups of bioactive compounds have become a subject of many antimicrobials and antioxidant investigations. Accordingly, the current study aimed to conduct biological and phytochemical screening for two Palestinian traditional medicinal plants, Erodium laciniatum and Lactuca orientalis . Methods : Current plants phytoconstituents and their antioxidant activities were evaluated by using standard phytochemical methods; meanwhile, antimicrobial activities were estimated by using several types of American Type Culture Collection and multidrug resistant clinical isolates by using agar diffusion well-variant, agar diffusion disc-variant and broth microdilution methods. Results : Phytochemical screenings showed that L. orientalis and E. laciniatum contain mixtures of secondary and primary metabolites Moreover, total flavonoid, tannins and phenols content in E. laciniatum extract were higher than the L. orientalis extracts with almost the same antioxidant potentials. Additionally, both plants organic and aqueous extracts showed various potentials of antimicrobial activity Conclusions : Overall, the studied species have a mixture of phytochemicals, flavonoids, phenols and tannins also have antioxidant and antimicrobial activities which approved their folk uses in treatments of infectious and Alzheimer diseases and simultaneously can be used as therapeutic agents in the pharmaceutical industries.

Background Herbs have been used as an aphrodisiac since ages. This study was designed to investigate the effects of Hunteria umbellata (HU) seeds and Cylicodiscus gabunensis (CG) stem barks aqueous extracts on key enzymes relevant to erectile dysfunction (phosphodiesterase-5 and arginase) and type-2 diabetes (α-amylase and α-glucosidase). Methods In ascertaining the erectogenic and antidiabetic properties of the extracts, the effects of the extracts on activities of some enzymes relevant to erectile dysfunction (arginase and phosphodiesterase-5) and type-2 diabetes (α-amylase and α-glucosidase) were determined. Antioxidant properties of the extracts were assessed through several antioxidant assays (DPPH˙, OH˙). Furthermore, their phenolic constituents were estimated and quantified using HPLC. Results The results revealed that both extracts inhibited α-amylase and α-glucosidase in a concentration-dependent manner. HU showed higher α-amylase (IC 50 =221.30 µg/mL) and α-glucosidase (IC 50 =184.35 µg/mL) inhibition than CG. Also, both extracts inhibited phosphodiesterase-5 and arginase in a dose-dependent manner in vitro ; nevertheless, HU showed higher inhibition [phosphodiesterase-5 (IC 50 =539.72 µg/mL); arginase (41.53 µg/mL)] than CG [phosphodiesterase-5 (IC 50 =611.35 µg/mL); arginase (47.95 µg/mL)]. In addition, the extracts possess antioxidant properties through radical (DPPH and OH) scavenging and metal (Fe 2+ ) chelating abilities. HPLC analysis of phenolic constituents revealed the abundance of gallic acid, chlorogenic acid, caffeic acid, ellagic acid and quercetin. Conclusions The ability of samples’ extract to inhibit some of key enzymes relevant to erectile dysfunction and type-2 diabetes could render them cheap, natural and alternative therapy with erectogenic and antidiabetic potentials.

Background Ardisia crispa Thunb A.DC (Myrsinaceae), commonly known as “hen’s eyes”, has been traditionally used in treating various inflammatory diseases. The present study evaluated anti-arthritic, gastroprotective and antioxidant activities of Ardisia crispa root hexane extract (ACRH) in various animal models. Methods Anti-arthritic activity was evaluated in complete Freund adjuvant (CFA)-induced adjuvant arthritis and gastroprotective effect was studied in the ethanol-induced ulcer model in rats. ACRH was further isolated to yield quinone-rich fraction (QRF) and both were analyzed for their total phenolic content, total flavonoid content and antioxidant activities in various antioxidant assays. Both ACRH and QRF were also analyzed for the quinone composition via gas chromatography analysis. Results ACRH exerted significant reduction of IL-1β and TNF-α at a lower dose range in CFA-induced arthritis, as well as exhibited its cytoprotective effect against ethanol-induced ulcer lesion via involvement of mucosal nonprotein sulfhydryl (NP-SH) groups. ACRH also showed higher phenolic and flavonoid contents, as well as better antioxidant activities than QRF. Conclusions These findings demonstrated the plant as a potential anti-inflammatory agent, with ACRH succeeded in inhibiting both arthritic and ulcerogenic effect, possibly mediated via its antioxidant effect.

Background Abnormal metabolism is a common event in cancerous cells. For example, the increase of reactive oxygen species (ROS) production, particularly due to aerobic respiration during invasive stage, results in cancer progression. Herein, the impact of kombucha tea prepared from ginger on the alteration of antioxidant agents was assessed in the breast cancer animal model. Methods Two types of kombucha tea with or without ginger were administered to BALB/c mice before and after tumor challenge. Superoxide dismutase (SOD), catalase, glutathione (GSH) and malondialdehyde (MDA) were evaluated in tumor, liver and kidney. Results Administration of kombucha ginger tea significantly decreased catalase activity as well as GSH and MDA level in tumor homogenate (p<0.001). A significant decrease in SOD activity and increase in MDA quantity was determined in the kidney which had received kombucha ginger tea (p < 0.01). Conclusions The consumption of kombucha prepared from ginger could exert minor antioxidant impacts by balancing multi antioxidant factors in different tissues in the breast cancer models.

Background Hunteria umbellata (HU) (K. Schum) is used in ethnomedicine for the management of pain, diabetes mellitus and dysmenorrhoea. This study evaluated the analgesic and antioxidant activities of aqueous extract of HU stem bark and the possible mechanism(s) of action. Methods The antinociceptive effect of HU was evaluated using acetic acid mouse writhing, tail flick, hot plate and formalin-induced paw licking models. To establish the possible mechanism(s) of action of HU, separate group of animals were pretreated with naloxone (1 mg/kg, i.p.), atropine (1 mg/kg, i.p.), haloperidol (0.1 mg/kg, i.p.), ondansetron (1 mg/kg, i.p.) and phenoxybenzamine (0.1 mg/kg, i.p.), 15 min before HU. The in vivo and in vitro antioxidant potential was evaluated using established methods. Results The extract at 150 and 300 mg/kg, significantly (p < 0.05) reduced the number of writhes and paw licking times and increased pain threshold in writhing assay, paw licking and hotplate tests respectively. Pretreatment of animals with ondansetron, naloxone and haloperidol, significantly (p < 0.05 and p < 0.01) attenuated the analgesic activity of HU. The extract demonstrated significant (p<0.05) radical scavenging activity (IC 50 0.39 µg/mL), with high phenol content and reducing property. The total phenol content was 124.19 per gram of gallic acid. In vivo antioxidant assay showed significant (p < 0.05) increase in catalase and superoxide levels. Conclusions Results obtained in this study suggest the involvement of serotonergic, opioidergic and dopaminergic pathways in the analgesic effect of HU stem bark, in addition to its potent antioxidant potential.

Background The Garcinia kola seeds have been reported for its antibacterial, antioxidant, antidiabetic and also for its chemoprevention property. The use of doxorubicin as an anticancer drug has been accompanied with avalanche of side effects including cardiotoxicity. The aim of this study was to investigate the cardioprotective effect of Kolaviron and Garcinia kola and their mechanisms of action. Methods Sixty male rats (Wistar strain) were used in this study. They were divided into 6 groups (A-F) each containing 10 animals. Group A was the control. Rats in Groups B, C, D, E and F were treated with doxorubicin at the dosage of 15 mg/kg body weight i.p. Prior to this treatment, rats in groups C, D, E and F were pre-treated orally with Kolaviron at the dosage of 100 mg/kg and 200 mg/kg, and Garcinia kola 100 mg/kg and 200 mg/kg for 7 days, respectively. Results The results show that doxorubicin caused a significant increase in heart rate and prolonged QT, reduced antioxidant status, increased oxidative stress, inflammation and markers of cardiac damage which were reversed by pre-treatment with Kolaviron and Garcinia kola . Conclusions Overall, pre-treatment with Kolaviron or Garcinia kola caused reversal of cardiac damage, ECG alteration and oxidative stress by increasing the activity of antioxidant enzymes and reducing the markers of inflammation on doxorubicin-induced cardiotoxicity.

Background Cisplatin-induced acute liver and kidney injuries are serious problems in cancer patients during treatment of solid tumours. Objective This study sought to investigate possible protective effect of ethanolic fruit extract of Citrullus colocynthis (CC) against cisplatin-induced hepato-renal toxicity in rats. Methods Thirty male albino rats (150–200 g) were divided into five groups (n=6) and treated as follows: group 1: vehicle (10 mL/kg, p.o.; normal control); group 2: vehicle (10 mL/kg); groups 3–5: CC (100, 200 or 400 mg/kg, p.o.), respectively, for 10 days. Cisplatin (7.5 mg/kg; i.p.) was administered on the 7th day to animals in groups (2–5) 1 h after pretreatment. The animals were euthanized on day 10 for haematological, biochemical and histological analysis. Results Cisplatin induced a significant increase in the serum levels of ALT, ALP, creatinine and blood urea nitrogen indicative of hepato-renal injury. More so, cisplatin caused marked increase in granulocyte, lymphocyte and platelets counts which were ameliorated by CC (100–400 mg/kg) treatment. In addition, cisplatin induced marked increase in MDA and nitrite levels coupled with deficits in glutathione, catalase and superoxide dismutase activities which were attenuated by CC administration. In vitro assay showed that CC scavenged DPPH and nitrite radicals (69.50 and 64.50 µg/mL, respectively). Total antioxidant capacity, phenolic and flavonoid contents are 24.27±0.09 mg QUE/g, 17.14±0.12 mg GAE/g and 10.20±0.09 mg QUE/g, respectively. CC preserved the liver and kidney histoarchitecture. Conclusions This study showed that C. colocynthis possesses hepatoprotective and nephroprotective actions possibly through enhancement of antioxidant defence system. Thus, it could be a potential adjuvant in cisplatin-based chemotherapy.

Background Nitrite salts are still common additives in the meat industry. The present study provides a first approach on the employment of the lyophilized aqueous extract (WE) of the Tunisian seaweed Cystoseira barbata for the quality enhancement of turkey meat sausage. Methods WE was supplemented as a natural antioxidant agent to investigate its effectiveness in delaying lipid oxidation turkey meat sausages containing reduced amounts of sodium nitrites. Results On storage day 5, all concentrations of WE (0.01–0.4 %) reduced the meat lipid oxidation by approximately 36 %, as compared to the negative control containing only 80 mg/kg of meat of sodium nitrites as antioxidant. It was noted that within 15 days of refrigerated storage, a meat system containing 80 mg/kg of meat of sodium nitrites and 0.02 % and 0.04 % of WE had similar Thiobarbituric Acid Reactive Substances (TBARS) levels (19±1.32 and 17±1.12 µmol/kg of meat, respectively), which were comparable to the positive control containing sodium nitrites (150 mg/kg of meat) and 0.045 % vitamin C (18.46±1.27 µmol/kg of meat). In-depth, the metabolomic profiling using gas chromatography–mass spectrometry (GC/MS) and liquid chromatography–quadripole–time–of–flight–mass spectrometry (LC-QTOF-MS) analyses of the Tunisian seaweed C. barbata solvent extracts showed that the main active compounds were phenolic compounds, fatty acids and sterols. Conclusions Overall, the cold medium containing C. barbata lyophilized aqueous extrac, with strong antioxidant activity and antihypertensive properties, may open the way to the development of a natural quality enhancement strategy for new functional and ever healthier reduced nitrites meat sausages based on algae.

Background Donepezil hydrochloride commonly used in the management of Alzheimer’s disease (AD), exhibiting its inhibitory effects on acetylcholinesterase and butyrylcholinesterase activity thereby enhance cognitive function. Caffeic acid member of hydroxycinnamic acid is widely present in human diet. This study aims to investigate influence of caffeic acid on acetylcholinesterase and butyrylcholinesterase inhibitory properties of donepezil ( in vitro ). Methods 5 mg of donepezil was dissolved in 50 mL distilled water while 10 mg of caffeic acid was dissolved in 100 mL distilled water. Therefore, mixtures of samples were prepared as follows: A2=donepezil 0.075 mg/mL+caffeic acid 0.025 mg/mL; A3=donepezil 0.050 mg/mL+caffeic acid 0.050 mg/mL; A4=donepezil 0.025 mg/mL+caffeic acid 0.075 mg/mL. All samples were kept in the refrigerator at 4 °C for subsequent analysis. Results The result showed that all the combinations show an inhibitory effect on acetylcholinesterase and butyrylcholinesterase activity in vitro , with the combination A4=donepezil 0.025 mg/mL+caffeic acid 0.075 mg/mL had significant (p<0.05) highest inhibitory effect on acetylcholinesterase and butyrylcholinesterase activity in vitro . More so, all the samples were able to prevent pro-oxidants (FeSO 4 and sodium nitroprusside [SNP] ) induced lipid peroxidation in rat brain homogenate, with the combination A4=donepezil 0.025 mg/mL+caffeic acid 0.075 mg/mL and A3=donepezil 0.050 mg/mL+caffeic acid 0.050 mg/mL had highest inhibitory effect against FeSO 4 and SNP induced lipid peroxidation in rat brain homogenate in vitro respectively. Moreover, all the samples exhibit antioxidant properties as typified by their ability to chelate iron (II) ion (Fe 2+ ), hydroxyl radical (OH٭) radical scavenging ability and ferric reducing property (FRAP). Conclusions Therefore, the combination of caffeic acid with donepezil enhances the antioxidant properties of donepezil. The combination of caffeic acid with donepezil could be a therapeutic aid in the management of AD, possibly with fewer side effects of donepezil. Nevertheless, the combination donepezil 0.025 mg/mL+caffeic acid 0.075 mg/mL acid look promising.

Background This study investigates and compares the effect of phenytoin and honey cream on intensity of pain and episiotomy wound healing in nulliparous women. Methods This research was conducted by double-blinded randomized clinical trial method on 120 nulliparous women in three groups of phenytoin, honey and placebo. After delivery and episiotomy, mothers used a knuckle of the prescribed creams on their episiotomy area, every night until 10-night. Evaluation of wound healing using REEDA scale and pain intensity with numerical rating scale of pain took place within the first 24 h and after 7 and 14 days of delivery. Results Results showed significant differences between healing scores of the three groups for the seventh day after delivery. Healing score in the honey group was lower than that in placebo group. On the fourteenth day after delivery, the healing scores showed no significant differences between the three groups. Measuring pain intensity did not show any significant difference in the three groups after 7 and 14 days of delivery. Conclusions Both honey and phenytoin led to episiotomy wound healing; however, honey caused the wound healing better than the phenytoin. Honey and phenytoin did not reduce episiotomy pain.

Background Societal expectations around traditional binary gender roles result in some professions being considered “men’s work” or “women’s work”. Massage therapy (MT) is one such profession that, despite being predominantly female, is joined by an increasing number of men with a desire to help others. Methods This descriptive phenomenological study asked male massage therapists in Ontario, Canada, about their experience of gender in their professional lives. Fourteen men shared their experiences of practice, which included discriminatory hiring and patient preferences for female practitioners. These issues resulted in difficulty establishing a clinical practice. To create a successful practice, men described the need for professionalism, clear communication, and a comfortable treatment environment. Results and conclusions Researchers should explore the impact of discrimination on men in MT, patient preferences based on the therapist’s gender, and the role of education in perpetuating societal heterosexual norms. Finally, as with any shift in culture, all levels of organization must take action to remove discrimination and bias within the profession of MT.