Thesis (MSc.(Pharmacology)--Faculty of Health Sciences)-University of Pretoria, 2002.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / A utilização de ervas e plantas para finalidades terapêuticas é bastante antiga e registrada em várias sociedades. Esta pesquisa procura investigar como se dá o processo de construção e reprodução do conhecimento em medicina popular (particularmente o cuidado com ervas e plantas medicinais) através da história de vida de terapeutas populares pessoas que se tornaram referências em suas comunidades por adquirir, praticar e transmitir esse conhecimento. Tem como objetivos conhecer e compreender o processo de construção do conhecimento sobre plantas medicinais por terapeutas populares do município do Rio de Janeiro; compreender as formas de reprodução deste conhecimento; entender o contexto de relações destes terapeutas com o saber científico. Utilizou-se como opção metodológica a história oral com ênfase na história de vida. Foram entrevistados sete terapeutas populares de diferentes bairros do município. Observou-se que o conhecimento em relação às ervas medicinais não está restrito a um pequeno grupo e limitado a uma forma de transmissão oral. O conhecimento tem se reproduzido, mas também tem se modificado, mesclando-se com outras formas de conhecimento e entremeado por diversas fontes de informação que vão desde a transmissão oral até informações disponíveis na mídia. A principal forma de reprodução do conhecimento parece ser a perpetuação do negócio, que evoca o discurso do tradicional, a natureza das ervas e suas propriedades benéficas e se sustenta por uma rede de informação que se utiliza dos diversos meios de comunicação e uma rede de produção e comércio que garante o sustento econômico dos terapeutas populares. A transformação das práticas de utilização de ervas medicinais em patrimônio cultural ou negócio de família além de garantir a perpetuação do conhecimento, garante um espaço diferente dentro das práticas de cuidado em saúde. As relações dos terapeutas com a medicina oficial não são relações de tensões, embora haja criticas, mas de interposição de sistemas terapêuticos. / The use of herbs and plants for therapeutic purposes is quite old and registered in various societies. This research seeks to investigate how the process of construction and reproduction of knowledge in folk medicine (particularly the use of herbs and medicinal plants) through the life story of popular therapists - people who have become references in their communities for acquiring, practicing and transmitting this knowledge. It aims to identify and understand the process of knowledge construction about medicinal plants by popular therapists in the city of Rio de Janeiro; to understand the forms of reproduction of this knowledge; and to understand the context of the relationship between these practitioners and the scientific knowledge. The oral history, with an emphasis on life history, was used as a methodological approach. Seven popular therapists were interviewed in different districts of the city. It was observed that the knowledge about the medicinal herbs is not restricted to a small group and limited to a form of oral transmission. Knowledge has been reproduced, but also has been modified, mingling with other forms of knowledge and punctuated by several information sources ranging from oral transmission to information available in the media. The main form of knowledge reproduction seems to be the perpetuation of a business, which evokes the traditional speech, the nature of herbs and their beneficial properties and is supported by an information network that uses various means of communication and a production and trade network that ensures economic sustenance for the popular therapists. The transformation of the practice of using herbs in cultural heritage or family business ensures the perpetuation of knowledge, and it also ensures a different space within the practices of health care. The relationship of therapists with official medicine is not a tensioned one, although there are criticisms, but one with the interposal of the therapeutic systems.

In response to the urgent call for investigations into antiretroviral (ARV)-African traditional medicine (ATM) interactions, this research was undertaken to ascertain whether chronic administration of the ATM, Sutherlandia frutescens (SF) may alter the bioavailability of the protease inhibitor (PI), atazanavir (ATV), which may impact on the safety or efficacy of the ARV. Prior to investigating a potential interaction between ATV and SF in vitro and in vivo, a high performance liquid chromatography method with ultraviolet detection (HPLC-UV) was developed and validated for the bioanalysis of ATV in human plasma and liver microsomes. An improved and efficient analytical method with minimal use of solvents and short run time was achieved in comparison to methods published in the literature. In addition, the method was selective, linear, accurate and precise for quantitative analysis of ATV in these studies. Molecular docking studies were conducted to compare the binding modes and affinities of ATV and two major SF constituents, Sutherlandioside B and Sutherlandin C, with the efflux transporter, P-glycoprotein (P-gp) and the CYP450 isoenzyme, CYP3A4 to determine the potential for these phytochemicals to competitively inhibit the binding of ATV to these two proteins, which are mediators of absorption and metabolism. These studies revealed that modulation of P-gp transport of ATV by Sutherlandioside B and Sutherlandin C was not likely to occur via competitive inhibition. The results further indicated that weak competitive inhibition of CYP3A4 may possibly occur in the presence of either of these two SF constituents. The Caco-2 cell line was used as an in vitro model of human intestinal absorption. Accumulation studies in these cells were conducted to ascertain whether extracts and constituents of SF have the ability to alter the absorption of ATV. The results showed that the aqueous extract of SF significantly reduced ATV accumulation, suggesting decreased ATV absorption, whilst a triterpenoid glycoside fraction isolated from SF exhibited an opposing effect. Analogous responses were elicited by the aqueous extract and a triterpenoid glycoside fraction in similar accumulation studies in P-gp overexpressing Madin–Darby Canine Kidney Strain II cells (MDCKII-MDR1), which signified that the effects of this extract and component on ATV transport in the Caco-2 cells were P-gp-mediated. The quantitative analysis of ATV in human liver microsomes after co-incubation with extracts and components of SF was conducted to determine the effects of SF on the metabolism of ATV. The aqueous and methanolic extracts of SF inhibited ATV metabolism, whilst the triterpenoid glycoside fraction had a converse effect. Analogous effects by the extracts were demonstrated in experiments conducted in CYP3A4-transfected microsomes, suggesting that the inhibition of ATV metabolism in the liver microsomes by these SF extracts was CYP3A4-mediated. A combination of Sutherlandiosides C and D also inhibited CYP3A4-mediated ATV metabolism, which was in contrast to the response elicited by the triterpenoid fraction in the liver microsomes, where other unidentified compounds, shown to be present therein, may have contributed to the activation of ATV metabolism. The in vitro studies revealed the potential for SF to alter the bioavailability of ATV, therefore a clinical study in which the effect of a multiple dose regimen of SF on the pharmacokinetics (PK) of a single dose of ATV was conducted in healthy male volunteers. The statistical analysis showed that the 90 % confidence intervals around the geometric mean ratios (ATV + SF/ATV alone) for both Cmax and AUC0-24 hours, fell well below the lower limit of the "no-effect" boundary of 0.8 – 1.25, implying that the bioavailability of ATV was significantly reduced in this cohort of subjects. It may thus be concluded that if the reduction in bioavailability observed in this clinical study is found to be clinically relevant, co-administration of SF commercial dosage forms and ATV in HIV/AIDS patients may potentially result in subtherapeutic ATV levels, which may in turn contribute to ATV resistance and/or treatment failure. This research has therefore highlighted the potential risk for toxicity or lack of efficacy of ARV regimens which may result when ATMs and PIs are used concurrently and that patients and health care practitioners alike should be aware of these perils.

Magister Scientiae - MSc / The aim of this study is to isolate and evaluate the anticonvulsant components from the leaves of Leonotis leonorus (L) R.aR. and to see if there is any change in activity with the origin of the plant material and I or the season in which plant material is collected. Therefore, in this study, two sites were chosen for collection of plant material and the collection was made in summer and in winter. Chemical, physical and pharmacological methods were used to isolate, identify and to evaluate compounds isolated from the leaves of Leonotis leonorus for anticonvulsant activity. / South Africa

This qualitative study was aimed at exploring midwives’ responses and attitudes towards women in labour, as well as their perception of the pain experienced during labour. A non-probability purposive sampling method was followed, and the data collection methods selected were in-depth individual interviews and focus-group interviews, with the aid of an interview guide for both methods, the researcher being the main data collecting instrument. More than one data collection method (triangulation) was used to ensure the trustworthiness of the study. Concerning the perception of midwives towards women experiencing labour pain, the study revealed that firstly, labour pain is unique to individual women, it is natural and bearable. Secondly, labour pain may be unbearable, and the women in labour need to be given medication for pain. Furthermore, certain behaviour was identified and viewed as unacceptable by participating midwives because it could put both the lives of the mother and the unborn baby at risk; these include: drinking herbal medicines during pregnancy and childbirth; extreme activities like jumping out of bed and rolling on the floor. These behaviours were sources of frustration to midwives. / Health Studies / M.A. (Health Studies)

La présente étude a été menée dans le but de documenter les connaissances concernant l'utilisation traditionnelle de plantes médicinales par la minorité ethnique K'Ho qui réside au parc national BiDoup-Núi Bà, province de Lâm Đồng, au Vietnam. Une enquête ethnobotanique a été réalisée de 2013 à 2015 sur 139 habitants de trois villages, dont 12 informateurs référents compétents en plantes médicinales et 127 informateurs non spécialistes. À partir de 133 plantes médicinales obtenues à l’issue de l’enquête, deux plantes ont été choisies pour des travaux de recherche. Medinilla septentrionalis (Melastomataceae) est utilisé pour la toux et la diarrhée dans l’ethnie K'Ho. Le criblage phytochimique préliminaire a été réalisé sur 16 extraits bruts obtenus à partir des pousses, tiges, feuilles et des parties aériennes avec différents solvants. Leurs bioactivités ont également été évaluées. L’alpha-amyrine a été isolée à partir de l’extrait dichlorométhane de la tige. Quatre composés: vescalagine, castalagine, méthylvescalagine et l'acide protocatéchique, ont été identifiés à partir de l'extrait méthanolique des tiges.Dacrycarpus imbricatus (Podocarpaceae) est utilisé traditionnelle pour traiter la diarrhée, la toux et les démangeaisons. Seize extraits bruts provenant du bois, de l'écorce, des feuilles et des parties aériennes avec différents solvants ont été soumis à des études phytochimiques et pharmacologiques préliminaires. L’extrait aqueux du bois a été sélectionné pour un fractionnement bioguidé, permettant l’isolement du 3-O--D-Glucopyranosyl--sitosterol. Deux alcaloïdes: la sanjoinine A et à la scutianine C, ont été isolés à partir des parties aériennes par RNM. / The present study was conducted to document the traditional knowledge of medicinal plants used by K’Ho people who reside at BiDoup-Núi Bà National Park, Lâm Đồng Province, Vietnam. An ethnobotanical survey from 2013 to 2015 was carried out with 139 local people from three K’Ho villages, including 12 key informants who are knowledgeable in medicinal plants and 127 non-specialist informants. From 133 medicinal plants obtained through the survey, two potential plants were chosen for further studies. Medinilla septentrionalis (Melastomataceae) is traditionally used for cough and diarrhea. The preliminary phytochemical screening was carried out on 16 crude extracts obtained from sprout, stem, leaves and aerial parts of the plant with different solvents. At the same time, their bioactivities were also evaluated. Dichloromethane extract of stem and methanol extract of sprout exhibiting anti-inflammatory activity were chosen for bioguided fractionation. Alpha-amyrin was isolated from dichloromethane extract of stem. Four compounds, including vescalagin, castalagin, methylvescalagin and protocatechoic acid, were purified from methanol extract of sprout.Dacrycarpus imbricatus (Podocarpaceae) is used for the treatment of diarrhea, cough and itching by local people. Sixteen crude extracts obtained from wood, bark, leaves and aerial parts with different solvents were subjected to preliminary phytochemical and pharmacological studies. Aqueous extract of wood was chosen for the next bioguided fractionation, from which 3-O--D-Glucopyranosyl--sitosterol was isolated. Moreover, two alkaloids obtained from the aerial parts were identified as sanjoinine A and scutianine C.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / A utilização de ervas e plantas para finalidades terapêuticas é bastante antiga e registrada em várias sociedades. Esta pesquisa procura investigar como se dá o processo de construção e reprodução do conhecimento em medicina popular (particularmente o cuidado com ervas e plantas medicinais) através da história de vida de terapeutas populares pessoas que se tornaram referências em suas comunidades por adquirir, praticar e transmitir esse conhecimento. Tem como objetivos conhecer e compreender o processo de construção do conhecimento sobre plantas medicinais por terapeutas populares do município do Rio de Janeiro; compreender as formas de reprodução deste conhecimento; entender o contexto de relações destes terapeutas com o saber científico. Utilizou-se como opção metodológica a história oral com ênfase na história de vida. Foram entrevistados sete terapeutas populares de diferentes bairros do município. Observou-se que o conhecimento em relação às ervas medicinais não está restrito a um pequeno grupo e limitado a uma forma de transmissão oral. O conhecimento tem se reproduzido, mas também tem se modificado, mesclando-se com outras formas de conhecimento e entremeado por diversas fontes de informação que vão desde a transmissão oral até informações disponíveis na mídia. A principal forma de reprodução do conhecimento parece ser a perpetuação do negócio, que evoca o discurso do tradicional, a natureza das ervas e suas propriedades benéficas e se sustenta por uma rede de informação que se utiliza dos diversos meios de comunicação e uma rede de produção e comércio que garante o sustento econômico dos terapeutas populares. A transformação das práticas de utilização de ervas medicinais em patrimônio cultural ou negócio de família além de garantir a perpetuação do conhecimento, garante um espaço diferente dentro das práticas de cuidado em saúde. As relações dos terapeutas com a medicina oficial não são relações de tensões, embora haja criticas, mas de interposição de sistemas terapêuticos. / The use of herbs and plants for therapeutic purposes is quite old and registered in various societies. This research seeks to investigate how the process of construction and reproduction of knowledge in folk medicine (particularly the use of herbs and medicinal plants) through the life story of popular therapists - people who have become references in their communities for acquiring, practicing and transmitting this knowledge. It aims to identify and understand the process of knowledge construction about medicinal plants by popular therapists in the city of Rio de Janeiro; to understand the forms of reproduction of this knowledge; and to understand the context of the relationship between these practitioners and the scientific knowledge. The oral history, with an emphasis on life history, was used as a methodological approach. Seven popular therapists were interviewed in different districts of the city. It was observed that the knowledge about the medicinal herbs is not restricted to a small group and limited to a form of oral transmission. Knowledge has been reproduced, but also has been modified, mingling with other forms of knowledge and punctuated by several information sources ranging from oral transmission to information available in the media. The main form of knowledge reproduction seems to be the perpetuation of a business, which evokes the traditional speech, the nature of herbs and their beneficial properties and is supported by an information network that uses various means of communication and a production and trade network that ensures economic sustenance for the popular therapists. The transformation of the practice of using herbs in cultural heritage or family business ensures the perpetuation of knowledge, and it also ensures a different space within the practices of health care. The relationship of therapists with official medicine is not a tensioned one, although there are criticisms, but one with the interposal of the therapeutic systems.

This dissertation explores discourses about culture and illness in the talk of mental health professionals and indigenous healers. It represents an attempt to situate the issue of indigenous healing in South Africa within a particular strand of critical discourse analytic research. In the context of current deliberations on the value, or otherwise, of indigenous healing in a changing health and specifically mental health system, the talk of both mental health practitioners and indigenous healers as they conceptualise “disorder”, and discuss possibilities for collaboration, is chosen as a specific focus for this study. Disputes over what constitutes “disorder” both within mental health, and between mental health and indigenous healing are an important site in which the negotiation of power relations between mental health professionals and indigenous healers is played out. The results of this study suggest that despite the construction of cogent commendations for the inclusion of indigenous healing in mental health, it remains largely marginalised within talk about mental health practice. While this study reproduces to some extent the marginalisation of indigenous healing discourse, it also examines some of the discursive practices and methodological difficulties implicated in its marginalisation. However, in the context of “cultural pride strategies” associated with talk about an African Renaissance, indigenous healing may also function as a site of assertion of African power and resistance in its construction as an essentially African enterprise. At the same time, it may achieve disciplinary effects consonant with cultural pride strategies, in constructing afflictions in terms of neglect of, or disloyalty to cultural tradition. These results are discussed in terms of the methodological difficulties associated with interviewing and discourse analysis of translated texts, which contributes to difficulties with articulating indigenous healing discourse in a way that challenges the dominant psychiatric discourses implicated in its marginalisation within mental health. It concludes with recommendations for future research which addresses indigenous healing discourse in its own terms, and examines its operation as a disciplinary apparatus in South African society.

Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2016-06-23T20:55:01Z No. of bitstreams: 1 CinthyaSaraivaDeAssis_DISSERT.pdf: 1209351 bytes, checksum: 5bb50037084ea9c40b94cff6abdaf523 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2016-06-28T17:58:44Z (GMT) No. of bitstreams: 1 CinthyaSaraivaDeAssis_DISSERT.pdf: 1209351 bytes, checksum: 5bb50037084ea9c40b94cff6abdaf523 (MD5) / Made available in DSpace on 2016-06-28T17:58:44Z (GMT). No. of bitstreams: 1 CinthyaSaraivaDeAssis_DISSERT.pdf: 1209351 bytes, checksum: 5bb50037084ea9c40b94cff6abdaf523 (MD5) Previous issue date: 2015-10-27 / O uso terap?utico de plantas medicinais tem contribu?do desde a antiguidade de forma ben?fica para a sa?de. No entanto, muitas esp?cies carecem de evid?ncias cient?ficas que forne?am embasamento para a sua utiliza??o na pr?tica terap?utica. Neste contexto, encontra-se a esp?cie Genipa americana L. (Rubiaceae), conhecida popularmente como jenipapo e utilizada como antissifil?tica, antiulcerosa e anti-hemorr?gica, contra hematomas, como t?nico, afrodis?aco, etc. Visto que, essa esp?cie carece de estudos toxicol?gicos, o objetivo deste trabalho foi avaliar a toxicidade in vivo (toxicidade aguda e subcr?nica) e in vitro (citotoxicidade) do extrato dos frutos da G. americana. O extrato hidroetan?lico dos frutos de G. americana foi preparado por macera??o. Foi realizada uma an?lise fitoqu?mica preliminar para avaliar a presen?a de metab?litos secund?rios no extrato. No estudo da citotoxicidade do extrato (0,1; 1,0; 10; 100 e 1000 ?g/100?L) foram utilizadas linhagens de c?lulas normais (3T3) e tumorais (786-0, HepG2 e B16), analisados pelo ensaio do MTT. Para a avalia??o da toxicidade aguda (dose ?nica de 2000 mg/Kg) e subcr?nica (100, 500 e 1000 mg/Kg por 30 dias) foram utilizados camundongos Swiss de ambos os sexos. Ao final dos experimentos, amostras de sangue e ?rg?os foram coletados para an?lise. Os dados entre os grupos foram comparados pelo test T ou por ANOVA com p?s-teste de Dunnett com n?vel de signific?ncia de 5%. O estudo fitoqu?mico do extrato indicou principalmente a presen?a de irid?ides. Os ensaios de citotoxicidade apresentaram resultados de at? 70% de inibi??o celular frente ? linhagem de B16, na dose de 1000 ?g/100?L, e at? 29% frente ? linhagem 786-0, na dose de 10 ?g/100?L. O extrato n?o promoveu morte nas c?lulas 3T3 e HepG2. Durante as avalia??es in vivo, n?o houve mortes de animais. A an?lise das amostras de sangue revelou que os animais submetidos ? avalia??o da toxicidade aguda apresentaram leves altera??es hep?ticas, e que os animais submetidos ? avalia??o da toxicidade subcr?nica apresentaram altera??es no peso relativo do rim esquerdo e na concentra??o plasm?tica de ur?ia. N?o foram observadas diferen?as entre grupos testes e controles na avalia??o histopatol?gica dos ?rg?os coletados. Apesar das altera??es encontradas nos ensaios de toxicidade in vivo, segundo os crit?rios descritos pelos Guias OECD, sugere-se que o extrato hidroetan?lico dos frutos da G. americana seja classificado como de baixa toxicidade. A citotoxicidade do extrato sugere que omesmo possui potencial contra as linhagens de melanoma (B16) e carcinoma renal (786-0). / The therapeutic use of medicinal plants has contributed since antiquity in a beneficial way for health. However, many species lacks of scientific evidence which provide basis for their use in therapeutic practice. In this context is the Genipa americana L. species (Rubiaceae), popularly known as jenipapo and used to treat syfilis, ulcer and hemorrhagic disturbs. It's also used against bruising, as tonic and as aphrodisiac. Due this species lacks toxicological studies, the aim of this study was to evaluate the toxicity in vivo (acute and sub-chronic toxicity) and in vitro (cytotoxicity) of the hydroethanolic extract from G. americana fruits. The hydroethanolic extract of G. americana fruits was prepared by maceration. A preliminary phytochemical analysis was performed to assess the presence of secondary metabolites in the extract. The cytotoxicity study of the extract (0.1, 1.0, 10, 100 and 1000 mg / 100 ul) were performed against normal cells (3T3) and tumor (786-0, HepG2 and B16), analyzed by the MTT assay. To evaluate the acute (single dose of 2000 mg / Kg) and subchronic (100, 500 and 1000 mg / kg for 30 days) toxicity Swiss mice of both sexes were used. At the end of the experiment, blood samples and organs were collected for analysis. Data between groups were compared by t test or ANOVA with Dunnett's post-test with 5% significance level. The phytochemical study of the extracts mainly indicated the presence of iridoids. Results for cytotoxicity tests showed up to 70% inhibition of B16 cell line at a dose of 1000 mg / 100 ul, and up to 29% inhibition of 786-0 at a dose of 10 ug / 100 ul. The extract did not cause death in 3T3 and HepG2 cells. During the in vivo assays, there were no animal deaths. Analysis of blood samples revealed that the animals submitted to the evaluation of acute toxicity had changes in AST and ALT, and that the animals evaluated for subchronic toxicity showed changes in the relative wet weight of the kidney and plasma urea concentration. No differences were observed between groups on histopathological evaluation of the collected organs. Despite the changes found in the in vivo toxicity tests, using the criteria described by the OECD Guidelines, it is suggested that the hydroethanolic extract of the fruits of the G. americana is classified as low toxicity. The cytotoxicity of the extract suggests that they have potential against melanoma cell lines (B16).

M.Sc. / Scientific relevance: Qualitative and quantitative data is presented that give a new perspective on the traditional medicinal plants of the Khoisan (Khoe-San), one of the most ancient of human cultures. The data is not only of considerable historical and cultural value, but allows for fascinating comparative studies relating to new species records, novel use records and the spatial distribution of traditional medicinal plant use knowledge within the Cape Floristic Region. Aim of the study: A detailed documentation and quantitative analysis of medicinal plants of the Kamiesberg area (an important Khoisan and Nama cultural centre) and their medicinal traditional uses, which have hitherto remained unrecorded. Materials and methods: During four study visits to the Kamiesberg, semi-structured and structured interviews were conducted with 23 local inhabitants of the Kamiesberg, mostly of Khoisan decent. In addition to standard methodology, a newly developed Matrix Method was used to quantity medicinal plant knowledge. Results: The Kamiesberg is an important center of extant Nama ethnomedicinal information but the knowledge is rapidly disappearing. Of a total of 101 medicinal plants and 1375 anecdotes, 21 species were recorded for the first time as having traditional medicinal uses and at least 284 medicinal use records were new. The relative importance, popularity and uses of the plants were quantified. The 97 newly documented vernacular names include 23 Nama (Khoekhoegowab) names and an additional 55 new variations of known names. The calculated Ethnobotanical Knowledge Index (EKI) and other indices accurately quantify the level of knowledge and will allow for future comparisons, not only within the Kamiesberg area but also with other southern African communities of Khoisan decent. Conclusion: The results showed that the Kamiesberg is an important focal point of Khoisan (Nama) traditional knowledge but that the medicinal plants have not yet been systematically recorded in the scientific literature. There are numerous new use records and new species records that are in need of scientific study. Comparative data is now available for broader comparisons of the pattern of Khoisan plants use in southern Africa and the study represents another step towards a complete synthesis of Cape Herbal Medicine.