Submitted by Renata Lopes (renatasil82@gmail.com) on 2017-03-21T13:28:30Z No. of bitstreams: 1 andreaestevesmartins.pdf: 1701841 bytes, checksum: d826ca1efe63f5753a059df76821a657 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2017-03-21T13:43:51Z (GMT) No. of bitstreams: 1 andreaestevesmartins.pdf: 1701841 bytes, checksum: d826ca1efe63f5753a059df76821a657 (MD5) / Made available in DSpace on 2017-03-21T13:43:51Z (GMT). No. of bitstreams: 1 andreaestevesmartins.pdf: 1701841 bytes, checksum: d826ca1efe63f5753a059df76821a657 (MD5) Previous issue date: 2016-03-31 / Dentre os principais biomas brasileiros está a Mata Atlântica, onde se encontra inserido o Assentamento Denis Gonçalves, área da antiga Fazenda Fortaleza de Santana, em Goianá, no Estado de Minas Gerais. Sendo assim o presente estudo teve como objetivo, realizar estudo etnofarmacológico no Assentamento Denis Gonçalves com assentados rurais do MST e Colonos, para avaliação do repasse do conhecimento etnofarmacológico e o grau de vulnerabilidade quanto ao uso das principais espécies nativas utilizadas. Para tal, utilizou-se dos métodos: entrevistas semi-estruturadas; coleta de material botânico e obtenção de voucher em Herbário, Análise quantitativa com a utilização do cálculo de risco de utilização e do valor de uso. Também foram realizadas comparações dos conhecimentos etnofarmacológicos em relação à literatura científica e as recomendações da RDC nº 10 – ANVISA, para sugestão de implantação prioritária em horto medicinal. Com utilização de cálculos estatísticos, as plantas medicinais foram selecionadas quanto a sua relevância de uso para os entrevistados e, para aquelas espécies nativas de Floresta Atlântica, foram avaliadas quanto ao estado atual de conservação na área de estudo, para assim levantar consequentemente, subsídios à construção de plano de manejo sustentável. Em relação ao conhecimento etnofarmacológico local, foi possível inventariar no grupo do MST, 105 espécies referentes a 41 famílias botânicas, e nos Colonos, 75 espécies referentes a 32 famílias botânicas. Não foi verificado extrativismo específico quanto às espécies nativas em relação ao uso medicinal local. As espécies utilizadas em ambos os grupos, atendem as demanda de saúde local. Sendo assim, elencou-se 20 espécies com respaldo da RDC nº10 – ANVISA, para posterior implantação em horto medicinal comunitário que se encontra em fase de implantação no presente momento. / Among the main Brazilian biomes is the Atlantic Forest, which is located settlement Denis Goncalves, area of old farm Fortaleza de Santana, in Goianá in the state of Minas Gerais. This study aimed, perform ethnopharmacological study on settlement Denis Gonçalves (with the MST and Colonos groups), to evaluate the transfer of ethnopharmacological knowledge and the degree of vulnerability regarding the use of the main native species used. We used the methods: semi-structured interviews; collection of botanical material and voucher record in Herbarium, quantitative analysis using the use of risk calculation and use value. They were also made comparisons of ethnopharmacological knowledge regarding the scientific literature and the recommendations of the RDC nº 10 - ANVISA for priority implementation of suggestion in medicinal garden. Medicinal plants have been selected as their relevance to use for the respondents and for those native species of Atlantic Forest, they were evaluated for the current condition in the study area, thus raising consequently subsidies for the construction of sustainable management plan. Regarding the location ethnopharmacological knowledge, it was possible to inventory the MST group, 105 species pertaining to 41 botany families, and the Colonos groups, 75 species related to 32 botany families. It was verified as specific extraction to native species in relation to the local medicinal use. The species used in both groups, local health meet the demand. Thus, it has listed 20 species, with support from the RDC º 10 - ANVISA for later implementation in Community medicinal garden that is being implemented at present.

>Magister Scientiae - MSc / Hypertension is a common chronic health problem worldwide due to contributing factors such as obesity, physical inactivity, unhealthy diet and changes in lifestyle. The standard of care for hypertension in South Africa is prescription medication, as well as a stepwise programme; this treatment approach is for the treatment of hypertension according to severity using diuretics, beta-blockers, vasodilators in a stepwise progressive manner. In South Africa,traditional herbal medicines have been used to treat many ailments especially hypertension.Garlic and African olive has been reported as herbal medicines that have anti-hypertensive properties and may be used to control hypertension, either individually or in combination.The objective of this study is to 1) prevalence of these traditional herbal medicines will be investigated and 2) determine the prevalence of garlic and/ or African olive use among hypertensive patients lieu of/or in combination with prescription medication. The study design was cross-sectional, comprising of two phases. Phase one was the administration of questionnaires concerning the participants‘ demographics, medical/clinical history, chronic illness and traditional herbal treatment. One hundred and eighty participants from Prospective Urban Rural Epidemiological study (PURE) cohort were administered questionnaires. Of the 180 participants, 139 indicated that they are hypertensive, 30 hypertensive participants were selected to participate in the in-depth interviews. Phase two was divided into two parts which were detailed interviews including in-depth interviews and a focus group discussion. The focus group discussion was conducted with a convenience sample of 10 hypertensive patients who were available on the day of data collection. The questionnaire data was analysed with the Statistical Package for the Social Sciences (SPSS) and the interviews and focus group discussion was analysed using thematic content analysis.The results show that the participants with hypertension who are on prescription medication are also using traditional herbs, garlic and African olive as part of a dualistic health care treatment for their hypertension. The use of garlic is more prevalent than the use of African olive, as African olive was not well known among the participants.The results will facilitate in the acknowledgment of traditional herbal medicine use for hypertension, as either a home remedy for (other) chronic conditions or treatment in combination with prescription medication. It also highlights the necessity to educate participants and healthcare providers in the use of traditional herbal medicine. Furthermore, healthcare workers needs to be trained about THM and should also be obligated to ask about traditional herbal medicine among their patients.

Magister Scientiae (Medical Bioscience) - MSc(MBS) / Amygdalin, a controversial anti-cancer agent, is a cyanogenic glycoside plant compound found in apricot and peach kernels. Both amygdalin and its patented form, Laetrile®, have been promoted and sold as "vitamin B-17", although neither compound is a vitamin. No consensus on the efficacy of amygdalin regarding the treatment of different cancers has been reached. Cancer is now the third leading cause of death worldwide. More than 7.6 million deaths were estimated to have occurred in 2007 and by 2030 it is projected to increase to 17 million cancer deaths per year. Cancers of the lung, breast, colon/rectum, liver and prostate are no longer largely confined to Western industrialized countries but are among the most common cancers worldwide (Thun et al. 2010). In South Africa it is estimated that one in every four males and one in every five females will be affected by a cancer diagnosis in their lifetime. The most common cancers in males are prostrate, lung, oesophagus, bladder and colorectal and in females they are cervix, breast, colorectal, oesophagus and lung (Haggar & Boushey 2009). Colon cancer is one of the most prevalent cancers worldwide, especially in western societies and is nutrition dependent (Klenow et al. 2009). It is one of the leading causes of death in both men and women in industrialised western countries. Colon cancer development involves both hereditary factors and lifestyle factors which include absence of physical exercise, unbalanced nutrition and long term smoking (Forman et al. 2004; Heavey et al. 2004). Colon cancer is traditionally treated by the resection of the colon, chemotherapy, radium therapy, and pharmaceutical hormonal drugs (Willson et al. 1987; Padussis et al. 2004)). Epidemiological studies supports evidence that colon cancer is preventable by adjusting the diet (Forman et al. 2004) and a protective effect is attributable to polyphenols and foods such as fruits and vegetables (Araújo et al. 2011). It was reported by Ruan et al. (2006) that the addition of Chinese Herbal Medicine in conjunction with chemotherapy notonly raised the efficacy of the chemotherapeutic drug, but also reduced the toxic side-effects. The aim of this research was to carry out a comparative in vitro study of the anti-tumour effect of the Chinese , South African and Turkish apricot (Xing ren / Armeniacea Semen) and Chinese and South African peach (Tao ren / Persica Semen) kernel extracts on the HT-29 colon cancer cell line.All the extracts significantly reduced cell viability and inhibited proliferation in the HT-29 cancer cells after 24 hours with the lipophilic and total fractions of CAK being the most effective. After 72 hours, it is clear that the inhibitory effects have been abolished and replaced by a stimulatory effect as the cell viability is higher in the treated cultures than the untreated controls. Results show that the total and the hydrophilic fractions of all the kernels increased cell viability more than the lipophilic fractions. It cannot be said with certainty that it was the amygdalin metabolite cyanide that affected the cell viability or induced apoptosis on its own. If hydrolysis of amygdalin indeed happened and cyanide was produced, it would affect the cells by shutting down aerobic respiration. Since cancer cells have more β- glucosidases and less rhodanese than normal cells, it is a possibility that the HT-29 cancer cells had some rhodanese to convert cyanide into a relatively harmless compound thiocyanate. It could be that in vitro this conversion, in light of the low enzyme levels in the HT-29 cancer cells, happened slowly and that the effect was only seen after 48 hour. However, this does not explain the overall inhibition even by the lipophilic fractions that should not contain any amygdalin or the eventual stimulatory effect, observed from 48 hour onwards.The S phase block observed, was mostly seen after 24 hour exposure to organic extractions, with the SAK showing 86% of cells in the S phase in contrast to the aqueous extractions which only slightly increased the S phase fraction. This could indicate that synergistic and/or additive effects between polyphenolic compounds may also be responsible for the reduction of cell viability, proliferation and apoptosis. All the kernels and the various fractions affected cell viability and to an extent cell cycle progression, but more studies is needed to establish the most effective kernel and specific fraction or signature active component. Inhibition of cell viability and proliferation and the induction of apoptosis could be an important preventive approach in chemoprevention. Understanding how dietary components regulate proliferation and cell survival could play a critical role in development of new enriched agents that can prevent and treat cancer with reduced risk of toxicity.

Magister Pharmaceuticae - MPharm / Medicines (CMs) are widely available to the South African public. However, CMs have not yet been evaluated by the Medicines Control Council (MCC). The MCC has published new guidelines for the regulation of CMs, with which CM companies are required to comply. OBJECTIVE: Determine to what degree Western Herbal CM labelling complies with the MCC’s requirements. METHODS: Thirteen CM products containing recognised Western Herbal ingredients were selected from pharmacies in the northern suburbs of Johannesburg. Labelling information on the immediate and outer container labels, as well as the package inserts, was investigated. The relevant corresponding European Medicines Agency (EMA) monographs and MCC guidelines were used to assess compliance. RESULTS: None of the products complied with the product dosage section of the monographs. Furthermore, the products contained indications that were not present in the monographs. The products did not fully meet the MCC’s mandatory minimum labelling requirements, and they did not demonstrate total compliance with all of the MCC’s requirements for product labels and package inserts.

This thesis applied a novel interdisciplinary approach for pharmacovigilance to examine the use of complementary and integrative medicine (CIM), focusing on herbal remedies, to manage pediatric attention-deficit hyperactivity disorder (ADHD). The safety and potential risk of herb-drug interactions in ADHD management were first evaluated through an assessment of available information on the safety and efficacy of natural health products (NHPs) commonly used by ADHD patients as a means of identifying knowledge gaps. A clinical questionnaire was administered to caregivers of pediatric patients with ADHD to determine the factors and related outcomes of CIM use, including adverse events. A systematic search was conducted to further identify clinical adverse events involving herbal remedies and ADHD drugs to determine causal links to herb-drug interactions. In vitro analysis of identified herbal remedies was conducted to determine their potential for pharmacokinetic interactions, specifically on carboxylesterase-1 (CES1) mediated metabolism. The presented research builds on otherwise scarce evidence of the safety of herbal remedies for ADHD, particularly with respect to herb-drug interactions and adverse events (AEs) associated with concurrent use of NHPs and ADHD prescription drugs. Beyond studies conducted on the pharmacokinetic safety of herbal remedies through the cytochrome P450 pathways that metabolize some ADHD drugs, including amphetamine, atomoxetine and guanfacine, few data were available for CES1, which metabolizes methylphenidate, the first line of drug used to manage ADHD. The clinical questionnaire revealed that 40% of patients had used CIM and confirmed the use of a variety of CIM. Moreover, the majority of CIM users were also concurrently taking ADHD medication, and eight mild adverse events were self-reported. The systematic search on the adverse event reporting system highlighted a potential NHP-drug interaction between methylphenidate and St. John’s wort, and the overall poor quality of NHP-related adverse event reports. As a follow-up from the adverse event results, various commercial St. John’s wort products showed variable inhibition of recombinant human CES1 in vitro. Although the concentration of marker phytochemicals was not correlated to inhibition, hyperforin showed stronger activity than hypericin and quercetin. The preliminary in vitro investigation revealed that the herbal remedies used by ADHD patients have the potential to interact with CES1 mediated metabolism, with Rhodiola rosea identified as the most potent inhibitor. Further investigation on various commercial products of Rhodiola rosea revealed both reversible and irreversible inhibition of recombinant CES1. However, the inhibition was not dependent on the concentration of marker phytochemicals, and rosarin, rosavin, rosin, and salidroside were not potent inhibitors of recombinant CES1. Moreover, a commercial Rhodiola rosea extract showed concentration-dependent inhibition of human liver microsome meditated metabolism of methylphenidate. Overall, results from this thesis suggest potential risk from use of NHPs concurrently with conventional medicine used to manage ADHD. Improved evidence and pharmacovigilance for the use of NHPs in a pediatric population is warranted.

There is an increasing interest in ethnomedical and ethnoveterinary practices, especially as it relates to the use of medicinal plants for treating various ailments. As a result, the current trend in government health authorities is to integrate herbal medicine with primary healthcare. This arises because nearly 80% of people in the developing world, particularly those from rural communities where modern drugs are unaffordable, inaccessible or, unavailable, depend on phytomedicine for primary healthcare. Despite this, however, most medical and veterinary professionals distrust herbal medicines due to concerns of scientific evidence of efficacy and safety. Hence, there is need for their validation, before herbal medicines gain wider acceptance and use. Traditional healers and rural farmers use extracts of Peltophorum africanum (a medicinal plant wide-spread in southern Africa and other tropical regions), to treat diarrhoea, helminths and abdominal parasites, dysentery, HIV-AIDS, acute and chronic pain, anxiety and depression, infertility, and to promote well-being and resistance to diseases. To evaluate these ethnobotanical leads, dried leaves, bark and root from mature P. africanum (Fabaceae) trees were extracted with acetone, ethanol, dichloromethane and hexane. Chromatograms were made on silica gel plates. Thin layer chromatograms (TLC) were sprayed with 0.2% 2, 2-diphenyl-1-picryl hydrazyl (DPPH) for qualitative screening for antioxidants. Quantification of antioxidant activity was done in comparison with L-ascorbic acid and Trolox (6-hydroxy-2, 5, 7, 8-tetranethylchromane-2-carboxylic acid). With regard to the extracts, minimum inhibitory concentrations (MIC) were determined for Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa and Enterococcus faecalis. The total antibacterial activity (TAA), signifying the volume to which active compounds present in 1 g of plant material can be diluted and still inhibit bacterial growth, was also determined. In vitro anthelmintic activity was evaluated by effects of acetone extracts on the egg hatching and larval development of parasitic nematodes Haemonchus contortus and Trichostrongylus colubriformis. The eggs and larvae of the two parasites were incubated in various concentrations of the leaf, bark and root extracts for two and five days respectively. Furthermore the efficacies of the acetone extracts were tested on lambs artificially induced with H. contortus and T. colubriformis infections. Toxicity was performed in brine shrimp and MTT assay on Vero monkey kidney cells. The extracts had substantial activity against both Gram-positive and Gram-negative bacteria, with MIC values of 0.08 mg ml-1 for Staphylococcus aureus and 0.16 mg ml-1 for Pseudomonas aeruginosa ; the corresponding TAA values were 1263 and 631 ml g-1. The acetone extracts the bark, and root of P. africanum had higher antioxidant activity than L-ascorbic acid (Vitamin-C) and Trolox (6-hydroxy-2, 5, 7, 8-tetramethylchromane-2-carboxylic acid), a synthetic vitamin-E analogue, and much higher than Ginkgo biloba extract (EGb 761). The standardized extract of Ginkgo biloba (EGb 761) is widely employed for its significant benefit in neurological disorders. The respective EC50 for the P. africanum root , bark and leaf extracts, L-ascorbic acid, and EGb761 were 3.82 µg ml-1, 4.37 µg ml-1, 6.54 µg ml-1, 5.04 µg ml-1, and 40.72 µg ml-1. The extracts inhibited egg hatchability and larval development (from L1 to infective stage L3) of both H. contortus and T. colubriformis (both parasitic nematodes of ruminants) at concentrations of 0.2-1.0 mg ml-1. The plant extracts, at concentrations of 5-25 mg ml-1 completely lysed larval forms (L1) and eggs of the nematodes. In all assays, the root extracts had higher antibacterial, antioxidant and anthelmintic activity than the bark and leaf. Although the extracts were safe and non-toxic, the reduction in faecal egg and adult worm counts in lambs infected with H. contortus and T. colubriformis was not statistically significant (P=0.073). From the acetone extracts of the root, a brownish crystalline compound, bergenin was isolated. Bergenin was also assayed for toxicity with brine shrimp and Vero monkey kidney cells like the extracts, where the compound was found to be not toxic. In a disc diffusion test, the inhibitory activition of bergenin was determined for the bacteria E. coli, P. aeruginosa, Mycobacterium vaccae, and the fungi Sporobolomyces salmonicolor and Penicillium notatum. Bergenin had reasonable antimicrobial activity against S. salmonicolor, moderate activity against M. vaccae, E. coli and P. aeruginosa, but non inhibitory against P. notatum. P. africanum extracts have therefore, potential for treatment of infection-related diseases by either directly inhibiting bacterial growth or by stimulating the immune system of the host. The traditional use of P. africanum concoctions against diarrhoea, dysentery and unthriftness, may be also due to anthelmintic activity as these signs are consistent with parasitic astroenteritis. Antioxidants are also important in boosting the immunity, critical in the management of helminthosis. There is ample scientific and empirical evidence supporting the use of plantderived antioxidants in the control of human immunodeficiency virus (HIV) and neurological diseases. Synergistic activity of plant antioxidants has been proposed as a mechanism by which viral replication and immune cell killing in HIV infection can be inhibited. Antioxidants may have neuro-protective (preventing apoptosis), as well as neuro-regenerative roles. Due to the high antioxidant activity of its extracts, P. africanum has prospects in the chemotherapy of HIV and management or control of neurodegenerative diseases. Thus there is great potential of P. africanum extracts in medicine. Further isolation and bioassay characterization of bioactive compounds from P. africanum is recommended as well as refinement of in vivo tests in target livestock, or clinical trials. Better methods of plant extraction easily adaptable to rural communities for sustainable exploitation of the tree, may have to be devised especially those using the leaves instead of bark or root. / Thesis (PhD(Paraclinical Sciences))--University of Pretoria, 2007. / Paraclinical Sciences / unrestricted

Thesis (M.Sc. (Nursing Science)) -- University of Limpopo, 2021 / Black South African women use herbal medicine during the intrapartum period. Research has proven that some herbal medicine may have a negative impact on both the mother and the fetus during labour and delivery. The aim of the study was to investigate the use of herbal medicine by pregnant women during the intrapartum period, at selected public hospitals in the Sekhukhune District, Limpopo, South Africa. The objectives of the study were to determine the use of herbal medicine by pregnant women during the intrapartum period and to develop a health education programme for communities around the Sekhukhune District, Limpopo, South Africa. Quantitative research method was used, and data were collected using selfdesigned questionnaire. Total of 192 respondents out of 370 population participated in the study. Simple random sampling was used. The questionnaire was piloted in a different setting to ensure reliability. Data were analysed using SPSS version 24. The outcome of the analysis was presented as frequencies and percentages in tables, pie charts and bar graphs. Ethical standards were adhered to throughout the study. One hundred and ninety-two (192) women were invited to participate in the study all of which were from surrounding areas. None of the women declined participation. A total of 192 post-partum women answered the questionnaires. Of the 192, 76% used herbal medicine during the intrapartum period. The mean age is 19 years. Mostly, those who are Sepedi speaking are dominant in the area (at 76%). Pregnant women commonly ingested herbal medicine to induce labour or during labour to accelerate delivery at 56%. The result highlighted that the prevalence of the use of herbal medicine during the intrapartum period was high among women in the Sekhukhune District. Therefore, healthcare professionals should have knowledge about herbal medicine used by pregnant women during the intrapartum period and educate them about the dangers and effects of the herbal medicines, both to the mother and the fetus.

京都大学 / 0048 / 新制・論文博士 / 博士(農学) / 乙第12822号 / 論農博第2795号 / 新制||農||1025(附属図書館) / 学位論文||H26||N4817(農学部図書室) / 31309 / 京都大学農学研究科食品生物科学専攻 / (主査)教授 喜多 恵子, 教授 三上 文三, 教授 栗原 達夫 / 学位規則第4条第2項該当 / Doctor of Agricultural Science / Kyoto University / DFAM

京都大学 / 0048 / 新制・課程博士 / 博士(社会健康医学) / 甲第18516号 / 社医博第57号 / 新制||社医||8(附属図書館) / 31402 / 京都大学大学院医学研究科社会健康医学系専攻 / (主査)教授 川上 浩司, 教授 横出 正之, 教授 佐藤 俊哉 / 学位規則第4条第1項該当 / Doctor of Public Health / Kyoto University / DGAM

Health can be described as both a product and a process of life, and is necessary for human wellbeing, overall quality of life and productivity. While health is generally desirable, many factors affect health and health outcomes of individuals and populations the world over. Virtually all individuals will be faced with one health problem or another during their lifetime, that requires some form of health care intervention. Whatever their reasons for seeking care, all health care consumers share a common interest – a desire to get better. In a pluralistic health care environment where different avenues exist for seeking and receiving health care, differential choice of care may be influenced by sociodemographic and related factors. To the extent that the available avenues for seeking and receiving health care do not offer the same opportunities for improving health, significantly different health outcomes may be realized for comparable conditions for which different types and volume of health care are sought and received. Understanding the factors that influence health-seeking behaviors among various populations may therefore, be an important first step in designing intervention programs that nudge health consumers toward better health-seeking behaviors with the goal to improving health and health outcomes among these populations. The purpose of this research was to develop a research instrument for studying health-seeking behaviors based on the Health Belief Model, and to use the instrument to study the factors that influence/predict health-seeking behaviors among Ghanaians. Using a convenience sample of 504 participants recruited from the Greater Accra, Ashanti, Volta and Northern Regions, analyses of the data showed that different sociodemographic characteristics such as age group, gender and health insurance status as well as selected modified constructs of the Health Belief Model such as Perceived Barriers to mainstream care, variously and collectively influence health-seeking behaviors at government and private health facilities, self-medication with herbal and pharmaceutical drugs, faith healing and care from traditional/herbal practitioners. Based on the findings of this study, the author concludes that health-seeking behaviors in Ghana are influenced by a multiplicity of factors including sociodemographic characteristics. Subsequently, recommendations for a more extensive study with a complementary qualitative enquiry are made in order to gain a more wholistic insight of the drivers of health-seeking behaviors in Ghana.