The gut-brain axis is a bidirectional communication system that exists between the brain and gut. Several studies claimed that some types of headaches are associated with various gastrointestinal (GI) disorders. In Persian medicine (PM), physicians believed gastric disturbances could stimulate headache and introduced some herbs for boosting gastric function as a therapeutic remedy for headache. Here we review the current evidence for the gastroprotective and antiheadache effects of herbs used in PM. Herbs used for their gastrotonic effects in PM were identified from selected Persian medical and pharmaceutical textbooks. PubMed, Scopus and Google Scholar were used to search for contemporary scientific evidence relating to the gastric and neurologic effects of these plants. A total of 24 plants were recorded from the selected sources included in this review, most of which belonged to the Rosaceae family. Phyllanthus emblica, Zingiber officinale, Boswellias errata, Punica granatum and Hypericum perforatum had the most recent studies related to GI disorder and headache, while current research about quince, rose, apple, hawthorn and pear was limited. Reducing Helicobacter pylori growth, gastritis, erosion of the stomach lining, hemorrhage and perforation, improving gastric mucosal resistance, antisecretary, antiulcer, antipyretic, analgesic, sedative, anxiolytic, anti-inflammatory, anticonvulsant, neuroprotective and antioxidant effects as well as improvement in memory scores were some of the gastrotonic and neuroprotective mechanisms described in the current research. These results confirmed that medicinal plants prescribed in PM may improve headache in patients through the management of GI abnormalities. However, further studies are recommended to investigate the efficacy and safety of the mentioned medicinal plants.

Natural plant-based remedies for diabetes mellitus have been proven to be safe and effective alternatives to Western medications, and details about more than 400 plants are available in the literature. Sri Lanka is a tropical country which is blessed with many natural plant products that can be utilized for the treatment of diabetes. But the knowledge of these plant-derived remedies, especially their doses, mechanism of action and toxicity has not been extensively researched. Therefore, this review focuses on documenting the plant-based remedies that the Sri Lankan Aurvedic physicians use and the extent of research that has been carried out on each of these plant-based remedies.

Galen (129–199 A.D.), an ancient Greek scholar, is one of the most influential and recognized physicians and surgeons in the history of medicine. He is one of the most influential Greek scholar in Persian medicine, which has been repeatedly cited by Iranian scholars. The purpose of this article is to describe the exact position of Galen in Avicenna’s The Canon of Medicine, the most important work of Persian medicine. In The Canon of Medicine, Galen is cited about 300 times, and Avicenna always admired and praised Galen repeatedly. Galen’s ideas were important to Avicenna, but there are also many elements of Galen’s views that Avicenna challenged or criticized. For example, Avicenna diverged from Galen’s philosophical view in medicine and rejected some of Galen’s pharmaceutical opinions and Galen’s views on the physiology of pain, the physiology of pulse, the same nature of the tendons and nerves and separation of the mind and body. Although the views of Greek scholars, especially Galen, in The Canon of Medicine have been quoted abundantly, Avicenna revised the knowledge of the ancient scholars through critical thinking and relying on observation and testing, systematized the science of medicine and introduced many ideas and innovations. As such, Europeans considered Avicenna as the most prominent physician of the Islamic Golden Age.

Background

Venous ulcer represents the most advanced stage of chronic venous insufficiency. It is an important public health problem and has a significant impact on patients’ quality of life due to chronic pain, inability to work, need for hospitalization and frequent outpatient follow-up.

Objective

We investigated the treatment benefits of far-infrared ceramic (cFIR), in a 90-day study of lower limb venous ulcers and looked at ulcer healing scores, quality of life, serum bio-markers of oxidative stress and antioxidant defense enzymes.

Design, setting, participants and interventions

This is a randomized double-blind placebo-controlled study conducted in the Vascular Surgery Service of a hospital located in the northwest region of the State of Rio Grande do Sul, Brazil. We included patients with lower limb venous ulcers who were randomized to use either a bioceramics wrap or a placebo wrap for 90 days.

Main outcome measures

The following evaluations were conducted at baseline and after 15, 30, 60 and 90 days: ulcer healing score, quality of life, and serum markers of oxidative stress and antioxidant enzyme activity.

Results

Patients (n = 24) with lower limb venous ulcers were randomized into two treatment groups. cFIR decreased the ulcer size on day 30 (P = 0.042) and 90 (P = 0.034) and the total ulcer healing scale scores on day 30 (P = 0.049) and 90 (P = 0.02) of the treatment, when compared to baseline. Additionally, cFIR improved tissue type (epithelial tissue) on day 60 (P = 0.022) when compared to baseline evaluation.

Conclusion

cFIR clinically improved ulcer healing in patients with lower limb venous ulcers.

Trial registration

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Background

Triphala extract is a well known medicinal herbal formula which is usually prescribed by Thai traditional doctors to adjust the physiological functions of the body. Previous studies have reported that Triphala has antioxidant, anti-inflammatory, antihypercholesterolemia and anticancer properties. Though this herbal recipe is commonly used in Thailand, its human safety, especially in the oral form, has not been studied. We therefore conducted a clinical trial (Phase I).

Objective

This study evaluated the safety of administering the aqueous extract of Triphala to healthy volunteers at 2500 mg/d.

Design, setting, participants and interventions

An open-label, single-arm trial was conducted at Chulabhorn International College of Medicine, Thammasat University, Pathum Thani, Thailand, between July 2017 and July 2018. The study enrolled 10 male and 10 female healthy volunteers; all were given Triphala (water extract; five capsules of 500 mg each) orally, once a day, at bedtime, for four consecutive weeks.

Main outcome measures

Signs and symptoms, physical examinations, hematology and blood chemistry were assessed at the beginning of the trial and every week thereafter, for four consecutive weeks. After finishing the trial, on day 28, all volunteers were invited to a follow-up session on day 35 to evaluate the safety of the herbal recipe using the same measurements.

Results

At the oral dose of 2500 mg/d, Triphala had no serious adverse effects in healthy volunteers. Moreover, it was found to have significantly improved the volunteers’ high-density lipoprotein cholesterol (HDL-C) levels on day 35 and also reduced their blood sugar levels on days 14 and 35.

Conclusions

We conclude that aqueous extract of Triphala is safe for healthy volunteers and that it elevates HDL-C levels and lowers blood sugar. Further clinical study should investigate its effects on HDL-C and blood sugar levels among the dyslipidemic and prediabetic groups.

Trial registration

This trial was registered in the Thai Clinical Trial Registry with the identifier TCTR20180423002.

Objective

This study investigated the biochemical, histopathological and physiological effects of Citrullus colocynthis on peripheral neuropathy in rats with streptozotocin (STZ)-induced diabetes.

Methods

Seventy adult male Sprague-Dawley rats were included in the present study. Diabetes was induced in 60 rats, with a single intraperitoneal injection of STZ (65 mg/kg). After 4 weeks, the diabetic rats were assessed for neuropathy. Then, the diabetic rats with neuropathy were randomly divided into 6 groups for a 4-week treatment with gabapentin, oral administration of C. colocynthis fruit pulp powder (100 and 300 mg/kg per day), topical preparations as oil-based solution and ointment, or placebo. Changes in metabolic, physiological, biochemical and histological parameters were considered as treatment outcomes.

Results

Metabolic outcomes (body weight and blood glucose level) were improved in the C. colocynthis-treated groups as compared to placebo. Tail-flick and hot-plate tests also had lower latency in the C. colocynthis-treated groups. Measurement of oxidative stress markers (malondialdehyde, superoxide dismutase and catalase) showed the antioxidant effect of C. colocynthis. Histological evaluation of the sciatic nerve showed that C. colocynthis decreased the number of demyelinated and degenerated nerve fibers. Among the C. colocynthis-treated groups, the one receiving 100 mg/kg per day oral powder had the best treatment outcomes.

Conclusion

The present study showed that C. colocynthis fruit, through its antioxidant and hypoglycemic activities, has a positive effect in the treatment of diabetic neuropathy.

Objective
Tocotrienols (T3s) have been hypothesized to have greater antioxidant capacity than tocopherols (Ts) due to differences in biokinetics that affect their absorption and function. The present trial compares the antioxidant effectiveness following postprandial challenge of two different doses of α-T or palm T3-rich fraction (TRF) treatments and evaluates their dose-response effects on antioxidant status.

Methods
Ten healthy volunteers were given four different doses of vitamin E formulations (268 mg α-T, 537 mg α-T, 263 mg TRF or 526 mg TRF) in a cross-over postprandial trial. Blood was sampled at 0, 2, 4, 5, 6 and 8 hours after meal consumption and plasma antioxidant status, including total glutathione, superoxide dismutase, malondialdehyde (MDA), ferric reducing antioxidant potential and trolox-equivalent antioxidant capacity, was analyzed.

Results
Supplementation with the different doses of either α-T or TRF did not significantly improve overall antioxidant status. There was no significant difference in overall antioxidant status among treatments at the different doses compared. However, a significant dose-response effect was observed for plasma MDA throughout the 8-hour postprandial period. MDA was significantly lower after the 537 mg α-T treatment, compared to the 268 mg α-T treatment; it was also lower after the 526 mg TRF treatment compared to the 263 mg TRF treatment (P < 0.05).

Conclusion
T3 and α-T demonstrated similar antioxidant capacity, despite markedly lower levels of T3 in blood and lipoproteins, compared to α-T.

Objective

The objective of this study was to evaluate the in vitro antiplasmodial properties against malaria parasite in 15 plants mentioned in Indian traditional medicine texts.

Methods

In vitro antiplasmodial activity of methanolic extracts obtained from Indian traditional medicinal plants was evaluated on Plasmodium falciparum of FCK2 and INDO strains using schizont maturation inhibition assay and parasite lactate dehydrogenase inhibition assay.

Results

Methanolic extracts of Adhatoda zeylanica, Embelia ribes, Piper nigrum and Plumbago zeylanica exhibited more than 50% inhibition in both the stains in schizont maturation inhibition asaay. Methanolic extracts of seven medicinal plants exhibited antiplasmodial activity at half maximal inhibitory concentration (IC50) ? 100 μg/mL, and methanolic extracts of five medicinal plants exhibited antiplasmodial activity at IC50 ? 50 μg/mL in P. falciparum lactate dehydrogenase (PfLDH) inhibition assay. A. zeylanica, E. ribes and P. nigrum exhibited promising antiplasmodial activity in PfLDH inhibition assay. A. zeylanica and E. ribes exhibited improved activity against resistant in comparison to sensitive strain.

Conclusion

A. zeylanica and E. ribes were the most promising extracts from this study and deserve further investigation of their antiplasmodial properties.