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Medicinal plants: new opportunities
Conservative treatment can prevent knee-replacement surgery
Health Notes
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Medicinal plants: new opportunities
The reason for greater acceptability of plant products in human body can be traced to the “biological friendliness” between the animal and plant kingdoms. A synthetic compound, on the other hand, is a “foreign body” in the human system which may cause toxic side-effects. It is, therefore, not surprising that out of about 1000 new drugs introduced in the last 25 years, more than half are natural products or derived from them or are mimics. Nearly one-third sale of anti-cancer drugs is from taxols and camptothecin which are derived from plants. Prolonged use of drugs may be harmful. It has been estimated that about a 100,000 people die every year in the US alone due to the side-effects of drugs. Alarmed with such a situation, US Congress passed the Dietary Supplement Health and Education Act (DSHEA) in 1994, allowing the sale of herbal preparations without the expensive and time-intensive clinical trials, thereby getting products to the store shelf more quickly and cheaply. It was also stipulated in DSHEA that such products (dietary supplements) can only claim to prevent a disease’s symptom and not cure the disease! DSHEA puts the onus on the FDA to prove that a supplement poses risk or harms rather than on the manufacturer to prove the supplement’s safety. European Parliament passed a adequate law in 2003 making easy the marketing of traditional herbal medicines with the rider that marketing companies will have to demonstrate safe use of herbal products for 15 years within Europe and at least 30 years in its country of origin. Canada also allowed the entry of herbal products if traditional references like translated Sanskrit texts or anthropologically validated traditions can prove that it has been safely used for at least 50 years. Thus, we are witnessing an era of world-wide interest in plant products being used as drugs. Herbal preparations are particularly used for the management of chronic disorders. It has been estimated that some of the diseases where these products have found wide application are breast cancer, liver diseases, HIV, asthma and rheumatological disorders. Obtaining drugs from plants has been a traditional way in the Indian system of medicine. It is rightly said that ancient wisdom has been and will remain the basis of modern medicine. The Ayurvedic system, well documented in the ancient scriptures such as the Atherv-Veda (1200 BC), Charak Samhita and Sushruta Samhita (1000 BC), is being still practised in India. This system is of great significance due to the wide variation in climatic conditions when one travels from Kanyakumari to Kashmir and from the deserts of Rajasthan to the rain forests of Assam. Such a great biodiversity had allowed Ayurvedic practitioners to do experimentation with plants which were thought to possess therapeutic properties. The Ayurvedic system should not be confused with folk medicines as it is based on sound scientific principles developed over hundreds of years of experimentation, careful observation of medicinal properties and the side-effects associated with their use. Many compounds, including reserpine (sarpgandha, rauwolfia serpentina) and psoralene (babchi, psorylia corylifolia), have indeed been isolated using modern methodology of isolation and have been shown to display the same medicinal properties as described for the plant extract thousands of years before. As a result of sustained efforts, a few leads developed in India are: bacoside (memory enhancer) from bacopa monnieri, picroliv (hepatoprotective) from picrorhiza kurrora, curcumin (anti-inflammatory) from curcuma domestica and contraceptive cream from sapindus mukorossi. India’s traditional system of medicine, primarily based on Ayurveda, has been exploited by companies in the West by filing patents. It was found that a majority of the patents granted by the US Patent and Trademark Office (US PTO) on medicinal plants were on plants of Indian origin. The European Patent Office (EPO) has also granted patents on the use of many Indian medicinal plants such as methi, amla, zira, kali tulsi, papaya and pudina. It is estimated that till now, India has lost over 15,000 patents of medicinal plants to the West. Some recent examples include granting a patent on the wound-healing properties of haldi (turmeric) by the US PTO and the anti-fungal properties of neem by the EPO, even though the plants were being used for centuries in India for such benefits. India contested these patents and they were revoked in 1997 and 2005, respectively. Since contesting and revoking the patents is a time-consuming and expensive process, the Council of Scientific and Industrial Research (CSIR) has prepared the world’s first Traditional Knowledge Digital Library (TKDL) early this year. TKDL documents over two lakh medical formulations of Ayurveda, Siddha and Unani systems to save them from piracy. This library, which is available in five languages — English, French, German, Japanese and Spanish — has millions of pages of information about the application of plant products (and other traditional sources) being used for medicinal purposes. Researches have indicated that many herbal medicines, edible plants and plant products play a significant role in cancer chemoprevention due to their long history of human consumption. Many such products and the compounds isolated from plants, which are currently under clinical trials, are: curcumin (phase 1, colon cancer), genistein (phase 1, breast cancer), green tea (phase 2, breast cancer), resveratrol (phase 2, cancer of the bladder), soya isoflavanones (phase 2, prostate cancer) and indole-3-carbinol (phase 1, breast cancer). A few typical examples proving the efficacy of herbal preparations: garlic has been found to decrease the total cholesterol level by 4-6 per cent as allicin, a component of garlic, inhibits cholesterol synthesis. Extract of ginko biloba is equally effective as the drug Tacrine for the treatment of Alzheimer’s disease. The extract of saw palmetto has been shown to improve urinary track symptoms and flow rates, and the extract of St. John’s wart has been shown to be more potent than the drug Imiprimine in the treatment of depression with fewer side-effects. It thus emerges that in order to provide a strong scientific base, Indian traditional medicinal plants need to be explored using modern scientific tools. Also, rapid steps are to be taken for the export of herbal medicines to a global market of $60 billion. The writer is Professor Emeritus, Department of Chemistry, Kurukshetra University, Kurukshetra.
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Conservative treatment can prevent knee-replacement surgery
Osteoarthritis of the knee is a very common ailment mostly in females. Most individuals go in for conservative treatment in the form of analgesics/ cartilage building drugs like Glucosamine/Diacerein. Many of these patients are in a predicament when they have to take a decision regarding knee replacement surgery. There is no doubt that cases of knee replacement surgery have increased during the last few years due to good success rate as well as easy accessibility to reimbursement from the office. It is very difficult for an individual with a moderate income to spend about Rs 3 lakh for undergoing this procedure. It is important to undertake proper conservative treatment in the form of medicines, enhancing the biomechanics/alignment of the lower limbs, injections of hyaluronic acid, appropriate physical activity and exercises. This can help avoid surgery. In osteoarthritis, there is a marked reduction in the visco-elasticity of the synovial fluid. The damaged cartilage lacks the ability to produce the lubricating fluid rendering the joint dry, stiff and painful. Hyaluronic acid injections dramatically alleviate pain and
stiffness. The mechanism of action is cushioning of the knee joints due to
anti-inflammatory action and production of hyaluronan. There is a misconception that once the injections of hyaluronic acid are administered, they must be repeated after a gap of six or nine months. The fact is that they need not to be repeated in the case of those who are walking about and undertake proper rehabilitation measures. The exception can be there when an individual is bed-ridden and is unable to do any physical activity. Although hyaluronic acid does not entail the same risk as is there in the case of steroids, it is of utmost importance that people experienced in giving joint injections must do so. The only adverse reaction is temporary localised pain /swelling for 24-48 hours. It is advisable not to undertake any excessive weight-bearing exercise
for two or three days.
Indication for usage
Most of the patients notice an improvement in pain and stiffness after the completing the course of injections.
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Useful in prospective candidates for knee replacement with the aim of delaying/ postponing surgery.
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Afflicted individuals who cannot the side-effects of painkillers.
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For delaying knee replacement surgery in young patients.
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Patients medically unfit to undertake total knee replacement. These injections are available in pre-filled syringes, and the recommended dose is one injection per week for
three or five injections. Due to its high cost patients are apprehensive to
get it administered. Recently some firms decreased the cost of one injection to Rs1600 as compared to the earlier cost of Rs3000.
Physiotherapy
As the knee joint becomes unstable due to muscle wasting, strengthening of these muscles helps relieve the symptoms of pain and stiffness. Strong muscles provide the needed support, facilitating easy and painless knee movement. The following exercises with a
stretch-band are ideal for improving muscle strength: Quadriceps strengthening: Loop an stretch-band around your ankle. Lie on the back, raise one leg till you get a stretch on the front side of the thigh. Repeat 10 times. Groin strengthening: Loop the stretch-band around the ankle. Lie in the
side on position. Raise the upper leg as far as possible. Return back and
repeat 10 times. Hamstring strength: Loop the stretch-band around the ankle. Lie down while facing the floor. Bend one knee till a stretch is felt on the back of the thigh. Return back and repeat 10 times. Most patients of knee arthritis will never need surgery. People who are unable to walk and are in constant pain in spite of taking treatment should consider joint replacement surgery. Individuals undergoing knee replacement should not gain weight. They must strengthen the muscles controlling the knee joint; otherwise the huge amount spent on surgery is wasted. Though more and more successful knee-replacement surgeries are being performed in India, it would be appropriate to say that conservative treatment with physiotherapy and injections of hyaluronic acid go a long way in alleviating pain and stiffness in the knee joint. This can also help delay or prevent surgical intervention. The writer runs a pain management clinic in Chandigarh. Email—— chadha_r2003@y ahoo.co.in
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Health Notes
LONDON: Hospitals in the UK will ban sugar in the tea of patients amid fears that it is a risk to health. National Health Services officials have been ordered to remove sugary coffee from all its vending machines. It is believed that a cup of tea is packed with health-boosting properties that cut the risk of heart disease, and help brainpower. But hospitals in Wales have been ordered to remove any sugary drinks from their premises as they have no nutritional SDHp benefit and pose a risk to the teeth. Junk foods, including crisps and fizzy drinks in machines, were disallowed according to guidelines from the Welsh Assembly. Instead it suggested that water and dried fruit should be sold in place. — ANI
Statins ‘may prevent
re-growth of prostate cancer’
LONDON: Cholesterol-lowering drugs or statins might help in preventing the return of prostate cancer in men who undertake surgery for the disease, a new study has revealed. A study suggests that patients who took statins were 30 per cent less likely to suffer an evident relapse than those who did not. Higher doses of the drugs were associated with a lower risk of showing signs of cancer re-growth. “The findings add another layer of evidence suggesting that statins may have an important role in slowing the growth and progression of prostate cancer,” the Scotsman quoted Dr Stephen Freedland from Duke University Medical Centre as saying.
— ANI
Chocolate can ‘help reduce blood pressure’
LONDON: New research suggests that eating a chunk of chocolate every day could treat high blood pressure. Chocolate contains chemicals known as flavanols, which naturally open up blood vessels in the body - so blood flows more easily and the pressure drops. “You don’t always need medication to reduce blood pressure. This shows that there are some foods that can help,” The Telegraph quoted Dr Karin Ried of Adelaide University as saying. Dr Ried and her team found that for people with hypertension, eating chocolate could reduce the blood pressure by up to 5 per cent. However, more research is required to find the optimal amount of chocolate that was needed to make the most difference.
— ANI
Living near a road is bad
for your health
SYDNEY: A new study has revealed that children living within 500 metres of a major road or freeway are more prone to developing asthma, while adults face an increased likelihood of lung and heart-related illnesses. The biggest international study on vehicular air pollution and health research has found that traffic pollution within a 500-metre radius of a major road is likely to aggravate asthma in children, start new asthma cases across all ages, impair lung functioning in adults and cause cardiovascular illness and death. The US Health Effects Institute analysed around 700 worldwide health-pollution studies, and found that there was a clear health risk for those living near arterial roads or highways.
— ANI
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The reason for greater acceptability of plant products in human body can be traced to the “biological friendliness” between the animal and plant kingdoms. A synthetic compound, on the other hand, is a “foreign body” in the human system which may cause toxic side-effects. It is, therefore, not surprising that out of about 1000 new drugs introduced in the last 25 years, more than half are natural products or derived from them or are mimics. Nearly one-third sale of anti-cancer drugs is from taxols and camptothecin which are derived from plants.
