Baseline Knowledge, Attitude, Practice and Barriers (KAPB) Regarding Lifestyle Risk Factors for Non-Communicable Diseases in Ba Province, Fiji

Introduction@#Non-communicable diseases (NCDs) are the major causes of premature death and disability in Fiji, accounting for 80% of mortality in the Fijian population [1]. This is the first community-based research in Fiji on knowledge, attitude, practice and barriers (KAPB) regarding lifestyle risk factors that contribute to NCDs and the impact of health promotion activities on their KAPB. This paper reports on baseline demographics and KAPB findings. Paper 2 will report on the impact of health promotion activities on KAPB.@*Methods@#This is a prospective questionnaire based survey in 30 randomly selected communities located in Ba Province, Fiji, conducted between May 2016 and April 2018.@*Results@#There were 952 participants with mean age was 43.2years (SD=15.4) range 18 to 83; 63.4% were iTaukei, 35.8% were Fijians of Indian Descent (FID) and 0.7% ‘Others’ and 70% were females. There was high awareness that smoking (94.3%), alcohol abuse (82.8%), kava abuse (72.6%), high salt intake (94.3%) and physical inactivity (97.9%) were not good for health. However, in-depth knowledge of effects of these risk factors was low, with only around 20% having a good knowledge. For attitude, 52.6% disagreed and 41.4% were neutral to smoking, 89.9% disagreed with alcohol abuse, 79% disagreed with Kava abuse, 84% agreed with low salt intake, and 84.6% agreed with being physically active. As for practice, 20.7%of participants were current smokers, 20.6% drank alcohol, 37.9% drank kava, 30.5% added extra salt to food, and 30.1% were physically inactive. Having good knowledge did not significantly decrease practice of smoking, alcohol or kava use. Addiction was the major reported barrier to cessation of smoking (60.2%), alcohol abuse (46%) and kava abuse (34.2%) whereas, ‘unwilling to change’ for good nutrition (51.6%) and ‘laziness’ for physical activity (43%).@*Conclusion@#The awareness of the various NCD lifestyle risk factors is high with poor in-depth knowledge of their impact on NCDs. Unfortunately having good knowledge and appropriate attitude did not translate to decreases in risky lifestyle practices.

Carcinogenic herbs: a review

Herbal toxicity is a field that has rapidly grown over the last few years along with increased use of herbal products worldwide. People prefer using herbal medicines rather than allopathic because herbals are considered safe. Use of herbal medicines from ancient times does not ensure their complete safety. With the growing awareness regarding pharmacovigilance worldwide, there has been an increase in the number of reported adverse events occurring with the use of herbal products. The objective of the study is to aware the researchers about most commonly used Indian medicinal herbs inducing carcinogenicity like Aloe vera, Ginkgo biloba, Kava kava, etc.

Analgesic effect of Hypericum perforatum, Valeriana officinalis and Piper methysticum for orofacial pain

To evaluate in vivo the association of hypericum Hypericum perforatum, valerian Valeriana officinalis and kava Piper methysticum with analgesia by assessing their effects in reducing orofacial pain as well as the possible hepatic, hematologic and biochemical alterations induced by regular administration of these extracts. METHODS: Orofacial pain was induced in mice with the administration of 2.5% formalin in the upper lip. After 60 min, the animals were treated with saline, carbamazepine and hydroalcoholic plant extracts. The nociceptive intensity was determined by the timing at which the animal remained rubbing the injected area. To assess the hepatotoxic effect, mice were chronically treated for 25 days with saline, carbamazepine and hydroalcoholic extract. The animals were euthanized and the liver weighed, followed by a differential count of leukocytes and measurement of alanine transaminase and alkaline phosphatase. RESULTS: The evaluation of analgesic activity in phase 1 reduced the time of rubbing compared to the control by 86% 0.05 mL/10 g and 76% 0.10 mL/10 g. In phase 2, the extracts reduced rubbing time by 94% and 85%, respectively. In the evaluation of alkaline phosphatase, the groups treated with extracts at doses of 0.05 mL/10 g and 0.1 mL/10 g increased by 16.1% and 9.5% compared to the control group and a reduction of 8.5% and 9.1% in the evaluation of alanine transaminase respectively. It was demonstrated that in the differential counts showed an increase in eosinophils in the treated group with 0.05 mL/10 g. CONCLUSIONS: The use of hydroalcoholic extract of the associated plants reduced the orofacial formalin-induced pain with better results than carbamazepine, at both the neural conductor level of pain phase 1 and in inflammatory or later pain phase 2 without presenting hepatotoxicity. The observed eosinophilia is suggestive of a phenomenon called hormesis...

Avaliação da mutagenicidade de Piper methysticum L. f. no sistema methG1 em Aspergillus nidulans / Mutagenic evaluation of Piper methysticum L. f. in Aspergillus nidulans methG1 system

O extrato seco da raiz de Piper methysticum L. f. Forster (PIPERACEAE), a kava-kava, é usado no tratamento de diversos problemas envolvendo ansiedade como um dos sintomas. Por não causar dependência, sedação e ter ação ansiolítica, muitas pessoas têm recorrido a kava-kava para auxiliá-las no emagrecimento. Isto pode levar ao consumo indiscriminado da planta e acarretar riscos, pois todo medicamento fitoterápico deve respeitar limites de doses. Um risco na utilização de plantas medicinais é a toxicidade e, dentro deste, a mutagenicidade. Como a mutagenicidade está relacionada com a carcinogenicidade torna-se importante testar este potencial na kava-kava. Assim, o objetivo deste trabalho foi avaliar o potencial mutagênico do extrato seco da raiz de P. methysticum no sistema methG1 em Aspergillus nidulans. A linhagem utilizada foi a biA1methG1, auxotrófica para biotina e metionina. Conídios dormentes de colônias crescidas por cinco dias foram tratados com soluções da kava-kava nas concentrações de 0,35 mg mL-1 e 3,5 mg mL-1, e depois de 24h, semeados em meio seletivo contendo metionina, para análise dos sobreviventes, e sem metionina, para a análise dos mutantes. Os números de sobreviventes e mutantes dos tratamentos foram comparados aos do controle. Os resultados indicaram que o extrato da raiz da kava-kava é mutagênica, pois a freqüência de mutação dos tratamentos foi maior que da mutação espontânea, porém não ocorrendo diferença significativa entre as doses.

The dry root extract of Piper methysticum L. f. Forster (Piperaceae), kava-kava, is used as to treat several health problems involving anxiety symptoms. As it causes no addiction, it can be applied as a sedative and anxiolytic. Many people have been relying on kava-kava as an auxiliary treatment. This can lead to an indiscriminate plant consumption and lead to risks, because all phytotherapic medications must observe dosage limits. One risk in the folk medicinal plant use is toxicity, and within it, mutagenicity. As mutagenicity is closely related to carcinogenicity, it is important to test the kava-kava mutagenicity potential. Thus, the purpose of this work was to test the mutagenicity of the dry root extract of P. methysticum in the methG1 system of Aspergillus nidulans. The bia1methG1 lineage, which is auxotrophic for biotine and methione, was used. Conidia from five-day-old colonies were collected and treated with kava-kava solutions at 0.35 mg mL-1 and 3.5 mg mL-1 concentrations and, after 24h, they were planted in selective growth medium with and without methione, in order to analyze the survivors and mutants, respectively. The number of survivors and mutants analyzed under effect of the treatments was compared with the control. The results indicated that the kava-kava dry root extract is mutagenic, since the mutation frequency of the treatments was higher than spontaneous mutation, however, there were no differences between the doses tested.

The controvertible role of kava (Piper methysticum G. Foster) an anxiolytic herb, on toxic hepatitis

Kava is an anxiolytic herbal medicine used in the treatment of sleep and anxiety disorders. Some cases of kava-induced hepatotoxicity have been reported in the literature leading to its banishment in most countries worldwide. Clinically, the spectrum ranged from transient elevations of liver enzyme levels to fulminant liver failure and death. Liver transplantation was performed in a few cases. This paper provides a review of the currently available literature on kava-related toxic hepatitis which may result from its use, discusses the possible mechanisms for the potentially severe hepatotoxicity and describes some features which must be considered when adverse liver effects seem to be associated to kava administration. In conclusion, the incidence of kava toxicity on the liver remains to be investigated; however, some concerns before or during kava use are important, due to the possibility of severe liver dysfunction.

Kava é um fitoterápico ansiolítico usado no tratamento da insônia e da ansiedade. Alguns casos de hepatotoxicidade induzida pela kava foram relatados na literatura, levando à proibição do seu uso em muitos países. Clinicamente, o espectro dessas alterações variou de elevações transitórias das enzimas hepáticas, até à falência hepática fulminante e morte. Em alguns casos, realizou-se transplante hepático. Este artigo revisa a literatura atual sobre a hepatite tóxica provavelmente relacionada à kava, discute os possíveis mecanismos responsáveis pela hepatotoxicidade potencialmente grave e descreve alguns aspectos que devem ser considerados quando eventos adversos hepáticos pareçam ser relacionados à administração dessa substância. Conclui-se que a possível toxicidade hepática pela kava ainda deve ser investigada e que algumas medidas antes e durante o seu uso são importantes, dada a possibilidade de disfunção hepática grave.

Interações medicamentosas de fitoterápicos e fármacos: Hypericum perforatum e Piper methysticum / Drug interactions between herbs and medicines: Hypericum perforatum and Piper methysticum

A utilização de produtos naturais na medicina popular é milenar e persiste até os dias atuais. Entretanto, a idéia de que estes produtos são isentos de toxicidade torna o uso de medicamentos fitoterápicos cada vez maior e indiscriminado. Este trabalho trata de uma revisão sobre as interações que podem ocorrer com a utilização concomitante de Hypericum perforatum L. (erva de são joão) e Piper methysticum F. (kava-kava) com fármacos, podendo levar a sérios efeitos tóxicos, incluindo a fatalidade.

Natural products in popular medicine have been used for hundreds of years and persists nowadays. However, the idea that these products are exempted of toxicity turns the use of herbs to be larger and indiscriminate. This work is a review of interactions that can happen with concomitant use of Hypericum perforatum L. (St. John's wort) and Piper methysticum F. (kava-kava) with medicines that can result in serious toxicological effects including fate.