Anti-Inflammatory Properties of Plants from Serbian Traditional Medicine.

Inflammation is a natural protective response of the human body to a variety of hostile agents and noxious stimuli. Standard anti-inflammatory therapy includes drugs whose usage is associated with a number of side effects. Since ancient times, natural compounds have been used for the treatment of inflammation. Traditionally, the use of medicinal plants is considered safe, inexpensive, and widely acceptable. In Serbia, traditional medicine, based on the strong belief in the power of medicinal herbs, is the widespread form of treatment. This is supported by the fact that Serbia is classified as one of 158 world centers of biodiversity, which confirms that this country is a treasure of medicinal herbs. Some of the most used herbs for the treatment of inflammations of various causes in Serbian tradition are yarrow, common agrimony, couch grass, onion, garlic, marshmallow, common birch, calendula, liquorice, walnut, St. John's wort, chamomile, peppermint, white willow, sage, and many others. The biological activity and anti-inflammatory effect of selected plants are attributed to different groups of secondary biomolecules such as flavonoids, phenolic acids, sterols, terpenoids, sesquiterpenes, and tannins. This paper provides an overview of plants with traditional anti-inflammatory use in Serbia with reference to available studies that examined this effect. Plants used in traditional medicine could be a powerful source for the development of new remedies. Therefore intensive research on the bioactive potential of medicinal plants in each region should be the focus of scientists around the world.

Coping with the burden of the COVID-19 pandemic: a cross-sectional study of community pharmacists from Serbia.

BACKGROUND: Rapid spread of COVID-19 forced the public to turn to community pharmacies as the most accessible points of primary healthcare, overloading pharmacy services. The objectives of this research were to detect and describe the changes in work environment of community pharmacists in Vojvodina during the state of emergency due to COVID-19 pandemic. Moreover, the COVID-19 pandemic effects on job related stress were assessed. METHODS: Community pharmacists from Vojvodina completed an online questionnaire on work environment changes related to COVID-19 (cross-sectional study). RESULTS: Out of the 1574 licenced pharmacists in Vojvodina, 392 completed the survey. Workload increase, reported by 90.8% of pharmacists, was caused mostly by higher demand for safety equipment, antiseptics and disinfectants, dietary products and medicines. Most pharmacists (93.1%) considered pharmacy workflow to be more complex than before the pandemic. Clients' behavior was described as less pleasant since the start of the pandemic by 67.6% of the community pharmacists. Many were concerned for their health and the health of their families (68.9%). Community pharmacists rated their stress levels higher if they i) were working in larger chains, ii) experienced clients' behavior as less pleasant or/and iii) were concerned for their/their family health. CONCLUSIONS: Current research pointed out the need for a more robust healthcare system which would allow rapid introduction of new activities and roles for community pharmacists that could possibly decrease job-related stress. Legal steps to improve the work environment in community pharmacies are necessary and urgent in order to fully utilize their skills and knowledge.

Garlic burn injuries- a systematic review of reported cases.

Medicinal plants have many beneficial effects on human health. Garlic (Allium sativum, Alliaceae) is one of the most famous herbal species, used for various diseases and conditions. Unfortunately, garlic is also associated with adverse effects, including cutaneous manifestations. In this review, burn injuries caused by application of raw garlic are reported. Searching through PubMed, Google Scholar and ResearchGate, a total of 32 articles with 39 patients were found. Demographics of patients, reasons for garlic use, details on garlic application, as well as description of burns and its treatment are thoroughly described and discussed. In most of the cases, garlic caused second-degree burns, although some circumstances can cause formation of necrotic tissue. Various body parts were affected, legs being most common. The chemistry of garlic is also presented, with focus on volatile organic sulfur compounds, which also seem to be responsible for burns formation. Treatment of garlic burns was mainly symptomatic, and various types of drugs were used. Although not commonly expected, garlic should be taken into consideration as causative agents of burns by treating doctors, and patients should be advised against application of fresh garlic onto skin and mucosa.

Rosmarinic Acid-Human Pharmacokinetics and Health Benefits.

Rosmarinic acid is a phenolic compound commonly found in the Lamiaceae (Labiateae) plant species. It is considered responsible for a wide spectrum of biological and pharmacological activities of plants containing this compound. The aim of the current review is to present the fate of rosmarinic acid inside the human body, explained through pharmacokinetic steps and to briefly present the health benefits of RA. Pharmacokinetics was at first studied in animal models, but several studies were conducted in humans as well. This compound can be applied topically, pulmonary, intranasally, and via intravenous infusion. However, peroral application is the main route of entry into the human body. Presumably, it is mainly metabolized by the gut microflora, providing simple, more easily absorbed phenolic units. Inside the body, the rosmarinic acid molecule undergoes structural changes, as well as conjugation reactions. Renal excretion represents the main path of elimination. Previously conducted studies reported no serious adverse effects of herbal remedies containing RA, as well as their positive effects on human health. In addition to in vitro studies, clinical investigations suggested its benefits in dermatological, allergic, and osteoarthritic disorders, as well as for improving cognitive performance and in metabolic syndrome treatment. Future studies should investigate the kinetics during long-term application in patients who would have potential benefits from RA usage. Pharmaceutical formulations designed to prevent the fast metabolism of RA and allow its penetration into other compartments of the human body are also interesting topics for future research.

Marrubium vulgare L.: A Phytochemical and Pharmacological Overview.

Marrubium vulgare is a plant with high bioactive potential. It contains marrubiin, a labdane diterpene that is characteristic for this genus, as well as a complex mixture of phenolic compounds. According to numerous studies, M. vulgare acts as a good antioxidant agent, and due to this, it could potentially be useful in treatments of cancer, diabetes mellitus, and liver diseases. In addition, its anti-inflammatory, wound-healing, antihypertensive, hypolipidemic, and sedative potential are discussed. Apart from that, its antimicrobial activity, especially against Gram+ bacteria, fungi, herpes simplex virus, and parasites such as Toxoplasma gondii, Trichomonas vaginalis, and Plasmodium berghei-berghei was recorded. Additionally, it could be used as a chicken lice repellent, herbicide, and natural insecticide against mosquito larvae and natural molluscicide. In veterinary medicine, M. vulgare can be used as an anthelmintic against the eggs and larvae of bovine strongyles parasites, and as an antibiotic against bovine mastitis caused by resistant bacterial strains. Due to the mentioned benefits, there is a tendency for the cultivation of M. vulgare in order to ensure high-quality raw material, but more firm scientific evidence and well-designed clinical trials are necessary for the well-established use of M. vulgare herb and its preparations.

St. John's Wort Herbal Teas - Biological Potential and Chemometric Approach to Quality Control.

St. John's wort has been used for centuries in traditional medicine of many cultures, and nowadays it is well-known as a clinically important antidepressant drug. Considering the rising market demand for Hyperici herba, quality control of crude drug is of paramount importance. In this paper we performed HPLC-DAD chemical profiling of St. John's wort tea samples obtained at local markets, pharmacies and health food stores in the Balkan Peninsula countries, Austria and Turkey. Furthermore, water alcoholic extracts of the collected samples were evaluated in terms of their antioxidant potential, as well as the ability to inhibit biologically important enzymes such as acetylcholinesterase, monoamine oxidases A and B (MAO-A and MAO-B), α-amylase and α-glucosidase. Significant variability within the samples in the quantities of hypericin, hyperforin, rutin, quercetin, gallic, chlorogenic, caffeic and p-hydroxybenzoic acid was noticed. Chemotaxonomic modelling enabled the identification of three clusters of samples based on the quantities of rutin, hypericin and hyperforin. Generally, the extracts exhibited a significant potential to inhibit MAO-A (median IC50 = 10.01 µg/mL) and α-glucosidase (median IC50 = 12.40 µg/mL). The results of antioxidant potential evaluation suggest strong neutralization of hydroxyl and nitroso radicals, but moderate inhibition of lipid peroxidation process. Overall, the conducted study emphasizes the possibility of St. John's wort teas quality control, taking into account unavoidable variability of chemical profile as well. The stated is of great importance when grinding degree of herbal material excludes taxonomic identification of biological origin as an option within quality control.

Herbal preparations use in prevention and treatment of gastrointestinal and hepatic disorders-Data from Vojvodina, Serbia.

OBJECTIVE: Gastrointestinal (GI) disorders are estimated to be frequent among general population. Various types of traditional and complementary therapies, primarily phytotherapy, can be used for prevention and treatment of many diseases and conditions, including GI complaints. Thus, the aim of this study was to investigate the patterns of use of medicinal herbs in treatment and prevention of GI disorders, together with their efficacy and safety. METHODS: A prospective, repeated cross-sectional, descriptive study was conducted in the form of a specifically created questionnaire, filled in by consumers and/or patients in pharmacies on the territory of Autonomous Province of Vojvodina, Republic of Serbia. All data were statistically analyzed in Microsoft Excel 2007. RESULTS: In the total number of 1137 patients, 10.4% declared themselves as consumers of phytopreparations for GI disorders. The most common diseases were constipation (44%) and dyspepsia (23%). The most frequently used preparations contained laxatives (with both anthraquinones and dietary fibers), artichoke and silymarin. Iberogast® was also frequently used. Pharmacists were the main source of recommendation for the most adequate herbal remedies. At the same time, phytopreparations were well tolerated, with no major side effects, and were evidently or presumably effective. CONCLUSIONS: Some mild and moderate GI disorders seem to be treated frequently with phytopreparatons. Various herbal remedies are well accepted by patients, and the phytopreparations seem to have favorable ratio of safety and efficacy. Further integration into conventional medicine will improve the quality of the products used and provide a rational plan of use of medicinal plants.

Garlic clove applied as vaginal suppository - A case report.

OBJECTIVE: Besides conventional drugs, various vaginal disorders are often treated with complementary and alternative medicines. Different natural products are often used in treatment of genital infections. The aim is to present a case of treatment of vaginal infection with a garlic clove. METHODS: A detailed interview was conducted with the subject whose condition was described in this case. RESULTS: Young woman was diagnosed with vaginal Ureaplasma sp. infection. After failed local treatment with antibiotics and antifungals, subject obtained advice to treat the disorder with incised clove of garlic. Control examination by her gynecologist confirmed that infection was successfully cured. Subject experienced no adverse effects. CONCLUSIONS: Garlic clove successfully cured vaginal infection presented in this case. However, application to genital organs should be reserved for dosage forms, in order to prevent potential toxicity and to obtain reproducibility of active compounds concentrations.

Potential of selected Lamiaceae plants in anti(retro)viral therapy.

Constant search for new drugs with antiviral properties often extends to products of natural origin. Lamiaceae is one of the most important herbal families, well known for various biological and medicinal effects of a variety of aromatic spices, including thyme, mint, oregano, basil, sage, savory, rosemary, self-heal, hyssop, lemon balm and many others. The paper provides a review of antiviral potential of previously mentioned plants which has been demonstrated so far, with special emphasis on anti-HIV properties. Relevant articles were compiled by searching plant names combined with keywords describing antiviral activity. The antiviral effect is direct, with prominent activity against enveloped viral species. Initial stages of the viral life cycle are the most affected, as these plants appear to be targeting mainly viral structures responsible for attachment to target cells. In case of HIV, there is some activity against key enzymes in the viral life cycle. Even in the case of drug resistance, there is an equal susceptibility to applied herbal preparations. Some in vivo experiments suggest that use of Lamiaceae representatives could help in prevention and treatment of some viral diseases. A possible reduction of side effects of diseases and conventional drug therapy are also some aspects worth further investigations.

Hypericum perforatum: Synthesis of Active Principles during Flowering and Fruitification-Novel Aspects of Biological Potential.

St. John's wort is a widely used medicinal plant. The quality of herbal drug, which is in most of the cases collected from nature, varies. Therefore, the aim of the present study was detailed chemical characterization of Hypericum perforatum subsp. perforatum samples collected in close time intervals during flowering and fruitification with the purpose to state the phenological stage characterized by maximum levels of active principles. The antioxidant potential and potential to inhibit biologically important enzymes, as well as the cytotoxicity and genotoxicity of the sample collected during the full flowering period, were evaluated. Data showed that the optimal period for the achieving of maximum level of active principles is the phenophase between floral budding and flowering stage. Significant antioxidant potential and the ability to inhibit biologically important enzymes (especially α-glucosidase) were recorded. The extract exhibited no genotoxicity in subcytotoxic concentrations, while increased cytotoxicity recorded in cotreatment with bleomycin on malignant cell lines was especially significant.

The Phenolics of the Ornithogalum umbellatum L. (Hyacinthaceae): Phytochemical and Ecological Characterization.

Ornithogalum umbellatum L. is a widely distributed species in Europe, that exhibits considerable variability at ecological, morphological, anatomical, and karyological level. Previous reports of the chemical investigations among Ornithogalum species indicate significant diversity of the secondary metabolites, as well. Knowing that environment affects the phenolic composition in plants to a large extent, the main objective of the research was to define relationship between phytochemical and ecological characters. To estimate an environmental influence on these results, plant material was collected at four habitats that differ in ecological factors and belong to two biogeographical regions: the Balkan Peninsula and the Pannonian Plane. Measured phytochemical characters are yield of dry extract, total phenolic and flavonoid contents, the presence of selected phenolic compounds as well as free-radical scavenging activity (neutralization of DPPH and OH radicals). Results revealed that all analyzed phytochemical parameters differ between investigated O. umbellatum samples. The moisture level of habitat has the highest correlation, either positive or negative, with most of phytochemical characters, and is followed by temperature and soil reaction. Light intensity and nitrogen level have mostly moderate correlation coefficient with phytochemical characters. More complex correlation is revealed between ecological factors and nine phenolic compounds, with three observed patterns of relationship.

Ganoderma: insights into anticancer effects.

The genus Ganoderma includes about 80 species growing on cut or rotten trees. The most commonly used species is Ganoderma ludicum. Biomolecules responsible for the health benefits of Ganoderma are polysaccharides with an immunostimulative effect and triterpenes with a cytotoxic action. For more than 2000 years, it has been used traditionally in the treatment of various pathological conditions and recently, its immunoregulatory, antiviral, antibacterial, antioxidant, hepatoprotective, and anticancer potential has been confirmed. A wide range of Ganoderma extracts and preparations arrest the cell cycle in different phases and consequently inhibit the growth of various types of cancer cells. Extracts containing polysaccharides stimulate immunological reactions through the production of various cytokines and mobilization of immune system cells. In-vivo studies have confirmed the anticancer potential and the antimetastatic effects of compounds originating from Ganoderma. There is also evidence for the chemopreventive action of Ganoderma extracts in bladder, prostate, liver, and breast cancer. The results of clinical studies suggest the combined use of G. lucidum with conventional chemotherapy/radiotherapy, but the methodology and the results of these studies are being questioned. Therefore, a constant need for new clinical trials exists.

Effects of selected essential oils on the growth and production of ochratoxin A by Penicillium verrucosum.

Essential oils from oregano (Origanum vulgare L.), mint (Mentha piperita L.), fennel (Foeniculum vulgare Mill.), and pine (Abies alba Mill.) needles and cones, and their active substances thymol, carvacrol, menthol, and anisaldehyde were tested for antifungal activity against Penicillium verrucosum. The lowest minimal inhibitory concentrations (MICs) were achieved for essential oil of oregano, followed by carvacrol, thymol, and menthol. These antifungal components were further investigated, as the main aim of our study was to elucidate the effect of natural antifungals on ochratoxin A production. During 21 days of exposure, the growth of P. verrucosum, and subsequently the production of ochratoxin A, was fully inhibited by thymol at ½ MIC (0.0625 mg mL-1), but menthol at » and ½ MIC (0.1875 and 3750 mg mL-1) showed no growth inhibition. After 21 days of incubation, the greatest inhibitory effect on ochratoxin production (inhibition was 96.9 %) was also achieved with thymol at » MIC (0.0313 mg mL-1). Essential oil of oregano (» MIC, 0.2930 µL mL-1) and carvacrol (½ MIC, 0.1953 µL mL-1) stimulate production of ochratoxin A at 13.9 % to 28.8 %, respectively. The observed antifungal effects depended on the agent, the concentration used, and the time of interaction between the agent and P. verrucosum. Our results indicate the possibility of using oregano essential oil as a substitute for artificial preservatives in certain foods, but further research is needed.

Impact of origin and biological source on chemical composition, anticholinesterase and antioxidant properties of some St. John's wort species (Hypericum spp., Hypericaceae) from the Central Balkans.

The study shows the influence of the origin of plant material and biological source on the in vitro antioxidant (neutralization of DPPH and OH radical, nitric oxide, and inhibition of lipid peroxidation) and anticholinesterase activity of chemically characterized and quantified ethanol extracts of ten St. John's wort samples. The investigated samples were: five Hypericum perforatum species representatives collected at different localities, one commercial sample of Hyperici herba purchased at a local market and four Hypericum species autochtonous to the Balkan Peninsula (H. maculatum subsp. immaculatum, H. olympicum, H. richeri subsp. grisebachii and H. barbatum). All the examined extracts exhibited notable antioxidant potential, but in most of the cases indigenous Hypericum species expressed stronger effects compared to the original source of the drug, H. perforatum. The changes in the content of phenolic compounds, especially flavonoids, hyperforin and hypericin, related to the source of the drug affected the investigated activities. Since all of the investigated species have shown prominent inhibition of acetylcholinesterase in vitro activity, they could be further investigated as potential substances in preventing of Alzheimer's disease.

Consumers' attitude towards the use and safety of herbal medicines and herbal dietary supplements in Serbia.

BACKGROUND: The use of herbal medicines and herbal dietary supplements in Serbia is very common and many patients consume herbal preparations with conventional drug therapy. OBJECTIVE: The aim of this survey was to evaluate the consumers' awareness of herbal remedies and the safety of herbal dietary supplements, their attitude towards combining herbals and drugs, and the source of recommendations for their use. SETTING: The study included all consumers who bought herbal remedies and herbal dietary supplements in 15 pharmacies on the territory of Novi Sad during 2011 and who accepted to be interviewed. METHODS: Structured interviews using questionnaire, conducted by pharmacists. The questionnaire included 4 parts: socio-demographic characteristics of consumers, source of recommendations for the use of herbal products, attitude towards safety of herbal remedies and herbal dietary supplements use and their combination with regular drugs, as well as the question of purchased herbal products. MAIN OUTCOME MEASURE: Consumers' attitude towards the safety and use of herbal medicines and herbal dietary supplements measured by 9 items. RESULTS: The majority of interviewed participants were highly educated, aged 41-60 and they consumed herbal remedies on their own initiative or on recommendation of nonmedically educated person, without previous consultation with medical doctor or pharmacist. Out of all participants: 88.9 % did not consider it important to inform their physician or pharmacist about use of herbal remedies and herbal dietary supplements; 73.3 % found the use of herbal remedies harmless (where 9.4 % did not have any attitude towards that issue), while 40.3 % of participants regarded the combining of herbal and regular drugs unsafe. CONCLUSION: There is a need for consumers' education on reliable use of herbal medicines and herbal dietary supplements, in order to improve their awareness of the limits of herbal remedies safety and potential risks of their combination with drugs.