The effects of a traditional drug, turmeric (Curcuma longa), and placebo on the healing of duodenal ulcer.

In a joint Vietnam-Sweden prospective double-blind two-center study, the herbal remedy of Curcuma longa (turmeric) - in a dosage of 6 g daily as suggested in the Vietnamese pharmacopoeia - was compared with an equal amount of placebo in 118 patients, suffering from duodenal ulcer. The patients in the two groups were well matched prior to treatment. Clinical assessments were carried out weekly, while laboratory investigations were carried out before beginning of the treatment and after four and eight weeks: Only patients, having one duodenal ulcer with a minimum diameter of 5 mm verified by endoscopy (Uong Bi General Hospital, UBGH) and/or radiography (UBGH and Viet Due University Hospital, VDUH) not more than 4 days prior the study were included in the study. No treatment with H(2)-receptor antagonists, anticholinergics or other drugs used in the treatment of ulcer disease during the preceding week were allowed. Follow-up endoscopy and/or radiography were performed after 28 ± 4 days and 56 ± 4 days. Turmeric was not superior to placebo in healing duodenal ulcer either after four or eight weeks of treatment. After eight weeks the ulcer-healing rate of turmeric was 27% while placebo had healed 29%. Both drugs were well tolerated.

The use of a water extract from the bark of Choerospondias axillaris in the treatment of second degree burns.

Burns are common in Vietnam, and because of economic constraints and limited resources for the import of appropriate treatments, the health authorities are obliged to rely on traditional herbal remedies. It is therefore essential to evaluate current drugs, one of which is the water extract of the bark of the tree Choerospondias axillaris. It has been used for many years in the Vietnam-Sweden hospital at Uong Bi in northern Vietnam. We assessed the efficacy of the remedy in an open, randomised controlled clinical trial, in which 20 patients with second degree burns were treated with the extract of the Choerospondias axillaris and 19 with saline gauze. The mean healing time was significantly shorter for patients treated with Choerospondias axillaris (11 days) compared with patients treated with saline gauze (17 days) (p < 0.01), and the number of wound infections was significantly lower in the Choerospondias axillaris group (7/20 compared with 16/19, p = 0.003). The bark extract was easy to apply and additional wound care was not usually necessary, while the treatment with saline gauze was laborious for both patients and staff and was much more expensive. The extract from Choerospondias axillaris is a convenient treatment for second degree burns in both children and adults.

Studies on the individual and combined diuretic effects of four Vietnamese traditional herbal remedies (Zea mays, Imperata cylindrica, Plantago major and Orthosiphon stamineus).

Herbal remedies are widely used in Vietnam alongside modern drugs. We assessed the diuretic effect of four traditional Vietnamese herbal remedies from Zea mays, Imperata cylindrica, Plantago major and Orthosiphon stamineus, all claimed to produce an increase of diuresis. No influence was recorded for the 12- and 24-h urine output or on the sodium excretion for any of the drugs when tested under standardized conditions in a placebo controlled double-blind crossover model. The present study indicates the need for critical review of the present recommendations regarding therapy with plant materials in countries relying on empiric traditions.

Stability of essential drugs during shipment to the tropics.

OBJECTIVE: To determine whether present methods of international transport of essential drugs by sea adversely affect their quality. DESIGN: Controlled longitudinal study of drug shipments sent by sea from Unicef in Copenhagen to Lagos; to Mombasa and by land to Kampala; and to Bangkok. 11 essential drugs were stored in four locations on board the ships. SETTING: Main shipping routes from Unicef, Copenhagen, to tropical countries. MAIN OUTCOME MEASURES: Temperature and relative humidity in the test packs during the journey. Amount of active ingredient in the drugs before and after shipment. RESULTS: Temperatures recorded within the test packs range from -3.5 degrees C to 42.4 degrees C and were 3-12 degrees C higher than the ambient temperature. Relative humidity within the packs ranged from 20% to 88%. Differences between the locations on board were negligible. Ergometrine injection, methylergometrine injection, and retinol capsules lost 1.5-5.8% of their activity. Ampoules of ergometrine showed a large variation in the amount of active ingredient after shipment, with three of 80 samples having concentrations 60% below those stated. Ampicillin, benzylpenicillin, phenoxymethylpenicillin, and tetracycline were not affected by transport. CONCLUSIONS: Drugs were exposed to a much higher temperature and humidity than is recommended by the manufacturer, especially in tropical harbours and during inland transport. Except for ergometrine and methylergometrine the transport would not affect clinical effectiveness.

In vitro metabolism of propoxyphene in rat liver: reaction of a carbinol metabolite with acetaldehyde.

The metabolism of the analgesic drug propoxyphene (alpha-d-propoxyphene) has been investigated in the rat liver 9,000 X g supernatant fraction. The incubations were analyzed by HPLC. The major metabolite was norpropoxyphene carbinol, obtained through demethylation and ester hydrolysis. The demethylated metabolite of propoxyphene, norpropoxyphene, was also detected. Addition of acetaldehyde to the incubation mixture decreased the metabolism of propoxyphene. Reactions between norpropoxyphene carbinol and acetaldehyde resulted in a fast disappearance of the carbinol and the formation of a reaction product, the significance of which is discussed.