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      Use of complementary and alternative medicines in haemodialysis patients: a cross-sectional study from Palestine

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          Abstract

          Background

          Complementary and alternative medicine (CAM), and herbal therapies, are accepted worldwide, and have been important from medical, sociological and economic perspectives, among haemodialysis (HD) patients. The primary aim of this study was to evaluate the use of CAM among patients with end-stage renal disease (ESRD) who are undergoing HD.

          Methods

          Face-to-face interviews of patients with ESRD undergoing HD from ten outpatient renal departments at a national level in Palestine were conducted from June 2014 to January 2015. A survey questionnaire, which included questions on socio-demographic and clinical characteristics, and on the CAM therapies that were used, was administered.

          Results

          Out of 267 patients interviewed, 172 patients used at least one type of CAM in the last month prior to the interview, and thus the utilisation rate was 64.4 %. Forty one (15.4 %) patients reported using one type of CAMs, while 18.7 % used two different CAMs and 30.3 % used more than two types of CAMs for their health status. Of the patients who used CAM, herbal therapies were used most often (43.5 %), followed by honey (35.6 %), diet (22.8 %), and exorcism in Islam (16.9 %). The herbal therapies mentioned most often were Nigella sativa L. (18.7 %), followed by Salvia officinalis L. (16.9 %), and Pimpinella anisum L. (10.5 %).

          Conclusions

          In conclusion, the prevalence of CAM is relatively high in the selected population. Most patients used biological therapies such as herbal remedies, thus highlighting a greater need for patient education regarding CAM therapies and possible herb-drug interactions. Health care providers must be aware of the potential benefits and risks related to CAM use. There is a need for more clinical research pertaining to CAM to reach stronger evidence regarding potential benefits and risks related to CAM use.

          Electronic supplementary material

          The online version of this article (doi:10.1186/s12906-016-1196-8) contains supplementary material, which is available to authorized users.

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          Most cited references68

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          Ethnobotanical survey in the Palestinian area: a classification of the healing potential of medicinal plants.

          An ethnobotanical survey was carried out in the West Bank to evaluate the relative efficacy of the plants used to treat skin diseases and prostate cancer. A total number of 102 informants, 30 years and older and either native born or had been living in the West Bank for more than 30 years, were interviewed using a previously prepared questionnaire. Of about 165 plant species mentioned by the informants, 63 (38.1%) were mentioned by three or more informants. On the basis of their primary uses, 21 of these plants were reported to relieve skin disorders, 17 for urinary system disorders, 16 for gastric disorders, nine for cancer and prostate disorders, eight for arthritis, five for respiratory problems, and five for other ailments. Indices on fidelity levels (FLs), relative popularity level (RPL), and rank-order priority (ROP) were calculated. Plants were classified in two groups: 'popular' (RPL=1) or 'unpopular' (RPL<1). The following plant species were classified as popular in this study: Teucrium polium, Matricaria aurea, Urtica pilulifera, Paronychia argentea, Petroselinum sativum, and Salvia fruticosa. The remaining 57 species were classified as 'unpopular'. Fifty-nine plants were claimed to be effective against cancer and prostate disorders, which include Arum dioscorides, U. pilulifera, Allium sativum, Viscum cruciatum, and Allium cepa.
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            Tradition and Perspectives of Arab Herbal Medicine: A Review

            Complementary and Alternative Medicine (CAM), including herbal medicine, are popular in the general population worldwide. Parallel to the increasing interest in ‘modern’ CAM therapies and the historical importance of Arab medicine, there is also a similar trend in research activities dealing with the efficacy and safety of medicinal plants in our region. Historical and current studies and surveys indicate that the Eastern region of the Mediterranean has been distinguished throughout the generations with a rich inventory of natural medicinal herbs. It is well documented that indigenous Arab medicine has contributed greatly to the development of modern medicine in Europe and remains one of the closest forms of original European medicine. The rapid increase in consumption of herbal remedies worldwide has been stimulated by several factors, including the notion that all herbal products are safe and effective. This article presents a systematic review on traditional Arab medicine including historical background, medical innovations introduced by Arab physicians in the field of safety and efficacy of herbal medicine and a state-of-the-art description of traditional Arab herbal medicine in the Mediterranean region.
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              Safety of Traditional Arab Herbal Medicine

              Herbal remedies are widely used for the treatment and prevention of various diseases and often contain highly active pharmacological compounds. Many medicinal herbs and pharmaceutical drugs are therapeutic at one dose and toxic at another. Toxicity related to traditional medicines is becoming more widely recognized as these remedies become popular in the Mediterranean region as well as worldwide. Most reports concerning the toxic effects of herbal medicines are associated with hepatotoxicity although reports of other toxic effects including kidney, nervous system, blood, cardiovascular and dermatologic effects, mutagenicity and carcinogenicity have also been published in the medical literature. This article presents a systematic review on safety of traditional Arab medicine and the contribution of Arab scholars to toxicology. Use of modern cell biological, biochemical, in vitro and in vivo techniques for the evaluation of medicinal plants safety is also discussed.
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                Author and article information

                Contributors
                saedzyoud@yahoo.com , saedzyoud@najah.edu
                samahjabi@yahoo.com
                waleedsweileh@yahoo.com
                ghada_tabib@hotmail.com
                noraayaseh@hotmail.com
                mayas.sawafta@hotmail.com
                razan91phd@hotmail.com
                diana.mezyed.91@hotmail.com
                dadaraghmeh@gmail.com
                rahmatawang@yahoo.com
                Journal
                BMC Complement Altern Med
                BMC Complement Altern Med
                BMC Complementary and Alternative Medicine
                BioMed Central (London )
                1472-6882
                11 July 2016
                11 July 2016
                2016
                : 16
                : 204
                Affiliations
                [ ]Poison Control and Drug Information Center (PCDIC), College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
                [ ]Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
                [ ]WHO Collaborating Centre for Drug Information, National Poison Centre, Universiti Sains Malaysia (USM), Penang, 11800 Malaysia
                [ ]Department of Pharmacology and Toxicology, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
                [ ]PharmD program, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
                Article
                1196
                10.1186/s12906-016-1196-8
                4940841
                27400742
                1dde7d06-5635-4012-9b8b-2c7d978cae5e
                © The Author(s). 2016

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 10 December 2015
                : 7 July 2016
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2016

                Complementary & Alternative medicine
                haemodialysis,end-stage renal disease,complementary and alternative medicine,herbal medicine,palestine

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