Archive for the 'Medicine' Category

Called guayaba in Spanish-speaking countries and goiaba in Brazil, guava is a common shade tree or shrub in door-yard gardens in the tropics. It provides shade while the guava fruits are eaten fresh and made into drinks, ice cream, and preserves. Guava herbal medicine has been around and been used for ages, and although it has proven time and time again to be incredibly effective and successful at treating sickness and disease, it is important that you take the time to learn about guava and understand what it has to offer before using it yourself.

Guava fruit today is considered minor in terms of commercial world trade but is widely grown in the tropics, enriching the diet of hundreds of millions of people in the tropics of the world. Guava has spread widely throughout the tropics because it thrives in a variety of soils, propagates easily, and bears fruit relatively quickly. The fruits contain numerous seeds that can produce a mature fruit-bearing plant within four years. In the Guava is known for being one of the most popular therapeutic plants in the Philippines. It is used as an antiseptic, astringent and anthelminthic, and kills bacteria, fungi, and ameba. The fresh leaves of the plant are used to facilitate the healing of wounds and cuts and are also very effective for toothaches.

The Tikuna Indians decoct the leaves or bark of guava as a cure for diarrhea. In fact, an infusion or decoction made from the leaves and/or bark has been used by many tribes for diarrhea and dysentery throughout the Amazon, and Indians also employ it for sore throats, vomiting, stomach upsets, for vertigo, and to regulate menstrual periods. The health benefits of guava herbal medicine are truly incredible, and in particular it contains quercetin which is an antioxidant that blocks enzymes that are responsible for building sorbitol, the sugar that forms the cloudy white clusters that cause cataracts. Guava is also rich in folate which helps to fight bad breath that causes gum disease gingivitis.

Guava herbal medicine is only one aspect to Chinese medicine however, and there are many other options as well when it comes to herbal medicine. Besides guava herbal medicine one of the most popular herbal medicines is green tea. Green tea has been around and been used for ages but only recently has it really come into serious popularity. Green tea medicine has shown to have even more health benefits than guava herbal medicine, and this is largely due to the catechins that are found in green tea. These catechins, otherwise known as polyphenols, have been shown in recent studies to fight viruses, slow aging, and have a beneficial effect on health in general. Green tea helps to reduce high blood pressure, lower blood sugar, and even fight cancer.

There are also many powerful antioxidants found in green tea, one in particular being epigallocatechin gallate which is at least 100 more times effective than vitamin C and 25 more effective than vitamin E when it comes to protecting cells and DNA from damage linked to illness and disease. Herbal medicines are extracts from plants and flowers that are used to treat and prevent illness, and they have been used for a wide range of different conditions, including headaches, depression, PMS, and insomnia. Just make sure to remember that herbal medicine, although natural and basically completely safe, is still a form of medicine and so you have to use it with caution and follow recommended dosage instructions.

Part 1.

It’s remarkable that rooster combs have provided the source of a frequently used treatment for osteoarthritis (OA) of the knee. Through a combination of research and serendipity, viscosupplements- a type of lubrication treatment for OA of the knee- originally derived from rooster combs, are widely used by both rheumatologists as well as orthopedic surgeons. But do they really work? This two part article discusses the evidence in the medical literature.

Viscosupplements are compounds that have been created to mimic the effects of normal synovial fluid. Synovial fluid is the lubricating liquid present in normal joints that permits gliding and also helps with cushioning. Synovial fluid is produced by cells that line the joints and is essential for proper nourishment of the cartilage that caps the ends of long bones. At low levels of shear force (standing and walking for instance), synovial fluid’s primary effect is a lubricating one. At high levels of shear force (running and jumping), synovial fluid has a more shock absorbing function.

The major component of synovial fluid is a substance called hyaluronic acid. (HA). All synthetic viscosupplements also have HA as their major component. In this article I will use the term viscosupplement and HA interchangeably.

The first question is do these compounds work for osteoarthritis (OA) of the knee? As with any treatment, there is the possibility of negative studies. Viscosupplementation is no exception. Lo concluded that HA products have only a small effect compared with placebo (Lo GH, et al. JAMA. 2003; 290: 3115-3121). Brandt stated that HA and placebo produce similar results (Brandt KD, et al. Arthritis Rheum. 2000; 43: 1192-1203). And Karlsson posited that neither of two HA products did better than placebo at 26 weeks (Karlsson J, et al. Rheumatol. 2002; 41:1240-1248).

However, the majority of studies have demonstrated that there is a significant effect. But how well do they work? The interpretation of how effective these preparations are has been difficult because of a number of factors. These include:

Global use of these compounds with different measuring instruments and techniques in the research studies;

? Single versus multi-center studies

? Varying inclusion and exclusion criteria

? Different statistical outcome measurements

? Other study design issues

And comparisons have been made to treatments other than placebo. Two studies looked at viscosupplements compared with non-steroidal anti-inflammatory drugs (NSAIDs). (Altman RD, et al. J Rheum. 1998; 25:2203-2212; Adams ME, et al. Osteoarthritis and Cart. 1995; 3: 213-216). They found that viscosupplements performed as well or better than NSAIDS. However, design issues of the studies make interpretation somewhat difficult. It must be pointed out that adverse events were noted in both treatment groups. Not surprisingly, systemic therapies (NSAIDS) had more systemic side effects and HA therapies had more local adverse events.

One question that clinicians often wonder about is, “What about corticosteroid injections?” How do they compare? These preparations are used to reduce pain and inflammation, especially in acute knee osteoarthritis flare-ups and are relatively fast-acting

However, there are shortcomings. They include:

? Duration of efficacy may not last

? Frequent injections (more than 3 per year) may cause cartilage damage

? Local adverse effects

? Post-injection flares of pain

? Skin atrophy

? Osteonecrosis (dead bone)

Studies have evaluated the effects of viscosupplements vs intraarticular glucocorticoids. These include the following studies:

[Leardini G, et al. Clin Exp Rheumatol. 1991; 9: 375-381 (both equivalent until day 28 when divergence favored Hyalgan)]

[Caborn D, et al. J Rheum. 2004; 31:333-343 (both worked @ 1-4 weeks post injection; Synvisc better @ 5-13 weeks post injection)]

[Tekeoglu I, et al. J Rheumatol and Medical Rehab. 1998; 9: 220-224. (For first 4 weeks Orthovisc and methylpredsolone acetate similar; @ 5-13 weeks post injection, Orthovisc better)]

Most studies show this divergence of effect occurring at 5-13 weeks post injection.

(Raynauld JP, et al. Osteoarthritis and Cart. 2002; 10: 506-517). This is an interesting study from Canada where they looked at the difference between usual care, meaning all the things you would do for a knee OA patient except viscosupplementation versus another group where viscosupplementation was added. And they found that the usual care group + visco supplementation did better.

So what about repeating treatment? This was one study that looked at patients receiving 5 injections of viscosupplement every 6 months for a total of 25 injections. While the results showed that good safety and positive outcomes, design issues made this study a bit difficult to interpret. (Scali JJ. Eur J Rheumatol Inflamm. 1995; 15: 57-62).

One important bit of information that we can glean from many of these studies, regardless of viscosupplement used, is that the period of maximum onset of relief is @ 5-13 weeks post injection.

Part 2 of this series will discuss more about what the medical literature can tell patients about “rooster comb” treatments.