direct use of active medicinal constituents, on the development of semi-synthetic drugs,
and the active screening of natural products to yield pharmacologically-active synthetic
compounds. In Germany, for example, over 1500 plant species belonging to some 200
families and 800 genera have been processed into medicinal products. In South Aftica,
likewise, some 500 species are commercialised trade products [3]
‘The development and commercialisation of medicinal plant-based industries in the
developing countries is dependent upon the availability of facilities and information
concerning upstream and downstream bioprocessing, extraction, purification, and
marketing of the industrial potential of medicinal plants, Furthermore the absence of
modernised st
economic and public healthcare systems reinforces reliance of rural
and lower-income urban populations on the use of traditional medicinal herbs and plants
as complementary aids to routine pharmaceutical market products.
The prophylactic and therapeutic effects of plant foods and extracts in reducing
cardiovascular diseases have been reviewed. Phytochemicals are increasingly being
recognised as potential health promoters in reducing the risks of cardiovascular diseases.
Prominent herbs identified were Achillea millefolium (yarrow), Allium sativum (garlic),
Convatlaria majalis (lily of the valley), Cratageus laevigata (hawthorm), Cynara
scolymus (globe artichoke), Gingko biloba (gingko) and Viburnum opulus (cramp bark)
(3)
Medicinal plants can make a
important contribution to the WHO goal to ensure, that all
people worldwide, will lead a sustainable socio-economic productive life.
Concluding Remarks
Recent and renewed interest in medicinal plants coupled with developments in
information technology has fuelled an explosion in the utilization of medicinal plants as a
re-cmergent health aid, Recently reviewed diverse sources of such information in
traditional abstracting services as well as in a variety of online electronic databases are
abundantly available. As a result of such developments, access to indigenous people and
ixcultures concerning medicinal plants are greatly facilitated. Furthermore, the active
participation of practitioners of valuable knowledge is guaranteed in the research
fou
Wg on screening programmes dealing with the isolation of bioactive principles and
the development of new drugs.PART -I
PEPTIC ULCERNTRODUCTION: PEPTIC ULCER
General Considerations
Peptic ulcer is a break in the gastric or duodenal mucosa that arises when the normal
mucosal defensive factors are impaired or are overwhelmed by aggressive luminal factors
such as acid and pepsin. Ulcers extend through the muscularis mucosae and are usually
‘over 5 mm in diameter. In the developed country like United States, there are about
5,00,000 new cases per year of peptic ulcer and 4 million ulcer recurrences; the lifetime:
prevalence of ulcers in the adult population is approximately 10%. Uleer occurs five
times more commonly in the duodenum, where over 95% are in the bulb or pyloric
channel. In the stomach benign ulcers are located most commonly in the antrum (60%)
and at the junction of the antrum and body on the lesser curvature (25%) [6].
Ulcers usually occur more commonly in men than in women (3:1). Although ulcers can
‘occur in any age group, duodenal ulcers most commonly occur between the ages of 30
and 55, whereas gastric uleers are more common between the ages of 55 and 70. Ulcers
are more common in smokers and in patients taking Non Steroida! Anti-inflammatory
drugs (NSAIDs) on a chronic basis. The role of stress in ulcer formation is uncertain. The
incidence of duodenal ulcer has been declining dramatically for the past 30 years, but the
incidence of gastric ulcers have been shown to be increasing, perhaps as a result of the
widespread use of NSAIDs.
Etiology
‘Three major causes of peptic ulcer are now identified and recognized, these are acid
hypersccretory, chronic H. pylori infection and NSAIDs states such as Zollinger-Ellison
syndrome. Evidence of H. pylori infection or NSAID ingestion should be considered in
all patients with peptic ulcer.
A. H pylori-Associated Uleers: H pylori appear to be a necessary cofactor for the
majority of duodenal and gastric ulcers not associated with NSAIDs. However, it is nowexhibited that the prevalence of #. pylori infection in duodenal ulcer patients is about 70-
75%. Many H. pylori-infected patients have increased gastric acid secretion. It is
suggested that increased acid exposure can produce and initiate cellular and mucosal
changes which _are_most_liable
production of duodenal / gastric ulceration. The development of*gastric uleer ice. its
al damage resulting in
incidence is less as compared to duodenal ulcer. However, the association with gastric
ulcers is lower, but H. pylori is found in the majority in whom NSAIDs cannot be
implicated. Consequently, it is estimated that one in six infected patients will develop
s [7]
ulcer disease, and that this situation may be more in developing count
The history of peptic ulcer is well defined, after standard therapies. 70-85% of patients
will have an endoscopically documented recurrence within one year, half of these will be
asymptomatic, in clinical trials. Successful eradication of H. pylori was reported to
decrease the ulcer recurrence rate to less than 5% per year [8]. Analysis of trials have
cited that the ulcer recurrence rate afler 1. pylori eradication is substantially higher than
reported in documented studies approximately 20%) at one year, At least some of these
recurrences are due to NSAID use, notwithstanding these discrepancies. ‘The importance
of H pylori in the vast majority of cases of duodenal and gastric ulcers is undeniable,
B. NSAID-Induced Ulcers: There is a 10-20% prevalence of gastric ulcers and a 2-5%
prevalence of duodenal ulcers in chronic NSALD users. The relative risk of gastric ulcers
is increased 40-fold. But the risk of duodenal ulcers is only slightly increased; Users of
NSAIDs are at least three times more likely than non-users to suffer serious
gastrointestinal complications from these ulcers such as bleeding ‘perforation’ or death, It
is to note that gastric ulcers and duodenal uleers exhibit about the same number of
complications, Approximately 1-2% of chronic NSAID users will have a major
‘complication within one year. The NSAID complications is greater with higher NSAID
dosage during the first three months of administration, with advanced age, and with a
prior history of ulcer disease, concomitant corticosteroid administration, or serious
illness. Newer NSAIDs such as nabumetone, etodolac and celecoxib is associated with a