The clinical efficacy and safety of tulsi in humans: A systematic review of the literature

The clinical efficacy and safety of tulsi in humans: A systematic review of the literature

Jamshidi, N., Cohen, M. (2017) The clinical efficacy and safety of tulsi in humans: A systematic review of the literature Evidenced Based Complementary and Alternative Medicine ID 9217567

Abstract

 

Tulsi, also known as holy basil, is indigenous to the Indian continent and highly revered for its medicinal uses within the Ayurvedic and Siddha medical systems. Many in vitro, animal and human studies attest to tulsi having multiple therapeutic actions including adaptogenic, antimicrobial, anti-inflammatory, cardioprotective, and immunomodulatory effects, yet to date there are no systematic reviews of human research on tulsi’s clinical efficacy and safety. We conducted a comprehensive literature review of human studies that reported on a clinical outcome after ingestion of tulsi. We searched for studies published in books, theses, conference proceedings, and electronic databases including Cochrane Library, Google Scholar, Embase, Medline, PubMed, Science Direct, and Indian Medical databases. A total of 24 studies were identified that reported therapeutic effects on metabolic disorders, cardiovascular disease, immunity, and neurocognition. All studies reported favourable clinical outcomes with no studies reporting any significant adverse events. The reviewed studies reinforce traditional uses and suggest tulsi is an effective treatment for lifestyle-related chronic diseases including diabetes, metabolic syndrome, and psychological stress. Further studies are required to explore mechanisms of action, clarify the dosage and dose form, and determine the populations most likely to benefit from tulsi’s therapeutic effects.

Complementary medicine products– interpreting the evidence base

Complementary medicine products– interpreting the evidence base

Cohen, M., Hunter, J. Complementary medicine products– interpreting the evidence base. (2017) Internal Medicine Journal

Abstract

 

Many patients use complementary medicine (CM) products, such as vitamins, minerals and herbs as part of self-care without professional advice or disclosure to their doctors. While use of CM products is gaining awareness by the medical community and there is mounting evidence for their safety, efficacy and cost-effectiveness, there is also the potential for adverse events from inappropriate use and/or withdrawal, as well as interactions with other medicines. Due to the unique and complex properties of many CM products, research evidence is specific to individual preparations and this can lead to confusion when assessing label claims and interpreting the results of clinical trials and systematic reviews. While the Australian regulatory environment for CM products is the same as for prescription medicines and is based on risk, there is a great need for consumers and clinicians to have access to easily understood, evidence-based information to facilitate informed decision-making.

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No Guesswork with this alternative: desktop guide to Complementary and Alternative Medicine: An evidence-based approach.

No Guesswork with this alternative: desktop guide to Complementary and Alternative Medicine: An evidence-based approach.

Cohen, M. No Guesswork with this alternative: Desktop guide to complementary and Alternative Medicine: An evidence-based approach. Book Review Medical Journal of Australia, 176(4), p185, 2002

Abstract

 

Ever wondered which complementary therapies could be recommended based on a rigorous assessment of available evidence? This is the book that can provide the answers! It is a practical and transparent approach to presenting evidence on a wide range of complementary therapies, written by heavyweights in the field of complementary medicine and evidence appraisal. The book consists of three main parts. The first provides a brief background of different therapies, including an account of the clinical evidence and a risk–benefit assessment. The second part deals with common conditions and summarises the evidence supporting the use of different therapies, along with overall recommendations. The third part of the book provides an account of the legal, ethical, economic, social and safety issues surrounding the use of complementary therapies, albeit from a Canadian, American, and European perspective.

Non-prescription complementary treatments used by rheumatoid arthritis patients attending a community-based rheumatology practice

Non-prescription complementary treatments used by rheumatoid arthritis patients attending a community-based rheumatology practice

Gingold, M. Buchbinder, R. Cohen, M. Hall, S. Non-prescription complementary treatments used by rheumatoid arthritis patients attending a community-based rheumatology practice Internal Medicine Journal 32: 208-214, 2002.

Abstract

 

BACKGROUND:
Over 80% of rheumatoid arthritis (RA) patients have used some type of complementary medicine (CM) at some time. Little is known about RA patients’ perceptions of the efficacy, hazards and costs associated with CM use relative to physician-prescribed medicine. These data may be helpful in better understanding patients’ needs and in improving their care.
AIMS:
To determine the prevalence and features of CM use among RA patients attending a community-based private rheumatology practice. CM was defined as treatment that was initiated by the patient, excluding treatment that had been prescribed or specifically recommended by their doctor. telephone-administered questionnaire was used to survey a stratified random sample of 200 RA patients who had attended the practice within the preceding year. The main outcome measures were: (i) CM use in the past year, (ii) patient expenditure on CM, (iii) patients’ perceptions of CM and (iv) characteristics of patients using CM.
RESULTS:
One hundred and six patients responded (response rate 53%) and 101 completed the interview. Seventy-four patients (73.3%) had used some form of CM in the past year. There were 68 (67.3%) patients who had utilized complementary therapies and 32 patients (31.7%) who had consulted a complementary practitioner for their RA. The most commonly used treatments were dietary (64 instances) and behavioural/cognitive therapies (45 instances). Prescription medicine was considered more beneficial than either form of CM, and users and non-users of CM held a similar perception of the efficacy of prescription medicine. The median amount spent on RA treatment per month was $A7 (range 0-91) for complementary treatments, $A26 (1-270) for complementary practitioners and $A7 (0-80) for prescription medicine. Women were more likely to have consulted a CM practitioner (OR = 1.5; 95% CI: 1.2-1.9), as were patients who were not receiving a pension (OR = 1.7; 95% CI: 1.1-2.6).
CONCLUSIONS:
This study confirmed that CM use is prevalent among RA patients attending a community-based private rheumatology practice. Despite lesser perceived benefit, patients spent at least as much money on CM as they did on prescription medicine. These findings suggest that there are other factors motivating the use of alternative treatments.

A randomised, double-blind, placebo-controlled trial – Glucosamine – Osteoarthritis of the knee

A randomised, double-blind, placebo-controlled trial – Glucosamine – Osteoarthritis of the knee

Cohen, M. Wolfe, R. Mai, T. Lewis, D. A Randomised, Double-blind, Placebo-controlled Trial of a Topical Cream containing Glucosamine Sulfate Chondroitin Sulfate and Camphor for Osteoarthritis of the Knee. Journal of Rheumatology, 30 (3):523-8, 2003

Abstract

 

OBJECTIVE:
To assess the ability of a topical preparation of glucosamine sulfate and chondroitin sulfate to reduce pain related to osteoarthritis (OA) of the knee.
METHODS:
Sixty-three patients were randomized to receive either a topical glucosamine and chondroitin preparation or placebo to be used as required over an 8 week period. Efficacy was assessed using a visual analog scale (VAS) for pain as well as the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the SF-36 questionnaire.
RESULTS:
VAS scores indicated a greater mean reduction in pain for the glucosamine/chondroitin preparation group (mean change -3.4 cm, SD 2.6 cm) compared to the placebo group (mean change -1.6 cm, SD 2.7 cm) after 8 weeks. After 4 weeks the difference between active and placebo groups in their mean reduction from baseline was 1.2 (95% CI 0.1 to 2.4, p = 0.03) and after 8 weeks was 1.8 (95% CI for difference between groups, 0.6 to 2.9 cm; p = 0.002).
CONCLUSION:
Topical application of glucosamine and chondroitin sulfate is effective in relieving the pain from OA of the knee and improvement is evident within 4 weeks.