Lupine Publishers | Use of Complementaries By Pregnant Women

  Lupine Publishers | Open access Journal of Complimentary and Alternative Medicine

Abstract

Background: Complementary itoms (CI), Traditional therapies (TTs), and Alternative therapies (ATs) use is common. ATs and TTs are used singly or with modern medicare for prevention, treatment as complementary therapy (CT), even during pregnancy globally. Their use seems to have increased, even in developed countries, with little recorded evidence of reasons for use, efficacy, and side effects.

Objectives: To know types of complementaries or CT used by pregnant women and reasons for use.

Material Methods: Present study was carried out. by interviews of 1200 women with predesigned tool in postnatal wards a day after delivery. More rural women delivered, but were equalized, 600 rural, 600 urban.

Results: Use of CI/CT was reported by 11.4% rural,11.2% urban women. Most frequently used item was Kesar (3%) during pregnancy, Coram seeds (2%) during labour, Aniseed (0.75%) and Coram seeds (0.75%) in postpartum. period with no difference weather rural or urban, less or more educated or of any, economic class. Those with physical symptoms were more likely to use CT/CI. Primigravida used for having natural birth. Six percent used CI postpartum for better lactation, elevated mood, prevent postpartum depression. CI were given to baby too, Honey was most commonly used for religious belief, source of energy, and to increase immunity of newborn too. Massage was universal.

Conclusion: CI/CT were used during pregnancy, labor, postpartum in wards, labour room without service providers knowing. Health professionals of modern medicine need to ask. Many of CI used were harmless, may be helping. Community based research is needed Institutes of Health (NIH) now has a division dedicated to the investigation of alternative and complementary therapies. (https://www.nccih.nih.gov/).

Keywords: Pregnant women; Complementary therapies; Reasons

Background

Traditional modes of prevention and treatment have always played a role in health care. They are used globally, and their use seems to have increased, even in the developed countries [1-5]. It was believed that almost four billion people worldwide used such therapies [6], either because nothing else was available, or accessible or not affordable or due to dissatisfaction with the modern medicine or may be the faith on such modes. In the Indian culture, use of traditional therapies (TT) have always been there. Am Fam Physician reported that in the present times women use TT with conventional modern medicine specially during pregnancy as complementary therapies (CTs). Some use kitchen itoms as complementary itoms (CI) While reviews have concentrated on the use of CI/CTs by pregnant women with recommendations for use by health professionals too during pregnancy, findings of relevant CTs-based studies have placed less emphasis on critically appraising the core elements of study designs and reporting. Limited reviews of CTs recommendations made by healthcare professionals revealed that CTs, particularly Aayurvedic, Herbal therapy, Chiropractic, Acupuncture/Acupressure, Massage, Homeopathy, and Aromatherapy were commonly recommended and used in the maternity settings [7-9].

Objectives

To know the types of CIs, CTs used by women, during pregnancy, labor, post birth, and reasons for use.

Materials and Methods

Present study was carried out after institute’s ethics’ committee’s approval over a year in the Obstetrics Gynecology department of a rural medical institute in Central India. Since sample size would have been hypothetical, so study duration was considered a key component and it was decided to collect information over 10 months to get sufficient study subjects , with one month for plans and one month for analysis, total one year study duration. The research assistant who was briefed about the objectives of the study, interviewed women with the help of a predesigned questionnaire in the local language, after taking consent a day after delivery. Subjects were interviewed, until maximum 6 days postpartum. If there were more than 6 births on a day, randomly 6 were interviewed and if less women delivered then all were interviewed, making around 120 cases in a month. Twelve hundred postpartum women were interviewed, they were asked about. CIs/ CTs they used during pregnancy, labour and postpartum. These women were of 20-39 years. Though more women who delivered were rural, as were overall health seekers at the rural institute, they were equalized, 600 rural and 600 urbans to get information as per the objectives. and see the differences in rural and urban women. Though more women were from lower economic class, but some were from middle and middle upper economic class. (Modified from Tiwari) [10] 58.1% were from middle economic status, more women were educated till primary school or secondary school. But some study subjects were undergraduate, and postgraduate studied too, 48.3% women were educated till secondary and 37.5% were graduates Education did not make any difference. In use of CT/CI Most of the women were of 20-29yrs, around 92%, Overall, 80.2% were housewives, 66% were nulliparous and 30.1 % were primi para (Table 1).

Table 1: Age, Rural Urban, Literacy, Occupation, Socio –economic status, Parity.
P –primary 1-Housewife U- Upper
S- Secondary 2- Labourer UM – Upper Middle
G- Graduate 3- Work in Own Farm M - Middle
PG- Post Graduate 4- Office work LM- Lower middle
5- Skilled worker L- Lower

Results

When the details of the use of CIs/CTs, in the past pregnancy were asked it was revealed that it was mainly use of CIs. Massage was universal. Kesar was used by 0.92% urban and 0.83% rural women. Other items specially used were honey and dry fruits (Table 2).

Table 2: Complimentary Therapy in Past Pregnancy.
U- Upper UM – Upper Middle M- Middle LM – Lower Middle L- Lower P0- P1 P2- Parity

In the present pregnancy 135 (11.3%) urban and 68 (5.7%) rural women had used CIs during pregnancy. CI were Kesar, Honey, Coconut water, Coconut, Chavanprash Ayurvedic mixture of various Herbs and Dry fruits. Kesar was the most commonly used CI during pregnancy, by rural as well as urban women 3.3% and 3% respectively, Dry fruits by 0.8% and Coconut water by 7%. Chavanprash was used by 0.3% rural women and 0.3% urban women. Honey was also used Chavanprash and Honey were considered source of energy for the mother and baby (Table 3 & 4).

Table 3: Complimentary Therapy During Pregnancy.
U- Upper UM – Upper Middle M- Middle LM – Lower Middle L- Lower P1 P2- Parity

Table 4: Complimentary Therapy During Labour.
U- Upper UM – Upper Middle M- Middle LM – Lower Middle L- Lower P0- P1 P2- Parity

During labour the CIs used were Cloves, Saunf, Beetle Nut, Coram Seeds and Cardamom by 2.5% rural women and 3.3% urban. Most of those who consumed CIs were of middle class and of 20-29yrs. Overall nearly 6% laboring women used CIs. They did not inform about CIs to any health provider. The reasons given were that medication given in the hospital did not completely resolve the labour related ailments and CIs provided a more natural and faster relief. They said the usage of CIs increased the chances of natural birth and decreased the pain during delivery. Coram seeds were used by 1.6% women. CIs were used by 2.5% women in postpartum period. Common items used in post-partum were Cloves, Beetle nut, Ani seeds, Coram seeds, and Cardamom. Aniseeds and Coram seeds were used by 0.75%, Beetle nut by 0.4%. Women used CIs for preventing postpartum depression, mood elevation and improving lactation (Table 5).

Table 5: Complimentary Therapy in Postpartum period.
U- Upper UM – Upper Middle M- Middle LM – Lower Middle L- Lower P0- P1 P2- Parity

CIs like. Honey, Jaggery water, Jira water, Glucose water and Sugar water were also given to the babies. Over all 4.3% women gave CIs to their babies. Mostly Honey and jira water. with no difference in rural or urban women. Over all 4% women gave CIs to babies, Honey or Sugar in water, by 1.8% followed by Jaggery. It was revealed that more urban women, 34 (5.6%) used CIs for baby compared to rural women 18 (3%). CTs for baby were considered a source of energy to the newborn as well as were believed to boost the immunity of the newborn in conjunction with breastfeeding (Table 6). Tradition of massage was almost universal, legs and back during pregnancy and all over the body in postpartum, and to the baby too. This was irrespective of economic status or education.

Table 6: Complimentary Therapy Given to Baby.
U- Upper UM – Upper Middle M- Middle LM – Lower Middle L- Lower P0- P1 P2- Parity S – Strong H - Healthy

Discussion

AT, TT, CTs and CIs encompass a broad spectrum of beliefs and practices used for treating or preventing various disorders and also for health promotion. Such CTs or CIs are believed to be used by pregnant women, for better growth of the baby or treating minor aliments or smooth birth process and may be women or their families had other notions Tiran [11] also opined that CTs may not be entirely free of risk. Still the use of TTs or ATs, CTs has become increasingly common in developed countries too, with women being the most frequent users. After review of various studies about CTs for perinatal depression. Sparling [12] reported that adequately powered systematic studies were necessary for knowing the role of ATs/CTs in the treatment of perinatal depression. Researchers reported that the estimates varied widely from 1% to 87%, but the general trend indicated that a significant number of pregnant women used CTs. Common modalities used included Massage, Herbal medicine, Relaxation therapies and Aromatherapy. Reasons for use varied and included the belief that these therapies offered safe alternative to pharmaceuticals and had better efficacy. They allowed greater choice and control over the childbearing experiences, In the present study when the usage of CIs/CTs was studied it was found that women of 20-29 years of age used these therapies the most. Body massage was universal. Women used CTs/CI for relief from anxiety during pregnancy and delivery and used them for a smoother delivery process and better outcome No difference was found with education or economic status. Most of the women using CTs had studied upto secondary school. Most of the women were housewives.

Truijens et al. [13] reported that many women were habitual users of such items in daily life. So, they continued using them even in pregnancy and delivery with the belief that CTs/CIs prepared the body better for pregnancy and labor. It was found that CIs were used more often in labor by primigravidae. This could be due to anxiety about the birthing experience with a lower threshold for tolerance of minor ailments, pain and desire of better birthing experience. And also, women listened to whatever was told by the family. Most expectant women used CIs on advice of family and friends, and they did not disclose use of CIs to their care providers. Skouteris [14] in his study, reported that half the Australian women surveyed consulted ATs practitioner for pregnancy related health conditions. It was quite common for women to consult multiple AT practitioners alongside their conventional maternity care providers. If a woman consulted a AT practitioner and conventional care provider simultaneously for the management of the same condition, without disclosing use of ATs to either practitioner, this could creat risk for mother or baby or both through possible pharmacological interactions between treatments or broader conflicts between the treatment goals of the two (or more). Bridee [15] reported that CTs use among pregnancy similar to non-pregnant, while during postpartum CTs use decreased., only 7.6% of women did not take any medicinal product throughout pregnancy. In various studies done for CTs results varied because they were affected by a number of factors. Health professionals of modern medicine needed to ask women about use of ATs or TTs CTs. Women may choose AT or CTs in pregnancy to have control over growth of baby and hence perceived as safer treatment option in pregnancy and childbirth or to select a treatment choice not covered by conventional medicine to prepare the womb and cervix for childbirth.

In the study by Jung et. al [16,17] the proposition of CT user among pregnant women was relatively high. Health providers, while respecting the beliefs of communities, needed to find means of best advocacy for safe practices. Knowledge of ATs/TTs, CTs CIs needed to be part of everyday clinical practice for the practitioners of modern medicine. They needed to promote beneficial practices and discourage the harmful modalities, for which research is essential. Awareness needs to be created in a sensitive way and also make health providers aware of existing ATs, TTs and CIs. Study by Hollyer [18] revealed a generalized lack of knowledge and poor understanding of the possible risks to women. and researcher reported that women’s holistic needs may not be met within a medical model of maternity care So CTs have a place. Many pregnant women who used CTs did not know whether they did good or bad to the mother and/ or the baby. The lack of awareness could lead to serious hazards in the mother and /or the baby. Massage and Aromatherapy were used for treating anxiety, Acupressure for back and pelvic pain and Acupressure, and ginger for morning sickness is known.

In the present study in past pregnancy less women had taken traditional medicine and Low Dog [19] reported that they had lack of knowledge of these products and hesitated because the safety of these products was not known. The women felt that they could have better control of pregnancy and improved growth of the baby. In general, CTs are increasingly being integrated into maternity care [20]. Use of Herbal and other natural treatments have been reported to be increasing in the United States and Canada, also as valid treatments [21]. Because Herbal and other natural remedies were not regulated to the same degree as traditional pharmaceutical products, use in pregnancy a potentially vulnerable time for both mother and fetus, so monitoring such things was thought to be essential [22]. Kesar and Carom seed use in pregnancy as per their traditional belief, cleaned the stomach and helped in reducing vomiting and indigestion. During post-partum period it increased the energy in the body and prevented infection Health and Balanve Guife [23] reported that for Nausea; Acupuncture, Acupressure, Ginger root worked well and were considered safe for pregnant women, Exercise, hypnosis and on Herbs close to the skin have been stated to be beneficial in turning a breech baby. Relaxation techniques, patterned breathing, emotional support, and selfhypnosis are already widely used CT in labor. Robust research is needed to understand their utility, benefits and concern if any. Pregnant women struggle with various health issues that can affect fetal development and normal delivery in the present study overall use was somewhat lower than expected. Conovar [24] from a single, urban hospital found that, 4.1% of women reported using an Her

During labour Coram seeds were consumed by women with the beliefs that the conventional medications did not cover all the ailments and CI provided better and faster relief of symptoms. Moreover, they prepared the uterus and cervix for a better birthing experience and increased the chances of natural birth. Women reported CIs improved lactation and specially in prim para lowered the chances of postpartum depression, elevated mood and symptomatically treated minor ailments. For the baby honey was the commonest CI given. According to Pallivalappila et al. [25] the application of a consistent and useable CTs definition proved to be a major issue. However, what is used, why is used are not well known. There are very few high-quality studies about the effectiveness CTs or ATs and more studies are needed. Studies should focus on the safety of specific with respect to wide range of pregnancy conditions and outcomes. Indeed, whether or not a particular therapy is deemed to be CTs may differ between countries, healthcare settings, and specialities. The lack of definitions and checklists may explain why the reported prevalence of CTS use appears to be highly variable, even within similar populations. However, what is used, why is used are not well known. Research is needed.

Conclusion

Community based research is needed to gain a greater understanding of the true use of AT, TT, CTs, CIs by pregnant women. Health professionals should ask women about use. It is essential to know what they use during pregnancy, labour and after delivery. Further evaluation of CTs among pregnant and postpartum women is necessary to determine the costs and benefits of integrative TTs in conventional care. Larger studies are needed for better understanding of the role of CTs in pregnancy (Graph 1-5).

Graph 1: Complimentary Therapy in Past Pregnancy.

Graph 2: Complimentary Therapy During Pregnancy.

Graph 3: Complimentary Therapy During Labour.

Graph 4: Complimentary Therapy in Postpartum period.

Graph 5: Complimentary Therapy Given to Baby.

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Lupine Publishers | A Study to Assess Relationship between Different Obesity Indices and Musculoskeletal Discomfort Score in Agricultural Workers in Southern Districts of West Bengal, India

 Lupine Publishers | Open access Journal of Complimentary and Alternative Medicine

 

Abstract

Occupation is an important determinant of health in general and its overall positive or negative effect on well-being results from the interaction between individual characteristics and work-related features, the latter comprising biomechanical, psychosocial, and sociological axes. In India, about three fourth of the population are dependent on different type of crop cultivation; of which paddy cultivation is an important one. Paddy cultivation involves in various processes, some of the postures, which were taken by crop cultivators, were very harmful. Some of the works are dominated by static muscular contraction and some other works are involved with repeated dynamic activity. In this backdrop, the present study has been undertaken to assess the relationship between works related musculoskeletal discomforts score and obesity indices among the human resources engaged in paddy cultivation task. Significant association was observed between obesity indices and MSD discomfort score.

Keywords: MSD; Agriculture; Obesity; Job demand; Paddy cultivation

Introduction

Rice is one of the major food crops of the world. It provides the bulk of daily calories; moreover, rice is also one of food which is considered to be a potential food vehicle for the fortification of micronutrients because of its regularly consumption. It is a good source of thiamine (vitamin B1), riboflavin (vitamin B2) and niacin (vitamin B3). The nutrients content of rice was varies depending on the variety of rice soil, and the conditions they growth. On the other hand, rice cultivation is an important sector of earning opportunity for the human resources engaged in agricultural task; 58.4% of the human resources are engaged in the different agricultural task during the paddy cultivating time in India. And 43.5% of male and 46.3% of the female human resources are engaged in different agricultural work during the paddy cultivating time in WB. The area under paddy cultivation is about 44.79 million hectares, the largest in the world. Yet, the agricultural sector in the rural villages of India is still dependent on non-mechanized technique i.e. dependent on the physical effort of the human resources involved [1-4].
During the paddy cultivating time the agricultural workers has to carry out different tasks-ploughing, transplanting, reaping, threshing, and parboiling throughout the year even in a single day too. Earlier studies report that, drudgery is generally conceived as physical and mental strain, agony, monotony, and hardship experienced by human beings [5-8]. While all these results in decline in living and working conditions affecting men and women [9-15]. Therefore, in order to ensure health, wellbeing and thereby improving the work performance, the assessment of occupational health status is considered as an essential factor for the human resources engaged in outdoor occupations especially those who are engaged in different types of tasks during the period of paddy cultivating time [16-22].

Paddy cultivation involves in various processes, some of the postures, which were taken by the food growers were very harmful. Some of the works are dominated by static muscular contraction and some other works are involved with repeated dynamic activity [23-24]. According to public health perspective, effective well-documented initiatives for reducing body weight, improving physical capacity, and reducing musculoskeletal pain among health care workers are therefore required. Moreover, there is lack of evidence about the association between body weight status and musculoskeletal injury in different body regions. In this backdrop the present study aims to assess the relationship between different obesity indices and musculoskeletal discomfort score in human resources occupationally engaged in agricultural task especially paddy cultivating task.

Materials and Methods

Human resources engaged in paddy cultivation, with no known chronic disease history (self-reported) and having a minimum working experience of three years, regularly working on an average for at least a period of six to six and half hours in the agricultural field in Arambagh subdivision in the district Hooghly [(latitude (23⁰01’N to 22⁰39’N) and longitude (88⁰30’E to 87⁰39’E)] were approached for participation in the study. The study was carried out on 34 adult Bengalee male food growers (age range 21-30 years) occupationally engaged in paddy cultivation. After obtaining necessary human ethical clearance, along with initial consents from the individuals, the names of volunteers were enlisted, and the procedural requirements were explained elaborately. Basic information regarding participants’ age (year), working experience (year) and average working time (hr.day-1) recorded in a predesigned schedule. Socio-economic status (SES) was assessed by using Kuppuswamy’s scale [25].
Stature (cm) and body weight (BW) (kg) were measured using anthropometric measurement set and weighing scale respectively. Body mass index (BMI) was calculated from the measured stature (cm) and body weight (kg) data. The pre working heart rate (HR Prework) (beats. min-1), systolic and diastolic blood pressure (SBP Prework) and (DBP Pre-work) (mm Hg) were recorded in the morning hours before the individuals started working using an automated blood pressure monitor in sitting condition. Waist circumference cm) [26] and hip circumference (cm) [27] were measured by using non elastic tape. Conicity index (CI) [28], abdominal volume index (AVI) [29], Rohrer index (RI), hip adiposity index (HAI) [30-31] and a body shape index (ABSI) [31] were also obtained. Work related musculoskeletal discomfort was assessed by Cornell University’s Musculoskeletal Discomfort Questionnaire (CMDQ) [32]. The obtained data were tabulated for statistical analysis. Obtained data were statistically analyzed. P value lower than 0.05 (P<0.05) was considered significant.

Results and Discussions

The basic profile including age (year), ethnic background, SES, working experience (year), average working time (hr.day-1) of the male food growers are presented in Table 1. The physical and physiological variables in terms of stature (cm), body weight (kg), HR Pre work (beats.min-1), SBP Pre work (mm Hg), and DBP Pre work (mm Hg) have been presented in Table 2. Association between different obesity indices in terms of BMI, CI, RI, AVI, HAI and ABSI with CMDQ score have been presented in Figure 1.

Table 1:

Table 2:

Figure 1: Association between different obesity indices and CMDQ score.

Obesity is a common condition and its prevalence is increasing worldwide [33-38] and our country is neither an exception [39-40]. It is characterized by excess body fat which is usually accompanied by increased total body mass. It is associated with numerous chronic health conditions, such as type 2 diabetes mellitus, cardiovascular disease, hypertension, and cancer. On the other hand, BMI is considered as one of the most popular indicator of obesity status [41]. In the present study, according to the BMI status of the participants, it was found that 12.9% of the participants were underweight, 35.5% were within normal BMI range and 51.6% of study participants (maximum percentage of subjects) were overweight as per WHO recommendation of BMI classification.
The main focus of the present study was to assess the musculoskeletal discomfort score and to find its association, if any, with the obesity indices among the study participants. CMDQ is a reliable and valid tool, for measurement of WMSD. Maximum CMDQ score has been found with individuals categorized as overweight followed by normal and underweight individuals. Significant association (P < 0.01) existed between BMI and CMDQ scores (Figure 1) which is in agreement with earlier studies [3-4,22-23]. In the present study it is observed that, CMDQ score is significantly associated with CI (P < 0.01), AVI (P < 0.01), HAI (P<0.01) and ABSI (P<0.05), which is in agreement with other studies [7-10]. An earlier study [42] reported that, the risk of musculoskeletal pain among overweight/obese individuals was 1.7-times more as compared to individuals with normal body weight; especially increased BMI value which may be contribute to musculoskeletal discomforts [42].
Human resources working in front of a computer with high BMI were found to be more prone to WMSD, may be because overweight acts as a contributing factor in increasing the physiological and mechanical load on tissues. Relative disk pressure is being experienced during sitting with various inclinations of the back support. Intra-diskal pressure of the nucleus pulposus, acts as a load transducer and indicates the magnitude of axial loading on the spinal column and the increased pressure indicates a greater muscular effort in maintaining the posture and hence a larger stress on spinal column. Moreover, overweight yields a decreased postural stability and potentially negative impact on control of upper limb movements but its effect on control of balance imposes constraints on goal-directed movements. From a clinical perspective, obese individuals might be less efficient and more at risk of injuries than normal individuals in a large number of work tasks and daily activities especially requiring upper limb movements [43-44]. The result of the present study indicates positive association of obesity indices with MSDs among computer operators, occupationally engaged in organized sector and thereby reducing the performance level of the individual workers.

Conclusion

From the present study it may be concluded that that obesity indices are associated with musculoskeletal symptoms; and a rise in BMI, CI, AVI, HAI and ABSI increases the chance of MSD occurrence inhuman resources working with a computer in course of their regular occupationally engaged in paddy cultivating task.

Acknowledgement

We are thankful to all volunteers for their participation.

Conflicts of Interest

Nil.

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Lupine Publishers | The Use of Acupuncture in Eye Diseases: An Overview

  Lupine Publishers | Open access Journal of Complimentary and Alternative Medicine

 

Introduction (Historical overview)

Allopathic or western medical approaches to ocular conditions such as cataract, diabetic retinopathy, and wet age-related macular degeneration have been largely successful, resulting in the decline of severe visual loss worldwide for patients with these conditions. Despite these successes, a variety of other ocular conditions continue to pose substantial ongoing threats to vision. Dry macular degeneration, optic nerve disease, and myopic degeneration not only lack effective treatments, but are increasing sharply. As the limits of western approaches become apparent, there is rising interest in alternatives. Traditional Chinese acupuncture has existed for thousands of years. The National Institutes of Health (NIH) now has a division dedicated to the investigation of alternative and complementary therapies. (https://www.nccih.nih.gov/). Clinicians should be familiar with existing knowledge and potential benefits of complementary and alternative therapies. Few western or allopathically trained clinicians are familiar with acupuncture. No consensus has been reached on the precise biomedical model for the mechanism of action of acupuncture. Neuromodulation, alteration in local blood flow, and micro-injury with repair have been proposed as factors involved in response to acupuncture.
The early record of acupuncture in the treatment of eye disease can be found in “The Yellow Emperor’s canon of internal medicine” written in the Han dynasty of 2000 years ago. In the “Chapter Heat Disease of Ling Shu” [1,2] it stated that “if redness and pain of the eyes start from the inner can thus, Yin Qiao should be taken as the needling point”. In “Chapter the evil Qi and the morphology of Zang and Fu”, it said “the Qi and blood from the 12 meridians and 365 branches go to the head and then to each orifice, the most essential part of it, the pure Yang Qi, goes to eyes and makes the eye clear”, emphasizing a close relationship between the eye and the internal organs as well as other part of the body, which was thought to provide a basis of theory for acupuncture treatment of eye diseases [3]. From then on, acupuncture practitioners of different dynasties have contributed a variety of theories and treatment modalities, which tremendously enriched our knowledge of acupuncture treatment for eye diseases. Nowadays, more and more patients with eye diseases seek acupuncture treatment in China and around the world [4-6]. Ophthalmologists from Hong Kong, China and Sofia, Bulgaria published two earliest English case reports respectively in 1980s. In the first report, over 500 cases treated shows that acupuncture can be successful in the treatment of eye diseases, especially in cases of retinitis pigmentosa (RP), high myopia, cataracts, surgical aphakia, controlled glaucoma and re-attached ablation retinae [7]. In the second report, acupuncture treatments for myopia, glaucoma, RP and optic nerve atrophy showed some improvement in visual acuity subjectively [8]. A survey conducted in 2006–07 in US showed that 42 per cent of retinitis pigmentosa patients had tried acupuncture [9]. Here we review the recently published use of acupuncture as a primary and adjunctive treatment for ocular disease. We focus on glaucoma, optic atrophy, RP and amblyopia as they were the most common eye disorders presenting for treatment to acupuncturists.

Clinical Studies

Glaucoma

Despite progress in the development of novel medical and surgical approaches for treatment, glaucoma is still one of the leading causes of irreversible blindness worldwide [10]. Therefore, many patients sought acupuncture treatment to reduce progression of glaucoma. Wong and Ching [7] show a subset of patients with glaucoma showed improvement in visual acuity with three out of eight patients showing a decrease in intra-ocular pressure (IOP). A similar result was also shown in Liu’s clinical study [8]. In 2004, Ren and Wang [11-13] summarized the reports of treatment of glaucoma with acupuncture and other acupuncture related treatment modalities published in China from as early as 1963. The reported modalities included body acupuncture (acupoints around the eye and in the other parts of the body, especially the foot, leg and hand), moxibustion, ear acupuncture, blood pricking, etc. Their conclusion was that acupuncture could reduce the intraocular pressure (IOP) and was effective in the treatment of glaucoma, especially for the open angle glaucoma. As with pharmacologic therapy, benefits were not permanent and failed to show lasting impact with respect to IOP reduction.

In a 2005 Japanese study, 11 glaucoma patients were given 9 sessions of acupuncture in 5 weeks. IOP was significantly improved at 15 minutes after acupuncture, and also at one week, two weeks and five weeks after acupuncture. Uncorrected visual acuity was improved at three to five weeks, and best-corrected visual acuity was improved only at five weeks. The acupuncture induced improvement in IOP disappeared four weeks after stopping acupuncture treatment [14].
In another study, hemodynamic changes in retrobulbar vessels of OAG eyes before and after acupuncture showed a significant decrease in the vascular resistance of the short posterior ciliary arteries along with the a decrease in IOP, suggesting an increase in retinal and choroidal blood flow after acupuncture [15,16]. Similarly, IOP decreases were also seen by Her et al. [17] and Yeh et al [18]. In Leszczynska et al’s randomized study [19] Primary Open-Angle Glaucoma patients were randomly assigned either to an eye-specific acupuncture (group I, n=28) or to a non-specific acupuncture treatment (group II, n=28). Blood flow parameters were measured before and 10 minutes after treatment. They did not find the change of IOP but found that ocular blood flow increased significantly after the eye-specific acupuncture treatment. The inconsistent results of the above studies are likely due to numerous factors, including acupoint selection, needling technique, measuring method, subject recruitment, diagnostic criterion and medication history. The relationship between IOP and ocular hemodynamics has been shown to depend on arterial blood pressure (BP) and blood flow autoregulation (AR) [20-23], suggesting that the ability of IOP to induce noticeable changes in retinal hemodynamics depends on the levels of BP and AR of the individual. Thus, the impact of IOP reduction depends on hemodynamic criteria. Without controlling for those variables, it is difficult to show clear benefits of acupuncture upon glaucoma progression. Strong clinical evidence to justify the routine use of acupuncture is still lacking. Authors conclude that it is impossible to draw reliable conclusions from available data to support the use of acupuncture for treatment of patients with glaucoma [24,25].

Optic atrophy (Optic Neuropathy)

The term optic atrophy indicates the end stage of a neuropathic process in which there is end stage damage to the optic nerve. Examples of optic atrophy include end stage glaucoma, nerves damaged from compression via tumors, etc. There are two metaanalysis studies regarding the effect of acupuncture in the treatment of optic atrophy. The first one Included 13 randomized clinical trials (RCT) studies of total 1180 eyes (acupuncture 619, control 561) [26]. Among these trials, two studies comparing manual acupuncture (as treatment) with medication alone (as control), 11 studies comparing manual acupuncture plus medication (as treatment) and medication alone (as control). Meta-analyses showed that the effect of acupuncture or combined with medicine was superior to medicine alone in terms of total effectiveness, visual acuity, and visual field, The authors concluded that acupuncture is superior to medicine in terms of improved visual acuity, visual field and pattern visual evoked potential. But they also mentioned that the flaw in the design of the clinical studies and a large scale, multiple-center, high-quality studies is needed to make stronger evidence. The second one included 9 studies (a total of 513 participants: 262 in experiment groups and 251 in control groups) [27]. Among three trials, three studies comparing manual acupuncture (as treatment) with medication alone (as control); six studies comparing manual acupuncture plus medication (as treatment) and medication alone (as control). The meta-analysis showed significant differences in favor of manual acupuncture or manual acupuncture plus medication compared with medication alone in the improvement of visual acuity, mean sensitivity of visual field, the latent period and the total effectiveness. However, due to serious methodological flaws in study design, such as discrepancy in randomization, lack of blindness, publication bias (all published in Chinese), and lack of follow-ups, etc. The authors failed to conclude that manual acupuncture is more effective than medicine alone.

Retinitis pigmentosa (RP)

Currently, there is treatment for only one of several thousand variants of retinitis pigmentosa. Thus, the vast majority of patients with this condition have no proven therapeutic options to improve or halt the slowly progressive visual loss. In Kiser AK, Dagnelie G ‘s survey, 42 per cent of RP patients tried acupuncture. A total of 96 patients participated in the survey and 61 per cent indicated a subjective improvement in vision. Kiser and Dagnelie [9]. To investigate the effect of acupuncture in RP, physicians from Wilmer Eye Institute, Johns Hopkins University in Maryland, and College of Optometry, Nova Southeastern University in Florida, conducted two clinical studies. In one study [28], 12 adult RP patients were given 10 half-hour sessions of acupuncture treatment over two weeks. Patients were administered pre- and post-treatment visual acuity, contrast sensitivity, visual fields, and dark-adapted full-field stimulus threshold testing (FST). Six of 12 subjects had significant visual function improvements after treatment. Three of nine subjects tested with the FST had a significant (13- to 53-fold) improvement in both eyes at one week after acupuncture, maintained for at least 10 to 12 months. Dark-daptation was shortened in both subjects tested on average by 48.5 per cent by one week. Four of the five subjects with psychophysically measured scotopic sensitivity improvements reported subjective improvements in vision at night or in dark environments. One subject had 0.2 log MAR improvement in VA; another had 0.55 logCS improvement. Another subject developed more than 20 per cent improvement in the area of the Goldmann visual fields.
In another study [29], twenty-one RP participants were randomized (1:1:1) to transcorneal electrical stimulation (TES), electro-acupuncture (EA) or inactive laser acupuncture (sham control). After treatment of 10 half-hour sessions over 2 weeks, a significant improvement in retrobulbar central retinal artery mean flow velocity for both the TES and electro-acupuncture groups were found when compared to sham controls. Electro-acupuncture subjects had significant 34% greater increases in retinal blood flow in the macular vessels when compared to sham controls (p = 0.008), There was a significant difference in the proportion of eyes that had improved visual function when comparing EA with sham (29% vs. 0%), indicating that acupuncture stimulation had a better treatment effect.

Amblyopia

The use of acupuncture for the treatment of amblyopia treatment has become more and more common in recent 20 years [30]. In 2013, a non-Cochrane review examined the efficacy of acupuncture for amblyopia. The authors analyzed 14 RCTs (2,662 participants) out of 115 possible trials (most were published in Chinese). They found that the acupuncture group had higher rates of clinical improvements than the conventional treatment group [31]. Later on, two RCT reports on using acupuncture in amblyopia treatment were published in English journals. Zhao, et al reported the results of two groups of anisometropic amblyopes aged 7–12 years, one group received acupuncture while the other group (control groups) received 2 h of occlusion therapy. At 15 weeks, follow-up subjects in the acupuncture group were found to have significantly greater improvements in visual acuity in comparison to the control group (2.27 lines and 1.83 lines respectively) [32]. Lam et al. [33] reported the effects of acupuncture on anisometropic children aged 3–7-year-old, Participants were randomized to receive spectacles alone (n = 42) or spectacles + acupuncture (n = 41) for 15 weeks. Using a randomized cross-over trial method, they found a greater improvement in visual acuity using refractive correction with acupuncture compared with refractive correction alone.

Although it is still controversial regarding the design of these RCTs as the set-up of sham acupuncture, the balance between the time used in acupuncture group and the control group, etc [34,35], the clinical data so far seem to support a favorable effect of acupuncture treatment of amblyopia. The flaws in the design of the clinical trials need to be minimized in future and clinical trials involving more participants seem necessary.

It needs to mention that recently Vanzini and Gallamini [36], developed an ultra-low-light-intensity Laser acupuncture and they use the laser acupuncture for the treatment of 13 cases of anisometropic children of 3-11-year-old. The treatment was performed once a week with each session lasted <15 minutes. After 6 weeks, 11 out of 13 patients received remarkable improvement. They thought that laser acupuncture could provide similar, if not better, results to conventional acupuncture stimulation, but with higher patient compliance.

Mechanism

There are few studies investigating the mechanism of acupuncture in the treatment of eye disease. As mentioned above some clinical studies show that acupuncture may increase intraocular blood flow. There are some experimental studies showing that acupuncture could stimulate the vision cortex. Another factor may be promotion of photoreceptor cell survival through a pathway of neuroprotection or anti-apoptosis, etc.

Acupuncture affect vision area in the brain

Acupuncture has been shown, using fMRI, to improve blood flow in the visual cortex. A laser acupuncture at UB-67 was found to cause activation in the cuneus corresponding to Brodmann Area (BA) 18 and the medial occipital gyrus (BA 19) of the ipsilateral visual cortex while placebo stimulation did not show any activation [37]. The visual cortex was also activated by in some subjects during conventional or electro-acupuncture over four visionimplicated acupoints on the right foot [38]. However, one report also showed that electroacupuncture stimulation at point in the leg produced fMRI signal decreases in the occipital cortex, and there is no difference between vision related acupoint with an adjacent non-acupoint [39]. The inconsistence in the above studies might be related to the difference in the acu-points and needling method used in the study.

Effect on photoreceptor cell survival or function

Acupuncture is capable of inhibiting morphological changes of photoreceptor cells [40], and electrical stimulation is capable of ameliorating MNU-induced photoreceptor degeneration and rectifying abnormalities in the inner visual signal pathways [41]. This action may be through an indirect effect on photoreceptors through its modulation of secretion of several retinal neurotrophic factors and nerve growth factors, anti-apoptotic or antiendoplasmic reticulum (ER) stress pathway molecules as well as changes in the microenvironment. Acupuncture can raise the expression of Bcl-xl and brain-derived neurotrophic factor (BDNF) of retina, so as to prevent optic nerve damage caused by intraocular hypertension [42]. Daily sessions of low-frequency EA to rats during a critical developmental stage of retinal cell degeneration cause an increase of retinal nerve growth factor (NGF) and NGF high-affinity receptor (TrkA) expression; and increase of outer nuclear layer thickness; and enhanced visualization, suggesting that acupuncture treatment of RP might work through activation of some neurotrophic factors and their receptors in the retina [43]. A recently published review on the biology of acupuncture treatment of amblyopia also point out that acupuncture induced changes in the action of neurotransmitters in the visual system, promoted the secretion and synthesis of brain-derived neurotrophic factor, and stimulated the expression of genes related to visual plasticity [44]. In addition, Acupuncture treatment at acupoint GB20 or BL1 and GV16 respectively can reverse some pro-apoptotic molecules and ER stress pathway molecules generated in axotomized retina [45].

Conclusion

Since more and more patients of eye disorder are seeking acupuncture treatment, it is important to validate the effect of acupuncture in the treatment of these diseases. Up till now, there are several case reports and RCTs on the use of acupuncture to treat such disorders as glaucoma, optic atrophy, RP and amblyopia. Most of these reports tend to support that acupuncture possesses beneficial effect in the treatment of these disorders. However, since the bias that existed in these case reports and the flaws in the design and carrying out of these RCTs, it is still unable to validate that acupuncture is an effective choice for these eye patients. Therefore, more rigorous, multicenter randomized, double blind, placebo-controlled, clinical trial of acupuncture as a treatment in these eye disorders are needed in the future studies. Several clinical experiments showed that acupuncture could increase the retina blood flow, low IOP and change the fMRI signal in the vision cortex of the brain. However, inconsistent results existed owing to the disparity in acupoint selection, needling technique, measuring method, subject recruitment, diagnostic and evaluation criterion, etc. A unified standard need to be postulated in doing these clinical experiments so as to minimize the variation and inconsistence. It is promising that some animal studies showed that acupuncture could stimulate the release of endogenous neurotrophic factors such as NGF, BDNF, and regulate the gene related to the apoptosis and ER-stress pathway. However, these research were still at the primary stage. High quality, systemic and consistent research studies are needed to investigate the mechanism of acupuncture in the treatment of eye disorders.

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Lupine Publishers | Antibacterial activity of the rose extract

 Lupine Publishers | Open access Journal of Complimentary and Alternative Medicine

Abstract

Antimicrobial agents are defined as those substances which possess inhibitory effects against gram-positive and gram-negative bacteria, preventing their growth. Antibacterial agents are classified based on the type of action, source of antibacterial agent, and range of the spectrum. Rose belongs to the family Rosaceae. Hundred (n=100) species of roses are locally available. Roses are native primarily to the temperate regions of the Northern Hemisphere. There is a wide variety of colors available in roses which enhances the beauty of the rose. Most roses are locally available in Asia, North America and few are available in Europe. Many parts of rose have been used to check the antibacterial and antifungal property and they are highly active to remove toxins from the body and shown positive results to inhibit the growth of bacteria. Different parts of rose can be used separately against bacteria. Rose extract can also be used to treat sore throat and to relieve chest congestion. The agents which are responsible for the antibacterial and antifungal properties of the rose extract are flavonoid and phenolic compounds. The rose petals are powdered and mixed in distilled water and concentrated using a rotary evaporator. Pure cultures were swabbed on MHA plates and wells were made using sterile borer by agar well diffusion method. Twenty (20ul) of the extract was added in well and incubated at 37°C for 24 hours. Next day zone of inhibition was observed. To compare the activity of rose extract with amikacin, pure cultures were swabbed on MHA and amikacin disk was placed on each plate. Next day zones were observed. Rose extract has shown maximum inhibitory effects against Staphylococcus aureus whereas the inhibitory effects against Bacillus cereus, Bacillus subtilis, and Klebsiella pneumoniaewere not satisfactory. We have also observed that Vibrio cholera also showed sensitivity to rose extract whereas E.coli and Pseudomonas aureginosagave intermediate zones, therefore we suggest that we can use rose extract against Staph aureus, E.coli, Pseudomonas aureginosa and Vibrio cholera.

Keywords: Rose extract; Antibacterial activity; Sensitivity; Resistance; Disc diffusion

Introduction

Rose belongs to the family Rosaceae. Hundred (n=100) species of roses are locally available. Roses are native primarily to the temperate regions of the Northern Hemisphere. There is a wide variety of colors available in roses which enhances the beauty of the rose. Most roses are locally available in Asia, North America and few are available in Europe. There are so many important components of rose which plays an important role in the antibacterial activity of rose. Among them, the components which possess antibacterial activity are flavonoids, terpenes, anthocyanins. Flavonoids are classified as natural plant compounds usually they are secondary metabolites of plants with various phenolic structures saulriuzcruz et al. [1]. They have many properties that help to treat cancer Alzheimer’s disease like they pose biochemical and antioxidant effects, antimutagenic effect, anticarcinogenic effects, etc. A.N Panche et al. [2]. They are extracted from plants and are classified as a low molecular weight compound. Rose, onion is the major source of flavonoids Aleksandra et al. [3]. Apart from antibacterial and antifungal properties, flavonoids are also responsible for color and aroma production in flowersDr. Nicola. [4].They are helpful for plants in a way that they act as a UV filter which protects the DNA of plant from UV radiations Burak M et al. [5]. Classification is done based on C ring which contains carbonCalhoun et al. [6].Terpene is a biological compound present in the rose flower. Terpenes have great industrial and pharmaceutical usage. In food industries, it is used as a flavoring agent or fragrancing agent. Pharmaceutical industries have medicinal uses of terpeneJiang z et al. [7]. Concentrates in ongoing decades have shown that terpenes apply anti-inflammatory impacts by hindering different proinflammatory pathways. Terpenes have been shown to exert activity against cancer and tumorsCho KS et al. [8].

Anthocyanins belong to flavonoids class which includes a subset of the polyphenol. Red, blue, and purple shades of organic products, vegetables, grains, blossoms, and herbs are due to anthocyanin. Anthocyanin is a Greek word, anthos means to bloom and kyanos means blue. Anthocyanins are transcendently found in nature as glycosides of polyhydroxy and polymethoxy subordinates of 2-phenyl-benzopyryliurn or flavylium salts. They are separated by the quantity of hydroxyl and methoxyl types of the B-ring, by the number of sugars connected to the aglycon and the situation of connection, and by the nature and number of aliphatic or aromatic acids appended to the sugar deposits welch et al. [9]. In a past report, quiniccorrosiv, 5-hydroxymethylfurfural, pyrogallol, levoglucosan, and 4H-pyran-4- one, 2, 3-dihydro-3, 5-dihydroxy-6-methyl were the major distinguished segments in methanolic concentrate of R. indica petals. In like manner, another examination demonstrated that unstable oils of new blooms of R. Damascena, for the most part, have citronellol, geraniol, nonadecane, and heneicosane in the fundamental oil, while they have alcoholic segments, citronellol and geraniol in rose water portion bai S. et al. [10].

Several studies have been done on rose and its products. It was found that several diseases can be treated with rose products and rose extracts. A recent study was done to check the antiviral activity of rose flower. In this research rose petals extract were made with water and ethanol separately. Now, this extract used against HIV. Rose petals extract showed antiviral activity against HIV. It inhibits the activity of HIV by interfering in replication at different stages. A common flavonoid known as kaempferol found in rose petals inhibits the activity of viral proteasesPonvelayutham et al.[11] Mahmood n, et al.[12]. Rose extract also used against several bacterial species to treat various bacterial infections. It is effective against both gram-positive and gram-negative bacteria. But on the other hand, several rose species possess no antibacterial activity, it includes Bulgarian roseKalemba d et al. [13]. When the rose extract was made with different solutions it shows that rose extract along with petroleum ether showed great antibacterial activity as compared to rose extract with water or ethanolhirulkar n,b [14]. Without a doubt, the antimicrobial action of rose concentrates particularly rose fundamental oil is identified with compound segments particularly geraniol, citronellol and nerol or interdependent impacts between these segments. The antibacterial and antifungal exercises of geraniol were affirmed against an enormous number of microorganisms. Likewise, the interdependent impact between citronellol, geraniol and nerol were shown against Gram-positive, Gram-negative bacteria. On the other hand, the antimicrobial movement of rose concentrates is identified with compound parts of concentrates and their interdependent or adversarial impactsandogan B.C et al. [15]. Several compositions of the rose extract showed anti-cancerous activity. The geraniol as the fundamental mixes of R. Damascena'sacts using various systems. It causes the apoptosis in malignant growth cells and expands the outflow of apoptotic protein Bak-47 captures the G0/G1 period of cell cycle and diminishes cdk2 activity, restrains the 3-hydroxy-3-methylglutaryl-CoA (HMG-CoA) reductase and ornithine decarboxylase activity that at last causes the passing in diseased cells Elson C, E [16]. Rose extract also showed antidepressant activity.R. Damascenausing animating the β-adrenergic receptors repressing the histamine H1 receptors and obstructing the calcium channels of the tracheal chain, hindering the KCl-related withdrawal and electrical field incitement thus acts as a relaxant boskabady m. et al.[17]. The antidepressant impacts of R. Damascenafluid concentrate were affirmed in animal models. Rose total shows the energizer movement by diminishing the lipid peroxidation and expanding the cancer prevention agents in the cerebral cortex. As referenced previously, it is accepted that rose fundamental oil and rose water bring joy, fearlessness and are known as an erotic and sexual enhancer. It has been affirmed that rose fundamental oil used in infertility and drive through expanding the widths of seminiferous tubules, sperm check, and motility and upgrading the testosterone production. Furthermore, the organization of rose basic oil improves sexual brokenness and manifestations of depression in male patients experiencing significant depression issuesFarina v et al. [18]. Rose extract also showed antioxidant activity. Phenolic compounds and flavonoids are responsible for the antioxidant activity of rose. The advantages impact of rose fundamental oil against formaldehyde inward breath on the reproductive system are identified with the cancer prevention agent movement of rose basic oil.

Material and Methods

Sample collection

The rose petals were collected from the local flower market. The petals were dried under shade for 1 week, pulverized into fine particles Devyani Bahl et al. [19].

Preparation of rose extract

The petals were dried under shade for 1 week, pulverized into fine particles by using a home chopper machine. The extract was prepared using distilled water. 200g of fine powder of rose petal was mixed in distilled water. Then it was concentrated using a rotary evaporator. The mixture was strained using Whatman filter paper and was placed on the funnel to obtain a filtrate. The filtrate was refrigerated for further use.

Identification of Cultures and Biochemical Testing

Biochemical tests are the tests utilized for the recognizable proof of microscopic organism’s species dependent on the distinctions in the biochemical characteristics of various microorganisms. The biochemical test used for gram-positive strains is catalase, oxidase, coagulase, and urease. Catalase test is utilized to distinguish bacteria that produce the catalase. This catalyst detoxifies hydrogen peroxide by separating it into water and oxygen gas. Coagulase test is used to check the ability of an organism to clot blood plasma. Oxidase test is used to check the presence of an enzyme cytochrome oxidase that transfers electron in the electron transport chain. A urease test is done to identify that an organism can utilize urea or not. As a result of the breakdown of urea, ammonia is produced. For gram-negative organisms, the IMVIC test is used. IMVIC test contains an indole test, methyl red test, Voges Proskauer test and citrate test. Along with IMVIC, the TSI test is also performed. TSI is a triple sugar iron test in which an organism utilizes sugar and produced hydrogen sulfide

Antibacterial activity/susceptibility testing

To assess the antibacterial activity of the rose extract, eight cultures were collected from the known clinical laboratory of Karachi. Gram-positive cultures include S.aureus, B.cereus, B.subtilis. Gram-negative cultures include Pseudomonas aeruginosa, Vibrio cholera, E.coli, Klebsiella pneumonia, Enterobacter.They were all gram stained and confirmed by biochemical testing and then they were cultured on nutrient agar plates and preserved for further use.

The antibacterial activity of the rose extract was analyzed against these isolates by using Tryptic Soy Agar (TSA) plates, by agar well diffusion technique. Pure culture of test organism is transferred into 5ml nutrient broth, incubated for 24 hours at 37 °C and the test strain was swabbed on TSA plates. Well were made using sterile borer. 20ul of the filtrate was added in well. The plates were then incubated for the formation of zones.

Comparative analysis of rose extract with antimicrobial agent

For comparative analysis, we have tested the strains by Kirby Buer disc diffusion test in which we had used amikacin for comparison with rose extract. Amikacin disc was placed against these isolates on MHA plates. The plates were then incubated for the formation of zones.

Results

Identification of test organism

The test organism was identified based on by gram reaction of isolates, cultural characteristics, and biochemical tests such as IMVIC, TSI (Table 1-3).

Table 1: Morphological and cultural characteristics of identified strains.

Table 2: Biochemical characteristics of gram-positive strains.

Table 3: Biochemical characteristics of gram-negative strains.

Antibacterial activity assay

The antibacterial activity is checked against all seven test organisms. The results of the zone of inhibition showed in Table 4 and Figure 1-3. Table 5 and Figure 4-8.

Figure 1: Staph. aureus

Figure 2: B. cereus

Figure 3: B. subtilis

Figure 4: Vibrio cholera

Figure 5: E.coli

Figure 6: P aureginosa

Figure 7: K. pneumonia

Figure 8: Enterobacter

Table 4:

Table 5:

Antibiotic susceptibility testing

Table 6 and Figure 9-11.
Table 7 and Figure 12-16.

Table 6:

Table 7:

Figure 9: Bacillus cereus

Figure 10: Bacillus subtilis

Figure 11: Staph aureus

Figure 12: P. aeroginosa

Figure 13: Vibrio cholera

Figure 14: K.pneumoniae

Figure 15: E.coli

Figure 16: Enterobacter

Discussion

Pathogenic microorganisms are the major cause of infectious illness worldwide because of their resistance ability. Today the most important need is the discovery of those natural agents that have the potential to kill or inhibit the growth of the microorganism and should have no toxic effects on the human body after consumption. Several types of research have been conducted to fulfill the requirement of the discovery of natural compounds. The traditional use of plants as medicines provide the basis for indicating which plant extract could be useful for specific medical conditions. In the past, many plant extracts such as rose extract, tea extract, clove extract have been used as an antibacterial agent which may help to treat several infections. It is important to investigate that the natural plants which possess antimicrobial activity can be used for large group or pathogens or not. Several studies have been conducted to check the antibacterial activity of various plants extract to prove that either they are helpful to treat various infections or not.

The present study represents the antibacterial activity of the rose extract. This plant contains a few parts, for example, terpenes, glycosides, flavonoids, and anthocyanins that affect the health of humans. The pharmacological impacts of R. damascene are vast. The majority of the CNS impacts are sleep-inducing, pain-relieving, and anticonvulsant impacts. The respiratory, cardiovascular, purgative, antidiabetic, antimicrobial, hostile to HIV, calming, and cancer prevention agent are different impacts of this plant. It is recommended that lipid dissolvable (non-polar) constituents of this plant are principally responsible for the vast majority of the previously mentioned impacts. According to results, the rose extract showed the highest activity against Enterobacter, S. aurus and vibrio cholera. But rose extract also showed activity against other tested microbes but to a lower extent.

To compare the activity of rose extract with an antibiotic, we selected amikacin to compare the antibacterial and antifungal activity. Amikacin is a novel antibiotic because it gives the best results against Pseudo and drug-resistant bacilli. It also showed activity against all tested strains.

Conclusion

This study shows there are many compounds present in rose flowers that possess antibacterial activity so it has confirmed that rose extract could be used for the treatment of various infections including multidrug-resistant staph aureus infections. Further studies should be done for antimicrobial screening of this product so that it can use in health care needs.

Authors’ Contributions

Conceived and designed the experiments: T Malik, Performed the experiments: Y Safdar, Analyzed the data: T Malik & Y Safdar contributed reagents/ materials/ analysis tools: T Malik & Y Safdar, Wrote the paper: Y Safdar.

 

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