The research, led by scientists at the Korea Research Institute of Bioscience and Biotechnology together with colleagues at Hanyang University ERICA and Dong-A University, set out to answer a deceptively simple question: how much of the plant’s nutritional and antioxidant value depends on when it is picked and where it is grown? To find out, the team cultivated G. affine under two different cultivation environments and sampled it at multiple growth stages, then subjected every sample to ultra-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry, a technique abbreviated as UPLC-QTOF/MS. This platform allows researchers to detect and tentatively identify hundreds of small molecules in a single run, generating a chemical fingerprint of each sample that can be compared statistically across conditions.

In total, the team annotated fifty metabolites, and from that pool they isolated eight compounds through successive chromatographic separations, determining their structures using nuclear magnetic resonance spectroscopy and mass spectrometry. This is a crucial step that many metabolomics studies skip. Untargeted profiling can suggest what a compound might be, but only isolation and structural elucidation provide certainty about identity. By purifying these eight molecules, the researchers created their own reference standards, which they then used to build a targeted high-performance liquid chromatography method with diode-array detection, or HPLC-DAD, capable of precisely quantifying the most important constituents in any sample of the plant.

The analytical performance of that quantification method was rigorous. Calibration curves showed excellent linearity, with coefficients of determination of at least 0.999 across the tested ranges, and detection limits fell between 0.671 and 1.088 micrograms per milliliter. In practical terms, this means the method can reliably detect and measure even trace amounts of the key bioactive compounds, making it suitable for quality control in food and nutraceutical manufacturing, where batch-to-batch consistency is essential and regulatory standards demand validated analytical procedures.

To make sense of the enormous datasets generated by untargeted metabolomics, the researchers turned to chemometrics, the statistical analysis of chemical data. Principal component analysis, or PCA, provided an unbiased overview of the variation, and it revealed that the metabolite profiles of G. affine were shaped by both growth stage and cultivation environment. Samples clustered according to how mature the plants were and where they had been grown, indicating that these two factors leave distinct chemical signatures in the plant tissue. A second, supervised method, partial least squares discriminant analysis, or PLS-DA, sharpened the picture further, showing particularly clear separation between samples from the two cultivation environments. Supervised models like PLS-DA actively search for the variables that best distinguish predefined groups, so the strong discrimination confirmed that growing conditions exert a powerful and consistent influence on the plant’s secondary chemistry.

The compounds driving that discrimination belonged overwhelmingly to two chemical families: phenylpropanoids and flavonoids. Within these broad classes, three subgroups stood out as the main discriminatory metabolites. Caffeoylquinic acid derivatives, which arise when caffeic acid is esterified with quinic acid, are well-known phenolic compounds with documented antioxidant and anti-inflammatory activities in the food science literature. Quercetin glycosides and luteolin glycosides, meanwhile, are sugar-conjugated forms of two of the most studied plant flavonoids, molecules that plants typically produce as protective agents against ultraviolet radiation, herbivores, and oxidative stress. That these particular compounds dominated the statistical separation suggests that the plant’s defensive chemistry is highly sensitive to both its developmental program and its growing environment.

The functional consequences of these chemical shifts were confirmed by classical assays. The researchers measured total phenolic content and total flavonoid content across all samples, alongside antioxidant capacity tests. Both the phytochemical contents and the antioxidant activities varied significantly across growth stages and between the two cultivation environments, mirroring the metabolomic patterns. Most notably, samples grown in the open field showed increased phenolic contents and enhanced ABTS radical-scavenging activity at later growth stages under the conditions examined. The ABTS assay works by measuring a sample’s ability to neutralize a synthetic green-colored radical cation, providing a rapid proxy for antioxidant capacity. The finding that open-field plants became chemically richer as they matured is consistent with a well-established principle in plant physiology: environmental stresses such as full sunlight exposure tend to stimulate the phenylpropanoid and flavonoid pathways, prompting plants to accumulate protective phenolic compounds.

For the food and nutraceutical industries, these results carry immediate practical weight. G. affine is already consumed as a food and medicinal plant valued for its nutritional and bioactive properties, but like many botanical raw materials, its chemical quality can fluctuate dramatically depending on agronomic choices. The study demonstrates that harvest timing and cultivation system are not minor variables but primary determinants of the plant’s functional value. A processor seeking maximum phenolic content and antioxidant activity, for example, now has evidence-based guidance pointing toward open-field cultivation and later growth stages under the conditions tested. Conversely, the detailed metabolite maps allow manufacturers to verify that incoming plant material meets expected chemical specifications, using the validated HPLC-DAD method as a quality gate.

Scientifically, the work also illustrates the power of combining untargeted and targeted approaches. Untargeted metabolomics excels at discovery, revealing unexpected patterns and flagging candidate biomarkers, but it produces tentative identifications that require confirmation. By following up with isolation, structural elucidation, and targeted quantification using purified reference standards, the Korean team closed the loop from pattern to proof. The fifty annotated metabolites and eight fully characterized compounds now constitute a chemical library for G. affine that future researchers can build upon, whether they are investigating the plant’s bioactivity, breeding improved cultivars, or optimizing cultivation protocols for industrial production.

The broader significance extends beyond a single species. As consumer demand for plant-based functional foods grows, the industry increasingly needs rigorous, systems-level data on how agricultural practices shape phytochemical quality. This study offers a template: profile broadly, discriminate statistically, isolate the key players, quantify them precisely, and connect the chemistry to measurable biological function. Applied to G. affine, that template transformed a traditional spring vegetable into a chemically characterized functional food candidate, and the authors conclude that their findings support the plant as a promising resource for future nutraceutical applications. For a plant that has quietly flavored festival rice cakes for centuries, modern metabolomics has finally revealed just how much its chemistry depends on the sun, the soil, and the season.

Subject of Research: Metabolomic profiling of secondary metabolites in Gnaphalium affine across growth stages and cultivation systems

Article Title: Comparative metabolomic characterization of secondary metabolites in Gnaphalium affine D. Don considering the influence of growth stages and cultivation systems

Article References: Hong, S., Lee, H. G., Oh, S. M., Kim, H.-G., An, Y. M., Lee, S.-Y., Kim, D.-Y., Oh, S.-R., Kim, C. Y., Lee, J. H., & Ryu, H. W. (2026). Comparative metabolomic characterization of secondary metabolites in Gnaphalium affine D. Don considering the influence of growth stages and cultivation systems. npj Science of Food. https://doi.org/10.1038/s41538-026-01194-8

Image Credits: AI Generated

DOI: 10.1038/s41538-026-01194-8

Keywords: Gnaphalium affine, metabolomics, secondary metabolites, flavonoids, phenylpropanoids, caffeoylquinic acid, quercetin glycosides, luteolin glycosides, antioxidant activity, cultivation systems, UPLC-QTOF/MS, functional food

The research team, led by Raden M. Febriyanti of Universitas Padjadjaran, mined the 2023 Indonesian Health Survey, a nationally representative dataset collected by the Ministry of Health. From it, they isolated 2,703 adults aged fifteen and older who reported a physician diagnosis of diabetes mellitus, hypertension, or both, and who had complete records for the exposures, biomarkers, and covariates the analysis required. This was not a small convenience sample of herbal enthusiasts; it was a statistically weighted cross-section of the entire archipelago, designed so that the findings could be projected onto the national population of chronically ill adults.

The headline number is arresting. Among these diagnosed patients, 1,309 individuals reported using traditional health services during the previous twelve months, which translates to a weighted prevalence of 53 percent. In other words, more than one in every two Indonesian adults with diabetes or hypertension had sought out some form of traditional care within a single year. Herbal preparations dominated the menu, used by 76.2 percent of those who turned to traditional services, while manual therapies such as massage and related hands-on practices were used by 52.9 percent. The two categories overlap, meaning many users combined swallowing botanical remedies with submitting their bodies to manipulation.

Who was most likely to reach for these services? The sociodemographic patterning turned out to be one of the most interesting dimensions of the study. After adjusting for confounders, urban residents showed higher odds of traditional health service use than their rural counterparts, with an adjusted odds ratio of 1.28 and a 95 percent confidence interval of 1.05 to 1.56. That finding cuts against the common assumption that traditional medicine is primarily a rural phenomenon sustained by distance from clinics. Self-employed respondents were also significantly more likely to be users, with an adjusted odds ratio of 1.49, as were people working in agriculture or fisheries, whose adjusted odds ratio of 1.44 suggests that occupational culture and perhaps traditional knowledge transmission within these sectors play a role.

Methodologically, the study took considerable care to avoid the statistical traps that plague cross-sectional research. The analysts applied survey-weighted multinomial and binary logistic regression, explicitly incorporating stratification, clustering, and sampling weights to reflect the complex design of the national survey. Recognizing that testing multiple biomarkers invites false positives, they controlled the false discovery rate using the Benjamini-Hochberg procedure, a standard guard against mistaking statistical noise for signal. They then ran a propensity-score weighting analysis as a sensitivity check, attempting to balance the characteristics of users and non-users as if the exposure had been assigned at random. It is a rigorous architecture for an observational question, and it makes the null results that follow harder to dismiss.

And those null results are the study’s second headline. Across every outcome examined, HbA1c, total cholesterol, LDL cholesterol, HDL cholesterol, systolic blood pressure, and diastolic blood pressure, the researchers detected no association with traditional health service use. No modality-specific analysis, separating herbal users from manual therapy users, produced a signal that survived correction for multiple testing. Nor did stratifying by pharmacotherapy status, comparing patients who were taking conventional medications against those who were not, reveal any hidden relationship. For a practice used by half the chronic disease population, the laboratory values of its users look, on average, indistinguishable from those of non-users.

The authors are careful, and rightly so, about what this null finding does and does not mean. The survey captured whether people used traditional health services, but not why, not what they took, not in what dose, not how often, and not for how long. Information on indication, product, frequency, duration, and treatment timing was simply unavailable. A person who sips a mild ginger infusion once a month and a person who takes concentrated herbal antidiabetic preparations daily are lumped into the same exposure category. Without dose-response data, a genuine biological effect could be diluted into invisibility, or a harmful one could hide behind population averaging. The findings, the team emphasizes, describe population-level patterns rather than evidence of benefit or harm.

There is also the matter of temporality. A cross-sectional snapshot cannot tell you whether biomarker differences preceded or followed traditional service use, and the study’s own design rules out causal inference entirely. What it can do, and does, is establish that traditional care is not a fringe behavior among Indonesia’s chronically ill. It is mainstream, socially patterned, and concentrated in identifiable groups, which matters enormously for public health planning. If clinicians assume their diabetic and hypertensive patients are not using herbal products, they are wrong half the time, and that assumption carries real risks, from herb-drug interactions to delayed care-seeking, that this study cannot measure but its prevalence data make impossible to ignore.

The urban skew in the results deserves particular attention. Higher use in cities may reflect the commercialization of traditional medicine, with jamu products now packaged, branded, and sold through modern retail channels, alongside urban wellness culture that embraces complementary therapies. Meanwhile, the elevated odds among agricultural and fisheries workers hint at communities where traditional knowledge remains embedded in daily life and occupational networks. Self-employment, too, may grant the schedule flexibility that clinic visits do not. These patterns sketch a picture of traditional health services as an accessible, culturally familiar supplement to formal care rather than a substitute born of desperation or lack of access.

For a country where diabetes and hypertension are rising relentlessly and health system resources are stretched across seventeen thousand islands, the study offers a pragmatic message. Traditional health service use is too common to ignore and too clinically silent, at least at the biomarker level, to celebrate or condemn. The next generation of research, the authors’ caveats imply, needs to capture what people actually consume, in what quantities and for how long, before anyone can say whether Indonesia’s beloved jamu is helping, harming, or simply accompanying its millions of chronic disease patients on their long road of daily management. Until then, the safest reading is that half the country is experimenting, and the blood tests, for now, are keeping their secrets.

Subject of Research: Traditional health service use and cardiometabolic biomarker profiles among Indonesian adults with diabetes or hypertension

Article Title: Traditional health service use and cardiometabolic biomarker profiles among Indonesian adults with diabetes mellitus or hypertension: a national cross-sectional study

Article References: Febriyanti, R. M., Irawan, A. A., Pangestu, D. S., Alfian, S. D., Levita, J., & Diantini, A. (2026). Traditional health service use and cardiometabolic biomarker profiles among Indonesian adults with diabetes mellitus or hypertension: a national cross-sectional study. BMC Complementary Medicine and Therapies. https://doi.org/10.1186/s12906-026-05558-1

Image Credits: AI Generated

DOI: 10.1186/s12906-026-05558-1

Keywords: traditional medicine, complementary medicine, diabetes mellitus, hypertension, Indonesia, cardiometabolic biomarkers, HbA1c, cholesterol, blood pressure, herbal medicine, cross-sectional study, public health

The retrospective descriptive study, conducted by Mikyung Kim and Dong-jun Choi of the Department of Internal Medicine and the Regional Pharmacovigilance Center for Korean Herbal Medicines, mined the shared adverse event reporting databases of the two hospitals. After removing duplicates, the researchers identified 454 reports in which an herbal medicine was recorded as the suspected agent. That figure represents just 1.2 percent of the 38,367 adverse event reports handled by the centers over the entire study period, a proportion that itself hints at how rarely herbal products are formally flagged as suspected causes of harm even in institutions where they are prescribed routinely.

The most striking finding concerns the regulatory status of the products involved. Non-licensed oral herbal medicines accounted for the largest share of suspected agents at 48.7 percent, narrowly exceeding the 47.0 percent share of oral herbal medicine products licensed by Korea’s Ministry of Food and Drug Safety. At the report level, 51.3 percent of cases involved at least one non-licensed formulation. These are preparations that fall outside the standard regulatory licensing pathway, including individualized herbal decoctions compounded for specific patients, and they are precisely the products that national databases built around licensed pharmaceuticals are least equipped to track.

The clinical profile of the reported events followed recognizable patterns. Gastrointestinal disorders were the most frequently reported system organ class, classified according to the Medical Dictionary for Regulatory Activities, followed by skin and subcutaneous tissue disorders. Among the 572 drug-event pairs with evaluable causality assessments, the overwhelming majority, 87.7 percent, were judged merely possible, while cases assessed as certain were vanishingly rare at 0.2 percent. That distribution reflects a familiar limitation of spontaneous reporting: without rechallenge or unambiguous temporal and biological evidence, causality in herbal medicine cases usually remains provisional, complicated by polypharmacy, delayed onset, and the multi-component nature of herbal formulas.

The surveillance gap emerges most clearly when the researchers compared reports that were forwarded to the national system with those that were not. Overall, 24.0 percent of the 454 reports were never submitted to national pharmacovigilance. The differences between the two groups were stark and statistically significant. Non-submitted reports far more frequently involved non-licensed herbal medicines, at 83.5 percent compared with 41.2 percent of submitted reports. They were far less likely to include documented clinical severity grading, at 7.3 percent versus 59.1 percent, and far less likely to contain a causality assessment, at 26.6 percent versus 98.8 percent, with p values below 0.001 across all three comparisons.

In other words, the reports most likely to slip through the cracks were those describing the products least visible to regulators, and those least complete in the clinical detail that pharmacovigilance assessment depends on. Severity grading in the study followed the Common Terminology Criteria for Adverse Events, the standardized scale used in oncology and increasingly across drug safety work, while causality was evaluated within the framework of individual case safety reports submitted through Korea’s adverse event reporting infrastructure. A report lacking both a severity grade and a causality judgment offers national assessors little to work with, which may partly explain why incomplete cases were not prioritized for submission.

The structural reasons behind the gap are not difficult to infer from the Korean context. Traditional Korean medicine doctors routinely prescribe individualized multi-herb decoctions that are compounded fresh for each patient. These formulations do not carry product licenses in the way manufactured drugs do, so they sit awkwardly within a reporting system whose data structures, coding conventions, and regulatory workflows were designed around licensed medicinal products. A suspected reaction to a ten-herb decoction does not map neatly onto a single product code, and the paper’s authors argue that the current pharmacovigilance framework therefore does not fully capture the range of herbal medicines actually used in real-world Korean practice.

The study’s setting gives its findings particular weight. Dongguk University Ilsan Oriental Hospital hosts a regional pharmacovigilance center specifically dedicated to Korean herbal medicines, one of the institutional mechanisms Korea has built to strengthen reporting from the traditional medicine sector. If, even at a center with dedicated reporting infrastructure, a quarter of herbal adverse event reports failed to reach the national system and half involved non-licensed formulations, the authors suggest that the true blind spots in less specialized settings are likely to be larger. Fifteen years of data also lend temporal depth, spanning a period in which Korea expanded its pharmacovigilance networks and electronic reporting systems considerably.

The methodological caveats are worth noting. This was a single-center retrospective descriptive analysis, so the absolute numbers and proportions cannot be generalized to the whole country, and spontaneous reporting data inherently capture only a fraction of adverse events that actually occur, with underreporting the norm rather than the exception across all drug classes. The study was exempted from full ethical review because it used de-identified data from previously collected reports. Still, the internal comparison between submitted and non-submitted reports is the analytically powerful part of the design, because both groups came from the same institutions over the same period, isolating the characteristics that predict whether a case enters national surveillance.

The authors’ conclusions point toward concrete reforms: broader surveillance coverage that explicitly encompasses non-licensed formulations, improved documentation of clinical severity and causality assessments at the point of reporting, and stronger reporting support for traditional Korean medicine professionals, who are often the first and only clinicians positioned to recognize a herbal adverse event. As herbal medicine use grows globally and integrative care models spread, the Korean experience offers a cautionary lesson for any country attempting to fold traditional formulations into regulatory safety systems built for licensed pharmaceuticals. A safety net with holes in exactly the places where the most-used products fall through is, the study implies, a net that needs reweaving.

Subject of Research: Herbal medicine adverse event reporting and pharmacovigilance surveillance gaps in traditional Korean medicine

Article Title: Real-world patterns of herbal medicine-related adverse event reports and surveillance gaps in national pharmacovigilance: a 15-year retrospective analysis from a single integrative medical center in Korea

Article References: Kim, M., & Choi, D.-J. (2026). Real-world patterns of herbal medicine-related adverse event reports and surveillance gaps in national pharmacovigilance: a 15-year retrospective analysis from a single integrative medical center in Korea. BMC Complementary Medicine and Therapies. https://doi.org/10.1186/s12906-026-05532-x

Image Credits: AI Generated

DOI: 10.1186/s12906-026-05532-x

Keywords: pharmacovigilance, herbal medicine, adverse event reporting, traditional Korean medicine, drug safety, non-licensed formulations, spontaneous reporting, causality assessment, real-world data, Korea, integrative medicine, surveillance gap

The research team, led by Mamo Feyissa Senbeta of Addis Ababa University together with colleagues Teferi Gedif Fenta, Kaleab Asres, and Tsige Gebre-Mariam, employed a qualitative descriptive design built around key informant interviews. Twenty-five healthcare professionals who provide direct care to HIV/AIDS and TB patients in selected facilities across Metekel Zone were interviewed, with conversations audio recorded, transcribed verbatim, and then systematically coded and thematically analyzed using the qualitative analysis software MAXQDA 2020. The choice of a qualitative approach is significant: rather than counting how many patients use herbal remedies, the study sought to understand the texture of professional experience, the reasoning behind counseling decisions, and the structural conditions that make herb-drug interactions so difficult to detect in practice.

Thematic analysis of the interviews surfaced six major themes capturing the range of professional encounters with herbal medicine use. Perhaps the most striking finding was the deep divide in what clinicians actually observed. Some healthcare professionals reported having no direct encounters with herbal medicine users at all, a gap the researchers attribute to patient non-disclosure or to the failure of routine clinical assessment to probe for concurrent traditional remedy use. Others, working in the same zone and caring for similar patient populations, described encounters spanning the full clinical spectrum: patients presenting with relief of symptoms after taking plant-based preparations, but also cases of severe toxicity, advanced AIDS, and even fatalities that clinicians linked to herbal medicine use alongside or instead of prescribed therapy.

This inconsistency in reported encounters is not merely a curiosity of qualitative research; it points to a structural blind spot in clinical practice. When patients conceal their herbal medicine use, whether out of fear of judgment, anticipation of disapproval, or simple belief that traditional remedies are not relevant to biomedical care, the pharmacological dialogue between clinician and patient breaks down. Antiretroviral therapy and anti-tuberculosis drugs are among the most interaction-prone medications in clinical use, with narrow therapeutic windows and dependence on metabolic enzymes such as those of the cytochrome P450 family. Plant constituents can induce or inhibit these pathways, alter drug absorption, or add hepatotoxic and nephrotoxic burdens, meaning that undisclosed co-use can silently undermine treatment efficacy or precipitate harm that is misattributed to disease progression.

The counseling behaviors reported by the healthcare professionals were equally varied, and this variability emerged as a central theme. Some clinicians advised patients against using herbal medicines entirely, taking a prohibitive stance grounded in the unknown composition and unquantified risk of most local preparations. Others adopted harm-reduction strategies, recommending that patients separate the timing of herbal medicine use from their antiretroviral therapy or anti-TB medications, a pragmatic attempt to reduce the chance of direct pharmacokinetic interaction. Still others suggested limiting herbal remedies to topical use only, confining application to the skin where systemic absorption and interaction potential are lower. The absence of a standardized counseling protocol means that a patient’s guidance may depend less on evidence than on which professional happens to be on duty.

Underlying all of these counseling positions was a consistent current of safety concern. The interviewed professionals expressed considerable worry about toxicity, herb-drug interactions, and the potential for herbal medicine use to drive disease progression, particularly when remedies substituted for or delayed effective biomedical treatment. These concerns are grounded in well-documented pharmacological realities. Herbal preparations are chemically complex mixtures whose active constituents, concentrations, and contaminants vary with plant species, harvest conditions, preparation method, and storage. Without quality control, dose standardization, or interaction studies, neither clinician nor patient can know what a given decoction contains or how it will behave in a body already metabolizing combination antiretroviral therapy and months of anti-TB chemotherapy.

Yet the study’s authors are careful to note that the healthcare professionals did not dismiss herbal medicine out of hand. The same clinicians who voiced safety concerns also acknowledged the powerful cultural, economic, and accessibility factors that drive patients toward plant-based remedies. In rural Ethiopia, traditional medical practitioners are embedded in community life, trusted across generations, and often geographically and financially more accessible than formal health services. Anecdotal claims of efficacy circulate through social networks and reinforce use. For patients managing the stigma, cost, and lifelong demands of HIV care, or the exhausting six-month regimen of TB treatment, herbal medicine can represent continuity with cultural identity, a perceived supplement to incomplete relief, or simply the most reachable option when clinics are distant and drug supplies uncertain.

The consequence of this collision between biomedical and traditional systems, the study concludes, is compromised integrated care. Inadequate assessment means clinicians rarely ask about herbal use; limited counseling means patients receive inconsistent or no guidance; and patient non-disclosure means that even motivated clinicians are working without essential information. The researchers recommend a multi-pronged response: improved communication between patients and providers, formal training of healthcare professionals on herbal medicine and its interaction potential, dedicated research into the safety and efficacy of commonly used Ethiopian remedies, and collaboration between the formal health system and traditional practitioners rather than mutual exclusion. Such collaboration, the findings suggest, could convert a hidden risk into a managed, monitored component of patient care.

The significance of the work extends well beyond Metekel Zone. The World Health Organization has long recognized that traditional and complementary medicine use is widespread across sub-Saharan Africa, particularly among people living with HIV/AIDS, and that the evidence base for safety in combination with antiretroviral therapy remains thin. Studies of this kind, which capture the lived experience of providers rather than simply surveying prevalence, are essential for designing interventions that clinicians will actually adopt. The Ethiopian context adds urgency: with one of the largest HIV-positive populations in the region and an expanding rural health infrastructure, the country is well positioned to pioneer models of integrated care that formally acknowledge, assess, and counsel on herbal medicine use rather than pretending it does not exist.

Funded in part by the German Academic Exchange Service and Germany’s Federal Ministry of Education and Research through the Tri-Sustain Project, and conducted under the ethical approval of Addis Ababa University’s School of Pharmacy, the study offers a candid portrait of a health system negotiating between two medical worlds. Its message to the global health community is direct: wherever antiretroviral therapy and tuberculosis treatment meet deep traditions of plant-based healing, patient safety depends on asking the right questions, training providers to answer them, and building bridges to the traditional practitioners that patients already trust. Until then, the most dangerous ingredient in a rural Ethiopian patient’s treatment regimen may be silence.

Subject of Research: Healthcare professionals' experiences with herbal medicine use among HIV/AIDS and tuberculosis patients in rural Ethiopia

Article Title: Experiences and perspectives of healthcare professionals on herbal medicine use among HIV/AIDS and tuberculosis patients in Metekel Zone, northwest Ethiopia: a qualitative descriptive study

Article References: Senbeta, M. F., Fenta, T. G., Asres, K., & Gebre-Mariam, T. (2026). Experiences and perspectives of healthcare professionals on herbal medicine use among HIV/AIDS and tuberculosis patients in Metekel Zone, northwest Ethiopia: a qualitative descriptive study. BMC Complementary Medicine and Therapies. https://doi.org/10.1186/s12906-026-05624-8

Image Credits: AI Generated

DOI: 10.1186/s12906-026-05624-8

Keywords: herbal medicine, HIV/AIDS, tuberculosis, Ethiopia, healthcare professionals, herb-drug interactions, antiretroviral therapy, qualitative research, traditional medicine, patient safety, Metekel Zone, integrated care

The study was conducted by researchers at the National Research Center in Complementary and Alternative Medicine at UiT The Arctic University of Norway, together with a colleague from VID Specialized University in Oslo. Between February and August 2024, the team administered an online cross-sectional survey built on an adapted version of the International Complementary and Alternative Medicine Questionnaire, known as the I-CAM-Q, an instrument designed to allow comparisons of complementary medicine use across countries and populations. Participants were 488 first-generation immigrants, meaning people born in Pakistan who migrated to Norway, and 445 second-generation immigrants born in Norway to Pakistani parents, all aged 18 or older. To avoid the skewed samples that plague many online surveys, the researchers used proportional stratified random sampling, drawing participants from the National Register of Citizens so that gender, generation, and age groups were represented in proportion to the underlying population.

The headline numbers are striking. Natural products, which in this context include herbal remedies, spices, oils, and other ingestible preparations rooted in South Asian tradition, were used by 99.3 percent of respondents in the previous year. Religious self-care practices, encompassing prayer and other spiritually grounded health activities, were reported by 75.7 percent. Self-care activities such as yoga and meditation were practiced by 35.1 percent, and 27.8 percent had visited a traditional and complementary medicine provider, whether a herbalist, a practitioner of Unani medicine, or another kind of traditional healer. Taken together, these figures suggest that for this community, complementary medicine is not an occasional experiment or a fringe preference but a continuous, everyday framework of health maintenance.

The intensity of use varied considerably across subgroups, and the patterns are statistically revealing. First-generation women emerged as the heaviest users of all, reporting a median of 16 different traditional and complementary medicine modalities, with an interquartile range of 23, meaning the middle half of these women reported anywhere from a handful to dozens of distinct practices. After adjusting for other variables in logistic regression models, women were significantly more likely than men to engage in self-care practices. Meanwhile, visiting traditional and complementary medicine providers was significantly associated with older age, higher income, and the presence of chronic disease. That last association makes intuitive sense: people living with long-term conditions often seek additional sources of relief when conventional care does not fully resolve their symptoms, and those with more disposable income can afford to pursue options outside the public health system.

One of the most consequential findings concerns geography. Several participants reported visiting traditional and complementary medicine providers abroad, typically during trips to Pakistan or other countries where such practitioners are embedded in the mainstream health landscape. This detail matters for patient safety in ways that a simple prevalence figure cannot capture. Practitioners operating outside Norway are beyond the reach of Norwegian regulation, and the products they dispense may not have been assessed under European standards. When patients later return to Norwegian general practitioners, they may not mention these consultations or the remedies they brought home, creating a hidden layer of pharmacological exposure that clinicians cannot see. The researchers argue that this pattern underscores the need for open, non-judgmental communication about traditional medicine use during clinical encounters.

Why do people turn to these practices? The survey found that traditional and complementary medicine was used mainly for well-being and illness prevention, framing it as part of a proactive, holistic approach to health rather than a desperate fallback. At the same time, 42.7 percent of participants reported using natural products for acute conditions, such as infections, digestive complaints, or minor injuries. This dual role, both preventive and curative, mirrors patterns documented in Pakistan itself, where traditional and complementary medicine is widely used for both health maintenance and illness management, and it confirms that migration does not sever these habits. The researchers interpret the persistence as evidence of a culturally rooted, holistic model of health that continues to make sense to people regardless of which country they live in.

The perceived benefits were overwhelmingly positive, but the survey did not shy away from risks. Although most participants found traditional and complementary medicine helpful, some reported adverse effects, and these were attributed mainly to natural products, with 23.8 percent of users of such products reporting harm. This is a critical nuance. The word natural carries a halo of safety in popular discourse, yet herbal preparations are pharmacologically active substances. They can interact with prescription drugs, vary unpredictably in potency and purity, and in some cases contain contaminants. For a community in which essentially everyone uses natural products, even a modest adverse effect rate translates into a substantial number of people. The authors highlight this as a central argument for integrating questions about traditional medicine into routine healthcare conversations rather than leaving patients to volunteer the information.

The generational comparison embedded in the study design adds another layer of interest. Because the sample deliberately included both migrants and their Norwegian-born children, it offers a window into how health practices transmit, or fade, across generations. The persistence of high overall use suggests that the family remains a powerful conduit for health culture, but the differences between generations in specific modalities hint at selective adaptation. Second-generation immigrants navigate two healthcare worlds simultaneously, and understanding which practices they retain, which they abandon, and which they reinterpret is essential for designing health services that actually meet them where they are. The study’s stratified sampling and statistical adjustments, using Pearson’s chi-square and Fisher’s exact tests for categorical associations alongside non-parametric tests for differences in natural product use and overall use, give these comparisons a methodological solidity that convenience-sample surveys often lack.

Methodologically, the study took care with ethics and privacy. Approval was obtained from the Norwegian Agency for Shared Services in Education and Research, and the Regional Committees for Medical and Health Research Ethics determined that the project did not constitute health research requiring their approval. Participants received information letters in both Norwegian and Urdu and gave explicit informed consent before proceeding. No identifying information such as names, birth dates, or addresses was collected by the researchers, although the survey company linked responses to basic demographic data from the national register to enable the stratified sampling. The work was funded by the National Research Centre for Complementary and Alternative Medicine at UiT, with publication charges covered by the university’s publication fund.

The broader significance of this research extends well beyond the Pakistani-Norwegian community. European health systems are increasingly serving multicultural populations, and studies like this one demonstrate that complementary and traditional medicine is not a marginal phenomenon confined to alternative-lifestyle subcultures. It is a mainstream reality for entire communities, woven into religious practice, family tradition, and everyday self-care. The Norwegian findings argue for a pragmatic response: healthcare providers should routinely and respectfully ask about traditional medicine use, pharmacists should be prepared to advise on interactions involving herbal products, and health services should develop culturally sensitive approaches that acknowledge, rather than dismiss, the healing frameworks patients bring with them. With 99.8 percent of a community engaged in some form of traditional health practice, the choice facing clinicians is not whether these practices exist in their patients’ lives, but whether they will be visible in the medical record.

Subject of Research: Traditional and complementary medicine use among first- and second-generation Pakistani immigrants in Norway

Article Title: Use of traditional and complementary medicines among first- and second-generation Norwegian Pakistanis: a cross-sectional survey

Article References: Use of traditional and complementary medicines among first- and second-generation Norwegian Pakistanis: a cross-sectional survey. (n.d.). https://doi.org/10.1186/s12906-026-05521-0

Image Credits: AI Generated

DOI: 10.1186/s12906-026-05521-0

Keywords: traditional medicine, complementary medicine, Pakistani immigrants, Norway, natural products, herbal medicine, self-care, cross-sectional survey, migrant health, cultural health practices, patient safety, I-CAM-Q

Those three bottlenecks are high recurrence after treatment, refractory ascites, and malignant intestinal obstruction. Ascites, the accumulation of fluid in the abdomen caused by tumor implants spreading across the peritoneal surfaces, causes painful distension and breathing difficulty. Malignant bowel obstruction, often a late consequence of tumor growth compressing the intestines, can leave patients unable to eat and facing repeated hospitalizations. Once these complications take hold, options narrow dramatically, and quality of life collapses. It is precisely in this territory that traditional Chinese medicine, or TCM, has long claimed a supporting role, and it is here that the newly published guideline attempts to bring scientific order to a field that has historically operated without one.

The document, published as an open-access guideline in the journal Holistic Integrative Oncology, was developed by a team led by researchers at the First Affiliated Hospital of Anhui Medical University, working with colleagues from Guang’anmen Hospital of the China Academy of Chinese Medical Sciences and the Guangdong Provincial Hospital of Traditional Chinese Medicine. The effort was commissioned in 2018, when the Cancer Society of the Chinese Society of Traditional Chinese Medicine was entrusted by the National Administration of Traditional Chinese Medicine to select drafting units from hospitals across the country based on clinical effectiveness and patient volume. The result is China’s first unified TCM diagnostic and treatment guideline for ovarian cancer, designed to be used alongside, not instead of, conventional Western oncology.

The rationale for standardization is straightforward. Before this guideline existed, different hospitals and individual physicians applied widely varying criteria for syndrome differentiation, the TCM process of classifying a patient’s condition into a diagnostic pattern. Prescriptions, dosages, and methods of administration varied just as widely, which made it nearly impossible to promote effective treatment programs, compare outcomes between institutions, or train new clinicians in a consistent way. A patient with the same symptoms might receive entirely different herbal formulas in Beijing and Guangzhou, with no framework for judging which approach worked better. The new guideline addresses that fragmentation head-on by anchoring the Western-medicine side of the diagnosis to the National Comprehensive Cancer Network clinical practice guidelines for ovarian cancer, in their 2024 version.

On the diagnostic side, the guideline describes the clinical picture physicians should recognize. Early ovarian cancer is notoriously subtle; many cases are discovered incidentally when a pelvic mass exceeds the capacity of the pelvic cavity or turns up during a routine gynecological examination. Later stages bring lower abdominal discomfort and pain, menstrual irregularities, ascites detectable as shifting dullness on percussion, difficulty with bowel movements as tumors compress surrounding organs, and, in advanced disease, the wasting syndrome of cachexia marked by progressive weight loss, anemia, and fever. The recommended workup combines imaging, including B-ultrasound, CT, MRI, and PET-CT, which typically reveal inhomogeneous solid masses in one or both pelvic adnexal regions, with pathological confirmation through cytology of ascites fluid, image-guided needle biopsy, laparoscopy, or exploratory laparotomy. Biomarker panels, including CA125, HE4, CEA, CA199, and AFP, complete the diagnostic toolkit.

The guideline’s most distinctive contribution is its formal classification of ovarian cancer into six TCM syndromes, each defined by a constellation of symptoms, tongue appearance, and pulse qualities. The liver-stomach disharmony syndrome presents with vomiting, belching, abdominal distension, and poor appetite. Yang deficiency with water retention produces a distended, frog-like abdomen that feels better in the morning and worse in the evening, accompanied by cold limbs, edema, and difficult urination. Qi stagnation and blood stasis, phlegm-dampness accumulation, deficiency of liver-yin and kidney-yin, and combined qi and blood deficiency round out the six patterns. Each syndrome maps to a specific therapeutic principle and a recommended classical formula, drawn from canonical texts such as the Treatise on Febrile Diseases and the Synopsis of Prescriptions of the Golden Chamber, alongside named modern compositions like Shaofu Zhuyu Decoction and Zhibai Dihuang Pill.

For each syndrome, the guideline names the herbs involved, from bupleurum and white peony root for liver-stomach disharmony to aconite, dried ginger, and ginseng for yang deficiency with water retention, and permits substitution with Chinese patent medicines or TCM injections of similar efficacy. Notably, the authors attach an explicit caution to every prescription: because dosages are deliberately not specified, patients should not self-administer these formulas, and treatment must proceed under a physician’s direction. That warning reflects a genuine tension in integrative oncology, where classical formulas are adapted to individual patients rather than dispensed as fixed products, and it signals the guideline’s intent as a professional reference rather than a self-care manual.

Beyond oral herbal medicine, the document codifies a range of external therapies that have circulated in Chinese oncology wards for years without formal standards. For abdominal pain, a tincture of olibanum, myrrh, borneol, and safflower soaked in 90 percent ethanol is applied topically to sore areas. For ascites and pleural effusion, herbal pastes containing astragalus, peach kernel, and other ingredients are spread onto non-woven plaster cloths roughly 9 by 12 centimeters and applied to the skin overlying the affected body cavity, with one paste for small effusions and two for medium or large ones. For palpable masses, a mixture of rhubarb, mirabilite, and borneol is applied for at least eight hours daily. Acupuncture protocols specify point selections along the liver, stomach, and conception vessels, with additional points tailored to pain, ascites, pleural effusion, loss of appetite, or intestinal obstruction, using combined tonification and purgation techniques with 30-minute needle retention over ten-session courses.

The guideline is equally explicit about how success should be measured, borrowing evaluation frameworks from both traditions. TCM symptom scores, graded from zero for asymptomatic to three for severe presentations of pain, distension, fatigue, insomnia, and constipation, are tallied before and after treatment, with a reduction of 70 percent or more counted as a significant effect and 30 percent or more as effective. Quality of life is tracked with the Karnofsky performance score, where a change of ten points or more marks improvement or decline. Objective tumor response follows the World Health Organization criteria and the RECIST standard, distinguishing complete remission, partial remission of at least 30 percent reduction in lesion diameter, stable disease, and progression. Laboratory monitoring of blood counts, liver and kidney function, and tumor markers anchors the assessment in routine clinical chemistry.

What emerges from the full document is less a challenge to Western oncology than a formal framework for coexistence. Conventional chemotherapy regimens remain the reference standard, with the guideline directing clinicians to the NCCN Chinese edition for adjuvant and palliative treatment, while TCM occupies the space where conventional medicine struggles most: reducing postoperative recurrence, easing refractory ascites, relieving malignant bowel obstruction, softening the adverse effects of chemotherapy, and extending survival. The guideline also addresses nursing, recommending small, frequent, low-salt, low-fat meals, fluid and sodium restriction for patients with effusions, gentle abdominal examination, hygiene precautions, and deliberate emotional care to counter the anxiety and depression that accompany a cancer diagnosis. Whether the standardized protocols improve outcomes at the population level will depend on the clinical studies that follow, but for the first time, Chinese physicians treating ovarian cancer with integrated medicine now share a common language, a common formulary, and a common yardstick for judging whether it works.

Subject of Research: Integrated traditional Chinese and Western medicine guidelines for ovarian cancer diagnosis and treatment

Article Title: Guidelines for diagnosis and treatment of ovarian cancer with integrated traditional Chinese and Western medicine

Article References: Li, P., Zhang, M., Zhu, Y., Hou, W., Zheng, H., Wu, W., Jiang, H., & Sun, T. (2026). Guidelines for diagnosis and treatment of ovarian cancer with integrated traditional Chinese and Western medicine. Holistic Integrative Oncology, 5(1), Article 54. https://doi.org/10.1007/s44178-026-00253-0

Image Credits: AI Generated

DOI: 10.1007/s44178-026-00253-0

Keywords: ovarian cancer, traditional Chinese medicine, integrative oncology, clinical guidelines, syndrome differentiation, acupuncture, ascites, chemotherapy, herbal medicine, China, gynecological cancer, RECIST

The study, led by Nevin Cambaz Kurt of the Department of Pediatrics at Başakşehir Çam and Sakura City Hospital in Istanbul, together with colleagues from hospitals and universities across Türkiye, set out to fill a well-defined gap. Although interest in herbal products and complementary medicine for pediatric patients has grown steadily, the authors note that pediatricians’ attitudes toward phytotherapy and the factors driving those attitudes remained insufficiently characterized. To address this, the team recruited 206 physicians practicing in pediatric care through professional communication networks and online platforms, using convenience sampling, and measured their views with a structured psychometric instrument rather than ad hoc questions.

That instrument was a modified 22-item version of the Attitude Scale for Phytotherapy Practices, a questionnaire designed to quantify where a clinician falls on a spectrum from skepticism to enthusiasm about plant-based treatment. The researchers subjected the scale to rigorous statistical scrutiny. Internal consistency, the degree to which items measuring the same underlying construct produce similar responses, was assessed with Cronbach’s alpha, and the modified scale returned an exceptionally high value of 0.966, well above the conventional 0.70 threshold for reliability. Exploratory factor analysis, a technique that examines whether groups of items cluster around shared latent dimensions, supported a dominant general factor structure, meaning the scale behaves as a coherent measure of a single overall attitude rather than a loose collection of unrelated opinions.

The demographic profile of the sample reflects the modern pediatric workforce in Türkiye. Of the 206 participants, 144 were women, representing 69.9 percent of respondents, and the largest age group was 30 to 40 years old, accounting for 42.7 percent. Against this backdrop, the headline numbers on training are stark. Only 5.3 percent of the pediatricians surveyed held any formal phytotherapy certificate, meaning roughly one in twenty had structured credentials in the field. Yet when asked whether they wanted such education, 66.0 percent said yes. That gap, between barely any formal training and a two-thirds majority hungry for it, is arguably the single most consequential finding of the study, because it suggests demand for evidence-based herbal medicine instruction that current pediatric curricula are not meeting.

The mean total phytotherapy attitude score across the sample was 75.99, with a standard deviation of 16.79, indicating a moderately positive average attitude with substantial spread between individuals. The more interesting question is what predicts where a given pediatrician falls within that spread. To answer it, the researchers turned to multivariable linear regression, a statistical method that estimates the independent contribution of each predictor while holding the others constant. The model adjusted for demographic and professional characteristics and produced a result that is unusually strong for survey research of this kind: the adjusted model explained 55.4 percent of the variance in attitude scores, a proportion of explained variation that few psychosocial models achieve.

Three factors emerged as independent predictors of more favorable attitudes toward phytotherapy. The first was possession of a phytotherapy certificate, which was associated with an increase of 7.99 points on the attitude scale, with a 95 percent confidence interval of 1.76 to 14.23 and a p-value of 0.012. The second, and by far the largest, was a stated desire to receive phytotherapy education, which added 14.60 points on average, with a confidence interval of 10.58 to 18.62 and a p-value below 0.001. The third was the frequency with which a physician used phytotherapy for themselves or close relatives, contributing 5.05 points per unit increase in frequency, with a confidence interval of 2.94 to 7.17 and a p-value below 0.001. Notably absent from the list of significant predictors were the demographic and professional variables that often dominate such analyses.

This pattern carries a clear interpretive message: what pediatricians know, want to know, and have personally experienced with herbal medicine matters far more than who they are. Attitudes toward phytotherapy were associated mainly with educational interest, certification status, and experiential familiarity rather than demographic or professional characteristics alone, the authors conclude. The finding that a desire for education is such a powerful predictor is statistically interesting in itself, since it raises the possibility of a feedback loop: physicians who already view herbal medicine favorably are the ones most likely to seek training, which in turn reinforces favorable attitudes. The researchers addressed this concern with a sensitivity analysis, reported in supplementary material, that re-ran the regression model excluding the desire for phytotherapy education, a standard robustness check for a predictor that may be conceptually entangled with the outcome.

The methodological apparatus of the study deserves attention because it signals a level of statistical care that is not always present in survey-based complementary medicine research. The authors report using a heteroscedasticity-consistent covariance estimator, specifically the HC3 variant, which makes regression standard errors robust to uneven variance in the residuals, a common problem in Likert-scale survey data. They also report variance inflation factors, used to detect multicollinearity among predictors, and interquartile ranges alongside standard deviations for descriptive statistics. The study was reported in accordance with the STROBE guidelines, the widely used checklist for strengthening the reporting of observational studies, and was approved by the Van Training and Research Hospital Clinical Research Ethics Committee with electronic informed consent obtained from all participants in line with the Declaration of Helsinki.

As with any cross-sectional survey, there are limits to how far the findings can be generalized. The sample of 206 physicians was recruited through convenience sampling, which means participants may be more engaged with the topic of complementary medicine than the average pediatrician, potentially inflating both attitude scores and expressed demand for education. The survey captures attitudes at a single point in time, so the causal direction between experience, education, and attitude cannot be definitively established. The study was also conducted entirely within Türkiye, and attitudes toward herbal medicine are known to vary across cultures and health systems, shaped by national traditions, regulatory frameworks, and the availability of herbal products. The authors themselves frame their conclusions carefully, emphasizing associations rather than causal claims.

Even with those caveats, the practical implications are hard to ignore. If two-thirds of pediatricians want structured phytotherapy education while fewer than six percent have any formal certification, then children’s doctors are being asked questions about herbal teas, plant extracts, and supplements that most have never been trained to answer, in an environment where families are already using these products regardless of physician guidance. The authors argue that their findings support the integration of evidence-based, safety-oriented, and clinically oriented phytotherapy content into pediatric education. That framing matters: the goal they describe is not to promote herbal medicine but to ensure that the physicians on the front lines of child health can evaluate it with the same rigor they apply to any other therapy, distinguishing preparations with genuine evidence from those with only marketing behind them. In a medical landscape where patient demand for complementary therapies shows no sign of slowing, that may be the most sensible prescription of all.

Subject of Research: Pediatricians' attitudes toward phytotherapy and the factors associated with them

Article Title: Pediatricians’ views and attitudes toward phytotherapy: a cross-sectional survey study

Article References: Kurt, N. C., Güven, D., Erol, C., Güzel, M., & Kurt, B. (2026). Pediatricians’ views and attitudes toward phytotherapy: a cross-sectional survey study. BMC Complementary Medicine and Therapies. https://doi.org/10.1186/s12906-026-05551-8

Image Credits: AI Generated

DOI: 10.1186/s12906-026-05551-8

Keywords: phytotherapy, pediatrics, complementary medicine, physician attitudes, cross-sectional survey, medical education, herbal medicine, Türkiye, attitude scale, linear regression, pediatricians, survey research

The team, led by Nina Dyakova with colleagues Dmitry Lyubashevsky, Julia Shcherbina and Julia Lyubashevskaya, measured the specific activity of five radionuclides in paired samples of soil and plantain leaves collected across the Voronezh Region of Russia. Two of them, cesium-137 and strontium-90, are artificial isotopes that trace the legacy of twentieth-century nuclear activities and atmospheric fallout. The other three, potassium-40, thorium-232 and radium-226, are natural radionuclides that have always been present in the Earth’s crust. By analysing soil and leaf material from the same sampling points, the researchers could calculate how efficiently each isotope crosses the soil-to-plant boundary.

The headline result is reassuring for public health: every sample examined fell comfortably within radiological safety limits. The researchers computed an integral safety index for each sample, and all values ranged between 0.17 and 0.45, well below the threshold value of 1.0 that would signal a concern. In other words, the plantain leaves harvested in the region are radiologically safe as raw material for herbal preparations, a finding that matters because demand for wild-harvested medicinal plants has been rising steadily in the Russian pharmaceutical market and elsewhere.

Beneath that reassuring surface, however, the study uncovered a rich structure in how different radionuclides behave. Strong positive Pearson correlations between soil concentrations and leaf concentrations confirmed that the plant is genuinely taking these isotopes up from the ground rather than accumulating them from atmospheric deposition. The correlations were remarkably tight for strontium-90, cesium-137 and potassium-40, each with a coefficient of about 0.89, followed closely by radium-226 at 0.86. Thorium-232 showed a weaker but still meaningful correlation of 0.47, consistent with its well-known tendency to remain locked in soil minerals and resist root uptake.

The accumulation factor, defined as the ratio of the radionuclide concentration in leaves to its concentration in the corresponding soil, revealed a clear hierarchy of mobility. Cesium-137 proved the most readily accumulated isotope, with an accumulation factor of 2.55, meaning plantain leaves can concentrate this isotope to more than twice its soil level. Potassium-40 followed at 1.47, then strontium-90 at 1.12. Radium-226 hovered near parity at 0.93, while thorium-232 lagged far behind at just 0.37. This ordering makes chemical sense: cesium and potassium are alkali metals that travel through the same membrane transport channels in plant roots, while strontium mimics calcium, and thorium forms highly insoluble complexes that plants largely exclude.

Perhaps the most striking insight emerged when the researchers plotted accumulation factors against soil radionuclide concentrations. Across the dataset, they identified a universal inverse relationship: the more concentrated a given radionuclide is in the soil, the lower the accumulation factor measured in the plant. This pattern suggests active homeostatic regulation, a kind of internal control system by which the plant moderates its ion uptake. Rather than absorbing isotopes in strict proportion to their availability, plantain leaves appear to dampen accumulation as soil levels rise, a phenomenon with major implications for how transfer of radioactivity from environments to food and medicine chains is modelled.

This finding speaks to a long-standing debate in radioecology. Classic models of radionuclide transfer, including widely used handbooks of parameter values published by the International Atomic Energy Agency, rely on concentration ratios that assume a broadly linear relationship between soil and plant burdens. Earlier experimental work by researchers such as Sheppard and Evenden in the late 1980s had already questioned the linearity assumption, and subsequent studies on radium and thorium uptake by groups including Vandenhove and colleagues confirmed that soil properties and plant physiology can bend the transfer curve substantially. The new plantain dataset adds a medicinal-plant data point to that critical tradition, showing that the deviation from simple proportionality is systematic enough to be described with regression equations.

Those regression equations, together with the measured accumulation factors, are the study’s most practical product. By fitting linear models to the paired soil and leaf data, the authors produced predictive parameters that can be used to estimate radionuclide content in plantain leaves directly from soil measurements. For environmental monitoring agencies, this means soil surveys could become a screening tool for the safety of wild-harvested medicinal raw materials, reducing the need to analyse every batch of plant material. For pharmaceutical regulators, the derived transfer parameters offer a defensible basis for setting harvesting guidance, particularly in regions where residual contamination from historical fallout or industrial activity remains a concern.

The choice of study region is significant. The Voronezh Region sits within Russia’s Central Black Earth belt, famous for its fertile chernozem soils, and it hosts an active tradition of harvesting wild medicinal plants. Earlier work by the same research group had examined radionuclide accumulation in nettle leaves and in burdock roots, and the plantain study extends that programme into one of the most commonly gathered species. Because plantain is harvested for its leaves, which are used in expectorant and wound-healing preparations, the leaf-soil transfer parameters generated here apply directly to the part of the plant that enters commerce.

The authors conclude that the region enjoys a favourable radiation status and that plantain’s homeostatic mechanisms actively regulate isotope uptake in a predictable way. Beyond the immediate reassurance for consumers of herbal medicine, the study demonstrates how a humble, ubiquitous weed can serve as a bioindicator of environmental radioactivity. As demand for plant-based remedies grows worldwide, systematic soil-to-plant transfer measurements of this kind, grounded in paired sampling and quantitative modelling, provide exactly the kind of evidence base needed to keep natural products both trusted and safe.

Subject of Research: Soil-to-plant transfer of natural and technogenic radionuclides in the medicinal plant Plantago major L.

Article Title: Radionuclide accumulation in leaves of the medicinal plant Plantago major L

Article References: Radionuclide accumulation in leaves of the medicinal plant Plantago major L. (n.d.). https://doi.org/10.1007/s11104-026-08754-7

Image Credits: AI Generated

DOI: 10.1007/s11104-026-08754-7

Keywords: Plantago major, radionuclides, cesium-137, strontium-90, medicinal plants, soil-to-plant transfer, radiation safety, environmental monitoring, accumulation factor, Voronezh Region, radioecology, herbal medicine

Researchers at the University of Sharjah conducted a cross-sectional survey between February and March 2021, targeting UAE residents aged 18 and above. The study, published in BMC Complementary Medicine and Therapies, gathered responses through self-administered questionnaires distributed via social media platforms, a distribution method that reflected the lockdown conditions under which the data was collected. After analysis using SPSS statistical software, version 26, the team found that while natural remedies were deeply embedded in everyday health practices before the pandemic, they played a surprisingly modest role in COVID-19 prevention and treatment specifically.

The numbers tell a nuanced story. Before the pandemic, a striking 74.6 percent of the 382 participants analyzed reported using natural remedies for disease prevention or treatment, confirming that these products were already a routine part of health maintenance for roughly three out of four adults surveyed. Yet when the same population was asked about remedies specifically aimed at COVID-19, the figures collapsed. Only 27.7 percent reported using natural products to prevent the disease, a mere 3.9 percent used them as treatment after infection, and 11.8 percent reported using them for both purposes combined.

This gap between general use and pandemic-specific use is one of the most intriguing aspects of the study. It suggests that the population did not wholesale abandon conventional public health guidance in favor of herbal alternatives, as some feared during the pandemic’s most chaotic months. Instead, the Emirati respondents appear to have largely maintained their pre-existing habits while relying on official prevention measures, vaccination campaigns, and medical care for COVID-19 itself. The authors suggest this separation between general wellness practices and acute disease management reflects a pragmatic approach to health decision-making.

Demographic analysis revealed that two factors significantly influenced whether individuals turned to natural remedies against COVID-19: sex and age. Women were more likely than men to use natural products for pandemic protection, a pattern consistent with broader literature showing that women tend to be the primary consumers of complementary and alternative medicine worldwide. Age also played a statistically significant role, with the association reaching p = 0.045, while the association with sex reached p = 0.011, both conventional thresholds of statistical significance. Other demographic variables did not show meaningful relationships with remedy use in this sample.

Perhaps most revealing were the perceptions surrounding efficacy. A substantial majority of participants expressed skepticism about natural remedies as pandemic tools. Fully 41.6 percent believed natural remedies had low efficacy in preventing COVID-19, and an even larger 52.9 percent considered them ineffective for treating the disease. In other words, half of the surveyed population regarded herbal and natural approaches as therapeutically weak against the virus itself, even while maintaining their general use of these products for everyday health purposes.

This perception gap between general wellness and acute antiviral protection is scientifically coherent. Many commonly used natural products, such as honey, ginger, garlic, lemon, and various herbal teas, have documented antioxidant, anti-inflammatory, or general immunomodulatory properties that may support overall health. However, none have demonstrated the ability to prevent SARS-CoV-2 infection or to neutralize the virus once it has established itself in the respiratory tract. The respondents’ skepticism, therefore, appears to align with the available scientific evidence, even if it was likely shaped more by personal experience and public messaging than by clinical trial data.

One of the more concerning findings emerged when the researchers examined attitudes toward quarantine. Among participants who had a history of COVID-19 infection, 42.9 percent believed that using natural remedies made quarantine unnecessary, compared with 25.6 percent of those without such a history. This belief, that natural products could substitute for isolation protocols, represents a potential public health risk, as it could encourage infected individuals to continue social contact while relying on remedies that cannot stop viral transmission. The elevated rate among those who had experienced infection suggests that personal experience with the disease may have fostered overconfidence in alternative approaches, or that those who relied on remedies during illness rationalized their choices after the fact.

Interestingly, the study found no significant difference in perceived risk of COVID-19 between natural remedy users and non-users. This challenges a common hypothesis in the complementary medicine literature, which holds that people turn to natural remedies because they fear conventional medicine, distrust pharmaceutical interventions, or perceive the disease itself differently. In the UAE sample, the decision to use or avoid natural products during the pandemic appears to have been driven by other factors, possibly including cultural traditions, family practices, or simple habit, rather than differential risk perception.

The methodology of the study warrants careful consideration when interpreting these findings. The cross-sectional design captures a single moment in time and cannot establish causation. The social media distribution, while practical during lockdown conditions, may have introduced sampling bias toward younger, more digitally connected residents, potentially underrepresenting older adults who might hold different attitudes toward traditional medicine. The relatively modest sample size of 382 participants, while adequate for detecting the observed associations, limits the statistical power available for subgroup analyses. Additionally, the data collection window in early 2021 preceded widespread vaccine availability in many regions, meaning attitudes may have shifted substantially as vaccination campaigns accelerated later that year.

Nevertheless, the study fills an important geographic gap in the global literature on pandemic-era alternative medicine use. Much of the published research on natural remedies and COVID-19 has focused on North America, Europe, and East Asia, leaving the Gulf region comparatively understudied despite its rich traditions of herbal medicine rooted in Arabic and Islamic healing practices. The UAE, with its highly multicultural population comprising Emiratis and large expatriate communities from South Asia, the Middle East, and beyond, offers a particularly interesting setting for such research, as diverse cultural traditions of natural medicine coexist within a modern, well-resourced healthcare system.

The authors conclude that the frequency of natural remedy use for COVID-19 prevention or treatment was very low in the UAE, a finding they interpret with some concern. Rather than viewing low usage purely as a triumph of evidence-based public health messaging, the research team argues that community outreach and public health programs are needed to raise awareness about the potential role of natural remedies in supporting general health and well-being. This framing reflects a growing consensus in integrative medicine that natural products may have a legitimate supportive role in overall wellness, provided they are not positioned as substitutes for vaccination, isolation, or medical treatment.

That dual message, embracing natural remedies for wellness while firmly directing people toward conventional measures for acute infectious disease, captures the delicate balance that public health authorities worldwide have had to strike. On one hand, dismissing traditional and natural medicine entirely risks alienating populations for whom these practices carry deep cultural significance, potentially undermining trust in health institutions more broadly. On the other hand, tolerating claims that honey or herbs can replace proven interventions like vaccination and quarantine invites the kind of dangerous substitution behavior hinted at in the quarantine findings of this very study.

As the world moves into the post-pandemic era, studies like this one provide valuable baseline data for understanding how populations actually behaved during a once-in-a-century health crisis. The UAE findings paint a picture of a population that largely resisted pandemic-specific alternative medicine fads while maintaining its traditional wellness practices, and whose skepticism about herbal antivirals proved largely justified by subsequent scientific evidence. For public health planners preparing for future infectious disease emergencies, the lesson is clear: cultural health practices are resilient and should be respected and integrated where appropriate, but crystal-clear communication about the limits of natural remedies against acute viral infections remains essential to keeping communities safe.

The study conducted by an interdisciplinary team led by researchers Jang, Shin, and Lee, delves into the intricacies of how different preparation methods influence the bioactive components of Palmijihwang-tang. The formula, historically used in Asian medicine, comprises several herbal ingredients, each contributing unique properties that collectively promote health and wellness. However, how these constituents interact during the decoction process has remained a subject of debate and inquiry.

Utilizing a theoretical framework, the researchers meticulously dissected the chemical transformations that occur when the individual ingredients are combined and heated in water. This scientific approach underscores the complexity of herbal interactions, revealing that the functionality of a formula is not merely a sum of its parts but rather a dynamic interplay of active compounds. By showcasing how certain decocting conditions can either enhance or diminish specific bioactive elements, the research opens doors to more personalized and refined applications of traditional herbs.

As the study progresses, it is evident that understanding the chemical architecture of Palmijihwang-tang is crucial for optimizing its health benefits. The research highlights critical factors affecting the extraction and potency of herbal compounds, such as water temperature, steeping time, and ingredient ratios. The implications of these findings extend beyond traditional practices; they suggest pathways for maximizing efficacy in modern herbal preparations, paving the way for further academic inquiry and clinical applications.

One fascinating aspect of the study involves the exploration of synergistic effects—how certain combinations of herbs within Palmijihwang-tang work together to amplify health benefits. This concept of synergy is particularly pivotal in herbal medicine, where the whole is often considered to be greater than the sum of its isolated parts. The researchers emphasized that this synergy can lead to enhanced bioavailability and therapeutic efficacy, underscoring the importance of considering these interactions in future herbal formulations.

Moreover, the investigators found that by selectively adjusting decoction parameters, practitioners may effectively tailor the medicinal qualities of Palmijihwang-tang to meet individual patient needs. This personalized approach is a significant advancement in the field of traditional medicine, bridging the gap between empirical knowledge and scientific evidence. The findings suggest a move towards more individualized medicine, allowing for customized herbal interventions that cater to specific health conditions and patient profiles.

The implications of this research are profound, as they encourage a reevaluation of traditional decoction methods through the lens of modern scientific inquiry. As traditional practices are often steeped in historical context, marrying them with contemporary research provides a richer narrative and broader acceptance among healthcare communities. This interplay between tradition and innovation serves to validate the efficacy of herbal medicine in a world increasingly driven by evidence-based practices.

Moreover, the systematic analysis presents a compelling case for further investigation into other traditional herbal formulations. If the findings regarding Palmijihwang-tang hold true across various formulations, this could revolutionize how practitioners employ these remedies in clinical settings. The research thus opens the door for a new era in the field of herbal medicine, wherein scientists and practitioners alike can collaborate to enhance understanding and therapeutic applications.

The potential for optimized decoction processes extends beyond the immediate study of Palmijihwang-tang; it suggests broader applications in herbal medicine as a whole. Deciding how best to extract and formulate herbal remedies can result in not only increased potencies but also reduced side effects—a common concern in any form of medicine. The researchers advocate for a comprehensive approach in which traditional knowledge and modern science coalesce, providing a holistic avenue for healthcare advancements.

This research also highlights the need for standardization in traditional herbal practices. As more studies emerge, establishing guidelines based on empirical evidence can help authenticate the dosage and preparation methods for practitioners, aiding them in providing the most effective treatments for their patients. Such a framework would not only enhance the credibility of traditional medicines but also reinforce their place in contemporary healthcare.

Furthermore, the researchers called attention to the importance of continued education among herbal practitioners regarding the science behind their practices. By fostering a better understanding of how various factors influence herbal pharmacology, practitioners can make more informed decisions, ultimately leading to improved patient outcomes. Education, therefore, becomes a pivotal component in bridging the gap between traditional knowledge and modern scientific insight.

In conclusion, the study marks a significant milestone for the scientific community, highlighting the vital relationship between traditional Asian medicine and contemporary research methodologies. As we delve deeper into the world of herbal remedies, it is only through studies such as this that we will unlock the full potential of nature’s treasures. The journey of understanding and refining traditional practices is just beginning, but the climate is ripe for innovation and collaboration in the realm of herbal medicine.

Emphasizing a future where traditional knowledge is seamlessly integrated into modern wellness paradigms, this research inspires a renewed appreciation for the art and science of herbal decoctions. As more discoveries surface, we anticipate transformative changes in how these time-honored practices are perceived, treated, and utilized in today’s health-conscious society.

Subject of Research: Modifications in chemical composition of Palmijihwang-tang through combined decoction methods.

Article Title: Combined decoction selectively modifies chemical composition of traditional Asian medicine: a systematic analysis on Palmijihwang-tang using theoretical additive model.

Article References:

Jang, D., Shin, S., Lee, S.M. et al. Combined decoction selectively modifies chemical composition of traditional Asian medicine: a systematic analysis on Palmijihwang-tang using theoretical additive model.
BMC Complement Med Ther 25, 417 (2025). https://doi.org/10.1186/s12906-025-05153-w

Image Credits: AI Generated

DOI: https://doi.org/10.1186/s12906-025-05153-w

Keywords: Herbal medicine, decoction, traditional medicine, Palmijihwang-tang, chemical composition, synergistic effects, personalized medicine.