Review Article Phytochemical, Therapeutic, and...

Review ArticlePhytochemical Therapeutic andEthnopharmacological Overview for a TraditionallyImportant Herb Boerhavia diffusa Linn

Shikha Mishra1 Vidhu Aeri1 Praveen Kumar Gaur2 and Sanjay M Jachak3

1 Department of Pharmacognosy and Phytochemistry Faculty of Pharmacy JamiaHamdard HamdardNagar NewDelhi 110062 India2Department of Pharmaceutics ITS Pharmacy College Muradnagar Ghaziabad 201006 India3 Department of Natural Products National Institute of Pharmaceutical Education amp Research SAS Nagar Punjab 160062 India

Correspondence should be addressed to Shikha Mishra shikha nphrediffmailcom

Received 2 February 2014 Revised 14 March 2014 Accepted 8 April 2014 Published 14 May 2014

Academic Editor Kazim Husain

Copyright copy 2014 Shikha Mishra et al This is an open access article distributed under the Creative Commons Attribution Licensewhich permits unrestricted use distribution and reproduction in any medium provided the original work is properly cited

Boerhavia diffusa (BD) is a plant of rasayana category as per ayurvedic claims It is reported to possess antiaging disease preventionand life strengthening activities which hold enormous influence in disease burden and affordabilityavailability of healthcare in theworldObjectiveThis paper has been compiled to comment on the studies reported for BD to highlight its chemical and therapeuticpotential along with its ethnopharmacological considerations Methods In the present paper a detailed account of chemicalconstituents and pharmacological activities has been presented All the findings were correlated with modern pharmacologicalactivities to appraise the value of BD Results Chemical analysis of BD gives a wide variety of chemical constituents namelyrotenoids flavonoids xanthones purine nucleoside lignans and steroids Various ethnopharmacological reports emphasize itsrole in disorders of reproductive system gastrointestinal system respiratory system urinary system hepatic systemjaundicecardiovascular system and cancerConclusionsThe studies on the therapeutic activities of BD range from studies on crude extractsto isolated compounds however some of the studies require sophistication and validated results BD is a plant of enormousimportance in the purview of its chemical and therapeutic properties

1 Introduction

Boerhavia diffusa (BD) Linn (Nyctaginaceae) is a well-knownmedicinal plant in traditional Indianmedicine as wellas other parts of world for example Southern Americanand African continent Its various parts and especially rootshave been used for gastrointestinal hepatoprotective andgynecological indications in above mentioned parts of theworld and also throughout India In ayurvedic texts morethan 35 formulations of different types contain it as majoringredient

In Ayurveda BD has been classified as ldquorasayanardquo herbwhich is said to possess properties like antiaging reestab-lishing youth strengthening life and brain power and dis-ease prevention all of which imply that they increase theresistance of the body against any onslaught in other wordsproviding hepatoprotection and immunomodulation [1]

BD has been widely studied for its chemical constituentsand therapeutic activities The roots are the source of anovel class of isoflavonoids known as rotenoids flavonoidsflavonoid glycosides xanthones purine nucleoside lignansecdysteroids and steroids Various animal studies and tri-als have confirmed the presence of activities for exampleimmunomodulation hepatoprotection antifibrinolysis anti-cancer activity antidiabetic activity anti-inflammation anddiuresis In this paper traditional uses chemical constituentsand reported pharmacological activities have been summa-rized to present the chemical and therapeutic potential of thisplant Present review also provides an ethnopharmacologicalappraisal of an important medicinal herb

Botany and Substitutes Boerhavia genus is a collection of 40tropical and subtropical species It is found as a weed duringrainy seasons in Indian Northern and Southern American

Hindawi Publishing CorporationBioMed Research InternationalVolume 2014 Article ID 808302 19 pageshttpdxdoiorg1011552014808302

2 BioMed Research International

continents and South Eastern Africa Boerhavia was namedafter Hermann Boerhaave a famous Dutch physician ofthe 18th century while the species got the name from itstypical diffuse branching Two views have been taken onthe application of the name BD a broad view regardingseveral Boerhavia taxa (including Boerhavia repens L andBoerhavia coccinea Mill) as a single very variable speciesand a restricted concept in which BD is applied to the taxonwith an apparently terminal panicle It is called by severaldifferent names owing to its wide distribution throughout theworld (Figure 1) that is alena (Hawaii) erva tostao agarra-pinto and amarra-pinto (Brazil) hogweed (Barbados) redspiderling spreading hogweed (English) Huang Xi Xin(Chinese) ipecacuanha de Cayenne (French Guiana) andhierba de cabra (Spanish)

In Indian context BD goes by several names dueto the variety of languages that is Assamese RangaPunarnabha Bengali Rakta Punarnava Gujrati Dholisat-urdi Motosatodo Hindi Gadapurna Lalpunarnava Kan-nada Sanadika Kommeberu and Komma Kashmiri Van-jula Punarnava Malayalam Chuvanna Tazhutawa MarathiGhetuli Vasuchimuli Satodimula Punarnava and Kha-parkhuti Oriya Lalapuiruni Nalipuruni Punjabi ltcit (Ial)Khattan Tamil Mukurattai (Shihappu) and Telugu Atika-mamidi Erra galijeru

However one of its names in Sanskrit (kathillasophaghni sothaghni and varsabhu) varshabhu hasgiven rise to a long standing confusion on identity As permodern taxonomy varshabhu is the name for Trianthemaportulacastrum Both of these plants also bear morphologicalsimilarities

2 Chemistry

BD is a good source of nutritional supplements as reportedby Miralles and Ujowundu Miralles et al reported 15 aminoacids (6 essential) in the whole plant and 14 amino acids (7essential) in the roots alongwith isopalmitate acetate behenicacid arachidic acid (63) and saturated fatty acids (38)[2] Ujowundu et al [3] accounted the presence of vitaminsC B3 and B

2(4480 9700mg and 2200mg) along with

calcium (17409mg) in roots In various tribal areas BD rootsas well as whole plant have been reported to be used asculinary ingredient Based on the above studies this use canbe a validated claim

BD contains various categories of secondary metabolitesfor example flavonoid glycosides isoflavonoids (rotenoids)steroids (ecdysteroid) alkaloids and phenolic and lignanglycosides Table 1 gives an account of various chemicalconstituents isolated till date from BD along with activityobserved for that compound Figure 2 shows the structuraldiversity of the compounds isolated from BD Figure 3and Table 2 give a detailed survey of compounds fromisoflavonoids category Recently a rapid method was devel-oped for quantitative estimation of boeravinones in BD[4] Rotenoids are isoflavonoids derivatives with a proto-type compound named rotenone which is a mitochondrialinhibitor (Figure 4) It causes inhibition of mitochondrial

electron transport chain at complex I [5] however theldquotoxophorerdquo of the rotenoid structure was reported to be theprenyl-derived ring and the dimethoxy substitution on ringA [6] So the rotenoids isolated from BD are noncytotoxicsince they lack the isoprenoid residue on ring D or have amonosubstituted or unsubstituted ring A [7] The chemicalmarker for BD belongs to rotenoid category namely boer-avinone B and authentic samples of BD should contain notless than 0005 boeravinone B [8]

3 Status of BD in TraditionalSystems of Medicine

As stated earlier BD is an important herbal constituent ofvarious ayurvedic formulations It has been used in variousformulations meant for inflammation jaundice asthmarheumatism nephrological disorders ascites anemia andgynecological disorders Table 3 enlists various traditionalformulations having BD as a main ingredient

4 Ethnopharmacological Reports for BD

Tables 4 and 5 give a detailed account of ethnopharmaco-logical reports for the use of BD throughout India and inother parts of the world respectively It can be inferred fromthe data presented that ethnopharmacological wisdom runsparallel with the modern evidence based system of medicineMost cited uses were for reproductive system jaundicekidney problems skin troubles eye diseases wounds andinflammation All of these uses can be verified in the lightof current therapeutic studies or the compounds isolatedfrom BD

5 Pharmacological Activities

51 Immunomodulatory Activity

511 Immunostimulatory Activity In vivo studies Mungan-tiwar and coworkers analyzed the immunomodulation byBD (aqueous extract 50ndash200mgKgday orally) and showedsignificant leucocytosis and reduced mortality (50) inpretreated mice using E coli-induced abdominal sepsis stressmodel The extract also reversed the elevation in the levelsof glucose cholesterol SGPT and BUN and reduction intriglycerides induced by cold and forced swimming stressin rats [9] The alkaloidal fraction has shown a remarkableeffect in leveling the increase in plasma cortisol and avertingthe decrease in immune system performance in rats [10] Inanother study Sumanth and coworker compared the effectof BD with ashwagandha and found comparable increasein total swimming time in mice when fed with alcoholicextract The extract showed more potent effect on the countof total WBC glucose level and plasma cortisol level Theextract produced macrophage phagocytic activity compara-ble to the drug levamisole [11] Mungantiwar and coworkerscontinued the studies on immunomodulation and foundthat the alkaloidal fraction (25ndash100mgKg po) considerablydecreased and delayed hypersensitivity reactions in animals

BioMed Research International 3

Boerhavia diffusa

Geographical distribution of BD

Figure 1 Worldwide distribution of BD

The author recommended that the immunostimulation is dueto metabolic alteration of the alkaloid to its active form [12]

BD has been said to possess adaptogenic effects howeverthe term adaptogen includes a myriad of activities Theterm actually infers an overall increase in adaptability ofan organism against any type of stress namely physicalchemical or biological This term can be loosely correlatedwith the rasayana concept of Ayurveda Immunomodulationis an important activity of rasayana herbs Mungantiwar andSumantha studied the immunomodulation but the activityhas been ascribed to crude or semipurified alkaloidal extractSyringaresinol mono-120573-D-glucoside (eleutheroside E

1 acan-

thoside B) punarnavine and quercetin are the compoundswhich have been found to have immunomodulatory activityisolated from BD or other plants Apart from quercetinthe other two compounds have been exclusively reportedto be present in the roots the official source of the drugldquopunarnavardquo

512 Immunosuppressive Activity In vitro studies Mehrotraand coworkers studied the immunomodulation produced byan ethanolic extract of BD roots (100 and 500 120583gmL) ininhibition of NK cells cytotoxicity LPS-induced NO pro-duction and quantification of mRNA The extract preventedin vitro cytotoxicity in human NK cells and also inhibitedNO generation in mouse macrophage cells along with pro-duction of IL-2 and TNF-120572 (MIC sim 10 120583gmL) in humanPBMCs The author suggested good immunosuppressiveproperties possibly because of alkaloidlignan [13] HoweverPandey and coworkers worked on hexane chloroform andethanol extracts of BD leaves and found inhibition of PHAstimulated proliferation of PBMCs two-way MLR NK cellcytotoxicity and LPS-induced NO production by RAW 2647when treated with chloroform and ethanol extracts (5ndash500120583gmL) Eupalitin-3-O-120573-D-galactopyranoside isolatedfrom the ethanolic extract showed more effectiveness Itdecreased the production of IL-2 and TNF-120572 in human

PBMCs and repressed NF-120581B and AP-1 thereby depressingactivation and proliferation of T cells The author suggestedspecific potential of eupalitin-3-O-120573-D-galactopyranosidefor immunosuppression [14]

Above reports indicate the immunosuppression by BDhowever both reports are from different plant parts Theroots have been the source of two documented immunos-timulants syringaresinol mono-120573-D glucoside (eleuthero-side E1 and acanthoside B) and punarnavine Further-more Pandey and coworkers isolated eupalitin-3-O-120573-D-galactopyranoside and ascribed the immunosuppressiveproperty to it [14] This compound has also been reportedto possess antiosteoporotic activity [15] Osteoporosis isa disorder with an inflammation-aging component and ithas been emerged that it has an immune component alsoCytokines which are secreted for immune response are alsoimportant for development and activation of osteoclastsbesides being critical for the immunity [16]The immunosup-pressive property of eupalitin-3-O-120573-D-galactopyranosidecould be linked with antiosteoporotic activity shown byBD extract in various cell cultures and in vitro studiesBD has been an integral part of traditional and ethnophar-macological medicine for treating rheumatism which is anonspecific term for medical problems affecting the jointsand connective tissues The evidence for presence of com-pounds with antiosteoporotic immunosuppressive and anti-inflammatory activities approves the use of BD in rheumaticdisorders for which it has been known since ancient times

52 Anticancer Activity In vitro studies Srivastava andcoworker showed a dose-dependent in vitro cytotoxic effectof the extract of the BD root and the leaf in HeLa andU-87 tumor cell lines Crude ethanolic extract of the root(200120583gmL) and the leaf (300 120583gmL) showed 30 and40 cell death while alkaloidal fraction (300120583gmL) andmethotrexate (200 nM) showed 40 cell death [17]


O

O

O

O CO

O

O

Boeravinone J Punarnavoside

OHHO

CH

CH

CHO

O

CH

HOOC

HO COOH

HO

HO

O

O

O

O

Borhaavone

OHOHO

HOOH

OH

OH

OH

OH

O

CH

O

O

OH OH

OH

OH

OH

OH

OH

HOHO

HO

HO

HO

H3C

CH2CH2

H3CH3C

H3C OCH3

OCH3

OCH3

OCH3

R1

R2

Trans-caftaric acid(Caffeoyl tartaric acid)

Quercetin R1 = OHR2 = OH

Kaempfero1 R1 = OHR2 = H -Dihydroxy-5-methoxycinnamoyl-rhamnoside

O

O

O

O

O

O

O

OO

OO O

O

O

O

OHO

HOHO

HOHO

OH

O

HO OHO

O

O

OH

OOH

HO

HO

HO

HO

HO

O

OHO

O

O

O

OH

O

O

OH

OHOH OH

OH

OH

OH

OHOH

OH

OO

OH

O

OH

O

O

OO

O

OH

OH

OH

OH

OHOH

OHOH

OH

OH

OH

OH

HO

HO

HO

HO

HO

HOHO HO

HO

HO

OH

HOHO

Quercetin 3-O-robinobioside Kaempferol 3-O-robinobioside

H3CO

H3CO

H3CO

H3CO

OH

OH

OH

OH

Eupalitin-3-O-120573-D-galactopyranoside

O

O

H

H

H

H

HN

N

N

N OH

OH

O

Hypoxanthine-9-L-arabinofuranoside

Liriodendrin R1 = R2 = glucose

Syringaresinol mono-120573-D- glucoside R1 = HR2 = glucose

OCH3

OCH3

OCH3

O-R1

R2-O

H3CO

CH2OH

O

O

O

O

H

H

OHH

HOH

OCO

Boerhavisterol Boeravilanostenyl benzoate

HOH2C

O

COOH

Boeradiffusene

OH OH

OH

HO

HO

Triacont-24-en-1-oic acid120573-Ecdysone

34

Quercetin 3-O-(2998400998400-rhamnosyl)-robinobioside Kaempferol 3-O-(2998400998400-rhamnosyl)-robinobioside Eupalitin 3-O-galactosyl (1 rarr 2) glucoside

( )3

( )20

2998400 O-Methyl abronisoflavone

Figure 2 Major chemical constituents isolated from BD

Mehrotra and coworkers analyzed the effect of 95ethanolic root extract on T cell mitogen PHA Con-A andPPD antigen-stimulated proliferation of human PBMC Itinhibited PBMC proliferation induced by all above stimu-lators and human mixed lymphocyte culture The extract

showed the inhibition of various cell lines (mouse andhuman) with special mention of lymphoma and leukemiccells [18]

Ahmed-Belkacem and coworkers isolated two rotenoids(boeravinones G and H) from BD roots and found them


OO

O 1 3

4

56789

12a

OH

7a 6a

1211

2

10

OO

OOH OH

H

OO

OOH

Dehydrorotenoid Rotenoid

R1 R1

R2 R2

R3 R3R4 R4

R5 R5

R6 R6

12a-Hydroxy-rotenoid

R1

R2

R3R4

R5

R6

Figure 3 Categories of rotenoids

OO

O

O

H

H

OH O

HO

OH

OO

Rotenone Boeravinone B

H3COCH3

OCH3

Figure 4 Prototype compound of rotenoid category and chemical marker of BD

potential efflux inhibitors for breast cancer resistance protein(ABCG2) The authors also proposed a correlation betweenstructure and activity of compounds having BCRP inhibitoryactivity [7]

Chopra and coworkers performed bioassay guided frac-tionation of 95 ethanolic extract of BD root and haveobserved 30 cell death in HeLa cell line (300120583gmL)Further purification with column chromatography yieldeda more potent fraction which has shown 85 and 55 celldeath in 72 and 24 h respectively at a dose of 300 120583gmL [19]

S Sreeja and coworkers analyzed antiproliferative andantiestrogenic potential of methanolic extract of whole plantof BD in MCF-7 cell line and showed reduction in cellviability (468) in 48 h at 320120583gmL [20] The extractalso showed reduction in estradiol-induced cell proliferationMCF-7 cells treated with varying concentrations of theextract (20ndash320120583gmL) showed G

0-G1arrest by increasing

the population of G0-G1phase from 691 to 758

In vivo studies Leyon and coworkers studied the effectof aqueous methanolic (3 7) extract of BD whole plant onmetastasis in a model of B16F10 melanoma in C57BL6 miceThe extract showed 87 and 95 inhibition of metasta-sis at 05mgdose simultaneously and prophylactically Thesurvival rate of mice was also increased up to 157 Theextract given prophylactically produced 85 reduction inserum parameters indicative of metastasis [21] Further theauthor isolated punarnavine from the extract which hasshown antibody-dependent cellular and complement medi-ated cytotoxicity alongwith enhancement ofNK cells activityPunarnavine increased the production of IL-2 and IFN-120574

[22] Levels of GM-CSF and proinflammatory cytokines suchas IL-1120572 IL-6 and TNF-120572 were significantly lowered bypunarnavine administration Further the author found thatprophylactic and simultaneous treatment with punarnavine(40mgkg) can restrain the lung melanoma metastasis up to9525ndash939 respectively for 10 days after tumor inocu-lation Punarnavine administration probably suppresses ordownregulates the expression of MMP-2 MMP-9 VEGFERK-1 and ERK-2 in the lung tissue of metastasis-inducedanimals [23]

Manu and coworkers estimated the protection providedby 70 aq methanolic extract of the whole plant (20mgkgip) in bone marrow and intestine of mice (dosed sublethallyby 600 rads in single dose) Total WBC count was reduced by4666 in the extract treated group in comparison to 80in the control group on day 9 after radiation exposure Inthe presence of BD extract the effect of radiation on bonemarrow cellularity can be seen by only 46 reduction incellularity compared with 68 reduction in radiation aloneAn interesting fact is that on the 11th day the count ofbone marrow cellularity surpassed the initial value by 92The elevated level of serum and liver LAP GPT and lipidperoxidation after radiation exposure was normalized in theextract treated group [24]

An important indication of BD in traditional medicineis abdominal tumor Various studies (in vitro and in vivo)suggest the presence of potential anticancer compounds invarious extracts prepared from various plant parts Manuand coworker isolated the alkaloid punarnavine from therootsband reported it to have an antimetastatic potential [23]


Table 1 Chemical constituents isolated from BD

Chemical class Name of compound Activity reported Plant part ReferencePhenolicglycoside Punarnavoside Antifibrinolytic Roots [66]

C-Methyl flavone Borhaavone lowast Roots [67]Isoflavone 21015840-O-Methyl abronisoflavone lowast lowast [68]Flavonol Quercetin kaempferol lowast Leaves [65]

Flavonoidglycoside

34-Dihydroxy-5-methoxycinnamoylrhamnoside lowast Leaves [65]

Quercetin 3-O-rhamnosyl (1rarr 6)galactoside (quercetin 3-O-robinobioside) lowast Leaves rdquo

Eupalitin 3-O-galactosyl (1rarr 2) glucoside lowast

Kaempferol 3-O-robinobioside lowast Leaves rdquoEupalitin-3-O-120573-D-galactopyranoside lowast Leaves

Phenolic acid trans-caftaric acid lowast Roots rdquo

Rotenoids

Boeravinones A B C D E F lowast Roots [68ndash74]

Boeravinones G H Anticancerspasmolytic Roots [68]

Boeravinones I J lowast Roots [7]9-O-Methyl-10-hydroxy coccineone E lowast Roots [60]Diffusarotenoid lowast Roots [75]6-O-Demethyl-boeravinone H lowast Roots [60]10-Demethyl boeravinone C lowast Roots rdquoCoccineones E B lowast Roots rdquoBoeravinones M PQ R S Roots [76]

Xanthone Boerhavine lowast Roots [77]

Lignan Liriodendrin Ca2+ channelantagonist Roots [78]

Syringaresinol mono-120573-D-glucoside Ca2+ channelantagonist Roots rdquo

Purine nucleoside Hypoxanthine-9-L-arabinofuranoside Cardiotonic Roots [79]Sterol Boerhavisterol lowast Roots [75]Sterol ester Boeravilanostenyl benzoate lowast Roots rdquo

Ecdysteroid 120573-Ecdysone

Increases proteinsynthesis

antidepressantantistress and

immunomodulationantihyperglycemichepatoprotective

Roots [80 81]

Fatty acid Triacont-24-en-1-oic acid lowast Roots rdquoHydrocarbons Boeradiffusene lowast Roots [75]

In another study boeravinonesG andHhave shownpotentialinhibition of drug efflux by breast cancer resistance protein(ABCG2) [7]

Radiotherapy holds an important stake in cancer treat-ment in spite of the major adverse effect of myelosuppressionor immunosuppression which may result in increased sus-ceptibility to infection during the course of cancer treatmentThere are several approaches to maintain the immunity levelof the cancer patient to improve the overall condition Herbalformulations containing plant derived immunomodulators

might be a considerable approach in this regard BD offersa multiple target regimen in cancer therapy It has anticancerimmunomodulatory and radioprotective activity So it couldbe proven to be a beneficial supplement in the cancer therapy

53 Antidiabetic and Hypoglycemic Activity In vivo studiesChude and coworkers showed non-dose-dependent reduc-tion in sugar levels in alloxan induced diabetic rats uponadministration of aqueous extract of leaf of BD They


Table 2 Substitution pattern in rotenoids isolated from BD

S No Name R1 R2 R3 R4 R5 R6

Dehydrorotenoid1 Boeravinone A H H OCH3 H OH CH3

2 Boeravinone B H H OH H OH CH3

3 Boeravinone D OH H OCH3 H OH CH3

4 Boeravinone E OH H OH H OH CH3

5 Boeravinone F OH H O H OH CH3

6 Boeravinone G H OH OCH3 H OCH3 H7 Boeravinone H H OH OCH3 H OCH3 CH3

8 Boeravinone I H H OH OH OCH3 CH3

9 9-O-Methyl-10-hydroxy coccineone E H H OH H OCH3 OH10 Diffusarotenoid H OH OCOC4H9 H OH CH3

11 6-O-Demethyl boeravinone H H OH OH H OCH3 CH3

12 Coccineone B H H OH H OH H13 Boeravinone M H OH OH H OCH3 H14 Boeravinone P H H OCH3 H OH H15 Boeravinone Q H H OCH3 OCH3 OH CH3

16 Boeravinone R H H OH OCH3 OH CH3

17 Boeravinone S OH H OH H OH H12a-Hydroxy rotenoids

1 Boeravinone C H OH H H OH CH3

2 10-Demethyl boeravinone C H OH H H OCH3 H3 Coccineone E H H H H OCH3 OCH3

showed 5195 reduction in sugar level at the 6th hourafter administration of 200mgKg extract [25] In anotherwork Satheesh and coworkers compared the aqueous extractof the leaves (200mgKg) with glibenclamide (600120583gKg)in alloxan induced diabetic rats The extract increases theplasma insulin level from 492 120583UmL to 104 120583UmL whileglibenclamide attains the peak insulin level of 974 120583UmLThe extract completely restores initial glucose concentrationin 120min while glibenclamide leaves the level of glucoseelevated by almost 10 [26 27]

BD leaves chloroform extract has shown dose-dependenthypoglycemia in experimentally diabetic rats Glibenclamide(25 120583gKg) and BD leaf extract (200mgKg) gave the percentglucose reduction of 5901 and 3863 respectively in thefourth weekThe author hypothesized that 120573-cells renewal orsome extrapancreatic action is responsible for such activity[28]

Ex vivo Gulati and coworkers have accounted the 120572-glucosidase inhibitory activity for the ethanolic extract(172 120583gmL) [29]

The author found no traditional or ethnobotanicalreports of the antidiabetic activity in BD plant and theformulations containing BD as an ingredient however theabove studies clearly indicate the antihyperglycemic potentialof BD Only one proprietary formulation from Unani-Tibbsystem (Glucostop) has been indicated in the management ofdiabetes

54 Antifibrinolytic Activity In vivo studies Srivastava andcoworkers studied the effect of BD extract on IUD-induced

bleeding in rhesus monkeys and established antifibrinolyticactivity of BD extract [30] Further they evaluated themechanism of this activity and discovered NAD-dependent-15-hydroxy-prostagtandin dehydrogenase activity in theendometrium [31] Further exploration showed the role ofvascular and t-PA in IUD-fitted menstruating monkeys [32]

Barthwal and Srivastava compared antifibrinolytic agents(120576-aminocaproic acid 100mgKgday orally and tranex-amic acid 55mgKgday iv) anti-inflammatory drugs(indomethacin 15mgKgday ibuprofen 33mgKgdayand naproxen 3mgKgDay orally) and root extract ofthe BD (50mgKgDay orally) on various parameters ofmenstrual cycle in IUD-fittedmonkeysThey observed a highincrease in duration and loss of iron after IUD insertionAntifibrinolytic and anti-inflammatory agents reduced theduration and iron loss in menstruation and the activity oft-PA independently whereas root extract of BD (50mgKgorally) showed greater reduction in the duration ofmenstrualflow iron loss and t-PA activity The author suggestedreduction in t-PA activity leading to decrease inMBL causingreduced MIL in IUD-fitted monkeys [33 34]

Traditional systems of medicines in India and other partsof the world endorse the use of BD roots in gynecologicaldisorders for example abortion prolapsed uterus pain infemale genital tract regulation of menstruation and soforth Anemia is an easily predictable outcome of mostof the gynecological disorders which further compromisethe health of females This set of elaborated studies on theeffect of BD extract on menstrual parameters in IUD-fittedmonkeys and isolation of phenolic glycoside punarnavoside


Table 3 Ayurvedic formulations containing BD as main ingredient

S No Name of formulation Uses ReferenceAyurvedic formulations

1 Punarnavadyarishta

Heart disease anaemia inflammation splenomegalyvertigo hard stools chronic obstructivejaundicechlorosisadvanced stage of jaundiceabdominal lump fistula-in-ano coughdyspnoeaasthma malabsorption syndrome diseases ofskin and itching

(BhaisajyaratnavaliSotharogadhikara

192ndash196)

2 Punarnava gugguluGout inguinoscrotal swellings sciatica pain incalves-thighs-back-sacral and bladder region andrheumatism

(Bharat BhaishajyaRatnakar Trtiyabhaga 4012)

3 Punarnavasava

Dyspepsia abdominal lump diseases ofabdomenenlargement of abdomen inflammationdisorder of spleen and liver and all types of disorderswith difficult prognosis


197ndash201)

4 Punarnavadi kvathacurna

Generalized tremors ascites cough colicky paindyspneaasthma and anaemia

(BhaisajyaratnavaliUdararogadhikara

43-44)

5 Punarnavastakakvatha curna

Ascites anasarca cough dyspneaasthma and colickypain

(ChakradattaSothacikitsa 10)

6 Punarnavadimandura

Anaemia malabsorption syndrome inflammationsplenic disease intermittent fever haemorrhoidsdiseases of skin and helminthiasisworm infestation

(CarakasamhitCikitsasthana

Adhyaya 16 93ndash95)

7 Sukumara ghrita

Constipation diseases of abdomenenlargement ofabdomen abdominal lump splenic disease abscessedema pain in female genital tract haemorrhoidsinguinoscrotal swellings diseases due to vata doshaand gout

(SahasrayogaGhrtaprakarana 4)

6 Maha Narayan Taila

Facial palsy deafness paraplegia tremors neckrigiditytorticollis lock jaw wasting of one limboligospermia infertility headache glossal palsy dentalpain maniapsychosis hump-backkyphosis feversenilityprogeriasis emaciation tendon tear and bonefracture

(BhaisajyaratnavaliVatavyadhyadhikara

151ndash162)

9 Sothaghna Lepa All types of inflammation(Sarngadharasamhita

UttarakhandaAdhyaya 11 3)

10 Varuni Rhinitis and pain [82]Siddha formulation

1 TalakacenturamDiseases due to heatpitta humour wheezing jaundicearthritisarthralgia itching oliguriaanuria ascites anddiseases due to vata humour

(Anonymous 2008)

having an antifibrinolytic activity explain its use in diversegynecological disorders

55 Anti-Inflammatory Activity In vivo studies Mudgalstudied the anti-inflammatory effect of aqueous insolublealcoholic extract of BD in rats The leaves and flowerextracts have shown anti-inflammatory activity by only5578 decrease in rat paw edema [35] Hiruma-Lima andcoworkers evaluated BD leaf extracts (juice and lyophilizeddecoction) for its toxicity and analgesic-anti-inflammatoryactivities Juice and lyophilized decoction of the leaves (both

1000mgkg po) produced 50 and 47 inhibition of abdom-inal writhing in mice in comparison to dipyrone sodium(200mgkg) The juice also increased the latency in hot platetest in mice in comparison to morphine Another importantobservation was reversal of action of juice by pretreatmentwith naloxone (5mgkg ip) except for the decoctionSo the author proposed the opioid related mechanism ofantinociception [36] Asadulla isolated 120573-sitosterol from BDroots and reported 6129 edema in rats [37]

Inflammation is an important use of BD This plantis also called sothaghni which means that who alleviate


Table 4 Ethnopharmacological reports of uses of BD in various parts of India

S No Diseaseorganinvolved Plant partformulationdose Method Geographical

arealocation Reference

1Male

reproductivesystem

Root15 g powder with 100mL cowmilk twice daily20 g powder with 250mL cow milktwice daily20 g powder 15mL honey with 250mLcow milk twice daily

Interview with Vaidyas Uttar Pradesh(5 Districts) [83]

2Femalereproductivesystem

Rootdecoction Interview with elderlywomen Uttar Pradesh [84]

Root2 g paste with cowrsquos milk Questionnaire survey withtraditional practitioners

Churu districtRajasthan [85]

Plantpowder twice a day for onemonth

Discussion with elderlywomen and tribalpractitioners

Warli tribe ofMaharashtra [86]

Rootpaste Survey among aboriginepeoples Tribals of Maharashtra [87]

3 HepaticsystemJaundice

Rootdecoction Field surveys Tribe of Dehradun [88]

Leaveslowast Field surveys Tribe of Madhya Pradesh [89]

Rootdecoction Ethnobotanical survey withlocal Vaidya Rewa Madhya Pradesh [90]

Whole plantlowast Tribal physician Tribes of Central India [91]

LeavesextractInterview with men andwomen between 20 and 80years

Tribes of Kerala [92]

Rootdecoction Field survey Kanyakumari TamilNadu [93]

Rootlowast Questionnaire interviewsand discussions with tribes Tamil Nadu [94]

lowastlowast Field trips and localvillagers Assam [95]

Whole plantinfusion orally on emptystomach

Interviews with thetraditional practitioners Assam [96]

Leavesjuice orally twice daily Enlisting plants Tribes of Meghalaya [97]

4 Diureticnephrologicalsystem

Rootdecoction daily for one monthSurvey with local healersand herbalists priestshakims and Vaidyas

Muzaffarnagar districtUttar Pradesh [98]

Leaveslowast Field survey Tribes of MadhyaPradesh [89]

Whole plantlowast Tribal physicians Tribes of Central India [91]

Rootlowast Interviews with localvillagers and herbalists Tribes of Maharashtra Petkar 2002

Whole plantdecoction Field trips and interviewwith the tribal

Tribes of NortheastGujarat Bhat 2002

Root or tender shootsdecoction Oneteaspoonful twice daily

10-year ethnobotanical fieldsurvey Tribes of Tamil Nadu [99]

Leavesdecoction Interviews with localVaidyas Tamil Nadu [100]

Whole plantlowast Interviews with localpeople Vaidyas Karnataka [101]


Table 4 Continued



5 Wound healingRootlowast

Interviews with womenhaving knowledge ofmedicinal plants

Garhwal HimalayaUttaranchal [102]

Leavespaste Interviews with tribalmedicine men

Tribes of MadhyaPradesh [103]

Leavespaste Field surveys Tribes of Tamil Nadu [104]

6 Respiratorysystem

Plantinfusion Field surveys Tribes of Dehradun [88]Rootlowast lowast Chhattisgarh [105]Whole plantdecoction (15ndash20mL)twice a day

Field trips and interviewwith the tribal Maharashtra [106]

Rootpowder with equal amount ofsugar candy

Questionnaire and surveyswith traditional healers andfield survey

Orissa [107]


Rootjuice mixed with crushed chilliestaken orally twice daily Enlisting plants Tribes of Meghalaya [97]

Rootjuice 15mL taken twice a dayorally

Interviews with tribal andnontribal inhabitants andwith herbalists

Tribes of AndhraPradesh [108]

7 Insectscorpionsnake bite

Leaveswhole leaves chewed 5-year survey withmedicine men priests Rajsthan [109]

LeaveslowastEthnobotanical survey withlocalVaidyas

Rewa Madhya Pradesh [90]

Plantpaste with black pepper takenorally and applied locally

Questionnaire survey withtraditional healers Orissa [107]

Leavesjuice 2-3 times applied locallyand taken orally for 7 days

Interview with traditionalhealer Assam [110]

8Ophthalmia

Leavesextract Field surveys Tribes of Dehradun [88]

Root and leavesash Questionnaire survey withrural folk Rajsthan [85]

RootdecoctionEthnobotanical survey withlocalVaidyas


Rootlowast lowast Chhattisgarh [105]

Rootpaste Ethnomedicinal surveyamong aborigine peoples Maharashtra [87]

LeavesjuiceParticipatory ruralappraisal and questionnairesurvey

Kerala [111]

Leavesjuice with cow milk is appliedon eyelids


9 Skin disorders

Leavespowderwith mustard oil

Questionnaire survey withexperienced traditionalpractitioners

Rajsthan [85]

Root barkpaste Elderly persons Tamil Nadu [112]Whole plantlowast Tribal physician Tribals of Central India [91]


Table 4 Continued



10Rheumatism

Leaves boiled with rice garlic andwater are rubbed on the body


Rajsthan [85]

Rootdecoction Field survey Kanyakumari [93]


11 Cardiovascularsystem


Leaveslowast Interviews usingunstructured questionnaire KeralaWestern Ghats [113]

Leavescooked as a curry Enlisting plants Tribals of Meghalaya [97]

12 Inflammationedemaarthritis

Rootdecoction Ethnomedicinal surveyamong aborigine peoples Tribes of Maharashtra [87]

Root decoction (along with otherherbs)

Questionnaires among thetribal practitioners Tribes of Tamil Nadu [114]

Leavesjuice with black pepper takenorally on empty stomach twice a dayfor 7 days


Leavesjuice taken orally 2-3 timesand applied locally


Leavesjuice thrice a day Field survey Uttaranchal [115]

inflammation Almost all the ayurvedic formulations listed inTable 3 have uses in inflammationThere are several reports ofthe use of leaves either intact or in a formulation taken orallyor applied locally in cases of scorpion and snake bite or forwound healing Liriodendrin (eleutheroside E syringaresinoldiglucoside) quercetin and kaempferol have been reportedfrom various extracts from roots and leaves of the plant andhave shown potential for anti-inflammatory activity

56 Diuretic and Renal Activity In vitro studies Chauhanand coworkers studied the effect of aqueous extract ongrowth inhibition of struvite crystals made up of ammoniummagnesium phosphate hexahydrate (AMPH) commonlyfound in urinary stone (calculi) in women 05 and 10extract administration produced 50 and 7142 decrease incrystal size The administration of 10 BD extract causeddissolution of crystal by day 4 When studied in vitro 05and 1 extracts have respectively shown 8889 and 13889enhanced rate of dissolution in gel at the gel-liquid interface[38]

In vivo studies Mudgal compared the effect of Con-volvulus pluricaulis and BD against hypotension potentiationof barbiturate hypnosis and diuretic and anti-inflammatoryactivities The authors found significant diuretic activity inBD root extract (water insoluble portion of alcoholic extract)collected in a rainy seasonThe authors found 903 increasein the volume of urine in rats treated with the extract(300mgKg) whereas extract of leaves and flower showed6722 increase in the volume of urine [35]

Singh and coworkers studied the effect of aqueousethanolic extract on E coli-induced acute pyelonephritis inrats The extract (50mgKg po) administered twice orally

showed 4285 decrease in number of animals showing signsof renal changesThe administration of the extract (50mgKgpo) twice orally showed 9909 decrease in bacterial countper mL of urine [39]

Wahi and coworkers isolated alkaloid punarnavine andwater soluble base choline from BD roots and evaluatedthem for effects on frogsrsquo heart frogsrsquo skeletal muscle (rectusabdominis) and diuresis The authors found significantdiuresis after administration of the alkaloid (5mg100 g) inrats [40]

Sathyapriya and coworkers evaluated the effect of theaqueous extract of the whole plant of BD on osmoticfragility in erythrocyte from polycystic ESRD patients Itsignificantly decreased the osmotic fragility in erythrocytefrom polycystic ESRD patientsThe authors suggested it for aproperty of altering the erythrocyte membrane compositionor a directindirect effect on the intracellular sodium andalleviation of oxidative stress [41]

Pareta et al [42] studied the antioxidant potential of BDextract in urinary stones by means of inhibition of oxidativetrauma and kidney cell damage and observed decrease incalcium oxalate deposition

Yasir et al [43] reported the ability of ethanolic extract ofBD in shrinking crystal size and promoting calcium oxalatedihydrate (COD) crystals formationmore thanmonohydrate(COM) crystals Singh and coworkers reported the potentrenoprotective potentials of BD on alloxan induced diabeticrats indicated by effective glucoregulation maintenance ofserum ionic status and renal Na+-K+ ATPase activity andantioxidant status [39]

BD is a well-known diuretic and renoprotective plantin the traditional system of medicine Studies approving


Table 5 Ethnopharmacological reports of uses of BD in various parts of the world

S No Location Plant part and formulation Uses Reference

1 Northeastern Brazil Sitting baths made with tea fromthe bark

Problems of genitourinarysystem in females andinflammations

[116]

2 Nigeria Whole plant Treatment of threatenedmiscarriage [117]

3 Tropical AfricaBoiled roots Ulcers abscesses and Guinea

worm disease [118]

Boiled roots and leaves Expectorant and febrifuge and inlarge doses emetic rdquo

Decoction of aerial partsGastrointestinal painsconvulsions intestinal wormsand regulation of menstruation

rdquo

4 Ghana Root decoctionAnaemia heart troublespalpitations and jaundice andapplied externally to yaws

[118]

Powdered root with butter or oil Abdominal tumours rdquo

5 CongoRoot sap is rubbed on the neckand throat in water or palm oil orin a decoction

Mumps laryngitis and burnsspleen troubles diarrhoeadysentery haematuria andgonorrhea

[118]

6 Democratic Republicof Congo Leaf decoction Gonorrhoea and pain [118]

7 Angola Root decoction Jaundice [118]

8Berg Damara people

Namibia Chew or boil the root Gastroenteritic problems [118]

Damara peopleNamibia Tea made from the root Prolapsed uterus rdquo

9 Buner DistrictNWFP Pakistan

Bandage of roots crushed inboiled milk used externally

Ulcersinterviews with the localinhabitants selected informantsthe herbalists ldquoHakimsrdquo andsellersrdquo pansarisrsquo

[119]

10

Chakma Arma andTripura communityChittagong Hill tracts

Bangladesh

Whole plant juice and powder

Blood purification urinarytroubles contraception andjaundicequestionnaire surveywith local herbalists

[120]

rdquo Whole plant Pulmonary tuberculosis rdquo

rdquo Plant powder Abdominal tumor dysenteryand renal diseases rdquo

rdquo Flowers and seeds Contraceptives rdquo

rdquo RootsJaundice anemia gonorrheablood purification and asstimulant

rdquo

diuretic and kidney stone dissolving properties of BD extractsalong with the isolation of a diuretic alkaloid punarnavinedescribe the use of BD in urinary disorders Formulationscontaining BD as the main ingredient are routinely used inascites anasarca dropsy kidney troubles urinary stones andswelling of the legs In case of ascites cirrhosis is the majorcause which is followed by congestive heart failure Diureticsare the first line of therapy in such cases because all of thesediseases involve abnormalities in fluid dynamics in the bodyhowever hepatoprotective activity of BD would be an addedbenefit in such a caseTheuse of BD could also be beneficial in

congestive heart failure by means of decreasing cardiac loadand ACE inhibitor activity

57 Hepatoprotective Activity In vivo studies Gulati andcoworkers prepared 50 aqueous ethanolic extract ofBD roots and evaluated hepatoprotection at a dose of100mg100 g in hepatotoxicity induced by country madeliquor BD extract reduced the increment in serum param-eters indicative of damage to the liver The increase in SGPTSAP triglycerides and total lipid levels was decreased byalmost 50 by administration of BD extract while the level


of cholesterol was completely restored SGOT level was notmuch affected by BD extract Histopathological study of theliver showed minimal fatty cysts in BD treated group Theauthor suggested an additional antilipidemic activity alongwith hepatoprotective activity [29]

Chandan and coworkers evaluated the 50 aqueousethanolic extract of BD whole plant given orally for itshepatoprotective activity in carbon tetrachloride inducedhepatotoxicity in rats The extract significantly decreasedCCl4induced increase in hexobarbitone sleeping time from

225min to 200min It also lowers the SGPT level from260120583molmin to 200120583molmin It showed reduction of theserum levels of SGPT SGOT and bilirubin from 270 to205 140 to 120 and 195 to 12 120583mol respectively It alsosignificantly decreased the increase in prothrombin timeinduced by CCl

4from 3043 to 1901 sec In this test bromo-

sulphalein clearance was reduced to 3 times from 16 times byadministration of BD extract It also almost doubles the flowof bile [44]

Rawat and coworkers studied the effect of various factorsfor the hepatoprotection by BD extract and found thataqueous extract (2mLKg) of 1ndash3 cm diameter roots fromMay displayed significant protection for serum parametersthat is GOT (8255) GPT (7416) and ALP (5147)but not GLDH and bilirubin in thioacetamide-induced hep-atotoxicity It has been noted in this study that the rootswhich were thin showed maximum protection of serumparameters [45]

Devaki and coworkers studied the effect of ethanolicextract of BD on tissue defense system against ethanol-induced hepatic injury in rats The administration of BDextract (150mgkgday for 30 days orally) reversed theincrease in the levels of lipid peroxides and increasedthe activities of superoxide dismutase catalase glutathioneperoxidase and glutathione-S-transferase and reduced glu-tathione levels [46]

Olaleye and coworkers evaluated the aqueous andethanolic extracts of fresh leaves for antioxidant componentsand activity by in vitro and in vivo assays Antioxidative eval-uation of the ethanolic extract has shown appreciable quan-tities of phenolic and flavonoid content along with vitaminsC and E It also contained selenium and zinc Pretreatmentwith BD aqueous and ethanolic extracts reduced enzymaticactivities and serum bilirubin caused by acetaminophenTheincrease in alkaline phosphatase was reduced by almost 50by aqueous and ethanolic extracts (both 400mgKg orally for7 days) whereas the increase in ALT and AST was decreasedby more than 70 and serum LDH level was restored Theincrease in TBARS was also neutralized by aqueous andethanolic extracts [47] Venkatalakshmi et al accounted forprotection against paracetamol induced hepatotoxicity forBD extracts (Venkatalakshmi 2011) [48]

Liver is a vital organ of the body and is the first lineof defence against xenobiotics That is why it is targetedby harmful and toxic effects of chemicals It prepares thebody for any onslaught A good health depends on thehealth of liver Jaundice is a disease for which BD has beenconstantly used either in traditional system of medicine orin ethnopharmacological reports To prove the efficacy of

BD in hepatic disorders and against various hepatotoxinsseveral workers have evaluated its hepatoprotective potentialagainst different types of toxins In each and every study thehepatoprotection provided by BD is proved

58 Antimicrobial Activity

581 Antibacterial Activity In vitro studies the aqueousand ethanolic extracts of BD (whole plant) were foundactive against Streptococcus group (10ndash19mm) Neisseriagonorrhoeae (ethanolic and water ex 5ndash9mm) Salmonellatyphimurium (ethanolic and water ex more than 20mm)Shigella dysenteriae (ethanolic and water ex more than20mm) Corynebacterium diphtheriae (water ex more than20mm) and Clostridium tetani (ethanolic ex 10ndash19mm)[49] It was observed that ethanolic and aqueous extractspossess antibacterial activity against Bacillus subtilis andEscherichia coli The minimum inhibitory concentration ofethanolic extract was found to be 125 and 250 120583gmL forB subtilis and E coli while the aqueous extract showed250120583gmL for B subtilis and E coli respectively [50]

Umamaheswari and coworkers studied the effect of var-ious extracts prepared from BD roots against Gram-positive(Staphylococcus Bacillus Streptococcus andMicrococcus) andGram-negative (E coli Pseudomonas Salmonella KlebsiellaProteus Serratia and Shigella) bacterial strains by observingthe zone of inhibition The ethanol extract of BD leavesdemonstrated highest activity [51]

Kant and coworkers established the effectiveness of BDas an adjuvant to chemotherapy in clinical trials conductedon 50 patients newly diagnosedwith pulmonary tuberculosisThe clinical recovery rate was faster in BD treated group thanin the control At the end of the 4-week follow-up 80 ofthe patients were relieved of cough compared to only 52 inthe control group Similarly 88 of the patients in the treatedgroup were afebrile in 4 weeks compared to 60 of controlFever relief was observed in 6weeks in comparison to 8weeksin the control groups respectively The mean weight gain inthe treated group was higher than that in the control groupThe rate of sputum conversion was significantly faster in thetreated group than in the control group [52]

The rationale for studying the effects on selectedmicroor-ganisms lies in their potential for causing human diseasesHuman pathogenic bacteria cause different types of diseaseswith varying degree of morbidity and mortality for exampleKlebsiella infections have a high mortality rate of approxi-mately 50 even with antimicrobial therapy The diseases ofskin itching or eczema conjunctivitis diarhoea dysenteryand urinary troubles are caused by the microorganisms

582 Antifungal Activity In vitro studies Agrawal andcoworkers evaluated the antifungal activity of ethyl acetateextract of the roots of BD and have shown mycelial growthinhibition for Microsporum gypseum (7883) M fulvum(6233) and M canis (4230) in that order at 1mgmLThe increase in concentration of extract also inhibitedsporulation [53]

Microsporum gypseum have been documented as a causeof dermatophytosis which can be characterized by redness


of the skin small papular vesicles fissures and scaling For-mulations containing BD (punarnavadyarishta punarnavadimandura) have been used for such indications

59 Antioxidant Activity In vitro studies Gacche and Dholestudied the antioxidant and possible anti-inflammatorypotentials by evaluating DPPH radical scavenging activityOH radical scavenging activity vitamin C content and totalpolyphenols 50 ethanolic extract of BDwhole plant showed021mgmL IC

50for DPPH scavenging vitamin C content of

2296mg100 g and 425mgg polyphenols [54]Priyadarsini and coworkers have shown dose-dependent

radical quenching and reducing power of BD extract againstBHAThe IC

50of BD extract (4995 gmL)was lower than that

of BHA (5327 120583gmL) in radical scavenging The extract hasalso shown remarkable rise of reducing power as indicatedby higher absorbance Ethanolic extracts of BD also showedpotential cytotoxic activity (50 120583gmL) against the Vero celllines [55]

Rachh and coworkers evaluated ethanolic andmethanolicextracts of the dried root powder for antioxidant activityThe extract showed good in vitro antioxidant activities interms of ferric reduction and hydrogen peroxide quenchingin comparison to ascorbic acid [56]

In vivo studies Satheesh and coworkers demonstrated theantioxidant potential of BD leaf extract in alloxan induceddiabetic rats and reported reduction in TBARS and hydroper-oxides and considerable enhancement in various enzymesand reduced markers [27]

In vivo activity Vineetha et al reported the cardiopro-tective action of BD ethanolic extract against ATO-inducedtoxicity on various cell organelles in H9c2 cardiomyocytesThe animals demonstrated decreased levels of lactate dehy-drogenase oxidative stress and calcium influx [57]

Free radicals contain at least one unpaired electron andcan exist independently despite of being highly reactive Freeradicals containing oxygen are also called reactive oxygenspecies (ROS) and have two unpaired electrons When thefree radicals react with a surrounding entity they generate anew free radical initiating a chain reaction Inside the phys-iological system free radicals are controlled by antioxidantenzymes (superoxide dismutase catalase and glutathioneperoxidase)

Tumor formation (initiation and promotion) is linkedwith chromosomal defects and regulation of oncogenes andtumor suppressor genes It might be probable that endoge-nous free radicals reactions may cause tumor formation asthe case with ionizing radiation

There is significant connection between fats and oilsconsumption and death rates from leukaemia and malignantneoplasiawhichmay be due to greater lipid peroxidation [58]Several studies indicated the role of free radical reactionsin arterial wall and serum for diet-derived lipids causingendothelial cell injury [59] Other diseases having a cor-relation with oxidative strain are Parkinsonrsquos disease heartfailure myocardial infarction Alzheimerrsquos disease and agerelated symptoms

BD has been ascribed with various activities whichimplies the antioxidant activity The prominent examples are

anticancer hepatoprotective immunosuppressive andantidiabetic activities Moreover it has been characterizedas rasayana herb in Ayurveda All these facts substantiateits use as a rejuvenator and also approve its Sanskrit nameldquopunarnavardquo which means rejuvenated

510 Spasmolytic Activity In vivo studies Borrelli andcoworkers have shown spasmolytic effect of methanolic rootextract on exogenous (ie acetylcholine histamine andbarium chloride) as well as electrically stimulated contrac-tions in the isolated ileum The IC

50were 182 120583gmL (elec-

tric field stimulated) 160 120583gmL (acetylcholine-induced)158120583gmL (histamine-induced) and 168 120583gmL (bariumchloride-induced) The authors concluded that the spas-molytic activity might involve extracellular calcium whereasintracellular calcium provides negative modulation forintestinal motility The authors established that boeravinoneE is the most potent spasmolytic compound present in theextract and that nonprenylated rotenoids are the spasmolyticagents in BD root extracts [60]

Involuntary muscle spasm is the symptom of variousmuscle disorders Common examples include colic tremorsneck rigiditytorticollis pain in female genital tract threat-ened miscarriages palsyglossal palsy and paraplegia Anti-spasmodicsspasmolytics offer a symptomatic relief in suchconditionsThe above study demonstrates the effectiveness ofBD in spasms caused by different spasmogens and substanti-ates the use of BD in the above conditions

511 Antiasthmatic Activity Ex vivo activity Irie-NrsquoGuessanet al documented tracheal relaxation effect against carbachol(1 120583M) induced trachea contraction [61]

512 Anticonvulsant Activity In vivo activity Goel andcoworkers have shown anticonvulsant activity in pentylenete-trazol (PTZ) induced seizures in mice and concluded thatthe calcium antagonist activity is responsible for this sincethe activity was maintained only by liodendrin-rich fractionadditionally established by anticonvulsant activity in BAY k-8644-induced seizures [62]

6 Drug Interactions

BD extracts have several documented activities To namea few there are diuretic vasodilatory immunomodulatoryACE inhibitory and anticonvulsant activities So it can bedevised that the products containing BD as main ingredientcan have potential for interaction with medications havingsimilar or opposing activities It is of therapeutic consid-eration that diuresis vasodilation and ACE inhibition areroutinely used in cardiac complications and hypertensivecrisis and in such cases a delicate balance has to bemaintainedfor patients survival So it could be advised that the personswith the above kind of cardiac complications should takethe formulations containing BD under medical supervisionBD extracts have shown an anticonvulsant activity so itcan potentiate the actions of anxiolytics especially benzodi-azepines and barbiturates


In another study quercetin has shown alteration inthe bioavailability of tamoxifen upon coadministration Theabsolute bioavailability of tamoxifen has been increased from20 to 60 when administered with 25 and 75mgkgquercetin [63] Quercetin (10mgkg) also increased thebioavailability of simvastatin in pigs when given as a pre-treatment by means of increased expression of CYP3A4the main enzyme responsible for metabolism of simvastatin[64] Ferreres and coworkers determined the concentration ofquercetin in leaves to be up to 150mgKg on dry weight basis[65] So the formulation containing whole plant or aerial partof BD should be taken with precautions

7 Conclusions

BD is a plant of repute in traditional as well as ethnob-otanical systems of medicine in various parts of world Itcontains diverse chemical compounds which have showntherapeutic activities for example diuresis anticancer anti-inflammation hepatoprotection and immunomodulationHowever it still has not been able to claim its positionin herbal market In the current scenario of plant basedmedicinal products BD can prove to be an effective andaffordable commodity for hepatoprotection diuresis andimmunomodulation It is also a source of structurally novelrotenoid compounds which can show possibilities to designnovel semisynthetic compounds for newer indications

Conflict of Interests

The authors declare that they have no conflict of interests

References

[1] R Govindarajan M Vijayakumar and P PushpangadanldquoAntioxidant approach to disease management and the role ofrsquoRasayanarsquo herbs of Ayurvedardquo Journal of Ethnopharmacologyvol 99 no 2 pp 165ndash178 2005

[2] J Miralles K Noba A T Ba E M Gaydou and J-M Korn-probst ldquoChemotaxonomy in Nyctagynaceae family sterolsand fatty acids from the leaves of three Boerhaavia speciesrdquoBiochemical Systematics and Ecology vol 16 no 5 pp 475ndash4781988

[3] COUjowundu CU Igwe VHA Enemor L ANwaoguandand O E Okafor ldquoNutritive and anti-nutritive properties ofBoerhavia diffusa and Commelina nudiflora leavesrdquo PakistanJournal of Nutrition vol 7 no 1 pp 90ndash92 2008

[4] K Bairwa A Srivastava and S M Jachak ldquoQuantitativeanalysis of Boeravinones in the roots of Boerhaavia diffusa byUPLCPDArdquo Phytochemical Analysis 2014

[5] M Gutman T P Singer and J E Casida ldquoStudies on therespiratory chain-linked reduced nicotinamide adenine dinu-cleotide dehydrogenase XVII Reaction sites of piericidinA androtenonerdquo Journal of Biological Chemistry vol 245 no 8 pp1992ndash1997 1970

[6] L Crombie J L Josephs J Cayley J Larkin and J BWeston ldquoThe rotenoid core structure modifications to definethe requirements of the toxophorerdquo Bioorganic and MedicinalChemistry Letters vol 2 no 1 pp 13ndash16 1992

[7] A Ahmed-Belkacem S Macalou F Borrelli et al ldquoNonpreny-lated rotenoids a new class of potent breast cancer resistanceprotein inhibitorsrdquo Journal of Medicinal Chemistry vol 50 no8 pp 1933ndash1938 2007

[8] Herbs amp Herbal Products The Indian Pharmacopoeia Commis-sion Ghaziabad India 2007

[9] A A Mungantiwar A M Nair K K Kamal and M NSaraf ldquoAdaptogenic activity of aqueous extract of the roots ofBoerhaavia diffusa linnrdquo Indian Drugs vol 34 no 4 pp 184ndash189 1997

[10] A A Muntgantiwar A M Nair U A Shinde and M NSaraf ldquoEffect of stress on plasma and adrenal cortisol levelsand immune responsiveness in rats modulation by alkaloidalfraction of Boerhaavia diffusardquo Fitoterapia vol 68 no 6 pp498ndash500 1997

[11] M Sumanth and S S Mustafa ldquoAntistress adoptogenic andimmunopotentiating activity roots of Boerhaavia diffusa inmicerdquo International Journal of Pharmacology vol 3 no 5 pp416ndash420 2007

[12] A A Mungantiwar A M Nair U A Shinde et al ldquoStudies onthe immunomodulatory effects of Boerhaavia diffusa alkaloidalfractionrdquo Journal of Ethnopharmacology vol 65 no 2 pp 125ndash131 1999

[13] S Mehrotra K P Mishra R Maurya R C Srimal and V KSingh ldquoImmunomodulation by ethanolic extract of Boerhaaviadiffusa rootsrdquo International Immunopharmacology vol 2 no 7pp 987ndash996 2002

[14] R Pandey R Maurya G Singh B Sathiamoorthy and S NaikldquoImmunosuppressive properties of flavonoids isolated fromBoerhaavia diffusa Linnrdquo International Immunopharmacologyvol 5 no 3 pp 541ndash553 2005

[15] J Li H Li S Kadota T Namba T Miyahara and U G KhanldquoEffects on cultured neonatal mouse calvaria of the flavonoidsisolated from Boerhaavia repensrdquo Journal of Natural Productsvol 59 no 11 pp 1015ndash1018 1996

[16] M de Martinis M C di Benedetto L P Mengoli andL Ginaldi ldquoSenile osteoporosis Is it an immune-mediateddiseaserdquo Inflammation Research vol 55 no 10 pp 399ndash4042006

[17] R Srivastava D Saluja and M Chopra ldquoIsolation and screen-ing of anticancer metabolites from Boerhavia diffusardquo IndianJournal of Medical Research vol 151 supplement 1 p S19 2005

[18] S Mehrotra V K Singh S S Agarwal R Maurya and R CSrimal ldquoAntilymphoproliferative activity of ethanolic extract ofBoerhaavia diffusa rootsrdquo Experimental and Molecular Pathol-ogy vol 72 no 3 pp 236ndash242 2002

[19] M Chopra R Srivastava D Saluja and B S DwarakanathldquoInhibition of human cervical cancer cell growth by ethanolicextract of Boerhaavia diffusa Linn (punarnava) rootrdquo Evidence-based Complementary and Alternative Medicine vol 2011 Arti-cle ID 427031 13 pages 2011

[20] S Sreeja and S Sreeja ldquoAn in vitro study on antiproliferative andantiestrogenic effects of Boerhaavia diffusa L extractsrdquo Journalof Ethnopharmacology vol 126 no 2 pp 221ndash225 2009

[21] P V Leyon C C Lini and G Kuttan ldquoInhibitory effectof Boerhaavia diffusa on experimental metastasis by B16F10melanoma in C57BL6 micerdquo Life Sciences vol 76 no 12 pp1339ndash1349 2005


[22] K A Manu and G Kuttan ldquoEffect of punarnavine an alkaloidfrom Boerhaavia diffusa on cell-mediated immune responsesand TIMP-1 in B16F-10 metastatic melanoma-bearing micerdquoImmunopharmacology and Immunotoxicology vol 29 no 3-4pp 569ndash586 2007

[23] K A Manu and G Kuttan ldquoAnti-metastatic potential of Punar-navine an alkaloid from Boerhaavia diffusa Linnrdquo Immunobi-ology vol 214 no 4 pp 245ndash255 2009

[24] K A Manu P V Leyon and G Kuttan ldquoStudies on the protec-tive effects of Boerhaavia diffusa L against gamma radiation-induced damage in micerdquo Integrative Cancer Therapies vol 6no 4 pp 381ndash388 2007

[25] M A Chude O E Orisakwe O J Afonne K S GamanielO H Vongtau and E Obi ldquoHypoglycaemic effect of theaqueous extract of Boerhavia diffusa leavesrdquo Indian Journal ofPharmacology vol 33 no 3 pp 215ndash216 2001

[26] L Pari and M Amarnath Satheesh ldquoAntidiabetic effect of Boer-havia diffusa effect on serum and tissue lipids in experimentaldiabetesrdquo Journal of Medicinal Food vol 7 no 4 pp 472ndash4762004

[27] M A Satheesh and L Pari ldquoAntioxidant effect of Boerhaviadiffusa L in tissues of alloxan induced diabetic ratsrdquo IndianJournal of Experimental Biology vol 42 no 10 pp 989ndash9922004

[28] K N Rao K M Boini and R Srinivas ldquoEffect of chronicadministration of BD L leaf extract on experimental diabetesin ratsrdquo Tropical Journal of Pharmaceutical Research vol 3 pp305ndash309 2004

[29] R Gulati S Agarwal and S S Agarwal ldquoHepatoprotectiveactivity of Boerhaavia diffusa linn against country made liquorinduced hepatotoxicity in albino rats fed on controlled caloriedietrdquo Indian Journal of Pharmacology vol 23 pp 264ndash267 1991

[30] K Srivastava G N Srivastava N S Rizvi and P K DasguptaldquoEffect of Boerhaavia diffusa on IUD-induced bleeding inrhesusmonkeysrdquoContraceptive Delivery Systems vol 2 pp 157ndash161 1981

[31] K Srivastava and P K Dasgupta ldquoNAD-dependent-15-hydroxy-prostagtandin dehydrogenase activity in theendometrium of IUD- and Boerhaavia diffusa Linntreatedfemale rhesus monkeysrdquo Malaysian Journal of ReproductiveHealth vol 4 pp 1ndash5 1986

[32] M Barthwal P K Dasgupta and K Srivastava ldquoVascular andtissue plasminogen activator activity in IUD-fitted female rhe-sus monkeys (Macaca mulatta)rdquo Singapore Journal of Obstetricsamp Gynecology vol 19 pp 94ndash97 1988

[33] M Barthwal and K Srivastava ldquoHistologic studies onendometrium of menstruating monkeys wearing IUDscomparative evaluation of drugsrdquo Advances in Contraceptionvol 6 no 2 pp 113ndash124 1990

[34] M Barthwal and K Srivastava ldquoMangement of IUD-associatedmenorrhagia in female rhesus monkeys (Macaca mulatta)rdquoAdvances in Contraception vol 7 no 1 pp 67ndash76 1991

[35] V Mudgal ldquoStudies on medicinal properties of Convolvuluspluricaulis and Boerhaavia diffusardquo Planta Medica vol 28 no1 pp 62ndash68 1975

[36] C A Hiruma-Lima J S Gracioso E J B Bighetti L Ger-monsen Robineou and A R M Souza Brito ldquoThe juice offresh leaves of Boerhaavia diffusa L (Nyctaginaceae) markedly

reduces pain inmicerdquo Journal of Ethnopharmacology vol 71 no1-2 pp 267ndash274 2000

[37] S Asadulla ldquoAnti-inflammatory activities of Boerhavia diffusaroots in Albino ratsrdquo Archive of Pharmaceutical Science ampResearch vol 2 pp 267ndash270 2010

[38] C K Chauhan M J Joshi and A D B Vaidya ldquoGrowthinhibition of struvite crystals in the presence of herbal extractBoerhaavia diffusa Linnrdquo The American Journal of InfectiousDiseases vol 5 no 3 pp 177ndash186 2009

[39] A Singh R H Singh R G Singh et al ldquoEffects of Boerhaaviadiffusa Linn (Punarnava) in experimental acute pyelonephritisin albino ratsrdquo Indian Drugs vol 26 pp 10ndash13 1988

[40] A K Wahi V K Aggarwal and R C Gupta ldquoPhytochemicalamp pharmacological studies on Boerhavia diffusa Linn (Pubar-nava) alkaloidsrdquo National Academy of Science Letters vol 201997

[41] K Sathyapriya V Vijayachandrika and C S ParameswarildquoAntioxidant status in polycystic end-staged renal diseasedpatients and antihemolytic effect of Boerhaavia diffusardquo IndianJournal of Biochemistry and Biophysics vol 46 no 3 pp 269ndash272 2009

[42] S K Pareta K C Patra P M Mazumder and D SasmalldquoBoerhavia diffusa linn aqueous extract as curative agent inethylene glycol induced urolithiasisrdquo Pharmacologyonline vol3 pp 112ndash120 2010

[43] F Yasir and M A Waqar ldquoEffect of indigenous plant extractson calcium oxalate crystallization having a role in urolithiasisrdquoUrology Research vol 39 pp 345ndash350 2011

[44] B K Chandan A K Sharma and K K Anand ldquoBoerhaaviadiffusa a study of its hepatoprotective activityrdquo Journal ofEthnopharmacology vol 31 no 3 pp 299ndash307 1991

[45] A K S Rawat S Mehrotra S C Tripathi and U ShomeldquoHepatoprotective activity of Boerhaavia diffusa L rootsmdashapopular Indian ethnomedicinerdquo Journal of Ethnopharmacologyvol 56 no 1 pp 61ndash66 1997

[46] T Devaki K S Shivashangari V Ravikumar and P Govin-daraju ldquoEffect of Boerhaavia diffusa on tissue anti-oxidantdefense system during ethanol-induced hepatotoxicity in ratsrdquoJournal of Natural Remedies vol 5 no 2 pp 102ndash107 2005

[47] M T Olaleye A C Akinmoladun A A Ogunboye and AA Akindahunsi ldquoAntioxidant activity and hepatoprotectiveproperty of leaf extracts of Boerhaavia diffusa Linn againstacetaminophen-induced liver damage in ratsrdquo Food and Chem-ical Toxicology vol 48 no 8-9 pp 2200ndash2205 2010

[48] P Venkatalakshmi V D Eazhisai and S Netaji ldquoHepatoprotec-tive Activity of Boerhavia diffusa against paracetamol inducedtoxicity in ratsrdquo Journal of Chemical amp Pharmaceutical Researchvol 3 pp 229ndash232 2011

[49] D K Olukoya N Idika and T Odugbemi ldquoAntibacterialactivity of some medicinal plants from Nigeriardquo Journal ofEthnopharmacology vol 39 no 1 pp 69ndash72 1993

[50] B Sangameswaran N Balakrishnan V H Bhaskar and BJayakar ldquoAnti-inflammatory and anti-bacterial activity of leavesofBoerhavia diffusa Lrdquo PharmacognosyMagazine pp S65ndashS682008

[51] A Umamaheswari A Nuni and R Shreevidya ldquoEvaluation ofantibacterial activity of boerhaavia diffusa L leavesrdquo Interna-tional Journal of Green Pharmacy vol 4 no 2 pp 75ndash78 2010


[52] S Kant M S Agnihotri and K S Dixit ldquoClinical evaluation ofBoerhaavia diffusa as an adjuvant in the treatment of pulmonarytuberculosisrdquo Phytomedica vol 2 no 1-2 pp 89ndash94 2001

[53] A Agrawal S Srivastava and M M Srivastava ldquoAntifun-gal activity of Boerhavia diffusa against some dermatophyticspecies of Microsporumrdquo Hindustan Antibiotics Bulletin vol45-46 no 1ndash4 pp 1ndash4 2003

[54] R N Gacche and N A Dhole ldquoAntioxidant and possible anti-inflammatory potential of selected medicinal plants prescribedin the Indian traditional system of medicinerdquo PharmaceuticalBiology vol 44 no 5 pp 389ndash395 2006

[55] T D Priyadarsini J M Sasikumar and M Kulandhaivel ldquoInvitro antioxidant and cytotoxic analysis of Boerhavia diffusa LrdquoEthnobotanical Leaflets vol 13 pp 263ndash268 2009

[56] P R Rachh M R Rachh D C Modi et al ldquoIn-vitro evaluationof antioxidant activity of punarnava (Boerhavia diffusa L)rdquoInternational Journal of Pharmaceutical Research vol 1 pp 36ndash40 2009

[57] V P Vineetha A Prathapan R S Soumya and K G RaghuldquoArsenic trioxide toxicity in H9c2 myoblastsmdashdamage to cellorganelles and possible amelioration with Boerhavia diffusardquoCardiovascular Toxicology vol 13 pp 123ndash137 2013

[58] A J Lea ldquoDietary factors associated with death-rates fromcertain neoplasms inmanrdquoThe Lancet vol 2 no 7458 pp 332ndash333 1966

[59] D Harman ldquoRole of free radicals in aging and diseaserdquo Annalsof the New York Academy of Sciences vol 673 pp 126ndash141 1992

[60] F Borrelli V Ascione R Capasso A A Izzo E Fattorusso andO Taglialatela-Scafati ldquoSpasmolytic effects of nonprenylatedrotenoid constituents of Boerhaavia diffusa rootsrdquo Journal ofNatural Products vol 69 no 6 pp 903ndash906 2006

[61] G Irie-NrsquoGuessan P Champy G Kouakou-Siransy A Koffi BJ Kablan and V Leblais ldquoTracheal relaxation of five Ivoriananti-asthmatic plants role of epithelium and K+ channels in theeffect of the aqueous-alcoholic extract of Dichrostachys cinerearoot barkrdquo Journal of Ethnopharmacology vol 138 no 2 pp432ndash438 2011

[62] R K Goel and M Kaur ldquoAnti-convulsant activity of boer-haavia diffusa plausible role of calcium channel antagonismrdquoEvidence-based Complementary and Alternative Medicine vol2011 Article ID 310420 7 pages 2011

[63] S C Shin J S Choi and X Li ldquoEnhanced bioavailability oftamoxifen after oral administration of tamoxifen with quercetinin ratsrdquo International Journal of Pharmaceutics vol 313 no 1-2pp 144ndash149 2006

[64] R Cermak S Wein S Wolffram and P Langguth ldquoEffects ofthe flavonol quercetin on the bioavailability of simvastatin inpigsrdquo European Journal of Pharmaceutical Sciences vol 38 no5 pp 519ndash524 2009

[65] F Ferreres C Sousa M Justin et al ldquoCharacterisation ofthe phenolic profile of Boerhaavia diffusa L by HPLC-PAD-MSMS as a tool for quality controlrdquo Phytochemical Analysisvol 16 no 6 pp 451ndash458 2005

[66] G K Jain and N M Khanna ldquoPunarnavoside a new antifibri-nolytic agent from Boerhaavia diffusa Linnrdquo Indian Journal ofChemistry B vol 28 no 2 pp 163ndash166 1989

[67] D R Gupta and B Ahmed ldquoA new C -methyl flavone fromBoerhavia diffusa Linn rootsrdquo Indian Journal of Chemistry Bvol 23 pp 682ndash684 1984

[68] F Borrelli NMilic V Ascione et al ldquoIsolation of new rotenoidsfrom Boerhaavia diffusa and evaluation of their effect onintestinal motilityrdquo Planta Medica vol 71 no 10 pp 928ndash9322005

[69] S Kadota N Lami Y Tezuka and T Kikuchi ldquoStructure ofA new rotenoid from Boerhavia diffusa A Nepalese MedicinalPlantrdquo Journal of Pharmaceutical Sciences vol 76 p S201 1987

[70] S Kadota N Lami Y Tezuka and T Kikuchi ldquoBoeravinone Aand B new rotenoid analogues from Boerhavia diffusa LinnrdquoChemical and Pharmaceutical Bulletin vol 36 no 6 pp 834ndash836 1988

[71] S Kadota N Lami Y Tezuka and T Kikuchi ldquoStructureand NMR spectra of boeravinone C a new rotenoid analoguefrom Boerhaavia diffusa Linnrdquo Chemical and PharmaceuticalBulletin vol 36 no 6 pp 2289ndash2292 1988

[72] S Kadota N Lami Y Tezuka and T Kikuchi ldquoConstituents ofthe roots of Boerhaavia diffusa L I Examination of sterols andstructures of new rotenoids boeravinones A and Brdquo Chemicaland Pharmaceutical Bulletin vol 37 no 12 pp 3214ndash3220 1989

[73] N Lami S Kadota and T Kikuchi ldquoConstituents of the roots ofBoerhaavia diffusa L IV Isolation and structure determinationof boeravinones D E and Frdquo Chemical and PharmaceuticalBulletin vol 39 no 7 pp 1863ndash1865 1991

[74] N Lami S Kadota Y Tezuka and T Kikuchi ldquoConstituentsof the roots of Boerhaavia diffusa L II Structure and stereo-chemistry of a new rotenoid boeravinone C2rdquo Chemical andPharmaceutical Bulletin vol 38 no 6 pp 1558ndash1562 1990

[75] J Gupta andMAli ldquoChemical constituents ofBoerhavia diffusaLinn rootsrdquo Indian Journal of Chemistry B vol 37 no 9 pp912ndash917 1998

[76] K Bairwa I N Singh S K Roy J Grover A Srivastava andS M Jachak ldquoRotenoids from Boerhaavia diffusa as potentialAnti-inflammatory agentsrdquo Journal of Natural Products vol 76pp 1393ndash1398 2013

[77] B Ahmed and C P Yu ldquoBoerhavine a dihydroisofuroxanthonefrom Boerhavia diffusardquo Chemical amp Pharmaceutical Bulletinvol 31 pp 4382ndash4384 1992

[78] N Lami S Kadota T Kikuchi and Y Momose ldquoConstituentsof the roots of Boerhaavia diffusa L III Identification of Ca2+channel antagonistic compound from the methanol extractrdquoChemical and Pharmaceutical Bulletin vol 39 no 6 pp 1551ndash1555 1991

[79] J A O Ojewole and S K Adesina ldquoIsolation identification andsome cardiovascular actions of a purine nucleoside from theroots of Boerhaavia diffusardquo Fitoterapia vol 56 no 1 pp 31ndash36 1985

[80] O P Suri R Kant and R S Jamwal ldquoBoerhaavia diffusa a newsource of phytoecdysonesrdquo Planta Medica vol 44 no 3 pp180ndash181 1982

[81] M Bathori and Z Pongracz ldquoPhytoecdysteroidsmdashfrom isola-tion to their effects on humansrdquo Current Medicinal Chemistryvol 12 no 2 pp 153ndash172 2005

[82] S Sekar ldquoTraditional alcoholic beverages from Ayurveda andtheir role on human healthrdquo Indian Journal of TraditionalKnowledge vol 6 pp 144ndash149 2007

[83] V A Khan and A A Khan ldquoHerbal folklore for male sexualdisorders and debilities in western Uttar pradeshrdquo IndianJournal of Traditional Knowledge vol 4 pp 317ndash324 2005


[84] R K Singh and A Singh ldquoWomenrsquos wisdom amp indigenoushuman healthcare practicesrdquo Indian Journal of TraditionalKnowledge vol 8 pp 262ndash269 2009

[85] P Parveen BUpadhyay S Roy andAKumar ldquoTraditional usesof medicinal plants among the rural communities of Churu dis-trict in the Thar Desert Indiardquo Journal of Ethnopharmacologyvol 113 no 3 pp 387ndash399 2007

[86] N Z Sayed R Deo and U Mukundan ldquoHerbal remedies usedby Warlis of Dahanu to induce lactation in nursing mothersrdquoIndian Journal of Traditional Knowledge vol 6 pp 602ndash6052007

[87] S K Tayade and D K Patil ldquoEthnomedicinal wisdom oftribals of Nandurbar districts maharashtrardquo Natural ProductRadiance vol 5 pp 64ndash69 2006

[88] V P Bhatt and G C S Negi ldquoEthnomedicinal plant resourcesof Jaunsari tribe of Garhwal Himalaya Uttaranchalrdquo IndianJournal of Traditional Knowledge vol 5 pp 331ndash335 2006

[89] S K Mahajan ldquoTraditional herbal remedies among the tribesof Bijagarh of West Nimar district Madhya Pradeshrdquo IndianJournal of Traditional Knowledge vol 6 pp 375ndash377 2007

[90] A N Shukla S Srinivastan and A K S Rawat ldquoAn ethnob-otanical study of medicinal plants of Rewa district MadhyaPradeshrdquo Indian Journal of Traditional Knowledge vol 9 no 1pp 191ndash202 2010

[91] A K Pandey and P K Shukla ldquoRole of medicinal plants inhealth care and rural economy in the tribals of Satpura Plateauregion of Central India Indian Foresterrdquo vol 134 pp 1438ndash14462008

[92] V Silja K S Verma and K V Mohanan ldquoEthnomedicinalplant knowledge of the mullu kuruma tribe of wayanad districtkeralardquo Indian Journal of Traditional Knowledge vol 7 pp 604ndash612 2008

[93] S Jeeva S Kiruba B P Mishra et al ldquoWeeds of kanyakumaridistrict amp their value in rural liferdquo Indian Journal of TraditionalKnowledge vol 5 pp 501ndash509 2006

[94] T Thirumalai E K Elumalai S V Therasa B Senthilkumarand E David ldquoEthnobotanical Survey of Folklore Plants forthe Treatment of Jaundice and Snakebites in Vellore Districts ofTamilnadu Indiardquo Ethnobotanical Leaflets vol 14 pp 529ndash5362010

[95] S Das M L Khan A Rabha and D K BhattacharyaldquoEthnomedicinal plants ofManasNational Park Assamrdquo IndianJournal of Traditional Knowledge vol 8 pp 514ndash517 2009

[96] J Purkayastha M Dutta and S C Nath ldquoEthnomedicinalplants from Dibru-Saikhowa biosphere reserve Assamrdquo IndianJournal of Traditional Knowledge vol 6 pp 477ndash480 2007

[97] V Jaiswal ldquoCulture and ethnobotany of Jaintia tribal commu-nity of Meghalaya Northeast India - a mini reviewrdquo IndianJournal of Traditional Knowledge vol 9 no 1 pp 38ndash44 2010

[98] C N Prachi D Kumar and M S Kasana ldquoMedicinal plants ofMuzaffarnagar district used in treatment of urinary tract andkidney stonesrdquo Indian Journal of Traditional Knowledge vol 8pp 191ndash195 2009

[99] B L Punjani ldquoHerbal folk medicines used for urinary com-plaints in tribal pockets of northeast Gujaratrdquo Indian Journal ofTraditional Knowledge vol 9 no 1 pp 126ndash130 2010

[100] E Soudahmini P S Kumar M S Ganesh V S Brindha LPanayappan and M C Divakar ldquoHerbal remedies of Madugga

tribes of Siruvani forest South IndiardquoNatural Product Radiance vol 4 pp 492ndash499 2005

[101] N Shiddamallayya A Yasmeen and K Gopakumar ldquoHundredcommon forest medicinal plants of Karnataka in primaryhealthcarerdquo Indian Journal of Traditional Knowledge vol 9 no1 pp 90ndash95 2010

[102] B Uniyal and V Shiva ldquoTraditional knowledge on medicinalplants among rural women of the Garhwal Himalaya Uttaran-chalrdquo Indian Journal of Traditional Knowledge vol 4 pp 259ndash266 2005

[103] C Kadel and A K Jain ldquoFolklore claims on snakebite amongsome tribal communities of Central Indiardquo Indian Journal ofTraditional Knowledge vol 7 pp 296ndash299 2008

[104] M Senthilkumar P Gurumoorthi and K Janardhanan ldquoSomemedicinal plants used by Irular the tribal people of Marud-hamalai hills Coimbatore Tamil Nadurdquo Natural Product Radi-ance vol 5 pp 382ndash388 2006

[105] N S Chandra ldquoassessment of export potential of medicinalplants and its derivative from chhatisgarh amp its policy implica-tionrdquo In Chhattisgarh StateMedicinal Plants Board (CGSMPB)Raipur India pp 44ndash47

[106] G G Patil P Y Mali and V V Bhadane ldquoFolk remedies usedagainst respiratory disorders in Jalgaon district MaharashtardquoNatural Product Radiance vol 7 no 4 pp 354ndash358 2008

[107] S K Behera A Panda S K Behera and M K MisraldquoMedicinal plants used by the Kandhas of Kandhamal districtof Orissardquo Indian Journal of Traditional Knowledge vol 5 pp519ndash528 2006

[108] N Savithramma C Sulochana and K N Rao ldquoEthnobotanicalsurvey of plants used to treat asthma in Andhra Pradesh IndiardquoJournal of Ethnopharmacology vol 113 no 1 pp 54ndash61 2007

[109] A Jain S S Katewa P Galav and A Nag ldquoSome therapeuticuses of biodiversity among tribals of Rajsthanrdquo Indian Journalof Traditional Knowledge vol 7 pp 256ndash262 2008

[110] R Sharma and H K Sharma ldquoEthnomedicines of SonapurKamrup district Assamrdquo Indian Journal of Traditional Knowl-edge vol 9 no 1 pp 163ndash165 2010

[111] K Yasodharan and K A Sujana ldquoEthnomedicinal knowledgeamongmalamalasar tribe of Parambikulumwild life SanctuaryrdquoKerala Indian Journal of Traditional Knowledge vol 6 pp 481ndash485 2007

[112] S Ganesan G Venkateshan and N Banumathy ldquoMedicinalplants used by ethnic group Thottianaickans of Semmalai hills(reserved forest) Tiruchirappalli district Tamil Nadurdquo IndianJournal of Traditional Knowledge vol 5 pp 245ndash252 2006

[113] M K R Narayanan and N A Kumar ldquoGendered knowledgeand changing trends in utilization of wild edible greens inWestern Ghats Indiardquo Indian Journal of Traditional Knowledgevol 6 pp 204ndash216 2007

[114] P P Kumar M Ayyanar and S Ignacimuthu ldquoMedicinal plantsused by Malasar tribes of Coimbatore district Tamil NadurdquoIndian Journal of Traditional Knowledge vol 6 pp 579ndash5822007

[115] P Singh B K Singh G C Joshi and L M Tewari ldquoVeterinaryEthno-Medicinal Plants in Uttarakhand Himalayan RegionrdquoNature amp Science vol 7 pp 44ndash52 2009

[116] L R S Gazzaneo R F Paiva de Lucena and U P deAlbuquerque ldquoKnowledge and use of medicinal plants by


local specialists in an region of Atlantic Forest in the stateof Pernambuco (Northeastern Brazil)rdquo Journal of Ethnobiologyand Ethnomedicine vol 1 article 9 2005

[117] F I Akaneme ldquoIdentification and preliminary phytochemicalanalysis of herbs that can arrest threatened miscarriage inOrba and Nsukka towns of Enugu Staterdquo African Journal ofBiotechnology vol 7 no 1 pp 6ndash11 2008

[118] M Muzila Boerhavia Diffusa L The Haworth Press Wagenin-gen The Netherlands 2006

[119] M Hamayun A Khan S Afzal and M A Khan ldquoStudyon traditional knowledge and utility of medicinal herbs ofdistrict Buner NWFP Pakistanrdquo Indian Journal of TraditionalKnowledge vol 5 pp 407ndash412 2006

[120] A Biswas M A Bari M Roy and S K Bhadra ldquoInherited folkpharmaceutical knowledge of tribal people in the Chittagonghill tracts Bangladeshrdquo Indian Journal of Traditional Knowledgevol 9 no 1 pp 77ndash89 2010

Submit your manuscripts athttpwwwhindawicom

PainResearch and TreatmentHindawi Publishing Corporationhttpwwwhindawicom Volume 2014

The Scientific World JournalHindawi Publishing Corporation httpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom

Volume 2014

ToxinsJournal of

VaccinesJournal of

Hindawi Publishing Corporation httpwwwhindawicom Volume 2014

Hindawi Publishing Corporationhttpwwwhindawicom Volume 2014

AntibioticsInternational Journal of

ToxicologyJournal of


StrokeResearch and TreatmentHindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Drug DeliveryJournal of



Advances in Pharmacological Sciences

Tropical MedicineJournal of


Medicinal ChemistryInternational Journal of


AddictionJournal of



BioMed Research International

Emergency Medicine InternationalHindawi Publishing Corporationhttpwwwhindawicom Volume 2014


Autoimmune Diseases


Anesthesiology Research and Practice

ScientificaHindawi Publishing Corporationhttpwwwhindawicom Volume 2014

Journal of


Pharmaceutics


MEDIATORSINFLAMMATION

of


continents and South Eastern Africa Boerhavia was namedafter Hermann Boerhaave a famous Dutch physician ofthe 18th century while the species got the name from itstypical diffuse branching Two views have been taken onthe application of the name BD a broad view regardingseveral Boerhavia taxa (including Boerhavia repens L andBoerhavia coccinea Mill) as a single very variable speciesand a restricted concept in which BD is applied to the taxonwith an apparently terminal panicle It is called by severaldifferent names owing to its wide distribution throughout theworld (Figure 1) that is alena (Hawaii) erva tostao agarra-pinto and amarra-pinto (Brazil) hogweed (Barbados) redspiderling spreading hogweed (English) Huang Xi Xin(Chinese) ipecacuanha de Cayenne (French Guiana) andhierba de cabra (Spanish)

In Indian context BD goes by several names dueto the variety of languages that is Assamese RangaPunarnabha Bengali Rakta Punarnava Gujrati Dholisat-urdi Motosatodo Hindi Gadapurna Lalpunarnava Kan-nada Sanadika Kommeberu and Komma Kashmiri Van-jula Punarnava Malayalam Chuvanna Tazhutawa MarathiGhetuli Vasuchimuli Satodimula Punarnava and Kha-parkhuti Oriya Lalapuiruni Nalipuruni Punjabi ltcit (Ial)Khattan Tamil Mukurattai (Shihappu) and Telugu Atika-mamidi Erra galijeru

However one of its names in Sanskrit (kathillasophaghni sothaghni and varsabhu) varshabhu hasgiven rise to a long standing confusion on identity As permodern taxonomy varshabhu is the name for Trianthemaportulacastrum Both of these plants also bear morphologicalsimilarities

2 Chemistry

BD is a good source of nutritional supplements as reportedby Miralles and Ujowundu Miralles et al reported 15 aminoacids (6 essential) in the whole plant and 14 amino acids (7essential) in the roots alongwith isopalmitate acetate behenicacid arachidic acid (63) and saturated fatty acids (38)[2] Ujowundu et al [3] accounted the presence of vitaminsC B3 and B

2(4480 9700mg and 2200mg) along with

calcium (17409mg) in roots In various tribal areas BD rootsas well as whole plant have been reported to be used asculinary ingredient Based on the above studies this use canbe a validated claim

BD contains various categories of secondary metabolitesfor example flavonoid glycosides isoflavonoids (rotenoids)steroids (ecdysteroid) alkaloids and phenolic and lignanglycosides Table 1 gives an account of various chemicalconstituents isolated till date from BD along with activityobserved for that compound Figure 2 shows the structuraldiversity of the compounds isolated from BD Figure 3and Table 2 give a detailed survey of compounds fromisoflavonoids category Recently a rapid method was devel-oped for quantitative estimation of boeravinones in BD[4] Rotenoids are isoflavonoids derivatives with a proto-type compound named rotenone which is a mitochondrialinhibitor (Figure 4) It causes inhibition of mitochondrial

electron transport chain at complex I [5] however theldquotoxophorerdquo of the rotenoid structure was reported to be theprenyl-derived ring and the dimethoxy substitution on ringA [6] So the rotenoids isolated from BD are noncytotoxicsince they lack the isoprenoid residue on ring D or have amonosubstituted or unsubstituted ring A [7] The chemicalmarker for BD belongs to rotenoid category namely boer-avinone B and authentic samples of BD should contain notless than 0005 boeravinone B [8]

3 Status of BD in TraditionalSystems of Medicine

As stated earlier BD is an important herbal constituent ofvarious ayurvedic formulations It has been used in variousformulations meant for inflammation jaundice asthmarheumatism nephrological disorders ascites anemia andgynecological disorders Table 3 enlists various traditionalformulations having BD as a main ingredient

4 Ethnopharmacological Reports for BD

Tables 4 and 5 give a detailed account of ethnopharmaco-logical reports for the use of BD throughout India and inother parts of the world respectively It can be inferred fromthe data presented that ethnopharmacological wisdom runsparallel with the modern evidence based system of medicineMost cited uses were for reproductive system jaundicekidney problems skin troubles eye diseases wounds andinflammation All of these uses can be verified in the lightof current therapeutic studies or the compounds isolatedfrom BD

5 Pharmacological Activities

51 Immunomodulatory Activity

511 Immunostimulatory Activity In vivo studies Mungan-tiwar and coworkers analyzed the immunomodulation byBD (aqueous extract 50ndash200mgKgday orally) and showedsignificant leucocytosis and reduced mortality (50) inpretreated mice using E coli-induced abdominal sepsis stressmodel The extract also reversed the elevation in the levelsof glucose cholesterol SGPT and BUN and reduction intriglycerides induced by cold and forced swimming stressin rats [9] The alkaloidal fraction has shown a remarkableeffect in leveling the increase in plasma cortisol and avertingthe decrease in immune system performance in rats [10] Inanother study Sumanth and coworker compared the effectof BD with ashwagandha and found comparable increasein total swimming time in mice when fed with alcoholicextract The extract showed more potent effect on the countof total WBC glucose level and plasma cortisol level Theextract produced macrophage phagocytic activity compara-ble to the drug levamisole [11] Mungantiwar and coworkerscontinued the studies on immunomodulation and foundthat the alkaloidal fraction (25ndash100mgKg po) considerablydecreased and delayed hypersensitivity reactions in animals


Boerhavia diffusa





1 acan-







O

O

O

O CO

O

O


OHHO

CH

CH

CHO

O

CH

HOOC

HO COOH

HO

HO

O

O

O

O

Borhaavone

OHOHO

HOOH

OH

OH

OH

OH

O

CH

O

O

OH OH

OH

OH

OH

OH

OH

HOHO

HO

HO

HO

H3C

CH2CH2

H3CH3C

H3C OCH3

OCH3

OCH3

OCH3

R1

R2




O

O

O

O

O

O

O

OO

OO O

O

O

O

OHO

HOHO

HOHO

OH

O

HO OHO

O

O

OH

OOH

HO

HO

HO

HO

HO

O

OHO

O

O

O

OH

O

O

OH

OHOH OH

OH

OH

OH

OHOH

OH

OO

OH

O

OH

O

O

OO

O

OH

OH

OH

OH

OHOH

OHOH

OH

OH

OH

OH

HO

HO

HO

HO

HO

HOHO HO

HO

HO

OH

HOHO


H3CO

H3CO

H3CO

H3CO

OH

OH

OH

OH


O

O

H

H

H

H

HN

N

N

N OH

OH

O




OCH3

OCH3

OCH3

O-R1

R2-O

H3CO

CH2OH

O

O

O

O

H

H

OHH

HOH

OCO


HOH2C

O

COOH

Boeradiffusene

OH OH

OH

HO

HO


34


( )3

( )20







OO

O 1 3

4

56789

12a

OH

7a 6a

1211

2

10

OO

OOH OH

H

OO

OOH


R1 R1

R2 R2

R3 R3R4 R4

R5 R5

R6 R6


R1

R2

R3R4

R5

R6


OO

O

O

H

H

OH O

HO

OH

OO


H3COCH3

OCH3















Flavonoidglycoside






Rotenoids












Roots [80 81]





































192ndash196)



3 Punarnavasava



197ndash201)




43-44)








7 Sukumara ghrita






151ndash162)





(Anonymous 2008)









1Male

reproductivesystem





































Table 4 Continued









6 Respiratorysystem





Orissa [107]














8Ophthalmia








Kerala [111]



9 Skin disorders



Rajsthan [85]



Table 4 Continued



10Rheumatism



Rajsthan [85]































[116]



worm disease [118]



rdquo


[118]




[118]



8Berg Damara people






[119]

10


Bangladesh



[120]





rdquo












































6 Drug Interactions




7 Conclusions




References




































































































































Volume 2014

ToxinsJournal of

VaccinesJournal of















AddictionJournal of






Autoimmune Diseases




Journal of


Pharmaceutics



of


Boerhavia diffusa





1 acan-







O

O

O

O CO

O

O


OHHO

CH

CH

CHO

O

CH

HOOC

HO COOH

HO

HO

O

O

O

O

Borhaavone

OHOHO

HOOH

OH

OH

OH

OH

O

CH

O

O

OH OH

OH

OH

OH

OH

OH

HOHO

HO

HO

HO

H3C

CH2CH2

H3CH3C

H3C OCH3

OCH3

OCH3

OCH3

R1

R2




O

O

O

O

O

O

O

OO

OO O

O

O

O

OHO

HOHO

HOHO

OH

O

HO OHO

O

O

OH

OOH

HO

HO

HO

HO

HO

O

OHO

O

O

O

OH

O

O

OH

OHOH OH

OH

OH

OH

OHOH

OH

OO

OH

O

OH

O

O

OO

O

OH

OH

OH

OH

OHOH

OHOH

OH

OH

OH

OH

HO

HO

HO

HO

HO

HOHO HO

HO

HO

OH

HOHO


H3CO

H3CO

H3CO

H3CO

OH

OH

OH

OH


O

O

H

H

H

H

HN

N

N

N OH

OH

O




OCH3

OCH3

OCH3

O-R1

R2-O

H3CO

CH2OH

O

O

O

O

H

H

OHH

HOH

OCO


HOH2C

O

COOH

Boeradiffusene

OH OH

OH

HO

HO


34


( )3

( )20







OO

O 1 3

4

56789

12a

OH

7a 6a

1211

2

10

OO

OOH OH

H

OO

OOH


R1 R1

R2 R2

R3 R3R4 R4

R5 R5

R6 R6


R1

R2

R3R4

R5

R6


OO

O

O

H

H

OH O

HO

OH

OO


H3COCH3

OCH3















Flavonoidglycoside






Rotenoids












Roots [80 81]





































192ndash196)



3 Punarnavasava



197ndash201)




43-44)








7 Sukumara ghrita






151ndash162)





(Anonymous 2008)









1Male

reproductivesystem





































Table 4 Continued









6 Respiratorysystem





Orissa [107]














8Ophthalmia








Kerala [111]



9 Skin disorders



Rajsthan [85]



Table 4 Continued



10Rheumatism



Rajsthan [85]































[116]



worm disease [118]



rdquo


[118]




[118]



8Berg Damara people






[119]

10


Bangladesh



[120]





rdquo












































6 Drug Interactions




7 Conclusions




References




































































































































Volume 2014

ToxinsJournal of

VaccinesJournal of















AddictionJournal of






Autoimmune Diseases




Journal of


Pharmaceutics



of


O

O

O

O CO

O

O


OHHO

CH

CH

CHO

O

CH

HOOC

HO COOH

HO

HO

O

O

O

O

Borhaavone

OHOHO

HOOH

OH

OH

OH

OH

O

CH

O

O

OH OH

OH

OH

OH

OH

OH

HOHO

HO

HO

HO

H3C

CH2CH2

H3CH3C

H3C OCH3

OCH3

OCH3

OCH3

R1

R2




O

O

O

O

O

O

O

OO

OO O

O

O

O

OHO

HOHO

HOHO

OH

O

HO OHO

O

O

OH

OOH

HO

HO

HO

HO

HO

O

OHO

O

O

O

OH

O

O

OH

OHOH OH

OH

OH

OH

OHOH

OH

OO

OH

O

OH

O

O

OO

O

OH

OH

OH

OH

OHOH

OHOH

OH

OH

OH

OH

HO

HO

HO

HO

HO

HOHO HO

HO

HO

OH

HOHO


H3CO

H3CO

H3CO

H3CO

OH

OH

OH

OH


O

O

H

H

H

H

HN

N

N

N OH

OH

O




OCH3

OCH3

OCH3

O-R1

R2-O

H3CO

CH2OH

O

O

O

O

H

H

OHH

HOH

OCO


HOH2C

O

COOH

Boeradiffusene

OH OH

OH

HO

HO


34


( )3

( )20







OO

O 1 3

4

56789

12a

OH

7a 6a

1211

2

10

OO

OOH OH

H

OO

OOH


R1 R1

R2 R2

R3 R3R4 R4

R5 R5

R6 R6


R1

R2

R3R4

R5

R6


OO

O

O

H

H

OH O

HO

OH

OO


H3COCH3

OCH3















Flavonoidglycoside






Rotenoids












Roots [80 81]





































192ndash196)



3 Punarnavasava



197ndash201)




43-44)








7 Sukumara ghrita






151ndash162)





(Anonymous 2008)









1Male

reproductivesystem





































Table 4 Continued









6 Respiratorysystem





Orissa [107]














8Ophthalmia








Kerala [111]



9 Skin disorders



Rajsthan [85]



Table 4 Continued



10Rheumatism



Rajsthan [85]































[116]



worm disease [118]



rdquo


[118]




[118]



8Berg Damara people






[119]

10


Bangladesh



[120]





rdquo












































6 Drug Interactions




7 Conclusions




References




































































































































Volume 2014

ToxinsJournal of

VaccinesJournal of















AddictionJournal of






Autoimmune Diseases




Journal of


Pharmaceutics



of


OO

O 1 3

4

56789

12a

OH

7a 6a

1211

2

10

OO

OOH OH

H

OO

OOH


R1 R1

R2 R2

R3 R3R4 R4

R5 R5

R6 R6


R1

R2

R3R4

R5

R6


OO

O

O

H

H

OH O

HO

OH

OO


H3COCH3

OCH3















Flavonoidglycoside






Rotenoids












Roots [80 81]





































192ndash196)



3 Punarnavasava



197ndash201)




43-44)








7 Sukumara ghrita






151ndash162)





(Anonymous 2008)









1Male

reproductivesystem





































Table 4 Continued









6 Respiratorysystem





Orissa [107]














8Ophthalmia








Kerala [111]



9 Skin disorders



Rajsthan [85]



Table 4 Continued



10Rheumatism



Rajsthan [85]































[116]



worm disease [118]



rdquo


[118]




[118]



8Berg Damara people






[119]

10


Bangladesh



[120]





rdquo












































6 Drug Interactions




7 Conclusions




References




































































































































Volume 2014

ToxinsJournal of

VaccinesJournal of















AddictionJournal of






Autoimmune Diseases




Journal of


Pharmaceutics



of





Flavonoidglycoside






Rotenoids












Roots [80 81]





































192ndash196)



3 Punarnavasava



197ndash201)




43-44)








7 Sukumara ghrita






151ndash162)





(Anonymous 2008)









1Male

reproductivesystem





































Table 4 Continued









6 Respiratorysystem





Orissa [107]














8Ophthalmia








Kerala [111]



9 Skin disorders



Rajsthan [85]



Table 4 Continued



10Rheumatism



Rajsthan [85]































[116]



worm disease [118]



rdquo


[118]




[118]



8Berg Damara people






[119]

10


Bangladesh



[120]





rdquo












































6 Drug Interactions




7 Conclusions




References




































































































































Volume 2014

ToxinsJournal of

VaccinesJournal of















AddictionJournal of






Autoimmune Diseases




Journal of


Pharmaceutics



of
































192ndash196)



3 Punarnavasava



197ndash201)




43-44)








7 Sukumara ghrita






151ndash162)





(Anonymous 2008)









1Male

reproductivesystem





































Table 4 Continued









6 Respiratorysystem





Orissa [107]














8Ophthalmia








Kerala [111]



9 Skin disorders



Rajsthan [85]



Table 4 Continued



10Rheumatism



Rajsthan [85]































[116]



worm disease [118]



rdquo


[118]




[118]



8Berg Damara people






[119]

10


Bangladesh



[120]





rdquo












































6 Drug Interactions




7 Conclusions




References




































































































































Volume 2014

ToxinsJournal of

VaccinesJournal of















AddictionJournal of






Autoimmune Diseases




Journal of


Pharmaceutics



of





1Male

reproductivesystem





































Table 4 Continued









6 Respiratorysystem





Orissa [107]














8Ophthalmia








Kerala [111]



9 Skin disorders



Rajsthan [85]



Table 4 Continued



10Rheumatism



Rajsthan [85]































[116]



worm disease [118]



rdquo


[118]




[118]



8Berg Damara people






[119]

10


Bangladesh



[120]





rdquo












































6 Drug Interactions




7 Conclusions




References




































































































































Volume 2014

ToxinsJournal of

VaccinesJournal of















AddictionJournal of






Autoimmune Diseases




Journal of


Pharmaceutics



of


Table 4 Continued









6 Respiratorysystem





Orissa [107]














8Ophthalmia








Kerala [111]



9 Skin disorders



Rajsthan [85]



Table 4 Continued



10Rheumatism



Rajsthan [85]































[116]



worm disease [118]



rdquo


[118]




[118]



8Berg Damara people






[119]

10


Bangladesh



[120]





rdquo












































6 Drug Interactions




7 Conclusions




References




































































































































Volume 2014

ToxinsJournal of

VaccinesJournal of















AddictionJournal of






Autoimmune Diseases




Journal of


Pharmaceutics



of


Table 4 Continued



10Rheumatism



Rajsthan [85]































[116]



worm disease [118]



rdquo


[118]




[118]



8Berg Damara people






[119]

10


Bangladesh



[120]





rdquo












































6 Drug Interactions




7 Conclusions




References




































































































































Volume 2014

ToxinsJournal of

VaccinesJournal of















AddictionJournal of






Autoimmune Diseases




Journal of


Pharmaceutics



of






[116]



worm disease [118]



rdquo


[118]




[118]



8Berg Damara people






[119]

10


Bangladesh



[120]





rdquo












































6 Drug Interactions




7 Conclusions




References




































































































































Volume 2014

ToxinsJournal of

VaccinesJournal of















AddictionJournal of






Autoimmune Diseases




Journal of


Pharmaceutics



of









































6 Drug Interactions




7 Conclusions




References




































































































































Volume 2014

ToxinsJournal of

VaccinesJournal of















AddictionJournal of






Autoimmune Diseases




Journal of


Pharmaceutics



of



7 Conclusions




References




































































































































Volume 2014

ToxinsJournal of

VaccinesJournal of















AddictionJournal of






Autoimmune Diseases




Journal of


Pharmaceutics



of















































































































Volume 2014

ToxinsJournal of

VaccinesJournal of















AddictionJournal of






Autoimmune Diseases




Journal of


Pharmaceutics



of

Review Article Phytochemical, Therapeutic, and...

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